Do British travel agents provide adequate health advice for travellers?

Travel-related illness is a burden for primary care, with more than two million travellers consulting a general practitioner each year. The annual cost of travel-related illness in the United Kingdom is 11 million Pounds. Travel agents are in a unique position to influence this burden as the most common and most serious problems are preventable with simple advice and/or immunisation. This study, using covert researchers, suggests this potential is not being fully utilised.     

基于复杂网络的患者就医公交路径选择

目的 为方便患者解决就医过程中有关就医路线、时间耗费、路径长度、换乘次数等路径选择问题,本文基于复杂网络就患者就医公交路径选择进行研究。方法 首先从复杂网络角度对泰安市公交线路进行建模,然后基于不同因素建立患者就医公交路径网络、公交站点网络和公交换乘网络。结果 通过对三种复杂公交网络拓扑特征的理论分析与仿真计算,分别从最短路径长度、容错能力、有效性和介数等角度对路径可达性、换乘次数等因素做出患者就医公交路径选择的指导。结论 患者就医公交路径选择不仅利于患者出行,也为医疗单位和公共交通部门提供参考和指导。     

Modulators of immune responses: the evolutionary trail

The evolutionary aspects of immunoregulation and the immunotoxic effects of xenobiotics in species ranging from lumious to marine invertebrates were discussed at a recent meeting, this report describes progress in our understanding of this fascinating field.     

Asthma: some basic methods of prevention.

Present traditional measures employed in the prevention of asthma are reviewed. It is recommended that in view of the extensive and possibly increasing prevalence of the disease together with continuing high death rates more attention in our treatment programs should be devoted to basic prevention in possibly susceptible people. High risk groups such as among small children, in certain industries and in developing counties make this approach especially desirable. An outline of suggested measures is presented.     

Children speak about neighborhoods: using mixed methods to measure the construct neighborhood

This study contributes to the knowledge base of community practice and research by examining the construct neighborhood from qualitative and quantitative perspectives. Mixed methodology was employed to explore the associations and discrepancies between a census measure of neighborhood based in social disorganization theory and a qualitative measure based on the voices of children (N=59). Qualitative results indicate nine dimensions of the construct neighborhood that are not found in census‐based measures of the construct. Mixed methods results demonstrate that children in both higher and lower socially disorganized neighborhoods express the presence of neighborhood resources and neighborly affiliations as well as negative neighborhood experiences. Expressions of fear, needs for safety, and qualities of unsavory characters distinguish the two types of neighborhoods. © 2008 Wiley Periodicals, Inc.     

Exploring the applicability of the pregnancy and childbirth outcome set: A mixed methods study

ObjectiveThe International Consortium for Health Outcomes Measurement developed the Pregnancy and Childbirth (PCB) outcome set to improve value-based perinatal care. This set contains clinician-reported outcomes and patient-reported outcomes. We validated the set for use in the Netherlands by exploring its applicability among all end-users prior to implementation.MethodsA mixed-methods design was applied. A survey was performed to assess patients (n = 142), professionals (n = 134) and administrators (n = 35) views on the PCB set. To further explore applicability, separate focus groups were held with representatives of each of these groups.ResultsThe majority of survey participants agreed that the PCB set contains the most important outcomes. Patient-reported experience measures were considered relevant by the majority of participants. Perceived relevance of patient-reported outcome measures varied. Main themes from the focus groups were content of the set, data collection timing, implementation (also IT and transparency), and quality-based governance.ConclusionThis study supports suitability of the PCB outcome set for implementation, evaluation of quality of care and shared decision making in perinatal care.Practice ImplicationsImplementation of the PCB set may change existing care pathways of perinatal care. Focus on transparency of outcomes is required in order to achieve quality-based governance with proper IT solutions.     

Written advice: compliance and recall

Sixty-two women consulting their general practitioner with symptoms of urinary tract infection were assigned at random to either an experimental group, who were given a set of pre-standardized instructions both verbally and in written form, or a control group, who received the same advice in verbal form only.

On follow-up, the written advice was found to increase the amount of information remembered by the patients both about the medication and other behavioural advice, but to have no obvious effect on compliance with the course of antibiotics prescribed.

Further research is needed, investigating different diseases, to substantiate these findings and help to decide whether patients in general practice should be given written advice.

     

On the trail of empty MHC class-I

Since being proposed nearly 25 years ago that MHC-I molecules free of peptide ligand possess a conformation that is distinct from that of the mature loaded form, considerable research has been conducted in order to isolate and characterise such a species. While some progress has been made in our understanding, many questions still surround the nature and loading of empty MHC-I. However, the necessary tools to address these questions may finally be at hand.