• Attitudes toward genetic testing and personalised nutrition in a representative sample of European consumers

      Stewart-Knox, Barbara; Bunting, B.P.; Gilpin, S.; Parr, H.J.; Pinhao, S.; Strain, J.J.; de Almeida, M.D.V.; Gibney, M.J. (2009)
      Negative consumer opinion poses a potential barrier to the application of nutrigenomic intervention. The present study has aimed to determine attitudes toward genetic testing and personalised nutrition among the European public. An omnibus opinion survey of a representative sample aged 14-55+ years (n 5967) took place in France, Italy, Great Britain, Portugal, Poland and Germany during June 2005 as part of the Lipgene project. A majority of respondents (66 %) reported that they would be willing to undergo genetic testing and 27 % to follow a personalised diet. Individuals who indicated a willingness to have a genetic test for the personalising of their diets were more likely to report a history of high blood cholesterol levels, central obesity and/or high levels of stress than those who would have a test only for general interest. Those who indicated that they would not have a genetic test were more likely to be male and less likely to report having central obesity. Individuals with a history of high blood cholesterol were less likely than those who did not to worry if intervention foods contained GM ingredients. Individuals who were aware that they had health problems associated with the metabolic syndrome appeared particularly favourable toward nutrigenomic intervention. These findings are encouraging for the future application of personalised nutrition provided that policies are put in place to address public concern about how genetic information is used and held.
    • Can commercially-oriented microfinance help meet the Millennium Development Goals? Evidence from Pakistan.

      Montgomery, H.; Weiss, John A. (Elsevier, 2011)
      The current emphasis in the microfinance industry is a shift from donor-funded to commercially sustainable operations. This article evaluates the impact of access to microloans from the Khushhali Bank - Pakistan's first and largest microfinance bank which operates on commercial principles. Using primary data from a detailed household survey of nearly 3000 borrower and non-borrower households, a difference in difference approach is used to test for the impact of access to loans. Once the results are disaggregated between rural and urban areas there is a positive impact in rural areas on food expenditure and on some social indicators.
    • Developing country health systems and the governance of international HIV/AIDS funding

      Poku, Nana K.; Whitman, Jim R. (2012)
      Donor country initiatives for the prevention and mitigation of HIV/AIDS are not a matter of simple burden sharing. Instead, they have brought in their wake many of the complexities and unforeseen effects that have long been associated with more general overseas development assistance. In the case of funding directed toward HIV/AIDS, these effects are by no means either secondary or easily calculable. It is widely acknowledged that there is no consensus framework on how these impacts may be defined, no framework/toolkit for the evaluation of impacts and no longitudinally significant data that could provide the substance for those evaluations. The subject of this study focuses not on the health outcomes of funding but on how donor-recipient relations could be better deliberated, negotiated and coordinated. We argue that effective leadership and governance of developing country health systems for HIV/AIDS work requires a reconfiguration of how donor-recipient relations are conceived and contracted, and for this purpose, we propose an adaptation of the Organisation for Economic Co-operation and Development Paris Declaration principles of aid effectiveness.
    • Embodied ideas and divided selves: revisiting Laing via Bakhtin

      Burkitt, Ian; Sullivan, Paul W. (2009)
      In this article, we apply Mikhail Bakhtin's model of a 'divided self' to R.D. Laing's eponymous work on the lived experience of divided selves in 'psychosis'. Both of these authors offer intriguing insights into the fracturing of self through its social relationships (including the 'micro-dialogues' staged for oneself) but from uniquely different perspectives. Bakhtin (1984) uses Dostoevsky's novels as his material for a theory of self, centrally concerned with moments of split identity, crisis, and personal transformation, while Laing relies on his patient's accounts of 'psychosis'. We will outline how two key Bakhtinian divisions of the self (spirit/soul and authoritative/internally persuasive discourse) help to make sense of Laing's descriptions of his patient's experiences and micro-dialogues. Conversely, when refracted through Laing's phenomenology Bakhtin's account of the self becomes richer and somewhat darkened in terms of a double-edged ontology, which describes a maximally open self but one that is consumed by ideas, unable to manage their contradictions. The implications of this for managing the dilemmas of self-identity will be drawn out.
    • Factors influencing European consumer uptake of personalised nutrition. Results of a qualitative analysis

      Stewart-Knox, Barbara; Kuznesof, S.; Robinson, J.; Rankin, A.; Orr, K.; Duffy, M.; Poinhos, R.; de Almeida, M.D.V.; Macready, A.L.; Gallagher, C.; et al. (2013)
      The aim of this research was to explore consumer perceptions of personalised nutrition and to compare these across three different levels of "medicalization": lifestyle assessment (no blood sampling); phenotypic assessment (blood sampling); genomic assessment (blood and buccal sampling). The protocol was developed from two pilot focus groups conducted in the UK. Two focus groups (one comprising only "older" individuals between 30 and 60 years old, the other of adults 18-65 yrs of age) were run in the UK, Spain, the Netherlands, Poland, Portugal, Ireland, Greece and Germany (N=16). The analysis (guided using grounded theory) suggested that personalised nutrition was perceived in terms of benefit to health and fitness and that convenience was an important driver of uptake. Negative attitudes were associated with internet delivery but not with personalised nutrition per se. Barriers to uptake were linked to broader technological issues associated with data protection, trust in regulator and service providers. Services that required a fee were expected to be of better quality and more secure. An efficacious, transparent and trustworthy regulatory framework for personalised nutrition is required to alleviate consumer concern. In addition, developing trust in service providers is important if such services to be successful.
    • Ideological Coalitions and the International Promotion of Social Accountability: The Philippines and Cambodia Compared

      Rodan, G.; Hughes, Caroline (2012)
      International aid agencies are increasingly placing social accountability at the heart of their governance reform programs, involving a range of social activist mechanisms through which officials are rendered answerable to the public. Crucially, aid agencies are not just promoting these mechanisms in emerging democracies, but now also in authoritarian societies. What then are the likely political regime effects of these mechanisms? We approach this by examining who supports social accountability, why, and the implications for political authority. Focusing on the Philippines and Cambodia cases, it is argued that, to differing degrees, social accountability mechanisms have been subordinated to liberal and ⁄ or moral ideologies favoring existing power hierarchies. These ideologies often privilege nonconfrontational state–society partnerships, drawing activists into technical and administrative processes limiting reform possibilities by marginalizing, or substituting for, independent political action pivotal to the democratic political authority of citizens.
    • Medical training as adventure-wonder and adventure-ordeal: a dialogical analysis of affect-laden pedagogy

      Madill, A.; Sullivan, Paul W. (2010)
      Our purpose is to examine the possibilities of Bakhtinian dialogical analysis for understanding students' experiences of medical training. Twenty-three interviews were conducted with eleven British medical students intercalating in psychology. Forty emotionally resonant key moments were identified for analysis. Our analysis illustrates students' use of the professional genre to present their training as emotionally neutral. However, we show how medical training can be framed in more unofficial and affective-laden ways in which threshold moments of crisis are presented as space-time breaches characteristic of the genres of adventure-wonder and adventure-ordeal. This affect was often depotentiated in the narratives through brief allusion to the professional genre. This cycling between genres suggests that the students were searching for an appropriate way in which to frame their experiences, a central dilemma being the extent to which medical training makes sense within an immediate and affect-laden, or future-orientated and affect-neutral, pedagogy. Finally, we identify how consultants are an important aspect of the affective experience of medical training who, at their best, offer inspiring exemplars of flexible movement between official and unofficial ways of being a doctor. In conclusion, we demonstrate the potential of genres to make sense, and to organize the experience, of medical training spatially in terms of moving between personal and impersonal contact, temporally in terms of moving between the extraordinary and routine, and affectively in terms of moving between potent and neutral affect. Learning to use the professional genre is part of enculturation as a doctor and can be helpful in providing a framework restoring coherence and composure through engaging with, and reformulating, difficult experiences. However, it is important to take seriously the resistance many of the students demonstrated to the professional genre as a possible barometer of its acceptability to the general public.
    • Predictors of taste acuity in healthy older Europeans

      Simpson, E.E.A.; Rae, G.; Parr, H.J.; O'Connor, J.M.; Bonham, M.; Polito, A.; Meunier, N.; Andriollo-Sanchez, M.; Intorre, F.; Coudray, C.; et al. (2012)
      This study aimed to identify factors associated with taste acuity in healthy older European adults aged 55-87 years, employing a factorial independent design to recruit older adults from centres in France, Italy and United Kingdom. Adults aged 70-87 years (N=387) were recruited in Rome (Italy) (n=108) and Grenoble (France) (n=91) and aged 55-70 years in Northern Ireland (United Kingdom) (n=93) and Clermont-Ferrand (C-F) (France) (n=95). A signal detection theory (SDT) approach was used for detection threshold assessment of the four basic tastes (salt; sweet; bitter; and, sour). Trial data were converted to R-indices. Diet was assessed by means of four day food diaries. Dietary data were converted using WISP and then reduced, using a principal components analysis, to four components: Component 1 'high fat and salt'; Component 2 'high vitamins and fibre'; Component 3 'high fat and carbohydrate'; and, Component 4 'high trace elements'. Socio-demographic information was collected by self report survey. Four separate regression analyses were carried out, one for each of the four basic taste qualities (sweet; sour; bitter; salt). Mean ROC scores for each taste quality were the response variables and age, sex, country, social class and dietary components were predictor variables. The main predictors of taste acuity were age, sex, social class and country, which had differential effects for each taste quality. These data suggest that socio-demographic and cultural factors should be taken into account when considering taste acuity in older people.
    • Supplemented zinc does not alter mood in healthy older European adults - a randomised placebo-controlled trial: the Zenith study

      Stewart-Knox, Barbara; Rae, G.; Simpson, E.E.A.; McConville, C.; O'Connor, J.M.; Polito, A.; Andriollo-Sanchez, M.; Coudray, C.; Strain, J.J. (2011)
      OBJECTIVE: Older people are vulnerable to zinc deficiency, which may impact upon their mood. This randomised, placebo-controlled, double-blind intervention study aimed to investigate the effect of oral zinc gluconate supplementation (15 mg/d; 30 mg/d; and placebo) on subjective mood (affect) in older Europeans. SUBJECTS: Healthy volunteers (n 387) aged 55-87 years were recruited. SETTING: Volunteers in Rome (Italy; n 108) and Grenoble (France; n 91) were aged 70-87 years and those in Coleraine (Northern Ireland; n 93) and Clermont-Ferrand (France; n 95) were aged 55-70 years. DESIGN: Mood was measured using the Positive and Negative Affect Scale on four occasions per day over 4 d at baseline, 3 and 6 months post-intervention. RESULTS: Mixed ANOVA indicated that neither positive nor negative affect altered in response to zinc (15 mg/d or 30 mg/d) compared to placebo in either the 55-70 years or the >/=70 years age group. CONCLUSIONS: These results suggest that zinc does not benefit mood in healthy older people.
    • Whose peace?: critical perspectives on the political economy of peacebuilding

      Pugh, Michael C.; Cooper, Neil; Turner, Mandy (2008)
      The book provides critical perspectives that reach beyond the technical approaches of international financial institutions and proponents of the liberal peace formula. It investigates political economies characterized by the legacies of disruption to production and exchange, by population displacement, poverty, and by 'criminality'.