The Broad and Narrow: Case Studies and International Perspectives on Rural Women’s Research

(2004) The Broad and Narrow: Case Studies and International Perspectives on Rural Women’s Research Rural Society Vol. 14 No. 2 pp. 254-270

Clinical trial designs for rare diseases: Studies developed and discussed by the International Rare Cancers Initiative

BACKGROUND: The past three decades have seen rapid improvements in the diagnosis and treatment of most cancers and the most important contributor has been research. Progress in rare cancers has been slower, not least because of the challenges of undertaking research.

SETTINGS: The International Rare Cancers Initiative (IRCI) is a partnership which aims to stimulate and facilitate the development of international clinical trials for patients with rare cancers. It is focused on interventional--usually randomized--clinical trials with the clear goal of improving outcomes for patients. The key challenges are organisational and methodological. A multi-disciplinary workshop to review the methods used in ICRI portfolio trials was held in Amsterdam in September 2013. Other as-yet unrealised methods were also discussed.

RESULTS: The IRCI trials are each presented to exemplify possible approaches to designing credible trials in rare cancers. Researchers may consider these for use in future trials and understand the choices made for each design.

INTERPRETATION: Trials can be designed using a wide array of possibilities. There is no 'one size fits all' solution. In order to make progress in the rare diseases, decisions to change practice will have to be based on less direct evidence from clinical trials than in more common diseases.

Routledge International Handbook of Rural Studies.:Understanding the association between rural ethnicity and inequalities

Rural areas are facing demographic transformation. Some localities have experienced significant levels of (internal and international) immigration in recent decades. In other rural places, a shifting minority: majority ratio (arising mainly from increased minority fertility and decreases in the majority population) is altering the rural landscape. It is this context of increasingly diverse rural societies that frames this chapter. It begins by examining inequalities arising from ethnicity in a rural context. The review proceeds by identifying how different factors, including recent patterns of international migration and historical legacies of ethnic diversity, intertwine to produce multi-cultural rural areas. First of all an overview of the significance of the ‘ethnic’ label is presented, recognizing its limitations and also its usefulness. Having established this context the chapter proceeds by highlighting the way in which rural ethnic inequalities are measured and also the particular challenges of measuring rural poverty. The processes that produce inequalities among ethnic groups are examined, with particular attention on migration and space and place, but mindful of historical legacies along with economic transformations and associated recent migration patterns. Finally, the conclusion of the chapter highlights gaps and identifies areas for future research agendas.