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Many universities run Writing Centers to provide support for students wishing to improve their academic literacy. These centers are ideal venues for peer tutoring, which may benefit both student-tutors (through tutoring skills development), and those tutored (through opportunities to discuss writing with a supportive peer). In the context of a university in the GCC region, peer tutors, prior to working, must complete required Communication courses. The syllabuses reflect student-centered and collaborative post-process writing approaches, where scaffolding is emphasized over direction, and word-by-word instructor correction of student writing is de-emphasized. Peer tutors also undergo preparation aimed at equipping them with an understanding of the rationale for these approaches and the skills needed to adapt them to tutoring. Given these experiences, the researchers set out to determine whether tutors are able to articulate such understandings and apply them to tutoring. Interconnected interpretative methods were deployed, including tutoring observation, consultation-conversation analysis and semi-structured interviews with tutors. Results indicate that tutors have significant recent experience of non-directive writing classes and may be aware of the rationale and benefits of such approaches. However, in their tutoring, content appears to be transferred from their most recent experiences but their style relies on instruction predominated by telling, explaining, demonstrating and directing, reflecting formative experience at school. The relationship between tutors’ experience, preparation, articulation and practice is explored, and recommendations are made to enhance Writing Center practices, in line with the concept of a constructively-aligned instruction system where all components address the same agenda and support each other.

A range of strategies to improve pharmaceutical care has been implemented by population health management (PHM) initiatives. However, which strategies generate the desired outcomes is largely unknown. The purpose of this paper is to identify guiding principles underlying collaborative strategies to improve pharmaceutical care and the contextual factors and mechanisms through which these principles operate.

The evaluation was informed by a realist methodology examining the links between PHM strategies, their outcomes and the contexts and mechanisms by which these strategies operate. Guiding principles were identified by grouping context-specific strategies with specific outcomes.

In total, ten guiding principles were identified: create agreement and commitment based on a long-term vision; foster cooperation and representation at the board level; use layered governance structures; create awareness at all levels; enable interpersonal links at all levels; create learning environments; organize shared responsibility; adjust financial strategies to market contexts; organize mutual gains; and align regional agreements with national policies and regulations. Contextual factors such as shared savings influenced the effectiveness of the guiding principles. Mechanisms by which these guiding principles operate were, for instance, fostering trust and creating a shared sense of the problem.

The guiding principles highlight how collaboration can be stimulated to improve pharmaceutical care while taking into account local constraints and possibilities. The interdependency of these principles necessitates effectuating them together in order to realize the best possible improvements and outcomes.

This is the first study using a realist approach to understand the guiding principles underlying collaboration to improve pharmaceutical care.

The purpose of this paper is to gain insight into how population health management (PHM) strategies can successfully integrate and reorganize public health, health care, social care and community services to improve population health and quality of care while reducing costs growth, this study compared four large-scale transformation programs: Greater Manchester Devolution, Vancouver Healthy City Strategy, Gen-H Cincinnati and Gesundes Kinzigtal.

Following the realist methodology, this explorative comparative case-study investigated PHM initiatives' key features and participants' experiences of developing such initiatives. A semi-structured interview guideline based on a theoretical framework for PHM guided the interviews with stakeholders (20) from different sectors.

Five initial program theories important to the development of PHM were formulated: (1) create trust in a shared vision and understanding of the PHM rationale to establish stakeholders' commitment to the partnership; (2) create shared ownership for achieving the initiative's goals; (3) create shared financial interest that reduces perceived financial risks to provide financial sustainability; (4) create a learning environment to secure initiative's credibility and (5) create citizens' and professionals' awareness of the required attitudes and behaviours.

The study highlights initial program theories for the implementation of PHM including different strategies and structures underpinning the initiatives. These insights provide a deeper understanding of how large-scale transformation could be developed.