Protection alone may not promote natural recovery of biogenic habitats of high biodiversity damaged by mobile fishing gears.

The horse mussel Modiolus modiolus (L.) is a large marine bivalve that aggregates to create complex habitats of high biodiversity. As a keystone species, M.

Identifying, highlighting and reducing polypharmacy in a UK hospice inpatient unit using improvement Science methods.

Polypharmacy, the concurrent use of multiple medications by one individual is a growing global issue driven by an ageing population and increasing prevalence of multi-morbidity[1]. Polypharmacy can be problematic: interactions between medications, reduced adherence to medication, burden of medication to patients, administration time, increased risk of errors and increased cost. Quality improvement methods were applied to identify and highlight polypharmacy patients with the aim of reducing their average number of regular tablets/capsules per day by 25%.

Benthic assemblages associated with native and non-native oysters are similar.

Invasive species can impact native species and alter assemblage structure, which affects associated ecosystem functioning. The pervasive Pacific oyster, Crassostrea gigas, has been shown to affect the diversity and composition of many host ecosystems. We tested for effects of the presence of the invasive C.

Evaluating palliative care ward staffing using bed occupancy, patient dependency, staff activity, service quality and cost data.

Background: Palliative care staffing has remained unchallenged for decades while service provision has changed markedly, bringing new workforce demands. There is little evidence to inform hospice workforce structures, which strive to deliver the highest-quality holistic care.

Aim: The study had three main aims, to: (i) adapt the acuity-quality workforce planning method used extensively in the UK National Health Service (NHS) for use in hospices; (ii) compare hospice and NHS palliative care staffing establishments and their implications; and (iii) create ward staffing benchmarks and formulae for hospice managers.

Incidence and causes for syringe driver site reactions in palliative care: A prospective hospice-based study.

Background: Syringe drivers are routinely used in palliative care for the subcutaneous infusion of drugs for pain and symptom control. Local site reactions occurring at the site of infusion can lead to patient discomfort and the potential for sub-optimal symptom control.

Aim: The aim of this study was to investigate whether there was a correlation between drugs administered subcutaneously via a syringe driver and the incidence of syringe driver site reactions, further linking this to time to syringe driver site reaction.

Can the spread of non-native oysters (Crassostrea gigas) at the early stages of population expansion be managed?

The Pacific oyster (Crassostrea gigas) was introduced into Strangford Lough, Northern Ireland in the 1970s. It was assumed that local environmental conditions would not facilitate successful reproduction. However, in the 1990s there were reports of C.

Exploring differences in referrals to a hospice at home service in two socio-economically distinct areas of Manchester, UK.

In order to provide equitable access to hospice at home palliative care services, it is important to identify the socio-economic factors associated with poorer access. In this population-based study we aimed to test the inverse care law by exploring how socio-economic status and other key demographic indicators were associated with referral rates in two distinct areas (Salford and Trafford) served by the same service. Secondary data from the UK National Census 2001, North West Cancer Intelligence Service (2004) and hospice at home service referral data (2004-06) was collated for both areas.

Complementary therapists' motivation to work in cancer/supportive and palliative care: a multi-centre case study.

Purpose: To uncover complementary therapists' motivation to work in cancer/supportive and palliative care.

Method: The study employed a multiple case-study design, involving three cancer/supportive and palliative care settings in the North West of England. A questionnaire survey (n=51) was undertaken, followed by semi-structured interviews with a subgroup of the sample (n=28).

Experiences of 24-hour advice line services: a framework for good practice and meeting NICE guidelines.

This article presents a framework for the practical implementation of a 24-hour specialist palliative care advice line, illustrated by two case examples from the authors' experience. In the UK, National Institute for Health and Clinical Excellence guidance requires provision of 24-hour access to specialist palliative care advice for healthcare professionals and carers regardless of a patient's location. Effective implementation of a telephone advice line for specialist advice is one approach to addressing the current variability in palliative care service provision, both in the UK and elsewhere.

Complementary therapists' training and cancer care: a multi-site study.

Purpose: To explore professional experience and training of complementary therapists working within cancer care.

Method: A Questionnaire survey of complementary therapists practising in three cancer care settings in North West England.

Results: Respondents (n=51; n=47 female; mean age 50 years, range 23-78 years) had varied career backgrounds; 24 were healthcare professionals who also practised as complementary therapists (nurse n=19; physiotherapist n=3; doctor n=2) whilst 27 were complementary therapists with no prior healthcare background.

Development of a holistic admission assessment: an integrated care pathway for the hospice setting.

This article describes the development of a holistic admission assessment for all inpatients admitted to a 66-bedded hospice, structured in the form of an integrated care pathway (ICP). The need for an improved assessment process was identified by clinical staff, who recognized that the existing assessment was not truly holistic and was dependent on the skills of the assessors. The assessment also lacked appropriate goals and actions.

Current issues in the delivery of complementary therapies in cancer care--policy, perceptions and expectations: an overview.

This review discusses the current policies, perceptions and expectations around the use of complementary therapies (CTs) in cancer care. Whilst the last two decades have seen a marked increase in the demand for and provision of CTs amongst cancer patients, this has not been matched with an increase in the understanding of their effectiveness or their benefits to cancer patients. The issues discussed highlight the need to understand more fully the benefits of integrated services.

Professionals' perceptions of maintaining personhood in hospice care.

This qualitative study examines the attempts made by hospice staff to support and maintain the personhood of hospice patients. The study was conducted over a six-month period at two hospice facilities in northwest England. Thirty staff members were interviewed about their interpretation of the hospice philosophy and how this influences their work with regard to patient personhood.