The assessment of pain in older people

Pain is under-recognised and under-treated in older people. It is a subjective, personal experience, only known to the person who suffers. The assessment of pain is particularly challenging in the presence of severe cognitive impairment, communication difficulties or language and cultural barriers. These guidelines set out the key components of assessing pain in older people, together with a variety of practical scales that may be used with different groups, including those with varying levels of cognitive or communication impairment. The purpose is to provide professionals with a set of practical skills to assess pain as the first step towards its effective management. The guidance has implications for all healthcare and social care staff and can be applied in all settings, including the older person’s own home, in care homes, and in hospital

Sigurðar saga fóts (The Saga of Sigurðr Foot): A Translation

This is the first English translation of the short Icelandic romance Sigurðar saga fóts, with an introduction presenting the evidence for its dating and immediate literary context. Like most Icelandic romances, Sigurðar saga is a bridal-quest story; the support of a foster-brother is key to the hero winning the bride; and the foster-brothers start out as opponents before recognising their mutual excellence and swearing foster-brotherhood. Uniquely, however, the men who become foster-brothers begin by competing for the same bride (Signý): the eponymous Sigurðr fótr wins Signý only because Ásmundr gives her to him in exchange for foster-brotherhood. Ásmundr’s decision can be read as demonstrating with unusual starkness the superior importance in much Icelandic romance of homosocial relationships over heterosexual ones, giving the saga a certain paradigmatic status. Translating the saga in an open-access forum and reconstructing its literary context will, we hope, encourage further analyses

Sigurðar saga fóts (The Saga of Sigurðr Foot): A Translation

This is the first English translation of the short Icelandic romance Sigurðar saga fóts, with an introduction presenting the evidence for its dating and immediate literary context. Like most Icelandic romances, Sigurðar saga is a bridal-quest story; the support of a foster-brother is key to the hero winning the bride; and the foster-brothers start out as opponents before recognising their mutual excellence and swearing foster-brotherhood. Uniquely, however, the men who become foster-brothers begin by competing for the same bride (Signý): the eponymous Sigurðr fótr wins Signý only because Ásmundr gives her to him in exchange for foster-brotherhood. Ásmundr’s decision can be read as demonstrating with unusual starkness the superior importance in much Icelandic romance of homosocial relationships over heterosexual ones, giving the saga a certain paradigmatic status. Translating the saga in an open-access forum and reconstructing its literary context will, we hope, encourage further analyses

The 'causes' of teenage pregnancy: review of South African research - Part 2

This article forms the second of a two-part series in which South African research on teenage pregnancy is reviewed. Part 1 of the series dealt with the consequences of teenage pregnancy; this paper reviews the 'causes' thereof. International literature is incorporated in the discussion by way of comparison. Contributory factors which have been investigated by South African researchers include: reproductive ignorance; the earlier occurrence of menarche; risktaking behaviour; psychological problems; peer influence; co-ercive sexual relations; dysfunctional family patterns; poor health services; socio-economic status; the breakdown of cultural traditions; and the cultural value placed on children. Preston-Whyte and colleagues present a revisionist argument, stating that early pregnancy may represent a rational life choice for certain adolescent women. The article is concluded with comments on methodological problems encountered in the South African research, and a discussion on the implications in terms of policy formulation

From Interactions to Institutions: Microprocesses of Framing and Mechanisms for the Structuring of Institutional Fields

Despite the centrality of meaning to institutionalization, little attention has been paid to how meanings evolve and amplify to become institutionalized cultural conventions. We develop an interactional framing perspective to explain the microprocesses and mechanisms by which this occurs. We identify three amplification processes and three ways frames stack up or laminate that become the building blocks for diffusion and institutionalization of meanings within organizations and fields. Although we focus on “bottom-up” dynamics, we argue that framing occurs in a politicized social context and is inherently bidirectional, in line with structuration, because microlevel interactions instantiate macrostructures. We consider how our approach complements other theories of meaning making, its utility for informing related theoretical streams, and its implications for organizing at the meso and macro levels

International lower limb collaborative (INTELLECT) study: a multicentre, international retrospective audit of lower extremity open fractures

Trauma remains a major cause of mortality and disability across the world1, with a higher burden in developing nations2. Open lower extremity injuries are devastating events from a physical3, mental health4, and socioeconomic5 standpoint. The potential sequelae, including risk of chronic infection and amputation, can lead to delayed recovery and major disability6. This international study aimed to describe global disparities, timely intervention, guideline-directed care, and economic aspects of open lower limb injuries