The present article describes a qualitative study designed to evaluate the effectiveness of a peer-support intervention to promote breast-feeding in a deprived area. The aims of the study were to: explore stakeholders' experiences of the intervention; explore the development of a 'culture' of breast-feeding; and consider the potential of the initiative for building community capacity. The methods used in the research were in-depth interviews, diaries and direct observation. The findings describe the social and cultural barriers to breast-feeding experienced by women, and the ways in which professional and lay participants in the peer-support project attempt to reduce them. The advantages of partnership working between health professionals and lay volunteers are then explored. These include: sharing the workload; providing an informal tier of support to mothers; and importantly, offering support and advice stemming from personal experience. For lay supporters, the benefits of taking part in the project range from personal satisfaction at being recognised as skilled, to gains in confidence which potentially open up further educational and training opportunities. In conclusion, it is suggested that the 'success' of such interventions is unlikely to be captured solely by monitoring breast-feeding rates, but needs to take into account the wider context of community development.

With an increased interest in and policy commitment to involving service users in the planning and delivery of health service provision, there is a clear need to explore both the rhetoric and realities of what user involvement entails. In the present paper, by drawing upon an evaluation of a community-based exercise facility for people with mental health problems, the authors explore ways in which the reality of user involvement is subject to a range of configurations within health services. The paper describes a piece of qualitative research that was undertaken within a participatory framework to explore the nature of user involvement within the facility. The data have been analysed using a grounded theory approach to provide insights into: the organisational context in which user involvement takes place; factors which encourage meaningful participation on the part of service users; perceived barriers to user involvement; and issues of sustainability and continuity. This research approach has enabled the authors to explore the views and experiences of users, service providers and referral agencies in relation to the nature and potential for user involvement. The findings illustrate ways in which user involvement may take place under both flexible and formal arrangements across a variety of activities. The present paper provides an account of some of the meanings and experiences of what 'successful' user participation may involve and the conditions which underpin 'success'. The authors conclude that successful and meaningful user involvement should enable and support users to recognise their existing skills, and to develop new ones, at a pace that suits their particular circumstances and personal resources. This process may require adaptation not only by organisations, but also by service providers and non-involved users.

AB S T R A C T User involvement has become a central tenet of government policy regarding health and social care. Likewise, the role of 'evidence' is seen as being at the heart of effective planning and delivery of health services (Our Healthier Nation, 1999). This paper examines the role of user involvement in evaluative research within the provision of an evidence base related to practice development. By focusing on the role of participatory research in the creation of an evidence base for healthcare provision, the authors explore the nature and possibilities of user involvement in providing an evidence base within a community mental health service. The paper identi es factors that may facilitate or inhibit user involvement and participation in evaluative research. It is argued that whilst the effective involvement of users may improve the quality and validity of research evidence, user participation in the research process is both contextual and contingent. For users to participate in the research process in a meaningful way requires changes in the way that research is commissioned and assessed so that the nature of user involvement may become viable. The authors suggest that the creation of evidence in health research is shaped by the social relations of the research process as well as by the methodologies used.

The Scafell caldera-lake volcaniclastic succession is exceptionally well exposed. At the eastern margin of the caldera, a large andesitic explosive eruption (>5 km 3 ) generated a high-mass-flux pyroclastic density current that flowed into the caldera lake for several hours and deposited the extensive Pavey Ark ignimbrite. The ignimbrite comprises a thick (≤125 m), proximal, spatter-and scoria-rich breccia that grades laterally and upwards into massive lapillituff, which, in turn, is gradationally overlain by massive and normal-graded tuff showing evidence of soft-state disruption. The subaqueous pyroclastic current carried juvenile clasts ranging from fine ash to metre-scale blocks and from dense andesite through variably vesicular scoria to pumice (<10 3 kg m −3 ). Extreme ignimbrite lithofacies diversity resulted via particle segregation and selective deposition from the current. The lacustrine proximal ignimbrite breccia mainly comprises clast-to matrix-supported blocks and lapilli of vesicular andesite, but includes several layers rich in spatter (≤1.7 m diameter) that was emplaced in a ductile, hot state. In proximal locations, rapid deposition of the large and dense clasts caused displacement of interstitial fluid with elutriation of low-density lapilli and ash upwards, so that these particles were retained in the current and thus overpassed to medial and distal reaches. Medially, the lithofacies architecture records partial blocking, channelling and reflection of the depletive current by substantial basinfloor topography that included a lava dome and developing fault scarps. Diffuse layers reflect surging of the sustained current, and the overall normal grading reflects gradually waning flow with, finally, a transition to suspension sedimentation from an ash-choked water column. Fine to extremely fine tuff overlying the ignimbrite forms ∼25% of the whole and is the water-settled equivalent of co-ignimbrite ash; its great thickness (≤55 m) formed because the suspended ash was trapped within an enclosed basin and could not drift away. The ignimbrite architecture records widespread caldera subsidence during the eruption, involving volcanotectonic faulting of the lake floor. The eruption was partly driven by explosive disruption of a groundwaterhydrothermal system adjacent to the magma reservoir.

In this paper we explore the ways in which one innovative mental health service has attempted to address the issue of psychological accessibility and 'safety' for its users. Drawing upon an evaluation of a community-based exercise facility for people with mental health problems, and using a qualitative research approach, we explore the views of users, service providers and referral agencies to draw out those aspects of the service, which influence accessibility. Our findings emphasise the importance of the facility's non-institutional appearance, its community location, and the perceived (physical and psychological) 'distance' from medically based mental health services. Activities on offer are meaningful to service users and socially valued (and therefore non-stigmatising). Crucial to reducing any potential psychological 'risk' involved in participating in exercise regimes for vulnerable people is the relationship fostered between staff and service users, the level of individual support provided, and the flexible approach to users' progress.