Taking the Pulse of the European Foundation Sector : Moving from Proving Impact to Improving Impact

This report contains key insights, survey data and case studies from the first year of the European and Spanish Communities of Practice on Impact Measurement and Management (IMM), coordinated by the Esade Center for Social Impact with the support of BBK. These groups of foundation professionals from 15 countries have come together to increase the level of transparency, knowledge-sharing and exchange within the European foundation sector on this topic. Building on the transcribed discussions and surveys of approximately 40 European foundations, the authors have developed several learnings they hope will help the whole European foundation sector, as well as any other organizations that want to measure and manage their impact. In this perspective, the report also includes tables outlining what the different 'levels' of practice might be, so that the reader can understand what the impact management learning journey looks like at different stages (beginner, on the journey, and advanced).In addition to the present report, the following page provides links to the recording of the launch of the report as well as presentation slides: https://www.esade.edu/en/faculty-and-research/research/knowledge-units/center-social-impact/research/community-practice

General Anosmia Caused by a Targeted Disruption of the Mouse Olfactory Cyclic Nucleotide–Gated Cation Channel

AbstractOlfactory neurons transduce the binding of odorants into membrane depolarization. Two intracellular messengers, cyclic AMP (cAMP) and inositol trisphosphate (IP3), are thought to mediate this process, with cAMP generating responses to some odorants and IP3 mediating responses to others. cAMP causes membrane depolarization by activating a cation-selective cyclic nucleotide–gated (CNG) channel. We created a mutant “knockout” mouse lacking functional olfactory CNG channels to assess the roles of different second messenger pathways in olfactory transduction. Using an electrophysiological assay, we find that excitatory responses to both cAMP- and IP3-producing odorants are undetectable in knockout mice. Our results provide direct evidence that the CNG channel subserves excitatory olfactory signal transduction, and further suggest that cAMP is the sole second messenger mediating this process

Are the potential benefits of a community-based participatory approach to public health research worth the potential cost?

Much of public health research is conducted in a community setting or is designed to target particular population groups. Community-based participatory research (CBPR) is gaining recognition as good practice in studies of this type(Flicker et al 2007). Its merit is based on the inclusion of the community as active participants at all stages of the research process (Goodman 2006). The focus on justice and equity in this approach is seen to contribute to a range of additional potential research benefits including increased relevance and sustainability of interventions arising from the research ( Blumenthal 2004; Wallestein 2006) However, it is widely acknowledged that adoption of a consciously CBPR approach requires additional expertise. time and resources from researchers and from communities (Tanjasiri et al 2002; Massaro &amp; Claiborne 2001; Israel et al 1998). Adoption of CBPR is also limited by existing infrastructures which are supportive of more&middot; traditional models of research. Changes to professional development programs, funding guidelines and criteria. grant review processes and ethics requirements are needed to support increased application of this approach (Israel et al 2001). As all research resources are limited, the potential additional benefits offered by CBPR over and above a more traditional research approach need to be weighed against the potential additional costs involved. Changes to research infrastructure are unlikely to occur until the costs andbenefits of a consciously CBPR approach as compared to a more traditional research approach can be demonstrated. This is an exploratory paper that summarises the arguments put forward to date in relation to CBPR. A research case study and an evaluation framework are then used for a conceptual analysis of differences in the potential costs and benefits of the two approaches. Firstly, the paper describes the differences between traditional and consciously CBPR approaches. The reported benefits of CBPR are then outlined, followed by a discussion of the potential costs. Finally, the potential costs are compared to the potential benefits of using a CBPR approach, using a case study of existing research.<br /

Food insecurity in Australia: Implications for general practitioners

Background In Australia, it would appear that food is abundant. For a proportion of people, however, accessing enough food to eat can be a daily or weekly struggle. Objectives This article provides a summary about the prevalence, causes and consequences of food insecurity that affects vulnerable populations in Australia, and discusses the implications for general practitioners (GPs). Discussion It is estimated that 4% of Australians cannot access sufficient, safe and nutritious food. Food insecurity can be both a precursor to, and a by-product of, chronic disease and poverty. Patients who are food insecure may skip meals, eat cheap food and experience stress. They may show incredible resilience and skills in managing and masking this issue. Identifying this vulnerable population is of high importance to GPs as it has an impact on the work-up and care of such individuals. Effective links between welfare and health services are required to address patients&rsquo; material, financial and environmental barriers to food security<br /

Community water fluoridation : is it still worthwhile

Community Water Fluoridation (CWF) is the adjustment of fluoride concentration in community drinking water to a level that confers optimal protection from dental caries (Truman et al 2002). It is supported by many authorities as the single most effective public health measure for reducing dental caries (DHS 2007). It has consistently been shown to be effective in reducing the prevalence and severity of dental caries in populations following its introduction (NHMRC 1999). The most dramatic reductions (50-60%) were demonstrated in the earlier studies although more recent research has still shown reductions of between 30 and 50% (Truman et al 2002). Despite the strong scientific evidence for its beneficial effects and safety the issue of the appropriateness of CWF is often the focus of public debate. Proponents argue that it reduces dental caries. is safe and cost effective. and that it provides significant benefits to all social classes (Slade et al 1995: Slade et a 1996: Spencer et al 1996). Opponents question its efficacy and safety and argue that its addition to community water supplies is unethical mass medication (Colquhoun 1990: Diesendorf 1986: Diesendorf et al 1997).More recently, however, there have been important questions raised regarding the continuing benefit of CWF over and above that produced by the widespread use of other sources of fluoride (toothpaste. mouth rinses. varnish and other professionally applied fluorides). Generally, dental caries has declined steeply in the last thirty years and many have observed that dental caries has also reduced in parts of Australia and other countries where there has never been CWF or where it has ceased. It has been suggested that because of the current low population levels of dental caries and the increase in alternate sources of fluoride, CWF no longer offers the benefits it may have in the past. Given this notion, together with the concerns of a minority subgroup of the population regarding the safety of CWF, it is valuable to examine current evidence to answer the question: Is there still a role for CWF in Australia?This paper will firstly examine the history of water fluoridation and its mechanisms of action. Secondly. trends in dental decay experience over the last three decades with particular emphasis on social and geographical inequities in Australia will be described. We also review the current state of scientific evidence for the benefits of CWF including the contribution it makes to the reduction of oral health inequalities. In light of this we will provide a response to the question posed above.<br /

An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds: a protocol paper for Teeth Tales

Introduction: Inequalities are evident in early childhood caries rates with the socially disadvantaged experiencing greater burden of disease. This study builds on formative qualitative research, conducted in the Moreland/Hume local government areas of Melbourne, Victoria 2006–2009, in response to community concerns for oral health of children from refugee and migrant backgrounds. Development of the community-based intervention described here extends the partnership approach to cogeneration of contemporary evidence with continued and meaningful involvement of investigators, community, cultural and government partners. This trial aims to establish a model for child oral health promotion for culturally diverse communities in Australia.&lt;p&gt;&lt;/p&gt; Methods and analysis: This is an exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds. Families from an Iraqi, Lebanese or Pakistani background with children aged 1–4 years, residing in metropolitan Melbourne, were invited to participate in the trial by peer educators from their respective communities using snowball and purposive sampling techniques. Target sample size was 600. Moreland, a culturally diverse, inner-urban metropolitan area of Melbourne, was chosen as the intervention site. The intervention comprised peer educator led community oral health education sessions and reorienting of dental health and family services through cultural Competency Organisational Review (CORe).&lt;p&gt;&lt;/p&gt; Ethics and dissemination: Ethics approval for this trial was granted by the University of Melbourne Human Research Ethics Committee and the Department of Education and Early Childhood Development Research Committee. Study progress and output will be disseminated via periodic newsletters, peer-reviewed research papers, reports, community seminars and at National and International conferences.&lt;p&gt;&lt;/p&gt

Integration of Medication Abortion into Primary Care Practice and Teaching: An Intersection of Patient Care, Reproductive Justice and Advocacy

Presentation: 50:45 Note: PowerPoint slides are located at the bottom of this page

Improving infant sleep and maternal mental health: a cluster randomised trial

Objectives: To determine whether a community-delivered intervention targeting infant sleep problems improves infant sleep and maternal well-being and to report the costs of this approach to the healthcare system. Design: Cluster randomised trial. Setting: 49 Maternal and Child Health (MCH) centres (clusters) in Melbourne, Australia. Participants: 328 mothers reporting an infant sleep problem at 7 months recruited during October&ndash;November 2003. Intervention: Behavioural strategies delivered over individual structured MCH consultations versus usual care. Main outcome measures: Maternal report of infant sleep problem, depression symptoms (Edinburgh Postnatal Depression Scale (EPDS)), and SF-12 mental and physical health scores when infants were 10 and 12 months old. Costs included MCH sleep consultations, other healthcare services and intervention costs. Results: Prevalence of infant sleep problems was lower in the intervention than control group at 10 months (56% vs 68%; adjusted OR 0.58 (95% CI: 0.36 to 0.94)) and 12 months (39% vs 55%; adjusted OR 0.50 (0.31 to 0.80)). EPDS scores indicated less depression at 10 months (adjusted mean difference &ndash;1.4 (&ndash;2.3 to &ndash;0.4) and 12 months (&ndash;1.7 (&ndash;2.6 to &ndash;0.7)). SF-12 mental health scores indicated better health at 10 months (adjusted mean difference 3.7 (1.5 to 5.8)) and 12 months (3.9 (1.8 to 6.1)). Total mean costs including intervention design, delivery and use of non-MCH nurse services were &pound;96.93 and &pound;116.79 per intervention and control family, respectively. Conclusions: Implementing this sleep intervention may lead to health gains for infants and mothers and resource savings for the healthcare system.<br /

Two-year follow up of a cluster randomised controlled trial for women experiencing intimate partner violence:Effect of screening and family doctor-delivered counselling on quality of life, mental and physical health, and abuse exposure

Objectives: This was a 2-year follow-up study of a primary care-based counselling intervention (weave) for women experiencing intimate partner violence (IPV). We aimed to assess whether differences in depression found at 12 months (lower depression for intervention than control participants) would be sustained at 24 months and differences in quality in life, general mental and physical health and IPV would emerge. Design: Cluster randomised controlled trial. Researchers blinded to allocation. Unit of randomisation: family doctors. Setting: Fifty-two primary care clinics, Victoria, Australia. Participants: Baseline: 272 English-speaking, female patients (intervention n=137, doctors=35; control n=135, doctors=37), who screened positive for fear of partner in past 12 months. Twenty-four-month response rates: intervention 59% (81/137), control 63% (85/135). Interventions: Intervention doctors received training to deliver brief, woman-centred counselling. Intervention patients were invited to receive this counselling (uptake rate: 49%). Control doctors received standard IPV information; delivered usual care. Primary and secondary outcome measures: Twenty-four months primary outcomes: WHO Quality of Life-Bref dimensions, Short-Form Health Survey (SF-12) mental health. Secondary outcomes: SF-12 physical health and caseness for depression and anxiety (Hospital Anxiety Depression Scale), post-traumatic stress disorder (Check List-Civilian), IPV (Composite Abuse Scale), physical symptoms (&ge;6 in last month). Data collected through postal survey. Mixed-effects regressions adjusted for location (rural/urban) and clustering. Results: No differences detected between groups on quality of life (physical: 1.5, 95% CI &minus;2.9 to 5.9; psychological: &minus;0.2, 95% CI &minus;4.8 to 4.4,; social: &minus;1.4, 95% CI &minus;8.2 to 5.4; environmental: &minus;0.8, 95% CI &minus;4.0 to 2.5), mental health status (&minus;1.6, 95% CI &minus;5.3 to 2.1) or secondary outcomes. Both groups improved on primary outcomes, IPV, anxiety. Conclusions: Intervention was no more effective than usual care in improving 2-year quality of life, mental and physical health and IPV, despite differences in depression at 12 months. Future refinement and testing of type, duration and intensity of primary care IPV interventions is needed. Trial registration number: ACTRN12608000032358.</jats:sec