Management of Rural Water Services in Nicaragua: A Systematic Network Approach to Evaluating Stakeholder Alignment

Water sector literature attributes a substantial cause of rural water system failure in developing countries to poor alignment between water service stakeholders. This study aimed to investigate a means for assessing stakeholder alignment by comparing the systemic interaction of stakeholder values, where the term ‘stakeholder values’ refers to aspects stakeholders believe are necessary to ensure rural water services are sustainable. The research held focus groups with key stakeholder groups involved in the management of rural water infrastructure in Terrabona, Nicaragua, to identify stakeholder values, and then used cross-impact analysis to evaluate how these values interacted to form stakeholder value networks (SVNs). Using normalized betweenness centrality measures, the structures of SVNs were compared to determine alignment. Results from this study showed high levels of stakeholder alignment on the topics of water resources and technology for the sustainability of rural water systems, while there was marked nonalignment regarding the involvement of local government and organizations in the management of water infrastructure. This study offers compelling evidence for future studies to assess stakeholder alignment by identifying and structurally analyzing SVNs

Mindfulness and Life Experiences as Predictors of Perceived Stress in Speech Language Pathologists

Speech language pathologists (SLPs) struggle with significant levels of stress during training, which impacts their academic success and well-being and may be carried into the workforce. Many institutions are implementing mindfulness-based programs (MBPs) to help students manage their stress because research shows that MBPs are moderately effective in helping reduce stress. The purpose of this study, grounded by the transtheoretical theory of stress and coping and the mindfulness to meaning theory, was to determine if facets of mindfulness and the experience of positive or negative life experiences predict levels of perceived stress in SLPs who participated in a mindfulness training. Quantitative data were collected through an online survey of all SLP graduates of a private institution (N = 270) who agreed to participate in the study (n = 33). The survey assessed facets of mindfulness with the Five Facet Mindfulness Questionnaire, stress with the Perceived Stress Scale, and positive and negative life experiences with the Life Experiences Survey. Data were analyzed with linear regression with the facets of mindfulness and life experiences as the predictors and perceived stress as the outcome. Facets of mindfulness and positive and negative life experiences were found to predict perceived stress, while acting with awareness was the only facet to be predictive of stress in all models. The findings should be interpreted with caution due to low power and are not generalizable beyond this sample; however, mindfulness training emphasizing acting with awareness and having a nonjudgmental attitude may promote positive change by decreasing academic stress in students and burnout in health care professionals

Family Perspectives of the Professional-Paraprofessional Partnership Model of Home-Based Early Intervention Service Delivery

Current legislation regarding early intervention services has focused on the family unit, rather than the individual child, as the recipient of services. A model of family-centered care has been adopted and as a result, new models for service delivery have been developed. The present study examined family perspectives of the professional-paraprofessional partnership model, and assessed the ecological validity of this model as it relates to the basic principles of family-centered care. Families who participated in an early intervention program that utilized the professional-paraprofessional partnership model were interviewed upon program completion. Families reported receiving a wide range of child and family services, as well as assistance from their home visitor in accessing formal and informal resources within their community. Families recognized and positively responded to visitors who were flexible, supportive, and respectful of their family. A positive relationship was found between the number of family services received and ratings of the home visitor on variables of flexibility, support, and control. The majority of families described the home visiting service as the most helpful service they received. In addition, there were no differences in the services provided by professional and paraprofessional visitors, as reported by families. Overall, family reports indicated parent satisfaction with the professional-paraprofessional partnership model, and this model was found to meet the proposed family-centered objectives for early intervention services

Factors Influencing Revenue Collection for Preventative Maintenance of Community Water Systems: A Fuzzy-Set Qualitative Comparative Analysis

This study analyzed combinations of conditions that influence regular payments for water service in resource-limited communities. To do so, the study investigated 16 communities participating in a new preventive maintenance program in the Kamuli District of Uganda under a public–private partnership framework. First, this study identified conditions posited as important for collective payment compliance from a literature review. Then, drawing from data included in a water source report and by conducting semi-structured interviews with households and water user committees (WUC), we identified communities that were compliant with, or suspended from, preventative maintenance service payments. Through qualitative analyses of these data and case knowledge, we identified and characterized conditions that appeared to contribute to these outcomes. Then, we employed fuzzy-set qualitative comparative analysis (fsQCA) to determine the combinations of conditions that led to payment compliance. Overall, the findings from this study reveal distinct pathways of conditions that impact payment compliance and reflect the multifaceted nature of water point sustainability. Practically, the findings identify the processes needed for successful payment compliance, which include a strong WUC with proper support and training, user perceptions that the water quality is high and available in adequate quantities, ongoing support, and a lack of nearby water sources. A comprehensive understanding of the combined factors that lead to payment compliance can improve future preventative maintenance programs, guide the design of water service arrangements, and ultimately increase water service sustainability

Elisabeth Schüssler Fiorenza: within or beyond the Third Quest for the historical Jesus?

The quests for the historical Jesus have seen a number of developments in the ways in which we study Jesus, and in the conclusions we come to about his life and influence. One of these developments has been the increased number of feminist publications, in part driven by Elisabeth Schüssler Fiorenza. Schüssler Fiorenza’s work looks to uncover the reality of Christianity’s kyriarchal origins, and to encourage her peers to engage in historical Jesus research that is self-evaluating. These concerns are also evident in the work of other Third Quest feminist researchers who recognise the negative impact of continued patriarchal publications on the lives of women today. Through an evaluation of Schüssler Fiorenza’s work on fundamentalism, feminism, and anti-Semitism, this dissertation situates Schüssler Fiorenza’s work and that of other feminist researchers within the quests and asks whether the Third Quest was ready for the work of Elisabeth Schüssler Fiorenza. The reformative and critical work of Schüssler Fiorenza, like that of her fellow feminist researchers, often goes uncited, despite its value in problematising historical Jesus research. By comparing the work of prominent Third Questers with that of Schüssler Fiorenza et al., this dissertation finds cause to propose the existence of a Third Quest Critical-Stream, whereby feminist researchers not only contribute to malestream scholarship but also engage in work that looks to inform and improve the state of the Third Quest

System Approaches to Water, Sanitation, and Hygiene: A Systematic Literature Review

Endemic issues of sustainability in the water, sanitation, and hygiene (WASH) sector have led to the rapid expansion of ‘system approaches’ for assessing the multitude of interconnected factors that affect WASH outcomes. However, the sector lacks a systematic analysis and characterization of the knowledge base for systems approaches, in particular how and where they are being implemented and what outcomes have resulted from their application. To address this need, we conducted a wide-ranging systematic literature review of systems approaches for WASH across peer-reviewed, grey, and organizational literature. Our results show a myriad of methods, scopes, and applications within the sector, but an inadequate level of information in the literature to evaluate the utility and efficacy of systems approaches for improving WASH service sustainability. Based on this analysis, we propose four recommendations for improving the evidence base including: diversifying methods that explicitly evaluate interconnections between factors within WASH systems; expanding geopolitical applications; improving reporting on resources required to implement given approaches; and enhancing documentation of effects of systems approaches on WASH services. Overall, these findings provide a robust survey of the existing landscape of systems approaches for WASH and propose a path for future research in this emerging field

System Dynamics Modelling as a Tool for Assessing Rural Water Sustainability

System dynamics modelling is a tool that has been used for decades in business management and economics applications, but little focus has been applied to the WASH sector. Specifically, this paper discusses the use of causal loop diagrams and stock flow diagrams as methods to better understand the systemic drivers affecting sustainability of rural water service delivery

Understanding Rural Water Services as a Complex System: An Assessment of Key Factors as Potential Leverage Points for Improved Service Sustainability

Rural water supply services worldwide consistently fail to deliver full public health impacts as intended due to a low service sustainability. This failure is increasingly attributed to weak local systems composed of social, financial and environmental factors. Current approaches in the water, sanitation and hygiene (WASH) sector for understanding and improving these systems typically focus on the strength and capacity of these factors, but not the interactions between them. We contend that these approaches overlook the inherent complexity and context-specific nature of each local system. To assess this complexity, we conducted four participatory factor mapping workshops with local stakeholders across multiple rural water contexts to identify the factors and interactions that support service sustainability. We then evaluate the potential for factors to act as strategic leverage points based on influence, dependence and feedback metrics that arise from their interactions with other factors. We find that while participants across the contexts tend to identify a common set of factors, the interactions amongst those factors and their individual ability to influence service sustainability varies considerably across contexts. These findings suggest that a more intentional focus on factor interactions inWASH systems could lead to more effective strategies for improving service sustainability

Cardiff ONline Cognitive Assessment (CONCA): Results from a web-based national population cohort

Background: Psychiatric disorders are associated with cognitive impairment. We have developed a web-based, 9-task cognitive battery to measure the core domains affected in people with psychiatric disorders. To date, this assessment has been used to collect data on a clinical sample of participants with psychiatric disorders. Objective: The aims of this study were (1) to establish a briefer version of the battery (called the Cardiff Online Cognitive Assessment [CONCA]) that can give a valid measure of cognitive ability (“g”) and (2) to collect normative data and demonstrate CONCA’s application in a health population sample. Methods: Based on 6 criteria and data from our previous study, we selected 5 out of the original 9 tasks to include in CONCA. These included 3 core tasks that were sufficient to derive a measure of “g” and 2 optional tasks. Participants from a web-based national cohort study (HealthWise Wales) were invited to complete CONCA. Completion rates, sample characteristics, performance distributions, and associations between cognitive performance and demographic characteristics and mental health measures were examined. Results: A total of 3679 participants completed at least one CONCA task, of which 3135 completed all 3 core CONCA tasks. Performance on CONCA was associated with age (B=–0.05, SE 0.002; P<.001), device (tablet computer: B=–0.26, SE 0.05; P<.001; smartphone: B=–0.46, SE 0.05; P<.001), education (degree: B=1.68, SE 0.14; P<.001), depression symptoms (B=–0.04, SE 0.01; P<.001), and anxiety symptoms (B=–0.04, SE 0.01; P<.001). Conclusions: CONCA provides a valid measure of “g,” which can be derived using as few as 3 tasks that take no more than 15 minutes. Performance on CONCA showed associations with demographic characteristics in the expected direction and was associated with current depression and anxiety symptoms. The effect of device on cognitive performance is an important consideration for research using web-based assessments