Problem drug use the public health imperative: what some of the literature says

<p>Abstract</p> <p>Background</p> <p>With more than 200,000 problem drug users is contact with structured treatment services in England the public health imperative behind drug treatment is great. Problem drug use for many is a chronic and relapsing condition, where "cure" is often neither a reasonable or appropriate expectation and it can further be argued that in these circumstances problem drug use is no different from any number of chronic and enduring health conditions that are managed in the health care system and therefore should be conceptualised as such.</p> <p>Discussion</p> <p>A public health approach to drug treatment emphasises the need for drug users in or accessing treatment, to reduce their harmful drug use, reduce drug use related risks such as sepsis and overdose and stay alive for longer. However a public health perspective in relation to problem drug use isn't always either apparent or readily understood and to that end there is still a significant need to continue the arguments and debate that treatment and interventions for problem and dependent drug users need to extend beyond an individualistic approach. For the purposes of discussion in this article public and population health will be used interchangeably.</p> <p>Summary</p> <p>A recognition and acceptance that a public and population health approach to the management of problem drug users is sound public health policy also then requires a long term commitment in terms of staffing and resources where service delivery mirrors that of chronic condition management.</p

Nutritional quality of organic rice grown on organic composts

The use of organic nutrient sources in improving crop quality can be a viable alternative to traditional farming. Organic farming encourages the reduction of agrochemicals and promotes soil conservation principles. Although crop quality depends on several factors, among which the nutrient source plays a great role, there is little information available on how rice quality is affected by different organic composts. Here we grew aromatic rice on two levels of four organic composts made from kudzu vine (Pueraria lobata) at 5 and 10 Mg ha$^{-1}$, Urtica sp. (nettle) at 5 and 10 Mg ha$^{-1}$, Lantana sp. at 5 and 10 Mg ha$^{-1}$, winter weeds at 2.5 and 5 Mg ha$^{-1}$, and two other organic amendments of poultry at 2.5 and 5 Mg ha$^{-1}$ and farmyard manure at 5 and 10 Mg ha$^{-1}$. We studied the effect of these organic sources on nutritional and physico-chemical properties, and on the cooking quality of the rice, using a fertilized, chemical treatment as positive control. Our results show that grain yield was significantly influenced by the supply of major plant nutrients. The highest rice yield of 4.0 Mg ha$^{-1}$ was obtained from the inorganically fertilized treatment. The protein content in grains was the highest, 8.98%, in the inorganic treatment (100:60:40 kg N, P, K ha$^{-1}$) and lowest, 7.55%, in the control. Among organic treatments, farmyard manure at 10 Mg ha$^{-1}$ contributed the least in terms of the protein content of the rice (7.78%). Significantly higher iron content, of 52.2 $\mu$g g$^{-1}$, was recorded with organic fertilization than inorganic fertilization (42.1 $\mu$g Fe g$^{-1})$. However, inorganic fertilization was superior in terms of copper content, of 4.1 $\mu$g Fe g$^{-1}$, compared with organic treatments: 3.1–4.0 $\mu$g Fe g$^{-1}$. Quality attributes indicated that cooked kernel length was positively correlated with the kernel elongation ratio. Winter weed compost provided comparative benefits for rice yield (3.87 Mg ha$^{-1})$ and quality in terms of protein (8.42%), iron (48.31 $\mu$g g$^{-1})$ and head rice recovery (49.39%) compared with other sources of nutrients. The results of this study suggest that organic nutrient sources can perform comparatively well as regards chemical and physico-chemical properties, and cooking quality of rice, if not better in some parameters than inorganic fertilization

Nutritional quality of organic rice grown on organic composts

The use of organic nutrient sources in improving crop quality can be a viable alternative to traditional farming. Organic farming encourages the reduction of agrochemicals and promotes soil conservation principles. Although crop quality depends on several factors, among which the nutrient source plays a great role, there is little information available on how rice quality is affected by different organic composts. Here we grew aromatic rice on two levels of four organic composts made from kudzu vine (Pueraria lobata) at 5 and 10 Mg ha$^{-1}$, Urtica sp. (nettle) at 5 and 10 Mg ha$^{-1}$, Lantana sp. at 5 and 10 Mg ha$^{-1}$, winter weeds at 2.5 and 5 Mg ha$^{-1}$, and two other organic amendments of poultry at 2.5 and 5 Mg ha$^{-1}$ and farmyard manure at 5 and 10 Mg ha$^{-1}$. We studied the effect of these organic sources on nutritional and physico-chemical properties, and on the cooking quality of the rice, using a fertilized, chemical treatment as positive control. Our results show that grain yield was significantly influenced by the supply of major plant nutrients. The highest rice yield of 4.0 Mg ha$^{-1}$ was obtained from the inorganically fertilized treatment. The protein content in grains was the highest, 8.98%, in the inorganic treatment (100:60:40 kg N, P, K ha$^{-1}$) and lowest, 7.55%, in the control. Among organic treatments, farmyard manure at 10 Mg ha$^{-1}$ contributed the least in terms of the protein content of the rice (7.78%). Significantly higher iron content, of 52.2 $\mu$g g$^{-1}$, was recorded with organic fertilization than inorganic fertilization (42.1 $\mu$g Fe g$^{-1})$. However, inorganic fertilization was superior in terms of copper content, of 4.1 $\mu$g Fe g$^{-1}$, compared with organic treatments: 3.1–4.0 $\mu$g Fe g$^{-1}$. Quality attributes indicated that cooked kernel length was positively correlated with the kernel elongation ratio. Winter weed compost provided comparative benefits for rice yield (3.87 Mg ha$^{-1})$ and quality in terms of protein (8.42%), iron (48.31 $\mu$g g$^{-1})$ and head rice recovery (49.39%) compared with other sources of nutrients. The results of this study suggest that organic nutrient sources can perform comparatively well as regards chemical and physico-chemical properties, and cooking quality of rice, if not better in some parameters than inorganic fertilization

Seebeck coefficient in quantum dots and quantum dot super lattices of heavily doped semiconductors under large magnetic field

In this chapter, an attempt is made to study the Seebeck coefficient under large magnetic field (S) in quantum dots of heavily doped nonlinear optical, III-V, II-VI, GaP, Ge, Te, PtSb2, II-V, GaSb, stressed materials, IV-VI, Lead Germanium Telluride, Zinc and Cadmium diphosphides and Bi2Te3 on the basis of newly formulated carrier dispersion laws respectively. We have also investigated the S in heavily doped III-V,IIVI, IV-VI, HgTe/CdTe and strained layer Quantum Dot Superlattices (QDSL) with graded interfaces together with the effective mass superlattices of the afore mentioned materials by formulating new carrier energy spectra. It has been found that the S for the said heavily doped quantum dots and QDSL oscillate with increasing thickness and changes with increasing electron concentration in various manners for all types of superlattices with two entirely different signatures of quantization as appropriate in respective cases of the aforementioned quantized structures. © 2013 by Nova Science Publishers, Inc. All rights reserved

Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study

Background There is much enthusiasm from clinicians, industry and the government to utilise digital technologies and introduce alternatives to face-to-face consultations. Objective(s) To define good practice and inform digital technology implementation in relation to remote consultations via Skype™ (Microsoft Corporation, Redmond, WA, USA) and similar technologies. Design Multilevel mixed-methods study of remote video consultations (micro level) embedded in an organisational case study (meso level), taking account of the national context and wider influences (macro level). Setting Three contrasting clinical settings (Diabetes, Antenatal Diabetes and Cancer Surgery) in a NHS acute trust. Data collection and analysis Macro level – interviews with 12 national-level stakeholders combined with document analysis. Meso level – longitudinal organisational ethnography comprising over 300 hours of observations, 24 staff interviews and analysis of 16 documents. Micro level – 30 video-recorded remote consultations; 17 matched audio-recorded face-to-face consultations. Interview and ethnographic data were analysed thematically and theorised using strong structuration theory. Consultations were transcribed verbatim and analysed using the Roter interaction analysis system (RIAS), producing descriptive statistics on different kinds of talk and interaction. Results Policy-makers viewed remote video consultations as a way of delivering health care efficiently in the context of rising rates of chronic illness and growing demand for services. However, the reality of establishing such services in a busy and financially stretched NHS acute trust proved to be far more complex and expensive than anticipated. Embedding new models of care took much time and many resources, and required multiple workarounds. Considerable ongoing effort was needed to adapt and align structures, processes and people within clinics and across the organisation. For practical and safety reasons, virtual consultations were not appropriate for every patient or every consultation. By the end of this study, between 2% and 20% of all consultations were being undertaken remotely in participating clinics. Technical challenges in setting up such consultations were typically minor, but potentially prohibitive. When clinical, technical and practical preconditions were met, virtual consultations appeared to be safe and were popular with both patients and staff. Compared with face-to-face consultations, virtual consultations were very slightly shorter, patients did slightly more talking and both parties sometimes needed to make explicit things that typically remained implicit in a traditional encounter. Virtual consultations appeared to work better when the clinician and the patient knew and trusted each other. Some clinicians used Skype adaptively to support ad hoc clinician-initiated and spontaneous patient-initiated encounters. Other clinicians chose not to use the new service model at all. Conclusions Virtual consultations appear to be safe, effective and convenient for patients who are preselected by their clinicians as ‘suitable’, but such patients represent a small fraction of clinic workloads. There are complex challenges to embedding virtual consultation services within routine practice in the NHS. Roll-out (across the organisation) and scale-up (to other organisations) are likely to require considerable support. Limitations The focus on a single NHS organisation raises questions about the transferability of findings, especially quantitative data on likely uptake rates. Future research Further studies on the micro-analysis of virtual consultations and on the spread and scale-up of virtual consulting services are planned. Funding The National Institute for Health Research Health Services and Delivery Research programme