Defining sustainable transport in rural tourism: experiences from the New Forest

Transport policy agendas have long sought to bring about more sustainable transport at tourism destinations. While there are examples of successes, it remains unclear what inroads have been made towards creating a sustainable transport future. Policy directions have evolved over a number of years and in many tourism destination contexts it is far from clear what a desirable transport future looks like. When translated to implementation, the aims of initiatives can be unclear and baseline measures inconsistent, making success difficult to judge. This paper analyses how sustainable travel has been implemented in practice at a destination level. The focus is rural tourism and data are derived from a specific case, the New Forest National Park, UK, where a wide range of transport initiatives have been implemented since the Park’s designation in 2005. The study adopts a social practice theory perspective. Data are derived from a visitor survey, interviews and observations. It finds there is scope to improve sustainable transport provision at destinations through understanding visitor practices, but limited scope to influence meanings associated with visitor travel and travel skills. Policy meets the needs of some visitors more than others

Primary health care delivery models in rural and remote Australia – a systematic review

© 2008 Wakerman et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background One third of all Australians live outside of its major cities. Access to health services and health outcomes are generally poorer in rural and remote areas relative to metropolitan areas. In order to improve access to services, many new programs and models of service delivery have been trialled since the first National Rural Health Strategy in 1994. Inadequate evaluation of these initiatives has resulted in failure to garner knowledge, which would facilitate the establishment of evidence-based service models, sustain and systematise them over time and facilitate transfer of successful programs. This is the first study to systematically review the available published literature describing innovative models of comprehensive primary health care (PHC) in rural and remote Australia since the development of the first National Rural Health Strategy (1993–2006). The study aimed to describe what health service models were reported to work, where they worked and why. Methods A reference group of experts in rural health assisted in the development and implementation of the study. Peer-reviewed publications were identified from the relevant electronic databases. 'Grey' literature was identified pragmatically from works known to the researchers, reference lists and from relevant websites. Data were extracted and synthesised from papers meeting inclusion criteria. Results A total of 5391 abstracts were reviewed. Data were extracted finally from 76 'rural' and 17 'remote' papers. Synthesis of extracted data resulted in a typology of models with five broad groupings: discrete services, integrated services, comprehensive PHC, outreach models and virtual outreach models. Different model types assume prominence with increasing remoteness and decreasing population density. Whilst different models suit different locations, a number of 'environmental enablers' and 'essential service requirements' are common across all model types. Conclusion Synthesised data suggest that, moving away from Australian coastal population centres, sustainable models are able to address diseconomies of scale which result from large distances and small dispersed populations. Based on the service requirements and enablers derived from analysis of reported successful PHC service models, we have developed a conceptual framework that is particularly useful in underpinning the development of sustainable PHC models in rural and remote communities

Analysis of ground-source heat pumps in north-of-England homes

YesThe performance of Ground Source Heat Pump (GSHP) systems for domestic use is an increasing area of study in the UK. This paper examines the thermal performance of three bespoke shallow horizontal GSHP systems installed in newly built residential houses in the North of England against a control house which was fitted with a standard gas boiler. A total of 350 metres of High Density Polyethylene pipe with an external diameter of 40 mm was used for each house as a heat pump loop. The study investigated (i) the performance of a single loop horizontal Ground Heat Exchanger (GHE) against a double loop GHE and (ii) rainfall effects on heat extraction by comparing a system with an infiltration trench connected to roof drainage against a system without an infiltration trench above the ground loops. Parameters monitored for a full year from October 2013 to September 2014. Using the double GHE has shown an enhanced performance of up to 20% compared with single GHE. The infiltration trench is found to improve performance of the heat pumps; the double loop GHE system with an infiltration trench had a COP 5% higher than that of the double loop GHE system without a trench

Flood vulnerability, risk and social disadvantage: current and future patterns in the UK

Present day and future social vulnerability, flood risk and disadvantage across the UK are explored using the UK Future Flood Explorer. In doing so, new indices of neighbourhood flood vulnerability and social flood risk are introduced and used to provide a quantitative comparison of the flood risks faced by more and less socially vulnerable neighbourhoods. The results show the concentrated nature of geographic flood disadvantage. For example, ten local authorities account for fifty percent of the most socially vulnerable people that live in flood prone areas. The results also highlight the systematic nature of flood disadvantage. For example, flood risks are higher in socially vulnerable communities than elsewhere; this is shown to be particularly the case in coastal areas, economically struggling cities and dispersed rural communities. Results from a re-analysis of the Environment Agency’s Long-Term Investment Scenarios (for England) suggests a long-term economic case for improving the protection afforded to the most socially vulnerable communities; a finding that reinforces the need to develop a better understanding of flood risk in socially vulnerable communities if flood risk management efforts are to deliver fair outcomes. In response to these findings the paper advocates an approach to flood risk management that emphasizes Rawlsian principles of preferentially targeting risk reduction for the most socially vulnerable and avoids a process of prioritisation based upon strict utilitarian or purely egalitarian principles

A Corporate Social Entrepreneurship Approach to Market-Based Poverty Reduction

In this article, we aim to conceptualize a market-based approach to poverty reduction from a corporate social entrepreneurship (CSE) perspective. Specifically, we describe some market-based initiatives at the base of the economic pyramid and relate them to the social entrepreneurship literature. We refer to the entrepreneurial activities of multinational corporations that create social value as CSE. We then conceptualize CSE according to the corporate entrepreneurship and social entrepreneurship domains and shed light on how corporations can implement CSE. Finally, by reviewing relevant literature, we propose some of the factors that can stimulate CSE in organizations and some of the benefits companies can gain by implementing CSE

Community mobilisation with women's groups facilitated by Accredited Social Health Activists (ASHAs) to improve maternal and newborn health in underserved areas of Jharkhand and Orissa: study protocol for a cluster-randomised controlled trial

Background: Around a quarter of the world's neonatal and maternal deaths occur in India. Morbidity and mortality are highest in rural areas and among the poorest wealth quintiles. Few interventions to improve maternal and newborn health outcomes with government-mandated community health workers have been rigorously evaluated at scale in this setting.The study aims to assess the impact of a community mobilisation intervention with women's groups facilitated by ASHAs to improve maternal and newborn health outcomes among rural tribal communities of Jharkhand and Orissa.Methods/design: The study is a cluster-randomised controlled trial and will be implemented in five districts, three in Jharkhand and two in Orissa. The unit of randomisation is a rural cluster of approximately 5000 population. We identified villages within rural, tribal areas of five districts, approached them for participation in the study and enrolled them into 30 clusters, with approximately 10 ASHAs per cluster. Within each district, 6 clusters were randomly allocated to receive the community intervention or to the control group, resulting in 15 intervention and 15 control clusters. Randomisation was carried out in the presence of local stakeholders who selected the cluster numbers and allocated them to intervention or control using a pre-generated random number sequence. The intervention is a participatory learning and action cycle where ASHAs support community women's groups through a four-phase process in which they identify and prioritise local maternal and newborn health problems, implement strategies to address these and evaluate the result. The cycle is designed to fit with the ASHAs' mandate to mobilise communities for health and to complement their other tasks, including increasing institutional delivery rates and providing home visits to mothers and newborns. The trial's primary endpoint is neonatal mortality during 24 months of intervention. Additional endpoints include home care practices and health care-seeking in the antenatal, delivery and postnatal period. The impact of the intervention will be measured through a prospective surveillance system implemented by the project team, through which mothers will be interviewed around six weeks after delivery. Cost data and qualitative data are collected for cost-effectiveness and process evaluations

Describing the impact of health research: a Research Impact Framework

BACKGROUND: Researchers are increasingly required to describe the impact of their work, e.g. in grant proposals, project reports, press releases and research assessment exercises. Specialised impact assessment studies can be difficult to replicate and may require resources and skills not available to individual researchers. Researchers are often hard-pressed to identify and describe research impacts and ad hoc accounts do not facilitate comparison across time or projects. METHODS: The Research Impact Framework was developed by identifying potential areas of health research impact from the research impact assessment literature and based on research assessment criteria, for example, as set out by the UK Research Assessment Exercise panels. A prototype of the framework was used to guide an analysis of the impact of selected research projects at the London School of Hygiene and Tropical Medicine. Additional areas of impact were identified in the process and researchers also provided feedback on which descriptive categories they thought were useful and valid vis-à-vis the nature and impact of their work. RESULTS: We identified four broad areas of impact: I. Research-related impacts; II. Policy impacts; III. Service impacts: health and intersectoral and IV. Societal impacts. Within each of these areas, further descriptive categories were identified. For example, the nature of research impact on policy can be described using the following categorisation, put forward by Weiss: Instrumental use where research findings drive policy-making; Mobilisation of support where research provides support for policy proposals; Conceptual use where research influences the concepts and language of policy deliberations and Redefining/wider influence where research leads to rethinking and changing established practices and beliefs. CONCLUSION: Researchers, while initially sceptical, found that the Research Impact Framework provided prompts and descriptive categories that helped them systematically identify a range of specific and verifiable impacts related to their work (compared to ad hoc approaches they had previously used). The framework could also help researchers think through implementation strategies and identify unintended or harmful effects. The standardised structure of the framework facilitates comparison of research impacts across projects and time, which is useful from analytical, management and assessment perspectives

Beliefs and expectations of rural hospital practitioners towards a developing trauma system: A qualitative case study

Background: An understanding of stakeholders’ views is key to the successful development and operation of a rural trauma system. Scotland, which has large remote and rural areas, is currently implementing a national trauma system. The aim of this study was to identify key barriers and enablers to the development of an effective trauma system from the perspective of rural healthcare professionals. Methods: This is a qualitative study, which was conducted in rural general hospitals (RGH) in Scotland, from April to June 2017. We used an opportunistic sampling strategy to include hospital providers of rural trauma care across the region. Semi-structured interviews were conducted, recorded, and transcribed. Thematic analysis was used to identify and group participant perspectives on key barriers and enablers to the development of the new trauma system. Results: We conducted 15 interviews with 18 participants in six RGHs. Study participants described barriers and enablers across three themes: 1) quality of care, 2) interfaces within the system and 3) interfaces with the wider healthcare system. For quality of care, enablers included confidence in basic trauma management, whilst a perceived lack of change from current management was seen as a barrier. The theme of interfaces within the system identified good interaction with other services and a single point of contact for referral as enablers. Perceived barriers included challenges in referring to tertiary care. The final theme of interfaces with the wider healthcare system included an improved transport system, increased audit resource and coordinated clinical training as enablers. Perceived barriers included a rural staffing crisis and problematic patient transfer to further care. Conclusions: This study provides insight into rural professionals’ perceptions regarding the implementation of a trauma system in rural Scotland. Barriers included practical issues, such as retrieval, transfer and referral processes. Importantly, there is a degree of uncertainty, discontent and disengagement towards trauma system development, and concerns regarding staffing levels and governance. These issues are unlikely to be unique to Scotland and warrant further study to inform service planning and the effective delivery of rural trauma systems

Land tenure in Scotland

SIGLEAvailable from British Library Document Supply Centre-DSC:4671.14(1st) / BLDSC - British Library Document Supply CentreGBUnited Kingdo