Forty-eight hour access to primary care: practice factors predicting patients' perceptions

Background: The government has proposed a 48-hour target for GP availability. Although many practices are moving towards delivering that goal, recent national patient surveys have reported a deterioration in patients' reports of doctor availability. What practice factors contribute to patients' perceptions of doctor availability? Method: A cross sectional patient survey (11 000 patients from 54 inner London practices, 7247 (66%) respondents) using the General Practice Assessment Survey. We asked patients how soon they could be seen in their practice following non-urgent consultation requests and related their aggregated responses to the characteristics of their practice. Results: Three factors relating to practice administration and appointments systems operation independently predicted patients' reports of doctor availability. These were the proportion of patients asked to attend the surgery and wait to be seen, the proportion of patients seen using an emergency surgery arrangement, and the extent of practice computerization. Conclusion: Some practices may have difficulty in meeting the target for GP availability. Meeting the target will involve careful review of practice administrative procedures.

Benevolence, hegemony and nationalism: fifty years of the 1949 National Parks and Access to the Countryside Act

This paper reviews the National Parks and Access to the Countryside Act 1949 fifty years since its enactment. The Act is assessed in the light of fifty years of access policy and within the present context of political debates and manoeuvres over the ‘right to roam’. It is concluded that benevolence is still the prevailing attitude towards access provision, maintaining as it does the scope for alternative freedoms and opportunities to exploit land for consumptive practices such as leisure and recreation. As such, it is argued that the notion of the gift (Mauss, 1990) continues to dominate the provision of countryside access in England and Wales.

Protocol for ACCESS: a qualitative study exploring barriers and facilitators to accessing the emergency contraceptive pill from community pharmacies in Australia

Introduction The rate of unplanned pregnancy in Australia remains high, which has contributed to Australia having one of the highest abortion rates of developed countries with an estimated 1 in 5 women having an abortion. The emergency contraceptive pill (ECP) offers a safe way of preventing unintended pregnancy after unprotected sex has occurred. While the ECP has been available over-the-counter in Australian pharmacies for over a decade, its use has not significantly increased. This paper presents a protocol for a qualitative study that aims to identify the barriers and facilitators to accessing the ECP from community pharmacies in Australia. Methods and analysis Data will be collected through one-on-one interviews that are semistructured and in-depth. Partnerships have been established with 2 pharmacy groups and 2 women's health organisations to aid with the recruitment of women and pharmacists for data collection purposes. Interview questions explore domains from the Theoretical Domains Framework in order to assess the factors aiding and/or hindering access to ECP from community pharmacies. Data collected will be analysed using deductive content analysis. The expected benefits of this study are that it will help develop evidence-based workforce interventions to strengthen the capacity and performance of community pharmacists as key ECP providers. Ethics and dissemination The findings will be disseminated to the research team and study partners, who will brainstorm ideas for interventions that would address barriers and facilitators to access identified from the interviews. Dissemination will also occur through presentations and peer-reviewed publications and the study participants will receive an executive summary of the findings. The study has been evaluated and approved by the Monash Human Research Ethics Committee.

Access to historic environments for tourists with disabilities: a compromise?

Historic environments, the basis for heritage tourism, are difficult to access for people with disabilities. Many countries have introduced legislation to promote equal rights for people with disabilities. Historic environments, however, enjoy protection under national planning systems which limit the physical access improvements that can be made. The significance of historic environments for tourism in the UK is outlined. Barriers restricting tourists with disabilities accessing historic sites are reviewed from the heritage tourism service provider's viewpoint. Interests of the major stakeholders are considered in terms of the apparent conflict between conservation and access issues as heritage tourism service providers seek to comply with disability discrimination legislation. From a study of access improvements made by major heritage tourism service providers, good practice is identified. However, physical access improvements to enable tourists with disabilities to visit historic environments are a compromise because of the strength of conservation interests. Questions remain as to whether this compromise is acceptable to the tourist with disabilities and whether intellectual access is an acceptable substitute for physical presence.

Post-dispersal seed predation of non-target weeds in arable crops

Field experiments were conducted to quantify the natural levels of post-dispersal seed predation of arable weed species in spring barley and to identify the main groups of seed predators. Four arable weed species were investigated that were of high biodiversity value, yet of low to moderate competitive ability with the crop. These were Chenopodium album, Sinapis arvensis, Stellaria media and Polygonum aviculare. Exclusion treatments were used to allow selective access to dishes of seeds by different predator groups. Seed predation was highest early in the season, followed by a gradual decline in predation over the summer for all species. All species were taken by invertebrates. The activity of two phytophagous carabid genera showed significant correlations with seed predation levels. However, in general carabid activity was not related to seed predation and this is discussed in terms of the mainly polyphagous nature of many Carabid species that utilized the seed resource early in the season, but then switched to carnivory as prey populations increased. The potential relevance of post-dispersal seed predation to the development of weed management systems that maximize biological control through conservation and optimize herbicide use, is discussed.

Post-dispersal seed predation of non-target weeds in arable crops

Field experiments were conducted to quantify the natural levels of post-dispersal seed predation of arable weed species in spring barley and to identify the main groups of seed predators. Four arable weed species were investigated that were of high biodiversity value, yet of low to moderate competitive ability with the crop. These were Chenopodium album, Sinapis arvensis, Stellaria media and Polygonum aviculare. Exclusion treatments were used to allow selective access to dishes of seeds by different predator groups. Seed predation was highest early in the season, followed by a gradual decline in predation over the summer for all species. All species were taken by invertebrates. The activity of two phytophagous carabid genera showed significant correlations with seed predation levels. However, in general carabid activity was not related to seed predation and this is discussed in terms of the mainly polyphagous nature of many Carabid species that utilized the seed resource early in the season, but then switched to carnivory as prey populations increased. The potential relevance of post-dispersal seed predation to the development of weed management systems that maximize biological control through conservation and optimize herbicide use, is discussed.

Movement time for motion-impaired users assisted by force-feedback: effects of movement amplitude, target width and gravity well width

This paper presents a study investigating how the performance of motion-impaired computer users in point and click tasks varies with target distance (A), target width (W), and force-feedback gravity well width (GWW). Six motion-impaired users performed point and click tasks across a range of values for A, W, and GWW. Times were observed to increase with A, and to decrease with W. Times also improved with GWW, and, with the addition of a gravity well, a greater improvement was observed for smaller targets than for bigger ones. It was found that Fitts Law gave a good description of behaviour for each value of GWW, and that gravity wells reduced the effect of task difficulty on performance. A model based on Fitts Law is proposed, which incorporates the effect of GWW on movement time. The model accounts for 88.8% of the variance in the observed data.

Cooperative patronage: The National Smallholder Farmers’ Association of Malawi in Kasungu District

This paper estimates the determinants of farmers’ decisions to join a rural producer organisation, the National Smallholder Farmers’ Association of Malawi (NASFAM), in Kasungu District. Data for the study were collected in June and August 2003 using household-level questionnaires and stratified random sampling, where strata were membership status and gender. Probit analysis of 250 farmers shows that off-farm sources of income, distance of the farmer’s household from Kasungu District centre, age of the farmer, tobacco farming, education, household level land holding and gender determined the decision to join NASFAM. These results suggest that farmers should be informed of the potential benefits of participating in rural development efforts, and that rural communication and information infrastructure should be improved so as to reduce the costs of information access and transactions in general, if participation in organisations such as NASFAM is to be enhanced.

Paradise postponed? The Department of National Heritage and political hegemony

Established following the Conservative Party's election victory in April 1992, the Department of National Heritage has been heralded as an important stage in the growing recognition of the significance of the leisure industry to Britain. By combining, for the first time, responsibility for sport, tourism, the arts, libraries, heritage, broadcasting and film, and by providing them with Cabinet representation, a unique opportunity has, seemingly, been provided to develop and promote the interests of leisure in Britain. This paper takes the view that although this initiative has been broadly welcomed, there are important inconsistencies which require attention. On the one hand the selection of the portfolio appears somewhat eclectic. On the other hand, it is questionable why such a department should have been developed at all. An inspection of the implicit ideology suggests that rather than the traditional use of the state to promote leisure interests, the introduction of the department signifies a shift to the use of leisure to promote the Government's interests. Thus the new Department of National Heritage is to be used as a central feature in the legitimation of the government's political programme. Rather than emphasising its traditional quasi-welfare role, the new place for leisure and heritage is firmly in the market economy. Whilst a leisured society may be the epitome of post-industrialism, therefore, the citizen rights claim for access to leisure activities can only be secured by engaging with the market. This legitimised construction of post- modern citizenship is at the centre of a new political order where choice has been replaced by means and where the classless paradigm championed by the Prime Minister will be a classlessness of constructed omission.

Causal evidence for frontal involvement in memory target maintenance by posterior brain areas during distracter interference of visual working memory

Dorsolateral prefrontal cortex (DLPFC) is recruited during visual working memory (WM) when relevant information must be maintained in the presence of distracting information. The mechanism by which DLPFC might ensure successful maintenance of the contents of WM is, however, unclear; it might enhance neural maintenance of memory targets or suppress processing of distracters. To adjudicate between these possibilities, we applied time-locked transcranial magnetic stimulation (TMS) during functional MRI, an approach that permits causal assessment of a stimulated brain region's influence on connected brain regions, and evaluated how this influence may change under different task conditions. Participants performed a visual WM task requiring retention of visual stimuli (faces or houses) across a delay during which visual distracters could be present or absent. When distracters were present, they were always from the opposite stimulus category, so that targets and distracters were represented in distinct posterior cortical areas. We then measured whether DLPFC-TMS, administered in the delay at the time point when distracters could appear, would modulate posterior regions representing memory targets or distracters. We found that DLPFC-TMS influenced posterior areas only when distracters were present and, critically, that this influence consisted of increased activity in regions representing the current memory targets. DLPFC-TMS did not affect regions representing current distracters. These results provide a new line of causal evidence for a top-down DLPFC-based control mechanism that promotes successful maintenance of relevant information in WM in the presence of distraction.

History education in comprehensive schools: using school level data to interpret national patterns

This paper reports the findings from two large scale national on-line surveys carried out in 2009 and 2010, which explored the state of history teaching in English secondary schools. Large variation in provision was identified within comprehensive schools in response to national policy decisions and initiatives. Using the data from the surveys and school level data that is publicly available, this study examines situated factors, particularly the nature of the school intake, the numbers of pupils with special educational needs and the socio-economic status of the area surrounding the school, and the impact these have on the provision of history education. The findings show that there is a growing divide between those students that have access to the ‘powerful knowledge’, provided by subjects like history, and those that do not.

Inheritance, access to resources and poverty in Serer families in Senegal

This research explores the relationship between inheritance, access to resources and the intergenerational transmission of poverty among the Serer ethnic group in rural and urban environments in Senegal. In many Sub-Saharan African countries, customary law excludes women from owning and inheriting assets, such as land and property. Yet, assets controlled by women often result in increased investments in the next generation's health, nutrition and schooling and reduce the intergenerational transmission of poverty. Qualitative research with 60 participants in Senegal reveals the important role that land, housing and financial assets may play in building resilience to household shocks and interrupting the intergenerational transmission of poverty. However, the protection afforded by these assets was often dependent on other factors, including human, social and environmental capital. The death of a spouse or parent had major emotional and material impacts on many Serer families. The inheritance and control of assets and resources was strongly differentiated among family members along lines of gender, age and generation. Younger widows and their children were particularly vulnerable to chronic poverty. Although inheritance disputes were rare, the research suggests they are more likely between co-wives in polygamous unions and their children, particularly in urban areas. In addition to experiencing economic and health-related shocks, many interviewees were exposed to a range of climate-related risks and environmental pressures which increased their vulnerability. Family members coped with these shocks and risks by diversifying livelihoods, migrating to urban areas and other regions for work, participating in women's co-operatives and associations and developing supportive social networks with extended family and community members. Policies and practices that may help to alleviate poverty, safeguard women's and young people's inheritance and build resilience to financial, health-related and environmental shocks and risks include: - Social protection measures targeted towards poor widows and orphaned children, such as social and cash transfers to pay for basic needs including food, healthcare and children's schooling. - Micro-finance initiatives and credit and savings schemes, alongside training and capacity-building targeted to women and young people to develop income-generation activities and skills. - Free legal advice, support and advocacy for women and young people to pursue inheritance claims through the legal system. - Raising awareness about women's and children's legal rights and working with government and community and religious leaders to tackle discriminatory inheritance practices and contradictions caused by legal pluralism. - Increasing women's control of land and access to inputs, enhancing their business, organisational, and leadership skills and promoting civic participation in local, regional and national decision-making processes. - Improving access to basic services in rural areas, particularly healthcare, building the quality of education and promoting girls' access to education - Enhancing agricultural production and providing more employment opportunities, apprenticeships and vocational training for young people, particularly in rural areas.

Bioscience Horizons: the national journal of undergraduate research

Bioscience Horizons (BH)commenced publication in 2008 and features research papers and reviews written by graduating UK bioscience students. The journal is run by a consortium of UK universities (the Universities of Nottingham, Reading, Leeds and Chester) in association with Oxford University Press. Its submissions encompass the full range of subjects taught by UK bioscience departments, ranging from agronomy to zoology and including animal behaviour, cancer research, environmental biology, microbial sciences, molecular biology, pharmacolgy, primatology, taxonomy and other areas. BH receives manuscripts from recent graduates (with a bachelor of science or equivalent first degree) describing research carried out during their undergraduate studies, usually as a final-year research project. All submissions undergo expert review and have to meet strict criteria for scientific excellence and originality. Articles are written by a single author and published with the agreement of the graduate's home university department. The journal has an ISSN number and is open-access; articles are freely 'cite-able' contributions to the bioscience research literature.