Australasian Sleep Association position statement on consensus and evidence based treatment for primary snoring.

Primary snoring impacts a significant portion of the adult population and has the potential to significantly impair quality of life. The purpose of these guidelines is to provide evidence-based recommendations to assist Australasian practitioners in the management of adult patients who present with primary snoring without significant obstructive sleep apnoea. The Timetable, Methodology and Standards by which this Position Statement has been established is outlined in the Appendix S1.

Design Recommendations for Presenting Clinical Guidelines on Mobile Devices.

Some areas of clinical practice are still required to access and utilise clinical information that is inefficient or restrictive. Therefore, mobile device information delivery is becoming a key factor. However, recommendations on presenting clinical information on mobile devices are limited or not optimised for modern mobile design.

Reproducibility of nasal allergen challenge responses in adults with allergic rhinitis.

Background: Allergic rhinitis is characterized by nasal inflammation in response to allergen exposure. Nasal allergen challenges are used in clinical trials evaluating drug effects. Reproducibility of nasal secretion cytokine responses and physiological measurements are needed to determine the optimum measurements and power calculations for future studies.

Social Media Monitoring of Discrimination and HIV Testing in Brazil, 2014-2015.

Big data can be used to assess perceptions about public health issues. This study assessed social media data from Twitter to inform communication campaigns to promote HIV testing and reduce discrimination related to HIV/AIDS or towards key populations to the HIV epidemic, and its potential utility to evaluate such campaigns through HIV testing uptake. Tweets from Brazil were collected from January 2014 to March 2015 and filtered by four categories of keywords including discrimination, HIV prevention, HIV testing, and HIV campaigns.

Shift work effects on serial PEF measurements for occupational asthma.

Background: Diurnal variation (DV) affects lung function but the changes are thought to be related to sleep patterns rather than time of day. When diagnosing occupational asthma (OA), serial peak expiratory flow (PEF) measurements are the recommended first line investigation, but could be confounded by shift work.

Aims: The aim of the study was to investigate the effects of shift work on PEF measurements used for diagnosing OA.

Do long periods off work in peak expiratory flow monitoring improve the sensitivity of occupational asthma diagnosis?

Introduction: Serial peak expiratory flow (PEF) monitoring is a useful confirmatory test for occupational asthma diagnosis. As weekends off work may not be long enough for PEF records to recover, this study investigated whether including longer periods off work in PEF monitoring improves the sensitivity of occupational asthma diagnosis.

Methods: Serial PEF measurements from workers with occupational asthma and from workers not at work during their PEF record, containing minimum data amounts and at least one rest period with > or = 7 consecutive days off work, were analysed.

Serial lung function variability using four portable logging meters.

Objective: Portable lung function logging meters that allow measurement of peak expiratory flow (PEF) and forced expiratory volume in 1 second (FEV(1)) are useful for the diagnosis and exclusion of asthma. The aim of this study was to investigate the within and between-session variability of PEF and FEV(1) for four logging meters and to determine the sensitivity of meters to detect FEV(1) and PEF diurnal changes.

Methods: Thirteen assessors (all hospital staff members) were asked to record 1 week of 2-hour PEF and FEV(1) measurements using four portable lung function meters.

Diagnosis of occupational asthma from time point differences in serial PEF measurements.

Background: The diagnosis of occupational asthma requires objective confirmation. Analysis of serial measurements of peak expiratory flow (PEF) is usually the most convenient first step in the diagnostic process. A new method of analysis originally developed to detect late asthmatic reactions following specific inhalation testing is described.

PEF analysis requiring shorter records for occupational asthma diagnosis.

Background: The Oasys programme plots serial peak expiratory flow (PEF) measurements and produces scores of the likelihood that the recordings demonstrate occupational asthma. We have previously shown that the area between the mean workday and rest day PEF curves [the area between the curves (ABC) score] has a sensitivity of 69% and specificity of 100% when plotted from waking time using a cut-off score of 15 l/min/h.

Aims: To investigate the minimum data requirements to maintain the sensitivity and specificity of the ABC score.

A new diagnostic score for occupational asthma: the area between the curves (ABC score) of peak expiratory flow on days at and away from work.

Background: Evidence-based guidelines recommend serial measurements of peak expiratory flow (PEF) on days at and away from work as the first step in the objective confirmation of occupational asthma. The aim of this study was to improve the diagnostic value of computer-based PEF analysis by using the program Oasys-2 to calculate a score from the area between the curves (ABC) of PEF on days at and away from work.

Methods: Mean 2-hourly PEFs were plotted separately for workdays and rest days for 109 workers with occupational asthma and 117 control asthmatics.

Vascular access in cystic fibrosis--does size matter?

Unlabelled: Vascular access is an important part of patient management in cystic fibrosis. In most instances, vascular access is straightforward. However, a single bad experience with venepuncture has a lasting impact.

Bedside clinical guidelines: the missing link.

Clinical guidelines for acute general (adult) medicine, general (adult) surgery, nursing and acute paediatrics, for use at the bedside, were developed over 10 years in North Staffordshire. The guidelines have been adopted by 15 other hospitals, all members of the Bedside Clinical Guidelines Partnership. The guidelines include advice on clinical management, prescribing aids, and practical procedures.

Improving the quality of peak flow measurements for the diagnosis of occupational asthma.

Introduction: Serial measurements of peak expiratory flow (PEF) are recommended in the evidence-based review list as the first stage in objective confirmation of occupational asthma. Different centres have reported widely different success in obtaining records of sufficient data quantity for diagnosis. We investigated different methods of instruction and determined the return rate and quality of the resulting record for the diagnosis of occupational asthma.

Effect of peak expiratory flow data quantity on diagnostic sensitivity and specificity in occupational asthma.

Serial peak expiratory flow records are recommended in the first-line investigation of suspected occupational asthma. The effects of sequentially reducing the numbers of working weeks, consecutive days at work and readings taken per day on diagnostic sensitivity and specificity were investigated, using good quality peak expiratory flow records from 81 workers with independently confirmed occupational asthma and 60 asthmatics without occupational exposure. Sensitivity was 81.

Interpretation of occupational peak flow records: level of agreement between expert clinicians and Oasys-2.

Background: Oasys-2 is a validated diagnostic aid for occupational asthma that interprets peak expiratory flow (PEF) records as well as generating summary plots. The system removes inconsistency in interpretation, which is important if there is limited agreement between experts. A study was undertaken to assess the level of agreement between expert clinicians interpreting serial PEF measurements in relation to work exposure and to compare the responses given by Oasys-2.

OASYS-3: improved analysis of serial peak expiratory flow in suspected occupational asthma.

Serial peak expiratory flow (PEF) records are useful for the screening and diagnosis of patients with occupational asthma. We have presented work on a method based on linear discriminant analysis (OASYS-2) and have now tried to improve on this technique and investigate the repeatabilities of expert interpretation. 268 serial PEF records made by workers with possible occupational asthma were divided into four sets.

Pseudomonas aeruginosa in cystic fibrosis: cross-infection and the need for segregation.

Evidence-based reasons for segregation of patients colonized with Pseudomonas aerugionsa in the outpatient setting are unclear. To clarify local decisions, Pseudomonas genotyping of the local environment, patients and patient contacts was undertaken in 1993. The hospital environment was re-swabbed in 1997.

Is the quality of asthma prescribing, as measured by the general practice ratio of corticosteroid to bronchodilator, associated with asthma morbidity?

The objective of this study was to determine whether the quality of asthma prescribing in general practice is associated with the severity of asthma patients' symptoms. Cross-sectional survey of asthma-like symptoms in patients prescribed antiasthma therapy was used. The setting was two general practices with contrasting ratios of corticosteroid to bronchodilator (high vs.

Elective versus symptomatic antibiotic treatment in cystic fibrosis patients with chronic Pseudomonas infection of the lungs.

Background: A previous retrospective study suggested that a policy of regular anti-pseudomonal antibiotic treatment improved pulmonary function and increased survival in patients with cystic fibrosis chronically infected with Pseudomonas species. The results of a prospective multicentre study to compare the effects on pulmonary function and mortality of three monthly elective anti-pseudomonal antibiotic treatment with conventional symptomatic treatment are reported.

Methods: Sixty patients with cystic fibrosis, chronically infected with P aeruginosa, were randomised to the two treatment arms (elective or symptomatic) and followed clinically at yearly reviews.

Development of an expert system for the interpretation of serial peak expiratory flow measurements in the diagnosis of occupational asthma. Midlands Thoracic Society Research Group.

If asthma is due to work exposures there must be a relation between these exposures and the asthma. Asthma causes airway hyperresponsiveness and obstruction; the obstruction can be measured with portable meters, which usually measure peak expiratory flow, or sometimes forced expiratory volume in 1 second (FEV1). These can be measured serially (for instance 2 hourly) over several weeks at and away from work.

The effect of patient technique and training on the accuracy of self-recorded peak expiratory flow.

The aim of the study was to investigate the difference between encouraged self-recorded peak expiratory flow (PEF) with unobserved readings and to investigate any long-term changes in PEF self-recording. Patients were trained in the PEF technique and asked to keep 2-hourly PEF records until the next clinic visit. The patients PEF were then rechecked at the second clinic visit by a series of two unobserved, an observed and an encouraged PEF measurement.

Effect of the number of peak expiratory flow readings per day on the estimation of diurnal variation.

Background: The number of peak expiratory flow (PEF) readings required per day to assess diurnal variation accurately is not known; published studies have used between two and seven PEF readings per day. This study compares the diurnal variation calculated using 2-10 PEF readings per day.

Methods: All days with 10 readings were selected from a database of PEF records.