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This paper highlights the transformative potential of place-based community organizing as a theory and practice of progressive social change and as a critical approach to the social purpose of community engagement in Higher Education Institutions. The aim is to expose power asymmetries and civic renewal "from below" through a focus on community engaged learning, specifically community organizing on the curriculum for geography undergraduates. The empirical focus is an English university, but the issues and observations are widespread. Around the world, students are coping with disruptions following a global pandemic, austerity, and loss of trust in local democracy – participating in climate emergency and racial justice movements. This paper advances community organising and community engaged learning as a mutually co-constitutive challenge to conventional notions of the student as a passive consumer of recruitment, learning, and individualised notions of civic responsibility. Methods of community organising are based on the theory that if you want change, you need power: change ultimately traces a motivational journey from anger to agitation and action. Empirical vignettes explore the transformative role of emotionally stirring "political theatre" and direct action, while exposing tensions that arise due to the transitory status of students in place and time. [ABSTRACT FROM AUTHOR]

This document is a compilation of summaries of various articles from the British Journal of General Practice. The articles cover a range of topics related to primary care, including continuity of care for patients with mesothelioma, the use of longitudinal qualitative methods in asthma research, the management of chronic diseases in different patient populations, the attitudes of primary care professionals towards their title, suicide prevention in primary care, non-pharmacological interventions for dementia-related psychosis, healthcare access for Afghan refugees, inquiry-based stress reduction for obesity, non-pharmacological interventions for perinatal anxiety, and the impact of remote consulting in general practice. Each summary provides a brief overview of the background, aim, method, results, and conclusion of the respective article. [Extracted from the article]

Background: Morbidity from liver disease is rising in the UK. Most cases are caused by alcohol or non-alcoholic fatty liver disease (NAFLD) and treatable if caught early. Liver disease pathways have been shown to increase detection in the community, but have not been adopted into routine primary care work. Aim: To explore primary care healthcare professional (HCP) experiences and understanding of chronic liver disease, and where it might fit into management of long-term conditions. Design and setting: Qualitative interview study with 20 HCPs in primary care in the north of England. Method: A semi-structured approach informed by a theory of implementation (normalisation process theory [NPT]). Data collection and analysis were concurrent. Interview data were analysed using thematic analysis. Results: Participants identified the following key areas for action: incentivised frameworks and protocols to drive understanding, organise, and sustain practice; inclusion of common liver diseases into multimorbidity care to reduce complexity and workload; a need to define the GP role within a lifestyle-focused treatment pathway; and education/local champions to initiate and legitimise individual and organisational participation in change. Conclusion: To embed chronic liver disease management in routine primary care work, researchers and policymakers must be aware of the implementation challenges. These findings can guide the adoption of effective pathways and help bridge the implementation gap. [ABSTRACT FROM AUTHOR]

Cycling is promoted as a form of urban travel with well-established benefits to health, liveability and wellbeing. These benefits are comparatively large for older people, a growing segment in many populations. Yet, support for the normalisation of cycling mobilities for all ages varies considerably. It is usual to contrast low-cycling contexts, such as the UK, with high-cycling areas, typically favouring highest-rate paradigmatic urban centres. To challenge a too simplistic imitation and re-creation of engineering solutions elsewhere, we draw attention to diverse cycling habits and norms in residents of a more ordinary high-cycling area (suburban Rotterdam), and observe how cycling is normalised throughout the lifecourse. Using mobile and biographical methods, we argue that a more nuanced appreciation of cycling normalisation is gained from viewing ageing and cycling relationally and biographically. This is because the habit-forming realm of normalisation functions through both conscious decisions and unconscious practice, bound up with life events and the external environment. The findings suggest that age-friendly city strategies and urban mobility policies should more closely consider locally constituted social and cultural processes, beyond providing infrastructure. This article thus provides an in-depth account of what it takes for planning and policy to normalise positive, empowering, and age-friendly qualities in everyday mobility. [ABSTRACT FROM AUTHOR]

Background: The ease of contemporary hepatitis C virus (HCV) therapy has prompted a global drive towards simplified and decentralised treatment pathways. In some countries, primary care has become an integral component of community-based HCV treatment provision. In the UK, however, the role of primary care providers remains largely focused on testing and diagnosis alone. Aim: To develop a primary care-initiated HCV treatment pathway for people who use drugs, and recommend theory-informed interventions to help embed that pathway into practice. Design and setting: A qualitative study informed by behaviour change theory. Semi-structured interviews were undertaken with key stakeholders (n = 38) primarily from two large conurbations in Scotland. Method: Analysis was three-stage. First, a broad pathway structure was outlined and then sequential pathway steps were specified; second, thematic data were aligned to pathway steps, and significant barriers and enablers were identified; and, third, the Theoretical Domains Framework and Behaviour Change Wheel were employed to systematically develop ideas to enhance pathway implementation, which stakeholders then appraised. Results: The proposed pathway structure spans broad, overarching challenges to primary care-initiated HCV treatment. The theory-informed recommendations align with influences on different behaviours at key pathway steps, and focus on relationship building, routinisation, education, combating stigmas, publicising the pathway, and treatment protocol development. Conclusion: This study provides the first practicable pathway for primary care-initiated HCV treatment in Scotland, and provides recommendations for wider implementation in the UK. It positions primary care providers as an integral part of community-based HCV treatment, providing workable solutions to ingrained barriers to care. [ABSTRACT FROM AUTHOR]

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1468-2427.2007.00715.x Byline: HELEN JARVIS (1) Abstract: Abstract The literature on city-regionalism can be criticized for neglecting the mundane ways that cities and regions are socially reproduced (and contested) through processes of household decision-making and routine coordination. Moreover, dominant debates on macro-scale governance and economic competitiveness rarely question the way strategic city-regional partnerships equate notions of 'liveability' with marketability. However 'smart', these initiatives persistently fetishize growth, allowing little scope for collective endeavour or an ethic of care - values which Linda McDowell (2004) points out are fundamentally undermined by neoliberalism. This paper challenges the 'top-down' discourse of city-regionalism both on the grounds of what it examines (economic efficiency and governance) and how this is viewed (partially and globally). The case is made for raising awareness of the structural inequalities which restrict the 'choice of choices' actually available to households competing for public services on the basis of uneven resource entitlement. This calls for an understanding of a 'whole' economy, recognizing the full value of unpaid care-giving, volunteering and 'free' environmental resources. Author Affiliation: (1)Department of Geography, Politics and Sociology, University of Newcastle, Daysh Building, UK Article note: Helen Jarvis (helen.jarvis@ncl.ac.uk), Department of Geography, Politics and Sociology, University of Newcastle, Daysh Building, Newcastle upon Tyne NE3 1UL, UK.

The way in which secondary data analysis has shaped the polarization thesis as it is popularly conceived in the British context was examined. Secondary data sources demonstrate the perceived division of the population into extremes of multi-earner and no-earner households. A pattern of household employment compositions for 'nuclear family' households is identified from data gathered from the Sample of Anonymized Records. It was suggested that more qualitative research was necessary to examine the ways that households negotiate labor market prospects and regional housing through changing power relations and divisions of labor., JARVIS H. (1997) Housing, labour markets and household structure: questioning the role of secondary data analysis in sustaining the polarization debate, Reg. Studies 31, 521-531. This paper presents a critique [...]

Background: Liver disease is an increasing cause of premature mortality in the UK. Its management in primary care is not well understood. It is unclear what role commissioning bodies are playing in liver disease in the UK. Aim: To assess the level of engagement with community chronic liver disease management among clinical commissioning groups (CCGs) and health authorities across the UK. Design & setting: A cross-sectional survey to all UK CCGs and health authorities. Method: Survey questions were developed by the British Liver Trust, in collaboration with topic experts, and evaluated structures in place relating to liver disease management at commissioning and health board level. Results: There were 159 responses representing 99% UK coverage of CCGs and health boards. Twenty per cent reported an individual responsible for liver disease within their organisation, with 40% and 29% reporting having pathways in place to respond to abnormal liver blood tests and liver disease more generally, respectively. All those reporting use of pathways reported using national guidelines to guide content. Twenty-five per cent made use of transient elastography (FibroScan) and 16% of direct serum fibrosis markers (for example, enhanced liver fibrosis [ELF] score), which are both part of current National Institute for Health and Care Excellence (NICE) guidelines. There was marked regional variation in all areas of engagement surveyed, with Wales having exceptionally high levels of engagement in all areas in contrast to the other nations. Conclusion: The results of this survey should be used as a catalyst to highlight necessary regional improvements to the primary care management of chronic liver disease across the UK. [ABSTRACT FROM AUTHOR]

The ease of direct‐acting antiviral (DAA) medications for hepatitis C virus (HCV) has provided an opportunity to decentralize HCV treatment into community settings. However, the role of non‐specialist clinicians in community‐based pathways has received scant attention to date. This study examined barriers and enablers to expanding the role of general practitioners (GPs) in HCV treatment provision, using simple behaviour change theory as a conceptual framework. A maximum variation sample of 22 HCV treatment providers, GPs and HCV support workers participated in semi‐structured interviews. Data were inductively coded, and the resulting codes deductively mapped into three principal components of behaviour change: capability, opportunity and motivation (COM‐B). By this process, a number of provider‐ and systemic‐level barriers and enablers were identified. Key barriers included the pre‐treatment assessment of liver fibrosis, GP capacity and the 'speciality' of HCV care. Enablers included the simplicity of the drugs, existing GP/patient relationships and the provision of holistic care. In addition to these specific factors, the data also exposed an overarching provider understanding of 'HCV treatment' as triumvirate in nature, incorporating the assessment of liver fibrosis, the provision of holistic support and the treatment of disease. This understanding imposes a further fundamental barrier to GP‐led treatment as each of these three components needs to be individually addressed. To enable sustainable models of HCV treatment provision by GPs, a pragmatic re‐examination of the 'HCV treatment triumvirate' is required, and a paradigm shift from the 'refer and treat' status quo. [ABSTRACT FROM AUTHOR]

Background: Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease worldwide. Many individuals have risk factors associated with NAFLD, but the majority do not develop advanced liver disease: cirrhosis, hepatic decompensation, or hepatocellular carcinoma. Identifying people at high risk of experiencing these complications is important in order to prevent disease progression. This review synthesises the evidence on metabolic risk factors and their potential to predict liver disease outcomes in the general population at risk of NAFLD or with diagnosed NAFLD.Methods and Findings: We conducted a systematic review and meta-analysis of population-based cohort studies. Databases (including MEDLINE, EMBASE, the Cochrane Library, and ClinicalTrials.gov) were searched up to 9 January 2020. Studies were included that reported severe liver disease outcomes (defined as liver cirrhosis, complications of cirrhosis, or liver-related death) or advanced fibrosis/non-alcoholic steatohepatitis (NASH) in adult individuals with metabolic risk factors, compared with individuals with no metabolic risk factors. Cohorts selected on the basis of a clinically indicated liver biopsy were excluded to better reflect general population risk. Risk of bias was assessed using the QUIPS tool. The results of similar studies were pooled, and overall estimates of hazard ratio (HR) were obtained using random-effects meta-analyses. Of 7,300 unique citations, 22 studies met the inclusion criteria and were of sufficient quality, with 18 studies contributing data suitable for pooling in 2 random-effects meta-analyses. Type 2 diabetes mellitus (T2DM) was associated with an increased risk of incident severe liver disease events (adjusted HR 2.25, 95% CI 1.83-2.76, p < 0.001, I2 99%). T2DM data were from 12 studies, with 22.8 million individuals followed up for a median of 10 years (IQR 6.4 to 16.9) experiencing 72,792 liver events. Fourteen studies were included in the meta-analysis of obesity (BMI > 30 kg/m2) as a prognostic factor, providing data on 19.3 million individuals followed up for a median of 13.8 years (IQR 9.0 to 19.8) experiencing 49,541 liver events. Obesity was associated with a modest increase in risk of incident severe liver disease outcomes (adjusted HR 1.20, 95% CI 1.12-1.28, p < 0.001, I2 87%). There was also evidence to suggest that lipid abnormalities (low high-density lipoprotein and high triglycerides) and hypertension were both independently associated with incident severe liver disease. Significant study heterogeneity observed in the meta-analyses and possible under-publishing of smaller negative studies are acknowledged to be limitations, as well as the potential effect of competing risks on outcome.Conclusions: In this review, we observed that T2DM is associated with a greater than 2-fold increase in the risk of developing severe liver disease. As the incidence of diabetes and obesity continue to rise, using these findings to improve case finding for people at high risk of liver disease will allow for effective management to help address the increasing morbidity and mortality from liver disease.Trial Registration: PROSPERO CRD42018115459. [ABSTRACT FROM AUTHOR]

Improving our understanding of the complex relationship between health and social care utilisation is vital as populations age. This systematic review aimed to synthesise evidence on the relationship between older adults' use of social care and their healthcare utilisation. Ten databases were searched for international literature on social care (exposure), healthcare use (outcome) and older adults (population). Searches were carried out in October 2016, and updated May 2018. Studies were eligible if they were published after 2000 in a high income country, examined the relationship between use of social care and healthcare utilisation by older adults (aged ≥60 years), and controlled for an indicator of need. Study quality and bias were rated using the National Institute of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross‐Sectional Studies. Study data were extracted and a narrative synthesis was conducted. Data were not suitable for quantitative synthesis. Thirteen studies were identified from 12,065 citations. Overall, the quality and volume of evidence was low. There was limited evidence to suggest that longer lengths of stay in care homes were associated with a lower risk of inpatient admissions. Residents of care homes with onsite nursing had fewer than expected admissions to hospital, compared to people in care homes without nursing, and adjusting for need. Evidence for other healthcare use outcomes was even more limited and heterogeneous, with notable gaps in primary care. We conclude that older adults' use of care homes may moderate inpatient admissions. In particular, the presence of registered nurses in care homes may reduce the need to transfer residents to hospital. However, further evidence is needed to add weight to this conclusion. Future research should build on this evidence and address gaps regarding the influence of community based social care on older adults' healthcare use. A greater focus on primary care outcomes is imperative. [ABSTRACT FROM AUTHOR]

This article proposes a social phenomenology of intentional sharing and togetherness from a degrowth perspective: extending human relations instead of market relations; deepening democracy; defending ecosystems; and realizing a more equal global distribution of wealth. Social phenomenology looks beyond individual mutual exchange to the rich but fragile social construction of collectively negotiated ethical purpose. Intentional communities of cohousing are identified as part of a solution to dismantle privatized, conspicuous consumption. This approach challenges the tendency in popular sharing economy discourse to conflate different types of togetherness, highlighting instead the social significance of skilful cooperation and conviviality in groups and associations. [ABSTRACT FROM AUTHOR]

Background: The incidence of liver disease is increasing in the UK and primary care is a key setting where improvement in the detection and management of liver disease is required. Little is known about GPs' understanding and confidence in detecting liver disease.Aim: To explore GPs' experiences of liver disease with a focus on early detection and interpretation of liver function tests (LFTs).Design and Setting: A qualitative study employing semi-structured interviews of a purposive sample of GPs from five UK primary care study sites.Method: Telephone and face-to-face interviews of GPs were undertaken. Data were analysed thematically, using a constant comparative approach.Results: From a total of 25 GP interviews (N = 25), four themes were identified from the data: test-requesting behaviour, confidence and challenges in diagnosing disease, access to specialist tests, and guidance and education. Participants' descriptions of how they request and interpret LFTs varied widely. Concern over missing diagnoses was a common reason for requesting blood tests; patients with mildly abnormal LFTs and those at risk of non-alcoholic fatty liver disease (NAFLD) were a particular cause of concern. GPs saw themselves as generalists, with a reluctance to take on specialist investigations. Guidelines promoted confidence for some clinicians, but others felt that liver disease was too complex to be amenable to simple instructions. Most felt that they did not have access to relevant, focused education on liver disease.Conclusion: Liver disease is not perceived as a priority in primary care. If GPs are to take on a greater role in identification and management of liver disease, support is needed to promote awareness, knowledge, and confidence. [ABSTRACT FROM AUTHOR]

Is becoming clearer: if primary care is serious about improving outcomes for patients with liver disease, now is the time to implement change. If these patients had been triaged using abnormal liver blood tests alone, 39% of these cirrhosis cases would have been missed.[19] Both the Scarred Liver Project and Camden/Islington approach have been shown to be highly cost-effective as compared with standard care.[20] SP , sp [21] WHAT NEXT FOR CHRONIC LIVER DISEASE MANAGEMENT IN PRIMARY CARE? Liver disease, most commonly caused by alcohol or the metabolic syndrome (leading to non-alcohol related fatty liver disease [NAFLD]), is now a leading cause of premature death in the UK.[1] Morbidity and mortality due to liver disease have been rising in line with obesity, diabetes, and high levels of hazardous alcohol consumption. In order to increase the early detection of significant liver disease, alternative approaches using liver disease risk factors to trigger an assessment have been studied. [Extracted from the article]

Working Hard and Making Do: Surviving in Small Town America, M. K. NELSON and J. SMITH, University of California Press (1999). x + 279 pp. No price given. ISBN 0 [...]

Background Liver disease is the third most common cause of premature death in the UK. The symptoms of terminal liver disease are often difficult to treat, but very few patients see a palliative care specialist and a high proportion die in hospital. Primary care has been identified as a setting where knowledge and awareness of liver disease is poor. Little is known about general practitioners' (GPs) perceptions of their role in managing end-stage liver disease. Objective To explore GPs' experiences and perceptions of how primary care can enhance end-of-life care for patients with liver disease. Design Qualitative interview study, thematic analysis. Participants Purposive sample of 25 GPs from five regions of England. Results GPs expressed a desire to be more closely involved in end-of-life care for patients with liver disease but identified a number of factors that constrained their ability to contribute. These fell into three main areas; those relating directly to the condition, (symptom management and the need to combine a palliative care approach with ongoing medical interventions); issues arising from patients' social circumstances (stigma, social isolation and the social consequences of liver disease) and deficiencies in the organisation and delivery of services. Collaborative working with support from specialist hospital clinicians was regarded as essential, with GPs acknowledging their lack of experience and expertise in this area. Conclusions End-of-life care for patients with liver disease merits attention from both primary and secondary care services. Development of care pathways and equitable access to symptom relief should be a priority. [ABSTRACT FROM AUTHOR]

GPs with special interests in particular conditions or groups of patients may also develop knowledge and skills beyond the scope of GP training and the MRCGP exam, becoming GPs with Extended Roles.[11] Such professional development opportunities offer expert medical generalists the options of specialist practice while remaining embedded in primary care. General practice has been increasingly required to expand its role to take on more complex care - demands enabled by the fluid boundaries of what constitutes "general practice". RISKS OF AN EXPANDED GP ROLE Demands on general practice continue to rise year on year. [Extracted from the article]

Coinciding with the ideological agenda of 'new localism' in welfare and planning policy is popular re-engagement with a convivial scale of participation in civil society. This is evident in a growing number and variety of community-led housing (CLH) groups and projects. It is also evident in 'slow' social movements, such as Cittaslow, that emphasise 'quality of life' and 'sustainability'. Paradoxically, while home and community are essential to a local sense of identity and belonging, connections have not been made between 'slow' opposition to the homogenizing effects of corporate development and CLH. This paper draws particular attention to groups of ordinary citizens creating new or modified forms of housing that are not available in the mainstream housing market. A view is taken of CLH that encompasses wider aspects of community organising and resilience. The paper highlights the socio-spatial functions to citizen participation and motivations that drive CLH from the bottom-up. These need to be better understood if research and policy are to support and enable the process of growing locally driven housing solutions. [ABSTRACT FROM AUTHOR]

This article draws attention to the micro-social practices that self-organising resident groups engage in over the years that it takes to build a co-housing community. This ‘social architecture’ is what distinguishes co-housing from superficially similar shared-space neighbourhoods. Co-housing developments are attracting renewed attention in Anglophone neo-liberal economies against a backdrop of crisis in conventional housing. Discussion draws on the views of co-housing residents from participatory research from the UK, USA and Australia. By engaging with a deeper understanding of group processes, shared visions and interpersonal capabilities – the ‘glue’ binding collaborative community relations – this paper challenges the priority usually given to the material characteristics of home and neighbourhood design. [ABSTRACT FROM PUBLISHER]

The hepatitis C virus (HCV) is a blood-borne flavivirus causing liver infection in humans, which exhibits 55% to 85% chronicity after initial acute infection.[1] Left untreated a significant percentage of those with chronic HCV will go on to develop liver cirrhosis and hepatocellular carcinoma (HCC).[1] In the UK, HCV disproportionately affects marginalised populations, with past or present injecting drug use being the most important risk factor. Sexual transmission of hepatitis C virus among monogamous heterosexual couples: the HCV partners study. [Extracted from the article]

The article focuses on the social conditions of women in the city of Bucharest, Romania. It reflects on the role of women in the social and political spaces of everyday life. It mentions the exploitation of gendered and sexed bodies in contemporary urban public space. It outlines the findings of the International Violence Against Women Survey which shows the prevalence of violence against women worldwide.

Ownership of a single-family dwelling remains the dominant aspiration in market-led economies. In a hyper-privatised landscape, it is widely assumed that people will not share housing except in extraordinary circumstances. There is nevertheless a long and rich history of countercultural groups who imagine and practise alternative forms of shared housekeeping and collaborative dwelling. This article draws on first-hand observations of daily life from the countercultural community of Christiania, in the Danish capital of Copenhagen, at a critical moment in a 40-year history of state-threatened ‘normalization’. Christiania is an intriguing lens through which to re-imagine affordable, adaptable, gender democratic housing and urban structure: it reveals how sharing, mutuality and innovation intersect at multiple scales of homemaking and community governance. These insights are relevant for provoking new thinking about dwelling and mutuality in the context of a deepening crisis in housing provision and access across Europe. [ABSTRACT FROM PUBLISHER]

Essential Understandings: International Students, Learning, Libraries by Carolyn McSwincy. Adelaide Auslib Press 1995 201p This is a most timely publication which examines the academic library needs of international students at [...]