Explore the vast range of titles available.

Concerns remain about effectiveness in older adults

The traditional separation of the producers of research evidence in academia from the users of that evidence in healthcare organisations has not succeeded in closing the gap between what is known about the organisation and delivery of health services and what is actually done in practice. As a consequence, there is growing interest in alternative models of knowledge creation and mobilisation, ones which emphasise collaboration, active participation of all stakeholders, and a commitment to shared learning. Such models have robust historical, philosophical and methodological foundations but have not yet been embraced by many of the people working in the health sector. This paper presents an emerging model of participation, the Researcher-in-Residence. The model positions the researcher as a core member of a delivery team, actively negotiating a body of expertise which is different from, but complementary to, the expertise of managers and clinicians. Three examples of in-residence models are presented: an anthropologist working as a member of an executive team, operational researchers working in a front-line delivery team, and a Health Services Researcher working across an integrated care organisation. Each of these examples illustrates the contribution that an embedded researcher can make to a service-based team. They also highlight a number of unanswered questions about the model, including the required level of experience of the researcher and their areas of expertise, the institutional facilitators and barriers to embedding the model, and the risk that the independence of an embedded researcher might be compromised. The Researcher-in-Residence model has the potential to engage both academics and practitioners in the promotion of evidence-informed service improvement, but further evaluation is required before the model should be routinely used in practice.

Deliberative public engagement is now needed to inform the values and objectives underlying prevention strategies for future emergencies

It is reasonably certain that we have entered another covid-19 wave, writes Christina Pagel. But what are the implications?

The UK needs a stronger, more efficient system for ensuring that recommendations from inquiries are implemented to avoid repeated failures, writes Christina Pagel

Health in all policies is also emergency preparedness in all policies, writes Christina Pagel

Omicron continues to drive waves of covid infections, writes Christina Pagel, but let’s not give up trying to control transmission

Community mobilisation through participatory women's groups might improve birth outcomes in poor rural communities. We therefore assessed this approach in a largely tribal and rural population in three districts in eastern India. From 36 clusters in Jharkhand and Orissa, with an estimated population of 228 186, we assigned 18 clusters to intervention or control using stratified randomisation. Women were eligible to participate if they were aged 15–49 years, residing in the project area, and had given birth during the study. In intervention clusters, a facilitator convened 13 groups every month to support participatory action and learning for women, and facilitated the development and implementation of strategies to address maternal and newborn health problems. The primary outcomes were reductions in neonatal mortality rate (NMR) and maternal depression scores. Analysis was by intention to treat. This trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN21817853. After baseline surveillance of 4692 births, we monitored outcomes for 19 030 births during 3 years (2005–08). NMRs per 1000 were 55·6, 37·1, and 36·3 during the first, second, and third years, respectively, in intervention clusters, and 53·4, 59·6, and 64·3, respectively, in control clusters. NMR was 32% lower in intervention clusters adjusted for clustering, stratification, and baseline differences (odds ratio 0·68, 95% CI 0·59–0·78) during the 3 years, and 45% lower in years 2 and 3 (0·55, 0·46–0·66). Although we did not note a significant effect on maternal depression overall, reduction in moderate depression was 57% in year 3 (0·43, 0·23–0·80). This intervention could be used with or as a potential alternative to health-worker-led interventions, and presents new opportunities for policy makers to improve maternal and newborn health outcomes in poor populations. Health Foundation, UK Department for International Development, Wellcome Trust, and the Big Lottery Fund (UK).

We must act now to prevent a further widening in wellbeing between poor and rich

Amid record waiting lists and full hospitals, there are rapidly rising covid hospital admissions and—for the first time in three years—rapidly rising hospital admissions for flu.23 A recent large wave of RSV also added pressure and is only now declining.2 Emergency care is grinding to a halt. Ambulance handover delays are getting ever longer. Since the summer of 2021, emergency care has been increasingly stretched and as of this week almost a quarter of handovers take over an hour and this is getting worse, not better.4 The longer handovers take, the worse it is for that patient, but also for the next patient waiting for the ambulance crew to help them. 36280255 2 Weekly_Flu_and_COVID-19_report_w51.pdf. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1126555/Weekly_Flu_and_COVID-19_report_w51.pdf 3 Statistics » COVID-19 Hospital Activity. https://www.england.nhs.uk/statistics/statistical-work-areas/covid-19-hospital-activity/ 4 Statistics » Urgent and Emergency Care Daily Situation Reports 2022-23. https://www.england.nhs.uk/statistics/statistical-work-areas/uec-sitrep/urgent-and-emergency-care-daily-situation-reports-2022-23/ 5 Statistics » A&E Attendances and Emergency Admissions. https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/ 6 Lawrence Dunhill. The King’s Fund. https://www.kingsfund.org.uk/publications/health-and-social-care-england-myths 18 UK spent around a fifth less than European neighbours on health care in last decade. https://www.health.org.uk/news-and-comment/news/uk-spent-around-a-fifth-less-than-european-neighbours-on-health-care-in-last-decade 19 Campbell D, editor.