Towards evaluation criteria in participatory flood risk management

Flood risk consists of complex and dynamic problems, whose management calls for innovative ways of engaging with a wide range of local stakeholders, many of whom lack the technical expertise to engage with traditional flood risk management practices. Participatory approaches offer potential for involving these stakeholders in decision-making, yet limited advice is available to users in choosing which techniques to employ and what they might expect them to deliver. Assessing the effectiveness of participatory approaches in local flood risk management is a critical step towards better understanding how community resilience is built. This paper presents a framework for evaluating participatory approaches to flood risk management that covers four evaluation elements (context, process, substantive and social outcomes). Practical success criteria are provided for evaluation, with references indicating where further advice and guidance can be sought. Criteria are tailored to the requirements of flood risk management, and aim to be sufficiently flexible for the framework to be easily transferable

Shared Decision-Making With a Virtual Patient in Medical Education: Mixed Methods Evaluation Study.

BACKGROUND: Shared decision-making (SDM) is a process in which clinicians and patients work together to select tests, treatments, management, or support packages based on clinical evidence and the patient's informed preferences. Similar to any skill, SDM requires practice to improve. Virtual patients (VPs) are simulations that allow one to practice a variety of clinical skills, including communication. VPs can be used to help professionals and students practice communication skills required to engage in SDM; however, this specific focus has not received much attention within the literature. A multiple-choice VP was developed to allow students the opportunity to practice SDM. To interact with the VP, users chose what they wanted to say to the VP by choosing from multiple predefined options, rather than typing in what they wanted to say. OBJECTIVE: This study aims to evaluate a VP workshop for medical students aimed at developing the communication skills required for SDM. METHODS: Preintervention and postintervention questionnaires were administered, followed by semistructured interviews. The questionnaires provided cohort-level data on the participants' views of the VP and helped to inform the interview guide; the interviews were used to explore some of the data from the questionnaire in more depth, including the participants' experience of using the VP. RESULTS: The interviews and questionnaires suggested that the VP was enjoyable and easy to use. When the participants were asked to rank their priorities in both pre- and post-VP consultations, there was a change in the rank position of respecting patient choices, with the median rank changing from second to first. Owing to the small sample size, this was not analyzed for statistical significance. The VP allowed the participants to explore a consultation in a way that they could not with simulated or real patients, which may be part of the reason that the VP was suggested as a useful intervention for bridging from the early, theory-focused years of the curriculum to the more patient-focused ones later. CONCLUSIONS: The VP was well accepted by the participants. The multiple-choice system of interaction was reported to be both useful and restrictive. Future work should look at further developing the mode of interaction and explore whether the VP results in any changes in observed behavior or practice

A cohort study of influences, health outcomes and costs of patients' health-seeking behaviour for minor ailments from primary and emergency care settings

To compare health-related and cost-related outcomes of consultations for symptoms suggestive of minor ailments in emergency departments (EDs), general practices and community pharmacies

Estimating the burden of minor ailment consultations in general practices and emergency departments through retrospective review of routine data in North East Scotland

Minor ailment attendances in general practices and emergency departments (EDs) place significant burden on health care resources

A Study to Validate a Self-Reported Version of the ONS Drug Dependence Questionnaire

Aim: A prospective study to establish the reliability of a self-completion version of the Office for National Statistics (ONS) questionnaire for assessing drug dependence of substance misuse clients. Method: A total of 47 treatment seeking opioid-dependent clients completed the self-complete version of the ONS questionnaire (ONS-sc) followed by the interviewer-administered ONS questionnaire (ONS-ia) at a single clinic appointment. Scores for four Class A drugs (heroin, methadone, speed and crack/cocaine) from both formats were compared. Results: The observed agreement was 87% or more and Cohen's kappa was 0.7 (p < 0.001) or more for all four Class A drugs. Sensitivity for each Class A drugs was 56% or higher and specificity was 87% or higher. Sensitivity for severe heroin dependency was 98% (CI 89–100%). There was a 100% correlation between the ONS-sc and positive urine analysis for heroin use. However, methadone and crack/cocaine drug use appeared under reported. Conclusion: ONS-sc is a feasible, practical and time-saving alternative to a detailed interview on drug dependence. Further research with a larger sample size and non-opiate-dependent clients are needed, as this could prove a useful tool for monitoring clients in everyday practice, or for survey purposes where interviews are impractical

A Five-Component Biginelli-Diels-Alder Cascade Reaction

A new multi-component condensation was discovered during the reaction of a urea, β-keto ester, and formaldehyde. In the presence of catalytic indium bromide, a Biginelli dihydropyrimidinone intermediate was further converted to a five-component condensation product through a formal hetero Diels-Alder reaction. The product structure was confirmed by NMR and NOE analysis, and the proposed stepwise mechanism was supported by the reaction of the Biginelli intermediate with ethyl 2-methylene-3-oxobutanoate

The blue-green path to urban flood resilience

Abstract Achieving urban flood resilience at local, regional and national levels requires a transformative change in planning, design and implementation of urban water systems. Flood risk, wastewater and stormwater management should be re-envisaged and transformed to: ensure satisfactory service delivery under flood, normal and drought conditions, and enhance and extend the useful lives of ageing grey assets by supplementing them with multi-functional Blue-Green infrastructure. The aim of the multidisciplinary Urban Flood Resilience (UFR) research project, which launched in 2016 and comprises academics from nine UK institutions, is to investigate how transformative change may be possible through a whole systems approach. UFR research outputs to date are summarised under three themes. Theme 1 investigates how Blue-Green and Grey (BG + G) systems can be co-optimised to offer maximum flood risk reduction, continuous service delivery and multiple co-benefits. Theme 2 investigates the resource capacity of urban stormwater and evaluates the potential for interoperability. Theme 3 focuses on the interfaces between planners, developers, engineers and beneficiary communities and investigates citizens’ interactions with BG + G infrastructure. Focussing on retrofit and new build case studies, UFR research demonstrates how urban flood resilience may be achieved through changes in planning practice and policy to enable widespread uptake of BG + G infrastructure.EPSR