Living with chronic migraine: a qualitative study on female patients' perspectives from a specialised headache clinic in Spain

OBJECTIVES: The aim of this study was to explore the views and experiences of a group of Spanish women suffering from chronic migraine (CM). SETTING: Headache clinic at a university hospital in Madrid (Spain). PARTICIPANTS: Purposeful sampling of patients that attended a specialised headache clinic for the first time between June 2016 and February 2017 was performed. The patients included were females aged 18–65 and with positive diagnoses of CM according to the International Classification of Headache disorders (third edition, beta version), with or without medication overuse. Accordingly, 20 patients participated in the study with a mean age of 38.65 years (SD 13.85). DESIGN: Qualitative phenomenological study. METHODS: Data were collected through in-depth interviews, researchers’ field notes and patients’ drawings. A thematic analysis was performed following appropriate guidelines for qualitative research. RESULTS: Five main themes describing the significance of suffering emerged: (a) the shame of suffering from an invisible condition; (b) treatment: between need, scepticism and fear; (c) looking for physicians’ support and sincerity and fighting misconceptions; (d) limiting the impact on daily life through self-control; and (e) family and work: between understanding and disbelief. The disease is experienced as an invisible process, and the journey to diagnosis can be a long and tortuous one. Drug prescription by the physician is greeted with distrust and scepticism. Patients expect sincerity, support and the involvement of their doctors in relation to their disease. Pain becomes the main focus of the patient’s life, and it requires considerable self-control. The disease has a strong impact in the work and family environment, where the patient may feel misunderstood. CONCLUSIONS: Qualitative research offers insight into the way patients with CM experience their disease and it may be helpful in establishing a more fruitful relationship with these patients

Community structure of woody plants on islands along a bioclimatic gradient

Peer reviewe

Global Island Monitoring Scheme (GIMS): a proposal for the long-term coordinated survey and monitoring of native island forest biota

Islands harbour evolutionary and ecologically unique biota, which are currently disproportionately threatened by a multitude of anthropogenic factors, including habitat loss, invasive species and climate change. Native forests on oceanic islands are important refugia for endemic species, many of which are rare and highly threatened. Long-term monitoring schemes for those biota and ecosystems are urgently needed: (i) to provide quantitative baselines for detecting changes within island ecosystems, (ii) to evaluate the effectiveness of conservation and management actions, and (iii) to identify general ecological patterns and processes using multiple island systems as repeated ‘natural experiments’. In this contribution, we call for a Global Island Monitoring Scheme (GIMS) for monitoring the remaining native island forests, using bryophytes, vascular plants, selected groups of arthropods and vertebrates as model taxa. As a basis for the GIMS, we also present new, optimized monitoring protocols for bryophytes and arthropods that were developed based on former standardized inventory protocols. Effective inventorying and monitoring of native island forests will require: (i) permanent plots covering diverse ecological gradients (e.g. elevation, age of terrain, anthropogenic disturbance); (ii) a multiple-taxa approach that is based on standardized and replicable protocols; (iii) a common set of indicator taxa and community properties that are indicative of native island forests’ welfare, building on, and harmonized with existing sampling and monitoring efforts; (iv) capacity building and training of local researchers, collaboration and continuous dialogue with local stakeholders; and (v) long-term commitment by funding agencies to maintain a global network of native island forest monitoring plots

Drivers of social innovation for tourism enterprises: A study on lifestyle entrepreneurship

The importance of tourism lifestyle entrepreneurs (TLEs) for the sustainability and competitiveness of tourism destinations has gained much attention from academic researchers and policy makers. A key characteristic of TLEs is their social ties and attachment to the physical and social environment, this in turn drives motivations to support and protect the destination that enables entrepreneurs to achieve their lifestyle goals. Thus, the interdependencies between TLEs and destination is a catalyst for value co-creation and social innovation (i.e., generating and implementing new solutions to social problems and needs). While the extant research has focused on business’ financial performance outcomes, our understanding of the drivers of TLE social innovation and the implications for the sustainability of tourism-based communities remains a major gap. This study analyzes survey data through PLS-SEM and fsQCA to identify the factors influencing TLEs social innovation activities. Findings suggest that 1) value co-creation, and 2) TLE proactiveness directly influence social innovation, and support a mediation effect on the relationship between the businesses’ market orientation and social innovation practices. These finding introduce new knowledge on the drivers of TLE social innovation, with practical implications for local governments and destination authorities in supporting the sustainability of destinations.info:eu-repo/semantics/acceptedVersio

The corporate social responsibility paradox: Present-day firm challenges in the cacao sector of Indonesia

Some radical transformations are taking place in the Indonesian cacao sector that are highly relevant for the further development of far-reaching corporate social responsibility (CSR) and sustainable entrepreneurship. Leading international firms in the cacao sector of Indonesia are increasingly seeking sustainable long-term solutions and innovations by adapting a variety of context-specific measures through dialogue, negotiation, and collaboration with various stakeholders in order to secure the long-term production of cacao by smallholder farmers. At first sight, this seems highly paradoxical: they are in the process of upgrading their CSR activities, but avoid labelling it as such. In this chapter, we examine the contemporary policies and practices of these leading firms, and their collaborations with other stakeholders in the field, to unravel this paradox. Based on the findings, we argue that the CSR debate needs to be reframed and moved from a consumer-informed to a producer-informed approach - shifting the focus from downstream consumption to upstream production, i.e. sustainable production and entrepreneurship

Global Island Monitoring Scheme (GIMS): a proposal for the long-term coordinated survey and monitoring of native island forest biota

Islands harbour evolutionary and ecologically unique biota, which are currently disproportionately threatened by a multitude of anthropogenic factors, including habitat loss, invasive species and climate change. Native forests on oceanic islands are important refugia for endemic species, many of which are rare and highly threatened. Long-term monitoring schemes for those biota and ecosystems are urgently needed: (i) to provide quantitative baselines for detecting changes within island ecosystems, (ii) to evaluate the effectiveness of conservation and management actions, and (iii) to identify general ecological patterns and processes using multiple island systems as repeated ‘natural experiments’. In this contribution, we call for a Global Island Monitoring Scheme (GIMS) for monitoring the remaining native island forests, using bryophytes, vascular plants, selected groups of arthropods and vertebrates as model taxa. As a basis for the GIMS, we also present new, optimized monitoring protocols for bryophytes and arthropods that were developed based on former standardized inventory protocols. Effective inventorying and monitoring of native island forests will require: (i) permanent plots covering diverse ecological gradients (e.g. elevation, age of terrain, anthropogenic disturbance); (ii) a multiple-taxa approach that is based on standardized and replicable protocols; (iii) a common set of indicator taxa and community properties that are indicative of native island forests’ welfare, building on, and harmonized with existing sampling and monitoring efforts; (iv) capacity building and training of local researchers, collaboration and continuous dialogue with local stakeholders; and (v) long-term commitment by funding agencies to maintain a global network of native island forest monitoring plots