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This paper aims to make known the materials on action learning that are held in the universities of Salford and Manchester, with the aim of bringing these unique resources to the attention of researchers and other interested parties. It is a joint effort between the Editorial Board members of the Journal, Action Learning: Research & Practice and staff at the two universities. Subsequently, we hope to publicise further resources available elsewhere. The paper begins with a brief history. Starting with Revans, his career and the early development of the action learning idea, it also records his long association with Manchester and some recent institutional history beginning with him donating his archives to the University of Salford. This is followed by introductions to the Revans Archive at Salford University and the action learning materials held at Alliance Manchester Business School (AMBS). Details of the two collections are in the latter part of the paper.

Background: The Bristol Knowledge Mobilisation (KM) Team was an unusual collective brokering model, consisting of a multi-professional team of four managers and three academics embedded in both local healthcare policymaking (aka commissioning) and academic primary care. Aims and objectives: They aimed to encourage 'research-informed commissioning' and 'commissioning-informed research'. This paper covers context, structure, processes, advantages, challenges and impact. Methods: Data sources from brokers included personal logs, reflective essays, exit interviews and a team workshop. These were analysed inductively using constant comparison. To obtain critical distance, three external evaluations were conducted, using interviews, observations and documentation. Findings: Stable, solvent organisations; senior involvement with good inter-professional relationships; secure funding; and networks of engaged allies in host organisations supported the brokers. Essential elements were two-way embedding, 'buddying up', team leadership, brokers' interpersonal skills, and two-year, part-time contracts. By working collectively, the brokers fostered cross-community interactions and modelled collaborative behaviour, drawing on each other's 'insider' knowledge, networks and experience. Challenges included too many taskmasters, unrealistic expectations and work overload. However, team-brokering provided a safe space to be vulnerable, share learning, and build confidence. As host organisations benefitted most from embedded brokers, both communities noted changes in attitude, knowledge, skills and confidence. The team were more successful in fostering 'commissioning-informed research' with co-produced research grants than 'research-informed commissioning'. Discussion and conclusions: Although still difficult, the collective support and comradery of an embedded, two-way, multi-professional team made encouraging interactions, and therefore brokering, easier. A team approach modelled collaborative behaviour and created a critical mass to affect cultural change.

Aim: Policymaking decisions are often uninformed by research and research is rarely influenced by policymakers. To bridge this 'know-do' gap, a boundary-spanning knowledge mobilisation (KM) team was created by embedding researchers-in-residence and local policymakers into each other's organisations. Through increasing the two-way flow of knowledge via social contact, KM team members fostered collaborations and the sharing of 'mindlines', aiming to generate more relevant research bids and research-informed decision-making. This paper describes the activities of the KM team, types of knowledge and how that knowledge was exchanged to influence mindlines. Discussion: KM team activities were classified into--relational, dissemination, transferable skills, evaluation, research and awareness raising. Knowledge available included: profession-specific (for example, research methods, healthcare landscape), insider (for example, relational, organisation and experiential) and KM theory and practice. KM team members brokered relationships through conversations interweaving different types of knowledge, particularly organisational and relational. Academics were interested in policymakers' knowledge of healthcare policy and the commissioning landscape. More than research results, policymakers valued researchers' methodological knowledge. Both groups appreciated each other as 'critical friends'. Conclusion: To increase research impact, 'expertise into practice' could be leveraged, specifically researchers' critical thinking and research methodology skills. As policymakers' expertise into practice also bridges the know-do gap, future impact models could focus less on evidence into practice and more on fostering this mutual flow of expertise. Embedded knowledge brokers from the two communities working in teams can influence the mindlines of both. These ambassadors can create improvements in 'inter-cultural competence' to draw academia and policymaking closer.

Background: An earlier study (Baxter "et al." 2006) found that a structured health check conducted in primary care identified clinically significant previously unrecognized morbidity among adults with intellectual disabilities. The aim here was to examine whether follow-up health checks would identify equally significant newly identified morbidity and to investigate this as a function of the interval between health checks. Method: Adults with intellectual disabilities who had had an initial health check (n = 108) participated: group 1 (n = 39) had a repeat health check an average of 28 months later, group 2 (n = 36) had a repeat health check an average of 44 months later and group 3 (n = 33) did not have a subsequent health check. Thirty participants in group 1 had a second repeat health check an average of 14 months after the first repeat. An audit of the results of the health check established whether morbidity was newly identified. Information was collected on each participant's age, gender, place of residence, skills, challenging behaviour, social abilities, psychiatric status and perceived health. Comparisons within groups over time or between groups at a point in time were made using non-parametric statistics. Results: A similar number of newly identified health problems were found at the repeat health check compared to the initial check. The nature of needs identified was also similar. There was no association between the number of new needs identified at the repeat health check and the interval between it and the initial check. The perceived health of participants receiving health checks tended to decline. Conclusions: As the level of new need revealed by repeated checks at even the shortest interval since the previous check studied here (mean = 14 months) was as high as that found by the initial check, annual health checking could be a justifiable intervention for this population. Decline in perceived health may represent more accurate assessment by carers following feedback from the health checks

Background: Studies have found that health checking in primary care led to the identification of previously unrecognized morbidity among adults with intellectual disabilities. The aim here was to evaluate whether health checking stimulated increased consultation with the general practitioner or another member of the primary care team, increased health promotion actions undertaken outside the health check or increased contact with specialists. Method: Data on the above three categories of activity were abstracted from the medical records of 77 adult participants with intellectual disabilities for eight 6-month periods before and seven 6 month periods after they had undergone a health check. Comparisons of access to care before and after the health check were made using non-parametric statistics. Results: On average, participants had 5.4 and 1.8 primary care and specialist consultations per year respectively. There were no significant differences in either rate before and after the health check. The frequency of health promotion actions increased significantly after the health check from a mean of 1.2 to 2.2/year. Conclusions: Comparison of the primary care and specialist consultations rates of people with intellectual disabilities with those for the general population might suggest that the former have greater access to these services. However, comparison to the general practitioner consultation rates of patients with other chronic conditions would seem to indicate that contact with primary care may not be commensurate with need. Attention to health promotion is inadequate. Further research is required to substantiate whether health checking increases health promotion and how increased health promotion activity would affect the health of this population.

Background: In older people living with frailty, polypharmacy can lead to preventable harm like adverse drug reactions and hospitalization. Deprescribing is a strategy to reduce problematic polypharmacy. All stakeholders should be actively involved in developing a person‐centred deprescribing process that involves shared decision‐making. Objective: To co‐design an intervention, supported by a logic model, to increase the engagement of older people living with frailty in the process of deprescribing. Design: Experience‐based co‐design is an approach to service improvement, which uses service users and providers to identify problems and design solutions. This was used to create a person‐centred intervention with the potential to improve the quality and outcomes of the deprescribing process. A 'trigger film' showing older people talking about their healthcare experiences was created and facilitated discussions about current problems in the deprescribing process. Problems were then prioritized and appropriate solutions were developed. The review located the solutions in the context of current processes and procedures. An ideal care pathway and a complex intervention to deliver better care were developed. Setting and Participants: Older people living with frailty, their informal carers and professionals living and/or working in West Yorkshire, England, UK. Deprescribing was considered in the context of primary care. Results: The current deprescribing process differed from an ideal pathway. A complex intervention containing seven elements was required to move towards the ideal pathway. Three of these elements were prototyped and four still need development. The complex intervention responded to priorities about (a) clarity for older people about what was happening at all stages in the deprescribing process and (b) the quality of one‐to‐one consultations. Conclusions: Priorities for improving the current deprescribing process were successfully identified. Solutions were developed and structured as a complex intervention. Further work is underway to (a) complete the prototyping of the intervention and (b) conduct feasibility testing. Patient or Public Contribution: Older people living with frailty (and their informal carers) have made a central contribution, as collaborators, to ensure that a complex intervention has the greatest possible potential to enhance the experience of deprescribing medicines. [ABSTRACT FROM AUTHOR]

Examination of the prevalence of epilepsy and health service utilization in 1,595 people with intellectual disabilities in Wales found 16.1% had epilepsy. Standardized activity ratios were 3.07, 2.03, and 3.09 for inpatients, outpatients, and accident and emergency, respectively. Patients with intellectual disability and co-existing epilepsy used secondary care services more frequently than did those with intellectual disability only. (Contains references.) (Author/DB)

Active Support, a package of procedures which includes activity planning, support planning, and training on providing effective assistance, was evaluated in five community residences serving 19 adults with severe mental retardation. Findings indicated that the likelihood of a resident engaging in activity significantly increased following staff training in Active Support, an increase that was maintained at follow-up. (Contains references.) (Author/DB)

Objective: To identify research priorities of people with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) and those who support and care for them. Method: Using the James Lind Alliance's protocols, online surveys and workshops were held. The first survey asked participants from the U.K. to submit research questions about ME/CFS which were important to them. In the second, participants prioritised frequently submitted questions from the 1st survey. These were short listed and then workshop discussions were held to reach consensus on the top ten research priorities. Results: 1565 participated in the 1st survey and 5300 research priorities were submitted. 1752 participated in the 2nd. In both surveys, the predominant demographic was white, middle-aged women with ME/CFS. 15–17% were family/carers of people with ME/CFS and 4–6% were health and social care workers. From the 1st survey, 59 summary questions were identified. These were prioritised and short listed to 18 questions. Of these, the top 10 covered 1. Post-exertional malaise, 2. Use of existing drugs for other conditions, 3. Diagnosis, 4. Autoimmunity, 5. Sub-types, 6. Post-infective cause, 7. Neurological symptomology, 8. Genetics, 9. Severe ME/CFS, 10. Mitochronical dysfunction and 10 (equal) Oxygenation dysfunction. Conclusion: People with ME/CFS, their families and carers, and health care professionals worked together to identify, for the first time, the research priorities for ME/CFS. These focus on the biomedical causes of ME/CFS and how to diagnose, treat and manage it. Researchers and funding bodies should consider these in their plans for future research. [ABSTRACT FROM AUTHOR]

Most of the research about Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) has focused on ambulant patients who are able to attend clinics. It is estimated that 25% of people with ME/CFS are severely, or very severely, affected and are housebound or bedbound; some require tube feeding. Due to the severity of their illness, these patients have largely been excluded from research and are often described as 'hard to reach.' A questionnaire was devised to gather data about their experiences of accessing tube feeding. By making the necessary reasonable adjustments, such as direct outreach and the option to complete the questionnaire by telephone or texting, very severely affected patients were enabled to participate and provided invaluable contributions. This study aimed to act as a model for future researchers. [ABSTRACT FROM AUTHOR]

Background: Eczema affects one in five children in the UK. Regular application of emollients is routinely recommended for children with eczema. There are four main emollient types, but no clear evidence of which is best. The current 'trial and error' approach to find suitable emollients can be frustrating for parents, children, and clinicians.Aim: To identify how parents and children experience and evaluate emollients.Design and Setting: Qualitative interview study, nested within a primary care trial of emollients (Best Emollients for Eczema [BEE] trial).Method: Semi-structured interviews with children with eczema and their parents were conducted. Participants were purposively sampled on emollient type (lotion, cream, gel, or ointment), age, and eczema severity.Results: Forty-four parents were interviewed, with children participating in 24 of those interviews. There was no clear preference for any one emollient type. The strongest theme was the variation of experience in each of the four types. Participants focused on thickness and absorbency, both positively and negatively, to frame their evaluations. Effectiveness and acceptability were both considered when evaluating an emollient but effectiveness was the primary driver for continued use. For some, participating in the trial had changed their knowledge and behaviour of emollients, resulting in use that was more regular and for a longer duration.Conclusion: There is no one emollient that is suitable for everyone, and parents/children prioritise different aspects of emollients. Future research could evaluate decision aids and/or tester pots of different types, which could enable clinicians and parents/children to work collaboratively to identify the best emollient for them. [ABSTRACT FROM AUTHOR]

The decontamination of a range of 'in-use' stainless steel surgical instruments by conventional hospital reprocessing techniques was studied, using scanning electron microscopic (SEM) and energy dispersive X-ray spectroscopic (EDX) analyses, with results obtained when an Ar:[O.sub.2] RF gas-plasma treatment step was added to the cleaning cycle. In some cases, protein contaminants were still retained on instruments subjected to conventional cleaning and sterilization after seven cleaning cycles. No retention of contamination was evident on the surfaces of instruments that were subjected to gas-plasma cleaning. The efficacy of the plasma decontamination is significantly improved by hydration of the tissue residues immediately before exposure to the plasma. The reasons for this are not known, but it is suggested that the production of excited OH radicals and H atoms within the tissue matrix may play some part. Deposition of fluorescently labeled protein from physiological saline solution shows that protein is incorporated into salt crystals formed on stainless steel surfaces. This protein is resistant to plasma etching, but it is shown that water treatment results in improved cleaning. A combination of effects including physical 'cracking' of the salt crystals under vacuum and dissolution of the inorganic matrix, which could possibly be accelerated by dipolar heating of the aqueous phase, may be responsible. Index Terms--Creutzfeldt-Jakob disease (CJD), decontamination, radio frequency (RF) gas-plasma, surgical instruments.

Background: Admission stroke severity is an important clinical predictor of stroke outcomes. Pre-stroke physical activity contributes to stroke prevention and may also be associated with reduced stroke severity. Summarizing the evidence to date will inform strategies to reduce burden after stroke. Aims: To summarize the published evidence for the relationship between pre-stroke physical activity and admission stroke severity and to provide recommendations for future research. Summary of review: MEDLINE, Embase, Emcare, CENTRAL, and gray literature databases were searched on 14 February 2020 using search terms related to stroke and pre-stroke physical activity in adult stroke survivors. We screened 8,152 references and assessed 172 full-text references for eligibility. We included seven studies (n = 41,800 stroke survivors). All studies were observational, assessed pre-stroke physical activity using self-reported questionnaires, and assessed admission stroke severity using the National Institute of Health Stroke Scale. Analyses were categorized as the presence of pre-stroke physical activity (four studies) or dose-response (five studies). In three studies, presence of pre-stroke physical activity was associated with milder stroke severity, and no association in one study. Greater pre-stroke physical activity duration and intensity (two studies) or amount (three studies) were associated with milder stroke severity. Studies ranged between moderate to critical risk of bias, primarily due to confounding factors. Pre-stroke physical activity may be associated with reduced risk factors for severe stroke, distal occlusion, smaller infarcts, and shorter time-to-treatment delivery. Conclusion: Pre-stroke physical activity may be associated with reduced admission stroke severity. Lack of randomized controlled trials limited causality conclusions. Future research recommendations were provided. [ABSTRACT FROM AUTHOR]