Applying systems leadership and participatory action research in developing a water contamination management tool.

OBJECTIVE: This research used systems leadership to explore stakeholder engagement regarding requirements, incentives and barriers to adopting a faecal source tracking method to identify contamination sources in surface waters. SETTING: The research comprised two branches, one quantitative, conducted in a food and water laboratory; the other qualitative, conducted within stakeholder organisations and meeting premises. PARTICIPANTS: Ten stakeholder representatives participated in semi-structured interviews and ten in a focus group. Seven individuals participated in both activities while three who were interviewed were replaced by alternate representatives for the focus group. DESIGN: A multimethod participatory action research project was completed, with a quantitative trial of a microbial source tracking method conducted concurrently with two iterations of qualitative research into the needs of the stakeholder system through semi-structured interviews and a focus group. RESULTS: Thematic analysis of stakeholder interviews yielded key incentive and barrier themes, while the laboratory trial created a comparison library and tested the efficacy of the laboratory method. The focus group further explored key themes and identified requirements for collaborative effort across the system, and the need to address misinterpretation of statistical associations. CONCLUSION: Systems leadership was effective in exploring stakeholder interest in the proposed faecal source tracking method. Two iterations of qualitative research helped to identify the needs of individual stakeholders, and then develop collective strategies for addressing the critical incentives and barriers.

An Assets-Based Approach to Co-Producing a Culturally Adapted Family Intervention (CaFI) with African Caribbeans Diagnosed with Schizophrenia and Their Families.

Objective: To determine how to improve the cultural appropriateness and acceptability of an extant evidence-based model of family intervention (FI), a form of 'talking treatment,' for use with African Caribbean service users diagnosed with schizophrenia and their families. Design: Community partnered participatory research (CPPR) using four focus groups comprising 31 key stakeholders. Setting: Community locations and National Health Service (NHS) mental health care settings in northwest England, UK. Participants: African Caribbean service users (n=10), family members, caregivers and advocates (n=14) and health care professionals (n=7). Results: According to participants, components of the extant model of FI were valid but required additional items (such as racism and discrimination and different models of mental health and illness) to improve cultural appropriateness. Additionally, emphasis was placed on developing a new ethos of delivery, which participants called 'shared learning.' This approach explicitly acknowledges that power imbalances are likely to be magnified where delivery of interventions involves White therapists and Black clients. In this context, therapists' cultural competence was regarded as fundamental for successful therapeutic engagement and outcomes. Conclusions: Despite being labelled 'hard-to-reach' by mainstream mental health services and under-represented in research, our experience suggests that, given the opportunity, members of the African Caribbean community were highly motivated to engage in all aspects of research. Participating in research related to schizophrenia, a highly stigmatized condition, suggests CPPR approaches might prove fruitful in developing interventions to address other health conditions that disproportionately affect members of this community.

Alkali-Doped Nanopaper Membranes Applied as a Gate Dielectric in FETs and Logic Gates with an Enhanced Dynamic Response.

The market for flexible, hybrid, and printed electronic systems, which can appear in everything from sensors and wearables to displays and lighting, is still uncertain. What is clear is that these systems are appearing every day, enabling devices and systems that can, in the near future, be crumpled up and tucked in our pockets. Within this context, cellulose-based modified nanopapers were developed to serve both as a physical support and a gate dielectric layer in field-effect transistors (FETs) that are fully recyclable. It was found that the impregnation of those nanopapers with sodium (Na+) ions allows for low operating voltage FETs (<3 V), with mobility above 10 cm2 V-1 s-1, current modulation surpassing 105, and an improved dynamic response. Thus, it was possible to implement those transistors into simple circuits such as inverters, reaching a clear discrimination between logic states. Besides the overall improvement in electrical performance, these devices have shown to be an interesting alternative for reliable, sustainable, and flexible electronics, maintaining proper operation even under stress conditions.

Fully Printed Zinc Oxide Electrolyte-Gated Transistors on Paper.

Fully printed and flexible inorganic electrolyte gated transistors (EGTs) on paper with a channel layer based on an interconnected zinc oxide (ZnO) nanoparticle matrix are reported in this work. The required rheological properties and good layer formation after printing are obtained using an eco-friendly binder such as ethyl cellulose (EC) to disperse the ZnO nanoparticles. Fully printed devices on glass substrates using a composite solid polymer electrolyte as gate dielectric exhibit saturation mobility above 5 cm² V-1 s-1 after annealing at 350 °C. Proper optimization of the nanoparticle content in the ink allows for the formation of a ZnO channel layer at a maximum annealing temperature of 150 °C, compatible with paper substrates. These devices show low operation voltages, with a subthreshold slope of 0.21 V dec-1, a turn on voltage of 1.90 V, a saturation mobility of 0.07 cm² V-1 s-1 and an Ion/Ioff ratio of more than three orders of magnitude.

Culturally-adapted Family Intervention (CaFI) for African-Caribbeans diagnosed with schizophrenia and their families: a feasibility study protocol of implementation and acceptability.

BACKGROUND: African-Caribbeans in the UK have the highest schizophrenia incidence and greatest inequity in access to mental health services of all ethnic groups. The National Institute for Health and Care Excellence (NICE) highlights this crisis in care and urgent need to improve evidence-based mental healthcare, experiences of services and outcomes for this group. Family intervention (FI) is clinically and cost-effective for the management of schizophrenia but it is rarely offered. Evidence for FI with minority ethnic groups generally, and African-Caribbeans in particular, is lacking. This study aims to test the feasibility and acceptability of delivering Culturally-adapted Family Intervention (CaFI) to African-Caribbean service users diagnosed with schizophrenia. METHODS/DESIGN: This is a feasibility cohort design study. Over a 12-month intervention period, 30 service users and their families, recruited from hospital and community settings, will receive ten one-hourly sessions of CaFI. Where biological families are absent, access to the intervention will be optimised through 'family support members'; trusted individuals nominated by service users or study volunteers. We shall collect data on eligibility, uptake, retention and attrition and assess the utility and feasibility of collecting various outcome measures including readmission, service engagement, working alliance, clinical symptoms and functioning, perceived criticism, psychosis knowledge, familial stress and economic costs. Measures will be collected at baseline, post-intervention and at 3-month follow-up using validated questionnaires and standardised interviews. Admission rates and change in care management will be rated by independent case note examination. Variability in the measures will inform sample size estimates for a future trial. Independent raters will assess fidelity to the intervention in 10 % of sessions. Feedback at the end of each session along with thematically-analysed qualitative interviews will examine CaFI's acceptability to service users, families and healthcare professionals. DISCUSSION: This innovative response to inequalities in mental healthcare experienced by African-Caribbeans diagnosed with schizophrenia might improve engagement in services, access to evidence-based interventions and clinical outcomes. Successful implementation of CaFI in this group could pave the way for better engagement and provision across marginalised groups and therefore has potentially important implications for commissioning and service delivery in ethnically diverse populations. This study will demonstrate whether the approach is feasible and acceptable and can be implemented with fidelity in different settings.