Best Practice Statement for Screening, Assessment and Management of Vision Problems in the First 30 Days after an Acute Stroke

No abstract available

Conserving tropical biodiversity via market forces and spatial targeting

The recent report from the Secretariat of the Convention on Biological Diversity [(2010) Global Biodiversity Outlook 3] acknowledges that ongoing biodiversity loss necessitates swift, radical action. Protecting undisturbed lands, although vital, is clearly insufficient, and the key role of unprotected, private land owned is being increasingly recognized. Seeking to avoid common assumptions of a social planner backed by government interventions, the present work focuses on the incentives of the individual landowner. We use detailed data to show that successful conservation on private land depends on three factors: conservation effectiveness (impact on target species), private costs (especially reductions in production), and private benefits (the extent to which conservation activities provide compensation, for example, by enhancing the value of remaining production). By examining the high-profile issue of palm-oil production in a major tropical biodiversity hotspot, we show that the levels of both conservation effectiveness and private costs are inherently spatial; varying the location of conservation activities can radically change both their effectiveness and private cost implications. We also use an economic choice experiment to show that consumers’ willingness to pay for conservation-grade palm-oil products has the potential to incentivize private producers sufficiently to engage in conservation activities, supporting vulnerable International Union for Conservation of Nature Red Listed species. However, these incentives vary according to the scale and efficiency of production and the extent to which conservation is targeted to optimize its cost-effectiveness. Our integrated, interdisciplinary approach shows how strategies to harness the power of the market can usefully complement existing—and to-date insufficient—approaches to conservation

Adolescents' experiences of isolation in cystic fibrosis

Cystic fibrosis (CF) infectious isolation guidelines and clinical recommendations exist in standards of CF care to reduce the risk of cross-infection between individuals with CF. Chronic infection is associated with deterioration in lung function and increased rates of morbidity and mortality, thus preventing and reducing cross-infection is a concern for individuals with CF. Understanding the bio-psychosocial implications of isolation is vital to developing and providing holistic approaches to CF care. This study aimed to make sense of how adolescents with CF understand and experience infectious isolation during their care. Qualitative, semistructured interviews were conducted with 9 adolescents, aged 12 to 19 years old, with a diagnosis of CF who had experienced isolation. Interviews were analyzed using inductive thematic analysis. Participants experienced difficulty adjusting to living with isolation and attempted to integrate their isolation experiences. Isolation highlighted a sense of threat posed by cross-infection, a threat which participants experienced as originating from others and from themselves to others. Participants described striving to protect themselves and others from this threat. Isolation also appeared to exacerbate differences participants noticed between themselves and others without CF. For adolescents with CF, isolation is not a neutral experience. Adolescents reported difficulty understanding isolation and challenges associated with this experience across settings. Given these difficulties, multidisciplinary teams should increase awareness, understanding and discussion about the psychosocial impact of isolation among those with CF, their families and wider systems, to promote optimal bio-psychosocial outcomes. Future research could explore experiences of isolation from children, family and staff perspectives

Modelling the effect of worship attendance and personal prayer on spiritual wellbeing among 9- to 11-year-old students attending Anglican church schools in Wales

This study employs a modified form of the Fisher 16-item Feeling Good, Living Life measure of spiritual wellbeing (assessing quality of relationships across four domains: self, family, nature, and God) among a sample of 1,328 students drawn from year five and year six classes within Church in Wales primary schools, alongside measures of frequency of worship attendance and frequency of personal prayer. The data demonstrate frequency of personal prayer is a much stronger predictor than frequency of worship attendance in respect of spiritual wellbeing. This finding is consistent with the view that personal prayer is a key factor in the formation of individual spirituality

Testing self-report time-use diaries against objective instruments in real time

This study provides a new test of time-use diary methodology, comparing diaries with a pair of objective criterion measures: wearable cameras and accelerometers. A volunteer sample of respondents (n = 148) completed conventional self-report paper time-use diaries using the standard UK Harmonised European Time Use Study (HETUS) instrument. On the diary day, respondents wore a camera that continuously recorded images of their activities during waking hours (approximately 1,500–2,000 images/day) and also an accelerometer that tracked their physical activity continuously throughout the 24-hour period covered by the diary. Of the initial 148 participants recruited, 131 returned usable diary and camera records, of whom 124 also provided a usable whole-day accelerometer record. The comparison of the diary data with the camera and accelerometer records strongly supports the use of diary methodology at both the aggregate (sample) and individual levels. It provides evidence that time-use data could be used to complement physical activity questionnaires for providing population-level estimates of physical activity. It also implies new opportunities for investigating techniques for calibrating metabolic equivalent of task (MET) attributions to daily activities using large-scale, population-representative time-use diary studies

Effects of confinement and surface enhancement on superconductivity

Within the Ginzburg-Landau approach a theoretical study is performed of the effects of confinement on the transition to superconductivity for type-I and type-II materials with surface enhancement. The superconducting order parameter is characterized by a negative surface extrapolation length $b$. This leads to an increase of the critical field $H_{c3}$ and to a surface critical temperature in zero field, $T_{cs}$, which exceeds the bulk $T_c$. When the sample is {\em mesoscopic} of linear size $L$ the surface induces superconductivity in the interior for $T T_{cs}$. In analogy with adsorbed fluids, superconductivity in thin films of type-I materials is akin to {\em capillary condensation} and competes with the interface delocalization or "wetting" transition. The finite-size scaling properties of capillary condensation in superconductors are scrutinized in the limit that the ratio of magnetic penetration depth to superconducting coherence length, $\kappa \equiv \lambda/\xi$, goes to zero, using analytic calculations. While standard finite-size scaling holds for the transition in non-zero magnetic field $H$, an anomalous critical-point shift is found for H=0. The increase of $T_c$ for H=0 is calculated for mesoscopic films, cylindrical wires, and spherical grains of type-I and type-II materials. Surface curvature is shown to induce a significant increase of $T_c$, characterized by a shift $T_c(R)-T_c(\infty)$ inversely proportional to the radius $R$.Comment: 37 pages, 5 figures, accepted for PR

Assessment and management of recurrent abdominal pain in the emergency department

Recurrent abdominal pain accounts for a significant proportion of attenders and high impact users in the emergency department. Due to the heterogeneity of presentation and the broad spectrum of possible causes, abdominal pain presents as a significant clinical challenge within the emergency department, particularly as distress and pain are commonly elevated. Patients in this group are routinely prescribed opiate-based interventions and repeated investigations in a 'better safe than sorry' culture which saturates the field of persistent physical symptoms. This approach is contributing to the growing problem, and fuelling a cycle of repeated attendance and failure to resolve. This article reviews the current clinical and psychophysiological understanding of recurrent abdominal pain, critiquing guidelines and approaches to diagnosis and management. We offer an alternative evidence-based biopsychosocial approach using the mnemonic 'ERROR', recommending five steps to assessment and clinical management of recurrent abdominal pain in the emergency department.</p

Assessment and management of recurrent abdominal pain in the emergency department

Recurrent abdominal pain accounts for a significant proportion of attenders and high impact users in the emergency department. Due to the heterogeneity of presentation and the broad spectrum of possible causes, abdominal pain presents as a significant clinical challenge within the emergency department, particularly as distress and pain are commonly elevated. Patients in this group are routinely prescribed opiate-based interventions and repeated investigations in a 'better safe than sorry' culture which saturates the field of persistent physical symptoms. This approach is contributing to the growing problem, and fuelling a cycle of repeated attendance and failure to resolve. This article reviews the current clinical and psychophysiological understanding of recurrent abdominal pain, critiquing guidelines and approaches to diagnosis and management. We offer an alternative evidence-based biopsychosocial approach using the mnemonic 'ERROR', recommending five steps to assessment and clinical management of recurrent abdominal pain in the emergency department.</p