13 resultados para Mixed episode

em WestminsterResearch - UK


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A comprehensive guide to planning and consultation issues around mixed income communities. This guide explores how to create attractive and well-managed places that meet the needs of all sections of the community. Drawing on the latest research, and featuring nine case study areas, it includes detailed guidance on: developing a strategy and negotiating the planning process; good practice in masterplanning, design, layout and long-term financial viability; how stakeholders can collaborate effectively and ensure that local residents are fully involved at all stages; how barriers to the development of sustainable communities might be overcome. The guide explores all types of mixed income communities, from the diversification of single-tenure inner-city estates to greenfield development on the urban fringe.

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A good practice guide to creating and sustaining mixed income communities in Scotland. This guide explores how to create attractive and well-managed places that meet the needs of all sections of the community. Drawing on the latest research, and featuring 11 case studies from Scotland and England, it offers a comprehensive guide to the issues that need to be planned for and addressed. The book includes detailed guidance on: -Developing a strategy and negotiating the planning process; -Good practice in masterplanning, design, layout and long-term financial viability; -How stakeholders can collaborate effectively and ensure that local residents are fully involved at all stages; -How barriers to the development of sustainable communities might be overcome. The guide explores all types of mixed income communities, from the diversification of mono-tenure estates in inner city areas to greenfield development on the urban fringe.

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An important feature of UK housing policy has been the promotion of consortia between local authorities, private developers and housing associations in order to develop mixed tenure estates to meet a wide range of housing needs. Central to this approach has been a focus on the management of neighbourhoods, based on the assumption that high densities and the inter-mixing of tenure exacerbates the potential for incivility and anti-social behaviour and exerts a disproportionate impact on residents' quality of life. Landlord strategies are therefore based on a need to address such issues at an early stage in the development. In some cases community-based, third sector organisations are established in order to manage community assets and to provide a community development service to residents. In others, a common response is to appoint caretakers and wardens to tackle social and environmental problems before they escalate and undermine residents’ quality of life. A number of innovative developments have promoted such neighbourhood governance approaches to housing practice by applying community development methods to address potential management problems. In the process, there is an increasing trend towards strategies that shape behaviour, govern ethical conduct, promote aesthetic standards and determine resident and landlord expectations. These processes can be related to the wider concept of governmentality whereby residents are encouraged to become actively engaged in managing their own environments, based on the assumption that this produces more cohesive, integrated communities and projects positive images. Evidence is emerging from a number of countries that increasingly integrated and mutually supportive roles and relationships between public, private and third sector agencies are transforming neighbourhood governance in similar ways. This paper will review the evidence for this trend towards community governance in mixed housing developments by drawing on a series of UK case studies prepared for two national agencies in 2007. It will review in particular the contractual arrangements with different tenures, identify codes and guidelines promoting 'good neighbour' behaviour and discuss the role of community development trusts and other neighbourhood organisations in providing facilities and services, designed to generate a well integrated community. The second part of the paper will review evidence from the USA and Australia to see how far there is a convergence in this respect in advanced economies. The paper will conclude by discussing the extent to which housing management practice is changing, particularly in areas of mixed development, whether there is a convergence in practice between different countries and how far these trends are supported by theories of governmentality.

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Introduction: Coronary heart disease (CHD) is one of the leading causes of death in both men and women worldwide. Despite the common misconception that CHD is a ‘man's disease’, it is now well accepted that women endure worse clinical outcomes than men following CHD-related events. A number of studies have explored whether or not gender differences exist in patients presenting with CHD, and specifically whether women delay seeking help for cardiac conditions. UK and overseas studies on help-seeking for emergency cardiac events are contradictory, yet suggest that women often delay help-seeking. In addition, no studies have looked at presumed cardiac symptoms outside an emergency situation. Given the lack of understanding in this area, an explorative qualitative study on the gender differences in help-seeking for a non-emergency cardiac events is needed. Methods and analysis: A purposive sample of 20–30 participants of different ethnic backgrounds and ages attending a rapid access chest pain clinic will be recruited to achieve saturation. Semistructured interviews focusing on help-seeking decision-making for apparent cardiac symptoms will be undertaken. Interview data will be analysed thematically using qualitative software (NVivo) to understand any similarities and differences between the way men and women construct help-seeking. Findings will also be used to inform the preliminary development of a cardiac help-seeking intentions questionnaire. Ethics and dissemination: Ethical approvals were sought and granted. Namely, the University of Westminster (sponsor) and St Georges NHS Trust REC, and the Trust Research and Development Office granted approval to host the study on the Queen Mary's Roehampton site. The study is low risk, with interviews being conducted on hospital premises during working hours. Investigators will disseminate findings via presentations and publications. Participants will receive a written summary of the key findings.

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Introduction: Improved models of care are needed to meet all the support needs of people with cancer, which encompass psychological, emotional, physical, spiritual, sexual, occupational, social and existential needs. The aim of this paper is to (1) evaluate short and long-term impacts of using a whole person approach to support people with cancer on the Living Well with the Impact of Cancer Course (LWC); (2) use these data to inform strategic decisions about future service provision at Penny Brohn UK. Methods: Longitudinal mixed-methods service evaluation (n=135). Data collected included health related quality of life (HRQoL) (FACIT-SpEx); Concerns (types and severity - MYCaW); lifestyle behaviour (bespoke questionnaire) and participants’ experiences over 12 months post course. Results: Statistically and clinically significant improvements from baseline - 12 months in severity of MYCaW Concerns (n=64; p<0.000) and mean total HRQoL (n=66; p<0.000). The majority of MYCaW concerns were ‘psychological and emotional’ and about participants’ wellbeing. Spiritual, emotional and functional wellbeing contributed most to HRQoL improvements at 12 months. Barriers to maintaining healthy lifestyle changes included lack of support from family and friends, time constraints, and returning to work. 3-6 months post-course was identified as the time when more support was most likely to be needed. Conclusions: Using a whole person approach for the LWC enabled the needs of participants to be met, and statistically and clinically significant improvements in HRQoL and MYCaW Concerns were reported. Qualitative data analysis explored how experiencing whole person support enabled participants to make and sustain healthy lifestyle changes associated with improved survivorship. Barriers experienced to making health behaviour change were also identified. These data then informed wider and more person-centred clinical provision to increase the maintenance of positive long-term behaviour changes. Comparison of whole person approaches to cancer treatment and support and standard care are now urgently needed.

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This is a study of the interplay of market-mediated and religious authority in the context of new religious movements. Specifically, we explore the ambivalent relationship followers of Wicca have with the marketplace. Our main argument is that in this context marketplace success can be a source of religious legitimacy and validation. At the same time, however, excessive engagement with the market can act as a powerful delegitimizing mechanism, leading religious leaders to continually monitor their practices. Market success is thus a mixed blessing that can increase religious authority and influence, but is just as likely to decrease authority and credibility. Based on an ethnographic study, we explore the boundary work carried out by religious marketers and consumers in order to establish themselves in a “safety area” where engagement with the market brings its positive effects without causing a loss of credibility.

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The objective of this study was to develop, test and benchmark a framework and a predictive risk model for hospital emergency readmission within 12 months. We performed the development using routinely collected Hospital Episode Statistics data covering inpatient hospital admissions in England. Three different timeframes were used for training, testing and benchmarking: 1999 to 2004, 2000 to 2005 and 2004 to 2009 financial years. Each timeframe includes 20% of all inpatients admitted within the trigger year. The comparisons were made using positive predictive value, sensitivity and specificity for different risk cut-offs, risk bands and top risk segments, together with the receiver operating characteristic curve. The constructed Bayes Point Machine using this feature selection framework produces a risk probability for each admitted patient, and it was validated for different timeframes, sub-populations and cut-off points. At risk cut-off of 50%, the positive predictive value was 69.3% to 73.7%, the specificity was 88.0% to 88.9% and sensitivity was 44.5% to 46.3% across different timeframes. Also, the area under the receiver operating characteristic curve was 73.0% to 74.3%. The developed framework and model performed considerably better than existing modelling approaches with high precision and moderate sensitivity.