968 resultados para P21 - Planning, Coordination, and Reform


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Malaria is a threat to United States military personnel operating in endemic areas, from which there have been hundreds of cases reported over the past decade. Each of these cases might have been avoided with proper adherence to malaria chemoprophylaxis medications. Military operations may detract from the strict 100% adherence required of these preventive medications. However, the reasons for non-adherence in military populations are not well understood. This behavior was investigated using a cross sectional study design on a convenience sample of U.S. Army Ranger volunteers (n=150) located at three military instillations. Theoretical support was based on components of the Health Belief Model, the Theory of Reasoned Action/Theory of Planned Behavior, and the Social Cognitive Theory. ^ Data on knowledge, attitudes, and practices, as well as multiple environmental domains was collected using an original yet unvalidated questionnaire. The data was analyzed using bivariate Pearson correlations, binary logistic regression, and moderated logistic regressions employing a 0.05 criterion of statistical significance. Power analyses predicted 96-98% power for this analysis. ^ Multiple significant medium strength Pearson correlation coefficients were identified relative to the two dependent variables Take medications as directed and Intend to take the medications as directed the next time. Binary logistic regression analyses identified multiple variables that may predict behavioral intentions to adhere to these preventive medications, as a proxy for behavioral change. Moderated logistic regression analyses identified Command Support for adherence to these medications as a potential significant moderator that interacts with independent variables within three domains of the survey questionnaire. ^ The findings indicate that there may be potential significant beneficial effects, which may improve this behavior in this population of Rangers through 1) promoting affirmative interpersonal communications that emphasize adherence to these medications, 2) including malaria chemoprophylaxis medications in the mission planning process, and 3) military command support, in the form of including the importance of proper adherence to these medications in the unit safety briefings.^

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Modern power networks incorporate communications and information technology infrastructure into the electrical power system to create a smart grid in terms of control and operation. The smart grid enables real-time communication and control between consumers and utility companies allowing suppliers to optimize energy usage based on price preference and system technical issues. The smart grid design aims to provide overall power system monitoring, create protection and control strategies to maintain system performance, stability and security. This dissertation contributed to the development of a unique and novel smart grid test-bed laboratory with integrated monitoring, protection and control systems. This test-bed was used as a platform to test the smart grid operational ideas developed here. The implementation of this system in the real-time software creates an environment for studying, implementing and verifying novel control and protection schemes developed in this dissertation. Phasor measurement techniques were developed using the available Data Acquisition (DAQ) devices in order to monitor all points in the power system in real time. This provides a practical view of system parameter changes, system abnormal conditions and its stability and security information system. These developments provide valuable measurements for technical power system operators in the energy control centers. Phasor Measurement technology is an excellent solution for improving system planning, operation and energy trading in addition to enabling advanced applications in Wide Area Monitoring, Protection and Control (WAMPAC). Moreover, a virtual protection system was developed and implemented in the smart grid laboratory with integrated functionality for wide area applications. Experiments and procedures were developed in the system in order to detect the system abnormal conditions and apply proper remedies to heal the system. A design for DC microgrid was developed to integrate it to the AC system with appropriate control capability. This system represents realistic hybrid AC/DC microgrids connectivity to the AC side to study the use of such architecture in system operation to help remedy system abnormal conditions. In addition, this dissertation explored the challenges and feasibility of the implementation of real-time system analysis features in order to monitor the system security and stability measures. These indices are measured experimentally during the operation of the developed hybrid AC/DC microgrids. Furthermore, a real-time optimal power flow system was implemented to optimally manage the power sharing between AC generators and DC side resources. A study relating to real-time energy management algorithm in hybrid microgrids was performed to evaluate the effects of using energy storage resources and their use in mitigating heavy load impacts on system stability and operational security.

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The improvement in living standards and the development of telecommunications have led to a large increase in the number of Internet users in China. It has been reported by China National Network Information Center that the number of Internet users in China has reached 33.7 million in 2001, ranting the country third in the world. This figure also shows that more and more Chinese residents have accepted the Internet and use it to obtain information and compete their travel planning. Milne and Ateljevic stated that the integration of computing and telecommunications would create a global information network based mostly on the Internet. The Internet, especially the World Wide Web, has had a great impact on the hospitality and tourism industry in recent years. The WWW plays an important role in mediating between customers and hotel companies as a place to acquire information acquisition and transact business.

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The purpose of this study was to analyze the network performance by observing the effect of varying network size and data link rate on one of the most commonly found network configurations. Computer networks have been growing explosively. Networking is used in every aspect of business, including advertising, production, shipping, planning, billing, and accounting. Communication takes place through networks that form the basis of transfer of information. The number and type of components may vary from network to network depending on several factors such as requirement and actual physical placement of the networks. There is no fixed size of the networks and they can be very small consisting of say five to six nodes or very large consisting of over two thousand nodes. The varying network sizes make it very important to study the network performance so as to be able to predict the functioning and the suitability of the network. The findings demonstrated that the network performance parameters such as global delay, load, router processor utilization, router processor delay, etc. are affected. The findings demonstrated that the network performance parameters such as global delay, load, router processor utilization, router processor delay, etc. are affected significantly due to the increase in the size of the network and that there exists a correlation between the various parameters and the size of the network. These variations are not only dependent on the magnitude of the change in the actual physical area of the network but also on the data link rate used to connect the various components of the network.

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The authors would like to thank the leadership of the Deep Ocean Stewardship Initiative (DOSI), including Lisa Levin, Maria Baker, and Kristina Gjerde, for their support in developing this review. This work evolved from a meeting of the DOSI Oil and Gas working group supported by the J.M. Kaplan Fund, and associated with the Deep-Sea Biology Symposium in Aveiro, Portugal in September 2015. The members of the Oil and Gas working group that contributed to our discussions at that meeting or through the listserve are acknowledged for their contributions to this work. We would also like to thank the three reviewers and the editor who provided valuable comments and insight into the work presented here. DJ and AD were supported by funding from the European Union's Horizon 2020 research and innovation programme under the MERCES (Marine Ecosystem Restoration in Changing European Seas) project, grant agreement No 689518. AB was supported by CNPq grants 301412/2013-8 and 200504/2015-0. LH acknowledges funding provided by a Natural Environment Research Council grant (NE/L008181/1). This output reflects only the authors' views and the funders cannot be held responsible for any use that may be made of the information contained therein.

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Purpose: The purpose of this paper is to ascertain how today’s international marketers can perform better on the global scene by harnessing spontaneity. Design/methodology/approach: The authors draw on contingency theory to develop a model of the spontaneity – international marketing performance relationship, and identify three potential moderators, namely, strategic planning, centralization, and market dynamism. The authors test the model via structural equation modeling with survey data from 197 UK exporters. Findings: The results indicate that spontaneity is beneficial to exporters in terms of enhancing profit performance. In addition, greater centralization and strategic planning strengthen the positive effects of spontaneity. However, market dynamism mitigates the positive effect of spontaneity on export performance (when customer needs are volatile, spontaneous decisions do not function as well in terms of ensuring success). Practical implications: Learning to be spontaneous when making export decisions appears to result in favorable outcomes for the export function. To harness spontaneity, export managers should look to develop company heuristics (increase centralization and strategic planning). Finally, if operating in dynamic export market environments, the role of spontaneity is weaker, so more conventional decision-making approaches should be adopted. Originality/value: The international marketing environment typically requires decisions to be flexible and fast. In this context, spontaneity could enable accelerated and responsive decision-making, allowing international marketers to realize superior performance. Yet, there is a lack of research on decision-making spontaneity and its potential for international marketing performance enhancement.

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Background:

Knowing the scope of neurosurgical disease at Mbarara Hospital is critical for infrastructure planning, education and training. In this study, we aim to evaluate the neurosurgical outcomes and identify predictors of mortality in order to potentiate platforms for more effective interventions and inform future research efforts at Mbarara Hospital.

Methods:

This is retrospective chart review including patients of all ages with a neurosurgical disease or injury presenting to Mbarara Regional Referral Hospital (MRRH) between January 2012 to September 2015. Descriptive statistics were presented. A univariate analysis was used to obtain the odds ratios of mortality and 95% confidence intervals. Predictors of mortality were determined using multivariate logistic regression model.

Results:

A total of 1876 charts were reviewed. Of these, 1854 (had complete data and were?) were included in the analysis. The overall mortality rate was 12.75%; the mortality rates among all persons who underwent a neurosurgical procedure was 9.72%, and was 13.68% among those who did not undergo a neurosurgical procedure. Over 50% of patients were between 19 and 40 years old and the majority of were males (76.10%). The overall median length of stay was 5 days. Of all neurosurgical admissions, 87% were trauma patients. In comparison to mild head injury, closed head injury and intracranial hematoma patients were 5 (95% CI: 3.77, 8.26) and 2.5 times (95% CI: 1.64,3.98) more likely to die respectively. Procedure and diagnostic imaging were independent negative predictors of mortality (P <0.05). While age, ICU admission, admission GCS were positive predictors of mortality (P <0.05).

Conclusions:

The majority of hospital admissions were TBI patients, with RTIs being the most common mechanism of injury. Age, ICU admission, admission GCS, diagnostic imaging and undergoing surgery were independent predictors of mortality. Going forward, further exploration of patient characteristics is necessary to fully describe mortality outcomes and implement resource appropriate interventions that ultimately improve morbidity and mortality.

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Background: Haiti has the highest maternal mortality rate in the Latin American and Caribbean region. Despite the fact that Haiti has received twice as much family planning assistance as any other country in the western hemisphere, the unmet need for contraception remains particularly high. Our hypothesis is that unsuccessful efforts of family planning programs may be related to a misconstrued understanding of the complex role of gender in relationships and community in Haiti. This manuscript is one of four parts of a study that intends to examine some of these issues with a particular focus on the influence of uptake and adherence to long acting contraceptive (LAC) methods.

Methods: We conducted a three-month community-based qualitative assessment through 20 in-depth interviews in Fondwa, Haiti. Participants were divided into 4 groups of five: female users, female non-users, men and key community stakeholders.

Results: Based on the qualitative interviews, we found that main barriers included lack of access to family planning education and services and concerns regarding side effects and health risks, especially related to menstrual disruption and fears of infertility. Women have a constant pressure to remain fertile and bear children, due not only to social but also economic needs. As relationships are conceived as means for economic provision, the likelihood of uptake of irreversible methods (vasectomy and tubal ligation) was restricted by loss of fertility. Consequently, the discourse of family planning, though self-recognized in their favor, assumes women can afford not to bear children. This assumption should be questioned given the complexities of the other social determinants at play, all which affect the reproductive decisions made by Haitians.

Conclusions: Overall, our study indicated awareness surrounding contraception in the Haitian Fondwa community. Combining the substantial impact of birth spacing with the elevated yet unmet need for contraceptives in the area, it is necessary to address the intricacies of gender issues in order to implement successful programing. In Haiti not being able to bear a child poses a threat to economic and social survival, possibly explaining a dimension of the low uptake of LACs in the region, even when made available. For this reason, we believe IUDs (Intrauterine Devices) provide a suitable alternative, allowing the couple to comprehend all of the factors involved in decision making, thus decreasing the imbalances of power and knowledge prior to considering an irreversible alternative.

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As the world population continues to grow past seven billion people and global challenges continue to persist including resource availability, biodiversity loss, climate change and human well-being, a new science is required that can address the integrated nature of these challenges and the multiple scales on which they are manifest. Sustainability science has emerged to fill this role. In the fifteen years since it was first called for in the pages of Science, it has rapidly matured, however its place in the history of science and the way it is practiced today must be continually evaluated. In Part I, two chapters address this theoretical and practical grounding. Part II transitions to the applied practice of sustainability science in addressing the urban heat island (UHI) challenge wherein the climate of urban areas are warmer than their surrounding rural environs. The UHI has become increasingly important within the study of earth sciences given the increased focus on climate change and as the balance of humans now live in urban areas.

In Chapter 2 a novel contribution to the historical context of sustainability is argued. Sustainability as a concept characterizing the relationship between humans and nature emerged in the mid to late 20th century as a response to findings used to also characterize the Anthropocene. Emerging from the human-nature relationships that came before it, evidence is provided that suggests Sustainability was enabled by technology and a reorientation of world-view and is unique in its global boundary, systematic approach and ambition for both well being and the continued availability of resources and Earth system function. Sustainability is further an ambition that has wide appeal, making it one of the first normative concepts of the Anthropocene.

Despite its widespread emergence and adoption, sustainability science continues to suffer from definitional ambiguity within the academe. In Chapter 3, a review of efforts to provide direction and structure to the science reveals a continuum of approaches anchored at either end by differing visions of how the science interfaces with practice (solutions). At one end, basic science of societally defined problems informs decisions about possible solutions and their application. At the other end, applied research directly affects the options available to decision makers. While clear from the literature, survey data further suggests that the dichotomy does not appear to be as apparent in the minds of practitioners.

In Chapter 4, the UHI is first addressed at the synoptic, mesoscale. Urban climate is the most immediate manifestation of the warming global climate for the majority of people on earth. Nearly half of those people live in small to medium sized cities, an understudied scale in urban climate research. Widespread characterization would be useful to decision makers in planning and design. Using a multi-method approach, the mesoscale UHI in the study region is characterized and the secular trend over the last sixty years evaluated. Under isolated ideal conditions the findings indicate a UHI of 5.3 ± 0.97 °C to be present in the study area, the magnitude of which is growing over time.

Although urban heat islands (UHI) are well studied, there remain no panaceas for local scale mitigation and adaptation methods, therefore continued attention to characterization of the phenomenon in urban centers of different scales around the globe is required. In Chapter 5, a local scale analysis of the canopy layer and surface UHI in a medium sized city in North Carolina, USA is conducted using multiple methods including stationary urban sensors, mobile transects and remote sensing. Focusing on the ideal conditions for UHI development during an anticyclonic summer heat event, the study observes a range of UHI intensity depending on the method of observation: 8.7 °C from the stationary urban sensors; 6.9 °C from mobile transects; and, 2.2 °C from remote sensing. Additional attention is paid to the diurnal dynamics of the UHI and its correlation with vegetation indices, dewpoint and albedo. Evapotranspiration is shown to drive dynamics in the study region.

Finally, recognizing that a bridge must be established between the physical science community studying the Urban Heat Island (UHI) effect, and the planning community and decision makers implementing urban form and development policies, Chapter 6 evaluates multiple urban form characterization methods. Methods evaluated include local climate zones (LCZ), national land cover database (NCLD) classes and urban cluster analysis (UCA) to determine their utility in describing the distribution of the UHI based on three standard observation types 1) fixed urban temperature sensors, 2) mobile transects and, 3) remote sensing. Bivariate, regression and ANOVA tests are used to conduct the analyses. Findings indicate that the NLCD classes are best correlated to the UHI intensity and distribution in the study area. Further, while the UCA method is not useful directly, the variables included in the method are predictive based on regression analysis so the potential for better model design exists. Land cover variables including albedo, impervious surface fraction and pervious surface fraction are found to dominate the distribution of the UHI in the study area regardless of observation method.

Chapter 7 provides a summary of findings, and offers a brief analysis of their implications for both the scientific discourse generally, and the study area specifically. In general, the work undertaken does not achieve the full ambition of sustainability science, additional work is required to translate findings to practice and more fully evaluate adoption. The implications for planning and development in the local region are addressed in the context of a major light-rail infrastructure project including several systems level considerations like human health and development. Finally, several avenues for future work are outlined. Within the theoretical development of sustainability science, these pathways include more robust evaluations of the theoretical and actual practice. Within the UHI context, these include development of an integrated urban form characterization model, application of study methodology in other geographic areas and at different scales, and use of novel experimental methods including distributed sensor networks and citizen science.

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Monitoring and enforcement are perhaps the biggest challenges in the design and implementation of environmental policies in developing countries where the actions of many small informal actors cause significant impacts on the ecosystem services and where the transaction costs for the state to regulate them could be enormous. This dissertation studies the potential of innovative institutions based on decentralized coordination and enforcement to induce better environmental outcomes. Such policies have in common that the state plays the role of providing the incentives for organization but the process of compliance happens through decentralized agreements, trust building, signaling and monitoring. I draw from the literatures in collective action, common-pool resources, game-theory and non-point source pollution to develop the instruments proposed here. To test the different conditions in which such policies could be implemented I designed two field-experiments that I conducted with small-scale gold miners in the Colombian Pacific and with users and providers of ecosystem services in the states of Veracruz, Quintana Roo and Yucatan in Mexico. This dissertation is organized in three essays.

The first essay, “Collective Incentives for Cleaner Small-Scale Gold Mining on the Frontier: Experimental Tests of Compliance with Group Incentives given Limited State Monitoring”, examines whether collective incentives, i.e. incentives provided to a group conditional on collective compliance, could “outsource” the required local monitoring, i.e. induce group interactions that extend the reach of the state that can observe only aggregate consequences in the context of small-scale gold mining. I employed a framed field-lab experiment in which the miners make decisions regarding mining intensity. The state sets a collective target for an environmental outcome, verifies compliance and provides a group reward for compliance which is split equally among members. Since the target set by the state transforms the situation into a coordination game, outcomes depend on expectations of what others will do. I conducted this experiment with 640 participants in a mining region of the Colombian Pacific and I examine different levels of policy severity and their ordering. The findings of the experiment suggest that such instruments can induce compliance but this regulation involves tradeoffs. For most severe targets – with rewards just above costs – raise gains if successful but can collapse rapidly and completely. In terms of group interactions, better outcomes are found when severity initially is lower suggesting learning.

The second essay, “Collective Compliance can be Efficient and Inequitable: Impacts of Leaders among Small-Scale Gold Miners in Colombia”, explores the channels through which communication help groups to coordinate in presence of collective incentives and whether the reached solutions are equitable or not. Also in the context of small-scale gold mining in the Colombian Pacific, I test the effect of communication in compliance with a collective environmental target. The results suggest that communication, as expected, helps to solve coordination challenges but still some groups reach agreements involving unequal outcomes. By examining the agreements that took place in each group, I observe that the main coordination mechanism was the presence of leaders that help other group members to clarify the situation. Interestingly, leaders not only helped groups to reach efficiency but also played a key role in equity by defining how the costs of compliance would be distributed among group members.

The third essay, “Creating Local PES Institutions and Increasing Impacts of PES in Mexico: A real-Time Watershed-Level Framed Field Experiment on Coordination and Conditionality”, considers the creation of a local payments for ecosystem services (PES) mechanism as an assurance game that requires the coordination between two groups of participants: upstream and downstream. Based on this assurance interaction, I explore the effect of allowing peer-sanctions on upstream behavior in the functioning of the mechanism. This field-lab experiment was implemented in three real cases of the Mexican Fondos Concurrentes (matching funds) program in the states of Veracruz, Quintana Roo and Yucatan, where 240 real users and 240 real providers of hydrological services were recruited and interacted with each other in real time. The experimental results suggest that initial trust-game behaviors align with participants’ perceptions and predicts baseline giving in assurance game. For upstream providers, i.e. those who get sanctioned, the threat and the use of sanctions increase contributions. Downstream users contribute less when offered the option to sanction – as if that option signal an uncooperative upstream – then the contributions rise in line with the complementarity in payments of the assurance game.

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To reveal the theories and practices that linked education to the development within the cities of Boston and Buenos Aires, and in turn to the development of US and Argentina nationalism, “Cosmopolitan Imperialism” centers on two education reformers, Horace Mann (1776-1859) and Domingo Faustino Sarmiento (1811-1888). Mann and Sarmiento formed part of a supra-national community where liberal intellectual elites created a republic of letters, or perhaps better said, a republic of schools. As different versions of education branched out from a common Atlantic origin during the nineteenth century, Mann and Sarmiento searched for those ideas that better fit their national projects, a local project that started in the cities and moved to the interior parts of the country. In Boston and Buenos Aires, modern nationalism intertwined with imperial projects. This dissertation thus analyzes nationalism and reform in the nineteenth-century as an imperial project led by cosmopolitan intellectual elites. While we might expect to find Mann and Sarmiento’s ideas on education to be centered on their national experiences, looking to Europe for inspiration, this dissertation shows that it was quite the opposite. Educational ideas developed within an interconnected network and traveled within the North-South axis connecting Boston with Buenos Aires. This framework moves the focus from the interchange of ideas between America and Europe and places it within the American continent. At the same time, it allows us to consider Latin American and the US as both creators and recipients of educational ideas. There is a traditional way of talking about nationalism and reform in the nineteenth-century, especially in terms of education and educational policies. It is common to imagine that in the US, and even more certainly in Latin America, educated elites looked to the so-called West for inspiration. The argument is that they ended up adapting foreign models to their local and internal contexts. This dissertation challenges that idea and shows that different versions of education developed from a shared Atlantic milieu in which reformers in certain cities saw themselves as part of the same cosmopolitan empires.

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Maintaining and enhancing living conditions in cities through a combination of physical planning and environmental management is a newly emerging focus of governments around the world. For example, local governments seek to insulate sensitive land uses such as residential areas from environmentally intrusive activities such as major transport facilities and manufacturing. Regional governments protect water quality and natural habitat by enforcing pollution controls and regulating the location of growth. Some national governments fund acquisition of strategically important sites, facilitate the renewal of brown fields, and even develop integrated environmental quality plans. This book provides recently developed and tested methods for assessing the strengths and weaknesses of planning and policy options. Several contributions focus on new substantive areas of concern in planning evaluation, including environmental justice and sustainable urban development. Applications of evaluation in several planning contexts are demonstrated, and special problems that these pose are assessed. Several chapters address how to communicate the process and results to several stakeholder groups, and how to engage these groups in the evaluation process. Each chapter employs a realworld case in practice, thus dealing with the complexity of applying planning evaluation, and providing practical advice useful in similar situations.

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This book brings together experts in the fields of spatial planning, landuse and infrastructure management to explore the emerging agenda of spatially-oriented integrated evaluation. It weaves together the latest theories, case studies, methods, policy and practice to examine and assess the values, impacts, benefits and the overall success in integrated land-use management. In doing so, the book clarifies the nature and roles of evaluation and puts forward guidance for future policy and practice.

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In the Jakarta Metropolitan Region (JMR), the lack of co-ordination and appropriate governance has resulted in paralyzing traffic jams at the metropolitan scale that cannot be resolved by a single government entity. The issue of metropolitan governance is especially crucial here as the JMR lacks an established and formally pre-designed system of governance (e.g., in a constitution or other legal regulations). Instead, it relies on the interaction, coordination and cooperation of a multitude of different stakeholders, ranging from local and regional authorities to private entities and citizens. This chapter offers a discussion on the various governance approaches relating to an appropriate institutional design required for transportation issues at the metropolitan scale. The case used is a regional Bus Rapid Transit (BRT) system as an extension to the metropolitan transport system. Institutional design analysis is applied to the case and three possible improvements - i) a ‘Megapolitan’ concept, ii) a regional spatial plan and iii) inter-local government cooperation; were identified that correspond to current debates on metropolitan governance approaches of regionalism, localism and new regionalism. The findings, which are relevant to similar metropolitan regions, suggest that i) improvements at the meso-level of institutional design are more readily accepted and effective than improvements at the macro-level and ii) that the appropriate institutional design for governing metropolitan transportation in the JMR requires enhanced coordination and cooperation amongst four important actors - local governments, the regional agency, the central government, and private companies.

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Drawing on a thematic analysis of relevant policy documents, the aim of this paper is to comment on an apparent disconnect between two associated contemporary UK policy areas: planning for heatwaves and community resilience. Regional and national policy documents that plan for heatwaves in the UK tend to focus on institutional emergency responses and infrastructure development. In these documents, although communities are mentioned, they are understood as passive recipients of resilience that is provided by active institutions. Meanwhile, contemporary discussion about community resilience highlights the potential for involving communities in planning for and responding to emergencies (although the concept is also the subject of critique). Within this context, the paper proposes that – through engagement with the ‘community resilience’ policy agenda and its critique – effort should be made to articulate and realise greater participation by individuals, and voluntary and community sector groups in heatwave preparation, planning and response.