Gender inequity has persisted in academic medicine. Yet equity is vital for countries to achieve their full potential terms of translational research and patient benefit. This study sought understand how the gender programme, Athena SWAN, can be enabled constrained by interactions between programme context it implemented into, whether these might produce unintended consequences.Multimethod qualitative case studies using a realist evaluation approach.5 departments from university medical...

In the UK, recruitment of patients into clinical research is a national health and development policy priority. There has been limited investigation how level factors operate as barriers or facilitators to work, particularly from perspective staff undertaking patient work. The aim this study identify examine views key organisational work in one group located an NHS Academic Health Science Centre. A qualitative utilizing in-depth, one-to-one semi-structured interviews with 11 purposively...

There is growing interest in evaluating policy implementation ways that grapple with the complexity of process. This article offers an example using systems methodology to explore how child protection contact centres has functioned practice. Rather than just asking traditional evaluation question ‘is it working?’ this study sought understand was working and interpreted as interacted other systems, producing conflicts, local variation emergent effects. It illustrates concepts ‘emergence’,...

Internationally, there has been increasing focus on creating health research systems. This article aims to investigate the challenges of implementing apparently simple strategies support development a system. We case study an English National Health Service Hospital Trust that sought implement national recommendation organisations should introduce statement about all patient admission letters. apply core concepts from complexity theory and undertake documentary analysis email dialogue...

Abstract Of utmost concern for effective child protection and family services is evidence-based practice. There an onus of accountability on providers therapeutic to establish the merit cost efficiency their work. Developing standardised outcome measures children families, towards which service provider can strive, assuredly required as a yardstick against progress be measured modified. Yet, will only work in conducive organisational conditions. Specifically, operationalise suite into...

Abstract Signs of Safety (SofS) is a popular framework for child protection social work practice, used in more than 200 jurisdictions worldwide. Although workers tend to find SofS tools easy use, skilled application the approach challenging, and research has found that often not implemented as intended. This study aimed deepen inform explanation (initial theory) what key processes are expected achieve family–worker interaction why. A realist synthesis was used, involving review literature...

Implementing a new initiative in any complex system is known to be deeply challenging and children's services are no exception this regard. Yet understanding implementation important support service planning as well avoid inappropriate (de)commissioning. Complexity-informed Realist methods established, especially health sciences research, but have seen little uptake social work, despite calls embrace the approach. This paper utilises Synthesis understand evaluate how interactions between...

Whether New Public Management (NPM) ideas and practices have remained resilient or are now in decline remains a topic of contention. We investigate the case national system, introduced 2006, for performance managing medical research United Kingdom's National Health System (NHS). argue that system conforms to traditional NPM, providing empirical evidence its late adoption resilience. highlight potential conflicts NPM this context demonstrate first time NPM-style produce unintended unwanted...

Research in the late 1990s and early 2000s raised concerns that safeguarding implications of domestic abuse (DA) were not being sufficiently accounted for child contact cases England. Since time, reforms have been introduced, which sought to emphasise importance safety this context. Despite these developments, there is concern problematic management DA may persisted. This article presents findings on supported centres The suggest services continue facilitate cases, although service designed...

Internationally, little is known about the experiences of minority who have birthed both in hospital and at home. This group are a unique position to provide experiential evidence regarding perceptions care under each approach.Obstetric within setting hegemonic approach birth western cultures. Homebirth least as safe for those with low-risk pregnancies, yet access strictly regulated.To explore how experienced homebirth maternity Ireland perceived received, setting.141 participants home...

Abstract Background UK Hospital Trusts are charged with increasing patients’ research awareness and willingness to take part in research. This includes implementing strategies encourage patient‐initiated enquiries about participation. Objectives To evaluate the impact of a statement inserted outpatient letters one clinical service, derive suggestions on potential steps towards recruitment. Setting A medical clinic research‐active hospital trust, serving an inner‐city multi‐ethnic population...

The purpose of this paper is to make a novel contribution new-materialist approaches, toward advancing existing ontological debates. We present bricolage method that was developed from an interpretive Community Practice (CofP) known as the Pivot Project research consortium. This interpretative community used theorise implications in COVID-19 global pandemic. specific focus on digitalisation five qualitative multidisciplinary projects because impacts unexpected were able formulate bespoke...

BackgroundParticipation by children and young people is an increasingly important guiding principle in child protection policy practice. However, the focus, terms timing of such participation are still often determined adults.ObjectiveDrawing on qualitative data about children's experiences their own family's involvement process, we explore perspectives participation, concerns that arise for them, ideas how to enhance participation.Participants SettingTwenty living Ireland participated...

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In recent years, global attention to disability inclusion in humanitarian and development contexts, notably comprising within the Sustainable Development Goals, has significantly increased. As a result, UN agencies programmes are increasingly seeking understand increase extent which persons with disabilities accounted for included their efforts provide life-saving assistance. To explore effects effectiveness of such measurement, this paper applies complexity-informed, realist evaluation...