Microsphere Assemblies via Phosphonate Monoester Coordination Chemistry.

By complexing a bent phosphonate monoester ligand with cobalt(II), coupled with in situ ester hydrolysis, coordination microspheres (CALS=CALgary Sphere) are formed whereas the use of the phosphonic acid directly resulted in a sheet-like structure. Manipulation of the synthetic conditions gave spheres with different sizes, mechanical stabilities, and porosities. Time-dependent studies determined that the sphere formation likely occurred through the formation of a Co2+ and ligand chain that propagates in three dimensions through different sets of interactions. The relative rates of these assembly processes versus annealing by ester hydrolysis and metal dehydration determine the growth of the microspheres. Hardness testing by nanoindentation is carried out on the spheres and sheets. Notably, no templates or capping agents are employed, the growth of the spheres is intrinsic to the ligand geometry and the coordination chemistry of cobalt(II) and the phosphonate monoester.

Willingness of young men and women to be tested for Chlamydia trachomatis in three non-medical settings in Glasgow, UK.

OBJECTIVE: To assess the willingness of young men and women to be tested for Chlamydia trachomatis in three non-medical settings. METHODS: Men and women aged between 16 and 24 years were invited to complete a self-administered questionnaire and provide a urine sample in non-medical settings: 'education' (one further education college), 'health and fitness' (three local authority leisure centres) and 'workplace' (two call centres). RESULTS: Eighty-four percent of age-eligible users approached in the settings agreed to complete a questionnaire (n = 363). Among the sexually active people (n = 346), the uptake of screening varied by setting [education 19.1% (22/115), health and fitness 48.8% (62/127), workplace 27.8% (29/104); p<0.001]. Health and fitness settings (OR 4.08; 95% CI 2.04-8.14) and perception of being at risk of having chlamydia (OR 2.47; 95% CI 1.33-4.58) were strong predictors of providing a urine sample. Adjusting for setting and age group (<20 years vs 20+ years), women were less likely than men to provide a urine sample (OR 0.42; 95% CI 0.26-0.70). All five positive cases (4.4%; 4.9% in men, 3.8% in women) were contacted with their results by a health adviser and invited to be treated at a local genitourinary medicine clinic. CONCLUSIONS: Men were more willing than women to be tested for C. trachomatis in these non-medical settings, but uptake varied by setting. Thus, increasing opportunities for the take-up of testing in particular non-medical settings might be a more effective approach to including young men who are not reached by clinic control efforts.

The complex nature of informal care in home-based heart failure management.

AIM: This paper is a report of a study to examine the complexities of informal caregiving for people with chronic heart failure. BACKGROUND: Little is known of the activities involved and underlying informal care. Heart failure is a common and burdensome condition in which carers play an important management role. METHOD: Semi-structured interviews were carried out with 30 informal carers nominated by patients with mild-to-moderate heart failure (24 spouses, four children, one sibling and one neighbour). Interviews examined knowledge of heart failure, its effects, reported management practices and concerns, decision making and support. The data were collected in 2001. FINDINGS: The management of heart failure was a shared and ongoing responsibility between the carer and patient. Carers' clinical knowledge of the condition and management was often limited, but they developed extensive knowledge of its personal effects on the patient. Invisible care activities included monitoring signs of symptom exacerbation and energy boundaries against perceived current and future demands and priorities. Visible care activities included medication management, dressing, bathing and help-seeking. Carers responded to patients' capacities, and adopted philosophies that sought to foster independence while facilitating as normal a life for the patient as was possible and safe. CONCLUSION: Interventions for informal carers around effective chronic heart failure management should address both visible and invisible informal caring. Future research is needed to develop interventions with carers to improve quality of care, reduce costs and improve patient quality of life. More research is needed to explore the complexities of lay caregiving and to explore the invisible dimensions of informal care further.

A qualitative study of the contribution of pharmacists to heart failure management in Scotland.

STUDY OBJECTIVES: (1) To identify the medication management needs of chronic heart failure (CHF) patients and their caregivers; (2) To examine the perceived support for medication management available to these people from health professionals; (3) To identify the actual and potential perceived contribution of pharmacists to medication management. SETTING: A mixed urban/ rural region in the west of Scotland. DESIGN: Semi-structured qualitative research interviews. PARTICIPANTS: A total of 50 people with CHF (NYHA Class II and III) due to left ventricular systolic dysfunction (33 males; mean age 67 years, 17 females; mean age 68 years) and 30 nominated caregivers recruited from the outpatient departments of two hospitals in the West of Scotland. Sampling was purposive to include patients from a range of CHF severity, ages and sexes. MAIN RESULTS: Managing medications was a responsibility shared by both the patients with CHF and caregivers. Treatment regimens were reported to be difficult to comply with. Health professionals were seen to provide little support for medication management. Pharmacists were viewed as being a good and accessible source of practical assistance who were also knowledgeable about the individual's heart health history. Participants reported valuing advice from pharmacists about the side effects of medications and for their assistance in reducing the complex logistics of medication management and in having medications delivered. CONCLUSIONS: Patients with CHF and caregivers voiced a willingness to try to manage their medication regimen accurately but had a limited capacity to do so. Pharmacists were viewed as providing valuable support to patients with CHF and their caregivers, in terms of medication management. The extended role of pharmacists in medication management of CHF should be encouraged.

Why do men and women respond differently to chest pain? A qualitative study.

OBJECTIVES: to explore sex differences in responses to chest pain. METHOD: Qualitative interviews were conducted with 30 men and 30 women with chest pain, age 45 to 64, living in two socioeconomically divergent areas of Glasgow, Scotland. RESULTS: Three themes underpinned sex differences in responses to chest pain: perceived vulnerability to heart disease, previous experience of health care, and nonmedical care strategies. Men were perceived to be at greater risk of heart disease. Women were concerned that reporting their chest pain wasted the doctors' time. Men and women were equally likely to discuss their pain with lay others, but women were less likely to be directed to medical care. CONCLUSIONS: Despite initiatives to raise awareness that heart disease is important for women, women and their lay consultants continue to underestimate the significance of chest pain. Women's reluctance to seek medical care may contribute to sex differences in use of cardiology services.