Focus groups have become a popular method in nursing research. Their history can be traced back to marketing research methods, but they have also been used in qualitative, ethnographic research. Our study, which used this approach as part of data collection, raised many issues of analysis and interpretation: in particular, the importance of paying attention to the sequence of focus group discussions, the individuals involved, and the social context of the focus group. We conclude that focus groups are not a 'quick and easy' method of collecting data, and that issues of validity and the relationship between focus group data and other data require careful consideration.

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PurposeThis paper reports on some of the findings of a literature review commissioned to explore integrated care for older people.MethodsThe process of revising included finding and selecting literature from multidisciplinary sources, and encompassed both published papers and ‘grey’ literature, i.e. material which had not been reviewed for publication.ResultsThe study found that thinking has moved on from a focus on the problems of accessing services to exploring ways in which they may function in an integrated way.ConclusionsThe study shows how thinking on integrated care for older people has developed, and knowledge of micro, mezzo and macro strategies is now more available.

This paper reports on a project that involved a number of agencies and groups, including older people, working together to examine and develop practice in an area of shared concern -- going home from hospital. The project was stimulated by a 'whole-system event', and was based on appreciative inquiry (AI) methodology, which has roots in both action research and organisational development. In AI, the research is directed towards appreciating what it is about the social world that is positive, and exploring this. The study was planned around three workshops to streamline data collection and analysis. Group members were also required to carry out some activities between workshops. Invitations were sent out to groups and individuals previously identified as involved or interested in the discharge process across one health district (n = 71). Workshop one discussed the planned research schedule, and introduced the basic concepts of AI. This workshop also took participants through the interview process. Each participant was asked to undertake two interviews. Thirty-five individual interviews and one focus group were completed. At workshop two, interview data were analysed by the group using the nominal group technique. Subsequent group discussion produced 'provocative propositions'. At the third workshop, provocative propositions were developed into action plans. This paper gives an overview of the study, and explores some of the issues involved when working with service users and providers as co-researchers.

Background-In several longitudinal studies changes in body mass and in forced expiratory volume in one second (FEVI) have been found to be negatively correlated. This paper tests the hypothesis that failure to allow for the association can lead to-error in the interpretation of longitudinal measurements of ventilatory capacity. Methods -Male shipyard workers (n= 1005) were assessed on two occasions with an average interval between measurements of 6-9 years. A respiratory symptoms questionnaire, detailed anthropometric measurements, and dynamic spirometric tests were undertaken. Multiple regression analysis was used to identify variables which contributed to the changes in lung function. Results -After allowing for age and growth in stature, a change in body mass of 1 kg was, on average, associated with a mean (SE) converse change in FEV, of 17-6 (2 0) ml, and in forced vital capacity (FVC) of211 (2.5) ml. Neglect of changes in body mass (which in this context reflected changes in body fat) led to underestimation of the longitudinal decline in FEV, with age and failure to detect significant improvements in FEV,, both in smokers following discontinuation of smoking and in shipyard welders and caulkerlburners as a consequence of leaving their employment. The estimated peak ages and associated peak levels of the indices were found to differ, depending on whether or not they were expressed at constant body mass. Conclusions -Neglect of changes in body mass can lead to erroneous conclusions being drawn from longitudinal measurements of FEVy. (Thorax 1996;51:699-704) Keywords: body mass, lung function, respiratory surveys, ageing, smoking, welding fumes, occupation.Understanding the factors that influence longitudinal change in ventilatory capacity is important for the interpretation of many clinical, epidemiological, and occupational studies. Hence, the potential confounding factors that influence the annual change in ventilatory capacity need to be identified. One such factor which has been relatively overlooked is change in body mass which, in three different studies, for a man aged 40 years, has been found to be associated with reductions in forced expiratory volume in one second (FEVy) per kg gain in mass of, on average, 21-4 ml/kg, 139 ml/kg, and 23 ml/kg.'-' Since the magnitude of this change is of the same order as the annual change in FEVI, this could be an important confounding influence because a change in exposure to tobacco smoke or to an occupational pollutant can be accompanied by a change in body mass. Similarly, since body mass usually increases from youth to middle age and then diminishes,4 some of the agerelated decline in lung function could be due to the associated changes in body mass.6 This paper explores these interrelationships using data obtained from longitudinal studies of shipyard workers, and attempts to answer the question "Can neglect of changes in body mass, standardised for stature, materially affect the interpretation of longitudinal measurements of FEV, and FVC?" Method...