Risks to home care workers: Professional perspectives

Care at home is fundamental to community care policy, but the simultaneous growth of health and safety regulation has implications for home care services because of the duty of employers towards home care workers. This grounded theory study set in Northern Ireland used data from 19 focus groups and nine semi-structured interviews with a range of health and social services professionals and managers to explore perspectives on planning long term care for older people. Home care workers faced a wide range of hazards in the homes of clients, who themselves were faced with adapting their living habits due to their changing health and care needs and 'risks.' Creative approaches were used to ensure the health and safety of home care workers and simultaneously to meet the choices of clients. Staff experienced feelings of conflict when they judged it necessary to impose their way of providing home care and thus impose their values on clients to create a safe working environment. There was variation between and within organizations in terms of the staff focus on client needs or on their employer responsibility towards home care workers. The planning of home care services must take account of both the choices of clients and the hazards facing home care staff.

Aligning conservation priorities across taxa in Madagascar with high-resolution planning tools

Globally, priority areas for biodiversity are relatively well known, yet few detailed plans exist to direct conservation action within them, despite urgent need. Madagascar, like other globally recognized biodiversity hot spots, has complex spatial patterns of endemism that differ among taxonomic groups, creating challenges for the selection of within-country priorities. We show, in an analysis of wide taxonomic and geographic breadth and high spatial resolution, that multitaxonomic rather than single-taxon approaches are critical for identifying areas likely to promote the persistence of most species. Our conservation prioritization, facilitated by newly available techniques, identifies optimal expansion sites for the Madagascar government's current goal of tripling the land area under protection. Our findings further suggest that high-resolution multitaxonomic approaches to prioritization may be necessary to ensure protection for biodiversity in other global hot spots.

Establishing ex ante public construction supply chain guidelines in the public procurement of Schools' estate

Purpose – The purpose of this study is to explore the formative development of construction supply chain guidelines or proposals in a UK region’s schools’ estates procurement process to more effectively address a forthcoming increase in investment.

Design/methodology/approach – The research approach is interpretive. Using an action research approach, repeated semi-structured interviews and focus groups with a range of stakeholders are conducted.

Findings – The current construction supply chain in schools’ estate procurement has many difficulties, not least given the highly fragmented and disconnected nature of the projects. Synergies are being missed and there is little or no continuous improvement. Drawing on these findings, the research iteratively develops a range of proposals and guidelines to address this situation.

Research limitations/implications – This research adds weight to the current focus on pressing for change in the construction industry. It presents potentially valuable insights into the benefits of partnering arrangements and how these might usefully be incorporated into schools’ estate supply chain.

Practical implications – A set of guidelines is developed to guide the public procurement of schools’ estate in a UK region. These guidelines are set within the context of the Modernising and Rethinking Construction agenda.

Originality/value – The action research approach enabled the researchers to gain a unique insight into how public procurement and contractor personnel interact and to establish effective practical guidelines.

Multiprofessional Views on Older Patients' Participation in Care Planning Meetings in a Hospital Context

Care planning meetings (CPMs; sometimes referred to as family meetings) for older patients involve group decision-making between the multidisciplinary team, the older person and their family. However, service user participation is challenged by the inequity of knowledge and power between participants, together with organisational and resource pressures for timely discharge. The effective use and perhaps, potential misuse of communication strategies within CPMs is of ethical concern to all participants. Habermas' essential critique of participatory communication provides insight as to how older people's involvement can be either enabled or blocked by healthcare professionals (HCPs) depending on their use of communication strategies. Seven discipline-specific mini-focus groups provided an opportunity for HCPs to reflect on the participation of patients over 65 and their families in CPMs. Findings explore HCPs' understanding of older patients involvement based on key dimensions of communicative participation, namely, mutuality, inclusiveness, patient centredness and clear outcomes. Whilst the benefits of collaborative decision-making were confirmed, legitimate concerns as to the quality of participatory practices, limited attention to group work processes and the exclusion of older patients with cognitive impairment were identified. © 2013 Copyright British Association of Social Workers.

A roadmap for marine spatial planning: A critical examination of the European Commission's guiding principles based on their application in the Clyde MSP Pilot Project

The European Commission has developed a set of common principles for marine spatial planning in the European Union. A critical examination of these principles in practice is undertaken through an evaluation of the Clyde Marine Spatial Planning Pilot Project. The principles are found to be lacking in specificity and somewhat inconsistent with the ecosystem based approach, which they advocate. Lessons for new marine spatial planning initiatives, relating particularly to stakeholder participation, governance, data requirements, objective setting, and skills and knowledge needs, are derived from the Clyde Pilot. © 2011.

Stakeholder Participation in Marine Spatial Planning:Lessons from the Channel Islands National Marine Sanctuary

Stakeholder participation is advanced as a key element of marine spatial planning (MSP) by the U.S. Interagency Ocean Policy Task Force. It provides little guidance, however, regarding stakeholder participation. We argue that much can be learned from existing ecosystem-based marine management initiatives. The Channel Islands National Marine Sanctuary, which utilizes an advisory council to facilitate stakeholder participation, is evaluated in this article with a view to identifying key lessons for new MSP initiatives. A set of criteria, derived from collaborative planning theory, is employed to evaluate the effectiveness of this approach. The advisory council meets some criteria for effective stakeholder participation but is found to be lacking in key elements, including shared purpose and interdependency. Benefits associated with stakeholder participation are constrained accordingly. Deficiencies in the design of the council and its decision-making procedures, requiring attention in order to facilitate more effective stakeholder participation in new MSP initiatives, are highlighted. © 2012 Copyright Taylor and Francis Group, LLC.

The 'Europeanization' of Reference Groups

In this paper we address the question of the relative importance of within and between country differences in income and material deprivation in the European Union in the context of recent suggestions that insufficient attention has been paid to the latter. In particular, we respond to the argument that the 'state bounded' relative income approach obscures the significance of EU-wide reference groups. Making use of EU-SILC 2004, we have sought to quantify the magnitude of relevant within and between country differences and their relative impact. Overall, our analysis supports the view that the predominant frame of reference is a national one. The limited impact of European reference groups observed in our analysis does not require explanation in terms of the emergence of a European social stratification system. Furthermore, the significance of such comparisons depends not only on the expectations of those affected by European inequalities but on the degree of legitimacy afforded to ensuing demands. While an EU-wide income-threshold can provide information regarding progress of the Union towards greater social cohesion, its usage for this purpose does not require a strong sense of European identity. Given the current status of the European Social Model, it would seem unwise to attribute an undue degree of policy relevance to the relatively modest impact of EU-wide reference groups revealed in our analysis.

Assessing health service needs:tools for health planning.

As fiscal pressures mount, health-planning and decision-making at smaller geographics scales must be more effective. Involving local constituents in needs assessments, it is believed, would lead to better identification and serving of regional demands and needs for health services. This article examines needs assessment as a tool to determine a community's service needs and establish priorities for the creation of programs. Various approaches used in needs assessments are described, including survey methods, structured groups and geographic information systems.

The relationship between spatial planning and economic competitiveness: the ‘path to economic nirvana’ or a ‘dangerous obsession’?

This paper offers a contribution to contemporary studies of spatial planning. In particular, it problematises the relationship between neoliberal competitiveness and spatial planning. Neoliberal competitiveness is a hegemonic discourse in public policy as it (allegedly) provides the ‘path to economic nirvana’. However, commentators have critiqued its theoretical underpinnings and labelled it a ‘dangerous obsession’ for policy makers. Another set of literatures argues that spatial planning can be understood as a form of ‘neoliberal spatial governance’ and read in a ‘postpolitical’ framework that ‘privileges competitiveness’. Synthesising these debates this paper critically analyses the application and operationalisation of neoliberal competitiveness in Northern Ireland and Belfast. In focusing on this unique case study—a deeply divided society with a turbulent history—the paper takes the debate forward in arguing that rather than offering the ‘path to economic nirvana’ neoliberal competitiveness is a ‘postpolitical strategy’ and represents a ‘dangerous obsession’ for spatial planning.

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.

Participatory Action Research with and within community activist groups: capturing the collective experience of Ireland's Community and Voluntary Pillar

The inclusion of community activists in policy planning is increasingly recognized at the highest international level. This article shows how the use of Participatory Action Research (PAR) can present a deeper and more holistic picture of the experiences of Civil Society Organizations (CSOs) in shaping national-level social policy. By utilizing action-based research, the Community and Voluntary Pillar (CVP) of Ireland’s system of social partnership is shown to be an important agent in deliberating national bargaining outcomes (known as the Towards 2016 national agreement). The key contribution of this research is the reflective methodological considerations in terms of PAR design, execution and participant integration in the research process as a way to enrich and develop a deeper and more informed community of practice.

Planning, Devolution and the Territorialisation of Wind Energy in the UK

The decarbonisation of energy systems draw a new set of stakeholders into debates over energy generation, engage a complex set of social, political, economic and environmental processes and impact at a wide range of geographical scales, including local landscape changes, national energy markets and regional infrastructure investment. This paper focusses on a particular geographic scale, that of the regions/nations of the UK (Scotland, Wales, Northern Ireland), who have been operating under devolved arrangements since the late 1990s, coinciding with the mass deployment of wind energy. The devolved administrations of the UK possess an asymmetrical set of competencies over energy policy, yet also host the majority of the UK wind resource. This context provides a useful way to consider the different ways in which geographies of "territory" are reflected in energy governance, such through techno-rational assessments of demand or infrastructure investment, but also through new spatially-defined institutions that seek to develop their own energy future, using limited regulatory competencies. By focussing on the way the devolved administrations have used their responsibilities for planning over the last decade this paper will assess the way in which the spatial politics of wind energy is giving rise to renewed forms of territorialisation of natural resources. In so doing, we aim to contribute to clarifying the questions raised by Hodson and Marvin (2013) on whether low carbon futures will reinforce or challenge dominant ways of organising relationships between the nation-state, regions, energy systems and the environment.

Core Outcomes in Ventilation Trials (COVenT): protocol for a core outcome set using a Delphi survey with a nested randomised trial and observational cohort study

Background
Among clinical trials of interventions that aim to modify time spent on mechanical ventilation for critically ill patients there is considerable inconsistency in chosen outcomes and how they are measured. The Core Outcomes in Ventilation Trials (COVenT) study aims to develop a set of core outcomes for use in future ventilation trials in mechanically ventilated adults and children.

Methods/design
We will use a mixed methods approach that incorporates a randomised trial nested within a Delphi study and a consensus meeting. Additionally, we will conduct an observational cohort study to evaluate uptake of the core outcome set in published studies at 5 and 10 years following core outcome set publication. The three-round online Delphi study will use a list of outcomes that have been reported previously in a review of ventilation trials. The Delphi panel will include a range of stakeholder groups including patient support groups. The panel will be randomised to one of three feedback methods to assess the impact of the feedback mechanism on subsequent ranking of outcomes. A final consensus meeting will be held with stakeholder representatives to review outcomes.

Discussion
The COVenT study aims to develop a core outcome set for ventilation trials in critical care, explore the best Delphi feedback mechanism for achieving consensus and determine if participation increases use of the core outcome set in the long term.

Sets of p-multiplicity in locally compact groups

We initiate the study of sets of p-multiplicity in locally compact groups and their operator versions. We show that a closed subset E of a second countable locally compact group G is a set of p-multiplicity if and only if E∗={(s,t):ts−1∈E} is a set of operator p-multiplicity. We exhibit examples of sets of p-multiplicity, establish preservation properties for unions and direct products, and prove a p-version of the Stone–von Neumann Theorem.

Planning Bill (3): Community Involvement

This paper looks at the Community Involvement provisions set out in the Planning Bill. It is one of four papers prepared for the Bill, which follow a common format that highlights: the key issues arising in the Bill; summarises the findings of the public consultation and the Government’s response; reviews comparable arrangements in comparable jurisdictions and highlights potential contentious issues that arise.