Power, norms and institutional change in the European Union: the protection of the free movement of goods

How do institutions of the European Union change? Using an institutionalist approach, this article highlights the interplay between power, cognitive limits, and the normative order that underpins institutional settings and assesses their impact upon the process of institutional change. Empirical evidence from recent attempts to reinforce the protection of the free movement of goods in the EU suggests that, under conditions of uncertainty, actors with ambiguous preferences assess attempts at institutional change on the basis of the historically defined normative order which holds a given institutional structure together. Hence, path dependent and incremental change occurs even when more ambitious and functionally superior proposals are on offer

The challenges of communicating research evidence in practice: perspectives from UK health visitors and practice nurses

<p>Background: Health practitioners play a pivotal role in providing patients with up-to-date evidence and health information. Evidence-based practice and patient-centred care are transforming the delivery of healthcare in the UK. Health practitioners are increasingly balancing the need to provide evidence-based information against that of facilitating patient choice, which may not always concur with the evidence base. There is limited research exploring how health practitioners working in the UK, and particularly those more autonomous practitioners such as health visitors and practice nurses working in community practice settings, negotiate this challenge. This research provides a descriptive account of how health visitors and practice nurses negotiate the challenges of communicating health information and research evidence in practice.</p> <p>Methods: A total of eighteen in-depth telephone interviews were conducted in the UK between September 2008 and May 2009. The participants comprised nine health visitors and nine practice nurses, recruited via adverts on a nursing website, posters at a practitioner conference and through recommendation. Thematic analysis, with a focus on constant comparative method, was used to analyse the data.</p> <p>Results: The data were grouped into three main themes: communicating evidence to the critically-minded patient; confidence in communicating evidence; and maintaining the integrity of the patient-practitioner relationship. These findings highlight some of the daily challenges that health visitors and practice nurses face with regard to the complex and dynamic nature of evidence and the changing attitudes and expectations of patients. The findings also highlight the tensions that exist between differing philosophies of evidence-based practice and patient-centred care, which can make communicating about evidence a daunting task.</p> <p>Conclusions: If health practitioners are to be effective at communicating research evidence, we suggest that more research and resources need to be focused on contextual factors, such as how research evidence is negotiated, appraised and communicated within the dynamic patient-practitioner relationship.</p&gt

A novel evolutionary strategy revealed in the Phaeoviruses

Phaeoviruses infect the brown algae, which are major contributors to primary production of coastal waters and estuaries. They exploit a Persistent evolutionary strategy akin to a K- selected life strategy via genome integration and are the only known representatives to do so within the giant algal viruses that are typified by r- selected Acute lytic viruses. In screening the genomes of five species within the filamentous brown algal lineage, here we show an unprecedented diversity of viral gene sequence variants especially amongst the smaller phaeoviral genomes. Moreover, one variant shares features from both the two major sub-groups within the phaeoviruses. These phaeoviruses have exploited the reduction of their giant dsDNA genomes and accompanying loss of DNA proofreading capability, typical of an Acute life strategist, but uniquely retain a Persistent life strategy

Mechanisms of redundancy and specificity of the Aspergillus fumigatus Crh transglycosylases

Transglycosylases strengthen the fungal cell wall by forming a rigid network of crosslinks. Here, Fang et al. show that the five Crh transglycosylases of Aspergillus fumigatus are dispensable for cell wall integrity in vitro, and solve the crystal structure of Crh5 in complex with chitooligosaccharides

Usefulness and engagement with a guided workbook intervention (WorkPlan) to support work related goals among cancer survivors

Background: Returning to work after cancer is associated with improved physical and psychological functioning, but managing this return can be a challenging process. A workbook based intervention (WorkPlan) was developed to support return-to-work among cancer survivors. The aim of this study was to explore how participants using the workbook engaged with the intervention and utilised the content of the intervention in their plan to return-to-work. Methods: As part of a feasibility randomised controlled trial, 23 participants from the intervention group were interviewed 4-weeks post intervention. Interviews focussed on intervention delivery and data was analysed using Framework analysis. Results: Participants revealed a sense of empowerment and changes in their outlook as they transitioned from patient to employee, citing the act of writing as a medium for creating their own return-to-work narrative. Participants found the generation of a return-to-work plan useful for identifying potential problems and solutions, which also served as a tool for aiding discussion with the employer on return-to-work. Additionally, participants reported feeling less uncertain and anxious about returning to work. Timing of the intervention in coordination with ongoing cancer treatments was crucial to perceived effectiveness; participants identified the sole or final treatment as the ideal time to receive the intervention. Conclusions: The self-guided workbook supports people diagnosed with cancer to build their communication and planning skills to successfully manage their return-to-work. Further research could examine how writing plays a role in this process

Enquête Connaissance Attitude Perception Et Pratique Sur La Covid-19 Du Personnel De Sante Dans La Région Analamanga

Introduction :La transmission du COVID-19 est très facile. Les personnels de la santé sont plus exposés au COVID-19 que le reste de la population. Cette étude a pour objectif d’évaluer les connaissances, les perceptions et les préventions de personnel de santé dans la lutte contre l’infection à COVID-19 et de déterminer les facteurs influençant ces paramètres et d’évoquer les sources principales de connaissance du professionnel de santé.Méthode Il s’agit d’une étude transversale analytique pour évaluer la connaissance, l’attitude et le pratique du personnel de santé sur la maladie COVID-19 dans la région Analamanga à Madagascar pour une période de 12 mois. Une échantillonnage aléatoire simple stratifié a été utilisée. L’Odds ratio a été utilisé pour mesurer la liaison entre les CAP et ses déterminants.RésultatsAu total, 194 de personnel de santé ont été enquêtés dont 67% ont déjà été infecté par la COVID-19 avec 9% de formes sévères. La proportion des personnels de santé ayant une bonne connaissance des symptômes a été 48,45%.  Une bonne connaissance de la mode de transmission de la COVID-19 est observée chez les 69,07%. La motivation de personnel de santé d’aller au travail a été faible 5/10 selon l’évaluation. En somme : 21% de personnel de santé portent de manière adapté l’EPI au cours de l’examen des cas suspects ; 30% de personnel de santé portent de manière adapté l’EPI lors de l’examen des cas confirmés ; et 16% de personnel de santé ont respecté l’ordre de la mise en place d’EPI. La proportion des personnels de santé vaccinée a été de 31%. La formation sur la COVID-19 (31%) est la principale source de connaissance sur la COVID-19. L’Obtention de la formation sur la COVID-19 a été associé à la bonne connaissance des signes de la COVID-19 [OR= 5,13(1,88-13,98)] ; à la bonne connaissance de son mode de transmission [OR=1,96(1,05-3,64)]. La source de formation par publications scientifiques sur la COVID-19 sont associées à la bonne connaissance de mode de transmission du COVID-19 [OR=2,75(1,48-5,12)].CONCLUSIONLe renforcement de la formation des personnels de santé est crucial dans l’amélioration de la Connaissance, Attitude et Pratique sur la COVID-19.Mots clés : Attitude ; Connaissance ; COVID-19 ; Madagascar ; Personnel de Santé ; Pratiqu

Gauweiler and Others v. Deutscher Bundestag

Case challenging the authority of the ECB to conduct Outright Monetary Purchase

Weiss and Others v. ECB

Case challenging the authority of the ECB to conduct the PSP