Validation Workshops Research Articles

Planning for wastewater infrastructure adaptation under deep uncertainty

Infrastructure in low-lying coastal areas faces challenges from climate change, sea level rise, and the impact of compound hazards. Dynamic adaptive pathways planning (DAPP) is increasingly being applied as a way of planning under deep uncertainty. Stress testing for robustness is an integral part of DAPP which provides decision-makers with confidence. We outline a seven-step approach—combining scoping workshops, systems mapping, DAPP, exploratory modelling, robust decision-making, real options analysis and validation workshops—to support decision-making for infrastructure in low-lying coastal areas. We apply the seven steps to two wastewater treatment plant (WWTP) case studies in New Zealand to quantify indicators, signals, triggers and adaptation thresholds within DAPP plans and to identify adaptation pathways that are robust against future uncertainty. Case study one focuses on the implementation of an existing DAPP at Helensville WWTP. Our modelling enabled the challenge of quantifying indicators for adaptation thresholds and triggers to be overcome. We show that an adaptation threshold occurs at 31 cm of RSLR, the trigger point is sufficient lead time to enable relocation, and the indicator is the rate of observed RSLR. Case study one demonstrates in a quantitative way how an existing DAPP can be functionally implemented by a water management agency. Modelling for case study two, the Seaview WWTP, showed that 26 cm and 56 cm of RSLR are key thresholds. Nuisance flooding may occur after 26 cm of RSLR, which could happen as early as 2040 under a high emissions scenario. Inundation of plant assets may occur after 56 cm of RSLR, which could occur as early as 2060. Modelling showed that implementing changes to plant layout would allow the plant to remain on site for its design life (until 2080). Five adaptation archetypes were developed—sequences of adaptive actions that achieve the performance objective of continuing levels of service and avoid inundation of WWTPs. The seven-step approach is a way to stress-test a DAPP, to quantify signals, triggers and adaptation thresholds and to simulate implementation of a DAPP under a range of scenarios. This can facilitate more robust decision-making for wastewater infrastructure assets under future uncertainty.

Healthy food, unhealthy food: Indigenous perspectives on the nutrition transition

ABSTRACT Amazonian Indigenous Peoples are undergoing drastic changes in their ways of life including the quality and availability of food and its impact on their health and well-being. Indigenous populations have their own perspectives and interpretations of dietary changes unfolding in their communities. Based on in-depth interviews, observations and validation workshops we explored the way Awajún describe and problematise the concept of healthy and unhealthy food in the context of the nutrition transition. We learn that the characteristics of ‘good food' are informed by their capacity to give strength, protect health and enable them to be hardworking people. On the contrary, food that comes from the city weakens the body and may result in health problems. For the Awajún, chicken with hormones, fish preserved in cans, and powdered milk negatively affect their health. We argue that the dichotomy ‘healthy' and ‘unhealthy’ used to classify food provides information not only about Indigenous conceptualisations of health and die, but is also a critique of broader structural processes affecting their well-being. The terms, explanations and idioms used by the Awajún to talk about food, provide an insight into Indigenous perspectives and knowledge key to informing global health interventions in culturally appropriate ways.

Participatory planning to conserve freshwater ecosystems in the Rift Valley Lakes Basin, Ethiopia

Freshwater ecosystems are important for directly ensuring a range of benefits and services that sustain local livelihoods and help mitigate climate change. However, freshwater ecosystems are threatened by anthropogenic and natural pressures affecting their ability to sustainably provide these services. Managing freshwater ecosystems is mainly challenged by the complexity of the drivers of their degradation and by the difficulty of balancing the need for short-term socioeconomic development and protecting and restoring ecosystems to support long-term, sustainable development. Addressing such challenges requires an integrated and systematic approach, catchment-wide management and meaningful engagement and collaboration among stakeholders. The present study was conducted in Lake Ziway, Rift Valley Lakes Basin, Ethiopia. The overarching objective was to conserve the freshwater ecosystem through co-planning and designing management options for the buffer zone and entire catchment. The study engaged local communities through multiple approaches including inception and validation workshops, reconnaissance surveys, key informant interviews and focus group discussions. It also employed quantitative data collection methods to characterize the freshwater ecosystem and entire catchment. The participatory approach employed in this study identified multiple management options including tree-based forest and landscape restoration measures, integrated soil and water conservation, and multiple buffer zone restoration measures. The identified and validated management options are aimed at improving the functionality of the freshwater ecosystem in the face of increased need of economic development and climate change. Furthermore, the study provided key recommendations to support the processes of policy development and the effective implementation of suggested and validated management options.

Red Como Estrategia Para Romper Silos y Fomentar la Innovación Abierta

ABSTRACT Objectives: The central objective of this paper is to propose and test a model for the development of network governance structures to respond to the silo effect in the innovation management process in a large research organization. Method: A case study was used with the objective of building a governance model that could address the problems derived from the silo effect. To achieve the objective, validation workshops were held, with teams being challenged to reflect on the mechanisms and basic rules used to assemble the model. Results: The efforts made to inhibit the silo effect in the organization investigated were successful. Internal events were held to exchange knowledge between research centers, which resulted in greater stimulation of connections between these and other actors throughout the innovation ecosystem. Conclusions: The governance model adopted to mitigate the problems derived from the silo effect proved to be effective in promoting interaction between research centers on issues related to open innovation. The model, supported by mechanisms and basic rules inserted in the key actions, proved to be efficient in promoting a more intense relationship between the research units of the institution studied, resulting in new network actions.

EMS Potentials in MENA region

Background Emergency Medical Services (EMS) have been always considered as a vital service provided by of many Red Cross and Red Crescent (RCRC) national societies worldwide and in Middle East and North Africa (MENA) region in particular during emergency and non-emergency contexts. The role to supporting the national wide health system in prehospital stage has got special attention during COVID 19 due to overwhelming health care facilities. The national societies have played a key role in mitigating the impact of the COVID 19 on the healthcare facilities by activating and growing their EMS capacities and expanding their scope of services in the prehospital stage. To define capacities and areas for improvement in RCRC national societies, we've developed a tool to survey different aspects of EMS. Methodology A questionnaire was designed by the IFRC MENA health team based on Prehospital emergency management system PEMS conceptual framework for assessment. 67 questions were grouped into 5 domains: governance and dispatch, Human Resources (H.R.) & Logistics, EMS Education, EMS operation and quality , and EMS disaster preparedness. Two open-ended questions were added to define areas of improvement and what national societies can offer to enhance capacities for other national societies in the region… The questionnaire was piloted with EMS leaders at Lebanese Red Cross. Between the period of April 2022 and August 2022, the online questionnaire was sent to four national society EMS managements, Lebanese Red Cross LRC , Palestine Red Crescent Society PRCS , Saudi Red Crescent Authority SRCA and Syria Arab Red Crescent SARC. The answers were collected using SurveyMonkey platform and validation workshops were held with all four EMS managements. For the qualitative questions of the perceived weaknesses and strengths, interviews with EMS managements were recorded and transcript. Analysis tools of SurveyMonkey was utilized for quantitative data analysis, and qualitative data was explored manually using thematic analysis methodology. Results The input from the four national societies revealed variation in governance, structure, and scope of services of EMS among them. We can highlight the main outcomes under each domain EMS Governance and Dispatch The four NSs are considering scoop and run operational model. The percentage of acute to cold cases in day to day practice is varying with predominance of cold cases among all. SRCA, PRCS in West Bank, and LRCS central dispatch center are using fully automated dispatch system, while LRC is using semi-automated in the regional dispatch centers, and SARC and PRCS branches in Gaza and Jerusalem are using manual (paper based) dispatch system. EMS H.R. & Logistics LRC, PRCS and SARC are mainly relying on volunteers to run EMS daily operations while SRCA depends on 6000 full time employees to operate 24/7 EMS services. SRCA EMS fleet is considered the largest among the four NSs with around 1,400 vehicles, LRC came next with 390 vehicles, then PRCS with 180, and lastly SARC with 112. EMS Education Both LRC and SRCA are running international accredited emergency courses including Basic Life Support (BLS), Advanced Life Support, Prehospital Trauma Life Support (PTLS), Advanced Trauma Life Support, and other relevant courses. On the other hand, PRCS and SARC are considering academic and locally customized training courses to train their EMS staff and volunteers. EMS Operation and Quality The service coverage of the four EMS in urban areas ranges between 80 – 100% while coverage decreases in rural areas to reach under 50% in some regions. Quality assurance and regular monitoring are areas that need to be standardized and systematized in most cases. EMS Disaster Preparedness Specialized training program for Mass Causality Incidences (MCI) is conducted in LRC, PRCS and SRCA. LRC, SARC, and SRCA possess a standardized approach for major incidence management as part of their disaster management

Prevention of childhood overweight and obesity in Mongolia, the Philippines and Vietnam: identifying priority actions.

Low- and middle-income countries are increasingly faced with a triple burden of malnutrition: endemic underweight, micronutrient deficiencies and rising prevalence of overweight. This study aimed to address existing knowledge gaps and to identify priority policy options in Mongolia, the Philippines and Vietnam. A landscape analysis approach was adopted using methods set out in a UNICEF global toolkit. Quantitative and qualitative data were compiled from a range of global and national sources on childhood overweight and obesity, risk factors and policy responses. Key informant interviews and validation workshops were undertaken with key food and nutrition stakeholders from government and non-government organizations to identify priority policy options for the prevention of overweight and obesity among children. Overweight and obesity among children are increasing in all three countries. Associated risk factors are related to maternal nutrition, birthweight, breastfeeding, as well as diets and physical activity shaped by increasingly obesogenic environments. Key informants identified undefined policy approaches, poor community understanding and food and beverage industry influence as barriers to addressing overweight and obesity. Key policy priorities include restricting the marketing of unhealthy food and beverages, unhealthy food and beverage taxation, introduction of front-of-pack nutrition labels and improving school nutrition environments. Mongolia, the Philippines and Vietnam are all facing an increasing burden of childhood overweight and obesity. Despite differing national contexts, similar environmental factors are driving this rise. A suite of evidence-based policies can effectively be introduced to address obesogenic environments.

NorthBEAT: exploring the service needs of youth experiencing early psychosis in Northern Ontario.

Early Psychosis Intervention (EPI) is critical for best outcomes. Among 369 diseases, psychosis is among those causing the greatest disability. Evidence-based interventions for youth in early stages of psychosis (EPI programs) have prevented chronic disability. Yet, EPI is frequently inaccessible for youth living in rural communities. Moreover, Indigenous youth often face more precipitous situations given inadequate staffing, and culturally unsafe care. The NorthBEAT (Barriers to Early Assessment and Treatment) project sought to understand the service needs of youth with psychosis in Northern Ontario. The goals were: (1) to describe the mental health of a subset of adolescents receiving EPI care; (2) examine Indigenous youth as a significant and vulnerable population; (3) to understand the barriers and facilitators for Indigenous and non-Indigenous youth receiving EPI. Mixed methods (structured and narrative interviews) included: psychometric scales interviews with youth, and narrative interviews with youth, their family, and service providers Data validation workshops were held with participants. Structured interviews with 26 youth (M = 17 years) found the participants functioning moderately well with duration of untreated psychosis ranging from 1 to 96 months (M = 26 months). No significant differences were found in functioning or duration of psychosis between Indigenous and non-Indigenous youth. Narrative interviews were conducted with 18 youth, 11 family members, and 14 service providers. Identified barriers were a lack of knowledge about psychosis among service providers, a disconnected system leading to delays in treatment, help not wanted by youth, expansive geographical context. Service needs were: finding the right point of access, support for families, pre-crisis intervention, reduced stigma for youth and their families, and an EPI approach to care. Rural and northern youth face similar barriers to accessing EPI as urban youth. However, northern youth face additional unique challenges due to expansive geographical context, limited resources and lack of knowledge about services.

Landscape agroecology: woody vegetation heterogeneity and its association with natural and human factors at a multifunctional peasant socio-ecosystem from a semi-arid mountain range area (Dry Chaco, Argentina)

ABSTRACT In this study we investigate the landscape of a multifunctional peasant socio-ecosystem using a dialectic and complex theoretical-methodological framework rooted in agroecology. We describe vegetation floristics and structure, as well as biophysical and anthropic variables. We use maps, multivariate analysis and validation workshops to integrate and analyze information. The vegetation showcases distinct typologies, marked by gradual, non-linear variations, without precise boundaries tied to biophysical and anthropic drivers. Furthermore, based on vegetation structure and floristic heterogeneity, this agroecosystem constitutes a well-managed multifunctional native forest landscape, exemplifying a case of biocultural conservation.

Uneven Geographies of the Embodied Effects of Water Insecurity Among Women Irrigators in Northern Ghana

The linkages between water insecurity and human health have been of long-standing research interest to geographers, especially those studying the human–environment dimensions of health. This article contributes to this scholarship by demonstrating how insecure access to irrigation water produces differentiated bodily effects for women. Data for the article come from empirical field work using interviews, focus group discussions, drone-based participatory mapping, and community validation workshops. Grounded in the literature on embodiment and intersectional feminist political ecology and through the firsthand experiences of women and their struggles to secure irrigation water, the article makes two main contributions. First, it demonstrates how drones could be innovatively integrated into qualitative and political ecology field work to better understand human–environment interactions. Second, it shows that space and time are critical to understanding the differentiated embodied experiences of water insecurity. More specifically, different irrigators experience different bodily effects depending on where their irrigated fields are located. Compared to women with plots near irrigation canals, the article shows that those with plots further afield experience more debilitating pains in the limbs, waist, and hips as they struggle to secure water. Overall, the article’s findings highlight how the uneven geographies of access to irrigation water warrant closer attention by scholars studying hydrosocial relations and health. Key Words: embodiment, feminist political ecology, intersectionality, participatory mapping, water security.

The dynamic versus the stable team: The unspoken question in large‐scale agile development

SummaryThe importance of the team, its internal dynamics, and its performance are widely recognized within the software engineering community. While popular frameworks identify wholeness, stability over time, and smallness as important factors, they offer little guidance on how to form teams that achieve these three characteristics. The objective of this study is to investigate how these team characteristics interact in large‐scale software development contexts, particularly focusing on the impact of stable and dynamic teaming approaches. This was done through a multivocal study of literature, followed by individual semi‐structured interviews with 19 engineers from two companies and validation workshops with an additional two companies from unrelated industry segments. The study results show that the question of stable versus dynamic approaches to forming software engineering teams is largely unaddressed in industry, with stable teams representing a habitual default option. Meanwhile, both stable and dynamic teams clearly have respective strengths and weaknesses, calling for careful consideration of the most suitable approach in any given situation. To support such consideration, this paper presents a model of how team stability, wholeness, and smallness interact. This model is found relevant, accurate, generalizable, and useful by practitioners.

Medical education system (re)building in a fragile setting: Northwest Syria as a case study.

Syria has witnessed more than a decade of armed conflict through which healthcare workers and facilities have not only been affected, but targeted. Amidst this targeting of healthcare workers, subsequent displacement, and 'weaponization' of healthcare, the medical education and health professional training (MEHPT) of those that remain has split into at least two distinctive contexts: government controlled, and non-government controlled. Efforts to rebuild MEHPT in light of this polarisation and fragmentation have led to a new MEHPT system in non-government controlled northwest Syria, that functions through what we describe as a 'hybrid kinetic model'. This mixed-methods study provides an in-depth analysis of this MEHPT system as a case study to inform future policy planning and interventions in the context of future post-conflict health workforce development. We used mixed methods to investigate the state of MEHPT in northwest Syria during September 2021 and May 2022. This included a) Stakeholder analysis, b) 15 preparatory experts consultations c) 8 Focus group discussions d) 13 Semi-structured interviews e) 2 Questionnaires and f) Validation workshops. We identified three main categories of key stakeholders working on MEHPT in northwest Syria: 12 newly established academic institutions, 7 local governance authorities involved in MEHPT, and 12 non-governmental organisations (NGOs). The MEHPT system operated through these stakeholders in a three-layer system to provide undergraduate and postgraduate MEHPT. In the first, top, layer, external NGOs and donors hold the strongest capacity at the expense of relatively under resourced internal governance in the second, middle, level. In the third, bottom, level, local academic bodies operate. We uncovered several levels of challenges facing these stakeholders including governance challenges, institutional challenges, individual challenges, and political challenges. Despite these challenges, participants in our study highlighted significant opportunities within the MEHPT system and that MEHPT can be a peace building pillar for the community. To our knowledge, this is the first paper that provides an in-depth situational analysis of the MEHPT system in a conflict setting while engaging the voice of local key stakeholders. We found that local actors in MEHPT in non-government controlled northwest Syria have made efforts towards (re)building a new, hybrid and kinetic MEHPT system, through a bottom-up approach. Despite these efforts, the MEHPT system remains fragile and polarised, suffering from several levels of challenges with limited involvement of internal governance. Building on our findings, to improve this approach and build bridges of trust among stakeholders and the MEHPT community, further studies are needed to determine feasible approaches to increasing the role of internal governance structures in the MEHPT system through: 1-Formalisation of efforts through establishing a MEPHT technical coordination unit. 2-Further shifting of power from external supporting NGOs and funders to internal governance structures. 3- Working towards achieving sustainable long-term partnerships.

Perspectives on DMPA-SC for self-injection among adolescents with unmet need for contraception in Malawi.

Malawi has made progress in expanding access to modern contraceptive methods over the last decade, including the introduction of depot-medroxyprogesterone acetate subcutaneous (DMPA-SC) in 2018. DMPA-SC offers women the option to self-inject at home and may benefit adolescents with unmet need for contraception due to its discretion. This qualitative study was conducted to assess perspectives and preferences of adolescents with unmet need for contraception regarding the self-injection option of DMPA-SC in Malawi. Six focus group discussions were conducted involving 36 adolescents with unmet need for contraception (aged between 15 and 19 years, married and never-married) in October 2021 in three districts in Malawi. Data were coded inductively and analyzed thematically, using Dedoose software. Two validation workshops were conducted with other adolescents with unmet need in February 2022 to elucidate the preliminary findings. DMPA-SC attributes such as discretion and reduced facility visits were ranked most appealing by both married and never-married adolescents, particularly for adolescents needing covert contraception use. Concerns about self-injection included fear of pain, injury, and doubt in ability to self-inject. Never-married adolescents had additional concerns around privacy at home if using covertly, and fears of affecting long-term fertility. Overall, health surveillance assistants (community-based healthcare workers) were voted to be the most private, convenient, and affordable sources for potential DMPA-SC self-injection training. Self-injection of DMPA-SC may offer an appealing option for adolescents in Malawi, aligning most closely to the needs of married adolescents who may wish to delay or space pregnancies conveniently and discreetly, and who also may face fewer access barriers to receiving self-injection training from health care providers. Access barriers including stigma and concerns about privacy at home for adolescents needing to use contraception covertly would need to be adequately addressed if never-married adolescents were to consider taking up this option.

Patient and Healthcare Professional Insights of Home- and Remote-Based Clinical Assessment: A Qualitative Study from Spain and Brazil to Determine Implications for Clinical Trials and Current Practice.

The SARS-CoV-2 virus pandemic has accelerated the growing trend towards using home- and remote-based medical testing (H/RMT). The aim of this study was to gather insights and explore the opinions of patients and healthcare professionals (HCPs) in Spain and Brazil regarding H/RMT and the impact of decentralised clinical trials. This qualitative study consisted of in-depth open question interviews of HCPs and patients/caregivers followed by a workshop that aimed to determine the advantages and barriers to H/RMT in general, and in the context of clinical trials. There were 47 participants in the interviews (37 patients, 2 caregivers, 8 HCPs) and 32 in the validation workshops (13 patients, 7 caregivers, 12 HCPs). The main advantages for the use of H/RMT in current practice were the comfort and convenience, the ability to improve the relationship between HCPs and patients and personalise patient care, and the increased patient awareness towards their disease. Barriers to H/RMT included accessibility, digitalisation, and the training requirements for both HCPs and patients. Furthermore, according to the Brazilian participants, there is a general distrust in the logistical management of H/RMT. Patients indicated that the convenience of H/RMT did not influence their decision to participate in a clinical trial, with the main reason for participating in a clinical trial being to improve health; however, H/RMT in clinical research does aid adherence to the long-term follow-up associated with trials and provides access to patients living far from the clinical sites. Insights from patients and HCPs suggest that the advantages of H/RMT may outweigh the barriers, and that social, cultural and geographical factors and the HCP-patient relationship are critical aspects to be considered. Moreover, the convenience of H/RMT does not appear to be a driver for participating in a clinical trial but can facilitate patient diversity and study adherence.

Penguatan Budaya Literasi Mahasiswa melalui Workshop Instrumen Pengenalan Lapangan Persekolahan (PLP) Berbasis Unity of Sciences

EMPOWERING STUDENT’S LITERACY CULTURE TROUGH INSTRUMENT WORKSHOP OF SCHOOL INTRODUCTION PROGRAM (PENGENALAN LAPANGAN PERSEKOLAHAN OR PLP) BASED ON UNITY OF SCIENCES. The development of instrument for the PLP program at UIN Walisongo Semarang and its socialization need to be done. The purpose of this service activity is to develop a Unity of Science-based PLP instrument and socialize it to students. The implementation of this service activity includes team formation, instrument design, instrument validation and instrument socialization workshops. The development of the instrument refers to the Research and Development (R & D) method. For socialization to students delivered through workshops. The achievement of strengthening literacy culture is measured through a questionnaire. The results of this activity were instrument for the PLP program at UIN Walisongo Semarang has developed. It has shared to the students. The students are familiar with the PLP program and its instruments based on Unity of Sciences. Students stated that they obtained the information from several sources, including from lecturers, seniors, friends, social media, guardianship books, informants from other universities, and articles. The strengthening of qur'an and hadith literacy of students also increased. The conclusion of this service was student’s literacy for Qur’an and Hadith have increase and student’s insight to PLP instrument escalated.

The Prospects and Challenges of Using Drone-Based Participatory Mapping in Human–Environment Research

This article contributes to the emergent methodological application of uncrewed aerial vehicles (drones) in the study of human–environment interactions. Drawing on empirical field experiences, the article discusses the benefits and challenges of combining high spatial and temporal resolution drone remote sensing with qualitative in-depth interviews, focus group discussions, and community map validation workshops within a single study. The article argues that drone-based participatory mapping elicits deeper insights that are not apparent when remote sensing and conventional qualitative methods are used as stand-alone methods. By highlighting the prospects and challenges in using drone-based participatory mapping, this article contributes to debates on “socializing the pixel and pixeling the social,” and advances methodological integration of qualitative and spatial analysis in the study of human–environment interactions.

Scaling inclusive business impacts at the Base of the Pyramid: A framework inspired by business model ecosystems research

Scaling the social impact of inclusive business models that provide solutions to basic needs of Bottom of the Pyramid (BoP) communities through firm-centric approaches has proven challenging. Researchers have proposed that scaling strategies at the BoP should go beyond firm-centric approaches by inclusive businesses and involve coordinated synergistic action of their entire ecosystem to overcome systemic challenges and create value for all ecosystem actors. However, current research on this topic remains abstract and difficult to implement. This paper presents an empirically validated scaling framework designed to overcome this weakness and documents its design process. The framework takes account of the fact that inclusive businesses must work out scaling strategies together with key ecosystem actors, and that implementing a scaling strategy will almost always require mutual adaptation of business models. The framework design process entailed an extensive literature review and practitioner interviews as a first step, followed by testing, evaluation and iterative improvement through a series of validation workshops with actors of four inclusive business initiatives in Africa and Asia. The results indicate that the framework helps workshop participants to expand their mental frame, encouraging them to adopt a broader ecosystems perspective on scaling. This leads to identification and exploration of valuable business model adaptations for scaling that can be achieved through collaboration and assessment of the practical feasibility of different scaling strategies.

Demand and supply-side barriers and opportunities to enhance access to healthcare for urban poor populations in Kenya: a qualitative study

ObjectiveTo explore the barriers to and options for improving access to quality healthcare for the urban poor in Nairobi, Kenya.Design and participantsThis was a qualitative approach. In-depth interviews (n=12), focus...

Renewable Energy Communities as a New Actor in Home Energy Savings

Renewable energy communities (RECs) might be an interesting new stakeholder in stimulating home energy-saving efforts by tenants and homeowners due to their potential of raising awareness locally and gaining public support for low-carbon energy and energy-savings projects, because RECs are often locally sited, in close social proximity of residents, and are already part of local structures and share local institutions. This comes with many benefits since they already have a reputation locally, a social history with the local community, and can be trusted by the latter. This makes them potentially better suited than other—often less-trusted—parties (i.e., government and business companies) to use their agency to encourage sustainable change. The article builds on empirical data from the EU Horizon 2020 project REScoop Plus, using a mixed-methods research approach, including desk research, expert interviews, validation workshops, and multiple surveys among RECs in six EU member states about energy-saving actions implemented, and their effectiveness in terms of raising awareness, influencing the intention to save energy, and actual energy-saving behaviour. This article provides more insight into the assessment of actions and measures for coaching householders to achieve energy savings and low carbon goals. In addition, it shows the potential of using RECs as a new strategy to address home energy savings in the current housing stock, including options to improve the energy performance thereof.

Residents transitioning between hospital and care homes: protocol for codesigning a systems-level response to safety issues (SafeST study)

IntroductionThe aim of this study is to develop a better understanding of incident reporting in relation to transitions in care between hospital and care home, and to codesign a systems-level...

Community-level responses to extreme flooding: the case of Brazilian Amazon ribeirinhos

ABSTRACT Rural communities are among the most vulnerable to extreme climatic events but usually have context-specific knowledge on strategies to overcome impacts. We have used the Community-Based Adaptations (CBA) lens to explore how Brazilian Amazon communities have responded to extreme flooding in the last decade. Using a variety of data collection methods, including semi-structured interviews and validation workshops, we found a wide range of locally-devised coping, adaptive, and transformative responses, despite a lack of governmental support. A newly-proposed category of ‘annual responses' was crafted to describe short-term measures taken that were repeated when necessary, but were not fixed, allowing for flexibility and agility. Through our findings, we propose an absorb-cope-adapt-transform (ACAT) spectrum that captures the range of responses and the interplay among response categories. This spectrum highlights transformative responses which have become more important due to the increased severity of the changes experienced by communities. We conclude that the expected increase in the variability and unpredictability of environmental and social conditions will require increased robustness and flexibility of rural communities exposed to climatic changes. This will demand conceptual tools analytically more powerful to detect such systems’ attributes. We intend that our ACAT spectrum contributes to CBA research in this regard.