A Transdisciplinary Approach to Water Access: An Exploratory Case Study in Indigenous Communities in Chiapas, Mexico

In this article, we address the water challenges faced by Indigenous communities (ICs) in the context of Sustainable Development Goal 6 (SDG 6). The importance of ICs for sustainable regional development is increasingly recognised both at, a policy level and in practice. However, there is a reported lack of empirical evidence that gives voice to how such communities perceive development, particularly sustainable water development as articulated in the United Nations Sustainable Development Goals (2015–2030). This article provides case-based evidence from one Indigenous community setting, which challenges assumptions concerning water-related development. Using a qualitative methodology, this case study explores the problem of access to safe water faced by ICs and applies a value cocreation framework based on service-dominant logic. The findings highlight the need to develop sustainable water service models focused on the provision of water not just as a commodity or resource but also as a service. Initiatives aimed at addressing water-related challenges will be more likely to succeed when the culture, experiences, knowledge and practices of the communities in need of clean water access are valued and meaningfully incorporated into value cocreation processes

Suicide in post agreement Northern Ireland: A Study of the Role of Paramilitary Intimidation 2007-2009

Since the end of the ‘Troubles’ in Northern Ireland, there has been a rise in the number of acts of intimidation and Paramilitary Punishment Attacks (PPA). Anecdotally, some suicides have been linked to such incidents. To date, there has been a lack of research examining this association. This article details a case series study exploring how individual deaths by suicide in Northern Ireland were connected to intimidation. Data from Coroners, GP records and interviews with family members were examined to identify experiences of intimidation among a two-year cohort who died by suicide. Further case based analysis was conducted using a modified version of the psychological autopsy method. Our results indicate that in 19 male suicides there were incidents of intimidation in the twelve months prior to death. The suicides of these men are discussed in relation to the suicide model of entrapment. Our findings highlight the continuing problem of intimidation in Northern Ireland and suggest further research into the connection between these incidents and suicide is warranted

A systematic review of electronic assistive technology within supporting living environments for people with dementia

Health and social care provision needs to change in order to meet the needs of an increase in the number of people living with dementia. Environmental design, technology and assistive devices have the potential to complement care, help address some of the challenges presented by this growing need and impact on the lived experience of this vulnerable population. This systematic review was undertaken to identify the research on the use of electronic assistive technology within long-term residential care settings. A total of 3229 papers published from the inception of each of the databases up until May 2016 were retrieved from searches in four major databases. Sixty-one were identified to be included in the review. The inclusion criteria were: original peer reviewed journals; an electronic assistive technology intervention; with residents or tenants living with dementia or their family or paid caregivers; in supported living environments or residential care. The data extracted from the included studies focused on the methodology, technology, outcomes and the role of people living with dementia within the research. Overall, an extensive variety of technical interventions were found, with a broad range of methodological heterogeneity to explore their effect. Additionally, wide-spanning outcomes to support the potential of technology solutions and the challenges presented by such intervention were found

The transition to technology-enriched supported accommodation (TESA) for people living with dementia: the experience of formal carers

Brendan McCormack - ORCID: 0000-0001-8525-8905 https://orcid.org/0000-0001-8525-8905This paper presents the experiences of formal carers working in technology-enriched supported accommodation for people living with dementia, examining their care-giving role from a person-centred care perspective. Within a qualitative study, 21 semi-structured interviews were conducted with formal carers and data were analysed following a thematic approach. Four main themes were identified that mapped to the attributes of the person-centred practice framework (PCPF): promoting choice and autonomy, staffing model, using assistive technology and feeling that ‘you're doing a good job’. Central to person-centred practice in these settings was the promotion of choice, autonomy and independence. The dichotomy between safety and independence was evident, curtailing the opportunities within the environmental enablers and associated embedded assistive technologies. Formal carers reported considerable job satisfaction working in these settings. The small-scale, home-like facilities seemed to have a positive effect on job satisfaction. These findings are relevant to policy makers, commissioners and service providers, highlighting the facilitators of person-centred care in community dwellings for people living with dementia and the role of formal carers in promoting this approach.This project was funded by the Health and Social Care (HSC) Research & Development Division of the Public Health Agency in Northern Ireland (Reference COM/4955/14) in conjunction with the Atlantic Philanthropies, an international grant-awarding body. The project is part of the HSC research strand into the ‘Care of People with Dementia in Northern Ireland’. None of the awarding bodies have participated in any of the activities related to the research.https://doi.org/10.1017/S0144686X1900058840pubpub1

When health services are powerless to prevent suicide: results from a linkage study of suicide among men with no service contact in the year prior to death

Aims: To investigate cases of suicide in which there was no healthcare contact, by looking at history of help-seeking and evidence of previous mental health vulnerability. To identify any life events associated with suicide for which individuals did not seek help. Background: Previous research has suggested that non-consultation is the main barrier to suicide prevention among men. Estimates suggest approximately 22% of men who die by suicide have not consulted their GP in the year before their death. Little is known about the lifetime pattern of engagement with services among these individuals and whether or not this may influence their help-seeking behaviour before death. Methods: Coroner records of suicide deaths in Northern Ireland over 2 years were linked to general practice (GP) records. This identified 63 individuals who had not attended health services in the 12 months before death. Coroner’s data were used to categorise life events associated with the male deaths. Lifetime mental health help-seeking at the GP was assessed. Findings: The vast majority of individuals who did not seek help were males (n=60, 15% of all suicide deaths). Lack of consultation in the year before suicide was consistent with behaviour over the lifespan; over two-thirds had no previous consultations for mental health. In Coroner’s records, suicides with no prior consultation were primarily linked to relationship breakdown and job loss. These findings highlight the limitations of primary care in suicide prevention as most had never attended GP for mental health issues and there was a high rate of supported consultation among those who had previously sought help. Public health campaigns that promote service use among vulnerable groups at times of crisis might usefully be targeted at those likely to be experiencing financial and relationship issues

The Business Model as a technique for problem identification and scoping: a case study of Brazilian drinking water quality assessment sector

In this case study, a Business Model Canvas (BMC) was used as a technique for problem identification and scoping for the introduction of a new technology or methodology for water quality assessment. Therefore, information about the Brazilian water supply sector was used for the application of a BMC based on technological innovations for coliform analysis. The innovations proposed in the study include faster results, internet connection, and portability. To populate the model, data regarding the drinking water quality from Brazil were used from public data banks and reports. Also, a group of accountable representatives from diverse water supply systems and water quality laboratories reported their experience with the new coliform analysis and their perception of its technological improvement. The major gaps identified in this study were simplicity and faster results. These may be associated with technological improvements such as portability and internet connection. It was possible to conclude that the segment is diverse, and the BMC highlighted that value might differ for different niches. The results emphasized that the application of a BMC may be more than a business tool. It can also be used by developers or scientists to understand and improve both technology concepts and applications. HIGHLIGHTS A Business Model was applied to structure coliform analysis in drinking water.; Characteristics of water supply systems influence value proposition priorities.; Legal demands have influences in different levels and applications.; Technological innovation and advantages alone may not fit customer needs.; Information gathered reveals a technological gap in coliform analysis.

The failure of suicide prevention in primary care: family and GP perspectives - a qualitative study

Background Although Primary care is crucial for suicide prevention, clinicians tend to report completed suicides in their care as non-preventable. We aimed to examine systemic inadequacies in suicide prevention from the perspectives of bereaved family members and GPs.Methods Qualitative study of 72 relatives or close friends bereaved by suicide and 19 General Practitioners who have experienced the suicide of patients.Results Relatives highlight failures in detecting symptoms and behavioral changes and the inability of GPs to understand the needs of patients and their social contexts. A perceived overreliance on anti-depressant treatment is a major source of criticism by family members. GPs tend to lack confidence in the recognition and management of suicidal patients, and report structural inadequacies in service provision.Conclusions Mental health and primary care services must find innovative and ethical ways to involve families in the decision-making process for patients at risk of suicide