Accessing Socially Excluded People — Trust and the Gatekeeper in the Researcher-Participant Relationship

This paper describes methodological findings from research to recruit and research hard-to-reach socially excluded people. We review the ways in which researchers have used particular strategies to access hard-to-reach individuals and groups and note that little attention has been given to understanding the implications of the nature of the trust relationship between researcher and participant. Gatekeepers invariably play a role in accessing socially excluded people in research, yet discussion to date invariably focuses on the instrumental role gatekeepers play in facilitating researchers\' access. In this paper we explore the possibilities for analysing relationships in terms of trust and distrust between gatekeeper and socially excluded participant. Our analysis considers the different kinds of relationships that exist between gatekeepers and socially excluded people and, in particular, the relationships of power between gatekeepers and socially excluded people. Insights into the nature of trust among socially excluded people will also be considered. Finally, we discuss how size and use of social networks among socially excluded groups and perceptions of risk in interactions with gatekeepers are important to understanding the possibilities for trustful relationships, and for meaningful and successful access for researchers to socially excluded individuals and groups.Social Exclusion, Access, Research, Gatekeepers, Trust, Distrust, Risk

Time for TIF? The prospects for the introduction of Tax Increment Financing in the UK from a local authority perspective

In September 2010, following an endorsement by Deputy Prime Minister Nick Clegg at the Liberal Democrat Party Conference, HM Treasury released a press statement confirming that TIF would be introduced in the UK.1 It stated that Treasury and local authorities would work together in order to design a framework of rules within which TIF would operate. This research investigates what this framework of rules may comprise and how it may operate in the UK. There is surprising neglect, in literature on TIF, of what local authorities think about it and its potential to facilitate regeneration projects. A survey of 200 local authorities in the UK was conducted, complemented by interviews with local authority officers in Scotland, where pilot TIF projects are already under way. The research focuses in particular on the approval process necessary to ensure viable TIF schemes are identified and progressed, how these schemes are managed and financed, and what the main risks are for local authorities. Of primary concern to LA officers is the financial viability of a project, followed by its long-term commercial viability, overall cost, value for money and impact on surrounding areas. The main risks are identified as being that: the uplift in business rates is insufficient to cover the cost of the loan; TIF does not work in areas of greatest need; private sector investment fails to materialise; and displacement is generated. The paper concludes that such risks may be mitigated by adopting a rigorous appraisal process and robust management structure, and predicts that a two-tier TIF approval process, with similarities to that employed by the Scottish TIF pilots, may emerge

Enhancing the tax system to halt the decline of nature in New Zealand

New Zealand is world-renowned for its nature – its lush forests, spectacular mountain landscapes, wild and scenic rivers, beautiful coastlines and extraordinary biodiversity.  This natural heritage is the foundation of New Zealand’s identity and its branding, and the premier attraction for the tourism industry. It provides habitable environments, contributes to economic production and assimilates wastes, and is an important source of great enjoyment, health and well-being (Roberts et al., 2015). Nature contributes to the success of the nation’s fishing, farming, forestry and tourism industries, which provide about 52% of national export income (Ministry of Business, Innovation and Employment, 2013). But these values and the well-being and prosperity they enable are being diminished and degraded  at an alarming rate.&nbsp

Flowstream Architectures

The Internet has seen a proliferation of specialized middlebox devices that carry out crucial network functionality such as load balancing, packet inspection or intrusion detection, amongst others. Traditionally, high performance network devices have been built on custom multi-core, specialized memory hierarchies, architectures which are well suited to packet processing. Recently, commodity PC hardware has experienced a move to multiple multi-core chips, as well as the routine inclusion of multiple memory hierarchies in the so-called NUMA architectures. While a PC architecture is obviously not specifically targeted to network applications, it nevertheless provides high performance cheaply. Furthermore, a few commodity switch technologies have recently emerged offering the possibility to control the switching of flows in a rather fine grained manner. Put together, these new technologies offer a new network commodity platform enabling new flow processing and forwarding at an unprecedented flexibility and low cost

Implementing Network Virtualization for a Future Internet

Abstract — The Internet has become an essential communication medium upon which billions of people rely every day. However, necessary evolution of the Internet has been severely limited by reliability constrains and social-economic factors. Experts fear that current growth rates will threaten the future of the Internet as a whole, despite the fact that new core technologies already exist. Network virtualization presents a promising approach to overcome ossification and facilitate service deployment for a future Internet. Exploring this approach, we present a prototype implementation which realizes a subset of the 4WARD virtual network (VNet) architecture, allowing multiple VNets to coexist on top of a shared physical infrastructure. We discuss the functionality of our prototype and demonstrate experimental results to assess its performance. I

Patients report improvements in continuity of care when quality of life assessments are used routinely in oncology practice: Secondary outcomes of a randomised controlled trial.

INTRODUCTION AND AIM: In a randomised trial investigating the effects of regular use of health-related quality of life (HRQOL) in oncology practice, we previously reported an improvement in communication (objective analysis of recorded encounters) and patient well-being. The secondary aims of the trial were to measure any impact on patient satisfaction and patients' perspectives on continuity and coordination of their care. METHODS: In a prospective trial involving 28 oncologists, 286 cancer patients were randomised to: (1) intervention arm: regular touch-screen completion of HRQOL with feedback to physicians; (2) attention-control arm: completion of HRQOL without feedback; and (3) control arm: no HRQOL assessment. Secondary outcomes were patients' experience of continuity of care (Medical Care Questionnaire, MCQ) including 'Communication', 'Coordination' and 'Preferences to see usual doctor' subscales, patients' satisfaction, and patients' and physicians' evaluation of the intervention. Analysis employed mixed-effects modelling, multiple regression and descriptive statistics. RESULTS: Patients in the intervention arm rated their continuity of care as better than the control group for 'Communication' subscale (p=0.03). No significant effects were found for 'Coordination' or 'Preferences to see usual doctor'. Patients' evaluation of the intervention was positive. More patients in the intervention group rated the HRQOL assessment as useful compared to the attention-control group (86% versus 29%), and reported their doctors considered daily activities, emotions and quality of life. CONCLUSION: Regular use of HRQOL measures in oncology practice brought changes to doctor-patient communication of sufficient magnitude and importance to be reported by patients. HRQOL data may improve care through facilitating rapport and building inter-personal relationships

Financial incentives for large-scale wetland restoration: beyond markets to common asset trusts

Wetlands provide $47.4 trillion/year worth of ecosystem services globally and support immense biodiversity, yet face widespread drainage and pollution, and large-scale wetlands restoration is urgently needed. Payment for ecosystem service (PES) schemes provide a viable avenue for funding large-scale wetland restoration. However, schemes around the globe differ substantially in their goals, structure, challenges, and effectiveness in supporting large-scale wetland restoration. Here, we suggest wetland-based PES schemes use common asset trusts (CATs) to build investment portfolios of wetlands across landscapes that sustain and enhance overall provision of multiple ecosystem services. CATs can meet the needs of multiple investors, permit bundled payments, and provide flexibility to invest in the restoration of numerous services/values, all using a coordinated, highly collaborative, prioritized, and transparent process. CATs would support financial viability, facilitate efficiency to reduce administrative burdens, and enable credibility and social licence building to restore wetland values and services globally

Can-Pain-a digital intervention to optimise cancer pain control in the community : development and feasibility testing

Purpose: To develop a novel digital intervention to optimise cancer pain control in the community. This paper describes intervention development, content/rationale and initial feasibility testing. Methods: Determinants of suboptimal cancer pain management were characterised through two systematic reviews; patient, caregiver and healthcare professional (HCP) interviews (n = 39); and two HCP focus groups (n = 12). Intervention mapping was used to translate results into theory-based content, creating the app “Can-Pain”. Patients with/without a linked caregiver, their general practitioners and community palliative care nurses were recruited to feasibility test Can-Pain over 4 weeks. Results: Patients on strong opioids described challenges balancing pain levels with opioid intake, side effects and activities and communicating about pain management problems with HCPs. Can-Pain addresses these challenges through educational resources, contemporaneous short-acting opioid tracking and weekly patient-reported outcome monitoring. Novel aspects of Can-Pain include the use of contemporaneous breakthrough analgesic reports as a surrogate measure of pain control and measuring the level at which pain becomes bothersome to the individual. Patients were unwell due to advanced cancer, making recruitment to feasibility testing difficult. Two patients and one caregiver used Can-Pain for 4 weeks, sharing weekly reports with four HCPs. Can-Pain highlighted unrecognised problems, promoted shared understanding about symptoms between patients and HCPs and supported shared decision-making. Conclusions: Preliminary testing suggests that Can-Pain is feasible and could promote patient-centred pain management. We will conduct further small-scale evaluations to inform a future randomised, stepped-wedge trial