The challenges of joint working: lessons from the Supporting People Health Pilot evaluation

Purpose: This paper reports the findings of the evaluation of the Supporting People Health Pilots programme, which was established to demonstrate the policy links between housing support services and health and social care services by encouraging the development of integrated services. The paper highlights the challenges Method: The evaluation of the six health pilots rested on two main sources of data collection: Quarterly Project Evaluation Reports collected process data as well as reporting progress against aims and objectives. Semi-structured interviews—conducted across all key professional stakeholder groups and agencies and with people who used services—explored their experiences of these new services. Results: The ability of pilots to work across organisational boundaries to achieve their aims and objectives was associated not only with agencies sharing an understanding of the purpose of the joint venture, a history of joint working and clear and efficient governance arrangements but on two other characteristics: the extent and nature of statutory sector participation and, whether or not the service is defined by a history of voluntary sector involvement. In particular the pilots demonstrated how voluntary sector agencies appeared to be less constrained by organisational priorities and professional agenda and more able to respond flexibly to meet the complex needs of individuals. Conclusion and discussion: The pilots demonstrate that integrating services to support people with complex needs works best

Procurement and the Public Sector Equality Duty: Lessons for the Implementation of the Equality Act 2010 from Northern Ireland?

The use of public sector equality duties that require public authorities to do more than simply not discriminate and that in addition require such authorities in exercising their functions to actively promote equality has increasingly been considered as relevant for procurement. This article examines the Northern Ireland experience regarding the application of a public sector equality duty to procurement and addresses whether, and if so to what extent, this experience provides any useful lessons for the operation of the ‘equality duty’ in the recently enacted British Equality Act 2010.

Modelling coronary heart disease mortality in Northern Ireland between 1987 and 2007: broader lessons for prevention

To quantify how much of the coronary heart disease (CHD) mortality decline in Northern Ireland between 1987 and 2007 could be attributed to medical and surgical treatments and how much to changes in population cardiovascular risk factors.

Responsible Participation, Community Engagement and Policing in Transitional Societies: Lessons from a Local Crime Survey in Northern Ireland

The new structures of policing in Northern Ireland have been internationally lauded as a success, but the manner in which police-community relations are unfolding in local settings is less clear. In this article we draw on a local crime survey conducted in a Republican area in Belfast to examine residents’ views of policing and to highlight residents’ concerns about police effectiveness in dealing with crime and disorder. Drawing on Habermas’s concept of ‘responsible participation’, we also consider the role that community organisations can play in helping overcome local scepticism and developing positive forms of engagement with the police. © 2012 The Authors

Measles immune suppression:lessons from the Macaque Model

Measles remains a significant childhood disease, and is associated with a transient immune suppression. Paradoxically, measles virus (MV) infection also induces robust MV-specific immune responses. Current hypotheses for the mechanism underlying measles immune suppression focus on functional impairment of lymphocytes or antigen-presenting cells, caused by infection with or exposure to MV. We have generated stable recombinant MVs that express enhanced green fluorescent protein, and remain virulent in non-human primates. By performing a comprehensive study of virological, immunological, hematological and histopathological observations made in animals euthanized at different time points after MV infection, we developed a model explaining measles immune suppression which fits with the "measles paradox". Here we show that MV preferentially infects CD45RA - memory T-lymphocytes and follicular B-lymphocytes, resulting in high infection levels in these populations. After the peak of viremia MV-infected lymphocytes were cleared within days, followed by immune activation and lymph node enlargement. During this period tuberculin-specific T-lymphocyte responses disappeared, whilst strong MV-specific T-lymphocyte responses emerged. Histopathological analysis of lymphoid tissues showed lymphocyte depletion in the B- and T-cell areas in the absence of apoptotic cells, paralleled by infiltration of T-lymphocytes into B-cell follicles and reappearance of proliferating cells. Our findings indicate an immune-mediated clearance of MV-infected CD45RA - memory T-lymphocytes and follicular B-lymphocytes, which causes temporary immunological amnesia. The rapid oligoclonal expansion of MV-specific lymphocytes and bystander cells masks this depletion, explaining the short duration of measles lymphopenia yet long duration of immune suppression. © 2012 de Vries et al.

Deriving lessons relating to marine spatial planning from Canada's Eastern Scotian Shelf Integrated Management Initiative

Stakeholder participation is viewed as a key element of ecosystem-based marine spatial planning (MSP). There is much debate over the effectiveness of stakeholder participation in ecosystem-based management (EBM) in general and over the form it should take. Particular challenges relating to participation in the marine environment are highlighted. A study of the Eastern Scotian Shelf Integrated Management initiative, which uses a collaborative planning model to implement EBM, is presented in order to explore these issues further. Criteria derived from a review of collaborative planning literature are employed to evaluate the effectiveness of this model, which is found to be a useful consensus-building tool. Although a strategic-level plan has been adopted, the initiative has encountered difficulties transitioning from plan development to plan implementation. These are attributable in large measure to deficiencies in the design of the collaborative model. Useful lessons relating mainly to stakeholder engagement, the role of the lead agency, and implementation strategies are advanced for those engaging in MSP processes.

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.

Using Non-Monetary Deprivation Indicators to Analyze Poverty and Social Exclusion: Lessons from Europe?

Non-monetary indicators of deprivation are now widely used in studying poverty in Europe. While measuring financial resources remains central, having reliable information about material deprivation adds to the ability to capture poverty and social exclusion. Non-monetary indicators can help improve the identification of those experiencing poverty and understand how it comes about. They are most productively used when multidimensionality is explicitly taken into account, both in framing the question and in empirical application. While serious methodological and measurement issues remain to be addressed, material deprivation indicators allow for new insights in making poverty comparisons across countries and analyzing changes over time. (C) 2010 by the Association for Public Policy Analysis and Management.

Measuring material deprivation with EU-SILC: Lessons from the Irish survey

In this paper we consider the consequences for measurement of material deprivation, consistent poverty and economic vulnerability of the shift from the ECHP data set to the EU-SILC instrument. Despite the restricted number of deprivation items available in EU-SILC, we show that there is a substantial overlap between such measures when they are estimated using EU-wide and a set of Irish specific indicators. By placing the EU-wide measures in the context of the full range of Irish indicators, we demonstrate that they allow us to identify clusters of individuals sharply differentiated in terms of their multidimensional deprivation profiles. They also provide an understanding of the socio-economic factors associated with such differentiation that departs in only modest respects from that derived from the more comprehensive set of Irish specific indicators.