Emerging communities of child-healthcare practice in the management of long-term conditions such as chronic kidney disease: Qualitative study of parents' accounts

Background: Parents of children and young people with long-term conditions who need to deliver clinical care to their child at home with remote support from hospital-based professionals, often search the internet for care-giving information. However, there is little evidence that the information available online was developed and evaluated with parents or that it acknowledges the communities of practice that exist as parents and healthcare professionals share responsibility for condition management. Methods. The data reported here are part of a wider study that developed and tested a condition-specific, online parent information and support application with children and young people with chronic-kidney disease, parents and professionals. Semi-structured interviews were conducted with 19 fathers and 24 mothers who had recently tested the novel application. Data were analysed using Framework Analysis and the Communities of Practice concept. Results: Evolving communities of child-healthcare practice were identified comprising three components and several sub components: (1) Experiencing (parents making sense of clinical tasks) through Normalising care, Normalising illness, Acceptance & action, Gaining strength from the affected child and Building relationships to formalise a routine; (2) Doing (Parents executing tasks according to their individual skills) illustrated by Developing coping strategies, Importance of parents' efficacy of care and Fear of the child's health failing; and (3) Belonging/Becoming (Parents defining task and group members' worth and creating a personal identity within the community) consisting of Information sharing, Negotiation with health professionals and Achieving expertise in care. Parents also recalled factors affecting the development of their respective communities of healthcare practice; these included Service transition, Poor parent social life, Psycho-social affects, Family chronic illness, Difficulty in learning new procedures, Shielding and avoidance, and Language and cultural barriers. Health care professionals will benefit from using the communities of child-healthcare practice model when they support parents of children with chronic kidney disease. Conclusions: Understanding some of the factors that may influence the development of communities of child-healthcare practice will help professionals to tailor information and support for parents learning to manage their child's healthcare. Our results are potentially transferrable to professionals managing the care of children and young people with other long-term conditions. © 2014 Carolan et al.; licensee BioMed Central Ltd

NASA Lewis 8 by 6 foot supersonic wind tunnel

Performance data are presented for the tunnel, which has a Mach number range from 0.36 to 2.0. The tunnel circuit, test section, model support systems, auxiliary systems, instrumentation, control room equipment, and automatic recording and computing equipment are also described. Information is presented on criteria for designing models and on shop facilities available to prospective users

TOWARD ASSESSING THE NON-MARKET BENEFITS OF EXPERIMENT STATION RESEARCH: A CASE STUDY OF PUBLIC PREFERENCES FOR AES RESEARCH IN RHODE ISLAND

This study reports on a survey assessment of the public preferences for the Rhode Island Agricultural Experiment Station's research program. The study summarizes preferences to allocate effort to alternative research projects and estimates the public's willingness to pay to maintain or increase research effort.Teaching/Communication/Extension/Profession,

Water, women and local social organization in the Western Kenya highlands

Safe water is widely recognized as both a fundamental human need and a key input into economic activity. Across the developing world, the typical approach to addressing these needs is to segregate supplies of water for domestic use from water for large-scale agricultural production. In that arrangement, the goal of domestic water supply is to provide small amounts of clean safe water for direct consumption, cleaning, bathing and sanitation, while the goal of agricultural water supply is to provide large amounts of lower quality water for irrigated agriculture. A new third use of water is now being given more attention by researchers: small amounts of water employed in selected household enterprises. This third use may be particularly important for women. There is a potential, therefore, that provision of modest amounts of water to smallholder farmers can enhance household economic production, save labor time for women and girls, and improve family health. This paper adds to the merger literature on the multiple values of improved water supplies – improved health, time savings, and small-scale production for individual farmers and collectives – for the case of a rural community in the western highlands of Kenya. With minimum external support, two groups in this community have managed to install and operate systems of spring protection and piped water to their members’ homesteads. A third group is in the process of replicating this success. The experience of this community also illustrates some of the challenges that must be faced for a community to effectively selforganize the investment and maintenance of a community-based water scheme. There are challenges of finance, gender relations, conflicts over scarce water supplies, group leadership, enforcement of community bi-laws, and policy. Data from a census of springs in the same area show that successful collective action for water management is unusual, but certainly not unique, in this region of Kenya. Although women emerge as the main beneficiaries of improved water management in the community, their substantial contributions are largely hidden behind social norms regarding gender roles and relations. Research methods need to carefully triangulate information sources in order to clarify the very substantial and active roles performed by women.Length: 21p.WomenGenderWater supplyWater rightsHealthCollective actionParticipatory management

The conditions for functional mechanisms of compensation and reward for environmental services

Mechanisms of compensation and reward for environmental services (CRES) are becoming increasingly contemplated as means for managing human–environment interactions. Most of the functional mechanisms in the tropics have been developed within the last 15 years; many developing countries still have had little experience with functional mechanisms. We consider the conditions that foster the origin and implementation of functional mechanisms. Deductive and inductive approaches are combined. Eight hypotheses are derived from theories of institution and policy change. Five case studies, from Latin America, Africa, and Asia, are then reviewed according to a common framework. The results suggest the following to be important conditions for functional CRES mechanisms: (1) localized scarcity for particular environmental services, (2) influence from international environmental agreements and international organizations, (3) government policies and public attitudes favoring a mixture of regulatory and marketbased instruments, and (4) security of individual and group property rights