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Background: Concerns have been raised about the use/misuse of tobacco and alcohol by people with mild/moderate intellectual disabilities. Aiming to address an identified gap in the current evidence base, this study sought to gain an understanding of the tobacco- and alcohol-related health promotion needs of this client group. Methods: Informed by the principles of social cognitive theory, data were collected using focus group and telephone interviews. Participants were 16 people with intellectual disabilities, two family carers and 15 health and social care professionals. Data were analysed using the Framework approach. Findings: Four themes were described: being like others; social and emotional influences; understandings, misunderstandings and learning from experience; and choices and challenges. Reasons for smoking and drinking alcohol echoed those of the general population; however, health promotion needs were more complex (e.g. linked to problems with consequential thinking; low levels of self-efficacy). Conclusion: This article provides insight into the tobacco- and alcohol-related health promotion needs of people with intellectual disabilities. There is a need for integrated service provision that addresses both personal and environmental influences on behaviour.

This article contends that university continuing education is in need of a dramatic repositioning in the minds and wallets of most university administrations. In order to respond both to a developed economy's need for the continuous upgrading of skills and knowledge and to universities' needs for new funding sources, the provision of lifelong education and training--lifelong learning--needs to be strategically central to a university's vision, mission, and goals. Right now, in its non-degree form, it is a peripheral activity making only minor contributions to universities' reputation and revenue: according to the Association of Universities and Colleges of Canada in its 2008 report "Trends in Higher Education--Volume 3: Finance," only $300 million was earned by universities in noncredit courses. This had not changed much in a decade. Canadian universities are missing out on opportunities in reputation, revenue, and relevance, both domestically and globally. The article goes on to suggest the steps needed in the development of an effective lifelong learning strategy. Some would require changes in university management processes and philosophy to be effective, but continuation of the present half-hearted approach will not succeed in serving either Canada's lifelong learning needs or its universities' needs for relevance and revenue. (Contains 1 table.)

In the context of globalization and policies to promote free trade on an international scale, this paper discusses what has happened to artisans in Quito, Ecuador, over the past 30 years. The trends of conservation and decline have not been uniform over time and they have not affected all micro-firms in the same way. There has been a long-term process of restructuring and decline of these producers and they have clearly suffered from national and international free trade policies. This has resulted in levels of alienation, xenophobia and racism that are likely to have negative political consequences. Key words--Latin America, Ecuador, informal sector, artisans, globalization, free trade

Abstract Introduction Ankle arthrodesis is primarily undertaken to control severe pain in the ankle joint. Immediate postoperative pain is usually treated using oral analgesics, intravenous opiates and regional anaesthesia. The outcomes of ankle fusion, including patient satisfaction studies, are well documented in the literature. However, the advantage of popliteal block in the management of early postoperative pain after ankle fusion for osteoarthritis has not been widely reported. This study aims to determine the role of popliteal block using ankle fusion in the management of ankle osteoarthritis. Case presentation Ankle arthrodeses were performed in 27 patients over a five-year period. Eighteen patients were males (one had bilateral arthrodesis) and eight were females. Their mean age was 56 years and they were all Caucasians. The notes and radiographs of the patients were reviewed in retrospect for the duration of their hospital admission, time to union and complications. Conclusion Popliteal block is a safe and effective technique for postoperative analgesia in ankle arthrodesis. By using this technique, we achieved a significant reduction in the duration of hospital stay for our patients after ankle arthrodesis. The resultant cost saving was GBP717 for each patient.

Background Concerns have been raised about the use/misuse of tobacco and alcohol by people with mild/moderate intellectual disabilities. Aiming to address an identified gap in the current evidence base, this study sought to gain an understanding of the tobacco- and alcohol-related health promotion needs of this client group. Methods Informed by the principles of social cognitive theory, data were collected using focus group and telephone interviews. Participants were 16 people with intellectual disabilities, two family carers and 15 health and social care professionals. Data were analysed using the Framework approach. Findings Four themes were described: being like others; social and emotional influences; understandings, misunderstandings and learning from experience; and choices and challenges. Reasons for smoking and drinking alcohol echoed those of the general population; however, health promotion needs were more complex (e.g. linked to problems with consequential thinking; low levels of self-efficacy). Conclusion This article provides insight into the tobacco- and alcohol-related health promotion needs of people with intellectual disabilities. There is a need for integrated service provision that addresses both personal and environmental influences on behaviour. [ABSTRACT FROM AUTHOR]