Use of the kidney failure risk equation to inform clinical care of patients with chronic kidney disease: a mixed-methods systematic review

Rationale and objective The Kidney Failure Risk Equation (KFRE) predicts the risk of end-stage kidney disease in patients with chronic kidney disease (CKD). This study aimed to evaluate the impact of the utility of KFRE in clinical practice. Study design Systematic review. Setting and study populations Adult patients with CKD but not receiving renal replacement therapy enrolled in studies where KFRE was used in clinical care pathways. Selection criteria for studies All studies published from April 2011 to October 2021 identified from Medline, Cumulative Index to Nursing and Allied Health Literature, Embase and reference and citation searches of included studies. Data extraction Relevant data were extracted, and two reviewers independently assessed study quality using appropriate appraisal tools. Analytical approach Findings reported as a narrative synthesis due to heterogeneity of the included studies. Results Of 1635 studies identified, 440 duplicates were removed. The remaining 1195 titles and abstracts were screened. All five studies for full-text review were included in the analysis. Three uses of KFRE were assessed: (1) primary to specialty care interface; (2) general nephrology to multidisciplinary care transition; and (3) treatment planning. Evidence of impact on number of patient referrals into nephrology care was conflicting. However, wait times improved in one study. Although KFRE identified high-risk patients for increased multidisciplinary support, there was concern patients stepped down, no longer meeting eligibility criteria, may lack access to services. Conclusions This is the first systematic review of studies that have assessed the actual impact of KFRE in clinical practice with five studies of varying quality reported to date. Trials are in progress assessing the impact on clinical outcomes of using KFRE in clinical practice, and KFRE is being incorporated into guidelines for CKD management. Further studies are needed to assess the impact of KFRE on clinical care. Trial registration number Protocol registered on PROSPERO before initiation of the study (Ref: CRD42020219926)

Ogbu and the debate on educational achievement: an exploration of the links between education, migration, identity and belonging

This paper looks at some of the issues raised by Ogbu’s work in relation to the education of different minority ethnic groups. Ogbu poses questions such as the value attached to education, its links to the future and its measurable outcomes in terms of ‘success’ as experienced by black participants. The desire for better life chances leads families to consider migration to a new country or resettlement within the same country, thus making migration both a local and a global phenomenon. As an example, attention is drawn to the situation facing South Asian children and their families in the UK. In terms of ethnicity and belonging, the wider question that is significant for many countries in the West after ‘Nine-Eleven’ is the education of Muslim children. A consideration of this current situation throws Ogbu’s identification of ‘autonomous minority’ into question. It is argued that a greater understanding of diverse needs has to be accompanied by a concerted effort to confront racism and intolerance in schools and in society, thus enabling all communities to make a useful contribution and to avoid the ‘risk’ of failure and disenchantment

Diasporic virginities: social representations of virginity and identity formation amongst British arab muslim women

This study compares how practising and non-practising British Arab Muslim women position themselves in relation to representations of virginity. Overall, in our qualitative study, we found that representations of culture and religion influenced social practices and social beliefs in different ways: non-practising Muslim women felt bound by culture to remain virgins, while practising Muslim women saw it as a religious obligation but were still governed by culture regarding the consequences of engaging in premarital sex. Interestingly, some practising Muslim participants used Mut’a (a form of temporary ‘marriage’) to justify premarital sex. This, however, did not diminish the importance of virginity in their understanding and identification as Arab women. In fact, this study found that virginity, for the British Arabs interviewed, embodied a sense of ‘Arabness’ in British society. Positioning themselves as virgins went beyond simply honour; it was a significant cultural symbol that secured their sense of cultural identity. In fact this cultural identity was often so powerful that it overrode their Islamic identities, prescribing their behaviour even if religion was seen as more ‘forgiving’

Awareness and understanding of dementia in South Asians: A synthesis of qualitative evidence

Hossain, M., Crossland, J., Stores, R., Dewey, A., & Hakak, Y. (2020). Awareness and understanding of dementia in South Asians: A synthesis of qualitative evidence. Dementia, 19(5), 1441–1473. Copyright © [2020] (The Author) DOI: https://doi.org/10.1177%2F147130121880064

Multifunctional P-Doped TiO 2

Multifunctional P-doped TiO2 thin films were synthesized by atmospheric pressure chemical vapor deposition (APCVD). This is the first example of P-doped TiO2 films with both P5+ and P3– states, with the relative proportion being determined by synthesis conditions. This technique to control the oxidation state of the impurities presents a new approach to achieve films with both self-cleaning and TCO properties. The origin of electrical conductivity in these materials was correlated to the incorporation of P5+ species, as suggested by Hall Effect probe measurements. The photocatalytic performance of the films was investigated using the model organic pollutant, stearic acid, with films containing predominately P3– states found to be vastly inferior photocatalysts compared to undoped TiO2 films. Transient absorption spectroscopy studies also showed that charge carrier concentrations increased by several orders of magnitude in films containing P5+ species only, whereas photogenerated carrier lifetimes—and thus photocatalytic activity—were severely reduced upon incorporation of P3– species. The results presented here provide important insights on the influence of dopant nature and location within a semiconductor structure. These new P-doped TiO2 films are a breakthrough in the development of multifunctional advanced materials with tuned properties for a wide range of applications

The Diasporic Pursuit of Home and Identity: Dynamic Punjabi Transnationalism

This paper examines the pursuit of home within a diasporic British Indian Punjabi community. It is argued that the British Asian transnational pursuit of home is significantly shaped by the dynamic social context of South Asia as well as social processes within Britain and across the South Asian diaspora. Drawing upon a decade of original, transnational, ethnographic research within the UK and India, I analyze the rapidly changing social context of Punjab, India, and the impact of this upon the diasporic Punjabi pursuit of home. I particularly argue that increasing divisions between the UK diasporic group studied and the non migrant permanent residents of Punjab, which are intrinsically related to processes of inclusion and exclusion within Punjab, especially the changing role and significance of land ownership and changing consumption practices therein, in turn connected to the increasing influence of economic neoliberalization and global consumer culture within India, significantly shapes the (re)production of home and identity amongst the Punjabi diaspora. Recent manifestations of these social processes within Punjab are threatening the very lived Indian home of some diasporic Punjabis, their Indian ‘roots’

Marriage and Migration through the Life Course: Experiences of Widowhood, Separation and Divorce amongst Transnational Sikh Women

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Inequality in access to local environments: the experiences of Asian and non-Asian girls

The growing emphasis on building healthy public policy draws attention to social and environmental inequalities in health, including the impact of racism and crime. This study reports on questionnaire and focus group research with a sample of 214 Year 7 and Year 9 girls (11-14 years old), of whom just under half were of Asian origin. The findings highlighted considerable differences between the attitudes and behaviour reported by Asian-origin and non-Asian girls. The problems encountered in managing hostile urban environments were seen as significantly greater by Asian-origin girls and fears about assault and harassment resulted in restricted access and a home-focused style of life. They reported restrictions on their physical activity, and some degree of frustration about their lack of freedom, which have policy implications for health promoters