119 research outputs found
Promoting community renewable energy in a corporate energy world.
Small-scale, decentralized and community-owned renewable energy is widely acknowledged to be a desirable feature of low carbon futures, but faces a range of challenges in the context of conventional, centralized energy systems. This paper draws on transition frameworks to investigate why the UK has been an inhospitable context for community-owned renewables and assesses whether anything fundamental is changing in this regard. We give particular attention to whether political devolution, the creation of elected governments for Scotland, Wales and Northern Ireland, has affected the trajectory of community renewables. Our analysis notes that devolution has increased political attention to community renewables, including new policy targets and support schemes. However, these initiatives are arguably less important than the persistence of key features of socio-technical regimes: market support systems for renewable energy and land-use planning arrangements that systemically favour major projects and large corporations, and keep community renewables to the margins. There is scope for rolling out hybrid pathways to community renewables, via joint ownership or through community benefit funds, but this still positions community energy as an adjunct to energy pathways dominated by large, corporate generation facilities
A randomised controlled trial to evaluate the impact of a human rights based approach to dementia care in inpatient ward and care home settings
BackgroundAlthough it is widely recognised that adopting a person-centred approach is beneficial in the care of people living with dementia, a gap remains between the rhetoric and the reality of quality care. Some widely adopted care practices can result in the personhood of this group being threatened and their human rights being undermined.ObjectivesTo evaluate the impact of applying a human rights based approach in dementia inpatient wards and care homes on the quality of care delivered and the well-being of the person living with dementia.DesignA cluster randomised design was employed to compare the impact of implementing a human rights based approach intervention (i.e. training, applying the ‘Getting It Right’ assessment tool and receiving booster sessions) at 10 intervention sites with 10 control sites.SettingEight NHS dementia inpatient wards and 12 care homes in the north-west of England.ParticipantsPeople living with dementia who were residing on dementia inpatient wards or in care homes, and staff working at these sites. The aim was to recruit 280 people living with dementia.InterventionsA sample of staff (an average of 8.9 per site) at each of the sites was trained in a human rights based approach to care, including the application of the ‘Getting It Right’ assessment tool. The tool was then introduced at the site and monthly booster sessions were delivered.Main outcome measuresThe primary outcome measure used in the research was the Quality of Life in Alzheimer’s Disease scale to assess the subjective well-being of the person with dementia. Secondary outcome measures included measures of the quality of care provided (dementia care mapping) and direct measures of the effectiveness of the training in increasing knowledge of and attitudes towards human rights. The study also included an economic evaluation utilising the EuroQol-5 Dimensions, three-level version, and the Adult Social Care Outcomes Toolkit measure.ResultsThe study recruited 439 people living with dementia: 213 to the intervention arm and 226 to the control arm. Primary outcome data were analysed using a linear mixed model. There were no significant differences found in the reported quality of life of residents between the control and intervention groups after the intervention [F(1,16.51) = 3.63;p = 0.074]. The mean difference between the groups was 1.48 (95% confidence interval –7.86 to 10.82).ConclusionsDespite the fact that the training increased staff knowledge of and positive attitudes towards human rights, and although there were some changes in staff decision-making strategies in clinical situations, there was no change in the quality of care provided or in the reported well-being of people living with dementia in these settings. This led to questions about the efficacy of training in bringing about cultural change and improving care practices.LimitationsThere was limited uptake of the training and booster sessions that were integral to the intervention.Future workFuture work could usefully focus on understanding the difficulty in translating change in attitude and knowledge into behaviour.Trial registrationCurrent Controlled Trials ISRCTN94553028.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full inHealth Services and Delivery Research; Vol. 6, No. 13. See the NIHR Journals Library website for further project information.</jats:sec
Edinburgh, June 19. 1690. The general meeting of the ministers and elders of this Church ...
A remonstrance and declaration of the Generall Assembly of the Church of Scotland, concerning present and imminent dangers, and concerning duties relating thereto.
Causes of an humiliation appointed by the commission of the General Assembly to be observed through this whole Kirk on the last Sabbath of March, and first Sabbath of Aprile, 1653.
A seasonable and necessary warning concerning present dangers and duties from the commissioners of the Generall Assembly, unto all the members of this kirk.
Causes of a publike fast and humiliation appointed by the commission of the General Assembly to be kept in all the congregations of this Kirk upon the third Sabbath of September, in this yeer 1646.
Directions of the Generall Assembly concerning secret and private worship, and mutual edification, for cherishing piety, for maintaining unity, and avoyding schism and division. With an act for observing these directions, and for censuring such as use to neglect family worship. And an act against such as withdraw themselves from the publick worship in their own congregations.
Treason and rebellion against their native country justly rewarded upon severall traitors and rebels lately executed in Scotland. Certified by an expresse in two letters dated at Saint Andrews, Jan. 26. 1645. Together with a declaration of the Generall Assembly of the Church of Scotland. Published by authority.
Causes of a solemn national fast and humiliation, agreed upon by the Commissioners of the late General Assembly, met at Edinburgh the 4. of June 1696 and presented to the Lords of His Majesties most honourable Privy Council, to be read by the ministers, in all the churches at the intimation of the said fast.
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