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Open in a separate window S Are evaluated respiratory service developments implemented into clinical practice? This has led to a number of publications regarding service developments or similar which have been evaluated in key centres. However, it is not clear whether all such service developments subsequently become normal practice, even in the originating institution MethodsMethodical search and review of potential service development studies in 4 respiratory journals over a 4 year period.
A questionnaire was then sent to the corresponding authors regarding implementation of the study findings into clinical practice.
Results papers were identified in the four journals during the 4 year period, of which had a title or key word which suggested the possibility that they were reports of a respiratory service development.
The remainder of the studies involved new technologies, use of the telephone, patient information sheets, mailing patients, education and guideline implementation.
Delays in implementation of 12—60 months were due to staffing and organisational issues in 3 cases and the institution not being prepared to pick up costs in 1 case. One study was completed 9 years ago and although initally implemented is no longer used.
These were equally distributed between studies of the use of different healthcare professionals and new technologies, but process changes were particularly unlikely to be continued. In a couple of cases reflection suggested the benefit of the reported intervention was not large, and in the remainder, costs or loss of key personnel were the explanation for non continuation of the service development.
S Establishment of a community respiratory assessment unit R. There are many types and symptoms are shared with disorders of other systems. Spirometry is one tool which can enhance diagnostic accuracy; previous studies have shown that without its use mistaken diagnoses occur in primary care.
The service was developed and run by two specialist nurses. Where a diagnosis was obvious, self management advice and checking of inhaler techniques, SaO2 and breath CO measurements were also undertaken.
Educational materials for different respiratory scenarios were included with the report to GPs and these were designed to be of use for all patients not just those attending CRAU.
Of the 33 primary care facilities in Hammersmith and Fulham PCT, 16 were given access to the service initially and the remaining 17 six months later. The service was based at Charing Cross Hospital and a peripatetic service was offered to practices furthest away. As part of the referral process GPs stated reasons for referral and what they would have done if the service had not been available.
A community orientated respiratory diagnosis assessment service, offering more than spirometry alone, has the potential to improve the accuracy of respiratory diagnosis in primary care and potentially to lead to savings associated with delayed diagnosis and inappropriate trials of therapy.
S Picture archiving and communications system: A postal questionnaire on PACS was sent to respiratory consultants BTS database in the first quarter of to make assessments of 1 current availability, 2 involvement of respiratory consultants in implementation, 3 clinical acceptability of the system, and 4 anticipated timing of introduction in hospitals which do not currently use PACS.
Further difficulties had been experienced: We conclude that although the majority of respiratory specialists in hospitals with PACS respond positively about its use, too many clinicians complain of suboptimal image quality and other problems, particularly image transfer between hospitals, this being a stated aim of CfH.
The responses suggest that there is room for increased respiratory specialist involvement in local implementation and raise questions about the need for generic guidance for clinicians involved in this process. Cellular mechanisms in asthma S Primary airway fibroblasts in the understanding of asthma: Southampton General Hospital, Inflammation, Infection and Repair IIR Department, UK IntroductionAsthma is a disease characterised by both chronic inflammation and structural airway changes associated with alterations in the extracellular matrix composition.
The fibroblast is pivotal in maintaining the balance between production and breakdown of the ECM in the healthy lung.The reaction of magnesium with copper(II) oxide Demonstration Copper(II) oxide reacts with magnesium, demonstrating the ability of magnesium to remove oxygen from an oxide of copper, and hence the relative positions of copper and magnesium in the reactivity series.
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