Making context work in primary health care

Health care in the community setting is one of the more challenging contexts for evidence-based practice. Community-based care comprises more than simply transplanting hospital care into people’s homes; in addition to the provision of supportive services, it also takes a range of approaches to health care practice that promotes optimal health and builds the capacity of individuals and communities to respond to their health needs. Primary health care is comprised of the diverse activities that build sustainable community capacity to achieve health and well-being throughout all of life’s stages. The expansive nature of primary health care means that a map for practice is not feasible; however a framework which can be adapted to suit the variety of situations and practice settings can be identified. The focus of this chapter is to broadly define and explore the principles of primary health care and consider the contexts of primary health care in relation to evidence-based practice.

Assessment Understood as Enabling

This chapter outlines a perspective of educational assessment as enabling, whereby the learner is central and assessment is focused on supporting the knowledge, skills and dispositions necessary for lifelong learning. It argues that better education for young people is achievable when educational policy and practice give priority to learning improvement, thereby making assessment for accountability a related, though secondary, concern. The chapter describes how this work of internationally recognized scholars brings together diverse perspectives and theoretical frameworks and, in so doing, provides readers with a range of ways to consider their pathway through the book. A ‘map’ and summaries of chapters suggest a reading according to a thematic approach, geographical setting, author/s profile or content purposes depending on the reader’s own priorities. A section on assessment past, present, and futures calls for a rebalancing of improvement and accountability goals, and for countries to be careful to avoid privileging large-scale testing over other forms of data about learning and achievement.

Barbara's story : a thematic analysis of a relative's reflection of being in the intensive care unit

Aim The aim of this reflective account is to provide a view of the intensive care unit (ICU) relative’s experiences of supporting and being supported in the ICU. Background Understanding the relatives’ experiences of ICU is important especially because a recent work has identified the potential for this group to develop post-traumatic stress disorder, a condition that is normally equated with the ICU survivor. Design A thematic analysis was used in identifying emerging themes that would be significant in an ICU nursing context. Setting The incident took place in two 8-bedded ICUs (Private and National Health Service) in October. Results Two emergent themes were identified from the reflective story – fear of the technological environment and feeling hopeless and helpless. Conclusion The use of relative stories as an insight into the live experiences of ICU relatives may give a deeper understanding of their life-world. The loneliness, anguish and pain of the ICU relative extends beyond the walls of the ICU, and this is often negated as the focus of the ICU team is the patient. Relevance to clinical practice: Developing strategies to support relatives might include the use of relative diaries used concurrently with patient diaries to support this groups recovery or at the very least a gaining a sense of understanding for their ICU experience. Relative follow-up clinics designed specifically to meet their needs where support and advice can be given by the ICU team, in addition to making timely and appropriate referrals to counselling services and perhaps involving spiritual leaders where appropriate.

Competition and its influence on consumer decision making in social marketing

This paper extends the largely conceptual understanding of competition in social marketing by empirically investigating, from a consumer perspective, the nature of competition and its influence on decision making at the individual level. Two phases of qualitative inquiry in Australia, comprising 30 and 20 semi-structured interviews respectively, examined the role of competition in young adults’ decision to adopt and maintain help-seeking for mental ill-health. The findings from thematic analysis suggest that competition operates at both the behavioural and goal level to influence consumers’ decision to perform behaviour and that the types of competition in operation may vary from the adoption to the maintenance of behaviour. The findings are integrated into a framework that social marketers could employ to identify, analyse and address competition.

Shortest path and vehicle trajectory aided map-matching for low frequency GPS data

Map-matching algorithms that utilise road segment connectivity along with other data (i.e.position, speed and heading) in the process of map-matching are normally suitable for high frequency (1 Hz or higher) positioning data from GPS. While applying such map-matching algorithms to low frequency data (such as data from a fleet of private cars, buses or light duty vehicles or smartphones), the performance of these algorithms reduces to in the region of 70% in terms of correct link identification, especially in urban and sub-urban road networks. This level of performance may be insufficient for some real-time Intelligent Transport System (ITS) applications and services such as estimating link travel time and speed from low frequency GPS data. Therefore, this paper develops a new weight-based shortest path and vehicle trajectory aided map-matching (stMM) algorithm that enhances the map-matching of low frequency positioning data on a road map. The well-known A* search algorithm is employed to derive the shortest path between two points while taking into account both link connectivity and turn restrictions at junctions. In the developed stMM algorithm, two additional weights related to the shortest path and vehicle trajectory are considered: one shortest path-based weight is related to the distance along the shortest path and the distance along the vehicle trajectory, while the other is associated with the heading difference of the vehicle trajectory. The developed stMM algorithm is tested using a series of real-world datasets of varying frequencies (i.e. 1 s, 5 s, 30 s, 60 s sampling intervals). A high-accuracy integrated navigation system (a high-grade inertial navigation system and a carrier-phase GPS receiver) is used to measure the accuracy of the developed algorithm. The results suggest that the algorithm identifies 98.9% of the links correctly for every 30 s GPS data. Omitting the information from the shortest path and vehicle trajectory, the accuracy of the algorithm reduces to about 73% in terms of correct link identification. The algorithm can process on average 50 positioning fixes per second making it suitable for real-time ITS applications and services.

Geographic Resources Decision Support System – an Open Source GIS

Fully structured and matured open source spatial and temporal analysis technology seems to be the official carrier of the future for planning of the natural resources especially in the developing nations. This technology has gained enormous momentum because of technical superiority, affordability and ability to join expertise from all sections of the society. Sustainable development of a region depends on the integrated planning approaches adopted in decision making which requires timely and accurate spatial data. With the increased developmental programmes, the need for appropriate decision support system has increased in order to analyse and visualise the decisions associated with spatial and temporal aspects of natural resources. In this regard Geographic Information System (GIS) along with remote sensing data support the applications that involve spatial and temporal analysis on digital thematic maps and the remotely sensed images. Open source GIS would help in wide scale applications involving decisions at various hierarchical levels (for example from village panchayat to planning commission) on economic viability, social acceptance apart from technical feasibility. GRASS (Geographic Resources Analysis Support System, http://wgbis.ces.iisc.ernet.in/grass) is an open source GIS that works on Linux platform (freeware), but most of the applications are in command line argument, necessitating a user friendly and cost effective graphical user interface (GUI). Keeping these aspects in mind, Geographic Resources Decision Support System (GRDSS) has been developed with functionality such as raster, topological vector, image processing, statistical analysis, geographical analysis, graphics production, etc. This operates through a GUI developed in Tcltk (Tool command language / Tool kit) under Linux as well as with a shell in X-Windows. GRDSS include options such as Import /Export of different data formats, Display, Digital Image processing, Map editing, Raster Analysis, Vector Analysis, Point Analysis, Spatial Query, which are required for regional planning such as watershed Analysis, Landscape Analysis etc. This is customised to Indian context with an option to extract individual band from the IRS (Indian Remote Sensing Satellites) data, which is in BIL (Band Interleaved by Lines) format. The integration of PostgreSQL (a freeware) in GRDSS aids as an efficient database management system.

A Multicast Authentication Protocol (MAP) for Dynamic Multicast Groups in Wireless Networks

In this paper, we have proposed a centralized multicast authentication protocol (MAP) for dynamic multicast groups in wireless networks. In our protocol, a multicast group is defined only at the time of the multicasting. The authentication server (AS) in the network generates a session key and authenticates it to each of the members of a multicast group using the computationally inexpensive least common multiple (LCM) method. In addition, a pseudo random function (PRF) is used to bind the secret keys of the network members with their identities. By doing this, the AS is relieved from storing per member secrets in its memory, making the scheme completely storage scalable. The protocol minimizes the load on the network members by shifting the computational tasks towards the AS node as far as possible. The protocol possesses a membership revocation mechanism and is protected against replay attack and brute force attack. Analytical and simulation results confirm the effectiveness of the proposed protocol.

To pave or not to pave: A social landscape analysis of land use decision-making in the towns of the lamprey watershed

Population pressure in coastal New Hampshire challenges land use decision-making and threatens the ecological health and functioning of Great Bay, an estuary designated as both a NOAA National Estuarine Research Reserve and an EPA National Estuary Program site. Regional population in the seacoast has quadrupled in four decades resulting in sprawl, increased impervious surface cover and larger lot rural development (Zankel, et.al., 2006). All of Great Bay’s contributing watersheds face these challenges, resulting in calls for strategies addressing growth, development and land use planning. The communities within the Lamprey River watershed comprise this case study. Do these towns communicate upstream and downstream when making land use decisions? Are cumulative effects considered while debating development? Do town land use groups consider the Bay or the coasts in their decision-making? This presentation, a follow-up from the TCS 2008 conference and a completed dissertation, will discuss a novel social science approach to analyze and understand the social landscape of land use decision-making in the towns of the Lamprey River watershed. The methods include semi-structured interviews with GIS based maps in a grounded theory analytical strategy. The discussion will include key findings, opportunities and challenges in moving towards a watershed approach for land use planning. This presentation reviews the results of the case study and developed methodology, which can be used in watersheds elsewhere to map out the potential for moving towns towards EBM and watershed-scaled, land use planning. (PDF contains 4 pages)

Mapeamento digital do uso da terra da cobertura vegetal no Parque Estadual da Serra da Tiririca (PESET) a partir de imagens orbitais de alta resolução.

No Brasil, entre as áreas protegidas e regulamentadas por lei estão às denominadas Unidades de Conservação (UC) e são definidas assim por possuírem características ambientais, estéticas, históricas ou culturais relevantes, importantes na manutenção dos ciclos naturais, demandando regimes especiais de preservação, conservação ou exploração racional dos seus recursos. O Parque Estadual da Serra da Tiririca (PESET), criado pela Lei 1.901, de 29 de novembro de 1991 localizado entre os municípios de Niterói e Maricá no Estado do Rio de Janeiro, enquadra-se na categoria de UC de Proteção Integral abrigando uma extensa faixa de Mata Atlântica em seus limites. Para a presente pesquisa foi feita uma classificação de Uso da terra e cobertura vegetal, refinada por pesquisas feitas através do trabalho de campo, que subsidiou a elaboração da proposta de Zoneamento Ambiental para o parque. O processamento digital da imagem foi feito utilizando-se o sistema SPRING desenvolvido pelo Instituto de Pesquisas Espaciais (INPE). A confecção dos mapas temáticos foi feita com apoio do sistema Arcgis desenvolvido pela ESRI. O Sistema de Informação Geográfica (SIG) foi empregado para as modelagens ambientais. Nessa etapa foram consideradas, de forma integrada, a variabilidade taxonômica, a expressão territorial e as alterações temporais verificáveis em uma base de dados georreferenciada. A tecnologia SIG integra operações convencionais de bases de dados, relativas ao armazenamento, manipulação, análise, consulta e apresentação de dados, com possibilidades de seleção e busca de informações e suporte à análise geoestatística, conjuntamente com a possibilidade de visualização de mapas sofisticados e de análise espacial proporcionada pelos mapas. A opção por esta tecnologia busca potencializar a eficiência operacional e permitir planejamento estratégico e administração de problemas, tanto minimizando os custos operacionais como acelerando processos decisórios. O estudo feito através da modelagem computacional do PESET apresentará o emprego das técnicas amplamente utilizadas no monitoramento ambiental, sendo úteis aos profissionais destinados à gestão e aos tomadores de decisão no âmbito das políticas públicas relacionadas à gestão ambiental de Unidades de Conservação.

Patterns of scale-dependency and the influence of map resolution on the seascape ecology of reef fish

Detection and perception of ecological relationships between biota and their surrounding habitats is sensitive to analysis scale and resolution of habitat data. We measured strength of univariate linear correlations between reef fish and seascape variables at multiple spatial scales (25 to 800 m). Correlation strength was used to identify the scale that best associates fish to their surrounding habitat. To evaluate the influence of map resolution, seascape variables were calculated based on 4 separate benthic maps produced using 2 levels of spatial and thematic resolution, respectively. Individual seascape variables explained only 25% of the variability in fish distributions. Length of reef edge was correlated with more aspects of the fish assemblage than other features. Area of seagrass and bare sand correlated with distribution of many fish, not just obligate users. No fish variables correlated with habitat diversity. Individual fish species achieved a wider range of correlations than mobility guilds or the entire fish assemblage. Scales of peak correlation were the same for juveniles and adults in a majority of comparisons. Highly mobile species exhibited broader scales of peak correlation than either resident or moderately mobile fish. Use of different input maps changed perception of the strength and even the scale of peak correlations for many comparisons involving hard bottom edge length and area of sand, whereas results were consistent regardless of map type for comparisons involving area of seagrass and habitat diversity.

Fisheries profile mapping of coastal districts in Maharashtra state through GIS

In recent times, GIS is being increasingly used as a decision support system for management of fisheries and aquaculture. It provides new innovative approaches of the dynamic relations that characterize this sector. In this context, a study is conducted based on the secondary data of a major maritime state, Maharashtra, where mapping of fisheries profile of coastal districts in the state is performed through GIS tool having critical geographic dimensions. This paper aims to map information of the state which can be used for the purpose of planning and decision making as each aspect of map has a different component involved. For this purpose, at the core of the system, the data were accessed and integrated from different sources mainly from the five coastal districts of Maharashtra state. Data were brought in tabular form through Microsoft Excel and then joined to Map info Professional version 8.0 GIS software was used with the digitized map of Maharashtra state to enable mapping. This was further synchronized and integrated to generate four thematic maps searchable on several criteria. Map 1 contains the searchable criteria as regards to the fish growth for the year 1997-2004 and fish seed production for the year 2003-04. Map 2 contains fisher population along with their occupation for the year 1992. Map 3 contains brackish water and shrimp farming production and culture area. Map 4 contains infrastructural facilities which include type of boats etc. With this mapping, planners and various stakeholders have accessible information as regards to the various components of fisheries in the state of Maharashtra.

Re-conceptualising value in the engineering design process: The value cycle map

Introducing a "Cheaper, Faster, Better" product in today's highly competitive market is a challenging target. Therefore, for organizations to improve their performance in this area, they need to adopt methods such as process modelling, risk mitigation and lean principles. Recently, several industries and researchers focused efforts on transferring the value orientation concept to other phases of the Product Life Cycle (PLC) such as Product Development (PD), after its evident success in manufacturing. In PD, value maximization, which is the main objective of lean theory, has been of particular interest as an improvement concept that can enhance process flow logistics and support decision-making. This paper presents an ongoing study of the current understanding of value thinking in PD (VPD) with a focus on value dimensions and implementation benefits. The purpose of this study is to consider the current state of knowledge regarding value thinking in PD, and to propose a definition of value and a framework for analyzing value delivery. The framework-named the Value Cycle Map (VCM)- intends to facilitate understanding of value and its delivery mechanism in the context of the PLC. We suggest the VCM could be used as a foundation for future research in value modelling and measurement in PD.

Choice and Welfare Reform: Lone Parents’ Decision Making around Paid Work and Family Life

Welfare-to-work policy in the UK sees ‘choice’ regarding lone parents’ employment decisions increasingly defined in terms of powers of selection between options within active labour market programmes, with constraints on the option of non-market activity progressively tightened. In this paper, we examine the wider choice agenda in public services in relation to lone-parent employment, focusing on the period of welfare reform following the 2007 Freud review of welfare provision. Survey data is used to estimate the extent to which recent policies promoting compulsory job search by youngest dependent child age map onto lone parents' own stated decision-making regarding if and when to enter the labour market. The findings indicate a substantial proportion of lone parents targeted by policy reform currently do not want a job and that their main reported reason is that they are looking after their children. Economically inactive lone mothers also remain more likely to have other chronic employment barriers, which traverse dependent child age categories. Some problems, such as poor health, sickness or disability, are particularly acute among those with older dependent children who are the target of recent activation policy.

Using sketch-map coordinates to analyze and bias molecular dynamics simulations

When examining complex problems, such as the folding of proteins, coarse grained descriptions of the system drive our investigation and help us to rationalize the results. Oftentimes collective variables (CVs), derived through some chemical intuition about the process of interest, serve this purpose. Because finding these CVs is the most difficult part of any investigation, we recently developed a dimensionality reduction algorithm, sketch-map, that can be used to build a low-dimensional map of a phase space of high-dimensionality. In this paper we discuss how these machine-generated CVs can be used to accelerate the exploration of phase space and to reconstruct free-energy landscapes. To do so, we develop a formalism in which high-dimensional configurations are no longer represented by low-dimensional position vectors. Instead, for each configuration we calculate a probability distribution, which has a domain that encompasses the entirety of the low-dimensional space. To construct a biasing potential, we exploit an analogy with metadynamics and use the trajectory to adaptively construct a repulsive, history-dependent bias from the distributions that correspond to the previously visited configurations. This potential forces the system to explore more of phase space by making it desirable to adopt configurations whose distributions do not overlap with the bias. We apply this algorithm to a small model protein and succeed in reproducing the free-energy surface that we obtain from a parallel tempering calculation.

Making a Constitution in a Globalized World

This piece argues that constitutions must be documents which meet the needs and demands of the nation's people and that, as a nation's relationship with the world beyond its borders has increased in complexity in recent years, so individuals' expectations of their nation's constitutions have also increased considerably compared with the past. Using Northern Ireland as an exemplar, the chapter argues that Turkey has the potential to re-make itself through the adoption of a more modern, pluralistic and outward-looking constitution.