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This article explores the experiences of those who lead undergraduate education-related programmes in further education (FE) colleges in England. Questionnaire and interview fieldwork with 14 further education-based programme leaders were supplemented by a comparison survey of equivalent professionals from higher education institutions (HEIs). Drawing on Hodgson and Spours's four-level lifelong learning ecology and Nardi and O'Day's keystone species concept, our analysis characterises the role of the undergraduate programme leader as distinctive and critical within the further education context. Extremely multifaceted and busy, this role is also poorly defined, often involving individuals relying on craft wisdom accrued within specific contexts. Three overall strands of responsibility emerged in participants' view of their role: the administrative and organisational demands of colleges and the validation/franchising of higher education partners; the provision to learners of appropriate support in their studies; and the recognition of and response to pastoral needs of students. Tensions were identified between these, with one strand tending to preoccupy programme leaders at any time, obscuring their view of other important role objectives. As such, we introduce the concept of sightlines to capture the importance of enabling programme leaders to see through and beyond their institutional context and engage outwards, rather than turn inwards. Practical recommendations include the provision of time and licence to study for advanced qualifications, to undertake research and to help nurture distinctive cultures of higher education learning.

Ecosystems are rapidly degraded by anthropogenic pressures, affecting the provision of ecosystem services. Therefore, it is increasingly important that we can quantify and manage ecosystem services to maintain human well‐being.Many ecosystem services are underpinned by ecosystem functions and processes that are driven by interspecific ecological interactions. Humans then benefit from ecosystem services through socio‐ecological interactions. Therefore, interaction network approaches can provide a unique understanding of ecosystem service flows.In this paper, we assess the current interface between network ecology and ecosystem services, before exploring how work linking these two fields could be enhanced.We emphasise the value of network approaches and explore network methods to improve the assessment and management of ecosystem services. Within this, we highlight the role of local and indigenous knowledge in operationalising network approaches in a useful ecosystem service context. Read the free Plain Language Summary for this article on the Journal blog. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

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Background: Health systems are seeking to harness digital tools to promote patient autonomy and increase the efficiency of care worldwide. The NHS Long Term Plan created the right for patients to access 'digital first' primary care by 2023–2024, including online patient access to full medical records. Aim: To identify and understand the unintended consequences of online patient access to medical records. Design and setting: Qualitative interview study in 10 general practices in South West and North West England. Method: Semi-structured individual interviews with 13 patients and 16 general practice staff with experience of patient online access to health records. Results: Online access generated unintended consequences that negatively impacted patients' understanding of their health care, with patients finding surprising or difficult to interpret information. Online access impacted GPs' documentation practices, such as when GPs pre-emptively attempted to minimise potential misunderstandings to aid patient understanding of their health care. In other cases, this negatively impacted the quality of the records and patient safety when GPs avoided documenting speculations or concerns. Contrary to assumptions that workload would be reduced, online access introduced extra work, such as managing and monitoring access, and taking measures to prevent possible harm to patients. Conclusion: The unintended consequences described by both staff and patients show that, to achieve the intended consequences set out in NHS policy, additional work is necessary to prepare records for sharing and to prepare patients about what to expect. It is crucial that practices are adequately supported and resourced to manage the unintended consequences of online access, now that it is the default position. A table of potential unintended consequences and mitigation measures is provided to aid practice managers and clinicians implementing online access. [ABSTRACT FROM AUTHOR]

Design is a key part of the healthcare intervention development process, yet it is often viewed as unclear, unstructured, and challenging. INDIGO ("INtervention DesIGn with stakehOlders") is a new mixed method that brings structure and creativity to the healthcare intervention design process and facilitates a holistic perspective of complex interventions. INDIGO combines and adapts timelining and storyboarding and enables users to create a visual representation of a complex intervention. It comprises card storyboard tokens representing intervention elements that can be moved around on a timeline chart. We discuss the background and development of INDIGO, including existing mixed methods approaches to intervention design. We then provide examples of the use of INDIGO in two empirical studies that informed the development of a brief mindfulness-based intervention, illustrating how INDIGO supported the generation of new insights. We go on to discuss the practicalities, benefits and challenges of INDIGO, including feedback from study participants. This article contributes to the field of mixed methods research by extending the scope and utility of timelining and storyboarding, and by clearly describing INDIGO so the method can be used by other researchers or intervention developers. [ABSTRACT FROM AUTHOR]

Background: Health services are increasingly using digital tools to deliver care, and online consultations are being widely adopted in primary care settings. The intended consequences of online consultations are to increase patient access to care and increase the efficiency of care.Aim: To identify and understand the unintended consequences of online consultations in primary care.Design and Setting: Qualitative interview study in eight general practices using online consultation tools in South West and North West England between February 2019 and January 2020.Method: Thematic analysis of semi-structured interviews with 19 patients and 18 general practice staff.Results: Consequences of online consultations were identified that restricted patient access to care by making it difficult for some patients to communicate effectively with a GP and disadvantaging digitally-excluded patients. This stemmed from patient uncertainty about how their queries were dealt with, and whether practices used online consultations as their preferred method for patients to contact the practice. Consequences were identified that limited increases in practice efficiency by creating additional work, isolation, and dissatisfaction for some staff.Conclusion: Unintended consequences often present operational challenges that are foreseeable and partly preventable. However, these challenges must be recognised and solutions resourced sufficiently. Not everyone may benefit and local decisions will need to be made about trade-offs. Process changes tailored to local circumstances are critical to making effective use of online consultation tools. Unintended consequences also present clinical challenges that result from asynchronous communication. Online consultation tools favour simple, well-formulated information exchange that leads to diffuse relationships and a more transactional style of medicine. [ABSTRACT FROM AUTHOR]

A growing body of evidence suggests the interaction between arc magmas and crustal carbonates may play a large role in outgassed CO2 at arcs. We examine magma–carbonate interactions within the shallow (< 0.2 GPa) crust in the Jurassic Bonanza arc on Vancouver Island, a well-exposed island arc crustal section. Detailed mapping in the Merry Widow mountain area revealed unique, late-stage orbicular mafic dikes that only occur above the stratigraphic level of subsurface carbonates. The orbicular dikes are primitive, show physical and chemical evidence of interaction with limestone, including high CaO/SiO2 and low REE (~ 10–20× chondrite) that correlate with orbicule abundance, and are geochemically discordant from other rocks of the Bonanza arc. The orbicules have identical intergranular textures to the host melt but markedly higher Ca/Si. Simple binary mixing and MELTS modeling indicates the orbicular dike compositions are a mixture of a primitive hydrous arc basalt with 3–25% limestone addition. Comparisons to published experimental data on basalt–calcite reaction suggest some of the dike compositions result from > 25% calcite assimilation, producing up to 11 wt% CO2, orders of magnitude higher than the CO2 solubility of the parent melt (0.11 wt% CO2). We interpret the orbicules as Ca-rich hybrid melts produced from limestone assimilation that did not homogenize with the host dike magma and underwent crystallization during rapid ascent, possibly propelled by the excess CO2. Our results inform on the amount and mechanism of CO2 transport at low crustal pressures (< 0.5 GPa) in island arcs built on carbonate platforms. We estimate the CO2 flux of the Jurassic Bonanza arc to have ranged from 0.14 to > 1.16 Tg CO2/year during its ~ 34 Myr lifespan. [ABSTRACT FROM AUTHOR]