Patient and public involvement in healthcare quality improvement: how organizations can help patients and professionals to collaborate

Citizens across the world are increasingly called upon to participate in healthcare improvement. It is often unclear how this can be made to work in practice. This 4- year ethnography of a UK healthcare improvement initiative showed that patients used elements of organizational culture as resources to help them collaborate with healthcare professionals. The four elements were: (1) organizational emphasis on nonhierarchical, multidisciplinary collaboration; (2) organizational staff ability to model desired behaviours of recognition and respect; (3) commitment to rapid action, including quick translation of research into practice; and (4) the constant data collection and reflection process facilitated by improvement methods.

Social innovation and social entrepreneurship a systematic review

Corporate social responsibility (CSR) literature suggests CSR initiatives extend beyond meeting the immediate interests of stakeholders of for-profit enterprises, offering the potential to also enhance performance. Growing disillusionment of for-profit business models has drawn attention to social entrepreneurship and social innovation to ease social issues. Adopting a systematic review of relevant research, the article provides collective insights into research linking social innovation with social entrepreneurship, demonstrating growing interest in the area over the last decade. The past 5 years have seen a surge in attention with particular focus on the role of the entrepreneur, networks, systems, institutions, and cross-sectoral partnerships. Based on the findings of the review, the authors synthesize formerly dispersed fields of research into an analytical framework, signposting a “systems of innovation” approach for future studies of social innovation and social entrepreneurship.

Formulaic sequences in native and non-native argumentative writing in German

Whereas there is substantial scholarship on formulaic language in L1 and L2 English, there is less research on formulaicity in other languages. The aim of this paper is to contribute to learner corpus research into formulaic language in native and non-native German. To this effect, a corpus of argumentative essays written by advanced British students of German (WHiG) was compared with a corpus of argumentative essays written by German native speakers (Falko-L1). A corpus-driven analysis reveals a larger number of 3-grams in WHiG than in Falko-L1, which suggests that British advanced learners of German are more likely to use formulaic language in argumentative writing than their native-speaker counterparts. Secondly, by classifying the formulaic sequences according to their functions, this study finds that native speakers of German prefer discourse-structuring devices to stance expressions, whilst British advanced learners display the opposite preferences. Thirdly, the results show that learners of German make greater use of macro-discourse-structuring devices and cautious language, whereas native speakers favour micro-discourse structuring devices and tend to use more direct language. This study increases our understanding of formulaic language typical of British advanced learners of German and reveals how diverging cultural paradigms can shape written native speaker and learner output.

Dominant role of greenhouse-gas forcing in the recovery of Sahel rainfall

Sahelian summer rainfall, controlled by the West African monsoon, exhibited large-amplitude multidecadal variability during the twentieth century. Particularly important was the severe drought of the 1970s and 1980s, which had widespread impacts1–6. Research into the causes of this drought has identified anthropogenic aerosol forcing3,4,7 and changes in sea surface temperatures (SSTs; refs 1,2,6,8–11) as the most important drivers. Since the 1980s, there has been some recovery of Sahel rainfall amounts2–6,11–14, although not to the pre-drought levels of the 1940s and 1950s. Here we report on experiments with the atmospheric component of a state-of-the-art global climate model to identify the causes of this recovery. Our results suggest that the direct influence of higher levels of greenhouse gases in the atmosphere was the main cause, with an additional role for changes in anthropogenic aerosol precursor emissions. We find that recent changes in SSTs, although substantial, did not have a significant impact on the recovery. The simulated response to anthropogenic greenhouse-gas and aerosol forcing is consistent with a multivariate fingerprint of the observed recovery, raising confidence in our findings. Although robust predictions are not yet possible, our results suggest that the recent recovery in Sahel rainfall amounts is most likely to be sustained or amplified in the near term.

Synapses in digital medium: computational investigations of neural basis of anticipation

Anticipation is an emerging concept that can provide a bridge between the deepest philosophical theories about the nature of life and cognition on one hand and the empirical biological sciences steeped in reductionist and Newtonian conception of causality. Three conceptions of anticipation have been emerging from the literature that may be operationalised in a way leading to a viable empirical programme. The discussion of the research into a novel dynamical concept of anticipating synchronisation lends credence to such a possibility and suggests further links between the three anticipation paradigms. A careful progress mindful to the deep philosophical concerns but also respecting empirical evidence will ultimately lead towards unifying theoretical and empirical biological sciences and may offer progress where reductionist science have been so far faltering.

Climate variability and human impact in South America during the last 2000 years: synthesis and perspectives from pollen records

An improved understanding of present-day climate variability and change relies on high-quality data sets from the past 2 millennia. Global efforts to model regional climate modes are in the process of being validated against, and integrated with, records of past vegetation change. For South America, however, the full potential of vegetation records for evaluating and improving climate models has hitherto not been sufficiently acknowledged due to an absence of information on the spatial and temporal coverage of study sites. This paper therefore serves as a guide to high-quality pollen records that capture environmental variability during the last 2 millennia. We identify 60 vegetation (pollen) records from across South America which satisfy geochronological requirements set out for climate modelling, and we discuss their sensitivity to the spatial signature of climate modes throughout the continent. Diverse patterns of vegetation response to climate change are observed, with more similar patterns of change in the lowlands and varying intensity and direction of responses in the highlands. Pollen records display local-scale responses to climate modes; thus, it is necessary to understand how vegetation–climate interactions might diverge under variable settings. We provide a qualitative translation from pollen metrics to climate variables. Additionally, pollen is an excellent indicator of human impact through time. We discuss evidence for human land use in pollen records and provide an overview considered useful for archaeological hypothesis testing and important in distinguishing natural from anthropogenically driven vegetation change. We stress the need for the palynological community to be more familiar with climate variability patterns to correctly attribute the potential causes of observed vegetation dynamics. This manuscript forms part of the wider LOng-Term multi-proxy climate REconstructions and Dynamics in South America – 2k initiative that provides the ideal framework for the integration of the various palaeoclimatic subdisciplines and palaeo-science, thereby jump-starting and fostering multidisciplinary research into environmental change on centennial and millennial timescales.

Should healthy eating programmes incorporate interaction with foods in different sensory modalities? A review of the evidence

Commercial interventions seeking to promote fruit and vegetable consumption by encouraging preschool- and school-aged children to engage with foods with ‘all their senses’ are increasing in number. We review the efficacy of such sensory interaction programmes and consider the components of these that are likely to encourage food acceptance. Repeated exposure to a food's flavour has robust empirical support in terms of its potential to increase food intake. However, children are naturally reluctant to taste new or disliked foods, and parents often struggle to provide sufficient taste opportunities for these foods to be adopted into the child's diet. We therefore explore whether prior exposure to a new food's non-taste sensory properties, such as its smell, sound, appearance or texture, might facilitate the food's introduction into the child's diet, by providing the child with an opportunity to become partially familiar with the food without invoking the distress associated with tasting it. We review the literature pertaining to the benefits associated with exposure to foods through each of the five sensory modalities in turn. We conclude by calling for further research into the potential for familiarisation with the visual, olfactory, somaesthetic and auditory properties of foods to enhance children's willingness to consume a variety of fruits and vegetables.

Departmental differences in attitudes to special educational needs in the secondary school

As trends in favour of inclusion continue, questions arise concerning the extent to which teachers in mainstream schools feel prepared for the task of meeting pupils' special educational needs. Little previous research has considered how the subject taught impacts upon the attitudes of mainstream teachers towards pupils with special educational needs. In this article, Jean Ellins, research fellow at the University of Birmingham, and Jill Porter, senior lecturer at the University of Bath, report on their research into the attitudes of teachers in one mainstream secondary school. Building a detailed case study using documents, records of pupil progress, an interview and a questionnaire using a Likert-type attitude scale and open-ended questions, these researchers set out to explore distinctions between the attitudes of teachers working in different departments. Their findings suggest that the teachers of the core subjects, English, mathematics and science, had less positive attitudes than their colleagues. Further, pupils with special educational needs made least progress in science where teacher attitudes were the least positive. Jean Ellins and Jill Porter review the implications of these findings and make recommendations for future practice and further enquiry.

Application of biochar for soil remediation

Research into the use of biochar for the remediation of contaminated soils has expanded rapidly over the past 5 yr. We review recent developments in the field and present the findings emanating from small-scale batch sorption experiments, through soil incubations and bioassays, to large-scale field experiments. We discuss the evidence that these experiments have contributed toward a mechanistic understanding of how biochar is capable of remediating soils contaminated with both organic and inorganic contaminants. The effects of biochar pyrolysis temperature, biochar source material, soil type, and contaminant type on the performance of biochars for remediation are identified. The risks associated with applying biochar to uncontaminated agricultural soils are discussed. Knowledge gaps and questions are identified which, if addressed, will considerably advance the application of biochar as a soil remediation tool in the future.

An open book: what and how young children learn from picture and story books

Looking at and listening to picture and story books is a ubiquitous activity, frequently enjoyed by many young children and their parents. Well before children can read for themselves they are able to learn from books. Looking at and listening to books increases children’s general knowledge, understanding about the world and promotes language acquisition. This collection of papers demonstrates the breadth of information pre-reading children learn from books and increases our understanding of the social and cognitive mechanisms that support this learning. Our hope is that this Research Topic/eBook will be useful for researchers as well as educational practitioners and parents who are interested in optimizing children’s learning. We conceptually divide this research topic into four broad sections, which focus on the nature and attributes of picture and story books, what children learn from picture and story books, the interactions children experience during shared reading, and potential applications of research into shared reading, respectively.

What are the limitations on the wider therapeutic use of phage?

Bacterial resistance to antibiotics poses a serious health threat. Since research into new antibiotics is not progressing at the same rate as the development of bacterial resistance, widespread calls for alternatives to antibiotics have been made. Phage therapy is an ideal alternative candidate to be investigated. However the success of phage therapy may be hampered by a lack of investment support from large pharmaceutical companies, due to their narrow spectrum of activity in antibiotics, very large costs associated with clinical trials of the variety of phages needed, and regulatory requirements remaining unclear. Intellectual property is difficult to secure for therapeutic phage products for a variety of reasons, and patenting procedures vary widely between the US and the EU. Consequently, companies are more likely to invest in phage products for decontamination or veterinary use, rather than clinical use in humans. Some still raise questions as to the safety of phage therapy overall, suggesting the possibility of cytotoxicity and immunogenicity, depending on the phage preparation and route. On the other hand, with patients dying because of infections untreatable with conventional antibiotics, the question arises as to whether it is ethical not to pursue phage therapy more diligently. A paradigm shift about how phage therapy is perceived is required, as well as more rigorous proof of efficacy in the form of clinical trials of existing medicinal phage products. Phage therapy potential may be fulfilled in the meantime by allowing individual preparations to be used on a named-patient basis, with extensive monitoring and multidisciplinary team input. The National Health Service and academia have a role in carrying out clinical phage research, which would be beneficial to public health, but not necessarily financially rewarding.

Anticipatory governance for social-ecological resilience

Anticipation is increasingly central to urgent contemporary debates, from climate change to the global economic crisis. Anticipatory practices are coming to the forefront of political, organizational, and citizens’ society. Research into anticipation, however, has not kept pace with public demand for insights into anticipatory practices, their risks and uses. Where research exists, it is deeply fragmented. This paper seeks to identify how anticipation is defined and understood in the literature and to explore the role of anticipatory practice to address individual, social, and global challenges. We use a resilience lens to examine these questions. We illustrate how varying forms of anticipatory governance are enhanced by multi-scale regional networks and technologies and by the agency of individuals, drawing from an empirical case study on regional water governance of Mälaren, Sweden. Finally, we discuss how an anticipatory approach can inform adaptive institutions, decision making, strategy formation, and societal resilience.

Elderly learners and Massive Open Online Courses: a review

Background: Massive open online courses (MOOCs) have become commonplace in the e-learning landscape. Thousands of elderly learners are participating in courses offered by various institutions on a multitude of platforms in many different languages. However, there is very little research into understanding elderly learners in MOOCs. Objective: We aim to show that a considerable proportion of elderly learners are participating in MOOCs and that there is a lack of research in this area. We hope this assertion of the wide gap in research on elderly learners in MOOCs will pave the way for more research in this area. Methods: Pre-course survey data for 10 University of Reading courses on the FutureLearn platform were analyzed to show the level of participation of elderly learners in MOOCs. Two MOOC aggregator sites (Class Central and MOOC List) were consulted to gather data on MOOC offerings that include topics relating to aging. In parallel, a selected set of MOOC platform catalogues, along with a recently published review on health and medicine-related MOOCs, were searched to find courses relating to aging. A systematic literature search was then employed to identify research articles on elderly learners in MOOCs. Results: The 10 courses reviewed had a considerable proportion of elderly learners participating in them. For the over-66 age group, this varied from 0.5% (on the course “Managing people”) to 16.3% (on the course “Our changing climate”), while for the over-56 age group it ranged from 3.0% (on “A beginners guide to writing in English”) to 39.5% (on “Heart health”). Only six MOOCs were found to include topics related to aging: three were on the Coursera platform, two on the FutureLearn platform, and one on the Open2Study platform. Just three scholarly articles relating to MOOCs and elderly learners were retrieved from the literature search. Conclusions: This review presents evidence to suggest that elderly learners are already participating in MOOCs. Despite this, there has been very little research into their engagement with MOOCs. Similarly, there has been little research into exploiting the scope of MOOCs for delivering topics that would be of interest to elderly learners. We believe there is potential to use MOOCs as a way of tackling the issue of loneliness among older adults by engaging them as either resource personnel or learners.

Progress report from the strategic sanctuary for the destruction of free will

Progress Report from the Strategic Sanctuary for the Destruction of Free Will presents a new work combining film, music and installation that juxtaposes the setting of the institution with the aesthetics of psychedelia.Progress Report from the Strategic Sanctuary for the Destruction of Free Will is an installation, film and sound work that takes over the gallery. Using plain white card, it distorts the structure of the gallery’s architecture, producing a paranoid shrunken space. Inside this space, performers in cardboard costumes re-enact abstracted, broken gestures drawn from video documentation of acid trips, psychedelic dancing, rehab sessions and radical psychotherapy workshops. Progress Report from the Strategic Sanctuary for the Destruction of Free Will has been formed through Pil and Galia Kollectiv’s research into the anti-psychiatry movement, their interests in counter cultural movements and their studies around biopolitics and the proliferation of societal medication. In 1958, having had a life changing experience with LSD, former alcoholic Charles Dederich founded Synanon, a drug rehabilitation program based on residential care and an aggressive form of group therapy called ‘The Game’. The organisation gradually evolved into a controversial alternative community, described in a critical pamphlet as creating Strategic Sanctuaries for the Destruction of Free Will, “a subversive program for mixing delinquents and lefties”. In 1984, anti-psychiatrist R. D. Laing described tranquillizers as chemical straight jackets. With our growing understanding of the plasticity of the brain and the potential to shape it, the tension between liberation and control in the struggle over the mind continues to define our relationship to labour, culture and production. Interrogating these ideas, the exhibition poses the question of whether a collective body can overcome the solipsism of the incommunicable experience of the individual mind.

The impact of location and type on the performance of Low-Voltage network connected Battery Energy Storage Systems

This paper assesses the impact of the location and configuration of Battery Energy Storage Systems (BESS) on Low-Voltage (LV) feeders. BESS are now being deployed on LV networks by Distribution Network Operators (DNOs) as an alternative to conventional reinforcement (e.g. upgrading cables and transformers) in response to increased electricity demand from new technologies such as electric vehicles. By storing energy during periods of low demand and then releasing that energy at times of high demand, the peak demand of a given LV substation on the grid can be reduced therefore mitigating or at least delaying the need for replacement and upgrade. However, existing research into this application of BESS tends to evaluate the aggregated impact of such systems at the substation level and does not systematically consider the impact of the location and configuration of BESS on the voltage profiles, losses and utilisation within a given feeder. In this paper, four configurations of BESS are considered: single-phase, unlinked three-phase, linked three-phase without storage for phase-balancing only, and linked three-phase with storage. These four configurations are then assessed based on models of two real LV networks. In each case, the impact of the BESS is systematically evaluated at every node in the LV network using Matlab linked with OpenDSS. The location and configuration of a BESS is shown to be critical when seeking the best overall network impact or when considering specific impacts on voltage, losses, or utilisation separately. Furthermore, the paper also demonstrates that phase-balancing without energy storage can provide much of the gains on unbalanced networks compared to systems with energy storage.