Domestic Kitchen Practices: findings from the ‘Kitchen Life’ study

This report presents a study designed to investigate, document, analyse and interpret domestic kitchen practices. The study was intended to generate insights about ‘what goes on and why’ in UK kitchens, to inform the Food Standards Agency’s (FSA) thinking about how to reduce the burden of foodborne disease. A key focus of earlier FSA research has been on reported behaviours – the Kitchen Life study took a different approach, to examine what people do, what they say about what they do and the role of the kitchen itself and its assorted things, technologies and resources (chopping boards, microwaves and cupboards, for example). A qualitative and ethnographic approach was taken to investigate domestic kitchen practices in 20 UK households. The practices of those aged 60+ years and pregnant women are of particular interest to the FSA as these groups are vulnerable to foodborne illness; these household-types were therefore included in the study. The study findings are organised around four themes which broadly relate to where, exactly, kitchen life takes place, how, with whom and why. Potential pathways to foodborne illness have been highlighted through this study, revealing the way that non-food actions and things interact with food-related activities. This suggests that it is important to consider practices with their meaning and context intact. The findings offer new ways to consider how vulnerability and risk are defined. We suggest that older people (aged 60+ but particularly those aged 80+) have more ‘working against them’ in the home (mobility problems and ageing kitchen appliances for example) which might increase their risk of foodborne illness. Considering a household’s assets (not just economic assets) and coping capacities (e.g. asking for advice about reheating food) may complement an approach which examines why and how households fail to adhere to recommended practice

Early Computed Tomography Coronary Angiography and Preventative Treatment in Patients with Suspected Acute Coronary Syndrome A secondary analysis of the RAPID-CTCA trial

BackgroundComputed tomography coronary angiography (CTCA) offers detailed assessment of the presence of coronary atherosclerosis and helps guide patient management. We investigated influences of early CTCA on the subsequent use of preventative treatment in patients with suspected acute coronary syndrome.MethodsIn this secondary analysis of a multicentre randomised controlled trial of early CTCA in intermediate-risk patients with suspected acute coronary syndrome, prescription of aspirin, P2Y12 receptor antagonist, statin, renin–angiotensin system blocker, and beta-blocker therapies from randomisation to discharge were compared within then between those randomised to early CTCA or to standard of care only. Effects of CTCA findings on adjustment of these therapies were further examined.ResultsIn 1743 patients (874 randomised to early CTCA and 869 to standard of care only), prescription of P2Y12 receptor antagonist, dual antiplatelet, and statin therapiesincreased more in the early CTCA group (between-group difference: 4.6% (95% confidence interval, 0.3 to 8.9), 4.5% (95% confidence interval, 0.2 to 8.7), and 4.3% (95% confidence interval, 0.2 to 8.5), respectively), whereas prescription of other preventative therapies increased by similar extent in both study groups. Amongst patients randomised to early CTCA, there were additional increments of preventative treatment in those with obstructive coronary artery disease and higher rates of 6 reductions in antiplatelet and beta-blocker therapies in those with normal coronary arteries.ConclusionsPrescription patterns of preventative treatment varied during index hospitalisation in patients with suspected acute coronary syndrome. Early CTCA facilitated targeted individualisation of these therapies based on the extent of coronary artery disease.<br/

The SESAMI evaluation of employment support in the UK: background and baseline data

Aims: This study evaluates real world employment support for people with severe mental health problems in the UK. Given a policy context which promotes social inclusion and welfare to work, we wanted to find out about typical employment services and their effects on people with mental health problems. Method: A case study design was adopted, incorporating qualitative and quantitative interviews with staff and users of each service. After screening for severity, 182 individuals met our inclusion criteria for current use of the services. They were interviewed about their current engagement with support services, their employment and job satisfaction if employed. Measures of self esteem, hope/optimism and job satisfaction were taken as outcomes. Results: We report here associations between the outcome measures and: current working status; support from the agency; and demographic features at baseline. People who were working had higher outcome scores than those who were in work preparation or training. People working with support had higher job satisfaction. Conclusions: The study highlights the methodological issues raised by doing real world research. These findings were generated by heterogeneous interventions in non-experimental settings. Despite this, they tend to support previous evidence in favour of early placement and ongoing support in work

Coronary Atherosclerotic Plaque Activity and Future Coronary Events

This study was funded by a Wellcome Trust Senior Investigator Award (WT103782AIA). Image analysis was supported by National Institutes for Health (R34HL161195 and 1R01HL135557). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Wellcome Trust or the National Institutes of Health. The British Heart Foundation supports DEN (CH/09/002, RG/16/10/32375, RE/18/5/34216), MRD (FS/SCRF/21/32010), NLM (CH/F/21/90010, RG/20/10/34966, RE/18/5/34216) AJM (AA/18/3/34220) and MCW (FS/ICRF/20/26002) and DD (FS/RTF/20/30009, NH/19/1/34595, PG/18/35/33786, PG/15/88/31780, PG/17/64/33205). MRD is the recipient of the Sir Jules Thorn Award for Biomedical Research 2015 (15/JTA). PJS is supported by outstanding investigator award National Institutes for Health (R35HL161195). JK is supported by the National Science Centre 2021/41/B/NZ5/02630. EvB is supported by SINAPSE (www.sinapse.ac.uk). AB is supported by a Clinical Research Training Fellowships (MR/V007254/1). DD is supported by Chest Heart and Stroke Scotland (19/53), Tenovus Scotland (G.18.01), and Friends of Anchor and Grampian NHS-Endowments. The Edinburgh Clinical Research Facilities, Edinburgh Imaging facility and Edinburgh Clinical Trials Unit are supported by the National Health Service Research Scotland through National Health Service Lothian Health Board. The Leeds Clinical Research Facilities are supported by the UK National Institute for Health Research (NIHR) via its Clinical Research Facility programme. The work at Cedars-Sinai Medical Center (the Los Angeles site) was supported in part by the Dr. Miriam and Sheldon G. Adelson Medical Research Foundation. For the purpose of open access, the author has applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising from this submission. The Chief Investigator and Edinburgh Clinical Trials Unit had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.Peer reviewedPostprin

Crowded kitchens: The 'democratisation' of domesticity?

Building on previous work concerning the gendered nature of domestic space, this article focuses on the kitchen as a key site in which gendered roles and responsibilities are experienced and contested. As men have begun to engage more frequently in cooking and other domestic practices (albeit selectively and often on their own terms), this article argues that kitchens have become ‘crowded’ spaces for women. Drawing on evidence from focus groups, interviews and ethnographic observation of kitchen practices in South Yorkshire (UK), we suggest that men's entry into the kitchen has facilitated the expression of a more diverse range of masculine subjectivities, while also creating new anxieties for women. Specifically, our evidence suggests that family meals may be experienced as a site of domestic conflict as well as a celebration of family life; that convenience and shortcuts can be embraced by women without incurring feelings of guilt and imperfection; that cooking is being embraced as a lifestyle choice by an increasing numbers of men who use it as an opportunity to demonstrate competence and skill, while women are more pragmatic; and that kitchens may be experienced as ‘uncanny’ spaces by women as men increasingly assert their presence in this domain. Our analysis confirms that while the relationship between domestic practices and gendered subjectivities is changing, this does not amount to a fundamental ‘democratisation’ of domesticity with significantly greater equality between men and women

Reconceptualizing power and gendered subjectivities in domestic cooking spaces

Drawing on evidence from the Global North and South, this paper explores the power dynamics of domestic kitchens in different geographical contexts. Noting the gendered nature of domesticity, it contrasts those perspectives which regard women’s primary responsibility for foodwork as inherently oppressive, with others which see kitchens and associated domestic spaces as sites of potential empowerment for women. The paper explores the complex, spatially-distributed, character of power surrounding domestic foodwork, decentring Anglo-American understandings of the relationship between gender, power and domestic space by foregrounding the experiences of a range of women from across the globe. The paper also examines the increasing role of men in domestic settings, particularly in the Global North, assessing the extent to which their engagement in cooking and other domestic practices may be challenging conventional understandings of the relationship between gender, power and space. Focusing on the spatial dynamics of the domestic kitchen, this paper advances a more nuanced understanding of the co-constitutive nature of the relationship between gender and power, including the instabilities and slippages that occur in the performance of various domestic foodwork tasks. The paper advocates future research on the boundaries of home, work and leisure, focusing on their significance in the constitution and transformation of male and female subjectivities

A thematic analysis of factors influencing recruitment to maternal and perinatal trials

Background: Recruitment of eligible participants remains one of the biggest challenges to successful completion of randomised controlled trials (RCTs). Only one third of trials recruit on time, often requiring a lengthy extension to the recruitment period. We identified factors influencing recruitment success and potentially effective recruitment strategies. Methods: We searched MEDLINE and EMBASE from 1966 to December Week 2, 2006, the Cochrane Library Methodology Register in December 2006, and hand searched reference lists for studies of any design which focused on recruitment to maternal/perinatal trials, or if no studies of maternal or perinatal research could be identified, other areas of healthcare. Studies of nurses' and midwives' attitudes to research were included as none specifically about trials were located. We synthesised the data narratively, using a basic thematic analysis, with themes derived from the literature and after discussion between the authors. Results: Around half of the included papers (29/53) were specific to maternal and perinatal healthcare. Only one study was identified which focused on factors for maternal and perinatal clinicians and only seven studies considered recruitment strategies specific to perinatal research. Themes included: participant assessment of risk; recruitment process; participant understanding of research; patient characteristics; clinician attitudes to research and trials; protocol issues; and institutional or organisational issues. While no reliable evidence base for strategies to enhance recruitment was identified in any of the review studies, four maternal/perinatal primary studies suggest that specialised recruitment staff, mass mailings, physician referrals and strategies targeting minority women may increase recruitment. However these findings may only be applicable to the particular trials and settings studied. Conclusion: Although factors reported by both participants and clinicians which influence recruitment were quite consistent across the included studies, studies comparing different recruitment strategies were largely missing. Trials of different recruitment strategies could be embedded in large multicentre RCTs, with strategies tailored to the factors specific to the trial and institution.Rebecca L Tooher, Philippa F Middleton and Caroline A Crowthe

A common variant near TGFBR3 is associated with primary open angle glaucoma

Primary open angle glaucoma (POAG), a major cause of blindness worldwide, is a complex disease with a significant genetic contribution. We performed Exome Array (Illumina) analysis on 3504 POAG cases and 9746 controls with replication of the most significant findings in 9173 POAG cases and 26 780 controls across 18 collections of Asian, African and European descent. Apart from confirming strong evidence of association at CDKN2B-AS1 (rs2157719 [G], odds ratio [OR] = 0.71, P = 2.81 × 10−33), we observed one SNP showing significant association to POAG (CDC7–TGFBR3 rs1192415, ORG-allele = 1.13, Pmeta = 1.60 × 10−8). This particular SNP has previously been shown to be strongly associated with optic disc area and vertical cup-to-disc ratio, which are regarded as glaucoma-related quantitative traits. Our study now extends this by directly implicating it in POAG disease pathogenesis