Understanding Collaboration: Introducing the Collaborative Governance Case Databank

Studying collaborative governance has become a booming business. However, the empirical literature still struggles to produce robust generalizations and cumulative knowledge that link contextual, situational and institutional design factors to processes and outcomes. We still have not mustered the broad and deep evidence base that will really help us sort fact from fiction and identify more and less productive approaches to collaboration. The current empirical evidence in the study of collaborative governance consists chiefly of small-N case studies or large-N surveys. The challenge is to move from case-based, mid-range theory building to more large N-driven systematic theory-testing, while also retaining the rich contextual and process insights that only small-N studies tend to yield. This article, and the articles in the accompanying special issue, introduces an attempt to provide this middle ground – the Collaborative Governance Case Database. The database has been developed to serve as a free common pool resource for researchers to systematically collect and compare high-quality collaborative governance case studies. This article is an introduction to the database, exploring its design, opportunities and limitations. This article is also an invitation; inviting all researchers to freely use the cases in the database for their own research interest and to help strengthening the database by adding new cases there are eager to share with colleagues

Health, education, and social care provision after diagnosis of childhood visual disability

Aim: To investigate the health, education, and social care provision for children newly diagnosed with visual disability.Method: This was a national prospective study, the British Childhood Visual Impairment and Blindness Study 2 (BCVIS2), ascertaining new diagnoses of visual impairment or severe visual impairment and blindness (SVIBL), or equivalent vi-sion. Data collection was performed by managing clinicians up to 1-year follow-up, and included health and developmental needs, and health, education, and social care provision.Results: BCVIS2 identified 784 children newly diagnosed with visual impairment/SVIBL (313 with visual impairment, 471 with SVIBL). Most children had associated systemic disorders (559 [71%], 167 [54%] with visual impairment, and 392 [84%] with SVIBL). Care from multidisciplinary teams was provided for 549 children (70%). Two-thirds (515) had not received an Education, Health, and Care Plan (EHCP). Fewer children with visual impairment had seen a specialist teacher (SVIBL 35%, visual impairment 28%, χ2p < 0.001), or had an EHCP (11% vs 7%, χ2p < 0 . 01).Interpretation: Families need additional support from managing clinicians to access recommended complex interventions such as the use of multidisciplinary teams and educational support. This need is pressing, as the population of children with visual impairment/SVIBL is expected to grow in size and complexity.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden

Getting a Grip on the Performance of Collaborations: Examining Collaborative Performance Regimes and Collaborative Performance Summits

Collaborative governance is popular among practitioners and scholars, but getting a grip on the performance of collaborations remains a challenge. Recent research has made progress by identifying appropriate performance measures, yet managing performance also requires appropriate performance routines. This article brings together insights from collaborative governance and performance management to conceptualize collaborative performance regimes; the collection of routines used by actors working together on a societal issue to explicate their goals, exchange performance information, examine progress, and explore performance improvement actions. The concept of regimes is made concrete by focusing on the specific routine of organizing a collaborative performance summit; a periodic gathering where partners review their joint performance. Such summits are both manifestations of the performance regime and potential turning points for regime change. Using three local public health collaborations as illustration, this article offers a framework for understanding collaborative performance regimes, summits, and the dynamics between them