Purpose: The study aimed to construct narratives of journeys that cancer patients and their families experience and to investigate participants' perceptions of related interagency collaboration spanning any engagements with the National Health Service (NHS); social services; local authority; voluntary; private and independent sectors. Methods: Using a qualitative design and focus groups the key facets of integrated care were explored with clients from a charity that focussed on cancer care. The 'talking wall' approach was adapted for use in the focus groups. Framework analysis was used to extrapolate the key themes. Results: Focus groups with 44 volunteers were conducted. Data included visual representations; textual comments and researcher reflections. The findings highlighted that the care received by many of the volunteers was variable with reports of very satisfactory experiences and also poor experiences. Respondents expected collaborative care and only in its absence was there cognisance of its importance in streamlining services for their care journeys. The role for the voluntary and independent sectors was significant. Conclusions and Implications for cancer survivors: Effective interprofessional collaboration was perceived to ease the pain of the cancer journey. The different yet interlocking interventions and support from statutory and voluntary agencies is clearly a holistic approach that is appreciated by the patient. Care management for cancer patients is complex in its nature necessitating professionals to work across organisational boundaries and achieve the best outcomes for long term care management. When professionals do not do this effectively cancer survivors and their carers are often left to 'join up' the services themselves and there is greater reliance on voluntary organisations.
The findings are described of a combined clinical, bacteriological and virological study which included all children admitted to the City Hospital, Edinburgh, with acute respiratory infection and whooping cough during the winters 1961–62 and 1962–63. During the first winter 131 cases aged 0–12 years and in the second winter 133 aged 0–6 years were examined. The respiratory illnesses were divisible into upper respiratory tract infection, bronchitis, pneumonia, and whooping cough; many of the cases of whooping cough had respiratory complications with bronchitis or pneumonia. Paired sera, a throat swab and a faecal specimen were taken from each child and investigated vircdogically. Over both winters the highest total virus isolation rate was found in the group suffering from upper respiratory disease. Approximately two-thirds of the total number of patients from whom virus was isolated and from whom both acute and convalescent sera were available gave a serological response to the homologous virus; the highest proportion of these patients occurred in the pneumonia and URTI groups. The groups of viruses associated with a fourfold or greater rise in antibodies occurred in the following proportions of the cases: myxovirus 9 %; adeno virus 7 %; entero virus 4 %; herpes simplex 3 %. Bacterial pathogens were isolated from 37 % of patients in 1961–62 and from 49 % in 1962–63, Staph. pyogenes being the most common pathogen. Isolation of pneumococci was facilitated during the second year by the examination of a nasal swab. Pre-admission chemotherapy did not significantly alter the bacterial isolation rates. Agglutination studies were carried out on forty clinical cases of whooping cough admitted during the two winters and thirty-two showed significant stable titres to Bordetella pertussis ; only 9 (18 %) of these cases gave a history of prophylactic immunization. A third of the patients had neither bacterial nor viral pathogens. The findings in this survey illustrate the need for further intensive virological and bacteriological studies of acute respiratory infections in early childhood.
Neutralization tests for poliovirus antibodies were carried out on 74 patients in an adult mental deficiency hospital: 37 patients with Down's syndrome and 37 non-Down's mental defectives. The distribution of antibody titres to poliovirus types 1, 2 and 3 did not differ significantly between the two groups. Most patients had antibody to at least one poliovirus type but less than a third had antibodies at a titre of 1/8 or greater to all three types. The low level of poliovirus immunity in this population may be of epidemiological importance.
The benefits of an accelerated pavement testing program are often discussed in terms of improvements to pavement design and analysis, the introduction of new materials and construction techniques, and a better understanding of long term pavement performance. A highly significant, and often overlooked, additional benefit is the opportunity an accelerated pavement testing program creates for staff training and learning. Pavement engineering represents only a small proportion of the curriculum at most tertiary engineering education institutions, and it is widely recognised that there is a current global shortage of skilled pavement engineers. The paper describes how the Australian operation of the Accelerated Loading Facility (ALF) has exposed student and graduate engineers to a wide range of learning experiences. Some case studies are presented to demonstrate the range of learning opportunities presented by accelerated pavement testing.
Introduction and aim A local substance misuse study and anecdotal evidence from primary care, suggested many methadone patients have respiratory disease and/or prescriptions for respiratory preparations. Anecdotal evidence from clinical colleagues supports this. With little published literature in this area, this preliminary study aimed to explore the prevalence of respiratory diseases and prescriptions for respiratory medication in drug misusers. Method This exploratory study used a historical cohort design with matched controls. An analysis of Primary Care Clinical Informatics Unit (PCCIU) GP consultation data was conducted. The prevalence of common respiratory diseases (ever appearing in the patient's medical records) and commonly used respiratory prescriptions (in 2008) between drug misusers and matched controls (general population sample) was compared. Results The PCCIU data contained a cohort of 18 570 patients (9285 per group), of which, 64% (n=11885) were male and 75.7% (n=14060) were aged 31–59. Results revealed an increased prevalence of chronic respiratory disease in drug misusers versus controls. Drug misusers were more likely to be prescribed chronic respiratory diseases medications than controls. These results were still significant when adjusted for smoking status, where those who had never smoked were compared to those who had ever smoked (current and ex smokers) (See [Abstract S108 Table 1][1]). Median quantity of SABA and ICS prescriptions during 2008 were also statistically significantly higher in drug misusers*. The median quantity of SABA prescribed for drug misusers were 4 (IQR 2–8) vs 3 (IQR 1–7) in controls**. The median quantity of ICS prescribed for drug misusers were 4 (IQR 2–8) vs 2 (IQR 1–5) in controls**. *Median Prescription for patients on ≥1 prescription. **p<0.001 Mann–Whitney U. View this table: Abstract S108 Table 1 Comparisons using PCCIU SPICE data Conclusion These data suggest, drug misusers have a significantly higher prevalence of respiratory diseases and are prescribed significantly more respiratory medications than matched controls. Adjusting for smoking status, still revealed drug misusers have significantly increased odds of have a respiratory disease or being prescribed respiratory medication, indicating there may be more complex factors involved related to drug use needing further exploration. As a first stage exploratory study, we have set the scene for future work to begin to determine the potential reasons for this association. [1]: #T1
From a review of 530 patients with viral meningitis during a 10-year period, no new epidemiological features emerged. Mumps virus was responsible for 24 per cent of the infections and in 20 per cent of these no salivary swellings occurred. Good evidence incriminating a particular virus was found in only 20 per cent of the others. The paucity of physical signs indicating a specific virus was confirmed; only 5 per cent had rashes and 1.5 per cent pleurodynia. A small number showed temporary encephalitic features, the proportion being higher in mumps infections. In this variety fever tended to be higher and the E.S.R. lower than in enteroviral infections. The C.S.F. findings confirmed the mixed pleocytosis and the higher but more lymphocytic counts in mumps. Relatively few patients had normal C.S.F. findings within 2 weeks of onset and resolution appeared to be slower in mumps.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)
'%3e%3cpath fill='%23001489' d='M0 0v6h9V0z'/%3e%3cpath fill='%23e03c31' d='M0 0v3h9V0z'/%3e%3cg stroke='%23fff' stroke-width='2'%3e%3cpath id='d' d='m0 0 4.5 3L0 6m4.5-3H9'/%3e%3cuse xlink:href='%23b' stroke='%23ffb81c' clip-path='url(%23c)'/%3e%3c/g%3e%3cuse xlink:href='%23d' fill='none' stroke='%23007749' stroke-width='1.2'/%3e%3c/g%3e%3c/svg%3e)
