336 research outputs found

    Assessment and decision making in beta

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    How sharing can contribute to more sustainable cities

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    \ua9 2017 by the authors. Recently, much of the literature on sharing in cities has focused on the sharing economy, in which people use online platforms to share underutilized assets in the marketplace. This view of sharing is too narrow for cities, as it neglects the myriad of ways, reasons, and scales in which citizens share in urban environments. Research presented here by the Liveable Cities team in the form of participant workshops in Lancaster and Birmingham, UK, suggests that a broader approach to understanding sharing in cities is essential. The research also highlighted tools and methods that may be used to help to identify sharing in communities. The paper ends with advice to city stakeholders, such as policymakers, urban planners, and urban designers, who are considering how to enhance sustainability in cities through sharing

    Reform of nursing education in Hong Kong : a study of nurse leadership and policy development

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    Nursing education in Hong Kong has undergone major reform in recent year similar to that in some Western countries, involving the introduction of degree level preparation. This reform occurred just before Hong Kong was returned to the sovereignty of China. While a combination of complex factors contributed to the reform, the role of nurse leaders was instrumental in influencing policy development. This study investigated the role of nurse leaders in this reform and the factors influencing their effectiveness. A case study approach was used with multiple data collection methods that included a documentary search of report newspapers, newsletters and journal articles; semi-structured interviews (n=26) nurse leaders and policy makers; and a questionnaire survey of nurses from fh regional hospitals in Hong Kong (n=678). The period studied extended from the first proposal for a nursing degree programme in 1985, to 1995 when 180 nursing degree places were secured. An integrated leadership model is derived from this study that contains dimensions that influence leadership effectiveness: situational variables, leader power base, leaders' attributes and style, and leaders' reciprocal relationships with followers. Data analysis indicated that nursing education reform could be conceptualised as an evolution process. Nurse leaders' roles focused on the acquisition of power which involved: establishing goals, communicating directions, increasing power through unity, increasing power through influences empowering followers and preparing self. Situational variables that impacted on leadership effectiveness were categorised as inertia and facilitation. Though the findings indicated that nurse leaders had the ability to influence nursing education reform to some extent, the questionnaire survey suggested that frontline nurse did not regard nurse leaders as having good leadership skills. Their evaluation of nurse leaders' effectiveness was generally negative. Furthermore, a lack of experience in the political arena and lack of unity within nursing further weakened nurse leaders' power. Nurse leaders' potential had not been maximised This study expands the knowledge on leadership by providing a multidimensional framework to comprehend or predict leadership behaviour. The findings also highlight the problems associated with nursing leadership development in Hong Kong and suggest the importance of education, positive socialisation professionalisation and power base in promoting nursing leadership development Further studies, using a prospective design, of nurse leadership in other areas are needed to test the generalisability of these findings

    Access, agency, assimilation: exploring literacy among adult Gypsies and travellers in three authorities in Southern England

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    This thesis explored Gypsies’ and Travellers’ perceptions of the value and importance of literacy to themselves and their communities. It examined the political and social factors that affected the extent and availability of literacy provision for adult Gypsies and Travellers and their level of participation. It focused on how Gypsies’ and Travellers’ levels of literacy impacted on their ability to engage effectively with authority. The research focused on two rural and one urban authority in the South of England but also drew on information from neighbouring authorities and Ireland. A qualitative constructivist epistemology was adopted in which ethnography was the main research tool. The data were collected through in-depth interviews and informal conversations with Gypsies and Travellers, public officials and local politicians, a survey of adult education providers, observation of sundry national and local meetings, participant observation and analysis of the discourse and dialogue of two official forums and data from a variety of sources including television programmes and press reports. The research found that Gypsies and Travellers attached little value to textual literacy, did not view literacy as important to economic success and did not perceive the ability to read and write as contributing to their status or self esteem. Other skills were valued more highly. These attitudes challenge dominant education and development discourses which perceive textual literacy as essential to economic achievement, self esteem and status. The research also highlighted a vacuum in literacy and education policy and provision for adult Gypsies and Travellers who were largely invisible in post-school policy documents, even in those purporting to address equality issues. There was no targeted provision in the three authorities, only a few short term projects elsewhere and little interest among providers. Although mainstream provision was available to Gypsy and Travellers as to all adults, those who wished to learn preferred to teach themselves or be taught by friends and family. The research drew on current theories of discourse, power and control. Primary and secondary Discourses impacted on two areas, the absence of educational opportunities for adult Gypsies and Travellers and on their communicative practices and agency. The lack of targeted literacy provision for Gypsies and Travellers was not accidental but a result of deep seated negative attitudes constructed and maintained through the secondary Discourses of dominant groups and bureaucratic institutions. Interviews and observations revealed that language and discourse was more important to Gypsies and Travellers than the ability to read and write, particularly when communicating privately or publicly with authorities. In these contexts, their own primary discourses, learned through home and community practices, were insufficient. The Gypsies and Travellers who were formally educated and were bi-discoursal were able to operate within secondary institutional Discourses. Though others had life experiences which gave them some understanding of the Discourses of power and bureaucracy, they were not able to communicate or challenge as effectively. The research critiques current models of literacy provision for adults. Though aspects of the models can address specific literacy requirements in specific situations, none of the models including New Literacy Studies and critical literacies, sufficiently address the need to become bi-discoursal or develop the agency to affect decisions controlling their lives. Gypsies and Travellers fear formal education will lead to loss of identity, acculturation and assimilation, but without it they may lose what they seek to preserve. Different communities have different aspirations and face different tensions in different circumstances and each will make decisions accordingly. This research on Gypsies’ and Travellers’ perceptions and uses of literacy provides new insights into complex tensions and contradictions at both an empirical and theoretical level

    Homelessness and leaving care: The experiences of young adults in Queensland and Victoria, and implications for practice

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    This research first asks ‘What happens when young people leave state care?’ in respect of Victoria and Queensland and second ‘What are the service support implications of this?’ A number of methods were used to explore these questions including semi-structured interviews with 27 young adults aged 19-23 years who had been homeless or at risk of homelessness, and focus groups with young people and service providers. This study provides support for the proposition that young people should be proactively and voluntarily involved in periodic monitoring of their lived experience post care and linkage of this monitoring to the activation of timely support. The great majority of young people involved in this study thought this was not only desirable but important. Whilst some young people will be in close contact with leaving care services many others will not. New research is recommended to develop a mentoring and support activation process using participatory monitoring and action research methods. This type of approach reflects the importance of utilising processes with young people in care and leaving care which acknowledge their personhood and capacity to contribute voluntarily to the processes which seek to support them

    The vice presidency of Richard M Nixon: One man\u27s quest for national respect, an international reputation, and the presidency

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    Richard M. Nixon served as Vice President under Dwight D. Eisenhower from 1953 to 1961. During this time, he worked to portray himself to the public as an international affairs expert and integral advisor within the Administration. Drawing on experiences as a Congressman and his close relationship with John Foster Dulles, Nixon made every effort to gain a meaningful advisory and decision-making role. His actual success was limited. The Vice President was motivated by his love of international affairs, desire for respect and vision of his position as a possible jump off point to the presidency in 1960. This last goal proved his most enduring accomplishment. Nixon improved public awareness of the vice presidency and added political overtones to the office that previously had not been evident

    A RURAL-URBAN COMPARISON OF SELF-MANAGEMENT IN PEOPLE AFFECTED BY CANCER FOLLOWING TREATMENT: A MIXED METHODS STUDY

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    Background: People affected by cancer have to self-manage the consequences of cancer long after primary treatment has ended. In cancer survivorship, self-management has been defined as awareness and active participation by the individual in their recovery, recuperation and rehabilitation to minimise the consequences of treatment, and promote survival, health and wellbeing (DH, Macmillan Cancer Support and NHS Improvement, 2010). Despite a significant drive towards promoting and supporting self-management with people affected by cancer there is a lack of research examining whether residence (rural-urban) has an influence on self-management following cancer treatment. The primary aim of this thesis was to investigate and compare self-management, in people affected by cancer following treatment from rural and urban areas. Methods: The study utilised a cross-sectional mixed methods design that incorporated both quantitative and qualitative methods of data collection. Firstly, this involved a self-completion postal questionnaire (N=227) that collected quantitative data on demographics, rural-urban residence, health status, health-promoting behaviours, patient activation, cancer-related self-efficacy and qualitative free-text information on self- management behaviours. This was followed by a series of in-depth qualitative interviews (N=34) that aimed to identify, and compare the barriers and facilitators to self-management in people affected by cancer from rural and urban settings in the East Midlands of England. Both datasets were integrated to further explain the quantitative differences that were identified between rural and urban participants. Results: Participants from rural areas reported higher scores across a range of quantitative variables, indicative of greater levels of engagement with health promoting behaviours and self-management compared to those from urban areas. Specifically, rural participants scored higher with regard to health responsibility (p<0.01; nutrition (p<0.001); spiritual growth (p<0.01); and interpersonal relationships (p<0.001). Rural respondents (63.31±13.66) had higher patient activation than those in urban areas (59.59±12.75) although this was not statistically significant at p<0.01. Those residing in rural areas (7.86±1.70) had significantly (p<0.01) greater cancer-related self-efficacy compared to those in urban areas (7.09±1.96). Rural respondents had significantly higher self-efficacy than urban respondents with regard to confidence to manage physical discomfort (p<0.01), emotional distress (p<0.001), and to contact their doctor about problems caused by cancer (p<0.01). The findings from the multivariate analysis highlighted that rural-urban residence was not a significant predictor of health-promoting behaviours, patient activation or cancer-related self-efficacy when adjusting for living arrangement, marital status, qualifications and self-reported health status. Self- reported health status proved to be a significant predictor on all three outcomes when controlling for confounders. Three themes were identified in the qualitative data which related to barriers that prevented participants from engaging with self-management: (1) Location (2) Relationship Based and (3) Personal. In relation to facilitators that enhanced participants’ active participation in their recovery, three subthemes were identified: (1) Effective Communication and Information; (2) Informal and Peer Support and (3) Motivation. The barriers and facilitators that were identified were prevalent in both the rural and urban setting. However, some aspects belonging to these barriers and facilitators were more explicit in the rural or urban environment. For example, there was a lack of bespoke support in rural areas and participants acknowledged how traveling long distances to urban centres for support groups was problematic. Motivation to engage with self-management was not unique and both sets of participants were motivated by a desire to be healthy and take part in group activities and sports. Although rural participants did have easier access to greenspaces and community activities, which could enhance motivation further. Conclusion: The quantitative findings highlighted that people in rural areas were more engaged with health-promoting behaviours and better at self-managing their health compared to those in urban areas. The majority of the barriers and facilitators that were identified were not necessarily unique to the urban or rural environment. Certainly, the qualitative data show that residency is not as unequivocal as the quantitative results would suggest. However, engagement with the local community was greater in rural areas which could account for the differences. Whilst the active treatment phase can present considerable challenges for people affected by cancer in rural areas the findings suggest that the rural environment has the potential to increase engagement with self-management in the transition to survivorship
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