The practice of home in old Cairo: Towards socio-spatial models of sustainable living

The article investigates the practice of home as an everyday system for sustainable living in Old Cairo. The idea of home in this historic urban space has long involved fluid socio-spatial associations and made efficient use of space-activity-time dynamics. As in the past, a individual’s sense of home may here extend beyond or shrink within the physical boundaries of a particular house, as spatial settings are produced and consumed according to time of day, gender association, or special events. The article argues that architects working in this context must understand the dynamics of this complex traditional system if they are to develop locally informed, genuine designs that build on everyday spatial practices. Work by the architect Salah Zaki Said and by the Historic Cities Program of the Aga Khan Trust for Culture is described to illustrate the potential of such engagement, especially as it contrasts to more abstract architectural proposals.

From Aspiration to Action: A Learning Intentions Model to Promote Critical Engagement with Science in the Print-Based Media

Science programmes which prepare students to read critically and respond thoughtfully to science-based reports in the media could play an important role in promoting informed participation in the public debate about issues relating to science, technology and society. Evidence based guidance about the practice and pattern of use of science-based media in the classroom is limited. This study sought to identify learning intentions that teachers believe ought to underpin the development of programmes of study designed to achieve this end-result. Teachers views of knowledge, skills and attitudes required to engage critically with science-based news served as a basis for this study. Teachers developed a pedagogical model by selecting appropriate statements of learning intentions, grouping these into coherent and manageable themes and coding them according to perceived level of difficulty. The model is largely compatible with current curricular provision in the UK, highlights opportunities for interdisciplinary collaboration and illustrates the developmental nature of the topic.

Bereavement Assessment Practice in Hospice Settings: Challenges for Palliative Care Social Workers

The management and delivery of bereavement support services in palliative care settings presents practical and ethical challenges. A national survey, conducted in 2007, examined bereavement practice in ten Marie Curie hospices across the United Kingdom. This qualitative study was undertaken using semi-structured telephone interviews with Bereavement Service Leaders located in each hospice. Although findings revealed that bereavement services were in operation and had been reviewed in response to the National Institute for Clinical Excellence Guidance (2004), and all bereaved families were offered support, there was no standardisation of service delivery across sites. Multi-disciplinary team meetings facilitated shared decision-making for bereavement follow-up, and expanded and clarified documentation completed by nursing staff around the time of the patient’s death. However, there was ambiguity regarding professional ‘duty of care’ and agency responses to bereaved individuals who were suicidal. Questions were raised around clinical effectiveness, reliability and professional accountability. The study highlighted ethical issues centred on documentation, user participation and consent, and found staff training was variable across the 10 hospices. The findings have informed the development of a post-bereavement service model which has been subsequently implemented across Marie Curie Cancer Care.

Analyzing the Influence of Gender Upon High Technology Venturing Within the Context of Business Incubation

We explore the influence of sex role attribution and associated gendered ascriptions upon the entrepreneurial experiences of a female high-technology business owner operating within the context of business incubation. Our literature analysis and empirical evidence suggest that stereotypical gendered expectations surrounding incubated high-technology venturing reproduce masculine norms of entrepreneurial behavior. The adoption of a gendered perspective to explore the experience of business incubation responds to contemporary calls to embed feminist analyses within the entrepreneurial field of enquiry. Furthermore, we draw upon evidence from a detailed case study informed by a life history narrative to explore a female entrepreneur's experience of incubated high-technology entrepreneurship. © 2011 Baylor University.

Working With Young Children as Co-Researchers: An Approach Informed by the United Nations Convention on the Rights of the Child

Research Findings: Under the United Nations Convention on the Rights of the Child (UNCRC), children have the right to express their views on all matters affecting them and to have those views given due weight. This right applies in the context of research; however, examples of young children being engaged as co-researchers remain rare. Practice or Policy: This article examines the implications of adopting an explicit UNCRC-informed approach to engaging children as co-researchers. It draws on a research project that sought to ascertain young children's views on after-school programs and that involved a university-based research team working along with 2 groups of co-researchers; each composed of 4 children aged 4 to 5. The article discusses the contribution made by children to the development of the research questions and choice of methods and their involvement in the interpretation of the data and dissemination of the findings. It suggests that, although there are limits to what young children can and will want to do in the context of adult-led research studies, an explicit UNCRC-informed approach requires the adoption of supportive strategies that can assist children to engage in a meaningful way, with consequent benefits for the research findings and outputs

Service User and Carer Involvement in Role-Plays to Assess Readiness for Practice

Service user and carer involvement in social work education is now well established since its inception as a compulsory requirement in the social work curriculum in the United Kingdom in 2003. Since then, there have been many examples of how such involvement has been approached by education providers. Nevertheless, one of the key obstacles and challenges in this field continues to centre on the need to achieve non-tokenistic user involvement which cements the engagement of service users and carers at the heart of social work education. This paper describes one such initiative where service user and carer colleagues in a university in Northern Ireland have been actively involved in the assessment of first year social work students’ preparation for their first period of practice learning. The paper presents the background to this initiative explaining how the project unfolded; the detailed preparations that were involved and the evidence gathered from evaluations undertaken with the students, service users and carers, and academic colleagues who were all involved. We believe that the findings from this project can contribute to the advancement of existing knowledge in the field in exploring and recommending creative methodologies for user involvement in social work education.

In pursuit of parrhesia: an investigation into knowledge selection in inquisitorial planning practice

Drawing upon interviews with procedural actants from Public Inquiry and Examination in Public fora, I draw upon relevant theoretical frameworks to evaluate modes of discourse in inquisitorial planning practice. In the investigation, which is based primarily upon an empirical study, I focus upon the role of evidence, the selection and handling of multiple knowledges, the behaviour of participants, and the methodology underpinning the process. It is established that such arenas can be effective mechanisms for testing complex evidence; and suggestions are made for improved practice, procedure, and future research. I conclude by raising serious ethical questions concerning participant behaviour, particularly on the part of advocates and especially chartered town planners.

Evidence and Ethics in Infrastructure Planning

Motivated by criticism of the new infrastructure planning process, the paper considers the role of the Infrastructure Planning Commission and National Policy Statements. Drawing upon lessons learnt from other jurisdictions where similar legislation, structures and procedures have been operational for some time, emerging issues regarding policy, practice and the role of participants are considered through an empirical investigation, in the context of professional ethics, legitimacy and evidence-based decision making. Remedies are suggested to potential operational problems and issues of structural concern are identified which have ramifications for wider planning practice.

Thalidomide for managing cancer cachexia [review paper]

Cancer cachexia is a multidimensional syndrome characterised by wasting, loss of weight, loss of appetite, metabolic alterations, fatigue and reduced performance status. A significant number of patients with advanced cancer develop cachexia before death. There is no identified optimum treatment for cancer cachexia. While the exact mechanism of the action of thalidomide is unclear, it is known to have immunomodulatory and anti-inflammatory properties, which are thought to help reduce the weight loss associated with cachexia. Preliminary studies of thalidomide have demonstrated encouraging results. This review aimed to (1) evaluate the effectiveness of thalidomide, and (2) identify and assess adverse effects from thalidomide for cancer cachexia. Electronic searches were undertaken in CENTRAL, MEDLINE, EMBASE, Web of Science and CINAHL (from inception to April 2011). Reference lists from reviewed articles, trial registers, relevant conference documents and thalidomide manufacturers identified additional literature. This review included randomised controlled trials (RCTs) and non-RCTs. Participants were adults diagnosed with advanced or incurable cancer and weight loss or a clinical diagnosis of cachexia who were administered thalidomide. All titles and abstracts retrieved by electronic searching were downloaded to a reference management database. Duplicates were removed and the remaining citations were read by two review authors and checked for eligibility. Studies that were deemed ineligible for inclusion had clear reasons for exclusion documented. Data were extracted independently by two review authors for all eligible studies. While a meta-analysis was planned for this review, this was not possible due to the small number of studies included and high heterogeneity among them. Thus a narrative synthesis of the findings is presented. The literature search revealed a dearth of large, well conducted trials in this area. This has hindered the review authors' ability to make an informed decision about thalidomide for the management of cancer cachexia. At present, there is insufficient evidence to refute or support the use of thalidomide for the management of cachexia in advanced cancer patients. The review authors cannot confirm or refute previous literature on the use of thalidomide for patients with advanced cancer who have cachexia and there is inadequate evidence to recommend it for clinical practice. Additional, well conducted, large RCTs are needed to test thalidomide both singularly and in combination with other treatment modalities to ascertain its true benefit, if any, for this population. Furthermore, one study (out of the three reviewed) highlighted that thalidomide was poorly tolerated and its use needs to be explored further in light of the frailty of this population

Enhancing social work students’ learning experience and readiness to undertake practice learning.

This project set out to evaluate the effectiveness of social work education by analysing student perceptions of the strengths and limitations of their education and training on the Bachelor of Social Work, Queen’s University, Belfast (QUB) at different stages of their ‘learning journey’ through the programme.
The author’s primary aim in undertaking this study was to contribute evidence-based understanding of the challenges and opportunities students identified themselves within contemporary practice environments. A secondary aim was to test the effectiveness of key approaches, theories and learning tools in common usage in social work education. The authors believe the outcomes generated by the project demonstrate the value of systematically researching student perceptions of their learning experience and feel the study provides important lessons which should help to inform the future development of social work education not only locally but in other parts of the UK.

Clinical practice with anti-dementia drugs:a revised (second) consensus statement from the British Association for Psychopharmacology

The British Association for Psychopharmacology (BAP) coordinated a meeting of experts to review and revise its first (2006) Guidelines for clinical practice with anti-dementia drugs. As before, levels of evidence were rated using accepted standards which were then translated into grades of recommendation A to D, with A having the strongest evidence base (from randomized controlled trials) and D the weakest (case studies or expert opinion). Current clinical diagnostic criteria for dementia have sufficient accuracy to be applied in clinical practice (B) and brain imaging can improve diagnostic accuracy (B). Cholinesterase inhibitors (donepezil, rivastigmine, and galantamine) are effective for mild to moderate Alzheimer's disease (A) and memantine for moderate to severe Alzheimer's disease (A). Until further evidence is available other drugs, including statins, anti-inflammatory drugs, vitamin E and Ginkgo biloba, cannot be recommended either for the treatment or prevention of Alzheimer's disease (A). Neither cholinesterase inhibitors nor memantine are effective in those with mild cognitive impairment (A). Cholinesterase inhibitors are not effective in frontotemporal dementia and may cause agitation (A), though selective serotonin reuptake inhibitors may help behavioural (but not cognitive) features (B). Cholinesterase inhibitors should be used for the treatment of people with Lewy body dementias (Parkinson's disease dementia and dementia with Lewy bodies (DLB)), especially for neuropsychiatric symptoms (A). Cholinesterase inhibitors and memantine can produce cognitive improvements in DLB (A). There is no clear evidence that any intervention can prevent or delay the onset of dementia. Although the consensus statement focuses on medication, psychological interventions can be effective in addition to pharmacotherapy, both for cognitive and non-cognitive symptoms. Many novel pharmacological approaches involving strategies to reduce amyloid and/or tau deposition are in progress. Although results of pivotal studies are awaited, results to date have been equivocal and no disease-modifying agents are either licensed or can be currently recommended for clinical use.

Catheter-related bloodstream infection in adult haematology patients:Catheter removal practice and outcome

The aim of the present study was to describe the practice of central venous catheter (CVC) removal and outcomes of catheter-related bloodstream infection (CR-BSI) in adult haematology patients. Patients were identified retrospectively according to diagnosis coding of inpatient episodes and evaluated when, on examination of medical records, there had been evidence of sepsis with strong clinical suspicion that the source was the CVC. Demographic and bacteriological data, as well as therapeutic measures and clinical outcomes, were recorded. One hundred and three patient episodes were evaluated. The most frequent type of CVC was the Hickman catheter and the most frequently isolated pathogen was coagulase-negative staphylococci. Twenty-five percent of episodes were managed with catheter removal. Treatment failure, defined as recurrence of infection within 90 days or mortality attributed to sepsis within 30 days, occurred significantly more frequently in the group managed without catheter removal (52.5% versus 4%, P

The influence of evidence-based medicine training on decision-making in relation to over-the-counter medicines: a qualitative study

Objectives
To explore the role of evidence of effectiveness when making decisions about over-the-counter (OTC) medication and to ascertain whether evidence-based medicine training raised awareness in decision-making. Additionally, this work aimed to complement the findings of a previous study because all participants in this current study had received training in evidence-based medicine (unlike the previous participants).

Methods
Following ethical approval and an e-mailed invitation, face-to-face, semi-structured interviews were conducted with newly registered pharmacists (who had received training in evidence-based medicine as part of their MPharm degree) to discuss the role of evidence of effectiveness with OTC medicines. Interviews were recorded and transcribed verbatim. Following transcription, all data were entered into the NVivo software package (version 8). Data were coded and analysed using a constant comparison approach.

Key findings
Twenty-five pharmacists (7 males and 18 females; registered for less than 4 months) were recruited and all participated in the study. Their primary focus with OTC medicines was safety; sales of products (including those that lack evidence of effectiveness) were justified provided they did no harm. Meeting patient expectation was also an important consideration and often superseded evidence. Despite knowledge of the concept, and an awareness of ethical requirements, an evidence-based approach was not routinely implemented by these pharmacists. Pharmacists did not routinely utilize evidence-based resources when making decisions about OTC medicines and some felt uncomfortable discussing the evidence-base for OTC products with patients.

Conclusions
The evidence-based medicine training that these pharmacists received appeared to have limited influence on OTC decision-making. More work could be conducted to ensure that an evidence-based approach is routinely implemented in practice

From theory to practice:Improving the impact of health services research

Background: While significant strides have been made in health research, the incorporation of research evidence into healthcare decision-making has been marginal. The purpose of this paper is to provide an overview of how the utility of health services research can be improved through the use of theory. Integrating theory into health services research can improve research methodology and encourage stronger collaboration with decision-makers. Discussion: Recognizing the importance of theory calls for new expectations in the practice of health services research. These include: the formation of interdisciplinary research teams; broadening the training for those who will practice health services research; and supportive organizational conditions that promote collaboration between researchers and decision makers. Further, funding bodies can provide a significant role in guiding and supporting the use of theory in the practice of health services research. Summary: Institutions and researchers should incorporate the use of theory if health services research is to fulfill its potential for improving the delivery of health care. © 2005 Brazil et al; licensee BioMed Central Ltd.