What are the implications of changing treatment delivery models for patients with inflammatory bowel disease: a discussion paper.

An integrated model of care has been used effectively to manage chronic diseases; however, there is limited, yet encouraging evidence on its introduction in the management of inflammatory bowel disease (IBD), a chronic gastrointestinal condition. Here, the rationale for and implications of introducing an integrated model of care for patients with IBD are discussed, with a particular focus on psychology input, patient-centred care, efficiency as perceived by patients and doctors, financial implications and the possible means of model introduction. This is a discussion paper on the integrated model of care for IBD against a background of what has been learned from an integrated model of care established in other chronic conditions. Although limited, the emerging data on an integrated model of care in IBD are encouraging with respect to patient outcomes and savings in healthcare costs. In other conditions, the model has been well received by both patients and practitioners, although the loss of autonomy by doctors is listed among its drawbacks. The cost-effectiveness data are now sufficiently convincing to recommend the model's acceptance in principle. The model should be promoted at the policy level rather than by individual practitioners to facilitate equal access for patients with IBD on a larger scale than currently.

Classic and Complex PTSD in Switzerland: Prevalence and Theoretical Discussion

Switzerland seems to present a different picture with reference to PTSD prevalence rates. Probably partly as a result of being largely spared by large-scale catastrophes, compared to other countries, there are rather low PTSD prevalence rates. However, in traumatized or clinical samples, these rates amount to comparable sizes as in other countries. Generally, the empirical landscape concerning PTSD in Switzerland is rather limited. More research is needed to further clarify unsolved questions indicated within this article.

Multifunctional Coordination Compounds: Design and Properties [and Discussion]

M. Verdaguer

Neuralgia of the glossopharyngeal nerve in a patient with posttonsillectomy scarring: recovery after local infiltration of procaine-case report and pathophysiologic discussion

We describe a patient with a three-year history of severe progressive left-sided glossopharyngeal neuralgia (GPN) that failed to adequately respond to various drug therapies. The application of lidocaine spray to the posterior pharyngeal wall provided no more than short-term relief. Apart from a large hypertrophic tonsillectomy scar on the left side all clinical and radiologic findings were normal. In terms of therapeutic local anaesthesia, the hypertrophic tonsillectomy scar tissue was completely infiltrated with the local anaesthetic (LA) procaine 1%. The patient has been almost completely pain-free ever since, and the lidocaine spray is no longer needed. Six weeks after the first treatment a repeat infiltration of the tonsillectomy scar led to the complete resolution of all symptoms. The patient has become totally symptom-free without the need to take any medication now for two and a half years. This is the first report of a successful therapeutic infiltration of a tonsillectomy scar using an LA in a patient with GPN that has been refractory to medical treatment for several years. A possible explanation may be that the positive feedback loop maintaining neurogenic inflammation is disrupted and "sympathetically maintained pain" resolved by LA infiltration.

Discussion: Food security and sustainable food systems: The role of soil

There is a general consensus that healthy soils are pivotal for food security. Food production is one of the main ecosystem services provided by and thus dependent on well-functioning soils. There are also intrinsic connections between the four pillars of food security: food availability, access, utilization, and stability; with how soils are managed, accessed and secured, in particular by food insecure and vulnerable populations. On the other hand, socio-political and economic processes that precipitate inequalities and heighten vulnerabilities among poor populations often increase pressure on soils due to unsustainable forms of land use and poor agricultural practises. This has often led to scenarios that can be described as: ‘poor soils, empty stomachs (hungry people) and poor livelihoods.' In 2015, in particular, as we head towards approval of the ‘Sustainable Development Goals' (SDGs), the role of Financing for Development is debated and agreed upon and a new climate pact is signed – these three political dimensions define how a new post-2015 agenda needs to be people-smart as well as resource-smart. For proposed SDG 2 (Food Security and Hunger), there can be so resolution without addressing people, policies and institutions.