Data on mid-Holocene climatic, vegetation and anthropogenic interactions at Stanshiel Rig, southern Scotland

Pollen, microscopic charcoal and peat humification analyses were applied to radiocarbon-dated peat cores to examine environmental change before and after the mid-Holocene transition from hunter-gatherer (Mesolithic) to agricultural (Neolithic) communities in presently marginal upland pasture at Stanshiel Rig, Annandale, southern Scotland. The Mesolithic-Neolithic transition in northern Britain is characterised by a number kf key environmental changes as well as economic shifts, including temporal patterns of fire and the Ulmus decline. Deliberate vegetation modification by Mesolithic communities is not demonstrable at Stanshiel Rig, and openings in the woodland canopy may have been promoted by grazing by wild animals or have been a consequence of climate change. Changes in fire frequency are also correlated with peat- and pollen-stratigraphic evidence for shifts to a drier climate in the late Mesolithic, probably mediated through pedological and biomass-storage change. A single Ulmus decline occurred between ca. 5650 and 5600 cal B. P., and is related here to climate change. Neolithic-age impacts on the woodland were limited, and no cereal-type pollen were found. The difference between hunter-gatherer and opportunistic farmer/hunter-gatherer at this locally is argued to be insignificant, or not detectable palynologically

Engaging patients in health care:an empirical study of the role of engagement on attitudes and action

Objective: Identify the role of engaging people affected by cancer in service development in influencing healthcare professionals and service-users’ attitudes toward, and enactment of, engagement. Methods: Focus group discussions with healthcare professionals and people affected by lung cancer, prior to and following an intervention where lung cancer teams were supported to engage with patients and family members. Results: Staff and people affected by cancer who participated displayed more positive attitudes toward involvement than those who did not participate. Conclusion: Progressing the involvement agenda requires the use of supported, small scale, projects where staff and patients/family members can develop their skills and knowledge of involvement. Practice implications: Doing patient engagement work is a vital step toward changing attitudes and actions toward the involvement agenda

Systematic review of reviews of behavioural HIV prevention interventions among men who have sex with men

Men who have sex with men (MSM) remain one of the groups most at risk of HIV. The growing evidence-base on behavioural HIV prevention interventions includes systematic review-level evidence, including reviews specific to MSM populations. Here, we provide an up-to-date review of these systematic reviews in which we examined the effectiveness of behavioural HIV prevention interventions among MSM. A systematic search of electronic databases, including MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, PsycInfo, from January 2000 to October 2010, along with hand searches of the reference lists of retrieved documents were conducted. Inclusion criteria included: study design limited to systematic reviews and meta-analyses; methodological quality; and review to focus on MSM and behavioural interventions. A narrative synthesis was conducted. Across the four included meta-analyses (102 studies; 52 independent studies), there was strong and consistent evidence for group- and community-level interventions being associated with reductions in UAI (27-30% and 30%, respectively) and increases in condom use amongst MSM, but inconsistent evidence for the effectiveness of individual-level interventions. Skills-building, trained professionals delivering the training and theory-based interventions were also consistently effective. The inherent limitations of the review of review method within a changing health domain meant it was difficult to develop contemporary and directly transferable guidance to HIV prevention policy development. However, the analysis does demonstrate a need for a step change in the kinds of data that are collated in the development of future systematic reviews of HIV prevention interventions among MSM

Telehealth in palliative care in the UK: a review of the evidence

We reviewed telehealth applications which were being used in palliative care settings in the UK. Electronic database searches (Medline, CINAHL, PsychInfo and Embase), searches of the grey literature and cited author searches were conducted. In total, 111 papers were identified and 21 documents were included in the review. Telehealth was being used by a range of health professionals in oncology care settings that included specialist palliative care, hospices, primary care settings, nursing homes and hospitals as well as patients and carers. The most common applications were: out-of-hours telephone support, advice services for palliative care patients, carers and health professionals, videoconferencing for interactive case discussions, consultations and assessments, and training and education of palliative care and other health-care staff. The review suggests that current technology is usable and acceptable to patients and health professionals in palliative care settings. However, there are several challenges in integrating telehealth into routine practice

Men with prostate cancer over the first year of illness:their experiences as biographical disruption

Goals This paper is one of five interrelated papers about cancer, drawn from a larger study exploring the experiences of 66 people diagnosed with cancer. Findings are reported separately because the way in which people experience cancer can vary by cancer type. Here, we determine the utility of liminality and biographical disruption as explanatory theories in relation to men's experiences of prostate cancer. We situate and explore notions of liminality and disruption in relation to self, identity and context to inform debate about the provision of supportive care and highlight the contribution this study makes to the understandings of men's health. Materials and methods This is a qualitative interview study of 66 people diagnosed with cancer. The study included five cancer types: gynaecological, prostate, lung, breast and colorectal. This paper illustrates the experiences of ten men diagnosed with prostate cancer. Three serial interviews were conducted at (1) diagnosis, (2) treatment and (3) follow-up. Drawing on the constant comparative method (Glaser and Strauss 1967), a descriptive and thematic approach to data analysis was adopted. This descriptive analysis evidenced that cancer caused disruption to people's lives. In order to move beyond this level of description, begin to explain this and develop theoretical insight, we drew on concepts of biographical disruption (Bury, Sociol Health Illn 4(2):167–182, 1982; Bury, Sociol Health Illn 13(4):451–468, 1991; Bury, Sociol Health Illn 23(3):263–285, 2001) and liminality (Navon and Morag, Soc Sci Med 58(11):2337–2347, 2004). Main results Notions of biography and identity weave their way through men's accounts of prostate cancer. Physical side effects and reconstructed futures each form key parts of men's narratives. Conclusions Our findings add to existing knowledge of supportive care needs for men living with prostate cancer. We suggest that studies exploring supportive care need to remain mindful of the disruption that cancer causes both during and after treatment, the complexity of such experience and respective demands on supportive care