Amanda Lees

The Role Familiarity With Science and Medicine Plays in Parents’ Decision Making About Enrolling a Child in Vaccine Research:

Parental consent to children’s participation in vaccine research has resulted in the licensure of essential vaccines. Recruitment to this type of research is typically difficult, however, and many parents decline. In this study, the authors interviewed parents about their decision for or against enrolling their child in a vaccine study. The data analysis suggests that parents’ ability to evaluate a vaccine study depends on how attuned they are with science and medicine, either professionally or as consumers of health services. Familiarity does not predispose parents to enrolling their child in research; rather, it is a predictor of parents’ confidence in their decision making. Many parents were motivated by altruism and trust, which, if uninformed, can leave the parents prone to exploitation. It is vital to ensure that parents are confident in their judgment of a study and its potential benefit to their child and society.

Theoretically speaking: use of a communities of practice framework to describe and evaluate interprofessional education

This article uses Wengers () theory of communities of practice, and in particular his learning design framework, to describe and evaluate the pedagogy of one interprofessional continuing professional development (CPD) programme for health, education and social care professionals. The article presents findings from 27 post-intervention interviews conducted 12 months after the CPD. Key pedagogic features of small group working, action planning, facilitation, continued independent learning and ‘safe’ learning environment were found to provide facilities for ‘engagement’, ‘imagination’ and ‘alignment’ (Wenger, ), with the use of task-focused small group work particularly appreciated by participants. Problems of falling attendance and marginalisation are discussed using Wengers concept of ‘identification/negotiability’. It is suggested that careful selection of delegates and provision of sufficient organisational support may mitigate such problems.

Positioning Children’s Voice in Clinical Trials Research: A New Model for Planning, Collaboration, and Reflection

Following the United Nations Convention on the Rights of the Child, there has been considerable growth in research with children about health and services that affect them. Creative methods to engage with children have also been developed. One area where progress has been slower is the inclusion of children’s perspectives in qualitative research in the context of clinical trials or feasibility studies. Addressing this gap, this article discusses experiences of, and reflections on, the process of researching children’s views as part of a clinical feasibility study. The article considers what worked well and highlights remaining dilemmas. A new continuum of children’s engagement in research is presented, designed to assist researchers to make explicit the contingent demands on their research, and to suggest a range of techniques from within the broader fields of health, childhood studies, and education research that could be used to forward qualitative research in clinical contexts.

Community governance in primary health care: towards an international Ideal Type

Against a global background of increased resource management responsibilities for primary health care agencies, general medical practices, in particular, are increasingly being required to demonstrate the legitimacy of their decision making in market oriented environments. In this context a scoping review explores the potential utility for health managers in primary health care of community governance as a policy concept. The review of recent research suggests that applied learning from international health systems with enhanced approaches to public and patient involvement may contribute to meeting this requirement. Such approaches often characterise local health systems in Latin America and North West Europe where innovative models are beginning to respond effectively to the growing demands on general practice. The study design draws on documentary and secondary data analyses to identify common components of community governance from the countries in these regions, supplemented by other relevant international studies and sources where appropriate. Within a comprehensive framework of collaborative governance the components are aggregated in an Ideal Type format to provide a point of reference for possible adaptation and transferable learning across market oriented health systems. Each component is illustrated with international exemplars from recent organisational practices in primary health care. The application of community governance is considered for the particular contexts of GP led Clinical Commissioning Groups in England and Primary Health Networks in Australia. Some components of the Ideal Type possess potentially powerful negative as well as positive motivational effects, with PPI at practice levels sometimes hindering the development of effective local governance. This highlights the importance of careful and competent management of the growing resources attributed to primary health care agencies, which possess an increasingly diverse range of non-governmental status. Future policy and research priorities are outlined. Copyright

Facts with feelings – social workers' experiences of sharing information across team and agency borders to safeguard children

This paper reports findings from a psycho-socially informed case study of information sharing across team and agency borders, carried out in three children and family social work teams within one local authority. The study investigated practitioners’ understanding and experiences of information sharing, the tasks, processes and technologies involved, as well as perceived barriers and facilitators. It also considered how the emotional and social dynamics of working contexts could impinge upon information work. Practitioners described information tasks relating to collecting, interpreting, communicating and recording information, guided by the demands of rigid organisational protocols. Performance of these tasks was, however, infused by the emotional complexities of child protection work, presenting a number of challenges for practitioners seeking robust and reliable information in the midst of ambiguity, complexity and heightened emotions. For practitioners across all teams, information work, and information itself, was both cognitive and affective, and often at odds with linear processes for its exchange across team boundaries, designed to filter out all but hard evidence. Increased recognition of the dual nature (facts and feelings) of information and information work, throughout the safeguarding process, has potential to enhance the generation of shared understandings and collaborative practice across team and agency borders.

Learning to Collaborate: An Application of Activity Theory to Interprofessional Learning Across Children's Services

This paper investigates the pedagogy of a continuing professional development (CPD) programme to develop interprofessional learning (IPL) and collaborative practice for professionals across childrens services, using a framework underpinned by Activity Theory. The aim of the study was to establish which pedagogical features enabled successful interprofessional learning and subsequent changes in collaborative, interprofessional practice. Activity Theory was used as a theoretical framework to analyse and identify the ways in which pedagogy impacts upon the development of collaborative practice. The qualitative study found that pedagogies designed to harness the ‘multi-voicedness’ of activity systems and the contradictions of multi-disciplinary practice can be used to inspire learning and practice change. From our analysis, ‘community’ and ‘division of labour’ were important contextual influences on the learning process. We propose that the ideas underpinning Activity Theory are useful guiding principles when looking at the design of CPD that aims to build collaborative, multi-disciplinary practice across agencies and professionals in childrens services.

Creational narratives for new housing communities: evidence synthesis.

Purpose: This paper reports the findings of a rapid evidence synthesis commissioned by the Diocese of Winchester with a remit to provide an empirical basis for church contributions to large housing community developments. It sought to respond to three questions concerning new community developments. These related to risks and causes of failure; learning from past corporate and intermediate tier interventions at diocesan and equivalent levels by religious denominations; and the transferable learning available from developments described in Community Health and Liveability literatures. Design/methodology/approach: The review took a purposive approach to sampling evidence from within academic literature, policy and ‘think tank’ outputs and theological texts. The search was instigated with the use of key words (including New Settlements, Urban Redevelopment, Diocese, Faith and Community), principally within the SCOPUS, NIHR, PUBMED and Google Scholar databases. A pragmatic snowballing approach to relevant references was then employed. Findings: Segregation and separation were identified as the main risk for new settlements. Connectivity is required between and across neighbours, ensuring communal access to services, transport and recreation. Communal places where people can come together for conversation and social interaction are identified as contributing significantly to healthy communities. Churches have a particular positive contribution to make here, through a focus on inclusion, hospitality and common values, rather than single faith-based, evangelical approaches. Research limitations/implications: The initial effect of the study has been to increase confidence in and awareness of the diocesan contribution. In the longer term the three areas of practice highlighted for enhanced faith based contributions are those of public communications, community integration and civic leadership. An evidence based approach appears to be especially significant in facilitating the latter. Originality/value: The importance of ‘creational narratives’ in defining and making explicit the values underpinning new housing communities, is identified as a singular source of shared motivation for planning and faith agencies.

Maintaining the wellbeing of clinicians

Burnout is a severe form of stress, characterised by emotional exhaustion, depersonalisation and a low sense of personal accomplishment, that is prevalent among frontline care clinicians and trainees. As well as the personal costs, it has implications for the quality of patient care. The papers reviewed here cover the causes and effective ways to intervene (either by preventive or remedial means) to address burnout and build resilience (enhanced capacity to deal with stress) throughout the career trajectory of trainees and experienced health professionals.

Getting Beneath the Surface: Scapegoating and the Systems Approach in a Post-Munro World

The publication of the Munro Review of Child Protection: Final Report (2011b, Department for Education, London) was the culmination of an extensive and expansive consultation process into the current state of child protection practice across the UK. Despite the concern about ‘blame’ within the report, there is, surprisingly, at no point an explicit reference to the dynamics and practices of ‘scapegoating’ that are so closely associated with organisational blame cultures. This paper examines this gap in understanding of the recurrence of shortcomings in child care social work practice and suggests that unless the dynamics of scapegoating are more fully understood, new developments, such as the systems approach advocated by Munro, will fall short of their potential impact. A critical review of existing understanding of scapegoating is presented and the paper concludes by outlining initiatives to counter the detrimental effect of scapegoating of everyday practice.