It seems that we increasingly walk by homeless people sleeping-or trying to sleep-on a cold sidewalk near the warmth of a heating vent. Even for those who secure a place in a shelter, it can be difficult to sleep in an unfamiliar, often crowded, and sometimes insecure place. Perhaps it's obvious that homeless people are more likely to have difficulty sleeping than people who sleep in their own homes. But given the importance of sleep for good physical and mental health, we think the work of Léger et al 1 in this issue of JAMA Internal Medicine in quantifying the prevalence of sleep problems in the homeless is important, and lays groundwork to start to address this problem. We recognize that the homeless population and homeless services are different in France than in the United States, but we believe that the magnitude of the problem of poor sleep is likely similar in homeless persons everywhere.

2019) Development of a tool to support person-centred medicine-focused consultations with stroke survivors. Patient Education and Counseling . ISSN 0738-3991. Abstract ObjectiveTo develop a tool to support medicine-focused person-centred consultations between community pharmacists and stroke survivors. MethodSemi-structured interviews with 15 stroke survivors and 16 community pharmacists were conducted.Thematic analysis of the data was performed and emerging themes examined to determine their relevance to the principles of delivering person-centred care. Findings were used to generate a framework from which a consultation tool was created. Face validity and the feasibility of using the tool in practice were explored with participating pharmacists. ResultsThree major themes were identified; personal, process and environmental factors. A tool, in two parts, was developed, A 'Getting to know me' form which would help the pharmacist to appreciate the individual needs of the stroke survivor and a consultation guide to facilitate the consultation process.Pharmacists considered that both were useful and would support a person-centred medicine-focussed consultation. ConclusionA consultation tool, reflecting the needs of stroke survivors, has been developed and is feasible for use within community pharmacy practice. Practice ImplicationsPharmacists must recognise the individual needs of stroke survivors to ensure that they provide consultations which are truly person-centred.The tool developed could support medicine-related consultations with patients with other long term conditions.Optimising communication  Take into account the individual's specific needs before you start -you will probably need to explore these in more depth during the first consultation Remember -the patient is often an expert about living with their condition  Introduce yourself as the pharmacist, don't assume stroke survivors know you as the pharmacist, and explain what you are going to do -i.e. to help them with their medicines  Don't speak too quickly  Allow the person time to speak -listen actively and be sure to not interrupt or finish sentences  Keep sentences simple and concise  Don't keep moving between topics -changing subjects quickly can be confusing  Don't seem rushed -appear relaxed, approachable and that you have time  Use repetition -i.e. to reinforce important points and to check understanding (visually/verbally)  Make sure that you always include the stroke survivor in the discussion -keep face to face contact with the stroke survivor -especially in the presence of carers  Use communication tools wisely -they can be useful if someone has memory or communication difficulties -but leaflets are not any good if you cannot read  Sometimes it is better to ask short yes/no questions instead of open questions  Check reliability of responses -some stroke survivors may jumble their words -'no' might mean 'yes'! In such cases, tick/crosses or thumbs up/thumbs down may help  Ask if a break or rest is needed -notice verbal and non-ve...