Can the quality of social research on ethnicity be improved through the introduction of guidance? Findings from a research commissioning pilot exercise

As the volume of UK social research addressing ethnicity grows, so too do concerns regarding the ethical and scientific rigour of this research domain and its potential to do more harm than good. The establishment of standards and principles and the introduction of guidance documents at critical points within the research cycle might be one way to enhance the quality of such research. This article reports the findings from the piloting of a guidance document within the research commissioning process of a major funder of UK social research. The guidance document was positively received by researchers, the majority of whom reported it to be comprehensible, relevant and potentially useful in improving the quality of research proposals. However, a review of the submitted proposals suggested the guidance had had little impact on practice. While guidance may have a role to play, it will need to be strongly promoted by commissioners and other gatekeepers. Findings also suggest the possibility that guidance may discourage some researchers from engaging with ethnicity if it raises problems without solutions; highlighting the need for complementary investments in research capacity development in this area

A new model for diabetes-focused capacity building – lessons from Sri Lanka

Abstract Sri Lanka is experiencing a rapid increase in the number of people with diabetes mellitus (DM) due to population growth and aging. Physician shortages, outdated technology, and insufficient health education have contributed to the difficulties associated with managing the burden of disease. New models of chronic disease management are needed to address the increasing prevalence of DM. Medical students, business students, and faculty members from the University of Michigan partnered with the Grace Girls’ Home, Trincomalee General Hospital, and Selvanayakapuram Central Hospital to identify and train diabetes-focused medical assistants (MAs) to collect and enter patient data and educate patients about their disease. Return visits to these MAs were encouraged so that patient progress and disease progression could be tracked longitudinally. Data entry was conducted through a cloud-based mechanism, facilitating patient management and descriptive characterization of the population. We implemented this pilot program in June 2016 in coordination with Trincomalee General Hospital and Selvanayakapuram Central Hospital. Over a 12-month period, 93 patients were systematically assessed by the medical assistants. All patients received education and were provided materials after the visit to better inform them about the importance of controlling their disease. Fifteen percent (14/93) of patients returned for follow-up consultation. Trained MAs have the potential to provide support to physicians working in congested health systems in low-resource settings. Public investment in training programs for MAs and greater acceptance by physicians and patients will be essential for handling the growing burden associated with chronic illnesses like DM. Trained MAs may also play a role in improved patient education and awareness regarding diabetes self-management.https://deepblue.lib.umich.edu/bitstream/2027.42/146742/1/40842_2018_Article_74.pd

Talk the talk, walk the walk: Defining Critical Race Theory in research

Over the last decade there has been a noticeable growth in published works citing Critical Race Theory (CRT). This has led to a growth in interest in the UK of practical research projects utilising CRT as their framework. It is clear that research on 'race' is an emerging topic of study. What is less visible is a debate on how CRT is positioned in relation to methodic practice, substantive theory and epistemological underpinnings. The efficacy of categories of data gathering tools, both traditional and non-traditional is a discussion point here to explore the complexities underpinning decisions to advocate a CRT framework. Notwithstanding intersectional issues, a CRT methodology is recognisable by how philosophical, political and ethical questions are established and maintained in relation to racialised problematics. This paper examines these tensions in establishing CRT methodologies and explores some of the essential criteria for researchers to consider in utilising a CRT framework. © 2012 Copyright Taylor and Francis Group, LLC

Racism, anti-racist practice and social work: articulating the teaching and learning experiences of Black social workers

In the mid 1990s a Black practice teacher programme was established in Manchester and Merseyside with the primary aim to increase the number of Black practice teachers in social work organisations, and in turn provide a supportive and encouraging learning environment for Black student social workers whilst on placement. In the north‐west of England research has been undertaken, to establish the quality of the practice teaching and student learning taking place with Black practice teachers and students. This paper is an exploration of the ideas generated within the placement process that particularly focused on the discourse of racism and ant‐racist practice. Black students and practice teachers explain their understanding of racism and anti‐racist practice within social work. From the research, the paper will critique some of the ideas concerning anti‐racism. In particular, it will question whether anti‐racist social work practice needs to be re‐evaluated in the light of a context with new migrants, asylum seekers and refugees. It will concluded, by arguing that whilst the terms anti‐racism, Black and Minority Ethnic have resonance as a form of political strategic essentialism, it is important to develop more positive representations in the future

Male fertility in cystic fibrosis.

Infertility rates among males with cystic fibrosis (CF) approximate 97%. No information is currently available within Ireland determining an understanding of fertility issues and the best methods of information provision to this specialized group. This study aimed to determine understanding and preferred approaches to information provision on fertility issues to Irish CF males. A Descriptive Study utilizing prospective coded questionnaires was mailed to a male CF cohort (n=50). Sections included demographics, fertility knowledge \u26 investigation. Response rate was 16/50 (32%). All were aware that CF affected their fertility. More than two-thirds (n=11) were able to provide explanations whilst only one-third (n=5) provided the correct explanation. Significant numbers stated thoughts of marriage and a future family. Half have discussed fertility with a healthcare professional (HCP). Mean age of discussion was 21.9 years. One third preferred an earlier discussion. The commonest first source for information was written material which was also the preferred source. Three-quarters requested further information preferring again, written material. Significant gaps in sex education of Irish CF males exist. Discussion should be initiated by HCPs and centre-directed written material devised to address deficiencies

Antiracist Feminism and the Politics of Solidarity in Neoliberal Times

The chapter analyses the establishment and expansion of antiracist feminism in the last decade throughout the Nordic region, with new groups, media sites, and public events organised, especially in the large cities. Keskinen examines antiracist feminist and queer of colour activism in which the main or sole actors belong to groups racialised as non-white or ‘others’ in Nordic societies. A fundamental argument developed in the chapter is the central role and potential of these emerging social movements in the reconfiguring of political agendas and tackling pressing societal issues, due to its capacity to overlap and connect the borders of antiracist, feminist, and (to some extent) class-based politics. The chapter further argues for the usefulness of theorising the neoliberal turn of racial capitalism as the societal condition in which feminist activism takes place.Peer reviewe

Pain in patients with pancreatic cancer: prevalence, mechanisms, management and future developments

Pain affects approximately 80% of patients with pancreatic cancer, with half requiring strong opioid analgesia, namely: morphine-based drugs on step three of the WHO analgesic ladder (as opposed to the weak opioids: codeine and tramadol). The presence of pain is associated with reduced survival. This article reviews the literature regarding pain: prevalence, mechanisms, pharmacological, and endoscopic treatments and identifies areas for research to develop individualized patient pain management pathways. The online literature review was conducted through: PubMed, Clinical Key, Uptodate, and NICE Evidence. There are two principal mechanisms for pain: pancreatic duct obstruction and pancreatic neuropathy which, respectively, activate mechanical and chemical nociceptors. In pancreatic neuropathy, several histological, molecular, and immunological changes occur which correlate with pain including: transient receptor potential cation channel activation and mast cell infiltration. Current pain management is empirical rather etiology-based and is informed by the WHO analgesic ladder for first-line therapies, and then endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) in patients with resistant pain. For EUS-CPN, there is only one clinical trial reporting a benefit, which has limited generalizability. Case series report pancreatic duct stenting gives effective analgesia, but there are no clinical trials. Progress in understanding the mechanisms for pain and when this occurs in the natural history, together with assessing new therapies both pharmacological and endoscopic, will enable individualized care and may improve patients’ quality of life and survival

The thing about pain: The remaking of illness narratives in chronic pain expressions on social media

In this article, we analyse chronic pain narratives on Flickr and Tumblr. We focus on how, by incorporating visual and multimodal elements, chronic pain expressions in social media significantly extend and challenge the logic, function and effects of traditional ‘illness narratives’. We examine a sample of images and blogs related to chronic pain and formulate a typology of chronic pain expressions on these sites. Flickr brings a form of narrative immediacy, making the pain experience visible, eliciting empathy and marking chronicity. Tumblr lends itself to more networked forms of interaction through the circulation of multimodal memes, and support communities are built through humour and social criticism. We argue that new forms of mediation and social media dynamics transform pain narratives. This has implications for our understandings of the forms and formats of pain communication and offers new possibilities for communicating pain within and beyond clinical contexts

Mechanisms Underlying Hypoxia Tolerance in Drosophila melanogaster: hairy as a Metabolic Switch

Hypoxia-induced cell injury has been related to multiple pathological conditions. In order to render hypoxia-sensitive cells and tissues resistant to low O2 environment, in this current study, we used Drosophila melanogaster as a model to dissect the mechanisms underlying hypoxia-tolerance. A D. melanogaster strain that lives perpetually in an extremely low-oxygen environment (4% O2, an oxygen level that is equivalent to that over about 4,000 m above Mt. Everest) was generated through laboratory selection pressure using a continuing reduction of O2 over many generations. This phenotype is genetically stable since selected flies, after several generations in room air, survive at this low O2 level. Gene expression profiling showed striking differences between tolerant and naïve flies, in larvae and adults, both quantitatively and qualitatively. Up-regulated genes in the tolerant flies included signal transduction pathways (e.g., Notch and Toll/Imd pathways), but metabolic genes were remarkably down-regulated in the larvae. Furthermore, a different allelic frequency and enzymatic activity of the triose phosphate isomerase (TPI) was present in the tolerant versus naïve flies. The transcriptional suppressor, hairy, was up-regulated in the microarrays and its binding elements were present in the regulatory region of the specifically down-regulated metabolic genes but not others, and mutations in hairy significantly reduced hypoxia tolerance. We conclude that, the hypoxia-selected flies: (a) altered their gene expression and genetic code, and (b) coordinated their metabolic suppression, especially during development, with hairy acting as a metabolic switch, thus playing a crucial role in hypoxia-tolerance