A realist synthesis of educational interventions to improve nutrition care competencies and delivery by doctors and other healthcare professionals

Objective: To determine what, how, for whom, why, and in what circumstances educational interventions to improve the delivery of nutrition care by doctors and other healthcare professionals work?

Design: Realist synthesis following a published protocol and reported following Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMESES) guidelines. A multidisciplinary team searched Medline, CINAHL, ERIC, EMBASE, PsyINFO, Sociological Abstracts, Web of Science, Google Scholar, and Science Direct for published and unpublished (grey) literature. The team identified studies with varied designs; appraised their ability to answer the review question; identified relationships between contexts, mechanisms, and outcomes (CMOs); and entered them into a spreadsheet configured for the purpose. The final synthesis identified commonalities across CMO configurations.

Results: Over half of the 46 studies from which we extracted data originated from the US. Interventions that improved the delivery of nutrition care improved skills and attitudes rather than just knowledge; provided opportunities for superiors to model nutrition care; removed barriers to nutrition care in health systems; provided participants with local, practically relevant tools and messages; and incorporated non-traditional, innovative teaching strategies. Operating in contexts where student and qualified healthcare professionals provided nutrition care in both developed and developing countries, these interventions yielded health outcomes by triggering a range of mechanisms, which included: feeling competent; feeling confident and comfortable; having greater self-efficacy; being less inhibited by barriers in healthcare systems; and feeling that nutrition care was accepted and recognised.

Conclusion: These findings show how important it is to move education for nutrition care beyond the simple acquisition of knowledge. They show how educational interventions embedded within systems of healthcare can improve patients’ health by helping health students and professionals to appreciate the importance of delivering nutrition care and feel competent to deliver it.

Oil on Troubled Waters-Multinational Corporations and Realising Human Rights in the Developing World with Particular Reference to Nigeria

This article examines the current state of tension in the Niger Delta of Nigeria. It locates the current unrest in the continued denial of economic, social and cultural rights to the oil-rich communities in the area. The author argues that this denial happened with the complicity and acquiescence of the international community. The Nigerian government as well as multinational corporations operating in the area have not been responsive to the development needs of the people. The article argues that, although the primary obligation for realising the economic, social and cultural rights of host communities rests on the government, multi-national corporations in developing countries, considering their awesome resources and influence on government policies, should be similarly obligated to respect, promote and protect those rights.

Emergency Management in Developed Countries: An Investigation of Hazard Risk, Vulnerability and Government Response in the UK and USA

During the summer of 2007 the United Kingdom experienced some of the worst flooding in its history, with the city of Hull amongst the worst affected. Meanwhile, the city of New Orleans, USA was subject to severe flooding in August 2005 as a result of Hurricane Katrina. The study has found that both the UK and US government disaster management programmes were ill prepared for these flood events. Many parallel issues have been discovered and discussed. The conditions of vulnerability that are evident in developing countries are not widely present in the UK or US but this must not be allowed to lead to complacency and lack of preparation and awareness. The cost in terms of mortality is relatively low compared to similar events in developing countries; however, the economic implications are considerable and must be addressed.

Education for global citizenship in Scotland: reciprocal partnership or politics of benevolence?

Links between schools in the United Kingdom and partner schools in developing countries are an increasingly popular approach to teaching global citizenship. This study addresses the limited empirical research to date on the influence of such links on pupils' learning and understanding. Following an overview of the curricular theme of global citizenship in the Scottish curriculum and in the context of a partnership between Scotland and Malawi, challenges and potential pitfalls of teaching global citizenship are illustrated by the voices of pupils at four schools. Data is analysed through the themes of knowledge and understanding, concerns about fairness, and giving and helping. We reflect on whether our study indicates the intended reciprocal partnership or a 'politics of benevolence'.

An analysis of International NGOs design decision making for housing reconstruction in developing country contexts

The purpose of this paper is to explore the current design decision making process of selected foreign international non governmental organisations (INGO’s) operating in the field of housing and post disaster housing design and delivery in developing countries. The study forms part of a wider on-going study relation to a decision making in relation to affordable and sustainable housing in developing
countries. The paper highlights the main challenges and opportunities in relation to the design and delivery of low cost sustainable housing in developing countries as identified in current literature on the subject. Interviews and case studies with INGO’s highlight any specific challenges faced by foreign INGO’s operating in a developing country. The preliminary results of this research study provide a concise insight into the design decision making process of leading foreign INGO’s operating in developing countries and will be beneficial to policy makers, NGOs, government bodies and community organisations in practice as it offers unique evidence based insights into international bodies housing design decision making process.