Barriers and Facilitators to Providing Palliative Care in Rural Communities: A Nursing Perspective

Nursing plays a key role in the coordination and delivery of palliative care services in rural settings. The purpose of this study is to identify barriers and enablers to providing palliative care in rural communities from a nursing perspective. This study utilized a qualitative descriptive design. Findings highlighted that the remoteness, limited access to resources and professional practice barriers created challenges for nurses as they tried to provide quality palliative care to their clients. System-related barriers were identified and included: lack of services, funding issues, and poor continuity of care. Despite these barriers, nurses drew from supports to optimize palliative care such as using a team approach to care, centers, utilizing local case managers and informal community members, and using palliative care resources. These results may help inform policy decisions around the needs of nurses who practice in rural settings to provide quality care to individuals who are dying and their families.

Reaching out: medical students leading in local communities

Background: Queen's University Red Cross is a medical student-led volunteer group with a key aim of promoting social change within local communities and empowering young people to aspire to higher education. We describe ‘The Personal Development Certificate’, a 12–week community development programme devised by third-year medical students at Queen's University Belfast to target young people who are lacking educational motivation, are disengaged at home or are marginalised through social circumstances.

Context: Community-based education is of increasing importance within undergraduate and postgraduate medical education in the UK, and further afield. We evaluated the perceived improvements in key skills such as teamwork, leadership, communication, and problem solving in students following participation in this programme, and the extent to which their attitude and appreciation of community-based medicine changed.

Innovation: Following facilitation of this community-based initiative, all students reported a perceived improvement in the acquired skill sets. Students made strong links from this programme to previous clinical experiences and appreciated the opportunity to translate a series of classroom-learned skills to real-life environments and interactions. The students’ appreciation and understanding of community-based medicine was the single most improved area of our evaluation.

Implications: We have demonstrated that medical students possess the skills to develop and facilitate their own educational projects. Non-clinical, student-led community projects have the potential to be reproduced using recognised frameworks and guidelines to complement the current undergraduate medical curriculum

Deglacial mesophotic reef demise on the Great Barrier Reef

Submerged reefs are important recorders of palaeo-environments and sea-level change, and provide a substrate for modern mesophotic (deep-water, light-dependent) coral communities. Mesophotic reefs are rarely, if ever, described from the fossil record and nothing is known of their long-term record on Great Barrier Reef (GBR). Sedimentological and palaeo-ecological analyses coupled with 67 14C AMS and U–Th radiometric dates from dredged coral, algae and bryozoan specimens, recovered from depths of 45 to 130 m, reveal two distinct generations of fossil mesophotic coral community development on the submerged shelf edge reefs of the GBR. They occurred from 13 to 10 ka and 8 ka to present. We identified eleven sedimentary facies representing both autochthonous (in situ) and allochthonous (detrital) genesis, and their palaeo-environmental settings have been interpreted based on their sedimentological characteristics, biological assemblages, and the distribution of similar modern biota within the dredges. Facies on the shelf edge represent deep sedimentary environments, primarily forereef slope and open platform settings in palaeo-water depths of 45–95 m. Two coral–algal assemblages and one non-coral encruster assemblage were identified: 1) Massive and tabular corals including Porites, Montipora and faviids associated with Lithophylloids and minor Mastophoroids, 2) platy and encrusting corals including Porites, Montipora and Pachyseris associated with melobesioids and Sporolithon, and 3) Melobesiods and Sporolithon with acervulinids (foraminifera) and bryozoans. Based on their modern occurrence on the GBR and Coral Sea and modern specimens collected in dredges, these are interpreted as representing palaeo-water depths of < 60 m, < 80–100 m and > 100 m respectively. The first mesophotic generation developed at modern depths of 85–130 m from 13 to 10.2 ka and exhibit a deepening succession of < 60 to > 100 m palaeo-water depth through time. The second generation developed at depths of 45–70 m on the shelf edge from 7.8 ka to present and exhibit stable environmental conditions through time. The apparent hiatus that interrupted the mesophotic coral communities coincided with the timing of modern reef initiation on the GBR as well as a wide-spread flux of siliciclastic sediments from the shelf to the basin. For the first time we have observed the response of mesophotic reef communities to millennial scale environmental perturbations, within the context of global sea-level rise and environmental changes.

Scene From a Different Angle: Attempts to Internationalize Northern Ireland’s Conflict Experience

Reviews the books, Lessons From the Northern Ireland Peace Process edited by Timothy J. White (2013) and Human Rights as War by Other Means by Jennifer Curtis (2014). Edited by a U.S.-based academic with an enduring interest in Ireland, the first book draws together an interdisciplinary group of academics from across North America and the U.K. (though notably not Northern Ireland itself) to cover such topics as third party intervention, nationalism, grassroots change, and community development. The second text to be reviewed may be seen as a thorough analysis of this particular point: what is the role played by human rights in Northern Ireland’s peace process?

Growing Up On an Interface: Findings and Implications for the Social Needs, Mental Health and Lifetime Opportunities of Belfast Youth

In this research we aimed to find out what types of risk (if any) affected young people and children growing up in places of high religious segregation or what we normally call interface communities. This is important as we know that risk and experiences of harm and violence can have negative impacts upon development, emotional well-being and future prospects. It is important to understand what types of risk affect young people and children so as we can respond to these in terms of aiding better personal and community development with regard to health, work, education and wider opportunities.

Competency-Based Theory For Achieving Innovation: The Case Of Post-Disaster Reconstruction

For those working in the humanitarian sector, achieving positive outcomes for postdisaster communities through reconstruction projects is a pressing concern. In the wake of recent natural disasters, NGOs have become increasingly involved in the permanent reconstruction of affected communities. They have encountered significant barriers as they implement reconstruction programmes and this paper argues that it is important to address the visible lack of innovation that is partially to blame. The theoretical bedrock of a current research project will be used as the starting point for this argument, the overall goal of which is to design a competency-based framework model that can be used by NGOs in post-disaster reconstruction projects. Drawing on established theories of management, a unique perspective has been developed from which a competency-based reconstruction theory emerges. This theoretical framework brings together 3 distinct fields; Disaster Management, Strategic Management and Project Management, each vital
to the success of the model. The objectives of this paper are a) to investigate the role of NGOs in post-disaster reconstruction and establish the current standard of practice b) to determine the extent to which NGOs have the opportunity to contribute to sustainable community development through reconstruction c) to outline the main factors of a theoretical framework first proposed by Von Meding et al. 2009 and d) to identify the innovative measures that can be taken by NGOs to achieve more positive outcomes in their interventions. It is important that NGOs involved in post-disaster reconstruction become familiar with concepts and strategies such as those contained in this paper. Competency-based organizational change on the basis of this theory has the potential to help define the standard of best practice to which future NGO projects might align themselves.

Land grabbing, investors, and indigenous peoples: new legal strategies for an old practice?

This article examines how new legal strategies need to be adopted by indigenous peoples to react to the increasing phenomenon of ‘land grabbing’ taking place across the globe. In examining the specificity of the ‘land grab’ and how it particularly affects indigenous peoples, it analyses how new legal strategies targeting the investors need to be adopted by communities to mitigate some of the negative aspects of land grabbing. It argues that since the current ‘land grab’ is driven by investors it is important that indigenous peoples, and their supportive organisations, target investors and lending institutions which are behind the massive investments in land acquisitions.

Spirituality and Basketball Fanship: An Interpretative Phenomenological Analysis and Synthesis

The world of competitive sport affords an individual the opportunity to enter a spiritual community adding meaning that transcends one’s current understanding of life (Parry et al. 2007). Previously established dimensions of sports fanship (group affiliation, psychological commitment and team identification) share characteristics commonly associated with religious or spiritual affiliation indicating that fans may generate substantial life meaning from observing sporting encounters. In the present study, 12 male basketball fans (M=32.42; SD=7.97) completed semi-structured interviews immediately prior to viewing a competitive match at the 2011 European Basketball Championships (Vilnius, Lithuania). Interviews were structured under four headings; 1) the most memorable moment as a basketball fan, 2) thoughts, feelings and emotions attached to their team, 3) affiliation to the team in the context of the fan’s meaning of life, 4) connection with members of the fan’s sporting community. Interpretative Phenomenological Analysis was employed to analyse interview transcripts. Raw data clustered into four dimensions; 1) devotion, 2) obscure emotions, 3) connectedness, and 4) universal values. The results indicate that sports fanship is characterised by, and synonymous with, an established understanding of spirituality derived from membership of wider spiritual and/or religious communities. The findings hold implications for the marketing and membership of local, amateur and professional sports clubs and brands, as well as community development, health and welfare.

Desenvolvimento comunitário e diversidade cultural no K’Cidade

Relatório de estágio de mestrado, Ciências da Educação (Educação Intercultural), Universidade de Lisboa, Instituto de Educação, 2013

Educação e desenvolvimento comunitário local : relato de uma experiência em Espanha

Relatório de estágio de mestrado, Ciências da Educação (Área de especialidade em Educação Intercultural), Universidade de Lisboa, Instituto de Educação, 2015

Transformar a comunidade em Vitória

Mestrado em Educação e Intervenção Social - Desenvolvimento Comunitário e Educação de Adultos

Drumming toward communitas : a case study of facilitated recreational music making and the Arthurian method

The phenomenon of communitas has been described as a moment 'in and out of time' in which a collective of individuals may be experienced by one as equal and individuated in an environment stripped of structural attributes (Turner, 1 969). In these moments, emotional bonds form and an experience of perceived 'oneness' and synergy may be described. As a result of the perceived value of these experiences, it has been suggested by Sharpe (2005) that more clearly understanding how this phenomenon may be purposefully facilitated would be beneficial for leisure service providers. Consequently, the purpose of this research endeavor was to examine the ways in which a particular leisure service provider systematically employs specific methods and sets specific parameters with the intention of guiding participants toward experiences associated with communitas or "shared spirit" as described by the organization. A qualitative case study taking a phenomenological approach was employed in order to capture the depth and complexity of both the phenomenon and the purposefiil negotiation of experiences in guiding participants toward this phenomenon. The means through which these experiences were intentionally facilitated was recreational music making in a group drumming context. As such, an organization which employs specific methods of rhythm circle facilitation as well as trains other facilitators all over the world was chosen purposely for their recognition as the most respectable and credible in this field. The specific facilitator was chosen based on high recommendation by the organization due to her level of experience and expertise. Two rhythm circles were held, and participants were chosen randomly by the facilitator. Data was collected through observation in the first circle and participant- observation in the second, as well as through focus groups with circle participants. Interviews with the facilitator were held both initially to gain broad understanding of concepts and phenomenon as well as after each circle to reflect on each circle specifically. Data was read repeatedly to drawn out patterns which emerged and were coded and organized accordingly. It was found that this specific process or system of implementation lead to experiences associated with communitas by participants. In order to more clearly understand this process and the ways in which experiences associated with communitas manifest as a result of deliberate facilitator actions, these objective facilitator actions were plotted along a continuum relating to subjective participant experiences. These findings were then linked to the literature with regards to specific characteristics of communitas. In so doing, the intentional manifestation of these experiences may be more clearly understood for ftiture facilitators in many contexts. Beyond this, findings summarized important considerations with regards to specific technical and communication competencies which were found to be essential to fostering these experiences for participants within each group. Findings surrounding the maintenance of a fluid negotiation of certain transition points within a group rhythm event overall were also highlighted, and this fluidity was found to be essential to the experience of absorption and engagement in the activity and experience. Emergent themes of structure, control, and consciousness have been presented as they manifested and were found to affect experiences within this study. Discussions surrounding the ethics and authenticity of these particular methods and their implementation has also been generated throughout. In conclusion, there was a breadth as well as depth of knowledge found in unpacking this complex process of guiding individuals toward experiences associated with communitas. The implications of these findings contribute in broadening the current theoretical as well as practical understanding as to how certain intentional parameters may be set and methods employed which may lead to experiences of communitas, and as well contribute a greater knowledge to conceptualizing the manifestation of these experiences when broken down.