The provision of NHS health checks in a community setting: an ethnographic account

Background: The UK National Health Service Health Checks programme aims to reduce avoidable cardiovascular deaths, disability and health inequalities in England. However, due to the reported lower uptake of screening in specific black and minority ethnic communities who are recognised as being more at risk of cardiovascular disease, there are concerns that NHS Health Checks may increase inequalities in health. This study aimed to examine the feasibility and acceptability of community outreach NHS Health Checks targeted at the Afro-Caribbean community. Methods: This paper reports findings from an ethnographic study including direct observation of four outreach events in four different community venues in inner-city Bristol, England and follow up semi-structured interviews with attendees (n = 16) and staff (n = 4). Interviews and field notes were transcribed, anonymized and analysed thematically using a process of constant comparison. Results: Analysis revealed the value of community assets (community engagement workers, churches, and community centres) to publicise the event and engage community members. People were motivated to attend for preventative reasons, often prompted by familial experience of cardiovascular disease. Attendees valued outreach NHS Health Checks, reinforcing or prompting some to make healthy lifestyle changes. The NHS Health Check provided an opportunity for attendees to raise other health concerns with health staff and to discuss their test results with peers. For some participants, the communication of test results, risk and lifestyle information was confusing and unwelcome. The findings additionally highlight the need to ensure community venues are fit for purpose in terms of assuring confidentiality. Conclusions: Outreach events provide evidence of how local health partnerships (family practice staff and health trainers) and community assets, including informal networks, can enhance the delivery of outreach NHS Health Checks and in promoting the health of targeted communities. To deliver NHS Health Checks effectively, the location and timing of events needs to be carefully considered and staff need to be provided with the appropriate training to ensure patients are supported and enabled to make lifestyle changes

Filtering informal learning in everyday life: invoking ordinariness and moving to civic engagement

This article explores the role of informal learning from television as it is anchored within the ordinariness of daily life. It examines the consequences for pedagogy and civic engagement, questioning how informal learning from television can enhance civic engagement. For many, this learning was localized through personalized and interpersonal relations of everyday life. Learning was not viewed as a distant institutional force, but as an embedded part of an ordinary life. The invoking of ordinariness rendered the relationship between learning and civic engagement unproblematic. Learning was localized in subjective terms for self-identity and interpersonal relations rather than critically reflecting on the power structures of everyday life

Modelling the Dynamics of Feral Alfalfa Populations and Its Management Implications

BACKGROUND: Feral populations of cultivated crops can pose challenges to novel trait confinement within agricultural landscapes. Simulation models can be helpful in investigating the underlying dynamics of feral populations and determining suitable management options. METHODOLOGY/PRINCIPAL FINDINGS: We developed a stage-structured matrix population model for roadside feral alfalfa populations occurring in southern Manitoba, Canada. The model accounted for the existence of density-dependence and recruitment subsidy in feral populations. We used the model to investigate the long-term dynamics of feral alfalfa populations, and to evaluate the effectiveness of simulated management strategies such as herbicide application and mowing in controlling feral alfalfa. Results suggest that alfalfa populations occurring in roadside habitats can be persistent and less likely to go extinct under current roadverge management scenarios. Management attempts focused on controlling adult plants alone can be counterproductive due to the presence of density-dependent effects. Targeted herbicide application, which can achieve complete control of seedlings, rosettes and established plants, will be an effective strategy, but the seedbank population may contribute to new recruits. In regions where roadside mowing is regularly practiced, devising a timely mowing strategy (early- to mid-August for southern Manitoba), one that can totally prevent seed production, will be a feasible option for managing feral alfalfa populations. CONCLUSIONS/SIGNIFICANCE: Feral alfalfa populations can be persistent in roadside habitats. Timely mowing or regular targeted herbicide application will be effective in managing feral alfalfa populations and limit feral-population-mediated gene flow in alfalfa. However, in the context of novel trait confinement, the extent to which feral alfalfa populations need to be managed will be dictated by the tolerance levels established by specific production systems for specific traits. The modelling framework outlined in this paper could be applied to other perennial herbaceous plants with similar life-history characteristics

Marketing (as) Rhetoric: paradigms, provocations, and perspectives

In this collection of short, invited essays on the topic of marketing (as) rhetoric we deal with a variety of issues that demonstrate the centrality of rhetoric and rhetorical considerations to the pursuit of marketing scholarship, research and practice. Stephen Brown examines the enduring rhetorical power of the 4Ps; Chris Hackley argues for the critical power of rhetorical orientations in marketing scholarship but cautions us on the need to work harder in conceptually connecting rhetorical theory and modern marketing frameworks; Shelby Hunt explains how rhetorical processes are incorporated in his inductive realist model of theory generation, using one of his most successful publications as an illustration; Charles Marsh demonstrates what Isocrates’ broad rhetorical project has to teach us about the importance of reputation cultivation in modern marketing; Nicholas O’Shaughnessy uses an analysis of Trump’s discourse to argue that political marketing as it is currently conceived is ill-equipped to engage effectively with the rhetorical force of Trump’s ‘unmarketing’; Barbara Phillips uses Vygotsky’s work on imagination to investigate the important of pleasure and play in advertising rhetoric; and finally, David Tonks, who in many ways started it all, reiterates the need for marketers to recognise the strength of the relationship between marketing and persuasion

Analysis of the Ush2a Gene in Medaka Fish (Oryzias latipes)

Patients suffering from Usher syndrome (USH) exhibit sensorineural hearing loss, retinitis pigmentosa (RP) and, in some cases, vestibular dysfunction. USH is the most common genetic disorder affecting hearing and vision and is included in a group of hereditary pathologies associated with defects in ciliary function known as ciliopathies. This syndrome is clinically classified into three types: USH1, USH2 and USH3. USH2 accounts for well over one-half of all Usher cases and mutations in the USH2A gene are responsible for the majority of USH2 cases, but also for atypical Usher syndrome and recessive non-syndromic RP. Because medaka fish (Oryzias latypes) is an attractive model organism for genetic-based studies in biomedical research, we investigated the expression and function of the USH2A ortholog in this teleost species. Ol-Ush2a encodes a protein of 5.445 aa codons, containing the same motif arrangement as the human USH2A. Ol-Ush2a is expressed during early stages of medaka fish development and persists into adulthood. Temporal Ol-Ush2a expression analysis using whole mount in situ hybridization (WMISH) on embryos at different embryonic stages showed restricted expression to otoliths and retina, suggesting that Ol-Ush2a might play a conserved role in the development and/or maintenance of retinal photoreceptors and cochlear hair cells. Knockdown of Ol-Ush2a in medaka fish caused embryonic developmental defects (small eyes and heads, otolith malformations and shortened bodies with curved tails) resulting in late embryo lethality. These embryonic defects, observed in our study and in other ciliary disorders, are associated with defective cell movement specifically implicated in left-right (LR) axis determination and planar cell polarity (PCP)

Place and Time in the Criminology of Place

This article evaluates developments in the ecological analysis of crime, which have found their most recent expression in a Criminology of Place. We argue that theoretical and methodological deficiencies are evident in the Criminology of Place and associated literatures with respect to their underlying treatment of place, time and causation. Big Data holds promise for helping address these shortfalls, but dangers also. The successful advance of the Criminology of Place requires elevating the why question to equal status with those of where and what in the analysis of crime. Ultimately, the paper positions the progress towards and prospects for a multi-scalar and time sensitive theoretical and empirical model of the Criminology of Place