21 research outputs found

    Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups

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    BACKGROUND: Conventional systematic review techniques have limitations when the aim of a review is to construct a critical analysis of a complex body of literature. This article offers a reflexive account of an attempt to conduct an interpretive review of the literature on access to healthcare by vulnerable groups in the UK METHODS: This project involved the development and use of the method of Critical Interpretive Synthesis (CIS). This approach is sensitised to the processes of conventional systematic review methodology and draws on recent advances in methods for interpretive synthesis. RESULTS: Many analyses of equity of access have rested on measures of utilisation of health services, but these are problematic both methodologically and conceptually. A more useful means of understanding access is offered by the synthetic construct of candidacy. Candidacy describes how people's eligibility for healthcare is determined between themselves and health services. It is a continually negotiated property of individuals, subject to multiple influences arising both from people and their social contexts and from macro-level influences on allocation of resources and configuration of services. Health services are continually constituting and seeking to define the appropriate objects of medical attention and intervention, while at the same time people are engaged in constituting and defining what they understand to be the appropriate objects of medical attention and intervention. Access represents a dynamic interplay between these simultaneous, iterative and mutually reinforcing processes. By attending to how vulnerabilities arise in relation to candidacy, the phenomenon of access can be better understood, and more appropriate recommendations made for policy, practice and future research. DISCUSSION: By innovating with existing methods for interpretive synthesis, it was possible to produce not only new methods for conducting what we have termed critical interpretive synthesis, but also a new theoretical conceptualisation of access to healthcare. This theoretical account of access is distinct from models already extant in the literature, and is the result of combining diverse constructs and evidence into a coherent whole. Both the method and the model should be evaluated in other contexts

    The Utility of Scatter Feeding as Enrichment: Do Broiler Chickens Engage with Scatter–Fed Items?

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    In recent years, welfare certification companies have encouraged the use of scatter feeding as enrichment material, though there is little scientific evidence to support a scatter feeding program. This study aimed to understand the impact of scatter feeding on the foraging behavior of broilers. One hundred eighty Ross 308 chicks were allocated into six treatment groups (six replicates/treatment). Broilers were scatter fed dried mealworms, whole wheat, shredded cabbage, alfalfa pellets, wood shavings, or no scatter feeding, respectively. Enrichment was provided on the first three days of each week. Total foraging, active foraging, and feeding were observed for one-hour periods immediately after scattering, 2 h later, and 6 h later. In all groups, broilers increased both total (p = 0.001) and active (p = 0.001) foraging, though this was most pronounced in the dried mealworm group. Across all groups, active foraging decreased with age (p = 0.001). The mealworm group also showed a corresponding decrease in feeding during hour one compared to the later hours (p = 0.001). These results did not provide evidence that scatter feeding encourages foraging behavior, except for a short-term effect of a high value feed item. This finding suggests that the item scattered and the delivery method should be studied further

    Intervention programmes in mathematics and literacy: teaching assistants’ perceptions of their training and support

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    We approach the recent argument put in this journal that teaching assistants (TAs) should be more strongly trained, monitored and supervised when teaching on intervention programmes. We suggest that the argument sits uneasily with 10 wider management and educational literature. We examine TAs’ experience of delivering important intervention programmes in mathematics and literacy. TAs report considerable variation in both their training and the quality of management involvement in their teaching. Consequently, we argue for an approach that includes TAs in a form of distributed leadership which recognises their specific 15 capabilities rather than the model advocated both by government documents and some researchers

    Pullet Rearing Affects Collisions and Perch Use in Enriched Colony Cage Layer Housing

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    Hens reared in aviaries (AVI) as pullets have improved spatial abilities compared to hens reared in non-enriched cages (CON). However, this effect on behavior has been shown only to 23 weeks of age. Lohmann LSL-Lite hens were reared in either CON or AVI until 19 weeks of age and then moved into enriched colony cages (ECC) containing two elevated perches of different heights (n = 6 ECC/treatment). Focal hens (3 per ECC) were fitted with tri-axial accelerometers to record acceleration events at 21, 35, and 49 weeks of age. Video recordings from each age were used to identify behaviors associated with acceleration events as well as the proportion of hens utilizing perches. CON hens experienced more acceleration events (p = 0.008) and more collisions (p = 0.04) than AVI hens during the day at 21 and 35 weeks of age. The total proportion of hens perching at night was similar between treatments across most time points, but fewer CON hens used the high perch compared to AVI hens throughout the study (p = < 0.001). Rearing in aviaries influences hen behavior out to peak lay for collisions and out to mid-lay for perch height preference in ECC

    Providing elevated structures in the pullet rearing environment affects behavior during initial acclimation to a layer aviary

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    ABSTRACT: Spatial abilities of hens are particularly sensitive to development during early life. Experiences in pullet housing may have lasting consequences on adult hens’ movements in cage-free environments. We tested whether opportunities to access elevated spaces during rearing improved hens’ use of a multitiered aviary. Female Dekalb White pullets were reared in either floor pens (FL), single-tiered aviaries (ST), or 2-tiered aviaries (TT; n = 5 pens/environment) through 16 wk of age. Rearing structures were replaced with identical multitiered aviaries at 17 wk. The distribution of the flock within the aviary and the vertical transitions of 10 focal hens/pen across the aviary were determined from videos recorded during their first (D1) and seventh (D7) day of aviary access, as well as at 19, 23, and 27 wk of age. Prevalence of floor eggs was recorded weekly from 17 to 28 wk of age. On D1, more ST and TT hens utilized the aviary during the daytime (P = 0.0077), made more vertical transitions when searching for a roosting spot in the evening (P = 0.0021), and maintained a consistent distance traveled during transitions compared to FL hens (P = 0.02). These differences disappeared by D7, except that ST and TT hens continued to roost on the highest perches of the aviary more (P < 0.0001) than FL hens through 27 wk of age. FL hens laid more floor eggs than ST and TT hens for the first 2 wk of lay (P < 0.0001). The majority (97.9%) of vertical transitions was controlled. Uncontrolled transitions were highest at D1 and decreased by D7 (P = 0.0009) and were not affected by rearing (P = 0.33). The results suggest that hens reared with minimal height are hesitant to use the laying hen aviaries when they are first transferred. They acclimate within 1 to 2 wk, but continue to roost less in the highest accessible level
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