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1. Meeting boundaries - An empirically grounded reflection on the contribution of meeting events to changing political, social and personal conceptions of mental health.

Author

Carole Walker and Sophie Thunus

Subjects
meeting, social interaction, system and process theories, mental health and occupation, Medicine (General), R5-920
Abstract

This paper is an empirically grounded argument in which meetings are considered as events linking differences (Luhmann 2006) and thus contributing to the ongoing displacement of boundaries between self and system, and between system and environment. It draws on a research that aimed to evaluate a mental health reform in the Brussels Region (Belgium), through professional and organizational practices subsequent to a shift from institutionalized to community-based mental health care. A key objective underlying this reform is the inclusion of service users within wider society. This research was specifically designed to understand the relationship between organizational changes and services users’ care and social trajectories. It drew focus on the trajectories of people in particularly vulnerable situations, including homeless and migrant populations, as well as users suffering from mental illness and addiction problems. The research methods were designed to gather a diversity of mental health service users and professionals through meeting events (Schwartzman 1989, Freeman 2008, Duffy 2016). It combined the use of focus groups (n=4), ethnographic meetings (n=9), semi-structured interviews (n=15) and informal discussions, which aimed either to prepare the focus groups or to deepen a question raised by group discussions. Circulating through meetings enables participants, from contrasting professional status and with diverse experiences with mental health services, to meet different ways of viewing the world and of understanding mental health. As a result, participant interactions in a given setting create meetings events, construed as interrelated systems of communication (Thunus & Walker 2018), allowing for opportunities to observe and make sense of individual narratives and the social context in which they unfold in a new light. Processing newly observed differences entails the continuous displacement of boundaries within and surrounding meetings. This paper discusses how the research process focusing on meetings contributes to displacing boundaries between self, system and environment. Based on a qualitative, thematic analysis of empirical data collected through meeting events, it evidences that the research process supported incremental changes in researchers, professionals as well as users’ perspectives on the very meaning of mental health, on the care system being assessed, and on the political objective of social inclusion. Specific attention is drawn to the internationally relevant question of mental health and occupation (Eu compass for action on mental health and well-being, 2016), which dominates the research results. In this respect, this paper demonstrates that meeting gathering professionals and users with different experiences and backgrounds, which usually prevent them from meeting together, enables the emergence of an alternative conception of the question of mental health and occupation. This conception entails a clear call to shift from curative to preventive policies. To conclude, this paper thus outlines a future research aiming to raise the question of mental health and occupation at the European level, through gathering participants with different health conditions and from diverse socio-economic status.

Published
2019
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2. The social nature of health policy implementation – an empirically-grounded reflection on the implementation of integrated care in the fields of mental health and chronic diseases.

Author

Sophie Thunus and Carole Walker

Subjects
policy implementation, realistic evaluation, systemic and process theories, mental health reforms, Medicine (General), R5-920
Abstract

This paper introduces an empirically-grounded theory of change in health care systems. It draws on three research projects focusing on the implementation of a mental health care reform. These projects include two evaluation studies commissioned by Belgian public health authorities and a scientific, PhD research supported by the Belgian National Fund for Scientific Research. They are based on qualitative methods, including document analysis, semi-structured interviews and focus groups. The generalisation of these research findings has recently started through ongoing projects devoted to the implementation of an integrated care model in the field of chronic diseases. This paper first draws on a realistic approach to health policy implementation (1). A particular attention is consequently paid to the context of implementation and to identify explicit and implicit mechanisms combining to give a particular direction to the change process. Moreover, the theory of change outlined in this paper importantly borrows from system and process theories (2). It emphasises the pivotal role fulfilled by repeated sequences of interactions, most of which take the form of meeting communication, between differentiated and interdependent social systems. Belgian policymakers started supporting a shift from an institution-based towards an integrated care model in the field of mental health in 2010. This shift was expanded to the field of chronic diseases in 2015. The Belgian health care system combines characteristics of the Bismarkian and Beveridgian models. It is decentralised, highly differentiated, and recognises the autonomy of health care providers and professionals. Moving towards integrated care is all the more challenging in that context. This challenge explains the preference of Belgian policymakers for soft regulation mechanisms, that is, pilot projects making room for local adaptations and depending on a phased approach to organisational change. In this framework, local coordinators are responsible for steering the implementation process, in a way to ensure consistency between local translations and global policy objectives. In-depth analysis of the mental health reform implementation evidenced a significant discrepancy between the policy programme and local adaptations. Professional cultures, organisational strategies and ideological pillars specific to the Belgian society have been identified as the main factors accounting for these discrepancies. Furthermore, inter-organisational meetings emerged as the very spaces where such influential logics of action are expressed and articulated with one another. In this respect, the main challenge lies in the stakeholders’ ability to create hinges (3), defined as visions of the situation which enable to coordinate the action of different systems, without preventing them from preserving their cognitive structure. Coordinators, acting as boundary spanners (4), play a strategic role in organising and reporting on these meetings. However, coordinators lack power, managerial skills and knowledge of innovation process to cope with social influence in a way consistent with policy objectives. Therefore, this paper outlines a theory of health system transformations which put professional culture, organisational strategies and social ideologies at the forefront. It argues that assuming the social nature of these transformations would enable to improve both the design of health policy and the training of change managers.

Published
2019
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3. Meeting Boundaries: Exploring the Faces of Social Inclusion beyond Mental Health Systems

Author

Sophie Thunus, Carole Walker, and UCL - SSS/IRSS - Institut de recherche santé et société

Subjects
mental health care, Sociology and Political Science, Social Psychology, lcsh:HM401-1281, Context (language use), ethnography, psychiatrische Versorgung, ddc:150, Ethnographie, Belgium, Systems theory, deinstitutionalisation, social inclusion, systems theory, psychische Gesundheit, 0502 economics and business, Ethnography, 050602 political science & public administration, Psychology, Service user, Sociology, Belgien, Psychological Disorders, Mental Health Treatment and Prevention, business.industry, Gesundheitsversorgung, 05 social sciences, social integration, Public relations, health care, Mental health, 0506 political science, inclusion, lcsh:Sociology (General), Psychologie, psychische Störungen, Behandlung und Prävention, psychiatric care, Mental health care, soziale Integration, business, Inclusion (education), Inklusion, mental health, 050203 business & management
Abstract

This article examines social inclusion in the context of the deinstitutionalisation of mental health care. It draws on a scientific evaluation of the Belgian reform of mental health care (2010), designed to assess the influence of organisational mechanisms on the social and care trajectories of service users. The findings highlight the ongoing challenge for mental health systems to support the inclusion of service users within the community, and the increasingly difficult access to mental health care for people with complex and chronic mental health problems. Drawing from Systems Theory (Luhmann, 2013) and the analysis of subjective experiences, this article delves into the complex processes of social inclusion using the empirically-grounded concepts of the patient role and the impatient role. By acknowledging the relational dimensions of social inclusion, this article argues that complementarities between two faces of the mental health system are key to achieving inclusion beyond the walls of institutions and within society at large.

Published
2020

4. D'une réunion à l'autre, à la recherche de la santé mentale

Author

Sophie Thunus, Carole Walker, and UCL - SSS/IRSS - Institut de recherche santé et société

Subjects
santé mentale, Sociology, réunion, inclusion sociale, politique publique
Abstract

Dans cet article, nous racontons une histoire relative au lancement et à l’installation d’une politique belge de santé mentale lancée en 2010. L’histoire s’articule autour de trois réunions partiellement fictives et re- constituées, dans une logique d’idéaltype, à partir de l’observation directe de plus de septante réunions dont elles résument les caractéristiques principales. Ces trois réunions se déroulent dans le monde politique, le monde professionnel et organisationnel, et le monde sensible représen- té par les « lieux du lien ». L’histoire vise à reconnecter ces mondes qui, dans la réalité, sont séparés par des divisions fonctionnelles et culturelles.

Published
2021

5. Stakeholder Coalitions and Priorities Around the Policy Goals of a Nation-Wide Mental Health Care Reform

Author

Pablo Nicaise, Pierre Smith, Sophie Thunus, Vincent Lorant, Carole Walker, Inge Neyens, and UCL - SSS/IRSS - Institut de recherche santé et société

Subjects
medicine.medical_specialty, media_common.quotation_subject, Public administration, Health administration, 03 medical and health sciences, 0302 clinical medicine, Social integration, Stakeholders, Belgium, Political science, medicine, Humans, Advocacy coalitions, 030212 general & internal medicine, Health policy, media_common, Health care reform, 030503 health policy & services, Public health, Health Policy, Environmental and Occupational Health, Public Health, Environmental and Occupational Health, Stakeholder, Mental health, Psychiatry and Mental health, Mental Health, Service (economics), Health Care Reform, MHSR, Phychiatric Mental Health, Public Health, Pshychiatric Mental Health, 0305 other medical science, Goals
Abstract

The difficulty of implementing mental healthcare reforms owes much to the influence of stakeholders. So far, the endorsement of mental health policy reforms by stakeholder coalitions has received little attention. This study describes stakeholder coalitions formed around common mental health policy goals and highlights their central goals and oppositions. Data were collected on the policy priorities of 469 stakeholders (policymakers, service managers, clinicians, and user representatives) involved in the Belgian mental healthcare reform. Four coalitions of stakeholders endorsing different mental health policy goals were identified using a hierarchical cluster analysis on stakeholders’ policy priorities. A belief network analysis was performed to identify the central and peripheral policy goals within coalitions. Coalitions brought together stakeholders with similar professional functions. Disagreements were observed between service managers and policymakers around policy goals. The two coalitions composed of policymakers supported a comprehensive approach that combines the different goals and also supported the shortening of hospital stays, whereas the two coalitions composed of service managers emphasised the personal recovery of users and continuity of care. Regardless of the coalitions’ differing policy priorities, strengthening community care was a central goal while patient-centred goals were peripheral. The competing policy positions of the coalitions identified may explain the slow and inconsistent pace of the Belgian mental healthcare reform. Strengthening community care may be an essential part of reaching consensus across coalitions. Finally, special care must be taken to ensure that patient-centred policy goals, such as social integration, are not set aside in favour of other goals.

Published
2021

6. Lobby Life : Inside Westminster's Secret Society

Author

Carole Walker and Carole Walker

Subjects
Great Britain. Parliament, Women journalists--Great Britain, Press and politics--Great Britain, Journalism--Political aspects--Great Britain
Abstract

Step into the closed corridors of Westminster with a journalist at the heart of the political establishment for more than two decades. Welcome to the secretive world of the Lobby.'An entertaining and revealing insight into the secretive Westminster club where politics and journalism collide.'Andrew Neil ___ The unassuming brown laminated card issued to Westminster Lobby journalists is a VIP pass to the heart of our political world. As a political correspondent for the BBC, Carole Walker was a member of this exclusive club for more than twenty years. Whether collaring MPs for a private word in Parliament, attending exclusive Lobby briefings with government officials or travelling with a succession of prime ministers, getting to the heart of the story was paramount. Lobby Life lifts the lid on the secretive world of the parliamentary Lobby, from its conception to the present day, revealing what really happens behind the closed doors of power. Through the rise and fall of successive governments – via war, industrial strife and scandal, the financial crash, Brexit and a global pandemic – we witness the rows and resignations, the drama and debate. Asking urgent questions about the role of the media today, when politicians can engage directly with voters online, bypassing journalists and accountability, Lobby Life will intrigue anyone who wants to understand modern politics. ___'Lobby journalists are the media's elite commandos. Carole Walker astutely captures their code of honour and critical place in the informed reporting of our politics.'Sir Alan Duncan, author of In the Thick of It: The Private Diaries of a Minister'Doesn't only lift the lid on the way our press functions in Westminster, it also does a wonderful job of explaining how the relationship between the Lobby and political parties has shaped the country over the past century.'Marie Le Conte, author of Haven't You Heard: Gossip, Politics and Power'Gripping, enjoyable and accessible.'Sir Anthony Seldon, author of May at 10

Published
2021

19. The National Lung Screening Trial: Overview and Study Design

Author

Natalie Cunningham, Michael Khalili, John Waltz, Ralph Weiben, Deb Gurtner, Linda DeAlmeida, Sanjay Gupta, Sharon Maxfield, Crissy Kibic, Kathleen DeWitt, David DeMets, Walter Allen Bowman, Robert Epstein, Mia Burkhard, Stephen J. Swensen, Hattie Cromwell, Kianoush Rezai, Steadman Sankey, Lisa Scott Wasson, Rita Musanti, Tamim Malbari, Joy Ferola, Qimei He, Patty Trapnell, Melba Francis, Sam Quattlebaum, Joanice Thompson, Ana Birofka, Robin Griggs, Elizabeth Johnson, Margaret R. Spitz, Nicole Richardson, Yuting Liang, Lawrence G. Hutchins, Mirjana Tecmire, Lila Camara, James J. Navin, Eileen Frost, Diane Romano, Carrie Petkus, Eric J. Berns, Pei Jan P Lin, Steve D. Uttecht, Marian Acerra, Lawrence R. Ragard, Leo P. Lawler, Christopher M. Rogers, Alan Lee Goodwin, L. Ellen Martinusen, Melissa Ford, Michael T. Fisher, Beverly Powell, Cindy Lin, Jamie Downs, Brent Fodera, Bonita Wohlers, Michael Brangan, Peggy Bradley, Todd B. Burt, Susan Allen, Shiva Borgheian, Mingying Zeng, Thomas Riley, Danielle Gherardini, Steven Shiff, Olivia Campa, Wahied Gendi, Fang F. Xu, Ivana K. Kazda, Anne Chung, Briar Doi, Helen Price, Maria Vlachou, Alan Morgan, Simone Vuong, Pierre P. Massion, Darcy Watson, Debbie William, Esther Nakano, Karen Broski, David Creed, Melanie Bvorak, Lakisha Hawkins, Gladys Hino, Raymond Dauphinais, Michele Sallas, Helene Shiratori, Venus Brown, Denise Brooks, Heather Porter, Ilana F. Gareen, Tracy Lee, Melissa Cates, Kyle Turner, Tiffanie Hammond, Margaret Paquette, Lorraine Kerchum, Barbara Lewis, Douglas J. Reding, Thomas E. Hartman, Cathy Longden, Melissa Laron, Reza Abaya, Beborah Robertson, J W Semenkovich, Christine Holland, Hugh McGinley, Chani Montalbo, Karen Zubena, Vanessa Ralda, Adam C. Stein, Jennifer Ott, Lawrence M. Kotner, Jing Lee, Arnold Ssali, Michael Young, Quinn A. DeMordaunt, Linda V. White, Steve Dubinett, Pearl Chan, Roxana Phillips, Mallory Kolich, Brent B. Nelson, Phi Do, Jill Spivak, Angele LaFleur, Kesha Smith, Elayne Weslowsky, Patricia Nieters, Maurice LeBlanc, Satinder Singh, Lonna Matthews, Quentin McMullen, Karen Lappe, Sharon Longacre, Cindy Cobb, Jane A. Zehner, Michael Teepe, Pamela M. Marcus, Kathleen Bow, Wendy Francis, Mary Gemmel, Robert S. Fontana, Linda Jurjans, Barbara Ginther, Jonathan B. Clapp, Monica Richel, Scott F. Pickering, Brenda Edwards, Kendrick Looney, Randy Marshall, Roni Atkins, Danielle Wicks, Julie Peterson, Dcanna Cape, Albert J. Cook, Jerry Brekke, Louisa Turner, Larry Stoller, Mark B. Salerno, Bavid E. Midthun, Mark Delano, Minnetta Belyea, Deborah Greene, Jonathan Goldin, Terry Lewis, Virginia Fischer, Andrea Chapman, Shari Jordan, Deb Warren, Demetria Johnson, Rekha Khatri, Lisa Sirianni, Guillermo Geisse, Michael A. Fuchs, Kanya Kumbalasiri, Jeremy J. Erasmus, Vicki Shambaugh, Denise Boyles, Sarah Hallsky, Anna Nanovski, Jill Heinz, Mollie King, Kay Vydareny, Olga Soukhanova, Patricia Rueweler, Perry G. Pernicano, Regina Rendas-Baum, Phyllis Pirotte, Russell Harris, Neil Argyle, Miyoung Kim, June Krebsbach, Audrey Gallego, Sheila Wein, Mukesh F. Karwat, Karla Myra-Bloom, Pamela Byrnes, Mitchell D. Schnall, Hector Ahumada, Eric Sanchez, Donna DesMarais, Julie Maderitz, Cindy Lavergne, Lori Kirchoff, Patricia C. Sanders, Elizabeth Thielke, Michael Sullivan, Jennifer Gaegler, Janet Manual, Jennifer R. Heinz, Ray Zisumbo, Diane C. Strollo, Candace Mueller, Irene Mahon, Brenda Delfosse, Carolyn M. Johnson, William E. Grizzle, Merideth Stanley, Sylvan Green, Pamela Harvey, Lindsay Richardson, Brenda K. Brewer, Philip Costello, Deanna Zapolski, John Worrell, Jeffrey G. Schragin, David S. Alberts, Edward L. Korn, Tamara Owens, Hank Brastater, Kay Mathiesen-Viergutz, Mark Broschinsky, Paul W. Spirn, Grace Isaacs, John S. Waltz, Mitch Goodsitt, Christi Newton-Foster, Sharlene Snowden, Barbara Voight, Gail Bizer, Kathy McDonough, William Huynh, Eduard Van Stam, Robert A. Carlson, Mike Florzyk, Paula M. Jacobs, Joan Fuller, Mauren Grunenwald, Ann Bangerter, Jacksonville, Adriane Andersen, Tess Thompson, Kenneth Nowers, Stephanie Helwi, Martin J. Edelman, Emmanuel Omoba, Rubenia Flores, Kevin T. White, Patrick W. Wolfe, Michael Milacek, Sharon Gard, Brandon B. Bigby, Cynthia H. McCollough, Andrew Burnside, Sheryl L. Ogden, Maisha Pollard, Thomas K. Pilgram, Sydney Laster, Claudia J. Kasales, Bruce W. Turnbull, Cheri Haselhuhn, Laura N. Myers, Jean Jacobsen, Melissa Love, Gavin D. Watt, Cheryl Love, Gerald F. Abbott, Susanne Kozakowski, Jerry L. Montague, Cynthia Hill, Neil F. O'Donnell, Anna Sear, Thomas M. Beck, Jean Wegner, Chrispina Wray, Edward M. Brown, Louise Ledbetter, Karen Bellware, Julie Moody, Noel Bahr, Matthew T. Freedman, Thomas Hensley, John E. Madewell, Leanne Hadfield, David R. Maffitt, Lisa Cottrell, John J. Warner, Deborah Graham, Krystal Arnold, Alejandra Reyes, Kristin Lieberman, Derek Omori, Donna Garland, Mike Burek, Mel Johnson, Judith Harkins, Martha Fronheiser, M. Y. M. Chen, Dawn Simmons, Kathleen Voight, Aaron O. Bungum, Marianne Rice, Lakeshia Murray, Tami Krpata, Donna Sammons, Leslie Kmetty, Catherine Duda, Carissa Krzeczkowski, Anne Nguyen, Richard H. Lane, Cynthia Mack, Loren C. Macey, Eddy Wicklander, Kelly McDaniel, Sue Zahradka, Hassan Bourija, Cristina Farkas, Jincy George, Renae Kiffmeyer, Wendell Christie, Catherine Engartner, John Crump, Mimi Kim, Carol Steinberg, Reginald F. Munden, Deb Kirby, Jo Ann Stetz, Barbara O'Brien, Sally Tenorio, Laura Multerer, Carlotta McCalister-Cross, Jessica Silva-Gietzen, Tamara Saunders, Harvey Glazer, Cam Vashel, Maria Oh, Rodkise Estell, Steven M. Moore, Tara Riley, Grant Izmirlian, D. Claire Anderson, James Burner, Steven Peace, Phil Hoffman, Angela Del Pino, Brian Irons, Carlos Jamis-Dow, John K. Lawlor, Edward F. Patz, Jay Afiat, Amber Barrow, Bawn M. Beno, Melissa S. Fritz, Lynn Coppage, Scott J. Sheltra, Tim Swan, Jerry Bergen, Charlie Fenton, Eric Deaton, Marilyn J. Siegel, Korinna Vigeant, Kerry Engber, Sarah Merrill, Buddy Williams, Kimberly Stryker, Bradley S. Snyder, Christina Romo, Andrea Hugill, Michael J. O'Shea, Linda White, Gail Fellows, Yasmeen Hafeez, Joe Woodside, Shauna Dave Scholl, Philip C. Prorok, Sharon Carmen, Kelly Hatton, Steven V. Marx, Sooah Kim, Robert Kobistek, Dawn Thomas, Lea Momongan, Chris Steward, Kari Bohman, Holly Bradford, Bradley S. Sabloff, Phillip Peterson, William C. Black, Lisa Pineda, James G. Ravenel, Karen Taylor, Beverly Trombley, Mona N. Fouad, Amber McDonald, Lauren J. Ramsay, Lisa Harmon, Jeffrey Geiger, David L. Spizarny, Jeffrey S. Klein, Xizeng Wu, Heather Tumberlinson, Joy Espiritu, Gina Varner, Dawn Fuehrer, Eric A. Hoffman, Sheila Moesinger, Nina Wadhwa, Steve King, Patricia Lavernick, Paola Spicker, Timothy R. Church, Cheryl Whistle, Sheila Greenup, Patricia Fantuz, Stephanie Levi, Peter Balkin, Mary E. Johnson, Johanna Ziegler, Susan Hoffman, Kathy L. Clingan, Craig Kuhlka, Maria Marchese, Lawrence F Cohen, Cylen Javidan-Nejad, Wilbur A. Franklin, Kevin J. Leonard, Tim A. Parritt, Jade Quijano, Kathleen Poler, Jennifer Rosenbaum, Xiuli Zhang, Christine Brown, Terri David-Schlegel, Susan M. Peterson, James R. Jett, Kenneth W. Clark, Edward P. Gelmann, Arthur Migo, Patricia Fox, Lori Hamm, Janie McMahon, Darlene Guillette, Robert C. Young, Patty Beckmann, Jerome Jones, Nikki Jablonsky, Roberta Yoffie, Heather L. Bradley, Darlene Higgins, Francine L. Jacobson, Christine B. Berg, Mark Bramwitt, Constantine N. Petrochko, Karen Stokes, Jennifer Rowe, Kathy McKeeta-Frobeck, Brenda Sleasman, Courtney Bell, Dave Tripp, Saundra S. Buys, Susan Walsh, Jo Rean D. Sicks, Richard G. Barr, Kirk Midkiff, Tom Caldwell, Elisabeth A. Grady, Subbarao Inampudi, Marilyn Calulot, Paul A. Kvale, Alice DuChateau, Kathy Berreth, Ruth Holdener, Katie Kuenhold, Thomas E. Warfel, David P. Naidich, Mandie Leming, Fraser Wilton, Leanne Franceshelli, Kathleen McMurtrie, Elaine Bowman, Donald F. Bittner, Helen Kaemmerer, Merri Mullennix, Adelheid Lowery, Andrew Karellas, Jenny Hirschy, Kate Naughton, Ashley B. Long, Kristin M. Gerndt, Kathleen Young, Richard M. Schwartzstein, Wendy Smith, Joseph Aisner, Shane Ball, Kathleen Krach, Cathy Mueller, Virginia May, Christopher Blue, Marsha Lawrence, Ronald S. Kuzo, Colleen McGuire, Alisha Moore, Sara Cantrell, Christie Leary, Pamela Allen, Maryann Trotta, Clifford Caughman, Peggy J. Gocala, Brian Mullen, Janan Alkilidar, Maryann Duggan, Lin Mueller, Alesis Nieves, Fenghai Duan, Frederick Olson, Edwin G. Williams, Jo Ann Hall Sky, Grant Izmirilian, Peggy Joyce, Judy Preston, Cristine Juul, Julianne Falcone, Bruce Neilson, Fla Lisa Beagle, Beth Evans, Jamie Mood, Janet Bishop, Jean Tsukamoto, Vivien Gardner, Gillian Devereux, Minesh Patel, Sally Fraki, Celia Stolin, Ami Lyn Taplin, Stephenie Johnson, Saeed Matinkhah, Jenna Bradford, Sanjeev Bhalla, Charles Jackson, Julie Haglage, Darlene R. Fleming, Allie M. Bell, Paul A. Bunn, Gail Orvis, Andrew J. Bierhals, Julie Ngo, Belores K. Prudoehl, Elaine N. Daniel, Peggy Olson, Paul F. Pinsky, Glenna M. Fehrmann, Aras Acemgil, Andrea Hamilton-Foss, Leeta Grayson, Smita Patel, Scott Emerson, Carl J. Zylak, James R. Maxwell, Jennifer Fleischer, Suzanne Smith, Jacqueline R. Sheeran, Alan Williams, Scott Gaerte, John Fletcher, Sonya Clark, Nancy Gankiewicz, Stuart S. Sagel, Jason Spaulding, Nancy E. Hanson, Nicole Fields, Richard D. Nawfel, Dinakar Gopalakrishnan, Margaret Oechsli, Susan Wenmoth, Isabelle Forter, Elizabeth Morrell, Jessica Rider, Letitia Clark, Michael Woo, Cynthia A. Brown, Camille Mueller, Mark T. Dransfield, Lois M. Roberts, Anne Randall, Eduard J. Gamito, Carrie O'Brien, Carolyn Palazzolo, Julie Schach, Robert Falk, Melissa Hudson, Jennifer Garcia Livingston, Cynthia L. Andrist, Tammy Fox, Elliott Drake, Tanya Zeiger, Renee Metz, Kevin Thomas, Neha Kumar, Elizabeth Couch, Beborah Bay, Mei Hsiu Chen, Jason Bronfman, Philip Dennis, Deb Engelhard, Pamela McBride, Daniel Kimball, Amy Haas, Pamela M. Mazuerk, Marlea Osterhout, Venetia Cooke, Tina Taylor, Amy St.Claire, Joe Hughes, Becky McElsain, Beverly Brittain, Michele Adkinson, Paige Beck, Martha Maineiro, Paula R. Beerman, Jackie Seivert, Mary M. Pollock, Donald Corle, Tina Herron, Marcella Petruzzi, Natalie F. Scully, Kenneth A. Coleman, Jennifer Yang, Debra Loria, Wendy Moss, Alan Brisendine, Cheryl M. Lewis, Dalphany Blalock, Lonni Schultz, Douglas Bashford, Nora Szabo, David Shea, Amanda Devore, Karen Schleip, Judy Netzer, Barry Clot, Gerald M. Mulligan, Nancy E. Krieger Black, David Schultz, Jim Pool, Craig E. Leymaster, Kathryn Rabanal, Kay Bohn, Tara Berg, Marisol Furlong, Stacey Mitchell, Donna Biracree, Laura Jones, Cassie Olson, Robin Stewart, Jeremy Pierce, Marilyn Bruger, Valene Kennedy, Stephanie Davis, Colin O'Donnell, Glenn A. Tung, Shannon Wright, William Lake, Sharon Jones, Vincent Girardi, Brad Benjamin, Veenu Harjani, Drew A. Torigian, Kevin Edelman, Sue Frederickson, Paul E. Smart, Michelle Wann Haynes, D S Gierada, Glenn Fletcher, Rosalie Ronan, Patricia Ann Street, Eleace Eldridge-Smith, Lynly Wilcox, Cindy Lewis-Burke, La Tonja Davis, Rachel Black Thomas, Dawn Shone, Evangeline Griesemer, Tim Budd, Lindsey Dymond, Marlene Semansky, Amy Rueth, Constantine Gatsonis, Kay H. Vydareny, Usha Singh, Amy Lita Evangelista, Angelica C. Barrett, Bethany Pitino, Shirley Wachholz, Angela M. Williams, Sandra Fiarman, Karen Luttrop, David Chellini, Michael Bradley, Helen Fink, Aaron Zirbes, Roger Inatomi, Joon K. Lee, Heather Bishop Blake, Lisa Woodard, Craig Hritz, Sarah Neff, Aine Marie Kelly, Deborah Harbison, Baigalmaa Yondonsambuu, Amy Lloyd, Christine Gjertson, Erin Cunningham, Angelee Mean, June Morfit, Ping Hu, William Thomas, Jazman Brooke, Paul Marcus, Jeremy Gorelick, Erin Lange, William Stanford, Denise R. Aberle, Lena Glick, Annabelle Lee, Ian Malcomb, Deanna L. Miller, Mary Mesnard, Jacqueline Jackson, Jhenny Hernandez, Desiree E. Morgan, Howard I. Jolies, Jacquie Marietta, Teresa Lanning, Debra Rempinski, Amanda C. Davis, Karen Mathews Batton, Mahadevappa Mahesh, Erik Wilson, Deana Nelson, Sharan L. Campleman, William Manor, Julie Sears, Howard Mann, E. David Crawford, Carl Krinopol, Greg Gambill, Margo Cousins, Rex C. Yung, Sangeeta Tekchandani, Thomas Vahey, Ann D. McGinnis, Kimberly Nolan, Kaylene Crawford, Kelli P. Rockwell, Dana Roeshe, Fred W. Prior, Kari Ranae Kramer, Heidi Nordstrom, Frank Stahan, Shawn Sams, Cherie Baiton, Joy Tani, Thomas J. Watson, Angela Cosas, Diane Kowalik, Pritha Dalal, Ann Jolly, Jeanine Wade, Laura Bailey, Julie Varner, Glen K. Nyborg, Christopher Toyn, David Gemmel, Susanna N. Dyer, Laurie Amendolare, Mary Ellen Frebes, Judy Ho, Adele Perryman, John Keller, D. Sullivan, George Mahoney, Scott Cupp, Linda L. Welch, Peter Greenwald, Robert Sole, Marcello Grigolo, Caroline Chiles, Patricia Sheridan, Deborah M. Chewar, Vijayasri Narayanaswami, Susan Blackwell, Suzanne B. Lenz, Alphonso Dial, Melvin Tockman, Carolyn Hill, John Stubblefield, Catherine E. Smith, Judith Lobaugh, Rosa M. Medina, Jackie Meier, Nandita Bhattacharjee, Robert Tokarz, Lisa Clement, Nancy Caird, Cindy Masiejczyk, Patricia Shwarts, Laura Springhetti, Sandra Schornak-Curtis, Edwin F. Donnelly, Patricia Tesch, Laurie Rathmell, Pamela K. Woodard, Edward A. Sausville, David R. Pickens, Kylee Hansen, Paulette Williams, Barbara Ferris, Rachel L. McCall, Nicole M. Carmichael, Dawn Whistler, Ramachandra Chanapatna, Glynis Marsh, Mary Wiseman, Tony DeAngelis, L. Heather, Vicki Prayer, Robin Laura, Priscilla Bland, Gregory W. Gladish, Amy Garrett, Kelly McNulty, Daniel J. Pluta, Mylene T. Truong, Serelda Young, Crista Cimis, Gordon Jacob Sen, Rhonda Rosario, Anthony B. Miller, Edward Hunt, Juanita Helms, Jill K. Bronson, Jeff Yates, Ginette D. Turgeon, Bo Lu, Nancy Fredericks, Pam Senn, Ryan Pena, Hakan Sahin, Mary Lynn Steele, Jill E. Cordes, Noel Maddy, R. Adam DeBaugh, Hope Hooks, Zipporah Lewis, Robert L. Berger, Shani Harris, Natalie Gray, Jennifer Kasecamp, Elizabeth King, Jacinta Mattingly, Hrudaya Nath, Kathy Torrence, Christine Cole Johnson, Sara Mc Clellan, Kalin Albertsen, Kim Sprenger, Ryan Norton, Jody Wietharn Kristopher, Linda Warren, Byung Choi, Casey O'Quinn, Mark K. Haron, Chris J. Jennings, Karen Robinson, Joan Molton, Dorothy Hastings, Robert I. Garver, Christopher J. Cangelosi, Jeannette Lynch, Peter Ohan, Angela Campbell, Dawn Mead, Miriam Galbraith, Divine Hartwell, Natalya Portnov, Gene L. Colice, Andetta R. Hunsaker, Analisa Somoza, Todd Risa, Daniel C. Sullivan, Karthikeyan Meganathan, Tammy DeCoste, Peter Zamora, Richard M. Fagerstrom, Iiana Gareen, Phyllis J. Walters, Barbara L. Carter, Alem Mulugeta, Rob Bowman, Kavita Garg, Andrea Franco, Mary Adams Zafar Awan, Edward Reed Smith, Rachel Phillips, Michelle Aganon-Acheta, Fred R. Hirsch, Peter Jenkins, Pamela Taybus, Joy Knowles, Karen M. Horton, Cheryl Spoutz-Ryan, Sarah Landes, William G. Hocking, Laura B. Schroeder, Erini Makariou, Jered Sieren, Kaylene Evans, Erin Nekervis, Brenda Polding, Tonda Robinson, Joel L. Weissfeld, Terry J. Sackett, Michael F. McNitt-Gray, Leslie Dobson, Raymond Weatherby, Randell Kruger, Revathy B. Iyer, Mary Krisk, Anthony Levering, Susan Collins, Alison Schmidt, William M. Hanson, Patricia Schuler, Karen Glanz, Morgan Ford, Beatrice Trotman-Bickenson, Richard Guzman, Paul Koppel, Judith K. Amorosa, Meredith Slear, Dayna Love, Carol Vaughn, Kellyn Adams, Celeste Monje, Garry Morrison, Sherri Mesquita, Paul Cronin, Tony Blake, Constance Elbon-Copp, Robert A. Clark, Felix Mestas, Erich Allman, Armen Markarian, Cheryl Souza, Karen O’Toole, Elliot K. Fishman, Karen Augustine, Jane Hill, Bonnie Kwit, Ralph Drosten, Susan Foley, Stacy E. Smith, Angie Bailey, Jennifer Bishop Kaufmann, Shelly Meese, Phillip M. Boiselle, Howard Morrow, Thomas D. Hinke, Barry Edelstein, Erin Schuler, William C. Bailey, Donna Letizia, David S. Gierada, Frederick J. Larke, Robin Haverman, Sarah Baum, Sally Hurst, Richard L. Morin, Ben Dickstein, William Russell, J. Anthony Seibert, Sophia Sabina, Mary Alyce Riley, Michael A. Taylor, Katherine BeAngelis, Robert A. Hawkins, Fernando R. Gutierrez, Amie Welch, Heather Lancor, George Armah, James Blaine, Eric Henricks, Joel Dunnington, Carole Walker, Laura Motley, Melody Kolich, Bruce J. Hillman, David W. Sturges, Mindy Lofthouse, Amy Warren, Michael Black, Mark Kolich, Lisa A. Holloway, Shannon M. Pretzel, Susan Shannon, Yassminda Harts, Dallas Sorrel, Lance A. Yokochi, Diana Wisler, Arthur Sandy, Roberta Clune, Shirley Terrian, Shalonda Manning, Bradley Willcox, Thomas J. Payne, James L. Tatum, Dale Brawner, Sandy Morales, Rodolfo C. Morice, Amy Vieth, Emily Jewitt, Chelsea O'Carroll, Theresa C. McLoud, John E. Langenfeld, Chris H. Cagnon, Lisa B. Hinshaw, Gena Kucera, Helena R. Richter, Drew Torigian, June McSwain, Courtney Eysmans, Vinis Salazar, David Spizarny, Mary Kelly-Truran, Mark Whitty, Henry Albano, Connie L. Sathre, William R. Geiser, Barnett S. Kramer, Marianna Gustitis, Gordon C. Jones, Neil E. Caporaso, Timothy Welsh, Roger Tischner, Ana Maria Mendez, Dominick A. Antico, Cathy L. Bornhorst, Carla Chadwell, Stephanie Pawlak, Kelli M. West, Joe V. Selby, Randall Kruger, Jodi Hildestad, Elaine Freesmeier, Nicole Rivas, Andrew Goodman, Naima Vera-Gonzalez, Stuart Lutzker, Eric M. Hart, Melanie Yeh, Shane Sorrell, Deb Multerer, Sharon Jacoby, Debbie Gembala, Elizabeth Fleming, Myrle Johnson, Michael J. Flynn, Frank Tabrah, Martin L. Schwartz, Deanna Mandley, Brad Siga, Guillermo Marquez, Jeffrey Koford, Victoria Jenkins, Janice Pitts, Constantine A. Gatsonis, Natalie Baptiste, Edith M. Marom, Gina Sammons, Anne Burrough, Martha Ramirez, Jack Cahill, Carl Jaffe, Linda Heinrichs, Aura Cole, Paul Rust, Alon Coppens, Gregg Hamm, Lisa Conklin, Kathleen A. Robbins, Carleaner Williams, Gwen Chalom, Winston Sterling, Colleen Hudak, Lea Matous, Ella A. Kazerooni, Denise Kriescher, David A. Lynch, Liz Bolan, Jacob Wolf, Jonathan G. Goldin, Roberta Quinn, L. A. Schneider, Kathleen A. Murray, Erica Sturgeon, Jennifer Avrin, Michelle T. Biringer, Mark Hinson, Cynthia Reiners, Brian Chin, Amy Brunst, Ann M. Lambrecht, Katherine Lohmann, Jennifer Bacon, Ulander Giles, Diane Shepherd, William T. Corey, Timothy Cosgrove, Lana C. Walters, Nancy Kadish, Hilary C. Nosker, Christine D. Berg, Thomas Payne, Jackie Becker, Kanistha Sookpisal, Lyn Seguin, Todd R. Hazelton, Roy Adaniya, James Fisher, Annmarie Walsh, Shirleen Hyun, Laura Stark, Kenneth Hansen, Carolyn Nelson, Martin Tammemagi, Mary A. Wolfsberger, Barry H. Gross, Valentina Ortico, Marge Watry, Jeff Childs, Gabe Herron, Loretta Thorpe, Lisa Damon, Evanthia Papadopoulos, Denise Moline, Voula E. Christopoulos, John D. Minna, Tony Jones, Mitchell Machtay, Michael Plunkett, Melissa Laughren, Luis Zagarra, Adam Leming, Eda Ordonez, Chris Howell, Marissa Peters, Wendy Mosiman, Joanne Gerber, Alfonso Lorenzo, Barbara L. McComb, Laura Hill, Gale Christensen, Hanna Comer, Carmen Guzman, Kathy Taylor, Misty Oviatt, Malcolm King, Lily Stone, Rex Welsh, Bernadette Pennetta, Cristina Raver, Jan E. Hyder, Stephanie Clabo, Peggy Lau, Jacqueline Fearon, Patricia Pangburn, Pamela Dow, William K. Evans, Victor De Caravalho, Mike Wirth, Brooke Johnson, Meridith Blevins, Lisa H. Gren, Sharon L. Kurjan, James P. Evans, Kirk E. Smith, Donna King, John A. Worrell, Mindy S. Geisser, Philip F. Judy, Richard Barr, Sue Misko, Stanley R. Phillips, Jillian Nickel, Christine M. McKey, Joe Austin, Donna Hartfeil, Laura Young, Shovonna White, Alexis K. Potemkin, Anthony Boulos, Tawny Martin, Karen Kofka, Heather McLaughlin, Matthew K. Siemionko, Melissa Houston, Angela Lee Rowley, Adys Fernandez, Murray Backer, Jagdish Singh, Mary Weston, Nancy Payte, Charles Apgar, John K. Gohagan, Jeff Fairbanks, Wylie Burke, David Chi, Michael Nahill, Kevin DeMarco, Karen Patella, Beverly Rozanok, Carol M. Moser, Nicole Matetic Mac, Karen Boyle, Dinah Lorenzo, Elanor Adkins, Phyllis Olsson, Amanda M. Adams, Sujaya Rao, K.E. Jones, Polly Kay, D. Lynn Werner, John B. Weaver, Sally Anne Kopesec, Jennifer Frye, Victoria Chun, Cathy Francow, Cheri Whiton, Jo Ann Nevilles, Andrew Bodd, Barbara Galen, Sabrina Chen, Cindy Cyphert, Stephen M. Moore, Petra J. Lewis, Shanna Nichols, Mareie Walters, Thea Palmer Zimmerman, Warren B. Gefter, Peter Dubbs, Ann Reinert, Holly Washburn, Renee MacDonald, Boleyn R. Andrist, Dianalyn M. Evans, Marvin Flores, Tricia Adrales-Bentz, Claudine Isaacs, Regina C. MacDougall, Greg M. Silverman, Nichoie Cadez, Lynne Bradford, Rochelle Williams, Angela M. McLaughlin, Ellen Sandberg, Cheryl Crozier, Robert Mayer, Richard P. Remitz, Sheron Bube, Leroy Riley, Vish Iyer, Sophie Breer, Stephen Baylin, Anna Boyle, Shannon Williams, Kristen Keating, Martin M. Oken, Gerald L. Andriole, Bruce E. Hubler, Eric T. Goodman, David Engelhart, Bonna Au, Brianne Whittaker, Tricia Hoffa, Eng Brown, Tammy Wolfsohn, Denise L. Foster, Barry H. Cohen, Linda Galocy, Matthew T. Bee, Jacqueline Matuza, Leslie Henry, Katherine Meagher, Mona Fouad, Beth McLellan, Troy Cook, John Sheflin, Lilian Villaruz, Marcella Moore, Brandy Mack-Pipkin, Vanessa Graves, Ryan Weyls, William T. Herbick, Geoffrey McLennan, Lynn Hoese, Janise Webb, Terrie Kitchner, Michele Lee, Robert T. Greenlee, Charles C. Matthews, Nicole Spiese, Jeffrey Heffernon, Dianna D. Cody, Patricia Blair, Kathy Garrett, Michael A. Sullivan, and Loretta Granger

Subjects
Oncology, medicine.medical_specialty, business.industry, Mortality rate, medicine.disease, law.invention, Quality-adjusted life year, Randomized controlled trial, law, Internal medicine, medicine, Radiology, Nuclear Medicine and imaging, National Lung Screening Trial, Radiology, Overdiagnosis, business, Lung cancer, Lung cancer screening, Mass screening
Abstract

The National Lung Screening Trial (NLST) is a randomized multicenter study comparing low-dose helical computed tomography (CT) with chest radiography in the screening of older current and former heavy smokers for early detection of lung cancer, which is the leading cause of cancer-related death in the United States. Five-year survival rates approach 70% with surgical resection of stage IA disease; however, more than 75% of individuals have incurable locally advanced or metastatic disease, the latter having a 5-year survival of less than 5%. It is plausible that treatment should be more effective and the likelihood of death decreased if asymptomatic lung cancer is detected through screening early enough in its preclinical phase. For these reasons, there is intense interest and intuitive appeal in lung cancer screening with low-dose CT. The use of survival as the determinant of screening effectiveness is, however, confounded by the well-described biases of lead time, length, and overdiagnosis. Despite previous attempts, no test has been shown to reduce lung cancer mortality, an endpoint that circumvents screening biases and provides a definitive measure of benefit when assessed in a randomized controlled trial that enables comparison of mortality rates between screened individuals and a control group that does not undergo the screening intervention of interest. The NLST is such a trial. The rationale for and design of the NLST are presented.

Published
2011
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20. Meeting for innovation in mental healthcare organisation

Author

Carole Walker, Sophie Thunus, and UCL - SSS/IRSS - Institut de recherche santé et société

Subjects
Health (social science), Sociology and Political Science, business.industry, Health Policy, media_common.quotation_subject, Context (language use), mental health care organisation, Ambiguity, Public relations, Mental health, mental healthcare organisation, innovation, inter-professional meetings, integrated care, Integrated care, Institution, Leadership style, Conversation, Sociology, business, media_common, Qualitative research
Abstract

The shift from institution-based mental healthcare system toward integrated care system is - not only but also- a question of organisation. Recognising the organisational dimension of this shift is a pre-requisite for improving the design of mental healthcare researches.In Belgium, the shift toward integrated care follows a change strategy inspired by the WHO: it is stimulated through pilot projects encouraging the transformation of mental healthcare delivery at the local level.Scientific evaluations of these projects evidenced that, despite the development of innovative practices, the shift is still not complete. The question of how innovative practices are arising and how to support their generalisation nevertheless remained overlooked.Theory: In this paper, we argue for reconsidering the design of scientific research on mental healthcare reforms, by integrating key learnings from organisational theories.Organisation theorists showed that talks are constitutive of organising process, particularly in complex environments where multiple interests, ideologies, and types of expertise are coexisting. The importance of talk in re-organising work processes, particularly inter-professional meetings, has been particularly emphasised in mental health services.We analysed the impact of inter-professional meetings on the reorganisation of mental healthcare in Belgium by relying on qualitative methods and the principle of triangulation: inter-professional meetings n=72 were observed as part of two scientific researches[1]; the meeting participants were interviewed n=57 and interview and observation data were confronted to documents linked to the observed meetings.Results: Based on excerpts of interviews and transcripts of observation, the paper evidences that:- meetings most of the time fail to reach their expected outcomes;- the meeting context and leadership style of the chair importantly influence their real outcomes;- despite the feeling that meetings are useless, they bring about changes in mental health professionals’ representations and ways of working.Discussions: Mental healthcare researches have underestimated the influence of inter-professional meetings on mental healthcare services’ transformation. Designing scientific researches integrating meeting as a research object to understand how the transformation occurs and instrument to experiment with different meeting techniques might help to address this gap.Conclusion: Two factors explaining the meeting contribution to innovation are:- the level of connectedness/separateness between the meeting context and institutional environment: increased separateness means increased possibilities to experiment with new roles and representations;- the management of meeting conversation: the meeting contribution to innovation is related to the level of ambiguity afforded by the conversation.Lessons: if meetings are supposed to bring solution to complex problems, they have first to be carefully prepared and managed, thus both researchers and practitioners might consider that meeting is a problem before being a solution.Limitations: the research was limited to the Belgian context and the results have not been generalised and tested in other countries and based on quantitative methods.Perspectives: Testing the results in other contexts and designing experimentation with meeting techniques for stimulating innovation in mental healthcare systems.References:1- 2009-2011 Know&Pol project, funded by the European Commission FP7; 2011-2015/2015-2017 – doctoral/post-doctoral researches funded by the National Fund for Scientific Research F.R.S – FNRS.

Published
2018
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21. Teacher Stories and Transactional Inquiry

Author

Catherine Zeek, Carole Walker, and Martha M. Foote

Subjects
media_common.quotation_subject, 05 social sciences, Professional development, 050401 social sciences methods, 050301 education, Literacy, Education, Narrative inquiry, 0504 sociology, Transactional leadership, Pedagogy, ComputingMilieux_COMPUTERSANDEDUCATION, Mathematics education, Psychology, 0503 education, media_common
Abstract

The authors trace their work with mentor teachers in a southwestern U.S. professional development school. These mentors met to tell, write, share, and analyze stories of their experiences as mentors to preservice teachers. As the authors worked with several groups of teachers, they began to analyze the processes involved in the sessions. An outcome of the authors’ discussions was the idea of transactional inquiry, a method grounded in narrative inquiry, transactional literacy theory, and literary analysis. Transactional inquiry provides a vehicle for teachers to reflect on their own and others’ professional development, identify lessons from their teaching, and connect with other teachers through the inquiry process. This article describes the evolution of transactional inquiry as well as the mentors’ stories and sharing.

Published
2001
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22. Powerful Learning

Author

Sally A. Hague and Carole Walker

Subjects
Urban Studies, Program evaluation, Medical education, Teaching method, Pedagogy, Peer relationships, Psychology, Checklist, Education
Abstract

The goal of the Accelerated Schools Project is to provide powerful learningexperiences for all children. Because teachers are sometimes reluctant to embracenew practices, this study investigated the effects of a yearlong project designed tobring powerful learning to the forefront in two urban accelerated schools. Theinterventions were Powerful Learning Partners, Powerful Learning Seminars,and a teacher-constructed checklist. Outcome measures were self-reported listingsof strengths and challenges, self-assessments, and essays about powerful learning.Results indicate that partners and seminars can increase accelerated practices.Inflated self-assessment scores suggest that teachers are not fully aware ofconstructivist learning principles and accelerated practices.

Published
1997
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24. A Second Moses in Bonnet and Shawl: Caroline Chisholm, 1808–1877

Author

Jane L. Littlewood and Carole Walker

Subjects
Faith, Daughter, History, media_common.quotation_subject, Art history, Geology, Ocean Engineering, General education, Religious studies, Water Science and Technology, media_common
Abstract

Caroline Chisholm was a Victorian philanthropist designated by the Australian Encyclopaedia as ‘the greatest of women pioneers in the history of Australia’. She was born in Northampton in 1808, the daughter of William Jones, hog-jobber of some substance. She married Archibald Chisholm in 1830, a lieutenant in the East India Company Army, ten years her senior, on the understanding that she be allowed to undertake philanthropic works. It is assumed she converted to her husband's Roman Catholic faith either just before or after the marriage. It was in Madras, where her husband was based, that her philanthropic endeavours began and she founded a ‘school of industry for the daughters of European soldiers’. The school educated the sadly-neglected girls in general education and domestic duties.

Published
1995
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25. Limbering up for a whole new life… in the 'Om Doome'.

Author

Carole Walker

Abstract

It is just before 8am on a Monday, and I am strolling to a yoga session. I am hoping this retreat will give me a fresh perspective on life after leaving my job. [ABSTRACT FROM PUBLISHER]

Published
2017

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