Changing times, changing places: urban development and the politics of space - time

Much of the writing on urban regeneration in the UK has been focused on the types of urban spaces that have been created in city centres. Less has been written about the issue of when the benefits of regeneration could and should be delivered to a range of different interests, and the different time frames that exist in any development area. Different perceptions of time have been reflected in dominant development philosophies in the UK and elsewhere. The trickle-down agendas of the 1980s, for example, were criticised for their focus on the short-term time frames and needs of developers, often at the expense of those of local communities. The recent emergence of sustainability discourses, however, ostensibly changes the time focus of development and promotes a broader concern with new imagined futures. This paper draws on the example of development in Salford Quays, in the North West of England, to argue that more attention needs to be given to the politics of space-time in urban development processes. It begins by discussing the importance and relevance of this approach before turning to the case study and the ways in which the local politics of space-time has influenced development agendas and outcomes. The paper argues that such an approach harbours the potential for more progressive, far-reaching, and sustainable development agendas to be developed and implemented.

Uptake of a free coronary heart disease risk screening programme in community pharmacy: the Healthy Heart Assessment service

Introduction Health promotion (HP) aims to enhance good health while preventing ill-health at three levels of activity; primary (preventative), secondary (diagnostic) and tertiary (management).1 It can range from simple provision of health education to ongoing support, but the effectiveness of HP is ultimately dependent on its ability to influence change. HP as part of the Community Pharmacy Contract (CPC) aims to increase public knowledge and target ‘hard-to-reach’ individuals by focusing mainly on primary and tertiary HP. The CPC does not include screening programmes (secondary HP) as a service. Coronary heart disease (CHD) is a significant cause of morbidity and mortality in the UK. While there is evidence to support the effectiveness of some community pharmacy HP strategies in CHD, there is paucity of research in relation to screening services.2 Against this background, Alliance Pharmacy introduced a free CHD risk screening programme to provide tailored HP advice as part of a participant–pharmacist consultation. The aim of this study is to report on the CHD risk levels of participants and to provide a qualitative indication of consultation outcomes. Methods Case records for 12 733 people who accessed a free CHD risk screening service between August 2004 and April 2006 offered at 217 community pharmacies were obtained. The service involved initial self-completion of the Healthy Heart Assessment (HHA) form and measurement of height, weight, body mass index, blood pressure, total cholesterol and highdensity lipoprotein levels by pharmacists to calculate CHD risk.3 Action taken by pharmacists (lifestyle advice, statin recommendation or general practitioner (GP) referral) and qualitative statements of advice were recorded, and a copy provided to the participants. The service did not include follow-up of participants. All participants consented to taking part in evaluations of the service. Ethical committee scrutiny was not required for this service development evaluation. Results Case records for 10 035 participants (3658 male) were evaluable; 5730 (57%) were at low CHD risk (<15%); 3636 (36%) at moderate-to-high CHD risk (≥15%); and 669 (7%) had existing heart disease. A significantly higher proportion of male (48% versus 30% female) participants were at moderate- to-high risk of CHD (chi-square test; P < 0.005). A range of outcomes resulted from consultations. Lifestyle advice was provided irrespective of participants’ CHD risk or existing disease. In the moderate-to-high-risk group, of which 52% received prescribed medication, lifestyle advice was recorded for 62%, 16% were referred and 34% were advised to have a re-assessment. Statin recommendations were made in 1% of all cases. There was evidence of supportive and motivational statements in the advice recorded. Discussion Pharmacists were able to identify individuals’ level of CHD risk and provide them with bespoke advice. Identification of at-risk participants did not automatically result in referrals or statin recommendation. One-third of those accessing the screening service had moderate-to-high risk of CHD, a significantly higher proportion of whom were men. It is not known whether these individuals had been previously exposed to HP but presumably by accessing this service they may have contemplated change. As effectiveness of HP advice will depend among other factors on ability to influence change, future consultations may need to explore patients’ attitude towards change in relation to the Trans Theoretical Model4 to better tailor HP advice. The high uptake of the service by those at moderate-to-high CHD risk indicates a need for this type of screening programme in community pharmacy, perhaps specifically to reach men who access medical services less.

The opening of Plutarch's Life of Themistokles

Plutarch begins the biography by selecting incidents and an epigram that anticipate the basic themes of Themistocles' life--his greatness, sometimes ambiguous, and his benefactions to all of Greece.

Framing the local and the global in the anti-nuclear movement: Law and the politics of place

This article examines the politics of place in relation to legal mobilization by the anti-nuclear movement. It examines two case examples - citizens' weapons inspections and civil disobedience strategies - which have involved the movement drawing upon the law in particular spatial contexts. The article begins by examining a number of factors which have been employed in recent social movement literature to explain strategy choice, including ideology, resources, political and legal opportunity, and framing. It then proceeds to argue that the issues of scale, space, and place play an important role in relation to framing by the movement in the two case examples. Both can be seen to involve scalar reframing, with the movement attempting to resist localizing tendencies and to replace them with a global frame. Both also involve an attempt to reframe the issue of nuclear weapons away from the contested frame of the past (unilateral disarmament) towards the more universal and widely accepted frame of international law.