scholarly journals Increasing and diversifying turnout in non-electoral participation - a field experiment

2020 ◽  
Author(s):  
Annabelle Sophie Wittels
Keyword(s):  
Field Experiment ◽  
Good Governance ◽  
Large Body ◽  
Large City ◽  
Evidence Base ◽  
Electoral Participation ◽  
Participation Rates ◽  
Rigorous Testing ◽  
Democratic Engagement ◽  
The Uk

Non-electoral participation initiatives are regarded as the gold standard for good governance - encouraging and sustaining democratic engagement. However, participation rates typically are low and disadvantaged groups under-represented. A large body of evidence shows that communication campaigns can increase participation in elections. However, the evidence base for non-electoral participation is scarce and in many aspects completely lacking. This study contributes to the literature by theorising and empirically testing whether such inequalities can be redressed. It uses a randomised field experiment with 29,008 households in a large city in the UK to test the effect of different direct mail messages on participation. It illustrates that rigorous testing of interventions is necessary to understand their impact across different democratic contexts: Contrary to what theory would predict for electoral contexts and paid-for work, all tested interventions significantly decrease participation in the governance initiative under study.

scholarly journals Evidence ν. rights-based decision making for nutrition

2003 ◽  
Vol 62 (2) ◽  
pp. 553-562 ◽  
Author(s):  
Roger Shrimpton
Keyword(s):  
Human Rights ◽  
Large Body ◽  
Well Being ◽  
Evidence Base ◽  
Wide Distribution ◽  
Role Of The State ◽  
Food And Nutrition ◽  
The Uk ◽  
The Right

The need for an evidence base for human nutrition action is analysed in the context of human rights. Over the last 50 years the twin tracks of development, economical needs based and normative rights based, have come progressively closer in terms of goals and objectives, even if they do maintain different orientations and origins. The international human rights machinery is described, together with those parts that are of relevance to the right to food and nutrition. The role of the State in respecting, protecting and facilitating these rights is further described. The evidence base for the benefit of nutrition interventions during the fetal and infant period to the health and well-being of populations throughout life's course is briefly reviewed, and reasons why such a large body of evidence has not been acted upon are discussed. The power of nutrition is in prevention more than cure, and the prevention of nutritional deficiency is best suited to radical population-wide strategies rather than high-risk strategies targeted at individuals. The population-wide distribution of benefits of nutrition is in congruence with universality of human rights. In the UK much remains to be done to ensure that food and nutrition rights are realised, especially during the critical period of fetal and infant growth. What role the Nutrition Society might play in the realisation of these rights, including the creation of a robust evidence base for nutrition action, is further discussed.

Best practice for chronic oedema in community settings: what can we learn?

2020 ◽  
Vol 25 (12) ◽  
pp. 610-614
Author(s):  
Garry Cooper-Stanton
Keyword(s):  
Service Provision ◽  
Best Practice ◽  
Evidence Base ◽  
Community Services ◽  
Guidance Document ◽  
Community Settings ◽  
Tissue Viability ◽  
Delivery Of Care ◽  
Specialist Nurses ◽  
The Uk

There are various opportunities and challenges in the delivery of care to those diagnosed with chronic oedema/lymphoedema. Service provision is not consistent within the UK, and non-specialist nurses and other health professionals may be called on to fill the gaps in this area. The latest best practice guidance on chronic oedema is directed at community services that care for people within their own homes in primary care. This guide was developed in order to increase awareness, knowledge and access to an evidence base. Those involved in its creation cross specialist fields (lymphoedema and tissue viability), resulting in the document covering a number of areas, including an explanation of chronic oedema, its assessment and management and the association between chronic oedema and wet legs. The document complements existing frameworks on the condition and its management and also increases the available tools within chronic oedema management in the community. The present article provides an overview of the guidance document and discusses its salient features.

scholarly journals A Delphi Study Investigating Clinicians’ Views on Access to, Delivery of, and Adaptations of MBCT in the UK Clinical Settings

Mindfulness ◽  
2021 ◽  
Author(s):  
Kate Williams ◽  
Samantha Hartley ◽  
Peter Taylor
Keyword(s):  
Delphi Study ◽  
Good Practice ◽  
Evidence Base ◽  
Clinical Settings ◽  
Training Support ◽  
Decision Making Processes ◽  
Complex Decision Making ◽  
Complex Decision ◽  
The Uk ◽  
Clinical Populations

Abstract Objectives Mindfulness-based cognitive therapy (MBCT) is a well-evidenced relapse-prevention intervention for depression with a growing evidence-base for use in other clinical populations. The UK initiatives have outlined plans for increasing access to MBCT in clinical settings, although evidence suggests that access remains limited. Given the increased popularity and access to MBCT, there may be deviations from the evidence-base and potential risks of harm. We aimed to understand what clinicians believe should be best clinical practice regarding access to, delivery of, and adaptations to MBCT. Methods We employed a two-stage Delphi methodology. First, to develop statements around best practices, we consulted five mindfulness-based experts and reviewed the literature. Second, a total of 59 statements were taken forward into three survey rating rounds. Results Twenty-nine clinicians completed round one, with 25 subsequently completing both rounds two and three. Forty-four statements reached consensus; 15 statements did not. Clinicians agreed with statements regarding sufficient preparation for accessing MBCT, adherence to the evidence-base and good practice guidelines, consideration of risks, sufficient access to training, support, and resources within services, and carefully considered adaptations. The consensus was not reached on statements which reflected a lack of evidence-base for specific clinical populations or the complex decision-making processes involved in delivering and making adaptations to MBCT. Conclusions Our findings highlight the delicate balance of maintaining a client-centred and transparent approach whilst adhering to the evidence-base in clinical decisions around access to, delivery of, and adaptations in MBCT and have important wide-reaching implications.

scholarly journals Older Carers and Carers of People with Dementia: Improving and Developing Effective Support

2020 ◽  
pp. 1-15
Author(s):  
Mary Larkin ◽  
Melanie Henwood ◽  
Alisoun Milne
Keyword(s):  
Third Sector ◽  
Evidence Base ◽  
Service Evaluation ◽  
People With Dementia ◽  
Carer Support ◽  
Tailored Approach ◽  
The Uk ◽  
Similar Stage

The policy drive to support carers is a longstanding national and international priority. Research about the design and delivery of support for carers is critical to the underpinning evidence base. Through a timely exploration of a third sector perspective, the UK-based study discussed in this article provides insights into approaches to, and the commissioning of, support for older carers and carers of people with dementia. The study highlights the importance of: embedding carers’ perspectives in service developments; the provision of both generic and targeted support which adopts a nuanced and tailored approach; titrating the delivery of information and advice at a pace to match carers’ needs; capturing quantitative and qualitative dimensions in service evaluation; and increased quantity and longevity of funding. Such insights not only complement existing research but are also generalisable to other countries at a similar stage in the development of carer support.

scholarly journals Combining antidepressants: a review of evidence

2009 ◽  
Vol 15 (2) ◽  
pp. 90-99 ◽  
Author(s):  
Lena Palaniyappan ◽  
Lisa Insole ◽  
Nicol Ferrier
Keyword(s):  
Side Effect ◽  
Evidence Base ◽  
Side Effect Profile ◽  
Combined Treatments ◽  
Limited Evidence ◽  
Additional Advantage ◽  
Treatment Approaches ◽  
The Uk

SummarySequenced (stepped) treatment approaches are widely endorsed in the management of depression. Combining antidepressants is a recognised step for those failing to respond to monotherapy. Despite the limited evidence base, this strategy is widely used by clinicians in practice. Not every combination used clinically has a sound neuropharmacological rationale and the use of such combinations may increase the side-effect burden without any additional advantage to the patient. Efficacy of various antidepressant combinations along with the data on side-effect profile and toxicity of such combined treatments are reviewed here. The different combinations are considered by each class of antidepressant available in the UK.

scholarly journals Changing dynamics in female employment around childbirth

2006 ◽  
Vol 20 (2) ◽  
pp. 329-347 ◽  
Author(s):  
Jan Dirk Vlasblom ◽  
Joop Schippers
Keyword(s):  
Panel Data ◽  
The Netherlands ◽  
Labour Force ◽  
Work And Family ◽  
Female Employment ◽  
Full Time ◽  
Participation Rates ◽  
Female Labour ◽  
Policy Measures ◽  
The Uk

There is a strong effect of childbirth on female labour supply.This effect, however, is changing over time.This article uses panel data on the last two decades on three European countries (the Netherlands, Germany, the UK) to study changes in female labour force behaviour around childbirth and tries to find an explanation for these changes by looking at differences between the three countries.We conclude that there are substantial differences in participation patterns between the three countries in our study and that policy measures and institutions such as childcare that make the costs of combining work and family lower relative to being a full-time mother seem to increase female participation rates.

scholarly journals Survey of UK practice for management of breast cancer metastases to the neck

2012 ◽  
Vol 94 (7) ◽  
pp. 484-489 ◽  
Author(s):  
B Bisase ◽  
C Kerawala
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Head And Neck ◽  
Neck Dissection ◽  
Current Practice ◽  
Stage Iv ◽  
Evidence Base ◽  
Cervical Metastases ◽  
Stage Iv Disease ◽  
The Uk

INTRODUCTION Cervical metastases from breast carcinoma are rare and their management is controversial. Between 1987 and 2002 the American Joint Committee on Cancer (AJCC) staged patients with supraclavicular fossa nodal disease as M1 but the subsequent demonstration that patients with regional stage IV disease had better outcomes than visceral stage IV disease led to a reclassification of the former to stage IIIC in 2003. The literature remains inconsistent regarding the fate of these patients. Despite the attendant morbidity of treatment and lack of knowledge regarding long-term survival, we hypothesised that current practice varies in the UK and a unified approach does not exist. The aim of this study was therefore to determine current practice and opinion of both head and neck specialists and breast cancer clinicians in the UK. METHODS Questionnaires were disseminated to 185 head and neck surgeons, breast surgeons and their oncology counterparts. These outlined a clinical scenario of a patient with a history of T3 primary breast cancer presenting with cervical and supraclavicular nodal metastases, with opinion being sought regarding the significance of this status and the individual’s practical approach to the problem. The extent of any proposed neck dissection was also explored. RESULTS Of the 117 respondents, a noticeable variation in opinion was evident. Contrary to the current AJCC staging, 61% of clinicians felt that both level V and III metastases represented stage IV disease. There was a tendency towards aggressive surgical treatment with a third recommending comprehensive neck dissection despite a lack of evidence base. A disparity was noted between adjuvant treatments offered and the final pN stage. CONCLUSIONS This study suggests that at present there is widespread inconsistency in the management of breast carcinoma cervical metastases in the UK. There is a need to unify practice with an evidence base in order to improve informed multidisciplinary decision making and, ultimately, patient care. This study goes some way to supporting multicentre collaboration in order to achieve that aim.

The ESRC Growing Older research programme, 1999–2004

2004 ◽  
Vol 24 (5) ◽  
pp. 657-674 ◽  
Author(s):  
ALAN WALKER
Keyword(s):  
Quality Of Life ◽  
Social Research ◽  
Research Programme ◽  
Later Life ◽  
Evidence Base ◽  
Active Ageing ◽  
New Knowledge ◽  
Full Capacity ◽  
The Uk

This article introduces the seven specially commissioned papers in this special issue of Ageing & Society from the projects funded by the UK Economic and Social Research Council's Growing Older Programme. The ESRC Programme has been the largest single investment in social sciences research on ageing in the United Kingdom. It comprised 24 projects and, when operating at full capacity, 96 researchers. The article details the background to the Programme, its commissioning process, its eventual structure and how it operated. Then a selection is made of some of the ways in which the Programme has contributed new knowledge to social gerontology. No attempt is made to achieve comprehensive coverage of the Programme's topics but rather a selection is presented of the new insights generated under its six themes: defining and measuring quality of life, inequalities in quality of life, technology and the built environment, healthy and active ageing, family and support networks, and participation and activities in later life. The projects were spread unevenly across these themes but important new knowledge has been produced under each theme. The conclusion emphasises the scientific contribution of the Programme and especially the extent to which older people's own attitudes, aspirations and preferences have been at the forefront, but it questions whether or not policy makers and practitioners will use this major evidence base.

scholarly journals Optimisation of dementia care in care homes: Dementia care framework (innovative practice)

Dementia ◽  
2017 ◽  
Vol 19 (4) ◽  
pp. 1316-1324
Author(s):  
Claire Royston ◽  
Gary Mitchell ◽  
Colin Sheeran ◽  
Joanne Strain ◽  
Sue Goldsmith
Keyword(s):  
Care Home ◽  
Evidence Base ◽  
Dementia Care ◽  
Care Homes ◽  
Spiritual Needs ◽  
Four Seasons ◽  
Care Partners ◽  
The Uk ◽  
Robust Evidence

There are an increasing number of people living with dementia in care home settings. Recent reports suggest that people who deliver care to residents living with dementia in care homes require specialist support to provide optimum care. To address this need Four Seasons Health Care, the largest provider of care homes within the UK today, sought to design a dementia care framework that enhanced the quality of life for people living with dementia in their care homes. The framework was designed using a robust evidence base, engagement with people living with dementia, their care partners, policy-writers, multidisciplinary professionals and people within the organisation. This paper describes the methodology behind the dementia care framework and outcomes data from the first phase (of 20 care homes that included the care of 451 people living with dementia). The main outcome was a significant improvement in the quality of the lives of residents across biological, psychological, social and spiritual needs.

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