MDI

Patient education is a critical factor in the use and misuse of medication inhalers. Inhalers represent advanced technology that is considered so easy to use that many patients and clinicians do not receive adequate training in their use. Between 28% and 68% of patients do not use metered-dose inhalers or powder inhalers well enough to benefit from the prescribed medication, and 39-67% of nurses, doctors, and respiratory therapists are unable to adequately describe or perform critical steps for using inhalers. Of an estimated 25 billion dollars spent for inhalers annually, 5-7 billion dollars is wasted because of inhaler misuse. Reimbursement and teaching strategies to improve patient education could substantially reduce these wasted resources. Problems with inhaler use, the cost of inhalers, and myths associated with inhalers are reviewed, with recommendations for strategies and techniques to better educate patients in inhaler use.

This experiment centred in metered dose inhaler (MDI) device which used routinely by asthma patient as controller therapy. MDI used ask patient's skill more when using their medication. MDI technique informnation provided by pharmachist are important to achive optimal medication in asthma therapy. By a non experimental study, mysterious patient collect MDI technique gived by pharmacist in Tuban pharmacy using observacional and cross sectional method. Information about MDI technique comprehensive collected by two ratter as mysterious patient which assessed with checklist that got measseured by kappa to know ratter aggrement percentage. The result showed from a total sampling under 41 pharmachist which represent each 41 pharmacy in Tuban, by purposive sampling Pharmacists as pharmaceutical personnel responsible for information services at pharmacies, including information on how to use MDI. Most of the apothecary's ability level in providing information is still lacking, then continued with adequate technique, and optimal technique in providing complete information of MDI use for asthma patient. Pharmacists know how to use MDI and no pharmacist is unexpected or not familiar with MDI as an asthma therapy. Pharmacists in Tuban district have a tendency to inform only four stages of the nine stages of MDI use from Osman et al (2012), ie at the 1st, 3rd, 5th, and 6th stages of MDI use.

Patient education is a critical factor in the use and misuse of medication inhalers. Inhalers represent advanced technology that is considered so easy to use that many patients and clinicians do not receive adequate training in their use. Between 28% and 68% of patients do not use metered-dose inhalers or powder inhalers well enough to benefit from the prescribed medication, and 39-67% of nurses, doctors, and respiratory therapists are unable to adequately describe or perform critical steps for using inhalers. Of an estimated 25 billion dollars spent for inhalers annually, 5-7 billion dollars is wasted because of inhaler misuse. Reimbursement and teaching strategies to improve patient education could substantially reduce these wasted resources. Problems with inhaler use, the cost of inhalers, and myths associated with inhalers are reviewed, with recommendations for strategies and techniques to better educate patients in inhaler use.

On 1 January 2007, Denmark went through a major reorganization, where most of its 275 municipalities and 14 counties merged into larger units. Our study aimed to examine the development of depressive symptoms and incident depression among employees affected by this organizational change. A total of 685 civil servants employed in the administration of 5 municipalities and 2 counties participated in the study. They answered a postal questionnaire, 8 months prior to and 16 months after the reorganization, regarding working conditions, psychosocial work environment factors, and depressive symptoms, based on the Major Depression Inventory (MDI). During the follow-up period of 2006-2008, 295 employees had experienced a merger with other workplaces (hereafter the merger group), 259 had got a new job (the new job group), and 131 who experienced no change in workplace served as the control group. The three groups were compared to each other for (i) mean score of MDI and (ii) incident cases o...

BACKGROUND: Left ventricular outflow tract tachycardia/premature depolarizations (VT/VPDs) arising near the anterior epicardial veins may be difficult to eliminate through the coronary venous system. OBJECTIVE: To describe the characteristics of an alternative successful ablation strategy targeting the left sinus of Valsalva (LSV) and/or the adjacent left ventricular (LV) endocardium. METHODS: Of 276 patients undergoing mapping/ablation for outflow tract VT/VPDs, 16 consecutive patients (8 men; mean age 52 ± 17 years) had an ablation attempt from the LSV and/or the adjacent LV endocardium for VT/VPDs mapped marginally closer to the distal great cardiac vein (GCV) or anterior interventricular vein (AIV). RESULTS: Successful ablation was achieved in 9 of the 16 patients (56%) targeting the LSV (5 patients), adjacent LV endocardium (2 patients), or both (2 patients). The R-wave amplitude ratio in lead III/II and the Q-wave amplitude ratio in aVL/aVR were smaller in the successful group...