Studies on the biosynthesis of 5-Hydroxytryptamine

Imperial Users onl

Working Relationships for Sustainability: Improving Work-based Relationships in Local Government to bring about Sustainability Goals

There’s no escape: we are always in relationship. Being aware of this matters. Doing something to build constructive relationships for sustainability, matters even more.This paper considers the connection between good relationships and effective sustainability work in local government. It draws on the collective experiences of four practitioners who have worked over many years in, with or for local government and argues that a good deal of project success is contingent upon the development of positive relationships with stakeholders, contractors, communities, businesses, colleagues, partners and other agencies and agency officers.Relationships can help or hinder project process, progress and outcomes. This paper identifies some approaches for building quality relationships and uses examples to highlight these strategies. These include: recognising that developing and maintaining resilient relationships and high quality communication is a critical foundation for success; designing projects with explicit relationship outcomes; and allocating time, money and other resources to support the development of effective relationships.

Physiotherapy management of joint hypermobility syndrome - a focus group study of patient and health professional perspectives.

OBJECTIVE: To develop an understanding of patient and health professional views and experiences of physiotherapy to manage joint hypermobility syndrome (JHS). DESIGN: An explorative qualitative design. Seven focus groups were convened, audio recorded, fully transcribed and analysed using a constant comparative method to inductively derive a thematic account of the data. SETTING: Four geographical areas of the UK. PARTICIPANTS: 25 people with JHS and 16 health professionals (14 physiotherapists and two podiatrists). RESULTS: Both patients and health professionals recognised the chronic heterogeneous nature of JHS and reported a lack of awareness of the condition amongst health professionals, patients and wider society. Diagnosis and subsequent referral to physiotherapy services for JHS was often difficult and convoluted. Referral was often for acute single joint injury, failing to recognise the long-term multi-joint nature of the condition. Health professionals and patients felt that if left undiagnosed, JHS was more difficult to treat because of its chronic nature. When JHS was treated by health professionals with knowledge of the condition patients reported satisfactory outcomes. There was considerable agreement between health professionals and patients regarding an 'ideal' physiotherapy service. Education was reported as an overarching requirement for patients and health care professionals. CONCLUSIONS: Physiotherapy should be applied holistically to manage JHS as a long-term condition and should address injury prevention and symptom amelioration rather than cure. Education for health professionals and patients is needed to optimise physiotherapy provision. Further research is required to explore the specific therapeutic actions of physiotherapy for managing JHS

Development and initial validation of the Bristol Impact of Hypermobility questionnaire

© 2016 Chartered Society of Physiotherapy Objectives Stage 1 – to identify the impact of joint hypermobility syndrome (JHS) on adults; Stage 2 – to develop a questionnaire to assess the impact of JHS; and Stage 3 – to undertake item reduction and establish the questionnaire's concurrent validity. Design A mixed methods study employing qualitative focus groups and interviews (Stage 1); a working group of patients, clinicians and researchers, and ‘think aloud’ interviews (Stage 2); and quantitative analysis of questionnaire responses (Stage 3). Setting Stages 1 and 2 took place in one secondary care hospital in the UK. Members of a UK-wide patient organisation were recruited in Stage 3. Participants In total, 15, four and 615 participants took part in Stages 1, 2 and 3, respectively. Inclusion criteria were: age ≥18 years; diagnosis of JHS; no other conditions affecting physical function; able to give informed consent; and able to understand and communicate in English. Interventions None. Main outcome measures The development of a questionnaire to assess the impact of JHS. Results Stage 1 identified a wide range of impairments, activity limitations and participation restrictions In Stage 2, a draft questionnaire was developed and refined following ‘think aloud’ analysis, leaving 94 scored items. In Stage 3, items were removed on the basis of low severity and/or high correlation with other items. The final Bristol Impact of Hypermobility (BIoH) questionnaire had 55 scored items, and correlated well with the physical component score of the Short Form 36 health questionnaire (r=−0.725). Conclusions The BIoH questionnaire demonstrated good concurrent validity. Further psychometric properties need to be established

Lagoonal littorinids: Shell shape and speciation

Variables related to shell shape have been measured in littorinids from brackish lagoons and coastal sites. After removal of size related effects, the data were analyzed using multivariate techniques. On Canonical Variate 1 there was good separation of the shells of the lagoonal animals from those of animals from the coast and a tidal lagoon. The former, for example, had lighter, and therefore thinner, shells for any given shell size and a smaller jugosity of the aperture lip. The lagoonal shells from Golam Head and the coastal animals from Robin Hood's Bay could each be separated clearly from the other samples. Although there are clear morphometric differences in the shells, it is not possible without appropriate breeding experiments to raise the lagoonal animals from L. saxatilis var. lagunae (L. tenebrosa) to species status. The importance of conserving lagoonal habitats is considered in terms of the preservation of biodiversit

Message to complementary and alternative medicine: evidence is a better friend than power

BACKGROUND: Evidence-based medicine (EBM) is being embraced by an increasing number of practitioners and advocates of complementary and alternative medicine (CAM). A significant constituency within CAM, however, appears to have substantive doubts about EBM and some are expressly hostile. DISCUSSION: Many of the arguments raised against EBM within the CAM community are based on a caricature radically at odds with established, accepted and published principles of EBM practice. Contrary to what has sometimes been argued, EBM is not cookbook medicine that ignores individual needs. Neither does EBM mandate that only proven therapies should be used. Before EBM, decisions on health care tended to be based on tradition, power and influence. Such modes usually act to the disadvantage of marginal groups. CONCLUSION: By placing CAM on an equal footing with conventional medicine - what matters for both is evidence of effectiveness - EBM provides an opportunity for CAM to find an appropriate and just place in health care