Evidence-based primary health care and local research: a necessary but problematic partnership

Background: Front-line NHS staff undertake small research projects to answer questions about local patients and services, but these projects often face considerable challenges. This paper reports on one such project. Aims and methods of study:The study used structured interviews in order to find out about the knowledge of nutrition among Bangladeshis using an NHS Walk-in Centre. Development of the study: Time constraints posed considerable difficulties in progressing and completing the study; flaws in the methodology emerged; and underpinning assumptions about health promotion and ethnic minority health beliefs were open to challenge. Learning from the study: Despite this, some findings were valuable and have considerable potential as a stimulus to critical thinking among practitioners about their own attitudes, as well as raising issues that future research would find it useful to address

Scientific mindfulness: a foundation for future themes in international business

We conceptualize new ways to qualify what themes should dominate the future IB research agenda by examining three questions: Whom should we ask? What should we ask and which selection criteria should we apply? What are the contextual forces? We propose scientific mindfulness as the way forward for generating themes in IB research

Why Are There So Few Female Leaders in Higher Education: A Case of Structure or Agency?

A significant gender imbalance remains at executive management level within higher education despite a number of initiatives to increase the number of women in the leadership pipeline and ensure they are better prepared for these roles. This article presents findings from a recent study on the appointment of deputy and pro vice chancellors in pre-1992 English universities that provide fresh insights into why this might be the case. These findings challenge the notion of women’s missing agency - characterised by a lack of confidence or ambition and a tendency to opt out of applying for the top jobs - as an explanation for their continued under-representation. Rather, they highlight the importance of three structural factors associated with the selection process: mobility and external career capital, conservatism, and homosociability. An approach of ‘fixing’ the women is therefore unlikely to be sufficient in redressing the current gender imbalance within university executive management teams

The Iowa Homemaker vol.26, no.7

Five-Pound Party Planning, Ruth Hackett, page 2 Homemaking Under the Round Roof, Shirliann Fortmann, page 3 Home Economists Look to New Horizons, Katherine Goeppinger, page 4 Graduate Studies Solve Research Questions, Marjorie Clampitt, page 5 Headlines Challenge Home Economists, Eloise Davison, page 6 Both Sides of the Pacific, Margaret Waterland, page 7 Wardrobe Accompaniments Chase Winter Blues, Jean Bunge, page 8 Home Economics Journeys from Iowa State to China, Jean Ory, page 9 What’s New, Marjorie Clampitt, page 10 Shoe Care Means Longer Wear, Charlene Stettler, page 11 Counselling Homemakers is Fun, Sue Marie Schreiber, page 12 Glamour is Her Business, Mary Margaret Ryan, page 13 Notions for Campus and Home, Margaret Buswell, page 14 ’46 Graduate Combines College and Career, Beverly Seig, page 15 Keeping Up With Today, Joyce Edgar, page 1

Exploring access to end of life care for ethnic minorities with end stage kidney disease through recruitment in action research

BACKGROUND: Variation in provision of palliative care in kidney services and practitioner concerns to provide equitable access led to the development of this study which focussed on the perspectives of South Asian patients and their care providers. As people with a South Asian background experience a higher risk of Type 2 Diabetes (T2DM) and end stage kidney failure (ESKF) compared to the majority population but wait longer for a transplant, there is a need for end of life care to be accessible for this group of patients. Furthermore because non English speakers and people at end of life are often excluded from research there is a dearth of research evidence with which to inform service improvement. This paper aims to explore issues relating to the process of recruitment of patients for a research project which contribute to our understanding of access to end of life care for ethnic minority patients in the kidney setting. METHODS: The study employed an action research methodology with interviews and focus groups to capture and reflect on the process of engaging with South Asian patients about end of life care. Researchers and kidney care clinicians on four NHS sites in the UK recruited South Asian patients with ESKF who were requiring end of life care to take part in individual interviews; and other clinicians who provided care to South Asian kidney patients at end of life to take part in focus groups exploring end of life care issues. In action research planning, action and evaluation are interlinked and data were analysed with emergent themes fed back to care providers through the research cycle. Reflections on the process of patient recruitment generated focus group discussions about access which were analysed thematically and reported here. RESULTS: Sixteen patients were recruited to interview and 45 different care providers took part in 14 focus groups across the sites. The process of recruiting patients to interview and subsequent focus group data highlighted some of the key issues concerning access to end of life care. These were: the identification of patients approaching end of life; and their awareness of end of life care; language barriers and informal carers' roles in mediating communication; and contrasting cultures in end of life kidney care. CONCLUSIONS: Reflection on the process of recruitment in this action research study provided insight into the complex scenario of end of life in kidney care. Some of the emerging issues such as the difficulty identifying patients are likely to be common across all patient groups, whilst others concerning language barriers and third party communication are more specific to ethnic minorities. A focus on South Asian ethnicity contributes to better understanding of patient perspectives and generic concepts as well as access to end of life kidney care for this group of patients in the UK. Action research was a useful methodology for achieving this and for informing future research to include informal carers and other ethnic groups.Peer reviewedFinal Published versio

Household Food Security Data Consensus Statement

Food insecurity in Australia is increasing, but a lack of consistent, regular monitoring and reporting of food insecurity using comprehensive, validated tools is limiting timely intervention. Regular monitoring is urgently needed from state/ territory and federal governments. Reporting of the prevalence of household food security needs to reflect levels of severity (marginal, moderate and severe food insecurity) in each state and territory across Australia. Commonly used short tools comprising one or two questions are inadequate for assessing the true prevalence of food insecurity and result in serious underestimation. The United States Department of Agriculture (USDA) 18-item Household Food Security Survey Module (HFSSM) should be adopted across settings to provide the most valid, internationally comparable data on food insecurity for both adults and children

US Scientific Leadership Addressing Energy, Ecosystems, Climate, and Sustainable Prosperity: Report in Brief from the BERAC Subcommittee on International Benchmarking

This document presents the subcommittee’s overarching and domain-specific findings and recommendations for the next decade, identified by consensus across the full BERAC subcommittee and experts interviewed for this assessment

Delivering stepped care: an analysis of implementation in routine practice

addresses: Mood Disorders Centre, University of Exeter, Exeter, EX4 4QG, UK. [email protected]: PMCID: PMC3283464types: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't© 2012 Richards et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.In the United Kingdom, clinical guidelines recommend that services for depression and anxiety should be structured around a stepped care model, where patients receive treatment at different 'steps,' with the intensity of treatment (i.e., the amount and type) increasing at each step if they fail to benefit at previous steps. There are very limited data available on the implementation of this model, particularly on the intensity of psychological treatment at each step. Our objective was to describe patient pathways through stepped care services and the impact of this on patient flow and management

Diversity of Beetle Genes Encoding Novel Plant Cell Wall Degrading Enzymes

Plant cell walls are a heterogeneous mixture of polysaccharides and proteins that require a range of different enzymes to degrade them. Plant cell walls are also the primary source of cellulose, the most abundant and useful biopolymer on the planet. Plant cell wall degrading enzymes (PCWDEs) are therefore important in a wide range of biotechnological processes from the production of biofuels and food to waste processing. However, despite the fact that the last common ancestor of all deuterostomes was inferred to be able to digest, or even synthesize, cellulose using endogenous genes, all model insects whose complete genomes have been sequenced lack genes encoding such enzymes. To establish if the apparent “disappearance” of PCWDEs from insects is simply a sampling problem, we used 454 mediated pyrosequencing to scan the gut transcriptomes of beetles that feed on a variety of plant derived diets. By sequencing the transcriptome of five beetles, and surveying publicly available ESTs, we describe 167 new beetle PCWDEs belonging to eight different enzyme families. This survey proves that these enzymes are not only present in non-model insects but that the multigene families that encode them are apparently undergoing complex birth-death dynamics. This reinforces the observation that insects themselves, and not just their microbial symbionts, are a rich source of PCWDEs. Further it emphasises that the apparent absence of genes encoding PCWDEs from model organisms is indeed simply a sampling artefact. Given the huge diversity of beetles alive today, and the diversity of their lifestyles and diets, we predict that beetle guts will emerge as an important new source of enzymes for use in biotechnology