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The purpose of this paper is to evaluate the claims made for the clinical microsystems approach of healthcare improvement within an English NHS context.

The research adopted a Realistic Evaluation approach to examine a series of pilot clinical microsystems sites to determine what worked for whom, when and within what circumstances. Interviews and group discussions were used to collect qualitative data, whist quantitative outcome data was also collected within each of the sites. Data was triangulated to produce case studies for each of the sites.

The research concurred with many of the claims for clinical microsystems, particularly that democratic, consensual approaches to change and improvement can be better received than externally derived initiatives with imposed targets. The clinical microsystem approach emphasises identifying and nurturing strengths – of both teams and individuals – and this reinforced these positive aspects. The case study sites demonstrated higher staff morale, empowerment, commitment and clarity of purpose. To a lesser extent the research also indicated an enhanced predisposition towards improvement and innovation and a seemingly embedded sense of improvement as an ongoing (if essentially episodic) process.

The evaluation was limited in terms of the numbers of case study sites that it was able to incorporate. This sample represented sites of different sizes, coverage of primary, secondary and tertiary care and those reporting more and less positive experiences of the clinical microsystems approach – but any findings may be limited in their generaliseability and further studies may be needed to test out the relevance of these findings in wider settings.

Future microsystem programmes will need to address components of patient involvement and process/outcome monitoring if the broader legitimacy of the approach is to be cemented and enhanced. In particular, the importance of strong data collection in achieving “high performing” status is emphasised.

There is currently no other empirical studies within the academic literature which investigate the value of the clinical microsystems approach to an English NHS context.

IN The verdict of you all, Rupert Croft‐Cooke has some uncomplimentary things to say about novel readers as a class, which is at least an unusual look at his public by a practitioner whose income for many years was provided by those he denigrates.

This paper aims to assess the current state, and various methods, of public and patient involvement, particularly but not exclusively in research on ageing and dementia.

Interviews were carried out with a researcher, who has had a leading role in research on dementia; a public contributor with extensive relevant experience; and a member of the research design service with responsibility for patient and public involvement.

All those involved in the research can benefit considerably from public and patient involvement and it can make a significant difference to the course of a project. The importance of choosing an appropriate method of involvement is discussed and planning for it in both financial terms and time allowed. Examples are given of successful studies.

Those who took part in the interviews were chosen for their record in furthering public and patient involvement in research. There is no attempt to compare their views with those of the wider research community.

The various ways in which patients and the public are involved in relevant research is a guide to those designing projects and those who may want to explore opportunities for involvement.

Social implications include being able to influence research projects, contributors of all ages find they are valued.

The format of the paper is original, eliciting material from three viewpoints on research and involvement.

Old age, in its most intense and extreme aspects involving frailty, dementia, Alzheimer's and death, is more often ignored rather than discussed in contemporary anthropology, remaining largely inaudible and invisible. This paper explores the marginal position of the study of old age in contemporary anthropology against the backdrop of the prominence of the post‐colonial agenda. The purpose of this paper is to discuss the comparison between the neglected Third Age and the abundantly discussed Third World in the context of the anthropological discourse on others.

This is a theoretical paper on ageing.

This paper explores the marginal position of the study of old age in contemporary anthropology against the backdrop of the prominence of the post‐colonial agenda. The comparison between the neglected Third Age and the abundantly discussed Third World is discussed in the context of the anthropological discourse on others. Studying the old‐as‐other reveals two types of alterity: that which is culturally constructed as different vs that which is essentially different. The others that dominate the agenda of contemporary anthropology are culturally constructed, while the old‐as‐other is an ontological essence. The condition of being old, it is argued, is essentially beyond culture, constituting an extra‐cultural materiality. As such, the old‐as‐other does not answer to the anthropological dictum of representing the “natives' point of view” and cannot fit the contemporary hermeneutics of anthropological relativism. Contemporary anthropology, which resists essential objects such as the savage and the old, thus ignores the raw materiality of old age while producing ethnographically‐informed commentaries on eldercare.

The paper is original in highlighting the juxtaposition between the savage and old age that is used to facilitate an understanding of the contemporary discipline of anthropology as a regime of social constructionism, which fails to confront and represent the bare materiality of old age.

I consider the following question: given my commitment to creating an inclusive classroom environment where students of all backgrounds and skill levels can feel comfortable taking emotional and intellectual risks, how do I responsibly teach a course on American Life Writing in which students both read and write narratives of trauma, many of which stem from gender-based violence? With the rise of the #MeToo movement, especially, many survivors of this kind of violence feel compelled to share their stories as a way to heal themselves and to create communities of care and support. In some cases, this kind of disclosure can be restorative. But it is also important to recognize that sharing one's narrative of trauma does not always serve as a path to healing and wholeness. There is also power in choosing to tell part of one's story, sharing one's story only with a certain audience, or not disclosing one's story at all. The works that I assign in the seminar highlight these different paths to healing and model for students the ways in which a confessional model is not the only model for dealing with trauma. In this chapter, I first describe how feminist pedagogy shapes my teaching. Then I outline my approach to teaching life writing, focusing on how I teach texts that highlight trauma and how I teach the personal narrative assignment. Finally, I reflect on how these pedagogical practices might inform our larger conversations about gendered oppression, trauma, and healing.

New South Wales (NSW) was the first state in Australia to introduce a legislative requirement to undertake affirmative action for members of particular target groups in order to achieve equality of opportunity in employment. This requirement was introduced in 1980 as an amendment to the NSW Anti‐ Discrimination Act 1977. Referred to as Part IXa, the amendment required all public service departments and statutory authorities to produce an Equal Employment Opportunity (EEO) Management Plan, setting out strategies by which EEO could be achieved for target group members, and to report annually to the Director of Equal Opportunity in Public Employment (DEOPE) on progress made towards this goal.

The purpose of this paper is to explore the research which has examined the link between autism spectrum disorders (ASDs) and offending behaviour and the impact of prison on individuals with ASDs. Studies suggest that inmates with ASDs may be at an increased risk of bullying, confrontations, exploitation, anxiety and social isolation as a result of their ASD traits such as obsessions, social naivety and impaired empathy.

An extensive review of the literature.

The review identifies a modest amount of studies (n=4) which have explored the experience of individuals with ASD in prison and highlights that inmates with ASDs face a multitude of problems when they enter prison. Despite an extensive literature search only one study was identified which investigated the knowledge and understanding of ASDs amongst prison staff.

Further research is urgently needed to consider the specific problems faced by inmates with ASD, to identify how to make the prison environment safer and more supportive for inmates with ASD and how to reduce the likelihood of re-offending.

This review highlights that, to date, there has been relatively little to guide service design in order to develop support services for individuals with ASD in prison. There has been a scarcity of studies investigating the effectiveness of various treatment models to target offending behaviour in individuals with ASD.

This paper fulfils an identified need to study and identify the specific problems faced by inmates with ASD and to identify changes which are required to provide an environment in prison which is safer and more supportive.