An alternative approach to urban nature in environmental education at KS2.

A dominant feature of environmental education in British schools has been\ud the centrality of the concepts of 'nature' and 'conservation'. Since the late\ud 1970s, two influences have shifted educational attitudes away from purely\ud considering rural nature and conservation, towards a more balanced\ud approach which includes urban nature and conservation.\ud The first influence was of the development of 'urban studies'. The second\ud was the growth of 'Urban Wildlife Groups' (UWGs). U\VGs have influenced\ud teacher approaches to urban nature at KS2 - not by using new ideas adapted\ud to the unique circumstances of urban ecosystems, as the founders of the\ud UWG movement had intended, but by using rurally-based ideas from their\ud own progenitors: the County Wildlife Trusts.\ud It is the contention of this thesis that curriculum planners and teachers at\ud KS2 have been influenced by UWGs, who have selected and promoted\ud concepts from a set of ecological values, theories and practices. The\ud distinction between 'native' and 'alien' plant species on the basis of utility to\ud wildlife is a key concept which permeates UWG theory and practice, and has\ud influenced teachers.\ud The 'alternative' approach provides both the contextual and theoretical\ud underpinnings for the study of urban nature at KS2, through the entity of\ud the Multicultural City Ecosystem and the process of multicultural ecology.\ud It provides a framework for thought and practical reflection amongst\ud education officers in UWGs, curriculum planners and teachers. It accepts\ud dynamism in ecology, especially in cities. It accepts change over different\ud scales of time and space in linking introduced species from overseas to\ud prehistoric and historic cultural, social, economic and other human\ud processes and agencies in cities. In so doing, it provides curriculum\ud planners and teachers with an approach to urban nature at KS2 which is\ud based upon an analysis of real events, historical (and prehistoric),\ud contemporary and future. In essence, it focusses on what is there and why\ud it is there, not on what urban ecologists say should be there. The KS2 text\ud 'People, Plants and Places' (Agyeman (1995)) is an outcome of this\ud approach

Integrated food systems governance: Scaling equitable and transformative food initiatives through scholaractivist engagement

Community-based efforts to transform food sys­tems involve a diverse range of actors and increas­ingly attempt to focus on public engagement in policymaking processes. These initiatives often emphasize opportunities for more participatory forms of engagement rooted in systems thinking, which recognizes the interconnections between environmental, social, and economic injustices. Similarly, food systems scholars are increasingly engaged in participatory action projects seeking to make productive linkages between academic research, policymakers, and community organiza­tions in search of tangible food systems change (...

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Rural identity and otherness

While rural populations and places are fluidly and diversely constituted, in governmental and popular thinking there are very fixed ideas as to ‘who is’ rural and who ‘legitimately’ inhabits rural spaces. Rural studies approaches, influenced by sociological and postcolonial debates about identity and otherness, have increasingly engaged in an analysis of the concept of rurality and the representational work rurality does in marking boundaries between socially included and socially excluded populations, that is, those populations considered not ‘of’ the rural or as having contentious claims to a place within rural spaces. In particular, ethnicity and the idea of the rural as a racialized, representational, and material space has been a key concern of rural studies. While there has been extended work in this area, this has mainly occurred in the context of England and Englishness. There is increasing interest as to the extent to which the rural otherness debates are nationally bounded or whether these debates, or parts of them, are more globally applicable

Remaking English ruralities: Processes of belonging and becoming, continuity and change in racialised spaces

About the book: This book explores issues of ethnicity, identity and racialised exclusion in rural Britain, in depth and for the first time. It questions what the countryside 'is', problematises who is seen as belonging to rural spaces, and argues for the recognition of a rural multiculture