‘It ain’t easy being green’: Sustainable Development between Environment and Economy in Northern Ireland’

Given the relative lack of research on sustainable development in Northern Ireland, this paper focuses on the tensions between environmental governance and regulation on the one hand, and the ‘post-conflict’ imperative for Northern Ireland to compete and grow as a regional economy without continued British state subvention and subsidisation. The paper outlines how this ‘trade-off’ between ‘environment’ and ‘economy’ is essentially misplaced. It argues that this trade-off can be avoided if there is a shift in focus from an ‘environment versus the economy’ policy position to one in which the ‘triple bottom line’ (social, economic and environmental) of sustainable development becomes the over-arching policy agenda. Sustainable development, unlike either orthodox environmental or economic policy, also connects centrally with the unique ‘post-conflict transformation’ agenda of Northern Ireland. For example, promoting a human rights civic culture, tackling socioeconomic inequality and social exclusion, and building a shared future based on supporting sustainable communities and an innovative model of a ‘green(ing) economy’ goes beyond orthodox economic growth. However, it is clear from the Executive’s Programme for Government, failure to support the creation of an independent Environment Protection Agency, and above all the prioritisation of orthodox economic growth based on foreign direct investment that neither environmental protection nor sustainable development is or will be high on the political or policy agenda in Northern Ireland.

The effect of patient characteristics upon uptake of the influenza vaccination: a study comparing community based older adults in two healthcare systems

Background: Uptake of influenza vaccination represents a simple marker of proactive care of older people. However, many still do not receive the vaccine. To understand this challenge better, we investigated the relationship between patient characteristics (demographic, physical and psychological health, and health service use) and vaccination uptake in a sample of community-dwelling older people in two adjacent but differently structured healthcare systems (Northern Ireland (NI) and the Republic of Ireland (RoI)). Methods: 2,033 randomly selected community-dwelling older adults (65 years and older) were interviewed in their homes. Results: Rates of uptake were 78% in NI and 72% in RoI. Uptake was greater with older age (odds ratio (OR) 1.6, 95% confidence interval (CI) = 1.3-2.1, p

Stroke presentation and hospital management: comparison of neighbouring healthcare systems with differing health policies.

Background: Acute stroke care is shaped by healthcare policies. Differing policies in similar populations allow for assessment of policy impact on health and healthcare outcomes. Aims: To compare stroke presentation and hospital care in two adjacent healthcare systems with differing healthcare policies. Methods: Interviews and chart review of consecutive acute stroke admissions in Northern Ireland (n=103) and the Republic of Ireland (n=100). Results: Marked regional contrasts were evident for key aspects of hospital care. Northern Ireland performed significantly better on 15 of 16 quality of care (Sentinel Audit) items. Delivery on standards was significantly better in Northern Ireland for early assessment (Northern Ireland 72%; Republic of Ireland 54%, p

The practice of home in old Cairo: Towards socio-spatial models of sustainable living

The article investigates the practice of home as an everyday system for sustainable living in Old Cairo. The idea of home in this historic urban space has long involved fluid socio-spatial associations and made efficient use of space-activity-time dynamics. As in the past, a individual’s sense of home may here extend beyond or shrink within the physical boundaries of a particular house, as spatial settings are produced and consumed according to time of day, gender association, or special events. The article argues that architects working in this context must understand the dynamics of this complex traditional system if they are to develop locally informed, genuine designs that build on everyday spatial practices. Work by the architect Salah Zaki Said and by the Historic Cities Program of the Aga Khan Trust for Culture is described to illustrate the potential of such engagement, especially as it contrasts to more abstract architectural proposals.

Sustainable Rural Tourism: Lessons for Rural Development

Rural areas are recognised for their complex, multi-functional capacities with a range of different interest groups claiming their rights to, and use of, different rural spaces. The current rural development paradigm that is evident across the globe is epitomised by the European LEADER approach. Using evidence from the proposed National Park in Northern Ireland, we ask the question: what is the potential of sustainable rural tourism to contribute to rural development? Within our analysis we consider the scope for adaptive tourism to overcome some of the ongoing challenges that have been identified within the LEADER approach. Four themes are revealed from this analysis: institutional (in)capacity; legitimacy of local groups; navigating between stakeholder interests; and sustainable tourism in practice. These issues, discussed in turn, have clear implications for the new rural development programme.

On the Problems of Mixing RCTs with Qualitative Research: The Case of the MRC Framework for the Evaluation of Complex Healthcare Interventions

In the perceived hierarchy of research designs, the results from randomized controlled trials are considered to provide the highest level of evidence. Indeed these trials have been upheld as the gold standard in research. The benefits and limitations of the randomized controlled trial as a method of evaluating the effectiveness of healthcare interventions are presented. The article then examines the different levels of complexity within healthcare interventions and the problems this poses in determining effectiveness. In an effort to provide a solution to this problem, the Medical Research Council produced a framework to assist investigators to develop and evaluate complex healthcare interventions. The framework is described with reference to an example of implementing and evaluating protocols for weaning patients in the intensive care unit. The framework is critiqued on the basis that it involves an ambiguous or contradictory ontology, which fails to articulate the relationship between the positivism of randomized controlled trials with the relativism of qualitative approaches. It is concluded that the use of realist strategies in combination with randomized controlled trials provides the most coherent solution to this quandary