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The 2008 BTS/SIGN British Guideline on the management of asthma provides comprehensive updated evidence-based guidance on asthma management for healthcare professionals. This primary care-focussed summary has been produced to aid dissemination and implementation of the key guideline messages into primary care. The section on diagnosis emphasises the new integrated symptombased approach with clinicians using their deductive skills to determine the probability that the patient has asthma. The various tools used for monitoring asthma are discussed. There are sections on both non-pharmacological and pharmacological management of chronic asthma in adults and children. Treatment options for children are subdivided into the under-5s and children aged 5-12 years. Poor asthma control is manifested by exacerbations and acute asthma. Personalised asthma action plans for guided self management should be provided and used when levels of asthma control change. There are sections on difficult asthma and the treatment of exacerbations and acute severe asthma. Various outcome measures for auditing the quality of asthma care are discussed. [ABSTRACT FROM AUTHOR]

The UK Department of Health (DoH), with input from with the Royal College of General Practitioners and UK General Practice Airways Group (GPIAG), has drawn up guidelines for the appointment of General Practitioners or other Practitioners with a Special Interest (GPwSIs or PwSIs, respectively) in respiratory medicine. This Discussion paper is based on the deliberations of a GPIAG-organised mult-iprofessional Working Party held in November 2005. It highlights the three key roles of respiratory GPwSIs/PwSIs, and it aims to provide existing and potential specialist practitioners with a checklist of specific points to consider when drawing up a contract with their employing authority. Whilst this system is particular to the provision of primary care in the UK, other countries may choose to follow this model. [ABSTRACT FROM AUTHOR]

The author reflects on a report regarding 20 deaths in children with asthma who aged 17 or under 11.5 years which occurred in the years 2001-2006 in Great Britain. He outlines the known severity-based risk factors in children placed on the at-risk asthma register. He also highlights the use of inhaled corticosteriod (ICS) and allergy assessment in treating asthma.

The article discusses various topics published within the issue including one on primary care respiratory community, roles and training levels of healthcare professionals and the roles of primary nurses in Great Britain.

An introduction is presented in which the editor discusses various reports within the issue on topics including one related to obstructive sleep apnoea (OSA ), the other on the public health issue in Great Britain and the third on body mass index (BMI) of old people.

The article offers news briefs related to nursing of older people in Great Britain. The King's College hospital conducted clinical trials for the treatment for wet age-related macular degeneration (AMD). Researchers from Boston University found that long-term use of ibuprofen could reduce the risk of developing Alzheimer's disease. The Medicines and Healthcare products Regulatory Agency released an alert report over the safety of walking frames manufactures by Trulife Ltd.

Reports on the mental health crisis in prisons in Great Britain. Importance of diverting mentally ill offenders away from custodial sentences or into hospital or other treatment facilities; Conference on mental health problems of male prisoners; Prisoners in Great Britain who have a diagnosis of a personality disorder, schizophrenia, or delusional disorders; Lack of treatment for mentally ill prisoners.

Reports on the necessity of improvements to the detection and treatment rates for hepatitis C in order to avoid a public health crisis in Great Britain. Infection of the British population with hepatitis C virus; Use of outreach nurse-led clinics in primary care, prisons and drug treatment services; Recommendation of treatment with combination therapies such as pegylated interferon alfa and ribavirin.