Potential hazard to human health from exposure to fragments of lead bullets and shot in the tissues of game animals

Lead is highly toxic to animals. Humans eating game killed using lead ammunition generally avoid swallowing shot or bullets and dietary lead exposure from this source has been considered low. Recent evidence illustrates that lead bullets fragment on impact, leaving small lead particles widely distributed in game tissues. Our paper asks whether lead gunshot pellets also fragment upon impact, and whether lead derived from spent gunshot and bullets in the tissues of game animals could pose a threat to human health.

Caregiving for the terminally ill:at what cost?

This literature review exposes the nature and extent of physical and psychosocial morbidity and economic disadvantage, home palliative caregivers suffer as a direct result of their caregiving role. Research has demonstrated that caregivers providing support to individuals receiving palliative care report unmet needs for information, communication, service provision and support from health and community services. Three sets of challenges are highlighted in this literature review which help explain why the needs of home palliative caregivers are largely unmet: (i) barriers to seeking help; (ii) a dearth of research-based interventions focused on reducing the negative aspects of caregiving; and (iii) a number of impediments to effective policy and service development for family caregivers. Furthermore, invited submissions from caregivers echoed and confirmed the issues reported in the literature. Recommendations for enhancing caregiver support are outlined.

A systematic review protocol on the use of online learning and blended learning for teaching clinical skills to undergraduate health professional students

Aim: This paper is a review protocol that will be used to identify, critically appraise and synthesize the best current evidence relating to the use of online learning and blended learning approaches in teaching clinical skills in undergraduate nursing.

Background: Although previous systematic reviews on online learning versus face to face learning have been undertaken (Cavanaugh et al. 2010, Cook et al. 2010), a systematic review on the impact of online learning and blended learning for teaching clinical skills has yet to be considered in undergraduate nursing. By reviewing nursing students’ online learning experiences, systems can potentially be designed to ensure all students’ are supported appropriately to meet their learning needs.

Methods/Design: The key objectives of the review are to evaluate how online-learning teaching strategies assist nursing students learn; to evaluate the students satisfaction with this form of teaching; to explore the variety of online-learning strategies used; to determine what online-learning strategies are more effective and to determine if supplementary face to face instruction enhances learning. A search of the following databases will be made MEDLINE, CINAHL, BREI, ERIC and AUEI. This review will follow the Joanna Briggs Institute guidance for systematic reviews of quantitative and qualitative research.

Conclusion: This review intends to report on a combination of student experience and learning outcomes therefore increasing its utility for educators and curriculum developers involved in healthcare education.

City visioning and the turn to community:The case of Derry/Londonderry

In the 1980s, urban re-imaging and place marketing were vital elements in the strategies of post-industrial cities aiming to redefine their role, make themselves more competitive and attract global investment and tourists. By the early 1990s, the questionable effects of trickle-down economics on deprived housing estates and the rediscovery of the 'community' as a social partner shifted both the substance and process of vision exercises. This paper examines the experience of building an input into a city vision that aimed to address social and ethno-religious segregation in Derry/Londonderry. Designing a consensus statement for a city that cannot agree its name, was wrecked by bloody violence and has its hinterland fractured by a contested international border, is a difficult and delicate process. The city had a population of 105 800 people in 1998, but is divided by the river Foyle between the mainly Catholic Cityside (to the north and west) and the mainly Protestant Waterside (to the south and east). The analysis connects with the literature on urban policy that emphasises the importance of argumentation and democratic debate in strategic planning and local regeneration (Forester, 1989; Healey, 1996). The paper concludes by arguing that strategies for 'listening' would help to shape a vision that could mobilise community interests around some common urban regional issues and help to promote social and ethno-religious polarisation as mainstream policy concerns.