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Aims: The number of older people with diabetes requiring care from district nursing teams is increasing. The role of district nursing teams in diabetes management has expanded to involve diagnosis, treatment and medication administration. As the complexity of caseloads increases, the current model is likely unsustainable. This study aims to understand the current diabetes workload of district nursing teams. Methods: An online survey was distributed via social media and key stakeholder networks to district nursing teams. Survey items were designed by the researchers prior to pilot testing with potential participants. Descriptive statistical and qualitative analyses were conducted. Data are median ± IQR. Results: 159 district nursing teams completed the survey. The median caseload per team was 300 (IQR 176–407) patients including 21 with diabetes (IQR 14–40; 8.7% (4–20%)). 1.09 home visits per day per person with diabetes lasting 13.8 minutes (excluding travel time) were needed, with most requiring insulin administration. 96% of nursing teams undertake multiple daily visits for some patients. 91% reported workloads relating to diabetes management had increased over the last 2 years; 76% stated current diabetes workloads were unsustainable. More insulin usage, more referrals and a lack of ability or willingness to self‐administer insulin has increased the diabetes workload. Possible solutions include better collaboration between healthcare professionals, simplification of insulin administration and glucose monitoring, better training and upskilling of healthcare assistants and promotion of self‐efficacy. Conclusions: Diabetes management forms an increasing component of district nursing workload and is likely to be unsustainable unless new models are found. [ABSTRACT FROM AUTHOR]

Bethan Cowley and colleagues outline the European Society of Cardiology's guidelines for the management of cardiomyopathies, highlighting the key implications for nurses. [ABSTRACT FROM AUTHOR]

Taxation is fundamental to citizen-government relations. Seminal accounts attribute democratization to direct taxation's rise, and recent evidence shows that direct taxes increase citizens' accountability demands. However, today many governments rely heavily on indirect taxes; evidence is mixed on whether they have similar effects. We present cross-national data demonstrating that indirect taxes are associated with lower levels of government accountability than direct taxes. We argue that the visibility of taxes affects their accountability consequences. We further posit that, on average, indirect taxes become less visible than direct once citizens have acclimated to higher prices. We combine lab-in-the-field experiments with survey experiments in a developing country to demonstrate that less visible taxes provoke less willingness to punish leaders politically and that established indirect taxes are not highly visible to citizens. The findings suggest that the growing reliance on indirect taxes may limit taxation's accountability dividends and impair democratic representation. [ABSTRACT FROM AUTHOR]

Seagrasses provide ecosystem services worth USD 2.28 trillion annually. However, their direct threats and our incomplete knowledge hamper our capabilities to protect and manage them. This study aims to evaluate if the NICFI Satellite Data Program basemaps could map Seychelles' extensive seagrass meadows, directly supporting the country's ambitions to protect this ecosystem. The Seychelles archipelago was divided into three geographical regions. Half-yearly basemaps from 2015 to 2020 were combined using an interval mean of the 10th percentile and median before land and deep water masking. Additional features were produced using the Depth Invariant Index, Normalised Differences, and segmentation. With 80% of the reference data, an initial Random Forest followed by a variable importance analysis was performed. Only the top ten contributing features were retained for a second classification, which was validated with the remaining 20%. The best overall accuracies across the three regions ranged between 69.7% and 75.7%. The biggest challenges for the NICFI basemaps are its four-band spectral resolution and uncertainties owing to sampling bias. As part of a nationwide seagrass extent and blue carbon mapping project, the estimates herein will be combined with ancillary satellite data and contribute to a full national estimate in a near-future report. However, the numbers reported showcase the broader potential for using NICFI basemaps for seagrass mapping at scale. [ABSTRACT FROM AUTHOR]

Cellular senescence is a cell surveillance mechanism that arrests the cell cycle in damaged cells. The senescent phenotype can spread from cell to cell through paracrine and juxtacrine signalling, but the dynamics of this process are not well understood. Although senescent cells are important in ageing, wound healing and cancer, it is unclear how the spread of senescence is contained in senescent lesions. In the absence of the immune system, senescence could theoretically spread infinitely from one cell to another, but this contradicts experimental evidence. To investigate this issue, we developed both a minimal mathematical model and a stochastic simulation of senescence spread. Our results suggest that differences in the number of signalling molecules secreted between subtypes of senescent cells can limit the spread of senescence. We found that dynamic, time‐dependent paracrine signalling prevents the uncontrolled spread of senescence, and we demonstrate how model parameters can be determined using Bayesian inference in a proposed experiment. [ABSTRACT FROM AUTHOR]

This article is the second instalment of the British Journal of Cardiac Nursing's series on genetics, and will focus on inherited cardiomyopathies. Collectively, cardiomyopathies are the most common inherited cardiac condition. They affect the structure of the heart muscle, sometimes leading to heart failure or sudden cardiac death. Advances in genetic testing for cardiomyopathies mean that this can now be offered to more patients, influencing care and treatment options. This article looks at the contributions made by nurses to the care of people who have, or are at risk of, an inherited cardiomyopathy. [ABSTRACT FROM AUTHOR]

Government accountability is severely lacking in many developing countries, yet we know relatively little about the causal dynamics that produce citizen demands for greater responsiveness. We argue that a sense of ownership over public money heightens expectations for government services and induces expressive demands for accountability, and we apply the new theory in sub-Saharan Africa. Results from a series of lab-in-the-field experiments in Uganda and Ghana and from a nationally representative survey-based field experiment in Uganda all demonstrate that higher feelings of ownership over public revenues significantly increase citizens' accountability pressures on leaders. Furthermore, simple interventions can significantly increase feelings of revenue ownership over oil and aid windfalls, producing demands for accountability indistinguishable from taxes. [ABSTRACT FROM AUTHOR]

Background: With a continued crisis of increasing workload and reduced workforce in general practice, supporting resilience is a key strategy for sustaining the profession into the future.Aim: How do GPs perceive professional resilience, and what workplace factors influence it?Design and Setting: A UK-based qualitative study of the perspectives of GPs currently practicing in mainly urban locations across the UK with ≥5 years' experience after completion of GP training.Method: Participants were recruited using convenience sampling, which included social media forums, and underwent semi-structured interviews undertaken in May and June 2020 (n = 27). Data were analysed using thematic analysis.Results: Participants offered definitions of and influences on resilience that largely fit with existing research, but in addition, may result in the perception that GPs are obstructive, or that resilience may be a 'surface act'. GPs agree that the current focus on methods of improving resilience does support them, but there is significantly more to be done in this field. Social media activity aiming at GP support may be counterproductive. Reduction of clinical working hours is a common strategy to improve resilience.Conclusion: That GPs feel to improve resilience they need to work fewer clinical hours may have huge implications for a workforce already in crisis, and ultimately, for the health care of the UK population. Urgent research is needed to formulate a bespoke assessment for measuring GP resilience to assess potential interventions, and to identify GPs at risk of mental ill-health or leaving the profession. [ABSTRACT FROM AUTHOR]

Unmodified timber is susceptible to biodegradation in the marine environment by wood-boring molluscs and crustaceans. Wood is a renewable resource and has a much lower carbon footprint than other alternative materials that are suitable for marine applications, such as concrete and steel. However, biodegradation causes expensive damage to wooden structures and protection by broad spectrum biocides entails environmental risks. Furfurylation offers an effective alternative protection from marine wood-borers. We investigate the changes in feeding rate, behaviour and digestion of the marine wood-boring crustacean, the gribble, on furfurylated wood under laboratory conditions. Pinus radiata was impregnated with furfuryl alcohol in a methanol solvent and polymerised at elevated temperatures. Wood was leached in seawater and then tested in a laboratory setting against the gribble Limnoria quadripunctata, by measuring its feeding rate (faecal pellet production), vitality and mortality. The wood samples were analysed using Attenuated Total Reflectance Infrared Spectroscopy (ATR-IR), while faecal pellets were analysed by Atomic Force Microscopy Infrared Spectroscopy (AFM-IR). A reduction in band intensity ascribed to carbonyl vibration was seen during leaching, possibly due to loss of hemicellulose or acetyl groups therein. Untreated wood faecal pellets showed a decrease in C–O absorbance in the 1100–1000 cm−1 range interpreted as a loss of cellulose and an increase in signal in the 1700–1600 cm−1 range interpreted as increase in lignin modification products. For furfurylated wood similar tendencies were seen, but to a smaller extent. Faecal pellet production was reduced on treated wood and a lack of burrowing behaviour was observed. Mortality began to increase after a month of decreased feeding rates which is comparable to mortality rates of starved gribble. Disruption to enzymatic activity within the gut and/or increased hardness of the wood could be the mechanisms protecting furfurylated wood from biodegradation by gribble. Modification of wood, such as by furfurylation, offers promising levels of protection against such degradation without the reliance on broad spectrum biocides and can reduce costs associated with damaged wooden structures. [ABSTRACT FROM AUTHOR]

Despite corruption's effects on citizen welfare, there is substantial variation in when citizens are willing to sanction government wrongdoing. This paper uses a conjoint survey experiment, conducted in Uganda, to test how information about the position a corrupt official holds, and the details of an act of embezzlement affect citizens' perceptions of corruption severity and willingness to punish. I find that the revenue source of stolen funds and the sector to which the funds had been allocated have the largest impact on perceived severity, followed by whether stolen funds are spent privately or recirculated through patronage or clientelism. The position the corrupt official holds has a smaller impact on severity, including whether the official was elected and whether he was a central or local official. [ABSTRACT FROM AUTHOR]

Purpose: Disruptive airline passenger behaviour (DAPB), i.e. "air rage", has an adverse impact on crew and passenger well-being and is costly to manage and prevent. Given recent changes in airport management, aircraft design, air traffic volume and behavioural norms this review summaries research findings 1985-2020. Design/methodology: A systematic review of the research literature containing qualitative or quantitative data examining DAPB. Findings: Nineteen articles satisfied the criteria for inclusion. Most studies involved surveys of cabin crew members and to a lesser extent pilots, airline representatives, passengers and business customers. Content primarily focussed on the frequency and characteristics of DAPB, whilst consequences for staff and evaluation of training to manage DAPB was less represented. A paucity of current research was noted which is not in keeping with the changes over the last decade in the aviation industry and the increase in DAPB events. Practical implications: A better understanding of the environmental, social and psychological factors underlying DAPB and the effectiveness of staff training and interventions that promote a safe travel environment are required. Social implications: The current industry trend toward sustainability and better management of security challenges must extend its focus to DAPB, in order to reverse the recent trend of social irresponsibility in air travellers. Originality/value: This study presents a summary of current findings on DAPB. [ABSTRACT FROM AUTHOR]

Background: Secondary lymphoedema is a chronic condition that has a financial, emotional and physical impact and causes a decrease in quality of life for affected patients. Twenty cases of lymphoedema presenting in patients undergoing sirolimus immunosuppresive therapy, for renal or hepatic transplantation, have been reported since 2004. Although some patients showed a marked improvement after cessation of sirolimus treatment, more recent reports have emerged of patients who show little or no improvement and must learn to adapt to manage this chronic condition. Aims: This review aims to summarise the cases that have been reported so far and identify areas of future study that may lead to improved methods of avoiding or managing this complication of sirolimus therapy. Methods: A literature review was carried out focusing on chemically induced lymphoedema using the National Library of Medicine's Medline database. Results: A Medline search revealed 20 cases of sirolimus-induced lymphoedema to date, 18 in kidney transplant patients. There has also been a reported case of lymphoedema as a side effect in a paediatric renal transplant patient treated with sirolimus. Conclusions: The fact that there is an increasing number of reports of transplant patients developing lymphoedema after having sirolimus therapy demonstrates that this area requires further investigation. [ABSTRACT FROM AUTHOR]

When faced with a diagnosis, it is empowering to be able to assess the evidence of treatment effectiveness and safety. To teach this skill to non-science majors, we assigned the "Responsible Patienthood Project" (RPP). For the RPP, students studied an array of disease and treatment literature: the final product of their work was a poster presentation, in which they did an in-depth analysis of one primary article, thus encouraging critical evaluation of experimental design, methods, and conclusions. Post-RPP, there was a 35% decrease in the student perception that they would unquestioningly accept a recommended treatment for a hypothetical diagnosis, and a 40% increase in the perception that they would consult a combination of resources, including primary articles. We recommend this project based on our results that suggest 1) non-science majors are able to successfully access and assess primary scientific literature, 2) students felt empowered by the RPP, and 3) skills in information gathering, via library instruction, may serve as a particularly helpful lifelong learning tool. [ABSTRACT FROM AUTHOR]

El artículo considera, desde una perspectiva social, el impacto de varias experiencias de fitomejoramiento participativo (FP) llevadas a cabo por investigadores del Instituto Nacional de Ciencias Agrícolas (INCA) de Cuba en cooperativas cubanas. Los autores consideran los cambios sociales generados por la autogestión y participación comunitaria en el proceso de desarrollo y suministro de insumos de agricultura (semillas de frijol y maíz).

Rectovaginal fistula (RVF) is an uncommon condition. We report a case of RVF which was initially suspected to be a complication of mesh surgery; however, after careful evaluation and review of the literature, a drug-induced RVF was diagnosed. [Extracted from the article]

We report a case of an unusual presentation of Wegener's granulomatosis (WG) in a patient with Crohn's disease (CD). She presented to our Wound Care Center with 7th cranial nerve palsy and facial pyoderma-like ulcerations. Although WG has a predilection for the lung, kidney, and eyes, cutaneous involvement can be seen in 50% of the cases, and it can be the presenting sign in 9–14%. Because of the lethality of WG if not properly treated, the diagnosis is imperative. [ABSTRACT FROM AUTHOR]

The author reflects on coronary heart disease in women, and mentions topics including signs of a heart attack, the prevalence of coronary heart disease in women in postmenopausal years, and the importance of educating women about heart diseases.

Comments on several articles related to nursing. Aim of the National Federation for Specialty Nursing Organizations; Membership of the American Nurses' Association; Opportunities for nurse practitioners seeking a job in which they can work outdoors.

Presents an obituary for Helen H. Shelton, retired librarian and member of the Association for Childhood Education International.

Se presentan los resultados de un estudio, desde las perspectivas de género, de la participación campesina en ferias de diversidad agrícola en Cuba. Se considera la participación relativa de hombres y mujeres, se describe la variación en sus criterios de selección de variedades de maíz y frijol y se analiza la participación e integración de las mujeres campesinas en los proyectos de fitomejoramiento participativo en comunidades de la provincia de La Habana, Cuba.

This paper presents a study of the implementation of Participatory Plant Breeding in Cuba, a methodology based on the experience gained by a group of researchers, farmers and technicians. The proposal presents in materials and methods the four fundamental phases of this process: 1) Diagnosis, 2) Collection of plant genetic resources, 3) Establishments of demonstration plots and development of diversity fairs and 4) Peasant experimentation; The structure provides the necessary flexibility that will allow a proper application of the method and follows a logical order of the activities to be executed in a way that facilitates its execution in the different contexts in which it is of interest to apply it. It was obtained as a result that in addition to the four basic stages of Participative Plant breeding, other tools were used that allowed a successful process, they were: action learning according to interests, Farmers' schools, Innovation festivals, Exchange visits and coexistence, Training of students' capacities in the local innovation scenarios and creation of local seed banks. [ABSTRACT FROM AUTHOR]

Local Agrobiodiversity Fairs started in Cuba late in 1999 by the I Maize Fair celebrated at the National Institute of Agricultural Sciences (INCA), signed up by the Cuban Project of Participatory Plant Breeding (CPPPB). This methodological guide was motivated by the significance of agrobiodiversity fair development on the varietal base diversification supporting food security and growers´ market as well as its further generalization in different crops and regions of the country. The objective of such a guide was to share the experience acquired by a staff of researchers from INCA, in such a way that it permits to preserve and widen plant genetic resource diversity of Cuban growers. The document is subdivided into two main sections: the first one which is entitled “General comments on agrobiodiversity fairs” gives a summarized information about different topics, as definition and kinds of fairs, experiences got on fairs in other countries, agrobiodiversity fairs celebrated in other countries, in Cuba and terms associated to them, whereas the second section refers to a strictly detailed way of organizing and developing fairs in our country, so that the reader may find the exact information of the most important aspects to be taken into account. Every subject is logically arranged to provide an easier work to readers. [ABSTRACT FROM AUTHOR]

Se presentan los resultados de un estudio de la diversidad genética de variedades locales de frijol común (Phaseolus vulgaris) en La Palma, Pinar del Río, Cuba. El estudio enfoca en la participación campesina en una feria de diversidad agrícola llevada a cabo en diciembre de 2001 en San José de las Lajas, La Habana. Se analizan los criterios de selección usados por los campesinos y se consideran las características y el rendimiento de las variedades más seleccionadas.