Seeing the wood for the trees: the role of woody resources for the construction of gender specific household cultural artefacts in non-traditional communities in the Eastern Cape, South Africa

There is a growing wealth of data capturing the direct-use values of the environment and recognition of forests and wild resources as representing ‘‘the poor man’s overcoat’’. This focus has however resulted in an emphasis on the utilitarian values of wild resources for rural livelihoods and has for the most part overlooked their cultural values. In tangent to these developments within the field of anthropology there has been increased attention directed towards the relationship between biodiversity and human diversity over the past decade. This has resulted in the recognition of what the Declaration of Belem calls an ‘inextricable link’ between biological and cultural diversity. The term bio-cultural diversity has been introduced as a concept denoting this link. Consequently there is a need for more elaborate assessments of the various ways in which different groups of people find value in biodiversity. The aim of this paper is to demonstrate the cultural significance of wild harvested plant resources for the maintenance of two gender specific cultural artefacts for amaXhosa people in South Africa, to assess the persistence of these practices in rapidly modernizing communities. We demonstrate the endurance of these ancient cultural artefacts in present-day peri-urban communities and suggest that they point to the need for improved understanding of the significance of bio-cultural diversity. The findings of the study should not be interpreted as illustrating stagnation in the traditional past, but rather as pointing at the need for improved understanding of the significance of bio-cultural diversity in a dynamic sense

Palliative and supportive care in head and neck cancer: United Kingdom National Multidisciplinary Guidelines

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. It provides recommendations on the assessments and interventions for this group of patients receiving palliative and supportive care. Recommendations • Palliative and supportive care must be multidisciplinary. (G) • All core team members should have training in advanced communication skills. (G) • Palliative surgery should be considered in selected cases. (R) • Hypofractionated or short course radiotherapy should be considered for local pain control and for painful bony metastases. (R) • All palliative patients should have a functional endoscopic evaluation of swallowing (FEES) assessment of swallow to assess for risk of aspiration. (G) • Pain relief should be based on the World Health Organization pain ladder. (R) • Specialist pain management service involvement should be considered early for those with refractory pain. (G) • Constipation should be avoided by the judicious use of prophylactic laxatives and the correction of systemic causes such as dehydration, hypercalcaemia and hypothyroidism. (G) • Organic causes of confusion should be identified and corrected where appropriate, failing this, treatment with benzodiazepines or antipsychotics should be considered. (G) • Patients with symptoms suggestive of spinal metastases or metastatic cord compression must be managed in accordance with the National Institute for Health and Care Excellence guidance. (R) • Cardiopulmonary resuscitation is inappropriate in the palliative dying patient. (R) • 'Do not attempt cardiopulmonary resuscitation' orders should be completed and discussed with the patient and/or the family unless good reasons exist not to do so where appropriate. This is absolutely necessary when a patient's care is to be managed at home. (G)

"Beat" patterns for the odd-even staggering in octupole bands from a quadrupole-octupole Hamiltonian

We propose a collective Hamiltonian which incorporates the standard quadrupole terms, octupole terms classified according to the irreducible representations of the octahedron group, a quadrupole-octupole interaction, as well as a term for the bandhead energy linear in K (the projection of angular momentum on the body-fixed z-axis). The energy is subsequently minimized with respect to K for each given value of the angular momentum I, resulting in K values increasing with I within each band, even in the case in which K is restricted to a set of microscopically plausible values. We demonstrate that this Hamiltonian is able to reproduce a variety of ``beat'' patterns observed recently for the odd-even staggering in octupole bands of light actinides.Comment: LaTeX, 20 pages plus 12 figures given in separate .ps file

Examples of individual supported living for adults with intellectual disability

Background: This article provides a qualitative account of four models of support for adults with intellectual disability in individual supported living (ISL) arrangements. Materials and Methods: Completion of the first 50 evaluations of 150 arrangements for the third phase of the ISL project provided the examples. Results: Four approaches are described: living alone, co-residency, relationship and host family. Within each type, wide variations occur particularly based on security of tenure, formal and informal support and management variations. Conclusion: Fifty evaluations so far illustrated a wide range of approaches to ISL, providing evidence of the critical importance of the formal and informal support environment and reinforcing the contention that ISL is appropriate for people with high support needs

A "novel" reading therapy programme for reading difficulties after a subarachnoid haemorrhage

Background: Although several treatments for acquired reading difficulties exist, few studies have explored the effectiveness of treatment for mild reading difficulties and treatment for reading difficulties associated with cognitive impairment. Aims: This study explored the effectiveness of an individual strategy-based reading treatment of 11 sessions given to a female participant (IW) who had mild reading difficulties following a subarachnoid haemorrhage (SAH). The impact of treatment on reading ability, confidence and emotions associated with reading were investigated. Methods & Procedures: Treatment focussed on the use of strategies to support IW’s memory when reading books, the use of a checklist to select appropriate reading materials, and increasing IW’s confidence in discussing the book she was reading with others. A person-centred approach and personally relevant materials were used throughout the treatment. Reading ability was assessed using the Gray Oral Reading Tests (GORT-4; Lee Wiederholt & Bryant, 2001), and IW’s perspective was obtained using the Reading Confidence and Emotions Questionnaire (RCEQ; see Cocks et al., 2010. Pre-treatment, post-treatment and maintenance (7 weeks post) assessments were undertaken, with an additional exit interview at the final time point. Outcomes & Results: Gains were noted in reading rate, accuracy, comprehension, and confidence, with parallel increased pleasure gained from reading and reduced negative emotions and frustration. Self-reported gains included conversing with others about material read, verbal communication, and re-engagement with the identity of being a reader. Conclusions: Strategy-based treatment resulted in positive gains in reading for pleasure, conversation, and identity, for an individual with mild chronic reading difficulties. Participant self-report and interview reveal the true value of this treatment for the individual. The positive results suggest that further research is warranted that investigates the effectiveness of strategy-based reading therapy approaches for others with acquired reading difficulties

The impact of COVID-19 on PRO development, collection and implementation: views of UK and Ireland professionals

Background PROs are valuable tools in clinical care to capture patients’ perspectives of their health, symptoms and quality of life. However the COVID-19 pandemic has had profound impacts on all aspects of life, in particular healthcare and research. This study explores the views of UK and Irish health professionals, third sector and pharmaceutical industry representatives and academic researchers on the impact of COVID-19 on PRO collection, use and development in clinical practice. Methods A volunteer sample took part in a 10 question cross sectional qualitative survey, on the impact of COVID-19, administered online via Qualtrics. Demographic data was descriptively analysed, and the qualitative free text response data was subject to thematic analysis and summarised within the Strengths, Weaknesses, Opportunities and Threats (SWOT) framework. Results Forty nine participants took part located in a range of UK settings and professions. Participants highlighted staff strengths during the pandemic including colleagues’ flexibility and ability to work collaboratively and the adoption of novel communication tools. Weaknesses were a lack of staff capacity to continue or start PRO projects and insufficient digital infrastructure to continue studies online. Opportunities included the added interest in PROs as useful outcomes, the value of electronic PROs for staff and patients particularly in relation to integration into systems and the electronic patient records. However, these opportunities came with an understanding that digital exclusion may be an issue for patient groups. Threats identified included that the majority of PRO research was stopped or delayed and funding streams were cut. Conclusions Although most PRO research was on hold during the pandemic, the consensus from participants was that PROs as meaningful outcomes were valued more than ever. From the opportunities afforded by the pandemic the development of electronic PROs and their integration into electronic patient record systems and clinical practice could be a lasting legacy from the COVID-19 pandemic