A comparison of the nationally important infection prevention and control documents in NHS England and NHS Scotland

Background: The devolution of health to Scotland in 1999, led for the first time in the NHS to different priorities and success indicators for infection prevention and control (IPC). This project sought to understand, compare and evaluate the national IPC priorities and available indicators of success. Aim: To identify the national infection prevention and control priorities alongside national indicators of success. Methods: Critical analysis of nationally produced documents and publicly available infection related data up to March 2018. Findings: For both NHS Scotland and England the local and national infection prevention and control priorities are evidenced by: a) People being cared for in an IPC safe environment, b) Staff following IPC safe procedures and c) organisations continuously striving not just to attain standards, but to improve on them. If national agencies that produce data were also charged with using a Continuous Quality Improvement (CQI) model, then there would be further opportunities to detect and improve on successes

Confirmed Sighting of a Spawning Aggregation of the Brown-marbled Grouper, Epinephelus fuscoguttatus, in Kenya

The occurrence of spawning aggregations at fixed sites and times is well documented for several species of reef fish. These aggregations are known to attract fishers and such species may therefore be vulnerable to overfishing. This is particularly true in the case of groupers which have intrinsically vulnerable life history traits. The brown-marbled grouper, Epinephelus fuscoguttatus, distributed throughout the Indo-Pacific region and classified by IUCN as Near Threatened, is reported to form spawning aggregations but little is known about its spawning behaviour; in the Western Indian Ocean this has only been reported for the Seychelles. This study confirmed spawning aggregation behaviour in E. fuscoguttatus in Kenya based on underwater observations and fishers’ knowledge of the phenomenon. We showed that E. fuscoguttatus forms short aggregations for ~5 days linked to the new moon for a 3-4 month period during the northeast monsoon (austral summer).  The numbers of aggregating fish appear to be low, however, and the species is currently not managed in Kenya. Considering the fact that only small areas of the Kenyan coastline are under total protection (8.6% of the country’s coral reefs), these factors suggest that there is an urgent need for additional management of E. fuscoguttatus if it is to survive in Kenya

Research partnerships across international contexts : a practice of unity or plurality?

This work was supported by Engineering and Physical Sciences Research Council [grant number EP/T025034/1].Partnership is not a benign practice; it is culturally and ethically loaded. The way in which partnerships are construed in international research determines its design, ethics and impacts. Despite this, and the growing assumption of partnership practice in our field, the concept has become increasingly abstract and the practice under-analysed. This article provides critical perspectives of current understandings of partnership in international development research from three angles: the motivations behind partnership working; an epistemological perspective in relation to epistemic justice and the agency of language; and finally, the systems that mediate partnerships, and the range of resources that guide them. Publisher PDFPeer reviewe

Smoke-free homes: what are the barriers, motivators and enablers? A qualitative systematic review and thematic synthesis

Objective: To thematically synthesise primary qualitative studies of the barriers, motivators and enablers of smoke-free homes (SFHs). Design: Systematic review and thematic synthesis. Data sources: Searches of MEDLINE, EBM Reviews (Cochrane Database of Systematic Reviews), PsycINFO, Global Health, CINAHL, Web of Science, Informit and EMBASE, combining terms for families, households and vulnerable populations; SFH and secondhand smoke; and qualitative research, were supplemented by searches of PhD theses, key authors, specialist journals and reference lists. Study selection: We included 22 articles, reporting on 18 studies, involving 646 participants. Inclusion criteria: peer-reviewed; English language; published from 1990 onwards (to week 3 of April 2014); used qualitative data collection methods; explored participants’ perspectives of home smoking behaviours; and the barriers, motivators and enablers to initiating and/or maintaining a SFH. Data extraction: 1 of 3 authors extracted data with checking by a second. Data synthesis: A thematic synthesis was performed to develop 7 core analytic themes: (1) knowledge, awareness and risk perception; (2) agency and personal skills/attributes; (3) wider community norms and personal moral responsibilities; (4) social relationships and influence of others; (5) perceived benefits, preferences and priorities; (6) addiction and habit; (7) practicalities. Conclusions: This synthesis highlights the complexity faced by many households in having a SFH, the practical, social, cultural and personal issues that need to be addressed and balanced by households, and that while some of these are common across study settings, specific social and cultural factors play a critical role in shaping household smoking behaviours. The findings can inform policy and practice and the development of interventions aimed at increasing SFHs. Trial registration number: CRD42014014115

Visual risk factors for falls in older adults: a case-control study

BACKGROUND: Falls are the second leading  cause of accidental deaths worldwide mainly in older people. Older people have poor vision and published evidence suggests that it is a risk factor for falls. Less than half of falls clinics assess vision as part of the multi-factorial assessment of older adults at risk of falls despite vision being an essential input for postural stability. The aim of our study was to investigate the relationship between all clinically assessed visual functions and falls amongst older adults in a prospective observational individually age-matched case control study. METHODS: Visual acuity (VA), contrast sensitivity (CS), depth perception, binocular vision and binocular visual field were measured using routinely used clinical methods in falls participants (N = 83) and non-falls participants (N = 83). Data were also collected on socio-demographic factors, general health, number of medications, health quality, fear of falling and physical activity. Logistic regression analysis was carried out to determine key visual and non-visual risk factors for falls whilst adjusting for confounding covariates. RESULTS: Older adults have an increased risk of experiencing a fall if they have reduced visual function (odds ratio (OR): 3.49, 1.64-7.45, p = 0.001), specifically impaired stereoacuity worse than 85” of arc (OR: 3.4, 1.20-9.69, p = 0.02) and reduced (by 0.15 log unit) high spatial frequency CS (18 cpd) (OR:1.40, 1.12-1.80, p = 0.003). Older adults with a hearing impairment are also at higher risk of falls (OR: 3.18, 95% CI: 1.36-7.40, p = 0.007). The risk decreases with living in a less deprived area (OR: 0.74, 0.64-0.86, <0.001), or socialising more out of the home (OR: 0.75, 0.60-0.93, p = 0.01). CONCLUSIONS: The combination of social, behavioural and biological determinants are significant predictors of a fall. The non-visual risk factors include older adults, living in deprived neighbourhoods, socialising less outside of the home and those who have a hearing impairment. Impaired functional visual measures; depth perception and contrast are significant visual risk factors for falls above visual acuity

Report of the ESRC Expert Advisory Group on International Development October 2014

Very real transformations are now occurring in the nature and extent of poverty, in the processes leading to impoverishment, inequality and injustice, and in the policy space and practices that can address these. The purpose of this report is to identify for ESRC the new challenges that these unfolding realities pose for social science researchers in the field of international development.This will (a) inform emerging ESRC research strategy more broadly and (b) inform the development of joint funding arrangements between ESRC and funding partners. In our increasingly interconnected world, the emerging research priorities in international development that we document inevitably dovetail closely with emergent social science agendas more generally.There is not one discipline for ‘the developing world’ and many for ‘the developed’. Development studies research and teaching centres do bring new tools, frameworks, methods and experience to grapple with these future development pressures and problems, but all social science disciplines are expanding their boundaries to think more globally rather than territorially – and in ways that the emergence of international development studies as a field has been encouraging. Re-emphasising the opportunities for research in international development to draw on and feed into wider methodological, theoretical and substantive research repertoires echoes a core principle of the post-2015 Sustainable Development Agenda which is to be ‘integrated, holistic and universal, applying to all countries and all people’ and which thus eschews specific geographical foci. It echoes, too, the proposed Sustainable Development Goals which, beyond the principles of ending extreme poverty, seek to integrate social, economic, and environmental sustainability and inclusive growth within “a common understanding of our shared humanity, based on mutual respect and mutual benefit.”The ‘Third World’ and its euphemisms are fast becoming history. International development studies research does not secure its identity in a focus on a particular sub-set of countries or methods. International development research is, however, characterised by a problem-focused approach which this report is built around. But whilst much research in international development studies is unashamedly impact-led and supports a ‘what works’ agenda that speaks directly to wider policy concerns, this report prioritises, too, increased attention to the rapid transformations in global environments, economy, societies, cultures, politics and technologies that now reshape poverty and so reshape ‘what works’ as well as ‘for whom, when and why’.These changes are happening so fast and are so massive that for research to have maximum impact in informing the alleviation of mid-21st century poverty and inequality, it will need to be couched within new conceptualisations and new theorisations that capture these future realities. In particular, given the rising inequalities associated with current economic growth and new geographies of poverty that do not easily fall into particular countries,‘worlds,’ or points of the compass, it is our contention that ‘international development’ research needs not only to dwell on a broader range of countries and regions, but also to capture changing global orders producing and addressing poverty. In particular, embracing research on ‘middle income countries’ (MICs) is now important for understanding not only the predicament of the poor within, but also the drivers of steeply rising inequalities there which are of significance to the poor in countries with middle income aspirations. It will help, too, in understanding the nature of the multi-polar international order in which this will happen. In addition, BRICS and other MICs are sources of enormous social policy innovation that other countries stand to learn from; yet are often not well analysed. This report outlines challenges for a wide range of research, from that focused on refining specific interventions (education, health etc.) to the much broader analytical challenges that will necessitate conceptual breakthroughs and new analytical paradigms. Given the availability of more operational funding for the former, we suggest that there is a clear opportunity (and need) for ESRC to focus more (though not exclusively) on the broader questions and conceptual challenges. There are many ways to relate the cross cutting issues that we identify. Rather than develop a matrix, we set out key challenges and opportunities for research in relation to eight key trends: 1. Increasing inequalities in a connected world 2. Massive, differentiated urbanisation 3. Climate change and pushing against planetary limits 4. Emerging sensitivity to shocks, and their securitisation 5. Increasing political multipolarity 6. Emerging challenges to nation states in delivering development: social and physical infrastructure 7. New cultural shaping of poverty 8. Digital development, Big Data and the technological revolution We also highlight more methodological challenges: - Levering change: learning, incentives and beyond - Governing ‘international development’: measurement and beyon

Why are there discrepancies between depressed patients' Global Rating of Change and scores on the Patient Health Questionnaire depression module? A qualitative study of primary care in England

Objectives: Our aims were to investigate discrepancies between depressed patients’ GlobalRating of Change (GRC) and scores on the Patient Health Questionnaire depression module (PHQ-9). Our objectives were to ascertain patients’ views on the source and meaning of mismatches and assess their clinical significance. Design: Qualitative study nested within a cohort, in a programme investigating the indications for prescribing antidepressants that will lead to a clinical benefit. Setting: Primary care practices in north-west England. Participants: We invited 32 adults with a recent diagnosis of depression and evidence of mismatch between GRC and PHQ-9 Scores to participate. Of these, 29 completed our interviews; most were women, identified as white British, had high school education or higher, were employed or retired and had been depressed for a long time. Main measures: We conducted semistructured interviews with a topic guide, focusing on experiences of depression; treatment experiences and expectations; effectiveness of the questionnaires; reasons for the mismatch; and social factors. Interviews were transcribed and subjected to interpretative phenomenological analysis. Results: We identified four themes as explanations for mismatch between GRC and PHQ-9: perceptions that GRC provided a more accurate assessment of current mental state than PHQ-9; impact of recent negative or positive life events on either measure; personal understanding of depression as normally fluctuating, and tendency to underscore on PHQ-9 as a means of self-motivation; and lack of recall. Conclusions: The combined used of the PHQ-9 and a more open question better captures the patient’s unique experiences of mental health. This approach ascertains the relevance of symptoms to the individual’s experience and influences treatment decisions. Study registration: This study was an element of NIHR Programme Grant RP-PG 0610 10048

Shall we dance? Welfarist incorporation and the politics of state-labour NGO relations in China

State-labour NGOs relations in China have been particularly fraught. In 2012 these took an interesting twist, as some local governments made overtures to labour NGOs to co-operate in providing services to migrant workers. This article argues that this shift is part of a broader strategy of `welfarist incorporation’ to redraw the social contract between state and labour. There are two key elements to this: first, relaxation of the registration regulations for social organisations; second, governmental purchasing of services from social organisations. These overtures have both a state and market logic to maintain social control and stabilise relations of production

Recent advances in acoustic diagnostics for electrochemical power systems

Acknowledgments The authors would like to gratefully acknowledge the EPSRC for supporting the electrochemical research in the Electrochemical Innovation Lab (EP/R020973/1; EP/R023581/1; EP/N032888/1; EP/R023581/1; EP/P009050/1; EP/M014371/1; EP/M009394; EP/L015749/1; EP/K038656/1) and Innovate UK for funding the VALUABLE project (Grant No. 104182). The authors would also like to acknowledge the Royal Academy of Engineering for funding Robinson and Shearing through ICRF1718\1\34 and CiET1718 respectively and the Faraday Institution (EP/S00353/1, Grant Nos. FIRG003, FIRG014). The authors also acknowledge the STFC for supporting Shearing and Brett (ST/K00171X/1) and ACEA for supporting ongoing research at the EIL. Support from the National Measurement System of the UK Department for Business, Energy and Industrial Strategy is also gratefully acknowledged.Peer reviewedPublisher PD