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

Centerscope

Centerscope, formerly Scope, was published by the Boston University Medical Center "to communicate the concern of the Medical Center for the development and maintenance of improved health care in contemporary society.

BMQ

BMQ: Boston Medical Quarterly was published from 1950-1966 by the Boston University School of Medicine and the Massachusetts Memorial Hospitals

2: Donor-Recipient Host-Versus-Graft Human Leukocyte Antigen Mismatches and Outcome of Cord Blood Transplants

Digitalitzat per Artypla

2016 AAPP Monograph Series: African American Professors Program

The African American Professors Program (AAPP) at the University of South Carolina is honored to publish this fifteenth edition of its annual monograph series. AAPP recognizes the significance of offering scholars a venue through which to engage actively in research and to publish their refereed papers. Parallel with the publication of their manuscripts is the opportunity to gain visibility among colleagues throughout postsecondary institutions at national and international levels. Scholars who have contributed papers for this monograph are acknowledged for embracing the value of including this responsibility within their academic milieu. Writing across disciplines adds to the intellectual diversity of these manuscripts. From neophytes to quite experienced individuals, the chapters have been researched and written in depth. Founded in 1997 through the Department of Educational Leadership and Policies in the College of Education, AAPP was designed originally to address the under-representation of African American professors on college and university campuses. Its mission is to expand the pool of these professors in critical academic and research areas. Sponsored historically by the University of South Carolina, the W.K. Kellogg Foundation, and the South Carolina General Assembly, the program recruits doctoral students for disciplines in which African Americans currently are underrepresented among faculty in higher education. The continuation of this monograph series is seen as responding to a window of opportunity to be sensitive to academic expectation of graduates as they pursue career placement and, at the same time, to allow for the dissemination of products of scholarship to a broader community. The importance of this series has been voiced by one of our 2002 AAPP graduates, Dr. Shundelle LaTjuan Dogan, formerly an Administrative Fellow at Harvard University, a Program Officer for the Southern Education Foundation, and a Program Officer for the Arthur M. Blank Foundation in Atlanta, Georgia. She is currently a Corporate Citizenship and Corporate Affairs Manager for IBM-International Business Machines in Atlanta, Georgia and has written the Foreword for the 2014 monograph. Dr. Dogan wrote: One thing in particular that I want to thank you for is having the African American Professors Program scholars publish articles for the monograph. I have to admit that writing the articles seemed like extra work at the time. However, in my recent interview process, organizations have asked me for samples of my writing. Including an article from a published monograph helped to make my portfolio much more impressive. You were \u27right on target\u27 in having us do the monograph series. (AAPP 2003 Monograph, p. xi) The African American Professors Program continues the tradition as a promoter of international scholarship in higher education evidenced through the inspiration from this group of interdisciplinary manuscripts. I hope that you will envision these published papers to serve as an invaluable contribution to your own professional development and career enhancement. John McFadden, PhD The Benjamin Elijah Mays Distinguished Professor Emeritus Director, African American Professors Program University of South Carolinahttps://scholarcommons.sc.edu/mcfadden_monographs/1003/thumbnail.jp

Proceedings of the Second Caldwell Conference, St. Catherines Island, Georgia, March 30-April 1, 2007

229 p. : ill. (some col.), maps (some col.) ; 26 cm. "Issued August 26, 2009." Includes bibliographical references (p. [213]-229).Archaeologists have long known that important changes took place in aboriginal ceramic assemblages of the northern Florida, Georgia, and South Carolina coast after the arrival of Europeans. New pottery designs emerged and aboriginal demographics became fluid. Catastrophic population loss occurred in some places, new groups formed in others, and movements of people occurred nearly everywhere. Although culturally and linguistically diverse, the native inhabitants of this region shared the unwelcome encounter with Spanish people and colonial institutions, beginning in the early decades of the 16th century and continuing into the 18th century. Spanish missions and military outposts were established at native communities throughout the area, and these sites have been studied by both archaeologists and historians for decades. As a consequence, the lower southeastern Atlantic coast offers one of the most intensively studied episodes of multicultural colonial engagement in America. The Second Caldwell Conference was organized to bring researchers working in South Carolina, Georgia, and Florida together to address and more precisely define aboriginal ceramic change throughout the region as a baseline for approaching a more broadly based anthropological perspective on the consequences of encounter. The scope of inquiry was restricted to late prehistoric and early historic (A.D. 1400-1700) aboriginal ceramic wares from Santa Elena (South Carolina) to St. Augustine (Florida). The primary objective was to more precisely establish the technology, form, and design of the archaeological ceramic evidence. Without devolving into semantic and/or taxonomic wrangles, we examined how well (or poorly) archaeological labels used throughout the region to identify pottery serve as reliable proxies for the physical examples of those ceramic traditions. We also attempted to define the time-space distribution of the various ceramic traditions and pottery types throughout the south Atlantic coast. Specifically, we asked: (1) Did the indigenous ceramic complexes change fundamentally with the arrival of the Spaniards? (2) Or did indigenous ceramic traditions essentially persist, and merely shifted geographically? The eight contributions of this volume examine, on a case-by-case basis, the most important aboriginal ceramic assemblages from Santa Elena southward to St. Augustine, across the region, contextualizing each assemblage with the relevant physical stratigraphy, radiocarbon dates, associations with Euro-American wares, and documentary evidence. We also attempt to situate the physical ceramic evidence from the northern Florida-Georgia-South Carolina coastline with the contemporary archaeological assemblages in the immediate interior. The volume concludes with an epilogue that summarizes the results and general contributions of the conference, relative to archaeological practice in the lower Atlantic coastal Southeast, and also to the larger cultural and methodological issues raised by these papers

Model of the complex of Parathyroid hormone-2 receptor and Tuberoinfundibular peptide of 39 residues

<p>Abstract</p> <p>Background</p> <p>We aim to propose interactions between the parathyroid hormone-2 receptor (PTH2R) and its ligand the tuberoinfundibular peptide of 39 residues (TIP39) by constructing a homology model of their complex. The two related peptides parathyroid hormone (PTH) and parathyroid hormone related protein (PTHrP) are compared with the complex to examine their interactions.</p> <p>Findings</p> <p>In the model, the hydrophobic N-terminus of TIP39 is buried in a hydrophobic part of the central cavity between helices 3 and 7. Comparison of the peptide sequences indicates that the main discriminator between the agonistic peptides TIP39 and PTH and the inactive PTHrP is a tryptophan-phenylalanine replacement. The model indicates that the smaller phenylalanine in PTHrP does not completely occupy the binding site of the larger tryptophan residue in the other peptides. As only TIP39 causes internalisation of the receptor and the primary difference being an aspartic acid in position 7 of TIP39 that interacts with histidine 396 in the receptor, versus isoleucine/histidine residues in the related hormones, this might be a trigger interaction for the events that cause internalisation.</p> <p>Conclusions</p> <p>A model is constructed for the complex and a trigger interaction for full agonistic activation between aspartic acid 7 of TIP39 and histidine 396 in the receptor is proposed.</p

Centerscope

Centerscope, formerly Scope, was published by the Boston University Medical Center "to communicate the concern of the Medical Center for the development and maintenance of improved health care in contemporary society.

The Prevalence of Sexually Transmitted Infections in Papua New Guinea: A Systematic Review and Meta-Analysis

Patellofemoral osteoarthritis (PF OA) is more prevalent than previously thought and contributes to patient's suffering from knee OA. Synthesis of prevalence data can provide estimates of the burden of PF OA