What can a participatory approach to evaluation contribute to the field of integrated care?

© 2017 BMJ Publishing Group. All rights reserved. Better integration of care within the health sector and between health and social care is seen in many countries as an essential way of addressing the enduring problems of dwindling resources, changing demographics and unacceptable variation in quality of care. Current research evidence about the effectiveness of integration efforts supports neither the enthusiasm of those promoting and designing integrated care programmes nor the growing efforts of practitioners attempting to integrate care on the ground. In this paper we present a methodological approach, based on the principles of participatory research, that attempts to address this challenge. Participatory approaches are characterised by a desire to use social science methods to solve practical problems and a commitment on the part of researchers to substantive and sustained collaboration with relevant stakeholders. We describe how we applied an emerging practical model of participatory research, the researcher-in-residence model, to evaluate a large-scale integrated care programme in the UK. We propose that the approach added value to the programme in a number of ways: by engaging stakeholders in using established evidence and with the benefits of rigorously evaluating their work, by providing insights for local stakeholders that they were either not familiar with or had not fully considered in relation to the development and implementation of the programme and by challenging established mindsets and norms. While there is still much to learn about the benefits and challenges of applying participatory approaches in the health sector, we demonstrate how using such approaches have the potential to help practitioners integrate care more effectively in their daily practice and help progress the academic study of integrated care

The Global Plastic Pollution Crisis: how should New Zealand respond?

The management of plastic waste is a global problem which currently lacks a global solution. As one of the highest per capita producers of household waste in the developed world, New Zealand has a key role to play in addressing the plastics crisis at multiple levels of governance. This article analyses the various policy options available to the New Zealand government and offers a series of recommendations, including prioritising policy and investment at the top of the waste hierarchy (refuse, rethink, redesign, reduce and reuse); linking plastic waste to toxicological risk and commitments to carbon reduction targets; implementing global commitments domestically; and supporting a proposed international legally binding agreement that captures the full lifecycle of plastics and regulates the transboundary flows of plastic pollution

Mutual Mate Choice Drives the Desirability of Altruism in Relationships

Although previous research has found that altruism is an important trait in human mate choice, much of this has concentrated on female preferences only. Subsequently, the current study explored how both men and women desire altruistic partners who varied in physical attractiveness for both short and long term romantic relationships. A sample of 136 women and 53 men viewed profiles of members of the opposite sex of either high or low physical attractiveness, alongside scenarios that described them as either being altruistic or not. Participants then rated each targets’ desirability as both a short and long term partner. As hypothesised, altruism was rated more desirable, particularly for long term relationships, by both men and women. However there were inconsistent findings when physical attractiveness was accounted for, which did not support the hypotheses nor directly replicate previous findings. Overall it was concluded that although the study provided strong support for the desirability of altruism being due to mutual mate choice, the additional effects of examining other mate choice traits such as attractiveness shows much is still to be known

An Equity Framework to Engage Community College Preservice Teachers in Black Liberatory Practices

While representation of teachers of color remains startlingly low nationwide, it is critical to recognize that increasing diversity is not enough to increase access to an inequitable system. Centering the strengths of Black students, on both an individual and institutional level, through culturally and historically-responsive pedagogical and curricular practices is a crucial step toward equitizing the teaching workforce. Using a culturally and historically-responsive literacy (HRL) framework, we discuss and reflect upon practical classroom-based approaches to engage community college preservice teachers in responsive pedagogical practices that are aligned with the legacy of Black literary societies. The paper is divided into four sections, each one aligning with a layer of this equity framework. By reflecting on practices and experiences within our urban community college teacher education program, we share pragmatic strategies for centering Black liberatory practices with other scholar-practitioners in the field of teacher education, while simultaneously acknowledging pathways to improvement

Machine Learning Inverse Problem for Topological Photonics

Topological concepts open many new horizons for photonic devices, from integrated optics to lasers. The complexity of large scale topological devices asks for an effective solution of the inverse problem: how best to engineer the topology for a specific application? We introduce a novel machine learning approach to the topological inverse problem. We train a neural network system with the band structure of the Aubry-Andre-Harper model and then adopt the network for solving the inverse problem. Our application is able to identify the parameters of a complex topological insulator in order to obtain protected edge states at target frequencies. One challenging aspect is handling the multivalued branches of the direct problem and discarding unphysical solutions. We overcome this problem by adopting a self-consistent method to only select physically relevant solutions. We demonstrate our technique in a realistic topological laser design and by resorting to the widely available open-source TensorFlow library. Our results are general and scalable to thousands of topological components. This new inverse design technique based on machine learning potentially extends the applications of topological photonics, for example, to frequency combs, quantum sources, neuromorphic computing and metrology

Non-sexist Language Policy and the Rise (and Fall?) of Combined Pronouns in British and American Written English

This paper focuses on the use of combined pronouns (s/he, his or her, him/her, etc.) as an example of late twentieth-century non-sexist language reform which had an overt democratizing aim. Within the scope of second-wave feminism, the use of combined pronouns increased the visibility of women in discourse by encouraging the use of feminine pronouns (she, her, hers) alongside masculine pronouns (he, him, his). Despite their promotion, however, the use of combined pronouns is relatively rare. This paper uses the LOB and Brown families of corpora to diachronically and synchronically study patterns in the use of combined pronouns in written American (AmE) and British English (BrE) from the 1930s to the early 2000s. The analysis not only determines what forms these patterns take, but questions whether combined pronouns are influenced by (a combination of) syntax and/or semantics, and questions whether combined pronouns are really democratic at all

European Network of Gynaecological Oncological Trial Groups’ requirements for trials between academic groups and industry partners – a new Model D for drug and medical device development

No abstract available

Collaborative research methods and best practice with children and young people: protocol for a mixed-method review of the health and social sciences literature

Introduction: Children and young people have the right to participate in research on matters that affect them, and their contribution improves research quality and insights from findings. Discrete participatory approaches are used across different disciplines. This review will provide a synthesis of existing literature from different disciplines by working with young people and adults experienced in participatory research to develop a broad definition of child and youth led research and to identify best practice. Methods and analysis: Comprehensive searches will be conducted in eight electronic databases (PsycINFO, Medline, CINAHL, Embase, SocINDEX, ASSIA: Applied Social Sciences Index and Abstracts (Proquest), Social Care Online and SCOPUS). Grey literature reports will also be sourced using Google searching. Eligible studies will be English-language primary studies and reviews on collaborative research with children and young people (aged 5–25 years) published from 2000 onwards. Qualitative and quantitative data will be integrated in a single qualitative synthesis following the JBI convergent integrated approach. Study quality will be assessed by developed checklists based on existing participation tools cocreated with the project steering group and co-creation activities with young people. Ethics and dissemination: Ethical approval is not required as no primary data will be collected. The review will develop guidance on best practice for collaborative research with children and young people, synthesising learnings from a wide variety of disciplines. Dissemination will be via peer-reviewed publications, presentations at academic conferences and lay summaries for various stakeholders. Opportunities for cocreation of outputs will be sought with the young researchers and the project steering committee. PROSPERO registration number: CRD42021246378

ICON 9—an international phase III randomized study to evaluate the efficacy of maintenance therapy with olaparib and cediranib or olaparib alone in patients with relapsed platinum-sensitive ovarian cancer following a response to platinum-based chemotherapy

BACKGROUND: Two novel biological agents-cediranib targeting angiogenesis, and olaparib targeting DNA repair processes-have individually led to an improvement in ovarian cancer control. The aim of ICON9 is to investigate the combination of cediranib and olaparib maintenance in recurrent ovarian cancer following platinum-based therapy. PRIMARY OBJECTIVE: To assess the efficacy of maintenance treatment with olaparib in combination with cediranib compared with olaparib alone following a response to platinum-based chemotherapy in women with platinum-sensitive ovarian, fallopian tube or peritoneal cancer during first relapse. STUDY HYPOTHESIS: Maintenance therapy with cediranib and olaparib in combination is associated with improved patient outcomes compared with olaparib alone. TRIAL DESIGN: International phase III randomized controlled trial. Following a response to platinum-based chemotherapy patients are randomized 1:1 to either oral olaparib and cediranib (intervention arm) or oral olaparib alone (control arm). MAJOR INCLUSION CRITERIA: Patients with a known diagnosis of high grade serous or endometrioid carcinoma of the ovary, fallopian tube or peritoneum, progressing more than 6 months after first-line platinum-based chemotherapy, who have responded to second-line platinum-based chemotherapy. PRIMARY ENDPOINTS: Progression-free and overall survival. Co-primary endpoints to be assessed using a fixed-sequence gatekeeping approach: (1) progression-free survival, all patients; (2) progression-free survival, BRCA wild type; (3) overall survival, all patients; (4) overall survival, BRCA wild type. SAMPLE SIZE: 618 patients will be recruited. ESTIMATED DATES FOR COMPLETING ACCRUAL AND PRESENTING RESULTS: Accrual is expected to be completed in 2024 with presentation of results in 2025. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03278717

A qualitative evaluation of a novel intervention using insight into tobacco industry tactics to prevent the uptake of smoking in school-aged children

Background: Evidence from the US Truth campaign suggests that interventions focusing on tobacco industry tactics can be effective in preventing smoking uptake by children. Operation Smoke Storm is the first school-based intervention based on this premise and comprises three classroom sessions in which students act as secret agents uncovering tobacco industry tactics through videos, quizzes, discussions, and presentations. We report a qualitative evaluation of its acceptability. Methods: We conducted eight focus groups with 79 students aged 11-12 who participated in Operation Smoke Storm at two UK schools in Autumn 2013, and 20 interviews with teachers who delivered the intervention. These were digitally audio-recorded, transcribed verbatim and analysed using the framework method. Results: Students enjoyed the secret agent scenario and reported acquiring new knowledge about smoking and the tobacco industry, which seemed to strengthen their aversion to smoking. Teachers felt confident delivering the ‘off the shelf’ resource, although they would have welcomed more background information about the topic and guidance on steering discussions. Teachers highlighted a need for the resource to be flexible and not dependent on lesson length, teacher confidence, or expertise. Students and teachers endorsed the idea of developing a booster component for older students and supported the development of printed information complementing the resource to encourage parents to support their child not to smoke. Conclusions: These findings demonstrate that Operation Smoke Storm can be delivered by teachers to raise awareness about smoking-related issues. The ideas and issues raised are now being used to improve and extend the resource for further evaluation