Childsmile: the national child oral health improvement programme in Scotland. Part 2: Monitoring and delivery.

This paper, the second of two reviewing the Childsmile programme, describes monitoring arrangements and summarises monitoring data covering the period 2006-2009. By mid-2009, around 28,000 infants in deprived areas of the West of Scotland had been given caries risk assessments by Health Visitors; 14,000 were enrolled with 142 Childsmile practices or clinics; and over 10,000 had begun making practice visits. The Childsmile Nursery and School programmes had provided 28,000 fluoride varnish treatments to nursery and primary school children. Daily supervised toothbrushing and distribution of oral health packs covered almost 100% of nursery schools and P1 and P2 classes in primary schools in the most deprived areas of Scotland. Feedback of monitoring information to programme managers is used to identify any variation or shortfall in programme coverage and delivery.

The influence of the secondary school setting on the food practices of young teenagers from disadvantaged backgrounds in Scotland.

In this paper, we explore the secondary school environment as an important context for understanding young teenagers' eating habits and food practices. We draw on data collected during semi-structured interviews with 36 young teenagers (aged 13/14 years) living in disadvantaged circumstances in Scotland. We found that the systems inherent in school had an impact on what, where and when participants ate their lunch. Each school had rules governing use of the school dining hall and participants sometimes chose to leave this environment to buy food outside school premises. Our interviews showed that parents determined how much money young people took to school and, therefore, had some control over their food choices. Participants rarely spoke of giving priority to food and eating during the non-curriculum parts of the school day, preferring to spend time 'hanging out' with friends. Eating with friends was sometimes reported as a cause of anxiety, particularly when participants had concerns about body image, appetite or appearance. We suggest that young teenagers' dislike for queuing for food, their ability to budget for food at school and their desire to maximize time spent with friends influence food choices; therefore, these are issues which have implications for health education and will be of interest to those responsible for school meal provision.

Practising what we preach? A practical approach to bringing research, policy and practice together in relation to children and health inequalities.

This paper explores the need for better links between research and practice in relation to work with children and health inequalities. Despite continuing discussion about the need to improve dissemination of research activity in general, study of this area remains largely neglected. As a result, despite the rhetoric, the research and practice gap continues to exist. An attempt to remedy this was undertaken through the support of a user fellowship as part of the UK Economic and Social Research Council Health Variations Programme. The paper describes a number of activities that were undertaken during the fellowship, and discusses the implications of these for improving connections and minimizing the research and practice 'gap'. It argues that a need exists for researchers to develop innovative dissemination strategies and suggests that potential exists for an interactive model of dissemination. Such a model implies a more active role for users of research in the shaping of research agendas.

Formal intramolecular [5 + 2] photocycloaddition reactions of maleimides: a novel approach to the CDE ring skeleton of (-)-cephalotaxine.

A concise approach to the cephalotaxine CDE ring skeleton based on the intramolecular formal [5 + 2] photocycloaddition of cyclopentenyl-substituted maleimides is described. An investigation of the diastereoselectivity afforded by various protected alkoxy groups demonstrated that the best selectivity (3.5:1) was afforded by the free hydroxyl group, strongly suggesting a hydrogen-bonded excited state. Reaction: see text.

Chemical characterisation of disruptants of the Streptomyces coelicolor A3(2) actVI genes involved in actinorhodin biosynthesis.

The actVI genetic region of Streptomyces coelicolor A3(2) is part of the biosynthetic gene cluster of actinorhodin (ACT), the act cluster, consisting of six ORFs: ORFB, ORFA, ORF1, ORF2, ORF3, ORF4. A newly devised method of ACT detection with a combination of HPLC and LC/MS was applied to the analysis of the disruptants of each ORF. ACT was produced by those of ORFB, ORFA, ORF3, and ORF4. Instead of ACT, the ORF1 disruptant produced 3,8-dihydroxy-1-methylanthraquinone-2-carboxylic acid (DMAC) and aloesaponarin II as shunt products. The ORF2 disruptant gave 4-dihydro-9-hydroxy-1-methyl-10-oxo-3-H-naphtho-[2,3-c]-pyran-3-(S)-acet ic acid, (S)-DNPA. These results support our previous proposal for stereospecific pyran ring formation in the biosynthesis of ACT, most importantly suggesting that the actVI-ORF2 product would recognize (S)-DNPA as a substrate for stereospecific reduction at C-15. The disruptant of ORFA produced (S)-DNPA together with ACT, suggesting that actVI-ORFA might play a role such as stabilising the multicomponent, type II PKS complex.

Understanding peer education: insights from a process evaluation.

In the UK, peer education has become an increasingly popular way of carrying out health promotion work with young people but evaluations of its effectiveness remain largely unpublished. In particular, illuminative evaluations using qualitative methods are rarely reported both in the UK and other countries. This paper presents insights from the process evaluation of a peer education project in Fife, Scotland which was funded to explore new ways of working with young people in the areas of sexual health, HIV/AIDS and drugs. The interactive approach of the evaluation and its responsiveness to the development of the project are outlined. Factors influencing the peer education process, such as recruitment, setting, organizational context and personal development of participants, are described. Aspects of the formal and informal work carried out by the peer educators are discussed. It is hoped that the paper may provide a starting point for developing more reflective understandings about the processes involved when peers educate peers.

'I'll worry about that when it comes along': osteoporosis, a meaningful issue for women at mid-life?

This paper reports findings from a qualitative study of the health concerns and perceptions of health risks and osteoporosis of women in the age group 40-55 years. Osteoporosis has been increasingly put forward in the popular and scientific press as an important issue for women in mid-life. A variety of preventive measures, including use of hormone replacement therapy (HRT), are suggested. The medicalization of women's experiences and associated use of HRT at this point in the life course is the subject of considerable debate in the medical, social scientific and feminist literatures, although, to date, this issue has received less attention in health promotion. Much of this debate is informed by quantitative and survey data, and there is a lack of in-depth qualitative information on women's own views. This study casts doubt on the salience of osteoporosis for women at mid-life. Our qualitative research suggests that, unless they had experiential knowledge which had rendered osteoporosis particularly salient, most women in this study evidenced a surprising degree of disinterest in this health issue. To make sense of this disinterest we examined women's wider accounts of their lives, health and the lifecourse, and the menopause. These findings would appear to present a challenge for those in health promotion who might wish to emphasize early preventive strategies for osteoporosis.

A critical appraisal of the draw and write technique.

The draw and write technique is increasingly popular in health education research with children. It is generally employed in the setting of the school classroom and is promoted as a 'bottom-up' approach which enhances participation by children. In this paper we critically appraise the use of this method. Against the background of a consideration of carrying out qualitative health promotion research with children we examine the origins and use of children's drawings in a number of disciplines and practice environments. We argue that, although the draw and write technique has made an important contribution to health education research, it fails to reflect the processes involved in the construction and collection of such data. A range of methodological, analytical and ethical issues are raised. We conclude that health education research with children must involve taking children seriously as social actors and query the assumption that drawing enables children to communicate their thought any more than does conversational language. We suggest that the development of research should be premised upon an appreciation of the social context and the world of the child.

Proof that the ACTVI genetic region of Streptomyces coelicolor A3(2) is involved in stereospecific pyran ring formation in the biosynthesis of actinorhodin.

Pyran ring formation in the biosynthesis of actinorhodin in Streptomyces coelicolor A3(2) was studied using the act cluster deficient strain, CH999, carrying pRM5-based plasmids harbouring combinations of the actVI genes. The strain, CH999/pIJ5660 (pRM5 + actVI-ORF1), produced a chiral intermediate, (S)-DNPA, suggesting that the actVI-ORF1 product is a reductase determining the C-3 stereochemical centre.

A critical review of peer education with young people with special reference to sexual health.

This paper presents a critical review of selected literature about peer education initiatives with young people principally in the area of sexual health. Reported work in this area was found to be diverse in terms of aims, objectives, methods, findings and levels of evaluation. The paper highlights the promise of the method but draws attention to its potential problems. Examples of peer health education are reviewed and the issues surrounding them discussed. These include: theoretical background, rationales, cultural constraints, ethical and operational issues, and the challenges for monitoring and evaluation. The paper concludes by suggesting that practitioners and evaluators must reflect on the difficulties inherent in artificially reconstructing a social process.