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When researching with or about families in home-based research, there are numerous unexpected ethical issues that can emerge, particularly in qualitative research. This paper is based on reflective accounts of four homed-based research projects, two in the UK and two Australia, which examined ethical dilemmas identified when engaged in home-based research with young children. Using a synergy of ecocultural theory and Foucauldian ideas of Heterotopia as theoretical conceptualisations, the authors employed reflective lenses to guide their approach, and examine dilemmas and complexities when conducting research in the home. We argue that, to address ethical dilemmas, researchers need to problematise and reflect upon the nature of respectful approaches and the ethical implications of their behaviours. We conclude that, although ethical codes are valuable when researching families at home, researchers should plan for and forefront their methodological approaches in ways that are family-centred, whilst also framed by practices that are ethical, respectful and reflective to the situated contexts of family's ecologies and heterotopias.

The analysis of exemplars of different quality is a potentially powerful tool in enabling students to understand assessment expectations and appreciate academic standards. Through a systematic review methodology, this paper synthesises exemplar-based research designs, exemplar implementation and the educational effects of exemplars. The review of 40 empirical exemplar-based studies indicated frequent use of post-intervention evaluation designs. The integrated use of exemplars and strategies such as rubrics, peer or self-assessment was a major pedagogic feature to enhance students' understanding of standards and aid their generation of internal feedback for self-monitoring. There was evidence suggesting that the combined use of exemplars with these strategies could advance students' academic performance and development of self-regulated learning. The review results set future directions for exemplar-based studies: quantitative research would benefit from controlled manipulation of variables to disentangle the effects of exemplars and those of other strategies; qualitative research could profitably use self-reflective diaries, think aloud protocols or classroom observations to develop deeper understandings of exemplar implementation. The key pedagogical implication recommends students' production of an assignment draft prior to exposure to exemplars so that they can compare their own work with exemplars and then make improvements independently of teachers.

Background: Spoken discourse impairments post‐traumatic brain injury (TBI) are well‐documented and heterogeneous in nature. These impairments have chronic implications for adults in terms of employment, socializing and community involvement. Intervention delivered by a speech–language pathologist (SLP) is recommended for adults with discourse impairments post‐TBI, with an emphasis on context‐sensitive treatment. The developing evidence base indicates a wide array of treatment components for SLPs to evaluate and implement within their clinical practice. However, there is limited insight into how SLPs are currently treating discourse impairments and the rationales informing clinical practice. Aims: To explore the under‐researched area of clinical practice for spoken discourse interventions with adults post‐TBI, including treatment components and clinician rationales, and to contribute towards a shared knowledge base. Methods & Procedures: Participants were recruited via purposeful sampling strategies. Six SLPs participated from Australia, the United Kingdom (UK) and the United States (US). Semi‐structured interviews were conducted via Zoom. Interviews were manually transcribed, coded and analysed via a qualitative content analysis approach. Outcomes & Results: :Participants described discourse treatment practices across various settings and TBI recovery stages. Results indicated that SLPs used numerous treatment activities, resources and outcome measures. Intervention approaches primarily targeted social communication skills, strategy development/utilization and insight‐building. Clinical practice conformed to available guidelines where possible, reflected best practice and incorporated components of the research literature. Participants reported using individualized treatment activities aimed at addressing client‐specific factors and rationales prioritized tailored, context‐sensitive and goal‐directed treatment. Conclusions & Implications: This study provided insight into a previously under‐researched area. It highlighted a wide range of treatment activities and factors informing current SLPs' treatment of spoken discourse impairment post‐TBI. Overall, clinical practice and rationales discussed in this study were aligned with best practice and emphasized a contextualized, individualized approach to discourse treatment across service settings and stages of recovery. Participants identified areas requiring further support, including access to training, resources and research, and the challenge of finding suitable outcome measures. Further investigation into discourse management post‐TBI, from initial assessment to outcome measurement, may help inform clinical decision‐making and the transfer of research to practice. WHAT THIS PAPER ADDS: What is already known on the subject: Spoken discourse impairments occur in dialogic and monologic productions post‐TBI. Interventions targeting both genres are detailed within the research literature; however, studies exploring clinical practice and decision‐making for discourse interventions post‐TBI are limited. What this paper adds to existing knowledge: This study provides new insight into the current treatment targets, activities, resources and outcome measures employed by clinicians supporting adults with discourse impairment post‐TBI. It details the factors that influence clinical decision‐making for this caseload and identifies an emphasis on client priorities and the value of clinician experience. What are the potential or actual clinical implications of this work?: This study identifies the broad and complex considerations required to deliver context‐sensitive discourse intervention post‐TBI. It indicates the need for an in‐depth review from assessment to treatment outcomes to better understand and support this area of practice and to direct future research. This study also highlighted the role of clinician experience in discourse intervention and the value of sharing clinical knowledge and resources within and across the profession to support all levels of clinician experience. [ABSTRACT FROM AUTHOR]

Engagement in health research is increasingly practised worldwide. Yet many questions remain under debate in the ethics field about its contribution to health research and these debates have largely not been informed by those who have been engaged in health research. This paper addresses the following key questions: what should the ethical goals of engagement in health research be and how should it be performed? Qualitative data were generated by interviewing 22 people with lived experience, members of the public, and engagement managers about power sharing in health research. Thematic analysis of study data identified the following five themes: the value of engagement in research, ideal engagement, tokenistic engagement, terms to describe those engaged, and engagement roles in research. The paper presents that data and then considers what insights it offers for what engagement should look like—its ethical goals and approach—according to those being engaged. [ABSTRACT FROM AUTHOR]

This paper explores the decision-making processes involved in giving physiotherapy students responsibility on clinical placement and the impact on their developing professional autonomy. The qualitative study, using semi-structured interviews, involved physiotherapy students and clinical educators (CEs) from two higher education institutions, one in Australia, and the other in the United Kingdom (UK). Findings led to the development of a heuristic framework of 'graduated supervision,' a process of progressively less direct observation and monitoring of students as clinical proficiency improved. By focusing on the measured exposure of students to increasing complexity and inverse levels of supervision, the framework captures tacit practices, and consistent, yet varied facilitation strategies adopted across specialties, and evident in clinical education settings in both countries. The framework formalizes, for the first time, assumptions and expectations previously unacknowledged. Factors identified as affecting students' progress toward autonomy include the student/CE relationship, the development of mutual trust through ongoing dialogue, and the importance of formal discussions at the commencement of a clinical placement to establish learning goals, preferred supervision styles and learner responsibilities. Insights have significance for the CE community, and students who at times have to second-guess what is required of them and how they might excel on clinical placement. [ABSTRACT FROM AUTHOR]

Job insecurity is a widespread workplace stressor that has been extensively investigated using quantitative approaches. With the use of a critical organisational psychology framework, we conducted a meta‐synthesis of 20 qualitative studies to investigate the experience of job insecurity among vulnerable employee groups (i.e., women and immigrants). The qualitative meta‐synthesis results suggest that there are meaningful differences. Specifically, whereas women were more concerned with and exposed to deteriorating working conditions, men experienced job insecurity as a threat to their identity. Among immigrants, the experience of job insecurity is viewed as largely intersecting with the legal system, impacting their ability to remain in their country and making them feel powerless. Thematic evidence also emerged regarding individual actions that participants use to attain security in contrast to corporate strategies that enhance job insecurity. We contribute to the critical organisational psychology literature by discussing how these results test common academic theories and neoliberal assumptions pervasive within the job insecurity literature: We highlight how organisations manufacture job insecurity, question the existence of harmonious social exchanges, discuss the use of job insecurity as a form of worker control, consider the role of the legal context in aiding worker exploitation and argue for an intersectional view of job insecurity. [ABSTRACT FROM AUTHOR]

Purpose: Health and social care professionals are ideally placed to identify and address gender-based violence (GBV), yet research continues to demonstrate that the subject is being poorly covered at undergraduate level. This qualitative study explored health and social care students' and educators' views on GBV education, with a view to identifying 'best practice'. We aimed to capture students' and educators' experiences and perceptions of GBV education across participating countries; how participants thought GBV should be taught/learned within their curricula; and their views on how GBV education might be 'optimized'. Methods: We conducted nine focus group discussions and one semi-structured interview with 23 students and 21 academic staff across the UK, Australia and Chile. Results: Thematic analysis yielded three themes: (1) GBV addressed in all but name, (2) Introduce sooner, explore later and (3) A qualitative approach to learning. Educators and students indicated that GBV is largely being overlooked or incompletely addressed within curricula. Many participants expressed a wish for the subject to be introduced early and revisited throughout their study, with content evolving as cohorts mature. Lastly, our findings indicate that GBV education could benefit from adopting a 'qualitative' approach, prioritizing survivor narratives and incorporating dialogue to facilitate student engagement. Conclusion: Though time constraints and competing demands within undergraduate curricula are frequently cited as barriers to moving away from traditional didactic methods, our findings suggest that teacher-centered strategies are insufficient and, in some regards, inappropriate for GBV education. The need for a paradigm shift in GBV education is discussed. [ABSTRACT FROM AUTHOR]

Bondage/discipline, dominance/submission, and sadism/masochism (BDSM; "kink") are frequently pathologized as derivatives of abuse. Although the link is unsubstantiated, some kink-identified people who happen to be survivors of trauma may engage in kink, or trauma play, to heal from, cope with, and transform childhood abuse or adolescent maltreatment. The present study sought a thematic model (Braun & Clarke, Qualitative Research in Psychology, 3(2), 77–101, 2006) of trauma recovery through kink using a critical realist, inductive approach to inquiry. Participants were eligible if they had experienced early abuse, were adults, and practiced kink. Six superordinate themes were generated from semi-structured interviews with 20 participants from five countries: cultural context of healing (e.g. using BDSM norms and previous therapy to reframe kink and trauma), restructuring the self-concept (e.g. strengthening internal characteristics which had been harmed or distorted), liberation through relationship (e.g. learning to be valued by intimate others), reclaiming power (e.g. setting and maintaining personal boundaries), repurposing behaviors (e.g. engaging in aspects of prolonged exposure), and redefining pain (e.g. transcending painful memories through masochism). Notably, participants only reported retraumatizing experiences prior to learning about the structural safeguards of BDSM. Research and clinical implications are discussed by drawing on general models of trauma recovery. [ABSTRACT FROM AUTHOR]

Background: Poor diet is implicated in multiple chronic diseases. Although doctors may be well placed to facilitate nutrition care, nutrition remains a low priority in medical education internationally. Consensus is required on nutrition competencies as a benchmark for education with a regulatory framework to ensure implementation. The aim of this qualitative study was to explore work roles, attitudes, barriers and enablers in the delivery of nutrition care among a cohort of Australian and UK doctors. Method: Semi‐structured interviews were conducted with primary care doctors/general practitioners (n = 14) and medical specialists (n = 8) based in Australia and the United Kingdom to explore work roles, attitudes, barriers and enablers in the delivery of nutrition care. Results: Framework analysis identified five key themes: (1) knowledge and skills in nutrition to support medical nutrition care, (2) the delivery of nutrition education, (3) multidisciplinary and interdisciplinary care, (4) systemic barriers and facilitators to care and (5) the need for a paradigm shift. Participants acknowledged nutrition as an important component of medical care but recognised they are currently ill‐equipped to support such care, identifying limitations to the systems supporting integrated care. Participants identified that nutrition sits within both a health promotion and medical/treatment model, but they currently work only within the latter. Conclusion: Participants highlighted a lack of knowledge and training regarding nutrition, without which change is not possible. Efforts to improve the nutrition capacity of the medical workforce must be matched by increased investments in primary prevention, including nutrition – a paradigm shift from the medical model. Key points: This qualitative study explores work roles, attitudes, barriers and enablers in the delivery of nutrition care among a cohort of Australian and UK doctors.Doctors acknowledge nutrition as an important component of nutrition care but are ill‐equipped to support such care, identifying limitations to the systems that might support integrated care.Efforts to build the nutrition capacity of the medical workforce must be matched by increased investments in primary prevention, including nutrition – a paradigm shift away from a traditional medical (treatment) model. [ABSTRACT FROM AUTHOR]

This study sought to explore qualitatively experiences of existential loneliness (EL) in 80 older people living in retirement communities across the United Kingdom and Australia. Qualitative semi-structured interviews permitted in-depth exploration of issues such as biographical narrative, close relationships, loss, feelings of loneliness and retirement living. It was our intention to conduct a large-scale, deep-listening exercise that would provide further clues about EL in older people and the circumstances that give rise to such feelings. Data provided rich insight into older people's inner lives. Core themes identified loss of close attachments, lack of physical touch and intimacy, deterioration of health and body, and lack of an emotional language through which to express EL as central to older people's experiences. Furthermore, there was a suggestion that the move to retirement living was for many people inextricably connected to their experience of EL. Our data further support and extend the notion that EL can be thought of as a gradual sense of separation from the world and that ageing intensifies a myriad of social, emotional and physical circumstances that prompt its emergence. This sense of existential isolation need not be thought of as exclusive to those experiencing extreme frailty or who face death imminently – our data pointed to a clear and gradual emergence of EL throughout later life. [ABSTRACT FROM AUTHOR]

This article reports findings from a large mixed-method study exploring the migration to the United Kingdom (UK) of social workers trained in Australia, Canada, India, Romania, South Africa, the US, and Zimbabwe, and the migration of British trained social workers to Australia. The project aimed at exploring the motivations for migration, the experiences of integration, and the impact of culture on these. This article focuses on the quantitative findings and will use some of the qualitative data to further explain and interrogate the differences between these groups based on their country of origin. The findings show the greater challenges migrants from developing countries have experienced, including lack of recognition of their qualifications and experience, and discrimination. The findings also show that contrary to common assumptions, the migration experiences of social workers coming from Australia, Canada and the US are not as easy as expected. American social workers who migrated to the UK turned out to be the group least professionally satisfied. The British in Australia on the other hand, were the most satisfied. Implications for practice and future research are explored. [ABSTRACT FROM AUTHOR]

In many countries across the world, older people are one of the groups most vulnerable to loneliness. Community‐based responses are well placed to support and enhance pre‐existing coping strategies in older people. However, the evidence base of these responses remain scattered and obscured, particularly in relation to their design and reasons behind their success. In this systematic review, we focus on qualitative studies on community‐based responses to loneliness among older people to learn how these responses work in practice with in‐depth details. At the end of a systematic searching and screening process, 17 studies conducted in five countries (Australia, Canada, New Zealand, Spain and the UK) published in English were selected and reviewed initially in October 2020 and then updated at the end of August 2021. Three themes were identified as being most valuable to addressing loneliness in a specific community, namely, autonomy, new social connections, and belonging. These interventions were also employed according to three primary considerations: what the community lacked, how that community experienced loneliness, or a combination of both. Several implications for policymakers and future research emerged, urging future interventions to take a more contextual approach that encompasses community‐level considerations before establishing a user‐led and tailored setting that facilitates social engagement. [ABSTRACT FROM AUTHOR]

Introduction: Post-stroke fatigue (PSF) is common and debilitating. However, while its effective management is a priority for clinicians and stroke survivors, there remains little evidence to provide guidance or underpin practice. Our aim, therefore, was to gain insights into the experiences of clinicians who routinely manage patients with fatigue. Method: Qualitative interview study. The target was to recruit a purposeful sample of approximately 20 participants with expertise in managing PSF and fatigue arising from other conditions. Maximum variation sampling was used to ensure a balance of participants across different settings. Data were analysed using a framework approach, iteratively developed and refined by including emergent themes. Results: We recruited 20 participants: nine occupational therapists (OTs), five physiotherapists, three nurses and three psychologists, which included three 'fatigue experts' from Europe and Australia. Analysis generated core themes around management and strategies used; these were similar regardless of professional background, clinical or geographical setting or condition treated. OTs felt a particular responsibility for fatigue management, although multidisciplinary teamwork was stressed by all. Conclusion: There are clear similarities in clinicians' experiences of managing PSF and fatigue across different conditions and also across professional groups. Clinicians rely predominantly on their own clinical knowledge for guidance. [ABSTRACT FROM AUTHOR]

Edelman and colleagues' analysis of the views of Board members of Australian Research Translation Centres (RTCs) is well timed. There has been little study of Australian RTCs to date. We focus on their recommendations regarding knowledge mobilisation (KM) to open broader debate on the wisdom of regarding UK practices as a blueprint. We go further and ask whether successful RTCs might, as a result of responding to local context, create idiosyncratic structures and solutions, making generalisable learning less likely? There has been much invested in Australian RTCs and implications of government's formative evaluation of their work is discussed. Five recommendations are made that could help RTCs: allowing system end-users a greater say in funding decisions, taking a broader, more democratic approach to kinds of knowledge that are valued; investing in methodologies derived from the innovation space; and, a creative attention to governance to support these ideas. [ABSTRACT FROM AUTHOR]

Objectives GCA is a large vessel vasculitis (LVV) presenting with headache, jaw claudication, musculoskeletal and visual involvement. Current treatment is glucocorticoids and anti-IL-6 tocilizumab in refractory disease. The objective of this study was to explore the impact of GCA and its treatment on people's health-related quality of life (HRQoL), to inform the development of a disease-specific patient-reported outcome measure (PROM) for use in clinical trials and practice. Methods Participants from the UK and Australia, with biopsy- or imaging-confirmed GCA, were interviewed to identify salient aspects of HRQoL in relation to GCA and its treatment. Purposive sampling included a range of demographic and disease features (cranial, LVV-GCA and visual involvement). Inductive analysis identified individual themes of importance, then domains. Candidate questionnaire items were developed from the individual themes, refined by piloting, cognitive interviews and a linguistic translatability assessment. Results Thirty-six interviews were conducted to saturation with participants with GCA from the UK (25) and Australia (11). Mean age was 74 years, 23 (63.9%) were female, 13 (36.1%) had visual loss and 5 (13.9%) had LVV-GCA. Thirty-nine individual themes within five domains were identified: physical symptoms; activity of daily living and function; participation; psychological impact; and impact on sense of self and perception of health. Sixty-nine candidate items were developed from individual themes; piloting and refinement resulted in a 40-item draft questionnaire. Conclusion This international qualitative study underpins the development of candidate items for a disease-specific PROM for GCA. The draft questionnaire is now ready for psychometric testing. [ABSTRACT FROM AUTHOR]