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This paper examines how “quality” was framed in the design and implementation of a policy to reform hospital funding and associated care delivery. The aims of the study were: (1) To describe how government policy-makers who designed the policy and managers and clinicians who implemented the policy framed the concept of “quality” and (2) To explore how frames of quality and the framing process may have influenced policy implementation.

The authors conducted a secondary analysis of data from a qualitative case study involving semi-structured interviews with 45 purposefully selected key informants involved in the design and implementation of the quality-based procedures policy in Ontario, Canada. The authors used framing theory to inform coding and analysis.

The authors found that policy designers perpetuated a broader frame of quality than implementers who held more narrow frames of quality. Frame divergence was further characterized by how informants framed the relationship between clinical and financial domains of quality. Several environmental and organizational factors influenced how quality was framed by implementers.

As health systems around the world increasingly implement new models of governance and financing to strengthen quality of care, there is a need to consider how “quality” is framed in the context of these policies and with what effect. This is the first framing analysis of “quality” in health policy.

To examine the evolution of health care integration strategies and associated conceptualization and practice through a review and synthesis of over 25 years of international academic research and literature.

A search of the health sciences literature was conducted using PubMed and EMBASE. A total of 114 articles were identified for inclusion and thematically analyzed using a strategy content model for systems-level integration.

Six major, inter-related shifts in integration strategies were identified: (1) from a focus on horizontal integration to an emphasis on vertical integration; (2) from acute care and institution-centered models of integration to a broader focus on community-based health and social services; (3) from economic arguments for integration to an emphasis on improving quality of care and creating value; (4) from evaluations of integration using an organizational perspective to an emerging interest in patient-centered measures; (5) from a focus on modifying organizational and environmental structures to an emphasis on changing ways of working and influencing underlying cultural attitudes and norms; and (6) from integration for all patients within defined regions to a strategic focus on integrating care for specific populations. We propose that underlying many of these shifts is a growing recognition of the value of understanding health care delivery and integration as processes situated in Complex-Adaptive Systems (CAS).

This review builds a descriptive framework against which to assess, compare, and track integration strategies over time.

Large-scale change involves modifying not only the structures and functions of multiple organizations, but also the mindsets and behaviours of diverse stakeholders. This paper focuses on the latter: the informal, less visible, and often neglected psychological and social factors implicated in change efforts. The purpose of this paper is to differentiate between the concepts of organizational culture and mental models, to argue for the value of applying a shared mental models (SMM) framework to large-scale change, and to suggest directions for future research.

The authors provide an overview of SMM theory and use it to explore the dynamic relationship between culture and cognition. The contributions and limitations of the theory to change efforts are also discussed.

Culture and cognition are complementary perspectives, providing insight into two different levels of the change process. SMM theory draws attention to important questions that add value to existing perspectives on large-scale change. The authors outline these questions for future research and argue that research and practice in this domain may be best served by focusing less on the potentially narrow goal of “achieving consensus” and more on identifying, understanding, and managing cognitive convergences and divergences as part of broader research and change management programmes.

Drawing from both cultural and cognitive paradigms can provide researchers with a more complete picture of the processes by which coordinated action are achieved in complex change initiatives in the healthcare domain.

Health service organizations and professionals are under increasing pressure to work together to deliver integrated patient care. A common understanding of integration strategies may facilitate the delivery of integrated care across inter‐organizational and inter‐professional boundaries. This paper aims to build a framework for exploring and potentially aligning multiple stakeholder perspectives of systems integration.

The authors draw from the literature on shared mental models, strategic management and change, framing, stakeholder management, and systems theory to develop a new construct, Mental Models of Integrated Care (MMIC), which consists of three types of mental models, i.e. integration‐task, system‐role, and integration‐belief.

The MMIC construct encompasses many of the known barriers and enablers to integrating care while also providing a comprehensive, theory‐based framework of psychological factors that may influence inter‐organizational and inter‐professional relations. While the existing literature on integration focuses on optimizing structures and processes, the MMIC construct emphasizes the convergence and divergence of stakeholders' knowledge and beliefs, and how these underlying cognitions influence interactions (or lack thereof) across the continuum of care.

MMIC may help to: explain what differentiates effective from ineffective integration initiatives; determine system readiness to integrate; diagnose integration problems; and develop interventions for enhancing integrative processes and ultimately the delivery of integrated care.

Global interest and ongoing challenges in integrating care underline the need for research on the mental models that characterize the behaviors of actors within health systems; the proposed framework offers a starting point for applying a cognitive perspective to health systems integration.

This article is intended to contribute towards furthering the understanding of researcher development as demonstrated by doctoral students' learning within scholarly communities. The article does this by reporting the findings of a study that explored the students' key learning experiences during their doctoral journey.

The 19 participants were natural science doctoral students from a top‐level research community in Finland. The data were collected through interviews that were qualitatively content analysed.

The participants emphasised the significance of participation, development as a scholar, developing specific research competences as well as learning to balance between doctoral research and other institutional tasks. They situated the key learning experiences in collaborative academic contexts such as research activities, taking courses, and academic meetings. The participants generally perceived their experiences as positive and enhancing.

Significant learning experiences identified by natural science doctoral students themselves are rarely studied. The results of the study reported in this article may be used by doctoral trainers, supervisors and students to create environments that foster students' learning and researcher development through their participation in scholarly communities.

This chapter explores the ethical complexities of researching location-aware social discovery Smartphone applications (apps) and how they mediate contemporary experiences of travel. We highlight the context-specific approach required to carrying out research on Tinder, a location-aware app that enables people to connect with others in close proximity to them. By journeying through the early stages of our research project, we demonstrate how ethical considerations and dilemmas began long before our project became a project. We discuss the pulls toward data extraction/mining of user-generated content (i.e., Tinder user profiles) within digital social research and the ethical challenges of using this data for research purposes. We focus particularly on issues of informed consent, privacy, and copyright, and the differences between manual and automated data mining/extraction techniques. Excerpts from our university ethics application are included to demonstrate how our research sits uneasily within standardized ethical protocols. Our moves away from a ‘big data’ approach to more ‘traditional’ and participatory methodologies are located within questions of epistemology and ontology including our commitment to practicing a feminist research ethic. Our chapter concludes with the lessons learned in the aim to push forward with research in challenging online spaces and with new data sources.

The range of tactical force options available to police is increasing, while public debate about police use of force is never far from the headlines. This paper aims to examine what factors shape how people accept police use of force.

The authors use two online experiments to test whether different force options affected judgments about the acceptability of police action and to explore the role of trust and legitimacy in people's judgments.

The authors found across both studies that respondents judged scenarios involving a weapon (baton, CS spray, Taser) as less acceptable compared to scenarios that did not (talking down, handcuffs), but they did not draw much distinction between the specific weapon used. In study 1, exposure to different police tactics had no effect on trust and legitimacy. In study 2, prior perceptions of trust were strong predictors of acceptability judgments.

There is a comparative paucity of British-based empirical research examining public attitudes toward different use of force resolutions by police. In this paper, the authors explore how use of force affects people's views of police at a time in which the nature and scope of force applications, how these are understood and indeed the basic enterprise of policing itself is being reconsidered and renegotiated.