Archive for January 2018

Somewhat off topic   Leave a comment

June 15, 2017  Source


LARO-mottagningar erbjuder personer som är beroende av opioider, som till exempel heroin, en läkemedelsassisterad behandling som består av narkotika.

Behandlingen bygger på frivillighet, den medicinska behandlingen kompletteras med samtal, stöd och rådgivning.

Opioider är ett samlingsnamn för droger och läkemedel som påverkar hjärnan på ett liknande sätt.äke

Allvarliga brister vid mottagning för missbrukare

Allvarliga brister har konstaterats vid en beroendemottagning i Helsingborg. Kliniken får kritik för att skriva ut stora mängder ångestdämpande läkemedel. Mottagningen rättar sig nu efter kritiken, men oroar sig för vad förändringen innebär för patienterna.

Flera av patienterna som besöker LARO-mottagningen i Helsingborg har både missbruksproblem och problem med psykisk ohälsa. Därför har mottagningen skrivit ut ångestdämpande bensodiazepiner, som också är beroendeframkallande.

Detta har skett i alldeles för stor utsträckning enligt Region Skåne som nu kritiserar mottagningen för allvarliga patientsäkerhetsbrister. Enligt enhetschefen har läkemedlen skrivits ut för att få bättre kontroll på patientens medicinering.

– Vi har velat jobba med en långsam nedtrappning där vi hjälper patienterna på vägen samtidigt som man trappar ner medicinen, säger Carolina Nostell, sjuksköterska och enhetschef på LARO Öresund.

Var är din farhåga om patienterna inte  får ångestdämpande läkemedel utskrivet av er?

– Att de köper detta själva på stan och att det blir en ökad dödlighet för att de känner en frustration att de inte får hjälp. Eller att de självmedicinerar med hemmatillverkade tabletter.

Ser ingen annan lösning

Mottagningen har enligt kritiken inte följt rekommendationerna för behandling av psykisk ohälsa i kombination med missbruk. Ångestdämpande bensodiazepiner och läkemedel för att ersätta bland annat heroin har lett till långvarigt höga doser istället för nedtrappning.

Carolina Nostell har  svårt att se någon annan, bättre lösning med de resurser som finns. Avgiftningen som finns i Malmö känns inte alltid som ett alternativ.

– Det är två månaders väntetid och avgiftningen är bara tio dagar. Man gör en fysisk avgiftning, sen står de kvar med sina problem. Det finns ingen slutenvård i nuläget som kan hjälpa de här patienterna om de mår dåligt, därför har vi blivit tvungna att göra det i öppenvården.

”Det gör ont”

Mottagningen rättar sig nu efter kritiken, trots oro för vad det kommer innebära för patienterna. Carolina Nostell hoppas att det ska klargöras hur personer med både missbruksproblem och psykisk ohälsa ska få hjälp i vården.

– Det som regionen säger går före det patienten vill ha hjälp med, det gör ont. Men jag hoppas vi kan jobba tillsammans med att skapa riktlinjer för vad som ska gälla, man måste våga diskutera de här frågorna.

Mottagningen får också kritik för att bristande läkemedelshantering och för ett självmord som mottagningen inte anmält enligt lex Mariah. Det senare är nu gjort och mottagningen har skärpt övriga rutiner.

Senast i slutet av augusti måste mottagningen visa upp en förbättring, annars ska Region Skåne överväga att säga upp avtalet med mottagningen.

LARO-MOTTAGNIING:

LARO-mottagningar erbjuder personer som är beroende av opioider, som till exempel heroin, en läkemedelsassisterad behandling som består av narkotika.

Behandlingen bygger på frivillighet, den medicinska behandlingen kompletteras med samtal, stöd och rådgivning.

Opioider är ett samlingsnamn för droger och läkemedel som påverkar hjärnan på ett liknande sätt.


 

Fotnot: I nuläget har Carolina Nostell sålt versamheten

France implements new six-year Wolf Plan   7 comments

January 3, 2018 by 

Starting this month, France implements their new National Action Plan 2018-2023 for wolves and livestock owners. The plan focuses on the support for herd protection measures, regulation of the wolf population, and providing of information and training to a target audience. The return of the wolf is a hot debated topic in France. Farmers demand more killing of wolves, while NGOs want to limit the shootings. Effective herd management, including protective measures such as electric fences and guard dogs, provide a likely solution to this problem. The European Wilderness Society is currently finalising the first edition of an international Best Practice Handbook on herd management in Europe. This handbook can provide local livestock owners with detailed Best practice examples from 7 different European Countries on effective protection measures. Besides France, a common strategy for coexistence with wolves and sheepherding has been developed in Germany.

Please also read: Shepherds, hunters, farmers and NGOs agree on common wolf strategy

A closer look

The first priority of the French Wolf Plan is a balance between the ecological and pastoral stakes. It considers a number of 500 wolves for a viable wolf population in France. Also, it stresses that effective defense of herds is necessary, with electric fences and guard dogs, or by shooting if wolf attacks on protected herds continue. Besides a clear support for herd protection measures and compensation of losses, implementation of population ‘control’ by annual killing is also part of the plan. Furthermore, it focuses on education and training to increase knowledge on the wolf’s behaviour and risks for livestock owners.

See hear why the Forest and hunting Departments of Switzerland welcome the return of the wolves.

 Supporting livestock owners

Important is the continued support for herd protection, as the Wolf Plan states. Studies proved that herd management is more effective than killing wolves. By developing a financial scheme, the plan will provide assistance to livestock owners for implementation of protection measures. It aims to advice and support the owners on implementation of protection and adaptations to new developments. Furthermore, the plan will establish a ‘guard dog network’, to facilitate guard dogs that are effective against predation, but not aggressive towards third parties. Additionally, the government will create a ‘technical support brigade’ to implement protection for newly attacked herds.

Financial support

The plan even supports the livestock owners and shepherds by financing pastoral huts, access to water and electricity, and better accommodation conditions. Compensation for losses due to a wolf attack are only paid when livestock owners have proper herd protection measures in place. Validation of protection measures and wolf presence are therefore essential.

Allowed killing of wolves

Following scientists’ advice, the plan allows hunters to kill 10-12% of the wolf population each year. According to the latest estimate, there are approximately 400 wolves in France. The quota of wolves that people can kill in 2018 is therefore 40. NGOs tried to stop the wolf hunts, which they claim as ‘political killing’. Earlier this year, the government allowed killing of 3 young wolves. Farmers who protect their animals gain the right to fire a gun as a defensive measure. Warning shots or scaring the animal is not mandatory. Also for herds that suffered from attacks at least three times in the last 12 months, it is now easier to gain defensive shooting rights. However, the plan does not allow killing of wolves from September to December.

Sharing information and knowledge

The Wolf Plan updates the existing communication strategy, to focus more on local involvement and provision of information. It targets all relevant stakeholders and the general public. The plan will develop new training curricula for farming schools to increase awareness and acceptance towards the wolf. Through the support of various studies, the Wolf Plan tries to improve the recognition towards shepherds, and the coexistence of wolf and livestock. It will assess the current vulnerable territories and the impact of wolves on the ecosystem.

The French Wolf Plan also states that cross-border and international collaboration should be strengthened to achieve shared ecological objectives. This also supports the exchange of knowledge and experiences regarding the coexistence between wolves and livestock farming.

What can we expect?

The Wolf Plan has ambitious targets to help livestock owners with financial, technical, and informative support to protect their animals. With this plan, the French government is showing the willingness to support both farmers and the wolf. It is now up to the French farmers to show equal willingness for coexistence. For the wolves, it looks like 1 in 10 will have to fear for it’s life every year. It remains unclear what the Wolf Plan recommends when wolf numbers exceed 500 individuals in France. At least according to the European Commission, the wolf remains a protected species, despite continued requests for legal hunting in Europe. It is often a misconception that hunting protects sheeps. On the contrary, hunting can often increase the depredation since killing a wolf in a wolf pack can cause the wolf pack to break up creating 5 and sometimes more individual wolves. Studies show, that individual wolves are much more inclined to attack livestock than wolf packs. Also the wolf plan ignores the many positive side effects of the return of the wolves to the rejuvenation of the forests and the natural education of the pressure on forests by deer and wild boar.

Find the French National Action Plan 2018-2023 for the wolf here:

VIDEO:  https://issuu.com/europeanwildernesssociety/docs/plan_detaille_pna_loup_2018-2022_ve


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