Bostin Value

“Bostin Value” was a pilot scheme aiming to improve fruit and vegetable consumption in a deprived neighborhood in the borough of Dudley, England. Research identified the need to address both supply and demand to encourage the target audience (parents/carers of young children) to consume more fruit and vegetables along with their children. Bostin Value improved supply through commissioning a local greengrocer to sell fresh fruit and vegetables twice a week at a local primary school. Promotions were used to encourage sales, including a loyalty card system, money off vouchers, and recipe cards. To increase demand, educational sessions were run at the school to improve parent’s skills in cooking seasonal produce. Children at the school received tasting workshops to encourage them to try a variety of fruit and vegetables. Results saw the mean portions of fruit consumed weekly by parents significantly increase from 2.4 portions in April 2009 to 3.1 in July 2010. This was mirrored in children whose weekly portions increased from 2.6 to 3.7. The mean number of different fruits and vegetables tasted by children also increased significantly. </jats:p

Treatment outcomes in schizophrenia: qualitative study of the views of family carers

Abstract Background Schizophrenia is a complex, heterogeneous disorder, with highly variable treatment outcomes, and relatively little is known about what is important to patients. The aim of the study was to understand treatment outcomes informal carers perceive to be important to people with schizophrenia. Method Qualitative interview study with 34 individuals and 8 couples who care for a person with schizophrenia/schizoaffective disorder. Interviews were transcribed verbatim and analysed by a thematic framework based approach. Results Carers described well-recognised outcomes of importance, alongside more novel outcomes relating to: Safety (of the patient/others); insight (e.g. into non-reality of psychotic phenomena); respite from fear, distress or pain; socially acceptable behaviour; getting out of the house; attainment of life milestones; changes in personality and/or temperament; reduction of vulnerability to stress; and several aspects of physical health. Conclusions These findings have the potential to inform the development of patient- or carer- focused outcome measures that take into account the full range of domains that carers feel are important for patients. Keywords Schizophrenia Treatment Patient Carer Outcom

Feminist Scholarship Review: Women and Philosophy

Published from 1991 through 2007 at Trinity College, Hartford, Connecticut, the Feminist Scholarship Review is a literary journal that describes women\u27s experiences around the world. FSR began as a review of feminist scholarly material, but evolved into a journal for poetry and short storie

Biosynthesis and signalling functions of central and peripheral nervous system neurosteroids in health and disease

Neurosteroids are steroid hormones synthesised de novo in the brain and peripheral nervous tissues. In contrast to adrenal steroid hormones that act on intracellular nuclear receptors, neurosteroids directly modulate plasma membrane ion channels and regulate intracellular signalling. This review provides an overview of the work that led to the discovery of neurosteroids, our current understanding of their intracellular biosynthetic machinery, and their roles in regulating the development and function of nervous tissue. Neurosteroids mediate signalling in the brain via multiple mechanisms. Here, we describe in detail their effects on GABA (inhibitory) and NMDA (excitatory) receptors, two signalling pathways of opposing function. Furthermore, emerging evidence points to altered neurosteroid function and signalling in neurological disease. This review focuses on neurodegenerative diseases associated with altered neurosteroid metabolism, mainly Niemann-Pick type C, multiple sclerosis and Alzheimer disease. Finally, we summarise the use of natural and synthetic neurosteroids as current and emerging therapeutics alongside their potential use as disease biomarkers

COVID-19 and childcare: why many nurseries will struggle to weather the storm

Helen Penn, Antonia Simon, and Eva Lloyd explain why nurseries are struggling to cope with the costs of the ongoing pandemic. They write that, as in many other areas, the crisis highlights the effects of years of austerity on the sector

Witness to a century: the autobiographical writings of Naomi Mitchison

This thesis is a study of the autobiographical writings of Naomi Mitchison, a prolific writer of exceptional versatility who was born in the last years of the Victorian period and is now best known as a writer of fiction, and as part of the 'Scottish literary Renaissance' of the first half of the twentieth century. In her late seventies, towards the end of a highly productive literary career, Mitchison published three volumes of autobiography, Small Talk: Memoirs of an Edwardian Childhood (1973), All Change Here: Girlhood and Marriage (1975) and You May Well Ask: A Memoir 1920-1940 (1979). Unusually for retrospective memoir, however, these texts cover less than half of her hundred and one years, leading the reader to question the location and mode of her complete autobiographical writings. Working extensively with archival material, much of which has been previously unavailable, this thesis sets out to demonstrate that Mitchison's personal writings are far more extensive than have been previously acknowledged, and are to be found through a wide range of out-of-print and unpublished material which include diaries, travel writing, personal correspondence, and, in few instances, poetry and prose fiction. In the course of this research I have compiled two substantial volumes of source materials which have been lodged in the Department of Scottish Literature Library. A contribution to Mitchison studies in themselves, I here draw attention to their existence and availability. While at first sight many of the texts on which this study focuses are minor writings in relation to the major achievements of Mitchison's literary career, this thesis argues that as a collected body of work, they form an autobiographical corpus which documents and bears witness to an extraordinary twentieth-century life, and constitutes a substantial literary achievement. Autobiographical- and life-writings often escape strict generic boundaries, and this study employs genre theory to interrogate the categorisation of literary genre. Central to this focus on traditionally marginalised non-fictional writings are questions of the changing position of memoir, the diary, epistolary and travel writings to the canon, and recent theoretical approaches are examined

Food for thought? Potential conflicts of interest in academic experts advising government and charities on dietary policies

Abstract Background A conflict of interest (CoI) can occur between public duty and private interest, in which a public official’s private-capacity interest could improperly influence the performance of their official duties and responsibilities. The most tangible and commonly considered CoI are financial. However, CoI can also arise due to other types of influence including interpersonal relationships, career progression, or ideology. CoI thus exist in academia, business, government and non-governmental organisations. However, public knowledge of CoI is currently limited due to a lack of information. The mechanisms of managing potential conflicts of interest also remain unclear due to a lack of guidelines. We therefore examined the independence of academic experts and how well potential CoI are identified and addressed in four government and non-governmental organisations in the UK responsible for the development of food policy. Methods Policy analysis. We developed an analytical framework to explore CoI in high-level UK food policy advice, using four case studies. Two government policy-making bodies: Department of Health ‘Obesity Review Group’ (ORG), ‘Scientific Advisory Committee on Nutrition’ (SACN) and two charities: ‘Action on Sugar’ (AoS), & ‘Heart of Mersey’ (HoM). Information was obtained from publicly available sources and declarations. We developed a five point ordinal scale based upon the ideology of the Nolan Principles of Public Life. Group members were individually categorised on the ordinal ConScale from “0”, (complete independence from the food and drink industry) to “4”, (employed by the food and drink industry or a representative organisation). Results CoI involving various industries have long been evident in policy making, academia and clinical practice. Suggested approaches for managing CoI could be categorised as “deny”, “describe”, or “diminish”. Declared CoI were common in the ORG and SACN. 4 out of 28 ORG members were direct industry employees. In SACN 11 out of 17 members declared industry advisory roles or industry research funding. The two charities appeared to have equally strong academic expertise but fewer conflicts. No HoM members declared CoI. 5 out of 21 AoS members declared links with industry, mainly pharmaceutical companies. We were unable to obtain information on conflicts for some individuals. Conclusions Conflicts of interest are unavoidable but potentially manageable. Government organisations responsible for policy development and implementation must institutionalize an approach to identify (disclose) and manage (mitigate or eliminate) perceived and actual CoI to improve public confidence in government decision-making relevant to food policy

The use of child oral-health-related quality of life measures in a randomised control trial of the Hall crown technique in a primary care setting

The first aim of this thesis was to analyse the health-related (HRQoL) and oral-health-related quality of life (OHRQoL) information collected during the clinical trial of the Hall technique, to determine whether there were differences between those receiving conventional dental treatment (restorations and conventional stainless-steel crowns), and those having the Hall technique of stainless-steel crown placement. The second aim was to see whether the current child HRQoL and OHRQoL measures were responsive to routine dental treatment in the primary health setting. Method The Transform a Tooth (TAT) study was undertaken in the Whanganui District Health Board Community Oral Health Service (COHS) from 2014-2018 by Dr LA Foster Page and Dr DH Boyd, with funding from the Cure Kids Foundation and support from 3MTM. It was a randomised control trial, investigating the use of the Hall technique for the placement of preformed stainless-steel crowns on children’s primary teeth to treat dental caries. The children involved in the study were aged 3-7 years at the time of recruitment. Prior to the initial appointment consent was obtained, and questionnaires were completed. A clinical examination was undertaken where the baseline oral health data was recorded, and posterior bitewing radiographs were taken. Those children who met the selection criteria, were randomly allocated to the test group (Hall) or control group (non-Hall) and proceeded to have their treatment. The children had subsequent dental examinations and completed repeat OHRQoL questionnaires at the 12-month, and 24-month follow-up appointments. Data from the clinical aspects of the trial are presented elsewhere. The parent questionnaire used in the TAT study contained five components. This included a global question on oral health impact, the short-form 16-item Parent/Caregivers Perceptions Questionnaire (P-CPQ) on OHRQoL, a short form version of the Family Impact Scale (FIS) consisting of eight questions on how oral health may have impacted family life, a global question on how the child’s oral health affects the family, and nine questions on the child’s general quality of life, collected using the Child Health Utility 9D (CHU-9D). The initial parent questionnaire also included the Index of Socioeconomic Deprivation (NZiDep) questions. The child questionnaire included the CHU-9D (child version) of nine questions relating to the child’s quality of life, the seven question Scale of Oral Health Outcomes (SOHO), and five general ‘global’ questions. The OHRQoL questionnaires were administered initially prior to selection into the study, and then repeated at the 12-month and 24-month follow-up appointments. Findings The children included in the study differed from those excluded by: being more likely to be from a high deprivation area (area-deprivation method only, no difference was found using the household deprivation method), having higher caries experience (respective dmft scores of 4.6 and 1.4), and higher mean OHRQoL scale scores on the both the P-CPQ and SOHO scales. The two randomised treatment groups of Hall (51% of included sample) and non-Hall (49%) had no significant differences in their demographic characteristics, caries experience or mean HRQoL/OHRQoL scale scores. The HRQoL/OHRQoL measures were tested for internal consistency using Cronbach’s alpha co-efficient. The P-CPQ had the strongest score (0.82), and the CHU-9D child version the lowest (0.63). At the 12-month follow-up there were 129 (92%) remaining in the Hall group, and 129 (88%) in the non-Hall group. There was a significantly higher proportion of Māori children lost to follow-up. For those followed up at 12 months, all repeat HRQoL/OHRQoL questionnaires showed slightly higher mean scale scores for the Hall group, with statistical significance for the CHU-9D parent measure. Change scores and effect sizes for the P-CPQ and FIS had small improvements for both Hall and non-Hall groups. The CHU-9D parent version Hall had a small worsening and the non-Hall had a small improvement. The CHU-9D child version Hall group had a moderate worsening and the non-Hall a small worsening. For the SOHO scale the Hall group had a small worsening and non-Hall a small improvement. By the 24-month follow-up fewer than half of the participants remained, with 43% and 48% (respectively) retained in the Hall and non-Hall groups. Despite this relatively high attrition rate there were no statistically significant differences in their demographic characteristics, caries experience or baseline mean HRQoL/OHRQoL scores for those assessed and those lost to follow-up. At that 24-month follow-up the Hall group had higher mean HRQoL/OHRQoL scale scores for three of the measures (P-CPQ, CHU-9D parent, and SOHO) than the non-Hall. The change scores and effect sizes at 24 months for both groups had moderate improvement in their mean the P-CPQ scores, and small improvements in their FIS scores. The CHU-9D parent version had no change for the Hall group and small improvement in the non-Hall, and the SOHO score had no change in the Hall group and small improvement in the non-Hall. The CHU-9D child measure had a small worsening for the Hall group, and moderate worsening in the non-Hall group. However, none of the differences were statistically significant. Conclusions The HRQoL/OHRQoL information is an important adjunct to the clinical data collected during clinical trials. It provides valuable information on the impact that different treatment modalities have on children and their families. This is important when new clinical techniques are being considered, such as the Hall technique, which should not be judged just on its clinical success or failure. It is important to consider the timeliness of the questionnaires with regard to the treatment intervention, and whether we can directly infer the studied intervention technique without allowing for the confounding variables over the period of a year. The children receiving the Hall crown treatment technique after 12 month had higher scale scores, but this effect was not clear at the 24-month review, with mixed results between the two groups. The P-CPQ was the only measure which did not have a large floor effect in the scale scores, and had the best internal reliability. The P-CPQ score showed a small improvement at 12-months and moderate improvement at 24 months in both the Hall and non-Hall groups. The P-CPQ may be the best measure suited to this younger age group (age 3-8) in this scenario type (routine dental treatment in primary care setting). Careful consideration needs to be given to whether these measures have the responsiveness to identify any meaningful change