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In England, climate change and sustainability education (CCSE) is predominantly taught with a focus on knowledge in school geography and science. However, whole-school approaches to CCSE exist which encompasses curriculum, campus, community and culture. Drawing on conceptualisations of the ecological approach to teacher agency we explored the ways in which the leadership of a whole-school approach to CCSE was implemented across four case study schools.

Four case study schools were identified as having implemented CCSE across the areas of classroom, culture, campus and community, with opportunities to share good practice. During visits to each school, we completed a series of 15 interviews with teachers who had roles leading geography (n = 4) and science (n = 4) curricular; school leaders (n = 4) and sustainability coordinators (n = 3). We engaged with a range of school curricula and policy materials and toured each site.

At the heart of an effective approach to whole-school CCSE are leaders who create the conditions for teachers to achieve agency and enact curriculum making as a social practice. School leaders themselves are critical in ensuring the culture, professional norms and expectations are established and nurtured. Over time, teachers are able to identify and create spaces of agency in relation to CCSE which reach beyond their immediate communities.

This research brings together teacher agency, curriculum making and leadership practices to better understand why some schools achieve agentic cultures as part of whole-school CCSE.

Clinical governance is the linchpin of the UK government's quality improvement strategy for the country's National Health Service. Extending quality accreditation programmes from hospitals into the primary care sector — local general practice surgeries — presents a critical set of challenges. In this extract from Accreditation in Primary Care, Nicola Walsh and Kieran Walshe explore how to evaluate accreditation initiatives to assure the quality of primary care.

The purpose of this paper is to describe a methodology to deal with conformance checking through the implementation of computer-interpretable-clinical guidelines (CIGs), and present an application of the methodology to real-world data and a clinical pathway for radiotherapy-related oncological treatment.

This methodology is implemented by a software able to use the hospital electronic health record data to assess the adherence of the actual executed clinical processes to a clinical pathway, monitoring at the same time management-related efficiency and performance parameters, and ideally, suggesting ways to improve them.

Three use cases are presented, in which the results of conformance checking are used to compare different branches of the executed guidelines with respect to the adherence to ideal process, temporal distribution of state-to-state transitions, and overall treatment efficacy, in order to extract data-driven evidence that could be of interest for the hospital management.

This approach has the result of applying management-oriented data mining technique on sequential data, typical of process mining, to the result of a conformity check between the preliminary knowledge defined by clinicians and the real-world data, typical of CIGs.

The purpose of this paper is to show how the Turning Point Initiative to improve the health of populations by improving the USA public health system has many lessons on collaboration for governance systems.

The article synthesizes published literature outlining the results of a Robert Wood Johnson Foundation/W.K. Kellogg Foundation grant program to 21 USA states and 43 communities and relationships to administrative practice.

Turning Point's creation of a formalized network of public health partners across the USA has led to innovations in collaboration, increased system capacity, and alternative structures for improving health.

Turning Point's efficacy in community health system improvement can be mirrored in clinical governance. A major potential for improvement in clinical delivery systems is available by re‐thinking key partners, organizational structures, and system administrative capacity.

Rape culture, described as when “violence is seen as sexy and sexuality as violent” (Buchwald, Fletcher, & Roth, 1993, p. vii), exists online and offline (Henry & Powell, 2014). Much of the research on rape culture focuses on the experiences of heterosexual women, and few studies have explored rape culture in the context of dating apps. This chapter explores how men who have sex with men (MSM) understand and experience rape culture through their use of Grindr and similar dating apps. A thematic analysis of interviews with 25 MSM dating app users revealed problematic user behavior as well as unwanted sexual messages and images as common manifestations of rape culture on dating apps. Participants explained that rape culture extends beyond in-app interactions to in-person encounters, as evident by incidents of sexual violence that several participants had experienced and one participant had committed. Participants were unsure about the extent to which MSM dating apps facilitate rape culture but asserted that some apps enable rape culture more than others. This chapter demonstrates the importance of investigating sexual violence against people of diverse gender and sexual identities to ensure their experiences are not minimized, ignored, or rendered invisible.

While the importance of leadership in quality improvement is increasingly being acknowledged, we still do not know enough about what improvement leaders actually do and how they behave. This paper describes how Alder Hey, using a range of experimental approaches, has created its own model of change and concluded that certain habits of mind are at the heart of sustainable improvement leadership.

In recent years, the use of dating and hook up apps has become an increasingly socially acceptable and commonly used method of seeking romantic and sexual partners. This has seen a corresponding rise in media and crime reports of sexual harms facilitated through these services, including sexual harassment, unsolicited sexual imagery, and sexual assault. Emerging empirical research shows that experiences of sexual harms in this context are common and predominantly impact women and girls. The aim of this chapter is to examine the sociocultural and sexual norms that underpin online dating and which perpetuate a “rape culture” within which sexual harms become both possible and normalized. This chapter also considers how the discourses that minimize and legitimize sexual harms are encoded within the responses undertaken by dating and hook up apps to sexual harms. It is argued that together these norms and discourses may act to facilitate and/or prevent sexual harms, and may normalize and excuse these harms when they occur.

Here, this study aims to report a case study of the initial design and programme theory of an interdisciplinary work-focused relational group cognitive behaviour therapy (CBT) treatment programme for moderate-severe depression using realist methods.

This case study shows how the authors designed the intervention using component analysis of existing literature and focus groups of frontline practitioners and former service users and mind-mapping analysis to establish its operational logic and evaluated the theory underpinning the intervention using realist synthesis and evaluation to establish its conceptual logic.

An iterative hybrid approach of literature review, component analysis, focus group discussion and realist methods established the initial design and programme theory for the new intervention. The intervention focused on three areas of therapy, three inter-dependent outcomes, in a group format, with opportunities created for peer interaction. The main theoretical principles most likely to promote efficacy were to accelerate and optimise activation of one or more of six hypothesised mechanisms: realise, reflect, regulate, resolve, relate and retain/resume in the context of skilfully facilitated group psychotherapy.

This study outlines a methodological approach based on the layered ontology of critical realist philosophy, applied to a successful example, which will be useful during the early stages of the design and development of new group-based psychotherapeutic interventions.

By adopting the critical realist approach, the authors identified underlying mechanisms of change in relational group CBT. The theoretically integrated approach involving service users and practitioners from different professional backgrounds was unique and meant that the treatment programme was multi-modal rather than informed by a single therapeutic or theoretical approach.

The scaling up of promising, innovative integration projects presents challenges to social and health care systems. Evidence that a new service provides (cost) effective care in a (pilot) locality can often leave us some way from understanding how the innovation worked and what was crucial about the context to achieve the goals evidenced when applied to other localities. Even unpacking the “black box” of the innovation can still leave gaps in understanding with regard to scaling it up. Theory-led approaches are increasingly proposed as a means of helping to address this knowledge gap in understanding implementation. Our particular interest here is exploring the potential use of theory to help with understanding scaling up integration models across sites. The theory under consideration is Normalisation Process Theory (NPT).

The article draws on a natural experiment providing a range of data from two sites working to scale up a well-thought-of, innovative integrated, primary care-based dementia service to other primary care sites. This provided an opportunity to use NPT as a means of framing understanding to explore what the theory adds to considering issues contributing to the success or failure of such a scaling up project.

NPT offers a framework to potentially develop greater consistency in understanding the roll out of models of integrated care. The knowledge gained here and through further application of NPT could be applied to inform evaluation and planning of scaling-up programmes in the future.

The research was limited in the data collected from the case study; nevertheless, in the context of an exploration of the use of the theory, the observations provided a practical context in which to begin to examine the usefulness of NPT prior to embarking on its use in more expensive, larger-scale studies.

NPT provides a promising framework to better understand the detail of integrated service models from the point of view of what may contribute to their successful scaling up.

NPT potentially provides a helpful framework to understand and manage efforts to have new integrated service models more widely adopted in practice and to help ensure that models which are effective in the small scale develop effectively when scaled up.

This paper examines the use of NPT as a theory to guide understanding of scaling up promising innovative integration service models.

The purpose of this paper is to review the role of social networks in the translation of research into practice, propose a broader model of communities of practice (CoPs) involving practitioners, researchers and service users, and describe a case report which adopts this broader model.

Using the evidence on both knowledge transfer and the use of CoPs to share practice, this work presents an approach to supporting and developing CoPs around the specific context of an applied research programme in health and social care.

The development of CoPs across the professional and organisational boundaries of researchers, practitioners, and service users has the potential to enhance the translation of evidence into practice. It requires bringing together the right people and providing a supportive infrastructure to facilitate exchanges. Methods of engaging and involving the different stakeholder groups vary according to the specific context and pre‐existing networks, but developing closer working relationships and sharing common values is an important step in this process. Within the applied health research partnership of the Collaboration for Leadership in Applied Health Research and Care for Nottinghamshire, Derbyshire and Lincolnshire (CLAHRC‐NDL), the role of Diffusion Fellows, Engagement Fellows and CLAHRC Associates provides a way of engaging with its diverse stakeholders.

This paper builds on existing evidence about CoPs and the role of social networks in knowledge transfer.