Co-production of "nature walks for wellbeing" public health intervention for people with severe mental illness: use of theory and practical know-how.

BACKGROUND: Interventions need to be developed in a timely and relatively low-cost manner in order to respond to, and quickly address, major public health concerns. We aimed to quickly develop an intervention to support people with severe mental ill-health, that is systematic, well founded both in theory and evidence, without the support of significant funding or resource. In this article we aim to open and elucidate the contents of the 'black box' of intervention development. METHODS: A multidisciplinary team of seven academics and health practitioners, together with service user input, developed an intervention in 2018 by scoping the literature, face-to-face meetings, email and telephone. Researcher fieldnotes were analysed to describe how the intervention was developed in four iterative steps. RESULTS: In step 1 and 2, scoping the literature showed that, a) people with severe mental illness have high mortality risk in part due to high levels of sedentary behaviour and low levels of exercise; b) barriers to being active include mood, stress, body weight, money, lack of programmes and facilities and stigma c) 'nature walks' has potential as an intervention to address the problem. In Step 3, the team agreed what needed to be included in the intervention so it addressed the "five ways to mental wellbeing" i.e., help people to connect, be active, take notice, keep learning and give. The intervention was mapped to key behavioural change concepts such as, personal relevance, relapse prevention, self-efficacy. In Step 4, the team worked out how best to implement the intervention. The intervention would be delivered over 12 weeks by members of the hospital team and community walk volunteers. Participants would receive a nature walks booklet and text messages. CONCLUSIONS: We developed a theoretically-informed, evidence-based nature walks programme in a timely and relatively low-cost manner relevant in an era of growing mental illness and funding austerity. Further research is required to test if the intervention is effective and if this approach to intervention development works.

Why is the rate of annual road fatalities increasing? A unit record analysis of New Zealand data (2010-2017).

INTRODUCTION: Recent increases in road crashes have reversed New Zealand's formerly declining crash rates to produce annual fatal and serious injury counts that are 49% higher than the lowest rates achieved in 2013. METHOD: We model twenty-one factors in fatal and serious injury crashes, four years before and after 2013 using logistic regression. Three major factors are significantly different in the period after 2013, when crash rates increased: (1) alcohol as a cause, (2) learner licence holders, and (3) a regional effect for Auckland. Newly defined speed zones are a more common setting for crashes in the period of upturn but there is no coinciding elevated likelihood of 'speed as a causal factor'. Three factors related to road safety were less common: aged under 25-years old, fatigue, and not wearing a seatbelt. RESULTS: Results are compared to rates of prosecutions for alcohol-related driving offences over this period. It is possible that New Zealand's successful road safety initiatives of the past have been undermined by reduced levels of enforcement and an unexpected outcome from the graduated driving licence system.

The Virtual Table: A Framework for Online Teamwork, Collaboration, and Communication.

This chapter reviews the complex relationship between technology and leadership, focusing on how technology affects the development and demonstration of skills in communication, teamwork, and collaboration. The chapter also proposes a framework for identifying and assessing key leadership competencies in the digital space.

Practitioner versus analyst methods: a nuclear decommissioning case study.

A requirement arose during decommissioning work at a UK Magnox Nuclear Power Station to identify the hazards involved in removing High Dose Rate Items from a Cartridge Cooling Pond. Removing objects from the cooling pond under normal situations is a routine event with well understood risks but the situation described in this paper is not a routine event. The power station has shifted from an operational phase in its life-cycle to a decommissioning phase, and as such the risks, and procedures to deal with them, have become more novel and uncertain. This raises an important question. Are the hazard identification methods that have proven useful in one phase of the system lifecycle just as useful in another, and if not, what methods should be used? An opportunity arose at this site to put the issue to a direct test. Two methods were used, one practitioner focussed and in widespread use during the plant's operational phase (the Structured What-If method), the other was an analyst method (Cognitive Work Analysis). The former is proven on this site but might not be best suited to the novelty and uncertainty brought about by a shift in context from operations to decommissioning. The latter is not proven on this site but it is designed for novelty and uncertainty. The paper presents the outcomes of applying both methods to a real-world hazard identification task.