Green Care: a Conceptual Framework. A Report of the Working Group on the Health Benefits of Green Care

‘Green Care’ is a range of activities that promotes physical and mental health and well-being through contact with nature. It utilises farms, gardens and other outdoor spaces as a therapeutic intervention for vulnerable adults and children. Green care includes care farming, therapeutic horticulture, animal assisted therapy and other nature-based approaches. These are now the subject of investigation by researchers from many different countries across the world

Nature-based supportive care opportunities: A conceptual framework

Objective: Given preliminary evidence for positive health outcomes related to contact with nature for cancer populations, research is warranted to ascertain possible strategies for incorporating nature-based care opportunities into oncology contexts as additional strategies for addressing multidimensional aspects of cancer patients’ health and recovery needs. The objective of this study was to consolidate existing research related to nature-based supportive care opportunities and generate a conceptual framework for discerning relevant applications in the supportive care setting. Methods: Drawing on research investigating nature-based engagement in oncology contexts, a two-step analytic process was used to construct a conceptual framework for guiding nature-based supportive care design and future research. Concept analysis methodology generated new representations of understanding by extracting and synthesising salient concepts. Newly formulated concepts were transposed to findings from related research about patient-reported and healthcare expert-developed recommendations for nature-based supportive care in oncology. Results: Five theoretical concepts (themes) were formulated describing patients’ reasons for engaging with nature and the underlying needs these interactions address. These included: connecting with what is genuinely valued, distancing from the cancer experience, meaning-making and reframing the cancer experience, finding comfort and safety, and vital nurturance. Eight shared patient and expert recommendations were compiled, which address the identified needs through nature-based initiatives. Eleven additional patient-reported recommendations attend to beneficial and adverse experiential qualities of patients’ nature-based engagement and complete the framework. Conclusions: The framework outlines salient findings about helpful nature-based supportive care opportunities for ready access by healthcare practitioners, designers, researchers and patients themselves

Aerospace Medicine and Biology: A continuing bibliography with indexes (supplement 314)

This bibliography lists 139 reports, articles, and other documents introduced into the NASA scientific and technical information system in August, 1988

Understanding the adaptive capacity of Australian small-to-medium enterprises to climate change and variability

Abstract Small-to-medium enterprises (SMEs) comprise 96 per cent of all private businesses in Australia. The SME sector is the economy’s largest employer and the largest contributor to GDP. Moreover, SMEs play a significant role within socio-economic systems: they provide employment, goods and services and tax revenue for communities. Climate change may result in adverse business outcomes including business interruptions, increased investment and insurance costs, and declines in financial indicators such as measures of value, return and growth. After natural disasters, SMEs face greater short-term losses than larger enterprises, and may have lower adaptive capacity for various reasons. This study examines the underlying factors and processes shaping adaptive capacity of Australian SMEs’ to climate change and associated sea level rise. Specifically, the research asks the following questions: 1) How have SMEs considered and integrated adaptation into business planning? 2) What are the key underlying processes that constrain and influence the adaptive capacities of SMEs? and 3) What types of support are required to promote SME business continuity under a changing climate? The study adopts theories from Political Ecology and draws on literature on vulnerability and hazards to understand the processes that mediate the adaptive capacity of SMEs. The empirical research involved an online survey targeting SMEs, attending business engagement events hosted by chambers of commerce, 30 semi-structured interviews with secondary stakeholders, five case studies involving SMEs and secondary stakeholders, and finally a stakeholder workshop which brought together participants from both groups. The central conclusion of this study is that underlying contextual processes are critical to enhancing the adaptive capacity of SMEs. These processes include: the social relationships between SMEs and support organisations; the relationships within support organisations themselves; the agency of SMEs to direct resources toward building resilience into business continuity; SMEs’ perceptions of climate risks; and power struggles between support organisations. Unfavourable combinations of these processes have the potential to limit the adaptive choices that SMEs can adopt in order to overcome climate change and other related stresses on business continuity. These processes generate vulnerability and often occur at scales external to the SMEs;including relationships between different tiers of government as well as between various support organisations working with SMEs. These contextual processes have been largely overlooked in formal programmes that aim to build business resilience. The programmes have tended to be reactive and have tended to focus on business recovery during and after disasters rather than on altering the vulnerability context of SMEs through anticipatory prevention and preparedness or adaptation planning. This study suggests that the success of efforts to build the adaptive capacity of SMEs to future climate and related stresses will depend on how they address these underlying processes to facilitate the ability of SMEs to exercise their agency in pursuing adaptive choices that they value

Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197

Developing and implementing an integrated delirium prevention system of care:a theory driven, participatory research study

Background: Delirium is a common complication for older people in hospital. Evidence suggests that delirium incidence in hospital may be reduced by about a third through a multi-component intervention targeted at known modifiable risk factors. We describe the research design and conceptual framework underpinning it that informed the development of a novel delirium prevention system of care for acute hospital wards. Particular focus of the study was on developing an implementation process aimed at embedding practice change within routine care delivery. Methods: We adopted a participatory action research approach involving staff, volunteers, and patient and carer representatives in three northern NHS Trusts in England. We employed Normalization Process Theory to explore knowledge and ward practices on delirium and delirium prevention. We established a Development Team in each Trust comprising senior and frontline staff from selected wards, and others with a potential role or interest in delirium prevention. Data collection included facilitated workshops, relevant documents/records, qualitative one-to-one interviews and focus groups with multiple stakeholders and observation of ward practices. We used grounded theory strategies in analysing and synthesising data. Results: Awareness of delirium was variable among staff with no attention on delirium prevention at any level; delirium prevention was typically neither understood nor perceived as meaningful. The busy, chaotic and challenging ward life rhythm focused primarily on diagnostics, clinical observations and treatment. Ward practices pertinent to delirium prevention were undertaken inconsistently. Staff welcomed the possibility of volunteers being engaged in delirium prevention work, but existing systems for volunteer support were viewed as a barrier. Our evolving conception of an integrated model of delirium prevention presented major implementation challenges flowing from minimal understanding of delirium prevention and securing engagement of volunteers alongside practice change. The resulting Prevention of Delirium (POD) Programme combines a multi-component delirium prevention and implementation process, incorporating systems and mechanisms to introduce and embed delirium prevention into routine ward practices. Conclusions: Although our substantive interest was in delirium prevention, the conceptual and methodological strategies pursued have implications for implementing and sustaining practice and service improvements more broadly

Model-Based Mitigation of Availability Risks

The assessment and mitigation of risks related to the availability of the IT infrastructure is becoming increasingly important in modern organizations. Unfortunately, present standards for Risk Assessment and Mitigation show limitations when evaluating and mitigating availability risks. This is due to the fact that they do not fully consider the dependencies between the constituents of an IT infrastructure that are paramount in large enterprises. These dependencies make the technical problem of assessing availability issues very challenging. In this paper we define a method and a tool for carrying out a Risk Mitigation activity which allows to assess the global impact of a set of risks and to choose the best set of countermeasures to cope with them. To this end, the presence of a tool is necessary due to the high complexity of the assessment problem. Our approach can be integrated in present Risk Management methodologies (e.g. COBIT) to provide a more precise Risk Mitigation activity. We substantiate the viability of this approach by showing that most of the input required by the tool is available as part of a standard business continuity plan, and/or by performing a common tool-assisted Risk Management

Oocyte cryopreservation as an adjunct to the assisted reproductive technologies

The document attached has been archived with permission from the editor of the Medical Journal of Australia. An external link to the publisher’s copy is included. See page 2 of PDF for this item.Keith L Harrison, Michelle T Lane, Jeremy C Osborn, Christine A Kirby, Regan Jeffrey, John H Esler and David Mollo

“It gave me something big in my life to wonder and think about which took over the space … and not MS”: Managing well-being in multiple sclerosis through art-making

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2014 Informa UK Ltd.Background and aim: Individuals living with Multiple Sclerosis (MS) often face progressive loss of function, uncertainty and disruption to self-image and valued roles. Previous studies show that creative self-expression is valued by some people living with long-term illness, yet its meaning for people living with MS is unclear. This research study explored the meanings of leisure-based visual art-making for people living with MS. Method: This qualitative study followed guidelines for Interpretative Phenomenological Analysis (IPA). Single semi-structured interviews were conducted with five adults (2 males; 3 females; 40–65 years), recruited from MS Ireland. Findings: Participants valued art-making for contributing to a more satisfying way of life; for filling occupational voids and using time well. Deep immersion offered respite from worry about illness. Creative classes offered social camaraderie and opportunities for learning and development. Art-making processes and products were highly affirmative, increasing emotional well-being and promoting self-worth. Most felt that they expressed valued aspects of self through their art. Art-making appeared to assist with identity maintenance, accommodating functional losses associated with MS whilst opening “new doors”. Conclusion: Art-making offered a multi-faceted means of supporting identity and increasing fulfilment in lives that were restricted in many ways by MS