Developing climate change adaptation plans for the health sector at the subnational level

Climate change impacts represent threats to the population worldwide, and the health sector which is responsible for taking care of their life and health will also be impacted. While the consequences of these impacts are imminent, little or nothing has been done by the health sector at national and sub-national levels worldwide to prepare to respond to them. Therefore, health adaptation planning in regard to climate change is crucial to building climate-resilient health systems. This research aims to propose an approach containing phases and steps for developing a Health Adaptation Plan at a sub-national level. The methodology involved the collection and analysis of several guidelines and tools provided by the WHO and other relevant organisations,. This is supplemented by analysis of existing Health Adaptation Plans at national and subnational levels developed in different governmental organisations and systems worldwide since 2003. The findings included four phases and twelve steps for developing Health Adaptation Plans at subnational- level organisations in the health sector. This establishes guidance for subnational organisations within the health sector that are planning to develop a Health Adaptation Pla

Extension\u27s Role in Facilitating Collaborative Initiatives: Direct Marketing Farm Products on the Internet

Using the Internet to direct market farm products provides multiple opportunities for producers to expand their existing businesses. Most often, these initiatives are undertaken by individual businesses. However, recent efforts in Central Pennsylvania suggest ways in which Extension can facilitate collaborative initiatives to direct market farm products online. In addition to increasing the profitability of small producers, collaborative marketing efforts can also contribute to sustainable community outcomes. Inherent in our discussion is the assumption that the principals of facilitating collaborative initiatives to direct market farm products online can be used to facilitate collaborate initiatives in other programmatic areas

A study of the innovation process within the construction project environment

Over the last decade the low levels of innovation observed within the construction industry have been identified as potentially threatening the long-term future and sustainability of the industry. The root of the problem centres not on its idea generation or creativity capabilities, but on an inability to implement and manage the innovation process. Construction management is identified as focusing predominantly on `innovation' and its management implications within three predominant lines of enquiry; by focusing on specific types of innovation, from an institutional viewpoint and from an emerging organisational perspective, and therefore neglecting a project focus. Academics expressed concern that this failure was aligned to a wider failure to understand the realities of managing innovation within the project environment as a mode of production.This thesis aims to understand the conceptual existence of innovation within the project environment, and to develop an understanding of the nature of the interaction of the innovation process and its management within the wider processes and requirements of the project. The research sought to develop a set of attributes for innovation in projects, assess the possibility of developing a model of the innovation process, and a set of management success factors.A qualitative research approach was adopted using the principles of grounded theory,with the objective of allowing an understanding of the innovation process to emerge within the context of the construction project. A representative sample of nine case studies were selected and considered using a longitudinal approach. 75 semi- structured interviews were conducted across the case studies and analysed using grounded theory. A pilot study of analysis techniques revealed the value of applying the Nvivo software package to assist in the handling of complex data and an advanced cross comparison of the influence of the individual attributes. The thesis presents a generic model of the innovation process, highlighting the factors of influence and management requirements for its successful management. The model is structured as a linear process model, with four phases (initial, formulation and development, implementation and handover) with the boundaries between each determined by a decision gate. Two layers of management were observed for each phase, the phase specific management control system and the overall innovation management. Emphasis was placed on the inclusion of feedback within the model, highlighted at all levels and phases of the process. The research observed the contrasting nature of the integration of the innovation and project processes for the different innovation types, highlighting the varying significance of the activities of the process depending on the form of the attribute. The model displayed a generic structure, however it was observed that within each phase the nature of the activities and influencing factors were fluid and fuzzy, determined by the contextual nature of the attributes.22 generic management success factors were identified across the innovation process divided into strategic, structural and cultural factors. Analysis observed that the significance for management of each of these factors varied depending on the influence of the form of each of the attributes. Key success factors for facilitating the form of each attribute were presented, however evidence suggested that only by considering the influence of the attributes as a set would successful management be achieved. A management facilitation grid is presented to aid practitioners in identifying the nature of an appropriate management response, representative of the requirements of the particular context.The findings of this research present the opportunity for the further investigation of its specifics and wider implications as it marks merely the starting point of our understanding. An expansion of the number of case studies would provide the opportunity to increase the focus on the specifics of the research and allow for the widening of its scope to include for example, the role of SME's and the implications of the supply- chain. However, it is the potential offered within the research by taking its findings back to the industry for practical consideration that is particularly exciting. The adoption of its principles within practical examples would further the development of the model and the understanding of its practical relevance. Further, the findings of the research have the potential to be developed into training packages for those managing innovation, with particular reference to the use of the grid as a tool.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

The ‘Rocket Framework’: a novel framework to define key performance indicators for nature-based solutions against shallow landslides and erosion

The idea of nature providing solutions to societal challenges is relatively easy to understand by the layperson. Nature-based solutions (NBS) against landslides and erosion mostly comprise plant-based interventions in which the reinforcement of slopes provided by vegetation plays a crucial role in natural hazard prevention and mitigation, and in the provision of multiple socio-ecological benefits. However, the full potential of NBS against landslides and erosion is not realised yet because a strong evidence base on their multi-functional performance is lacking, hindering the operational rigour of NBS practice and science. This knowledge gap can be addressed through the definition of repositories of key performance indicators (KPIs) and metrics, which should stem from holistic frameworks facilitating the multi-functional assessment of NBS. Herein, we propose the ‘rocket framework’ to promote the uptake of NBS against landslides and erosion through the provision of a comprehensive set of indicators which, through their appropriate selection and measurement, can contribute to build a robust evidence base on NBS performance. The ‘rocket framework’ is holistic, reproducible, dynamic, versatile, and flexible in helping define metrics for NBS actions against landslides and erosion along the NBS project timeline. The framework, resultant from an iterative research approach applied in a real-world environment, follows a hierarchical approach to deal with multiple scales and environmental contexts, and to integrate environmental, eco-engineering, and socio-ecological domains, thus establishing a balance between monitoring the engineering performance of NBS actions against landslides and erosion, and the wider provision of ecosystem functions and services. Using a case study, and following the principles of credibility, salience, legitimacy, and feasibility, we illustrate herein how the ‘rocket framework’ can be effectively employed to define a repository with over 40 performance indicators for monitoring NBS against landslides and erosion, and with over 60 metrics for establishing the context and baseline upon which the NBS are built and encourage their reproduction and upscaling

Applying the ROBINS-I tool to natural experiments: an example from public health

Background: A new tool to assess Risk of Bias In Non-randomised Studies of Interventions (ROBINS-I) was published in Autumn 2016. ROBINS-I uses the Cochrane-approved risk of bias (RoB) approach and focusses on internal validity. As such, ROBINS-I represents an important development for those conducting systematic reviews which include non-randomised studies (NRS), including public health researchers. We aimed to establish the applicability of ROBINS-I using a group of NRS which have evaluated non-clinical public health natural experiments. Methods: Five researchers, all experienced in critical appraisal of non-randomised studies, used ROBINS-I to independently assess risk of bias in five studies which had assessed the health impacts of a domestic energy efficiency intervention. ROBINS-I assessments for each study were entered into a database and checked for consensus across the group. Group discussions were used to identify reasons underpinning lack of consensus for specific questions and bias domains. Results: ROBINS-I helped to systematically articulate sources of bias in NRS. However, the lack of consensus in assessments for all seven bias domains raised questions about ROBINS-I’s reliability and applicability for natural experiment studies. The two RoB domains with least consensus were selection (Domain 2) and performance (Domain 4). Underlying the lack of consensus were difficulties in applying an intention to treat or per protocol effect of interest to the studies. This was linked to difficulties in determining whether the intervention status was classified retrospectively at follow-up, i.e. post hoc. The overall risk of bias ranged from moderate to critical; this was most closely linked to the assessment of confounders. Conclusion: The ROBINS-I tool is a conceptually rigorous tool which focusses on risk of bias due to the counterfactual. Difficulties in applying ROBINS-I may be due to poor design and reporting of evaluations of natural experiments. While the quality of reporting may improve in the future, improved guidance on applying ROBINS-I is needed to enable existing evidence from natural experiments to be assessed appropriately and consistently. We hope future refinements to ROBINS-I will address some of the issues raised here to allow wider use of the tool

A comprehensive evaluation of colonic mucosal isolates of Sutterella wadsworthensis from inflammatory bowel disease

Peer reviewedPublisher PD