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A narrative has developed in recent years to link ageing without children to support needs in later life. Social care has long been viewed as a private, familial responsibility, whilst health care is a societal, public good. Childlessness is framed negatively in terms of increased demands on care services and wider family networks. As governments tackle the issue of how to fund and deliver an equitable and sustainable long-term care sector, this paper aims to argue that it is more critical than ever to evaluate views of childlessness in the context of ageing.

Policy-oriented commentary paper.

If the focus on childlessness and ageing is through a lens of a potential care deficit, this continues to frame ageing without children as a risk and does little to challenge increasing reliance on unpaid care. Research and policy need to explore how to make access to social care more equitable and reduce expectations of unpaid care. They also need to increasingly emphasise exploration of aspects of later life beyond the issue of care, for example, by more of a focus on communities, what matters to people to age well and lives that extend beyond traditional views of nuclear families.

This paper uses the UK as a contextual example to argue that the research and policy communities have a role to play in evaluating their constructions of childlessness and ageing and questioning whether they do little more than legitimise government’s unwillingness to take responsibility for social care.

The purpose of this paper is to examine the relation between estate transformations produced during the governments of the Citizen Revolution (CR) in Ecuador (2007-2017) and welfare regime transformations.

The CR’s project registers an array of specificities that make it a relevant case study to understand it. Among them, it articulated the transformation of the development model with a comprehensive state reform: emphasized both the modernization of the state and the productive structure, and the creation of the basic pillars of a welfare state. The ambitious project materialized in an ambivalent manner, revealing accomplishments and limitations.

The recovery of resources for the state, the efficient organization of resources, decentralization and deconcentration processes, public administration transformations and policy de-corporatization processes accompanied and even propelled important achievements in the social sphere in terms of decommodification, stratification, commodification and defamiliarization. Ecuador’s starting point, as a small and impoverished country with pubic and communal goods and services dismantled through neoliberal reforms, was quite precarious. But, progress was made. Beyond the identified limitations, its accomplishments must be highlighted because they are novel in comparison to other progressive government experiences, especially in the context of Central Andean countries.

This article vindicates the need to link state transformation processes to welfare regime transformations, as well as the academic literature that informs both fields. The description of what took place in Ecuador in the field of social welfare during the ten years of the CR continues to confirm the theoretical potential of the concept of welfare regime with the necessary translations and appropriations that allow for the analysis of countries in the region. It enables an approach to a more theoretically and methodologically elusive object that is at the same time tremendously potent in analytical terms and in its contributions to social transformations. An object that alludes to areas gravely affected during neoliberal hegemony, linked to public institutionality, state capacity and state autonomy. This is why everything that affects the state and the management of public goods and services must be incorporated into the analysis.

The purpose of this study is to present a quality improvement approach titled “Picture-Understanding-Action” used in Ireland to enhance the role of healthcare boards in the oversight of healthcare quality and its improvement.

The novel and practical “Picture-Understanding-Action” approach was implemented using the Model for Improvement to iteratively introduce changes across three quality improvement projects. This approach outlines the concepts and activities used at each step to support planning and implementation of processes that allow a board to effectively achieve its role in overseeing and improving quality. This approach matured over three quality improvement projects.

The “Picture” included quantitative and qualitative aspects. The quantitative “Picture” consisted of a quality dashboard/profile of board selected outcome indicators representative of the health system using statistical process control (SPC) charts to focus discussion on real signals of change. The qualitative picture was based on the experience of people who use and work in health services which “people-ised” the numbers. Probing this “Picture” with collective grounding, curiosity and expert training/facilitation developed a shared “Understanding”. This led to “Action(s)” from board members to improve the “Picture” and “Understanding” (feedback action), to ask better questions and make better decisions and recommendations to the executive (feed-forward action). The Model for Improvement, Plan-Do-Study-Act cycles and a co-design approach in design and implementation were key to success.

To the authors’ knowledge, this is the first time a board has undertaken a quality improvement (QI) project to enhance its own processes. It addresses a gap in research by outlining actions that boards can take to improve their oversight of quality of care.

The purpose of this paper is to evaluate the impact of leadership development programmes, underpinned by Transformational Learning Theory (TLT).

A corpus-informed analysis was conducted using survey data from 690 participants. Data were collected from participants’ responses to the question “please tell us about the impact of your overall experience”, which culminated in a combined corpus of 75,053 words.

Findings identified patterns of language clustered around the following frequently used word types, namely, confidence; influence; self-awareness; insight; and impact.

This in-depth qualitative evaluation of participants’ feedback has provided insight into how TLT can be applied to develop future health-care leaders. The extent to which learning has had a transformational impact at the individual level, in relation to their perceived ability to influence, holds promise for the wider impact of this group in relation to policy, practice and the promotion of clinical excellence in the future. However, the latter can only be ascertained by undertaking further realist evaluation and longitudinal study to understand the mechanisms by which transformational learning occurs and is successfully translated to influence in practice.

Previous research has expounded traditional leadership theories to guide the practice of health-care leadership development. The paper goes some way to demonstrate the impact of using the principles of TLT within health-care leadership development programmes. The approach taken by The Florence Nightingale Foundation has the potential to generate confident leaders who may be instrumental in creating positive changes across various clinical environments.

Entrepreneurship requires the attitudes and capabilities needed to begin new and innovative projects able to create positive impacts in the economy of a society. Given that it forms the basis from which new companies, products and innovations emerge, it is a very relevant term in business. With the aim of strengthening these capabilities, many universities are incorporating new educational strategies into their curricula to boost entrepreneurial intention and business skills among their students. This study aims to determine the factors that intervene in the entrepreneurial spirit of students in Spanish universities by examining areas of study, different personal and contextual characteristics, and the type of training students receive in entrepreneurship.

Data collected from 33,182 students in 77 Spanish universities in the 2018 edition of the Global University Entrepreneurial Spirit Students' Survey (GUESSS) is examined in an exhaustive univariate and bivariate descriptive and inferential analysis. Furthermore, the relationship between the entrepreneurial index and the different explicative variables is modelled, and a basic random effect for the area of study is introduced to detect differences at this level.

Economics, engineering and health sciences presented higher than average entrepreneurial indices. Regarding the type of training, only voluntary education in entrepreneurship influenced entrepreneurial spirit, albeit not equally in all areas of study.

This study’s results can help universities to incorporate new educational strategies into their curricula to boost entrepreneurial intention and business skills among students by focusing resources where they are most efficient.

This paper describes a quality improvement project to improve oversight of quality at national board level using statistical process control (SPC) methods, complimented by a qualitative experience of patients and frontline staff. It demonstrates the application of the “Picture-Understanding-Action” approach and shares the lessons learnt.

Using co-design and applying the “Picture-Understanding-Action” approach, the project team supported the directors of the Irish health system to identify and test a qualitative and quantitative picture of the quality of care across the health system. A “Quality Profile” consisting of quantitative indicators, analysed using SPC methods was used to provide an overview of the “critical few” indicators across health and social care. Patient and front-line staff experiences added depth and context to the data. These methods were tested and evolved over the course of six meetings, leading to quality of care being prioritised and interrogated at board level.

This project resulted in the integration of quality as a substantive and prioritised agenda item. Using best practice SPC methods with associated training produced better understanding of performance of the system. In addition, bringing patient and staff experiences of quality to the forefront “people-ised” the data.

The application of the “Picture-Understanding-Action” approach facilitated the development of a co-designed quality agenda item. This is a novel process that shifted the focus from “providing” information to co-designing fit-for-purpose information at board level.

The objective of the chapter is to provide an integrative appraisal of recent participatory research projects with children on violence and maltreatment conducted by members of the COST Action CA 19106 working group on children's participation (WG3) and their colleagues to identify what is working well and what needs to change in future research. The evaluation of research examples clustered around four key questions: Why, when, how and how much do children participate in research? Data were collected using a unified tool designed to characterise participatory research, which was distributed among WG3 members. In addition, chapters of the current book were another source of data about participatory research. Overall, data on 19 studies involving 46,761 children were collected and analysed using Shier's matrix. Findings show that most studies (n = 10) engaged children as consultants to adults in data collection, whereas a few studies (n = 5) demonstrated a more children-led research approach. The analysis uncovered specific areas where more progress is required, including engaging children in decisions about the research topic, involving young children, utilising methods that are more natural and familiar to children, and gaining children's reflective accounts about their participation experience. The authors encourage scholars to publish their work to advance evidence-based knowledge and skills in participatory research with children about sensitive topics.