Pictures for ... from the Royal Academy and New Gallery.

Mode of access: Internet.

French Equatorial Africa.

Mode of access: Internet.

Technical education. A summary of the report of the Royal commission appointed to inquire into the state of technical instruction.

Published for the Cobden club.

Journal kept by David Douglas during his travels in North America 1823-1827, together with a particular description of thirty-three species of American oaks and eighteen species of Pinus, with appendices containing a list of the plants introduced by Douglas and an account of his death in 1834. Published under the direction of the Royal Horticultural Society.

Mode of access: Internet.

The Royal pavilion,

At head of title: Royal commission, Paris international exhibition, 1900.

By the day nurses bank up in a casual pool!

We suspect that the array of silly names used to refer to temporary staff worldwide may be indicative of the extent to which these nurses have been relegated to, and we would argue, remain in, a type of underclass – relatively unsupported by employers in terms of professional practice and ipso facto excluded from contributing professionally to team work, practice development, clinical governance and evidence based practice. This may be acceptable to some but in a climate of risk averseness and in the interests of strategic planning we would suggest it is an accident waiting to happen. The recent UK Royal College of Nursing (RCN) (Ball & Pike, 2006) survey of bank and agency nurses brings a welcome focus on a group of nurses that make a significant contribution to the smooth running of health services in many countries.

Platinum-based chemotherapy in metastatic breast cancer : the Leicester (UK) experience

Aims: After failure of anthracycline- and taxane-based chemotherapy in metastatic breast cancer, treatment options until recently were limited. Until the introduction of capecitabine and vinorelbine, no standard regimen was available. We conducted a retrospective study to determine the efficacy and toxicity of platinum-based chemotherapy in metastatic breast cancer. Materials and methods: Forty-two women with metastatic breast cancer previously treated with anthracyclines (93%) and/or taxanes (36%) received mitomycin-vinblastine-cisplatin (MVP) (n = 23), or cisplatin-etoposide (PE) (n = 19), as first-, second- and third-line treatment at a tertiary referral centre between 1997 and 2002. Chemotherapy was given every 3 weeks as follows: mitomycin-C (8 mg/m 2) (cycles 1, 2, 4, 6), vinblastine (6 mg/m 2), and cisplatin (50 mg/m 2) all on day 1; and cisplatin (75 mg/m 2) and etoposide (100 mg/m 2) on day 1 and (100 mg/m 2) orally twice a day on days 2-3. Results: The response rate for 40 evaluable patients (MVP: n = 23; PE: n = 17) was 18% (95% confidence interval [CI]: 9-32%). The response rate to MVP was 13% (95% CI: 5-32%, one complete and two partial responses) and to PE 24% (10-47%, four partial responses). Disease stabilised in 43% (26-63%) and 47% (26-69%) of women treated with MVP and PE, respectively. After a median follow-up of 18 months, 37 women (MVP: n = 19; PE: n = 18) died from their disease. Median (range) progression-free survival and overall survival were 6 months (0.4-18.7) and 9.9 months (1.3-40.8), respectively. Median progression-free survival for the MVP and PE groups was 5.5 and 6.2 months (Log-rank, P = 0.82), and median overall survival was 10.2 and 9.4 months (Log-rank, P = 0.46), respectively. The main toxicity was myelosuppression. Grades 3-4 neutropenia was more common in women treated with PE than in women treated with MVP (74% vs 30%; P = 0.012), but the incidence of neutropenic sepsis, relative to the number of chemotherapy cycles, was low (7% overall). The toxicity-related hospitalisation rate was 1.2 admissions per six cycles of chemotherapy. No treatment-related deaths occurred. MVP and PE chemotherapy have modest activity and are safe in women with metastatic breast cancer. © 2005 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Nurses’ views on the implementation of Individualised Medication Administration Guides in patients with dysphagia in care homes

As conditions such as stroke, cancer, Parkinson's disease and Huntingdon's chorea are commonly found in care homes between 15% and 30% of residents in care homes have been found to have difficulties in swallowing their medicines.To address the difficulties associated with administering medicines to patients who cannot swallow (with dysphagia), Individualised Medication Administration Guides (I-MAGs) were introduced by a specialised pharmacist in Care for Elderly wards in a general hospital in East Anglia. The guides contained detailed information about how to administer each medication and they were individualised to the needs of the patient. The I-MAGs were printed in green forms and attached to the medication chart in order to be used in conjunction with it. The ward nurses reported an increase in their confidence when administering medication when I-MAGs were present in the ward. Some patients with I-MAG were discharged to care homes where the I-MAG might have been equally useful. However, the design of such guides is not known to be suitable for care homes environment where they have never been used before. This study aims to explore the opinions of nurses and carers within care homes on the relevance and acceptability of individualised medication administration guides for patients with dysphagia (PWD).

Medicines related dysphagia in primary care: The prevalence of and impact on community pharmacists

Dysphagia is a common and problematic symptom characterised by varying degrees of difficulty swallowing food, fluids and medicines of differing consistencies. International primary care based studies have identified that between 1 in 4 and 1 in 5 patients have some form of dysphagia, it can affect medicines taking behaviour and healthcare professionals are largely unaware of this1,2. Similar research has not been undertaken in the UK. Adherence related pharmacy based services in the UK provide an opportunity for community pharmacists to identify the problem and facilitate better medicines use. The aim of this pilot study was to estimate the level of patient reported dysphagia in older persons using community pharmacies in the UK, describe how it affects their medicine taking behaviour and identify whether advanced pharmacy services are related to improved awareness of this.

Metsäpirulainen : Liikemies Erik Johan Längman (1799-1863) talousjärjestelmän murroksessa

The Forest devil. Businessman Erik Johan Längman (1799 1863) in the transition of economic system In Finnish historiography, Erik Johan Längman (1799-1863) bears a bad reputation of his own level: a mean, profit-seeking businessman who did not care too much about methods in his operations. Although little known, Längman has been praised as one of the pioneers of modern industry in the Grand Duchy of Finland, which belonged to the Russian Empire. From the mid 1830s Längman owned iron mill and several sawmills around the country. The growing demand of the markets in the 1830s, especially in Great Britain, marked a strong stimulus to Finnish lumber industry. At the same time claims for stricter rule over the sawmill industry were raised by high officials. The momentum of the conflict, the Forest Act of 1851, brought an end to illegal overproduction. In this biography, particular emphasis is laid on the entrepreneurial behaviour of Längman, but also on the effect the entrepreneurs had on the Crown s policies. On the other hand, how did the limitations imposed by the Crown guide the actions of the sawmill owners? The solutions adopted by the sawmill owners and the manoeuvring of the government are in a constant dialogue in this study. The Finnish sawmill industry experienced a major change in its techniques and methods of acquiring timber during the 1830s. Längman particularly, with his acquisition organisation, was able to find and reach faraway forests with unexpected results. The official regulating system with its strict producing quotas couldn t follow the changes. When the battle against the sawmill industry really started on, in 1840, it didn t happen for the benefit of iron industry, as argued previously, but to save Crown forests from depletion. After the mid 1840s Längman and the leader of the Finnish nationalistic movement, J. V. Snellman questioned the rationality of the entire regulation system and in doing so they also posed a threat against the aristocratic power. The influential but now also badly provoked chairman of the economic division of senate, Lars Gabriel von Haartman, accused the sawmill-owners harder than ever and took the advantage of the reactionary spirit of imperial Russia to launch the state forest administration. Längman circumvented the conditions of privileges, felled Crown forests illegally and accusations were brought against him for destroying his competitors. The repeated conflicts spoke primarily about a superior business idea and organisational ability. Although Längman spent his last years mostly abroad he still had interests in Finnish timber business when the liberation of sawmill-industry was established, in 1861. Surprisingly, the antagonism around the Crown forests continued, probably even more heated.

Pilottitutkimus apteekkien yksilöllisestä tupakoinninvieroituspalvelusta

Apteekkien yksilöllinen tupakoinninvieroituspalvelu on tupakoinnin lopettamiseen motivoituneille asiakkaille tarkoitettu maksullinen erikoispalvelu, joka sisältää 4–6 tapaamista vieroitusohjaajana toimivan farmaseutin tai proviisorin kanssa. Palvelu sisältää asiakkaalle räätälöityä neuvontaa, henkilökohtaisen vieroitussuunnitelman sekä seurantajakson. Apteekkien yksilöllinen tupakoinninvieroituspalvelu perustuu Isossa-Britanniassa kehitettyyn palvelumalliin, ja sitä on tarjottu suomalaisissa apteekeissa vuodesta 2006. Tämä pro gradu -tutkielma käsittelee apteekkien yksilöllisen tupakoinninvieroituspalvelun pilottitutkimusta, joka toteutettiin Suomen Apteekkariliiton ja Helsingin yliopiston farmasian tiedekunnan sosiaalifarmasian osaston yhteistyönä ja se kuului osana Hengitysliitto Heli ry:n koordinoimaa tupakasta vieroituksen hankekokonaisuutta. Tässä pro gradu -tutkielmassa tarkastellaan pilottitutkimuksessa saadun asiakasaineiston avulla apteekkien yksilöllisen tupakoinninvieroituspalvelumallin toimivuutta, asiakkaiden kokemuksia palvelusta, asiakkaiden onnistumista tupaakoinnin lopettamisessa sekä asiakkaiden kyvykkyyden tunteen kehittymistä palvelun aikana. Tässä interventiotutkimuksessa oli mukana 14 apteekkia, jotka rekrytoivat yhteensä 36 palveluasiakasta. Ennen asiakkaiden rekrytointia apteekit perehdytettiin palvelun tarjoamiseen. Apteekit tiedottivat pilottitutkimuksesta paikallisen terveydenhuollon lääkäreitä ja muita terveydenhuollon ammattilaisia, jotka voivat ohjata asiakkaita palveluun. Sosiaali- ja terveysministeriön pilottitutkimukselle myöntämä rahoitus mahdollisti asiantuntijapalkkion maksamisen apteekeille ja palvelun tarjoamisen asiakkaille ilmaiseksi tai pientä omakustannusosuutta vastaan. Asiakkaiden tupakoimattomana pysymistä sekä kokemuksia tupakoinninvieroituspalvelusta kartoitettiin kyselylomakkeilla, jotka asiakkaat saivat täytettäväkseen palvelun alussa sekä noin 3 kuukauden kohdalla palvelun alkamisesta. Asiakkaiden taustatiedot kerättiin ensimmäisen tapaamisen yhteydessä erillisille taustatietolomakkeille ja palvelun aikana tehtyjä huomioita niille tarkoitetuille kaavakkeille. Ensimmäisen kyselylomakkeen palauttaneista 28 henkilöstä 20 ja toisen kyselylomakkeen palauttaneista 17 henkilöstä 13 oli pysynyt tupakoimattomana (55,6 % ja 36,1 % kaikista asiakkaista). Kaikki tupakoinnin lopettaneet käyttivät jotakin tupakasta vieroituslääkettä. Tupakoinnin lopettaneilla asiakkailla kyvykkyyden tunne oli keskimääräistä parempi sekä palvelun alussa että koko palvelun ajan. Asiakkaat pitivät palvelua tarpeellisena ja apteekin vieroitusohjaajalta saatua tukea tärkeänä. Asiakkaat kokivat myös palvelun saamisen apteekista tärkeäksi. Noin 32 % ensimmäiseen kyselyyn vastanneista ja 41 % toiseen kyselyyn vastanneista oli valmis maksamaan palvelusta. Heidän ilmoittamansa maksuvalmius oli keskimäärin noin 45 euroa (10–100 euroa). Muusta terveydenhuollosta lähetettiin palveluun vain vähän tai ei lainkaan asiakkaita. Tästä syystä apteekit rekrytoivat asiakkaita myös ilman kontaktia muuhun terveydenhuoltoon. Palvelun 36 asiakkaasta noin 36 % oli pysynyt tupakoimattomana 3 kuukauden kohdalla. Verrokkiryhmä jouduttiin jättämään tutkimuksesta pois verrokkihenkilöiden rekrytoinnin epäonnistuttua. Tulos on kuitenkin vertailukelpoinen kansainvälisiin tutkimuksiin, joissa on saatu vastaavanlaisia tuloksia. Apteekkien yksilöllisestä tupakoinninvieroituspalvelusta saattaa olla hyötyä tupakoinnin lopettamisessa siihen motivoituneille henkilöille ja erityisesti henkilöille, jotka käyttävät lisäksi tupakasta vieroituslääkettä. Asiakkaat kokivat palvelun tärkeäksi ja tarpeelliseksi, mutta heikko maksuvalmius asettaa haasteita palvelun tarjoamiselle apteekeissa. Yhteistyömallia muun terveydenhuollon kanssa tulisi kehittää.

GB Non-native Species Information Portal: documenting the arrival of non-native species in Britain

Information on non-native species (NNS) is often scattered among a multitude of sources, such as regional and national databases, peer-reviewed and grey literature, unpublished research projects, institutional datasets and with taxonomic experts. Here we report on the development of a database designed for the collation of information in Britain. The project involved working with volunteer experts to populate a database of NNS (hereafter called “the species register”). Each species occupies a row within the database with information on aspects of the species’ biology such as environment (marine, freshwater, terrestrial etc.), functional type (predator, parasite etc.), habitats occupied in the invaded range (using EUNIS classification), invasion pathways, establishment status in Britain and impacts. The information is delivered through the Great Britain Non-Native Species Information Portal hosted by the Non-Native Species Secretariat. By the end of 2011 there were 1958 established NNS in Britain. There has been a dramatic increase over time in the rate of NNS arriving in Britain and those becoming established. The majority of established NNS are higher plants (1,376 species). Insects are the next most numerous group (344 species) followed by non-insect invertebrates (158 species), vertebrates (50 species), algae (24 species) and lower plants (6 species). Inventories of NNS are seen as an essential tool in the management of biological invasions. The use of such lists is diverse and far-reaching. However, the increasing number of new arrivals highlights both the dynamic nature of invasions and the importance of updating NNS inventories.

The pathobiology of the septin gene family.

Septins are an evolutionarily conserved group of GTP-binding and filament-forming proteins that belong to the large superclass of P-loop GTPases. While originally discovered in yeast as cell division cycle mutants with cytokinesis defects, they are now known to have diverse cellular roles which include polarity determination, cytoskeletal reorganization, membrane dynamics, vesicle trafficking, and exocytosis. Septin proteins form homo- and hetero-oligomeric polymers which can assemble into higher-order filaments. They are also known to interact with components of the cytoskeleton, ie actin and tubulin. The precise role of GTP binding is not clear but a current model suggests that it is associated with conformational changes which alter binding to other proteins. There are at least 12 human septin genes, and although information on expression patterns is limited, most undergo complex alternative splicing with some degree of tissue specificity. Nevertheless, an increasing body of data implicates the septin family in the pathogenesis of diverse disease states including neoplasia, neurodegenerative conditions, and infections. Here the known biochemical properties of mammalian septins are reviewed in the light of the data from yeast and other model organisms. The data implicating septins in human disease are considered and a model linking these data is proposed. It is posited that septins can act as regulatable scaffolds where the stoichiometry of septin associations, modifications, GTP status, and the interactions with other proteins allow the regulation of key cellular processes including polarity determination. Derangements of such septin scaffolds thus explain the role of septins in disease states. Copyright © 2004 Pathological Society of Great Britain and Ireland.

Ireland

‘Islands constitute natural unities; sea channels constitute natural divisions’. So wrote Kevin Howard (2006: 9) with particular reference to the two largest islands of the British Isles: Great Britain and Ireland. However, at the time of writing, the political unity of Great Britain is being called into question, while Ireland has been divided since the 1920s. Part of the island of Ireland is united not with the rest of the island, but with Great Britain across the other side of the ‘natural division��� that is the Irish Sea, for Ireland’s history, development and political structures have long been moulded by Great Britain. The journey to this ‘unnatural’ unity and the associated division of Ireland forms the material for this chapter.