Inter-sectoral Transfer of the Food for Life Settings Framework in England.

Organisational settings such as schools, workplaces and hospitals are well recognised as key environments for health promotion. Whilst there is extensive literature on specific types of settings, little empirical research has investigated the transfer of frameworks between sectors. This study analyses Food for Life, an England-wide healthy and sustainable food programme that evolved in schools and is being adapted for children's centres, universities, care homes, and hospital settings. Following a case study design, we interviewed 85 stakeholders in nine settings. Food for Life's systemic framework of 'food education, skills and experience' 'food and catering quality', 'community and partnerships' and 'leadership' carried salience in all types of settings. These were perceived to act both as principles and operational priorities for driving systemic change. However, each setting type differed in terms of the mix of facilitating factors and appropriate indicators for change. Barriers in common included the level of culture-shift required, cost perceptions and organisational complexity. For settings based health promotion practice, this study points to the importance of 'frame-working' (the systematic activity of scoping and categorising the field of change) alongside the development and application of benchmarks to stimulate change. These processes are critical in the transfer of learning from between sectors in a form that balances commonality with sufficient flexibility to adapt to specific settings. Synergy between types of settings is an under-recognised, but critical, part of action to address complex issues such as those emerging from the intersection between food, health and sustainability.

Conceptualizing age-friendly communities.

On the political and policy front, interest has increased in making communities more "age-friendly", an ongoing trend since the World Health Organization launched its global Age-Friendly Cities project. We conceptualize age-friendly communities by building on the WHO framework and applying an ecological perspective. We thereby aim to make explicit key assumptions of the interplay between the person and the environment to advance research or policy decisions in this area. Ecological premises (e.g., there must be a fit between the older adult and environmental conditions) suggest the need for a holistic and interdisciplinary research approach. Such an approach is needed because age-friendly domains (the physical environment, housing, the social environment, opportunities for participation, informal and formal community supports and health services, transportation, communication, and information) cannot be treated in isolation from intrapersonal factors, such as age, gender, income, and functional status, and other levels of influence, including the policy environment.

Using a scoping exercise to guide the development of a care homes learning network.

This article describes a project involving various stakeholders designed to develop a learning network for care homes in Bristol and the scoping exercise that gave the project team direction.

Nurse leadership, interprofessionalism and the modernization agenda.

As part of the drive to deliver effective health and social care, the Government's modernization agenda focuses on strengthening nursing leadership and developing interprofessional collaboration. Senior nurses are well placed to promote the latter by supporting substantive change in NHS culture. Findings from a research study, conducted by the Faculty of Health and Social Care, University of the West of England, Bristol, as part of a research programme evaluating its interprofessional curriculum, have highlighted senior nurses' potential contribution to implementing and maintaining effective interprofessional collaboration. The authors argue that senior nurses are particularly well placed to help students across disciplines gain the experience needed to develop the requisite skills for delivering care within interprofessional services; and that the implementation of roles and initiatives which support senior nurses in developing appropriate leadership skills is a key component underpinning the modernization agenda.

'How can they tell?' A qualitative study of the views of younger people about their dementia and dementia care services.

There is growing interest in eliciting the views of younger people with dementia (i.e. those under 65 years of age) within health and social care research. The often erroneous view that these individuals are not capable of expressing their views and experiences has now been seriously challenged. The present paper draws on the findings from 14 qualitative in-depth interviews with younger people with dementia conducted in the South-west of England, and considers some of the issues involved in interviewing people with dementia. Purposive and snowballing techniques were used to recruit participants. Data were transcribed and subjected to comparative textual analysis to index, code and analyse the data for emergent themes. Four major themes emerged: (1) the general experience of having dementia; (2) dementia diagnosis; (3) the importance of age; and (4) risk and danger issues. The results indicate that the majority of participants were articulate and insightful about their experiences and needs. The present paper concludes by arguing that the challenge for health and social care professionals is to engage with and consult such individuals about their experiences and what they want from dementia care services, and the authors consider some of the issues involved in interviewing people with dementia.

Evidence-based practice in health and social care: where are we now?

This paper explores evidence-based practice (EBP) in health and social care in the UK from the individual perspectives of professionals in physiotherapy, midwifery, nursing and social care. The present interest in EBP emerges as a natural derivative of contemporary economic, social and political trends and concerns. There is optimism and broad acceptance of the overall philosophy of EBP and each profession demonstrates a concerted organisational attempt to bridge the research--practice divide. This includes the interpretation of research outcomes in the form of practice guidelines, protocols and standards. However, adherence to these is poor and resistance to EBP is growing. This is attributed to practical and philosophical tensions common to all of the professions. These include the continued dominance of randomised controlled trials (RCTs) in the hierarchy of evidence. RCTs often fail to capture the multi-faceted individualistic nature of health and social care interactions or the development of qualitative methodologies within the professions. Concern is expressed that professional autonomy and the art of practice will be eroded by the enforcement of guidelines and protocols. EBP is currently located within individual professions rather than the broader context of interprofessional practice. The future of EBP is dependent, at least in part, on educational initiatives, organisational commitment and support, patient/client involvement and the development of a broader interprofessional perspective.