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The appointment of student governors to the governing board is mandatory in further education (FE) colleges across the UK. There is, however, confusion and lack of clarity over the role of the stud...

Normative expectations are that Governing Boards will be involved in setting the strategic direction of the organisation. However, knowledge of the processes and practices by which Boards engage in strategy is limited. In particular, very few empirical studies have penetrated the ‘black box’ of the Boardroom and examined the complex Board/Management interactions that amount to Boards ‘doing’ strategy. Here we address this gap, presenting an in-depth analysis of an unfolding process in which the Board and Management of a single organisation engaged in setting strategic direction over an 18-month period. We observed planning events, video-recorded Board meetings, analysed texts pertaining to the initiative, and spoke to key personnel. We adopt a ‘strong’ process approach which brings together strategy as process and as practice (SAPP). Our analysis is multi-modal: we track the iterative development of the strategy through documents/texts produced for Board meetings; and we adopt a sociomaterial approach in illuminating the entanglements of the human and nonhuman which constitute strategising. By considering events over a series of episodes, we have built a picture showing how micro-level practices in the Boardroom are layered incrementally in the emergence of strategy at organisational level. Relatedly, we show how these practices enable the Board to negotiate the tensions between control and service/collaboration. Hence the paper contributes to theory and knowledge around Board engagement in strategic activities.

The reproduction of the human form has been a universal practice amongst human ecologies for millennia. Over the past 200 years, popular culture has considered the imaginary consequences of the danger to humanity and human-ness of replicating the autonomous human form too faithfully. Today, the seductive allure of technologically advanced simulated human bodies and advances in robotics and artificial intelligence has brought us closer to facing this possibility. Alongside the simultaneous aversion and fascination of the possibility that autonomous simulated human forms may become indistinguishable from human beings is the deep-rooted uncanniness of the automaton in its strange familiarity – not only to ourselves but to our pleasant childhood imaginings of playing with dolls. As such, simulated human bodies are often enrolled in medical and nursing education models with the assumption that making the simulation teaching spaces seem as close to clinical spaces as possible will allow students to practise potentially harmful clinical skills without causing any harm to human patients. However similar the simulated human bodies may appear to a living, breathing human, a tension between the embodiment of particularly human attributes and their replication persists. How can computerized human patient simulators be enrolled to teach people to develop the necessary attributes of compassion and empathy when caring for human beings? This article explores the uncanny ecologies of simulated human patients in nursing education by presenting a posthuman analysis of the practices of nurse educators as they enrol these digital objects in their teaching. Guided by a selection of heuristics offered as a mode of interviewing digital objects, the analysis enrolled ‘Gathering Anecdotes’ and ‘Unravelling Translations’ to attune to the ways in which these uncanny posthuman assemblages become powerful modes of knowing to mobilize learning about human attributes within uncanny posthuman ecologies.

Background Women who have had gestational diabetes during pregnancy are at very high risk of developing type 2 diabetes later in life, but their understanding of the risks is often limited. In this study we explored the views of health care professionals regarding offering brief opportunistic advice to women after their pregnancy, during unrelated consultations in primary care, relating to reducing diabetes risk. Methods The study took place in three Health Boards in Scotland. We conducted semi-structured one-to-one interviews (either face-to-face or telephone) with two health visitors, three practice nurses, two GPs, two diabetes consultants and two obstetricians. A focus group with five health visitors was also held. A topic guide was followed, covering the feasibility and acceptability of delivering brief opportunistic advice during a routine consultation, the optimal way to identify and recall women with previous gestational diabetes, and the possible content and timing of any such intervention. A thematic approach was used to analyse the qualitative data generated. Results The interviews/discussion lasted from 15 to 51 min. There was widespread support from all participants for offering opportunistic advice, and general consensus that health visitors would be best placed to do this as part of the Universal Health Visiting Pathway in Scotland. Thematic analysis generated three significant points of discussion: implications for training of health visitors, the need for a systematic approach to identifying women with gestational diabetes, and the optimal timing of delivery. Despite an already demanding schedule of providing advice and education to women, health visitors were confident that they could offer educational advice, provided that they received appropriate training to do so. However, there would need to be a watertight system for identifying women in their care who had had gestational diabetes. In terms of timing, later visits around 6–8 months after delivery were considered most suitable. Conclusions There is support from health care professionals, and most pertinently from health visitors, that the frequency of routine visits with women during the Universal Health Visiting Pathway programme in Scotland provides potential opportunities for education around future diabetes risk to women who have had gestational diabetes.

Background Women who have had gestational diabetes during pregnancy are at very high risk of developing type 2 diabetes later in life, but their understanding of the risks is often limited. In this study we explored the views of health care professionals regarding offering brief opportunistic advice to women after their pregnancy, during unrelated consultations in primary care, relating to reducing diabetes risk. Methods The study took place in three Health Boards in Scotland. We conducted semi-structured one-to-one interviews (either face-to-face or telephone) with three health visitors, three practice nurses, two GPs, two diabetes consultant and two obstetricians. A focus group with five health visitors was also held. A topic guide was followed, covering the feasibility and acceptability of delivering a brief educational intervention during a routine consultation, the optimal way to identify and recall women with previous gestational diabetes, and the possible content and timing of the intervention. A thematic approach was used to analyse the qualitative data generated. Results The interviews/discussion lasted from 15 to 66 minutes. There was widespread support for such an intervention from all participants and general consensus that health visitors would be best placed to offer educational advice and support as part of the Health Visiting Pathway in Scotland. Thematic analysis generated three significant points of discussion: implications for training of health visitors, the need for a systematic approach to identifying women with gestational diabetes, and the optimal timing of delivery. Despite an already demanding schedule of providing advice and education to women, health visitors were confident that they could offer educational advice, provided that they received appropriate training to do so. However, there would need to be a watertight system for identifying women in their care who had had gestational diabetes. In terms of timing, later visits around 6–8 months after delivery were considered most suitable. Conclusions There is support from health care professionals, and most pertinently from health visitors, that the frequency of routine visits with women during the Health Visiting Pathway programme in Scotland provides potential opportunities for education around future diabetes risk to women who have had gestational diabetes.

Background: The benefits of physical activity are well established, yet large numbers of people are not sufficiently\ud active to gain health benefits. Certain population groups are less physically active than others, including older\ud women from areas of high economic deprivation. The Well!Bingo project was established with the aim of engaging\ud such women in the development of a health promotion intervention in a bingo club. This paper reports on the\ud assessment of health status, physical activity and sedentary behaviour of women attending a bingo club in central\ud Scotland, UK as part of the Well!Bingo project.\ud Methods: Women attending the bingo club were invited to provide information on demographic characteristics, and\ud self-reported physical activity and sedentary behaviour via a self-complete questionnaire as part of a cross-sectional\ud study (n = 151). A sub-sample (n = 29) wore an accelerometer for an average of 5.7 ± 1.4 days. Differences between\ud younger (under 60 years) and older adults (60 years and over) were assessed using a chi-square test for categorical\ud data and the independent samples t-test was used to assess continuous data (p < 0.05).\ud Results: The mean age was 56.5 ± 17.7 years, with 57% living in areas of high deprivation (Scottish Index of Multiple\ud Deprivation quintile one and two). Sixty-three percent of women (n = 87) reported they were meeting physical activity\ud guidelines. However, objective accelerometer data showed that, on average, only 18.1 ± 17.3 min a day were spent in\ud moderate to vigorous physical activity. Most accelerometer wear time was spent sedentary (9.6 ± 1.7 h). For both\ud self-report and accelerometer data, older women were significantly less active and more sedentary than younger women.\ud On average, older women spent 1.8 h more than younger women in sedentary activities per day, and took part in 21 min\ud less moderate to vigorous physical activity (9.4 mins per day).\ud Conclusion: The findings of this study suggest that bingo clubs are settings that attract women from areas of high\ud deprivation and older women in bingo clubs in particular would benefit from interventions to target their physical activity\ud and sedentary behaviour. Bingo clubs may therefore be potential intervention settings in which to influence these\ud behaviours.

This article considers the contribution of the governance professional to the governing of further education colleges in the United Kingdom and arises from a wider study of the ways in which college boards develop and implement college strategy. This is the first observational study to focus on what the governance professional does within the college governance space. From observation and other forms of evidence, the governance professional performs a significant, challenging and expert role in the processes and practices of governing colleges. The governance professional is instrumental as a governance sense-maker and, at a higher level, as translator of governing deliberations and decision making. The governance professional role in practice can vary depending upon a range of personal, local institutional and national factors. However, in essence the governance professional exists to legitimise college governance through the structures, processes and reporting of governing interactions. The article considers the extent to which the governance professional is pivotal to the governing of colleges and analyses the implications for college governing. Our research identifies some barriers to gaining greater impact from the college governance professional.

Walking is widely accepted as a safe and effective method of promoting rehabilitation and a return to physical activity after a cancer diagnosis. Little research has considered the therapeutic qualities of landscape in relation to understanding women's recovery from breast cancer, and no study has considered the supportive and therapeutic benefits that walking groups might contribute to their wellbeing. Through a study of a volunteer-led walking group intervention for women living with and beyond breast cancer (Best Foot Forward) we address this gap. A mixed-methods design was used including questionnaires with walkers (n = 35) and walk leaders (n = 13); telephone interviews with walkers (n = 4) and walk leaders (n = 9); and walking interviews conducted outdoors and on the move with walkers (n = 15) and walk leaders (n = 4). Questionnaires were analysed descriptively. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. Our study found that the combination of walking and talking enabled conversations to roam freely between topics and individuals, encouraging everyday and cancer-related conversation that created a form of ‘shoulder-to-shoulder support’ that might not occur in sedentary supportive care settings. Walking interviews pointed to three facets of the outdoor landscape – as un/natural, dis/placed and im/mobile – that walkers felt imbued it with therapeutic qualities. ‘Shoulder-to-shoulder support’ was therefore found to be contingent on the therapeutic assemblage of place, walk and talk. Thus, beyond the physical benefits that walking brings, it is the complex assemblage of walking and talking in combination with the fluid navigation between multiple spaces that mobilises a therapeutic assemblage that promotes wellbeing in people living with and beyond breast cancer.

Background\ud Our aim was to use participatory methods to investigate the feasibility and acceptability of using Bingo clubs for the design and delivery of an evidence-based physical activity and/or healthy eating intervention to socio-economically disadvantaged women. This paper describes the participatory process that has resulted in a physical activity intervention for women aged >55 years, ready for pilot-testing in a Bingo club setting.\ud \ud Methods\ud Studies using different quantitative and qualitative approaches were conducted among customers and staff of a Bingo club in a city of 85,000 inhabitants in central Scotland. These were designed to take the views of different stakeholders into account, with a view to enhancing uptake, engagement and effectiveness with any proposed intervention.\ud \ud Results\ud Sixteen relevant studies were identified in a literature review that generated ideas for intervention components. A questionnaire completed by 151 women in the Bingo club showed that almost half (47 %) aged >55 years were not meeting physical activity guidelines; evidence backed up by accelerometer data from 29 women. Discussions in six focus groups attended by 27 club members revealed different but overlapping motivations for attending the Bingo club (social benefits) and playing Bingo (cognitive benefits). There was some scepticism as to whether the Bingo club was an appropriate setting for an intervention, and a dietary intervention was not favoured. It was clear that any planned intervention needed to utilise the social motivation and habitual nature of attendance at the Bingo club, without taking women away from Bingo games. These results were taken forward to a 5-h long participative workshop with 27 stakeholders (including 19 Bingo players). Intervention design (form and content) was then finalised during two round table research team meetings.\ud \ud Conclusions\ud It was possible to access and engage with women living in areas of socio-economic disadvantage through a Bingo club setting. A physical activity intervention for women >55 years is realistic for recruitment, will address the needs of potential recipients in the Bingo club, appears to be feasible and acceptable to club members and staff, and has been designed with their input. A pilot study is underway, investigating recruitment, retention and feasibility of delivery.

Background Recruitment to randomised controlled trials (RCTs) is a perennial problem. Calls have been made for trialists to make recruitment performance publicly available. This article presents our experience of recruiting to a pilot RCT of cardiac rehabilitation for patients with bowel cancer with an embedded process evaluation. Methods Recruitment took place at three UK hospitals. Recruitment figures were based on the following: i) estimated number of patient admissions, ii) number of patients likely to meet inclusion criteria from clinician input and iii) recruitment rates in previous studies. The following recruitment procedure was used:Nurse assessed patients for eligibility.Patients signed a screening form indicating interest in and agreement to be approached by a researcher about the study.An appointment was made at which the patient signed a consent form and was randomised to the intervention or control group. Information about all patients considered for the study and subsequently included or excluded at each stage of the recruitment process and reasons given were recorded. Results There were variations in the time taken to award Research Management approval to run the study at the three sites (45–359 days). Sixty-two percent of the original recruitment estimate was reached. The main reason for under-recruitment was due to over-estimation of the number of patient admissions; other reasons were i) not assessing all patients for eligibility, ii) not completing a screening form for eligible patients and iii) patients who signed a screening form being lost to the study before consenting and randomisation. Conclusions Pilot trials should not simply aim to improve recruitment estimates but should also identify factors likely to influence recruitment performance in a future trial and inform the development of that trial’s recruitment strategies. Pilot trials are a crucial part of RCT design. Nevertheless, pilot trials are likely to be small scale, involving only a small number of sites, and contextual differences between sites are likely to impact recruitment performance in any future trial. This means that ongoing monitoring and evaluation in trials are likely to be required. Trial registration ISRCTN63510637; UKCRN id 14092.

Positioned within a hybrid of the human and technology, professional nursing practice has always occupied a space that is more than human. In nursing education, technology is central in providing tools with which practice knowledge is mobilized so that students can safely engage with simulated human patients without causing harm to real people. However, while there is an increased emphasis on deploying these simulated humans as emissaries from person-centred care to demonstrate what it is like to care for real humans, the nature of what is really going on in simulation-what is real and what is simulated-is very rarely discussed and poorly understood. This paper explores how elements of postcolonial critical thought can aid in understanding the challenges of educating nurses to provide person-centred care within a healthcare culture that is increasingly reliant on technology. Because nursing education is itself a hybrid of real and simulated practice, it provides an appropriate case study to explore the philosophical question of technology in healthcare discourse, particularly as it relates to the relationship between the human patient and its uncanny simulated double. Drawing on postcolonial elements such as the uncanny, diaspora, hybridity, and créolité, the hybrid conditions of nursing education are examined in order to open up new possibilities of thinking about how learning to care is entangled with this technological space to assist in shaping professional knowledge of person-centred care. Considering these issues through a postcolonial lens opens up questions about the nature of the difficulty in using simulated human technologies in clinical education, particularly with the paradoxical aim of providing person-centred care within a climate that increasingly characterized as posthuman.