Comparing palliative care provision in India and the UK.

The Prince & Princess of Wales Hospice in Glasgow is committed to developing culturally competent, sensitive services to meet the needs of local ethnic minority communities. The clinical nurse specialist for widening access travelled to India, funded by a travel scholarship from the Florence Nightingale Foundation. The main rationale for this visit was to observe and compare palliative care practice in India in community, hospice and hospital settings with the current service provision by the hospice/hospital palliative care teams in Glasgow. A second focus was to study the cultural differences and potential challenges of providing palliative care to a diverse Indian population from multi-faith communities and different socio-economic classes. Throughout the visit the barriers to accessing palliative care services in India were observed as well as cultural norms that might impact on clinical practice in the UK.

Experiences implementing a 6-month pilot of a 7-day community CNS service in an urban hospice in Scotland.

BACKGROUND: Patients and carers may face challenges in the out-of-hours period, with inadequate support and variations in service provision, including access to specialist palliative care. A pilot was undertaken to extend availability of the community clinical nurse specialist (CNS) team to include weekends and public holidays. AIM: To examine the need for a 7-day community CNS service. METHOD: Activity data was collected for 6 months and feedback was sought from service users and the CNS team. RESULTS: There were 132 out-of-hours telephone contacts in the 6-month period, generating 35 home visits. Almost two thirds of these calls were proactive, 'planned' contacts. Most unplanned calls (68%) were from a carer for advice about symptom management and support as the patient's condition changed. CONCLUSION: The pilot demonstrated the need for a CNS service 7 days a week, and the service is now embedded in practice. Seven-day working benefits patients and families while being valued by the professional team.

Immunogenicity of plasmids encoding T and B cell epitopes of foot-and-mouth disease virus (FMDV) in swine.

In this work, we have investigated the immune response in pigs to two recombinant plasmids containing immunodominant neutralizing antibody epitopes of foot-and-mouth disease virus structural protein (VP1) coexpressed with viral non-structural proteins as a source of T cell epitopes. The plasmid pcDNA3.1/3D15 contained a sequence coding for the 3D polymerase upstream of a sequence coding for peptide FMDV15, a peptide derived from VP1, previously shown to stimulate protective immunity to foot-and-mouth disease virus (FMDV), that consisted of the carboxy terminal peptide [VP1(200-213)] linked by ProProSer to the "loop" peptide [VP1(143-160)] and terminating in CysGly. The plasmid, pcDNA3.1/2B15 contained a sequence coding for the non-structural protein 2B, and the same FMDV15 peptide sequence. Pigs injected with both constructs showed antibody and T cell responses to 3D and 2B, but not to the FMDV15 peptide. Additionally, delayed type hypersensitivity responses were observed in some cases to both 3D or 2B and to FMDV virus. Finally, no protection was seen against FMDV infection in animals immunized with either of the two FMDV DNA constructs. The additional co-immunization of plasmids encoding for GMCSF did not result in any significant change in the immune responses to the plasmids encoding for FMDV. This work gives some optimism for the construction of a DNA vaccine for FMDV in the future.