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Research shows that, in mental healthcare, empathy and active listening skills play a fundamental role in the therapeutic relationship. Despite this, clinicians receive little training in cultivating these qualities, and there is a dearth of training in therapeutic relationships and relational care in this field more generally. In response to this paucity of training, a new intensive three-day training programme has been developed called Compassionate and Relational Enquiry (CARE). The CARE training programme has recently been delivered to a number of mental health teams in different boroughs of an NHS Trust and has undergone several rounds of redevelopment. This paper outlines the CARE training programme's objectives and mode of delivery, and subsequently presents questionnaire results from recent CARE trainees regarding their experience of the nature and utility of the training. Four main themes emerged from responses to the question of the utility of the training, these were 'A shift towards more person-centred care', 'Strengthens the therapeutic relationship', 'Facilitates more collaborative care with patients and their families' and 'Development of new skills and therapeutic techniques'. The paper concludes by discussing the potential of this training to help forge a substantial shift in the culture of mental health services in a systemic way. [ABSTRACT FROM AUTHOR]

Background: Impaired discourse production is commonly reported for individuals with traumatic brain injury (TBI). Discourse deficits can negatively impact community integration, return to employment and quality of life. COVID‐19 restrictions have reduced in‐person assessment services for people with communication impairments. Advances in telehealth may help speech and language therapists (SLTs) to assess monologic discourse more systematically and improve access to services for patients who may find it difficult to attend in‐person. Aims: To examine the feasibility of telehealth administration of narrative and procedural discourse tasks with individuals with TBI and matched controls. Methods & Procedures: A total of 20 individuals with TBI and 20 healthy controls, aged 18–55 years, were directly recruited from the UK and indirectly recruited from the US. For participants with TBI, time post‐injury was at least 3 months with no diagnosis of aphasia. Control participants were matched for sex and as closely as possible for age. Feasibility of measures was based upon the time to administer both narrative tasks, the report of any technological problems, and participant feed. Discourse samples were transcribed verbatim and analysed using story grammar analysis (for narrative discourse) and identification of propositions (for procedural discourse). Interrater reliability was calculated using percentage agreement for 50% of the data. Non‐parametric analyses were used to analyse the performance of the two groups. Outcomes & Results: Narrative and procedural discourse samples were collected via telehealth in approximately 10 min with no reported technical difficulties or complaints from any participants. For narrative discourse performance, there were significant differences for the TBI and control groups for measures of complete episodes (p < 0.001) and missing episodes (p = 0.005). No significant group differences were noted for any of the procedural discourse measures. Conclusions & Implications: Results support the feasibility of collecting discourse samples via telehealth. Although the participants' discourse performance distinguished the TBI and control groups on the narrative task, no differences between the groups were noted for the procedural task. The narrative discourse task may have been more difficult than the procedural task, or video cue support reduced the cognitive load of the procedural task. This finding suggests the use of more complex procedural tasks without video cue support may be needed. WHAT THIS PAPER ADDS: What is already known on this subject: Although little research has explored the feasibility of administering discourse assessments for individuals with TBI via telehealth, some studies have found that discourse interventions can be feasibly administered via telehealth. It is also well established that individuals with TBI struggle with the supra‐structural and macro‐linguistic elements of discourse production. Both procedural and narrative discourse tasks have been found to differentiate individuals with TBI from healthy controls. What this paper adds to existing knowledge: Few studies have investigated the feasibility of, and procedures for, administering discourse tasks via telehealth. Additionally, the inclusion of multiple types of discourse tasks to parse cognitive–communication abilities is lacking in the current literature. Findings from this study support that narrative and procedural discourse can be feasibly sampled via telehealth and that international collaboration for research on this topic can facilitate such studies. Individuals with TBI performed more poorly on three measures of narrative discourse. No differences between groups were identified for the procedural task. What are the potential or actual clinical implications of this work?: Telehealth assessment for discourse provides flexibility for both the individual with TBI and the speech–language therapist and does not compromise the quality of data collected. The administration of discourse tasks and collection of data was not time‐consuming and was well accepted by the study participants. Additionally, international research collaboration not only expands potential participation in research but increases the opportunity to recruit and study more diverse groups. [ABSTRACT FROM AUTHOR]

Introduction There is anecdotal evidence that health messages interpreted from waterpipe tobacco smoking (WTS) research are inconsistent, such as comparing the health effects of one WTS session with that of 100 cigarettes. This study aimed to identify key health themes about WTS discussed by online news media, and how numerical cigarette–waterpipe equivalence (CWE) was being interpreted. Methods We identified 1065 online news articles published between March 2011 and September 2012 using the ‘Google Alerts' service. We screened for health themes, assessed statements mentioning CWE and reported differences between countries. We used logistic regression to identify factors associated with articles incorrectly reporting a CWE equal to or greater than 100 cigarettes, in the absence of any comparative parameter (‘CWE ≥100 cigarettes'). Results Commonly mentioned health themes were the presence of tobacco (67%) and being as bad as cigarettes (49%), and we report on differences between countries. While 10.8% of all news articles contained at least one positive health theme, 22.9% contained a statement about a CWE. Most of these (18.6% total) were incorrectly a CWE ≥100 cigarettes, a quarter of which were made by healthcare professionals/organisations. Compared with the Middle East, articles from the USA and the UK were the most significant predictors to contain a CWE ≥100 cigarettes statement. Conclusions Those wishing to write or publish information related to WTS may wish to avoid comparing WTS to cigarettes using numerical values as this is a major source of confusion. Future research is needed to address the impact of the media on the attitudes, initiation and cessation rates of waterpipe smokers. [ABSTRACT FROM AUTHOR]

Background: The advantages of including people with learning disabilities in research teams have been well described, but it is rare for researchers with learning disabilities to be employed at a university. This paper explores the extent to which university recruitment procedures are accessible to job applicants with learning disabilities. Methods: We present reflections on the process of recruiting a Research Assistant with a learning disability onto a university research team. The recruitment process is described from the perspectives of the employee, line manager and Human Resources representative. Findings: The recruiting manager and Human Resources representative had to make adjustments to a wide range of standard processes, including centralised online recruitment systems that were difficult to navigate, inaccessible job descriptions and difficult application forms. Finding workarounds to ensure reasonable adjustments were made was time‐consuming. The employee needed significant support from within his own networks to cope with the application process and had concerns about the potential impact of fixed‐term job contracts on future benefits. Despite our efforts, procedures remained difficult for the applicants to navigate. Conclusions: Employing researchers with learning disabilities is important. Fundamental changes to job application systems are required, including easy‐to‐understand information, alternative formats of application forms, and support available where needed. Flexibility from the Human Resources departments is key. They will need support from teams with experience working with people with learning disabilities. Accessible summary: It is important that people with learning disabilities are involved in research, but not many people with learning disabilities have a job at a university as part of the research team.We can learn from examples where people with learning disabilities applied for a university job. One example is Richard Keagan‐Bull, who got a job as a Research Assistant at Kingston and St George's University of London.What was it like to advertise for the job, apply for the job, and get the job? In this article, three people talk about this: Richard (who got the job), Irene (his manager) and Maria (who sorts out the paperwork and computer systems at the university).They found that the university's systems for finding and employing new staff were too complicated for people with learning disabilities. They had to make many changes to it, such as writing an easy‐read job advert and asking easier questions on the application form.This all took a lot of time. Irene and Maria made things easier but didn't always get it right. Richard still found it all quite complicated. They wrote this article because they want other universities to learn from their mistakes. They hope that more universities will employ researchers with learning disabilities.People might lose their benefits when they start a job. Research jobs at universities are usually only for a short time (1 or 2 years). It can be hard and stressful to get back onto benefits. This may put people off doing these jobs.You can see an easy‐read version of this paper in Supporting Information Appendix 4. [ABSTRACT FROM AUTHOR]

This paper answers calls for further theoretical work into types of pictures used in health information. Pictures influence message reception, interpretation, and retention, making this an important area for research in health communication. A content analysis was used to produce a systematic and theory-orientated assessment of the use of pictures in cancer screening information materials (N = 44) produced for invitees to either cervical, breast or bowel screening in the United Kingdom. The main categories investigated in this study were function, content and style of the pictures. Pictures used in cancer screening information materials were twice as likely to be used to demonstrate what something looked like or depict a situation (display pictures) than to convey a specific cancer screening message (message pictures). The messages being conveyed were predominantly related to screening procedures (51%) or outcomes (38%) rather than screening experiences (6%) or decisions (9%). Pictures were rarely used to portray a narrative in the materials (n = 12). The paper brings conceptual clarity to the ways pictures can be, and have so far been used, to communicate cancer screening information. This study identifies that pictures conveying a cancer-related message, and pictures in the format of a narrative, should be used more often in print cancer screening communications. [ABSTRACT FROM AUTHOR]

Background: Many amateur singers enjoy singing in choirs. They are likely to lack the training and expertise of professional singers and this may have an impact on their vocal health. Aims: To assess the experiences of amateur singers, their use of warm‐up and cool‐down sessions, their vocal health, their sources of help and advice and their reactions to receiving a diagnosis and treatment. Methods and Procedures: A questionnaire was sent to amateur choir singers. Quantitative data on their use of warm‐up and cool‐down activities were collected and the singers rated how frequently they experienced adverse voice symptoms after singing. Qualitative data were collected from singers who had sought advice about their voice and from those who had received a diagnosis and treatment. Outcome and Results: Most choirs used warm‐up sessions but few used cool‐down. Singers who participated in choir warm‐ups experienced significantly less vocal symptoms. Individual warm‐ups were ineffective. Singers who had previously had a diagnosis continued to have significantly higher symptom scores. A quarter of the singers who had neither sought help nor had a diagnosis had high scores. Singers appeared uncertain about who to consult for help. Those who saw a speech and language therapist were much more likely to receive a diagnosis and treatment either by the therapist or by referral to an ear, nose and throat specialist. Those receiving treatment were mainly positive about it and likely to complete a course of therapy. Conclusions and Implications: Warm‐up sessions performed by choirs are helpful in avoiding voice symptoms and are recommended. The presence of singers who are unaware of potential damage to their voices is a concern. A simple rating system, as used in this research, may act to alert them to the dangers. Choir leaders could be more active in advising singers and refer them to professionals where necessary. Speech and language therapists appear more sensitive to their problems and could be a first point of contact. WHAT THIS PAPER ADDS: What is already known on this subject: Poor vocal health may occur in amateur singers and lead to voice disorders which will reduce the demonstrated benefits of regular singing. They may be less aware than professional singers of potential hazards and may not know how to sing in a way that ensures good vocal health. There has been less research on the extent of voice problems in amateurs or of the actions they may take to resolve the vocal difficulties they encounter. What this paper adds to the existing knowledge: This survey demonstrates that choir warm‐ups were effective in helping to avoid common symptoms associated with voice problems. A large minority of singers who had not sought help for voice problems had high symptom scores on our assessment. Singers frequently turned to a singing teacher for help. Those who consulted a speech and language therapist were much more likely to be referred for further investigation and treatment. What are the potential or actual clinical implications of this work?: We present a simple subjective measure of symptom severity which succeeds in distinguishing between singers who warm up their voices and those who do not and between singers who have received a past diagnosis and those who have not. There are a number of indications in this research that amateur singers are unsure if they need help and are uncertain who can offer it. In these circumstances the use of a simple measure of the severity of vocal abuse may be useful. [ABSTRACT FROM AUTHOR]

Background: Speech and language therapy (SLT) education must meet the needs of the future workforce, training enough students who are competent practitioners able to meet the workforce demands. Increasing student numbers and the impact on placement providers mean students must be equipped for learning on placement. Simulation is a way of supporting students to develop their clinical skills and decision‐making in a safe, supportive environment. Aims: To explore the perspectives of SLT students who were introduced to simulation during their undergraduate degree at a UK university as part of a pilot study. The aim of the pilot was to listen to the students' voices to begin to understand their lived experiences of simulation and to gather views on how simulation can support their clinical learning. Methods & Procedures: Focus groups and semi‐structured interviews were carried out with second‐year BSc SLT students in semester 2 following the simulated learning activities and clinical placement. Qualitative data were gathered and thematic analysis was applied to the data to identify the barriers and enablers to students' clinical learning in simulation. Outcomes & Results: A total of 11 students responded out of a cohort of 38. Three key themes were identified from the analysis: individual learning needs, facilitator skill and programme‐level organization. Conclusions & Implications: Student experience of simulation was positive. One of the key elements students found to support their clinical skills was the importance of the safe space; support for learning instead of correction led them to engage in active learning. Key barriers to simulation related to having sufficient prior knowledge, the skills of the facilitator, group size and the wider learning landscape of the programme. In response to this pilot, there are plans to continue developing this model of simulation and embed simulation across the programme, led by a sound pedagogical approach with clear preparation and planning and building the necessary infrastructure. Other SLT programmes and practice educators developing simulation as part of their programmes or placement may wish to consider some of these findings to support the use of simulation in their workplace. What this paper adds: What is already known on this subject: Simulation as a teaching methodology is widely used in medicine and nursing programmes. It is now used in various allied health professions and in some SLT programmes. There is evidence to suggest simulation increases student confidence and clinical skills without increasing the capacity on those offering clinical placements in practice. What is already known on this subject: This study offers a practical example of introducing simulation in an established undergraduate programme for SLT students. It explains the background to this innovative way of teaching clinical skills and explains why this approach could be beneficial for the future speech and language therapist. What are the clinical implications of this work?: This study gives practical examples of how simulation can work to facilitate student clinical learning and knowledge. It may offer ideas to those working in clinical practice to organize placements differently or add simulation elements to improve the student experience. Other educational establishments and placement educators may find the recommendations helpful in developing their own simulation approach. [ABSTRACT FROM AUTHOR]

Moral thinking and communication are critical competencies for confronting social dilemmas in a challenging world. We examined these moral competencies in 70 college students and graduates from Taiwan, the United Kingdom, and the United States. Participants were assessed through semi-structured written interviews, Facebook group discussions, and a questionnaire. In this paper, we describe the similarities and differences across cultural groupings in (1) the social issues of greatest importance to the participants; (2) the factors influencing their approaches to thinking about social issues and communicating with others; and (3) the characteristics of their moral functioning in terms of moral awareness, moral judgment, moral discourse, and moral decision-making. [ABSTRACT FROM AUTHOR]

Background: Research evidence suggests aphasia therapy must be delivered at high intensity to effect change. Comprehensive therapy, addressing all domains of the International Classification of Functioning, Disability and Health, is also called for by people with aphasia and their families. However, aphasia therapy is rarely intense or comprehensive. Intensive Comprehensive Aphasia Programmes (ICAPs) were designed to address this challenge, but such programmes are not widely implemented. Aims: This study surveyed the views of UK‐based speech and language therapists (SLTs) regarding intensive and comprehensive aphasia therapy. It explored definitions of intensive and comprehensive therapy, patterns of provision, views about candidacy and barriers/facilitators. It also investigated awareness of ICAPs and perceived potential of this service model. Differences across UK regions and workplace settings were explored. Methods & Procedures: An e‐survey ran for 5 months. Quantitative data were analysed using descriptive and inferential statistics. Qualitative free text comments were analysed using content analysis. Outcomes & Results: Two hundred twenty‐seven respondents engaged in the e‐survey. Definitions of intensive aphasia therapy did not reach UK clinical guideline/research‐level thresholds for most of the sample. Those providing more therapy provided definitions with higher standards of intensity. Mean therapy delivered was 128 min/week. Geographical location and workplace setting influenced the amount of therapy delivered. The most frequently delivered therapy approaches were functional language therapy and impairment‐based therapy. Cognitive disability and fatigue were concerns for therapy candidacy. Barriers included lack of resources and low levels of optimism that issues could be solved. 50% of respondents were aware of ICAPs and 15 had been involved in ICAP provision. Only 16.5% felt their service could be reconfigured to deliver an ICAP. Conclusions & Implications: This e‐survey evidences a mismatch between an SLT's concept of intensity and that espoused by clinical guidelines/research. Geographical variations in intensity are concerning. Although a wide range of therapy approaches are offered, certain aphasia therapies are delivered more frequently. Awareness of ICAPs was relatively high, but few respondents had experience of this model or felt it could be executed in their context. Further initiatives are needed if services are to move from a low‐dose or non‐comprehensive model of delivery. Such initiatives might include but not be confined to wider uptake of ICAPs. Pragmatic research might also explore which treatments are efficacious with a low‐dose model of delivery, given that this model is dominant in the United Kingdom. These clinical and research implications are raised in the discussion. What this paper adds: What is already known on this subject: There is a gap between the high intensity of aphasia treatment provided in research versus mainstream clinical settings. A lower standard of 45 min/day set by UK clinical guidelines is also not achieved. Although speech and language therapists (SLTs) provide a wide range of therapies, they typically focus on impairment‐based approaches. What this study adds: This is the first survey of UK SLTs asking about their concept of intensity in aphasia therapy and what types of aphasia therapy they provide. It explores geographical and workplace variations and barriers and facilitators to aphasia therapy provision. It investigates Intensive Comprehensive Aphasia Programmes (ICAPs) in a UK context. What are the clinical implications of this work?: There are barriers to the provision of intensive and comprehensive therapy in the United Kingdom and reservations about the feasibility of ICAPs in a mainstream UK context. However, there are also facilitators to aphasia therapy provision and evidence that a small proportion of UK SLTs are providing intensive/comprehensive aphasia therapy). Dissemination of good practice is necessary and suggestions for increasing intensity of service provision are listed in the discussion. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences of women who have had ovarian hyperstimulation syndrome, and healthcare professionals who care for them. Background: Ovarian hyperstimulation syndrome is a side effect of fertility treatment. Little research exists internationally that explores the experiences of women who have had this condition, or the healthcare professionals who manage it. Design: Qualitative study using semi‐structured interviews. Methods: Eighteen interviews with women who had experienced ovarian hyperstimulation syndrome (n = 10) and healthcare professionals (n = 8) in six UK fertility centres. Framework analysis was used. This paper is reported following COREQ guidelines. Results: Women described a range of symptoms and severity, sometimes experiencing worrying physical health problems such as abdominal swelling and shortness of breath. The combination of the symptoms, and their management, on delaying future fertility treatment could cause emotional distress. Healthcare professionals at different centres described variation in practice, which generally involved 'active monitoring' until symptoms became severe, when women would be hospitalised. Women expressed feeling 'left in limbo' while waiting for symptoms to improve or worsen, and described a lack of control during this waiting period. Healthcare professionals felt they provided adequate information about ovarian hyperstimulation syndrome and its management. This, however, did not align with women's perceptions that information, including potential delays to their fertility treatment, was missing. There was similar mismatch between women's and healthcare professionals' views of decision‐making about fertility treatment following ovarian hyperstimulation syndrome, including women's concerns about having to make rushed, unplanned decisions about their fertility treatment when they did not feel adequately informed to do so. Conclusion: Ovarian hyperstimulation syndrome and its management can have a significant physical and emotional impact on women, and influence their fertility treatment. Improvements could be made to the information women receive about this condition, its management and its implications for wider fertility treatment. Implications for the profession and/or patient care: Nurses have the skills and knowledge to support women through the physical and emotional stresses of fertility treatment. Therefore, they are well placed to provide specialist information and support for OHSS and ensure women are fully informed about all aspects of the condition, including how its management might delay fertility treatment. [ABSTRACT FROM AUTHOR]

This paper reports on the evaluation of an integrated violence and abuse prevention programme for children aged 5–11, focusing on children with special educational needs and disabilities (SEND). The Speak Out Stay Safe (SOSS) programme was delivered in mainstream primary schools across the UK. A small‐scale study of children with SEND nested within the larger evaluation captured their understandings of abuse and harm and readiness to seek help. A specially adapted survey was completed by 76 children with SEND (aged 6–7 and 9–10) at baseline (31 intervention; 45 comparison schools), 12 in intervention schools post‐programme and 37 (four intervention; 33 comparison schools) six months post‐baseline. Qualitative data was captured through 16 teacher interviews. Whilst this nested study was compromised by the COVID‐19 pandemic, it provides important evidence that with appropriate adaptations, a survey approach to investigating the learning of children with SEND can be effective. Findings indicate that awareness of abuse and help seeking strategies may improve over time, whilst interview data suggests that adapting the programme to be inclusive of those children may have a better effect. However, a much larger sample of children with SEND is required to confidently measure the effects of such programmes for this population. [ABSTRACT FROM AUTHOR]

Background: Silent aspiration (SA) is common post‐stroke and associated with increased risk of pneumonia, length of stay and healthcare costs. Clinical swallow examinations (CSEs) are unreliable measures of SA. There is no consensus on the clinical components that best detect SA. Cough reflex testing (CRT) is an alternative/adjunct whose SA detection accuracy also lacks consensus. Aims: To investigate the feasibility of CSE versus CRT against gold standard flexible endoscopic evaluation of swallowing (FEES) for SA identification and to estimate its prevalence in a hyperacute stroke setting. Methods & Procedures: A single‐arm preliminary, prospective, feasibility study of patients less than 72 h post‐stroke, over a 31‐day period on a hyperacute stroke unit: the Royal Victoria Infirmary, Newcastle‐upon‐Tyne, UK. Ethical approval for the study was obtained. The study tested the feasibility and acceptability of introducing CRT and developing a standardized CSE. Consent/assent was obtained for all participants. Patients unfit for study were excluded. Outcomes & Results: A total of 62% of patients less than 72 h post‐stroke (n = 61) were eligible. A total of 75% of those approached (n = 30) consented. A total of 23 patients completed all tests. The principal barrier was anxiety regarding FEES. Mean test time for CRT = 6 min; CSE = 8 min; FEES = 17 min. Patients rated CRT and FEES on average as moderately uncomfortable. A total of 30% (n = 7) of participants who received FEES presented with SA. Conclusions & Implications: CRT, CSE and FEES are feasible in 58% of hyperacute stroke patients in this setting. FEES anxiety is the main recruitment barrier and is not always well tolerated. Results support further work to establish optimum methods and differential sensitivity/specificity of CRT and CSE in hyperacute stroke for SA identification. WHAT THIS PAPER ADDS: What is already known on this subject: SA significantly increases the risk of pneumonia in the early days post‐stroke. CSEs are unreliable for identification of SA risk in this population. CRT is gaining popularity as a potential tool to identify stroke patients at risk of SA, though there are questions regarding the efficacy of the clinical protocol currently being used in the UK. What this study adds to existing knowledge: This study demonstrates that it is practical and feasible to carry out a larger scale study in this setting to compare CSE and CRT including a consideration of an approach combining both methods for clinical identification of SA versus FEES. Preliminary findings suggest that CSE may have higher levels of sensitivity than CRT for SA identification. What are the potential or actual clinical implications of this work?: The results of this study suggest that further work is needed to establish the optimum methods and differential sensitivity/specificity of clinical tools for SA detection in hyperacute stroke. [ABSTRACT FROM AUTHOR]

Previous research has found that music brings back more vivid and emotional autobiographical memories than various other retrieval cues. However, such studies have often been low in ecological validity and constrained by relatively limited cue selection and predominantly young adult samples. Here, we compared music to food as cues for autobiographical memories in everyday life in young and older adults. In two separate four‐day periods, 39 younger (ages 18–34) and 39 older (ages 60–77) adults recorded their music‐ and food‐evoked autobiographical memories in paper diaries. Across both age groups, music triggered more frequent autobiographical memories, a greater proportion of involuntary memories, and memories rated as more personally important in comparison to food cues. Age differences impacted music‐ and food‐evoked memories similarly, with older adults consistently recalling older and less specific memories, which they rated as more positive, vivid, and rehearsed. However, young and older adults did not differ in the number or involuntary nature of their recorded memories. This work represents an important step in understanding the phenomenology of naturally occurring music‐evoked autobiographical memories across adulthood and provides new insights into how and why music may be a more effective trigger for personally valued memories than certain other everyday cues. [ABSTRACT FROM AUTHOR]

Aims: This is the second of two papers conceptualizing emotional labour in the emergency department (ED). This paper aims to understand the environmental 'moderators' of ED nurses' emotional labour. Design: Ethnography, through an interpretivist philosophy, enabled immersion in the ED setting, gathering the lived experiences and narratives of the ED nurses. Methods: Observation and semi‐structured interviews over a 6‐month period. Two hospital sites (one district general and one major trauma centre based in the United Kingdom. Results: Over 200 h of observation plus 18 formal/semi‐structured interviews were completed. Environmental, institutional and organizational dynamics of the emergency department instrumented the emotional labour undertaken by the nursing team. Time and space were found to be 'moderators' of ED nurses' emotional labour. This paper focusses on the relevance of space and in particular, 'excessive visibility' with little respite for the nurses from their intense emotional performance. Conclusion: Emotional labour is critical to staff well‐being and the way in which healthcare spaces are designed has an impact on emotional labour. Understanding how emotional labour is moderated in different clinical settings can inform organizational, environmental and workforce‐related decision‐making. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic and subsequent measures to reduce transmission risk has led to unprecedented digital transformation across health, education and social care services. This includes UK paediatric speech and language therapy (SLT), which sits at the crossroads of these services. Given the rapid onset of this pandemic‐induced digital transition, there is now a need to capture, reflect and learn from the SLT profession so that benefits can be sustained, and barriers addressed. Aims: To survey the impact of COVID‐19 remote working on UK paediatric SLTs' digital views and experiences using the Capability, Opportunity, Motivation and Behaviour (COM‐B) model. Methods & Procedures: An online survey was conducted from May to October 2020. Respondents were asked to rate their use of technology in service delivery before and during the pandemic, to select factors facilitating digital practice, and to provide open‐response aspirations for the future role of technology in paediatric SLT which were analysed thematically using the COM‐B behaviour change model. Outcomes & Results: A total of 424 UK paediatric SLTs responded to the survey. Findings indicate a marked increase in clinicians' perception of their frequency, convenience and confidence with digital practice during COVID‐19 compared with before the pandemic. Respondents identified that specialist training (27%), funding for workplace devices (22%) and supportive leadership (19%) were most likely to facilitate sustained digital practice. Clinicians hoped for a blended approach going forward with technology enhancing existing best practice. Further prominent themes included digital accessibility for all and maintaining the increased opportunity for multidisciplinary working that videoconferencing has afforded. More service‐specific aspirations were bespoke technological solutions as well as parents/carers being able to engage remotely with school‐based provisions. Conclusions & Implications: During COVID‐19, paediatric SLTs' recognition and acceptance of how technology can augment practice has accelerated, with particular value being placed on inclusivity, choice, training, resources, leadership and indication of effectiveness. These are important considerations to help guide the profession towards the long‐term digital enhancement of SLT services. WHAT THIS PAPER ADDS: What is already known on the subject: The COVID‐19 pandemic led to an unprecedented interest in the use of technology across SLT practice. Studies are emerging nationally and internationally to identify the digital priorities of the SLT workforce, the areas of digital SLT provision that are thriving or lacking, and the evidence to guide clinical practice and service development. What this study adds to existing knowledge: This is the first UK‐wide COVID‐19 survey solely focusing on the digital practice of paediatric SLTs. The findings provide critical insights into SLT perception of how practice has been impacted in the early stages of the COVID‐19 pandemic, including digital trends that are service, condition and demographic specific. Tools and channels required to support sustained beneficial change are also discussed. What are the potential or actual clinical implications of this work?: This paper demonstrates the potential for digital solutions to enhance SLT practice, as long as implementation is guided by clinicians' experiences and perspectives. The findings lay groundwork for service development work, such as the creation of training packages, updating of clinical guidelines and care pathways, and development of processes to ensure equitable allocation of evidence‐based resources. [ABSTRACT FROM AUTHOR]

Background: Between 90% and 95% of deaf children are born to hearing parents who often need support with how to adapt their communication. Parent–child interaction (PCI) is an important predictor of deaf children's future language development. It is therefore necessary for professionals to assess parents' strengths and needs to identify areas for intervention. Qualified teachers of the deaf (QToDs), speech and language therapists (SLTs), psychologists, and national deaf child and adolescent mental health (NDCAMHS) professionals regularly support families with deaf children. With no current evidence‐based tool available to assist with the assessment of PCI in deafness, it is important to gather information on current professional practice as this may differ from known practices within research. Aims: To survey the practices of UK‐based professionals in the assessment of PCI where the deaf infant is aged 0–3 years. Professionals were QToDs, SLTs, psychologists or psychiatrists and professionals working at NDCAMHS services. Methods & Procedures: After a pilot phase, an 85‐item survey was distributed electronically through a range of professional and social media networks. Survey items were based on a systematic review of PCI with deaf infants. Survey questions were focused on parent behaviours that were assessed, methods of assessment, goal planning and service provision. Analysis was conducted using descriptive and inferential statistics. Outcomes & Results: A total of 190 professionals from across the UK completed part 1 of the survey; this decreased to 148 in part 4. Respondents were primarily female, hearing, used spoken English and had 16 years or more experience. Results indicate that PCI is routinely assessed by a large proportion of professionals and there is a substantial overlap in which parent behaviours are assessed. Some parent behaviours are assessed that do not feature in the research. Methods of assessment are informal and predominantly consist of observation and note making, with professionals using their own skills and experience to analyse interaction. Goal setting practices were largely similar between professionals, with many jointly deciding goals with parents. Conclusions & Implications: This survey highlights the range of parent behaviours assessed by UK professionals in PCI with deaf children aged 0–3. This survey provides valuable information about and for professionals who assess PCI and set intervention goals with parents. Information from research and professional practice is important to consider in the design of a future PCI assessment. Implications are included for future research in this area. What This Paper Adds: What is already known on this subject: Parental involvement is one of the greatest predictors of deaf children's language outcomes. With many deaf children born to hearing parents, parents often need guidance with how to facilitate effective communication. A recent systematic review identified the range of parent behaviours and methods used to analyse PCI in international research studies, but little evidence or guidance exists on how professionals assess this phenomenon in practice. What this study adds: This is the first survey to generate large, valuable practice‐based evidence for the assessment of parents' communication behaviours as they interact with their deaf infants aged 0–3. The survey recruited a range of multidisciplinary professionals working on interaction within this field: SLTs, qualified teachers of the deaf, psychologists or psychiatrists, and professionals working within deaf child and adolescent mental health services. The study reports on which behaviours these professionals assess and how, and includes information on the goal setting behaviours of practitioners. Most respondents were highly experienced; the survey, therefore, reveals expert practice within the field. What are the potential or actual clinical implications of this work?: We recommend the following practice: (1) incorporate a range of parent‐based behaviours in PCI assessments, including establishing joint engagement and parental sensitivity, as well as communication‐focused behaviours; (2) video record PCI assessments where possible to enable professionals and parents to watch and reflect together; (3) following assessment, set parent‐focused goals in collaboration with families, ensuring parents' skills, particularly their strengths, are considered. All primary caregivers should be included in the process where possible; and (4) reassess PCI regularly (at least termly) to monitor and encourage families' progress. The timing of reviews should be discussed between parent and professional. [ABSTRACT FROM AUTHOR]

Previous research has suggested that older trans and gender non-conforming (TGNC) people may face particular challenges related to stigma, social exclusion and discrimination in later life. However, direct data on social support and needs in older TGNC population both internationally and within the UK is limited due to the small, dispersed nature of this population, and the absence of specific data collection on aging TGNC populations. During the UK COVID-19 lockdown in summer 2020, older people and those with long-term health conditions were advised to adopt particular precautions. This study aimed to explore older TGNC people's social support networks, key concerns and unmet needs during the COVID-19 'lockdown'. A UK cross-sectional survey of LGBT + people aged 60+ (n = 375) was undertaken during the lockdown. This paper analyses responses from the subset (n = 38) of TGNC participants. The majority of TGNC respondents described diverse social networks, often centered around friends and non-kin social networks, although partners and adult children were also significant for some. In most cases, those with existing strong networks continued to maintain social connections during lockdown, albeit with some regrets about loss of activities and face-to-face connection. However, a minority of respondents had experienced greater challenges prior to lockdown, and may have been at increased vulnerability during the pandemic, for example indicating that they had no-one to call on for practical support in an emergency. When asked about unmet needs and challenges, social isolation was repeatedly raised as the most frequent concern. Several respondents also mentioned issues specifically affecting TGNC communities, including access to gender affirming care and a perceived rise in social intolerance. Health and social care providers should be aware of the diversity of support networks within TGNC communities. There may also be benefits in community sector interventions to help older TGNC build and maintain strong social networks. [ABSTRACT FROM AUTHOR]

Introduction: Queer pedagogy is a lens through which the hegemonic discourses of curricula and the heterosexual assumptions within them can be made visible. Using this lens, sexuality and gender norms incorporated in undergraduate medical and health curricula can be located and the lived experience of a curriculum examined. This paper seeks to determine the extent of hetero/cisnormativity within UK pharmacy education with the aim of problematising the normalisation of heterosexuality; following this, strategies to disrupt structured hetero/cisnormativity are considered. Methods: Online cross‐sectional surveys were distributed to course leads (n = 29) and students enrolled on undergraduate pharmacy (MPharm) programmes. Surveys captured quantitative data on curriculum design and perceived barriers to implementation of inclusive curriculum design (the espoused LGBTQI+ curriculum), as well qualitative data on the lived experience of the hidden curriculum. Quantitative data were analysed using descriptive statistics, whereas qualitative data were analysed thematically. Results: Responses were received from 19 course leads and students from 25 MPharm programmes, representing varying completion rates. Findings suggest the shared values and goals of pharmacy education act to normalise and legitimise hetero and cis identities within curriculum design that othering as a consequence of heterosexual normativity is experienced and that pharmacy education is an LGBTQI+ opponent and does not adopt an ally attitude. Moreover, both educator and student data suggest that the enacted and experienced curriculum fails to prepare learners to care for LGBTQI+ people. Discussion: Despite findings suggesting the espoused or enacted curriculum absents LGBTQI+ people, and the hidden curriculum is experienced as homonegative, learners are questioning, resisting and disrupting the hetero‐ and cisnormative benevolent heterosexism within UK pharmacy curricula. This method of curricula interrogation can be adopted across health professions education as a means for ongoing problematising and disruption of normativity in clinical education. The study establishes widespread hetero/cis normativity in UK pharmacy education, exposing a hidden curriculum that opposes LGBTQIA+ people. Queer pedagogy is offered as a means of questionining, resisting, and disrupting such patterns. [ABSTRACT FROM AUTHOR]

Background: Moral distress is recognized as an international problem that contributes to decreased work productivity, job dissatisfaction and intent to leave for adult Critical Care nurses. Aim: To explore Critical Care nurses moral distress levels using the Moral Distress Scale Revised (MDS‐R) and its relationship with intention to stay. The study reported in this paper was part of a larger study that also investigated Critical Care nurses' work environment in Canada and the Midlands region of the UK. Study design: During January to August 2017 a cross‐sectional survey was distributed to adult Critical Care nurses in the Midlands region of the UK. Methods: Surveys were distributed to adult Critical Care Registered Nurses in the Midlands region of the UK examining moral distress levels and intention to stay in Critical Care, the organization (NHS Trust) and in the nursing profession. Results: Two hundred sixty‐six number of a potential sample of 1066 Critical Care nurses completed the survey (25% response rate). Age and moral distress were significantly positively correlated with intention to stay on their current unit (r = 0.16, P =.05), indicating older nurses were more likely to stay in the critical care unit. Moral distress was negatively correlated with intent to stay scores, showing critical care nurses with higher levels of moral distress were less likely to stay on their unit (r = −0.20, P =.02). Moral distress was also significantly negatively correlated with intention to stay with their current employer (r = −0.28, P <.001). Nurses that stated they had high rates of moral distress were more likely to consider leaving their current employer. Conclusion: Moral distress appears to be an issue among adult Critical Care nurses requiring further exploration and development of effective strategies to reduce this phenomenon and stabilize the workforce by reducing turnover. Relevance to clinical practice: By identifying the top causes of moral distress, tools and strategies can be developed to allow the Critical Care nurse to work within an ethically safe clinical environment and reduce the turnover of experienced adult Critical Care nurses. [ABSTRACT FROM AUTHOR]

'Death administration' is a term used to describe the wide range of tasks which must be completed after someone has died, such as registering the death and obtaining a death certificate. This involves fulfilling a complex set of time-sensitive procedures during a period of sometimes intense vulnerability, which can further compound the stress and upset felt when grieving. Using data from a qualitative study exploring people's experiences of carrying out tasks related to death administration in the UK, this article seeks to demonstrate some of the problems inherent within the process. In doing so, it highlights some of the ways that the unavoidable challenge of completing death administration can be made less burdensome, both physically and emotionally, for those tasked with its undertaking. As such, this paper offers new insights into an aspect of being bereaved that is currently overlooked, but in much need of improvement. [ABSTRACT FROM AUTHOR]

Background: People with an intellectual disability who commit a criminal offence can be detained, by a court, in a forensic inpatient facility. There is limited understanding of how inpatients with an intellectual disability and their nurses navigate risk in U.K. forensic services. Methods: A traditional literature review design was followed to map evidence (2000–2021) around the forensic and health and wellbeing risks faced by inpatients with an intellectual disability, nurses' perceptions of managing risk, and patient experiences of informing risk assessment and management. Papers were analysed thematically. Results: Findings suggest that restrictive measures to mitigate forensic risks (e.g., violence) can exacerbate the risk of poor health and wellbeing outcomes. There was some limited evidence of direct patient involvement in risk assessment and management. Conclusion: Further research is required to explore how forensic inpatients with an intellectual disability can have input in care planning, risk assessment and management. [ABSTRACT FROM AUTHOR]

Objective: MindStep™ is an Australian low-intensity cognitive behaviour therapy (LICBT) program for individuals with mild-to-moderate symptoms of anxiety and depression. UK-produced LICBT guided self-help (GSH) materials were originally used in the MindStep™ program. In 2017, Australian LICBT GSH materials were developed to better suit Australian users. This study explored whether the Australian-produced materials continued to achieve the benchmark recovery rates established in the UK and maintained in recent Australian studies. Methods: Binomial logistic regression was conducted using retrospective client data, including the Patient Health Questionnaire-9 and the Generalised Anxiety Disorder 7-item scale, between 2016 and 2019. Results: During time periods in which the Australian-produced materials were used, equivalent rates of reliable recovery and improvement were achieved compared with time periods in which the UK-produced materials were used. Australian-trained LICBT coaches, using Australian-produced LICBT GSH materials, achieve client recovery rates of up to 60%, reliable improvement rates of 58% and reliable recovery rates of 46% (with the probability of recovery increasing with client age). Conclusions: These findings are particularly pertinent with COVID-19 changing the landscape of mental health service delivery, requiring greater flexibility in the use of teleservices to ensure access to effective mental health care for populations that may already experience problems with isolation, access and service engagement. What is known about the topic?: LICBT is an acceptable, feasible and effective treatment approach for people experiencing mild-to-moderate anxiety and depression in Australia. LICBT GSH materials used with clients in Australia originated from the UK. However, according to guidelines, LICBT GSH materials should be contextualised to suit the audience they are being used with. What does this paper add?: This paper demonstrates that LICBT GSH materials tailored to an Australian context can be used in place of UK-produced materials because they yield equivalent and consistent therapeutic outcomes. Although contextualising the LICBT GSH materials for health services users was important, it is likely that the evidence-based cognitive behaviour therapy techniques sitting 'under the hood' of these materials are most important to ensure successful therapeutic outcomes. What are the implications for practitioners?: As we face unprecedented challenges following 2020, the physical, social, psychological and economic impacts of life-changing events must not inhibit access to treatments for common mental health conditions. It is anticipated that more non-traditional, alternative providers of mental health services will be needed to scale-up and respond to increasing demand. This paper shows that the provision of telephone-based LICBT in Australia, by trained coaches using Australian-produced GSH materials, is an evidenced-based support pathway that can reduce the access gap to treatments. [ABSTRACT FROM AUTHOR]

Despite anecdotal evidence that the out of pocket costs of OCD can be substantial in some cases, there is no evidence on how many people they affect, or the magnitude of these costs. This paper explores the type and quantity of out of pocket expenses reported by a large sample of adults with OCD. Data on out of pocket expenses were collected from participants taking part in the OCTET multi-centre randomised controlled trial. Participants were aged 18+, meeting DSM-IV criteria for OCD, and scoring 16+ on the Yale Brown Obsessive Compulsive Scale. Individual-level resource use data including a description and estimated cost of out of pocket expenses were measured using an adapted version of the Adult Service Use Schedule (AD-SUS): a questionnaire used to collect data on resource use. Forty-five percent (208/465) reported out of pocket expenses due to their OCD. The mean cost of out of pocket expenses was £19.19 per week (SD £27.56 SD), range £0.06–£224.00. Future economic evaluations involving participants with OCD should include out of pocket expenses, but careful consideration of alternative approaches to the collection and costing of this data is needed. [ABSTRACT FROM AUTHOR]

Intimate partner homicides are often situated within the context of domestic abuse, and although less prevalent than domestic abuse, there have been several multi‐agency approaches to understanding the risk for these fatal crimes. Domestic Homicide Reviews (DHRs) were introduced in 2011 to provide information to help with assessing such risk. This paper aims to analyse DHRs in England and Wales to investigate/determine risk factors for domestic homicide following intimate partner abuse. All publicly available DHRs published between July 2011 and November 2020 where the victim and perpetrator were or had been intimate partners (N = 263) were retrieved from Community Safety Partnership websites in England and Wales. A quantitative design was used to extract data from DHRs, and descriptive and inferential statistics were generated by SPSS 26. Findings identified risk factors relating to domestic abuse, including stalking, separation, and the victim being in a new relationship. Sociodemographic risk factors included higher levels of deprivation, lower income and higher barriers to housing and services. This highlights the role of both individual and sociodemographic factors in domestic homicides, and particularly the need for greater socioeconomic security for victims of domestic abuse. In conclusion, though much of the data is in line with previous research, our analysis highlights the pivotal role of regional poverty, with comfortable socioeconomic conditions offering protection against intimate partner homicides. This research suggests important directions for future research and makes a valuable contribution to a more in‐depth understanding of the relationship between domestic abuse and intimate partner homicide. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: During the COVID‐19 pandemic, there has been research considering the impact on medical healthcare professionals and the mental health needs of the general population. However, limited focus has been placed on mental health services or mental health staff providing care in the community and in hospitals. While nurses make up the largest section of the mental health workforce in the UK, the impact that this pandemic has had on their work has been largely ignored. What the paper adds to existing knowledge?: This paper provides a unique insight into the experiences and impact that the COVID‐19 pandemic has had on mental health nurses across a range of community and inpatient settings to understand what has changed in their work and the care they can and do provide during this crisis. This includes exploring how services have changed, the move to remote working, the impact of the protective equipment crisis on nurses and the difficult working conditions facing those in inpatient settings where there is minimal guidance provided. What are the implications for practice?: By understanding the impact the pandemic has had on mental health nursing care, we can understand the gaps in guidance that exist, the challenges being faced and the impact the crisis has had on care for mental health service users. By doing so, we can plan for the ongoing nature of this pandemic and the aftermath that the crisis may leave for our service users and workforce alike. Introduction: While evidence has emerged concerning the impact of COVID‐19 on the general population and the challenges facing health services, much less is known regarding how the pandemic has directly affected the delivery of mental health nursing care. Aim: This paper aimed to explore how COVID‐19 has affected the ability of mental health nurses to deliver care in community and inpatient mental health services in the UK. Method: We investigated staff reports regarding the impact of the COVID‐19 pandemic on mental healthcare and mental health service users in the UK, using a mixed‐methods online survey. A total of 897 nurses across a range of inpatient and community settings participated. Discussion: Key themes within the data explore the following: new ways of working; remote working; risks of infection/infection control challenges; and the impact on service users. Targeted guidelines are required to support mental health nurses providing care and support during a pandemic to people in severe mental distress, often in unsuitable environments. Implications for Practice: Service developments need to occur alongside tailored guidance and support for staff welfare supported by clear leadership. These findings identify areas requiring attention and investment to prepare for future crises and the consequences of the pandemic. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to explore the impact of the pandemic on the emotional and mental well‐being of family carers, care home staff and residents, in light of changing restrictions, increased testing and vaccination rollout in the UK. Design Longitudinal, qualitative semi‐structured interview study. Methods: Remote semi‐structured interviews were conducted with family carers of care home residents with dementia and care home staff from different care homes across the UK. Baseline and follow‐up interviews were conducted in October/November 2020 and March 2021, respectively. Data were analysed using inductive thematic analysis involving members of the public with caring experiences. Results: In all, 42 family carers and care home staff participated at baseline, with 20 family carers and staff followed up. We identified four themes: (1) Developing anger and frustration; (2) Impact on relationships; (3) Stress and burnout; and (4) Behavioural changes, and perceived impact on residents. The mental health of everyone involved, including family carers, care home staff and residents, has been negatively affected, and relationships between family carers and staff have been severely strained. There was a general lack of adequate mental health support, with little relief. Conclusions: The pandemic has had a detrimental impact on the lives of those surrounding care homes—from residents and staff to family carers. Consideration should be given on how to best support the mental health needs of all three groups, by providing adequate easily accessible mental health care for all. This should also focus on rebuilding the relationships between family carers and care home staff. Impact This is the first paper to highlight the effects of the long‐lasting and miscommunicated restrictions on residents, carers and care home staff, and highlight the urgent need for continued mental health support. [ABSTRACT FROM AUTHOR]

To explore how the information-sharing context influences how speech and language therapy (SLT) and nursing staff interact on stroke units and what they discuss. Ethnographic methodology was used, with data collected during 40 weeks of fieldwork across three inner city stroke units in the UK. Data comprised field notes collected during 357 h of participant observation and 43 interviews. Interviews were conducted with 14 SLTs, 1 SLT assistant, 24 registered nurses and 4 nursing assistants. This paper is focused on informal information-sharing. SLTs and nurses had different experiences of time and space (the temporal-spatial context) with respect to ward presence and proximity to patients, influencing how they interacted, the content of their talk and their relationships. Most interactions had the quality of interruptions, in which SLTs seized moments in between nursing tasks. Conditions were less suited to sharing information about communication than swallowing and SLTs felt more allied to other therapists than nurses. The temporal-spatial context impeded information-sharing, particularly about patients' communication needs. Consideration should be given to developing relationships between SLTs and nurses as key partners for patient care and raising the profile of communication information in ways that are relevant and useful to nursing work. Strategic waiting for opportunities to interrupt nurses and gain their attention is central to how speech and language therapists manage their need to share information informally with nurses. The small "windows in time" available for interaction influence information-sharing, with a limiting effect on information about patients' communication. There is potential to improve information-sharing between speech and language therapists and nurses by considering how the relevance of information for patient care could be made clearer. [ABSTRACT FROM AUTHOR]

Background: There is increasing recognition of the impact that dementia has upon swallowing and at mealtimes, and the significant effect this can have on people with dementia's health and well‐being. However, there remains a paucity of evidence for assessment and intervention practices for dysphagia and mealtime difficulties. Furthermore, there is a limited understanding of how speech and language therapists (SLTs) support people with these dementia‐related issues and what are the barriers and facilitators to practice. Further research is therefore needed to guide policy as well as service guideline and delivery development. Aims: To establish the current practices of SLTs managing dementia‐related dysphagia and mealtime difficulties in the UK and Republic of Ireland (ROI), and to establish their opinions and experiences of what challenges or supports to practice they have encountered. Methods & Procedures: An anonymous, cross‐sectional web‐based survey was developed and distributed to SLTs working in the UK and ROI. Respondents completed a questionnaire that consisted of open and closed questions across nine topic areas. Closed responses were evaluated using descriptive statistics; open‐ended questions were analysed using conventional content analysis. Outcomes & Results: A total of 310 people accessed the survey, and 125 respondents completed it fully. While respondents agreed on their role in dysphagia management, they varied in their views on the extent of their role in managing mealtime difficulties. Additionally, their self‐rated knowledge of mealtime difficulties in dementia was lower than their dysphagia knowledge. The respondents predominantly based their management decisions on their clinical experience of working with people with dementia. They primarily used compensatory strategies and frequently cited the need for family and care staff training. Respondents also highlighted barriers to effective management and training provision such as inefficient referral systems, a lack of carer knowledge and lack of SLT resources. Conclusions & Implications: The results provide valuable insight into the issues facing SLTs practising in this area. The SLTs surveyed considered dysphagia a core part of their role when supporting people with dementia; however, respondents' views on mealtime difficulties varied. This highlights the need to establish consensus guidelines on the SLT's role in order to avoid variations in service delivery that could negatively impact the health and well‐being of people with dementia. Moreover, further research to develop efficient and effective training for care staff supporting mealtime difficulties and dysphagia is essential. What this paper addsWhat is already known on the subjectResearch indicates that people with dementia develop dysphagia and mealtime difficulties as dementia progresses. SLTs often manage these, but there is no research on the effective assessment and management procedures, or guidance on best practice.What this paper adds to existing knowledgeThis paper provides an understanding of the variation in practice across the UK and ROI. Respondents described barriers to delivering an effective service and frequently linked these to the SLTs' resources as well as service constraints.What are the potential or actual clinical implications of this work?These findings support the need for future research to develop guidelines for SLT practice in this area. They also support the need to examine resource allocation and workforce management to enable SLTs to manage dementia‐related dysphagia and mealtime difficulties effectively. [ABSTRACT FROM AUTHOR]

Background: Whilst research into the wide‐ranging needs of family members following traumatic brain injury (TBI) is well established, investigation into the specific needs of families in relation to supporting cognitive–communication difficulties, relationships and social participation is limited. Aims: To identify the family needs for cognitive‐communication difficulties following TBI and to explore whether current services are meeting these needs. Methods & Procedures: Following a successful pilot, family members from the UK and Australia were invited via posters, social media and e‐mail to take part in an anonymous, communication needs survey. Data arising from the thirty two closed questions (six eligibility, nine demographic and seventeen needs questions) were analysed using SPSS descriptive statistics. Data arising from one open question were analysed using qualitative content analysis. Outcomes & Results: A total of 102 family members from the UK (n = 89, 87%) and Australia (n = 13, 13%) completed the survey. The majority of respondents were female (n = 76; 75%), between the ages of 30 and 69 (n = 88; 87%), and either a parent or a partner of the person following TBI (n = 78;76%). Respondents rated information about expected recovery from cognitive‐communication difficulties and training in helpful strategies as their most important needs. The majority of respondents (more than 60%) were not satisfied that any of their cognitive–communication needs had been fully met and high levels of unmet need remained evident at three years or more post‐injury. Written information, communication partner training and counselling were identified as key supports. Conclusions & Implications: Families report high levels of unmet need for managing cognitive‐communication difficulties following TBI. Access to written information and communication partner training should be available to families at various time points following TBI and not just in the early stages. What this paper addsWhat is already known on this subjectAttempting to support a person who has cognitive‐communication difficulties following TBI has been found to be highly burdensome for family members. However, few studies have asked how families perceive their needs in relation to cognitive‐communication difficulties or measured how well current services are meeting their needs.What this paper adds to existing knowledgeThis study demonstrates that current speech and language therapy services are not yet meeting the needs of the relatives of individuals with cognitive‐communication difficulties following TBI. Important insights into the information, training and support families' rate as important are identified in addition to how these needs develop over time.What are the potential or actual clinical implications of this work?Speech and language therapy service design requires to reflect the ongoing nature of familial needs for cognitive‐communication difficulties following TBI. Families require access to appropriate literature, speech and language therapy support, and communication partner training in the longer term, not just in the acute phase. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is already known about this topic?: Individuals with severe mental illness (SMI) have elevated risks for physical health problems and low screening rates.No previous studies have compared the physical health promotion needs of people with SMI using the same screening tool across different international settings. What this paper adds to existing knowledge?: It appears feasible to use the HIP to profile and compare physical health‐related risks in people with SMI across different international settings.The HIP tool identified significant differences in areas of risk across the four countries. What are the implications for practice?: The HIP could be used to identify unique clusters of health promotion needs in different countries.Use of HIP health checks may support implementation of individualized interventions. Introduction: To date, no studies have contrasted physical health profiles of people with severe mental illness (SMI) in different countries. Aim: To evaluate feasibility of using the Health Improvement Profile (HIP) to compare and contrast physical health and health behaviours of people with SMI from four countries. Method: An observational feasibility study using secondary analysis of pooled health state and lifestyle data. Physical health checks using modified versions of HIP were administered in four countries. Results: Findings suggest feasibility of HIP screening to profile and compare physical health and health behaviours of people with SMI across international settings. High overall numbers of risk items (red flags) were identified in all but the Thailand sample. Despite some commonalities, there were important differences in health profiles across countries. Discussion: This is the first study to demonstrate feasibility of the HIP to compare health risks in individuals with SMI across countries. Future multi‐national HIP studies should recruit a fully powered stratified random sample of people with SMI that is representative of each setting. Implications for practice: It appears feasible to utilize the HIP to identify specific areas of health risk in different countries, which may help to better focus nursing interventions and use of resources. [ABSTRACT FROM AUTHOR]

This paper examines determinants of ethnic disparities in workplace risks of COVID-19 among health and social care workers (HCWs) in the UK. This was undertaken to inform public health policy in the management of COVID-19 relating to health and social care provision. A cross-sectional survey was administered in July–August 2020 (n = 456) to elicit HCWs' experiences of COVID-19 management in the workplace and their perceptions of exposure, personal protection against infection, involvement in local clinical management, and other workplace hazards. Findings suggest minority ethnic HCWs were twice as likely as White HCWs to be in a patient-facing role (OR = 2.14, 95% CI:1.21; 3.78, P < 0.01) and twice as likely (63% vs 39%) to be caring for COVID-19 positive patients (OR = 2.68, 95% CI: 1.77; 4.06, P < 0.01). Those in nursing, were three times as likely to be redeployed to a COVID-19 care setting (OR = 3.33, 95%CI: 1.23; 9.02, P= 0.02). Minority ethnic HCWs within lower- and mid-level roles carried a higher burden of frontline clinical management of COVID-19 positive patients than their White counterparts. This study found evidence of ethnic disparities across several workplace hazards, with increased exposure to and less protection against infection, more responsibility for the clinical management of infection, and evidence of systemic racial bias in the disproportionate redeployment of minority ethnic nursing staff to COVID-19 areas. An NHS-wide review is required to assess procedural fairness, ensure safe practices now, and to avert future crises. [ABSTRACT FROM AUTHOR]

Policy makers across the political spectrum have extolled the virtues of volunteering in achieving social policy aims. Yet little is known about the role that volunteering plays in addressing one of the significant challenges of an ageing population: the provision of care and support to people with dementia. We combine organisational survey data, secondary social survey data, and in-depth interviews with people with dementia, family carers and volunteers in order to better understand the context, role and challenges in which volunteers support people with dementia. Social policies connecting volunteering and dementia care in homes and communities often remain separate and disconnected and our paper draws on the concept of policy 'assemblages' to suggest that dementia care is a dynamic mixture of formal and informal volunteering activities that bridge and blur traditional policy boundaries. Linking home and community environments is a key motivation, benefit and outcome for volunteers, carers and those living with dementia. The paper calls to widen the definition and investigation of volunteering in social policy to include and support informal volunteering activity. [ABSTRACT FROM AUTHOR]

Background and aim: A Society's view of disability may influence the perception and use of Assistive Technology (AT) products. Semantic cues or cultural coding provide the viewer with a series of visual stimuli to be given or ascribed meaning. Previous research has shown cognitive approaches to visual perception and assignment of meaning vary between diverse cultures. This study reviews the influence of contextual settings on perception, to provide the basis for a debate on the societal perception of communicative content (semantic/meaning) of an AT product; and, the relevance of different cultural cognitive styles. The paper explores, from a cultural viewpoint, the overall understanding of disability internationally. Method: A Semantic Differential (SD) scale was used to obtain views on the image of an attendant wheelchair from nine hundred and ninety-one (991) young adults from the United Kingdom (UK) and Pakistan (PAK), reflecting the individualist and collectivist societies, respectively. This survey follows a previous paper-based study using the same image and protocol. Comparing the two surveys, a consensus of views from the two groups was achieved. Results and conclusion: The responses from the UK group were skewed towards a negative view of disability compared to the Pakistan group. This inferred greater social stigma associated with this AT product in the UK. The combined findings from both surveys provide insights into societal perception of AT products and disability. Areas for future research are suggested, including what visual components of an AT product (graphemes) appear to be associated with positive or negative responses for collectivist and individual societal groups. Assistive Technology (AT) product designers, academics, professionals and stakeholders need to be aware of challenges which are originated from one's socio-cultural environment. AT products convey certain meanings, semantics, which are interpreted by the society and are subjective to a specific cultural setting. •For the effective communication of meanings and values an AT product relies on the visual clues and design features embedded within the design. However, there have been a limited number of studies reviewing this aspect of product semantics. •The survey and associated testing has highlighted the differences in cultural perception towards AT products and demonstrated the importance of effectively designing the semantic attributes of an AT product as well as its function. •The demonstration of the efficacy of methods within the study for exploring the interpretation of semantic attributes of AT products will help designers and developers better understand the perceptions of individual cultures and societal groups. •A better understanding of different cultures and societies will enable designers and clinicians who specify AT products to reduce AT product abandonment; and, the associated stigma around disability. [ABSTRACT FROM AUTHOR]

Background and Purpose The aim of this study was to assess whether the severity of tinnitus, as measured using ratings of tinnitus loudness, annoyance, and effect on life, was influenced by the lockdown related to the coronavirus disease 2019 (COVID-19) pandemic. Research Design This was a retrospective study. Study Sample The data for 105 consecutive patients who were seen at a tinnitus clinic in an audiology department in the United Kingdom during the COVID-19 lockdown between April and June 2020 and 123 patients seen in the same period of the previous year, prior to the COVID-19 pandemic were included. Data Collection Demographic data for the patients, results of their pure-tone audiometry, and their score on visual analog scale (VAS) of tinnitus loudness, annoyance, and effect on life were imported from their records held at the audiology department. This was a retrospective survey comparing ratings on the VAS of tinnitus loudness, annoyance, and effect on life for consecutive patients seen during the COVID-19 lockdown and consecutive patients seen in the same period of the previous year, prior to the COVID-19 pandemic. Patients seen prior to lockdown used a pen and paper version of the VAS, while the patients who were assessed during the COVID-19 lockdown used an adapted version of the VAS, via telephone. All patients were seeking help for their tinnitus for the first time. Results The mean scores for tinnitus loudness, annoyance, and effect on life did not differ significantly for the groups seen prior to and during lockdown. Conclusion Any changes in psychological well-being or stress produced by the lockdown did not significantly affect ratings of the severity of tinnitus. [ABSTRACT FROM AUTHOR]

The importance of support to breastfeeding success is well established, as are the difficulties many mothers face in accessing the support they need. With the majority of UK mothers now accessing social media for support, Breastfeeding Support Facebook (BSF) groups have increased exponentially. BSF groups vary in type (local or national/international) and in moderation—overseen by breastfeeding mothers and by midwives or trained lactation specialists. Some groups aimed at supporting mothers in a specific geographical area also have associated face‐to‐face groups, facilitated as either professional or peer support. Little is currently known about these specific local groups, their prevalence, impact or value to mothers. This paper examines mothers' experiences of using local BSF groups and why they value them as part of a larger study exploring the impact of midwife moderation on these groups. An online survey consisting of open and closed questions was completed by 2028 mothers. Findings identified that local BSF groups are widely used and highly valued for their connection with local face‐to‐face services and other mothers. They offer access to expertise and shared experience in a format mothers find convenient and timely, improving confidence and self‐efficacy. Local BSF groups enable the formation of support networks and development of breastfeeding knowledge that mothers credit with increased well‐being, motivation and breastfeeding duration. As such, they have the potential to add value to local face‐to‐face services and improve breastfeeding experiences and knowledge in communities. The findings have important implications to support the development of integrated online interventions to improve public health. [ABSTRACT FROM AUTHOR]

Background: Global health research partnerships, which promote the exchange of ideas, knowledge and expertise across countries, are considered key to addressing complex challenges facing health systems. Yet, many studies report inequalities in these partnerships, particularly in those between high and low-and-middle-income countries (LMICs). Objective: This paper examines global research collaborations on community health worker (CHW) programmes, specifically analysing the structures of authorship teams and networks in publications reporting research on CHW programmes in low-income countries (LICs). Methods: A sub-set of 206 indexed journal articles reporting on CHW programmes in LICs was purposefully selected from a prior review of research authorship on CHW programmes in all LMICs over a five year period (2012–2016). Data on country and primary organisational affiliation and number of publications for all individual authors, programme area (e.g. maternal child health) and total citations per paper were extracted and coded in excel spreadsheets. Data were then exported and analysed in Stata/ICV.14 and Gephi. Results: The 206 papers were authored by 1045 authors from 299 institutions, based in 43 countries. Half (50.1%) the authors came from LIC-based institutions, 43.8% from high-income country (HIC) institutions, 2.9% from middle-income country (MIC) institutions and 3.2% had different first affiliations in different publications. Authors based in the USA (302) and UK (68) accounted for just over a third (35.4%) of all authors. Partnership patterns revealed a primary mode of North–South collaboration with authors from the US, and to a lesser extent the UK, playing central bridging roles between institutions. Strong network clusters of multiple-affiliated authors were evident in research on MCH and HIV/TB aspects of CHW programmes. Conclusion: Knowledge production on CHW programmes in LICs flows predominantly through a pool of connected HIC authors and North–South collaborations. There is a need for strategies harnessing more diverse, including South–South, forms of partnership. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Mental healthcare requires acceptance of suicide and flexible attitudes especially in relation to caring for people who have suicidal thoughts or who have attempted suicide. Nurse education programmes for student nurses can shape positively the attitudes of individual participants, yet limited research exists on what nursing students' attitudes currently are towards people who are suicidal. What this paper adds to existing knowledge?: This paper adds to the developing international comparative work that is providing a greater understanding of cultural perceptions of suicide amongst students. This paper along with existing literature highlights a potential relationship between certain religious belief systems and their potential to be protective against suicide. At the same time, such religious belief is more likely to be associated with more judgmental attitude towards suicidal behaviour. This paper using a validated research tool, devised by a research psychologist, scored for the first time, individual student attitudes towards caring for people that are suicidal, whilst establishing the overall differences between the two countries from which the data are collected. What are the implications for practice?: This paper offers potential explanations for differences in nursing students' attitudes between the UK and Turkey. Disparities under discussion include gender, type of education, culture and religion. This is an important discussion in the consideration of nurse education worldwide. It is recognized that students may come from a variety of different backgrounds, with varying personal and social attitudes to begin with; yet, there exists the potential to positively influence overall attitudes towards service users whilst learners are still within a training programme, consisting of education and practice experiences. The merits of a specialist mental health nurse training programme and its potential to impact more favourably on students attitudes deserve more attention and research. Abstract: Introduction: Suicide is a major public health issue internationally, and the impact of positive or negative attitudes amongst the mental health professional workforce warrants scrutiny. The study aimed to examine English and Turkish nursing students' attitudes towards people with suicidal behaviour. Method: This cross‐cultural study reports on attitudes of 240 nursing students towards suicide in Turkey and 82 nursing students in the UK. A reliable and valid 24 item “Attitudes towards Suicide Scale” and “Social Reactions to Suicidal Persons Scale” were used to measure attitudes. Results: The UK nursing students were found to display more accepting attitudes to suicide, and scored higher on acceptability of suicide, seeing suicide as a solution and open reporting and discussion of suicide subscales than their Turkish counterparts. Turkish nursing students scored higher on punishment after death and hiding suicidal behaviour subscales than the UK students. Turkish nursing students scored significantly higher on deterring subscale of reactions to a suicidal peer scale than the UK nursing students. Implications for practice: It is vital for nurse students to develop positive acceptance of suicide through education, reflection and clinical supervision to be more therapeutic towards suicidal patients. [ABSTRACT FROM AUTHOR]

There is limited provision of inpatient detoxification relative to other treatments for alcohol and other drug (AOD) use. This means people often need to wait prior to detoxifying. However, waiting for healthcare is generally perceived as negative and stressful. This paper aims to understand patients' experiences of waiting for inpatient AOD detoxification to ascertain whether and how service-level policies and practices might be improved. Semi-structured telephone interviews were conducted with 32 people (20 males, 12 females; aged 25–67 years) who were waiting for inpatient detoxification. Data collection was part of a wider evaluation of a policy initiative started in 2021 to increase detoxification service capacity in England, UK. Interviews were professionally transcribed and data on waiting experiences were coded using qualitative software. Analyses were informed by new materialist thinking and undertaken via Iterative Categorisation. We found that waiting was constituted through five dimensions: i. duration; ii. support; iii. information; iv. preparations; and v. emotions. These five dimensions were multi-faceted and operated in and through wider interacting social, material, and affective forces (e.g., professional judgements, formal and informal relationships, the availability of beds and funding, bureaucratic procedures, the utility and relevance of information, and participants' diverse feelings, including desperation for treatment). Not all accounts of waiting were negative. The experience was complex, non-uniform and variable over time. Moreover, it affected how people felt and how they behaved. Changes to service-level policies and practices can potentially minimise the stress of waiting for inpatient AOD detoxification. The negative impact of waiting may be reduced if professionals more consistently engage patients in a wider range of constructive pre-treatment activities, offer regular 'check-ins' to mitigate any anxiety, explain changes in wait duration to help with planning and demonstrate fairness, and facilitate contact between those waiting to lessen feelings of isolation. [ABSTRACT FROM AUTHOR]

Over the last decades, ovarian cancer mortality in Europe has been decreasing, but disparities in trends were observed. In this paper, we analysed ovarian cancer mortality trends in Europe over the period 1990–2020 and predicted the number of deaths and rates by 2025. We extracted population and death certification data from ovarian cancer in women for 31 European countries, between 1990 and 2020 from the World Health Organization database. We computed age-standardised mortality rates (ASMR) per 100,000 women-years, based on the world standard population. We also obtained predictions for 2025 using a joinpoint regression model and calculated the number of avoided deaths over the period 1994–2025. Over the observed period, mortality from ovarian cancer showed a favourable pattern in most countries. In the EU-27, rates declined by 5.9% from 2010–2014 to 2015–2019, reaching an ASMR of 4.66/100,000. During the same period, the decline in ovarian cancer mortality was more pronounced in the EU-14 countries (−7.0%) compared to Transitional countries (−2.1%). Declines were also observed in the United Kingdom, to reach an ASMR of 5.29. Decreases in mortality from ovarian cancer are predicted until 2025, to 4.17/100,000 for the EU-27. Favourable trends in ovarian cancer mortality are expected to persist in Europe and can be mainly attributed to the increased use of oral contraceptives in subsequent generations of European women. Decreased use of menopausal Hormone Replacement Therapy and improved diagnosis and management may also have played a role. • Ovarian cancer mortality decreased over the last decade in most European countries. • Favourable trends will continue in the next 5 years. • Less favourable epidemiological situation was observed in Transitional countries. • The largest decrease of mortality in 2025 is predicted to be in Germany. • Until 2025 nearly 131,000 deaths from ovarian cancer would be avoided in EU. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to consider the impact of mental capacity legislation when applied to parents with learning difficulties who lack capacity within childcare and family law proceedings in England and Wales.Design/methodology/approach The paper relies on a range of material including reports published by independent mental health foundations, official inquiries and other public bodies. It also refers to academic and practitioner material in journals and government guidance.Findings The paper critically reviews the application of the guidance when assessing mental capacity legislation as applied in England and Wales and offers by way of illustration several case examples where psychological assessments, and the enhancement of capacity, have assisted parents who were involved in childcare and family law proceedings.Research limitations/implications There has been little published research or governmental reports on the number of cases when parents involved in childcare and family law proceedings have been found to lack capacity. No published prevalence data are available on the times when enhancing capacity has resulted in a change of outcome in childcare and family law proceedings.Practical implications The duty is on the mental health practitioners assessing mental capacity that they do so in a structured and supportive role adhering to good practice guidance and follow the guiding principles of mental capacity legislation assuming that the individual has capacity unless it is established that they lack capacity. Guidance and training is needed to ensure that the interpretation of the Mental Capacity Act (MCA) and its application is applied consistently.Social implications For those who are considered to lack mental capacity to make specific decisions, particularly within childcare and family law proceedings, safeguards are in place to better support such individuals and enhance their capacity in order that they can participate more fully in proceedings.Originality/value While the MCA legislation has now been enacted for over ten years, there is very little analysis of the implications of capacity assessments on parents involved in childcare and family law proceedings. This paper presents an overview and, in places, a critical analysis of the new safeguarding duties of mental health practitioners when assessing for, and enhancing capacity in parents. [ABSTRACT FROM AUTHOR]

Background: Sleeping Beauties (SBs) are publications that are scarcely cited in the years immediately following publication but then suddenly become highly cited later. Such publications have unique citation patterns and can reveal important developments in the field in which they appear. Objectives: No holistic analysis of nursing SBs has been done yet. The aim of this study was to identify and analyze the SB phenomenon in the nursing research literature. Method: The corpus for the nursing SB identification was harvested from the Web of Science Core Collection (Thomas Reuters) for the period 1934-2015. Citation histories of 212,239 publications were screened. From those, 3,209 publications with more than 100 citations were selected for analysis. We used our own software and applied the van Raan (2004) and Baumgartner (2010) criteria for SBs-a 5-year sleeping period with at most 10 citations during that time, an average of at least five citations per year after the first 10 years, with at least 100 citations in total. The knowledge context for SBs was determined using citing papers. All citing papers were analyzed with the help of VOSviewer software. Results: Nine publications were identified as SBs (prevalence of 0.004%). The length of sleep duration ranged from 5 to 10 years (M = 6.8, SD = 2.0), depth of sleep ranged from 0.2 to 0.8 citations (M = 0.6, SD = 0.2), and awake intensity ranged from 6.4 to 15.0 citations (M = 11.0, SD = 3.8). The average number of citations to SBs was 229. Most nursing SBs were produced in the United States (n = 8) from top institutions in journals with high-impact factors. Nursing SBs covered topics including resilience, sampling in qualitative research, metasynthesis, postoperative pain in children, dementia rating scales, care of patients with Alzheimer's disease, nursing theory related to fatigue mechanisms in cancer patients, and family participation during resuscitation. Nursing SBs were cited by authors from a large number of institutions and countries; the number of publications citing nursing SBs is growing exponentially and showing increasing and global interest in the research presented in them. Discussion: This study demonstrated that SBs in nursing are similar to other scientific disciplines. Existence of SBs suggests that nursing knowledge accumulation is supported by research and professional processes similar to those that emerged in other academic disciplines. [ABSTRACT FROM AUTHOR]

In healthcare settings, there is an emotional cost to caring which can result in compassion fatigue, burnout, secondary trauma, and compromised patient care. Innovative workplace interventions such as the Schwartz Rounds offer a group reflective practice forum for clinical and non‐clinical professionals to reflect on the emotional aspects of working in health care. Whilst the Rounds are established in medical health practice, this study presents an evaluation of the Rounds offered to mental health services. The Rounds were piloted amongst 150 mental health professionals for 6 months and evaluated using a mixed‐methods approach with standardized evaluation forms completed after each Round and a focus group (n = 9) at one‐month follow‐up. This paper also offers a unique six‐year follow‐up of the evaluation of the Rounds. Rounds were rated as helpful, insightful, and relevant, and at six years follow‐up, Rounds were still rated as valuable and viewed as embedded. Focus groups indicated that Rounds were valued because of the opportunity to express emotions (in particular negative emotions towards patients that conflict with the professional care‐role), share experiences, and feel validated and supported by colleagues. The findings indicate that Schwartz Rounds offer a positive application in mental healthcare settings. The study supports the use of interventions which provide an ongoing forum in which to discuss emotions, develop emotional literacy, provide peer support and set an intention for becoming a more compassionate organization in which to work. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore whether a relationship exists between the number of disasters a jurisdiction has experienced and the presence of disaster-specific pharmacy legislation. Methods: Pharmacy legislation specific to disasters was reviewed for five countries: Australia, Canada, UK, US and New Zealand. A binary logistic regression test using a generalised estimating equation was used to examine the association between the number of disasters experienced by a state, province, territory or country and whether they had disaster-specific pharmacy legislation. Results: Three of six models were statistically significant, suggesting that the odds of a jurisdiction having disaster-specific pharmacy legislation increased as the number of disasters increased for the period 2007–17 and 2013–17. There was an association between the everyday emergency supply legislation and the presence of the extended disaster-specific emergency supply legislation AH19093_IE1.gif. Conclusions: It is evident from this review that there are inconsistencies as to the level of assistance pharmacists can provide during times of crisis depending on their jurisdiction and location of practice. It is not a question of whether pharmacists have the skills and capabilities to assist, but rather what legislative barriers are preventing them from being able to contribute further to the disaster healthcare team. What is known about the topic?: The contributing factors to disaster-specific pharmacy legislation has not previously been explored in Australia. It can be postulated that the number of disasters experienced by a jurisdiction increases the likelihood of governments introducing disaster-specific pharmacy legislation based on other countries. What does this paper add?: This study compared five countries and their pharmacy legislation specific to disasters. It identified that as the number of disasters increases, the odds of a jurisdiction having disaster-specific emergency supply or disaster relocation or mobile pharmacy legislation increases. However, this is likely to be only one of many factors affecting the political decisions of when and what legislation is passed in relation to pharmacists' roles in disasters. What are the implications for practitioners?: Pharmacists are well situated in the community to be of assistance during disasters. However, their ability to help patients with chronic disease management or providing necessary vaccinations in disasters is limited by the legislation in their jurisdiction. Releasing pharmacists' full potential in disasters could alleviate the burden of low-acuity patients on other healthcare services. This could subsequently free up other healthcare professionals to treat high-acuity patients and emergencies. [ABSTRACT FROM AUTHOR]

Purpose: The purpose this paper is to explore walking with purpose in extra care, retirement and domestic housing settings to better understand and support people living with dementia in these settings, develop recommendations and inform practice. Design/methodology/approach: A mixed-methods study was used: scoping literature review; online survey of extra care and retirement housing managers in the UK; case studies involving interviews with staff and family carers (n = 14) of ten individuals who engaged in walking with purpose in the different housing settings. Findings: Although residents who walk with purpose constitute a minority (0–2 residents), managing walking with purpose can be challenging and time consuming. Distraction or redirection was the most common response. Other strategies included identifying the resident's motivations and accommodating their wishes or walking with them. Culture of care, staff training and dementia-friendly design are keys to effective support for safe walking with purpose. Responses to walking with purpose in the domestic housing settings have raised serious deprivation of liberty issues. Research limitations/implications: This study had a number of limitations. The completed survey questionnaires represent a self-selected sample of extra care and retirement housing settings, and responses are based on the perceptions of the staff members completing the survey. There were a relatively small number of case study sites (three extra care housing and three retirement housing), and it was not possible to interview family members for all of the residents who walked with purpose. Originality/value: This study provides unique data on walking with purpose in extra care and retirement housing setting in the UK. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: There is a drive to use positive and proactive approaches to mental health care to reduce the use of restrictive practices such as seclusion and restraint.Positive behaviour support plans have been used successfully to do this in learning disability services, and in England, it is now a regulatory requirement that anyone with challenging behaviour should have an individualized behaviour support plan.However, positive behaviour support plans specifically have not been evaluated as part of routine mental health care and mental health nurses' and relatives' attitudes towards them are unknown. What this paper adds to existing knowledge?: This evaluation of positive behaviour support plans in routine mental health inpatient care found that they had not been widely implemented or completed as intended.Barriers to the use of the plans included confusion among nurses and relatives around the principles of positive behaviour support, including how, when and for whom the plans should be used, difficulties in being able to describe the function of a patient's behaviour and lack of engagement with relatives and patients.Nevertheless, nurses and relatives valued the plans, in particular for their potential to facilitate holistic care. What are the implications for practice?: To use the plans successfully, mental health nurses will need training to understand fully the rationale behind the positive behaviour support approach and will need to engage more with relatives and patients.Commitment to the approach from the whole care team and organization will be needed to implement the plans consistently for all patients. Introduction: An international drive is to minimize restrictive practices in mental health care. Positive behaviour support plans (PBSPs) help staff prevent behaviour which would require restrictive intervention. Originating in learning disability services, data within mental health care are limited. Aims: To evaluate PBSPs within a mental health inpatient service; understand mental health nurses' and relatives' attitudes to them; and understand the barriers and facilitators for their use in routine mental health care. Methods: Mixed methods—quality ratings and interviews with relatives and nurses. Results: Positive behaviour support plans were poorly implemented. Relatives and nurses valued the potential of PBSPs to facilitate holistic care, though no relative had contributed to one and not every eligible patient had one. Barriers to their use included confusion around positive behaviour support, including how, when and for whom PBSPs should be used, and difficulties describing the function of a behaviour. Discussion: The potential of PBSPs to improve mental health care is recognized. However, there are barriers to their use which should be addressed to ensure that PBSPs have been properly implemented before their impact on patient care can be assessed. Implications for practice: Mental health professionals implementing PBSPs should engage with relatives and patients, gain organizational commitment and ensure that those involved understand fully the positive behaviour support approach. [ABSTRACT FROM AUTHOR]

Assistive Technology (AT) product use occurs within a socio-cultural setting. The growth internationally in the AT product market suggests that designers need to be aware of the influences that diverse cultures may have on the societal perception of an AT product through its semantic attributes. The study aimed to evaluate the visual interaction with an AT product by young adults from Pakistan, a collectivist society, and the United Kingdom (UK), an individualist society. A paper-based questionnaire survey was carried out with 281 first-year undergraduate students from the UK and Pakistan to evaluate their perception towards the visual representation of a generic conventional wheelchair image. A semantics differential (SD) scale method was used involving a seven-point bipolar SD scale incorporating sixteen pairs of adjectives defining functional, meaning, and usability attributes of the product. The mean (M) and standard deviation (sd) values were obtained for each pair of adjectives and compared between both groups by employing appropriate parametric tests. The results show that having a diverse cultural background did not appear to have overtly influenced the meanings ascribed to the generic manual wheelchair, which was unexpected. The University 'Internationalist' environment may have influenced the results. Some minor but critical differences were found for some pairs of adjectives (bulky-compact, heavy-light), having p-value less than.05 (p <.05) that related to previous experience of wheelchairs and/or their use. Further studies are planned to investigate and validate outcomes with other student and non-student groups. The semantic attributes of assistive technologies highlight a number of aspects that have implications for those involved in Assistive Technology (AT) product development, manufacturing and marketing. • For online sales, the AT products rely on the web page image to communicate the purpose and attributes of the product. There are limited explorations related to the semantic/communicative attributes of AT product presented in images, as perceived by individuals from diverse cultural backgrounds. • The knowledge towards semantic meaning ascribed to the AT product is important to investigate to provide a perspective that goes beyond practical functions of the AT product towards the communicative function. • Information of comprehending semantics and significance of the AT product from a social (non-users) viewpoint may benefits manufacturers in the development of AT products that best meet the societal needs, preferences and expectations. • A model of best practice, with a focus on semantic manipulation will offer Industrial Designers (ID) internationally with the suitable process and tools to reframe perceptions of disability and enhance acceptance of AT products not only for users, but also for the society around them. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known about this subject?: Burnout is a prominent issue in psychiatric nursing and associated with significant adverse consequences for staff, service users and at an organizational level.Exploration of the extent and predictors of burnout in secure settings has received little research attention. It is not fully understood why prevalence rates of burnout in forensic settings are not elevated in comparison to other settings, despite the presence of known risk‐related correlates. What this paper adds to existing knowledge?: In contrast to previous research, findings suggest that clinical supervision may not be an effective, stand‐alone intervention to support staff experiencing burnout. Thus, the current focus on clinical supervision to mitigate burnout may be insufficient in forensic services.The ward environment (specifically how safe staff feel, how therapeutic the ward feels and how well service users relate to one another) was found to be more important than clinical supervision in terms of burnout for forensic psychiatric nursing staff. What are the implications for practice?: Policies regarding staff health and well‐being should be developed with due consideration given to the association between burnout and the working environment.It should not be assumed that clinical supervision is sufficient to mitigate burnout in practice. Further research assessing all types of support and the ward environment is needed to gain a better understanding of its relationship to burnout. Introduction: Despite extensive research examining burnout in psychiatric nursing staff, literature exploring key predictors of burnout in secure psychiatric settings has been relatively neglected. Research has yet to explore burnout in these settings by adopting previously identified predictors such as support or the ward environment. Aim: The current study aimed to reduce this gap by exploring burnout, the perceived effectiveness of clinical supervision and ward environment. Method: In 2014, nursing staff working in a medium secure forensic psychiatric unit in the United Kingdom (N = 137) provided demographic information and completed the measures assessing: Burnout, clinical supervision and the ward environment. Results: Approximately 10% of nursing staff could be classed as "burnt‐out". The main predictors of burnout were age and ward environment. Clinical supervision had minimal association with burnout. Discussion: The current study sheds doubt on clinical supervision as a potential intervention for burnout and results appear comparable to research within other settings. The implications of the ward environment, supervision and burnout are discussed herein. Implication for Practice: Interventions may need to focus on a positive ward environment (including patient cohesion, experienced safety and enhancing the therapeutic atmosphere). Organizations should support younger nursing staff as they appear particularly vulnerable to burnout. [ABSTRACT FROM AUTHOR]

This paper explores a retrospective analysis of children's file data as a research method of gathering information on children's experiences of informal disclosure of child sexual abuse. This study extracted data from files where children were seen for a child sexual abuse evaluation in Ireland and the children were deemed to have given a credible account of abuse by the professionals concerned. A content analysis was conducted using themes identified in previously published research, based on direct interviews with children about their experiences of informal disclosure. The paper discusses the relative merits and limitations of this method, through reporting on the findings of the file analysis and comparing these findings with findings obtained from a smaller sub-sample of this sample of children, who were interviewed about their experiences of disclosure. It is suggested that this method is worth exploring with a larger sample size which would enable statistical analysis and thus explore the predictive factors influencing early informal disclosure. Frontline services can contribute to the knowledge base on what helps children tell through service-based research that uses data already collected from evaluation interviews with children, thus eliminating the need to interview children for research purposes. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Messages Frontline professionals gather useful data on a daily basis on informal disclosures of child sexual abuse., Practitioners can contribute to the knowledge base on informal disclosure by systematically gathering information from service users., We need more information on what helps children tell. We therefore need to explore innovative methods of gathering such information directly from children in ways that do not rely on interviewing children repeatedly yet include the child's voice. [ABSTRACT FROM AUTHOR]

This study explores the impact of mental capacity in relation to breast screening for women with intellectual disabilities in the UK. Participation in breast screening is considerably lower for women with intellectual disabilities compared to the general population. Barriers to screening include poor mobility and behavioural difficulties. There is currently no research which primarily explores the relationship between mental capacity and breast screening for this group of individuals. This paper presents the results of a cross‐sectional survey of 131 women with intellectual disabilities supported by eight Social Care Providers within England and Wales. The data were collected between January 2017 and July 2017. The current research explores the decision‐making process surrounding breast screening, considering the impact of associated risk factors during this process. Participants completed a specifically created survey addressing the aforementioned issues. The results indicated that women who lacked capacity, were less likely to engage in breast screening. It was also demonstrated that the process outlined in the Mental Capacity Act (MCA; 2005) was not always followed; women were not routinely assessed if there were doubts regarding their decision‐making ability around breast screening and best interest meetings (BIM) were not always held if the person lacked capacity. In order to be able to generalise the current findings, further research is needed to gain a broader understanding of how professionals make decisions around breast screening for women with intellectual disabilities in case the individuals are unable to decide this independently. [ABSTRACT FROM AUTHOR]

Positive outcomes of social networking use in both informal and non-educational settings have attracted significant research attention. These benefits include social capital formation, higher job performance and satisfaction, an increased sense of belonging, improved knowledge management skills, and enabling of life-long learning opportunities. Compulsive use of social networking, however, remains a major issue among the younger users, potentially leaving a long-lasting impact on the younger population. Concerns have been raised regarding links between the compulsive use of social media and individual academic, social and physical performance. This study explores the motivations for social networking use, their relations to compulsive use, and implications for academic, physical and social performance, in an effort to inform strategies for the appropriate adoption and utilisation of social networking technologies. The study employs a finite mixture approach to segmenting the sample, and results show that two distinct groups motivated by utilitarian and social objectives respectively drive compulsive use by British students. Unlike previous studies, the UK sample does not display differences in terms of age or gender. This finding highlights the trend of gender agnostic views of social platforms by developers. The paper concludes with a discussion of the implications for practice and future research. [ABSTRACT FROM AUTHOR]