What impact does written information about fatigue have on patients with autoimmune rheumatic diseases? : Findings from a qualitative study

Objectives Although fatigue is a common symptom for people with rheumatic diseases, limited support is available. This study explored the impact of written information about fatigue, focusing on a booklet, Fatigue and arthritis. Methods Thirteen patients with rheumatic disease and fatigue were recruited purposively from a rheumatology outpatient service. They were interviewed before and after receiving the fatigue booklet. Two patients, plus six professionals with relevant interests, participated in a focus group. Transcripts were analysed thematically and a descriptive summary was produced. Results Interviewees consistently reported that fatigue made life more challenging, and none had previously received any support to manage it. Reflecting on the booklet, most said that it had made a difference to how they thought about fatigue, and that this had been valuable. Around half also said that it had affected, or would affect, how they managed fatigue. No one reported any impact on fatigue itself. Comments from interviewees and focus group members alike suggested that the research process may have contributed to the changes in thought and behaviour reported. Its key contributions appear to have been: clarifying the booklet's relevance; prompting reflection on current management; and introducing accountability. Conclusions This study indicated that written information can make a difference to how people think about fatigue and may also prompt behaviour change. However, context appeared to be important: it seems likely that the research process played a part and that the impact of the booklet may have been less if read in isolation. Aspects of the research appearing to facilitate impact could be integrated into routine care, providing a pragmatic (relatively low-cost) response to an unmet need

AGENDA: Water Negotiation Workshop

Sponsored by: The Natural Resources law Center of the University of Colorado Law School; Funding provided by: The William and Flora Hewlett Foundation. Facilitators: Lucy Moore and Steve Snyder. June 4 and 5, 2003, Community House, Chautauqua Park, Boulder, Colorado. Contents: Agenda -- Roster of workshop participants -- Biographies of workshop participants -- Maps of Klamath basin -- Key water-related events in the upper Klamath basin -- Federal-state decisionmaking on water : applying lessons learned / David J. Hayes -- Turbulence in the Klamath River basin / Sharon Lev

AGENDA: Water Negotiation Workshop

Sponsored by: The Natural Resources law Center of the University of Colorado Law School; Funding provided by: The William and Flora Hewlett Foundation. Facilitators: Lucy Moore and Steve Snyder. June 4 and 5, 2003, Community House, Chautauqua Park, Boulder, Colorado. Contents: Agenda -- Roster of workshop participants -- Biographies of workshop participants -- Maps of Klamath basin -- Key water-related events in the upper Klamath basin -- Federal-state decisionmaking on water : applying lessons learned / David J. Hayes -- Turbulence in the Klamath River basin / Sharon Lev

AGENDA: Water and Growth in the West

1 v. (various pagings) : ill., maps ; 29 cm. + 1 CD-ROM (4 3/4 in.) + supplement (207 p. ; 29 x 24 cm.) Conference co-sponsor The William and Flora Hewlett Foundation. Conference moderators included University of Colorado School of Law professors Gary C. Bryner, James N. Corbridge, Jr., David H. Getches, Douglas S. Kenney, Kathryn M. Mutz, Peter D. Nichols and Charles F. Wilkinson. Accompanied by: CD-ROM (4 3/4 in.) and supplement (xiv, 140, [49] p.) Includes bibliographical references The event will cover a breadth of issues, including demographics and water-use trends, improved planning and efficient use, implementation of TMDL and ESA requirements, groundwater management, tribal water resources, environmental protection, social costs of water transfers, climatic variability, and related issues. The third day of the event focuses exclusively on Colorado water issues. The focus of the conference not only reflects the continued salience of water issues in the modern West, but is a recognition that current rates of growth in the region have brought greater urgency and complexity to many longstanding issues. Over the last decade, nine of the ten fastest growing states are located in the West— a trend that is expected to continue. Most of these residents, both old and new, live in the region in part due to the considerable environmental amenities and recreational opportunities. Others are attracted to the strong regional economy, and an abundance of developable land. Water makes this possible. The potential exhaustion of available supplies, consequently, is a broad-ranging concern. While there is currently no evidence to suggest that potential water shortages are slowing current growth patterns, it is notable that virtually every western river of signifi­cance has at least one endangered species issue, and that competition for limited supplies increasingly pits sector against sector, basin against basin, community against community. In the modern West, it is increasingly difficult to separate issues of water quality and quantity, and water management and land-use. This is perhaps best illustrated by the emergence of TMDLs, the broadening influence of the Endangered Species Act, and the growing stresses on the agricultural sector. Nested within these concerns are thorny issues of equity and fairness, private fights versus public concerns, and the appropriate delineation of roles between federal, state, and local governments. The prospects of drought are also increasingly troublesome, as new demands threaten to reduce the “drought cushion” in water systems, and as new research shows that recent decades have been abnormally wet. On many levels, the world of western water resources is becoming more complicated, as strong growth pressures illustrate both the limits of current practice and the opportuni­ties for improved management

AGENDA: Water and Growth in the West

1 v. (various pagings) : ill., maps ; 29 cm. + 1 CD-ROM (4 3/4 in.) + supplement (207 p. ; 29 x 24 cm.) Conference co-sponsor The William and Flora Hewlett Foundation. Conference moderators included University of Colorado School of Law professors Gary C. Bryner, James N. Corbridge, Jr., David H. Getches, Douglas S. Kenney, Kathryn M. Mutz, Peter D. Nichols and Charles F. Wilkinson. Accompanied by: CD-ROM (4 3/4 in.) and supplement (xiv, 140, [49] p.) Includes bibliographical references The event will cover a breadth of issues, including demographics and water-use trends, improved planning and efficient use, implementation of TMDL and ESA requirements, groundwater management, tribal water resources, environmental protection, social costs of water transfers, climatic variability, and related issues. The third day of the event focuses exclusively on Colorado water issues. The focus of the conference not only reflects the continued salience of water issues in the modern West, but is a recognition that current rates of growth in the region have brought greater urgency and complexity to many longstanding issues. Over the last decade, nine of the ten fastest growing states are located in the West— a trend that is expected to continue. Most of these residents, both old and new, live in the region in part due to the considerable environmental amenities and recreational opportunities. Others are attracted to the strong regional economy, and an abundance of developable land. Water makes this possible. The potential exhaustion of available supplies, consequently, is a broad-ranging concern. While there is currently no evidence to suggest that potential water shortages are slowing current growth patterns, it is notable that virtually every western river of signifi­cance has at least one endangered species issue, and that competition for limited supplies increasingly pits sector against sector, basin against basin, community against community. In the modern West, it is increasingly difficult to separate issues of water quality and quantity, and water management and land-use. This is perhaps best illustrated by the emergence of TMDLs, the broadening influence of the Endangered Species Act, and the growing stresses on the agricultural sector. Nested within these concerns are thorny issues of equity and fairness, private fights versus public concerns, and the appropriate delineation of roles between federal, state, and local governments. The prospects of drought are also increasingly troublesome, as new demands threaten to reduce the “drought cushion” in water systems, and as new research shows that recent decades have been abnormally wet. On many levels, the world of western water resources is becoming more complicated, as strong growth pressures illustrate both the limits of current practice and the opportuni­ties for improved management

Values of the Federal Public Lands

v, 158 p. ; 28 cmhttps://scholar.law.colorado.edu/books_reports_studies/1038/thumbnail.jp

AGENDA: Hard Times on the Colorado River: Drought, Growth and the Future of the Compact

Sponsors and Contributors: Colorado Water Conservation Board, Center for Advanced Decision Support for Water and Environmental Systems, Western Water Assessment, CU-CIRES/NOAA, Hydrosphere Resource Consultants, Rocky Mountain Mineral Law Foundation, Colorado Foundation for Water Education, Patrick, Miller & Kropf, P.C., William and Flora Hewlett Foundation. The Colorado River is approaching a crossroads. For the first time in its history, satisfying water demands in one state may require curtailing legally-recognized uses in another. This is not the first instance of water shortages in the region, and conflict among the seven Colorado River states is certainly not new. But the potential shortages on the horizon are larger in scale and magnitude than ever seen before, and the regional insurance policy against this sort of catastrophe, the storage reservoirs of Lake Powell and Mead, are being pushed to their limits. Key water decision-makers from throughout the basin will come together to explore a variety of topics pertaining to the Law of the River: the ability of the system to meet water delivery and hydropower obligations, potential impacts of shortages to water users and the environment, and solutions for future management

AGENDA: Two Decades of Water Law and Policy Reform: A Retrospective and Agenda for the Future

1 v. (various pagings) ; 29 cm Sponsors: Hydrosphere Resource Consultants; Modrall, Sperling, Roehl, Harris & Sisk, P.A.; Patrick & Stowell, P.C.; Perkins Coie LLP; The William and Flora Hewlett Foundation. Conference speakers, moderators and/or panelists included University of Colorado School of Law professors Gary C. Bryner, Douglas S. Kenney, Sarah Krakoff, Kathryn Mutz, David H. Getches, Lawrence J. MacDonnell and James N. Corbridge, Jr. Includes bibliographical references The conference will examine the agenda for reforming and improving water law that has developed during the past two decades in the West, assesses what has (and has not) been accomplished by pursuing these reforms, and explores lessons and implications for future water law and policy. The papers and discussion will provide analysis and lessons that can guide the new administration, Congress, federal agencies, state governments, and communities as they seek to find policy solutions to the challenges posed by the tremendous economic and demographic changes occurring in the West, in order to ensure the sustainability of the region\u27s unique environment. Specific sessions will focus on reforms such as improving the scientific and technical basis for water management, water conservation and efficiency, protecting environmental values in meeting water demands, and creating new models of governance for water issues