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Marchant JM, Chang AB, Kennedy E, King D, Perret JL, Schultz A, Toombs MR, Versteegh L, Dharmage SC, Dingle R, Fitzerlakey N, George J, Holland A, Rigby D, Mann J, Mazzone S, O'Brien M, O'Grady KA, Petsky HL, Pham J, Smith SM, Wurzel DF, Vertigan AE, Wark P. Cough in Children and Adults: Diagnosis, Assessment and Management (CICADA). Summary of an updated position statement on chronic cough in Australia. Med J Aust 2024; 220:35-45. [PMID: 37982357 DOI: 10.5694/mja2.52157] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 09/18/2023] [Indexed: 11/21/2023]
Abstract
INTRODUCTION Cough is the most common symptom leading to medical consultation. Chronic cough results in significant health care costs, impairs quality of life, and may indicate the presence of a serious underlying condition. Here, we present a summary of an updated position statement on cough management in the clinical consultation. MAIN RECOMMENDATIONS Assessment of children and adults requires a focused history of chronic cough to identify any red flag cough pointers that may indicate an underlying disease. Further assessment with examination should include a chest x-ray and spirometry (when age > 6 years). Separate paediatric and adult diagnostic management algorithms should be followed. Management of the underlying condition(s) should follow specific disease guidelines, as well as address adverse environmental exposures and patient/carer concerns. First Nations adults and children should be considered a high risk group. The full statement from the Thoracic Society of Australia and New Zealand and Lung Foundation Australia for managing chronic cough is available at https://lungfoundation.com.au/resources/cicada-full-position-statement. CHANGES IN MANAGEMENT AS A RESULT OF THIS STATEMENT Algorithms for assessment and diagnosis of adult and paediatric chronic cough are recommended. High quality evidence supports the use of child-specific chronic cough management algorithms to improve clinical outcomes, but none exist in adults. Red flags that indicate serious underlying conditions requiring investigation or referral should be identified. Early and effective treatment of chronic wet/productive cough in children is critical. Culturally specific strategies for facilitating the management of chronic cough in First Nations populations should be adopted. If the chronic cough does not resolve or is unexplained, the patient should be referred to a respiratory specialist or cough clinic.
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Affiliation(s)
- Julie M Marchant
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD
- Queensland Children's Hospital, Brisbane, QLD
| | - Anne B Chang
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD
- Queensland Children's Hospital, Brisbane, QLD
- Menzies School of Health Research, Darwin, NT
| | - Emma Kennedy
- Rural and Remote Health, Flinders University, Darwin, NT
| | | | - Jennifer L Perret
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC
| | - Andre Schultz
- Wal-yan Respiratory Research Centre, Perth, WA
- Perth Children's Hospital, Perth, WA
| | | | | | - Shyamali C Dharmage
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC
| | | | | | - Johnson George
- Centre for Medicine Use and Safety, Monash University, Melbourne, VIC
| | - Anne Holland
- Alfred Health, Melbourne, VIC
- Monash University, Melbourne, VIC
- Institute for Breathing and Sleep, University of Melbourne, Melbourne, VIC
| | - Debbie Rigby
- University of Queensland, Brisbane, QLD
- Queensland University of Technology, Brisbane, QLD
| | - Jennifer Mann
- Institute for Breathing and Sleep, University of Melbourne, Melbourne, VIC
- Austin Health, Melbourne, VIC
| | | | | | - Kerry-Ann O'Grady
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, QLD
| | | | | | | | | | - Anne E Vertigan
- Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW
- John Hunter Hospital, Newcastle, NSW
| | - Peter Wark
- Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW
- John Hunter Hospital, Newcastle, NSW
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Weir KR, Bonner C, Naganathan V, Tam CWM, Rigby D, McLachlan AJ, Jansen J. Supporting conversations about medicines and deprescribing: GPs' perspectives on a Medicines Conversation Guide. Int J Pharm Pract 2023; 31:102-105. [PMID: 36413580 DOI: 10.1093/ijpp/riac088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/20/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To explore GP perspectives on a Medicines Conversation Guide to support deprescribing communication. METHODS Semistructured interviews with GPs from Australia (n = 32). Participants were purposively sampled with varying experiences and locations. Transcribed audio recordings of interviews were coded using framework analysis. KEY FINDINGS Most GPs stated they would use the Guide in consultation with an older patient to discuss medications. The strengths of the Guide included empowering the patient voice on an important topic. Limitations included time and complex concepts. CONCLUSIONS Overall, the Medicines Conversation Guide was perceived by GPs to be a useful communication tool to support discussions about deprescribing with patients.
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Affiliation(s)
- Kristie Rebecca Weir
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Carissa Bonner
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing (CERA), Department of Geriatric Medicine, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Chun Wah Michael Tam
- Primary and Integrated Care Unit, South Western Sydney Local Health District, Liverpool, New South Wales, Australia.,School of Population Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Debbie Rigby
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane City, Queensland, Australia
| | - Andrew J McLachlan
- Centre for Education and Research on Ageing (CERA), Department of Geriatric Medicine, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales, Australia
| | - Jesse Jansen
- Faculty of Health, Medicine and Life Sciences, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
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Sluggett JK, Rigby D. Simplifying medications for people with type 2 diabetes. BMJ 2022; 376:n3158. [PMID: 34987063 DOI: 10.1136/bmj.n3158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Janet K Sluggett
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Debbie Rigby
- School of Pharmacy, University of Queensland, Woolloongabba, QLD, Australia
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Rigby D. Digital psychiatry and COVID-19: a potential recruitment opportunity. Eur Psychiatry 2021. [PMCID: PMC9471737 DOI: 10.1192/j.eurpsy.2021.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Psychiatry has long been battling with a recruitment crisis in the UK which is also reflected across much of Europe. Covid-19 has brought about widespread changes to our ways of working, as well as driving technological developments, which provides potential opportunities for the profession to draw people into the speciality. Covid-19 has brought interest in digital psychiatry from the peripheries to the mainstream. Mental health professionals are currently using sophisticated technologies such as Virtual Reality, Artificial Intelligence and Natural Language Processing in the diagnosis and treatment of mental health disorders. Highlighting the ways in which our profession is at the cutting edge of innovation to junior doctors offers a fruitful avenue to improve recruitment into the speciality. Many outpatient clinics have made the move to online service delivery during the pandemic to varying degrees. For many clinicians this has allowed more flexible and efficient ways of working. Psychiatry is better placed than most other medical disciplines to retain online patient contact in future clinical practice, post pandemic and may provide an attractive proposition for future psychiatrists. This talk will review some of the ways in which developments in digital psychiatry have been used to help generate interest for recruitment into the discipline as well as evaluating the benefits and challenges of the shift to telepsychiatry during Covid-19 and will offer some suggestions what the profession can learn from this to help future recruitment.
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Weir KR, Naganathan V, Carter SM, Tam CWM, McCaffery K, Bonner C, Rigby D, McLachlan AJ, Jansen J. The role of older patients' goals in GP decision-making about medicines: a qualitative study. BMC Fam Pract 2021; 22:13. [PMID: 33419389 PMCID: PMC7796626 DOI: 10.1186/s12875-020-01347-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 12/07/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND To optimise medication use in older people, it is recommended that clinicians evaluate evidence on potential benefits and harms of medicines in light of the patients' overall health, values and goals. This suggests general practitioners (GPs) should attempt to facilitate patient involvement in decision-making. In practice this is often challenging. In this qualitative study, we explored GPs' perspectives on the importance of discussing patients' goals and preferences, and the role patient preferences play in medicines management and prioritisation. METHODS Semi-structured interviews were conducted with GPs from Australia (n = 32). Participants were purposively sampled to recruit GPs with variation in experience level and geographic location. Transcribed audio-recordings of interviews were coded using Framework Analysis. RESULTS The results showed that most GPs recognised some value in understanding older patients' goals and preferences regarding their medicines. Most reported some discussions of goals and preferences with patients, but often this was initiated by the patient. Practical barriers were reported such as limited time during busy consultations to discuss issues beyond acute problems. GPs differed on the following main themes: 1) definition and perception of patients' goals, 2) relationship with the patient, 3) approach to medicines management and prioritisation. We observed that GPs preferred one of three different practice patterns in their approach to patients' goals in medicines decisions: 1) goals and preferences considered lower priority - 'Directive'; 2) goals seen as central - 'Goal-oriented'; 3) goals and preferences considered but not explicitly elicited - 'Tacit'. CONCLUSIONS This study explores how GPs differ in their approach to eliciting patients' goals and preferences, and how these differences are operationalised in the context of older adults taking multiple medicines. Although there are challenges in providing care that aligns with patients' goals and preferences, this study shows how complex decisions are made between GPs and their older patients in clinical practice. This work may inform future research that investigates how GPs can best incorporate the priorities of older people in decision-making around medicines. Developing practical support strategies may assist clinicians to involve patients in discussions about their medicines.
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Affiliation(s)
- Kristie Rebecca Weir
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, 2006, Australia.
- Wiser Healthcare, Sydney School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Vasi Naganathan
- Centre for Education and Research on Ageing (CERA), Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, 2006, Australia
- Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, Concord West, New South Wales, 2139, Australia
| | - Stacy M Carter
- Australian Centre for Health Engagement, Evidence and Values (ACHEEV), School of Health and Society, Faculty of the Arts, Humanities and Social Sciences, University of Wollongong, Keiraville, New South Wales, 2522, Australia
| | - Chun Wah Michael Tam
- Primary and Integrated Care Unit, South Western Sydney Local Health District, Liverpool, New South Wales, 2170, Australia
- School of Population Health, The University of New South Wales, Sydney, New South Wales, 2052, Australia
| | - Kirsten McCaffery
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, 2006, Australia
- Wiser Healthcare, Sydney School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Carissa Bonner
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, 2006, Australia
- Wiser Healthcare, Sydney School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Debbie Rigby
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane City, Queensland, 4000, Australia
| | - Andrew J McLachlan
- Centre for Education and Research on Ageing (CERA), Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, 2006, Australia
- Faculty of Medicine and Health, Sydney Pharmacy School, The University of Sydney, Sydney, New South Wales, 2006, Australia
| | - Jesse Jansen
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, 2006, Australia
- Wiser Healthcare, Sydney School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia
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Sluggett JK, Harrison SL, Ritchie LA, Clough AJ, Rigby D, Caughey GE, Tan ECK. High-Risk Medication Use in Older Residents of Long-Term Care Facilities: Prevalence, Harms, and Strategies to Mitigate Risks and Enhance Use. Sr Care Pharm 2020. [DOI: 10.4140/tcp.n.2020.419.] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Older residents of long-term care facilities (LTCFs), also known as nursing homes, care homes, or residential aged care facilities, often have multiple health conditions and are exposed to polypharmacy. Use of high-risk medications such as opioids, glucose-lowering medications, antithrombotics,
and antipsychotics is prevalent among residents of LTCFs. Ensuring appropriate use of high-risk medications is important to minimize the risk of medication-related harm in this vulnerable population. This paper provides an overview of the prevalence and factors associated with high-risk medication
use among residents of LTCFs. Evidencebased strategies to optimize the use of high-risk medications and enhance resident outcomes are also discussed.
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Sluggett JK, Harrison SL, Ritchie LA, Clough AJ, Rigby D, Caughey GE, Tan ECK. High-Risk Medication Use in Older Residents of Long-Term Care Facilities: Prevalence, Harms, and Strategies to Mitigate Risks and Enhance Use. Sr Care Pharm 2020; 35:419-433. [PMID: 32972492 DOI: 10.4140/tcp.n.2020.419] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Older residents of long-term care facilities (LTCFs), also known as nursing homes, care homes, or residential aged care facilities, often have multiple health conditions and are exposed to polypharmacy. Use of high-risk medications such as opioids, glucose-lowering medications, antithrombotics, and antipsychotics is prevalent among residents of LTCFs. Ensuring appropriate use of high-risk medications is important to minimize the risk of medication-related harm in this vulnerable population. This paper provides an overview of the prevalence and factors associated with high-risk medication use among residents of LTCFs. Evidencebased strategies to optimize the use of high-risk medications and enhance resident outcomes are also discussed.
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Affiliation(s)
- Ian A Scott
- Princess Alexandra Hospital Brisbane Australia.,University of Queensland Brisbane Australia
| | - Debbie Rigby
- University of Queensland Brisbane Australia.,Queensland University of Technology Brisbane Australia
| | - Sarah N Hilmer
- Royal North Shore Hospital Sydney Australia.,Kolling Institute of Medical Research University of Sydney Sydney Australia
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Weir KR, Naganathan V, Rigby D, McCaffery K, Bonner C, Trevena L, McLachlan AJ, Jansen J. Home medicines reviews: a qualitative study of GPs' experiences. Aust J Prim Health 2019; 26:PY19072. [PMID: 31733660 DOI: 10.1071/py19072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 08/23/2019] [Indexed: 11/23/2022]
Abstract
This qualitative study explored GPs' experiences with pharmacist-led home medicines reviews (HMRs) and the barriers and facilitators to GPs using HMRs to optimise medicines for older people. Semi-structured interviews were conducted with 32 GPs Australia-wide. Purposeful sampling was undertaken to obtain a representative group in terms of age, gender and location. Data were analysed using framework analysis. Overall, GPs found HMRs useful for educating patients about their medicines, improving adherence and understanding the patient's home environment. Barriers to effective use of HMRs included patient resistance to having medicines reviewed and limited access to HMRs in regional or rural areas. GPs differed in the extent and way they use HMRs. One group found HMRs very useful, wanted more access to HMRs and reported frequent interactions with pharmacists. A second group was ambivalent, and perceived HMRs could be useful but had limitations in what they can achieve. A third group was sceptical, and reported HMRs rarely provide new insights, and recommendations were not clinically relevant to patients. Understanding GPs' expectations and preferences through interprofessional communication and partnerships are ways to address these barriers. Future improvements to the HMR program may include incentives and resources that promote collaboration between GPs and pharmacists.
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Affiliation(s)
- Kristie Rebecca Weir
- Wiser Healthcare, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia; and Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia; and Corresponding author
| | - Vasi Naganathan
- Centre for Education and Research on Ageing (CERA), Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia; and Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, NSW 2139, Australia
| | - Debbie Rigby
- DR Pharmacy Consulting, Brisbane, Qld 4001, Australia
| | - Kirsten McCaffery
- Wiser Healthcare, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia; and Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia
| | - Carissa Bonner
- Wiser Healthcare, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia; and Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia
| | - Lyndal Trevena
- Ask Share Know Centre for Research Excellence, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia
| | - Andrew J McLachlan
- Centre for Education and Research on Ageing (CERA), Concord Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia; and Faculty of Medicine and Health, Sydney Pharmacy School, University of Sydney, NSW 2006, Australia
| | - Jesse Jansen
- Wiser Healthcare, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia; and Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia
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Weir KR, Naganathan V, Bonner C, McCaffery K, Rigby D, McLachlan AJ, Jansen J. Pharmacists' and older adults' perspectives on the benefits and barriers of Home Medicines Reviews - a qualitative study. J Health Serv Res Policy 2019; 25:77-85. [PMID: 31505975 DOI: 10.1177/1355819619858632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives Conducting a medication review is one way to optimize medications and support older people to reduce the burden of polypharmacy. In Australia, a service called a Home Medicines Review (HMR) is conducted by pharmacists as part of a nationally funded program. HMRs aim to identify and resolve problems associated with polypharmacy and improve collaboration between patient, pharmacist and general practitioner. The aim of this study was to explore the benefits of and barriers to HMRs from the perspective of older patients and pharmacists. Methods This qualitative study involved observations of HMRs ( n = 12) and telephone interviews with 32 participants including 11 accredited pharmacists, 17 older adults aged 65 years and above, with 4 of their companions, in Australia. The researcher observing took notes during the HMR and added more detail and reflections afterwards. Transcribed audio-recordings and observational notes were thematically coded using framework analysis. Results Older patients and their companions found the HMR useful and they appreciated the opportunity to learn more about their medicines. However, many did not understand the purpose of the HMR, had limited understanding about their medicines and some did not want to know more. Pharmacists found HMRs useful for identifying medication errors and improving adherence. They also reported barriers to effective HMRs relating to patients (resistance to the evaluation of their medicines, misunderstanding about the aim of the HMR) and GPs (limited information upon referral, and limited follow-up afterwards). Conclusions Older patients and pharmacists reported a range of benefits for HMRs in terms of optimizing medicines use. Barriers to effective HMR use need to be addressed, including gaps in inter-professional communication and factors related to patient involvement, such as limited medicines understanding and health literacy.
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Affiliation(s)
- Kristie Rebecca Weir
- PhD Candidate, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Vasi Naganathan
- Consultant Geriatrician, Centre for Education and Research on Ageing (CERA), Concord Clinical School, The University of Sydney, Australia
| | - Carissa Bonner
- Research Fellow, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Kirsten McCaffery
- Professorial Research Fellow, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Debbie Rigby
- Consultant Pharmacist, DR Pharmacy Consulting, Brisbane, Australia
| | - Andrew J McLachlan
- Dean of Pharmacy, Sydney School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Australia
| | - Jesse Jansen
- Associate Professor, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
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Weir KR, Bonner C, McCaffery K, Naganathan V, Carter SM, Rigby D, Trevena L, McLachlan A, Jansen J. Pharmacists and patients sharing decisions about medicines: Development and feasibility of a conversation guide. Res Social Adm Pharm 2018; 15:682-690. [PMID: 30172642 DOI: 10.1016/j.sapharm.2018.08.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/27/2018] [Accepted: 08/20/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND In Australia, the Home Medicines Review (HMR) is a nationally-funded program, led by pharmacists to optimize medication use for older people. A Medicines Conversation Guide was developed for pharmacists to use in the context of a HMR. The Guide aims to increase patient involvement and support discussions about: general health understanding, decision-making and information preferences, health priorities related to medicines, patient goals and fears, views on important activities and trade-offs. OBJECTIVE This study describes the development and feasibility testing of a Medicines Conversation Guide in HMRs with pharmacists and older patients. METHODS The Guide was developed using a systematic and iterative process, followed by testing in clinical practice with 11 pharmacists, 17 patients (aged 65+) and their companions. A researcher observed HMRs, surveyed and qualitatively interviewed patients and pharmacists to discuss feasibility. Transcribed recordings of the interviews were thematically coded and a Framework Analysis method used. RESULTS Pharmacists found the Guide to be an acceptable and useful component to the HMR, especially among patients with limited knowledge of their medicines. The Guide seemed most effective when integrated with the HMR and tailored to suit the individual patient. Some questions were difficult for patients to grasp (e.g. trade-offs) or sounded formal. Most patients found the Guide focused the HMR on their perspective and encouraged a more holistic approach to the HMR. From the quantitative survey, pharmacists found the Guide easy to implement, balanced and understandable. CONCLUSIONS Pharmacists and patients reported the Guide fits with the HMR encounter relatively easily and promoted communication about goals and preferences in relation to medications. This study highlighted some key challenges for communication about medicines and how the Guide may help support the process of involving patients more in the HMR.
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Affiliation(s)
- Kristie Rebecca Weir
- Wiser Healthcare, Sydney School of Public Health, The University of Sydney, NSW, 2006, Australia; Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney, NSW, 2006, Australia
| | - Carissa Bonner
- Wiser Healthcare, Sydney School of Public Health, The University of Sydney, NSW, 2006, Australia; Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney, NSW, 2006, Australia
| | - Kirsten McCaffery
- Wiser Healthcare, Sydney School of Public Health, The University of Sydney, NSW, 2006, Australia; Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney, NSW, 2006, Australia
| | - Vasi Naganathan
- Centre for Education and Research on Ageing (CERA), Concord Clinical School, The University of Sydney, NSW, 2006, Australia; Ageing and Alzheimer's Institute, Concord Repatriation General Hospital, NSW, 2139, Australia
| | - Stacy M Carter
- Research for Social Change, Faculty of Social Science, The University of Wollongong, NSW, 2522, Australia
| | - Debbie Rigby
- DR Pharmacy Consulting, Brisbane, QLD, Australia
| | - Lyndal Trevena
- Ask Share Know Centre for Research Excellence, Sydney School of Public Health, The University of Sydney, NSW, 2006, Australia
| | - Andrew McLachlan
- Centre for Education and Research on Ageing (CERA), Concord Clinical School, The University of Sydney, NSW, 2006, Australia; Faculty of Pharmacy, University of Sydney, NSW, 2006, Australia
| | - Jesse Jansen
- Wiser Healthcare, Sydney School of Public Health, The University of Sydney, NSW, 2006, Australia; Sydney Health Literacy Lab, Sydney School of Public Health, The University of Sydney, NSW, 2006, Australia.
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Ha T, Abbott L, Mouchaileh N, Morrow M, Rawlins M, Naunton M, Ng M, Worthington R, Burke R, Rigby D. Drugscan. J Pharm Pract Res 2016. [DOI: 10.1002/jppr.1301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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13
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Ha T, Abbott L, Mouchaileh N, Morrow M, Rawlins M, Naunton M, Ng M, Worthington R, Burke R, Rigby D. Drugscan. J Pharm Pract Res 2016. [DOI: 10.1002/jppr.1261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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14
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Ha T, Abbott L, Mouchaileh N, Morrow M, Rawlins M, Naunton M, Ng M, Worthington R, Burke R, Rigby D. Drugscan. J Pharm Pract Res 2016. [DOI: 10.1002/jppr.1217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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15
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Ha T, Abbott L, Booth J, Patel B, Rawlins M, Naunton M, Ng M, Worthington R, Burke R, Rigby D. Drugscan. J Pharm Pract Res 2016. [DOI: 10.1002/jppr.1188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Affiliation(s)
- Andy Gilbert
- Division of Health Sciences, School of Pharmacy and Medical Sciences; University of South Australia; Adelaide SA 5001
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Affiliation(s)
- Christopher Freeman
- Charming Institute; Brisbane Australia
- School of Pharmacy; University of Queensland; Brisbane Australia
- School of Clinical Sciences; Queensland University of Technology; Brisbane Australia
| | - Neil Cottrell
- School of Pharmacy; University of Queensland; Brisbane Australia
| | | | | | - Lisa Nissen
- School of Clinical Sciences; Queensland University of Technology; Brisbane Australia
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Vass CM, Rigby D, Campbell S, Payne K. Investigating the Framing-Effects of Risk Attributes in Discrete Choice Experiments: A Pilot Study. Value Health 2014; 17:A648. [PMID: 27202331 DOI: 10.1016/j.jval.2014.08.2349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- C M Vass
- University of Manchester, Manchester, UK
| | - D Rigby
- University of Manchester, Manchester, UK
| | - S Campbell
- University of Manchester, Manchester, UK
| | - K Payne
- University of Manchester, Manchester, UK
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Angley M, Rigby D, Dowling HV, Coombes I, Criddle D, Dooley M, Driscoll SE, Jayasuriya PH, Kirsa SW, Tenni P, Bennett S, Vassarotti R. Advocating for Patients and the Pharmacist's Role in Primary Care. Journal of Pharmacy Practice and Research 2014. [DOI: 10.1002/j.2055-2335.2014.tb00004.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Manya Angley
- Sansom Institute for Health Research; University of South Australia
| | | | | | - Ian Coombes
- Safe Medication Management Unit Medication Services Queensland Queensland Health
| | | | | | | | | | | | - Peter Tenni
- Clinical Pharmacy Training and Consulting
- Consultant Pharmacy Services
- Clinical Division, Medscope
- University of Tasmania
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Jayasuriya P, Criddle D, Rigby D. Collaboration between doctors and pharmacists in the community. Aust Prescr 2011. [DOI: 10.18773/austprescr.2011.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Abstract
NVT molecular dynamics simulations were performed on liquid o-terphenyl as a function of temperature in the range 320-480 K. Computed translational diffusion coefficients displayed the non-Arrhenius behavior expected of a fragile glass-forming liquid and were in good, semiquantitative agreement with experimental results. Rotational correlation functions calculated for various vectors within the molecule exhibited a very short time (0-1 ps) initial decay, followed by a reversal, which corresponds to free reorientation within the "solvent" cage prior to collision with a wall. Rotational correlation times of three orthogonal vectors fixed on the central benzene were close to equal at all temperatures, indicating nearly isotropic overall molecular reorientation. The average correlation times exhibited a non-Arrhenius temperature dependence and were in very good agreement with experimental values derived from 2D and 1H NMR relaxation times. Correlation times of vectors located on the lateral phenyl rings were used to calculate the "spinning" internal rotation diffusion coefficients, which were approximately twice as great as the overall rotational diffusion constants, indicating rapid internal rotation of the phenyl side groups over wide ranges of angle in the liquid.
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Affiliation(s)
- R J Berry
- Air Force Research Laboratory, Materials and Manufacturing Directorate, Wright-Patterson AFB, Ohio 45433, USA
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Rigby D, Gray K. Understanding urine testing. Nurs Times 2005; 101:60-2. [PMID: 15822715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Urine is a natural waste product of the body and urine testing is a simple and quick way of monitoring disease and identifying new illness. The results from a urine test can prompt a change in a patient's medical management. Urine testing is not a new procedure: as far back as the ancient Egyptians there are descriptions of polyuria. In 7th Century AD, Protosharis suggested that it was important to look at the colour of urine and by 1674 Thomas Willis, a professor at Oxford University, recorded that the urine of his patients with diabetes tasted sweet (Beer, 1996).
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Rigby D. Manual evacuation of faeces. Nurs Times 2003; 99:48. [PMID: 12593287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Controversy surrounds the manual evacuation of faeces by nurses, and many are confused about their professional and legal responsibilities when asked to undertake this procedure. The argument that it is a well established and successful procedure is supported by many professionals, but there is very little documented evidence of its effectiveness as a method of bowel management.
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Rigby D. Championing men's health. Interview by Lynne Pearce. Nurs Stand 2002; 17:77. [PMID: 12452093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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Edwards CJC, Rigby D, Stepto RFT. Kirkwood-Riseman interpretation of the diffusion behavior of short polymer chains in dilute solution. Macromolecules 2002. [DOI: 10.1021/ma50007a038] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Nurses have an important role in continence promotion. Deborah Rigby argues that effective continence care should be multidisciplinary and seamless, from the patient's home through primary care and local community services to secondary hospital services.
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Affiliation(s)
- D Rigby
- Mendip Primary Care Trust, St Martin's Hospital, Bath.
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Rigby D, Whelan L. Parkinson's disease--continence management. Nurs Times 2001; 97:65-6. [PMID: 11957964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- D Rigby
- Bath and West Community NHS Trust
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Rigby D. Moving upward in a downturn. Harv Bus Rev 2001; 79:98-147. [PMID: 11408981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
As the recent bursting of the new economy bubble has shown, business cycles are still wih us. The question, then, is, what executives should do to help their companies weather these downturns. As in so many instances, there are conventional approaches that appear to make sense in the short term. But while these approaches seem reasonable in the heat of the moment, they can eventually damage competitive positions and financial performance. Drawing on extensive research of Fortune 500 companies that have lived through industry downturns and economic recessions over the past two decades, Darrell Rigby, a director of Bain & Company, reveals how companies need to go against the grain of convention and exploit industry downturns to harness their unique opportunities for upward mobility. The author explains that every downturn goes through three phases. He examines each phase and shows how successful players navigate the huge waves of a downturn. Smart executives, he says, don't panic: they look bad news in the eye and institutionalize an approach to detecting storms. Rather than hedge their bets through diversification, they focus on their core businesses and spend to gain market share. They manage costs relentlessly during good times and bad. They keep a long-term view and strive to maintain the loyalty of employees, suppliers, and customers. And coming out of the downturn, they maintain momentum in their businesses to stay ahead of the competition they've already surpassed. Every industry will face periodic downturns of varying severity, says Rigby. But executives with the vision and ingenuity to take unconventional approaches can buoy their companies to new heights.
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Rigby D, Whelan L. Parkinson's disease and the nurse's role in continence assessment. Nurs Times 2001; 97:64-5. [PMID: 11962053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- D Rigby
- Bath and West Community NHS Trust
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Abstract
Bowel dysfunction affects many people and encompasses a variety of problems. This article examines the different forms of bowel dysfunction and considers the nurse's role in caring for patients with this disorder, including manual evacuation.
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Affiliation(s)
- M Powell
- Bath and West Community NHS Trust, St Martins Hospital, Bath
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Thomas S, Rigby D. Focus on continence. A growing concern. Elder Care 1999; 11:28-30. [PMID: 10614305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- S Thomas
- Royal College of Nursing, London
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Rigby D. Persistence the key for patient who resists change. Nurs Times 1999; 95:61. [PMID: 10569023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- D Rigby
- Bath and West Community NHS Trust
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Rigby D. Continence. New solutions. Nurs Times 1999; 95:57-8. [PMID: 10569022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- D Rigby
- Bath and West Community NHS Trust
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Rigby D. Urinary tract infections: the hidden cause. Community Nurse 1998; 4:30-2. [PMID: 9763968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Urinary infections are a common problem mainly affecting women. Deborah Rigby outlines their causes and symptoms, and describes how they can be avoided.
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Rigby D. Long-term catheter care. Prof Nurse 1998; 13:S14-5. [PMID: 9526424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- D Rigby
- Continence Promotion Unit, St Martin's Hospital, Bath
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Rigby D. African diary. Br J Theatre Nurs 1997; 7:22-4. [PMID: 9283330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
You may have been wondering why there have been no further installments of African Diary. The short answer is that Diana was very ill from the side-effects of anti-malaria drugs. She has been back in this country being treated and having a spell of rest and recuperation. You will remember that Diana and Colin, her husband, had left Mozambique and were very busy building up a new mission station, funded by a business man from Liverpool, in Uganda. Before being taken ill, Diana had written some notes for the Journal which will be enough for two more articles. Diana and Colin have not yet decided whether they will return to Africa but we have told Diana how Journal readers enjoyed reading her news. We wish her well for the future.
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Rigby D. African diary. Br J Theatre Nurs 1996; 6:17-8. [PMID: 9052039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
You must all be wondering how we are getting on with the health centre, I must confess that it's not very fast! Well, anyone who has lived in Africa will not be surprised, things always go slowly. We spent six weeks in England, and virtually nothing happened, although we had left money and instructions. Somebody had begun to dig a deep hole for latrines that we had not asked for. Colin went and had a look and decided it can be made deeper and turned into a well, luckily we got back in time to make the change! We did want toilets constructed but the flush type for in-patients, well it was nearly right. The minister who is supposed to be organising people to work, has had visitors almost ever since we came back and has not found anyone to get on with the building. Some people are busy building new classrooms for the junior school that were not even mentioned before we left.
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Rigby D. Continence. Face to face support. Nurs Times 1996; 92:84. [PMID: 8932163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Rigby D. African diary returns. Br J Theatre Nurs 1996; 6:44-5. [PMID: 8974519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Alexander G, Allison J, Altekamp N, Ametewee K, Anderson KJ, Anderson S, Arcelli S, Asai S, Axen D, Azuelos G, Ball AH, Barberio E, Barlow RJ, Bartoldus R, Batley JR, Beaudoin G, Bechtluft J, Beeston C, Behnke T, Bell AN, Bell KW, Bella G, Bentvelsen S, Berlich P, Bethke S, Biebel O, Blobel V, Bloodworth IJ, Bloomer JE, Bock P, Bosch HM, Boutemeur M, Bouwens BT, Braibant S, Brown RM, Burckhart HJ, Burgard C, Bürgin R, Capiluppi P, Carnegie RK, Carter AA, Carter JR, Chang CY, Charlesworth C, Charlton DG, Chrisman D, Chu SL, Clarke PEL, Cohen I, Conboy JE, Cooke OC, Cuffiani M, Dado S, Dallapiccola C, Dallavalle GM, Jong S, Pozo LA, Desch K, Dixit MS, Couto e Silva E, Doucet M, Duchovni E, Duckeck G, Duerdoth IP, Edwards JEG, Estabrooks PG, Evans HG, Evans M, Fabbri F, Fath P, Fiedler F, Fierro M, Fischer HM, Folman R, Fong DG, Foucher M, Fukui H, Fürtjes A, Gagnon P, Gaidot A, Gary JW, Gascon J, Gascon-Shotkin SM, Geddes NI, Geich-Gimbel C, Gentit FX, Geralis T, Giacomelli G, Giacomelli P, Giacomelli R, Gibson V, Gibson WR, Gingrich DM, Goldberg J, Goodrick MJ, Gorn W, Grandi C, Gross E, Gruwé M, Hajdu C, Hanson GG, Hansroul M, Hapke M, Hargrove CK, Hart PA, Hartmann C, Hauschild M, Hawkes CM, Hawkings R, Hemingway RJ, Herten G, Heuer RD, Hildreth MD, Hill JC, Hillier SJ, Hilse T, Hoare J, Hobson PR, Homer RJ, Honma AK, Horváth D, Howard R, Hughes-Jones RE, Hutchcroft DE, Igo-Kemenes P, Imrie DC, Ingram MR, Jawahery A, Jeffreys PW, Jeremie H, Jimack M, Joly A, Jones CR, Jones G, Jones M, Jones RWL, Jost U, Jovanovic P, Junk TR, Karlen D, Kawagoe K, Kawamoto T, Keeler RK, Kellogg RG, Kennedy BW, King BJ, Kirk J, Kluth S, Kobayashi T, Kobel M, Koetke DS, Kokott TP, Komamiya S, Kowalewski R, Kress T, Krieger P, Krogh J, Kyberd P, Lafferty GD, Lafoux H, Lahmann R, Lai WP, Lanske D, Lauber J, Lautenschlager SR, Layter JG, Lazic D, Lee AM, Lefebvre E, Lellouch D, Letts J, Levinson L, Lewis C, Lloyd SL, Loebinger FK, Long GD, Losty MJ, Ludwig J, Luig A, Malik A, Mannelli M, Marcellini S, Markus C, Martin AJ, Martin JP, Martinez G, Mashimo T, Matthews W, Mättig P, McDonald WJ, McKenna J, Mckigney EA, McMahon TJ, McNab AI, McPherson RA, Meijers F, Menke S, Merritt FS, Mes H, Meyer J, Michelini A, Mikenberg G, Miller DJ, Mir R, Mohr W, Montanari A, Mori T, Morii M, Müller U, Neal HA, Nellen B, Nijjhar B, Nisius R, O’Neale SW, Oakham FG, Odorici F, Ogren HO, Omori T, Oreglia MJ, Orito S, Pálinkás J, Pansart JP, Pásżtor G, Pater JR, Patrick GN, Pearce MJ, Petzold S, Pfeifenschneider P, Pilcher JE, Pinfold J, Plane DE, Poffenberger P, Poli B, Posthaus A, Przysiezniak H, Rees DL, Rigby D, Robins SA, Rodning N, Roney JM, Rooke A, Ros E, Rossi AM, Rosvick M, Routenburg P, Rozen Y, Runge K, Runolfsson O, Ruppel U, Rust DR, Rylko R, Sarkisyan EKG, Sasaki M, Sbarra C, Schaile AD, Schaile O, Scharf F, Scharff-Hansen P, Schenk P, Schmitt B, Schmitt S, Schröder M, Schultz-Coulon HC, Schulz M, Schütz P, Scott WG, Shears TG, Shen BC, Shepherd-Themistocleous CH, Sherwood P, Siroli GP, Sittler A, Skillman A, Skuja A, Smith AM, Smith TJ, Snow GA, Sobie R, Söldner-Rembold S, Springer RW, Sproston M, Stahl A, Starks M, Steiert M, Stephens K, Steuerer J, Stockhausen B, Strom D, Strumia F, Szymanski P, Tafirout R, Talbot SD, Tanaka S, Taras P, Tarem S, Tecchio M, Thiergen M, Thomson MA, Törne E, Towers S, Tscheulin M, Tsukamoto T, Tsur E, Turcot AS, Turner-Watson MF, Utzat P, Kooten R, Vasseur G, Verzocchi M, Vikas P, Vincter M, Vokurka EH, Wäckerle F, Wagner A, Ward CP, Ward DR, Ward JJ, Watkins PM, Watson AT, Watson NK, Weber P, Wells PS, Wermes N, White JS, Wilkens B, Wilson GW, Wilson JA, Wlodek T, Wolf G, Wotton S, Wyatt TR, Yamashita S, Yekutieli G, Zacek V. A measurement of the B d 0 oscillation frequency using leptons and D*± mesons. ACTA ACUST UNITED AC 1996. [DOI: 10.1007/s002880050258] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rigby D. The electric effect. Nurs Times 1996; 92:72. [PMID: 8826425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Rigby D. African diary resurgent! Br J Theatre Nurs 1996; 6:33. [PMID: 8850890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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