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A new-onset seizure clinic (NOSC) was established at our hospital in 2011, with the aim to provide accurate diagnosis and appropriate management to children with new-onset seizures or seizure mimics.We report on the data analysis of the first 200 children seen in NOSC. A paediatric neurologist or paediatric/neurology trainee under supervision of a neurologist reviewed all the children. A detailed history and clinical examination were undertaken. Electroencephalogram (EEGs) were undertaken prior to clinic review in most emergency departments. Children were classified as 'epilepsy positive' (EP+) or 'epilepsy negative' (EP-) after the first consultation.Of 200 patients, 109 were classified as EP+: generalised epilepsy in 57 of 109, focal in 36, childhood seizure susceptibility syndrome in 26 and epileptic encephalopathy in 5. EEG was available in 192: in 117, it was abnormal - 23 with background abnormalities and 109 with epileptiform activity. Of the 109 patients, 80 were commenced on anti-epileptic drugs (AEDs): 12 were able to come off medication after seizure-free period, 61 were controlled on AEDs and 7 were refractory. Children were followed up for 12-48 months. None of the children had diagnosis revised on follow-up.This is the first Australian study to report on a large cohort of children from a NOSC. An EEG and a paediatric neurologist assessment is a good combination to enable diagnostic accuracy: In the first 200 patients seen, there were no revisions of the initial diagnosis on follow-up.

In a native forest on the south coast of New South Wales, Australia, five channels were instrumented with rain gauges and weirs to monitor rainfall, streamflow, turbidity, and suspended sediment yield over a seven and a half year period. After a five year calibration period, four of the catchments were harvested, while one remained as a control. In the harvested catchments there were two replicated treatments; selective harvesting in the 10 m buffers using Best Management Practices (BMPs), and no harvesting in the 10 m buffers. Results of the statistical analysis showed that harvesting had a significant impact on runoff and suspended sediment yield relative to the control, but did not have a significant impact on turbidity. There was no significant difference in post-harvest runoff, turbidity or suspended sediment yield between the treatments. In the treatment where there was no harvesting in the buffers, the significant increase in suspended sediment yield dissipated after 18 months and was accompanied by a hydrological recovery in peak flows toward pre-harvest values. In the treatment where there was harvesting in the buffers, there was no hydrological recovery in peak flows, nor was there a decrease in suspended sediment yields 18 months after harvesting. This lack of a hydrological recovery in the treatment where there was harvesting in the buffers had no significant effect on turbidity, hence the implementation of BMPs in the buffer strips along the ephemeral first-order channels were effective in maintaining the water quality status in an intensively harvested eucalypt forest. The implementation of BMPs outside of the selectively harvested buffers that are designed to reduce erosion on hillslopes and sediment delivery to streams were also effective in maintaining the water quality status in the same harvesting operation.

© 2018 Elsevier Ltd Sydney has emerged as a major global city in the 21st century. We review the “global city thesis”, which dominates urban scholarship and practice, and ask whether it adequately captures the Sydney experience. Although the global city thesis is a useful analytical construct for policy makers and scholars, we argue that it does not adequately chart Sydney's rise as a leading global city and its current problems. The global city thesis ignores the political institutions and processes that shape and direct the global city. The City of Sydney is a small area of the city-region, accounting for only about four percent of the metropolis. Sydney lacks a metropolitan or regional government and has few regional collaborative processes or platforms. Instead the global city strategy of Sydney is shaped and directed by the New South Wales state government. This is contrary to the political decentralisation and devolution trends heralded by international actors such as the Organisation for Economic Co-operation and Development. Sydney also illustrates the dilemma of global cities in that those members at the top of the knowledge economy are highly rewarded and those in the middle and lower strata face difficulty maintaining or improving their situations. Local governments lack the capacity to act independently and the state and federal governments are unwilling to address serious urban problems associated with globalisation, such as public transit or housing. Given the governments' embrace of neoliberalism, the global city vision advanced by leaders is threatened. There is little concrete policy offered by any level of government to address the crisis.

With a high prevalence of well-established risk dementia risk factors (e.g. tobacco, alcohol use, hypertension, and diabetes), there is a dire need for data on prevalence and correlates of cognitive impairment and related service utilization among older Korean Americans. Memory and Aging study of Koreans (MASK) is a two-stage epidemiological survey with two-step sampling strategy to obtain a representative sample. We screened 1,118 older Korean Americans (mean age: 70.7, female: 67.2%) with a Korean version of the Mini-Mental State Exam, and 118 persons sampled from two levels of performance on the MMSE underwent the second stage clinical evaluation that included the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD). Preliminary analysis estimated that community prevalence of mild cognitive impairment in this population was 28.4% (CI: 18.2%-41.5%) and dementia was 7.2% (3.8% - 13.2%). Correlates of cognitive impairment, and potential barriers to the services will be discussed during this presentation.

This article, taken from a presentation to the Medico-Legal Society, discusses the prospects for patient safety and access to justice in the wake of the Mid Staffordshire NHS Foundation Trust public inquiry and the Legal Aid Sentencing and Punishment of Offenders Act. Particular reference is made to the arguments for and against a statutory Duty of Candour; clinical negligence litigation; patient complaints and specialist advice and support for people affected by medical accidents.

Age-standardized rates of hip fracture in Canada declined during the period 1985 to 2005. We investigated whether this incidence pattern is explained by period effects, cohort effects, or both. All hospitalizations during the study period with primary diagnosis of hip fracture were identified. Age- and sex-specific hip fracture rates were calculated for nineteen 5-year age groups and four 5-year calendar periods, resulting in 20 birth cohorts. The effect of age, calendar period, and birth cohort on hip fracture rates was assessed using age-period-cohort models as proposed by Clayton and Schiffers. From 1985 to 2005, a total of 570,872 hospitalizations for hip fracture were identified. Age-standardized rates for hip fracture have progressively declined for females and males. The annual linear decrease in rates per 5-year period were 12% for females and 7% for males (both p

Objectives The number of hospital discharges involving type 1 or type 2 diabetes as the first-listed diagnosis has increased over the past few decades. Such cases are commonly associated with various comorbidities. We analyzed data collected from hospital separations in Canada to determine the number and proportion of comorbid conditions in Canadians hospitalized because of diabetes. Methods The most responsible diagnosis (MRDx) of diabetes (ICD-10-CA: E10 [type 1 diabetes] or E11 [type 2 diabetes]) was identified from acute care hospital separations (Discharge Abstract Database) from 2013 to 2014 in all Canadian jurisdictions except Quebec. Hospital separations were calculated by 5-year age groups and sex. The most common comorbid (secondary) diagnoses were identified for hospital separations with diabetes as the MRDx, and the average lengths of stay associated with diabetes were determined. Results The total number of hospital separations in 2013–2014 in Canada (excluding Quebec) with diabetes as the MRDx in all ages was 30,422, and males represented more than half (58.7%) of the separations. The median age group when diabetes is the MRDx is 60 to 64. For all patients hospitalized with an MRDx of diabetes, there were 2.2% deaths. Hypertension was the most common comorbid diagnosis in patients with diabetes as the MRDx, followed by glomerular disorders, peripheral angiopathy and acute renal failure. Conclusions Hospitalizations resulting from diabetes are associated with vascular comorbidities, and hypertension is the most common. Prevention of shared predisposing factors should reduce the burden of hospitalizations associated with diabetes.

While the history of early filmmaking and exhibition in Yorkshire has previously drawn only limited critical attention, the materials of the Fred Holmes Collection now offers us new insight into the region through the practices of Jasper Redfern. Drawing on both this newly uncovered collection, the materials of the National Media Museum, as well as on a series of business records held by the National Archives, this article presents an investigation of Redfern's unsteady progress through the changing market of film production and performance in the region. Starting as a demonstrator of the Kineoptikon, Redfern established himself as a localized showman who was able to tailor his show to high-profile music hall shows, as well to private performances for various social events. From this he developed his own ‘complete' touring programme of mixed live and screened entertainments, and ‘Jasper Redfern's No. 1 Vaudeville Company' broke into more permanent forms of exhibition, eventually forming a network of venue...

Introduction L’Agence de la santé publique du Canada, en collaboration avec 12 experts dans le domaine de la santé des os et de l’ostéoporose de partout au Canada, a sélectionné, par un processus de consensus formel, un ensemble d’indicateurs de base pour la surveillance de l’ostéoporose en santé publique. Méthodologie Une revue de la littérature a permis d’identifier des indicateurs potentiels, qui ont été par la suite regroupés dans un cadre d’indicateurs propre à l’ostéoporose. Un sondage a ensuite été élaboré pour connaître l’opinion des experts sur l’importance de ces indicateurs pour la santé publique. Les indicateurs ayant obtenu un score inférieur à 3 sur une échelle de Likert allant de 1 (faible importance) à 5 (importance élevée) ont été exclus de tout examen subséquent. Par la suite, l’importance des autres indicateurs pour la santé publique a été soumise à un vote majoritaire au cours d’une réunion en face-à-face. Résultats La littérature a permis de repérer 111 indicateurs, dont 88 ont été sélectionnés grâce au sondage en vue d’un examen approfondi. Lors de la réunion en face-à-face, 39 indicateurs ont été estimés importants du point de vue de la santé publique par au moins la moitié des experts. Conclusion Cet ensemble d’indicateurs de base servira à orienter la création de nouvelles sources de données ainsi que l’intégration, l’analyse et l’interprétation de données existantes sous la forme de produits de surveillance à des fins d’intervention dans le domaine de la santé publique.

Introduction The Public Health Agency of Canada, in collaboration with bone health and osteoporosis experts from across Canada (n = 12), selected a core set of indicators for the public health surveillance of osteoporosis using a formal consensus process. Methods A literature review identified candidate indicators that were subsequently categorized into an osteoporosis-specific indicator framework. A survey was then administered to obtain expert opinion on the indicators’ public health importance. Indicators that scored less than 3 on a Likert scale of 1 (low) to 5 (high) were excluded from further consideration. Subsequently, a majority vote on the remaining indicators’ level of public health importance was sought during a face-to-face meeting. Results The literature yielded 111 indicators, and 88 were selected for further consideration via the survey. At the face-to-face meeting, more than half the experts considered 39 indicators to be important from the public health perspective. Conclusion This core set of indicators will serve to inform the development of new data sources and the integration, analysis and interpretation of existing data into surveillance products for the purpose of public health action.

Background Heart failure (HF) is a leading morbid cause of hospitalization and death. HF is often accompanied by comorbid conditions, increasing the health care burden. This study describes hospital mortality and identifies comorbid conditions associated with HF. Methods Acute care hospital separations in 2005-2006, with a diagnosis of HF I50, I500, I501, I509 ( The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Canada [ICD-10-CA]) were identified from all Canadian jurisdictions except Quebec. Results A total of 2,457,527 hospital separations among 1,812,923 individuals, identifying 8,212,869 diagnoses were reported. Among those, a total of 33,693 (1.9%) of all hospitalized individuals had a most responsible diagnosis of HF, accounting for 42,399 hospital separations. Further, HF was coded 77,049 times as a comorbid diagnosis, altogether occurring in 4.9% of all hospitalizations. The most common primary diagnoses associated with comorbid HF were acute myocardial infarction (AMI), chronic obstructive pulmonary disease (COPD), and pneumonia. Seniors had a much higher hospitalization rate due to HF. Hospitalized individuals with a primary diagnosis of HF had an almost 3-fold higher 30-day in-hospital mortality rate and nearly double the mean hospital stay than that for all causes. On average, hospitalizations with a primary diagnosis of HF had 3.9 comorbidities, most commonly chronic ischemic heart disease (IHD), atrial fibrillation and flutter, diabetes, renal failure, etc.; 1.7 times greater for HF than for all causes. Conclusions HF has a high in-hospital mortality rate particularly among the elderly and is associated with many cardiac and noncardiac conditions. HF necessitates long hospital stays, which increases the burden on the health care system in Canada.

Galloway-Mowat syndrome is a rare condition that is likely hereditary though the underlying offending gene has not been identified, and is characterized by microcephaly and severe nephrotic syndrome culminating in childhood death. Some of the reported cases have abnormalities in neuronal migration and intractable seizures, but many of the described cases focus on the renal pathology and emphasize a diversity of clinical and pathological features. The case described herein includes a thorough neuropathological description, and when the neuroradiology and neuropathology of the previously published cases is scrutinized, a fairly consistent clinical and neuropathological phenotype emerges.

Most of the time care provided to people in the National Health Service (NHS) and by other care providers such as those in the independent and voluntary sectors is of a high standard with positive outcomes. However, things do go wrong from time to time and complaints are made. This article provides an understanding of how concerns and complaints should be managed in health and social care settings, with the aim to make the organisation that employs Health Care Assistants (HCA) and Assistant Practitioners (AP) an organisation that listens, responds and learns from peoples' experiences, these can be in the form of compliments, complaints or concerns. The article focuses primarily upon the NHS and England. Health and social care providers in other countries of the United Kingdom may have their own complaints procedures as do the independent and voluntary sectors, nevertheless the principles discussed here can apply across the board.

Many child protection practitioners struggle with the complexity of problems and the limited casework time for adolescent cases. However, there is little research on child protection practice or case management that can guide a practitioner working with adolescents in the child protection system. The aim of this study was to explore and describe the nature of effective child protection practice with adolescents from the perspective of statutory child protection practitioners in one state in Australia. Data were collected through focus group discussions and interviews with child protection practitioners and managers currently working with adolescents (n= 44). A grounded theory approach was used to identify the dominant themes or categories and form linkages and relationships through constant comparison techniques. Seven key categories emerged from this analysis: characteristics of the young person and their family; ‘walking it together’– the centrality of relationships; ‘looking back/looking forward’– practice strategies; practitioner attributes and skills; ‘walking a fine line’– working with the families of adolescents; ‘walking with services’– effective inter‐agency work; and organizational context in effective child protection practice with adolescents. Key implications for practice and areas for further research were discussed.

We identified hospitalizations throughout Canada during 2000–2005 in which the most responsible diagnosis was a proximal femoral fracture. Use of the US fracture risk assessment tool (FRAX) would be inappropriate for Canada as it would overestimate fracture risk in Canadian women and older men. It is recommended that the WHO fracture risk assessment tool should be calibrated to the target population. We identified hospitalizations for women and men throughout Canada during the study period 2000–2005 in which the most responsible diagnosis was a proximal femoral fracture (147,982 hip fractures). Age-standardized hip fracture rates were compared between Canadian provinces, and national rates were compared with those reported for the USA and Germany. There were relatively small differences in hip fracture rates between provinces, and most did not differ appreciably from the Canadian average. Hip fracture rates for women in Canada in 2001 were substantially lower than in the USA (population-weighted rate ratio 0.70) and were also lower than in Germany for 2004 (population-weighted rate ratio 0.74). Overall hip fracture rates for Canadian women were found to be substantially lower than those for the USA and Germany. This study underscores the importance of assessing country-specific fracture patterns prior to adopting an existing FRAX tool.

The thickest development of Carboniferous Limestone in Great Britain (about 1200 m) is in the Pembroke Peninsula of SW Wales. In various places, the regularity of the normally well-stratified limestone is broken by zones of disturbance, which are spectacularly displayed in magnificent near-vertical cliff sections. The zones generally occupy the whole of the 50 m-high cliffs and are up to 300 m wide. The chief component of these zones is a chaotic, clast-supported breccia, composed of angular limestone fragments welded together with varying degrees of firmness by sparry calcite veining or a normally sparse, red-pink sandy or silty matrix. The breccias are very easy to distinguish and form a striking contrast to the grey cliff scenery hereabouts (Figs 1, 2), yet they have not been discussed much—until now. Figure 1. Location map, showing localities mentioned in the text, the outcrop of the Carboniferous Limestone, the chief synclinal axes and the distribution envelope of the Gash Breccias (after Thomas 1971). 1. Flimston Bay; 2. Bullslaughter Bay (west); 3. Bullslaughter bay (east); 4. Trevallen; 5. Box Bay; 6. Draught; 7. Whitesheet Rock; 8. Lydstep Point; 9. St Margaret's Point; 10. Den Point; 11. Valleyfield Top; 12. Pembroke Castle. Download figure to PowerPoint Figure 2. The St Margaret's Point Gash (SS 119 974), viewing ESE along the Variscan strike direction. The contact is planar and faithfully follows a bedding plane in the Carboniferous Limestone succession. An exposure of the ‘undersurface’ of the breccia mass, examined by boat, displays a faint oblique slickensiding, which is inclined to the east at c. 30°. The height of the cliff at the junction is about 30 m. The breccia can be traced intermittently along the northern coast of St Margaret's Island for a distance of 220 m but it is not known where lie the northern, eastern and western boundaries beneath Caldey Sound. The air photograph reveals that either the southern boundary of this Gash is irregular, with sharp, near-right-angled indentations, or the Gash is affected by later cross faulting. Dixon records that the breccia mass is at least 45 m ‘thick’ so the implied minimum volume of this mass is c. 300 000 m3. Download figure to PowerPoint

Shared services arrangements in the Australian third sector are becoming more common. Notably, however, there is a lack of information to guide nonprofit organisations through the development and engagement of shared structures. This article reviews the lessons that have been recorded from the public and private sectors with respect to the engagement of shared services arrangements. Additionally this article explores the different types of shared services structures that can be adopted. Overall, this article highlights the need for further research and analysis of issues relating to shared services arrangements in order to assist the increasing number of Australian nonprofit organisations engaging these collective arrangements and structures.

Neurophysiological techniques have a long history of clinical and research use in the setting of Multiple Sclerosis. With the output of evoked potential and electroencephalographic recordings being a direct consequence of the underlying functional integrity and activity of the nervous system it is unsurprising there is currently a resurgent interest in their possible use as biomarkers of disease related dysfunction. Herein we discuss the promise and possible pitfalls associated with their use in translational research of MS therapeutics. The numerous advantages of these methods are touched upon as demonstrated by their application to date. A number of obstacles which must be overcome prior to their successful widespread implementation are also outlined and readily achievable solutions discussed.

The Ravensworth North Coal Handling and Preparation Plant Project was completed in late 2013 and it was designed to wash a wide range of coals. This paper describes the design and establishment of the facilities, in a difficult brownfields environment, and some learnings from subsequent operations. Stage 1 of the project included modifications and debottlenecking of the existing coal preparation facilities and the addition of a new raw coal system including crushing and raw coal stacking/reclaiming which linked the existing Ravensworth Open Cut ROM to the Ravensworth Coal Terminal (RCT). In Stage 2 of the project an 1800 t/h, two module extension to the existing CPP was constructed, along with an additional product stockpile and tunnel reclaim system. The processes used at Ravensworth include dense medium cyclones for the -50 + 1.4 mm (ww) coal and spirals for the -1.4 + 0.15 mm coal. The remaining slimes are treated in refurbished high rate thickeners. The plant has now been operating for two years and there have been a number of process and operational improvements.

This article describes how on the MSc Coastal Zone Management (CZM) course a range of teaching strategies have been used to bridge the gap between academia and practice in order to develop students who are well equipped for the workplace. The content and delivery of the course has been guided by practitioners in the field, including placement host and employers, to ensure that skills development is embedded into the curriculum. Examples of best practices are discussed with the view to providing recommendations for postgraduate level courses requiring a fine balance of academic content and vocational relevance.

This paper describes an alternative way to control the selection of items in computing devices. A survey of the issues of the current state-of-the art is performed and a solution is presented based on a cheap, head-mounted, IR sensitive camera tracking IR LEDs. Benefits related to this approach are indicated, initial performance results are presented from which we can conclude the feasibility of the proposed solution.

There is increasing pressure being placed on government agencies both in Australia and internationally to act in a more collaborative, integrated manner. Community and welfare programs are being conducted in new “shared” or “whole‐of‐government” ways, which pose a challenge to traditional models of public sector reporting. Existing accountability mechanisms are designed for vertical accountability relationships, and these are inadequate for horizontal or “networked” accountability across government agencies. This paper uses the case of the Community Renewal Program based in the Queensland state government department to illustrate the problems which arise when reporting on “shared” programs. The paper offers a different approach to improve reporting and accountability for shared programs.

DnaJ is a molecular chaperone and the prototypical member of the J-protein family. J proteins are defined by the presence of a J domain that can regulate the activity of 70-kDa heat-shock proteins. Sequence analysis on the genome of Saccharomyces cerevisiae has revealed 22 proteins that establish four distinguishing structural features of the J domain: predicted helicity in segments I–IV, precisely placed interhelical contact residues, a lysine-rich surface on helix II and placement of the diagnostic sequence HPD between the predicted helices II and III. We suggest that this definition of the J-protein family could be used for other genome-wide studies. In addition, three J-like proteins were identified in yeast that contain regions closely resembling a J domain, but in which the HPD motif is non-conservatively replaced. We suggest that J-like proteins might function to regulate the activity of bona fide J proteins during protein translocation, assembly and disassembly.

This study evaluates the characteristics of photoparoxysmal responses elicited with intermittent photic stimulation during a routine electroencephalogram in childhood and correlated this with the clinical profile of the child. Photoparoxysmal responses occurred in 8% (21/263) of children where activation was undertaken. Photoparoxysmal responses were often brief and had a variable onset latency. This study suggests increasing the duration of the stimulus train to 10 seconds or more will increase the diagnostic yield. Photoparoxysmal responses very rarely outlasted the stimulus, and self-limited photoparoxysmal responses probably have greater significance than previously attributed to them. They are highly correlated with epilepsy.

Lacosamide (LCM) is a novel anti-epileptic drug (AED) that enhances the slow inactivation of voltage-gated sodium channels. Its efficacy as adjunctive therapy for focal seizures is confirmed in adult placebo controlled trials with50% reduction in seizure frequency in up to 50% patients. There is paucity of data on its efficacy and tolerance in treatment-resistant epilepsy in childhood (TREC). This study aims to assess efficacy and tolerance of LCM as adjunct therapy in TREC.Audit of medical records and seizure diaries in children with TREC on LCM. A response (RR) was defined as ≥50% reduction in seizure frequency.Forty children (age range: 2-19 years) with TREC received LCM as add-on therapy. All had abnormal electroencephalograms, and 36 had abnormal neuroimaging. All children failed2 AED trials, nine had trialled the ketogenic diet, five had failed the vagal nerve stimulator and 11 had failed resective epilepsy surgery. Median dose and duration of LCM therapy were 5.7 mg/kg/day and 10.5 months, respectively. RR was seen in 20% with persistence of RR in 8/36, 8/30 and 8/26 children on LCM at 3-, 6- and 9-month follow-up. Two children became seizure free. Retention on LCM was 65% at 9 months. LCM was well tolerated with minor side effects in seven children; no child discontinued LCM because of side effects.LCM is a well-tolerated AED with RR in 20%: in 5%, it resulted in seizure freedom. LCM may be useful even in TREC when seizures have not responded to intervention with multiple modalities.

Objectives - To study the efficacy, tolerability and safety of the vagus nerve stimulation (VNS) therapy in clinical practice, in 16 children and adolescents with refractory epilepsy Methodology - We assessed the efficacy of VNS therapy, retrospectively by comparing seizure frequency, duration and severity at the time of most recent follow up (av: 24.9 months) to that in the 4 weeks prior to VNS surgery. Changes in quality of life, sleep and behaviour at last review was compared with that prior to VNS. Adverse effects elicited by specific questioning, spontaneous reporting and clinical examination are described. Results - Vagus nerve stimulation resulted in a > 50% reduction in seizure frequency in 62.5% of children with 25% achieving a > 90% % reduction. Vagus nerve stimulation was well tolerated in all hut one of our cohort, with no serious side-effects. Conclusion - Our results support its role as one of the options in intractable childhood epilepsy.

Many hundreds of solution pipes are exposed in quarries near Staszow, SE Poland. The pipes are contained in late Badenian (middle Miocene) carbonates of the Chmielnik Formation and are filled with sediment derived from a weathered Sanian (Elsterian) till cover. The pipes average 1 m3 in volume, though the largest is of the order of 15 m3. The average depth is 1.9 m; the average diameter, 0.6 m. The host limestone is fractured by several sets of open master joints, but, in respect of the way inclined pipes cross the joints without deflection in vertical exposures, and the absence of x-axis elongation along master joints in plan, the evidence is unequivocal that the structural fabric of the host-rock had little, if any, influence in determining pipe locus and form. Neither is there any evidence that irregularities of the interface between host and cover determined the points of entry for the focused groundwater flows which created the individual pipes. Therefore, unless the entry points into the upper surface of the limestone host were determined by an irregular network of first-to-decay channels in a relict permafrost zone at the end of the Elsterian cold period, for which there is no independent evidence, the focused flows must relate to selectively permeable pathways through the till cover and/or to concentrations of acid radicals there. Small quantities of organic carbon in the pipe cortices hint at the former presence of an appreciable content of peat in the till cover at the time of piping; this could have been the source of the acidic groundwater flows. The Staszow piping represents a covered, intraformational palaeokarst system. It is postulated that it developed as a product of fast-acting deglaciation and, possibly also, of irregular permafrost decay below the Elsterian till, early in the Holsteinian warm period.

The notion of place management is emerging in public sector discourse as a potential solution to improve governments' responses to issues confronting local communities, particularly those experiencing high levels of economic and social disadvantage. Despite the increased currency of the term, there is a degree of confusion surrounding what it actually means. And it is not always clear what is meant by the notion of ‘place’. This article attempts to clarify a working definition of ‘place management’ and to explore the policy and administrative implications for governments in adopting a place management approach.

We present a case of recurrent vago-glossopharyngeal neuralgia after previous surgery, treated successfully with microvascular decompression using intra-operative neurophysiology monitoring.