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Background Older people are often explicitly or implicitly excluded from research, in particular clinical trials. This means that study findings may not be applicable to them, or that older people may not be offered treatments due to an absence of evidence. Aims The aim of this work was to develop recommendations to guide all research relevant to older people. Methods A diverse stakeholder group identified barriers and solutions to including older people in research. In parallel, a rapid literature review of published papers was undertaken to identify existing papers on the inclusion of older people in research. The findings were synthesised and mapped onto a socio-ecological model. From the synthesis we identified themes that were developed into initial recommendations that were iteratively refined with the stakeholder group. Results A range of individual, interpersonal, organisational, community and policy factors impact on the inclusion of older people in research. A total of 14 recommendations were developed such as removing upper age limits and comorbidity exclusions, involving older people, advocates and health and social care professionals with expertise in ageing in designing the research, and considering flexible or alternative approaches to data collection to maximise opportunities for participation. We also developed four questions that may guide those developing, reviewing and funding research that is inclusive of older people. Conclusion Our recommendations provide up to date, practical advice on ways to improve the inclusion of older people in health and care research. [ABSTRACT FROM AUTHOR]

Although health education programmes have been implemented in higher music education (HME) and their evaluations published in peer-reviewed journals, guidelines as to what ought to be included in these programmes are still missing. This study aimed to document expert discussions on the content of an ideal health education curriculum for HME students in the UK, integrating critical thinking. Four interdisciplinary workshops were conducted, where 67 experts in relevant fields took part, and were asked to discuss four lists of topics and concepts created based on literature reviews (cognitive biases, logical fallacies, critical appraisal tools and health topics). Only the list on health topics is relevant here. Notes taken by the participants and ourselves were thematically analysed. Four themes were identified, two of which are reported in this paper: (i) The health education curriculum and (ii) A settings-based approach to health. Part I of this project (published elsewhere) is focussed on the critical thinking content of health education for conservatoire students. The present paper focusses on the ideal health education curriculum and its implications for the wider context of health promotion. [ABSTRACT FROM AUTHOR]

Background COVID-19 brought additional challenges to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision-making, which was already a contentious issue. In the UK, reports of poor DNACPR decision-making and communication emerged in 2020, including from the regulator, the Care Quality Commission. This paper explores the experiences of people who discussed DNACPR with a healthcare professional on behalf of a relative during the coronavirus pandemic, with the aim of identifying areas of good practice and what needs to be improved. Methods a total of 39 people participated in semi-structured interviews via video conferencing software or telephone. Data were evaluated using Framework Analysis. Findings results are presented around three main themes: understanding, communication and impact. Participants' understanding about DNACPR was important, as those with better understanding tended to reflect more positively on their discussions with clinicians. The role of relatives in the decision-making process was a frequent source of misunderstanding. Healthcare professionals' communication skills were important. Where discussions went well, relatives were given clear explanations and the opportunity to ask questions. However many relatives felt that conversations were rushed. DNACPR discussions can have a lasting impact—relatives reported them to be significant moments in care journeys. Many relatives perceived that they were asked to decide whether their relative should receive CPR and described enduring emotional consequences, including guilt. Conclusion the pandemic has illuminated deficiencies in current practice around DNACPR discussion, which can have difficult to anticipate and lasting negative consequences for relatives. This research raises questions about the current approach to DNACPR decision-making. [ABSTRACT FROM AUTHOR]

Hope is considered crucial to mental health recovery. However, the manner in which social inequalities shape individuals' meaning of hope has received little attention. Based on a close analysis of the recovery journeys of six Chinese service users in the UK, this paper explores the diverse meanings of hope among service users from non-dominant cultures. Illustrative stories are selected from in-depth life history interviews conducted with twenty-two participants. Based on the capabilities approach and intersectionality analysis, the findings reveal a paradox of hope and show how hope can be embraced, cautiously pursued or held at bay by individuals. Whilst hope is one expression of human agency, service users with reservations about hope maintain agency in other ways, despite their diminished life chances. This paper argues for an increased focus on individuals' agency development to support recovery and advocates for the challenging of inequalities to achieve this. [ABSTRACT FROM AUTHOR]

Background Given the globally ageing population, care homes have an important role in delivering palliative and end-of-life care. Advance care planning (ACP) is promoted to improve the quality of end-of-life care in this setting. While many professionals can be involved in ACP, little is known about what influences multi-professional involvement and how multi-professional working impacts the ACP process in the UK. This study investigated multi-professional practice in relation to ACP in nursing homes. Design and methods An ethnography was undertaken in two UK nursing homes using multiple methods of data collection: observations, interviews and document review. Participants included the following: nursing home residents (n  = 6), relatives (n  = 4), nursing home staff (n  = 19), and visiting health and social care professionals (n  = 7). Analysis integrated thematic analysis, mapping of resident ACP trajectories and documentary analysis. Findings This paper suggests that multi-professional and relatives' involvement in ACP was disjointed. Continuity and coordination were disrupted by misalignment of visiting professional and nursing home organisational structures. Findings show a 'knotworking' approach to teamwork and power imbalance between nursing home staff and visiting professionals, such as general practitioners. While residents wished their relatives to be involved in their ACP, this was not formally recognised, and limited support existed to facilitate their involvement. Conclusion The structure and organisation of multi-professional and relatives' involvement in ACP led to fragmentation of the process. This marginalised the voice of both the resident and nursing home staff, thereby limiting ACP as a tool to enhance quality of end-of-life care. [ABSTRACT FROM AUTHOR]

Background This paper presents insights into patient experiences of changes in workforce composition due to increasing deployment in general practice of practitioners from a number of different professional disciplines (skill mix). We explore these experiences via the concept of 'patient illness work'; how a patient's capacity for action is linked to the work arising from healthcare. Methods We conducted four focus group interviews with Patient Participation Group members across participating English general practitioner practices. Thematic analysis and a theoretical lens of illness work were used to explore patients' attempts to understand and navigate new structures, roles and ways to access healthcare. Results Participants' lack of knowledge about incoming practitioners constrained their agency in accessing primary care. They reported both increased and burdensome illness work as they were given responsibility for navigating and understanding new systems of access while simultaneously understanding new practitioner roles. Conclusions While skill mix changes were not resisted by patients, they were keen to improve their agency in capacity to access, by being better informed about newer practitioners to accept and trust them. Some patients require support to navigate change, especially where new systems demand specific capacities such as technological skills and adaptation to unfamiliar practitioners. [ABSTRACT FROM AUTHOR]

There is a significant diversity in approach to 'resilience' in the context of mental health recovery following experiences of psychosis, varying from clinically measurable outcomes to a personal trait within a recovery 'journey'. Given the contested nature of resilience within mental health literature, this study aimed to complete a scoping review to synthesise understandings of resilience by individuals with experiences of psychosis. Drawing on the holistic and person-centred principles that underpin social work approaches to mental distress, these perspectives are considered in the statutory, policy and critical contexts of British social work, establishing learning for practice. A meta-synthesis of qualitative studies was completed, drawing on searches of five databases (Social Care Online, APA PsychInfo, Cinahl, Medline and Web of Science), identifying twelve relevant papers. A thematic analysis identified three overarching themes (personal, social and professional factors) and eight associated sub-themes (personal responsibility, use of experience, coping strategies, peer support, social relationships, contribution, relationships with professionals and structured support). The study identifies systemic and life-course approaches as empowering service user engagements with psychosis, recovery and resilience, suggesting that the social work profession is well placed to engage with resilience enhancement in the context of mental health recovery. [ABSTRACT FROM AUTHOR]

Background: In the UK, general practitioners (GPs) are the most commonly used providers of care for emotional concerns.Objective: To update and synthesize literature on barriers and facilitators to GP-patient communication about emotional concerns in UK primary care.Design: Systematic review and qualitative synthesis.Method: We conducted a systematic search on MEDLINE (OvidSP), PsycInfo and EMBASE, supplemented by citation chasing. Eligible papers focused on how GPs and adult patients in the UK communicated about emotional concerns. Results were synthesized using thematic analysis.Results: Across 30 studies involving 342 GPs and 720 patients, four themes relating to barriers were: (i) emotional concerns are difficult to disclose; (ii) tension between understanding emotional concerns as a medical condition or arising from social stressors; (iii) unspoken assumptions about agency resulting in too little or too much involvement in decisions and (iv) providing limited care driven by little time. Three facilitative themes were: (v) a human connection improves identification of emotional concerns and is therapeutic; (vi) exploring, explaining and negotiating a shared understanding or guiding patients towards new understandings and (vii) upfront information provision and involvement manages expectations about recovery and improves engagement in treatment.Conclusion: The findings suggest that treatment guidelines should acknowledge: the therapeutic value of a positive GP-patient relationship; that diagnosis is a two-way negotiated process rather than an activity strictly in the doctor's domain of expertise; and the value of exploring and shaping new understandings about patients' emotional concerns and their management. [ABSTRACT FROM AUTHOR]

Background vaccination uptake in the UK and increased care home testing are likely affecting care home visitation. With scant scientific evidence to date, the aim of this longitudinal qualitative study was to explore the impact of both (vaccination and testing) on the conduct and experiences of care home visits. Methods family carers of care home residents with dementia and care home staff from across the UK took part in baseline (October/November 2020) and follow-up interviews (March 2021). Public advisers were involved in all elements of the research. Data were analysed using thematic analysis. Results across 62 baseline and follow-up interviews with family carers (n  = 26; 11) and care home staff (n  = 16; 9), five core themes were developed: delayed and inconsistent offers of face-to-face visits; procedures and facilitation of visits; variable uptake of the COVID-19 vaccine; misinformation, education and free choice; frustration and anger among family carers. The variable uptake in staff, compared to family carers, was a key factor seemingly influencing visitation, with a lack of clear guidance leading care homes to implement infection control measures and visitation rights differently. Conclusions we make five recommendations in this paper to enable improved care home visitation in the ongoing, and in future, pandemics. Visits need to be enabled and any changes to visiting rights must be used as a last resort, reviewed regularly in consultation with residents and carers and restored as soon as possible as a top priority, whilst more education needs to be provided surrounding vaccination for care home staff. [ABSTRACT FROM AUTHOR]

Background and Objectives A growing body of work suggests that co- or peer-research may contribute to understanding the complex health and social problems experienced in later life. Yet, only a limited number of studies have involved older persons as partners in the research process. Moreover, in conflict with the philosophy of participatory research, the views of those acting as coresearchers tend to be ignored. This paper gives an "insider" account of the process of coresearch, drawing upon the experiences of older people trained to undertake a community-based research project. Research Design and Methods Eighteen older adults were recruited and trained as coresearchers to take a leading role in a study aimed at developing "age-friendly" communities in Manchester, UK. The coresearchers completed 68 interviews with residents aged 60 years and over who were experiencing isolation within their neighborhood. The findings are based upon four reflection meetings held with the coresearchers, all of which were transcribed with thematic analysis conducted using Atlas.ti. Results Coresearchers identified a range of advantages associated with the coresearch approach, these linked to the recruitment of participants, quality of data, potential for social change as well as personal benefits. They also identified ethical, methodological, and practical issues encountered during the research. Discussion and Implications The study demonstrates the contribution of coresearch for expanding methodological diversity, accessing seldom heard populations, and utilizing the skills and resources of older people. The research also highlights the opportunities for partnerships between older people and local stakeholders to facilitate community change and social action. [ABSTRACT FROM AUTHOR]

Background Children's second-hand smoke (SHS) exposure in the home is highest in socio-economically disadvantaged areas. Personalized household air-quality measurements can promote changes in smoking that reduce SHS exposure. The 'First Steps 2 Smoke-free' (FS2SF) intervention is the first to trial this approach delivered as part of health professionals' routine work. This paper reports the findings of qualitative interviews with participants that explored their experiences of the intervention and why outcomes varied. Methods 120 women were recruited from the NHS First Steps Programme, which supports disadvantaged mothers. They received either personalized feedback on their home air quality and advice on reducing SHS or standard SHS advice. Qualitative interviews with 15 mothers were analyzed thematically using the Capability, Opportunity, Motivation, Behaviour (COM-B) model. Results The intervention increased women's capability to change home-smoking behaviour, through increasing awareness and salience of SHS risks to their children, and motivation to act. However, taking effective action was constrained by their limited social and environmental opportunities, including others' smoking in the home. Conclusions The FS2SF intervention was ineffective as it was unable to fully address the precarious, complex life circumstances that make creating a smoke-free home particularly difficult for women experiencing intersecting dimensions of disadvantage. [ABSTRACT FROM AUTHOR]

Introduction process evaluations (PE) are increasingly used in parallel with randomised controlled trials (RCT) to inform the implementation of complex health interventions. This paper explores the learning accrued from conducting a PE within the Falls in Care Homes Study (FinCH), a large UK RCT. Methods in the FinCH study, six purposively sampled care homes provided data for the PE, which followed a realist approach. In this study researchers kept written diaries of their experiences in completing the interviews, focus groups and observations. We have reflected on these and present the main themes for discussion. Findings care home staff were enthusiastic to participate in the PE but researchers found it difficult to collect data due to staff not having time to take part, environmental factors such as no space for focus groups and low levels of research understanding. Researchers found that the expectations of the PE protocol were often unrealistic due to these limitations. Flexible and pragmatic approaches such as interviews in place of focus groups enabled data collection but required a reduced sample size and length of data collection to be accepted by researchers. Conclusion to enable care home staff to participate in successful PEs, researchers should build flexibility into research schedules, spend time building trust, collaborate with all levels of care home staff prior to data collection, increase research capacity in care home staff and co-design research projects. [ABSTRACT FROM AUTHOR]

This paper examines the value of participatory approaches within interventions aimed at promoting mental health and wellbeing in the workplace. Specifically the paper explores data from the thematic evaluation of the Mental Health and Employment project strand within the Altogether Better programme being implemented in England in the Yorkshire and Humber region, which was funded through the BIG Lottery and aimed to empower people across the region to lead better lives. The evaluation combined a systematic evidence review with semi-structured interviews across mental health and employment projects. Drawing on both evaluation elements, the paper examines the potential of workplace-based ‘business champions’ to facilitate organizational culture change within enterprises within a deprived regional socio-economic environment. First, the paper identifies key policy drivers for interventions around mental health and employment, summarizes evidence review findings and describes the range of activities within three projects. The role of the ‘business champion’ emerged as crucial to these interventions and therefore, secondly, the paper examines how champions' potential to make a difference depends on the work settings and their existing roles, skills and motivation. In particular, champions can proactively coordinate project strands, embed the project, encourage participation, raise awareness, encourage changes to work procedures and strengthen networks and partnerships. The paper explores how these processes can facilitate changes in organizational culture. Challenges of implementation are identified, including achieving leverage with senior management, handover of ownership to fellow employees, assessing impact and sustainability. Finally, implications for policy and practice are discussed, and conclusions drawn concerning the roles of champions within different workplace environments. [ABSTRACT FROM AUTHOR]

Background: Ventricular assist devices (VADs) are a relatively new development in the management of advanced heart failure. In the UK, VAD recipients comprise a unique group of less than 200 patients. This is the first paper to explore the experience of VAD communities, the extent to which communities are developed around the device, and how these influence the experience of living with the VAD. Methods: Qualitative interviews were conducted with 20 VAD recipients (implanted as a bridge to transplantation), 11 interviews also included the VAD recipients’ partners. Interpretive phenomenology was employed as the theoretical basis guiding the analysis of the interviews. Results: Four key themes emerged from the data: the existence of VAD communities; experiential knowledge and understanding; social comparisons; and the impacts of deaths within the VAD community. Many of the interviewees valued the VAD communities and the relationships they had formed with fellow recipients. The beneficial impacts of the VAD communities included offering recently implanted patients a realistic view of what to expect from life with a VAD; this could aid them in accepting and adapting to the changes imparted by the device. However, negative impacts of the VAD communities were also reported, in particular following deaths within the group, which were a source of distress for many of the interviewees. Conclusions: In general, the VAD communities appeared to be a beneficial source of support for the majority of interviewees. Consideration should be given to how these communities could be supported by clinicians. [ABSTRACT FROM AUTHOR]

In the UK, Valuing People ( Department of Health, 2001, 2010b) has shaped services for people with learning difficulties for the past decade. Promoting choices and independence are two of the four key principles that underpin this White Paper and its subsequent delivery plans. This paper assesses the impact that these changes had on the availability of mundane choices. It draws on empirical evidence from interviews with adults with learning difficulties. First impressions of the findings indicate that individuals are indeed able to make an increased range of decisions. At closer inspection, it does however become apparent that not all of these decisions are based on an infinite spectrum of options. Under the guise of choice-based policy rhetoric, some people with learning difficulties are at times presented with a pre-arranged ‘menu of choices’. For instance, a person may be free to choose activities at their day centre, but they may have limited control when deciding whether to attend the service in the first place. The wider implications that tokenistic choice-making processes have for the development of personal autonomy are highlighted. It is argued that a lack of control in respect to mundane choices is disempowering and leads to learned passivity. [ABSTRACT FROM AUTHOR]

Focusing on the conceptualization of a whole university approach, this paper reports on an international qualitative study that explored vice-chancellors' and network members' understanding of and commitment to Health Promoting Universities, examined perspectives on leadership and investigated the Okanagan Charter's potential to catalyse whole university leadership and change. A multi-method qualitative approach was used: semi-structured interviews and focus groups were conducted face-to-face with vice-chancellors (n = 12) and Health Promoting University co-ordinators who were members of the UK Healthy Universities Network (n = 8); telephone interviews were conducted with a mix of UK and non-UK Health Promoting University co-ordinators (n = 5) and two online questionnaires were distributed to non-UK network co-ordinators (n = 6) and non-UK Health Promoting University co-ordinators (n = 10). Through thematic analysis, a number of key themes emerged that build a new conceptualization of the whole university approach (see Figure 1): building a broad understanding and framing of health; developing a supportive ethos and culture; embedding health into the university and joining up areas of work; focusing on the whole population and facing challenges and seizing opportunities. The study elicited rich and wide-ranging views from multiple stakeholders from universities and networks across four continents, confirming Health Promoting Universities as a truly global movement. Looking ahead, there are clear opportunities and challenges. First, the media narrative of a student mental health 'crisis' has focused universities' attention on 'health', but from a single issue 'illness' perspective. This risks detracting from the whole system Health Promoting Universities approach. Second, even with the Okanagan Charter inspiring individuals and universities, there are still major challenges in translating the rhetoric of whole system approaches into meaningful action within large, complex and culturally diverse organizations. [ABSTRACT FROM AUTHOR]

Defensive practice has received attention through the Munro review of child protection, which has identified that current organisational cultures increase the likelihood of defensive practice. Whilst the wider socio-political climate that gives rise to defensive practice has been explored within the literature, little attention has been paid to the everyday realities of defensive practice. This paper reports the findings of a study into final year social work students' attitudes towards defensive practice within social work. Three focus groups were completed with a total of ninety final-year students that collected qualitative and quantitative data using interactive software. This paper examines how participants perceived defensive practice, both in general and when faced with real-life vignettes. Participants distinguished between pro-active behaviour (sins of commission) and passive behaviour (sins of omission), generally regarding the latter as less serious because it was less tangible and easier to attribute to more positive motives. Whilst the literature identifies defensive practice as deliberate behaviour, the focus group discussions suggest that it is a subtler and less conscious process. Whilst there was there was a general consensus about the nature of defensive practice, there was considerable disagreement about specific vignettes and several competing explanations are explored. [ABSTRACT FROM AUTHOR]

This paper presents a comparative analysis of the feasibility studies submitted by six UK cities (London, Birmingham, Manchester, Glasgow, Bristol and Milton Keynes). The datasets were collected during the period of February–March 2017 by exploring their Open Data resources, common visions of their smart programmes and the themes of their projects. The aim of this work is to raise awareness and access of the existing data resources, encourage alignment of data collection and curation among projects with compatible objectives in different cities and to identify the gaps in coverage that are hampering achievement of the cities' visions. In this research, we distinguish between stored datasets that are accessible via data hubs, and live data that are only accessible via application programming interfaces in real time. Given that our findings are purely based on stored Open Data, we conclude that the Smart City dream will be only achieved in reality, where those involved in Smart Cities-related projects co-operate and share both experiences and resources in order to maximize progress towards the common goal but to minimize duplication of efforts and repetition of the same mistakes. [ABSTRACT FROM AUTHOR]

The paper explores the views of social work practitioners regarding their ability to explore the emotional content of their practice in formalandin formal forums. The responses from a questionnaire- and interview-based study of a Scottish local authority reveal that supervision is subject to issues of ‘safety', permissions, manageria list approaches and individual relationships. Informal support from peers was valued due to its unrecorded, on-demand and supportive nature. The findings have implications for seeking improvements in supervision as suggested by the Social Work Task Force,and for securing of the validity and place of emotions in practice. [ABSTRACT FROM AUTHOR]

The ‘health-promoting prison’ has been informed by a broader settings-based philosophy to health promotion which conceptualizes health as the responsibility for all social settings. Though in its relative infancy, the notion of a health-promoting prison has gained political backing from international organizations like the World Health Organization, but the implementation of the policy rhetoric has not translated across all prison environments. The aim of this paper is to consider how key elements of health promotion discourse—choice, control and implicitly, empowerment—can apply in the context of imprisonment. These concepts were examined in three category-C (secure) prisons in England, through interviews with 36 male prisoners and 19 prison staff conducted by the first author. Analysis showed that prisoners negotiated the norms, structures and strictures of prison life by both relinquishing control and also by taking control, showing resistance and exercising some element of choice. The paradox is that, as most prisoners are expected to be released at some point they need to exercise some agency, control and choice, but these learning experiences may be constrained whilst ‘inside’. The paper argues that if a settings approach in prison is truly to move forward, both conceptually and practically, then health promoters should seek to embed the key values of health promotion within the prison setting. [ABSTRACT FROM AUTHOR]

This paper explores the use of health impact assessment (HIA) as a means of facilitating community engagement in spatial planning. The paper discusses the background to the development of HIA as a tool for assessing the likely impact of policies and wider changes on health with a view to building those into planning and decision-making, and describes the evolution of HIA into more participatory forms. It then goes on to describe a case-study of plans for a waste incinerator in an inner-city area in the UK, where HIA was used in response to community concerns about the development as a means of building in the views of local people to the decision-making around the plan. We describe in detail how the HIA was conducted and additional research undertaken within a timescale set by the planning processes. We discuss the difficulties involved in conducting any kind of research-based HIA so rapidly and in a situation of multiple, competing stakeholder interests. We argue that although the HIA failed to influence the final decisions in this particular instance it does, nonetheless, provide a model for how to create ‘knowledge spaces’ in which different perspectives and information can be brought around the table to create more democratic approaches to planning for waste. [ABSTRACT FROM PUBLISHER]

Over recent years, there has been growing interest in Healthy Universities, evidenced by an increased number of national networks and the participation of 375 participants from over 30 countries in the 2015 International Conference on Health Promoting Universities and Colleges, which also saw the launch of the Okanagan Charter. This paper reports on research exploring the use and impact of the UK Healthy Universities Network's self review tool, specifically examining whether this has supported universities to understand and embed a whole system approach. The research study comprised two stages, the first using an online questionnaire and the second using focus groups. The findings revealed a wide range of perspectives under five overarching themes: motivations; process; outcomes/benefits; challenges/suggested improvements; and future use. In summary, the self review tool was extremely valuable and, when engaged with fully, offered significant benefits to universities seeking to improve the health and wellbeing of their communities. These benefits were felt by institutions at different stages in the journey and spanned outcome and process dimensions: not only did the tool offer an engaging and user-friendly means of undertaking internal benchmarking, generating an easy-to-understand report summarizing strengths and weaknesses; it also proved useful in building understanding of the whole system Healthy Universities approach and served as a catalyst to effective cross-university and cross-sectoral partnership working. Additionally, areas for potential enhancement were identified, offering opportunities to increase the tool's utility further whilst engaging actively in the development of a global movement for Healthy Universities. [ABSTRACT FROM AUTHOR]

This paper examines human-nature interaction and how therapeutic this relationship is by investigating the efficacy of structured outdoor experience. Two walking and solo experience (WSEs) explored university students' (aged 20--43 years) perceptions of walking through and being with nature. The first was a 5-day journey (n = 4; 3 females and 1 male) and the second (n = 5; 3 females and 2 males) took place over two weekends, with a 2-week interval in-between. Pre- and post-experience interviews, journal writing, group discussions and a 9-month follow-up interviews were used to collect data and thematic analysis [Braun and Clarke (Using thematic analysis in psychology. Qual Res Psychol 2006;3:77-101.)] was applied. Both WSEs were considered together during analysis, as well as comparisons made between the two, in order to evaluate implications for practice. Benefits of the WSE that contributed to a general sense of well-being were: (i) gaining a sense of freedom and escape; (ii) gaining a sense of awareness and sensitivity to one's environment and its influence (iii) gaining confidence in being able to cope and take action; (iv) gaining a sense of perspective on and appreciation for life. Furthermore, the meaning participants formed in relation to their environment before, during and after the WSE, and the activity within that environment, played a role in their sense of well-being and in their motivations to re-access nature in other places. Findings suggest that WSEs are a cost effective way to give rise to beneficial and durable experiences, but a more holistic approach to policy is needed. [ABSTRACT FROM AUTHOR]

In order to practise social work in England, all social workers must register with the Health and Care Professions Council (HCPC). Only those who are registered can legally work as or call themselves a social worker. Once registered, if concerns about their practice are raised, social workers may find they are then made subject to a 'Fitness to Practise' (FTP) process. This article reports on the findings from interviews with social workers who were referred to the HCPC for practice issues. Our rationale was to hear and report on the lived experience of those going through the investigatory process. We carried out semi-structured interviews with eight social workers and used thematic analysis to analyse our data. The three main themes to emerge from our findings were organisational issues, representation and cost and emotional toll. This paper discusses these findings in detail. We suggest that the current regulatory system situates social workers in a position of disadvantage during the FTP process, and conclude by making a number of recommendations for consideration if future changes are to be made to the social work regulatory process. [ABSTRACT FROM AUTHOR]

This paper examines lay interpretations of lay health worker roles within three UK community-based health promotion projects. It argues that understanding lay health worker roles requires critical analysis of the complex interrelationships between professionals, lay workers and the communities receiving a programme. Findings are presented that are drawn from a qualitative study of lay engagement in public health programme delivery where a key objective was to examine the perspectives of community members with the experience of receiving services delivered by lay health workers. Interviews and focus groups were conducted with 46 programme recipients from three case study projects; a breastfeeding peer support service, a walking for health scheme and a neighbourhood health project. The results show how participants interpreted the function and responsibilities of lay health workers and how those roles provided personalized support and facilitated engagement in group activities. Further insights into community participation processes are provided revealing the potential for active engagement in both formal and informal roles. The paper concludes that social relationships are core to understanding lay health worker programmes and therefore analysis needs to take account of the capacity for community members to move within a spectrum of participation defined by increasing responsibility for others. [ABSTRACT FROM PUBLISHER]

Contemporary child adoption in the UK and USA has been conceptualised as an extended kinship network of adopted children, birth relatives and adopters (Reitz and Watson, 1992; Grotevant and McRoy, 1998). This contrasts sharply with the traditional model of adoption as a form of family substitution. Yet, such a reconceptualisation raises many questions about the meaning of kinship for those involved. This paper draws on data from a series of biographical interviews with twenty-two parents who adopted children within the UK over a twenty-four-year period in order to explore post adoption ‘family relationships’ from the perspective of adoptive parents. It develops an analysis of definitions of ‘kinship’ created by adoptive parents in order to shape family relationships following adoption, particularly the processes through which birth relatives are rendered marginal or integral to adoptive family life. The relevance of current adoption policy and professional practices to these processes are explored. [ABSTRACT FROM PUBLISHER]

This paper reports on the first ever national study in the UK of the needs of disabled women experiencing domestic violence and of the services available to meet these needs. The study found that, in general, support services frequently overlook or respond inappropriately to disabled women in this situation. The overall findings of the research were very wide-ranging, as were the resultant recommendations for statutory agencies, disability organisations, domestic violence services and wider strategic and commissioning frameworks. In this paper, the general findings are discussed briefly, followed by a discussion of abuse by paid carers/personal assistants in the context of the personalisation agenda, with a focus on issues for adult care services. [ABSTRACT FROM PUBLISHER]

This paper presents findings from a Department of Health-funded study into the emotional well-being of young people seeking asylum on their own in the UK. It discusses how young people accounted for only partly disclosing information about the circumstances surrounding their quest for asylum and subsequent aspects of their lives since arriving in the UK. Foucault's panoptic mechanism and its focus on the effects of power as dispersed through scrutiny are applied as a theoretical framework to contextualise these experiences. The paper shows that young people's decisions about how much of their current or past lives they share with others are more complex than indicated by earlier research. The paper argues that, for many young people, the predominant impetus for selective disclosure was a desire to retain a degree of agency as they navigated their way through immigration, asylum, social care, health and education systems and simultaneously sought to establish themselves in the social world. These findings have implications for how social care (and other) professionals engage and work with young people seeking asylum alone. [ABSTRACT FROM PUBLISHER]

A key issue for the social work profession concerns the nature, quality and content of communicative encounters with children and families. This article introduces some findings from a project funded by the Economic and Social Research Council (ESRC) that took place across the UK between 2013 and 2015, which explored how social workers communicate with children in their everyday practice. The Talking and Listening to Children (TLC) project had three phases: the first was ethnographic, involving observations of social workers in their workplace and during visits; the second used videostimulated recall with a small number of children and their social workers; and the third developed online materials to support social workers. This paper discusses findings from the first phase. It highlights a diverse picture regarding the context and content of communicative processes; it is argued that attention to contextual issues is as important as focusing on individual practitioners' behaviours and outlines a model for so doing. [ABSTRACT FROM AUTHOR]

This paper presents findings from a study that explored the experiences of young people living in foster-care in the UK. Previous research highlights that children and young people in foster-care experience stigma. Qualitative methods were chosen to explore how the young people in this study experience and manage stigma in their day-to-day lives. Findings provide valuable insights into how the participants cope with the challenges of stigma. There were two key ways they did this: (i) by carefully managing the disclosure of their 'in-care' status and (ii) by drawing support from their social relationships. Furthermore, the participants particularly valued support from their peers who were also living in foster-care, as it enabled them to form an in-group, which presented them with a valuable sense of belonging. These findings have implications for practice and this paper proposes two ways to better support young people in foster-care to cope with stigma: first, by valuing the importance of friendship groups and enabling young people to maintain their existing friendships and, second, by developing more opportunities that bring fostered young people together, which enables them to interact with their peers without the pressure of managing stigma. [ABSTRACT FROM AUTHOR]

This paper draws on findings from a European project, 'Rights through Alliances: Innovating and Networking Both Within Homes And Schools' (RAINBOW-HAS), conducted in 2013-15. It built collaboration between six EU countries to analyse and improve the rights of children and youth regarding sexual orientation and gender identity in educational settings. The main focus of discussion derives from a secondary discourse analysis following thematic analyses of the qualitative interviews undertaken with a range of different families, schools and community associations across these European countries, which provide a snapshot of contemporary practice. We discuss the relative silence of social work in challenging homophobic and transphobic bullying, given their potential in promoting family and young people's engagement. [ABSTRACT FROM AUTHOR]

The public's perception of the social work profession is a rarely considered perspective and yet a topic that is a concern to front line professionals. This paper explores how social workers experience and attempt to cope with public perception of their profession. It highlights the impact of these concerns on social workers' personal experiences and professional practice. Using semi-structured interviews with sixteen UK social workers, from local authorities and private organisations, we explore the experiences of this group. Thematic analysis of the data identified four concerns: the experience of public perception, drivers of public perception, coping with public perception, and mechanisms to raise the professions profile. Examining public perception through the eyes of social workers provides valuable insights into the lived experiences of these professionals, and offers practical implications at both the micro and macro levels. It reveals two key ways in which the profession can begin to address the prevailing negative perception considered to be emanating from the public: through developing a more co-operative relationship with external sources of public perception (e.g. government and the media) and by engaging in more pro-active self-promotion of the service. [ABSTRACT FROM AUTHOR]

Background and Objectives Understanding the influences of marginalized cultural and social identities as experienced by the African Caribbean diaspora within the context of dementia care is essential to minimize the gaps in current practice and policy in the health care setting. This study explores the impact of marginalized identities upon the meaning-making process, access to services and experience of care provisions through a scoping review and consultancy exercises with key stakeholders. Research Design Fourteen databases were searched using key terms. Primary studies in English, any year, study design, and country of origin were eligible. Titles, abstracts, and full texts were screened for inclusion and data were extracted in stages. Thematic analysis was performed and the findings were discussed in a series of consultation meetings with people with dementia, carers, and health care professionals in Manchester (United Kingdom) and Jamaica. Results The scoping review retrieved n = 1,989 research articles. Nineteen were included, most were qualitative (n = 14), 3 quantitative, and 2 mixed-method. The findings revealed limited insight into cultural and multiple individual identities in explaining conceptualization and service access. Consultation meetings confirmed these findings and highlighted differences in health care services and systems in the United Kingdom and Jamaica. Discussion and Implications This study suggests there is a complex interaction of sociocultural processes that marginalize African Caribbean persons in and across various national settings within the context of dementia care. The study highlights the importance of acknowledging and addressing how prevalent racialized- and class-based divides and related marginalized social locations are reflected in inequities in access to and use of dementia services. [ABSTRACT FROM AUTHOR]

This paper describes the impact that learning about recovery has on mental health carers, exploring the implications of this research for UK social work and beyond. A steering group co-produced a training intervention on recovery that was delivered by the first author and a carer, both with experiences of recovery, to eleven carers. Mainly qualitative data, with supplementary socio-demographic data, were collected to evaluate the impact of this training. Thematic analysis was applied to the data. Findings suggest that being more 'recovery- aware' gives carers increased hope and optimism for the future. Awareness of the impact of caring upon the service user's life helps carers to promote recovery in their relative, and gain confidence in their own expertise-by-caring. Professional care is fundamental to recovery but needs to build on a partnership model. The carers evaluated the training as helpful, and valued its authenticity in being led by trainers with experience of recovery. Carers' expectations of professional practice are highlighted, with different approaches discussed that support effective carer involvement in their relative's care. Recognition of carers' expertise-by-caring demands a new approach to mental health care, with significant implications for British social work practice. [ABSTRACT FROM AUTHOR]

Incidents of online harassment are increasing and can have significant consequences for victims. Witnesses ("digital bystanders") can be crucial in identifying and challenging harassment. This study considered when and how young adults intervene online, with the aim of understanding the applicability of existing theoretical models (i.e. Bystander Intervention Model; Response Decision-Making Framework). Thematic analysis of eight focus groups (UK community sample, N  = 67, 18–25 years) resulted in five themes: Noticing and Interpreting the Harassment, Perceived Responsibility for Helping, Consequences of Intervening, Perceived Ability to Make a Difference, and Deciding How to Help. The online context amplified offline preferences, such as greater preference for anonymity and perceived costs of intervention (e.g. social costs). Intervention strategies varied in visibility and effort, preferring "indirect" micro-interventions focused on supporting victims. A new, merged model specific to digital bystanders is proposed, with implications for the design and messaging on social networking sites discussed. [ABSTRACT FROM AUTHOR]

The contribution of mental health social work (MHSW) to multidisciplinary care delivery has been subject to political pressures for change since the introduction in the UK of the National Service Framework for Mental Health in 1999 and subsequent New Ways of Working (NWW) initiative in 2003. Culminating in the new 2007 Mental Health Act for England and Wales, Approved Social Workers have been replaced by Approved Mental Health Practitioners (AMHPs) with the role and remit extended to other disciplines. Given this political context, this study uses an ethnographic methodology to draw together qualitative data from four reconfigured mental health teams to describe and debate the MHSW contribution to NWW. This contribution was of particular interest to the authors, as both were mental health social workers by background, with one of the authors having worked as a MHSW in Sri Lanka and the other having practised as an Approved Social Worker (ASW) and supervised ASWs in a multidisciplinary team England. Participant observations of team meetings/activities, together with joint home visits and interviews, provide an understanding of the social work contribution from a range of perspectives. Thematic analysis of data reveals that MHSWs experience a clash between their unique social work contribution and their role as generic care co-ordinators. Furthermore, there is stigma and reduced status associated with being a MHSW when compared with colleagues from other disciplines. Political issues beset the roles and responsibilities of MHSWs impacting at the level of pay and conditions of employment. The paper concludes with recommendations for managing the political schism in a service that is dominated by health and where local authorities play an increasingly peripheral role in managing and supervising seconded staff. [ABSTRACT FROM PUBLISHER]

Contemporary welfare is closely linked to policies designed to foster individual responsibility and self-development. This agenda, however, encounters problems when adults lack the capacity to make decisions about their lives, and/or are unable to protect themselves from the malign actions of their fellow citizens. These problems are addressed by the 2005 Mental Capacity Act (England and Wales) and adult safeguarding procedures. Specifically, the 2005 Mental Capacity Act (England and Wales) (MCA) introduced a statutory advocacy service, which empowers local authorities to appoint an Independent Mental Capacity Advocate (IMCA) to represent the interests of adult lacking capacity to make decisions about adult safeguarding procedures. This paper presents (i) a general overview of the development of adult safeguarding and the introduction of the MCA's IMCA service into these procedures; (ii) findings from a research project investigating the integration of IMCAs into these procedures; and (iii) a discussion of the challenges facing IMCAs involved in adult safeguarding procedures. [ABSTRACT FROM PUBLISHER]

This paper draws upon case study research to explore deviant social work. This is defined as small-scale acts of resistance, subterfuge, deception or even sabotage that are typically hidden yet scattered throughout parts of the social work labour process. Taking a wide variety of forms that can include recalcitrant attitudes as well as practices, deviant social work can be seen as being distinct from radical social work, most notably due to its implicit, pragmatic, non-idealistic and individual dispositions and strategies that are not rooted within epistemological, professional or other institutionally defined parameters. In contrast, positive deviant social work seeks as its maxim application and tangible support to vulnerable people above theoretical critique, rhetoric or perpetual reflexivity. Just as significant, because of its covert and disparate expressions, deviant social work also largely evades managerial or policy-led forms of location, surveillance and control. It is concluded that only engagement with an eclectic mix of critical theories is likely to help us locate and understand the many forms of resistance that inevitably emerge within an unpredictable, demanding, highly regulated and under-resourced quasi-professional labour process such as social work. [ABSTRACT FROM PUBLISHER]

Purpose: There is a fundamental knowledge gap regarding the experience of dementia within minority ethnic groups in the United Kingdom and elsewhere. The present study examined the subjective reality of living with dementia from the perspective of people with dementia within the 3 largest ethnic groups in the United Kingdom. Design and Methods: This was a qualitative study in which in-depth individual interviews were conducted with 11 Black Caribbean, 9 south Asian, and 10 White British older people with dementia. The lack of information in this area prompted the use of a grounded theory approach. Results: The main theme to emerge from the interviews with the people with dementia was “threat to valued elements of life.” Participants engaged in a process of appraisal in which they assessed the degree to which their condition and support needs interfered with valued elements of life. The analysis revealed that each element of this process was culturally informed. Implications: There is potential for modifying beliefs to reduce the perceived threat of dementia and for family and professional carers to promote the roles, relationships, and activities that each person with dementia values. The findings outlined in this paper can inform the development of a culturally sensitive approach. [ABSTRACT FROM PUBLISHER]

Adoption has changed significantly over the last four decades, placing new demands on those affected by adoption, including adopters, adoptees and birth relatives (i.e. the ‘adoption triangle’), as well as the professionals involved. Over the same period, sociological theories relating to the family have developed considerably, yet their application to adoptive family relationships has been limited. This paper reports the findings of an in-depth narrative study of twenty-two parents who adopted children over a twenty-four-year period, linking their experiences to the sociological concepts of ‘family practices’ and ‘displaying family’. A common challenge shared by adoptive parents following domestic stranger adoption in an era of increasing openness was the requirement to create a new version of kinship that includes both adoptive relatives and birth relatives within the conceptual model of the adoptive family as well as the day-to-day ‘doing’ of family. The relevance of findings are explored in relation to adoptive family life, adoption practice and, specifically, post-adoption support services. [ABSTRACT FROM PUBLISHER]

Since the Second World War, histories of social work have regularly confirmed that the activities of philanthropic visiting societies, chiefly the Charity Organisation Society (COS), supplied the principles and practices of late-twentieth-century social work. Similarly, histories of social work have asserted that there was no legacy from public sector welfare workers to the development of social work after 1948, which date marks the start of social work in the public sector. This paper reviews these orthodox assumptions, concluding that both are flawed. There is evidence that the reported legacy of charitable visiting societies owes a great deal to a particular set of circumstances after the Second World War and also that the public sector hosted social work roles and activity from before the Great War. Such practices and roles in the public sector developed in the interwar years and there was considerable continuity of staff and practice from before the Second World War into the 1950s. This public sector legacy was ignored, then forgotten by post-1948 historians of social work—partly by chance, partly as a deliberate policy by some social work historians and latterly because of a lack of rigour by those reviewing social work history. [ABSTRACT FROM PUBLISHER]

There has been substantial investment by governments and charities in the UK in the development, diffusion and evaluation of innovative practice models and systems to safeguard and support vulnerable children, young people and families. However, understandings of the processes of innovation within the sector are still at a relatively early stage—for example, in relation to what might be expected or planned for at each stage of an innovation journey. As a result, best use may not always be made of opportunities to address deficiencies in provision. To inform this knowledge gap, the literature was reviewed regarding innovation processes and trajectories within children's social care (statutory and voluntary settings) and within the field of social innovation more widely. Ten modellings of the stages of innovation were identified and synthesised into a directional map of six stages that might be commonly expected: mobilising, designing, developing, integrating, growing and system change. This trajectory framework poses key questions for innovators to consider at each stage to inform planning and determine if, when and how an innovation should progress further. [ABSTRACT FROM AUTHOR]

Lockdown restrictions imposed across the UK in response to the coronavirus disease 2019 (COVID-19) pandemic had a profound impact on many people's health and wellbeing. People were encouraged to be active, but population surveys suggest some groups found this easier than others. We explored the changes in health, wellbeing and physical activity levels among a sample in the UK who experienced the sudden loss of a weekly community-based physical activity opportunity, parkrun. A sample of UK parkrun participants responded to two surveys: pre-COVID-19 in January/February 2019 and during the COVID-19 pandemic in September 2020. Outcomes were happiness, life satisfaction, connections with others, physical health, mental health and physical activity. The sample was stratified by gender, age, deprivation status, physical activity and number of parkruns completed. Demographics were reported using descriptive statistics; distributions between sub-groups were compared using Chi-square tests while differences in outcomes were determined using the Mann–Whitney U test. Open text responses were also analysed. Happiness, life satisfaction, connections with others, physical health and mental health of 450 parkrun participants were negatively impacted for all sub-groups, although the impact was not experienced equally. Physical activity fell by 6% while happiness and life satisfaction fell by 12%. People experienced the worst negative impact on their connections with others. The COVID-19 pandemic negatively impacted the wellbeing of a greater proportion of females, younger adults, inactive people, those from higher deprivation areas, and those who had completed fewer parkruns. There is evidence that the wellbeing of those who were more active, and those more involved in a community-based physical activity initiative pre-pandemic, was less negatively affected during the COVID-19 lockdown. [ABSTRACT FROM AUTHOR]

Background Public Health registrars (SpRs) were an important component of the workforce that contributed to the COVID-19 response. This study explores their contribution and the impact the early stages of the pandemic had on their learning and training. Methods Data were collected from SpRs in the London and Kent, Surrey, Sussex training programme between July and September 2020 through a mixture of questionnaires and semi-structured interviews. A thematic analysis of interview transcripts was undertaken to identify themes. Results 35/128 SpRs responded to the survey and 11 were interviewed. SpRs were placed across a range of organizations and made a significant contribution to the COVID-19 response. Overall, SpRs learned important skills but working on the response may for some have impacted negatively on training. A number of facilitators and barriers to learning were identified. Conclusion The study findings highlight the opportunities for learning created by the pandemic. However, changing projects and the desire of SpRs to contribute to the response meant the impacts on training were mixed. Future deployment of SpRs should consider the balance of responsibility and pace when delegating work, as well as the need to supervise effectively and support remote working to maintain good mental wellbeing. [ABSTRACT FROM AUTHOR]

Objectives. Pain assessment in older adults with cognitive impairment is often challenging, and paramedics are not given sufficient tools/training to assess pain. The development of a mobile app may improve pain assessment and management in this vulnerable population. We conducted usability testing of a newly developed iPhone pain assessment application with potential users, in this case as a tool for clinical paramedic practice to improve pain assessment of older adults with cognitive impairment. Methods. We conducted usability testing with paramedic students and a Delphi panel of qualified paramedics. Participants studied the app and paper-based algorithm from which the app was developed. The potential use for the app was discussed. Usability testing focus groups were recorded, transcribed verbatim, and analyzed using a thematic approach. Proposed recommendations were disseminated to the Delphi panel that reviewed and confirmed them. Results. Twenty-four paramedic students from two UK ambulance services participated in the focus groups. Usability of the app and its potential were viewed positively. Four major themes were identified: 1) overall opinion of the app for use in paramedic services; 2) incorporating technological applications into the health care setting; 3) improving knowledge and governance; and 4) alternative uses for the app. Subthemes were identified and are presented. Discussion. Our results indicate that the pain assessment app constitutes a potentially useful tool in the prehospital setting. By providing access to a tool specifically developed to help identify/assess pain in a user-friendly format, paramedics are likely to have increased knowledge and confidence in assessing pain in patients with dementia. [ABSTRACT FROM AUTHOR]

The interpersonal harms that young people experience beyond their families have been documented internationally as have the challenges of protecting those effected using existing child welfare systems. Concern about this in the UK has led to development of 'contextual' child protection systems—capable of targeting the peer group, school and community contexts where extra-familial harm (EFH) occurs. This study examined whether reviews of serious incidents (serious case reviews (SCRs)) provide an evidence-base for understanding the contextual dynamics of EFH and/or developing contextual responses. SCRs (n  = 49) from 2010–2020, where adolescents were harmed in extra-familial contexts, were analysed over two stages. Stage 1 involved thematic coding under four research questions. Using a framework analysis, Stage 1 themes were grouped around according to: contexts associated with EFH; the nature of social work responses and case review recommendations. Findings suggest that SCRs provide a limited account of the contextual dynamics of EFH. Whilst reviews illustrate that social work responses rarely address the contextual dynamics of EFH, many reviewers have neglected to focus on this shortfall when recommending service improvements. For case reviews to inform contextual child protection systems, information provided to review authors and the design of review requires adaptation. [ABSTRACT FROM AUTHOR]

Background and Objectives Existing research reveals that single men living alone are at a heightened risk of isolation and precarity. This study traced the impact of the pandemic on the daily lives of a group of single men over three waves of the COVID-19 pandemic in the United Kingdom. Research Design and Methods A qualitative longitudinal study with older people aged 50 and older (n = 102), interviewed by telephone in 2020–2021. This analysis focuses on a subsample comprising single men (n = 16) who lived alone and were interviewed three times (n = 48). The men were White British, Black, and Asian, aged 58–88 years, and were identified as facing difficulties in their lives arising from long-term health problems and or/social isolation. Participants were asked about the impact of, and response to, three lockdowns. Data were analyzed using themes identified in the secondary literature using thematic and longitudinal analysis. Results For single men living alone, precarity intensified during the pandemic due to worsening physical and/or mental health combined with restricted access to relationships and activities. Key moments in the life course influenced how these men experienced and viewed the impact of COVID-19. Discussion and Implications This analysis sheds light on the deepening precarity of older men living alone during the pandemic, highlighting the emergence of new vulnerabilities for some. The findings emphasize the need, given the likelihood of future waves of the pandemic, to target support at those living alone, particularly in relation to the provision of community health services, social infrastructure, and combating digital exclusion. [ABSTRACT FROM AUTHOR]

The UEFA EURO 2020 football tournament was one of the largest Sporting Mega Events (SMEs) to take place during the COVID-19 pandemic. Mitigating the risk of virus transmission requires a multi-layered approach for any large event, more so in this case due to staging the tournament across eleven host countries. Yet, little is known about COVID-19 risks and mitigation from attending an event of this scale and nature. We examined the implementation of mitigation and messaging at EURO 2020 matches hosted at venues in the UK. The tournament was postponed from the summer of 2020 and played in June and July of 2021. Structured observations were conducted by 11 trained fieldwork-supporters at 10 matches played at Wembley Stadium, London, or Hampden Park, Glasgow. Fieldwork-supporters observed one-way systems and signage, and hand sanitizing stations inside the stadia, but reported significant variation in the implementation of staggered timeslots, testing upon entry, and procedures for exit. Adherence to planned measures by ticket holders and implementation by stewards waned as the tournament progressed culminating in an absence of enforced measures at the final. The non-compliance with COVID-19 mitigation measures was likely to have led to a significantly increased risk of transmission. Future events should consider how COVID-19 mitigation measures could become 'new norms' of fan behaviour, learning from what is already known about football fandom. Tournament organizers of SMEs can use these findings to promote clearer messaging on pandemic-driven changes in fan behaviour and best practices in mitigating risk at future sporting and cultural events. [ABSTRACT FROM AUTHOR]

This is the first study which has explored how social work students have applied the learning from a bespoke Mindfulness-Based Social Work and Self-Care (MBSWSC) programme to their social work practice. A qualitative research design was chosen, and a realist ontological position taken. The qualitative data were collected from reflective journals from seven social work students on placement who had completed the MBSWSC programme. An inductive thematic and comparative analysis methodology was used to identify key themes. This study found that the MBSWSC programme supported students to cope with the stress and anxiety that manifested before and during their placement. Students highlighted how switching from an avoidant to an approach oriented coping strategy allowed them to alleviate any negative thoughts or feelings they were experiencing. Students identified that this allowed them to employ more positive responses when dealing with stress. Students outlined that the learning from the programme allowed them to develop increased self-awareness, empathy, reflection and reflexivity skills, all of which will likely enhance their capacity for anti-oppressive social work practice. It is clear that improved access to the MBSWSC programme will allow social work students to develop the skills necessary to practice sustainably over the longer term. [ABSTRACT FROM AUTHOR]

Since the Care Act (2014), there is fresh impetus for social workers to apply strengths-based approaches (SBAs) when working with adults. However, implementation challenges remain. This article presents our synthesis of seven studies that examined Making Safeguarding Personal (MSP). It was conducted as part of a systematic review that aimed to summarise research evidence on the implementation of different SBAs within adult social work in the UK. Qualitative studies were analysed using a framework synthesis approach. Four themes were identified: (1) MSP as an intervention: seen as initially demanding but with long-term advantages; (2) Culture and settings: required broad cultural changes; 'outward facing' and smaller/specialist councils tended to find this easier; (3) Individual characteristics: related to enhancing the knowledge, skills and confidence of practitioner and stakeholders in MSP; and service user willingness to engage; and (4) Embedding and sustaining MSP: depended on strong leadership and active engagement at all levels. We found a wide range of factors affecting the implementation of MSP. These may have broader relevance for other strengths-based models of social work practice. [ABSTRACT FROM AUTHOR]