Linking Research and Policy: Assessing a Framework for Organic Agricultural Support in Ireland

This paper links social science research and agricultural policy through an analysis of support for organic agriculture and food. Globally, sales of organic food have experienced 20% annual increases for the past two decades, and represent the fastest growing segment of the grocery market. Although consumer interest has increased, farmers are not keeping up with demand. This is partly due to a lack of political support provided to farmers in their transition from conventional to organic production. Support policies vary by country and in some nations, such as the US, vary by state/province. There have been few attempts to document the types of support currently in place. This research draws on an existing Framework tool to investigate regionally specific and relevant policy support available to organic farmers in Ireland. This exploratory study develops a case study of Ireland within the framework of ten key categories of organic agricultural support: leadership, policy, research, technical support, financial support, marketing and promotion, education and information, consumer issues, inter-agency activities, and future developments. Data from the Irish Department of Agriculture, Fisheries and Food, the Irish Agriculture and Food Development Authority (Teagasc), and other governmental and semi-governmental agencies provide the basis for an assessment of support in each category. Assessments are based on the number of activities, availability of information to farmers, and attention from governmental personnel for each of the ten categories. This policy framework is a valuable tool for farmers, researchers, state agencies, and citizen groups seeking to document existing types of organic agricultural support and discover policy areas which deserve more attention

Preventing Homelessness: Exploring the Role of Clinical Psychology in Adult Mental Health Services

Aims: With homelessness rates continuing to rise, the government have attempted to address this issue over recent years by turning to public authority employees to take preventative action to those faced with threat of homelessness. How clinical psychology can contribute to the reduction of homelessness in adult mental health services is yet to be explored. This study aimed to better understand the role of clinical psychologists working in adult mental health services to prevent homelessness. Secondly, this study aimed to understand the facilitators and barriers that may get in the way of the profession contributing to the prevention of homelessness. Method: Twelve clinical psychologists working within adult mental health services in the UK participated in individual semi-structured interviews. Thematic analysis was used to identify the participants’ ideas on the role of clinical psychology in the prevention of homelessness within adult mental health services. Results: Three themes were identified through thematic analysis; (1) ‘Understanding Homelessness’ describing how clinical psychologists define and understand homelessness in addition to what influences their understanding. (2) ‘System Structures’ describing NHS structures which may create barriers to prevention, how clinical psychologists have learnt from other organisations and professions and the role of professional bodies, and (3) ‘Clinical Psychologists’ Skills and Relevance’ describing the skills clinical psychologists have to prevent homelessness in the profession before considering reasons why it may not be appropriate for clinical psychologists to intervene in this social issue. Conclusion: This study reviewed the role of clinical psychology in the prevention of homelessness from the perspective of clinical psychologists working in adult mental health services. Clinical psychologists can intervene at an individual, service and political level to prevent homelessness. The profession is encouraged to work at all levels to address the distress caused by social issues that perpetuate homelessness

The mechanisms of psychological therapy with people with long-term physical health conditions

This thesis comprises a literature review, a research paper and a critical appraisal of the research process. Qualitative literature was systematically reviewed using a meta-ethnography, with the aim of understanding how people with long-term physical health conditions (LTCs) experience psychological therapies. Thirteen articles were identified. Six themes emerged from the synthesis: i) ‘therapists’ expertise and empathic approach led to positive relationships’; ii) ‘therapy was a safe and neutral space’; iii) ‘therapy prompted change in LTC management’; iv) ‘psychological awareness reduced isolation and increased control’; v) how physical ill health interacts with being able to participate in therapy’; and vi) ‘time-limited therapy did not always match service users’ illness trajectory’. The findings were discussed in relation to the values of psychological therapy for people with LTCs and the current way services are delivered to people experiencing co-morbid mental health difficulties. The research paper comprised a qualitative study using a Discursive Action Model approach, which aimed to develop an understanding of how practitioners and service users construct resources and preferred futures within solution-focused therapy sessions. Eight participant dyads were recruited, formed by pairs of practitioners and service users. Data were collected via audio recordings. Four discourses were highlighted: i) ‘practitioners' use of assumptions drew out resources’; ii) ‘explicit commentaries construct change’; iii) ‘de-contextualising for goal construction’; and iv) ‘removing the blame, effort and failure’. The results highlighted the discursive mechanisms which enabled construction of resources and goals. The trans-theoretical applicability of the discourses, clinical implications and recommendations for future research were discussed. The critical appraisal discusses the importance of discourse in clinical psychology practice. The drivers behind conducting this thesis, strengths and weaknesses of the study, and lastly reflections on future practice in clinical psychology were offered

Advances in Bioengineering

The technological approach and the high level of innovation make bioengineering extremely dynamic and this forces researchers to continuous updating. It involves the publication of the results of the latest scientific research. This book covers a wide range of aspects and issues related to advances in bioengineering research with a particular focus on innovative technologies and applications. The book consists of 13 scientific contributions divided in four sections: Materials Science; Biosensors. Electronics and Telemetry; Light Therapy; Computing and Analysis Techniques

Unilever and economic power : a study of the market for margarine in the United Kingdom

This analysis of the margarine industry in the presence of Unilever, identifies and examines the economic issues of structure, behaviour and performance, against a background of policy issues related to international trade, concentration and nutrition. The major divisions of the thesis are (i) the political and international trade issues (ii) propaganda and advertising (iii) the nutrition problem (iv) margarine demand (v) the degree of monopoly in the margarine industry (vi) Government White Papers and multinational corporate activity.' An attempt is made, both by descriptive and empirical treatment of the subject matter, to demonstrate the danger inherent in the oligopolistic manipulation of consumer demand and public opinion by propaganda and advertising, and to consider the evidence of resource wasteage. Empirical work, mainly be using techniques of multivariate regression analysis, tests issues in the nutrition problem and also estimates aggregate demand functions for margarine as well as estimating the change in performance due to changing structure and performance. Attention is also paid to the influence of oligopolistic price adjustment in the macroeconomic problem of inflation. The main thrust lies in the direction of considering adjustment problems in time series data. In demand estimation it is shown by allowing for quality variation and by allowing the influence of advertising to build up over time, that whilst aggregate demand for margarine appears to remain uninfluenced by advertising expenditure, substantially higher values are obtained than are usual for own price elasticity. In relation to the performance issue, the results indicate a more rapid adjustment to changes in the aggregate advertising variable than are usually obtained. Results are also reported which suggest that price adjustment to cost changes are rapid, and this is attributed to the structure of margarine production. Apart from technical issues the main conclusions are that the nutrition controversy is being influenced unduly by propaganda and that independently of this, resource wasteage by the margarine oligopoly would be reduced by an increase in competition, and by the control of advertising. Again it is suggested gains, in relation to the problem of UK self sufficiency and in relation to the problem of inflation, could be expected following an increase in competition. The benefits of the control of costs as well as prices are considered as an alternative policy measure

Understanding Political Priority Development for Public Health Issues in Turkey: Lessons from Tobacco Control & Road Safety

Background: In the last decade, tobacco control received political priority in Turkey while road safety did not despite the large health and economic burden road traffic injuries posed on the Turkish population. Political priority relates to the agenda-setting phase of the policy process and has been widely acknowledged as an important facilitating factor in the attainment of public health goals. Unfortunately, however, few studies currently exist to help us understand how it develops for public health issues in countries like Turkey. Objective: Using a framework adapted from John Kingdon’s Multiple Streams Theory, the primary objective of this study was to compare tobacco control with road safety for the purpose of assessing how political priority for public health issues develop in Turkey. Method: A comparative mixed-methods case study design was used. Qualitative data were gathered from key informant interviews (N=42), and documents (N=307) and quantitative data were collected from online self-administered surveys (N=153). For each case, qualitative data were analyzed using deductive and inductive coding and quantitative data were analyzed using descriptive statistics and nonparametric tests. All results were triangulated. Finally, cross-case analysis was employed such that the themes from the two cases could be compared. Results: Political priority emerged for tobacco control as a result of the development and convergence of four streams – problem, policy, political, and global – while a policy window was opened. Although the full development of all streams was found to be crucial, the transformation of the political stream appeared to be most significant. These streams were found to overlap at different points in time and influenced by an integrated group of diverse actors. Without all of these events and actors in place at the same time, the study showed that a public health problem is not likely to reach political priority in Turkey as seen in the case of road safety where only two of the four streams were developed, a policy window never opened, and many key actors were absent. Conclusion: The revised framework generated from this study could potentially help actors promoting public health issues in Turkey or other similar contexts

A study of the impact of substituting Warfarin with Direct Oral Anticoagulants (DOAC), in Atrial Fibrillation (AF) patients over 65 years old: The Patients’ and Clinicians’ Perspectives.

The need for this research was identified during the researcher’s daily practice in her Haematology clinic in London. The clinic specialises in anticoagulated patients, particularly those with the condition of Atrial Fibrillation. The researcher noted that while extensive research had been undertaken into the medical issues associated with the established oral anticoagulant Warfarin, the newer medication referred to as Direct Oral Anticoagulants (DOACs) was less broadly studied. Importantly, little was known about how patients coped on a daily basis with this new treatment. Furthermore, the practical and social impact of a switch from Warfarin to a DOAC for clinical reasons had rarely been studied from the patient’s perspective. An inductive, mixed-method research study was set up comprising two questionnaires and individual interviews. A sample of 56 patients, aged 65ys and over, grouped by age and sex, were selected from the clinic. The first questionnaire was a Perceived Stress Scale (PSS), which explored the participants’ levels of stress at three time points: the switch over, then at 30 and 90 days. Concurrently a Medical Outcome Study (SF-36), a health survey was administered. Twenty of these patients were also interviewed by the researcher on two occasions, at the switch over then at 90 days. Thematic analysis was undertaken on the transcripts to identify themes across the patients’ responses. The findings showed that the switch to a DOAC had a positive impact on most of the respondents. They felt liberated from several of the constraints of taking Warfarin, for example, of not needing regular clinical monitoring so being able to travel further and more often, and eating a wider, healthier diet. The patients also reported feeling less stressed in general at the 30 day point, this was sustained over the remainder of the study period. There were some small differences between the ages, the older patients reported fewer benefits from the switch, although remaining positive about the experience. No significant difference was noted between the sexes. Patients highlighted the importance of personal resilience throughout, but that good GP support was also crucial in their continued wellbeing

Doctor of Philosophy

dissertationPhysicians are routinely exposed to dying patients and death, although some encounters are emotionally and existentially problematic, creating problems on two levels. Individuals are taught through medicine's hidden curriculum to detach from patients at the end-of-life, which can conflict with their personal values and result in moral distress. Institutionally, medical discourse does not officially encompass personal reflective writing, although it has been cited as potential remediation. This study uses discourse analysis, narrative discourse analysis, and rhetorical genre theory to critically investigate 126 physicians' personal articles recounting experiences from their postgraduate training with dying patients, which have been published in 14 general medical journals over 47 years. Findings disclose six rich discoursal features that distinguish physicians' personal discourse as rhetorical: repetition, metadiscourse, emotive language, euphemisms, metaphors, and narrative. Analysis of narrative, the dominant feature, reveals that physician authors consistently use personal writing to resist the hidden curriculum. Recurring themes--challenges to medical enculturation, counter-cultural medical practices at the end of life, and reincorporation of humanistic values--represent genre knowledge critical to an ethical practice of medicine. Therefore, physicians' personal discourse warrants rhetorical recognition as another genre of medical discourse, which I provisionally call perspective writing. Texts that focus on dying and death constitute the subgenre necrography. Findings from analysis of necrography using a combined method of material rhetoric, critical rhetoric, and phenomenology further reveal that narrative enables physician-authors to relate to the corpse in terms of kairos. They reconceptualize death as a critical time in which they can reconnect to the human body of the dead person and to their own mortality, humanizing the patient and themselves. I propose this representation of the corpse as the kairotic body, a theoretical model that expands upon other theories of the power of the unruly body. Rhetorical recognition of the genre of perspective writing, and by extension necrography, would substantiate the value of an existing body of medical writing as a significant and beneficial corrective to moral distress. Necrography especially provides new, crucial perspectives on dying that may contribute to the demedicalization of death in the medical profession and ultimately, in American society-at-large

Health literacy: Patients' texts, context and mediation

Health literacy encompasses people’s knowledge, motivation and competences to access, understand, appraise and apply health information to make judgments and take decisions in every-day life concerning health care, disease prevention and health promotion (Kickbusch et al., 2013). Research in health literacy has grown in prominence as a separate entity over the last twenty years, partly in response to the growth of chronic disease requiring greater patient self-management. Research has found significant relationships between reading comprehension levels and different health outcomes and health behaviours, with reading comprehension being used as a way to measure health literacy despite its accepted definition being much broader. However, there has been little research which takes a social practices perspective on health literacy. In this thesis, health literacy is viewed from a social practices perspective. Literacy events in this research have been predicated on the existence of written texts as part of a patient’s journey using health related texts, resources and services. The thesis explores how people go about accessing, understanding, appraising and using health-related services and information, and the social and cultural practices inherent in those activities. It asks how much written patient text is used with patients in hospital; who is using it; what the discourse features of those texts are; and how patients respond to the texts. This mode of exploration is called textual ethnography (Swales, 1998). The research takes an ethnographic perspective not only on text, but also on participants and their journey. It shadows eleven patients through a cardiology service of a hospital in New Zealand. It identifies literacy events and practices occurring in that space and examines the patient texts themselves using a discourse analysis (Bax 2011; Faircough, 2003; Clerehan, Hirsh, & Buchbinder, 2009; Franken & Hunter, 2011) and geosemiotic (Scollon & Scollon, 2003) approach. The key themes to emerge from the research centre around the complexity of access to patient information, both physically and linguistically, and around the dynamics of patient agency. The ability to encode and decode written text played a minor part in patient access to information. The analysis showed that the amount and types of text material present for patients in hospital were limited. Access to key texts required a deliberate decision by a health professional to dispense the text items. Mediation of text in the research by literacy sponsors supported Brandt and Clinton’s (2002) observation that “access to literacy has always required assistance, permission, sanction, or coercion by more powerful others or, at least, contact with existing ‘grooves’ of communication” (p. 349). Patient agency therefore came to the fore, and practices that patients did actually use to make information personal to them such as talking with room mates, or requesting paper and pencil were dynamic and socially mediated. Implications lie in the way health literacy is conceptualised, moving the focus from individual abilities as portrayed in current health literacy definitions, and pointing to the wider role of the health organisation and health care practitioners as literacy sponsors. Practice implications arising from this reconceptualisation relate to patient information strategies within health care organisations and pedagogical implications for health professionals and adult literacy educators. The notions of text mediation and full contextualisation of learning also became apparent with evidence pointing to the effectiveness of text mediation by a more knowing other. The hospital itself was found to be a potentially rich and meaningful setting for adult learning about health where full contextualisation of adult learning is possible. These patient learning opportunities need to be further exploited by health organisations and professionals

Authenicated action and the decision to stop smoking.

In this rational reconstruction, two rival research programmes are identified as dominating the Social Psychology of decision making. Behavioral Decision Theory and the Theory of Reasoned Action embody the Rationalist programme. Social Judgment Theory and Attributional Theory exemplify the Empiricist programme. As predicted by the Methodology of Scientific Research Programmes (MSRP), the negative heuristics are shown to condense as hard cores which remain protected from refutation. The historical reconstruction of Social Judgment Theory illustrates uneven development in algorithmic and propositional heuristics. Behavioral Decision Theory shows a progressive problem shift to Multi Attribute Utility Theory (MAUT). In a revision of MSRP to include practice shifts, the Theory of Reasoned Action illustrates progressive practice despite empirical anomalies. Attributional theory shows a progressive problem shift by predicting personal-efficacy to influence choice. Practice, however, is restrained through reliance on the ANOVA paradigm. The experimental study partitioned locus and stability attributes for subjects' choice of therapy programmes in an anti-smoking clinic. A significant main effect was found for stability expectancy, though this did not influence choice. The Lens Model algorithm was demonstrated to transpose successfully onto the Self-efficacy model with the intra-system capturing decisions combining the two forms of efficacy expectation. The Theory of Reasoned Action was augmented by transfer of MAUT techniques giving relative weighting to salience. Though Rationalist and Empiricist paradigms illuminate some aspects of stopping smoking, neither adequately addresses the decision-action gap perceived by smokers who disown their original intentions when the the correspondence is seen as inauthentic. An alternative model is proposed with a basis in Objectivist epistemology. Authenticated action is explained as a means of arriving at decisions through consideration of problem and practice shifts at the individual level