Commentary : missing targets on drugs-related deaths, and a Scottish paradox

The 10-year drug strategy for England and Wales was published in February 2008. It dropped drugs-related deaths (DRDs) as a key performance indicator. Scotland retained a necessary strong focus on DRDs. Scotland's DRDs numbered 1006 in 2000–02 and 1009 in 2003–05. The previous Scottish administration's claim that its number of current injectors had decreased substantially between 2000 and 2003 implied, paradoxically, that their DRD rate would have to have increased. Worse was to come: Scotland's DRDs had increased to 876 in 2006 + 2007. We analyse UK's DRDs by sex and age-group to reveal temporal trends (2000–02 versus 2003–05 versus 2006 + 2007) with different public health and epidemiological implications. We also address the above Scottish paradox and assess, by age-group, how consistent Scotland's 876 DRDs in 2006 + 2007 are with Scottish injectors’ DRD rate in 2003–05 of around 1 per 100 injector-years. Public health success in the UK in reducing DRDs at younger ages should not be overshadowed by the late consequence in terms of older-age DRDs of UK's injector epidemics; in the early 1980s in Scotland, and late 1980s in England and Wales. Targets for reducing DRDs should pay heed to UK's injector epidemics

Elected Mayors: Leading Locally?

The directly elected executive mayor was introduced to England a decade ago. Drawing inspiration from European and American experience, the elected mayor appealed to both New Labour and Conservative commentators in offering a solution to perceived problems of local leadership. There was a shared view that governance of local areas was failing and that elected mayors were the answer. The first local referendums were held in 2001. Most have continued to reject the idea of the elected mayor. During 2012, the coalition government initiated 10 further mayoral referendums in England's largest cities but only one, Bristol, opted for an elected mayor. Overall, there is no evidence of widespread public support, yet the prospect of more mayors - with enhanced powers - remains firmly on the policy agenda. Drawing from a decade of research, this paper considers reasons for the persistence of the mayoral experiment, the importance of local factors in the few areas where mayors hold office and the link to current policy debates. Using the authors' analytical leadership grid, this paper links the governmental, governance and allegiance roles of mayors to the problematic nature of local leadership. It then draws tentative conclusions about the strange case of the elected mayor in England

Financial inclusion: Policies and practices

As a key enabler for development, financial inclusion is firmly placed on the agenda of most governments as a key policy priority. Against this background, this round table provides a global and regional perspective on the policies and practices of financial inclusion. Using macro data, the collection reveals the diversity in the efforts towards achieving financial inclusion and the need for a progressive approach in financial inclusion. Further to this, the round table provides the regional perspectives on the policies and practices of financial inclusion in India, South Africa, and Australia

The travel behaviour intentions of young people in the context of climate change

This article examines the factors influencing the future travel behaviour intentions of young people (aged 11-18), with specific attention given to how climate change considerations affect these. Overall it is found that the participants' travel behaviour intentions are dominated by a desire to drive and that their values relating to identity, self-image, and social recognition (at the expense of their environmental values), as well as their affective attitudes towards transport modes, are key influences on this. Although they are aware of climate change, the participants' understanding of the link between transport and climate change was weak. At the same time, they illustrated an apathy towards climate change - in part due to the timing and intangibility of its associated impacts and their lack of self-efficacy with respect to tackling this issue. However, despite claiming that their current environmentally friendly travel behaviours (such as walking or cycling to school) are not influenced by the issue of climate change, a number are accepting of the idea of enforced travel behaviour change - away from use of the car, towards more 'environmentally friendly' modes. This acceptance was in part due to their belief that such action would remove the influence of the 'social dilemma', where their own efforts to tackle climate change may be rendered worthless by the inaction of others. © 2009 Elsevier Ltd. All rights reserved

Gender Socialization in Chinese Kindergartens: Teachers’ Contributions

Teacher-child interactions and peer exchanges were observed once a week for 10 months in four kindergartens in Hong Kong, China. A total of 206 anecdotes/scenes considered representative of the gender-related experiences of 109 4-year-old Chinese children in these kindergartens were analyzed. Descriptive codes, generated iteratively were clustered, categorized, integrated, recoded and recategorized and led to the identification of two major themes related to the socialization practices of teachers: Gendered Kindergarten Routines and Perpetuation of Gender Stereotypes. Findings indicated that these early years’ educational contexts were not gender neutral. Teachers interacted with boys significantly more than girls. They also subtly conveyed traditional Chinese gender values through their repeated use of gendered routines in the kindergartens and their behaviors reflected gender stereotypes

An Irish perspective on Cryptosporidium. Part 1

Cryptosporidiosis, a protozoal disease which causes significant morbidity in humans, is one of the chief causes of diarrhoea in neonatal ruminants. Although the parasite poses a significant threat to public health and animal health in Ireland, its epidemiology on the island is only poorly understood. Environmental studies have shown the waterborne parasite to be widespread in some untreated waterbodies around Ireland. The island's hydrogeological situation, combined with high stocking rates of livestock and the absence of filtration from regular water treatment, render it vulnerable to large-scale outbreaks. This review discusses the parasite in the Irish context and underlines the need for a reference facility to provide active surveillance on the island

A randomised controlled trial of a patient based Diabetes recall and Management system: the DREAM trial: A study protocol [ISRCTN32042030]

BACKGROUND: Whilst there is broad agreement on what constitutes high quality health care for people with diabetes, there is little consensus on the most efficient way of delivering it. Structured recall systems can improve the quality of care but the systems evaluated to date have been of limited sophistication and the evaluations have been carried out in small numbers of relatively unrepresentative settings. Hartlepool, Easington and Stockton currently operate a computerised diabetes register which has to date produced improvements in the quality of care but performance has now plateaued leaving substantial scope for further improvement. This study will evaluate the effectiveness and efficiency of an area wide 'extended' system incorporating a full structured recall and management system, actively involving patients and including clinical management prompts to primary care clinicians based on locally-adapted evidence based guidelines. METHODS: The study design is a two-armed cluster randomised controlled trial of 61 practices incorporating evaluations of the effectiveness of the system, its economic impact and its impact on patient wellbeing and functioning

Conceptualising fields of action for sustainable intensification A systematic literature review and application to regional case studies

[EN] After two decades of research on sustainable intensification (SI), namely securing food production on less environmental cost, heterogeneous understandings and perspectives prevail in a broad and partly fragmented scientific literature. Structuring and consolidating contributions to provide practice-oriented guidelines are lacking. The objectives of this study are to (1) comprehensively explore the academic SI literature, (2) propose an implementation-oriented conceptual framework, and (3) demonstrate its applicability for region-specific problem settings. In a systematic literature review of 349 papers covering the international literature of 20 years of SI research, we identified SI practices and analysed temporal, spatial and disciplinary trends and foci. Based on key SI practices, a conceptual framework was developed differentiating four fields of action from farm to regional and landscape scale and from land use to structural optimisation. Its applicability to derive region specific SI solutions was successfully tested through stakeholder processes in four European case studies. Disciplinary boundaries and the separation of the temporal and spatial strands in the literature prevent a holistic address of SI. This leads to the dominance of research describing SI practices in isolation, mainly on the farm scale. Coordinated actions on the regional scale and the coupling of multiple practices are comparatively un-derrepresented. Results from the case studies demonstrate that implementation is extremely context-sensitive and thus crucially depends on the situational knowledge of farmers and stakeholders. Although, there is no 'one size fits all' solution, practitioners in all regions identified the need for integrated solutions and common action to implement suitable SI strategies at the regional landscape level and in local ecosystems.This research was financially supported by the European Commission under grant agreement 652615 and conducted in the context of the ERA-Net FACCE SURPLUS project VITAL, with the national funders NWO (Netherlands), BMBF (Germany), INIA (Spain), ANR (France).Weltin, M.; Zasada, I.; Piorr, A.; Debolini, M.; Geniaux, G.; Moreno-Pérez, OM.; Scherer, L.... (2018). Conceptualising fields of action for sustainable intensification A systematic literature review and application to regional case studies. Agriculture Ecosystems & Environment. 257:68-80. https://doi.org/10.1016/j.agee.2018.01.023S688025