This document summarizes Thistle Foundation's journey towards implementing a person-centered approach over the past 15 years. It discusses how Thistle redesigned services, invested in training staff in person-centered concepts, and now uses the Talking Points framework to focus on identifying and realizing personal outcomes for those supported. The framework emphasizes building strong relationships, focusing on strengths and what matters most to each person, and involving natural supports. While progress has been made, fully translating positive changes to quality of life remains a work in progress.
Services of the Guidance Office:
1. Individual Inventory
2. Information
3. Counseling
4. Assessment and Appraisal
5. Referral
6. Follow-up
7. Consultation
8. Research and Evaluation
9. Prevention and Wellness
Services of the Guidance Office:
1. Individual Inventory
2. Information
3. Counseling
4. Assessment and Appraisal
5. Referral
6. Follow-up
7. Consultation
8. Research and Evaluation
9. Prevention and Wellness
For individuals who wish to improve the quality of life by resolving the emotional, behavioral, and personal problems, Individual Counseling Services prove useful. Anna Chandy is the popular counselor who provides the therapeutic counseling to individuals in one-to-one setting. You can reflect on your emotions, thoughts, and behavior during the session.
Person-Centred Recruitment and Hiring: LiveWorkPlay's Journey (So Far!)LiveWorkPlay
This session explores the LiveWorkPlay journey in developing and using person-centred practices. Supported individuals must have a say not only as to what, where, why, how, and when they are supported but also WHO will be invited into their lives. This presents a myriad of human resources challenges and opportunities!
For individuals who wish to improve the quality of life by resolving the emotional, behavioral, and personal problems, Individual Counseling Services prove useful. Anna Chandy is the popular counselor who provides the therapeutic counseling to individuals in one-to-one setting. You can reflect on your emotions, thoughts, and behavior during the session.
Person-Centred Recruitment and Hiring: LiveWorkPlay's Journey (So Far!)LiveWorkPlay
This session explores the LiveWorkPlay journey in developing and using person-centred practices. Supported individuals must have a say not only as to what, where, why, how, and when they are supported but also WHO will be invited into their lives. This presents a myriad of human resources challenges and opportunities!
Presentation given by S K Sinha, Senior Technical Director & Head, Smart Card Technology Division and NIC CA, NIC on August 2nd, 2011 at eWorld Forum (www.eworldforum.net) in the session Unique Identification Number (UID)
Cranford Real Estate Market Update - July 2014Jean Zuhl
Here's what you need to know before you buy or sell a home in Cranford. We'll explain the current market conditions, compare them to previous years, and offer advice for buyers or sellers.
Presentation given by Ravi S Saxena, Additional Chief Secretary, Department of Science &Technology, Government of Gujarat on August 2nd, 2011 at eWorld Forum (www.eworldforum.net) in the session ICT Leader's Conclave
Presentation given by A.V.V. Prasad, Additional commissioner (Admin, IT & Smart Cards), Govt. of Andhra Pradesh on August 3rd, 2011 at eWorld Forum (www.eworldforum.net) in the session ICT in Financial Inclusion, Taxation, Excise and Finance
Transforming Care: Share and Learn Webinar – 30 November 2017NHS England
Topic One: “What does good look like: Person-centred support to promoting positive outcomes for people with learning disability and autism”.
Guest speaker: Professor Julie Beadle-Brown, Professor in Intellectual and Developmental Disabilities at the Tizard Centre, University of Kent
This presentation introduces an evidence based practice framework for promoting positive outcomes for people with a learning disability, autism or both, including those who may display behaviours described as challenging. It considers what is needed for successful implementation, with a particular focus on practice leadership and introduce a tool for assessing and monitoring implementation. Participants can download the “What does good look like” guide and tool from https://www.unitedresponse.org.uk/what-does-good-look-like
Topic Two: High Impact Actions for service improvement and delivery by Transforming Care Partnerships.
Guest speaker: Emma Stark, Improvement Manager, Sustainable Improvement Team, NHS England
This presentation gives an in-depth reminder of the High Impact Actions for service improvement and delivery by Transforming Care Partnerships (TCP). Published a year ago this month, the High Impact Actions aim to help TCPs make the biggest strides forward in supporting people of all ages with a learning disability, autism or both to have a home within their community, be able to develop and maintain relationships and get the support they need to live health, safe and rewarding lives, thereby reducing the number of people in inpatient settings.
Judith Wolf's presentation in the "Providing Support in Housing First: User's Choice, Recovery and a Strengths-based Approach" workshop at the Housing First in Europe conference on the 9th of June 2016.
Nds forum acheiving quality outcomes 20 10 2013Christine Bigby
Achieving Quality Outcomes in Group Homes. Presentation at the Vic NDS forum on Housing and Support for People with Disabilitie, 21 October 2013. Professor Christine Bigby, Living with Disability Research Group, La Trobe University.
This is the slide that will be used for case work support briefing for volunteers. Feel free to take a look at it so that you will come prepared.
Of course, you may not understand some of it, it will be explained during the actual briefing itself.
Walk The Talk Turning Organization’s Purpose and values into HabitSeta Wicaksana
In "The Four Keys to Becoming a Talent Magnet Organization," Pamela Stroko, Vice President, HCM Transformation at Oracle, states that "what distinguishes talent magnet organizations from everyone else is that first and foremost, they live their values."
They consult values such as trust/character, focus/priorities, engagement, and telling the truth, when making decisions.
Values are lived through talent processes because they touch everyone in the organization.
Values are the "who we are" and "what we aspire to become" and the talent practices and habits in the organization are the how.
Bigby culture in group homes better and underperforming june 2016 Christine Bigby
This presentation summaries research about the culture in group homes in Australia - it contrasts the positive culture in better group homes which is respectful, coherent, enabling and empowering with culture in underperforming group homes. the difference is not accounted for by resources but organisational factors such as leadership, strong HR policies and translation of values into expectations for staff.
In 2015, LWB began the implementation of the Leading Practice strategy, aiming to build a learning culture among a 4,200-strong workforce that improves leadership and practice quality at the frontline.
Open, responsive and online, pop up uni, 1pm, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Are We There Yet Outcomes Framework Debra MooreDebra Moore
Presentation given to the National Clinical Leads and Modern Matrons Annual Conference (Mental Health and Learning Disability) outlining the Confirm & Challenge (6C\'s) Model and Outcomes Framework
Presentation from the final session a the CORE retreat - thinking about change, transformation, the future and how we as a company can be positioned to serve our community and clients to prepare them for their future and not our past.
Changing Group to High Performing Teams with SOBATWAY through ParticipatingSeta Wicaksana
Why is participation important in teams?
Increases productivity
No matter how you measure it, participation promotes productivity by helping teams work through problems, ideate different solutions, raise potential roadblocks, and communicate goals more clearly.
This workshop by Mandy Williams, Participation Cymru Manager, gave the opportunity to explore the relationship between effective staff engagement and improved public engagement.
Participants looked at the benefits of effective staff engagement, explored what it felt like to be an engaged employee and identified ways of engaging staff better.
Fe wnaeth y gweithdy yma gan Mandy Williams, Rheolwr Cyfranogaeth Cymru, rhoi’r cyfle i edrych ar y berthynas rhwng ymgysylltu effeithiol gyda staff a gwell ymgysylltu gyda staff.
Edrychodd cyfranogwyr ar y manteision o ymgysylltu’n effeithiol gyda staff, wnaethon nhw ystyried sut beth yw bod yn weithiwr sy’n ymgysylltu ac fe wnaethon nhw glustnodi ffyrdd o ymgysylltu'n well gyda staff.
Similar to Parallel Session 4.2 ‘It’s What Matters to me that Counts’ – Keeping the Person at the Heart of the Services we Deliver (20)
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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5. Thistle’s journey towards
a person centred approach
15 years ago Thistle Foundation became serious about
commitment to person centred services. Social care world
changing rapidly:
• large institutions closing
• people previously considered too disabled or too
challenging returning to the community
• existing services not able to respond to needs and
many new provider organisations emerged
6. So…
Thistle acted decisively and radically to survive in new
world:
• Implemented complete service restructure and redesign:
residential homes closed, people supported in own
homes, including people with much more complex
medical and social needs
• Expected staff to work in new ways, grappling with
concepts such as empowerment and inclusion
• Invested heavily in the development of new accredited
training programme for support staff
7. HEC in Person Centred Approaches
• From 2002, over 600 support workers (in Thistle and
other agencies) undertook this course, accredited by
Queen Margaret University
• Course synthesised ideas from person centred
therapeutic approaches (Carl Rogers) with person
centred planning tools and concepts originating in
North America and Canada (Michael Smull; John O‟Brien
and others)
8. Fast forward: What worked well?
• Course very successful, winning several awards
• Led to many positive changes in work practice resulting
in better outcomes for people using services
• Workers very focussed on building best possible
relationship with person being supported
• Experiential nature of learning worked: workers learned
much from sharing in consistent cohorts
• Length of course (two years part time) helped to process
learning and embed practice change
9. What else?
• Workers embraced modules relating to self awareness
• Workers became more reflective - aware of values,
prejudices, strengths and development needs – and able
to work on these
• Workers understood what is meant by active listening
10. What didn’t work so well?
In a number of cases, while huge beneficial impact on
course participants, this not translated into equally
positive changes in quality of life of someone using service
11. Which meant that...
• Workers did not always recognise development and
maintenance of „right relationship‟ was for clear purpose -
to be able to recognise and work towards personal
outcomes
• Sometimes when workers attempted this, focus was on
outputs rather than outcomes
• Some workers stuck in „helper mode‟, thinking they knew
what was in person‟s best interests based on own values
and judgements
12. Putting our learning into practice
All staff development activities delivered by Thistle
emphasise the concept of:
A person centred relationship with intent
13. Person centred approach – a trinity
Identifying and
realising personal
outcomes
(aka personalisation)
A relationship based A focus on assets and
on the core conditions positive reputations
14. What does a person centred approach
mean in practice at Thistle?
Workers must be able to...
• Keep person at centre – and in control - of process
• Build strong, real and respectful relationships with
person using the service
• Focus on person‟s assets and strengths
• Involve family and friends as partners
15. Cont‟d
Workers must be able to...
• Focus on what‟s important TO person...........while also
paying attention to what‟s important FOR person [ health
and safety and safeguard positive reputations]
• Intentionally sustain and build connections in community
• Go beyond conventional service responses
• Continue to listen and learn with person
16. Simultaneously…
Organisational systems and processes:
• Strategic direction must reflect outcomes
• Language must be used consistently
• Person centred relationships must be modelled
• Policies and procedures need to be responsive to
individual needs, as well as fulfilling statutory
requirements
• Participative leadership needs to move from rhetoric to
reality
• Cross organisational working groups can help e.g.
Personal Outcomes Group
17. One of the things that is
making a significant difference…
Using Talking Points framework helps to embed link
between person centred relationships and working towards
personal outcomes
18. Talking Points –
A Personal Outcomes Approach
• Outcomes are the end results of support and/or
service(s) in the person‟s life
• 15 years of research identified a framework of inter-
related outcomes relating to:
• Quality of Life (getting or maintaining it)
• Process (interaction between staff and person)
• Change (for a better life)
19. Outcomes for people we support
Quality of life Process Change
•Feeling safe •Listened to •Improved
•Having things to •Having a say confidence /
do •Treated with
morale
•Seeing people respect •Improved skills
•Staying as well •Responded to •Improved
as you can •Reliability
mobility
•Living where •Reduced
and as you want symptoms
•Dealing with
stigma/discrimin
ation
20. Supporting person to
identify and realise outcomes
•Holding good conversations (include people who don‟t
communicate verbally), actively listening to find out what
really matters to the person in life – the outcomes
•Working with person's outcomes to identify what activities,
supports and/or services are required to realise them over
agreed timescale
•Maximising person‟s own assets, strengths, skills, and
involvement in realising their outcomes along with family,
community etc.
21. What kind of outcomes?
Input Process Outputs Outcomes
Joe, Joe‟s Meet Joe, listen Training Joe wants to
SW, to him, find out certificates; do something
Employment what he can do, supported with his time to
Advisor, what he‟s paid or unpaid feel good and
Supported interested in job to increase his
Employment doing ; book skills.
service training
courses.
Ann, Ann‟s Meet Ann, listen Plan for Ann‟s Ann wants to
family, Ann‟s to her hopes, supported self stop worrying
SW, Heart discuss how management about
Failure Nurse everyone can diagnosis and
support Ann to get back to
live her life doings things
she enjoys
22. What are we learning?
• The personal outcomes journey takes time
• Don‟t start with paperwork
• Improve practice before proving practice
• To measure the difference made, get a baseline
• Common language in recording is essential for
consistency
• Workers need ongoing support and feedback
• Record all contributions (not attributions) to outcomes –
not just Thistle service
23. A cautionary reminder…
“The overwhelming evidence is that what people do for
themselves and with others – not services – delivers the
bulk of social outcomes”
Routledge and Witton, 2010
24. Contact us
Thistle Foundation:
Nikki Bruce Nikki.Bruce@thistle.org.uk
Learning and Development Manager
Gail Cunningham Gail.Cunningham@thistle.org.uk
Research and Development Coordinator
Joint Improvement Team:
Chris Bruce Chris.bruce@scotland.gsi.gov.uk
Lead on Outcomes
