Making Federal Financial Data More Reliable With Emerging Tech

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Long-term conditions, self-management and systems of support::An exploration of health beliefs and practices within the Sikh community, Birmingham, UK

Objective. The global prevalence of non-communicable diseases (NCDs), such as diabetes mellitus and coronary heart disease, continues to rise. Internationally, people of South Asian origin (i.e. by birth or heritage) are much more likely to develop and live with NCDs compared to the general population. The South Asian diaspora population is highly heterogeneous, varying by socioeconomic status, migration history, religion and ethnicity. This article reports the findings of a study to explore the types of support accessed by Punjabi Sikhs living in Birmingham and the Black Country, UK, who were living with NCDs. Design. The study sought to develop a greater understanding of past experiences of accessing support and the importance of relationships in the mobilisation of resources for self-management. It was nested within a larger programme of research which explored attitudes to prevention of chronic diseases in local communities in the region. Seventeen Punjabi Sikh men and women were recruited through purposive sampling. Narrative interviews were conducted and analysed by the research team. Sociological theories on systems of support and social relations were consulted to inform the interpretation of data. Results. The study findings suggest that participants interpreted chronic disease self-management in relation to four primary systems of support: health services for disease management; multiple sources of care, including traditional Indian medicines and the Internet, for symptom management; community groups for lifestyle management; and the family for emotional and physical care. Within these systems of support, participants identified barriers and facilitators to the maintenance of a healthy lifestyle. We focus on intra-group diversity; exploring the intersection of views and experiences by age, gender, generation and caste. Conclusion. The findings have implications for the design and delivery of primary care and community services which support the prevention and management of NCDs in an increasingly diverse population

Making Federal Financial Data More Reliable With Emerging Tech

Excerpt from the Proceedings of the Nineteenth Annual Acquisition Research SymposiumFederal agencies are stewards of billions in taxpayer funds. Given the scale of federal financial transactions, maintaining reliable, high-quality financial data can be challenging. The use of emerging technologies such as robotic process automation (RPA) and natural language processing can reduce manual work for agency employees and improve the consistency of financial data. These technologies are key to success on financial audits and maintaining public confidence in the reliability of procurement and nonprocurement financial information.Approved for public release; distribution is unlimited

Methodological challenges of cross-language qualitative research with South Asian communities living in the UK

Objective: We investigate (1) the influence of ethnic, gender, and age concordance with interviewers and (2) how expression of qualitative data varies between interviews delivered in English and community languages (Punjabi/Urdu) with monolingual and bilingual participants across three generations of the Indian Sikh and Pakistani Muslim communities living in the UK. Methods: We analyzed and interpreted semi-structured interview transcripts that were designed to collect data about lifestyles, disease management, community practices/beliefs, and social networks. First, qualitative content analysis was applied to transcripts. Second, a framework was applied as a guide to identify cross-language illustrations where responses varied in length, expression and depth. Results: Participant responses differed by language and topic. First-generation migrants when discussing religion, culture, or family practice were far likelier to use group or community narratives and give a longer response, indicating familiarity with or importance of such issues. Ethnic and gender concordance generated greater rapport between researchers and participants centered on community values and practices. Further, open-ended questions that were less direct were better suited for first-generation migrants. Conclusion: Community-based researchers need more time to complete interviews in second languages, need to acknowledge that narratives can be contextualized in both personal and community views, and reframe questions that may lead to greater expression. Furthermore, we detail a number of recommendations with regard to validating the translation of interviews from community languages to English as well as measures for testing language proficiency

From meadows to milk to mucosa – adaptation of Streptococcus and Lactococcus species to their nutritional environments

Lactic acid bacteria (LAB) are indigenous to food-related habitats as well as associated with the mucosal surfaces of animals. The LAB family Streptococcaceae consists of the genera Lactococcus and Streptococcus. Members of the family include the industrially important species Lactococcus lactis, which has a long history safe use in the fermentative food industry, and the disease-causing streptococci Streptococcus pneumoniae and Streptococcus pyogenes. The central metabolic pathways of the Streptococcaceae family have been extensively studied because of their relevance in the industrial use of some species, as well as their influence on virulence of others. Recent developments in high-throughput proteomic and DNA-microarray techniques, in in vivo NMR studies, and importantly in whole-genome sequencing have resulted in new insights into the metabolism of the Streptococcaceae family. The development of cost-effective high-throughput sequencing has resulted in the publication of numerous whole-genome sequences of lactococcal and streptococcal species. Comparative genomic analysis of these closely related but environmentally diverse species provides insight into the evolution of this family of LAB and shows that the relatively small genomes of members of the Streptococcaceae family have been largely shaped by the nutritionally rich environments they inhabit.

Building social capital through breastfeeding peer support: Insights from an evaluation of a voluntary breastfeeding peer support service in North-West England

Background: Peer support is reported to be a key method to help build social capital in communities. To date there are no studies that describe how this can be achieved through a breastfeeding peer support service. In this paper we present findings from an evaluation of a voluntary model of breastfeeding peer support in North-West England to describe how the service was operationalized and embedded into the community. This study was undertaken from May, 2012 to May, 2013. Methods: Interviews (group or individual) were held with 87 participants: 24 breastfeeding women, 13 peer supporters and 50 health and community professionals. The data contained within 23 monthly monitoring reports (January, 2011 to February 2013) compiled by the voluntary peer support service were also extracted and analysed. Results: Thematic analysis was undertaken using social capital concepts as a theoretical lens. Key findings were identified to resonate with ’bonding’, ‘bridging’ and ‘linking’ forms of social capital. These insights illuminate how the peer support service facilitates ‘bonds’ with its members, and within and between women who access the service; how the service ‘bridges’ with individuals from different interests and backgrounds, and how ‘links’ were forged with those in authority to gain access and reach to women and to promote a breastfeeding culture. Some of the tensions highlighted within the social capital literature were also identified. Conclusions: Horizontal and vertical relationships forged between the peer support service and community members enabled peer support to be embedded into care pathways, helped to promote positive attitudes to breastfeeding and to disseminate knowledge and maximise reach for breastfeeding support across the community. Further effort to engage with those of different ethnic backgrounds and to resolve tensions between peer supporters and health professionals is warranted

Finding Common Ground: relational concepts of land tenure and economy in the oil palm frontier of Papua New Guinea

In the oil palm frontier regions of West New Britain and Oro provinces, Papua New Guinea, customary land tenure arrangements are changing in response to the growing demand for land for agricultural development. This paper examines one aspect of these changes, namely the gifting and selling of customary land for oil palm development to people who have no customary birthrights to the land. By analysing how access rights are maintained over the relatively long cultivation cycle of oil palm (approximately 25 years), and in the context of the rapidly changing socio-economic and demographic environments of the oil palm frontiers, the paper demonstrates that while land transactions seemingly entail the commodification of land, land rights and security of land tenure remain embedded in social relationships. For customary landowners, the moral basis of land rights is contingent on ‘outsiders’ maintaining particular kinds of social and economic relationships with their customary landowning ‘hosts’. In exploring how these social relationships are constituted through the performance of particular kinds of exchange relationships, the paper provides insights into relational concepts of land rights and how these are able to persist in Papua New Guinea's oil palm frontier regions where resource struggles are often intense and where large migrant populations are seeking land for agricultural development

Cultural adaptation of a children's weight management programme for Bangladeshi and Pakistani families in the UK. A cluster-randomised feasibility study

AbstractBackground: Group-based children’s weight management programmes are widely available in the UK and evidence shows that these are effective in the short-term. No programmes have been specifically developed to meet the cultural requirements of UK minority ethnic communities. South Asian children are a high-risk group for obesity and its consequences; therefore, the study aim is to adapt an existing weight management programme for children aged 4-11 years and their families to ensure cultural relevance to Pakistani and Bangladeshicommunities, and undertake a feasibility study of the adapted programme.Methods/design: Pakistani and Bangladeshi families of overweight children who have been offered the existing children’s weight management programme in Birmingham, UK, will be invited to interviews and focus groups to explore their experiences and views of the programme. These data, together with existing literature and service provider information, will inform adaptation of the programme to be more culturally relevant to these families.The feasibility study will employ a cluster-randomised design, and will assess success of programme adaptation and feasibility of programme delivery. Planned programmes will be randomised to be delivered as the adapted programme (intervention) or the standard programme (comparator) with a 2:1 ratio. The primary outcome will be the proportion of Pakistani and Bangladeshi families completing the adapted programme. To assess recruitment, retention and data collection methods to inform a future trial, we aim to recruit 80 participants. A range of assessments will be undertaken with participants pre-, post- and 6-months post-intervention.Discussion: This study addresses the identified need to provide children’s weight management programmes that are suitable for minority ethnic communities. Whilst the focus of the intervention adaptation is on Pakistani and Bangladeshi communities, the programme will be developed to be flexibly delivered to meetthe cultural needs of communities of all ethnic compositions. The feasibility study will directly compare the adapted and existing weight management programmes, and will enable a comprehensive evaluation of the success of the adaptation. Essential information will also be gathered to inform the design and sample size calculation of a future trial to evaluate intervention effectiveness.Trial registration: ISRCTN81798055, registered: 13/05/2014.Keywords: Obesity, Children, Treatment, Weight management, Pakistani, Bangladesh

Rethinking global governance? Complexity, authority, power, change

Global governance remains notoriously slippery. While the term arose to describe change in the late twentieth century, its association with that specific moment has frozen it in time and deprived it of analytical utility. It has become an alternative moniker for international organizations, a descriptor for an increasingly crowded world stage, a call to arms, an attempt to control the pernicious aspects of globalization, and a synonym for world government. This article aims not to advance a theory of global governance but to highlight where core questions encourage us to go. A more rigorous conception should help us understand the nature of the contemporary phenomenon as well as look “backwards” and “forwards.” Such an investigation should provide historical insights as well as prescriptive elements to understand the kind of world order that we ought to be seeking and encourage us to investigate how that global governance could be realized

Assets-based infant feeding help Before and After birth: a randomised controlled feasibility trial for improving breastfeeding initiation and continuation

Background The UK has low levels of breastfeeding initiation and continuation, with evident socioeconomic disparities. To be inclusive, peer support interventions should be woman-centred rather than breastfeeding-centred. Assets-based approaches to public health focus on positive capabilities of individuals and communities, rather than their deficits and problems. The Assets-based feeding help Before and After birth (ABA) intervention offers an assets-based approach based on behaviour change theory. Objective To investigate the feasibility of delivering the ABA infant feeding intervention within a randomised controlled trial. Design Individually randomised controlled feasibility trial; women randomised on a 1:1 ratio to either the intervention or the comparator (usual care). Setting Two separate English sites, selected for having an existing breastfeeding peer support service, relatively high levels of socioeconomic disadvantage, and low rates of breastfeeding. Participants Women aged 16 years or older, pregnant with their first child, irrespective of feeding intention (n=103), recruited by researchers in antenatal clinics. Intervention Proactive, woman-centred support, using an assets-based approach and including Behaviour Change Techniques, provided by an Infant Feeding Helper (a breastfeeding peer supporter trained in ABA intervention), delivered through face-to-face contact, telephone conversations and text messages. The intervention commenced at around 30 weeks gestation and could continue until 5 months postnatally. Main outcome measures Feasibility of intervention delivery with the requisite intensity and duration; acceptability to women, Infant Feeding Helpers and maternity services; feasibility of a future randomised controlled trial. Outcomes included recruitment rates and follow up rates at 3 days, 8 weeks and 6 months postnatal, with collection of outcomes for a future full trial via participant questionnaires. A mixed methods process evaluation included qualitative interviews with women, Infant Feeding Helpers and maternity services; Infant Feeding Helper logs; and audio recordings of antenatal contacts to check intervention fidelity. Results Of 135 eligible women approached, 103 (76.3%) agreed to participate. The study was successful in recruiting teenagers (8.7%) and women living in areas of socioeconomic disadvantage (37.3% resided in the most deprived 40% of small areas in England). Postnatal follow up rates were 68.0%, 85.4% and 80.6% at 3 days, 8 weeks and 6 months respectively. Feeding status at 8-weeks was obtained for 95.1% of participants. Recruitment took place February-August 2017. It was possible to recruit and train existing peer supporters to the Infant Feeding Helper role. The intervention was delivered with relatively high fidelity to most women. Of 50 women, 39 received antenatal visits and 40 postnatal support. Qualitative data showed the intervention to be acceptable. There was no evidence of intervention-related harms. Limitations Birth notification delays resulted in delays in collection of postnatal feeding status data, and the offer of postnatal support. In addition, the intervention needs to better consider all infant feeding types and did not adequately accommodate women who delivered prematurely. Conclusions It is feasible to deliver the intervention and trial. Future work The intervention should be tested in a fully powered randomised controlled trial. Study registration ISRCTN1476097