Local Good Practices Research Articles

Integrating biological conservation into management: Community adaptive learning in the wetlands of Bangladesh

Wetlands in Bangladesh represent complex, dynamic natural environments rich in biological diversity and providing a range of ecosystem services to local people. Capture fisheries are a direct link between biodiversity and the poor, but have been declining from overexploitation and wetland degradation. Since 2007 a network of 250 community based organisations (CBOs) across the country has shown a growing interest in managing wetlands for the benefit of poor people, motivated to use their local knowledge and capabilities in collective action to manage wetland resources in ways that conserve biodiversity. Adaptive learning between CBOs has spread good practices to sustain biodiversity and thereby the livelihoods of the poor dependent on fish and other aquatic resources. By now, 59% of CBOs have created small fish sanctuaries, 10% have re-introduced scarce fish, a third of CBOs have banned hunting and a few have added a supplementary income from tourism. By developing and sharing their own knowledge of local ecosystem dynamics and related good practices, tangible ecological and developmental benefits have been derived, increasing the well-being of local people. In 91% of sites local people consider the CBO has improved access of the poor to natural resources. In many cases the main threats faced by CBOs have come from external factors: attempts by the powerful to take control of fisheries away from CBOs; pressure to pay government to lease waterbodies; and uncoordinated and unregulated development that blocks fish movement, drains and pollutes wetlands. As such, these are challenges of governance rather than management. The needs of the poor are represented by the CBOs (64% of members are poor, and almost all CBOs consult with the poor in decision making). By networking together, the CBOs are empowered to actively address these challenges and influence policy and practice to address conservation and poverty issues.

Facilitating participatory steps for planning and implementing low-cost improvements in small workplaces

In this paper, practical means of facilitating participatory steps taken in workplace improvement programs in small workplaces were reviewed. The reviewed programs included those organized by partners of our Asian inter-country network for small enterprises, construction sites, home workplaces and agricultural farms. Trainers who commonly acted as facilitators were found to play multiple roles in helping managers, workers and farmers take initiative and achieve immediate improvements. The participatory steps were more successfully facilitated when the trainers supported (a) building on local good practice, (b) focusing on a range of basic ergonomics principles, and (c) stepwise progress through feedback of achievements. The use of action-oriented toolkits comprising low-cost action checklists and group work guides was commonly helpful. The locally adjusted nature of the toolkits seemed essential. Trainers could thus help people build local initiative, plan and implement low-cost ideas through serial group work steps and confirm benefits in a stepwise manner. The review of the results suggested that a local network of trainers trained in the use of locally adjusted toolkits was vital for facilitating effective improvements in different small workplaces.

Improving antimicrobial prescribing through knowledge and skills

Sir, In their recent qualitative study of factors influencing antimicrobial prescribing by non-consultant hospital doctors De Souza et al. found that undergraduate education, hospital guidelines and concerns about emerging resistance were minor influences on prescribing practice. Prescribing was more influenced by instruction passed down through a hierarchical system and subsequently on personal experience. This will lead to poor adherence to local guidelines and inevitably poor prescribing. Poor prescribing by new UK graduates, often due to a lack of an integrated scientific and clinical knowledge base, and the lack of practical prescribing instruction for undergraduates are wellrecognized problems. Clinician education has been found to be the most effective workplace intervention on improving antibiotic selection in a recent systematic review. One apparent barrier to appropriate antimicrobial prescribing is the lack of awareness among senior and training grade clinicians of the local and national resources available to support decision making, including local hospital protocols. Prescribing guidelines appear to be ineffective unless accompanied by educational or financial incentives. Whilst in NHS hospitals it is unlikely that we will be able to meaningfully financially reward individuals or even clinical groups it would seem that optimizing prescribing through improving knowledge and clinical skills may be a more pragmatic approach. At Ninewells Hospital and Medical School in Dundee a concerted and multi-disciplinary effort has been made over recent years to promote and improve prudent antimicrobial prescribing through greater engagement in the undergraduate medical school curriculum and continuing postgraduate educational meetings. Pro-active promotion of local good practice guidance through a variety of educational activities is one such example. Audits of knowledge and behaviour regarding sepsis and antimicrobial therapy among training-grade doctors showed promising improvements between 1999 and 2003 as a result of these initiatives. However, these evaluations and those of others have highlighted the need for clinically focussed and sustainable national learning tools that address the technical and non-technical knowledge and skills of the antimicrobial prescriber. An outcomes based web-based program (Appropriate Antimicrobial Prescribing for Tomorrows Doctors: APT) for teaching and reflective learning of antimicrobial prescribing has recently been developed by infection specialists and medical educationalists and has been adopted by medical schools throughout the UK. The primary resource for the APT project is an interactive website (http://www.dundee.ac.uk/ facmedden/APT/index.htm) with access to clinical worked examples, prescribing exercises, self-assessment tools and a reflective learning logbook. Although the emphasis is on prudent prescribing of antibiotic therapy the principles learned through APT can be applied to all areas of prescribing. In our medical school this forms an integral part of clinical infection teaching in the fourth year that also includes recognition, diagnosis and management of common infections, infection control and health protection aspects of infection. This teaching is delivered by infectious disease physicians, microbiologists, infection control nurses, pharmacists and public health clinicians. Evaluation of this program through student and staff feedback has revealed very positive results and we are presently evaluating student knowledge through a series of short exams at the beginning and end of each attachment, and at the end of the year. In line with national Scottish Recommendations for improving antimicrobial prescribing practice in Scotland the APT work has been further adapted for providing mandatory online e-based training and assessment for foundation doctors in Scotland through the Doctors Online Training System (DOTS) developed by NHS Education Scotland (NES) (https://www. nhsdots.org/nhsdots/dotsx/login.asp). This site is password protected and linked to the NES Healthcare Acquired Infection portal (http://www.nes.scot.nhs.uk/hai/). At any given time there are more than 1600 foundation doctors in Scotland who will have to undertake this mandatory exercise and show evidence of satisfactory completion of this module. This program, through clinical vignettes, revises, evaluates and then reinforces the principles and practices taught at undergraduate level for foundation doctors. An extension and probable further adaptation of this program is proposed for more senior training and non-training grade doctors and ultimately non-medical prescribers. Any persons outside Scotland interested in this work should please contact dilip.nathwani@nhs.net. Ongoing evaluation of this program will inform its further development and impact.

Practical use of workplace improvements checklists for occupational health teamwork

The spreading use of workplace improvement checklists for occupational health and safety teamwork is reviewed in this paper. These checklists present practical improvement options in the action form and are used in different settings. Typical settings include small enterprises, agriculture, ergonomic interventions, needle stick injury prevention, mental stress reduction and various training workshops. Many concrete improvements have resulted in materials handling, workstation design and physical as well as psychosocial environments. The effectiveness of the checklists is found to derive from their practical nature. First, the check items present practicable improvements selected from among local good practices, including low-cost improvements achieved locally. Secondly, the checklists are suited for looking at multiple technical areas. Thirdly, the concise composition and the action form can facilitate participatory steps for planning and implementing practical improvements for risk reduction. Each checklist refers to basic occupational hygiene and ergonomics principles, and therefore is favorable for linking the checklist use with the process of risk management. The checklists reflecting local achievements can thus be effectively used in prioritizing necessary improvements. It is useful to design such checklists by adjusting the check items to good practices in different work settings and use them in teamwork involving local people.

Promotion of a Healthy Work Life at Small Enterprises in Thailand by Participatory Methods

The major problems of small enterprises include unfavourable working conditions and environment that affect safety and health of workers. The WISE (Work Improvement in Small Enterprises) methodology developed by the ILO has been widely applied to improve occupational safety and health in small enterprises in Thailand. The participatory methods building on local good practices and focusing on practicable improvements have proven effective in controlling the occupational hazards in these enterprises at their sources. As a result of applying the methods in small-scale industries, the frequency of occupational accidents was reduced and the working environment actually improved in the cases studied. The results prove that the participatory approach taken by the WISE activities is a useful and effective tool to make owner/managers and workers in small enterprises voluntarily improve their own working conditions and environment. In promoting a healthy work life at small enterprises in Thailand, it is important to further develop and spread the approach.

Advances in Participatory Occupational Health Aimed at Good Practices in Small Enterprises and the Informal Sector

Participatory programmes for occupational risk reduction are gaining importance particularly in small workplaces in both industrially developing and developed countries. To discuss the types of effective support, participatory steps commonly seen in our "work improvement-Asia" network are reviewed. The review covered training programmes for small enterprises, farmers, home workers and trade union members. Participatory steps commonly focusing on low-cost good practices locally achieved have led to concrete improvements in multiple technical areas including materials handling, workstation ergonomics, physical environment and work organization. These steps take advantage of positive features of small workplaces in two distinct ways. First, local key persons are ready to accept local good practices conveyed through personal, informal approaches. Second, workers and farmers are capable of understanding technical problems affecting routine work and taking flexible actions leading to solving them. This process is facilitated by the use of locally adjusted training tools such as local good examples, action checklists and group work methods. It is suggested that participatory occupational health programmes can work in small workplaces when they utilize low-cost good practices in a flexible manner. Networking of these positive experiences is essential.

Community Asset Management A Good Practice in Participatory Local Governance

This article places the concept of community asset management (CAM), the focus of a DFID Knowledge and Research (KAR) project which has been described elsewhere, in the context of the broader concepts of participatory local governance and good practice, themselves the subjects of other recent KAR projects. It is contended herein that it is imperative to local development, service delivery and poverty reduction that these concepts are fully operationalised by the stakeholders involved in the governance process. The article argues that, not only is CAM as a community participation approach a good practice in good governance ‘in its own right‘, but the very practice of the CAM approach involves the operationalisation of other participatory local governance principles.

Deposition and dissipation of chlorpyrifos in surface water following vineyard applications in northern Italy

Chlorpyrifos is an insecticide approved globally for use on a wide range of crops. Laboratory studies indicate that chlorpyrifos is toxic to fish and aquatic invertebrates, and so the adoption of practices that reduce aquatic exposure following use should be encouraged. This study assessed the exposure of surface water to the spray-drift of chlorpyrifos and the subsequent contamination of a realistic worst-case edge-of-field ditch in a vineyard in Northern Italy. Chlorpyrifos (DURSBAN 480 EC [Dow Elanco, Indianapolis, IN, USA]) was applied according to local Good Agricultural Practice (GAP) on two vineyard plots using atomizer equipment. Drift deposition and subsequent dissipation of chlorpyrifos were then monitored in an adjacent, common ditch, with an inherent buffer zone of approximately 7 m between the treated area and the ditch. The results showed that the drift loadings under the study conditions could reach predicted levels from standard spray-drift tables. However, the measured drift was highly variable due to physical factors such as the crop canopy and the distribution of vines within the rows. The amount of chlorpyrifos deposited onto the surface of the ditch water and intercepted by paper strips was approximately 2% of the applied amount after the two applications, with a maximum concentration of approximately 0.3 microg L(-1) immediately after the first application and 0.09 microg L(-1) after the second, which then dissipated from the water column within 12 to 24 h. The results showed that drift deposition spatially was variable and that chlorpyrifos residues dissipated rapidly from this surface water body. Both aspects are considered important in order to refine the aquatic risk assessment at a higher tier for both registration and management purposes.

Relations with Non-Elected Agencies: Local Authority Good Practice

The controversy over reform of the local unelected state has tended to over-shadow principles of good practice for local authorities. This article shows how local authorities can get the best out of their relationships with non-elected agencies. In particular, how should they develop their strategic capabilities and representational roles in the ‘new local governance’?