In 2016, "America's Best Idea", the United States National Park System, celebrated a century of national heritage in natural resource stewardship. As the NPS progresses into its next century, reflection on the semiotics of national park tourism offers a critical perspective on meanings of American Nationalism and identity with management implications for a twenty first century audience. This research acknowledges the originating confluences of artistic and literary romanticism, commercialization of natural resources through tourism, and political annexation of public land during the Reconstruction Era in the establishment of an institutional model that advanced the "monumentalism" of nature. This research analyses the varied political ecology of nature through the lens of historic design and rhetoric concerning cultural landscapes, the people within them, and periods of national crises using national park case studies. This research will offer clarifying perspectives on how nature itself became a national monument in these places.
This study investigates the variation in attitudes across stakeholders towards investments in the digital economy. Using semi-structured interviews to identify attitudes about the spatially evolving socioeconomic importance of the digital economy in New Zealand, we identified seven distinct yet partially overlapping concerns that prioritise preferences for digital investment. A key finding is that there are important asymmetries in stakeholders' narratives and epistemological foundations that currently align to collectively strengthen resolve to invest in digital infrastructure and training, but this alignment may splinter in future. Some stakeholders saw internet access as coalescing social economy, and there were concerns that some people and some places would get left behind if access is not rolled out uniformly and as a priority. There were disagreements about who will prosper, who will get left behind, who should pay for upgrading digital skills, the extent that investments were connected with wellbeing and identity, whether fake news was significant, and the longevity of the impact of digital economy investments. This study contributes to theory by demonstrating that practically-relevant, socially-informed policy decisions can be underpinned by collective efforts that draw on heterogeneous narratives and multidimensional understandings.
Abstract Background Structured, systematic methods to formulate consensus recommendations, such as the Delphi process or nominal group technique, among others, provide the opportunity to harness the knowledge of experts to support clinical decision making in areas of uncertainty. They are widely used in biomedical research, in particular where disease characteristics or resource limitations mean that high-quality evidence generation is difficult. However, poor reporting of methods used to reach a consensus – for example, not clearly explaining the definition of consensus, or not stating how consensus group panellists were selected – can potentially undermine confidence in this type of research and hinder reproducibility. Our objective is therefore to systematically develop a reporting guideline to help the biomedical research and clinical practice community describe the methods or techniques used to reach consensus in a complete, transparent, and consistent manner.
Methods The ACCORD (ACcurate COnsensus Reporting Document) project will take place in five stages and follow the EQUATOR Network guidance for the development of reporting guidelines. In Stage 1, a multidisciplinary Steering Committee has been established to lead and coordinate the guideline development process. In Stage 2, a systematic literature review will identify evidence on the quality of the reporting of consensus methodology, to obtain potential items for a reporting checklist. In Stage 3, Delphi methodology will be used to reach consensus regarding the checklist items, first among the Steering Committee, and then among a broader Delphi panel comprising participants with a range of expertise, including patient representatives. In Stage 4, the reporting guideline will be finalised in a consensus meeting, along with the production of an Explanation and Elaboration (E&E) document. In Stage 5, we plan to publish the reporting guideline and E&E document in open-access journals, supported by presentations at appropriate events. Dissemination of the reporting guideline, including a website linked to social media channels, is crucial for the document to be implemented in practice.
Discussion The ACCORD reporting guideline will provide a set of minimum items that should be reported about methods used to achieve consensus, including approaches ranging from simple unstructured opinion gatherings to highly structured processes.
BACKGROUND: Disorganised attachment patterns in infants have been linked to later psychopathology. Services have variable practices for identifying and providing interventions for families of children with disorganised attachment patterns, which is the attachment pattern leading to most future psychopathology. Several recent government reports have highlighted the need for better parenting interventions in at risk groups. OBJECTIVES: The objective of this review and meta-analysis was to evaluate the clinical effectiveness of available parenting interventions for families of children at high risk of developing, or already showing, a disorganised pattern of attachment. METHODS: Population: Studies were included if they involved parents or caregivers of young children with a mean age under 13 years who had a disorganised classification of attachment or were identified as at high risk of developing such problems. Included interventions were aimed at parents or caregivers (e.g. foster carers) seeking to improve attachment. Comparators included an alternative intervention, an attention control, treatment as usual or no intervention. The primary outcome was a disorganised pattern in childhood measured using a validated attachment instrument. Studies that did not use a true Randomised Controlled Trial (RCT) design were excluded from the review. Both published and unpublished papers were included, there were no restrictions on years since publication and foreign language papers were included where translation services could be accessed within necessary timescales. RESULTS: A comprehensive search of relevant databases yielded 15,298 papers. This paper reports a systematic review as part of an NIHR HTA study identifying studies pre-2012, updated to include all papers to October 2016. Two independent reviewers undertook two stage screening and data extraction of the included studies at all stages. A Cochrane quality assessment was carried out to assess the risk of bias. In total, fourteen studies were included in the review. In a meta-analysis of these fourteen studies the interventions saw less disorganised attachment at outcome compared to the control (OR = 0.50, (0.32, 0.77), p = 0.008). The majority of the interventions targeted maternal sensitivity. We carried out exploratory analyses to examine factors that may influence treatment outcome but these should be treated with caution given that we were limited by small numbers of studies. CONCLUSIONS: Parenting interventions that target parental sensitivity show promise in reducing disorganised attachment. This is limited by few high quality studies and the fact that most studies are with mothers. More high quality randomised controlled trials are required to elucidate this further.
