Improving immunization uptake rates among Gypsies, Roma and Travellers: a qualitative study of the views of service providers

BACKGROUND: Gypsies, Roma and Travellers are at risk of low uptake of routine immunizations. Interventions to improve uptake in these communities are seldom evaluated. As part of a qualitative study exploring barriers and facilitators to immunization uptake in Travellers, we report service provider (SP) perspectives. METHODS: We interviewed immunization SPs working with six Traveller communities across four UK cities. Participants included frontline staff and those with strategic or commissioning roles. Semi-structured interviews explored perceived attitudes of Travellers to vaccinations, local service delivery, and opportunities and challenges to improving uptake. Audio-recordings were transcribed, analyzed thematically and mapped to a socio-ecological model of health. RESULTS: 39 SPs participated. Four overarching themes were identified: building trusting relationships between SPs and Travellers; facilitating attendance at appointments; improving record keeping and monitoring and responding to local and national policy change. Travellers were perceived as largely supportive of immunizations, though system and organizational processes were recognized barriers to accessing services. CONCLUSIONS: Findings were broadly consistent across Traveller groups and settings. The barriers identified could often be addressed within existing infrastructure, though require system or policy change. Development of a culturally competent system appears important to enable equity in access to immunizations for Travellers

Measuring elimination of podoconiosis, endemicity classifications, case definition and targets: an international Delphi exercise

BACKGROUND Podoconiosis is one of the major causes of lymphoedema in the tropics. Nonetheless, currently there are no endemicity classifications or elimination targets to monitor the effects of interventions. This study aimed at establishing case definitions and indicators that can be used to assess endemicity, elimination and clinical outcomes of podoconiosis. METHODS This paper describes the result of a Delphi technique used among 28 experts. A questionnaire outlining possible case definitions, endemicity classifications, elimination targets and clinical outcomes was developed. The questionnaire was distributed to experts working on podoconiosis and other neglected tropical diseases in two rounds. The experts rated the importance of case definitions, endemic classifications, elimination targets and the clinical outcome measures. Median and mode were used to describe the central tendency of expert responses. The coefficient of variation was used to describe the dispersals of expert responses. RESULTS Consensus on definitions and indicators for assessing endemicity, elimination and clinical outcomes of podoconiosis directed at policy makers and health workers was achieved following the two rounds of Delphi approach among the experts. CONCLUSIONS Based on the two Delphi rounds we discuss potential indicators and endemicity classification of this disabling disease, and the ongoing challenges to its elimination in countries with the highest prevalence. Consensus will help to increase effectiveness of podoconiosis elimination efforts and ensure comparability of outcome data

Social cohesion and the notion of 'suspect communities': A study of the experiences and impacts of being 'suspect' for Irish communities and Muslim communities in Britain

In this article, we consider how the practice of conceiving of groups within civil society as 'communities' meshes with conceptualisations of certain populations as 'suspect' and consider some of the impacts and consequences of this for particular populations and for social cohesion. We examine how Irish and Muslim people in Britain have become aware of and have experienced themselves to be members of 'suspect communities' in relation to political violence and counterterrorism policies from 1974 to 2007 and investigate the impacts of these experiences on their everyday lives. The study focuses on two eras of political violence. The first coincides with the Irish Republican Army's (IRA) bombing campaigns in England between 1973 and 1996, when the perpetrators were perceived as 'Irish terrorists'; and the second since 2001, when, in Britain and elsewhere, the main threat of political violence has been portrayed as stemming from people who are assumed to be motivated by extreme interpretations of Islam and are often labelled as 'Islamic terrorists'. We outline why the concept of 'suspect communities' continues to be analytically useful for examining: the impact of 'bounded communities' on community cohesion policies; the development of traumatogenic environments and their ramifications; and for examining how lessons might be learnt from one era of political violence to another, especially as regards the negative impacts of practices of suspectification on Irish communities and Muslim communities. The research methods included discussion groups involving Irish and Muslim people. These demonstrated that with the removal of discourses of suspicion the common ground of Britain's urban multiculture was a sufficient basis for sympathetic exchanges. © 2012 Taylor and Francis Group, LLC

Interaction between bioluminescence and denticles in sharks

Etmopterid and dalatiid sharks are among the most enigmatic bioluminescent organisms. They display thousands of epidermal light-producing organs (photophores) that form a diversity of patterns and are primarily controlled by hormones rather than by nerves, the condition in other animals. Various adaptive benefits have been proposed for the light produced by these epidermal organs including camouflage by counterillumination (ventral photophores), intraspecific communication (lateral photophores) and aposematism (dorsal spine-associated photophores). Like other shark species, etmopterids and dalatiids have their skin covered with placoid scales (denticles), which are known to be involved in various tasks including hydrodynamism, protection from predators and ectoparasites and reduction of substrate abrasion. In bioluminescent sharks these denticles have evolved peculiar squamation patterns that are thought to allow photophore accomodation. However, variations in the crown morphology of these structures lead to different degrees of interaction with the photophores and their light emission. Here, we investigated the link between four squamation patterns (internal scales, pavement-like, thorn-like and bristle-like) and several parameters across specimens from 37 shark species (≈75% of current bioluminescent shark diversity) in order to determine if denticle morphology influences photophore organisation and performances. Unexpectedly, pavement-like squamation is linked to higher photophore density and cover (but smaller photophore diameter), and overall photophore performance appears equivalent in external denticles. Future work including optical lithography and computational modelling, will attempt to understand how needle-like denticles, which form a dense external coverage, still allow the delivery of underlying photophore light

Bio-inspired multilayer polarizer for anti-counterfeiting

Natural photonic crystals (PCs) are responsible for the colors of some species of butterfly and beetle. These photonic crystals show specific interactions with light depending on their shape [1] and can exhibit interesting properties as gas sensing [2] or polarization [3]. In this work, we are focused on the species that show polarization effects. It has been shown that polarization effects can be used as a way to secure bank notes or passports against counterfeiting [3]. We reproduce here bio-inspired photonic crystal for this purpose with classical microfabrication techniques and demonstrate the potential of the polarization effects in anti-counterfeiting domain