quinta-feira, 28 de agosto de 2014

Complex consultations in primary care: a tool for assessing the range of health problems and issues addressed in general practice consultations

There is an increasing recognition that many consultations in general practice involve several problems covering multiple disease domains. However there is a paucity of reliable tools and techniques to understand and quantify this phenomenon. The objective was to develop a tool that can be used to measure the number and type of problems discussed in primary care consultations.

Thirteen consultations between general practitioners and patients were initially videoed and reviewed to identify the problems and issues discussed. 

The iterative approach to development of the tool reflected the complexity of doctor-patient interactions. A reliable tool has been developed that can be used to analyse the number and range of problems managed in primary care consultations.

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Electronic cigarettes (e-cigarettes) or electronic nicotine delivery systems

Electronic nicotine delivery systems (ENDS), of which electronic cigarettes are the most common prototype, are devices that do not burn or use tobacco leaves but instead vaporise a solution the user then inhales. The main constituents of the solution, in addition to nicotine when nicotine is present, are propylene glycol, with or without glycerol and flavouring agents. ENDS solutions and emissions contain other chemicals, some of them considered to be toxicants.
Although some e-cigarettes look like tobacco products (e.g. cigarettes, cigars, cigarillos, pipes, hookahs, or shishas), they may be produced in the form of everyday items such as pens, USB memory sticks or larger cylindrical or rectangular devices.
The World Health Organization (WHO) is currently reviewing the existing evidence around ENDS and preparing a paper for submission to the meeting of the Parties of the WHO Framework Convention on Tobacco Control, which occurs later this year. WHO is also working with national regulatory bodies to look at regularity options as well as toxicology experts to understand more about the impact ENDS may have on health.
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quarta-feira, 16 de abril de 2014

Measuring respiratory symptoms in clinical trials of COPD: reliability and validity of a daily diary

Objective To evaluate the EXACT-Respiratory Symptom (E-RS) measure, a daily diary comprising 11 of
the 14 items in the Exacerbations of Chronic Pulmonary Disease Tool (EXACT).
Conclusions Results suggest the RS-Total is a reliable and valid instrument for evaluating respiratory symptom severity in stable COPD. Further study of sensitivity to change is warranted.
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