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Aim: This study aims to explore and understand factors influencing the decisions of mental health professionals releasing service users from seclusion. Background: Seclusion should only be used as a last resort and for the minimum possible duration. Current evidence outlines which service users are more likely to be secluded, why and what influences professionals' decision to seclude. Little is known about factors professionals consider when releasing service users. Design: A qualitative study was undertaken to explore factors which influence decision‐making of mental health professionals when terminating episodes of seclusion. Methods: Semi‐structured face‐to‐face interviews with 21 professionals were undertaken between May 2017–January 2018. Framework analysis was used to systematically manage, analyse, and identify themes, while maintaining links to primary data and providing a transparent audit trail. Results: Six themes were identified where professionals looked for service users to demonstrate cooperation and compliance before they would be released. Decisions were subjective, being influenced by the experience and composition of the review team, the availability of resources plus the emotional tone and physical environment of the ward. Release could be delayed by policy and protocol. Conclusion: Professionals should have greater awareness of factors that hinder or facilitate decisions to release service from seclusion and an understanding of how service user views and involves in decisions regarding seclusion should be explored. Impact: Senior staff should be available to facilitate release at the earliest opportunity. Staff should ensure that policy and procedures do not prolong the time service users remain secluded. [ABSTRACT FROM AUTHOR]

This article examines how social workers reinterpreted certain legal requirements to meet their organisation's performance targets. Using an ethnographic approach, I combine organisational misbehaviour theory and Goffmanesque conceptions of dramaturgy to explore the regional activity of one team in a statutory agency. I argue that singly neither misbehaviour theory nor dramaturgical performances account for our understanding of why workers respond differently to organisational changes in a neo-liberalist environment. This study differs from current literature by shifting emphasis away from workers either resisting or conforming with organisational directives on to the ways in which individuals and collectives devise methods which instead give the appearance of co-operation. I demonstrate how workers disguised their resistance in an attempt to achieve potentially unachievable objectives and in turn avoid disciplinary action. I conclude by suggesting that applying Goffman to studies of organisation can advance scholars' understanding of how certain individuals respond to change and might come to be defined as loyal and compliant. This approach can also encourage discussions relating to the concept of recalcitrance and whether it is developed, and enforced, by those in powerful positions on the basis of their own desire to be well regarded by others. [ABSTRACT FROM AUTHOR]

Background Patient and public involvement and engagement (PPIE) in systematic reviews remains uncommon, despite the policy imperative for patient involvement in research. The aim of this study was to investigate the process and impact of collaborating with members of a patient Research User Group (RUG) on a systematic review about shared decision making around prescribing analgesia in primary care consultations. Methods Five members of an established patient RUG collaborated with researchers undertaking a systematic review with narrative synthesis, through workshops held at three time-points. These addressed the following: designing the protocol, interpreting the results and planning dissemination. Support from a RUG coordinator and user support worker facilitated collaboration throughout the review process. Researchers reflected on how PPIE modified the review at each time-point. Results RUG members identified factors important in shared decision making around analgesic prescribing additional to those initially proposed by the research team. Search terms and specific outcomes of interest were amended to reflect these additional factors. Thirty of the 39 patient-identified factors were absent in the published literature. The categories of factors identified were used as a framework for the narrative synthesis and for reporting results. RUG members prioritized options for disseminating the results. Conclusion PPIE collaboration throughout the systematic review impacted on the scope of the review, highlighting gaps in the literature that were important to patients. Impact on interpretation and dissemination of findings ensured the review directly reflected patient priorities. Challenges and strategies to facilitate PPIE involvement in systematic reviews and suggestions for future researchers are highlighted. [ABSTRACT FROM AUTHOR]

Aims and objectives To identify how nurse leaders view and experience the opportunities offered by one of the largest global nursing organisations Sigma Theta Tau International. Background Worldwide, nursing leadership is challenged with addressing the complex issues impacting on care delivery. International nursing organisations are a means to bring together individuals to promote leadership and scholarship for nursing practice to promote patient safety and quality care. The newly established all-England chapter of Sigma Theta Tau International is a recent addition to the society in terms of nurse leadership in Europe, as such faces challenges as it establishes its identity and seeks to interpret the organisational vision: to advance world health through nursing leadership and scholarship. Moving forward, members views were sought on the goals of the chapter and how they may be enacted. Design In July 2013, all chapter members at that time had been nominated on the basis of achievement in nurse leadership; all were invited to participate in an online survey. The online questionnaire contained a series of closed and open questions. Results Most respondents joined because they believed in the vision and networking opportunities Sigma Theta Tau International provides. Three themes were extracted from the data: the value of networking and communication, leadership and the development of culturally sensitive organisations and the need for shared scholarship for nursing practice. Conclusion Findings indicate the growth of effective leadership at all levels of nursing could be harnessed through successful collaboration and keen support for robust connections between practice and education to promote quality care. Relevance to clinical practice Whilst challenging, globalisation presents an opportunity for a nursing society such as Sigma Theta Tau International to work collaboratively to address healthcare issues. A nursing society that explores and resolves its own complex issues by actively promoting leadership and collaborative scholarship reveals a potential to empower the profession to share our collective solutions towards enhancing clinical practice. [ABSTRACT FROM AUTHOR]

Background: Paramedics make important and increasingly complex decisions at scene about patient care. Patient safety implications of influences on decision making in the pre-hospital setting were previously under-researched. Cutting edge perspectives advocate exploring the whole system rather than individual influences on patient safety. Ethnography (the study of people and cultures) has been acknowledged as a suitable method for identifying health care issues as they occur within the natural context. In this paper we compare multiple methods used in a multi-site, qualitative study that aimed to identify system influences on decision making.Methods: The study was conducted in three NHS Ambulance Trusts in England and involved researchers from each Trust working alongside academic researchers. Exploratory interviews with key informants e.g. managers (n = 16) and document review provided contextual information. Between October 2012 and July 2013 researchers observed 34 paramedic shifts and ten paramedics provided additional accounts via audio-recorded 'digital diaries' (155 events). Three staff focus groups (total n = 21) and three service user focus groups (total n = 23) explored a range of experiences and perceptions. Data collection and analysis was carried out by academic and ambulance service researchers as well as service users. Workshops were held at each site to elicit feedback on the findings and facilitate prioritisation of issues identified.Results: The use of a multi-method qualitative approach allowed cross-validation of important issues for ambulance service staff and service users. A key factor in successful implementation of the study was establishing good working relationships with academic and ambulance service teams. Enrolling at least one research lead at each site facilitated the recruitment process as well as study progress. Active involvement with the study allowed ambulance service researchers and service users to gain a better understanding of the research process. Feedback workshops allowed stakeholders to discuss and prioritise findings as well as identify new research areas.Conclusion: Combining multiple qualitative methods with a collaborative research approach can facilitate exploration of system influences on patient safety in under-researched settings. The paper highlights empirical issues, strengths and limitations for this approach. Feedback workshops were effective for verifying findings and prioritising areas for future intervention and research. [ABSTRACT FROM AUTHOR]

Walking groups have known health benefits but may not operate in communities with the greatest health needs, leading to the potential for increasing health inequity. This study examined the process of implementing a new volunteer led walking group scheme in a deprived community in England with poor physical activity, health and socio-economic indicators. Documentary evidence and semi-structured interviews with stakeholders and volunteer walk leaders undertaken at the beginning and end of the funding period were analysed thematically. It was found that utilising community-based assets, forming collaborative partnerships with health and non-health organisations and ongoing sustainability issues were all factors that affected the scheme's effective implementation. Passive recruitment methods and mass publicity did not attract participants who were representative of their community. The findings firstly suggest the necessity of identifying and mobilising community based assets at the ‘grass roots’ in deprived communities during the preparatory stage to access those in greatest need and to plan and build capacity. Secondly, the findings highlight the key role that health professionals have in referring those in poorest health and the inactive into walking interventions. In the new era of fiscally constrained public health embedded within local authorities these findings are pertinent in supporting the utilisation of local assets to address entrenched physical inactivity and inequity within deprived communities. [ABSTRACT FROM AUTHOR]

Background: The English health system experienced a large-scale reorganisation in April 2013. A national tri-partite delivery framework involving the Department of Health, NHS England and Public Health England was agreed and a new local operational model applied. Evidence about how health system re-organisations affect constituent public health programmes is sparse and focused on low and middle income countries. We conducted an in-depth analysis of how the English immunisation programme adapted to the April 2013 health system reorganisation, and what facilitated or hindered the delivery of immunisation services in this context.Methods: A qualitative case study methodology involving interviews and observations at national and local level was applied. Three sites were selected to represent different localities, varying levels of immunisation coverage and a range of changes in governance. Study participants included 19 national decision-makers and 56 local implementers. Two rounds of interviews and observations (immunisation board/committee meetings) occurred between December 2014 and June 2015, and September and December 2015. Interviews were audio recorded and transcribed verbatim and written accounts of observed events compiled. Data was imported into NVIVO 10 and analysed thematically.Results: The new immunisation programme in the new health system was described as fragmented, and significant effort was expended to regroup. National tripartite arrangements required joint working and accountability; a shift from the simpler hierarchical pre-reform structure, typical of many public health programmes. New local inter-organisational arrangements resulted in ambiguity about organisational responsibilities and hindered data-sharing. Whilst making immunisation managers responsible for larger areas supported equitable resource distribution and strengthened service commissioning, it also reduced their ability to apply clinical expertise, support and evaluate immunisation providers' performance. Partnership working helped staff adapt, but the complexity of the health system hindered the development of consistent approaches for training and service evaluation.Conclusion: The April 2013 health system reorganisation in England resulted in significant fragmentation in the way the immunisation programme was delivered. Some of this was a temporary by-product of organisational change, other more persistent challenges were intrinsic to the complex architecture of the new health system. Partnership working helped immunisation leaders and implementers reconnect and now the challenge is to assess how inter-agency collaboration can be strengthened. [ABSTRACT FROM AUTHOR]

Background: Health services face the challenges created by complex problems, and so need complex intervention solutions. However they also experience ongoing difficulties in translating findings from research in this area in to quality improvement changes on the ground. BounceBack was a service development innovation project which sought to examine this issue through the implementation and evaluation in a primary care setting of a novel complex intervention.Methods: The project was a collaboration between a local mental health charity, an academic unit, and GP practices. The aim was to translate the charity's model of care into practice-based evidence describing delivery and impact. Normalisation Process Theory (NPT) was used to support the implementation of the new model of primary mental health care into six GP practices. An integrated process evaluation evaluated the process and impact of care.Results: Implementation quickly stalled as we identified problems with the described model of care when applied in a changing and variable primary care context. The team therefore switched to using the NPT framework to support the systematic identification and modification of the components of the complex intervention: including the core components that made it distinct (the consultation approach) and the variable components (organisational issues) that made it work in practice. The extra work significantly reduced the time available for outcome evaluation. However findings demonstrated moderately successful implementation of the model and a suggestion of hypothesised changes in outcomes.Conclusions: The BounceBack project demonstrates the development of a complex intervention from practice. It highlights the use of Normalisation Process Theory to support development, and not just implementation, of a complex intervention; and describes the use of the research process in the generation of practice-based evidence. Implications for future translational complex intervention research supporting practice change through scholarship are discussed. [ABSTRACT FROM AUTHOR]

Background: Hospital discharge is a vulnerable transitional stage in patient care. This qualitative study investigated the views of healthcare professionals and patients about the threats to safe hospital discharge with aim of identifying contributory and latent factors. The study was undertaken in two regional health and social care systems in the English National Health Service, each comprising three acute hospitals, community and primary care providers and municipal social care services. The study focused on the threats to safe discharge for hip fracture and stroke patients as exemplars of complex care transitions.Methods: A qualitative study involving narrative interviews with 213 representative stakeholders and professionals involved in discharge planning and care transition activities. Narratives were analysed in line with 'systems' thinking to identify proximal (active) and distal (latent) factors, and the relationships between them.Results: Three linked categories of commonly and consistently identified threat to safe discharge were identified: (1) 'direct' patient harms comprising falls, infection, sores and ulceration, medicines-related issues, and relapse; (2) proximal 'contributing' factors including completion of tests, assessment of patient, management of equipment and medicines, care plan, follow-up care and patient education; and distal 'latent' factors including discharge planning, referral processes, discharge timing, resources constraints, and organisational demands.Conclusion: From the perspective of stakeholders, the study elaborates the relationship between patient harms and systemic factors in the context of hospital discharge. It supports the importance of communication and collaboration across occupational and organisational boundaries, but also the challenges to supporting such communication with the inherent complexity of the care system. [ABSTRACT FROM AUTHOR]

Background: Challenges exist in recruitment to trials involving interventions delivered by different clinical specialties. Collaboration is required between clinical specialty and research teams. The aim of this study was to explore how teamwork influences recruitment to a multicentre randomised controlled trial (RCT) involving interventions delivered by different clinical specialties.Methods: Semi-structured interviews were conducted in three centres with a purposeful sample of members of the surgical, oncology and research teams recruiting to a feasibility RCT comparing definitive chemoradiotherapy with chemoradiotherapy and surgery for oesophageal squamous cell carcinoma. Interviews explored factors known to influence healthcare team effectiveness and were audio-recorded and thematically analysed. Sampling, data collection and analysis were undertaken iteratively and concurrently.Results: Twenty-one interviews were conducted. Factors that influenced how team working impacted upon trial recruitment were centred on: (1) the multidisciplinary team (MDT) meeting, (2) leadership of the trial, and (3) the recruitment process. The weekly MDT meeting was reported as central to successful recruitment and formed the focus for creating a 'study team', bringing together clinical and research teams. Shared study leadership positively influenced healthcare professionals' willingness to participate. Interviewees perceived their clinical colleagues to have strong treatment preferences which led to scepticism regarding whether the treatments were being described to patients in a balanced manner.Conclusions: This study has highlighted a number of aspects of team functioning that are important for recruitment to RCTs that span different clinical specialties. Understanding these issues will aid the production of guidance on team-relevant issues that should be considered in trial management and the development of interventions that will facilitate teamwork and improve recruitment to these challenging RCTs.Trial Registration: International Standard Randomised Controlled Trial Number (ISRCTN): ISRCTN89052791 . [ABSTRACT FROM AUTHOR]

Background: Self-management of inflammatory arthritis (IA) requires patients to address the impact of symptoms, treatment, and the psychosocial consequences of a long term condition. There are several possible mechanisms for facilitating self-management, including patient-clinician interactions in routine consultations. This requires patients to collaborate in their healthcare, and clinicians to specifically encourage and help patients to do so. To design training that enables clinicians to support patients to be actively involved and self-manage requires understanding both patients' and clinicians' perspectives about what is important and feasible. Previous research explored the perspectives of clinicians who had undertaken brief training which they were putting into practice in their routine consultations. This study explored the perspectives of patients attending those routine consultations to identify aspects of the interaction that influenced collaboration and self-management.Methods: Nineteen patients with IA who had attended a routine consultation with a rheumatology clinician at one of four hospitals in England took part in semi-structured interviews. Interviews were transcribed, anonymised and analysed using inductive thematic analysis.Results: Three themes encompass participants' thoughts about interactions that facilitated collaboration in consultations and their ability to self-manage their IA: first, patients and clinicians viewing care as a shared endeavour, including patients responding actively to their IA and clinicians exploring and negotiating with patients; second, the need for clinicians to understand the challenges faced by patients, appreciate the impact of IA and focus on patients' priorities; and third, clinicians using an open communication style, including the use of non-didactic, patient-centred approaches. A fourth theme was perceived benefits of actively engaging in consultations, including increased confidence to deal with the impact of IA and greater acceptance of a long term condition.Conclusions: Patients perceive that self-management can be facilitated when clinicians and patients view healthcare as a shared responsibility, underpinned by clinicians as experts in the disease and patients as experts in living with it. Clinicians can support patients' self-management by using non-didactic communication skills to identify patients' priorities, and to prompt patients to problem-solve and share in setting the consultation agenda. This should inform skills-training for rheumatology clinicians. [ABSTRACT FROM AUTHOR]

Background: In 2008, the National Institute for Health Research (NIHR) began funding a major 5-year pilot research programme of translational research in England, establishing nine 'Collaborations for Leadership in Applied Health Research and Care' (CLAHRCs). A number of evaluations were carried out to examine whether or not the various collaborations worked as intended and why. In this paper, we examine what the theory of co-production adds to understanding of processes of knowledge creation and translation we observed in one of the CLAHRCs.Methods: A case study of a successful knowledge translation project was identified from our wider realist evaluation of the mechanisms of closer collaboration at play in the CLAHRC. In the project, a computer simulation model of an emergency pathway for acute ischaemic stroke was built to explore if and how the time between the onset and treatment of the condition could be minimised by redesigning the pathway. The aim of the case study was to improve our understanding of the nature and workings of the mechanisms of closer collaboration that were associated with the more successful projects by examining the relevance of the theory of co-production. Qualitative methods of analysis were used to explore the fit between the mechanisms of closer collaboration we observed in the realist evaluation and the principles of co-production we identified from the literature.Results: We found a close fit between the nine mechanisms of closer collaboration at work in the project and the principles of co-production (active agents; equality of partners; reciprocity and mutuality; transformative; and facilitated). The successful style of collaborative working exemplified by the project was consistent with a strong form of co-production.Conclusions: In our view, the theory of co-production provides useful insights into what it is about the qualities of collaborative working that inspire the requisite mechanisms for generating knowledge that is translated into practice. The theory provides a potentially useful basis for future knowledge translation programmes and projects in applied health research in a range of contexts. [ABSTRACT FROM AUTHOR]

Background: Increasingly, it is being suggested that translational gaps might be eradicated or narrowed by bringing research users and producers closer together, a theory that is largely untested. This paper reports a national study to fill a gap in the evidence about the conditions, processes and outcomes related to collaboration and implementation.Methods: A longitudinal realist evaluation using multiple qualitative methods case studies was conducted with three Collaborations for Leadership in Applied Health Research in Care (England). Data were collected over four rounds of theory development, refinement and testing. Over 200 participants were involved in semi-structured interviews, non-participant observations of events and meetings, and stakeholder engagement. A combined inductive and deductive data analysis process was focused on proposition refinement and testing iteratively over data collection rounds.Results: The quality of existing relationships between higher education and local health service, and views about whether implementation was a collaborative act, created a path dependency. Where implementation was perceived to be removed from service and there was a lack of organisational connections, this resulted in a focus on knowledge production and transfer, rather than co-production. The collaborations' architectures were counterproductive because they did not facilitate connectivity and had emphasised professional and epistemic boundaries. More distributed leadership was associated with greater potential for engagement. The creation of boundary spanning roles was the most visible investment in implementation, and credible individuals in these roles resulted in cross-boundary work, in facilitation and in direct impacts. The academic-practice divide played out strongly as a context for motivation to engage, in that 'what's in it for me' resulted in variable levels of engagement along a co-operation-collaboration continuum. Learning within and across collaborations was patchy depending on attention to evaluation.Conclusions: These collaborations did not emerge from a vacuum, and they needed time to learn and develop. Their life cycle started with their position on collaboration, knowledge and implementation. More impactful attempts at collective action in implementation might be determined by the deliberate alignment of a number of features, including foundational relationships, vision, values, structures and processes and views about the nature of the collaboration and implementation. [ABSTRACT FROM AUTHOR]

Statutory guidance for promoting the health and wellbeing of looked after children stipulates that children and young people in the care system should receive health assessments on entry to care, and thereafter at six-monthly intervals for children aged under five and annually for those aged five to 18 years. Heart of England NHS Foundation Trust works in partnership with the local authority and clinical commissioners to meet the needs of local looked after children. It was found that many of these children and young people were refusing to have health assessments. This longitudinal study identified blocks to engagement, and explored alternative strategies to build compliance and participation. Findings have demonstrated that using a multi-agency and child-centred approach is effective in engaging 'hard to reach' children and young people. [ABSTRACT FROM AUTHOR]

Background: Health services research is expected to involve service users as active partners in the research process, but few examples report how this has been achieved in practice in trials. We implemented a model to involve service users in a multi-centre randomised controlled trial in pre-hospital emergency care. We used the generic Standard Operating Procedure (SOP) from our Clinical Trials Unit (CTU) as the basis for creating a model to fit the context and population of the SAFER 2 trial.Methods: In our model, we planned to involve service users at all stages in the trial through decision-making forums at 3 levels: 1) strategic; 2) site (e.g. Wales; London; East Midlands); 3) local. We linked with charities and community groups to recruit people with experience of our study population. We collected notes of meetings alongside other documentary evidence such as attendance records and study documentation to track how we implemented our model.Results: We involved service users at strategic, site and local level. We also added additional strategic level forums (Task and Finish Groups and Writing Days) where we included service users. Service user involvement varied in frequency and type across meetings, research stages and locations but stabilised and increased as the trial progressed.Conclusion: Involving service users in the SAFER 2 trial showed how it is feasible and achievable for patients, carers and potential patients sharing the demographic characteristics of our study population to collaborate in a multi-centre trial at the level which suited their health, location, skills and expertise. A standard model of involvement can be tailored by adopting a flexible approach to take account of the context and complexities of a multi-site trial.Trial Registration: Current Controlled Trials ISRCTN60481756. Registered: 13 March 2009. [ABSTRACT FROM AUTHOR]

In order to enhance patient outcome and patient safety in healthcare, interprofessional education (IPE) has over the years become a specific area of interest focusing on teaching concepts, research methods, and implementation strategies. To achieve commitment and positive attitudes as part of the institutional readiness towards IPE, the adoption of change management aspects can support its early implementation. This short report presents results of a baseline survey on attitudes and preferences for IPE among first-year students in medicine and nursing, as well as among chief physicians, nurse directors, and administrative directors at the associated university hospital. For the survey, the UWE-IP (University of the West of England Interprofessional Questionnaire) was used along with ten customised questions. Overall, a high degree of approval for IPE was observed in all participants. Furthermore, participants showed positive attitudes in three of the four UWE-IP subscales. However, neutral to negative attitudes were documented in subscale interprofessional interaction. [ABSTRACT FROM PUBLISHER]

ABSTRACT This paper examines the issue of parental engagement where children's services have brought court proceedings to protect children, from the perspective of specialist lawyers who represent parents. It draws on an in-depth, qualitative study of parents' representation conducted between 2008 and 2010. Parental non-co-operation with children's services is a common feature in these cases. Lawyers are partisans with duties to follow clients' instructions. They seek to build a trusting relationship and keep clients engaged in the process by giving advice, taking instructions and providing emotional support. Lawyers accept that parents have an absolute right to contest but use their power and authority to encourage their most vulnerable clients to concede. They are largely successful in keeping clients engaged in proceedings but parents rarely make the necessary changes in parenting. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper discusses findings from an evaluation of an advocacy scheme for parents whose children were subject to child protection proceedings including a pilot project where co-operation between parents and professionals was an issue. Encouraging findings of parents' experiences of being heard, being able to listen, and, in some cases, to act on concerns about their children's welfare are outlined. Three case studies offer accounts of practices that are gendered and occur against a backdrop of ethnic disadvantage. The paper suggests that current debates about reform need to recognize the need to support parents to manage intimidating systems. [ABSTRACT FROM AUTHOR]

This paper draws parallels between the market trend in the English NHS and Polanyi's (1957) The Great Transformation: The political and economic origins of our time, Beacon Press: Boston (originally published in 1944 in the United States as The Great Transformation, Rinehart: and Co: New York, and in 1945 in England as Origins of our time, Gollancz: London) account of how the rise of markets provokes a self-protective counter-reaction that tries to re-embed economic relations in social relations. We report findings from a qualitative study of NHS contracting, which examines the recent move to harder-edged contracts with greater use of financial penalties and incentives. In practice, use of these techniques tended to be confined to nationally-mandated sections of the contract rather than emerging from local bilateral agreements, and when things went wrong the parties relied more on cooperative behaviour than on the provisions of the contract to find solutions. Making the current contracting system work depended more on existing relational networks than on the incentive structures created by recent 'marketisation' initiatives, but the inability of the market to evolve as expected has encouraged policy makers to publish plans for further radical reforms. [ABSTRACT FROM AUTHOR]

When people occupy different social positions within a cooperative task they experience discrepant role and situation demands and thus have divergent perspectives. The reported research predicts that exchanging social positions within a cooperative task can overcome divergences of perspective. This prediction was tested in two experiments using the Communication Conflict Situation. The first experiment ( n = 88) found that position exchange increased the ability of dyads to solve a communication conflict arising through discrepant perspectives. The second experiment ( n = 120) found that the effect of position exchange exceeds that of purely cognitive perspective taking, thus suggesting that it cannot be reduced to a purely cognitive process. Exchanging social positions is a newly identified and powerful social mechanism through which perspective taking, within a cooperative task, can be enhanced. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This study investigates how mediated learning designed to improve peer cooperation within activity-based problem solving tasks influences cooperative learning outcomes. Two groups (n = 22) of Year 8 students (mean age 13 +/- 5 months) were randomly assigned to an experimental or control group. The study began with two one-hour sessions of activity-based problem-solving tasks for the control and experimental groups. These sessions were coded for on- and off-task communication. The experimental group then participated in a mediated cooperative learning experience (MCLE) focused on developing cooperative communication and pro-social behaviour. Following the MCLE, a one-hour problem-solving activity session for the collection of data related to on- and off-task communication was conducted for both the control and experimental groups. Results demonstrate that cooperative group on-task communication can be effectively influenced by mediated learning, both intra-group and inter-group, implying that the success associated with cooperative learning may be enhanced by first teaching students how to cooperate. [ABSTRACT FROM AUTHOR]

We experimentally investigated the effect of superordinate (i.e. British) versus subordinate (i.e. English) identity salience on willingness to contribute to a resource shared at the superordinate level (the British coast). Contrary to what would be expected from straightforward application of self-categorization theory, two studies demonstrated that willingness to contribute to this shared resource was higher when subordinate (rather than superordinate) identity was activated. To explain this effect, we suggest that subordinate identities sometimes provide a more meaningful basis for self-definition and, when this is the case, activating subordinate level of identity might lay the foundation for enhanced cooperation within higher-order identities. Indeed, consistent with this argument, Study 2 showed that increased meaningfulness and coherence of the self-concept mediated the effect of subordinate identity salience on contributions to the shared (superordinate) resource. The results are discussed with respect to the role of meaning in determining categorization effects. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of font size and paper thickness on the response to, and completion of, a self-completion postal questionnaire among older people with joint pain.Study Design and Setting: Randomized trial. People aged 50 years and older with joint pain who consulted a general practitioner at one of five general practices in Central Cheshire were sent a postal questionnaire. Questionnaire format (large or small font size, thick or thin paper) was randomly allocated using a 2 x 2 factorial design.Results: Questionnaires were received from 502 out of 650 participants (crude response 77%). Response was significantly higher for participants receiving questionnaires with a larger font size (79.3% vs. 75.2%; hazard ratio 1.26, 95% confidence interval: 1.02, 1.56). Paper thickness had no significant effect on response. Completion (measure by assessing double-page turnover error) was increased in participants receiving questionnaires printed on thicker paper (3.2% vs. 7.1%; P=0.049) but was not affected by font size.Conclusion: This study demonstrates that questionnaires in larger font and on thicker paper may produce higher and more complete responses than surveys using standard size font and standard thickness paper, and should therefore be considered in studies among older people. [ABSTRACT FROM AUTHOR]

Prosocial exchange systems support cooperation and exchange in support of more sustainable forms of consumption. While often assumed that exchanges within such systems are reciprocal, it remains unproven as to what extent reciprocity occurs. This study uses data from a live service – Streetbank.com - to present an analysis of direct and indirect reciprocal relationships (for interactions of giving, lending, and skillsharing) over 4 and half years. The dataset contains behavioural data relating to 5053 acts of offline non-monetary exchange. The analysis categorised different forms of exchange that took place – giving, lending, and skill sharing. These exchanges were then analysed for direct (one-to-one) and indirect reciprocity (chains of three or more users). The results show that instances of reciprocity are rare, and when present often span more than one type of exchange. The conclusion is that reciprocity cannot be assumed to be the norm in prosocial exchange systems. Practically, design and deployment should not be predicated on reciprocity. Furthermore, any means to encourage reciprocity should make patterns of exchange visible, and do so across hybrid forms of exchange. • Direct and indirect reciprocity between users of a popular prosocial exchange system are examined. •Reciprocal relationships are rare (1.58%) across three forms of prosocial behaviour (giving, lending, and skill-sharing). •Results challenge the idea that prosocial exchange is motivated and sustained through 'generalised reciprocity'. •Network analysis reveals users interact through fragmented chains of dyads rather than channels for indirect reciprocity. [ABSTRACT FROM AUTHOR]

Background: To increase the uptake of research evidence in practice, responsive research services have been developed within universities that broker access to academic expertise for practitioners and decision-makers. However, there has been little examination of the process of knowledge brokering within these services. This paper reflects on this process within the AskFuse service, which was launched in June 2013 by Fuse, the Centre for Translational Research in Public Health, in North East England. The paper outlines the challenges and opportunities faced by both academics and health practitioners collaborating through the service.Methods: The authors reflected on conversations between the AskFuse Research Manager and policy and practice partners accessing the service between June 2013 and March 2017. Summary notes of these conversations, including emails and documents relating to over 240 enquiries, have been analysed using an auto-ethnographic approach.Findings: We identified five challenges to knowledge brokering in an institutional service, namely length of brokerage time required, limits to collaboration, lack of resources, brokering research in a changing system, and multiple types of knowledge.Conclusions: To understand and overcome some of the identified challenges, we employ Goffman's dramaturgical perspective and argue for making better use of the distinction between front and back stages in the knowledge brokering process. We emphasise the importance of back stages for defusing destructive information that could discredit collaborative performances. [ABSTRACT FROM AUTHOR]

Background: Depression accounts for the greatest disease burden of all mental health disorders, contributes heavily to healthcare costs, and by 2020 is set to become the second largest cause of global disability. Although 10% to 16% of people aged 65 years and over are likely to experience depressive symptoms, the condition is under-diagnosed and often inadequately treated in primary care. Later-life depression is associated with chronic illness and disability, cognitive impairment and social isolation. With a progressively ageing population it becomes increasingly important to refine strategies to identity and manage depression in older people. Currently, management may be limited to the prescription of antidepressants where there may be poor concordance; older people may lack awareness of psychosocial interventions and general practitioners may neglect to offer this treatment option.Methods/design: CASPER Plus is a multi-centre, randomised controlled trial of a collaborative care intervention for individuals aged 65 years and over experiencing moderate to severe depression. Selected practices in the North of England identify potentially eligible patients and invite them to participate in the study. A diagnostic interview is carried out and participants with major depressive disorder are randomised to either collaborative care or usual care. The recruitment target is 450 participants. The intervention, behavioural activation and medication management in a collaborative care framework, has been adapted to meet the complex needs of older people. It is delivered over eight to 10 weekly sessions by a case manager liaising with general practitioners. The trial aims to evaluate the clinical and cost effectiveness of collaborative care in addition to usual GP care versus usual GP care alone. The primary clinical outcome, depression severity, will be measured with the Patient Health Questionnaire-9 (PHQ-9) at baseline, 4, 12 and 18 months. Cost effectiveness analysis will assess health-related quality of life using the SF-12 and EQ-5D and will examine cost-consequences of collaborative care. A qualitative process evaluation will be undertaken to explore acceptability, gauge the extent to which the intervention is implemented and to explore sustainability beyond the clinical trial.Discussion: Results will add to existing evidence and a positive outcome may lead to the commissioning of this model of service in primary care.Trial Registration: ISRCTN45842879 (24 July 2012). [ABSTRACT FROM AUTHOR]