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Services for refugees and asylum seekers frequently experience gaps in delivery and access, poor coordination, and service stress. The purpose of this paper is to examine the approach to integrated care within Companion House (CH), a refugee primary care service, whose service mix includes counselling, medical care, community development, and advocacy. Like all Australian refugee and asylum seeker support services, CH operates within an uncertain policy environment, constantly adapting to funding challenges, and changing needs of patient populations.

Interviews with staff, social network analysis, group patient interviews, and service mapping.

CH has created fluid links between teams, and encouraged open dialogue with client populations. There is a high level of networking between staff, much of it informal. This is underpinned by horizontal management and staff commitment to a shared mission and an ethos of mutual respect. The clinical teams are collectively oriented towards patients but not necessarily towards each other.

Part of the service’s resilience and ongoing service orientation is due to the fostering of an emergent self-organising form of integration through a complex adaptive systems approach. The outcome of this integration is characterised through the metaphors of “home” for patients, and “family” for staff. CH’s model of integration has relevance for other services for marginalised populations with complex service needs.

This study provides new evidence on the importance of both formal and informal communication, and that limited formal integration between clinical teams is no bar to integration as an outcome for patients.

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.

We argue for a broadened approach to brokerage by distinguishing between brokerage emphasizing a particular structural pattern in which two otherwise disconnected alters are connected through a third party (“brokerage structure”) and the social behavior of third parties (“brokerage process”). We explore a processual view of brokerage by examining three fundamental strategic orientations toward brokerage: conduit, tertius gaudens, and tertius iungens that occur in many different forms and combinations. This processual view is especially relevant in increasingly complex and dynamic environments where brokerage behavior is highly varied, intense, and purposeful, and has theoretical implications for studying multiplexity, heterogeneity, and brokerage intensity.

The purpose of this paper is to investigate the relationship between knowledge management (KM) and employee empowerment in institutions of higher education.

The research method in this study was the descriptive-correlative type, and was based on the goal of the method applied. Subjects in this research included the staff members of higher educational institutions in Iran. Descriptive and inferential statistics were used. To analyse research data, descriptive statistics, and for inferential statistics, the Pearson correlation, the Friedman ranking test and stepwise regression, were used. For data analysis, SPSS software was used.

The results from the study show that all alternative hypotheses were confirmed and there was a significant relationship between KM and employee empowerment. In addition, KM predicted the aspects of employee empowerment in institutions of higher education.

Through this study, the positive role of KM in employee empowerment in institutions of higher education has been described, and the importance of considering such studies has been specified for researchers.

This chapter introduces how the built environment and walking are connected. It looks at the interrelationships within the built environment, and how those are changing given planning and policy efforts to facilitate increased walking for both leisure activity and commuting. Using a broad review and case-based approach, the chapter examines this epistemological development of walking and the built environment over time, reviews the connections, policies and design strategies and emerging issues. The chapter shows many cases of cities which are creating a more walkable environment. It also reveals that emerging issues related to technology and autonomous vehicles, vision zero and car-free cities, and increased regional policy may play a continued role in shaping the built environment for walking. This dialogue provides both a core underpinning and a future vision for how the built environment can continue to influence and respond to pedestrians in shaping a more walkable world.

An NHS hospital is a complex organisation with many departments which are all inter‐dependent. The “millennium bug” can potentially affect any or all of its systems. Disruption in one department, over the millennium period, is likely to affect the overall delivery of health care with potential threat to life. The NHS Executive has identified the year 2000 issue as the first non‐clinical priority and every hospital has established a business continuity plan. However, many of the critical risks are outside the hospitals’ direct control and service delivery will essentially depend on the ability of key suppliers to maintain their business continuity. Unlike in industry or profit‐making organisations, the cost of assessing the risk, testing and replacing non‐compliant equipment in hospitals cannot be passed to the consumer. Additional costs will have to be met from within existing resources which will have a major effect on the already stretched health care provisions.

To examine whether or not exposing novice teachers in a graduate literacy education diversity course to particular texts and activities focused on economic diversity and lifestyle differences among students makes them more likely to positively respond to these lesser understood forms of diversity in their own teaching and if so, in what ways. The research design was qualitative and included written reflections from the teacher–participants at the beginning, middle, and end of the semester, and videotaping and transcribing activities and post-activity discussions. Ethnographic observations and notes were made by the primary investigator. The theoretical frameworks that were foundational to the study were critical literacy and teaching for social justice. The findings of this qualitative study indicate that exposing teachers to texts, discussions, and activities that educate them on economic diversity and lifestyle differences among students makes them more likely to positively respond to these forms of diversity in their own teaching. Specific examples of how participants did this are provided. This study contributes to the literature on diversity in literacy instruction by providing concrete, research-based suggestions for how both teacher educators and K-12 teachers can expand their definitions of student diversity to include economic disparities and lifestyle differences among students. It includes recommended texts and activities for both teacher educators and K-12 teachers to address less typical forms of diversity, with a focus on economic diversity and lifestyle differences.

Educators have always blended technology and pedagogy. With written, aural, and visual methods of sharing information optimized over time, the college and university classroom experience became a planned presentation of explicit knowledge through the revelation of course content. A respectable academic space emerged across disciplines where “the sage on the stage” could require textbooks and normalize assessment outcomes because content was decidedly controllable. There is a pedagogical crisis looming in higher education, however, the epicenter of which is student access to educational content that is useful and reliable without the major investment of a four-year degree. This crisis challenges higher education instruction to be less the medium of explicit knowledge (as it has been for decades) and more the dynamic and interactive medium whose mission is improving the thinking capacity of students through sharing and creating explicit and tacit knowledge. This chapter accordingly suggests that a seismic shift toward collaborative, problem-based approaches to learning is in order so that higher education instruction can redefine itself.