51 resultados para prioritisation


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Since Bowlby devised his theory of attachment, originally for clinical purposes, refinements and extensions have developed its clinical utility. The research question asked how experienced contemporary clinicians now perceive the role of attachment in the formulation and treatment of distress by reference to their clinical work. Using grounded theory methodology, underpinned by a relativist, moderate social constructionist epistemology, initial sampling consisted of 16 in-depth interviews with experienced clinicians. The tentative theoretical categories that emerged were then developed in theoretical sampling in further interviews with 5 of the initial interviewees. The final theoretical categories to emerge concerned the prevalence of caregiver-related problems, the provision of safety together with the prioritisation of the relationship with self as attachment-related treatment strategies, and attachment theory’s provision of understanding in problem formulation. Whilst this suggests that attachment-related ideas are integrated in contemporary practice, it also suggests that the clinical utility now offered by attachment theory, as established in the literature, has not found broad appeal amongst clinicians despite the commonness of attachment-related presenting problems. The implications of this are manifold. To begin with, attachment theorists have largely failed to bring the potential now offered by attachment-related therapeutic interventions to the market. This situation makes it incumbent on the next generation of attachment researchers to more clearly articulate techniques with which clinicians, of whatever theoretical orientation, can better leverage attachment-related knowledge in their clinical work. In this enterprise, perhaps the knowledge and experience of expert clinicians could be harvested, as this research has done. Moreover, researchers must expand the evidence base that such interventions actually work. Beyond the implications for clinical utility and efficacy, the findings strengthen counselling psychology’s influence on society’s perception and treatment of attachment-related problems.

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This James Lind Alliance (JLA) Priority Setting Partnership aimed to identify and prioritise unanswered questions about adult intensive care that are important to people who have been critically ill, their families, and the health professionals who care for them. Consensus techniques (modified Delphi and Nominal Group) were used to generate suggestions using online and postal surveys. Following verification and iterative editorial review, research topics were constructed from these suggestions. These topics were presented in a second online and postal survey for rating. A Nominal Group of 21 clinicians, patients and family representatives subsequently met to rank the most important research topics and produce a prioritised list. The project was coordinated by a representative Steering Group and independently overseen by the JLA. The initial survey and review of the literature generated over 1,300 suggestions. Preliminary editing and verification permitted us to encapsulate these suggestions within 151 research topics. Iterative review by members of the Steering Group produced 37 topic statements, subsequently rated by participants. Using the mode to determine importance, 19 topics were presented to the group from which a ‘top three’ intensive care research priorities were identified and a further nine topics were prioritised. By applying and adapting the JLA methodology to focus on an area of care rather than to a single disease, we have provided a means to ensure that patients, their families and professionals materially contribute to the prioritisation of intensive care research in the UK.

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The Internet has grown in size at rapid rates since BGP records began, and continues to do so. This has raised concerns about the scalability of the current BGP routing system, as the routing state at each router in a shortest-path routing protocol will grow at a supra-linearly rate as the network grows. The concerns are that the memory capacity of routers will not be able to keep up with demands, and that the growth of the Internet will become ever more cramped as more and more of the world seeks the benefits of being connected. Compact routing schemes, where the routing state grows only sub-linearly relative to the growth of the network, could solve this problem and ensure that router memory would not be a bottleneck to Internet growth. These schemes trade away shortest-path routing for scalable memory state, by allowing some paths to have a certain amount of bounded “stretch”. The most promising such scheme is Cowen Routing, which can provide scalable, compact routing state for Internet routing, while still providing shortest-path routing to nearly all other nodes, with only slightly stretched paths to a very small subset of the network. Currently, there is no fully distributed form of Cowen Routing that would be practical for the Internet. This dissertation describes a fully distributed and compact protocol for Cowen routing, using the k-core graph decomposition. Previous compact routing work showed the k-core graph decomposition is useful for Cowen Routing on the Internet, but no distributed form existed. This dissertation gives a distributed k-core algorithm optimised to be efficient on dynamic graphs, along with with proofs of its correctness. The performance and efficiency of this distributed k-core algorithm is evaluated on large, Internet AS graphs, with excellent results. This dissertation then goes on to describe a fully distributed and compact Cowen Routing protocol. This protocol being comprised of a landmark selection process for Cowen Routing using the k-core algorithm, with mechanisms to ensure compact state at all times, including at bootstrap; a local cluster routing process, with mechanisms for policy application and control of cluster sizes, ensuring again that state can remain compact at all times; and a landmark routing process is described with a prioritisation mechanism for announcements that ensures compact state at all times.

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As climate change continues to impact socio-ecological systems, tools that assist conservation managers to understand vulnerability and target adaptations are essential. Quantitative assessments of vulnerability are rare because available frameworks are complex and lack guidance for dealing with data limitations and integrating across scales and disciplines. This paper describes a semi-quantitative method for assessing vulnerability to climate change that integrates socio-ecological factors to address management objectives and support decision-making. The method applies a framework first adopted by the Intergovernmental Panel on Climate Change and uses a structured 10-step process. The scores for each framework element are normalized and multiplied to produce a vulnerability score and then the assessed components are ranked from high to low vulnerability. Sensitivity analyses determine which indicators most influence the analysis and the resultant decision-making process so data quality for these indicators can be reviewed to increase robustness. Prioritisation of components for conservation considers other economic, social and cultural values with vulnerability rankings to target actions that reduce vulnerability to climate change by decreasing exposure or sensitivity and/or increasing adaptive capacity. This framework provides practical decision-support and has been applied to marine ecosystems and fisheries, with two case applications provided as examples: (1) food security in Pacific Island nations under climate-driven fish declines, and (2) fisheries in the Gulf of Carpentaria, northern Australia. The step-wise process outlined here is broadly applicable and can be undertaken with minimal resources using existing data, thereby having great potential to inform adaptive natural resource management in diverse locations.

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This thesis investigates how ways of being in different ontologies emerge from material and embodied practice. This general concern is explored through the particular case study of Scotland in the period of the witch trials (the 16th and 17th centuries C.E.). The field of early modern Scottish witchcraft studies has been active and dynamic over the past 15 years but its prioritisation of what people said over what they did leaves a clear gap for a situated and relational approach focusing upon materiality. Such an approach requires a move away from the Cartesian dichotomies of modern ontology to recognise past beliefs as real to those who experienced them, coconstitutive of embodiment and of the material worlds people inhabited. In theory, method and practice, this demands a different way of exploring past worlds to avoid flattening strange data. To this end, the study incorporates narratives and ‘disruptions’ – unique engagements with Contemporary Art which facilitate understanding by enabling the temporary suspension of disbelief. The methodology is iterative, tacking between material and written sources in order to better understand the heterogeneous assemblages of early modern (counter-) witchcraft. Previously separate areas of discourse are (re-)constituted into alternative ontic categories of newly-parallel materials. New interpretations of things, places, bodies and personhoods emerge, raising questions about early modern experiences of the world. Three thematic chapters explore different sets of collaborative agencies as they entwine into new things, co-fabricating a very different world. Moving between witch trial accounts, healing wells, infant burial grounds, animals, discipline artefacts and charms, the boundaries of all prove highly permeable. People, cloth and place bleed into one another through contact; trees and water emerge as powerful agents of magical-place-making; and people and animals meet to become single, hybrid-persons spread over two bodies. Life and death consistently emerge as protracted processes with the capacity to overlap and occur simultaneously in problematic ways. The research presented in this thesis establishes a new way of looking at the nature of Being as experienced by early modern Scots. This provides a foundation for further studies, which can draw in other materials not explored here such as communion wares and metal charms. Comparison with other early modern Western societies may also prove fruitful. Furthermore, the methodology may be suitable for application to other interdisciplinary projects incorporating historical and material evidence.

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Waste prevention (WP) is a strategy which helps societies and individuals to strive for sufficiency in resource consumption within planetary boundaries alongside sustainable and equitable well-being and to decouple the concepts of well-being and life satisfaction from materialism. Within this dissertation, some instruments to promote WP are analysed, by adopting two perspectives: firstly, the one of policymakers, at different governance levels, and secondly, the one of business in the electrical and electronic equipment (EEE) sector. At a national level, the role of WP programmes and market-based instruments (extended producer responsibility, pay-as-you-throw schemes, deposit-refund systems, environmental taxes) in boosting prevention of municipal solid waste is investigated. Then, focusing on the Emilia-Romagna Region (Italy), the performances of the waste management system are assessed over a long period, including some years before and after an institutional reform of the waste management governance regime. The impact of a centralisation (at a regional level) of both planning and economic regulation of the waste services on waste generation and WP is analysed. Finally, to support the regional decision-makers in the prioritisation of publicly funded projects for WP, a framework for the sustainability assessment, the evaluation of success, and the prioritisation of WP measures was applied to some projects implemented by Municipalities in the Region. Trying to close the research gap between engineering and business, WP strategies are discussed as drivers for business model (BM) innovation in EEE sector. Firstly, an innovative approach to a digital tracking solution for professional EEE management is analysed. New BMs which facilitate repair, reuse, remanufacturing, and recycling are created and discussed. Secondly, the impact of BMs based on servitisation and on producer ownership on the extension of equipment lifetime is analysed, by performing a review of real cases of organizations in the EEE sector applying result- and use-oriented BMs.