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BACKGROUND: We have demonstrated the efficacy of a brief behavioral intervention for sleep in children with ADHD in a previous randomized controlled trial and now aim to examine whether this intervention is effective and cost-effective when delivered by pediatricians or psychologists in community settings. METHODS: Translational, cluster-randomized trial of a behavioral intervention versus usual care from 19th January, 2015 to 30th June, 2017. Participants (n = 361) were children aged 5-13 years with ADHD and parent report of a moderate/severe sleep problem who met criteria for American Academy of Sleep Medicine criteria for chronic insomnia disorder, delayed sleep-wake phase disorder, or were experiencing sleep-related anxiety. Participants were randomized at the level of the pediatrician (n = 61) to intervention (n = 183) or usual care (n = 178). Families in the intervention group received two consultations with a pediatrician or a psychologist covering sleep hygiene and tailored behavioral strategies. RESULTS: In an intention-to-treat analysis, at 3 and 6 months respectively, the proportion of children with moderate to severe sleep problems was lower in the intervention (28.0%, 35.8%) compared with usual care group (55.4%, 60.1%; 3 month: risk ratio (RR): 0.51, 95% CI 0.37, 0.70, p < .001; 6 month: RR: 0.58; 95% CI 0.45, 0.76, p < .001). Intervention children had improvements across multiple Children's Sleep Habits Questionnaire subscales at 3 and 6 months. No benefits of the intervention were observed in other domains. Cost-effectiveness of the intervention was AUD 13 per percentage point reduction in child sleep problem at 3 months. CONCLUSIONS: A low-cost brief behavioral sleep intervention is effective in improving sleep problems when delivered by community clinicians. Greater sample comorbidity, lower intervention dose or insufficient clinician supervisions may have contributed to the lack benefits seen in our previous trial.

INTRODUCTION: Up to 70% of children with attention-deficit/hyperactivity disorder (ADHD) experience sleep problems. We have demonstrated the efficacy of a brief behavioural intervention for children with ADHD in a large randomised controlled trial (RCT) and now aim to examine whether this intervention is effective in real-life clinical settings when delivered by paediatricians or psychologists. We will also assess the cost-effectiveness of the intervention. METHODS AND ANALYSIS: Children aged 5-12 years with ADHD (n=320) are being recruited for this translational cluster RCT through paediatrician practices in Victoria and Queensland, Australia. Children are eligible if they meet criteria for ADHD, have a moderate/severe sleep problem and meet American Academy of Sleep Medicine criteria for either chronic insomnia disorder or delayed sleep-wake phase disorder; or are experiencing sleep-related anxiety. Clinicians are randomly allocated at the level of the paediatrician to either receive the sleep training or not. The behavioural intervention comprises 2 consultations covering sleep hygiene and standardised behavioural strategies. The primary outcome is change in the proportion of children with moderate/severe sleep problems from moderate/severe to no/mild by parent report at 3 months postintervention. Secondary outcomes include a range of child (eg, sleep severity, ADHD symptoms, quality of life, behaviour, working memory, executive functioning, learning, academic achievement) and primary caregiver (mental health, parenting, work attendance) measures. Analyses will address clustering at the level of the paediatrician using linear mixed effect models adjusting for potential a priori confounding variables. ETHICS AND DISSEMINATION: Ethics approval has been granted. Findings will determine whether the benefits of an efficacy trial can be realised more broadly at the population level and will inform the development of clinical guidelines for managing sleep problems in th

INTRODUCTION: Up to 70% of children with attention-deficit/hyperactivity disorder (ADHD) experience sleep problems. We have demonstrated the efficacy of a brief behavioural intervention for children with ADHD in a large randomised controlled trial (RCT) and now aim to examine whether this intervention is effective in real-life clinical settings when delivered by paediatricians or psychologists. We will also assess the cost-effectiveness of the intervention. METHODS AND ANALYSIS: Children aged 5-12 years with ADHD (n=320) are being recruited for this translational cluster RCT through paediatrician practices in Victoria and Queensland, Australia. Children are eligible if they meet criteria for ADHD, have a moderate/severe sleep problem and meet American Academy of Sleep Medicine criteria for either chronic insomnia disorder or delayed sleep-wake phase disorder; or are experiencing sleep-related anxiety. Clinicians are randomly allocated at the level of the paediatrician to either receive the sleep training or not. The behavioural intervention comprises 2 consultations covering sleep hygiene and standardised behavioural strategies. The primary outcome is change in the proportion of children with moderate/severe sleep problems from moderate/severe to no/mild by parent report at 3 months postintervention. Secondary outcomes include a range of child (eg, sleep severity, ADHD symptoms, quality of life, behaviour, working memory, executive functioning, learning, academic achievement) and primary caregiver (mental health, parenting, work attendance) measures. Analyses will address clustering at the level of the paediatrician using linear mixed effect models adjusting for potential a priori confounding variables. ETHICS AND DISSEMINATION: Ethics approval has been granted. Findings will determine whether the benefits of an efficacy trial can be realised more broadly at the population level and will inform the development of clinical guidelines for managing sleep problems in th

In the context of an increasingly mobile student population, and Greek students specifically, this paper opens up and reveals the manner in which a specific culturally situated human actor (the Greek student) and a specific culturally situated non-human actor (the plagiarism detection system) encounter, interpret and constitute each other within the situated context of the UK higher education system. Methodologically, we base our paper on a longitudinal in-depth case study that focussed on the teaching, learning and assessment practices in Greek public sector universities. Based on our Greek case example we specifically focus on how the delegation of plagiarism detection to a technical actor produces a particular set of agencies and intentionalities (a politics one might say) which unintentionally and unexpectedly conspires to constitute some students as plagiarists (who are not) and others as not (who are). We suggest that this is best explored by looking exactly at what is rendered visible and invisible in such imbrications. This has important implications for the design, implementation and use of IS in situated contexts.

This paper considers the UK Government's major modernization programme for local government and its aim to use technology to bring about a radical transformation in the delivery of public services by joining up hitherto separate service departments and focusing the organization of services around the citizen. Drawing upon empirical fieldwork in the North of England, the paper seeks to shed light on the realization and operation of modernization and considers the issues of power and hybridity involved in the emplacement of new organizational configurations (`front office' contact centres and `back office' service departments) to handle citizen inquiries.

Environmental offsets are positive mitigation measures implemented during environmental impact assessment (EIA) approvals to compensate for unavoidable negative environmental actions. Through interviews with 29 practitioners experienced with offsets, this study investigated the level of support for environmental offsets in Western Australia, implementation of the mitigation sequence and achievement of 'net environmental gain' and 'like for like' in practice. In-principle support for the use of offsets was almost unanimous. However, the practical workability of 'like for like' was questioned along with claims that offsets failed to deliver net benefits. Greater guidance and follow-up will be necessary if practice is to live up to expectation.

The dramatic increase in the number of overseas students studying in the United Kingdom and other Western countries has required academics to reevaluate many aspects of their own, and their institutions', practices. This article considers differing cultural values among overseas students toward plagiarism and the implications this may have for postgraduate education in a Western context. Based on focus-group interviews, questionnaires, and informal discussions, we report the views of plagiarism among students in 2 postgraduate management programs, both of which had a high constituency of overseas students. We show that plagiarist practices are often the outcome of many complex and culturally situated influences. We suggest that educators need to appreciate these differing cultural assumptions if they are to act in an ethical manner when responding to issues of plagiarism among international students.

The dramatic increase in the number of overseas students studying in the UK and other western countries has required academics to re-evaluate many aspects of their own, and their institutions practice. This paper considers differing cultural attitudes and perceptions among overseas students towards plagiarism, and the implications this may have for postgraduate education in the UK. Based on focus groups, questionnaires and informal discussions, we report the views and perceptions of plagiarism among students on two postgraduate management courses, both of which had a high constituency of overseas students. We show that plagiarist practices are often the outcome of many diverse, complex and culturally situated influences, and consider the appreciation of these differing cultural assumptions to be fundamental in pre-emptively responding to issues of plagiarism among overseas students

This study examines how some employees coped with the exceptions that they encountered with their on-going use of a co-operative work-flow technology in an optronics company. By drawing on the case material, this paper will indicate that approaches which view work as being capable of being planned and managed through the formal authority of the hierarchy are insufficient, and instead this paper will suggest that exception handling, work-arounds and improvisation are more characteristic of human activity. The theoretical framework for the interpretive study was based on structuration theory. Structuration theory provides a theoretical lens that conceptualises action and structure as a duality, and emphasises how activity is both enabled and constrained. The principles underlying ethnography have informed the research approach.

This article discusses how the disembedding of social relations and their rearticulation across different tracts of time and space are implicated in knowledgeworking. We explore this theme within the context of the UK selling division of a multinationalpharmaceutical company. We will examine how the use of a groupware technologywas used to work across the functional, geographic and temporal boundaries that separated many employees, and most notably the sales force from those who were located at the head office. Specifically, we will consider the opportunities and limitations that surrounded the use of groupware to work within and between these boundaries. We will also discuss the innovative strategies that some employees devised to work around these difficulties. Knowledge production is conceptualised from a communities of practice perspective, and further sensitised with reference to Giddens thesis on the nature of contemporary society.

Background Preparing the nursing workforce to meet the challenges of an ageing population is a priority for many countries. The development of an Older Person's Nurse Fellowship (OPNF) programme for senior clinical nurses is an important innovation. Objectives This article describes the philosophical development, delivery and early evaluation of the OPNF. Design In 2014, Health Education England funded 24 senior clinical nurses to participate in the OPNF. The Fellowship was designed to build clinical leadership and innovation capability and develop a network of nurses to influence local and national strategy for older people's care. The Fellows selected were drawn from mental health (n = 4), community/primary care (n = 9) and acute care (n = 11). The twelve month programme consisted of two Masters-level modules, delivered through study days and e-learning. The first cohort (n = 12) commenced the course in November 2014 with a module designed to enhance clinical knowledge and skills. Methods Evaluation data were collected from the first cohort using anonymous surveys (n = 11) and focus group interviews (n = 9). Descriptive statistics are presented for the quantitative data and common themes are described in the qualitative data. Results The overall satisfaction with the clinical module was high with a median score of 18/20 (range 17–20). Topics such as comprehensive geriatric assessment, frailty, pharmacology and cognitive assessment were regarded as highly relevant and most likely to result in a change to clinical practice. In the focus group interviews students discussed their learning experience in terms of: module specificity, peer-to-peer learning and using the OPNF as leverage for change. Conclusions The OPNF is a timely innovation and a positive commitment to developing an academic pathway for senior nurses. It marks an important step in the future development of the older person's nursing workforce.