Well-Being: From Concept to Practice?

‘Well-being’ has become a high-profile and contested issue, for both policy and practice, since its introduction as an integral part of the Care Act (2014). A dynamic and fluid concept, the researchers were interested in how qualified social workers conceptualise concept of well-being. This small-scale qualitative study, arising from a partnership between a university and a local authority within England, explored how social workers, in one adult social work service, conceptualized ‘well-being’ in relation to service users who both did have the mental capacity, and also those who lacked capacity, to make informed decisions in relation to their care and support needs. The researchers adopted an interpretivist, qualitative approach to the research and used thematic analysis of the rich data arising from individual and group discussions. Interesting differences emerged that, we propose, related to the practitioners’ dominant ‘cognitive style’ or over-arching approach to considering how individuals, with and without capacity, defined their own well-being, becoming more risk-averse when considering the well-being (as defined within the Care Act 2014) of an individual who lacked capacity. Whilst local authorities have a duty under the Care Act to promote an individual’s well-being, firmly locating the well-being principle at the heart of adult social work assessments, it is important to remember that this is a concept that is mainly self-defined. However, the ways in which practitioners conceptualise well-being influence both how they approach an assessment, and indeed how they seek to build relationships with the person being assessed. Bringing the different cognitive styles to practitioners’ attention, we believe, provides an opportunity to challenge their own and their colleagues’ biases, whether systemic or individual, and free them to embrace the fluidity of experience and well-being, for all individuals seeking to access services

What Makes a City Liveable? Implications for Next-Generation Infrastructure Services

Abstract: Infrastructure forms the framework within which modern societies operate both at the physical and social level. It includes (amongst others) digital, green and social infrastructures, emergency services and food networks, water, energy, waste and transport. Infrastructure, by its very nature, locks in behaviours. The Liveable Cities research consortium aims to identify and test radical engineering interventions that will lead to future low carbon, resource secure cities in which societal wellbeing is prioritised, and these will necessarily influence the shape of infrastructure provision. This paper presents a discussion of what comprises a liveable city and how it might be achieved. It presents the City Design Framework, a technique for the analysis of city strategies that establishes a hierarchy of needs relevant to successfully achieving a liveable city. The framework supports changing perceptions of infrastructure since the necessary future changes have the potential to radically alter people’s lifestyle and wellbeing. Citation: Leach, J.M., Lee, S.E., Braithwaite, P.A., Bouch, C.J., Grayson, N. & Rogers, C.D.F. (2014). What Makes a City Liveable? Implications for Next-Generation Infrastructure Services. In: Campbell P. and Perez P. (Eds), Proceedings of the International Symposium of Next Generation Infrastructure, 1-4 October 2013, SMART Infrastructure Facility, University of Wollongong, Australia

Defining user perception of distributed multimedia quality

This article presents the results of a study that explored the human side of the multimedia experience. We propose a model that assesses quality variation from three distinct levels: the network, the media and the content levels; and from two views: the technical and the user perspective. By facilitating parameter variation at each of the quality levels and from each of the perspectives, we were able to examine their impact on user quality perception. Results show that a significant reduction in frame rate does not proportionally reduce the user's understanding of the presentation independent of technical parameters, that multimedia content type significantly impacts user information assimilation, user level of enjoyment, and user perception of quality, and that the device display type impacts user information assimilation and user perception of quality. Finally, to ensure the transfer of information, low-level abstraction (network-level) parameters, such as delay and jitter, should be adapted; to maintain the user's level of enjoyment, high-level abstraction quality parameters (content-level), such as the appropriate use of display screens, should be adapted

Cues and knowledge structures used by mental-health professionals when making risk assessments

Background: Research into mental-health risks has tended to focus on epidemiological approaches and to consider pieces of evidence in isolation. Less is known about the particular factors and their patterns of occurrence that influence clinicians’ risk judgements in practice. Aims: To identify the cues used by clinicians to make risk judgements and to explore how these combine within clinicians’ psychological representations of suicide, self-harm, self-neglect, and harm to others. Method: Content analysis was applied to semi-structured interviews conducted with 46 practitioners from various mental-health disciplines, using mind maps to represent the hierarchical relationships of data and concepts. Results: Strong consensus between experts meant their knowledge could be integrated into a single hierarchical structure for each risk. This revealed contrasting emphases between data and concepts underpinning risks, including: reflection and forethought for suicide; motivation for self-harm; situation and context for harm to others; and current presentation for self-neglect. Conclusions: Analysis of experts’ risk-assessment knowledge identified influential cues and their relationships to risks. It can inform development of valid risk-screening decision support systems that combine actuarial evidence with clinical expertise

Using XML and XSLT for flexible elicitation of mental-health risk knowledge

Current tools for assessing risks associated with mental-health problems require assessors to make high-level judgements based on clinical experience. This paper describes how new technologies can enhance qualitative research methods to identify lower-level cues underlying these judgements, which can be collected by people without a specialist mental-health background. Methods and evolving results: Content analysis of interviews with 46 multidisciplinary mental-health experts exposed the cues and their interrelationships, which were represented by a mind map using software that stores maps as XML. All 46 mind maps were integrated into a single XML knowledge structure and analysed by a Lisp program to generate quantitative information about the numbers of experts associated with each part of it. The knowledge was refined by the experts, using software developed in Flash to record their collective views within the XML itself. These views specified how the XML should be transformed by XSLT, a technology for rendering XML, which resulted in a validated hierarchical knowledge structure associating patient cues with risks. Conclusions: Changing knowledge elicitation requirements were accommodated by flexible transformations of XML data using XSLT, which also facilitated generation of multiple data-gathering tools suiting different assessment circumstances and levels of mental-health knowledge

Methods of the 7th National Audit Project (NAP7) of the Royal College of Anaesthetists: peri-operative cardiac arrest

Cardiac arrest in the peri-operative period is rare but associated with significant morbidity and mortality. Current reporting systems do not capture many such events, so there is an incomplete understanding of incidence and outcomes. As peri-operative cardiac arrest is rare, many hospitals may only see a small number of cases over long periods, and anaesthetists may not be involved in such cases for years. Therefore, a large-scale prospective cohort is needed to gain a deep understanding of events leading up to cardiac arrest, management of the arrest itself and patient outcomes. Consequently, the Royal College of Anaesthetists chose peri-operative cardiac arrest as the 7th National Audit Project topic. The study was open to all UK hospitals offering anaesthetic services and had a three-part design. First, baseline surveys of all anaesthetic departments and anaesthetists in the UK, examining respondents' prior peri-operative cardiac arrest experience, resuscitation training and local departmental preparedness. Second, an activity survey to record anonymised details of all anaesthetic activity in each site over 4 days, enabling national estimates of annual anaesthetic activity, complexity and complication rates. Third, a case registry of all instances of peri-operative cardiac arrest in the UK, reported confidentially and anonymously, over 1 year starting 16 June 2021, followed by expert review using a structured process to minimise bias. The definition of peri-operative cardiac arrest was the delivery of five or more chest compressions and/or defibrillation in a patient having a procedure under the care of an anaesthetist. The peri-operative period began with the World Health Organization 'sign-in' checklist or first hands-on contact with the patient and ended either 24 h after the patient handover (e.g. to the recovery room or intensive care unit) or at discharge if this occured earlier than 24 h. These components described the epidemiology of peri-operative cardiac arrest in the UK and provide a basis for developing guidelines and interventional studies

How sharing can contribute to more sustainable cities

\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