GPs' perspectives on managing the NHS Health Check in primary care:a qualitative evaluation of implementation in one area of England

OBJECTIVES: To evaluate the implementation of the National Health Service (NHS) Health Check programme in one area of England from the perspective of general practitioners (GPs). DESIGN: A qualitative exploratory study was conducted with GPs and other healthcare professionals involved in delivering the NHS Health Check and with patients. This paper reports the experience of GPs and focuses on the management of the Heath Check programme in primary care. SETTING: Primary care surgeries in the Heart of Birmingham region (now under the auspices of the Birmingham Cross City Clinical Commissioning Group) were invited to take part in the larger scale evaluation. This study focuses on a subset of those surgeries whose GPs were willing to participate. PARTICIPANTS: 9 GPs from different practices volunteered. GPs served an ethnically diverse region with areas of socioeconomic deprivation. Ethnicities of participant GPs included South Asian, South Asian British, white, black British and Chinese. METHODS: Individual semistructured interviews were conducted with GPs face to face or via telephone. Thematic analysis was used to analyse verbatim transcripts. RESULTS: Themes were generated which represent GPs' experiences of managing the NHS Health Check: primary care as a commercial enterprise; 'buy in' to concordance in preventive healthcare; following protocol and support provision. These themes represent the key issues raised by GPs. They reveal variability in the implementation of NHS Health Checks. GPs also need support in allocating resources to the Health Check including training on how to conduct checks in a concordant (or collaborative) way. CONCLUSIONS: The variability observed in this small-scale evaluation corroborates existing findings suggesting a need for more standardisation. Further large-scale research is needed to determine how that could be achieved. Work needs to be done to further develop a concordant approach to lifestyle advice which involves tailored individual goal setting rather than a paternalistic advice-giving model.

Development and evaluation of a geographic information system based method to estimate flooding susceptibility in an area of Broward County, Florida

The objective of this study was to develop a GIS-based multi-class index overlay model to determine areas susceptible to inland flooding during extreme precipitation events in Broward County, Florida. Data layers used in the method include Airborne Laser Terrain Mapper (ALTM) elevation data, excess precipitation depth determined through performing a Soil Conservation Service (SCS) Curve Number (CN) analysis, and the slope of the terrain. The method includes a calibration procedure that uses "weights and scores" criteria obtained from Hurricane Irene (1999) records, a reported 100-year precipitation event, Doppler radar data and documented flooding locations. Results are displayed in maps of Eastern Broward County depicting types of flooding scenarios for a 100-year, 24-hour storm based on the soil saturation conditions. As expected the results of the multi-class index overlay analysis showed that an increase for the potential of inland flooding could be expected when a higher antecedent moisture condition is experienced. The proposed method proves to have some potential as a predictive tool for flooding susceptibility based on a relatively simple approach.

Nutritional programs for the English-speaking elderly and disabled in the "Little Havana" area of Miami

N.A.

Annotated record of the detailed examination of Mn deposits from BLM Leg Alpha Cruise, R/V Kana Keoki off the south-western coastal area of the Gulf of Mexico off Texas

The BLM-OCS (Bureau of Land Management-Outer Continental Shelf) program was designed to establish chemical, biological, and geological baseline on the South Texas Continental Shelf. The focus for the geological program was to establish the nature and amount of the suspended sediment in the water column, of the Holocene sediments on the shelf, and to identify and locate regions of geology conditions which may be hazardous to OCS operations. To accomplish these goals three cruises were planned. The report constitutes results of the first cruise. The results of these cruises associated with the subsequent laboratory analysis, enabled to establish a detailed baseline in order to provide significant geologic and biologic data for environmental assessment. Dredges recovered are available at University of Texas (see: BLM/OCS South Texas Outer Continental Shelf (STOCS) Project Sediment Data http://www.ngdc.noaa.gov/docucomp/page?xml=NOAA/NESDIS/NGDC/MGG/Geology/iso/xml/G02888.xml&view=getDataView&header=none).

Annotated record of the detailed examination of Mn deposits from BLM Leg Bravo Cruise, R/V Kana Keoki off the south-western coastal area of the Gulf of Mexico off Texas

The BLM-OCS (Bureau of Land Management-Outer Continental Shelf) program was designed to establish chemical, biological, and geological baseline on the South Texas Continental Shelf. The focus for the geological program was to establish the nature and amount of the suspended sediment in the water column, of the Holocene sediments on the shelf, and to identify and locate regions of geology conditions which may be hazardous to OCS operations. To accomplish these goals three cruises were planned. The report constitutes results of the second cruise. The results of these cruises associated with the subsequent laboratory analysis, enabled to establish a detailed baseline in order to provide significant geologic and biologic data for environmental assessment. Dredges recovered are available at University of Texas (see: BLM/OCS South Texas Outer Continental Shelf (STOCS) Project Sediment Data http://www.ngdc.noaa.gov/docucomp/page?xml=NOAA/NESDIS/NGDC/MGG/Geology/iso/xml/G02888.xml&view=getDataView&header=none).

Annotated record of the detailed examination of Mn deposits on the coral banks of the continental shelf in the south-western coastal area of the Gulf of Mexico off Texas

During U.S. Department of Interior, Bureau of Land Management (BLM) public hearings held in 1973, 1974 and 1975 prior to Texas Outer Continental Shelf (OCS) oil and gas lease sales, concern was expressed by the National Marine Fisheries Service, scientists from Texas A&M and the University of Texas and private citizens over the possible environmental impact of oil and gas drilling and production operations on coral reefs and fishing banks in or adjacent to lease blocks to be sold. As a result, certain restrictive regulations concerning drilling operations in the vicinity of the well documented coral reefs and biostromal communities at the East and West Flower Gardens were established by BLM, and Signal Oil Company was required to provide a biological and geological baseline study of the less well known Stetson Bank before a drilling permit could be issued. Considering the almost total lack of knowledge of the geology and biotic communities associated with the South Texas OCS banks lying in or near lease blocks to be offered for sale in 1975, BLM contracted with Texas A&M University to provide the biological and geological baseline information required to facilitate judgments as to the extent and nature of restrictive regulations on drilling near these banks which might be required to insure their protection. In pursuit of this, scientists from Texas A&M University were to direct their attention toward assessments of ground fish populations, unique biological and geological features, substratum type and distribution, and the biotic and geologic relationships between these banks and those farther north.

Density of sand flies (diptera: psychodidae) in domestic and wild animal shelters in an area of visceral leishmaniasis in the state of Rio Grande do Norte, Brazil

XIMENES, Maria de Fátima Freire de Melo; SOUZA, Maria de Fátima de; CASTELLON, Eloy Guilhermo. Density of sand flies (Diptera: Psychodidae) in domestic and wild animal shelters in an area of visceral Leishmaniasis in the State of Rio Grande do Norte, Brazil. Memorias do Instituto Oswaldo Cruz, Rio de Janeiro, v.94, n.4, p.427-432, jul./ago. 1999. Disponivel em: Acesso em: 4 out. 2010.

Constructivism, constitutionalism and the EU's area of freedom security and justice post-Lisbon

This essay addresses the fundamental conceptual challenges which face the development of the Area of Freedom Security and Justice (AFSJ) in the post-Lisbon Treaty era. It argues that Onuf style constructivism is a valid lens with which to examine the development of the AFSJ to date, involving as it does the development of a shared understanding by practitioners, predominantly law enforcement and prosecution professionals, within the structures provided for them, in order to develop a completely new area of law and practice. While this approach will continue to need to be deployed in the development of further new operational areas, such as cybercrime, a new approach is now required, that of constitutionalism. A variety of forms of constitutionalism are then examined in order to establish their suitability as a mode of analysis for these developments.

Aspects of Land Take in the Metropolitan Area of Naples

Land take is a phenomenon of great concern nowadays because of the large number of its negative impacts regarding biological, economic and social balance. In Italy, the development of urban and other artificial land has been irreversibly transforming a nonrenewable resource such as soil, regardless the almost constant population rate, with different speed depending of the region considered. The aim of this paper is to analyze the phenomenon in the metropolitan area of Naples, which is an area highly affected by territorial aggression of human matrix. The data used are both by the Institute for Environmental Protection and Research (ISPRA) Report 2015 on the usage of the land and by ISTAT relating to the resident population up to the 1st of January 2015 and the extension of land for agricultural use (Census 2010). The mathematical combination of this data creates a new indicator that can be referred to as “residual land”; this residual area is of great extension with many different characteristics and it could represent the area where the phenomenon of land take most occurs. The identification, measurement and analysis of “residual land” provide new insights on the evolution of land take and this new indicator can represent a critical element to work on to prevent future land transformation and protect natural and agricultural areas within the Italian context.

Density of sand flies (diptera: psychodidae) in domestic and wild animal shelters in an area of visceral leishmaniasis in the state of Rio Grande do Norte, Brazil

XIMENES, Maria de Fátima Freire de Melo; SOUZA, Maria de Fátima de; CASTELLON, Eloy Guilhermo. Density of sand flies (Diptera: Psychodidae) in domestic and wild animal shelters in an area of visceral Leishmaniasis in the State of Rio Grande do Norte, Brazil. Memorias do Instituto Oswaldo Cruz, Rio de Janeiro, v.94, n.4, p.427-432, jul./ago. 1999. Disponivel em: Acesso em: 4 out. 2010.