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This paper examines how life story books were used in two care settings in the UK for people with complex support needs. The context of the research was the transition of six people from a long stay hospital to a community home. Discourse analysis was used to analyse talk and texts in the care settings including staff interviews, meetings and the written text in the life story books themselves. Three uses of the books are highlighted in the analysis. They were used as a resource for: getting to know the person; defining the person; and displaying personality and uniqueness. Mutual identities of the various participants were constantly changing with reference to the life story books. It is suggested that the books encourage acceptance in the care relationships. The analysis demonstrated that despite the different uses of the life story books, highlighted by the care staff, there is an underlying assumption that what is written in the books is a direct representation of the person. It appears that once this type of information is committed to paper the identity of the person becomes reified. [ABSTRACT FROM AUTHOR]

This article explores the impact of the 'hostile environment' on racialised migrant women's experiences of pregnancy and childbirth in England, arguing that the 'hostile environment' functions as a technology of 'stratified reproduction.' First coined by Shellee Colen, the concept of stratified reproduction describes the dynamic by which some individuals and groups may be supported in their reproductive activities, while others are disempowered and discouraged. This paper locates the stratified reproduction produced by the 'hostile environment' as intertwined with wider gendered and racialised discourses around British citizenship which have been 'designed to fail' racialised residents of the UK. Drawing on interviews with racialised migrant mothers in the north of England, this paper analyses how the proliferation and intensification of immigration controls interacts with gender, race, class, and other social regimes to differentially allocate the resources necessary for a safe and healthy pregnancy and childbirth, and how this is experienced materially by pregnant migrants. [ABSTRACT FROM AUTHOR]

Aim: Expanding and sustaining student nurse placements outside of the acute sector is a universal challenge. This paper aims to evaluate the Care Home Education Facilitator Role introduced in one area of Wales, United Kingdom, and to report on the outcomes achieved from this novel role. Methods: Semi‐structured interviews were undertaken with key stakeholders including the Care Home Education Facilitator postholder leading the pilot, care home managers, higher education institutions' placement managers/coordinators, student nurses and national health service staff. Results: Five key areas were identified, which included timing of introducing the post and establishing a clear rationale and understanding of the intention of the role. The benefits, challenges and suggested improvements to the Care Home Education Facilitator initiative are provided. Conclusion: Introducing the role of the Care Home Education Facilitator to work closely with key stakeholders resulted in increased placements for student nurses, but investing time in developing relationships with these stakeholders was critical to the success of the role. Summary statement: What is already known about this topic? There is a universal shortage of clinical placements for nursing students, particularly within a care home setting.The number of studies exploring how we might grow the number of nurses needed in this setting is limited. What this paper adds? This study evaluated a novel initiative introduced in South Wales, United Kingdom, that focuses on the development of nursing placements in the care home setting.Engaging with stakeholders involved in the development and implementation of the Care Home Education Facilitator initiative, a roadmap was provided to illustrate the stepped approach required to support an active care home placement including key governance arrangements. The implications of this paper: For those involved in identifying and developing student placements, this study provides valuable insight to a role that can help increase student numbers in a care setting often overlooked.It identifies viable career options for nurses at the point of registration.The role assists with widening networks for the care homes across health and social care sectors. [ABSTRACT FROM AUTHOR]

The discourse of deservingness has been mobilised against certain groups in the UK society navigating UK labour markets, among them refugees and asylum seekers. These discourses, leading to the stigmatisation of the unemployed are coupled with an emphasis on the importance of individuals taking responsibility to develop their 'employability'. Little attention has been paid to scrutinise the contrast between the deservingness rhetoric and policy making with the actual conditions newcomers, and in particular refugees and asylum seekers, are confronted with when seeking employment. Our paper fills such a gap by indicating key contradictions at the heart of labour market integration in the UK. On the one hand, the emphasis on deservingness is coupled with policy discourses that construct an environment shaped by welfare and labour market chauvinism. On the other hand, the policy architecture is fundamentally flawed in a number of ways in terms of the support mechanisms necessary to ensure that newcomers can successfully integrate into the labour market. [ABSTRACT FROM AUTHOR]

Introduction: Social Prescribing has an established recognition regarding the benefits provided to the health-related social needs of adults, but little is known about how the intervention addresses young people's needs. There is optimism regarding the central role of two core mechanisms that allows social prescribing to be effective, such as the empathetic role of Link Workers and the connection with community resources. This paper aims to describe the role played by Link Workers working a Social Prescribing intervention targeting young people. Description: This paper adopts a case study methodology to describe the role of Link Workers addressing young people's needs and implementing Social Prescribing scheme in Sheffield (UK). Data were collected through semi-structured interviews with four of the seven link workers of one organisation based in Sheffield. Data were analysed through an inductive approach for emerging themes. Discussion: We provided a description of the profiles and background of Link Workers and described the three models of referral pathways into the intervention. The paper also shows how Link Workers identify young people's needs and how they connect with the community. Conclusion: Based on the insights and the internationally accepted definition of Social Prescribing, we provide a visual representation of the Social Prescribing model and discuss challenges. The paper highlights lessons learned and future directions regarding the role of Link Workers from the case study. [ABSTRACT FROM AUTHOR]

This article explores how solicited paper diaries, and the accompanying materials, are carefully handled over the course of one research project. It foregrounds the value of attending to mundane moments with research materials, by tracing tangible material encounters together with intimate fieldnote reflections. Through drawing upon theories of materiality with feminist and relational ethics of care, this article centralises paper diaries as a key mediator of relationships and care within research. It considers the micro processes of choosing diaries, posting them, receiving and storing them and tracing the emotionally charged moments as a researcher in everyday research situations. Such reflections, from the perspective of the researcher, look to offer insights into research relationalities and care. It argues that these momentary fieldwork reflections extend understandings of material methodologies by emphasising relational intimacies as a researcher and connects material and sensory understandings with feminist ethics of care and researcher reciprocities. [ABSTRACT FROM AUTHOR]

Background: This paper describes a UK-based study, SPICES-Sussex, which aimed to co-produce and implement a community-based cardiovascular disease (CVD) risk assessment and reduction intervention to support underserved populations at moderate risk of CVD. The objectives were to enhance stakeholder engagement; to implement the intervention in four research sites and to evaluate the use of Voluntary and Community and Social Enterprises (VCSE) and Community Health Worker (CHW) partnerships in health interventions. Methods: A type three hybrid implementation study design was used with mixed methods data. This paper represents the process evaluation of the implementation of the SPICES-Sussex Project. The evaluation was conducted using the RE-AIM framework. Results: Reach: 381 individuals took part in the risk profiling questionnaire and forty-one women, and five men participated in the coaching intervention. Effectiveness: quantitative results from intervention participants showed significant improvements in CVD behavioural risk factors across several measures. Qualitative data indicated high acceptability, with the holistic, personalised, and person-centred approach being valued by participants. Adoption: 50% of VCSEs approached took part in the SPICES programme, The CHWs felt empowered to deliver high-quality and mutually beneficial coaching within a strong project infrastructure that made use of VCSE partnerships. Implementation: Co-design meetings resulted in local adaptations being made to the intervention. 29 (63%) of participants completed the intervention. Practical issues concerned how to embed CHWs in a health service context, how to keep engaging participants, and tensions between research integrity and the needs and expectations of those in the voluntary sector. Maintenance: Several VCSEs expressed an interest in continuing the intervention after the end of the SPICES programme. Conclusion: Community-engagement approaches have the potential to have positively impact the health and wellbeing of certain groups. Furthermore, VCSEs and CHWs represent a significant untapped resource in the UK. However, more work needs to be done to understand how links between the sectors can be bridged to deliver evidence-based effective alternative preventative healthcare. Reaching vulnerable populations remains a challenge despite partnerships with VCSEs which are embedded in the community. By showing what went well and what did not, this project can guide future work in community engagement for health. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to critically examine the effects of COVID-19 social discourses and policy decisions specifically on older adult volunteers in the UK, comparing the responses and their effects in England, Scotland, Wales and Northern Ireland, providing perspectives on effects of policy changes designed to reduce risk of infection as a result of COVID-19, specifically on volunteer involvement of and for older adults, and understand, from the perspectives of volunteer managers, how COVID-19 restrictions had impacted older people's volunteering and situating this within statutory public health policies. Design/methodology/approach: The study uses a critical discourse approach to explore, compare and contrast accounts of volunteering of and for older people in policy, and then compare the discourses within policy documents with the discourses in personal accounts of volunteering in health and social care settings in the four nations of the UK. This paper is co-produced in collaboration with co-authors who have direct experience with volunteer involvement responses and their impact on older people. Findings: The prevailing overall policy approach during the pandemic was that risk of morbidity and mortality to older people was too high to permit them to participate in volunteering activities. Disenfranchising of older people, as exemplified in volunteer involvement, was remarkably uniform across the four nations of the UK. However, the authors find that despite, rather than because of policy changes, older volunteers, as part of, or with the help of, volunteer involving organisations, are taking time to think and to reconsider their involvement and are renewing their volunteer involvement with associated health benefits. Research limitations/implications: Working with participants as co-authors helps to ensure the credibility of results in that there was agreement in the themes identified and the conclusions. A limitation of this study lies in the sampling method, as a convenience sample was used and there is only representation from one organisation in each of the four nations. Originality/value: The paper combines existing knowledge about volunteer involvement of and for older adults. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to follow up on a previous quantitative research project which established that outcome-focussed care appeared to be associated with an increase in the individuals' subjective well-being. The purpose of this paper is to establish why the intervention enabled this. Design/methodology/approach – The study utilised a qualitative approach to gather the subjective experience of the individual service users. The sample consisted of 20 service users, who were subject of two semi-structured interviews; one interview at the start of the intervention and one at the six month stage. The data were then analysed under core themes raised by the service user in these interviews. The sample was divided into two, with one group receiving the outcome-focussed model of care and the other group receiving the traditional time focussed care. Findings – The research established that service users' subjective well-being improved due to the ability of outcome-focussed care to provide consistency, flexibility and most importantly the ability of the service user to form a relationship with the homecare workers providing their care. Practical implications – This paper will assist professionals to understand why outcome-focus care has a profound impact upon service users' subjective well-being as opposed to the existing task focussed care. Originality/value – This and the previous paper provide an insight into how different processes and models of intervention impact upon the subjective well-being of socially isolated older people. [ABSTRACT FROM AUTHOR]

This paper argues that trust cannot be taken for granted in long-term participatory research and promotes greater consideration to conceptualizing the trusting process as fluid and fragile. This awareness by researchers can reveal to them how the passing of time shapes and reshapes the nature of trusting relationships and their constant negotiation and re-negotiation. The paper draws together literature from different disciplines on the themes of trust, temporality and participatory research and outcomes from interviews and workshops undertaken for The Trust Map project to focus on two key moments that reveal the fragility of trust. These are the subtlety of disruption and trust on trial and trust at a distance. We discuss how trust was built over time through processes of interaction that were continually tested, incremental and participatory. [ABSTRACT FROM AUTHOR]

The main aim of this paper is to explore and discuss the interesting juxtaposition of patient involvement within a standardised Enhanced Recovery After Surgery care programme (ERAS). We address our aim by examining the work and strategies of nursing staff caring for patients during postoperative recovery from surgery, exploring how these two potentially competing priorities might effectively co‐exist within a hospital ward. This was a qualitative exploratory study, with data generated through 42 semi‐structured interviews with patients and nurses who had taken part in an ERAS programme in one of three hospital wards in the United Kingdom, adopting a reflexive thematic approach to data analysis. We shine a light on the work undertaken by patients and nurses during the navigation of postoperative recovery, identifying strategies of collaboration and negotiation during this journey. Furthermore, we also identify and consider patients engaged in peer‐peer support during postoperative recovery. This paper adds to the existing literature and current ways of thinking in relation to the quest for standardised, clinically effective care balanced with the aspirations for individualised, patient‐centred care. This paper also helps inform thinking about the use of care pathways in relation to service delivery, considering how best to initiate and deploy best practice aimed at safe and effective postoperative recovery. [ABSTRACT FROM AUTHOR]

The last three census data highlighted that UK Bangladeshi communities have the worst health outcomes. This includes a higher risk of type two diabetes and heart diseases; both are risk factors for developing vascular dementia. However, little is known about Bangladeshi community members' understandings of dementia, including cultural myths. This paper focuses on the cultural myths, superstitions, and stigma surrounding dementia in an English Bangladeshi community from the direct experiences of people living with dementia, their caregivers, and the views of dementia service providers/stakeholders. This qualitative research was undertaken with three distinct participant groups using semistructured interviews (n = 25), who were recruited from community settings. The first and second participant groups explored the experiences of people with dementia (n = 10) and their family caregivers (n = 10). The third group examined stakeholders'/service providers' views (n = 5). Interviews were recorded digitally and transcribed verbatim. Findings were reached using an interpretive approach, emphasising the sense people make in their own lives and experiences and how they frame and understand dementia. The study revealed that participants with dementia and their caregivers have "alternative" knowledge about dementia and do not necessarily understand dementia in a Westernised scientific/biomedical context. Misconceptions about dementia and belief in various myths and superstitions can lead people to go to spiritual healers or practice traditional remedies rather than to their GPs, delaying their dementia diagnosis. This paper concludes that there is a lack of awareness among the Bangladeshi participants and a need for targeted awareness about dementia to help dispel cultural myths and combat the stigma surrounding dementia within the Bangladeshi community. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic placed a huge strain on healthcare services around the world, including community services. Students also faced substantial disturbance to educational programmes. Student district nurses are usually employed members of staff and can be recalled to the workforce, whereas pre-registration students cannot. Aims: This paper explores the feelings and experiences of student district nurses during the first UK national lockdown of the COVID-19 pandemic. An interpretative phenomenological approach was taken. Method: A semi structured 1:1 interview and focus group was held via zoom in July 2020. A total of eight student district nurses, who were all registered adult nurses, took part. Data was analysed using the Braun and Clarke model to identify themes. Results: The findings related to their experience of being a community adult registered nurse on the frontline, while also being a student district nurse. Three themes were identified from the analysis: anxiety and uncertainty, management of risk and teamwork. Conclusion: This study highlights the contribution that community nurses made in the clinical response to the COVID-19 pandemic. It adds to a paucity of literature available from this clinical setting and specifically from the viewpoint of a student district nurse. There is much written on the strains on hospital care, but it should be remembered that district nursing is the service that never shuts its doors because it has reached capacity. This study found that a lack of communication and uncertainty about their future as students contributed to heightened stress and anxiety. Teamwork and camaraderie are a vital aspect of any team and one that can support resilience in times of heightened stress. A lack of face-to-face interaction can lead to team members feeling isolated. Digital technology can be used to reduce this feeling when possible. [ABSTRACT FROM AUTHOR]

Physical activity and healthy eating are important for physical and mental health, yet long-standing inequalities constrain the ability of ethnic minorities in the United Kingdom (UK) to adopt these behaviours. Programmes aimed to improve these behaviours have also often not been engaged with by these communities. This study therefore aimed to: (1) identify the values underlying the physical activity and healthy eating behaviours of UK ethnic minorities and (2) explore how structural, socio-economic and environmental factors interact with these values to influence their physical activity and healthy eating behaviours. The study adopted a relativist ontological and subjectivist epistemological philosophical assumption. Qualitative interviews were used to address research objectives. A total of 10 group and five individual interviews were conducted with 41 participants. All participants were from an ethnic minority background (Black, Asian or Mixed according to the UK Office for National Statistics classification), recruited purposively and aged between 18 and 86 years and were living in England and Wales. Data were analysed using inductive thematic analysis. Community engagement was embedded throughout the study. We found that culture and family, community and social life, and health are important values underlying the physical activity and healthy eating behaviours of UK ethnic minority communities. External factors, including racism and access (geographical, social and economic), interact with these values to drive health behaviours. Using an illustrative guide, we conclude the paper with policy and practice recommendations on how public health programmes on physical activity and healthy eating can be aligned with these values to ensure relevance for ethnic minority communities. [ABSTRACT FROM AUTHOR]

Background: Children and young people (CYP) with complex neurodisability experience multiple physical, communication, educational and social challenges, which require complex packages of multidisciplinary care. Part of the holistic care required includes supporting the families and parents/caregivers. The aim of the wider study was to introduce a new programme ('Ubuntu') to parents/caregivers and healthcare professionals (HCPs) in order to test the feasibility and acceptability of the concept and content, with the goal of potential adaptation for the UK in mind. Data collection and analysis uncovered rich data on caregiving journeys, navigation of health services, and perceived service gaps. This paper focuses solely on these topics. Further papers will report on the feasibility and adaptation data. Methods: Two rounds of semi‐structured interviews were conducted with 12 caregivers of CYP with complex neurodisability and six HCPs from a variety of disciplines, recruited from a community child health service in London Borough of Newham, UK in 2020. The interviews included open‐ended questions to explore caregiving journeys, experiences of navigating health services and perceived service gaps. Transcripts were analysed using a data‐driven inductive thematic analysis. Results: Three themes were identified that related to the aim of understanding caregivers' experiences and unmet needs relating to current service provision. These were (1) Caregiver Mental Health, (2) The Information Gap and (3) The Need for Holistic Support. Mental health difficulties were reported, particularly around the period of diagnosis. Priority needs included the provision of clear information about the diagnosis and services offered, opportunities to forge peer support networks and for services across the community to collaborate. Conclusions: The delivery of health services for CYP with neurodisability should encompass the broad needs of the family as well as meeting the clinical needs of the CYP. [ABSTRACT FROM AUTHOR]

Purpose: Sociometric studies and adult reports have established that children with Language Disorder (LD) are at risk of peer relationship difficulties. However, we have limited knowledge of how children with LD understand friendship, whom they deem as a good or bad friend, and what role their friendship concepts play in their relationships with peers. This exploratory study aimed to conduct a qualitative investigation into the friendship concepts that children with LD hold and to explore their strategies for making friends. Methods: We conducted multiple, art‐informed interviews on the topic of friendship with 14 children with LD at the age of 6–8 years. Participating children were based in the United Kingdom and Republic of Ireland. They attended enhanced provision, specific speech and language classes and mainstream classrooms. We used framework analysis to map children's responses to Selman's (1979) developmental model of interpersonal understanding, which espouses a theory of children's social development within the context of peer relationships. Results: The understanding of friendship formation in children with LD varied from physical presence to mutual support and sharing. Children's ideas about a good/bad friend represented the lowest developmental stage. Participants from the mainstream classroom demonstrated the highest stages of interpersonal understanding. Children with LD did not mention their language abilities as a barrier to making friends. Conclusion: There are limited studies exploring friendship directly from children with LD, and this study provides insights into this gap, by utilising art‐informed interviews. Children's immature understanding of a good/bad friend points towards a potential susceptibility to false friends, which we suggest needs further empirical validation. We also found that children with LD did not pay attention to their language difficulties when making friends, which raises questions about the ways diagnoses are shared with children. WHAT THIS PAPER ADDS: What is already known on the subject: Children with Language Disorder (LD) are at risk of peer relationship difficulties. Studies to date are based on sociometrics and adult reports. Only a few studies employ participatory approaches to research with children, directly engaging children with LD when exploring their friendships What this paper adds: This paper directly asks children with LD about their understanding of friendship and strategies for making friends.Physical proximity and play are important to children.s understanding of friendship especially in recognising good and bad friends. This indicates potential reasons for children with LD being susceptible to false friendsAdditionally, children with LD do not perceive language and communication as a barrier to making friends. What are the potential or actual clinical implications of this work?: Concepts around friendship and good/bad friends should be routinely assessed and targeted (if appropriate) in interventions. The study highlights the need to continue discussing practices around sharing diagnoses with children with LD. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the complexity of the needs of people with delirium superimposed on dementia • To enhance your knowledge of second-generation activity theory • To recognise the consequences of the separation of physical health and mental healthcare. Background: Delirium superimposed on dementia (DSD) affects the physical, mental and cognitive well-being of the person. The separation of physical health and mental health means that the care of people with DSD is at odds with the multifaceted aetiology and presentation of the condition. There is a lack of research on DSD from a mental health perspective. Aim: To explore UK mental health nurses’ experiences of providing care for people with DSD. Method: Individual semi-structured interviews were conducted with seven mental health nurses from one NHS trust in England. Participants’ experiences were considered through the lens of second-generation activity theory. Data were analysed using framework analysis. Findings: Six themes were identified: awareness of guidance and tools; guidance or tools as ‘paper exercises’; knowing the patient; the multidisciplinary team; care burden; and mental health versus physical health. Conclusion: When providing care for people with DSD, mental health nurses use their skills in knowing patients as individuals. However, this aspect of ‘knowing’ cannot be readily translated into the use of a numerical scoring tool. An integrated approach is required to support the care of people with DSD. [ABSTRACT FROM AUTHOR]

Background: Those supporting children and young people who use augmentative and alternative communication (AAC) contribute to ongoing complex decision‐making about communication aid selection and support. Little is known about how these decisions are made in practice and how attributes of the communication aid are described or considered. Aims: To understand how communication aid attributes were described by those involved in AAC recommendations and support for children and young people, and how these attributes were described as impacting on AAC use. Methods & Procedures: A secondary qualitative analysis was completed of interview and focus group data from 91 participants involved in the support of 22 children and young people. Attributes of communication aids described by participants were extracted as themes and this paper reports a descriptive summary of the identified software (non‐hardware) attributes. Main Contribution: Decisions were described in terms of comparisons between commercially available pre‐existing vocabulary packages. Attributes related to vocabulary, graphic representation, consistency and intuitiveness of design, and ease of editing were identified. Developmental staging of vocabularies, core and fringe vocabulary, and vocabulary personalization were attributes that were described as being explicitly considered in decisions. The potential impact of graphic symbol choice did not seem to be considered strongly. The physical and social environment was described as the predominant factor driving the choice of a number of attributes. Conclusions & Implications: Specific attributes that appear to be established in decision‐making in these data have limited empirical research literature. Terms used in the literature to describe communication aid attributes were not observed in these data. Practice‐based evidence does not appear to be supported by the available research literature and these findings highlight several areas where empirical research is needed in order to provide a robust basis for practice. What This Paper Adds: What is already known on the subject: Communication aid attributes are viewed as a key consideration by practitioners and family members in AAC decision‐making; however, there are few empirical studies investigating language and communication attributes of communication aids. It is important to understand how those involved in AAC recommendations and support view communication aid attributes and the impact different attributes have. What this paper adds to existing knowledge: This study provides a picture of how communication aids are described by practitioners and family members involved in AAC support of children and young people. A range of attributes is identified from the analysis of these qualitative data as well as information about how participants perceive these attributes as informing decisions. What are the potential or actual clinical implications of this work?: This study provides a basis on which practitioners and others involved in AAC support for children and young people can review and reflect on their own practice and so improve the outcomes of AAC decisions. The study provides a list of attributes that appear to be considered in practice and so also provides a resource for researchers looking to ensure there is a strong empirical basis for AAC decisions. [ABSTRACT FROM AUTHOR]

Purpose: Many countries have a renewed focus on health inequalities since COVID-19. In England, integrated care systems (ICSs), formed in 2022 to promote integration, are required to reduce health inequalities. Integration is supported by population health management (PHM) which links data across health and care organisations to inform service delivery. It is not well-understood how PHM can help ICSs reduce health inequalities. This paper describes development of a programme theory to advance this understanding. Design/methodology/approach: This study was conducted as a mixed-methods process evaluation in a local ICS using PHM. The study used Framework to analyse interviews with health and care professionals about a PHM tool, the COVID-19 vaccination uptake Dashboard. Quantitative data on staff Dashboard usage were analysed descriptively. To develop a wider programme theory, local findings were discussed with national PHM stakeholders. Findings: ICS staff used PHM in heterogeneous ways to influence programme delivery and reduce inequalities in vaccine uptake. PHM data was most influential where it highlighted action was needed for "targetable" populations. PHM is more likely to influence decisions on reducing inequalities where data are trusted and valued, data platforms are underpinned by positive inter-organisational relationships and where the health inequality is a shared priority. Originality/value: The COVID-19 pandemic accelerated a shift toward use of digital health platforms and integrated working across ICSs. This paper used an evaluation of integrated data to reduce inequalities in COVID-19 vaccine delivery to propose a novel programme theory for how integrated data can support ICS staff to tackle health inequalities. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers (HCWs) in the United Kingdom (UK) have faced many challenges during the COVID-19 pandemic, some of these arising out of their social positions. Existing literature explicating these challenges (e.g., lack of appropriate PPE, redeployment, understaffing) have highlighted inequities in how these have been experienced by HCWs based on ethnicity, gender or, job role. In this paper, we move a step ahead and examine how the intersection of these social positions have impacted HCWs' experiences of challenges during the pandemic. Methods: We collected qualitative data, using interviews and focus groups, from 164 HCWs from different ethnicities, gender, job roles, migration statuses, and regions in the United Kingdom (UK) between December 2020 and July 2021. Interviews and focus groups were conducted online or by telephone, and recorded with participants' permission. Recordings were transcribed and a hybrid thematic analytical approach integrating inductive data-driven codes with deductive ones informed by an intersectional framework was adopted to analyse the transcripts. Results: Thematic analysis of transcripts identified disempowerment, disadvantage and, discrimination as the three main themes around which HCWs' experiences of challenges were centred, based on their intersecting identities (e.g., ethnicity gender, and/or migration status). Our analysis also acknowledges that disadvantages faced by HCWs were linked to systemic and structural factors at the micro, meso and macro ecosystemic levels. This merging of analysis which is grounded in intersectionality and considers the ecosystemic levels has been termed as 'intrasectionalism'. Discussion: Our research demonstrates how an intrasectional lens can help better understand how different forms of mutually reinforcing inequities exist at all levels within the healthcare workforce and how these impact HCWs from certain backgrounds who face greater disadvantage, discrimination and disempowerment, particularly during times of crisis like the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: People who have communication difficulties may benefit from using augmentative and alternative communication (AAC). Understanding and measuring outcomes from the use of AAC is an important part of evaluating the impact of devices and services. Outcome measurement needs to reflect the changing nature of the impact of using AAC on an individual's ability to participate in activities of daily life. There is a limited understanding of the concepts that should inform the evaluation of outcomes from AAC device provision, nor how people's expectations from AAC may change over time. Aims: To inform the development of a patient‐reported outcome measure for AAC by understanding more about people's expectations from AAC and how these change over time. Methods & Procedures: A longitudinal qualitative research study was designed and carried out with seven participants over a period of 2 years. Participants were recruited from a regional specialist assessment service for AAC in the south‐west of the UK. Four semi‐structured interviews were carried out: (1) before assessment for AAC, (2) after assessment, (3) directly after provision of an AAC device and (4) between 6 and 12 months after provision. An original analytic method was used in this study that built on the principles of longitudinal interpretative phenomenology analysis, applied with a dialogic theoretical lens. This approach enabled the inclusion of a range of multimodal and embodied data collected to this study and allowed the research team to draw out salient themes across the cohort group while attending to the influence of time and context on experience. Outcomes & Results: The results confirm and extend the three core concepts that were used to guide analysis: changes; contexts; future possibilities. The contextual and temporal influences on outcomes attainable from AAC for this cohort were also identified and illustrated through cross‐case comparison. Deeper, analytic, and conceptual engagement with theory, which was then applied to analysis of the data, provided methodological rigour in the study. The results enhance our understanding of people's hopes and expectations from AAC and how these change over time. Conclusions & Implications: This qualitative longitudinal research study provides new insights into the journeys of people who experience communication disability, and the shifting nature of their sense of identity as they engage with, and learn from using, AAC. The study is significant as it attends to the dynamic nature of experience and how contextual and experiential factors influence people's hopes and expectations from AAC. The paper presents an original application of longitudinal qualitative research methodology with people who use AAC which can be further applied and tested in the field of communication disability research. WHAT THIS PAPER ADDS: What is already known on this subject: We did not know the impact that time has on the concepts that have been identified to represent important outcomes from AAC. The existing concepts used to define outcomes from AAC were not adequately conceptualized to develop a patient‐reported outcome measure. This study sought to extend our knowledge about outcomes from AAC. What this paper adds to the existing knowledge: This study adds to the methodological toolkit available for qualitative inquiry in the field of communication disability research by presenting a longitudinal qualitative research methodology. It adds depth to our understanding of the concepts that underpin outcomes from AAC and highlights the dynamic nature of contexts and how this influences desired outcomes. What are the potential or actual clinical implications of this work?: This longitudinal qualitative research study provides a broader perspective on the experience of getting AAC. It will enable clinicians to better navigate the contextual and transitionary factors that influence people's experience of acquiring AAC devices. The enhanced concepts described will also support clinical conversations that consider the wider facets of communication and what AAC can add to existing communicative tool kits beyond getting a message across. [ABSTRACT FROM AUTHOR]

Purpose: This service evaluation aims to understand the experiences of service users (SUs) who accessed an early intervention in psychosis (EIP) service during the Coronavirus pandemic using qualitative and quantitative methodologies and compare these to a previous pre-pandemic study conducted within the same service (Watkins et al., 2018). Design/methodology/approach: This paper collated experiences of individuals accessing an EIP service to inform service development. Questionnaires and individual interviews were conducted to provide quantitative and qualitative data. Descriptive statistics and T-test confidence intervals were created from the results and compared to findings of Watkins et al. (2018). Interviews were transcribed verbatim and analysed using Braun and Clarke's (2006) thematic analysis. Findings: Data showed participants were largely satisfied with all areas of the service with "work or education", "living skills", and "addictions" scoring highest. Though participants reported no overall dissatisfaction, satisfaction levels dropped in "social activities" compared to the findings of Watkins et al. (2018), perhaps due to the national restrictions put in place to manage the spread of Coronavirus during this time. Interview analysis identified three themes of importance consistent with prior literature, highlighting the importance of relationships and validation during recovery. Research limitations/implications: This evaluation did not consider whether participants had accessed the service prior to the pandemic or only during, meaning that some participants could have a point of comparison with the service pre-pandemic, whereas others might not. Similarly, the participants were not the same as those of the Watkins et al.'s (2018) evaluation, meaning that direct comparisons of pre- and post-pandemic experiences were not possible. In addition, this evaluation collected data at only one time point early in the pandemic; therefore, it is unknown if client experiences of services differed as the pandemic and restrictions continued over time. Originality/value: The Covid-19 pandemic has been an unprecedented challenge for health services, and the effects of this are becoming widely reported. This evaluation of clinical services offers a valuable perspective of service user experience of receiving mental health services during a global health crisis further offering a comparison to pre-pandemic services and the experiences of those who used them. [ABSTRACT FROM AUTHOR]

Purpose: Refugees and asylum seekers worldwide face numerous barriers in accessing health systems. The evidence base regarding who and what helps refugees and asylum seekers facilitate access to and the navigation of the health system in the UK is small. This study aims to address this gap by analysing 14 semi-structured, in-depth interviews with refugees and asylum seekers of different countries of origin in the UK to identify where, when and how they came into contact with the health-care system and what the outcome of these interactions was. Design/methodology/approach: Semi-structured, in-depth interviews were chosen as the key method for this study. In total, 14 individual interviews were conducted. A trauma-informed research approach was applied to reduce the risk of re-traumatising participants. Findings: The paper identifies key obstacles as well as "facilitators" of refugees' and asylum seekers' health-care experience in the UK and suggests that host families, friends and third-party organisations all play an important role in ensuring refugees and asylum seekers receive the healthcare they need. Originality/value: To the best of the authors' knowledge, this is the first qualitative study in the UK that looks at comprehensive health journeys of refugees from their first encounter with health services through to secondary care, highlighting the important role along the way of facilitators such as host families, friends and third-party organisations. [ABSTRACT FROM AUTHOR]

Background: Motor neuron disease (MND) (also known as amyotrophic lateral sclerosis) is a life‐limiting neurodegenerative condition. In up to 20% of people with MND, a pathogenic variant associated with autosomal dominant inheritance can be identified. Children of people carrying a pathogenic variant have a 50% chance of inheriting this and a higher, although harder to predict, chance of developing the disease compared to the general adult population. This paper explores the experience of living with the genetic risk of MND. Methods: We undertook a UK‐based interview study with 35 individuals, including: 7 people living with genetically‐mediated forms of MND; 24 asymptomatic relatives, the majority of whom had an increased risk of developing the disease; and 4 unrelated partners. Results: We explore how individuals make sense of genetic risk, unpacking the interplay between genetic knowledge, personal perception, experiences of the disease in the family, age and life stage and the implications that living with risk has for different aspects of their lives. We balance an emphasis on the emotional and psychological impact described by participants, with a recognition that the salience of risk fluctuates over time. Furthermore, we highlight the diverse strategies and approaches people employ to live well in the face of uncertainty and the complex ways they engage with the possibility of developing symptoms in the future. Finally, we outline the need for open‐ended, tailored support and information provision. Conclusions: Drawing on wider literature on genetic risk, we foreground how knowledge of MND risk can disrupt individuals' taken‐for‐granted assumptions on life and perceptions of the future, but also its contextuality, whereby its relevance becomes more prominent at critical junctures. This research has been used in the development of a public‐facing resource on the healthtalk.org website. Patient or Public Contribution: People with experience of living with genetic risk were involved throughout the design and conduct of the study and advised on aspects including the topic guide, sampling and recruitment and the developing analysis. Two patient and public involvement contributors joined a formal advisory panel. [ABSTRACT FROM AUTHOR]

Purpose: In 2021, an opportunity arose to place four counselling and psychotherapy (C&P) students in three care homes across Greater Manchester as part of a 6‐week interprofessional education (IPE) care home scheme. Whilst, due to ethical concerns around confidentiality, the C&P students could not participate in interprofessional activities as intended, they still undertook their clinical placement in the home to provide accessible therapy support for care home staff. This paper aims at reporting on the varied factors that influenced the implementation of C&P student placements in care homes. Methods: At the start and end of their placement, four C&P students were interviewed about their experiences. We draw on data from these eight interviews and two reflective vignettes: one from a C&P student and the other from the C&P programme coordinator (C&PPC). Results: The data were thematically analysed, and two key themes and six subthemes were constructed. They broadly unpack the factors that facilitate and challenge the implementation of C&P student placements in care homes. Conclusion: This paper highlights the value of utilising care homes as placement sites for C&P students. We propose four key recommendations for future practice: (1) it is important to establish clear lines of communication, support and collaboration; (2) a dual‐space supervisory approach supports student learning in this "new" placement environment; (3) preplacement supportive frameworks are important to clarify initial role uncertainties within the care home; and (4) opportunities to provide therapy services should be well defined and referral processes put in place before the student arrives. [ABSTRACT FROM AUTHOR]

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

This qualitative study aims to contribute to our understanding of how second‐generation immigrants negotiate their multiple identities, and construct their feelings of belonging. We focus on second‐generation ethnic Kurds, a stateless ethnic group with a complex political and social history, who have seldom been investigated in a UK context. Drawing on data from interviews with 14 Kurds living in the UK, this paper outlines the tensions in Kurds' lived experiences of Kurdish and British identity; in particular, experiences of feeling "othered" and how this manifests in relation to their identities. We found that Kurds most commonly dealt with some of the tensions they experienced from not belonging or feeling like an "other" by constructing new identities with more permeable boundaries of belonging; in this study, this was achieved through a "place‐based" identity. In sum, this paper offers a novel contribution to discourses of belonging, by demonstrating how the nuances of belonging and its lived complexities manifest in the experiences of UK‐based second‐generation Kurds, and the resultant strategies that they adopt to navigate tensions. [ABSTRACT FROM AUTHOR]

Paediatric Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) is a disabling condition. Schools play a key role in adolescents' experiences with managing ME/CFS. However, little is known about the experiences of adolescents with ME/CFS (and their families) in schools. This paper is an incidental qualitative study, which combines data from two independent ME/CFS studies: study 1 researched ethnic minority adolescents with ME/CFS; study 2 explored Acceptance and Commitment Therapy for adolescents with ME/CFS who had not recovered after one year. Participants included: adolescents with ME/CFS; their families; and medical professionals (ME/CFS specialists and non‐specialists). Adolescents, their families, and ME/CFS medical professionals were recruited from a UK specialist paediatric ME/CFS service. Non‐ME/CFS medical professionals were recruited from the same region. Semi‐structured qualitative interviews and focus groups were undertaken. Participants' views on schools from each study were combined and thematic analysis was used to identify themes. Fifteen adolescents with ME/CFS (11–17 years old), sixteen family members, and ten medical professionals (GPs, school nurses and ME/CFS specialists) were interviewed. Four key themes were found: (1) adolescents identified school was important for aiding ME/CFS recovery, especially educationally and socially; (2) families described varying levels of support from schools and local authorities with help managing ME/CFS – some described significant practical and emotional difficulties to accessing education, whereas others recounted examples of positive supportive strategies, particularly when teachers had previous experience or knowledge of ME/CFS; (3) parents thought three‐way communication between schools, healthcare and families could improve support; (4) participants felt schools were an appropriate place for knowledge building and raising awareness of ME/CFS amongst teachers and pupils, to aid improved supportive measures. In conclusion, this paper provides rich data that highlights the importance of education and the realistic fears and hurdles for adolescents with ME/CFS remaining engaged in education and the impact on their future. Some families described positive strategies in school, which were viewed as helpful to manage ME/CFS in the classroom. These strategies could be implemented alongside knowledge building initiatives and improved communication between healthcare and education. There is a need to further investigate useful strategies and determine how teachers can be best supported in implementing them. [ABSTRACT FROM AUTHOR]

Qualitative research has long critiqued a simplistic association between youth parenting and poor outcomes. Despite this, the UK youth parenting policy continues to view young parents through a narrow deficit lens, focused on assumed risk rather than structural inequalities. The paper brings together the direct accounts of young parents' experiences, with ethnographic observation of practice, to argue that discrimination is the critical issue associated with being a young parent. This is then set within a wider critique of the policy framework which, it is argued, perpetuates and normalises negative ideas about young parents prevalent in political, societal and cultural processes. An integrative theoretical approach is used to highlight how a deficit lens at a policy level upholds, rather than undermines, young parents' intersectional experiences of discrimination and has ethical implications for practitioners working with them. The paper calls for a reorientation of policy which addresses and disrupts discrimination. [ABSTRACT FROM AUTHOR]

Background: The recent surge in applications to nursing in the United Kingdom together with the shift towards providing virtual interviews through the use of video platforms has provided an opportunity to review selection methodologies to meet a new set of challenges. However there remains the requirement to use selection methods which are evidence-based valid and reliable even under these new challenges. Method: This paper reports an evaluation study of applicants to nursing and midwifery and reports on how to plan and use online interviews for in excess of 3000 applicants to two schools of nursing in Northern Ireland. Data is reported from Participants, Assessors and Administrators who were asked to complete an online evaluation using Microsoft Forms. Results: A total of 1559 participants completed the questionnaire. The majority were aged 17–20. The findings provide evidence to support the validity and reliability of the online interview process. Importantly the paper reports on the design and implementation of a fully remote online interview process that involved a collaboration with two schools of nursing without compromising the rigour of the admissions process. The paper provides practical, quantitative, and qualitative reasons for concluding that the online remote selection process generated reliable data to support its use in the selection of candidates to nursing and midwifery. Conclusion: There are significant challenges in moving to online interviews and the paper discusses the challenges and reflects on some of the broader issues associated with selection to nursing and midwifery. The aim of the paper is to provide a platform for discussion amongst other nursing schools who might be considering major changes to their admissions processes. [ABSTRACT FROM AUTHOR]

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

A growing body of literature has focused on issues of migration in career development and guidance, however typically this research has focused on international migration rather than migration within a country's borders. This paper presents a specific case study of internal migration in the UK context, focusing on young people from two island communities as they move through higher education and into the working world. The paper is specifically focused on the importance of cultural differences, including workplace cultures, with regard to students' career development. The findings demonstrate the relevance of internal migration pathways to career development and indicate that a culturally informed approach to career guidance practice is important when working with internal as well as international migrants. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the lived experiences of key stakeholders working with homeless people during the implementation of universal credit during the austerity years. Design/methodology/approach: The literature on austerity reveals welfare reforms' impact on support services staff. Service providers' perceptions of the impact of austerity-led policies and welfare reform via nine interviews with people working in homelessness organisations in Brighton and Hove in the UK. Service providers see the situation for their service users has gotten worse and that the policies make it more difficult to extricate themselves from their current situation. Three central themes relating to the impact of austerity-led welfare reforms were, namely, Universal Credit: the imposition of a precarious livelihood on welfare claimants; a double-edged sword: "If people are sanctioned: people can't pay"; and "Hard to maintain my own mental equilibrium". Findings: More precisely, this paper captures service providers' perceptions and experiences of the impact of austerity-led policies on their services and how they believe this, in turn, impacts their clients and their own lives. Research limitations/implications: The dimension cuts across service provision to vulnerable people and is intertwined with health and well-being outcomes. Austerity is detrimental to the health of service users and their clients. It is known that when it comes to the health and well-being of the most vulnerable, who have suffered most from the impacts of austerity policies. However, in times of open austerity, it falls also on those trying to ease their suffering. Originality/value: The data suggest that policies were developed and accentuated by austerity, which led to the stripping of welfare support from vulnerable people. This process has impacted the people who rely on welfare and service providers. [ABSTRACT FROM AUTHOR]

Purpose: Following research into the application of Electronic Monitoring (EM), Criminal Justice Order (2016) no. 954 was published, which introduced EM for offenders leaving custody in England and Wales (Ministry of Justice, 2016). EM was later extended to include those subjected to release on temporary licence (ROTL). The purpose of this study is to be the first, to the best of the authors' knowledge, to evaluate a pilot project using EM during the ROTL process. The outcome allowed for recommendations to be made regarding the continued use of EM within the open prison estate. Design/methodology/approach: This is a qualitative research project involving semi-structured interviews with staff and residents. Transcripts were analysed using thematic analysis which resulted in exploration of 4 themes and 11 sub-themes and recommendations for future research/practice. Findings: Results demonstrated that both staff and residents evaluated the use of EM as helpful with regard to evidencing compliance with ROTL conditions. In addition, staff also found it helpful for providing additional reassurance to victims and providing evidence for ROTL breaches. Practical implications: To the best of the authors' knowledge, this was the first qualitative evaluation of EM relating to the ROTL process. The evaluation improves understanding of the value of EM for policymakers and the Ministry of Justice, especially in terms of the ROTL process. The recommendations made in this paper evidence the value of EM use in the future. Originality/value: This evaluation supports continued use of EM and its integration into policy and procedures for residents subject to temporary licence. This paper concluded that consistent and reliable use of EM may contribute to victim reassurance and reduce recidivism of residents during ROTL, subsequently increasing the public's perception of safety. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: It is known that people with a diagnosis of borderline personality disorder often experience crises in their mental wellbeing.There is little evidence about the approaches of mental health nurses in community‐based crisis teams when working with people with a diagnosis of BPD. What the paper adds to the existing knowledge?: This paper highlights that limited resources, work‐patterns and issues of stigma present challenges to delivering recovery‐oriented care.The paper highlights that nurses typically try to navigate the challenges to continue to provide individualized care, though their self‐assessment is that this is with mixed success. What are the implications for practice?: The findings suggest that support is needed to develop brief interventions specific to teams working with people with a diagnosis of BPD who are at a point of crisis. Introduction: People with a diagnosis of borderline personality disorder (BPD) are often in contact with mental health services at a point of crisis, and in the UK, this includes Crisis Resolution Home Treatment teams (CRHTT). There is a drive for services to be recovery orientated; however, there is little evidence about the degree to which community services achieve this for people with a diagnosis of BPD when in crisis. Research Aim: To understand the perceptions held by CRHTT clinicians about their provision of recovery‐orientated acute care, for people with a diagnosis of BPD. Method: From a purposive sample of a single CRHTT, seven registered mental health nurses were interviewed and Braun and Clarke's thematic analysis framework was used to interpret the data. Results: Five themes emerged: person‐centred care; the timing is wrong; inconsistent staffing; the risks are too great; and BPD as a label. Discussion: The results demonstrate tensions between a drive to deliver person‐centred care and a range of challenges that inhibit this, with the possibility of reframing a recovery approach as "recovery‐ready". Implications for Practice: A whole‐system approach is required to enable a consistent recovery‐oriented approach, but research is also needed for brief interventions specific to this context. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to consider how a South East project approached systems change to improve unsupported temporary accommodation (UTA) and the changes made for people experiencing multiple disadvantage ("multiple and complex needs"). This paper also covers some matters that are hard to change or uncertain, such as housing shortages and financial constraints. The paper focuses on a case study of the East Sussex Temporary Accommodation Action Group (TAAG) – a multi-agency action group. Design/methodology/approach: A qualitative case study involving a thematic analysis of seven semi-structured interviews, with a review of published literature and internal documentation. Findings: This example of setting up a TAAG shows us the value of having a dedicated forum to look at a part of the system that requires changing and to identify what works well. Creating a collaborative and democratic space with a common purpose brings different stakeholders and perspectives together and opens discussions to new ways of working. Equalising partners creates an opportunity to create change from the bottom-up within a system traditionally governed by statutory bodies. This study found that the TAAG has facilitated learning around trauma-informed practice and nurtured more sustainable changes towards a Standards Charter and women-only safe UTA. Originality/value: This is one of the first qualitative case studies of a local systems change approach to improving UTA for people experiencing multiple disadvantage in East Sussex. [ABSTRACT FROM AUTHOR]

Despite increasing scholarly and media attention on sexual violence in public spaces, including those associated with the night-time economy and licensed venues, music festivals have been largely absent from research and policy. This paper presents the findings from the first UK study of sexual violence at music festivals, drawing on data from interviews with 13 women who have experienced some form of sexual harassment or assault at a festival. Analysis reveals that sexual violence at festivals occurs on a continuum and represents an extension of rape culture through which sexual violence is culturally condoned and normalized, enabled through a number of environmental and culture features that are unique to festivals. [ABSTRACT FROM AUTHOR]

Introduction: Disparities in the uptake of routine and COVID‐19 vaccinations have been observed in migrant populations, and attributed to issues of mistrust, access and low vaccine confidence. Participatory research approaches and behaviour change theory hold the potential for developing tailored vaccination interventions that address these complex barriers in partnership with communities and should be explored further. Methods: This study used a theory‐informed, community‐based participatory research approach to co‐design a culturally tailored behaviour change intervention aimed at increasing COVID‐19 vaccine uptake among Congolese migrants in London, United Kingdom (2021–2022). It was designed and led by a community‐academic partnership in response to unmet needs in the Congolese community as the COVID‐19 pandemic started. Barriers and facilitators to COVID‐19 vaccination, information and communication preferences, and intervention suggestions were explored through qualitative in‐depth interviews with Congolese migrants, thematically analysed, and mapped to the theoretical domains framework (TDF) and the capability, opportunity, motivation, behaviour model to identify target behaviours and strategies to include in interventions. Interventions were co‐designed and tailored in workshops involving Congolese migrants. Results: Thirty‐two Congolese adult migrants (24 (75%) women, mean 14.3 (SD: 7.5) years in the United Kingdom, mean age 52.6 (SD: 11.0) years) took part in in‐depth interviews and 16 (same sample) took part in co‐design workshops. Fourteen barriers and 10 facilitators to COVID‐19 vaccination were identified; most barrier data related to four TDF domains (beliefs about consequences; emotion; social influences and environmental context and resources), and the behavioural diagnosis concluded interventions should target improving psychological capability, reflective and automatic motivations and social opportunities. Strategies included culturally tailored behaviour change techniques based on education, persuasion, modelling, enablement and environmental restructuring, which resulted in a co‐designed intervention comprising community‐led workshops, plays and posters. Findings and interventions were disseminated through a community celebration event. Conclusions: Our study demonstrates how behavioural theory can be applied to co‐designing tailored interventions with underserved migrant communities through a participatory research paradigm to address a range of health issues and inequalities. Future research should build on this empowering approach, with the goal of developing more sensitive vaccination services and interventions which respond to migrant communities' unique cultural needs and realities. Patient or Public Contribution: Patient and public involvement (PPI) were embedded in the participatory study design and approach, with community members co‐producing all stages of the study and co‐authoring this paper. An independent PPI board (St George's Migrant Health Research Group Patient and Public Involvement Advisory Board) comprising five adult migrants with lived experience of accessing healthcare in the United Kingdom were also consulted at significant points over the course of the study. [ABSTRACT FROM AUTHOR]

Introduction: People who call emergency ambulances frequently are often vulnerable because of health and social circumstances, have unresolved problems or cannot access appropriate care. They have higher mortality rates. Case management by interdisciplinary teams can help reduce demand for emergency services and is available in some UK regions. We report results of interviews with people who use emergency ambulance services frequently to understand their experiences of calling and receiving treatment. Methods: We used a two‐stage recruitment process. A UK ambulance service identified six people who were known to them as frequently calling emergency services. Through third‐sector organisations, we also recruited nine individuals with healthcare experiences reflecting the characteristics of people who call frequently. We gained informed consent to record and transcribe all telephone interviews. We used thematic analysis to explore the results. Results: People said they make frequent calls to emergency ambulance services as a last resort when they perceive their care needs are urgent and other routes to help have failed. Those with the most complex health needs generally felt their immediate requirements were not resolved and underlying mental and physical problems led them to call again. A third of respondents were also attended to by police and were arrested for behaviour associated with their health needs. Those callers receiving case management did not know they were selected for this. Some respondents were concerned that case management could label frequent callers as troublemakers. Conclusion: People who make frequent calls to emergency ambulance services feel their health and care needs are urgent and ongoing. They cannot see alternative ways to receive help and resolve problems. Communication between health professionals and service users appears inadequate. More research is needed to understand service users' motivations and requirements to inform design and delivery of accessible and effective services. Patient or Public Contribution: People with relevant experience were involved in developing, undertaking and disseminating this research. Two public contributors helped design and deliver the study, including developing and analysing service user interviews and drafting this paper. Eight public members of a Lived Experience Advisory Panel contributed at key stages of study design, interpretation and dissemination. Two more public contributors were members of an independent Study Steering Committee. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic caused major disruption in community support for vulnerable older people and is thought to have exacerbated existing issues within UK adult social care. This study aims to examine the legacy of that disruption on how meeting centres for people affected by dementia have been impacted in continually evolving circumstances. Design/methodology/approach: Semi-structured interviews and focus group discussions were conducted at three meeting centre case study sites. Ninety-eight participants, including people living with dementia, family carers, staff, volunteers, trustees and external partners, were asked about the impact and legacy of the pandemic upon meeting centres. A thematic analysis was carried out on the data. Findings: Ten themes were identified: ability to re-open venues; increased health decline and loss of members due to isolation; closure or halting of linking services and dementia community support; disruption to diagnosis and referrals; increase in outreach, building communities and overall reach; digital access and use of technology (boom and decline); changes to carer involvement and engagement; continued uncertainty and changes to funding, resources and governance; staff and volunteer recruitment issues; and relief at/wish for return to pre-pandemic norms. Originality/value: This paper offers new insight into a still-developing situation, namely, the legacy effects of the pandemic upon third-sector community support for people affected by dementia and the health and social care services that support it. The reduction in maintenance of pandemic-era technological innovations is a key finding. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to explore and understand the organizational culture of a workplace in terms of support and well‐being for staff experiencing perimenopausal and menopausal symptoms at work. Design: It is widely acknowledged that perimenopause and menopause symptoms are experienced by a large percentage of the female workforce. There is a lack of research into how nurses are supported through menopause (Cronin et al. Issues in Mental Health Nursing, 42, 2021, 541–548). The perimenopause and menopause transition can be a challenging time where many may require symptom management and support (RCN, The Menopause and Work: Guidance for RCN Representatives, 2020). This paper presents a case study research (CSR) approach to examine one healthcare organization. Methods: CSR design was used: A survey distributed to all staff employed, a review of the available documentation on menopause and interviews with managers from different levels of the organization. The COREQ consolidated criteria was used for reporting the qualitative research reported this study. Results: The case study generated both quantitative and qualitative data using surveys, interviews and documentation. Data from the organization (n = 6905) showed a majority female workforce of 81.9% with 40.6% aged between 41 and 55 years old, meaning a third of the organization working through perimenopause and menopause. Survey responses (n = 167) collected biographical and psychometric data on the prevalence of perimenopausal and menopausal symptoms. Seven managers were interviewed highlighting two themes: Access to support and culture of menopause and 13 documents from the organization on menopause were analysed for content. The study design permitted an iterative approach to data collection and providing an in‐depth understanding of the needs and support for those experiencing perimenopause and menopause. The findings help healthcare organizations to understand their workforce and take in to account the larger numbers of female employees particularly nurses with the need to provide person‐centred support mechanisms and an organizational approach for all employees. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore the experiences of black Sub-Saharan African (BSSA) migrants from war-torn zones in accessing health services in the West Midlands region of the UK. This may help to inform on factors influencing the uptake of health services for new migrant communities. Design/methodology/approach: This study explored the experiences of BSSA migrants from war-torn zones in accessing health services in the West Midlands using an explorative qualitative approach. Ten focus groups made up of seven participants each were followed up with three in-depth one-to-one interviews from each focus group using a conversational approach where research participants were encouraged to direct and shape the discussion in accordance with their own experiences, views and particular concerns (Kvale, 1996) as opposed to responding to a pre-determined agenda. Findings: Following transcription, coding and analysis of the focus group discussions and follow-up interviews, this study found that perceptions and attitudes of BSSA communities in accessing health services included difficulties in navigating the health system, intrusive and embarrassing questions from clinicians, stigmatisation through offering an HIV test, culturally unfriendly counselling support, unconfidently services and episodes of trauma flashbacks. Originality/value: The experiences of BSSA migrants who sought health services in the West Midlands in the UK demonstrated important implications for future practice and informed service delivery. There is a need to consider cultural education for both BSSA migrants and health professionals to enhance understanding and trust between the groups. Basic professional training for health professionals should also encompass the needs of the growing ethnic populations in the UK. [ABSTRACT FROM AUTHOR]

Purpose: The Village model, most extensively developed in the USA, is an innovative response to ageing populations and older adults who wish to remain living independently within their community. The "Urban Villages" participatory action research study aimed to test the potential of the Village model to work with groups of older adults in two economically deprived, inner-city neighbourhoods in Manchester, UK. Design/methodology/approach: Participatory methods were used to work with residents to, first, adapt the Village model to the Manchester setting, and second, to develop and deliver community projects that supported ageing in place. The study aimed to involve marginalised individuals and groups in the co-design, leadership and implementation of the projects. Ethnographic methods were applied to observe and reflect on the development of "Urban Villages". Interviews and focus groups were organised to gather the views of the residents involved in the community projects. Findings: Residents were supported to develop and test seven projects, all aimed at reducing social isolation and supporting ageing in place. The study provides new insights into challenges related to co-production with older people in deprived neighbourhoods. These challenges are presented under the following headings: individual capacity and expectations; collective capacity including communication and knowledge; and the capacity of place. Originality/value: To date, only a limited amount of literature is available showing how co-production with older adults can be realised when working with marginalised groups and deprived communities. The paper explores the potential of participatory approaches to develop age-friendly initiatives through strengthening the capacity of older adults to age in place. [ABSTRACT FROM AUTHOR]

Aim: Designing financial incentives for health behaviour change requires choices across several domains, including value (the size of the incentive), frequency of incentives, and direction (gain or loss). However, the rationale underlying complex incentive design is infrequently reported. Transparent reporting is important if we want to understand and improve the incentive development process. This paper describes a mixed methods approach for designing financial incentives for health behaviour change which involves stakeholders throughout the design process. Subject and methods: The mixed methods approach focuses on incentives for weight loss for men with obesity living in areas with high levels of disadvantage. The approach involves: (a) using an existing framework to identify all domains of a financial incentive scheme for which choices need to be made, deciding what criteria are relevant (such as effectiveness, acceptability and uptake) and making choices on each domain on the basis of the criteria; (b) conducting a survey of target population preferences to inform choices for domains and to design the incentive scheme; and (c) making final decisions at a stakeholder consensus workshop. Results: The approach was implemented and an incentive scheme for weight loss for men living with obesity was developed. Qualitative interview data from men receiving the incentives in a feasibility trial endorses our approach. Conclusion: This paper demonstrates that a mixed methods approach with stakeholder involvement can be used to design financial incentives for health behaviour change such as weight loss. Trial registration number: NCT03040518. Date: 2 February 2017. [ABSTRACT FROM AUTHOR]

Introduction: This paper draws on a study and its findings that set out to explore why some students appear to thrive, turning placement experiences into positive empowering opportunities despite the challenges, where others may not. Findings established a broader application beyond placements to inform curriculum design and delivery that nurtures professionalism, competence and identity from pre-admission to transition into practice as a journey of growth and development. Method: A mixed-methods approach was adopted. Questionnaires and interviews gathered data from two cohorts in traditional (n = 25) or role-emerging placements (n = 13). An interpretive approach was employed for the qualitative data. The quantitative data underwent statistical analysis. Findings: Students in role-emerging placements scored higher in resilience prior to and developed greater resilience as a consequence. These students scored higher in traits of openness, conscientiousness, extraversion and agreeableness and were more emotionally stable compared with students in traditional placements. Agreeableness was positively correlated with greater resilience in these students. Conclusion: Curricula design and delivery should embed opportunities throughout programmes of study enabling students to nurture an openness to new experiences, with positive risk taking, building an ability to thrive. Understanding individual differences in students informs the development of competence and identity pivotal for transition into practice. [ABSTRACT FROM AUTHOR]

Purpose: This paper presents qualitative research findings from the evaluation of a Parkinson's Dance well-being venture in the UK. Methods: Qualitative data was gathered to see how bespoke dancing sessions helped people with Parkinson's (PwP) to manage their conditions and improve their lives and prospects. Principles of a participatory approach were incorporated and methods included semi-structured interviewing, researchers participant observation and an elicitation-based activity. Nineteen PwP, six carers, four dance artists and seven helpers participated in the study. Results: Participating in Parkinson's Dance sessions meant that PwP could experience the possibilities to dance, develop a "can do" attitude, experience fun, enjoyment, social connection, exercise, movement to music, improvement and/or maintenance of their balance, suppleness, coordination and confidence with movement, symptoms being pushed back and ability to learn new things. Conclusions: Our findings add to the evidence-base about the benefits of dance for people experiencing Parkinson's and through novel application of the Life-world based well-being framework of K. T. Galvin and Todres (2011) we propose a theoretical basis for Parkinson's Dance as a resource for well-being. There is scope to consider application of the well-being framework to other arts activities and as the basis of an arts and well-being evaluation tool. [ABSTRACT FROM AUTHOR]

Recent political processes have rendered people with dementia an increasingly surveilled population. Surveillance is a contentious issue within dementia research, spanning technological monitoring, biomarker research and epidemiological data gathering. This paper explores surveillance in the relationships of people affected by dementia, how older relatives both with and without diagnoses are surveilled in everyday interactions, and the importance of expectations in guiding surveillance. This paper presents data from 41 in-depth interviews with people affected by dementia living in the community in the United Kingdom. Agedness was a key contributor to expectations that a person may have dementia, based on previous experiences, media accounts and wider awareness. Expectations provoked surveillance in interactions, with participants looking for signs of dementia when interacting with older relatives. Older people also enacted self-surveillance, monitoring their own behaviour. Various actions could be attributed to dementia because interpretation is malleable, partly vindicating expectations while leaving some uncertainties. Expectant surveillance transformed people's experiences because they organised their own actions, and interpreted those of others, in line with pre-existing meanings. The ability to interpret behaviours to fit expectations can bring coherence to uncertainties of ageing, cognition and dementia, but risks ascribing dementia to many older people who straddle those uncertainties. [ABSTRACT FROM AUTHOR]

There is increasing research interest in the experiences of new fathers taking paternity leave, but less insight into men's experiences of returning to work after the birth of their first baby. For many men in the UK context, this could take place immediately after the birth or after one or two weeks of paternity leave. This paper utilizes data from a UK-based study whilst also drawing on international literature and policy contexts. A constructivist grounded theory method was adopted to generate theory from the data gathered. Twelve new fathers shared their experiences in this study by participating in audio-recorded, semi-structured interviews. This paper focuses on fathers' experiences of negotiating the workplace as part of an overall theoretical framework related to broader transitions to fatherhood and sheds light on the distress, guilt and psychological challenges that the participants experienced when they initially returned to work. Whether fathers did or did not explicitly describe distress at this time, they all described a change in their worker identity, which for some participants led to uncertainty in the workplace. Men returning to work at this time in the postnatal period are vulnerable to experiencing distress. Flexibility and support in the workplace could be protective of their mental health. Finally, policy and practice developments are offered to support men's transitions to fatherhood in the workplace context. [ABSTRACT FROM AUTHOR]

Young people are more likely to seek help about abusive relationships from friends, rather than adults or professionals, irrespective of gender, age or ethnic group. However, friends may be unequipped to deal with relationship problems and unable to provide adequate emotional or practical support. The aim of this paper is to explore how young people would support friends if they were seeking help or shared experiences of abuse. Qualitative findings drawn from a larger UK mixed‐methods study are used to explicate this. Data was gathered using 16 focus groups and one interview with girls, young women and non‐binary young people aged 13 to 24 years. Thematic analysis provided six themes pertaining to supporting friends and help‐seeking around relationship abuse. Findings showed young people recommended supporting friends in a non‐judgemental way to keep conversations open and help them recognise unhealthy behaviours. However, young people confirmed this is a difficult topic and many would feel fearful, helpless and under pressure. Conversations illustrated the need for more awareness of non‐physical abuse and resources specifically aimed at young people to enable them to help friends and know where and when to seek professional support. [ABSTRACT FROM AUTHOR]