Engaging with a history of counselling, spirituality and faith in Scotland: a readers' theatre script

This paper presents an abbreviated version of a verbatim script developed from oral history interviews with individuals key to the development of counselling and psychotherapy in Scotland from 1960 to 2000. Earlier versions were used in workshops with counsellors and pastoral care practitioners to share counter-narratives of counselling and to provide opportunities for conversations about historical and contemporary relationships between faith, spirituality, counselling and psychotherapy. By presenting intertwined histories in a readers' theatre script, the narrative nature of lives lived in context was respected. By bringing oral histories into virtual dialogue with each other and with contemporary practitioners, whether through workshops or through publications, the interplay between individual, institutional and societal narratives remains visible and open to change.

We need an educated voice!

Newly qualified theatre nurses could benefit from a wider national availability of university based education specifically for theatre practice from which to develop both the technical and nontechnical skills of their role to enhance the delivery of optimum, safe and sensitive patient care. They would be better prepared for challenging situations and develop resilience, thereby reducing stress. The professional role of the theatre nurse would be advanced through engagement in recognised education with academic accreditation.

Patients' perspective of wide-awake hand surgery--100 consecutive cases

The wide-awake hand surgery (WAHS) technique involves injecting lidocaine with adrenaline for hand surgical procedures that are done without the use of tourniquets, sedation, regional or general anaesthetic. This is a retrospective review of the first 100 consecutive patients who underwent operations using this technique at our centre. The operations included carpal and cubital tunnel decompression, trapeziectomy, tendon transfer, and tenolysis. A questionnaire adapted from Lalonde's previous work on wide-awake surgery was used to assess patients' experiences. Sixty-five percent of the patients responded to the postal questionnaire, the majority reporting a high satisfaction level. Ninety-one percent of responders reported that the operation was less painful or comparable with a procedure at the dentist; 86% would prefer to be wide-awake if they needed to have hand surgery again, and 90% stated they would recommend WAHS to a friend.

Development and Field Evaluation of Multiple Virus-Resistant Bottle Gourd (Lagenaria siceraria)

In an effort to develop bottle gourd (Lagenaria siceraria) as a widely adapted rootstock for watermelon grafting, we sought to identify lines with broad resistance to several cucurbit viruses that are economically important in the United States. Preliminary analysis under greenhouse conditions indicated that the currently available commercial watermelon rootstocks were either highly susceptible or somewhat tolerant to one or more viruses. However, in greenhouse screening, several breeding lines of bottle gourd displayed broad-spectrum resistance to four viruses tested, including Zucchini yellow mosaic virus, Watermelon mosaic virus (WMV), Papaya ringspot virus watermelon strain (PRSV-W), and Squash vein yellowing virus. Resistance to PRSV-W and WMV was confirmed through field trials in two consecutive years at two different locations in South Carolina. Two breeding lines (USVL#1-8 and USVL#5-5) with broad-spectrum virus resistance could be useful materials for watermelon rootstock development.

R.D. Laing's theological hinterland: the contrast between mysticism and communion

Contrasting elements in R.D. Laing's psychiatry can be traced to two kinds of Christian theology: mystical theology and corporate theology. On one hand, Laing's mystical theology combined with psychoanalytic theory, to provide a New Age psychotherapeutic account of the recovery of authentic selfhood via metanoia. On the other, his incarnational, corporate theology promoted social inclusion of the mentally ill, particularly via therapeutic communities. For Laing, as for other post-war British Christians, a turn inwards, to mysticism and the sacralization of the self, and a turn outwards, to social and political activism, were ways of negotiating with the decline of traditional Christianity.

Glasgow supported self-management trial (GSuST) for patients with moderate to severe COPD: randomised controlled trial

OBJECTIVE

To determine whether supported self management in chronic obstructive pulmonary disease (COPD) can reduce hospital readmissions in the United Kingdom.

DESIGN

Randomised controlled trial.

SETTING

Community based intervention in the west of Scotland.

PARTICIPANTS

Patients admitted to hospital with acute exacerbation of COPD.

INTERVENTION

Participants in the intervention group were trained to detect and treat exacerbations promptly, with ongoing support for 12 months.

MAIN OUTCOME MEASURES

The primary outcome was hospital readmissions and deaths due to COPD assessed by record linkage of Scottish Morbidity Records; health related quality of life measures were secondary outcomes.

RESULTS

464 patients were randomised, stratified by age, sex, per cent predicted forced expiratory volume in 1 second, recent pulmonary rehabilitation attendance, smoking status, deprivation category of area of residence, and previous COPD admissions. No difference was found in COPD admissions or death (111/232 (48%) v 108/232 (47%); hazard ratio 1.05, 95% confidence interval 0.80 to 1.38). Return of health related quality of life questionnaires was poor (n=265; 57%), so that no useful conclusions could be made from these data. Pre-planned subgroup analysis showed no differential benefit in the primary outcome relating to disease severity or demographic variables. In an exploratory analysis, 42% (75/150) of patients in the intervention group were classified as successful self managers at study exit, from review of appropriateness of use of self management therapy. Predictors of successful self management on stepwise regression were younger age (P=0.012) and living with others (P=0.010). COPD readmissions/deaths were reduced in successful self managers compared with unsuccessful self managers (20/75 (27%) v 51/105 (49%); hazard ratio 0.44, 0.25 to 0.76; P=0.003).

CONCLUSION

Supported self management had no effect on time to first readmission or death with COPD. Exploratory subgroup analysis identified a minority of participants who learnt to self manage; this group had a significantly reduced risk of COPD readmission, were younger, and were more likely to be living with others.

TRIAL REGISTRATION

Clinical trials NCT 00706303.

Influenza vaccination in the organ transplant recipient: review and summary recommendations

Influenza virus causes a spectrum of illness in transplant recipients with a high rate of lower respiratory disease. Seasonal influenza vaccination is an important public health measure recommended for transplant recipients and their close contacts. Vaccine has been shown to be safe and generally well tolerated in both adult and pediatric transplant recipients. However, responses to vaccine are variable and are dependent on various factors including time from transplantation and specific immunosuppressive medication. Seasonal influenza vaccine has demonstrated safety and no conclusive evidence exists for a link between vaccination and allograft dysfunction. Annually updated trivalent inactivated influenza vaccines have been available and routinely used for several decades, although newer influenza vaccination formulations including high-dose vaccine, adjuvanted vaccine, quadrivalent inactivated vaccine and vaccine by intradermal delivery system are now available or will be available in the near future. Safety and immunogenicity data of these new formulations in transplant recipients requires investigation. In this document, we review the current state of knowledge on influenza vaccines in transplant recipients and make recommendations on the use of vaccine in both adult and pediatric organ transplant recipients.

Including pharmacists on consultant-led ward rounds: a prospective non-randomised controlled trial

This study aimed to compare interventions made by pharmacists attending consultant-led ward rounds in addition to providing a ward pharmacy service, with those made by pharmacists providing a word pharmacy service alone. A prospective non-randomised controlled study on five inpatient medical wards was carried out at two teaching hospitals. A mean of 1.73 physician-accepted interventions were made per patient for the study group, compared to 0.89 for the control (Mann Whitney U, p < 0.001) with no difference between groups in the nature or clinical importance of the interventions. One physician-accepted intervention was made every eight minutes during the consultant-led ward rounds, compared to one every 63 minutes during a ward pharmacist visit. Pharmacists attending consultant-led ward rounds in addition to undertaking a ward pharmacist visit make significantly more interventions per patient than those made by pharmacists undertaking a ward pharmacist visit alone, rectifying prescribing errors and optimising treatment.