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main product of mast cells plays critical role in the pathogenetic pathways of
both allergic rhinitis and asthma. The novel concept of the unique airway
diseases its only supported by the similarities within pathogenetic process.
Antagonists of H1 and H2 receptors are quite effective in allergic rhinitis,
but not effective enough in asthma. In an era of corticosteroids, leucotriene
antagonists and Anti-IgE treatment, there is still a challenge to search for
more effective, more acurate and more safe treatment option. Antagonists
(inversive agonists) of histamine receptors H4 seems to be one of the promising
targets in the allergic rhinitis and asthma treatment. The first H4 antagonist
entered to clinics and the results from a proof-of-concept Phase II clinical
study is expected to be disclosed soon. This review article summarizes
current knowledge on H4R that have been collected in various studies sharing
evidences about efficacy of H4R as a reasonable target for diseases with
histamine involved pathogenetic pathways.
Previous research has demonstrated a considerable amount of negative consequences resulting from psychological reactance. The purpose of this study was to explore opportunities to reduce the amount of reactance. Using the method of perspective taking as an intervention, the current study of 196 Austrians and 198 Filipinos examined whether reactance could be reduced and whether individualists and collectivists differ concerning reactance and their perspective taking abilities. Our results indicated that participants who took the perspective of the person who threatened them experienced less reactance than participants who did not take this approach. This was the case for people from both cultural backgrounds. Nevertheless, comparisons among the two cultural groups yielded different reactions to restrictions. This indicates that individualists are more sensitive to a self-experienced restriction than collectivists, but less sensitive to a restriction of another person. Consequently, we consider culture to be a crucial determinant in predicting the amount of reactance.
In the present article, we emphasize the symptom experience perspective in person-centred care and discuss barriers to implementation of this approach. There are obstacles to overcome: the diversity of understandings of symptoms in clinical settings, the current biomedical discourse and the incompleteness of symptom research. Since the 19th century, the biomedical perspective has been powerful in conceptualizing symptoms in terms of pathology and diagnosis. Many diagnoses conjure up preconceived notions about the persons receiving them. This perspective may influence person-centred care negatively. Yet symptoms often mean something beyond the diagnosis. Recognizing this discrepancy, it is crucial that we consider a perspective that starts from each person’s symptom experience, thus complementing the biomedical perspective. Using the notion caring about symptoms, we advocate a person-centred approach that includes a symptom experience perspective. This requires health-care professionals to be skilled in listening to patient narratives and acquire knowledge about how symptom experiences can be individually expressed and interpreted. Listening to symptom experiences may give insights into the personal meaning of illness as well as information about bodily and social restrictions caused by symptom distress. In this way, caring about symptoms will improve the prerequisites for establishing person-centred care planning.
Background: Patient records should both transfer and create knowledge about patients and their health care. A standardized care plan could be a way to implement evidence-based care directly in practice and improve the documentation in patient records. The aim of this study is to investigate and compare the development and implementation process of a standardized care plan in hospital and primary health care. A further aim is to evaluate the effects on the quality of documentation and the care given in two contexts. Methods and Analysis: Realistic evaluation will be used as a framework to investigate the implementation process. According to this framework, possible contexts, mechanisms, and outcomes in the study will be considered. The study will be performed in two contexts: an orthopedic clinic and primary health care centers. In both contexts, the two key mechanisms will be the same: the implementation process will be driven by internal facilitators (practitioners at the units) and the process will be guided by the Rules and Regulations for interoperability in the Health and Social Care specification, “National information structure for standardized care plans”. Two outcomes of the study will be studied: to investigate the development and implementation process by an evaluation of fidelity and to evaluate how a standardized care plan affects the quality of documentation and the use of evidence-based care. Discussion: Implementation of the SCP will probably meet the same resistance as implementation of guidelines. Documentation of care is an important but resource-consuming requirement in health care, a more standardized method of documenting is requested by health professionals. This project can provide insight into the complex process of developing and implement an SCP in different contexts, which will be useful in further implementation processes.