Adaptation without natural selection

Document is itself an extended abstract

Training in health coaching skills for health professionals who work with people with progressive neurological conditions: A realist evaluation

Background Supporting people to self‐manage their long‐term conditions is a UK policy priority. Health coaching is one approach health professionals can use to provide such support. There has been little research done on how to train clinicians in health coaching or how to target training to settings where it may be most effective. Objective To develop theories to describe how training health professionals in health coaching works, for whom and in what circumstances, with a focus on those working with people with progressive neurological conditions. Design Realist evaluation using mixed methods (participant observation, pre‐ and post‐training questionnaires, and telephone interviews with participants and trainers). Realist data analysis used to develop and refine theories. Intervention Two 1‐day face‐to‐face training sessions in health coaching with 11 weeks between first and second days. Setting and participants Twenty health‐care professionals who work with people with neurological conditions in the UK, two training facilitators. Results Four theories were developed using context‐mechanism‐outcome configurations to describe how training triggers critical reflection; builds knowledge, skills and confidence; how participants evaluate the relevance of the training; and their experiences of implementing the training. Some participants reported a major shift in practice, and others implemented the training in more limited ways. Discussion Fully embracing the role of coach is difficult for health professionals working in positions and settings where their clinical expertise appears most highly valued. Conclusions Training should address the practicality of using coaching approaches within existing roles, while organizations should consider their role in facilitating implementation

Using scenarios to explore UK upland futures

Uplands around the world are facing significant social, economic and environmental changes, and decision-makers need to better understand what the future may hold if they are to adapt and maintain upland goods and services. This paper draws together all major research comprising eight studies that have used scenarios to describe possible futures for UK uplands. The paper evaluates which scenarios are perceived by stakeholders to be most likely and desirable, and assesses the benefits and drawbacks of the scenario methods used in UK uplands to date. Stakeholders agreed that the most desirable and likely scenario would be a continuation of hill farming (albeit at reduced levels) based on cross-compliance with environmental measures. The least desirable scenario is a withdrawal of government financial support for hill farming. Although this was deemed by stakeholders to be the least likely scenario, the loss of government support warrants close attention due to its potential implications for the local economy. Stakeholders noted that the environmental implications of this scenario are much less clear-cut. As such, there is an urgent need to understand the full implications of this scenario, so that upland stakeholders can adequately prepare, and policy-makers can better evaluate the likely implications of different policy options. The paper concludes that in future, upland scenario research needs to: (1) better integrate in-depth and representative participation from stakeholders during both scenario development and evaluation; and (2) make more effective use of visualisation techniques and simulation models

Cost-benefit analysis of ecological networks assessed through spatial analysis of ecosystem services

1.The development of ecological networks could enhance the ability of species to disperse across fragmented landscapes and could mitigate against the negative impacts of climate change. The development of such networks will require widespread ecological restoration at the landscape scale, which is likely to be costly. However, little information is available regarding the cost-effectiveness of restoration approaches. 2.We address this knowledge gap by examining the potential impact of landscape-scale habitat restoration on the value of multiple ecosystem services across the catchment of the River Frome in Dorset, England. This was achieved by mapping the market value of four ecosystem services (carbon storage, crops, livestock and timber) under three different restoration scenarios, estimating restoration costs, and calculating net benefits. 3.The non-market value of additional services (cultural, aesthetic and recreational value) was elicited from local stakeholders using an online survey tool. Flood risk was assessed using a scoring approach. Spatial Multi-Criteria Analysis (MCA) was conducted, incorporating both market and non-market values, to evaluate the relative benefits of restoration scenarios. These were compared with impacts of restoration on biodiversity value. 4.Multi-Criteria Analysis results consistently ranked restoration scenarios above a non-restoration comparator, reflecting the increased provision of multiple ecosystem services. Restoration scenarios also provided benefits to biodiversity, in terms of increased species richness and habitat connectivity. However, restoration costs consistently exceeded the market value of ecosystem services. 5.Synthesis and applications. Establishment of ecological networks through ecological restoration is unlikely to deliver net economic benefits in landscapes dominated by agricultural land use. This reflects the high costs of ecological restoration in such landscapes. The cost-effectiveness of ecological networks will depend on how the benefits provided to people are valued, and on how the value of non-market benefits are weighted against the costs of reduced agricultural and timber production. Future plans for ecological restoration should incorporate local stakeholder values, to ensure that benefits to people are maximised. © 2012 The Authors. Journal of Applied Ecology © 2012 British Ecological Society

The Velocity Function of Galaxies

We present a galaxy circular velocity function, Psi(log v), derived from existing luminosity functions and luminosity-velocity relations. Such a velocity function is desirable for several reasons. First, it enables an objective comparison of luminosity functions obtained in different bands and for different galaxy morphologies, with a statistical correction for dust extinction. In addition, the velocity function simplifies comparison of observations with predictions from high-resolution cosmological N-body simulations. We derive velocity functions from five different data sets and find rough agreement among them, but about a factor of 2 variation in amplitude. These velocity functions are then compared with N-body simulations of a LCDM model (corrected for baryonic infall) in order to demonstrate both the utility and current limitations of this approach. The number density of dark matter halos and the slope of the velocity function near v_*, the circular velocity corresponding to an ~L_* spiral galaxy, are found to be comparable to that of observed galaxies. The primary sources of uncertainty in construction of Psi(log v) from observations and N-body simulations are discussed and explanations are suggected to account for these discrepancies.Comment: Latex. 28 pages, 4 figures. Accepted by Ap

Interventions to improve the self-management support health professionals provide for people with progressive neurological conditions: protocol for a realist synthesis

Introduction Supporting self-management among people with long term conditions is recognised as an important component of health care. Progressive neurological conditions (PNCs), for example, Parkinson’s disease and Multiple Sclerosis are associated with problems such as fatigue and cognitive impairment which may make self-management more challenging. Health professionals may need to develop specific skills in order to provide effective self-management support for these patients. The review aims to develop explanatory theories about how health professional-targeted interventions to improve self-management support provision for people with PNCs operate in different circumstances. Methods and Analysis A realist synthesis of the evidence is proposed. There are two priority questions for the review to address. These relate to the role of a shared concept of self-management support within the healthcare team, and the need to tailor the support provided to the requirements of people with PNCs. Key stakeholders will be involved throughout the process. The initial search strategy uses terms relating to 1) self-management, 2) health professionals and 3) PNCs. Searching, data extraction and synthesis will occur in parallel. Studies will be prioritised for inclusion based on anticipated contribution to generating explanatory theories. Key informant interviews are planned to direct supplementary searches and help further refine the theories developed. Results will be expressed in the form of context-mechanism-outcome configurations. Dissemination Publication guidelines on realist synthesis will be followed. The results will be published in a peer-reviewed journal and made available to organisations involved in the provision of health professional training

Shifting mindsets: a realist synthesis of evidence from self-management support training

Context Accompanying the growing expectation of patient self-management is the need to ensure health care professionals (HCPs) have the required attitudes and skills to provide effective self-management support (SMS). Results from existing training interventions for HCPs in SMS have been mixed and the evidence base is weaker for certain settings, including supporting people with progressive neurological conditions (PNCs). We set out to understand how training operates, and to identify barriers and facilitators to training designed to support shifts in attitudes amongst HCPs. Methods We undertook a realist literature synthesis focused on: (i) the influence of how HCPs, teams and organisations view and adopt self-management; and (ii) how SMS needs to be tailored for people with PNCs. A traditional database search strategy was used alongside citation tracking, grey literature searching and stakeholder recommendations. We supplemented PNC-specific literature with data from other long-term conditions. Key informant interviews and stakeholder advisory group meetings informed the synthesis process. Realist context-mechanism-outcome configurations were generated and mapped onto the stages described in Mezirow's Transformative Learning Theory. Results Forty-four original articles were included (19 relating to PNCs), from which seven refined theories were developed. The theories identified important training elements (evidence provision, building skills and confidence, facilitating reflection and generating empathy). The significant influence of workplace factors as possible barriers or facilitators was highlighted. Embracing SMS often required challenging traditional professional role boundaries. Conclusion The integration of SMS into routine care is not an automatic outcome from training. A transformative learning process is often required to trigger the necessary mindset shift. Training should focus on how individual HCPs define and value SMS and how their work context (patient group and organisational constraints) influences this process. Proactively addressing potential contextual barriers may facilitate implementation. These findings could be applied to other types of training designed to shift attitudes amongst HCPs

Mass and pressure constraints on galaxy clusters from interferometric SZ observations

Following on our previous study of an analytic parametric model to describe the baryonic and dark matter distributions in clusters of galaxies with spherical symmetry, we perform an SZ analysis of a set of simulated clusters and present their mass and pressure profiles. The simulated clusters span a wide range in mass, 2.0 x 10^14 Msun < M200 < 1.0 x 10^15Msun, and observations with the Arcminute Microkelvin Imager (AMI) are simulated through their Sunyaev- Zel'dovich (SZ) effect. We assume that the dark matter density follows a Navarro, Frenk and White (NFW) profile and that the gas pressure is described by a generalised NFW (GNFW) profile. By numerically exploring the probability distributions of the cluster parameters given simulated interferometric SZ data in the context of Bayesian methods, we investigate the capability of this model and analysis technique to return the simulated clusters input quantities. We show that considering the mass and redshift dependency of the cluster halo concentration parameter is crucial in obtaining an unbiased cluster mass estimate and hence deriving the radial profiles of the enclosed total mass and the gas pressure out to r200.Comment: 5 pages, 2 tables, 3 figure