Terms of Engagement: Consensus or Control in Remote Australian Resource Management?

Community based natural resource management (NRM) has seen a shift in the discourse from participation to engagement, reflecting a focus on increasingly active citizen involvement in management and action. This paper considers this shift in relation to two contrasting theoretical perspectives. The first is deliberative democracy, drawing on Habermas, which emphasises the importance of discussing and rationalising values and actions. The second is governmentality, or ‘governing through community’ which draws on Foucault, emphasising neo-liberal management styles and ‘self-help’. In considering the empirical relevance of these theoretical perspectives, this paper draws on a case study of public engagement in NRM in the Lake Eyre Basin, a remote, inland region of Australia. This research yielded a practical set of “factors for success” for public engagement in remote areas. The findings support the view that, especially in remote regions, public engagement in NRM reflects contrasting goals. We make two conclusions. First, that these contrasting objectives emphasise the tension between deliberative and neo-liberal conceptualisations of engagement; and second, the evidence for neo-liberal interpretations of engagement are stronger than for deliberative interpretations of engagement in the case study region.participation, decentralisation, governmentality, deliberation

Modifying the Recess Before Lunch Program: A Pilot Study in Kaneohe Elementary School

Moving recess before lunch (RBL), though a simple schedule change, may provide many benefits for both students and elementary schools. Having recess before lunch has been shown to decrease plate waste (Bergman, et al., 2003; Gettlinger, 1996; Montana OPI, 2003; Ruppenthal & Hogue, 1977), and may improve discipline problems. The RBL schedule change has not previously been implemented in Hawai‘i schools. The purpose of this pilot study was to assess the feasibility of implementing a modified version of RBL into elementary schools in Hawai‘i . The modified version of RBL allows for implementation into a three-bell lunch system, a system used by many elementary schools in Hawai‘i. A one-grade-per-lunch period RBL switch was assessed among 6th grade students for 1) shorter lunch line wait, 2) increased access to recess equipment 3) decrease in conduct-related referrals, and 4) moderate decrease in food and milk waste for the affected grade(s). Results indicate a significant decrease in lunch line wait, a decrease in discipline referrals, and a slight non-significant decrease in lunch waste. Additional comments from administrators and teaching staff indicate positive changes in student behavior on the playground, in the cafeteria, and in the classroom. One major finding was the reduction in discipline problems after the implementation of RBL, as seen in both the quantitative referral counts and qualitative teacher and administrator questionnaires. The positive results of this study support further implementation of RBL into schools in Hawai‘i. Kaneohe Elementary School has continued to apply recess before lunch to the sixth grade lunch periods and is considering further implementation into other grades. The Hawai‘i Action for Healthy Kids team plans to approach more schools in Hawai‘i about using the modified recess before lunch program

How to specify healthcare process improvements collaboratively using rapid, remote consensus-building: a framework and a case study of its application.

BackgroundPractical methods for facilitating process improvement are needed to support high quality, safe care. How best to specify (identify and define) process improvements - the changes that need to be made in a healthcare process - remains a key question. Methods for doing so collaboratively, rapidly and remotely offer much potential, but are under-developed. We propose an approach for engaging diverse stakeholders remotely in a consensus-building exercise to help specify improvements in a healthcare process, and we illustrate the approach in a case study.MethodsOrganised in a five-step framework, our proposed approach is informed by a participatory ethos, crowdsourcing and consensus-building methods: (1) define scope and objective of the process improvement; (2) produce a draft or prototype of the proposed process improvement specification; (3) identify participant recruitment strategy; (4) design and conduct a remote consensus-building exercise; (5) produce a final specification of the process improvement in light of learning from the exercise. We tested the approach in a case study that sought to specify process improvements for the management of obstetric emergencies during the COVID-19 pandemic. We used a brief video showing a process for managing a post-partum haemorrhage in women with COVID-19 to elicit recommendations on how the process could be improved. Two Delphi rounds were then conducted to reach consensus.ResultsWe gathered views from 105 participants, with a background in maternity care (n = 36), infection prevention and control (n = 17), or human factors (n = 52). The participants initially generated 818 recommendations for how to improve the process illustrated in the video, which we synthesised into a set of 22 recommendations. The consensus-building exercise yielded a final set of 16 recommendations. These were used to inform the specification of process improvements for managing the obstetric emergency and develop supporting resources, including an updated video.ConclusionsThe proposed methodological approach enabled the expertise and ingenuity of diverse stakeholders to be captured and mobilised to specify process improvements in an area of pressing service need. This approach has the potential to address current challenges in process improvement, but will require further evaluation

Autism in England: assessing underdiagnosis in a population-based cohort study of prospectively collected primary care data

Background: Autism has long been viewed as a paediatric condition, meaning that many autistic adults missed out on a diagnosis as children when autism was little known. We estimated numbers of diagnosed and undiagnosed autistic people in England, and examined how diagnostic rates differed by socio-demographic factors. / Methods: This population-based cohort study of prospectively collected primary care data from IQVIA Medical Research Data (IMRD) compared the prevalence of diagnosed autism to community prevalence to estimate underdiagnosis. 602,433 individuals registered at an English primary care practice in 2018 and 5,586,100 individuals registered between 2000 and 2018 were included. / Findings: Rates of diagnosed autism in children/young people were much higher than in adults/older adults. As of 2018, 2.94% of 10- to 14-year-olds had a diagnosis (1 in 34), vs. 0.02% aged 70+ (1 in 6000). Exploratory projections based on these data suggest that, as of 2018, 463,500 people (0.82% of the English population) may have been diagnosed autistic, and between 435,700 and 1,197,300 may be autistic and undiagnosed (59–72% of autistic people, 0.77%–2.12% of the English population). Age-related inequalities were also evident in new diagnoses (incidence): c.1 in 250 5- to 9-year-olds had a newly-recorded autism diagnosis in 2018, vs. c.1 in 4000 20- to 49-year-olds, and c.1 in 18,000 people aged 50+. / Interpretation: Substantial age-related differences in the proportions of people diagnosed suggest an urgent need to improve access to adult autism diagnostic services

Prospectus, September 21, 1983

CONSTRUCTION PROGRESSES; Manager runs unique Hardee\u27s; Elect your senator Sept. 21-22; Prisons pursue harsher sentencing; Student admits scary reality; Mr. Roberts: never a water shortage; StuGo elections held this week; Paxton- town of peace ; Working women ignored in many countries; Rape affects into past; Pregnancy problem for teenagers; Dress for success; Segregation exists-- progress is little; Classified; Stu-Go happenings; Produce prices will be stable; Rockabilly E.B.\u27s are Movin\u27 Up ; Campus Paperback Bestsellers; New & Recommended; Ballet Nacional Español to be at Assembly Hall; Stray Cats definitely strut; Crenshaw\u27s Field Day; UI Ticket Exchange Area designated; Gym guidelines; Henkels looks to volleyball nationals; Fast Freddy Contest; Traffic Changes for UI footballhttps://spark.parkland.edu/prospectus_1983/1010/thumbnail.jp

Experiences of a digital health intervention for young people exposed to technology assisted sexual abuse:A qualitative study

BACKGROUND: There is growing evidence that Technology Assisted Sexual Abuse (TASA) represents a serious problem for large numbers of children. To date, there are very few evidence-based interventions available to young people (YP) after they have been exposed to this form of abuse, and access to support services remains a challenge. Digital tools such as smartphones have the potential to increase access to mental health support and may provide an opportunity for YP to both manage their distress and reduce the possibility of further victimization. The current study explores the acceptability of a digital health intervention (DHI; the i-Minds app) which is a theory-driven, co-produced, mentalization-based DHI designed for YP aged 12-18 who have experienced TASA.METHODS: Semi-structured interviews were conducted with 15 YP recruited through Child and Adolescent Mental Health Services, a Sexual Assault Referral Centre and an e-therapy provider who had access to the i-Minds app as part of a feasibility clinical trial. Interviews focused on the acceptability and usability of i-Minds and were coded to themes based on the Acceptability of Healthcare Interventions framework.RESULTS: All participants found the i-Minds app acceptable. Many aspects of the app were seen as enjoyable and useful in helping YP understand their abuse, manage feelings, and change behavior. The app was seen as usable and easy to navigate, but for some participants the level of text was problematic and aspects of the content was, at times, emotionally distressing at times.CONCLUSIONS: The i-Minds app is useful in the management of TASA and helping change some risk-related vulnerabilities. The app was designed, developed and evaluated with YP who had experienced TASA and this may account for the high levels of acceptability seen.TRIAL REGISTRATION: The trial was registered on the ISRCTN registry on the 12/04/2022 as i-Minds: a digital intervention for young people exposed to online sexual abuse (ISRCTN43130832).</p

To Cut a Long Story Short: Formal Chronological Modelling for the Late Neolithic Site of Ness of Brodgar, Orkney

YesIn the context of unanswered questions about the nature and development of the Late Neolithic in Orkney, we present a summary of research up to 2015 on the major site at the Ness of Brodgar, Mainland Orkney, concentrating on the impressive buildings. Finding sufficient samples for radiocarbon dating was a considerable challenge. There are indications from both features and finds of activity predating the main set of buildings exposed so far by excavation. Forty-six dates on 39 samples are presented and are interpreted in a formal chronological framework. Two models are presented, reflecting different possible readings of the sequence. Both indicate that piered architecture was in use by the thirtieth century cal BC and that the massive Structure 10, not the first building in the sequence, was also in existence by the thirtieth century cal BC. Activity associated with piered architecture came to an end (in Model 2) around 2800 cal BC. Midden and rubble infill followed. After an appreciable interval, the hearth at the centre of Structure 10 was last used around 2500 cal BC, perhaps the only activity in an otherwise abandoned site. The remains of some 400 or more cattle were deposited over the ruins of Structure 10: in Model 2, in the mid-twenty-fifth century cal BC, but in Model 1 in the late twenty-fourth or twenty-third century cal BC. The chronologies invite comparison with the near-neighbour of Barnhouse, in use from the later thirty-second to the earlier twenty-ninth century cal BC, and the Stones of Stenness, probably erected by the thirtieth century cal BC. The Ness, including Structure 10, appears to have outlasted Barnhouse, but probably did not endure as long in its primary form as previously envisaged. The decay and decommissioning of the Ness may have coincided with the further development of the sacred landscape around it; but precise chronologies for other sites in the surrounding landscape are urgently required. The spectacular feasting remains of several hundred cattle deposited above Structure 10 may belong to a radically changing world, coinciding (in Model 2) with the appearance of Beakers nationally, but it was arguably the by now mythic status of that building which drew people back to it.We are very grateful to many institutions and individuals, in particular: Ness of Brodgar Trust, Foundation for World Health, Orkney Islands Council, University of the Highlands and Islands, Orkney Archaeology Society, American Friends of the Ness of Brodgar, Northlink, Talisman- Sinopec, Hiscox Insurance, Historic Environment Scotland, and numerous other supporters and volunteers; Mark Edmonds, Ann MacSween, Colin Richards, and Alison Sheridan for encouragement, advice, and critical comments on an earlier draft of this article; three anonymous referees for their comments; and Kirsty Harding for help with the figures. Dating and modelling have been supported by a European Research Council Advanced Investigator Grant (295412), The Times of Their Lives (www.totl.eu), led by Alasdair Whittle and Alex Bayliss