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Stepgrandparent-stepgrandchild relationships are increasingly common as a result of relatively high rates of divorce and remarriage and increased longevity. When relationships are close, stepgrandparents may be valuable resources for stepgrandchildren, but the relational processes salient to the development of these ties remain largely unknown. The purposes of our research were: (1) to explore the complexity of stepgrandparent-stepgrandchild relationships, and (2) to examine processes that affected stepgrandparent-stepgrandchild relationship development.

We present results from four grounded theory projects, which were based on semistructured interviews with 58 stepgrandchildren who provided data about 165 relationships with stepgrandparents. Collectively, these studies highlighted key processes of stepgrandparent-stepgrandchild relationship development operating within four distinct pathways to stepgrandparenthood – long-term, later life, skip-generation, and inherited pathways.

Stepgrandchildren’s closeness to stepgrandparents was influenced by factors such as timing (the child’s age and when in their life courses intergenerational relationships began), stepgrandparents’ roles in the life of the middle-generation parent and the quality of those relationships, whether or not the stepfamily defined the stepgrandparent as kin (e.g., through the use of claiming language), intergenerational contact frequency, and stepgrandparents’ affinity-building.

Our study furthers understanding of stepgrandparent-stepgrandchild by attending to the importance of context in examining the processes that affect intergenerational steprelationship development. Exploring processes related to intergenerational steprelationships strengthens our understanding of the benefits and challenges associated with steprelationship development. Our study also sheds light on the “new look at kinship” and the processes that inform the social construction of family in a changing familial landscape.

The purpose of this paper is to explore and discuss possible future pathways of the Finnish science, technology and innovation (STI) system. The paper sketches three speculative pathways for the Finnish STI system.

Theoretical considerations behind the pathways are based on analyses of the determinants and behaviour of small open economies, their innovation systems and governance. The empirical background of the paper is in the current trends of the Finnish economy and STI system. The analysis of pathways is based on three dimensions: institutionalized policy environment and economy, domestic interest groups and policy and STI institutions and funding. Changes in these dimensions are analysed by paying special attention to two variables: the position of the nation state and the general economic development.

The first future pathway outlined is based on an optimistic view by setting Finland on the basis of past success factors as an European and global STI hotspot. The second pathway is based on the assumption that the Finnish STI system will be increasingly subordinated to international structures and decision-making. The third one is geared around the assumption that the Finnish STI system will be dominated by industries.

While Finland has been seen as a European showpiece of innovation since the early 2000s, currently the country’s national economy and STI system are undergoing a critical period. The paper sheds light on this transformation and its potential future outcomes and attempts to raise debate on the options policy makers may face in the increasingly complex global environment in small countries.

The paper introduces potential future avenues for the Finnish STI system and provides a contribution to the debate of the future of small countries’ STI systems and innovation policies by emphasising the limited space of the STI policy choices and how the development paths and space for policy making evolve from the interaction of socio-economic factors between domestic and wider international context.

The purpose of this paper is to describe the development of an eating disorder care pathway for adults with eating disorders, in a northern borough town. It arose out of a need to reduce and address inconsistent access to services and treatment pathways.

The development involved a mapping exercise of current service delivery, a review of the literature on eating disorder care pathways, consultation workshops, the engagement of service users and carers, and the development of draft pathways for patients and carers.

Significant emphasis was on raising awareness, prevention, identification and assessment, treatment and recovery. Two pathways were proposed, one for service users focusing on awareness raising/prevention, identification and assessment, treatment, stabilisation and relapse prevention and one for carers/families focusing on carers being identifiable in their own right to receive support for caring for someone with an eating disorder.

A limitation of the care pathway under development was the difficulty obtaining an accurate figure of the true number of cases of eating disorders in the local area. This, together with the lack of any form of systematic review or meta-analysis of care pathways made identifying the number of people suffering from eating disorders and developing an effective model difficult.

The proposed pathway places significant emphasis on increasing knowledge, incorporating the patient perspective, and enhancing the recognition and understanding of eating disorders in the community. A model was created that could be implemented successfully and identify patients suffering from eating disorders, when the true incidence of eating disorders remains hidden.

This study seeks to extend knowledge of care pathways through describing the conception and development of them within a children’s hospital. The care pathway was conceived by the nurse manager as a tool to improve care to children with minor injuries, and to their families. More specifically, it was developed as a tool to multi‐skill experienced nurses in a children’s emergency department to assess and treat children with minor injuries. It is argued that the conception of care pathways aligned with the purposes of the manager, and integrated rather than reflected national NHS policies. Prospective managers are not confined to developing care pathways as prescribed; the care pathway tool may be used for varying management initiatives.

This paper describes the development and implementation of care pathways in two orthopaedic units in Scotland. Although originally developed as a tool of project management, care pathways have been promoted internationally as a response to concerns for patient safety, variability in care and increasing costs. Generally, care pathways can be seen as an example of clinician led rather than management led reform. However, it does reflect a wider shift towards process and away from hierarchical approaches to management. Within the UK care pathways have been promoted as a response to the modernisation initiative of the Labour Government. While the initiative was a success in both units it was more difficult to implement care pathways in a trauma rather than an elective unit. In conclusion, it is questionable whether care pathways are a universal response to the requirement for modernisation and service redesign in the NHS.

The purpose of this paper is to examine the suitability of current care pathway modelling techniques for supporting business improvement and the development of information systems. This is in the light of current UK government policies advocating the use of care pathways as part of the £12.4 billion programme for Information Technology and as a key strategy to reducing waiting times.

A qualitative analysis of the variety in purpose, syntax and semantics in a selection of existing care pathways is conducted.

Care pathways are typically modelled in an ad hoc manner with little reference to formal syntax or semantics.

The research reviews a small selection of existing pathways. The feature set used for evaluation could be further refined. Future research should examine the suitability of applying existing process modelling techniques to care pathways and explore the motivations for modelling care pathways in an ad hoc manner.

The development of care pathways can aid process improvement and the integration of information systems. However, while syntax and semantics are not standardised the impact of care pathways in the work of Department of Health agencies, in particular Connecting for Health, is likely to be limited.

The results provide insight into the limitations of the state of the art in care pathway models. This highlights a significant omission in the Department of Health's approach and identifies an important direction for further development that will aid Connecting for Health, healthcare organisations and healthcare professionals to deliver more effective services.

HealthPathways is an online decision support portal, primarily aimed at General Practitioners (GPs), that provides easy to access and up to date clinical, referral and resource pathways. It is free to access, with the intent of providing the right care, at the right place, at the right time. This case study focuses on the experience and learnings of a HealthPathways program in metropolitan Sydney during the COVID-19 pandemic. It reviews the team's program management responses and looks at key factors that have facilitated the spread and scale of HealthPathways.

Available data and experiences of two HealthPathways program managers were used to recount events and aspects influencing spread and scale.

The key factors for successful spread and scale are a coordinated response, the maturity of the HealthPathways program, having a single source of truth, high level governance, leadership, collaboration, flexible funding and ability to make local changes where required.

There are limited published articles on HealthPathways. The focus of spread and scale of HealthPathways during COVID-19 is unique.

Care pathways are becoming increasingly popular within UK healthcare organisations yet very little is known about the tool. Using the results from a survey of healthcare organisations, which are members of the National Pathways Association (NPA), the author suggests that different models of care pathways are being implemented. Four models or different types of care pathways are identified, with different features in each model. The models can be used prospectively by organisations to decide which particular features they may want to include. Alternatively, the models can be used as an assessment tool to identify the type of pathway being developed. This assessment can form the basis for any future evaluations of the effectiveness of the pathways which are developed.

Dynamic changes in the world bring challenges for making long-term future-oriented policy and strategy. A number of recent developments like drops in oil prices, increasing global conflicts, mass immigration and economic stagnation have had disruptive effects on long-term policies and strategies. The purpose of this paper is to provide a dynamic and adaptive Foresight approach as required by the fast-changing global landscape.

The scenario approach presented in the paper aims to develop multiple time horizons by bringing together short-term forecasts and long-term exploratory and visionary scenarios. Each time horizon allows for re-considering and dynamically changing drivers and assumptions of scenarios and thus builds not a single linear, but multiple and dynamic pathways into the future. Following the presentation on the background and description of the methodology, the paper illustrates the proposed approach with a case study on science and technology (S&T) development in Russia.

The flexible scenario approach allows developing and strategies with similar adaptability and flexibility.

The scenario approach presented in the paper may be applicable for Foresight exercises at all levels of governance, including national, international, regional and corporate.

A novel scenario approach is presented for the formulation of S&T policy with an illustrative case study.

Presents Cheviot and Wansbeck NHS Trust’s strategy for quality improvement with a patient‐focused approach. Describes the development and implementation of multidisciplinary pathways of care. Discusses the benefits of using the pathways. Proposes that multidisciplinary pathways of care are the ideal method of reviewing and co‐ordinating the care process.