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Complex and enduring mental health problems require greater treatment resources, usually in the form of multidisciplinary support, including providing psychological therapies. This paper reports on an NHS, tertiary-level specialist psychotherapy service offering Psychodynamic therapies with longer-term, exploratory transdiagnostic approaches to support complexity and sustained personality functioning. This paper adopts a naturalistic study design evaluating the effectiveness of Psychodynamic therapy using pre- and post-outcomes across a 10-year period. A total of n = 474 participants self-report pre- and post-outcome measures were used as the marker of effectiveness along with therapist assessments during intake and engagement. The findings showed that Psychodynamic therapy was effective in reducing psychological distress based on service-user self-report and therapist assessments. While intake scores varied by socio-demographic factors, the rate of change across most groups was similar. There were several limitations relating to data quality and completeness which reflect the naturalistic design. Despite the limits of a naturalistic design, this study provides evidence of support for the place of Psychodynamic therapies within NHS mental health care, catering to those with complex and enduring mental health problems. [ABSTRACT FROM AUTHOR]

The findings presented here derive from a wider study that sought to establish a baseline understanding of mental health and wellbeing among the agricultural community in England and Wales. This paper focuses on selected questions that investigated levels of anxiety and associated stress factors among farm women, a group which has been relatively neglected within previous research on farming mental health in the United Kingdom. A questionnaire survey was widely distributed to members of the agricultural community in England and Wales (n = 15,296) in both paper and online formats. The survey included a number of standardised instruments to assess mental health and wellbeing, including the Generalised Anxiety Disorder-7 scale (GAD-7). Focusing on a sub-sample of female respondents (n = 3487), this paper details the findings from the GAD-7, alongside those from a selection of other questions investigating sources of stress, loneliness and perceived business viability. A significant proportion of female respondents were experiencing anxiety at the time of survey completion, with 23.3% reaching the threshold for clinically relevant anxiety based on their GAD-7 scores (medium or severe anxiety, scores≥10). A further 34.6% were classified as experiencing mild anxiety (scores 5–9) whilst 42.1% were not suffering from anxiety (scores 0–4). Medium/severe anxiety was identified as being associated with a number of stress factors, feelings of loneliness and pessimistic perceptions of farm business viability. There were important age-based differences, with working-aged women identified as more likely to suffer from anxiety, loneliness and certain stressors than older women. The findings reported here indicate concerning levels of anxiety among farming women and this should be seen as a call to action. There are clear associations between anxiety and a range of stressors and, although we cannot ascertain causality, these point to issues that demand attention in efforts to improve mental health within this social group. The factors contributing to anxiety are, however, multiple and complex and farm women may be affected by particular gender-based challenges that have not yet been explicitly explored in relation to mental health. Further research is needed to investigate and understand these issues in greater depth. [ABSTRACT FROM AUTHOR]

This paper aims to explore how social work students can support lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ+) young people in schools. Drawing on the reflective practice portfolio documents of four students who worked with LGBTQ+ young people in a school as part of a social workers in school (SWIS) student placement project, the article uses thematic analysis to identify how the students were able to support young people identifying as LGBTQ+. The article subscribes to a poststructuralist theoretical framework which sees gender and sexual identities as multiple, fragmented and constructed in relation to others and within the systems of knowledge and power that exist in schools. The article demonstrates the benefit to schools of having social work students on practice placement. The students' own reflections critically contemplate the way in which they were able to spend more prolonged periods of time with young people than the teachers could, both with individuals and LGBTQ+ groups. The students' reflective portfolios show the value of the school placements to their own development of knowledge and skills [ABSTRACT FROM AUTHOR]

In 2023, the UK Government published its long-awaited reform strategy for England's children's social care system. Whilst the strategy set out planned reforms for several aspects of the wider system, an area requiring particular 'priority' was the purported workforce instability seen within child protection social work. However, the strategy has subsequently faced criticism on the basis that the suggested reforms were not satisfactorily informed by the testimonies of practicing social workers. This paper draws from a mixed-method study to report on the lived experiences of a sample of 201 child protection social workers practicing across England, in the context of better understanding the factors which they believed were impacting on workforce stability within England's child protection system. Implications that emerge are the need for an increase in the monetary commitment offered by the UK Government (especially in the context of tackling high caseloads, and improving local authority pay scales to reduce the allure of agency work); a targeted emphasis on challenging local cultures preoccupied with evidencing compliance over time spent with children; and the Government taking a more assertive role in tackling the often-counterproductive commentary perpetuated by politicians and media. [ABSTRACT FROM AUTHOR]

This action research study aimed to ascertain the usefulness of a modified version of the reflective approach to teaching practicum debriefing (MVRATPD) strategy in ascertaining the degree to which students in a United Kingdom university faculty of education achieved module learning outcomes (LOCs). Using purposeful convenient sampling, twenty-seven(n = 27) students on the education studies pathway at the university, studying the module entitled international and comparative education, participated. The usefulness of the MVRATPD is revealed in several ways. It is primarily a reflective assessment instrument as purported by Minott. It revealed a direct fulfilment of several module objectives linked to several LOCs. However, for this study, it was not useful in capturing data about all 4 LOCs. Specifically, it captured no data related to LOC 2. The conclusion is that the MVRATPD, in its present form should not be the sole determinant of the degree to which LOCs are achieved. It is however, a complementary indirect reflective instrument for assessing LOCs and a user-friendly, practical and uncomplicated data collection tool i.e. using three reflective questions. [ABSTRACT FROM AUTHOR]

As in many European states, a shortage of housing in England has resulted in some families who are 'waiting for' adequate and secure housing in England while also having the 'weight of' their children being placed outside their care hanging over them. This paper reports on the development of a practice guidance document that included an online survey with 38 children's social services practitioners in England regarding their practice experiences of responding to family homelessness. Findings suggest the complexity of the issue of family homelessness and implicitly highlight its neglect within contemporary research and policy in the UK. Homeless families are caught between the constraints of housing shortages and the complexity of the needs underpinning their homelessness. Despite these constraints, social work practice has an important role to play in providing, or facilitating families' pathway to, housing advocacy and advice. Most importantly of all, social work practice can maximise families' access to statutory family support provision so that families can be helped to remain together wherever this is safely possible. Suggestions for practice, policy, and research development are outlined. [ABSTRACT FROM AUTHOR]

This paper will examine students’ attitudes and responses to male sexual victimisation in England. In particular, it focuses on their thoughts, beliefs, views, and understandings of male rape. It does this by empirically researching male rape with the use of qualitative questionnaires, from 100 students of a university in West Yorkshire, England. There are some serious concerns that were highlighted by the findings. For example, the myths that “male rape is not a serious issue” and “male rape is solely a homosexual issue” (and more) emerge from the findings. This warrants close attention and analysis, given that students are a part of the community in which male rape often occurs. This paper outlines the implications of the findings. It argues that, in certain contexts, students’ attitudes and discourses about male rape are being shaped and re-shaped; this suggests that their thought patterns are fluid with regard to male rape, shaped by the contexts in which they are situated. [ABSTRACT FROM PUBLISHER]

This paper is based on a research study which explores Social Workers' feelings about professionals touching children during statutory child protection visits to clients' homes in one part of a southern English county. The study focussed on Social Worker visits to children aged between two and ten years who were subject to child protection plans following Section 47 enquiries of the Children Act 1989. A convenience sample of ten completed questionnaires recorded the types of touch, which were reported during the last visit made by the social worker. Semi-structured interviews followed with a further ten Social Workers. Analysis of the data revealed that most of the Social Workers in the study did touch children in a range of ways and for a variety of reasons during visits. 'Touch' was a term which some found uncomfortable and this paper considers whether terminology obstructs open reflection on the topic. Practitioners were keen to discuss the subject more amongst their peers in order to share best practice. [ABSTRACT FROM AUTHOR]

People who are seeking asylum often have lived experience of their personal boundaries and human rights being violated. For this reason, it is especially important that we consider the impact of boundaries in therapeutic work with this population. This paper explores work with a woman with a severe trauma history who was seeking asylum in England. Examples of perceived boundary crossings in the therapeutic relationship are examined. Considerations for other clinicians working with asylum seekers are discussed. These include: addressing socio-political factors; being sensitive to cultural differences; the importance of supervision and reflective practice; the personal impact of such work; and using critical thinking and warmth to manage boundaries rather than rigidly following rules. [ABSTRACT FROM AUTHOR]

This paper investigates how the use of Pupil Views Templates (PVTs), a tool designed to elicit, record and analyse the development of students' awareness of their own learning processes, supports teachers' professional learning. This paper reports on a three-year collaborative practitioner enquiry project involving more than 30 primary and secondary schools in England. The data set includes practitioners' case studies, interviews, questionnaires and cross-project analysis completed by the university team. Analysis focuses on the role of feedback, stimulated through the use of PVTs, in teachers' learning through three dimensions: the influence of student feedback on teachers as part of the pedagogical encounter; the influence of student feedback on schools within the context of the practitioner enquiry projects; the influence of feedback on the lead teacher researchers. Links between the tools used, the source of the feedback, and teachers' learning are mapped from a 'second order perspective' derived from the diverse data sources. [ABSTRACT FROM AUTHOR]

Student difficulties with the transition to writing in higher education are well documented whether from a 'study skills', an 'academic socialisation' or an 'academic literacies' perspective. In order to more closely examine the challenges faced by students from widening participation backgrounds and diverse routes into undergraduate study, this project focuses on first-year undergraduate experiences of developing academic literacies on an Education Studies programme at one university in England. It highlights the impact of different support and guidance within and beyond their degree programme where attempts to embed academic literacy development are part of subject modules. The paper reports the findings generated using a mixed methods interpretive approach. Questionnaires were collected at the beginning (n = 48) and end of the students' first year (n = 44), and interviews and visual data collection methods (n =19) were used at the mid-point of the academic year. Key findings highlight students' expectations of achievement on entry to university and the influence of the emotional journey of students as they begin to make progress as academic writers. Identifying, selecting and applying academic reading were an enduring concern whilst some students struggled with the digital literacy implicit in undergraduate work. Importantly, some strategies developed to support student transition to academic writing in higher education may have unintended consequences as they progress through the first year. [ABSTRACT FROM AUTHOR]

To evaluate different stroke early supported discharge (ESD) services in different geographical settings using cost-consequence analysis (CCA), which presents information about costs and outcomes in the form of a balance sheet. ESD is a multidisciplinary service intervention that facilitates discharge from hospital and includes delivery of stroke specialist rehabilitation at home. Data were collected from six purposively sampled services across the Midlands, East and North of England. All services, rural and urban, provided stroke rehabilitation to patients in their own homes. Cost data included direct and overhead costs of service provision and staff travel. Consequence data included service level adherence to an expert consensus regarding the specification of ESD service provision. We observed that the most rural services had the highest service cost per patient. The main costs associated with running each ESD service were staff costs. In terms of the consequences, there was a positive association between service costs per patient and greater adherence to meeting the evidence-based ESD service specification agreed by an expert panel. This study found that rural services were associated with higher costs per patient, which in turn were associated with greater adherence to the expert consensus regarding ESD service specification. We suggest additional resources and costs are required in order for rural services to meet evidence-based criteria. The main costs of an early supported discharge (ESD) service for stroke survivors were staff costs and these were positively associated with greater levels of rurality. Greater costs were associated with greater adherence to ESD core components, which has been previously found to enhance the effectiveness of ESD service provision. The cost-consequence analysis provides a descriptive summary for decision-makers about the costs of delivering ESD, suggesting additional resources and costs are required in order for rural services to meet evidence-based criteria. [ABSTRACT FROM AUTHOR]

This paper presents the results from a questionnaire on academic writing which was sent to a representative sample of 75 academics at the University of Keele, England, and 100 academics at the University of Waterloo, Canada. The response rate from each institution was low (41 and 34% respectively) but higher than that reported in earlier research. An analysis of the results obtained, comparing arts, social science and science faculties is presented, together with a discussion of the findings, their instructional implications and their limitations. [ABSTRACT FROM AUTHOR]

Foster care research and social work practice tend to focus on how women look after children living in foster care. This focus has limited our understanding of what it is that men do within foster caring families and they are automatically assigned secondary or breadwinning roles. Families who foster involve some form of renegotiation of roles to care for children they foster. While foster caring arrangements are internationally diverse, foster carers often work with social workers. It would therefore seem important for social workers to understand how foster carers negotiate their parenting roles. This paper reports findings from seven main caring foster-fathers who took part in a wider study involving twentythree foster-fathers. The evidence provided by these foster-fathers demonstrate they are highly motivated to care for children and, alongside delivering traditional parenting roles, they negotiate new, non-traditional parenting roles as foster-fathers. These new roles, taken on by foster-fathers, often challenge stereotyped masculinity while they also concurrently enact parenting norms. This study applied Judith Butler's work on performing gender to foster caring families to theorise on the process whereby foster-fathers negotiate diverse masculinities and continue to reproduce gendered relations in foster caring families. [ABSTRACT FROM AUTHOR]

In the UK, in common with many developed countries, there is a crisis in the provision of adequate, affordable and quality housing. This paper discusses how an unprecedented rise in the privately rented housing sector has impacted on housing security for vulnerable adults and the challenges for social work emerging from this situation (The core definition of 'vulnerable adult' from the 1997 Consultation 'Who Decides?' issued by the Lord Chancellor's Department, is a person: 'Who is or may be in need of community care services by reason of disability, age or illness; and is or may be unable to take care of unable to protect him or herself against significant harm or exploitation'. This definition of an adult covers all people over 18 years of age.). We report on a scoping review of the relevant literature and a subsequent online survey of practitioner's views on the challenges and possible solutions to this issue. Together these provide a snapshot of practice issues and concerns which can be used to promote further debate and help shape recommendations. [ABSTRACT FROM AUTHOR]

A small-scale consultation of care leavers in South London was undertaken in 2013–2014, in order to inform a pilot mentoring scheme to reduce depression in young women through supporting their transition from care to independence. Research on the social factors implicated in the onset and course of depression indicates that social support during stressful events can be protective. Youth mentoring is now widely offered to disadvantaged young people. This paper examines what some young people told us about if and how our proposed mentoring intervention might help in maintaining their well-being through the stress of leaving care. Eleven participants of focus group discussions told us they could see clear benefits in receiving mentoring at this time, and discussed the kind of mentor and activities they might like. However, most did not want a mentor now. Thematic analysis of the discussions arising identified unpaid, open-ended ‘natural mentoring’ relationships as particularly important to them in maintaining their well-being. We consider the fit with related research, and emerging new policy, and the implications for our proposed study, and conclude that supporting the establishment and continuation of natural mentoring is a particularly promising way forward. [ABSTRACT FROM PUBLISHER]

Background: The general public regard mass media as their main source of information about mental illness. Psychiatrists are reluctant to engage with the media. There is little understanding of why this is the case. Aims: The paper looks to explore attitudes of mental health clinicians and the media towards one another. Method: Media and mental health clinicians in the southwest of England completed self-report surveys. Results: Of 119 questionnaires returned 85 were mental health clinicians and 34 media professionals. Both groups agreed that stigma is a major issue and clinicians have a key role influencing media portrayal of mental illness. The media view their reporting to be more balanced than clinicians and lack awareness of clinician mistrust towards them. Those clinicians with media training (13%) felt significantly more comfortable talking to media and significantly less mistrustful of them. Clinicians who had experience of working with media felt more comfortable doing media work. Only 15% of media professionals had received mental health awareness training. Conclusions: Media training and experience are associated with an increased willingness of mental health professionals to engage with the media. Reciprocal awareness training between media and mental health professionals may be a simple intervention worth pursuing. [ABSTRACT FROM AUTHOR]

Background: A play about dementia care was taken on tour, funded by the Big Lottery through Arts Council England, to six cities. This paper explores its impact, mainly on professional carers. Methods: Mixed methods were applied; semi-structured self-completion questionnaires and subsequent telephone interviews to a stratified sample of respondents. Framework analysis was used, paying particular attention to critical comments. Results: Post-show questionnaires were submitted by 1035 (19%) and 64 people were later interviewed. Audience members expressed heightened awareness of the needs of people with dementia, with greater appreciation of the care process itself and of the challenges faced by professional dementia carers in hospitals and other long-term settings. Conclusions: This production ofInside Out of Mindafforded an effective medium for knowledge transfer. It engaged audiences with key issues – including dignity, identity and loss – and enabled them to reflect on these issues, while encouraging appropriate practical responses. [ABSTRACT FROM AUTHOR]

This paper presents key findings from a project commissioned by a group of young people to explore issues related to cyberbullying with 12–18-year olds. In particular, the paper focuses on those findings related to impact and support needs. The project collected data through a web-based Survey Monkey questionnaire and focus groups. A total of 473 young people aged 11–19 years in England responded to the questionnaire and 17 young people aged 10–18 took part in the focus groups: 19.7% (n = 87) admitted that they had been cyberbullied, just under half the young people in this study knew someone who had been cyberbullied and a similar proportion of girls and boys admitted having cyberbullied others. Most of the young people thought cyberbullying was as harmful as traditional face to face bullying. But while a few thought it could be more serious, others thought it less serious or even non-existent. Over a quarter of those who had been cyberbullied stayed away from school and over a third stopped socialising outside school. However, just over half the total sample said they did not worry about cyberbullying. The finding that 78% of those that sought support did so by talking to their parents contrasts starkly with previous research. Further research is needed to explore what makes some young people more resilient than others to cyberbullying; the role of the school and parents in dealing with cyberbullying. [ABSTRACT FROM AUTHOR]

This paper reports the findings from a project focused on teaching secondary aged pupils with moderate learning difficulties (MLD) using Lesson Study methodology – a collaborative approach for teachers to assess, evaluate and plan a sequence of lessons that focuses on the learning of one to two focus pupils identified as having MLD. The research aimed to examine the beliefs and attitudes of participating teachers about inclusion, teaching efficacy and the concept of MLD. It also aimed to examine what pedagogic approaches were developed through Lesson Study and whether these approaches represented a distinctive pedagogic approach for pupils with MLD. The study found that the views of teachers about inclusion reflected a conditional concept of inclusion and that their attitudes to inclusion were stronger in principle than in practice. Their concepts of MLD meanwhile reflected the uncertain place of intellectual abilities in defining the category and doubts about differentiating MLD from low attainment. Analysis of pedagogic approaches used by participating teachers at the end of the programme indicated a holistic model of approaches that go beyond cognitive adaptations to include input modes, grouping and learning relationships, while also indicating a continuum model of pedagogy for pupils with MLD in which pedagogy is not distinct but an extension and intensification of general approaches. [ABSTRACT FROM AUTHOR]

This paper describes the conceptual underpinnings, structure and operations of a novel service, the City and Hackney Primary Care Psychotherapy Consultation Service – a service set up partly with the aim of addressing the needs of patients who present with ‘medically unexplained symptoms’. As part of the Tavistock and Portman NHS Trust, this service moves its clinical base, staff members and daily work, as well as the foundations of psychoanalytic thinking that define the Trust's work, into the heart of a community, and provides psychoanalytically informed clinical practice and consultation to patients and general practitioners in the City and Hackney, one of London's (and the UK's) most deprived and ethnically diverse boroughs. The authors describe the psychoanalytical underpinnings of the model, the design and structure of the service, patient demographics and preliminary outcome data, as well as an example of consultation work with general practitioners. The authors propose that psychoanalytic applications have a place in primary care and that psychoanalytic thinking can help general practitioners and patients alike, even when the clinical interventions offered are not solely based on psychoanalytic technique or therapeutic approaches. The paper concludes with thoughts about the model, its origins and its future. [ABSTRACT FROM PUBLISHER]

The purpose of this paper is to explore the relationship between emotion and the experience of a mental health crisis, in particular how this relationship is understood in crisis resolution services and formal mental health (primary and secondary) services more broadly. The paper presents some findings from a small scale study of a Crisis Resolution/Home Treatment Team (CRT/HT) in the North West of England. The specific findings discussed relate to: (i) the nature of the crises people presented with; (ii) diagnostic category; and (iii) staff perceptions of what they felt had most helped individuals. The analysis of emotion is developed from these findings in this crisis service where practitioners seemed to implicitly understand crisis and emotion relationships even though these were seldom articulated or acknowledged in the practices and procedures intended to assist people in crisis. The paper goes on to develop an analysis of these findings in the context of current service provision and offers a conceptual exploration of the limitations which may be found in the acknowledgement of the relationships between emotion and crisis. The paper suggests that emotional context for an individual is considered differently depending on which parts of the formal mental health services are accessed. [ABSTRACT FROM AUTHOR]

This paper seeks to enhance understandings of underlying reasons for attitudes towards a recent landscape phenomenon— mobile telecommunications development— in a protected area. A public questionnaire survey was conducted, using photographs of mobile telecommunications development installed in the Peak District National Park, England. Building on existing theories about landscape perceptions and environmental values, the study examined the factors influencing the acceptability of such development: a) the degree of human influence in landscape; b) the purpose of development; and c) environmental values. The study highlights the fundamental influence of environmental values on people's attitudes towards incremental landscape change. The paper discusses the implications of people's generally high level of sensitivity to landscape change in a protected area and the predominance of ecocentric values for landscape planning and management. [ABSTRACT FROM AUTHOR]

This paper focuses on the evaluation of the therapeutic use of photocards by prisoners and facilitators in a counselling psychology led European project, based on responses to open-ended questionnaires. It is part of a wider project, involving seven partner organisations in six European countries (England, Finland, Greece, Italy, Malta and Romania), which developed and trialled four different approaches to using photography in the context of counselling in prisons. Of the 51 inmates that participated in the project, 48 (94%) completed the questionnaires; of those, 39 (77%) were available for individual analysis due to prison restrictions in one partner organisation only allowing group data. Of those 39, who returned their completed questionnaires, over 92% found the therapeutic use of photographs either very helpful (56.4%) or helpful (35.9%), and the remaining 7.7% described it as average. From the thematic analysis, main themes emerging regarding inmates’ experiences of working with photocards were that it: facilitates emotional expression and sharing; unlocks memories and reconnects with life outside; fosters insight, reflection and self-growth; breaks the monotony of prison life and, overall aids emotional learning. A thematic analysis of 11 psychological therapists/facilitators’ perspectives showed that the use of photocards: gives clients a voice; provides a safe and collaborative frame and a therapeutic relationship; and, provides a useful icebreaker, helpfully overcoming anxieties of both client and psychotherapist/facilitator. Overall, photocards were considered useful as their projective nature can help facilitate prisoners’ strong need for expression in a context where there are limited opportunities and trust is fragile. [ABSTRACT FROM PUBLISHER]

Health and social care integration has been promoted by successive governments as the answer to meeting increased need within limited budgets. However, there has been little research in the UK regarding Social Workers working in integrated health teams. This study explores how social work is perceived by a range of professionals working within three different models of integration in the same acute hospital in the South-East of England. The research team (all practicing social workers) used a mixed method approach - combining questionnaires and focus groups – to explore similarities and differences in the perception of the social work role held by professionals working within contexts which had different types or models of integration. Thematic analysis of the qualitative data identified five key themes. These included social workers: providing 'checks and balances' to health professionals, 'linking and bridging' between the hospital, the community and patients, holding 'mysterious knowledge', having 'strong interpersonal skills' and providing a 'function in team dynamics".We conclude by outlining recommendations for practice and further research, the limitations of our study and our approach to reflexivity as research practitioners. [ABSTRACT FROM AUTHOR]

Objectives:This paper reports on the acceptability and effectiveness of the FITS (Focussed Intervention Training and Support) into Practice Programme. This intervention was scaled up from an earlier cluster randomised-controlled trial that had proven successful in significantly decreasing antipsychotic prescribing in care homes. Method:An in depth 10-day education course in person-centred care was delivered over a three-month period, followed by six supervision sessions. Participants were care-home staff designated as Dementia Care Coaches (DCCs) responsible for implementing interventions in 1 or 2 care homes. The course and supervision was provided by educators called Dementia Practice Development Coaches (DPDCs). Effectiveness data included monitoring antipsychotic prescriptions, goal attainment, knowledge, attitudes and implementation questionnaires. Qualitative data included case studies and reflective journals to elucidate issues of implementation. Results:Of the 100 DCCs recruited, 66 DCCs completed the programme. Pre-post questionnaires demonstrated increased knowledge and confidence and improved attitudes to dementia. Twenty per cent of residents were prescribed antipsychotics at baseline which reduced to 14% (31% reduction) with additional dose reductions being reported alongside improved personalised goal attainment. Crucial for FITS into Practice to succeed was the allocation and protection of time for the DCC to attend training and supervision and to carry out implementation tasks in addition to their existing job role. Evaluation data showed that this was a substantial barrier to implementation in a small number of homes. Discussion and conclusions:The FITS into practice programme was well evaluated and resulted in reduction in inappropriate anti-psychotic prescribing. Revisions to the intervention are suggested to maximise successful implementation. [ABSTRACT FROM PUBLISHER]

A number of studies have previously been published on the benefits of GP appraisal. Ours is the first study that compares the views of doctors registered before and after the introduction of appraisals on various core elements of the appraisal process. This study aimed to explore potential differences, between GPs qualifying before and those after the introduction of NHS appraisals, on the utility of the appraisal process. Additionally, to discover the perceived impact of appraisals on interaction with colleagues and patients. Suffolk appraisers were recruited to distribute a paper questionnaire, in two sections, for each appraisal undertaken over a 12-month period. The first part of the questionnaire related to that specific appraisal. The second part, seven questions using Likert scales and free-text comments, asked about the appraisal process in general. The feedback from the second part forms the data for this study. Overall, doctors tended to agree that appraisals had a beneficial impact in the core areas investigated. However, there was a significant difference between generations: those registered before 1998 were less likely to find NHS appraisals beneficial. Both groups reported that preparation took up too much time. Opinions regarding the impact of appraisals on interaction were evenly divided amongst appraisees, with the older cohort more likely to report negatively. There is a generational difference amongst GP in the perceived utility of NHS appraisal. Current plans to redesign the process to make appraisals less onerous will be welcomed by both groups. [ABSTRACT FROM AUTHOR]

This paper describes a preliminary investigation on the effectiveness of Dynamic Interpersonal Therapy (DIT). The research was undertaken in an inner London primary care psychological therapies service. Outcome data on the symptoms of depression [Patient Health Questionnaire-9 (PHQ-9)] and anxiety [Generalised Anxiety Disorder-7 (GAD-7)] were collected from service-users (n = 24) at the first and last episodes of treatment. There were statistically significant reductions in depression (PHQ-9) and anxiety (GAD-7) associated with DIT, with medium and large effect sizes, respectively. Overall, 75% of patients showed an improvement on the PHQ-9 and GAD-7 following DIT. When this was calculated as statistically reliable change, the improvements reduced to 42% for anxiety and 25% for depression. As this study was uncontrolled, the significance cannot be reliably attributed to DIT. Future research may aim to investigate DIT's effectiveness in different settings with a larger sample size, using appropriate comparison groups under controlled conditions. [ABSTRACT FROM PUBLISHER]

Background Health literacy is important because of the high proportion of the population with skills below those needed to become and stay healthy, and the resultant negative impact on people's lives. A recent study in England has shown that, as is true in other industrialized nations, a significant proportion of people (43–61%) have literacy and numeracy skills below those needed to fully understand and use health materials. This paper describes a project designed to build on these findings with key stakeholders to develop an action plan to address a mismatch between population skills and the health system complexity. Method The multi-stage project involved an initial meeting of stakeholders that allowed participants to share knowledge and experience, and make suggestions for change. Subsequent web-based surveys enabled widening of the stakeholder group, identification of further potential actions, and participant rating of the impact of the suggested actions on this mismatch. Next, a meeting enabled the group to identify priorities for change that would be feasible and cost-effective. Results Forty-one participants were recruited from a range of patient, health, lifelong learning, civil service, and industry perspectives. Suggested topics for action fell into four areas; improving health services, building health literacy skills in the population and workforce, recognizing the importance of public information developed outside the health arena, and funding for health literacy research and development. Following consideration of likely cost, impact, and feasibility, five suggested areas were prioritized for action, three involving improvements in the health service, and two involving the development of public health literacy skills. The importance of inter-sectoral approaches to this complex issue was identified. Discussion This project recruited key stakeholders with a wide range of relevant expertise and perspectives. It resulted in a clear, coherent action plan to address the population skills: health system complexity mismatch. Next steps include implementation, evaluation, and widening to other areas of life important to public health and well-being such as public safety messages and social care. [ABSTRACT FROM AUTHOR]

Across Europe and North America, few young people meet the recommended levels of physical activity (PA) of 1 hour of moderate to vigorous PA per day. However, the lives of young people cannot simply be polarised as either completely sedentary or active. Drawing on findings from the World Health Organization Health Behaviour in School-aged Children cross sectional international study, this paper examines the domains of adolescent life associated with young people's participation in overall PA, including health behaviours, social relationships and family activities. Consideration is also given to gender differences. Information in England was collected from 4404 students aged 11, 13 and 15 years, using anonymised self-completed questionnaires. Physical aspects of lifestyle were determined using internationally validated items for measuring PA that met international guidelines for activity and the frequency and duration of vigorous exercise undertaken during leisure activities. Separate analyses were conducted for boys and girls. Levels of PA and vigorous exercise were compared using the chi-squared test for trend. The findings draw attention to the value for the health and well-being of young people participating in some form of PA, even if they do not meet the recommended levels. Medium levels of PA appear to be associated with high levels of life satisfaction, self-rated health and an improved sense of body image. Significant health gains are likely to be made for adolescents in encouraging sedentary young people to undertake some form of PA. [ABSTRACT FROM PUBLISHER]

This study is the first empirical investigation that has explored levels of athletic identity in elite-level English professional football. The importance of understanding athletes’ psychological well-being within professional sport has been well documented. This is especially important within the professional football industry, given the high attrition rate (Anderson, G., & Miller, R. M. (2011).The academy system in English professional football: Business value or following the herd?University of Liverpool, Management School Research Paper Series. Retrieved fromhttp://www.liv.ac.uk/managementschool/research/working%20papers/wp201143.pdf) and distinct occupational practices (Roderick, M. (2006).The work of professional football. A labour of love?London: Routledge). A total of 168 elite youth footballers from the English professional football leagues completed the Athletic Identity Measurement Scale (AIMS). Multilevel modelling was used to examine the effect of playing level, living arrangements and year of apprentice on the total AIMS score and its subscales (i.e., social identity, exclusivity and negative affectivity). Football club explained 30% of the variance in exclusivity among players (P = .022). Mean social identity was significantly higher for those players in the first year of their apprenticeship compared to the second year (P = .025). All other effects were not statistically significant (P > .05). The novel and unique findings have practical implications in the design and implementation of career support strategies with respect to social identity. This may facilitate the maintenance of motivation over a 2-year apprenticeship and positively impact on performance levels within the professional football environment. [ABSTRACT FROM AUTHOR]

Background The majority of deaths in the UK occur in acute hospitals, and older people have the highest hospital death rates. Improved palliative care for older people has been identified as an international priority, yet little is known about the profile of older patients with palliative care needs in hospitals. Objective To describe the profile of older hospital inpatients (≥85 years), and to explore the prevalence and nature of palliative care needs among this group. Methods A cross-sectional survey of palliative care need in older people was undertaken in two UK acute hospitals. Hospital case notes were examined for evidence of palliative care need according to Gold Standards Framework (GSF) prognostic indicator criteria. Patients (or consultees) completed assessments of palliative care need. Subjects Data were collected for 654 consenting patients/consultees. This paper describes data from 110 patients aged ≥85 years. Results Forty per cent of the older patients were identified as having palliative care needs according to GSF criteria. Frailty was the most common indicator of palliative care need (16.7%). The most common reason for admission to hospital was general frailty (25.5%). Conclusions While this study is limited by its small sample size, the results suggest that older people with frailty conditions constitute a substantial proportion of hospital inpatients with palliative care needs. However, it is unclear whether a specialist palliative care framework is the most appropriate model for this group. The care provided to older people at the end of life may best be provided by generalists such as geriatricians, as part of a comprehensive generalist-led palliative care framework. [ABSTRACT FROM AUTHOR]

The aim of the current paper was to examine externalizing and internalizing behaviors in adolescents with gender dysphoria. One hundred forty-one young people (84 natal females and 57 natal males, M age = 15.13, SD = 1.70) attending the Gender Identity Development Service in London completed the Youth Self Report form at the end of the assessment period (4 to 6 sessions). The main findings indicated that, overall, the adolescents showed significantly more internalizing than externalizing behaviors. Using cutoff points provided by Achenbach and Rescorla (2001), the mean internalizing score fell within the clinical range and the mean externalizing score within the normal range. There was also a significant positive relationship between these two behaviors both in the natal females and the natal males. The natal males presented with significantly more internalizing behaviors than the natal females; however, no significant difference was observed between the genders in terms of the number of externalizing behaviors and total problems. We discuss the implications of these findings with regard to clinical work. [ABSTRACT FROM AUTHOR]

Theories of offender motivation for treatment have proposed that external factors may be as important as internal factors in creating a state of readiness for treatment. This paper reports an exploratory study of the barriers to treatment for incarcerated sexual offenders. Qualitative and quantitative analysis of interview and questionnaire data from treatment refusers and accepters suggested that refusers were less aware of the effectiveness of treatment, reported seeing negative side effects of treatment in others and felt they had a higher social status in prison which could be damaged by attending treatment. While this study does not demonstrate a causal link between these experiences and the decision to refuse treatment, it seems reasonable to suggest that take-up of treatment could be increased by more sustained efforts to build relationships with treatment refusers and by the provision of accessible information about treatment and its potential benefits. [ABSTRACT FROM AUTHOR]

Research has identified a significant relationship between social, emotional and behavioural difficulties (SEBD) and speech, language and communication difficulties (SLCD). However, little has been published regarding the levels of knowledge and skill that practitioners working with pupils experiencing SEBD have in this important area, nor how they might more effectively detect and support SLCD in the children and young people with whom they work. This paper outlines a small-scale project intended to evaluate said knowledge and skills within an SEBD support team in central England, and to increase this team's effectiveness in detecting and supporting children experiencing SLCD. [ABSTRACT FROM PUBLISHER]

A small, self-selected convenience sample of male and female contraceptive users in the United Kingdom (n = 34) were interviewed between 2006 and 2008 concerning their feelings about the body and their contraceptive attitudes and experiences. The interviewees were a sub-sample of respondents (n = 188) who completed a paper-based questionnaire on similar topics, who were recruited through a poster placed in a family planning clinic, web-based advertisements on workplace and university websites, and through direct approaches to social groups. The bodily metaphors used when discussing contraception were analyzed using an interpretative phenomenological analytical approach facilitated by Atlas.ti software. The dominant bodily metaphor was mechanistic (i.e.,“body as machine”). A subordinate but influential bodily metaphor was the “natural” body, which had connotations of connection to nature and a quasi-sacred bodily order. Interviewees drew upon this “natural” metaphorical image in the context of discussing their anxieties about hormonal contraception. Drawing upon a “natural,” non-mechanistic body image in the context of contraceptive decision-making contributed to reluctance to use a hormonal form of contraception. This research suggests that clinicians could improve communication and advice about contraception by recognizing that some users may draw upon non-mechanistic body imagery. [ABSTRACT FROM PUBLISHER]

This paper addresses the question of benefits of education from a life course perspective. Using data from a study of 1600 students (response rate 48%) on an open access program at a London University college, it explores educational activity within the framework of a transitions model. In addition to the quantitative evidence, the article uses material from interviews to illustrate how different aspects of educational activity help individuals cope with transitions. This approach, while clearly not covering all possible education contexts, offers a way of adding to our understanding of the benefits of study in mid- and later-life. [ABSTRACT FROM PUBLISHER]

Primary objective: Neurobehavioural disability (NBD) has a major impact on long-term psychosocial outcome following acquired brain injury (ABI). A recent review highlighted that a reliable and valid measure that can adequately capture the subtle and varied characteristics of NBD has yet to be developed. In this paper, the work underpinning the 'St Andrews-Swansea Neurobehavioural Outcome Scale' (SASNOS) is described using a conceptual framework underpinned by the WHO ICF. The intention is that SASNOS will provide a reliable and valid means of measuring NBD. Methods and procedures: Three hundred and thirty-six sets of ratings were made regarding ABI and neurologically healthy samples. The initial pool of 117 items was subjected to exploratory factor analysis and Rasch analysis. Reliability and validity of the new measure were determined using a range of appropriate statistical methods. Main outcomes: Forty-nine items were retained, falling into five principal factors. Content and construct validity are calculated. SASNOS has excellent discriminant/diagnostic validity. Inter-rater and test-re-test reliability are good. Conclusions: SASNOS has a range of clinical and research applications and can be employed when measuring outcome. This new measure will enable neurorehabilitation services to directly compare the clinical populations they serve using the same frame of reference for NBD. [ABSTRACT FROM AUTHOR]

This article presents one English local authority's educational psychology service's approach to supporting children and young people's psychological well-being. Evidence for the effectiveness of the therapeutic approaches adopted by one intervention (the Child Behaviour Intervention Initiative [CBII]) is presented. The statistical analysis indicates positive impact and suggests the interventions are highly effective. The local authority is a pathfinder for the Targeted Mental Health in School Project (a United Kingdom government funded initiative to support children with developing mental health difficulties). The interventions being run through this programme are outlined and early impact indicated. The paper uses these examples to demonstrate how educational psychology services can practically support children's mental health and psychological well-being outside the classroom. [ABSTRACT FROM AUTHOR]

This paper discusses language usage patterns amongst Eastern European migrants living in the East Anglia region of Great Britain. It examines the relationship between individual speakers' language use and societal factors, with an emphasis of respondents' perceptions of ethnic, cultural and linguistic vitality. A linguistic vitality and language usage questionnaire adapted from Yagmur, and Yagmur and Akinci, capturing domain-specific language use as well as respondents' perception of their own and other ethnolinguistic groups, was completed by 58 migrants from new European Union member states. Data analysis uncovers three themes: first, language use is domain-specific, with preferences for the L1 in the home/family domain only, and L2 English being the language of choice elsewhere; second, there are low perceptions of ethnolinguistic vitality of the L1 group across the sample; and third, there is initial evidence for a potential longitudinal shift in language use as a result of an integrative attitude to migration by the respondents and long-term plans to reside in the UK from the outset. [ABSTRACT FROM AUTHOR]

In recent years, the rise in total student intake of medical schools across England has not been met by an increase in medical teachers. Computer aided learning (CAL) has the potential to address this disequilibrium. We conducted a survey of clinical medical students at our institution to ascertain the level of access to media devices capable of delivering vision and/or audio. The aim was to establish a baseline to assist CAL providers plan for appropriate modes of content delivery. A questionnaire was emailed to all clinical medical students at UCL. To validate the email survey, an identical paper questionnaire was distributed to a compulsory class for third year clinical medical students. The e-questionnaire and validation questionnaire response rate was 46 and 100% respectively. Eighty-six percent of students had home access to broadband Internet, and 85% of home computers were suitable for a full multimedia experience. Seventy-four percent of students indicated that their primary place of access was at home. Sixty-three percent of students had portable MP3 devices and over 50% owned an iPod. The hardware environment appears favourable for the introduction of complex multimedia teaching programs to medical students, but access is not universal. In addition to personal computers, inexpensive portable multimedia players might offer the opportunity to deliver 'on demand' learning. Medical schools planning for delivery of CAL should consider student access to desktop and portable media devices when designing an e-learning curriculum. [ABSTRACT FROM AUTHOR]

Internationally, as well as here in the UK, the concept of 'peer pressure' is widely used in analysing the factors influencing young people's experiences of sex and pregnancy - illustrated, for instance, by the following strapline from a recent English government-funded teenage pregnancy national media campaign: 'Should I let my friends control my sex life?' Through a focused interrogation of relevant literature alongside findings from two studies recently conducted by the authors, this paper critically examines some of the complexities of the concept of 'peer pressure', and how it may reveal itself in different contexts. Focusing on young people's narratives of sex and pregnancy, it argues that notions of 'peer pressure' may be inadequate to enable a full appreciation of the range of real pressures that two different groups of young people - those in public care, and a wider cross-section of youth living in the same geographical area - experience. The paper concludes by suggesting that a more sophisticated understanding of how (peer) pressure might operate requires that the concept be contextualised and seen as interacting with other factors influencing young people's experiences of sex and pregnancy. The implications of this analysis in relation to sex and relationships education are discussed. [ABSTRACT FROM AUTHOR]

This paper reports the views of 56 general practice registrars (GPRs) holding innovative posts in Yorkshire Deanery in November 2004. A questionnaire survey identified high levels of satisfaction with innovative posts, whether based on identified educational needs documented in a personal educational plan, or pre-existing structured posts developed to be relevant training for any GPR. Although perceived to be less onerous in workload, these posts were identified as more relevant to a career in general practice and more relevant to GPRs' educational needs. The main concerns related to the increased difficulty of becoming part of at least two teams and the need for careful timetabling if working between a number of sites, to facilitate both work and contact with supervisors. Despite the limitations in depth of this study, we believe it provides evidence that more innovative posts should be developed. [ABSTRACT FROM AUTHOR]

Group work projects are increasingly used in higher education, but there is little guidance on how best to allocate students to groups. If groups can be engineered to contain compatible people, then the process of group work may be easier and more productive. The Honey and Mumford learning styles questionnaire provides a quick and easy way in which students might be classified into purportedly complementary categories. This paper discusses a comparison of the performance of student groups formed randomly, with those formed using the learning styles questionnaire. We found no significant differences in the performances of these two sets of groups, and we discuss some possible reasons for this. [ABSTRACT FROM AUTHOR]

To establish whether ethnic inequalities exist in levels of self-reported hearing difficulty and hearing aid use among middle-aged adults. Cross-sectional data from the UK Biobank resource. 164,460 participants aged 40–69 who answered hearing questions at an assessment centre in England or Wales. After taking into account objectively assessed hearing performance and a corresponding correction for bias in non-native English speakers, as well as a range of correlates including demographic, socioeconomic, and health factors, there were lower levels of hearing aid use for people from Black African (OR 0.36, 95% CI 0.17–0.77), Black Caribbean (OR 0.38, 95% CI 0.22–0.65) and Indian (OR 0.60, 95% CI 0.41–0.86) ethnic groups, compared to the White British or Irish group. Men from most ethnic minority groups and women from Black African, Black Caribbean and Indian groups were less likely to report hearing difficulty than their White British or Irish counterparts. For equivalent levels of hearing loss, the use of hearing aids is lower among ethnic minority groups. Inequalities are partly due to lower levels of self-reported hearing difficulty among minority groups. However, even when self-reported hearing difficulty is considered, hearing aid use remains lower among many ethnic minority groups. [ABSTRACT FROM AUTHOR]

Studies have highlighted an association between motor laterality and speech production laterality. It is thought that common demands for sequential processing may underlie this association. However, most studies in this area have relied on relatively small samples and have infrequently explored the reliability of the tools used to assess lateralization. We, therefore, established the validity and reliability of an online battery measuring sequence-based motor laterality and language laterality before exploring the associations between laterality indices on language and motor tasks. The online battery was completed by 621 participants, 52 of whom returned to complete the battery a second time. The three motor tasks included in the battery showed good between-session reliability (r ≥.78) and were lateralized in concordance with hand preference. The novel measure of speech production laterality was left lateralized at population level as predicted, but reliability was less satisfactory (r =.62). We found no evidence of an association between sequence-based motor laterality and language laterality. Those with a left-hand preference were more strongly lateralized on motor tasks requiring midline crossing; this effect was not observed in right-handers. We conclude that there is little evidence of the co-lateralization of language and sequence-based motor skill on this battery. [ABSTRACT FROM AUTHOR]

Cancer is a disease that is imbued with notions of risk, with individuals expected to avoid 'risky' behaviours and act swiftly when symptoms indicating a risk of cancer emerge. Cancer symptoms, however, are often ambiguous and indicative of a number of other conditions, making it difficult for people to assess when symptoms may, or may not, be the result of cancer. Here, we discuss interview data from a study examining the symptom appraisal and help-seeking experiences of patients referred for assessment of symptoms suspicious of a lung or colorectal cancer in the North-East of England. We explore how individuals draw upon ideas about cancer risks to assess whether cancer may be a possible explanation for their symptoms and to inform their decisions about help-seeking. In our analysis, we applied the concept of candidacy to the data, to highlight how lay epidemiology shapes people's perceptions of cancer risk, and their subsequent responses to it. We found that participants appraised their symptoms, and the likelihood that they may have cancer, in light of relevant information on risk. These sources of information related to lifestyle factors, family history of cancer, environmental factors, and importantly, the symptomatic experience itself, including the absence of symptoms that participants associated with cancer. The importance of experienced, and absent, symptoms was a core element of participants' everyday constructions of the 'cancer candidate', which informed symptom appraisal and subsequent help-seeking decision-making. [ABSTRACT FROM AUTHOR]

Assessment of deaf children has found that their early understanding in science is behind that of their hearing peers. Research shows that parental attitudes and behaviours can affect educational outcomes but few studies have considered the effects of attitudes towards science on parent/child interactions in the home and thus, the effects on attainment. We studied whether caregiver participation in a pilot intervention would influence attitudes and reported behaviours towards science learning in the home. Method: Caregivers of deaf and hearing pre-school children (N = 18) completed a questionnaire at the start and end of a year-long intervention to determine whether there was a relationship between the level of engagement with the intervention and attitudes towards science both pre- and post-study. Findings: There was a significant positive shift in the amount of reported science talk between caregivers and their children. No relationship between engagement and attitudes was found. Conclusions: We propose that irrespective of group (control or intervention), participating in an intervention involving science talk led to a reported increase in science talk and a generally positive view of science across all groups. [ABSTRACT FROM AUTHOR]

Objectives: There is now a body of research into the attributions that carers make of the challenging behavior of people with intellectual disabilities; however the attributions that people with intellectual disabilities make have not been studied. This paper describes the attributions that people with intellectual disabilities make of challenging behavior and compares them to those of their carers. Methods: Twenty-three day-service staff and 34 adults with intellectual disabilities completed measures of attribution, optimism, emotion and need for help and gave open-ended responses to questions about the causes of and potential interventions for challenging behaviors. Results: The overall pattern of attribution, emotion, optimism and intention to help is similar for people with intellectual disabilities and staff. However, compared to staff, people with intellectual disabilities were less optimistic and less happy about challenging behavior. Conclusions: This area of research will help identify the impacts of challenging behavior on the well being of people with intellectual disabilities and may help structure support for people who live alongside those who challenge. [ABSTRACT FROM AUTHOR]

We aimed to assess one-year changes in physical fitness, health-related quality of life (HRQoL) and body mass index (BMI), encompassing the 2020 COVID-19 UK lockdowns. Data were collected (October 2019, November 2020) from 178 8–10–year-olds in Newcastle-upon-Tyne, England, 85% from England's most deprived quintile. Twenty-metre shuttle run test performance (20mSRT), handgrip strength (HGS), standing broad jump (SBJ), sit-and-reach, height, body mass, HRQoL (Kidscreen-27 questionnaire) and sports club participation were measured. BMI z-scores and overweight/obesity were calculated (≥85th centile). Paired t-tests and linear regression assessed change, adjusting for baseline BMI. Significant (p<0.001) changes were observed: increases in mean BMI (+1.5kg·m−2), overweight/obesity (33% to 47%), SBJ (+6.8cm) and HGS (+1.5kg); decreases in 20mSRT performance (−3 shuttles), sit-and-reach (−1.8cm). More children at follow-up were categorized "very low" for 20mSRT performance (35% baseline v 51%). Increased BMI z-score was associated with decreased "Physical Wellbeing" HRQoL. Follow-up sports club participation was associated with better 20mSRT performance (p=0.032), and "Autonomy & Parents" (p=0.011), "Social Support & Peers" (p=0.038) HRQoL. Children's 20mSRT performance and BMI changed adversely over one year; national lockdowns potentially made negative contributions. Physical fitness, physical activity and sports programmes should be part of children's physical and mental recovery from the pandemic. [ABSTRACT FROM AUTHOR]