80 research outputs found

    Homelessness and integrated care: an application of integrated care knowledge to understanding services for wicked issues

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    Purpose: People experiencing homelessness often have complex needs requiring a range of support. These may include health problems (physical illness, mental health and/or substance misuse) as well as social, financial and housing needs. Addressing these issues requires a high degree of coordination amongst services. It is, thus, an example of a wicked policy issue. The purpose of this paper is to examine the challenge of integrating care in this context using evidence from an evaluation of English hospital discharge services for people experiencing homelessness. Design/methodology/approach: The paper undertakes secondary analysis of qualitative data from a mixed methods evaluation of hospital discharge schemes and uses an established framework for understanding integrated care, the Rainbow Model of Integrated Care (RMIC), to help examine the complexities of integration in this area. Findings: Supporting people experiencing homelessness to have a good discharge from hospital was confirmed as a wicked policy issue. The RMIC provided a strong framework for exploring the concept of integration, demonstrating how intertwined the elements of the framework are and, hence, that solutions need to be holistically organised across the RMIC. Limitations to integration were also highlighted, such as shortages of suitable accommodation and the impacts of policies in aligned areas of the welfare state. Research limitations/implications: The data for this secondary analysis were not specifically focussed on integration which meant the themes in the RMIC could not be explored directly nor in as much depth. However, important issues raised in the data directly related to integration of support, and the RMIC emerged as a helpful organising framework for understanding integration in this wicked policy context. Practical implications: Integration is happening in services directly concerned with the discharge from hospital of people experiencing homelessness. Key challenges to this integration are reported in terms of the RMIC, which would be a helpful framework for planning better integrated care for this area of practice. Social implications: Addressing homelessness not only requires careful planning of integration of services at specific pathway points, such as hospital discharge, but also integration across wider systems. A complex set of challenges are discussed to help with planning the better integration desired, and the RMIC was seen as a helpful framework for thinking about key issues and their interactions. Originality/value: This paper examines an application of integrated care knowledge to a key complex, or wicked policy issue

    Recovery of the herbaceous layer in the young silver birch and black alder stands that developed spontaneously after a forest fire

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    The studies, which were conducted in southern Poland, focused on the recovery of the herb layer in 17-year-old post-fire silver birch and black alder forests. Although both types of stands, which are of the same age, developed spontaneously, the alder stands occupied damper sites (with thicker A horizons that survived the fire) than those in the birch forests. We surveyed the migration rates of 44 woodland species, primarily ancient woodland indicators, into both forests and the potential differences in these rates depending on their moisture regime and the community type represented by unburned forests, which were treated as the source of the woodland species pool. Additionally, the role of local depressions with high humidity that were covered by post-fire alder woods in the colonization process, as well as species survivorship and recolonisation, were estimated. Woodland species showed diverse migration paces among the sites; most of them migrated faster on more fertile sites with a higher humidity. Small patches of post-fire alder woods contributed to the recolonisation process since many woodland species in the herb layer survived the fire due to its high humidity, which inhibited the intensity of the forest fire. The recovery of woodland species in post-fire woods is the combined effect of regeneration, which relies on autochthonic propagules, and secondary succession, which is based on allochthonic propagules. Local depressions, which provide refuges for fire-sensitive, dispersal-limited species, contribute to their survivorship and thus to the successive recovery of herbaceous layers after a fire

    Virus infection and grazing exert counteracting influences on survivorship of native bunchgrass seedlings competing with invasive exotics

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    1.  Invasive annual grasses introduced by European settlers have largely displaced native grassland vegetation in California and now form dense stands that constrain the establishment of native perennial bunchgrass seedlings. Bunchgrass seedlings face additional pressures from both livestock grazing and barley and cereal yellow dwarf viruses (B/CYDVs), which infect both young and established grasses throughout the state. 2.  Previous work suggested that B/CYDVs could mediate apparent competition between invasive exotic grasses and native bunchgrasses in California. 3.  To investigate the potential significance of virus-mediated mortality for early survivorship of bunchgrass seedlings, we compared the separate and combined effects of virus infection, competition and simulated grazing in a field experiment. We infected two species of young bunchgrasses that show different sensitivity to B/CYDV infection, subjected them to competition with three different densities of exotic annuals crossed with two clipping treatments, and monitored their growth and first-year survivorship. 4.  Although virus infection alone did not reduce first-year survivorship, it halved the survivorship of bunchgrasses competing with exotics. Within an environment in which competition strongly reduces seedling survivorship (as in natural grasslands), virus infection therefore has the power to cause additional seedling mortality and alter patterns of establishment. 5.  Surprisingly, clipping did not reduce bunchgrass survivorship further, but rather doubled it and disproportionately increased survivorship of infected bunchgrasses. 6.  Together with previous work, these findings show that B/CYDVs can be potentially powerful elements influencing species interactions in natural grasslands. 7.  More generally, our findings demonstrate the potential significance of multitrophic interactions in virus ecology. Although sometimes treated collectively as plant ‘predators’, viruses and herbivores may exert influences that are distinctly different, even counteracting

    Voices off: Stanley Milgram's cyranoids in historical context

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    This article revisits a forgotten, late project by the social psychologist Stanley Milgram: the ‘cyranoid’ studies he conducted from 1977 to 1984. These investigations, inspired by the play Cyrano de Bergerac, explored how individuals often fail to notice when others do not speak their own thoughts but instead relay messages from a hidden source. We situate these experiments amidst the intellectual, cultural, and political concerns of late Cold-War America and show how Milgram’s studies pulled together a variety of ideas, anxieties, and interests that were prevalent at that time and have returned in new guises since. In discussing the cyranoid project’s background and afterlife, we argue that its strikingly equivocal quality has lent itself to multiple reinterpretations by historians, psychologists, performers, artists and others. Our purpose is neither to champion Milgram’s work nor amplify the critiques already made of his methods. Rather it is consider the uncertain, allusive, and elusive aspects of the cyranoid project, and to seek to place that project ‘in context’, whilst asking where ‘context’ might end. We show how the experiments’ range of meanings, in different temporal registers, far exceeded the explanatory rubric that Milgram and his intellectual critics provided at that time; and ponder the risk for the historian of making anachronistic or teleological assumptions. In short, cyranoids, we argue, invite our open-ended exploration of ‘voices off stage’ in social and psychological relations, and offer a useful tool for thinking about historical context and the nature of historical interpretations
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