Dabigatran in patients with atrial fibrillation: perioperative and periinterventional management

In any type of invasive surgery, the patient’s individual risk of thromboembolism has to be weighed against the risk of bleeding. Based on various everyday situations in clinical routine, the purpose of the present expert recommendations is to provide appropriate perioperative and periinterventional management for patients with atrial fibrillation undergoing long-term treatment with the thrombin inhibitor dabigatran. As we currently have no routine laboratory test to measure therapeutic levels of the substance or the risk of bleeding, general measures such as a standardized documentation of the patient’s history, a sufficient time interval between the last preoperative dose and the procedure, and careful control of local hemostasis should be given special attention

Bovine Tuberculosis and Badger Control in Britain: Science, Policy and Politics

Bovine tuberculosis (bovine TB) is the most economically important animal health policy issue in Britain. The problem of what to do about badgers has plagued successive governments since a dead badger was discovered with bovine TB in 1971. Successive Labour governments (1997–2010) oversaw the Randomised Badger Culling Trial (RBCT) from 1998 to 2006. Despite the RBCT recommendation against culling, the 2010–2015 Coalition government implemented pilot badger culls. This paper provides an account of the evolution of bovine TB and badger control policy, focusing on the 1997–2010 Labour, the 2010–2015 Coalition and the 2015-present Conservative governments. Interviews with bovine TB policy stakeholders supplement discussion of the development of bovine TB policy. The paper discusses the science and politics of bovine TB policy, in which there are different badger control policies in Westminster, Welsh and Scottish governments. Badger control is a highly polarised issue, and the Coalition and Conservative governments have been heavily criticised for a culling policy opposed by the independent scientific community. Recent governments have defended badger culling on the basis of veterinary advice and experience in countries such as New Zealand. The paper concludes with two key recommendations to inform controversial animal health and welfare policy issues such as bovine TB. First, mandatory Animal Welfare Impact Assessment provides objective data on the impacts of policy options on cows and badgers. Second, robust ethical analysis, conducted by independent experts using established moral frameworks, should be applied to animal health and welfare issues for the benefit of decision makers

Motivation types and mental health of UK hospitality workers.

The primary purposes of this study were to (i) assess levels of different types of work motivation in a sample of UK hospitality workers and make a cross-cultural comparison with Chinese counterparts and (ii) identify how work motivation and shame-based attitudes towards mental health explain the variance in mental health problems in UK hospitality workers. One hundred three UK hospitality workers completed self-report measures, and correlation and multiple regression analyses were conducted to identify significant relationships. Findings demonstrate that internal and external motivation levels were higher in UK versus Chinese hospitality workers. Furthermore, external motivation was more significantly associated with shame and mental health problems compared to internal motivation. Motivation accounted for 34–50% of mental health problems. This is the first study to explore the relationship between motivation, shame, and mental health in UK hospitality workers. Findings suggest that augmenting internal motivation may be a novel means of addressing mental health problems in this worker population.N/