The provision of fire services in rural areas

Fire services have been neglected in discussions of public service provision in rural areas. The way in which they are provided has a broader significance in terms of current debates about risk management. Fire service policy was transferred away from the Home Office, but the Bain Report provided the major stimulus to change. Early central government attempts to stimulate fire service provision in rural area were hampered by a lack of cooperation between local authorities. Rates of death from fire are influenced by attendance times and are particularly high in remote rural areas. The development of national standards of fire cover was focused on protecting property rather than saving lives with disproportionate funding being provided for urban areas. Social changes in rural areas have made it more difficult to secure sufficient numbers of retained fire fighters. It has proved particularly difficult to provide an adequate service in remote rural areas such as the Highlands and Islands of Scotland, despite recent policy initiatives there. Problems of providing fire cover are particularly acute on isolated islands. The development of integrated risk management plans should offer a more fine grained approach to providing fire cover. However, they may be too sophisticated for the task in rural areas and more traditional democratic mechanisms for expressing perceived community needs may have a greater relevance

Scotland, NATO, and transatlantic security

This article explores the political and strategic implications of Scottish Independence for existing transatlantic security arrangements. It examines the potential institutional, legal and political obstacles Scotland might face during the transition to independence and discusses the specific challenges in the area of security and defence, including the nuclear issue and the question of what form an independent Scottish Defence Force (SDF) would need to take to allow and facilitate integration in transatlantic security structures. It argues that a number of strategic and political issues could be mitigated in the course of negotiations between Edinburgh and London. Moreover, Scotland's geostrategic position and political orientation make it an important prospective partner in international security cooperation across the Eastern Atlantic, High North and North Sea, which suggests that an advanced partnership with NATO, and eventually full membership, seems like an option that is both politically viable and more likely than any scenario that predicts seeing an independent Scotland (IS) outside these structures. This challenges some of the main strategic and security political arguments against independence and thus seeks to spark a debate about the realistic options for Scotland should it become independent after 2016

Public attitudes towards alcohol control policies in Scotland and England: Results from a mixed-methods study

The harmful effects of heavy drinking on health have been widely reported, yet public opinion on governmental responsibility for alcohol control remains divided. This study examines UK public attitudes towards alcohol policies, identifies underlying dimensions that inform these, and relationships with perceived effectiveness. A cross-sectional mixed methods study involving a telephone survey of 3477 adult drinkers aged 16-65 and sixteen focus groups with 89 adult drinkers in Scotland and England was conducted between September 2012 and February 2013. Principal components analysis (PCA) was used to reduce twelve policy statements into underlying dimensions. These dimensions were used in linear regression models examining alcohol policy support by demographics, drinking behaviour and perceptions of UK drinking and government responsibility. Findings were supplemented with a thematic analysis of focus group transcripts. A majority of survey respondents supported all alcohol policies, although the level of support varied by type of policy. Greater enforcement of laws on under-age sales and more police patrolling the streets were strongly supported while support for pricing policies and restricting access to alcohol was more divided. PCA identified four main dimensions underlying support on policies: alcohol availability, provision of health information and treatment services, alcohol pricing, and greater law enforcement. Being female, older, a moderate drinker, and holding a belief that government should do more to reduce alcohol harms were associated with higher support on all policy dimensions. Focus group data revealed findings from the survey may have presented an overly positive level of support on all policies due to differences in perceived policy effectiveness. Perceived effectiveness can help inform underlying patterns of policy support and should be considered in conjunction with standard measures of support in future research on alcohol control policies

Is oral health an important factor for mental health among people in custody in Scottish prisons?

Objective: To test a theoretical mediation model and investigate whether drug use and/or dental anxiety act as mediating factors between depression and dental decay experience among prisoners.Method: A cross-sectional survey was conducted on a convenience sample of 300 prisoners across three prison establishments in Scotland. Depression and dental anxiety were measured using the Centre for Epidemiological Studies Depression Scale and the Modified Dental Anxiety Scale, respectively. Drug use was assessed using three yes (scoring 1)/ no (scoring 0) questions: ‘ever taken (illegal) drugs’, ‘injecting drugs’ and ‘ever participated in a rehabilitation programme’. Participants had an oral examination to determine dental caries experience (missing [MT] and untreated decay [D 3cvT]) in all four quadrants. Latent variable path analysis was conducted to test the mediation model.Results: A total of 342 prisoners participated, of which 298 yielded a complete data set. Depression was associated with missing teeth and untreated decay (D 3T) through an indirect pathway (Total standardized indirect effects = 0.11, P &lt;.01) via drug use and dental anxiety (X 2 [71] = 89.8, P =.07; Root Mean Square Error of Approximation: 0.03; Comparative Fit Index: 0.994 and Tucker-Lewis index: 0.992). Twenty-two percent of the variance in untreated decay and missing teeth was explained by both drug use and dental anxiety; however, the strongest predictor was drug use (total standardized direct effects = 0.45, P &lt;.001).Conclusion: A relatively simple model to assist understanding dental decay experience of people in prison has been proposed. The data collected were consistent with our specified model. Drug use acted as the primary mediator and dental anxiety as a secondary mediator between depression and dental decay experience. Given the co-morbidity between mental health and drug use and dental decay experience, an integrated or shared approach is proposed. We recommend that future research should concentrate on building a firmer picture by replicating and extending the framework presented. </p

Living at home after emergency hospital admission:prospective cohort study in older adults with and without cognitive spectrum disorder

Background: Cognitive spectrum disorders (CSDs) are common in hospitalised older adults and associated with adverse outcomes. Their association with the maintenance of independent living has not been established. The aim was to establish the role of CSDs on the likelihood of living at home 30 days after discharge or being newly admitted to a care home. Methods: A prospective cohort study with routine data linkage was conducted based on admissions data from the acute medical unit of a district general hospital in Scotland. 5570 people aged ≥ 65 years admitted from a private residence who survived to discharge and received the Older Persons Routine Acute Assessment (OPRAA) during an incident emergency medical admission were included. The outcome measures were living at home, defined as a private residential address, 30 days after discharge and new care home admission at hospital discharge. Outcomes were ascertained through linkage to routine data sources. Results: Of the 5570 individuals admitted from a private residence who survived to discharge, those without a CSD were more likely to be living at home at 30 days than those with a CSD (93.4% versus 81.7%; difference 11.7%, 95%CI 9.7–13.8%). New discharge to a care home affected 236 (4.2%) of the cohort, 181 (76.7%) of whom had a CSD. Logistic regression modelling identified that all four CSD categories were associated with a reduced likelihood of living at home and an increased likelihood of discharge to a care home. Those with delirium superimposed on dementia were the least likely to be living at home (OR 0.25), followed by those with dementia (OR 0.43), then unspecified cognitive impairment (OR 0.55) and finally delirium (OR 0.57). Conclusions: Individuals with a CSD are at significantly increased risk of not returning home after hospitalisation, and those with CSDs account for the majority of new admissions to care homes on discharge. Individuals with delirium superimposed on dementia are the most affected. We need to understand how to configure and deliver healthcare services to enable older people to remain as independent as possible for as long as possible and to ensure transitions of care are managed supportively

Working County Lines: Child Criminal Exploitation and Illicit Drug Dealing in Glasgow and Merseyside

This article explores recent developments within the U.K. drug market: that is, the commuting of gang members from major cities to small rural urban areas for the purpose of enhancing their profit from drug distribution. Such practice has come to be known as working “County Lines.” We present findings drawn from qualitative research with practitioners working to address serious and organized crime and participants involved in street gangs and illicit drug supply in both Glasgow and Merseyside, United Kingdom. We find evidence of Child Criminal Exploitation (CCE) in County Lines activity, often as a result of debt bondage; but also, cases of young people working the lines of their own volition to obtain financial and status rewards. In conclusion, we put forward a series of recommendations which are aimed at informing police strategy, practitioner intervention, and wider governmental policy to effectively address this growing, and highly problematic, phenomenon

Local governance in the new Police Scotland:Renegotiating power, recognition and responsiveness

A marked, but by no means universal, trend in Europe over the last decade or so has been the centralization or amalgamation of regional police organizations into larger or single units. Scotland is a case in point, its eight regional services becoming one Police Scotland in April 2013. Although the reform process was relatively consensual, the new organization has been the subject of numerous controversies, some of which reflect an actual or perceived loss of the local in Scottish policing. Drawing on a qualitative study of the emerging local governance arrangements, we explore the negotiated character of large-scale organizational reform, demonstrating that it is best understood as a process not an event. We also argue that appeals to localism are not mere expressions of sentiment and resistance to change. They reflect the particular historical development of policing and public service delivery in Scotland at the level of municipal government, but also strong convictions that policing should be subject to democratic deliberation and should recognize and be responsive to those subject to it – what we argue here are necessary functions of police governance in general

Can national policy blockages accelerate the development of polycentric governance? Evidence from climate change policy in the United Kingdom

Many factors can conspire to limit the scope for policy development at the national level. In this paper, we consider whether blockages in national policy processes − resulting for example from austerity or small state political philosophies − might be overcome by the development of more polycentric governance arrangements. Drawing on evidence from three stakeholder workshops and fifteen interviews, we address this question by exploring the United Kingdom’s recent retrenchment in the area of climate change policy, and the ways in which its policy community have responded. We identify two broad strategies based on polycentric principles: ‘working with gatekeepers’ to unlock political capital and ‘collaborate to innovate’ to develop policy outputs. We then empirically examine the advantages that these actions bring, analysing coordination across overlapping sites of authority, such as those associated with international regimes, devolved administrations and civic and private initiatives that operate in conjunction with, and sometimes independently of, the state. Despite constraining political and economic factors, which are by no means unique to the UK, we find that a polycentric climate policy network can create opportunities for overcoming central government blockages. However, we also argue that the ambiguous role of the state in empowering but also in constraining such a network will determine whether a polycentric approach to climate policy and governance is genuinely additional and innovative, or whether it is merely a temporary ‘sticking plaster’ for the retreat of the state and policy retrenchment during austere times

E-cigarette use in prisons with recently established smokefree policies:a qualitative interview study with people in custody in Scotland

Introduction E-cigarettes were one measure introduced to help people in custody (PiC) to prepare for and cope with implementation of comprehensive smokefree policies in Scottish prisons. Our earlier study explored experiences of vaping when e-cigarettes were first introduced and most participants were dual tobacco and e-cigarette users. Here we present findings of a subsequent study of vaping among a different sample of PiC when use of tobacco was prohibited in prison, and smokefree policy had become the norm. Methods Twenty eight qualitative interviews were conducted with PiC who were current or former users of e-cigarettes in prison, 6-10 months after implementation of a smokefree policy. Data were managed and analysed using the framework approach. Results PiC reported that vaping helped with mandated smoking abstinence. However, findings suggest that some PiC may be susceptible to heavy e-cigarette use potentially as a consequence of high nicotine dependence and situational factors such as e-cigarette product choice and availability in prisons; issues with nicotine delivery; prison regimes; and use of e-cigarettes for managing negative emotions. These factors may act as barriers to cutting down or stopping use of e-cigarettes by PiC who want to make changes due to dissatisfaction with vaping or lack of interest in continued use of nicotine, cost and/or health concerns. Conclusions E-cigarettes helped PiC to cope with smokefree rules, although concerns about e-cigarette efficacy, cost and safety were raised. PiC may desire or benefit both from conventional smoking cessation programmes, and interventions to support reduction, or cessation, of vaping. Implications Findings highlight successes, challenges and potential solutions in respect of use of e-cigarettes to cope with mandated smoking abstinence in populations with high smoking prevalence and heavy nicotine dependence. Experiences from prisons in Scotland may be of particular interest to health and/or justice services in other jurisdictions, with similar legislation on e-cigarettes to the UK, who are planning for institutional smokefree policies in their prisons or inpatient mental health settings in the future

Depression, drugs and dental anxiety in prisons:A mediation model explaining dental decay experience

Objective: To test a theoretical mediation model and investigate whether drug use and/or dental anxiety act as mediating factors between depression and dental decay experience among prisoners.Method: A cross-sectional survey was conducted on a convenience sample of 300 prisoners across three prison establishments in Scotland. Depression and dental anxiety were measured using the Centre for Epidemiological Studies Depression Scale and the Modified Dental Anxiety Scale, respectively. Drug use was assessed using three yes (scoring 1)/ no (scoring 0) questions: ‘ever taken (illegal) drugs’, ‘injecting drugs’ and ‘ever participated in a rehabilitation programme’. Participants had an oral examination to determine dental caries experience (missing [MT] and untreated decay [D 3cvT]) in all four quadrants. Latent variable path analysis was conducted to test the mediation model.Results: A total of 342 prisoners participated, of which 298 yielded a complete data set. Depression was associated with missing teeth and untreated decay (D 3T) through an indirect pathway (Total standardized indirect effects = 0.11, P &lt;.01) via drug use and dental anxiety (X 2 [71] = 89.8, P =.07; Root Mean Square Error of Approximation: 0.03; Comparative Fit Index: 0.994 and Tucker-Lewis index: 0.992). Twenty-two percent of the variance in untreated decay and missing teeth was explained by both drug use and dental anxiety; however, the strongest predictor was drug use (total standardized direct effects = 0.45, P &lt;.001).Conclusion: A relatively simple model to assist understanding dental decay experience of people in prison has been proposed. The data collected were consistent with our specified model. Drug use acted as the primary mediator and dental anxiety as a secondary mediator between depression and dental decay experience. Given the co-morbidity between mental health and drug use and dental decay experience, an integrated or shared approach is proposed. We recommend that future research should concentrate on building a firmer picture by replicating and extending the framework presented. </p