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Introduction: Emergency Departments (EDs) are frequently the first point of entry to access health services for First Nation (FN) members. In Alberta, FN members visit EDs at almost double the rate of non-FN persons. Furthermore, preliminary evidence demonstrates differences in ED experience for FN members as compared to the general population. The Alberta First Nations Information Governance Centre, Maskwacis Health Services, Yellowhead Tribal Council, Treaty 8 First Nations of Alberta, and Alberta Health Services are working together to research FN members ED experiences and concerns. Methods: This is participatory research guided by a two-eyed seeing approach that acknowledges the equal value of both Western and Indigenous worldviews. FN and non-FN leaders researchers are full partners in the development of the research project. Six sharing circles will be held in February 2018 across Alberta, with Elders, FN patients, FN and non-FN clinicians and FN and non-FN administrators. Sharing circles are similar to focus groups, but emphasize everyone having a turn to speak and demonstrating respect among participants in accordance with FN protocols. Elders will select the questions for discussion based on topics that arose in initial team meetings. Sharing circle discussions will be audio recorded and transcribed. Analysts will include both Western and Indigenous worldview researchers, who will collaboratively interpret findings. Elders will review, discuss, contextualize and expand upon study findings. The research is also guided by FN principles of Ownership, Control, Access, and Possession of FN information. It is through these principles that First Nation research projects can truly be classified as FN lead and driven. Results: Based on initial team meeting discussions, results of sharing circles are expected to provide insights on issues such as: healing, patient-provider communication (verbal and non-verbal), shared decision making, respect for patient preferences, experiences leading to trust or distrust, understandings of wait times and triage, times when multiple (repeat) ED presentations occur, distances travelled for care, choosing specific EDs when seeking care, impacts of stereotypes about FN patients, and racism and reconciliation. Conclusion: Understanding FN ED experience and bringing FN perspectives to Western conceptions of the goals and provision of ED care are important steps toward reconciliation.
For over a hundred years the fate of Russian Jews has been of special concern to many Americans. During the first half of this period, tsarist policies toward the Jews were the major irritant in the otherwise comparatively harmonious relations between the United States and Russia. The result was a recurring diplomatic dispute over the Jewish question, the course of which provides a barometer for gauging the changing situation of the Jews in the Russian empire. The dispute centered largely on individual acts of discrimination by Russian officials against Americans. Many of them involved naturalized citizens of Russian origin, most of whom were Jews. Behind the State Department protests on their behalf lay the more complex issue of mounting American indignation at the increasingly difficult situation of Jews in Russia after 1880.
American reactions varied from holding public meetings on the issue to exerting pressure on United States government agencies. Former president Ulysses Grant was one of the main initiators of a rally in New York in 1882 protesting anti-Jewish atrocities in Russia. The pogroms received considerable coverage in the Western press: the April 1882 Century, for instance, carried a vivid account of riots that raged for more than twenty-four hours in Elizavetgrad during Easter Week of 1881 and spoke of “world wide sympathy, and a protest almost unprecedented in its swiftness.”
This paper reports some results of a study of practitioners’ perspectives on performance assessment in the field of family support services. Existing empirical work on performance assessment emphasises the perspectives offunders and/or service users. However, practitioners are a key stakeholder in both service delivery and assessment, and consideration of how this group approaches and appropriates performance assessment can maximize its effectiveness, and ensure the incorporation of their practice-based knowledge about service delivery and outcomes. We find that family support workers are committed to understanding the effectiveness of their work, and use a variety of means to attempt to evaluate their own effectiveness. However, these means are rarely systematic, andare unlikely to provide data useful for measures of service economy and efficiency. This may be because their practice consists of processes to which conventional evaluation techniques are ill-suited. The challenge for providers of social services is to find ways to assess the caring work at the heart of their practice in ways which are ‘legible’ to all stakeholders, including government flinders.
To compare mental health (MH) outcomes of and service use by children born under 1500 g in Ireland with a matched control group.
Using a retrospective cohort design, semi-structured and standardised MH assessments were conducted with parents, teachers and youth.
A total of 64 of 127 surviving children from a very low birth weight (VLBW) cohort from a National Maternity Hospital participated at a mean age of 11.6 years (s.d. 1.0), along with 51 matched controls. More VLBW children received clinical or borderline scores when rated by parents [χ2 (1, n=114)=7.3, p=0.007] or youths [χ2 (1, n=114)=4.83, p=0.028], but not by teachers [χ2 (1, n=114)=1.243, p=0.463]. There was no increase in the use of MH services. A main effect of birth weight remained on the parent Strengths and Difficulties Questionnaire [F (1, 88)=5.07, p<0.05) after controlling for intelligence quotient (IQ) and socio-economic status (SES), but only on hyperactivity in males. SES, rather than IQ or birth weight, predicted identification of problems by teachers [F (1, 82)=6.99, p=0.01).
Teachers miss MH difficulties and are influenced more by SES than by IQ or birth weight. This has implications for MH service access. Initial perinatal investment needs to be matched with ongoing surveillance and psychoeducation to ensure that disorders are recognised early and offered appropriate interventions.
In this paper, we give an overview of our research exploring the impact of physical and chemical processing on food proteins. There are three themes, applied to the proteins of wheat, soya, egg and dairy foods. Firstly, the impact of the Maillard reaction on food proteins is discussed, with a particular focus on how the reactions might be harnessed to manipulate food texture. Secondly, the potential of enzymatic protein-protein crosslinking is considered, especially the enzyme transglutaminase. Thirdly, the broader question of how the aggregation of proteins within a food is altered by chemical and physical modification and how, in turn, this might impact on the overall nutritional quality of the food is considered.