Can the hospices survive the market? A financial analysis of palliative care provision in Scotland.

Hospices are undergoing changes in the way they are funded by health boards as a result of the change to a contract-setting regime in the NHS. This may have implications for the overall funding position of the hospices; particularly there is a concern as to whether charitable giving to these bodies will decrease as a result. Analyses the accounts of Scottish voluntary sector hospices over the transition period as a means of identifying any such changes. Finds no immediate threat to the continued functioning of the hospices, on a financial basis.

Manual handling of supplies in free and restricted headroom.

The handling of mining supplies still involves manual lifting and carrying, some of which is, of necessity, carried out in restricted headroom conditions. Laboratory studies previously reported in the literature have shown that a reduction in ceiling height led to a progressive increase in truncal stress as measured by intra-abdominal pressure (IAP). However, such studies involved standard stylised lifting procedures. Whether such effects of restricted headroom occurred when free-style lifting, or if the operator compensated by change in lifting style for the restriction, was not known. The effect of reduced headroom was examined on two handling tasks carried out in a simulated underground roadway using eight mining instructors as subjects. Both handling tasks involved the loading, unloading and carrying of stonedust bags (25-30 kg) into different vehicle types. The expected increase in IAP did not occur in the reduced headroom condition for one handling task and only a slight increase (average 3 mm Hg), corresponding to a 7% reduction in lifting capacity, was found for the second handling task. It appears that the subjects, who were free to adopt any posture and handling method, were able to compensate in some way for the effects of the restricted headroom. The vehicle type had a highly significant effect, both in free and restricted headroom conditions, which highlights the importance of design for manual handling tasks.

Intra-abdominal pressure responses of mineworkers to standard loads.

Intra-abdominal pressure (IAP) has been used as the basis for a series of force limits for manual handling based on a limiting pressure criterion of 12 kPa (90 mm Hg). Measurements of the IAP responses to a series of standard loads were carried out on a group of eight instructors from the British coal mining industry. The results showed that there was a very low probability (.0016 or less) of obtaining an IAP value of 12 kPa or greater from the population represented by our sample. Average responses were 33% lower than would have been expected from previous reports on force limits based on IAP measurements. While more data are necessary in order to confirm the applicability of these findings to the general mining population, the results clearly suggest that greater loads could safely be lifted by mineworkers than can be lifted by the industrial population represented by the guidelines.