Common data elements (CDEs) for concussion, as established by international bodies, are not being widely used in Ontario, resulting in significant variability in the data being assessed and collected across clinics. CDEs support standardization of care as well as large-scale data sharing for high impact research. A collaborative network – Concussion Ontario Network: Neuroinformatics to Enhance Clinical care and Translation (CONNECT) – comprised of health care professionals, researchers, members from advocacy groups, and patients was formed to establish and implement CDEs for concussion care and research. While the seeds have been planted and initial effectiveness demonstrated, future challenges exist.

The UK food system is distorted by inequalities in access, failing the people most in need, yet it should provide access to safe, nutritious affordable food for all citizens. Dietary patterns are associated with socio-demographic characteristics, with high levels of diet-related disease mortality attributed to poor dietary habits. Disadvantaged UK communities face urgent public health challenges, yet are often treated as powerless recipients of dietary and health initiatives. The need for food system transformation has been illustrated within recent UK government policy drivers and research funding. The Food Systems Equality project is a research consortium that aims to ‘co-produce healthy and sustainable food systems for disadvantaged communities’. The project focusses on innovating food products, supply chains and policies, placing communities at the centre of the change. Tackling the above issues requires new ways of working. Creative approaches in food research are known to empower a wider range of individuals to share their ‘lived food experience’ narratives, building relationships and corroborating co-production philosophies, thus promoting social justice, and challenging more traditional positivist/reductionist ‘biomedical’ approaches for nutrition and food studies. This review paper critiques the use of community-centric approaches for food system transformation, focusing on one, a community food researcher model(1) as an exemplar, to highlight their utility in advocating with rather than for less affluent communities. The potential for creative methods to lead to more equitable and lasting solutions for food system transformation is appraised, consolidating the need for community-driven systemic change to foster more progressive and inclusive approaches to strengthen social capital. The paper closes with practice insights and critical considerations offering recommendations for readers, researchers, and practitioners, enabling them to better understand and apply similar approaches.

Background: Standardized data collection for traumatic brain injury (TBI) (including concussion) using common data elements (CDEs) has strengthened clinical care and research capacity in the United States and Europe. Currently, Ontario healthcare providers do not collect uniform data on adult patients diagnosed with concussion. Objective: The Ontario Concussion Care Strategy (OCCS) is a collaborative network of multidisciplinary healthcare providers, brain injury advocacy groups, patient representatives, and researchers with a shared vision to improve concussion care across the province, starting with the collection of standardized data. Methods: The International Framework of Functioning Disability and Health was selected as the conceptual framework to inform the selection of CDEs. The CDEs recommended by the OCCS were identified using key literature, including the National Institute of Neurological Disorders and Stroke–Zurich Consensus Statements for concussion in sport and the Ontario Neurotrauma Foundation Concussion/mTBI clinical guidelines. Results: The OCCS has recommended and piloted CDEs for Ontario that are readily available at no cost, clinically relevant, patient friendly, easy to interpret, and recognized by the international scientific community. Conclusions: The implementation of CDEs can help to shift Ontario toward internationally recognized standard data collection, and in so doing yield a more comprehensive evidence-based approach to care while also supporting rigorous research.

Health professionals working in humanitarian relief projects encounter a range of ethical challenges. Applying professional and ethical norms may be especially challenging in crisis settings where needs are elevated, resources scarce, and socio-political structures strained. Situations when clinicians must decide whether to provide care that is near the margins of their professional competency are a source of moral uncertainty that can give rise to moral distress. The authors suggest that responding ethically to these dilemmas requires more than familiarity with ethical codes of conduct and guidelines; it requires practical wisdom, that is, the ability to relate past experience and general guidance to a current situation in order to render a morally sound action. Two sets of questions are proposed to guide reflection and deliberation for clinicians who face competency dilemmas. The first is prospective and intended to aid clinicians in evaluating an unfolding situation. The second is retrospective and designed to support debriefing about past experiences and difficult situations. The aim of this analysis is to support clinicians in evaluating competency dilemmas and provide ethical care and services.

HuntMR, SchwartzL, FraserV. “How Far Do You Go and Where Are the Issues Surrounding That?” Dilemmas at the Boundaries of Clinical Competency in Humanitarian Health Work. Prehosp Disaster Med. 2013;28(5):1-7.

People wounded during bombings or other events resulting in mass casualties or in conjunction with the resulting emergency response may be exposed to blood, body fluids, or tissue from other injured people and thus be at risk for bloodborne infections such as hepatitis B virus, hepatitis C virus, human immunodeficiency virus, or tetanus. This report adapts existing general recommendations on the use of immunization and postexposure prophylaxis for tetanus and for occupational and nonoccupational exposures to bloodborne pathogens to the specific situation of a mass casualty event. Decisions regarding the implementation of prophylaxis are complex, and drawing parallels from existing guidelines is difficult. For any prophylactic intervention to be implemented effectively, guidance must be simple, straightforward, and logistically undemanding. Critical review during development of this guidance was provided by representatives of the National Association of County and City Health Officials, the Council of State and Territorial Epidemiologists, and representatives of the acute injury care, trauma, and emergency response medical communities participating in the Centers for Disease Control and Prevention’s Terrorism Injuries: Information, Dissemination and Exchange project. The recommendations contained in this report represent the consensus of US federal public health officials and reflect the experience and input of public health officials at all levels of government and the acute injury response community. (Disaster Med Public Health Preparedness. 2008;2:150–165)

This article is based on the findings of research undertaken towards a doctoral thesis funded by the University of Leeds. The research focuses upon the actions and experiences of women asylum seekers and refugees living in West Yorkshire. While acknowledging that the context in which women find themselves can present a number of barriers, this paper looks at their actions and practices at the individual and collective levels. It illustrates that some women are able to draw on the resources available, and are engaged in activities that not only assist their own settlement in the host society but also assist the development of support structures for future arrivals of asylum seekers and refugees.

Pothos suggests dispensing with the distinction between rules and similarity, without defining what is meant by either term. We agree that there are problems with the distinction between rules and similarity, but believe these will be solved only by exploring the representations and processes underlying cases purported to involve rules and similarity.

Pickering & Garrod (P&G) suggest that communicators synchronize their processing at a number of linguistic levels. Whereas their explanation suggests that representations are being compared across individuals, there must be some representation of all conversation participants in each participant's head. At the level of the situation model, it is important to maintain separate representations for each participant. At other levels, it seems less crucial to have a separate representation for each participant. This analysis suggests that different mechanisms may synchronize representations at different linguistic levels.