Scottish Community Councils online: the 2014 survey.

This document reports the results of a survey, carried out in late spring 2014, of the public web presences of potentially over 1300 Scottish Community Councils (CCs). It follows on from similar survey in summer 2012. The report reviews content-types associated with up-to-date presences and examines Community Councils’ social media use, using three archetypes which may be used to derive models and examples of good practice, and create recommendations for Community Councils and their Local Authorities (LAs). The research found that there has little change overall since 2012, which combined with a high level of churn implies an increasing number of digitally disengaged Community Councils. A good way forward would be for to CCs emulate and adapt the examples of good practice identified, by publishing minutes, news, planning and local area information, limiting publication of other types of content, and using social media to engage with citizens. A number of broader recommendations are made to LAs, including that that they publish CC schemes on their websites, provide training in online methods and work together via their CCLOs and IT teams to support CCs

The quality of diabetes care in the community: practice, policy and culture

Aim: Diabetes is an important barometer of health system performance. This chronic condition is a source of significant morbidity, premature mortality and a major contributor to health care costs. There is an increasing focus internationally, and more recently nationally, on system, practice and professional-level initiatives to promote the quality of care. The aim of this thesis was to investigate the ‘quality chasm’ around the organisation and delivery of diabetes care in general practice, to explore GPs’ attitudes to engaging in quality improvement activities and to examine efforts to improve the quality of diabetes care in Ireland from practice to policy. Methods: Quantitative and qualitative methods were used. As part of a mixed methods sequential design, a postal survey of 600 GPs was conducted to assess the organization of care. This was followed by an in-depth qualitative study using semi-structured interviews with a purposive sample of 31 GPs from urban and rural areas. The qualitative methodology was also used to examine GPs’ attitudes to engaging in quality improvement. Data were analysed using a Framework approach. A 2nd observation study was used to assess the quality of care in 63 practices with a special interest in diabetes. Data on 3010 adults with Type 2 diabetes from 3 primary care initiatives were analysed and the results were benchmarked against national guidelines and standards of care in the UK. The final study was an instrumental case study of policy formulation. Semi-structured interviews were conducted with 15 members of the Expert Advisory Group (EAG) for Diabetes. Thematic analysis was applied to the data using 3 theories of the policy process as analytical tools. Results: The survey response rate was 44% (n=262). Results suggested care delivery was largely unstructured; 45% of GPs had a diabetes register (n=157), 53% reported using guidelines (n=140), 30% had formal call recall system (n=78) and 24% had none of these organizational features (n=62). Only 10% of GPs had a formal shared protocol with the local hospital specialist diabetes team (n=26). The lack of coordination between settings was identified as a major barrier to providing optimal care leading to waiting times, overburdened hospitals and avoidable duplication. The lack of remuneration for chronic disease management had a ripple effect also creating costs for patients and apathy among GPs. There was also a sense of inertia around quality improvement activities particularly at a national level. This attitude was strongly influenced by previous experiences of change in the health system. In contrast GP’s spoke positively about change at a local level which was facilitated by a practice ethos, leadership and special interest in diabetes. The 2nd quantitative study found that practices with a special interest in diabetes achieved a standard of care comparable to the UK in terms of the recording of clinical processes of care and the achievement of clinical targets; 35% of patients reached the HbA1c target of <6.5% compared to 26% in England and Wales. With regard to diabetes policy formulation, the evolving process of action and inaction was best described by the Multiple Streams Theory. Within the EAG, the formulation of recommendations was facilitated by overarching agreement on the “obvious” priorities while the details of proposals were influenced by personal preferences and local capacity. In contrast the national decision-making process was protracted and ambiguous. The lack of impetus from senior management coupled with the lack of power conferred on the EAG impeded progress. Conclusions: The findings highlight the inconsistency of diabetes care in Ireland. The main barriers to optimal diabetes management center on the organization and coordination of care at the systems level with consequences for practice, providers and patients. Quality improvement initiatives need to stimulate a sense of ownership and interest among frontline service providers to address the local sense of inertia to national change. To date quality improvement in diabetes care has been largely dependent the “special interest” of professionals. The challenge for the Irish health system is to embed this activity as part of routine practice, professional responsibility and the underlying health care culture.

Establishing a regional, multisite database for quality improvement and service planning in community-based palliative care and hospice.

BACKGROUND: Outpatient palliative care, an evolving delivery model, seeks to improve continuity of care across settings and to increase access to services in hospice and palliative medicine (HPM). It can provide a critical bridge between inpatient palliative care and hospice, filling the gap in community-based supportive care for patients with advanced life-limiting illness. Low capacities for data collection and quantitative research in HPM have impeded assessment of the impact of outpatient palliative care. APPROACH: In North Carolina, a regional database for community-based palliative care has been created through a unique partnership between a HPM organization and academic medical center. This database flexibly uses information technology to collect patient data, entered at the point of care (e.g., home, inpatient hospice, assisted living facility, nursing home). HPM physicians and nurse practitioners collect data; data are transferred to an academic site that assists with analyses and data management. Reports to community-based sites, based on data they provide, create a better understanding of local care quality. CURRENT STATUS: The data system was developed and implemented over a 2-year period, starting with one community-based HPM site and expanding to four. Data collection methods were collaboratively created and refined. The database continues to grow. Analyses presented herein examine data from one site and encompass 2572 visits from 970 new patients, characterizing the population, symptom profiles, and change in symptoms after intervention. CONCLUSION: A collaborative regional approach to HPM data can support evaluation and improvement of palliative care quality at the local, aggregated, and statewide levels.

Lack of cross-scale linkages reduces robustness of community-based fisheries management.

Community-based management and the establishment of marine reserves have been advocated worldwide as means to overcome overexploitation of fisheries. Yet, researchers and managers are divided regarding the effectiveness of these measures. The "tragedy of the commons" model is often accepted as a universal paradigm, which assumes that unless managed by the State or privatized, common-pool resources are inevitably overexploited due to conflicts between the self-interest of individuals and the goals of a group as a whole. Under this paradigm, the emergence and maintenance of effective community-based efforts that include cooperative risky decisions as the establishment of marine reserves could not occur. In this paper, we question these assumptions and show that outcomes of commons dilemmas can be complex and scale-dependent. We studied the evolution and effectiveness of a community-based management effort to establish, monitor, and enforce a marine reserve network in the Gulf of California, Mexico. Our findings build on social and ecological research before (1997-2001), during (2002) and after (2003-2004) the establishment of marine reserves, which included participant observation in >100 fishing trips and meetings, interviews, as well as fishery dependent and independent monitoring. We found that locally crafted and enforced harvesting rules led to a rapid increase in resource abundance. Nevertheless, news about this increase spread quickly at a regional scale, resulting in poaching from outsiders and a subsequent rapid cascading effect on fishing resources and locally-designed rule compliance. We show that cooperation for management of common-pool fisheries, in which marine reserves form a core component of the system, can emerge, evolve rapidly, and be effective at a local scale even in recently organized fisheries. Stakeholder participation in monitoring, where there is a rapid feedback of the systems response, can play a key role in reinforcing cooperation. However, without cross-scale linkages with higher levels of governance, increase of local fishery stocks may attract outsiders who, if not restricted, will overharvest and threaten local governance. Fishers and fishing communities require incentives to maintain their management efforts. Rewarding local effective management with formal cross-scale governance recognition and support can generate these incentives.

Comparing copepod time-series in the north of Spain: Spatial autocorrelation of community composition

Four time-series of copepod species biomass in the north of Spain were contrasted to demonstrate spatial autocorrelation of local communities and their responses to short-term local and regional variability in oceanographic conditions. The series represented coastal and oceanic environments along a marked gradient of influence of seasonal upwelling from Galicia to the Mar Cantábrico (S Bay of Biscay), and each one included at least 10 years of continuous data collected at monthly frequency. Community composition (i.e. species number and diversity) was very consistent through the region, but local variations in the presence of new species and the relative proportions of common species allowed for the characterisation of the response to the environment at each site. Small-sized species were more frequent near the coast. A few species, however, captured the main patterns of variability in all series. Calanus helgolandicus and Acartia (mainly Acartia clausi) were generally the main contributors to total biomass, while other species as Paracalanus parvus and Clausocalanus spp. were important only at some locations. Most copepod indices were positively correlated with upwelling, either considering the whole community (biomass, species richness and diversity) or individual species, but only in the coastal series analysed since 1991. Copepods in the nearby ocean, however, showed negative correlations with upwelling in the period 1960–1986. The effects of upwelling may have been modulated by local factors, as showed by the increases in biomass, number of species and diversity in associations with increases in sea surface temperature in Galicia, while in the Mar Cantábrico only the warming-tolerant species increased and those typical of upwelling decreased. Density stratification of the water column was associated with decreases in total copepod biomass in Galicia, while it favoured the increase in species richness in the Mar Cantábrico. Nearly all significant responses of copepods to environmental variability were delayed by up to 5 months, showing the importance of considering time-lags in the analysis of temporal responses of zooplankton.

Biodiversity and ecosystems: Change at the community level

Some commercial fish species of the northeast Atlantic Ocean have relocated in response to warming. The impact of warming on marine assemblages in the region may already be much greater than appreciated, however, with over 70% of common demersal fish species responding through changes in abundance, rather than range. The northeast Atlantic Ocean is one of the most productive marine ecoregions in the world with a substantial commercial fishery. It is also a region that has undergone particularly rapid warming over the past 50 years, up to four times faster than the global average1. Compared with other marine regions worldwide, the biological response in the northeast Atlantic Ocean has been particularly dramatic, reflecting this rapid warming. Studies have documented biogeographical movements in marine plankton of over 1,000 km northwards2 and advances in the onset of key life-history events by six to eight weeks3. In addition, there has been limited evidence of distributional shifts in some fish species along latitudinal and depth gradients in response to warming4, 5. Writing in Current Biology, Stephen Simpson and colleagues6 present the most comprehensive analysis so far of the impact of warming on commercially important European continental-shelf fish species in the region, and in doing so show that there has been a profound reorganization of local communities.

Local perceptions of the QICS experimental offshore CO2 release: Results from social science research

This paper explores the social dimensions of an experimental release of carbon dioxide (CO2) carried out in Ardmucknish Bay, Argyll, United Kingdom. The experiment, which aimed to understand detectability and potential effects on the marine environment should there be any leakage from a CO2 storage site, provided a rare opportunity to study the social aspects of a carbon dioxide capture and storage-related event taking place in a lived-in environment. Qualitative research was carried out in the form of observation at public information events about the release, in-depth interviews with key project staff and local stakeholders/community members, and a review of online media coverage of the experiment. Focusing mainly on the observation and interview data, we discuss three key findings: the role of experience and analogues in learning about unfamiliar concepts like CO2 storage; the challenge of addressing questions of uncertainty in public engagement; and the issue of when to commence engagement and how to frame the discussion. We conclude that whilst there are clearly slippages between a small-scale experiment and full-scale CCS, the social research carried out for this project demonstrates that issues of public and stakeholder perception are as relevant for offshore CO2 storage as they are for onshore.

Ecoturismo en comunidades rurales: análisis de los impactos negativos para la población local. Un estudio de caso

En los últimos años han aparecido nuevas formas de turismo más sostenibles, donde existen elementos relacionados con el descanso, el disfrute y la protección del medio ambiente o el conocimiento de la cultura local, a través de políticas que favorecen la sostenibilidad del destino. En este sentido, el ecoturismo se configura como una tipología turística que se desarrolla en contacto con la naturaleza. Este turismo ayuda a mejorar el desarrollo socioeconómico de las comunidades locales, a la vez, que fomenta la conservación de los recursos naturales y el respeto hacia el medio ambiente. Aunque, esta tipología de turismo también genera importantes impactos negativos. El objetivo principal de esta investigación es analizar los impactos socioeconómicos, culturales y medioambientales percibidos por el ecoturismo por parte de los residentes de comunidades rurales de República Dominicana. La técnica de recolección de datos utilizada ha consistido en un cuestionario. Entre las principales conclusiones, cabe destacar que actualmente no se perciben impactos negativos, pero si hay una serie de elementos que hay que ir considerando, con la finalidad de que no se conviertan en un impacto a corto plazo para la comunidad rural.

Community Relations in Northern Ireland: a shift in Attitudes?

The paper presents an analysis of Northern Ireland Social Attitudes data available at the time of writing. Its significance lay in emerging disparities in the responses, over time, of Protestants and Catholics to key social issues such as integrated education. The data, made public just one year after the signing of the Belfast/Good Friday Agreement, generated intense media interest. Findings were reported in 400 outlets worldwide (UU media monitoring). Hughes was also interviewed for local and national news programmes (including BBC World Service). The data informed a decision by Government to undertake a major review of community relations policy, and Hughes was invited to advise the Head of the Northern Ireland review team. She was also invited to Chair the Community Relations Panel of the ESRC Devolution

Assessing the determinants of public confidence in the police: A case study of a post-conflict community in Northern Ireland

Drawing upon original survey research this article seeks to identify the generative processes that influence perceptions of the police in the context of an inner-city neighbourhood in Northern Ireland that has been affected by increases in crime and disorder in the aftermath of the peace process. Conceptually we draw upon recent research from England and Wales that outlines confidence in the police in terms of instrumental and expressive dimensions. We apply this framework and consider whether it provides a useful template for understanding the post-conflict dynamics of police-community relations in our study area. Contrary to much received wisdom our analysis suggests that instrumental concerns about crime and illegal activity are a more influential predictor of attitudes to the police than expressive concerns with disorder and anti-social behaviour. Consequently our discussion points to the variance in local and national survey data and questions the degree to which the latter can usefully inform our understanding of trends and developments in discrete micro-spaces. Our conclusion outlines the potential policy implications for state policing practice in deprived urban spaces.

Anthropometric measurements from a cross-sectional survey of community dwelling subjects aged over 90 years of age

To measure anthropometric variables of weight, height, body mass index (BMI) and triceps skin fold thickness (TSF) and produce local percentiles for > 90 y old subjects. To assess prevalence of conventional measures of under nutrition (BMI at or below 18.5 kg/m2) or over nutrition (BMI values > 30 kg/m2) in this age group.