While recognizing the reservations held about strict ethical guidelines for qualitative research, we argue for further debate of these issues so that the health services research community can move towards the adoption of agreed standards of good practice. In addition, we suggest that empirical research is desirable in order to quantify the actual risks to participants in qualitative studies.

Appraising qualitative research depends on the transparency with which the research process is described. Awareness of professional background is particularly important for university departments of primary care (which often include doctors, nurses and social scientists) and should be considered carefully in designing, carrying out and disseminating the results of qualitative studies.

One of the most useful methods available for the quantitative measurement of hemolytic rates in clinical subjects and for the evaluation of red cell viability after storage is based on the survival of transfused erythrocytes. Access to such data, however, has been restricted because of limitations in the methods hithertofore available for measuring red cell survival in vivo.The differential agglutination method of counting donor cells, the procedure most commonly employed, has limitations in that large transfusions are required;* the donor blood must be devoid of all antigenic isoagglutinins which are not likewise possessed by the recipient; the recipient's cells must contain agglutinogen A or B or M or a combination of the three agglutinogens which is not contained in the donor blood; and, finally, this method excludes the use of autotransfusion, which would eliminate the risk of transmission of hemologous serum jaundice.The labelling of donor cells with radioactive iron (Fe55) permits the conduct of survival studies on a short term basis (1-3) but re-utilization of radioactive iron released from hemolyzed donor cells and the subsequent incorporation of this label in the recipient's red cells preclude its use in studies extending for periods longer than 24 to 48 hours.

Although primary healthcare professionals recognize the general benefits of eHealth, uptake is low. By acknowledging barriers to the uptake of eHealth in geographically isolated settings, broader policies on its implementation in primary care may be informed.

Scientific inveStigAtionSStudy objectives: To evaluate the psychometric properties and clinical significance of a new scale for measuring daytime fatigue associated with insomnia: The Flinders Fatigue Scale (FFS). Methods: The 7-item FFS was used in two separate studies. Study 1 was an on-line validation study involving 1093 volunteers (mean [SD] age = 38.6 [14.7] y, 626 poor sleepers, 467 good sleepers) in a crosssectional design; Study 2 investigated the clinical sensitivity of the FFS on 113 insomnia patients (mean [SD] age = 48.3 [15.0] y) in response to a 5-week cognitive-behavior therapy for insomnia (CBT-I) program. Results: The FFS had an internal consistency of 0.91; it comprised a single factor, accounting for 67% of the total variance. Poor sleepers in Study 1 scored significantly higher than good sleepers on the FFS (p < 0.0001).In Study 2, significant reductions in FFS scores were found in response to CBT-I (p < 0.0001). These reductions in fatigue correlated with improvements on subjective sleep parameters (all p < 0.0001). The FFS showed good discriminant validity with the Epworth Sleepiness Scale. conclusions: The Flinders Fatigue Scale is a brief, clinically sensitive measure with strong psychometric properties.