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Implementing change in healthcare is difficult to accomplish due to the unpredictability associated with challenging the status quo. Adapting the intervention/practice/program being implemented to better fit the complex context is an important aspect of implementation success. Despite the acknowledged influence of context, the concept continues to receive insufficient attention at the team-level within implementation research. Using two heterogeneous multidisciplinary healthcare teams as implementation case studies, this study evaluates the interplay between context and implementation and highlights the ways in which context influences the introduction of a collective leadership intervention in routine practice.

The multiple case study design adopted, employed a triangulation of qualitative research methods which involved observation (Case A = 16 h, Case B = 15 h) and interview data (Case A = 13 participants, Case B = 12 participants). Using an inductive approach, an in-depth thematic analysis of the data outlined the relationship between team-level contextual factors and implementation success.

Themes are presented under the headings: (1) adapting to the everyday realities, a key determinant for implementation success and (2) implementation stimulating change in context. The findings demonstrate a dynamic relationship between context and implementation. The challenges of engaging busy healthcare professionals emphasised that mapping the contextual complexity of a site and adapting implementation accordingly is essential to enhance the likelihood of successful implementation. However, implementation also altered the surrounding context, stimulating changes within both teams.

By exposing the reciprocal relationship between team-level contextual factors and implementation, this research supports the improved design of implementation strategies through better understanding the interplay and mutual evolution of evidence-based healthcare interventions within different contexts.

The influential Sainsbury Centre report, Making Recovery a Reality (Shepherd et al, 2008), talks about clinical and social aspects of recovery. The issue of psychological recovery is not discussed at length, although other workers have put forward a psychological model of recovery (Andresen et al, 2003). While there are numerous definitions of recovery, the one developed by Gordon, the focus of this profile, is unlikely to be matched for its parsimony. Gordon describes recovery as ‘coping with your illness and trying to have a meaningful life’ (McManus, 2008). In this paper, he outlines his background. He is then interviewed by Sarah Morgan about his life, illness and recovery. Finally, Jerome gives an appreciation of his contribution to our developing understanding of recovery.

14. For the purposes of these Regulations an application may be made to any Justice having jurisdiction in the District, and thereupon subsection (2) of Section 28 of the Public Health Acts Amendment Act, 1890, whether that subsection is or is not in force in the District, and any provision in any Act of Parliament which applies to a proceeding under or consequent upon that subsection, shall have effect in relation to the proceedings, as if the application were a complaint within the meaning of the said subsection and otherwise subject to the provisions of these Regulations.

People with a borderline personality disorder (BPD) diagnosis can require support from mental health services for managing risk behaviour. Current routine inpatient and community treatment can be unhelpful for this group. Positive risk taking has been developed to help community teams manage risk with people with a BPD. This study aims to explore experiences of risk management in an NHS Trust where positive risk taking is being implemented with people with a BPD.

Interpretative phenomenological analysis is the methodology of transcripts from semi-structured interviews. Nine adults with a diagnosis of BPD and current or previous experiences of risk management approaches were sampled from one NHS Trust.

Limited resources and interpersonal barriers had a negative impact on experiences of Positive risk taking. Participants experienced one-off risk assessments and short-term interventions such as medication which they described as “meaningless”. Traumatic experiences could make it difficult to establish therapeutic relationships and elicit unhelpful responses from professionals. Participants could only feel “taken seriously” when in crisis which contributed towards an increase in risky behaviour. Positive risk taking was contingent upon collaborative and consistent professional relationships which created a “safety net”, enabling open communication and responsibility taking which challenged recovery-relapse patterns of service use.

Positive risk taking approaches to risk management may benefit people with a BPD. Findings complement those from other studies emphasising the importance of compassion and empathy when working with personality disorder. Training and increased resources are required to implement effective risk management with this group.

Findings expand upon the sparse existing research in the area of risk management using the Positive risk taking approach with people with a BPD diagnosis, and provide idiographic understanding which is clinically meaningful. Participants’ experiences suggest Positive risk taking may provide a framework for improving quality of life and decreasing service use for people diagnosed with BPD engaging in risk management with Community Mental Health Teams, which facilitates recovery and other benefits.

This study aims to explore the motivation as well as barriers for ethical food consumption behaviour by focussing on the food consumption pattern of young adults in the North East of Scotland. Considering the recent involvement of young adults in environmental activism, consumption behaviour of young adults in the North East of Scotland, an oil-based community, presents essential research interest to understand whether young adults often contemplate the consequences of their lifestyle.

The authors explored the perceptions of ten purposive recruited young adults using semi-structured interviews to understand factors underpinning consumer's decision-making towards ethical food products.

The study reveals three key factors influencing ethical food consumption behaviour among young adults. The findings show that personal health and well-being are the main reasons why consumers engage in ethical food consumption. Also, it is observed that information facilitates decision-making by raising awareness regarding the social, environmental and health consequences of food production and consumption. Further, the findings show that situational attributes, such as product price and product availability, are creating dissonance when engaging in ethical food consumption.

This study contributes to sustainability research and the ongoing debate on consumerism by exploring ethical food consumption behaviour and highlights the need to address situational challenges, such as product price and availability. The study suggests that interventions to address current consumption patterns should also emphasise the social and personal benefits of food consumption rather than the environmental benefits that have been the focus of prior research.

This paper aims to describe the process and outcomes of restorative justice (RJ) between a detained patient with autism and a person he harmed.

A single case study design was used to provide an in-depth description of a RJ referral.

Restorative outcomes that align with the theories of RJ, in particular trauma processing and emotional reconnection, were observed by RJ practitioners and reported by participants. The person harmed reported a “safer” memory of the offence.

The absence of outcome assessments limits the findings to observational data and self-reported experiences from participants. A triangulated outcome approach is recommended.

RJ practices can safely be applied within a secure hospital environment. The RJ process can also be followed by a person with difficulties in social and emotional processing.

The RJ process provides a safe framework within which forensic mental health services can respond to the needs of victims, which are not routinely addressed in standard clinical practice, and in worst case scenarios, may even be overlooked.

The desirability of having a more flexible workforce is emphasised across many health systems yet this goal is as ambiguous as it is ubiquitous. In the absence of empirical studies in healthcare that have defined flexibility as an outcome, the purpose of this paper is to draw on classic management and sociological theory to reduce this ambiguity.

The paper uses the Weberian tool of “ideal types”. Key workforce reforms are held against Atkinson’s model of functional flexibility which aims to increase responsiveness and adaptability through multiskilling, autonomy and teams; and Taylorism which seeks stability and reduced costs through specialisation, fragmentation and management control.

Appeals to an amorphous goal of increasing workforce flexibility make an assumption that any reform will increase flexibility. However, this paper finds that the work of healthcare professionals already displays most of the essential features of functional flexibility but many widespread reforms are shifting healthcare work in a Taylorist direction. This contradiction is symptomatic of a failure to confront inevitable trade-offs in reform: between the benefits of specialisation and the costs of fragmentation; and between management control and professional autonomy.

The paper questions the conventional conception of “the problem” of workforce reform as primarily one of professional control over tasks. Holding reforms against the ideal types of Taylorism and functional flexibility is a simple, effective way the costs and benefits of workforce reform can be revealed.

Diffusion of fake news and pseudo-facts is becoming increasingly fast-paced and widespread, making it more difficult for the general public to separate reliable information from misleading content. The purpose of this article is to provide a more advanced understanding of the underlying processes that contribute to the spread of health- and beauty-related rumors and of the mechanisms that can mitigate the risks associated with the diffusion of fake news.

By adopting denialism as a conceptual lens, this article introduces a framework that aims to explain the mechanisms through which fake news and pseudo-facts propagate within the health and beauty industry. Three exemplary case studies situated within the context of the health and beauty industry reveal the persuasiveness of these principles and shed light on the diffusion of false and misleading information.

The following seven denialistic marketing tactics that contribute to diffusion of fake news can be identified: (1) promoting a socially accepted image; (2) associating brands with a healthy lifestyle; (3) use of experts; (4) working with celebrity influencers; (5) selectively using and omitting facts; (6) sponsoring research and pseudo-science; and (7)exploiting regulatory loopholes. Through a better understanding of how fake news spreads, brand managers can simultaneously improve the optics that surround their firms, promote sales organically and reinforce consumers’ trust toward the brand.

Within the wider context of the health and beauty industry, this article sets to explore the mechanisms through which fake news and pseudo-facts propagate and influence brands and consumers. The article offers several contributions not only to the emergent literature on fake news but also to the wider marketing and consumer behavior literature.

Purpose – This study analyzes the rhetoric casting U.S. President Barack Obama in the role of betraying and undermining the nation because he seeks government policies supporting a social safety net, gay rights, abortion rights, and other progressive agendas.

Methodology/Approach – The analysis is based on sociological social movement theories, especially the interrelationship of ideology, frames, and narratives in understanding how activists take their ideas and turn them in to action. The power devaluation model of Rory McVeigh is applied to the construction of reality used by right-wing anti-Obama forces, especially those linked to the various Tea Party movements.

Findings – The most militant anti-Obama ideologues construct frames and narratives based on a dualistic worldview in which Obama and liberals in general are demonized and scapegoated for existing economic, social, and political problems.

Research limitations/implications – More scholarly research using statistical analysis of the views and demographics of Tea Party supporters is needed to provide a complete picture of this new social/political movement.

Practical implications – By showing that right-wing populists are basing their beliefs on a long history of similar frames and narratives, this study can help prompt a more constructive response by political opponents who wrongly demonize the Tea Party supporters and their allies as ignorant or crazy.

This symposium analyses the mutually constitutive relationship between economic knowledge and political order. Through a wide range of case studies from Europe, Africa, and Latin America, the essays collected shed new light on the choices and constraints faced by economists under authoritarian rule in the twentieth century. The contribution of the symposium is twofold. Firstly, it expands the geographical and chronological scope of the conversation on the politics of economics. Secondly, it encourages a more nuanced understanding of economists’ agency in their different guises as educators, party propagandists, policy-makers, model-builders, and dissidents.