Nasal potential difference measurements are valuable endpoint assays in clinical studies of novel treatments for cystic fibrosis (CF). Similar measurements made on the lower airway via the bronchoscope have been successful in adults, but have not been reported in children, the group most likely to benefit from such therapies. Here we report the design and validation of a small, single-lumen catheter technique allowing baseline potential difference and chloride secretion to be assessed in the distal airways of children as young as 1 year of age. Tracheal baseline values were significantly higher in children with CF than those without, although this was not the case more distally. In airways between the third and seventh generation, perfusion with a zero chloride solution containing isoprenaline led to a significant change in potential difference in children without CF, whereas no change was seen in those with CF. This measure provided a reliable distinguishing test between the two disease groups. We confirm that invasive bronchoscopic techniques can be performed safely and reliably in small children. Potential difference measurements could form a useful functional endpoint assay for future studies of either the CFTR gene or protein-based therapies in future trials in the pediatric age group.

Merskey, Gillis, and Marszalek (1962) reported that in chronic schizophrenic patients reaction to pain was greatest in those patients showing either over-activity or under-activity as measured by a ward activity rating scale. They also reported a significant difference between certain age groups, the oldest and youngest age groups showing the greatest reaction to pain. The authors attributed the difference between age groups to the effects of tranquillizing drugs, since there existed a high correlation between age groups and their dosage of such drugs. It was concluded that ward behaviour in schizophrenics is a poor indicator of their sensitivity to stimulation.

No abstract

No abstract

No abstract

No abstract

MATERIALS AND METHODS Design A serial interview design, with an Interpretative Phenomenological Analysis approach (IPA; Smith, 1996). IPA as an approach aligns fittingly to the tenets of the CSM (Cameron & Leventhal, 2003) in acknowledging the individual's constructed understanding of illness. The authors followed an idiographic, phenomenological approach Recruitment and Participants

Esophageal cancer patients and carers report significant levels of psychological distress. Despite this, only a small number of patients and carers engage with existing psychological services. This study aims to explore the perception of esophageal cancer patients, carers, and healthcare professionals (HCPs) of psychological distress and current provision of support, the need for and format of tailored support and barriers to patient/carer engagement. Semistructured interviews were undertaken with n = 14 esophageal cancer patients, carers, and HCPs. Directed content analysis was utilized to code the transcripts according to the preconceived categories as defined by study aim. Participants reported key periods for heightened distress around diagnosis and postsurgery on discharge from hospital. Provision of existing support was not felt to be adequate. A number of patient/carer barriers to engaging with support were identified in addition to HCP barriers. Participants perceived enhanced psychological support as a priority supportive care need with a number of recommendations for tailoring existing support services more adequately to the clinical population. With reports of heightened psychological morbidity yet with few esophageal cancer patients engaging with psychological services, there is an impetus to develop detailed care pathways to facilitate meeting this prioritized support need.