The champion for improved delivery of care to older people in long-term care settings: effects on professional practice, quality of care and resident outcomes

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effectiveness of the champion on professional practice, quality of care and resident outcomes in long-term care for older people

Urban agriculture in shared spaces : the difficulties with collaboration in an age of austerity

The expanding critical literature on Urban Agriculture (UA) makes links between the withdrawal of state services and the institutionalisation of volunteering, while observing that challenging funding landscapes can foster competitive environments between third sector organisations. Where these organisations are forced to compete for survival at the expense of collaboration, their ability to collectively upscale and expand beneficial activities can be compromised. This paper focuses on a lottery-funded UA project and draws predominantly on observations and interviews held with project staff and growing group volunteers. Research conducted in Wythenshawe, Manchester (UK), highlights difficulties experienced by organisations attempting to function in an environment disfigured by depletion, illustrating conflicts that can arise between community groups and charitable organisations competing for space and resources. Inter-organisational dynamics are considered at two scales; at the grassroots level between growing groups, and at a structural level between project partners. In a landscape scarred by local authority cutbacks and restructures, a dearth of funding opportunities and increasingly precarious employment, external initiatives can be met with suspicion or hostility, particularly when viewed as superfluous interventions. The resulting “siege mentality” reflects the need for organisational self-preservation but perhaps paradoxically results in groups with similar goals and complementary ideologies working against each other rather than in cooperation. Keywords: Urban Agriculture; critical geography; neoliberalism; community growing; urban farmin

Care farming and green care in Salford

This report presents a University of Salford (UoS) investigation into the potential for care farming in Salford as part of the University’s teaching, research and enterprise activities. The work has critically engaged with the notion of care farming with a view to better understand how this approach can contribute to helping communities with diverse needs in terms of physical and mental health as well as wider determinants of health such as social inclusion and employability. Through the establishment of, and engagement with a network of key local stakeholders, the work developed a model that has explored the potential of a care farm. What has emerged is a first step towards the design and establishment of an urban care farm that that could serve as a centre for learning and research as well as integrate existing activities as part of a green and blue network identified through the stakeholder engagement work. This report provides a direction for future work on care farming in Salford in general, and in terms of the University’s teaching and learning activities in particular

Biofilm formation is a risk factor for mortality in patients with Candida albicans bloodstream infection-Scotland, 2012-2013

Acknowledgements This work was supported by the Wellcome Trust Strategic Award for Medical Mycology and Fungal Immunology 097377/Z/11/Z. Data collection was supported by a grant from Pfizer. G. Ramage was also supported by a research fellowship grant from Gilead Sciences. We are grateful to microbiology colleagues throughout Scotland for submitting isolates.Peer reviewedPublisher PD

The influence of soft acidic drinks in exposing dentinal tubules after non-surgical periodontal treatment: : a SEM investigation on the protective effects of oxalate-containing phytocomplex

Objective: The aim of this study was to investigate the different smear layer morphologies produced by instrumentation with a hand curette and a periodontal sonic scaler for potential removal by soft acidic solution. The effect of a new oxalate-containing phytocomplex spray in preventing tubules exposure after citric acid solution application was also evaluated. Methods: Thirty recently extracted human teeth were used to obtain root dentinal fragments and divided in two groups: Curette treatment (CRT) root planed applying 30 working strokes to each surface using a Gracey?s curette 5-6 and Ultrasonic scaler (USC) treated using a periodontal scaler mounted on an ultrasonic hand-piece for 30 seconds. Each principal group was further divided in three sub-groups (Control, Acid challenge and Acid/Phyto-oxalate). The control group samples were immersed in distilled water buffered to pH 7.4 using NH4 OH solution. The samples of the acid challenge group were immersed in a solution of citric acid 0,02M; [pH 2.5] for 3 minutes. The samples of the Acid/Phyto-oxalate group were sprayed for 15 sec with a 1.5% phytocomplex spray prior to immersion. Samples were examined using SEM. Results: Ultrasonic instrumentation created a very thin smear layer whereas curettes produced a multilayered smear layer. The acidic solution was able to remove the smear layer from root surfaces treated with ultrasonic instrumentation exposing the dentinal tubules. The smear layer on the root surfaces treated with hand instruments was not completely removed. The phytocomplex solution was able to prevent dentinal tubule exposure. Conclusions: Acidic soft drinks are able to remove the smear layer created on root surfaces during different non-surgical periodontally treatments. The smear plugs created by hand instrumentation appeared to be more resistant to acid attack. The tested phytocomplex solution protected the dentine from demineralization and it might prevent post-treatment dentinal hypersensitivity induced by acidic soft drinks

Reshaping health services and fuel poverty in the Outer Hebrides

Gluasad Còmhla (Moving Together) started in March 2018 with support or grant from the European Social Fund Aspiring Communities Fund. The project built on the existing practice of Tighean Innse Gall (TIG) and other partners in the Outer Hebrides, to develop an innovative approach to identifying and assisting people whose health is compromised by living in a cold or hard-to-heat home. Over the course of two years, 199 households were assisted through the project. Tighean Innse Gall is a Community Benefit Society working across the Outer Hebrides and operating principally across the housing, community group and small business sectors to support people to access homes and to help to make them comfortable and affordable, promote independent living and encourage businesses and communities to be energy-efficient

The effect of introducing a financial incentive to promote application of fluoride varnish in dental practice in Scotland:a natural experiment

Background: Financial incentives are often used to influence professional practice, yet the factors which influence their effectiveness and their behavioural mechanisms are not fully understood. In keeping with clinical guidelines, Childsmile (Scotland’s oral health improvement programme) advocates twice yearly fluoride varnish application (FVA) for children in dental practice. To support implementation Childsmile offered dental practitioners a fee-per-item payment for varnishing 2–5-year-olds’ teeth through a pilot. In October 2011 payment was extended to all dental practitioners. This paper compares FVA pre- and post-roll-out and explores the financial incentive’s behavioural mechanisms. Methods: A natural experimental approach using a longitudinal cohort of dental practitioners (n = 1090) compared FVA pre- (time 1) and post- (time 2) financial incentive. Responses from practitioners who did not work in a Childsmile pilot practice when considering their 2–5-year-old patients (novel incentive group) were compared with all other responses (continuous incentive group). The Theoretical Domains Framework (TDF) was used to measure change in behavioural mechanisms associated with the incentive. Analysis of covariance was used to investigate FVA rates and associated behavioural mechanisms in the two groups. Results: At time 2, 709 74%, of eligible responders, were followed up. In general, FVA rates increased over time for both groups; however, the novel incentive group experienced a greater increase (β [95% CI] = 0.82 [0.72 to 0.92]) than the continuous incentive group. Despite this, only 33% of practitioners reported ‘always’ varnishing increased risk 2–5-year-olds’ teeth following introduction of the financial incentive, 19% for standard risk children. Domain scores at time 2 (adjusting for time 1) increased more for the novel incentive group (compared to the continuous incentive group) for five domains: knowledge, social/professional role and identity, beliefs about consequences, social influences and emotion. Conclusions: In this large, prospective, population-wide study, a financial incentive moderately increased FVA in dental practice. Novel longitudinal use of a validated theoretical framework to understand behavioural mechanisms suggested that financial incentives operate through complex inter-linked belief systems. While financial incentives are useful in narrowing the gap between clinical guidelines and FVA, multiple intervention approaches are required