Short Communication: A qualitative assessment of food security in an internally displaced persons camp in Kenya

The 2007/08 post-election violence in Kenya resulted in the displacement of an estimated 600 000 people. Current published research suggests that many of these internally displaced persons (IDPs) continue to have issues accessing basic needs, including food and water, impacting morbidity and mortality. This study aimed to assess food security and access to cooking fuel and water within an internally displaced persons’ (IDP) camp in Kenya. It was designed as a descriptive, qualitative study involving semi-structured interviews with members of households residing in the IDP camp. Participants were recruited through respondent-driven sampling using a network of coupons. Semi-structured interviews were utilised to determine key issues associated with the attainment of food security, access to cooking fuel and water among resident IDPs, targeting male household heads. Interview structure was based on framework for assessment of food security provided by the International Federation of the Red Cross. Recorded interviews then underwent thematic analysis using NVivo 10 (QSR International, Melbourne, Victoria). A total of 15 semi-structured interviews were completed with men at the camp, aged between 18 and 53. Thematic analysis shows that key elicited concerns regarding food security included lack of capital for agriculture, lack of dietary diversity, seasonal insecurity and anxiety about the future. Access to water was limited to a single borehole located within the camp. Few reliable and safe sources could be identified for cooking fuel. Thus, internally displaced persons residing at this camp continue to experience significant food insecurity. Despite being allocated land for agriculture, they lack capital for investment in agriculture and access to local food markets. Access to water and cooking fuel is limited and a source of significant concern. Initiatives to improve food security delivered through government and non-government programs are necessary to minimise the significant impact of such food insecurity on mental health and disease profiles as reported in other IDP settings.Key words: Internally displaced persons, Kenya, Food security, Qualitative study, Nutritio

Clinical Fellowship for an Innovative, Integrated BSN-PhD Program: An Academic and Practice Partnership

Opportunities for research-focused doctoral education must be available to nurses early in their careers in order to ensure the further development of nursing science. Early entry into the research doctorate through an integrated BSN-PhD program is one innovative approach. This approach highlights the value of integrating post-licensure clinical training into the doctoral curriculum. To better prepare innovative nurse scientists early in their careers we developed a clinical nurse fellowship within an integrated BSN-PhD program in partnership with an affiliated health system. The aims of this clinical fellowship are to integrate post-licensure clinical experience with academic preparation, cultivate scholarly reflection on the connections between research and practice, educate nurse researchers to work effectively in interdisciplinary teams, and develop nurses\u27 contributions to health care innovation. Major considerations for the development of similar clinical training opportunities include clarifying and articulating the major aims of the fellowship, enlisting the support of executive clinical leadership, and placing fellows on nursing units with experienced and advanced nursing teams and management that supports the fellowship\u27s aims. We emphasize the fully integrated and collaborative activities, decision-making, and commitment required of both academic and health system partners to successfully implement similar clinical training opportunities

High-throughput sequencing reveals a simple model of nucleosome energetics

We use nucleosome maps obtained by high-throughput sequencing to study sequence specificity of intrinsic histone-DNA interactions. In contrast with previous approaches, we employ an analogy between a classical one-dimensional fluid of finite-size particles in an arbitrary external potential and arrays of DNA-bound histone octamers. We derive an analytical solution to infer free energies of nucleosome formation directly from nucleosome occupancies measured in high-throughput experiments. The sequence-specific part of free energies is then captured by fitting them to a sum of energies assigned to individual nucleotide motifs. We have developed hierarchical models of increasing complexity and spatial resolution, establishing that nucleosome occupancies can be explained by systematic differences in mono- and dinucleotide content between nucleosomal and linker DNA sequences, with periodic dinucleotide distributions and longer sequence motifs playing a secondary role. Furthermore, similar sequence signatures are exhibited by control experiments in which genomic DNA is either sonicated or digested with micrococcal nuclease in the absence of nucleosomes, making it possible that current predictions based on high-throughput nucleosome positioning maps are biased by experimental artifacts.Comment: 36 pages, 13 figure

Random Planar Lattices and Integrated SuperBrownian Excursion

In this paper, a surprising connection is described between a specific brand of random lattices, namely planar quadrangulations, and Aldous' Integrated SuperBrownian Excursion (ISE). As a consequence, the radius r_n of a random quadrangulation with n faces is shown to converge, up to scaling, to the width r=R-L of the support of the one-dimensional ISE. More generally the distribution of distances to a random vertex in a random quadrangulation is described in its scaled limit by the random measure ISE shifted to set the minimum of its support in zero. The first combinatorial ingredient is an encoding of quadrangulations by trees embedded in the positive half-line, reminiscent of Cori and Vauquelin's well labelled trees. The second step relates these trees to embedded (discrete) trees in the sense of Aldous, via the conjugation of tree principle, an analogue for trees of Vervaat's construction of the Brownian excursion from the bridge. From probability theory, we need a new result of independent interest: the weak convergence of the encoding of a random embedded plane tree by two contour walks to the Brownian snake description of ISE. Our results suggest the existence of a Continuum Random Map describing in term of ISE the scaled limit of the dynamical triangulations considered in two-dimensional pure quantum gravity.Comment: 44 pages, 22 figures. Slides and extended abstract version are available at http://www.loria.fr/~schaeffe/Pub/Diameter/ and http://www.iecn.u-nancy.fr/~chassain

Income distribution patterns from a complete social security database

We analyze the income distribution of employees for 9 consecutive years (2001-2009) using a complete social security database for an economically important district of Romania. The database contains detailed information on more than half million taxpayers, including their monthly salaries from all employers where they worked. Besides studying the characteristic distribution functions in the high and low/medium income limits, the database allows us a detailed dynamical study by following the time-evolution of the taxpayers income. To our knowledge, this is the first extensive study of this kind (a previous japanese taxpayers survey was limited to two years). In the high income limit we prove once again the validity of Pareto's law, obtaining a perfect scaling on four orders of magnitude in the rank for all the studied years. The obtained Pareto exponents are quite stable with values around $\alpha \approx 2.5$, in spite of the fact that during this period the economy developed rapidly and also a financial-economic crisis hit Romania in 2007-2008. For the low and medium income category we confirmed the exponential-type income distribution. Following the income of employees in time, we have found that the top limit of the income distribution is a highly dynamical region with strong fluctuations in the rank. In this region, the observed dynamics is consistent with a multiplicative random growth hypothesis. Contrarily with previous results obtained for the japanese employees, we find that the logarithmic growth-rate is not independent of the income.Comment: 10 pages, 7 Figure

‘Oh! - is that how you do it!’ Learning from cross-phase collaborative work in the Years 5-8 Continuity project

We report on work of the Years 5-8 Continuity project, which runs across England in Maths Hubs, led by the National Centre for Excellence in the Teaching of Mathematics (NCETM). The aim of this project is to strengthen primary to secondary transition by focusing on curriculum and pedagogical continuity in mathematics over Years 5 to 8. Promotion of cross-phase teacher collaboration is central. The vehicle for teacher development is the Work Group, whereby groups of teachers led by an experienced colleague work collaboratively over a period of time. In 2021-22 a small research team began to explore the impact of this project on teachers’ pedagogical practice and school policy/approaches. We discuss findings from internal evaluation, and from small scale case studies carried out by this team. Early findings indicate that cross-phase engagement with colleagues through focused and sustained professional activity is having a positive impact on practice and school/departmental approaches

Long-term epidemiological survey of Kudoa thyrsites (Myxozoa) in Atlantic salmon (Salmo salar L.) from commercial aquaculture farms

Kudoa thyrsites (Myxozoa) encysts within myocytes of a variety of fishes. While infected fish appear unharmed, parasite-derived enzymes degrade the flesh post-mortem. In regions of British Columbia (BC), Canada, up to 4–7% of fillets can be affected, thus having economic consequences and impacting the competitiveness of BC's farms. K. thyrsites was monitored in two farms having high (HP) or low (LP) historical infection prevalence. At each farm, 30 fish were sampled monthly for blood and muscle during the first year followed by nine samplings during year two. Prevalence and intensity were measured by PCR and histology of muscle samples. In parallel, fillet tests were used to quantify myoliquefaction. Infections were detected by PCR after 355 and 509 degree days at LP and HP farms, respectively. Prevalence reached 100% at the HP farm by 2265 degree days and declined during the second year, whereas it plateaued near 50% at the LP farm. Infection intensities decreased after 1 year at both farms. Blood was PCR-positive at both farms between 778 and 1113 degree days and again after 2000 degree days. This is the first monitoring project in a production environment and compares data between farms with different prevalence.This project was funded by Marine Harvest Canada and an NSERC IRDF Fellowship to WL Marshall.Peer Reviewe

Pharmaceutical care for elderly patients shared between community pharmacists and general practitioners: A randomised evaluation. RESPECT (Randomised Evaluation of Shared Prescribing for Elderly people in the Community over Time) [ISRCTN16932128]

Background: This trial aims to investigate the effectiveness and cost implications of 'pharmaceutical care' provided by community pharmacists to elderly patients in the community. As the UK government has proposed that by 2004 pharmaceutical care services should extend nationwide, this provides an opportunity to evaluate the effect of pharmaceutical care for the elderly. Design: The trial design is a randomised multiple interrupted time series. We aim to recruit 700 patients from about 20 general practices, each associated with about three community pharmacies, from each of the five Primary Care Trusts in North and East Yorkshire. We shall randomise the five resulting groups of practices, pharmacies and patients to begin pharmaceutical care in five successive phases. All five will act as controls until they receive the intervention in a random sequence. Until they receive training community pharmacists will provide their usual dispensing services and so act as controls. The community pharmacists and general practitioners will receive training in pharmaceutical care for the elderly. Once trained, community pharmacists will meet recruited patients, either in their pharmacies (in a consultation room or dispensary to preserve confidentiality) or at home. They will identify drug-related issues/problems, and design a pharmaceutical care plan in conjunction with both the GP and the patient. They will implement, monitor, and update this plan monthly. The primary outcome measure is the 'Medication Appropriateness Index'. Secondary measures include adverse events, quality of life, and patient knowledge and compliance. We shall also investigate the cost of pharmaceutical care to the NHS, to patients and to society as a whole.published_or_final_versio

Racial differences in user experiences and perceived value of electronic symptom monitoring in a cohort of black and white bladder and prostate cancer patients

Purpose: Electronic patient-reported outcomes (ePROs) are increasingly being used for symptom monitoring during routine cancer care, but have rarely been evaluated in diverse patient populations. We assessed ePRO user experiences and perceived value among Black and White cancer patients. Methods: We recruited 30 Black and 49 White bladder and prostate cancer patients from a single institution. Participants reported symptoms using either a web-based or automated telephone interface over 3 months and completed satisfaction surveys and qualitative interviews focused on user experiences and value. Using a narrative mixed methods approach, we evaluated overall and race-specific differences in ePRO user experiences and perceived value. Results: Most participants selected the web-based system, but Blacks were more likely to use the automated telephone-based system than Whites. In satisfaction surveys, Whites more commonly reported ease in understanding and reporting symptoms compared with Blacks. Blacks more often reported that the ePRO system was helpful in facilitating symptom-related discussions with clinicians. During interviews, Blacks described how the ePRO helped them recognize symptoms, while Whites found value in better understanding and tracking symptoms longitudinally. Blacks also expressed preferences for paper-based ePRO options due to perceived ease in better understanding of symptom items. Conclusion: Electronic patient-reported outcomes are perceived as valuable for variable reasons by Black and White cancer populations, with greater perceived value for communicating with clinicians reported among Blacks. To optimize equitable uptake of ePROs, oncology practices should offer several ePRO options (e.g., web-based, phone-based), as well as paper-based options, and consider the e-health literacy needs of patients during implementation