Interventions to improve cultural competency in healthcare: a systematic review of reviews

Cultural competency is a recognized and popular approach to improving the provision of health care to racial/ethnic minority groups in the community with the aim of reducing racial/ethnic health disparities. The aim of this systematic review of reviews is to gather and synthesize existing reviews of studies in the field to form a comprehensive understanding of the current evidence base that can guide future interventions and research in the area.

Recent trends in nanomaterials immobilised enzymes for biofuel production

Application of nanomaterials as novel supporting materials for enzyme immobilisation has generated incredible interest in the biotechnology community. These robust nanostructured forms, such as nanoparticles, nanofibres, nanotubes, nanoporous, nanosheets, and nanocomposites, possess a high surface area to volume ratios that can cause a high enzyme loading and facilitate reaction kinetics, thus improving biocatalytic efficiency for industrial applications. In this article, we discuss research opportunities of nanoscale materials in enzyme biotechnology and highlight recent developments in biofuel production using advanced material supports for enzyme immobilisation and stabilisation. Synthesis and functionalisation of nanomaterial forms using different methods are highlighted. Various simple and effective strategies designed to result in a stable, as well as functional protein-nanomaterial conjugates are also discussed. Analytical techniques confirming enzyme loading on nanomaterials and assessing post-immobilisation changes are discussed. The current status of versatile nanomaterial support for biofuel production employing cellulases and lipases is described in details. This report concludes with a discussion on the likely outcome that nanomaterials will become an integral part of sustainable bioenergy production.

Discovering implicit criteria preferences reflected in tourism journal ranking lists using the Choquet Integral

Variations between journal rankings may cause confusion. As such, prior attempts were made to compare and evaluate journal ranking criteria for obtaining insightful knowledge on how different research communities have ranked journals. However, existing approaches are unable to model the journal ranking process closely enough as they are incapable of considering the relationship between multiple criteria simultaneously. In this paper, we address the challenges by introducing the Choquet Integral (CI) for evaluating journal ranking criteria. The new approach is able to account for interactions between criteria in relation to overall ranking score, using a fuzzy measure in its computation. Its properties, the Shapley value and the Interaction index, allow for good representations of importance and interactions between criteria. We demonstrate the efficiency of the CI through a case study of journal ranking lists in tourism and service journals.

Self-reported access to and quality of healthcare for diabetes : Do the severely obese experience equal access?

Background: Given reported pejorative views that health professionals have about patients who are severely obese, we examined the self-reported views of the quality and availability of diabetes care from the perspective of adults with type 2 diabetes (T2DM), stratified by body mass index (BMI). Methods: 1795 respondents to the Diabetes MILES - Australia national survey had T2DM. Of these, 530 (30%) were severely obese (BMI ≥35 kg/m2) and these participants were matched with 530 controls (BMI <35 kg/m2). Data regarding participants' self-reported interactions with health practitioners and services were compared. Results: Over 70% of participants reported that their general practitioner was the professional they relied on most for diabetes care. There were no betweengroup differences in patient-reported availability of health services, quality of interaction with health practitioners, resources and support for selfmanagement, or access to almost all diabetes services. Discussion: Participants who were severely obese did not generally report greater difficulty in accessing diabetes care.

Intervention-driven predictive framework for modeling healthcare data

Assessing prognostic risk is crucial to clinical care, and critically dependent on both diagnosis and medical interventions. Current methods use this augmented information to build a single prediction rule. But this may not be expressive enough to capture differential effects of interventions on prognosis. To this end, we propose a supervised, Bayesian nonparametric framework that simultaneously discovers the latent intervention groups and builds a separate prediction rule for each intervention group. The prediction rule is learnt using diagnosis data through a Bayesian logistic regression. For inference, we develop an efficient collapsed Gibbs sampler. We demonstrate that our method outperforms baselines in predicting 30-day hospital readmission using two patient cohorts - Acute Myocardial Infarction and Pneumonia. The significance of this model is that it can be applied widely across a broad range of medical prognosis tasks. © 2014 Springer International Publishing.

Building healthcare workers' confidence to work with same-sex parented families.

This article reports on a qualitative study of barriers and access to healthcare for same-sex attracted parents and their children. Focus groups were held with same-sex attracted parents to explore their experiences with healthcare providers and identify barriers and facilitators to access. Parents reported experiencing uncomfortable or anxiety-provoking encounters with healthcare workers who struggled to adopt inclusive or appropriate language to engage their family. Parents valued healthcare workers who were able to be open and honest and comfortably ask questions about their relationships and family. A separate set of focus groups were held with mainstream healthcare workers to identity their experiences and concerns about delivering equitable and quality care for same-sex parented families. Healthcare workers reported lacking confidence to actively engage with same-sex attracted parents and their children. This lack of confidence related to workers' unfamiliarity with same-sex parents, or lesbian, gay and bisexual culture, and limited opportunities to gain information or training in this area. Workers were seeking training and resources that offered information about appropriate language and terminology as well as concrete strategies for engaging with same-sex parented families. For instance, workers suggested they would find it useful to have a set of 'door opening' questions they could utilize to ask clients about their sexuality, relationship status or family make-up. This article outlines a set of guidelines for healthcare providers for working with same-sex parented families which was a key outcome of this study.