Consumer medicines information : an international perspective

Consumer medicines information is increasingly relied upon to inform and empower consumers regarding their medicines. Legislation and guidelines are now in operation in the US, European Union (EU) countries and Australasia. The lack of an evidence base has led to a variety of approaches to written information provision across the three continents and each has apparent advantages and disadvantages. This review compares consumer medicines information in the three continents and examines the strengths and weaknesses of each system. It also includes an outline of research conducted by Professor Raynor’s team on the impact of the EU legislation. This will be of particular interest in Malta, in view of the imminent membership of the EU.peer-reviewe

Ask the patients - they may want to know more than you think

What information do patients need about medicines? Partnership between health professionals and patients depends, in part, on the provision and exchange of accurate and reliable information about drugs, but who should provide it? We invited contributors to answer the question from the perspectives of patients, clinicians, and the pharmaceutical industry People's appetite for information about their treatment is often greater than doctors believe.1 Clearly, patients vary in the extent of their desire for partnership in making medical decisions. It follows that part of the duty of a health professional is to work out how much partnership a patient wants, and what information he or she needs to support that level of partnership

Is low cardiac ejection fraction a risk factor for stroke?

Background and Purpose: Reduced ejection fraction (EF) ?35% has been suggested as a criterion for anticoagulation in persons with heart failure in sinus rhythm, but the literature supporting EF as an independent stroke risk factor is conflicting. We here review the status of reduced EF as a stroke risk factor. Methods: We performed a Medline search combining terms for stroke and heart failure (HF) or cardiac left ventricular systolic dysfunction and reviewed evidence that reduced EF increases the risk of stroke. We also reviewed clinical and epidemiological HF studies that included data on stroke and EF. Results: Two of three longitudinal cohort studies found reduced EF (<50%) to be a stroke risk factor but did not find an inverse relationship between EF level and degree of stroke risk. Exploratory analyses of three clinical studies found an inverse relationship between EF level and degree of stroke risk but only in specific subgroups and vascular risk factors appeared to attenuate this relationship. Three analyses suggested an increased stroke risk with EF ?20%. Conclusion: Reduced EF (<50%) probably increases stroke risk but this is not consistently demonstrated in all populations studied. Reduced EF of any degree may be a surrogate for atherosclerotic cerebrovascular disease and in these patients traditional vascular risk factors may be more important for stroke risk than EF. There is no evidence to support EF ?35% as a specific stroke risk factor. Research is needed to determine if very reduced EF (?20%) is a specific stroke risk factor.peer-reviewe

Moving Away from Social Work and Half Way Back Again: New Research on Skills in Probation

Research on social work in the criminal justice system was well represented in the social work literature until the 1990s. Since then, changes in the organisation, training and research base of probation practice, particularly in England and Wales, have all contributed to a separation between probation research and the mainstream social work research literature. However, recent probation research, by focusing on individual practice skills and on the quality of relationships, is producing findings which resonate with traditional social work concerns. The study presented here, based on analysis of videotaped interviews between probation staff and the people they are supervising, shows what skills are used and the effects of skilled supervision. People supervised by more skilled staff were significantly less likely to be reconvicted over a two-year follow-up, and the most effective supervisors combined good relationship skills with a range of ‘structuring’ or change-promoting skills. In effect, this can be regarded as a test of the impact of social work skills used by probation staff and suggests that a closer relationship between mainstream social work research and probation research could be productive for both

Foundations Need Capacity, Too: Initial Findings from the Foundation Core Capacity Assessment Tool

For many years, the social sector has paid substantial attention to the issue of nonprofit effectiveness. By contrast, comparatively little attention has been paid to the capacities that foundations themselves need to achieve impact. What capacities are essential to advancing a foundation's own mission? How do these elements compare to the capacities their grantee partners need?TCC Group believes that foundation capacity – like nonprofit capacity more broadly – is essential to impact. In developing the FCCAT and sharing aggregate findings in this report, the core purpose is to elevate attention to this important issue

Cryogenic Hydrogen/helium Storage and Supply System, Phase 1

An existing cryogenic tank was refurbished, microspheres were installed in the tank annulus, and the thermal performance of the unit was tested. The performance data was compared with NRC-2 multilayer insulation and low emittance aluminized surfaces installed in tanks of the same basic design. The cryogenic tank modified during the program was originally designed for the Manned Orbiting Laboratory (MOL) Program, and subsequently modified by vacuum-depositing aluminum on all annulus surfaces and leaving out the NRC-2 multilayer insulation. It is concluded that the application of aluminized-microsphere insulation is not yet very predictable for tank design purposes, especially at LH2 temperature and in the presence of a vapor-cooled shield