Mapping the “housing with care” concept with stakeholders: insights from a UK case study

Purpose - The purpose of this paper is to present the findings of an early stage, exploratory case study of a proposed housing with care initiative (the Crichton Care Campus (CCC)). This sought the perspectives of a range of key stakeholders on the proposed model and how it might be best realised. The analyses of these findings show their relevance to debates on integrated housing with care, and reflect on the methodology used and its potential relevance to similar projects. Design/methodology/approach - The study used a transactive planning approach, where grounded views are sought from a variety of stakeholders. A purposive sample identified informants from relevant health, social care and housing organisations and nine semi-structured interviews were conducted. These were transcribed and data analysis was undertaken on an “interactive” basis, relating care theory to empirical expressions. Findings - The authors identify two contrasting orientations – inclusive “community-oriented” and professional “service-oriented”. This distinction provides the basis for a rudimentary conceptual map which can continue to be used in the planning process. Two significant variables within the conceptual map were the extent to which CCC should be intergenerational and as such, the degree to which care should come from formalised and self-care/informal sources. The potential to achieve an integrated approach was high with stakeholders across all sectors fully supporting the CCC concept and agreeing on the need for it to have a mixed tenure basis and include a range of non-care amenities. Originality/value- This paper offers originality in two respects. Methodologically, it describes an attempt to undertake early stage care planning using a needs led transactive methodology. In more practical terms, it also offers an innovative environment for considering any approach to care planning that actively seeks integration – based on an acknowledgement of complexity, a variety of perspectives and possible conflicts. The authors propose that the concepts of “community-orientation” and “service-orientation” are used as a helpful basis for planning negotiations, making implicit divergences explicit and thus better delineated

Narrative Dimensions of Transformative Learning

The concept of narrative is useful for theorizing transformative learning. Three characteristics are that it (a) moves from past to future, (b) spans the psychological, social, cultural, and historical dimensions in content and form, and (c) includes cognitive, affective, spiritual, and somatic dimensions. Narrative analysis of data suggests insights unavailable with other analytic approaches

Approche géomatique pour la classification des paysages et applicabilité des modèles de pertes de sols Bassin versant du Simeto, Sicile, Italie

En Sicile, la géologie, l'agressivité climatique et la pression anthropique rendent le milieu fragile aux actions de l'érosion hydrique. La télédétection et les systèmes d'informations géographiques (SIG) sont de plus en plus appréciés pour l'étude des phénomènes de surface. Des études antérieures ont porté sur l'intégration des paramètres commandant l'érosion des sols à l'aide d'un SIG et de la télédétection en utilisant un modèle empirique basé sur l'USLE. Toutefois, les échelles de perception du phénomène d'érosion (parcelle) et les échelles régionales de la télédétection sont très divergentes. Le choix d'une échelle d'espace entraîne généralement certaines contraintes d'utilisation qui ne sont pas toujours respectées. L'hétérogénéité spatiale affecte tous les paramètres des modèles de pertes de sols quand ils sont appliqués à de vastes étendues. Il est donc important d'inciter à la prudence vis-à-vis de la généralisation trop rapide des modèles de pertes de sols sur de grandes étendues. Pour être en mesure de spatialiser les pertes de sols à l'aide d'un modèle de pertes de sols à l'échelle d'un vaste bassin versant (plus de 1 000 km 2 ), il est avantageux de représenter la diversité spatiale du paysage en fonction des risques d'érosion en utilisant la cartographie écologique couplée aux SIG et à l'imagerie satellitaire."--Résumé abrégé par UMI

Waste Disposal at Whiting Farm: Recommendations for Current Waste Removal and Future Recycling Systems

The goal of this report is to provide Whiting Farm in Auburn, Maine with an analysis of options and resources that will help the farm to make informed decisions for the removal and disposal of both existing and future waste, with a specific focus on recycling. Whiting Farm has never had an on-site waste disposal system. As a result, they have accumulated large amounts of agricultural plastic, which is stored mostly outside in three forested areas around the farm. Dealing with this waste is key in implementing the farm’s goals of environmental and economic sustainability, as well as functioning as an educational model for youth and other farmers. In collaboration with Kim Finnerty, Whiting Farm’s Manager, we have created this resource to inform waste removal and the development of a recycling system in order to mitigate future waste buildup. We first compare different options, given commercial infrastructure, for both the removal and disposal of the existing waste. We considered factors such as cost, environmental effects, and feasibility. We conclude that working with Casella Waste Management will be instrumental towards achieving these goals given Casella’s convenience, dumpster rental and waste disposal rates, and recycling capacity. We also discuss options for generating income by selling the metal, large machinery, and cardboard, which have also accumulated on the farm. The information gathered in determining the best removal and disposal methods for existing waste informed our recommendations for a system to recycle future waste, both compostable and non-compostable. Given a lack of local commercial options and innovative technology in the field of agricultural recycling, recommendations for a future system were limited to suggestions regarding commercial partners, dumpster locations, and a list of Whiting Farm’s recyclable waste. Additionally, options are given for compostable waste recycling, keeping in mind the specific practices of Whiting Farm. Our report presents these practical recommendations in the main body, but much of this research was informed and influenced by additional information compiled in Appendices. Among topics considered are rationale for removal of existing waste, barriers to recycling agricultural waste, and case studies referring to other farms’ disposal practices. Additionally, contacts for waste removal and disposal, model farms, as well as academics in the field of agricultural recycling are provided for future reference. This report aims to provide helpful and succinct recommendations for the implementation of a waste disposal system that is in line with Whiting Farm’s practical needs, vision of environmental sustainability, and educational goals

The challenge of rescheduling nursing staff: Informing the development of a mathematical model decision tool

Executive Summary: This report presents the findings and recommendations from a preliminary investigation into how an NHS organisation manages sudden nursing staff shortfalls. Unexpected staff absences, which can occur on a daily basis, can impact on the optimum skill mix for safe effective care delivery. Ward managers would welcome methodological support for daily rescheduling staff (i.e., re-rostering) within electronic rostering system

The Application of Half-Life in Clinical Decision Making: Comparison of the Pharmacokinetics of Extended-Release Topiramate (USL255) and Immediate-Release Topiramate

Objective: For extended-release drugs with multi-compartment kinetics, such as topiramate, effective half-life (t1/2eff) may be a more clinically relevant parameter than elimination half-life (t1/2z). Using topiramate as a real-life example, the objective was to compare these half-life values for immediate- and extended-release topiramate (TPM-IR and USL255, respectively) to understand how drug pharmacokinetics may impact drug dosing recommendations. Methods: The t1/2z and t1/2eff for USL255 and TPM-IR were compared using data from a phase I study (N = 36) of 200 mg USL255 administered once daily (QD) or TPM-IR twice daily (BID); effect of sampling duration on t1/2z was investigated. To further explore the relationship between half-life and dosing, steady-state PK was simulated for USL255 and TPM-IR. Results: As previously reported, mean t1/2z was similar between USL255 (80.2 h) and TPM-IR (82.8 h); TPM-IR t1/2z was ∼4 times longer than reported in the Topamax label (21 h). In contrast, USL255 displayed a 1.5 fold longer t1/2eff (55.7 vs 37.1 h for TPM-IR). When t1/2z was calculated from 48 to 336 h, values ranged from 28.8 to 82.8 h. Simulated steady-state PK profiles of USL255 QD exhibited reduced plasma fluctuations during a dosing interval vs TPM-IR QD or BID. Significance: As expected for the same moiety, t1/2z of USL255 and TPM-IR were similar; however, the longer t1/2eff for USL255 better approximates differences in recommend dosing (QD USL255 vs BID TPM-IR). Further, sampling duration impacted t1/2z, diminishing its predictive value for determining dose regimens; sampling-time differences may also explain t1/2z discrepancy between TPM-IR here versus Topamax label. As expected, steady-state simulations confirm that although TPM-IR has a long t1/2z, taking TPM-IR QD would lead to large plasma fluctuations. These data demonstrate that t1/2z may be less clinically meaningful than t1/2eff, and using t1/2z for some drugs may lead to erroneous conclusions regarding dosing regimens

Steering the conversation: a linguistic exploration of natural language interactions with a digital assistant during simulated driving

Given the proliferation of ‘intelligent’ and ‘socially-aware’ digital assistants embodying everyday mobile technology – and the undeniable logic that utilising voice-activated controls and interfaces in cars reduces the visual and manual distraction of interacting with in-vehicle devices – it appears inevitable that next generation vehicles will be embodied by digital assistants and utilise spoken language as a method of interaction. From a design perspective, defining the language and interaction style that a digital driving assistant should adopt is contingent on the role that they play within the social fabric and context in which they are situated. We therefore conducted a qualitative, Wizard-of-Oz study to explore how drivers might interact linguistically with a natural language digital driving assistant. Twenty-five participants drove for 10 min in a medium-fidelity driving simulator while interacting with a state-of-the-art, high-functioning, conversational digital driving assistant. All exchanges were transcribed and analysed using recognised linguistic techniques, such as discourse and conversation analysis, normally reserved for interpersonal investigation. Language usage patterns demonstrate that interactions with the digital assistant were fundamentally social in nature, with participants affording the assistant equal social status and high-level cognitive processing capability. For example, participants were polite, actively controlled turn-taking during the conversation, and used back-channelling, fillers and hesitation, as they might in human communication. Furthermore, participants expected the digital assistant to understand and process complex requests mitigated with hedging words and expressions, and peppered with vague language and deictic references requiring shared contextual information and mutual understanding. Findings are presented in six themes which emerged during the analysis – formulating responses; turn-taking; back-channelling, fillers and hesitation; vague language; mitigating requests and politeness and praise. The results can be used to inform the design of future in-vehicle natural language systems, in particular to help manage the tension between designing for an engaging dialogue (important for technology acceptance) and designing for an effective dialogue (important to minimise distraction in a driving context)

A solution to treat mixed-type human datasets from socio-ecological systems

Coupled human and natural systems (CHANS) are frequently represented by large datasets with varied data including continuous, ordinal, and categorical variables. Conventional multivariate analyses cannot handle these mixed data types. In this paper, our goal was to show how a clustering method that has not before been applied to understanding the human dimension of CHANS: a Gower dissimilarity matrix with partitioning around medoids (PAM) can be used to treat mixed-type human datasets. A case study of land managers responsible for invasive plant control projects across rivers of the southwestern U.S. was used to characterize managers’ backgrounds and decisions, and project properties through clustering. Results showed that managers could be classified as “federal multitaskers” or as “educated specialists”. Decisions were characterized by being either “quick and active” or “thorough and careful”. Project goals were either comprehensive with ecological goals or more limited in scope. This study shows that clustering with Gower and PAM can simplify the complex human dimension of this system, demonstrating the utility of this approach for systems frequently composed of mixed-type data such as CHANS. This clustering approach can be used to direct scientific recommendations towards homogeneous groups of managers and project types

A Solution to Treat Mixed-Type Human Datasets from Socio-Ecological Systems

Coupled human and natural systems (CHANS) are frequently represented by large datasets with varied data including continuous, ordinal, and categorical variables. Conventional multivariate analyses cannot handle these mixed data types. In this paper, our goal was to show how a clustering method that has not before been applied to understanding the human dimension of CHANS: a Gower dissimilarity matrix with partitioning around medoids (PAM) can be used to treat mixed-type human datasets. A case study of land managers responsible for invasive plant control projects across rivers of the southwestern U.S. was used to characterize managers’ backgrounds and decisions, and project properties through clustering. Results showed that managers could be classified as “federal multitaskers” or as “educated specialists”. Decisions were characterized by being either “quick and active” or “thorough and careful”. Project goals were either comprehensive with ecological goals or more limited in scope. This study shows that clustering with Gower and PAM can simplify the complex human dimension of this system, demonstrating the utility of this approach for systems frequently composed of mixed-type data such as CHANS. This clustering approach can be used to direct scientific recommendations towards homogeneous groups of managers and project types