Accessibility and Health: Towards Walkability Tools for Planning Practice

There is increasing research interest in how we can most effectively intervene in the built environment to change behaviours such as physical activity and improve health. Much of this work has focussed around the concept of walkability and the identification of those attributes of our cities that encourage pedestrian activity, including density, connectivity and the aesthetic of the urban realm (Saelens et al 2003, Frank et al 2010). Much of the existing research has clarified the strength of the relationships between various environmental attributes and the differential impact on different demographic groups (e.g. Panter et al 2011). This has not yet been effectively translated into tools to help integrate the concepts of walkability into decision-making by statutory authorities that can help shape the spatial development and delivery of public services which can support more active lifestyles. A key reason for this has been that standard models for transport planning and accessibility are based on networks of road infrastructure, which provides a weak basis for modelling pedestrian accessibility (Chin et al 2008).

This paper reports the findings of Knowledge Exchange project funded by UK’s Economic and Social Research Council (ES/J010588/1) and partners including Belfast and Derry City Councils and Northern Ireland’s Public Health Agency, the Department of Regional Development and Belfast Healthy Cities, that has attempted to address this problem. This project has mapped city-wide footpath networks and used these to assist partner organisations in developing the evidence base for making decisions on public services based on health impacts and pedestrian access. The paper describes the tool developed, uses a number of examples to highlight its impact on areas of decision-making and evaluates the benefits of further integrating walkability into planning and development practice.

Energy: lessons from devolution

Geraint Ellis and Richard Cowell explain the findings of the ‘Delivering renewable energy under devolution’ project, including some reasons for Scotland’s lead.

The UK has seen massive increases in renewable energy since 1998, with installed capacity growing from 2,600 MW to 12,300 MW in 2011. This has coincided with devolution and it is within Northern Ireland, Scotland and Wales that the greatest increases have been seen.

As devolved administrations now host half of the UK’s renewable energy capacity, their policies are critical to achieving the broader UK targets. This also provides a fascinating insight into what sort of approach works best, and why. This has been the focus of a two-year study, funded by the Economic and Social Research Council, involving universities from across the UK, which indicates that Scotland is leading the way on renewable energy.

All devolved governments have offered significant support to renewable energy but have different degrees of powers in relation to energy. Scotland’s success seems to be based on the centrality of energy issues to current political aspirations, particularly the SNP, but also has cross-party support. The research suggests that the consensus on the importance of renewable energy amongst élite interests in Scotland helps to explain why Scottish governments have been empowered and enabled to make robust use of the powers available.

As it has achieved successful growth in the sector, this too helps cultivate credibility among key business interests and gives increased leverage to its position in policy discussions with the UK Government. Scotland has been more consistent over time in presenting the expansion of renewable energy as a national economic agenda, rather than just an environmental or rural development agenda. The availability of larger, windy, but relatively less contested sites for onshore wind in Scotland has meant that more projects went through central consenting procedures rather than local planning authorities. Its enhanced support for wave and tidal power technologies is also notable. These political conditions have been harder to find in the rest of the UK, making progress a little more uncertain.

Northern Ireland has used its powers (which are more extensive than Scotland’s) to facilitate small-scale renewables and bio-fuel processes, with its liberalised planning regime offering an initial boost to expanding capacity.

This has contrasted with the position in Wales, which has least control over energy but the Welsh Government has adopted a more innovative approach to strategic spatial zoning; this appears to have pulled in a larger volume of onshore wind development interest than could be expected in a comparable region of England. A downside of the Welsh approach appears to be the fact that the concentration of these wind projects in these zones has triggered public opposition and political conflict.

It therefore appears that the powers available to the devolved governments do not seem to determine which country has been able to make greatest headway, with broader political commitments being more significant. Despite this, the research does not conclude that the actions and activities undertaken by the devolved governments are necessarily the most important factors in shaping the development of renewable energy in the UK. This is because devolution is still a relatively new dimension of energy governance in the UK and decisions affecting key drivers for renewable energy investment are still made mainly in Westminster, with the Treasury exercising close budgetary control. In all areas of the UK, grid capacity expansion remains slow to achieve. The major growth in offshore wind to date has been driven mainly by Westminster and cross-UK bodies with the most significant capacity growth being in English territorial waters.

Appealing to the Republic of Letters: An Autopsy of Anti-venereal Trials in Eighteenth-century Mexico

This study analyses the narrative elements of a little-known report into anti-venereal trials written by an Irish military physician-surgeon, Daniel O'Sullivan (1760–c.1797). It explores the way in which O'Sullivan as the narrator of the Historico-critical report creates medical heroes and anti-heroes as a means to criticise procedures initiated by staff in the Hospital General de San Andrés, Mexico City. The resulting work depicts a much less positive picture of medical trials and hospital authorities in this period than has been recorded to date, and provides a critical and complicated assessment of one of Spain's leading physicians of the nineteenth century, Francisco Javier Balmis (1753–1819).

The legacy of Hillsborough:Liberating truth, challenging power

In April 1989, ninety-six men, women and children, supporters of Liverpool Football Club, died in a severe crush at an FA Cup semi-final at Hillsborough Stadium, Sheffield. Hundreds were injured and thousands traumatised. Within hours, the causes and circumstances of the disaster were contested. While a judicial inquiry found serious institutional failures in the policing and management of the capacity crowd, no criminal prosecutions resulted, and the inquests returned ‘accidental death’ verdicts. Immediately, the authorities claimed that drunken, violent fans had caused the fatal crush. Denied legitimacy, survivors’ accounts revealed a different story criticising the parlous state of the stadium, inadequate stewarding, negligent policing, failures in the emergency response and flawed processes of inquiry and investigation. Reflecting on two decades of research and contemporaneous interviews with bereaved families and survivors, this article contrasts the official discourse with those alternative accounts – the ‘view from below’. It demonstrates the influence of powerful institutional interests on the inquiries and investigations. It maps the breakthrough to full documentary disclosure following the appointment of the Hillsborough Independent Panel, its research and key findings published in September 2012. The campaigns by families and survivors were vindicated and the fans, including those who died, were exonerated. The process is discussed as an alternative method for liberating truth, securing acknowledgement and pursuing justice.

Contemporary environmental issues of landfill leachate: assessment & remedies

Landfills are the primary option for waste disposal all over the world. Most of the landfill sites across the world are old and are not engineered to prevent contamination of the underlying soil and groundwater by the toxic leachate. The pollutants from landfill leachate have accumulative and detrimental effect on the ecology and food chains leading to carcinogenic effects, acute toxicity and genotoxicity among human beings. Management of this highly toxic leachate presents a challenging problem to the regulatory authorities who have set specific regulations regarding maximum limits of contaminants in treated leachate prior to disposal into the environment to ensure minimal environmental impact. There are different stages of leachate management such as monitoring of its formation and flow into the environment, identification of hazards associated with it and its treatment prior to disposal into the environment. This review focuses on: (i) leachate composition, (ii) Plume migration, (iii) Contaminant fate, (iv) Leachate plume monitoring techniques, (v) Risk assessment techniques, Hazard rating methods, mathematical modeling, and (vi) Recent innovations in leachate treatment technologies. However, due to seasonal fluctuations in leachate composition, flow rate and leachate volume, the management approaches cannot be stereotyped. Every scenario is unique and the strategy will vary accordingly. This paper lays out the choices for making an educated guess leading to the best management option.

Delaying Truth Recovery for Missing Persons

The fate of missing persons is a central issue in post-conflict societies facing truth recovery and human rights dilemmas. Despite widespread public sympathy towards relatives, societies emerging from conflict often defer the recovery of missing for decades. More paradoxically, in post-1974 Cyprus, the official authorities delayed unilateral exhumations of victims buried within cemeteries in their own jurisdiction. Analysis of official post-1974 discourse reveals a Greek-Cypriot consensus to emphasise the issue as one of Turkish aggression, thus downplaying in-group responsibilities and the legacy of intra-communal violence. We compare the experience of Cyprus with other post-conflict societies such as Spain, Northern Ireland, and Mozambique and explore the linkages between institutions and beliefs about transitional justice. We argue that elite consensus initiates and facilitates the transition to democracy but often leads to the institutionalization of groups opposing truth recovery even for in-group members.

Risks to patient confidentiality when communicating health information to blind and partially sighted patients.

The research reports on a survey of 228 blind and partially sighted persons in 15 health authorities across Scotland. The survey reports data on patient experience of receiving health information in accessible reading formats. Data indicated that about 90% of blind and partially sighted persons did not receive communications from various NHS health departments in a format that they could read by themselves. The implications for patient privacy, confidentiality and wider impact on life and health care are highlighted. The implications for professional ethical medical practice and for public policy are also discussed. Recommendations for improved practice are made.

Law in Northern Ireland

This is the latest edition of a book which is the standard introductory text for newcomers to the legal system of Northern Ireland. After explaining how law-making has evolved in Northern Ireland, particularly since the partition of Ireland in 1921, the book devotes separate chapters to the current constitutional position of Northern Ireland, to the making of legislation and case law for that jurisdiction, and to the influence of EU and European Convention law. It examines the principles of public law applying in Northern Ireland and outlines the role of some of the public authorities there. It then moves to chapters on criminal law and criminal procedure, followed by chapters on private law and civil procedure. It ends by examining the legal professions, legal education, the legal aid regimes and legal costs. There are also appendices with sample sources of law. Throughout the book, the focus is on conveying in comprehensible terms the essential features of this small, but historically very controversial, legal jurisdiction.

Identification of oil mixtures in extracted and refined vegetable oils

Identification of adulteration in mechanically extracted oils or the botanical origin of refined vegetable oil blends can be effectively achieved through the combination of spectroscopic methods and chemometric techniques. Chromatographic methods remain highly relevant but suffer from various limitations which derive from natural compositional variation. Modern multivariate techniques have demonstrated that it is possible to identify patterns and effectively classify unknown samples in both cases. Development of robust analytical methodologies requires however vigorous validation. Spectroscopic methods combined with chemometric techniques lack established validation protocols and this might hinder their use by law enforcement authorities. 

Donegall Pass: Towards a sustainable community:Chapter 5, Health and Wellbeing

Key Points

International research has long since established a gradient between health and socio-economic status and it is now clear that the social and physical context in which people live can have a negative influence on health.

Recent research has established an adverse effect on the health of people who remained in an area that had become more deprived over time

The mechanisms thought to influence health in declining communities include stress, loss of self-esteem, stigma, powerlessness, a lack of hope and fatalism.

These mechanisms are related to the concept of social capital, a resource produced when people co-operate for mutual benefit

Residents’ key concerns relating to the decline in the community are housing shortages which are perceived to be contributing to the breakdown of the family-based community, along with traffic; pollution; non-resident parking problems; a lack of youth facilities; and the influx of ethnic minorities who are less inclined to become involved with the community

In the Donegall Pass a dual process of outward migration and business development has resulted in a decline in social capital within the community which was particularly evident amongst the younger generations

People living in deprived areas, such as the Donegall Pass, that are adjacent to affluent areas, such as the new apartment developments surrounding the area, can often feel relatively more deprived due to such direct comparisons. Although relative deprivation was evident, peer comparisons with the Donegal Road/Sandy Row community were more commonly expressed

The area can be described as a ‘food desert’ as no affordable fresh grocery supplies are available within walking distance

Residents expressed mixed opinions about the future of the Donegall Pass including a common sense of resignation towards the decline in the core community

Many residents recognise the need for people to work together and gain empowerment in order to work with the authorities (i.e., the Housing Executive and the Council) towards progressive re-development that is in keeping with the aims of the community members, however, equally many were impervious towards these suggestions feeling that previous efforts had gone unrewarded.

Working with fathers to improve children's well-being: Results of a survey exploring service provision and intervention approach in the UK

Interventions for fathers are a recent growth area in family services. Although some specific approaches are beginning to be evaluated, there is little known about what kinds of interventions are more generally being used in practice. A web-based survey of practitioners was conducted in the UK, with contact being made via local authority service managers. Two hundred and twenty-one responses were received from 53% of local authorities. Both interventions specifically for fathers and services for both parents were targeted in the survey. Results are reported on organisational location; targeting of services; type of intervention; numbers and percentages of men attending services, recruitment of fathers; evaluation strategies; and ideological and theoretical approaches. Numbers of fathers engaged are relatively low - e.g. the median annual number of fathers attending structured parenting courses was eight and in courses for both parents, 21% of those attending were men. Responses on ideological and theoretical approaches suggest that overt gender politics play only a small part, but that the dominant views of practitioners are in line with mainstream approaches to parenting support. Cognitive and behavioral approaches were the most popular.

Right-Wing Violence in Germany: Assessing the Objectives, Personalities and Terror Trail of the National Socialist Underground and the State's Response to It

In the last five years the forces of organised right-wing extremism have made electoral advances across many states in contemporary Europe. Germany has not been immune and the extreme right party, the National Democratic Party of Germany won its first seat in the European Parliament since 1989. The recent successes of the extreme right pose issues for European society about tolerance and immigration policy, but this scene has also been associated with an upsurge in racially motivated political violence and acts of right-wing terrorism. Much of this violence is perpetrated by small neo-Nazi styled groups. This paper looks at the most notorious and recent of such groups to emerge in Germany, the National Socialist Underground. The paper explores the origins and personalities behind this terror cell, provides derails of its criminal activities and murder spree, and questions why it took so long for the authorities to identify the NSU.

Der deutsche Lebensstandard während des Ersten Weltkrieges in historischer Perspektive: Welche Rolle spielten Konsumentenpräferenzen?

After the outbreak of war in 1914 and the subsequent blockade implemented by British navy, the German economy faced serious food shortages leading to famine-like conditions, especially towards the end of the war. As a response to these shortages, the German authorities introduced and implemented socialist policies such as price ceilings and food rations. This study focuses on the inefficient use of high-quality foodstuffs by members of lower social strata by discussing consumer decisions during the First World War from a microeconomic perspective. The German rationing system provided small, but valuable – measured by black market prices – quantities of superior foodstuffs. Especially meat could have been traded on flourishing black markets for greater quantities of inferior staple foods such as bread and potatoes. In this paper I argue that a more efficient use of rations by the poor could have improved their nutritional situation.

Shared decision making in patients at risk of cancer: The role of domain and numeracy

Background
Shared decision making has become an integral part of medical consultation. Research has, however, reported wide differences in individuals' desires to be involved in the decision-making process, and these differences in preferences are likely to be the result of a number of factors including age, education and numeracy.

Objective
To investigate whether patients at genetic risk for cancer had preferences for shared decision making that differed depending on medical domain (general health vs. cancer) and whether decision preferences are linked to numeracy abilities.

Methods
Four hundred and seventy-six women who consented to participate in response to an email sent by a local branch of the U.S.-based Cancer Genetics Network (CGN) to its members. Participants completed the Control Preference Scale, as well as an objective and subjective numeracy scales.

Results
Decision domain (cancer vs. general health) was not associated with women's preferences for involvement in decision making. Objective and subjective numeracy predicted a preference for decision involvement in general, and only objective numeracy was predictive with regard to cancer.

Conclusion
Participants were equally likely to state they wanted to play an active, collaborative or passive role in both medical domains (general and cancer). High-numeracy participants were more likely to express a desire for an active role in general and in case they were diagnosed with cancer.

Practice implications
Health authorities' recommendations to clinicians to include patients in their medical decisions are supported by patients' desires, and clinicians should be cognizant of their patients' preferences as well as their numeracy skills.

Healthcare in Ireland and Britain 1850-1970: Voluntary, regional and comparative perspectives

This volume explores developments in health and social care in Ireland and Britain during the nineteenth and twentieth centuries. The central objectives are to highlight the role of voluntarism in healthcare, to examine healthcare in local and regional contexts, and to provide comparative perspectives. The collection is based on two interconnected and overlapping research themes: voluntarism and healthcare, and regionalism/localism and healthcare. It includes two synoptic overviews by leading authorities in the field, and ten case studies focusing on particular aspects of voluntary and/or regional healthcare in Ireland and Britain.