Getting Better by Design: Evaluation of a programme to support the voluntary sector in Scotland

Better by Design was developed in 2013 by the Big Lottery Fund Scotland in response to the complex and changing landscape for voluntary sector organisations delivering services on the ground with people or communities. It aimed to support a process of change, and prioritised organisations focusing on social care, employability, health and housing where intervening earlier or preventing needs emerging could make a real difference. The programme encouraged sustainability in the widest sense to enable organisations to meet the needs of their beneficiaries better now and in the future.The chance to learn in this way and the challenge to habitual ways of thinking and doing, have made a significant change to mindsets in a number of organisations and at times, brought a new quality of engagement in partnership settings. This report shows that design-led approaches do have a great deal to contribute in creating the new organisational cultures of collaboration and mutual learning necessary for public service reform

What can we do with our stories? Reflections from the Faroes

In my efforts to refresh my social theory and develop new perspectives on evaluation I recently attended a social constructivism conference on Communication, Collaboration and Relationships in the Faroe Islands[1].  I’d been alerted to this opportunity by one of the organisers, Gro Emmertsen Lund, a Danish organisational consultant and author with a shared interest in reshaping evaluation (Lund, 2011).  As a freelance action researcher, this was my annual dose of CPD.  Like many people from the UK, this was new territory for me and I couldn’t resist the location and the conference aims to ‘increase the motivation and the joy of learning, teaching, leading and serving’ and ‘bring public services into synchrony with emerging world conditions’.  One of the keynote speakers was Ken Gergen who, amongst his many writings, articulates a vision of the researcher as an active agent in fashioning the future and research as a form of social action (Gergen, 2014).  &nbsp

Improved synchronous production of Plasmodium falciparum gametocytes in vitro.

The sexual stages of the Plasmodium falciparum life cycle are attractive targets for vaccines and transmission blocking drugs. Difficulties in culturing and obtaining large amounts of sexual stage P. falciparum parasites, particularly early stages, have often limited research progress in this area. We present a new protocol which simplifies the process of stimulating gametocytogenesis leading to improved synchronous gametocyte production. This new method can be adapted to enrich for early stage gametocytes (I and II) with a higher degree of purity than has previously been achieved, using MACS magnetic affinity columns. The protocol described lends itself to large scale culturing and harvesting of synchronous parasites suitable for biochemical assays, northern blots, flow cytometry, microarrays and proteomic analysis

Caring Conversation Framework to promote person centred care:synthesising qualitative findings from a multi- phase programme of research

Background Little is known about how to support practitioners to enhance their interpersonal conversations to be more compassionate, person centred and relational with others. The Caring Conversations (CC) framework was empirically derived to address this issue and comprises seven attributes (be courageous, connect emotionally, be curious, consider other perspectives, collaborate, compromise and celebrate). Objective This paper synthesises the qualitative findings from a multi-phase programme of research, which implemented the CC framework across a variety of health and social care settings (acute hospitals, community, and residential care). It explores the perceived impact of the CC framework on staff and their practice. Methods Secondary analysis was conducted on the qualitative findings in the final reports of 5 studies, involved in the implementation of the CC framework. Results The analysis showed consistent positive outcomes for staff in their interactions with patients, families and others; including greater self-awareness during interactions, development of stronger relationships, and more open dialogue that supports relational practice. The secondary analysis confirmed the applicability of the framework across a number of different settings, strengthened confidence in its value, generated fresh insights to inform further research, and developed a deeper insight into the attributes of the framework and its application. Conclusions Policy and research advocate compassionate care and relational practice, but do not state how this can be delivered in practice. By synthesising the findings from 5 studies undertaken in a variety of different settings, we can be more confident in the value of the CC framework to ensure best practice

Variability in the Heritability of Body Mass Index: A Systematic Review and Meta-Regression

Evidence for a major role of genetic factors in the determination of body mass index (BMI) comes from studies of related individuals. Despite consistent evidence for a heritable component of BMI, estimates of BMI heritability vary widely between studies and the reasons for this remain unclear. While some variation is natural due to differences between populations and settings, study design factors may also explain some of the heterogeneity. We performed a systematic review that identified 88 independent estimates of BMI heritability from twin studies (total 140,525 twins) and 27 estimates from family studies (42,968 family members). BMI heritability estimates from twin studies ranged from 0.47 to 0.90 (5th/50th/95th centiles: 0.58/0.75/0.87) and were generally higher than those from family studies (range: 0.24–0.81; 5th/50th/95th centiles: 0.25/0.46/0.68). Meta-regression of the results from twin studies showed that BMI heritability estimates were 0.07 (P = 0.001) higher in children than in adults; estimates increased with mean age among childhood studies (+0.012/year, P = 0.002), but decreased with mean age in adult studies (−0.002/year, P = 0.002). Heritability estimates derived from AE twin models (which assume no contribution of shared environment) were 0.12 higher than those from ACE models (P < 0.001), whilst lower estimates were associated with self reported versus DNA-based determination of zygosity (−0.04, P = 0.02), and with self reported versus measured BMI (−0.05, P = 0.03). Although the observed differences in heritability according to aspects of study design are relatively small, together, the above factors explained 47% of the heterogeneity in estimates of BMI heritability from twin studies. In summary, while some variation in BMI heritability is expected due to population-level differences, study design factors explained nearly half the heterogeneity reported in twin studies. The genetic contribution to BMI appears to vary with age and may have a greater influence during childhood than adult life

Mendelian Randomisation Study of Childhood BMI and Early Menarche

To infer the causal association between childhood BMI and age at menarche, we performed a mendelian randomisation analysis using twelve established “BMI-increasing” genetic variants as an instrumental variable (IV) for higher BMI. In 8,156 women of European descent from the EPIC-Norfolk cohort, height was measured at age 39–77 years; age at menarche was self-recalled, as was body weight at age 20 years, and BMI at 20 was calculated as a proxy for childhood BMI. DNA was genotyped for twelve BMI-associated common variants (in/near FTO, MC4R, TMEM18, GNPDA2, KCTD15, NEGR1, BDNF, ETV5, MTCH2, SEC16B, FAIM2 and SH2B1), and for each individual a “BMI-increasing-allele-score” was calculated by summing the number of BMI-increasing alleles across all 12 loci. Using this BMI-increasing-allele-score as an instrumental variable for BMI, each 1 kg/m2 increase in childhood BMI was predicted to result in a 6.5% (95% CI: 4.6–8.5%) higher absolute risk of early menarche (before age 12 years). While mendelian randomisation analysis is dependent on a number of assumptions, our findings support a causal effect of BMI on early menarche and suggests that increasing prevalence of childhood obesity will lead to similar trends in the prevalence of early menarche

Storage of legacy print collections: the views of Australasian university librarians

This paper reports on the results of a qualitative survey conducted with seven managers of university libraries from Australia and New Zealand. The purpose of the survey was to explore both library responses to, and librarians’ attitudes towards, issues related to the long-term storage and management of legacy print collections. There is a focus on issues related to future planning for print storage, including the prospects for collaborative storage; the balance between on-site and off-site storage; the impact of mass-digitisation programs; and the desirability of collaboration outside the university library sector

Mendelian Randomisation Study of Childhood BMI and Early Menarche.

To infer the causal association between childhood BMI and age at menarche, we performed a mendelian randomisation analysis using twelve established "BMI-increasing" genetic variants as an instrumental variable (IV) for higher BMI. In 8,156 women of European descent from the EPIC-Norfolk cohort, height was measured at age 39-77 years; age at menarche was self-recalled, as was body weight at age 20 years, and BMI at 20 was calculated as a proxy for childhood BMI. DNA was genotyped for twelve BMI-associated common variants (in/near FTO, MC4R, TMEM18, GNPDA2, KCTD15, NEGR1, BDNF, ETV5, MTCH2, SEC16B, FAIM2 and SH2B1), and for each individual a "BMI-increasing-allele-score" was calculated by summing the number of BMI-increasing alleles across all 12 loci. Using this BMI-increasing-allele-score as an instrumental variable for BMI, each 1 kg/m(2) increase in childhood BMI was predicted to result in a 6.5% (95% CI: 4.6-8.5%) higher absolute risk of early menarche (before age 12 years). While mendelian randomisation analysis is dependent on a number of assumptions, our findings support a causal effect of BMI on early menarche and suggests that increasing prevalence of childhood obesity will lead to similar trends in the prevalence of early menarche.Peer Reviewe

How being appreciative creates change – theory in practice from health and social care in Scotland

This paper develops understanding of appreciative action research that generates curiosity and motivation as a better platform for collaborative change. Blending theory and practice it draws on the example of the My Home Life leadership programme in Scotland that explores the concepts and approaches of ‘Caring Conversations’ and ‘playful provocation’ in care homes for older people. The paper shows how they expand notions of appreciation and help people to deepen inquiry, explore values, acknowledge and express emotion without dispute or judgement, articulate tacit knowledge and give voice to things previously thought to be ‘unsayable’. We explore how these generative approaches act as a powerful positive ‘disruption’ that brings existing relationships to life, supports a positive attitude to risk-taking and helps to devise new approaches to the local design and testing of approaches to problems. Ultimately these approaches play an important part in developing understanding of how to do appreciative action research to enhance relationships and more strengths or assets-based and collaborative ways of working and so, to develop new possibilities for changing social systems and a more future-making orientation to action research