The Impact of Organic Farming on the Rural Economy in England

This research report seeks to explore the hypothesis that organic farming provides an additional benefit to the rural economy over and above that of conventional agriculture, defined for the purposes of this project as "non-organic". The approach adopted involved tracing the socio-economic footprint of a range of farm business types. The concept of the socio-economic footprint represents a development of earlier research (Errington and Courtney 2000) tracing the economic footprints of small towns. In contrast to conventional economic analysis, the research focused on examining the socio-economic linkages associated with different types of farming such as sales and purchasing patterns but also evidence of social connectivity and embeddedness.Community/Rural/Urban Development, Farm Management,

Diagnosis and management of acute aortic dissection in the emergency department

Acute aortic dissection (AAD) is often misdiagnosed due to its atypical presentations. It affects 4,000 patients a year in the UK of all ages, not just the elderly, with increasing cases expected in future due to the aging population. Dissection of the aortic wall leads to sudden, severe pain, and commonly endorgan symptoms which must be recognised. AAD can be challenging to diagnose in the ED due to the multitude of possible presentations and the need for selective testing with CT angiography (CTA). Clinicians often miss AAD because it's not considered in the differential diagnosis, and when considered, the challenge lies in identifying AAD in a sea of chest, back, and abdominal pain complaints. To improve diagnosis, awareness campaigns, better education on whom to consider AAD in, and improved detection strategies including who to CTA, are needed. Clinical decision tools and biomarkers could help, but further research is required and is a current Emergency Medicine research focus. Once diagnosed, blood pressure control, analgesia and urgent surgery or transfer to enable this to occur with minimal delay is required

Targeted HIV screening in the emergency department

Despite considerable improvement in human immunodeficiency virus (HIV) knowledge and treatment in the last 3 decades, the overall number of people living with HIV (PLHIV) is still rising with up to one quarter being unaware of their HIV status. Early HIV diagnosis and treatment prolongs life, reduces transmission, improves quality of life, and is a cost-effective public health intervention. The emergency department (ED) sees a large number of patients from marginalized and traditionally underserved populations in whom HIV is known to be more prevalent and who may not attend traditional services because of either cultural reasons or because of a chaotic lifestyle. This article discusses the two main approaches to screening; ‘Opt-out’ screening offers testing routinely in all clinical settings, and ‘Targeted’ screening offers testing to individuals presenting with indicator conditions. There are many studies of ‘Opt-out’ ED HIV screening in urban areas of high-HIV prevalence. However, little is known about the effectiveness of ‘targeted’ HIV screening, especially in areas of low prevalence. This review discusses the background to HIV screening in the ED and reviews the evidence around ‘targeted’ HIV screening in adult EDs in different HIV prevalence settings, concluding that targeted HIV screening at the ED can be impactful, cost-effective, and well accepted in the ED population, but its long-term implementation requires extra funding and increased staffing resource limiting its application in low resource setting. Despite most evidence being from areas of high-HIV prevalence, targeted screening might also be appropriate in low-HIV prevalence areas

Resuscitation of the trauma patient: tell me a trigger for early haemostatic resuscitation please!

The management of trauma-related coagulopathy and haemorrhage is changing from a reactive strategy to a proactive early intervention with blood products and haemostatic agents. Although major haemorrhage and massive transfusion are associated with higher mortality, the pattern of this association with modern trauma care is poorly described. In addition, early predictors of massive transfusion, which might trigger a proactive haemostatic resuscitation strategy, are not currently available. We review recent literature relating to predictors of massive transfusions and the relationship between transfusion and mortality

Modelling three-dimensional trajectories by using BÉzier curves with application to hand motion

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72561/1/j.1467-9876.2007.00592.x.pd

Management of syncope in the emergency department based on risk stratification

This article, based on the 2018 European Society of Cardiology syncope guidelines, highlights the key features of the management of syncope in the Emergency Department (ED) based on risk stratification. Firstly Transient Loss of Consciousness of a syncopal nature should be established. Secondly the treating clinician should ask whether syncope is the presenting feature of an obvious acute disease; if so, treatment and management should follow the guidelines of the specific complaint. If there is no obvious underlying cause, the treating clinician should assess the risk of a serious outcome aided by a risk stratification approach using history, past medical history, examination and ECG. Patients with low-risk characteristics are more likely to have reflex, situational or orthostatic syncope with generally an excellent prognosis and should likely be able to be discharged from the ED with education. Patients with high-risk characteristics are more likely to have cardiac syncope requiring urgent investigation and likely admission but alternatively may be able to be observed in an Observation or Syncope Unit. Patients with neither high nor low-risk features can probably be safely managed in an outpatient setting; there is evidence that management in an ED observation unit and/or fast track to a syncope clinic is beneficial. Risk stratification scores and clinical decision rules are yet to prove useful. There is little evidence that hospital admission in unexplained syncope is useful and novel organisational approaches such as ED observation units and syncope in- and outpatient units offer safe and effective alternatives to admission

Patch size drives colonization by aquatic insects, with minor priority effects of a cohabitant

Patch size is one of the most important factors affecting the distribution and abundance of species, and recent research has shown that patch size is an important niche dimension affecting community structure in aquatic insects. Building on this result, we examined the impact of patch size in conjunction with presence of larval anurans on colonization by aquatic insects. Hyla chrysoscelis (Cope\u27s gray treefrog) larvae are abundant and early colonists in fishless lentic habitats, and these larvae can fill multiple ecological roles. By establishing larvae in mesocosms prior to colonization, we were able to assess whether H. chrysoscelis larvae have priority effects on aquatic insect assemblages. We conducted a series of three experiments in naturally colonized experimental landscapes to test whether (1) H. chrysoscelis larval density affects insect colonization, (2) variation in patch size affects insect colonization, and (3) the presence and larval density of H. chrysoscelis shift colonization of insects between patches of different size. Larval density independently had almost no effect on colonization, while patch size had species-specific effects consistent with prior work. When larvae and patch size were tested in conjunction, patch size had numerous, often strong, species-specific effects on colonization; larval density had effects largely limited to the assemblages of colonizing beetles and water bugs, with few effects on individual species. Higher larval densities in large mesocosms shifted some insect colonization to smaller patches, resulting in higher beta diversity among small patches in proximity to high density large mesocosms. This indicates establishing H. chrysoscelis larvae prior to insect colonization can likely create priority effects that slightly shape insect communities. Our results support the importance of patch size in studying species abundances and distributions and also indicate that colonization order plays an important role in determining the communities found within habitat patches