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The paper investigates whether, how and in what circumstances boundary blurring or boundary maintenance is productive or destructive of sense in collaborative research based on a case study involving researchers from two universities and two principal organisational stakeholders in a local healthcare system in England between 2009 and 2012. Adopting a narrative method, using meeting observation, document analysis and interviews, we describe two key sets of activities in the evolution of collaboration, which allows us to tackle the question at two levels. Studying the production of documents and their use as boundary objects in project management meetings, we show how these were used to enable cooperation by establishing a truce between worldviews, giving participants a better feel for the game and a clearer perception of its stakes. Studying how the partnership expanded to take in other organisations besides the two formal partners, we show how the project accommodated pre-existing organisational interests but thereby sacrificed its experimental ethos. In showing how actors needed to subvert their experimental script to enact collaborative partnership, we argue for understanding and evaluating the latter as the co-produced outcome of disputes and co-orientations towards a practical ideal, not as an organisational format for knowledge co-production. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper reports on participatory processes using agent-based simulation models which were employed in the New Forest National Park, UK, to facilitate greater appreciation of recreational impact on wildlife and in turn support proposed revisions in management. The models helped to foster a greater understanding of the need for visitor management, but some stakeholders seemed intent on discrediting them and opposing any changes to recreational management. The inherent complexity and lack of user-friendly application of the models meant that use of them was compromised. Opportunities should be sought to increase stakeholder involvement in the long-term collection of data and validation of models, and to embed participatory processes in existing decision-making institutions. Overall, the decision support tools detracted attention from opportunities for researching social learning: tools need to be part of a well-run deliberative learning process that addresses stakeholder representation and power relationships, knowledge validation, social learning and improved transparency. Copyright © 2011 John Wiley & Sons, Ltd and ERP Environment. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess whether our online closed community heart care support group and information resource could sustain changes in health behaviour after the moderators withdrew their support. Heart patients (n = 108) living in a deprived area of Greater Manchester were recruited from general practi- tioners' coronary heart disease registries. The sample for this randomized controlled trial was divided in half at random where half of the participants received password-protected access to our health portal and the other half did not. At 6 months follow-up (based on the moderated phase), there was a significant difference between the experimental group and the controls in terms of self-reported diet (eating bad foods less often). This change in behaviour was not sustained during the 3-month unmoderated phase. During this unmoderated phase of the intervention, the experimental group had significantly more health care visits compared with the controls. There was no significant difference between the two phases for either group in terms of exercise, smoking or social support. This study offers insight into the potential implications for health changes of moderating arrangements for online health communities. [ABSTRACT FROM AUTHOR]

Questionnaires were sent to 900 secondary school teachers throughout England and Wales; 373 (41%) were returned. Teachers agreed on many issues but opinion was divided on the abolition of the remaining grammar schools and the question of mixed-ability teaching. Underlying dimensions of traditionalism, belief in equality of the sexes and feminism were identified in teachers' attitudes. Older teachers were more traditional than younger ones, and science and craft teachers were more traditional than arts teachers. Women were more emphatic about sex equality than men and London teachers were more feminist than others. Teachers in schools which had been involved in the Girls Into Science and Technology (GIST) project were slightly less traditional and more in favour of equality of the sexes than other teachers. [ABSTRACT FROM AUTHOR]

Abstract The UK government's Mental Health Act 2007 introduces compulsory supervised community treatment (SCT) to England and Wales. Estimates of the possible level of use of SCT are helpful both to address patient fears and to plan services. The number of patients under SCT is likely to rise over time, although the level of use will depend on a number of contextual variables and whether evidence of clinical and social benefits is forthcoming. [ABSTRACT FROM AUTHOR]

The author reflects on the International Conference on Persons held at the Nottingham University in Nottingham, England in August 2009. The author mentions that the audience in the conference was just small but generous. He states that the conference was originally the idea of Tom Buford and Charles Conti. He views that breaking bread indicates the importance of understanding the kind of connections between people which enables them to influence each other.

Background: The practical application of 'virtual' (computed) fractional flow reserve (vFFR) based on invasive coronary angiogram (ICA) images is unknown. The objective of this cohort study was to investigate the potential of vFFR to guide the management of unselected patients undergoing ICA. The hypothesis was that it changes management in >10% of cases., Methods: vFFR was computed using the Sheffield VIRTUheart system, at five hospitals in the North of England, on 'all-comers' undergoing ICA for non-ST-elevation myocardial infarction acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). The cardiologists' management plan (optimal medical therapy, percutaneous coronary intervention (PCI), coronary artery bypass surgery or 'more information required') and confidence level were recorded after ICA, and again after vFFR disclosure., Results: 517 patients were screened; 320 were recruited: 208 with ACS and 112 with CCS. The median vFFR was 0.82 (0.70-0.91). vFFR disclosure did not change the mean number of significantly stenosed vessels per patient (1.16 (±0.96) visually and 1.18 (±0.92) with vFFR (p=0.79)). A change in intended management following vFFR disclosure occurred in 22% of all patients; in the ACS cohort, there was a 62% increase in the number planned for medical management, and in the CCS cohort, there was a 31% increase in the number planned for PCI. In all patients, vFFR disclosure increased physician confidence from 8 of 10 (7.33-9) to 9 of 10 (8-10) (p<0.001)., Conclusion: The addition of vFFR to ICA changed intended management strategy in 22% of patients, provided a detailed and specific 'all-in-one' anatomical and physiological assessment of coronary artery disease, and was accompanied by augmentation of the operator's confidence in the treatment strategy., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Objective: Many emergency medicine staff report anecdotally that fellow hospital staff have a low opinion of emergency medicine. No research into this attitude has been published. The aim of this study is to determine whether there is stigma attached to emergency medicine and practitioners., Method: A postal questionnaire of all medical staff at a district general hospital, to evaluate the presence or absence of eight perceptions associated with stigma., Results: The response rate was 49.5%, with the response rate decreasing with decreasing grade. Of the stigmatizing themes tested in this study, six of the eight were demonstrated to be associated with negative attitudes, with the remaining two themes positive attitudes towards emergency medicine were suggested. The responses were similar, irrespective of grade and speciality (where given by respondees). Responses that were ambivalent or not completed varied between 25 and 48% in the returned questionnaires., Conclusions: This paper demonstrates that stigmatizing opinions towards emergency medicine exist and that these negative opinions may be widely held by hospital staff.