Conflicting Views on Fair Siting Processes: Evidence from Austria and the U.S.

The authors maintain that, by granting legitimacy to different notions of fairness and building on common values such as responsibility, it is possible to design siting procedures that promote social cohesion, trust and a sense of fair play

Management of chronic pain

[Extract] Chronic pain is suffered by a significant number of people from all age groups. Most of these people manage the pain themselves in a range of positive and sometimes negative ways - they take analgesics and remedies and modify their lifestyles to accommodate changes that may accrue in elements of life such as function and affect. People who suffer from chronic pain classically refer themselves to general practitioners who now act as agents for a broad range of conventional and complementary specialists to manage chronic pain. The majority of nurses become involved in the care of people with chronic pain when it affects function or psychological wellbeing to such an extent that independence in activities of living (Roper et al,2000) or self-care needs(Orem, 2001)are adversely affected. These nurses take a supportive and educative role to enable people with chronic pain to recognise positive strategies that ameliorate their state of pain and maximise their independence. However, there are nurse practitioners who specifically work with people who are referred to pain clinics and there are specialist nurses who work with people with conditions that are particularly associated with enduring pain, for example people with cancer and specialists in oncology nursing, or people with long-term angina and specialists in cardiac rehabilitation nursing. These nurses work in multidisciplinary teams and have extended knowledge of the aetiology of chronic pain and skills in the assessment, therapy and evaluation of chronic pain management. This chapter is written for nurses and other health professionals as a broad overview of a complex topic. There is no intention to delve into the specifics of specialist diagnosis and treatment but rather to draw a picture of the size and the nature of the problem, and the array of therapies that are available to suit particular individuals with chronic pain. While we refer to nursing and nursing theories of self-care, we recognise that the management of chronic pain is essentially in the hands of individuals and that support for them comes from a range of health professionals whose roles can overlap to a large degree in the offering and delivery of a person-centred philosophy of health care service

Supporting Communication Skills and Behaviours in Healthcare Staff: Evaluation of Two Pilots: The CARE Approach and Practice Based Small Group Learning - Summary Report

The ability to communicate effectively and to form productive human relationships is integral to the provision of effective, high quality, person‐centred care. This evaluation of 10 pilot sites across Scotland builds on previous work undertaken by NHS Education for Scotland (NES) and focuses on two approaches that aim to support the communication and human relationship skills of health practitioners and the integration of those skills into routine interactions with patients. The two approaches used were ‘The CARE Approach' (CARE) and Practice‐Based Small Group Learning (PBSGL)

Needs Assessment: Young People’s Drug and Alcohol Services in Edinburgh City - Final Report

The aim of this needs assessment is to inform the implementation of priority 1 and 3 of the Edinburgh Alcohol and Drugs Partnership (EADP) Children, Young People and Families Action Plan (2011) which states: - ‘Fewer children and young people using drugs and children and young people choosing to drink alcohol start later in life and take fewer risks.' - ‘More children and young people receive appropriate and timely support for alcohol and drug use' To do this effectively, the needs assessment set out to fulfil the following aims: - Provide an understanding of local need in relation to young people and alcohol and drug use in Edinburgh. - Analyse best practice in alcohol and drug services for young people elsewhere in Scotland and the UK. - Provide recommendations for future service development. Objectives: - To identify the prevalence of problem alcohol and drug use among young people in Edinburgh. - To map existing drug and alcohol services in Edinburgh. - To explore young people's perceptions of an effective alcohol and drug service. - To provide an overview of models of good practice in young people's alcohol and drug services elsewhere in Scotland and the UK.   - To make recommendations regarding priorities and models for young people's alcohol and drug services in Edinburgh

Medication adherence in patients with myotonic dystrophy and facioscapulohumeral muscular dystrophy

Myotonic dystrophy (DM) and facioscapulohumeral muscular dystrophy (FSHD) are the two most common adult muscular dystrophies and have progressive and often disabling manifestations. Higher levels of medication adherence lead to better health outcomes, especially important to patients with DM and FSHD because of their multisystem manifestations and complexity of care. However, medication adherence has not previously been studied in a large cohort of DM type 1 (DM1), DM type 2 (DM2), and FSHD patients. The purpose of our study was to survey medication adherence and disease manifestations in patients enrolled in the NIH-supported National DM and FSHD Registry. The study was completed by 110 DM1, 49 DM2, and 193 FSHD patients. Notable comorbidities were hypertension in FSHD (44 %) and DM2 (37 %), gastroesophageal reflux disease in DM1 (24 %) and DM2 (31 %) and arrhythmias (29 %) and thyroid disease (20 %) in DM1. Each group reported high levels of adherence based on regimen complexity, medication costs, health literacy, side effect profile, and their beliefs about treatment. Only dysphagia in DM1 was reported to significantly impact medication adherence. Approximately 35 % of study patients reported polypharmacy (taking 6 or more medications). Of the patients with polypharmacy, the DM1 cohort was significantly younger (mean 55.0 years) compared to DM2 (59.0 years) and FSHD (63.2 years), and had shorter disease duration (mean 26 years) compared to FSHD (26.8 years) and DM2 (34.8 years). Future research is needed to assess techniques to ease pill swallowing in DM1 and to monitor polypharmacy and potential drug interactions in DM and FSHD

Cytokine responses to Staphylococcus aureus bloodstream infection differ between patient cohorts that have different clinical courses of infection.

BackgroundThe clinical course of Staphylococcus aureus bloodstream infection is unpredictable and bacterial virulence, host immune response and patient characteristics are among the factors that contribute to the clinical course of infection. To investigate the relationship between cytokine response and clinical outcome, circulating cytokine levels were investigated in response to S. aureus bloodstream infection in patient with different clinical courses of infection.MethodsA prospective study was carried out in 61 patients with S. aureus bloodstream infection and circulating levels of IL-6, GRO-¿, RANTES and leptin were assessed over the course of the infection. Levels were compared in patients with complicated courses of infection (e.g. infective endocarditis) versus uncomplicated courses of S. aureus bloodstream infection and methicillin-resistant S. aureus Vs methicillin-susceptible S. aureus infection.ResultsSignificantly lower leptin levels (p

Screening of entomopathogenic fungi against citrus mealybug, Plannococcus citri (Hemiptera: Pseudococcidae)

Planococcus citri (citrus mealybug) is a common and damaging citrus crop pest which has proven difficult to control using conventional methods, such as chemical pesticides and insect growth regulators, particularly late in the citrus growing season. The virulence of two entomopathogenic fungal species was studied in laboratory bioassays against the crawlers and adults of P. citri. Isolates of Metarhizium anisopliae and Beauveria bassiana, collected from citrus orchards in the Eastern Cape Province in South Africa, were verified using and molecular techniques. Mealybug bioassays were performed in 24-well plates. Beauveria bassiana (GAR 17 B3) and M. anisopliae (FCM AR 23 B3) isolates both resulted in 67.5 % mortality of mealybug crawlers and B. bassiana (GB AR 23 13 3) resulted in 64 % crawler mortality with concentrations of 1 x 107 conidia/ml. These three isolates were further tested in multipledose bioassays to determine the median lethal concentration (LC50), which were 5.29 x 105conidia/ml for the M. anisopliae isolate (FCM AR 23 B3), 4.25 x 106 conidia/ml for B. bassiana (GAR 17 B3), and 6.65 x 107 conidia/ml B. bassiana (GB AR 23 13 3) for crawlers, respectively. The results of this study suggested that two isolates (M. anisopliae FCM AR 23 B3 and B. bassiana GAR 17 B3) showed potential for further development as biological control agents against citrus mealybug. Further research would be required to determine their ability to perform under field conditions