Now showing items 1-20 of 1932

    • Sikhi(sm), Sikhs and Sikh Studies: Contextualizing diversity of histories, practices and identities

      Jakobsh, Doris; Takhar, Opinderjit (Routledge, 2023-03-13)
      Much of the public sphere of global Sikh engagement presents a dichotomy of defining a "true" Sikh in the light of largely hegemonic definitions of the term "religion" and as a consequence of the historiography of the development of Sikh identity. As Singh highlights, both India and Pakistan exercise control over Sikh sacred shrines, since the Partition of India in 1947 resulted in key Sikh historical shrines being situated in the newly created Pakistan. A lived religion approach is based instead on the notion that "religion is the handiwork of people", that it is ongoing "cultural work" and that its value lies in "distinguishing the actual experience of religious persons from the prescribed religion of institutionally defined beliefs and practices". According to the Sikh Rehat Maryada, only amritdhari Sikhs are regarded as being "proper" or "true" Sikhs; as such, it is this form of Sikhi/sm that is generally called upon to speak for "the Sikhs.".
    • A comparison of self-reported and device measured sedentary behaviour in adults: a systematic review and meta-analysis

      Prince, Stephanie; Cardilli, Luca; Reed, Jennifer L.; Saunders, Travis; Kite, Chris; Douillette, Kevin; Fournier, Karine; Buckley, John P.; Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada. stephanie.princeware@canada.ca. (BMC, 2020-03-04)
      BACKGROUND:Sedentary behaviour (SB) is a risk factor for chronic disease and premature mortality. While many individual studies have examined the reliability and validity of various self-report measures for assessing SB, it is not clear, in general, how self-reported SB (e.g., questionnaires, logs, ecological momentary assessments (EMAs)) compares to device measures (e.g., accelerometers, inclinometers). OBJECTIVE:The primary objective of this systematic review was to compare self-report versus device measures of SB in adults. METHODS:Six bibliographic databases were searched to identify all studies which included a comparable self-report and device measure of SB in adults. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses. RESULTS:The review included 185 unique studies. A total of 123 studies comprising 173 comparisons and data from 55,199 participants were used to examine general criterion validity. The average mean difference was -105.19 minutes/day (95% CI: -127.21, -83.17); self-report underestimated sedentary time by ~1.74 hours/day compared to device measures. Self-reported time spent sedentary at work was ~40 minutes higher than when assessed by devices. Single item measures performed more poorly than multi-item questionnaires, EMAs and logs/diaries. On average, when compared to inclinometers, multi-item questionnaires, EMAs and logs/diaries were not significantly different, but had substantial amount of variability (up to 6 hours/day within individual studies) with approximately half over-reporting and half under-reporting. A total of 54 studies provided an assessment of reliability of a self-report measure, on average the reliability was good (ICC = 0.66). CONCLUSIONS:Evidence from this review suggests that single-item self-report measures generally underestimate sedentary time when compared to device measures. For accuracy, multi-item questionnaires, EMAs and logs/diaries with a shorter recall period should be encouraged above single item questions and longer recall periods if sedentary time is a primary outcome of study. Users should also be aware of the high degree of variability between and within tools. Studies should exert caution when comparing associations between different self-report and device measures with health outcomes. SYSTEMATIC REVIEW REGISTRATION:PROSPERO CRD42019118755.
    • Changes in physical activity and sedentary behaviour due to enforced COVID-19-related lockdown and movement restrictions: A protocol for a systematic review and meta-analysis

      Kite, Chris; Lagojda, Lukasz; Clark, Cain; Uthman, Olalekan; Denton, Francesca; McGregor, Gordon; Harwood, Amy; Atkinson, Lou; Broom, David R.; Kyrou, Ioannis; et al. (MDPI, 2021-05-14)
      Prolonged lockdown/restriction measures due to the COVID-19 pandemic have reportedly impacted opportunities to be physically active for a large proportion of the population in affected countries globally. The exact changes to physical activity and sedentary behaviours due to these measures have not been fully studied. Accordingly, the objective of this PROSPERO-registered systematic review is to evaluate the available evidence on physical activity and sedentary behaviours in the general population during COVID-19-related lockdown/restriction measures, compared to prior to restrictions being in place. Defined searches to identify eligible studies published in English, from November 2019 up to the date of submission, will be conducted using the following databases: CENTRAL, MEDLINE, EMBASE, CINAHL, SPORTDiscus, PSYCinfo, Coronavirus Research Database, Public Health Database, Publicly Available Content Database, SCOPUS, and Google Scholar. The applied inclusion criteria were selected to identify observational studies with no restrictions placed on participants, with outcomes regarding physical activity and/or sedentary behaviour during lockdown/restriction measures, and with comparisons for these outcomes to a time when no such measures were in place. Where appropriate, results from included studies will be pooled and effect estimates will be presented in random effects meta-analyses. To the best of our knowledge, this will be the first systematic review to evaluate one complete year of published data on the impact of COVID-19-related lockdown/restriction measures on physical activity and sedentary behaviour. Thus, this systematic review and meta-analysis will constitute the most up-to-date synthesis of published evidence on any such documented changes, and so will comprehensively inform clinical practitioners, public health agencies, researchers, policymakers and the general public regarding the effects of lockdown/restriction measures on both physical activity and sedentary behaviour.
    • Non-alcoholic fatty liver disease (NAFLD) and potential links to depression, anxiety, and chronic stress

      Shea, Sue; Lionis, Christos; Kite, Chris; Atkinson, Lou; Chaggar, Surinderjeet S.; Randeva, Harpal S.; Kyrou, Ioannis; Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK. (MDPI, 2021-11-16)
      Non-alcoholic fatty liver disease (NAFLD) constitutes the most common liver disease worldwide, and is frequently linked to the metabolic syndrome. The latter represents a clustering of related cardio-metabolic components, which are often observed in patients with NAFLD and increase the risk of cardiovascular disease. Furthermore, growing evidence suggests a positive association between metabolic syndrome and certain mental health problems (e.g., depression, anxiety, and chronic stress). Given the strong overlap between metabolic syndrome and NAFLD, and the common underlying mechanisms that link the two conditions, it is probable that potentially bidirectional associations are also present between NAFLD and mental health comorbidity. The identification of such links is worthy of further investigation, as this can inform more targeted interventions for patients with NAFLD. Therefore, the present review discusses published evidence in relation to associations of depression, anxiety, stress, and impaired health-related quality of life with NAFLD and metabolic syndrome. Attention is also drawn to the complex nature of affective disorders and potential overlapping symptoms between such conditions and NAFLD, while a focus is also placed on the postulated mechanisms mediating associations between mental health and both NAFLD and metabolic syndrome. Relevant gaps/weaknesses of the available literature are also highlighted, together with future research directions that need to be further explored.
    • Uncertainty, anxiety and isolation: Experiencing the COVID-19 pandemic and lockdown as a woman with polycystic ovary syndrome (PCOS)

      Atkinson, Lou; Kite, Chris; McGregor, Gordon; James, Tamsin; Clark, Cain; Randeva, Harpal S.; Kyrou, Ioannis; School of Psychology, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK. (MDPI, 2021-09-25)
      Background: The COVID-19 pandemic and the related lockdown measures presented a significant risk to physical and mental wellbeing in affected populations. Women with polycystic ovary syndrome (PCOS) are predisposed to several cardio-metabolic risk factors which increase the susceptibility to severe COVID-19 and also exhibit increased likelihood of impaired mental health wellbeing. Therefore, these women who usually receive care from multiple primary and specialist healthcare services may be disproportionately impacted by this pandemic and the related restrictions. This study aimed to explore the lived experience of the first UK national lockdown as a woman with PCOS. Methods: As part of a larger cross-sectional study, 12 women with PCOS living in the UK during the first national COVID-19 lockdown were recruited to a qualitative study. Telephone interviews were conducted in June/July of 2020, and data collected were subjected to thematic analysis. Results: Five themes were identified. "My PCOS Journey" describes participants' experiences of diagnosis, treatment and ongoing management of their PCOS. "Living Through Lockdown" describes the overall experience and impact of the lockdown on all aspects of participants' lives. "Self-care and Managing Symptoms" describe multiple challenges to living well with PCOS during the lockdown, including lack of access to supplies and services, and disruption to weight management. "Healthcare on Hold" describes the uncertainty and anxiety associated with delays in accessing specialised healthcare for a range of PCOS aspects, including fertility treatment. "Exacerbating Existing Issues" captures the worsening of pre-existing mental health issues, and an increase in health anxiety and feelings of isolation. Conclusion: For the women with PCOS in this study, the COVID-19 pandemic and the first national lockdown was mostly experienced as adding to the pre-existing challenges of living with their condition. The mental health impact experienced by the study participants was increased due to lack of access to their normal support strategies, limitations on healthcare services and uncertainty about their risk of COVID-19.
    • Support needs and coping strategies in non-alcoholic fatty liver disease (NAFLD): a multidisciplinary approach to potential unmet challenges beyond pharmacological treatment

      Shea, Sue; Lionis, Christos; Atkinson, Lou; Kite, Chris; Lagojda, Lukasz; Chaggar, Surinderjeet S.; Kyrou, Ioannis; Randeva, Harpal S. (MDPI, 2022-12-23)
      Non-alcoholic fatty liver disease (NAFLD) is the most frequently occurring chronic liver disease, affecting approximately 25–30% of the adult general population worldwide. NAFLD reflects excess hepatic accumulation of fat in the absence of increased alcohol intake, and, due to its close association with obesity, is frequently referred to as the ‘hepatic manifestation’ of metabolic syndrome. Indeed, a high percentage of individuals with NAFLD present with a combination of the cardio-metabolic comorbidities that are associated with the metabolic syndrome. In addition to its well-established link with the metabolic syndrome and increased risk for cardiovascular disease, NAFLD has also been associated with certain mental health issues (e.g., depression and stress). Although this link is now being increasingly recognized, there are still unmet needs regarding the holistic management of patients with NAFLD, which could further contribute to feelings of social isolation and loneliness. The latter conditions are also increasingly reported to pose a substantial risk to overall health and quality of life. To date, there is limited research that has explored these issues among patients with NAFLD, despite existing data which indicate that perceived loneliness and isolation may pose an additional health risk. Notably, many features associated with NAFLD have been related to these concepts, such as perceived stigma, fatigue, stress, and confusion regarding this diagnosis. As such, this review aimed to assess such potential problems faced by patients with NAFLD, and to explore the possibility of unmet support needs which could lead to perceived social isolation. Moreover, the importance of a compassionate approach towards such patients is discussed, together with potential coping strategies. Future research directions and the need for a multidisciplinary approach are also highlighted.
    • Mission impossible: inclusive teaching in a standards-driven system

      Williams-Brown, Zeta; Hodkinson, Alan; Jopling, Michael (Taylor & Francis, 2023-01-07)
      This paper discusses the findings of two studies that critically analysed teachers' perspectives on the operation of the standards and inclusion agenda in primary schools in England. The studies were carried out in 2010–2011 and 2019, respectively. Through the application of Q methodology, the paper examines whether teachers' perspectives of standards and inclusion have changed over time. Analysis of the data strongly suggests that teachers have experienced significant difficulties including children with SEND while at the same time trying to operationalise the objectives of the standards agenda. The research concludes that there needs to be a focus on developing effective strategies to include children with SEND within the hostile environment of the standards agenda. Within such an environment it is suggested that focus needs to move away from concentrating on ‘children with SEND having difficulties’ to the creation of inclusive educational settings which welcome all learners. In addition, it is argued that Statutory Assessment Tests (SATs) should also be revised to consider the needs of all learners.
    • Why are we tracking reception aged children? Teacher’s and key stakeholder’s perspectives on the reintroduction of national reception baseline assessment

      Meechan, David; Whatmore, Tracy; Williams-Brown, Zeta; Halfhead, Simon (British Education Studies Association, 2022-12-31)
      This paper considers the recent development and implementation of statutory Reception Baseline Assessment (RBA) in England introduced by the Department for Education (2021). Internal baseline assessments, undertaken by early years professionals, have traditionally been an integral part of gaining informed knowledge and understanding of individual children in Reception classes. Previous iterations of baseline assessment have included observations and interactions with children in order to begin to construct an overview of their holistic development, their experience, abilities, skills, strengths, and areas for development (TES, 2015). Such types of assessment are used by early years teachers and practitioners to inform learning and teaching during children’s first year of primary school (Brodie, 2013). In 2021, the RBA statutory guidance (DfE) established a formal assessment process for assessing all Reception-aged children within six weeks of starting primary school. This paper provides a review of literature and research and outlines the development and processes involved in the implementation of RBA. A research-based study, investigating teacher and key stakeholder perceptions of RBA is then detailed. The paper reports on the research, which utilised a qualitative survey (Bryman, 2004) to collect data from 70 teachers and stakeholders across 47 local authorities in England. Data was collected and analysed, and the findings detail distinctive differences in purpose and values of RBA in comparison to internal baseline assessment. The paper concludes by recommending that RBA is halted and reconsidered in relation to teachers’ priorities at this crucial time, and the purpose and values of internal baseline assessment be further discussed.
    • Co-designing health care solutions with patient representatives and clinicians in a large acute hospital setting: process and engagement

      Bollard, Martin; Dowling, Alison; Westwood, Lynne; Cannaby, Ann-Marie (Gavin Publishers, 2023-01-31)
      The benefits of involving patients and wider members of the public as partners in care are being increasingly recognised internationally. Co-design is one of the methods reported to promote patient-based health service improvements and offers a participatory approach to engage patients and citizens in solving health care challenges. However, current limitations are levelled at this corpus of work, indicating a lack of sustainability and substantive evidence of any known associated processes that can yield sustainable longer-term patient benefit. This service improvement project was underpinned by a Human Centred Design (HCD) methodology incorporating the Design Council’s process Discover, Define, Develop and Deliver [1]. This assisted in providing a participatory framework of co-produced work over a twelve-month period with three clinical pathway teams, Stroke, Children and Young People (CYP) and Learning and Developmental Disabilities (LD.) Meeting specific project objectives, patientbased projects were developed using a toolkit and Collaborative Action Plans that steered involvement throughout. Evaluative results elicited three themes, generating a product idea together, acknowledging the contribution of all, barriers and challenges. Within this, the clinicians and patient representatives reported the value of having a safe space to carry out experienced based work with their respective patient representatives. Additionally, they reported the chosen HCD framework guided the process of engagement determining co-produced health care solutions to patient derived challenges. Conclusions are drawn that suggest further work and research is required to testbed the ‘how to’ processes associated with successful co-design in health and social care. This could provide an empirical basis for the value and process associated with sustainable human centred design required at both a micro and macro level of healthcare.
    • Preferences for deinfibulation (opening) surgery and female genital mutilation service provision: A qualitative study

      Jones, Laura L.; Costello, Benjamin; Danks, Emma; Jolly, Kate; Cross-Sudworth, Fiona; Byrne, Alison; Fassam-Wright, Meg; Latthe, Pallavi; Clarke, Joanne; Adbi, Ayan; et al. (Wiley, 2022-12-26)
      Objective To explore the views of female genital mutilation (FGM) survivors, men and healthcare professionals (HCPs) on the timing of deinfibulation surgery and NHS service provision. Design Qualitative study informed by the sound of silence framework. Setting Survivors and men were recruited from three FGM prevalent areas of England. HCPs and stakeholders were from across the UK. Sample Forty-four survivors, 13 men and 44 HCPs. Ten participants at two community workshops and 30 stakeholders at a national workshop. Methods Hybrid framework analysis of 101 interviews and three workshops. Results There was no consensus across groups on the optimal timing of deinfibulation for survivors who wished to be deinfibulated. Within group, survivors expressed a preference for deinfibulation pre-pregnancy and HCPs antenatal deinfibulation. There was no consensus for men. Participants reported that deinfibulation should take place in a hospital setting and be undertaken by a suitable HCP. Decision making around deinfibulation was complex but for those who underwent surgery it helped to mitigate FGM impacts. Although there were examples of good practice, in general, FGM service provision was suboptimal. Conclusion Deinfibulation services need to be widely advertised. Information should highlight that the procedure can be carried out at different time points, according to preference, and in a hospital by suitable HCPs. Future services should ideally be developed with survivors, to ensure that they are clinically and culturally appropriate. Guidelines would benefit from being updated to reflect the needs of survivors and to ensure consistency in provision.
    • Advocacy leadership and the deprofessionalising of the special educational needs co‐ordinator role

      Done, Elizabeth; Knowler, Helen; Richards, Hazel; Brewster, Stephanie (Wiley/NASEN, 2022-12-31)
      The UK government is proposing to replace M-level national award for special educational needs co-ordination training, mandated for SENCos in England, with an unaccredited national professional qualification. Such downgrading of their qualification level is intended to significantly increase the number of qualified SENCos; however, this is likely to reduce SENCos' capacity to exercise ‘advocacy leadership’ in support of students at risk of marginalization and social exclusion. We reject a neoliberal political discourse of continual improvement that neglects the need for critical literacy and research-informed inclusive practice on the part of SENCos, and suggest that endemic exclusionary practices in English schools are more likely to go unchallenged. The move towards nonaccredited SENCo status risks their deprofessionalisation, and this proposal is linked to an academisation agenda and efforts to normalize a trichotomised education system (comprising mainstream, ‘special’ and ‘alternative’ provision) by presenting such changes as an improvement.
    • Sources and mechanisms of modality-specific distraction in visual short-term memory

      Mercer, Tom; Shaw, Raegan; Fisher, Luke (Taylor & Francis, 2023-01-18)
      Visual short-term and working memory can be disrupted by irrelevant, distracting input occurring after encoding. Distractors similar to the original memory are known to be interfering, but it is unclear whether dissimilar distractors have the same disruptive effect. The presence of dissimilar distraction would be problematic for views of similarity-based interference, hence the present study investigated modality-specific distraction using a procedure that required participants to compare single target and probe objects over a delay. An irrelevant distractor could be presented during the delay separating the target and probe, but it varied in its similarity to the target. In four experiments, recognition was disrupted by the presence of a distractor, even when the distractors were highly dissimilar to the target. Furthermore, the interference effect was not reduced when the same distractors were repeatedly used throughout the experiment, and interference from dissimilar distractors was only lessened when it was extremely predictable. These findings indicate that susceptibility to dissimilar distraction is a persistent limitation in visual short-term memory.
    • Rekindling Potohar [leaflet]

      Takhar, Opinderjit (2022-06)
    • RWT co-production toolkit template

      Bollard, Martin; Dowling, Alison; Westwood, Lynne; Cannaby, Ann-Marie (University of Wolverhampton and The Royal Wolverhampton Trust, 2022-06-30)
    • Influence of secondary organizational socialization on how physical education teacher education program coordinators execute their administrative roles and responsibilities

      Parkes, Craig; Brunsdon, Jamie; O'Leary, Nick (Human Kinetics, 2022-11-21)
      The purpose of this study was to investigate the influence of secondary organizational socialization on how physical education teacher education program coordinators execute their administrative roles and responsibilities. Two female program coordinators located within the United States were individually interviewed and provided documentation for analysis. Data analysis was conducted using analytic induction and constant comparison techniques. Both participants acted as customizers, persuaders, and interpreters. The factors influencing the socialization of physical education teacher education coordinators were department faculty, college administration, student enrollment data, and cooperating teacher feedback. Although working at very different institutions, the roles, responsibilities, and socialization influences for both participants were similar. In addition, and despite the prevalence of low enrollments and the educative teacher performance assessment, program coordinators appeared to negate these issues and were effective in executing their administrative roles and responsibilities. These findings would be of interest to those interested in and/or currently maintaining administrative positions in physical education teacher education.
    • Brookside safer street: community participation and evidencing change

      Arnull, Elaine; Kanjilal, Mahuya (University of Wolverhampton, 2022-11-23)
    • Defining ‘research inspired teaching’ and introducing a research inspired online/offline teaching (riot) framework for fostering it using a co-creation approach

      Pezaro, Sally; Jenkins, Martin; Bollard, Martin (Elsevier, 2021-10-29)
      Background There are calls to ensure that evidence-based practice is enabled for every midwife and nurse by means of education, research, leadership and access to evidence. Concurrently, there is a global call for universities to foster ‘Research Inspired Teaching’. Yet such teaching must first be defined and may usefully be developed, delivered, and evaluated as part of a framework approach. Objective To co-create a uniform definition of ‘Research Inspired Teaching’ and a framework for developing, delivering, and evaluating it. Design A co-creation approach was taken, underpinned by the interpretive framework of communal constructivism. Setting United Kingdom. Participants The sampling strategy was purposive, whereby those who had reportedly actively engaged in ‘Research Inspired Teaching’ were invited to participate. The resulting multidisciplinary team of co-creators (n = 14) included students, educators, and self-identified facilitators of ‘Research Inspired Teaching’. Methods The co-creation of outputs was facilitated by two online co-creation workshops. All creative, written, and verbal contributions made by co-creators were collected as data and used to ‘co-define’, ‘co-design’ and ‘co-refine’ outputs. To enhance credibility, triangulation was used throughout. A final review of results presented in this article via all co-creators concluded this process. Results This article presents a definition of teaching, a definition of research, a founding definition of Research Inspired Teaching and a guiding framework along with 10 core principles for developing, delivering, and evaluating it. Conclusions These outputs may be useful for both midwifery and nursing faculties, providing common language for collaboration and inspiring further developments and research. In pursuit of excellence, further international research could usefully investigate how these outputs may further bridge the Research-Teaching Nexus in Higher Education, and partner with other universities looking to cultivate, evidence and promote their own ‘Research Inspired Teaching’ in practice. In this pursuit, inter-university partnerships would be welcomed.
    • Myhealth–developing accessible health materials with men with intellectual disability: a co-created proof of concept

      Bollard, Martin; Magee, Paul (Taylor & Francis, 2020-12-04)
      This paper describes the development of user focussed health materials for men, in the form of a tactile set of health post cards and a digital web-based platform- Myhealth. Health experts with Intellectual Disability (ID) co-created Myhealth over the two phases of work reported in the paper. Men with ID experience more health concerns when compared with the non-disabled population and themselves require user sensitive health promotion materials to effectively access health provision. Following the successful co-creation of Men’s health postcards, Co-creation also underpinned the method adopted to create the digital version of Myhealth. Through a series of prototyping workshops, we co-created the content, key health messages and navigation of information for a web-based version. Human centred engagement with this able, but marginalized group of men enabled the production of user accessible health materials relevant for all men.
    • Use of functional near-infrared spectroscopy to evaluate cognitive change when using healthcare simulation tools

      Taylor, Natasha; Wyres, Martyn; Bollard, Martin; Kneafsey, Rosie (BMJ Publishing Group, 2020-11-01)
      Background The use of brain imaging techniques in healthcare simulation is relatively rare. However, the use of mobile, wireless technique, such as functional nearinfrared spectroscopy (fNIRS), is becoming a useful tool for assessing the unique demands of simulation learning. For this study, this imaging technique was used to evaluate cognitive load during simulation learning events. Methods This study took place in relation to six simulation activities, paired for similarity, and evaluated comparative cognitive change between the three task pairs. The three paired tasks were: receiving a (1) face-toface and (2) video patient handover; observing a simulated scene in (1) two dimensions and (2) 360° field of vision; and on a simulated patient (1) taking a pulse and (2) taking a pulse and respiratory rate simultaneously. The total number of participants was n=12. Results In this study, fNIRS was sensitive to variations in task difficulty in common simulation tools and scenarios, showing an increase in oxygenated haemoglobin concentration and a decrease in deoxygenated haemoglobin concentration, as tasks increased in cognitive load. Conclusion Overall, findings confirmed the usefulness of neurohaemoglobin concentration markers as an evaluation tool of cognitive change in healthcare simulation. Study findings suggested that cognitive load increases in more complex cognitive tasks in simulation learning events. Task performance that increased in complexity therefore affected cognitive markers, with increase in mental effort required.
    • People with learning disabilities participating in research as members of a steering group

      Bollard, Martin (Huddersfield University Press, 2010-10-18)
      As a result of the complexity of needs that people with learning disabilities have, this group of people often come into contact with a range of different health professionals and different types of teams. Despite this, people with learning disabilities are not always given the opportunity to share their knowledge and experience of being at the ‘receiving end’ of care and treatment from different types of teams. This paper reports on a 14 month funded project in which people with learning disabilities participated in the research as steering group members and interview informants. More and more methods are being adopted that involve people with learning disabilities in research in general. However, limited work has been reported regarding people with learning disabilities' involvement as members of research steering groups. The main aim of the research was to explore what people with learning disabilities thought about team working and how this may benefit different health and social care students. The research adopts a participatory approach and reports on how the steering group functioned. The study provides some useful insights from people with learning disabilities themselves, into how team-working can be taught and includes wider team-working considerations for health and social care professionals.