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Background: Documented inequalities in access to eye care for people with learning disabilities and/or autism are caused by poor uptake of primary eye care services, poor identification of eye problems, lack of signposting and reasonable adjustments of existing services, concerns about costs of care and the low priority historically given to these issues in eye care policy at a regional and national level. In 2019, the charity SeeAbility employed four eye care champions (ECCs) with lived experience of learning disability and/or autism to work in local communities in London and the Northwest of England. They provided peer‐to‐peer support on understanding the need for good eye health and engaged with policy makers, and learning disability, autism and eye care professionals at the local, regional and national levels to influence both the clinical practice of individual practitioners (within existing service/pathway models) and more widely to influence the commissioning of the Easy Eye Care pathway. This study explores the experiences of these ECCs. Methods: The study was conducted in April and May 2023. A case study approach was used to describe the experiences of the ECCs from March 2019 to March 2023. Data from structured interviews with the four ECCs and workload analysis were triangulated to provide a multifaceted understanding of this novel health promotion project. Findings: The ECCs found the role useful and reported that confidence in their practice and impact grew with time but they required ongoing support in the role. A good understanding of the promotional messages was reported. Developing a good network of contacts at an early stage, both people with learning disabilities and healthcare professionals, was key. Relationships with professionals were supportive and positive and a positive emotive response to their lived experience was reported in these interactions. Conclusions: From the perspective of the ECCs, the role is useful and beneficial. The work suggests some key recommendations for future development which include planning to build networks, support in presentation and communications skills and defining key messages and knowledge. Confidence of the ECCs builds with time in the role but also needs support the emotive impact of their lived experiences on audiences is highlighted. There is a need to evaluate how the programme is perceived by those who interact with it and how it changes behaviours which leads to better health outcomes. Accessible Summaries: People with learning disabilities are 10 times more likely than other people to have a problem with their eyes but less likely to get the eye care they need.This paper explains how people with a learning disability and/or autism are employed to tell other people with learning disabilities and/or autism, their supporters, health and care professionals and people who plan services about how important it is to get regular eye care. This job is an 'Eye Care Champion'.We share what the eye care champions did in their role, what worked well and what did not.We discuss how what we have learnt can help other people with learning disabilities and/or autism work as eye care champions and perhaps as champions for other areas of healthcare. [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]

Introduction: Associations between structural inequalities and health are well established. However, there is limited work examining this link in relation to mental health, or that centres public perspectives. This study explores people's experience and sense‐making of inequality in their daily lives, with particular consideration of impacts on mental health. Methods: We conducted a peer research study. Participants had to live in one of two London Boroughs and have an interest in inequalities and mental health. Using social media, newsletters, local organisations and our peer researchers' contacts, we recruited 30 participants who took photos representing their experience of inequality and discussed them during semi‐structured interviews. Data were analysed using reflexive thematic analysis. Results: Three themes were identified in this study: (1) inequalities are unjust, multilayered and intertwined with mental health. Accounts demonstrated a deep understanding of inequalities and their link to mental health outcomes, describing inequalities as 'suffering' and 'not good for anyone'. Financial, housing, immigration and healthcare problems exacerbated poor mental health, with racism, gender‐based violence and job loss also contributing factors for both poor mental health and experiences of inequality; (2) inequalities exclude and have far‐reaching mental health consequences, impacting personal sense of belonging and perceived societal value and (3) moving forwards—addressing long‐standing inequality and poor public mental health necessitated coping and resilience strategies that are often unacknowledged and undervalued by support systems. Conclusion: Lived experience expertise was central in this study, creating an innovative methodological approach. To improve public mental health, we must address the everyday, painful structural inequalities experienced by many as commonplace and unfair. New policies and strategies must be found that involve communities, redistributing resources and power, building on a collective knowledge base, to coproduce actions combatting inequalities and improving population mental health. Patient or Public Contribution: This study was peer‐led, designed and carried out by researchers who had experiences of poor mental health. Six authors of the paper worked as peer researchers on this study. [ABSTRACT FROM AUTHOR]

Making Every Contact Count (MECC) is a national, long‐term public health strategy in England. It supports public‐facing workers to use opportunities during routine contacts to enable healthy lifestyle changes. This paper reports the findings from an external evaluation of voluntary and community sector (VCS) delivery of MECC in the North East of England, which focused on engaging under‐represented client groups. The study aimed to (a) Establish if (and how) MECC had impacted the workforce, including changes to staff knowledge, confidence and behaviour; (b) Identify benefits, challenges and unintended consequences; and (c) Explore outcomes for service users. A multi‐stage qualitative design focused on understanding both process and outcomes. The study utilised three data collection methods, including a journey mapping workshop (n = 20), semi‐structured interviews with delivery leads, VCS workers and volunteers who had accessed MECC training (n = 11), and focus group discussions with clients (n = 22). The findings illustrated positive early outcomes, including improvements in self‐reported staff knowledge and confidence as well as emerging examples of organisational culture shift and individual behaviour change. Alongside this, the data provided a rich picture of barriers and challenges which are examined at different levels—national programme, local programme, VCS sector, partner organisation, worker and client. The research highlights clear successes of the VCS delivery model. However, it is presented as a 'double‐edged sword,' in light of associated challenges such as sector‐level funding uncertainty and accessibility of MECC resources to diverse client groups. The discussion considers issues related to the measurement and attribution of behaviour change outcomes for brief interventions, as well as fidelity, legacy and long‐term sustainability challenges. The recommendations call for system‐level analysis and comparison of different MECC implementation models, to improve our understanding of challenges, opportunities and programme reach for behaviour change intervention programmes—particularly in relation to seldom‐heard client groups. [ABSTRACT FROM AUTHOR]

There is renewed optimism about the development of policy and practices related to promoting health in prison settings, driven by the epidemiological data which suggests that the health of people in prison remains very poor. In England and Wales, the focus of this paper, independent prison inspections, conducted by Her Majesty's Inspectorate of Prisons for England and Wales (HMIP), form a critical element in how prisons are assessed. This includes efforts within prisons to promote health and well-being. This paper, using content and thematic analysis, analyses one year (2018) of inspection reports in 38 male prisons. Analysis demonstrates that a 'whole-prison approach' to promoting health and well-being is poorly understood, with only 41% of prisons showing characteristics of this approach. Of the male prisons inspected in 2018, there was good availability of disease prevention activities and screening programmes (88%) and smoking cessation support (94%). The provision of peer support mechanisms, access to condoms and access to health information was highly variable across prisons. The paper makes several conclusions about the state of health promotion in prison and moreover the current criteria adopted by HMIP to assess health and well-being which seems to offer a very narrow biomedical perspective. [ABSTRACT FROM AUTHOR]

This paper examines how non‐marine thrombolites are formed through a complex, multiphase process of microbial framework construction, erosion, cementation, recrystallization and episodes of internal sedimentation. Recognition of such phases of thrombolite construction provides a framework for the interpretation of the fluctuating environmental conditions leading to their formation. Microbialite frameworks are examined in detail from the Purbeck Limestone Group and their affinities and palaeo‐environmental significance assessed. Three types of thrombolite, one stromatolite and a leolite are described and interpreted. The thrombolite frameworks include: a peloidal mesoclotted type, a thrombolite constructed by the filamentous alga Cladophorites and a type with concentrically laminated micritic mesoclots. Physical and chemical erosion led to extensive early cavity formation within the frameworks. Early calcite rim cements with associated spherulites then developed over the microbial frameworks and these were reworked into cavities. Frameworks were also replaced by chalcedonic quartz and calcite spherulites. Internal sediments comprise peloids, intraclasts and brackish‐water molluscs and ostracods, together with their debris. The thrombolites grew in moderate‐energy to high‐energy shallow, lacustrine, microbial mounds whereas stromatolites occurred in deeper‐water settings. A brackish‐water, lacustrine setting is indicated by the preserved macro‐biota, microbes, absence of charophytes and syndepositional evaporites, and negative stable carbon and oxygen isotope ratios. Strontium isotopes suggest that the carbonate‐rich waters were fed from erosion of Mid–Lower Jurassic limestones on the western basin margin with possible mixing with waters from nearby uplifted Upper Jurassic limestones and with Late Jurassic seawater. The research indicates that non‐marine thrombolites have a complex, multiphase origin resulting in a diverse succession of textures and structures relating to microbially induced and influenced construction, dissolution, cementation, recrystallization and mineral replacement which have not been previously recorded and indicate the major differences between marine and non‐marine thrombolites. [ABSTRACT FROM AUTHOR]

The first Transplant Games took place in 1978 in Portsmouth, England. Since then, numerous Olympic-style sporting 'Games' have been established, each aiming to increase public awareness of organ donation, demonstrate the benefits of transplantation, and encourage patient fitness. Despite this, there is limited research exploring the psycho-social and health impacts of the Games. Drawing on qualitative research conducted at the 2022 British Transplant Games and the 2022 European Transplant and Dialysis Games, this paper explores the Games through a therapeutic landscapes framework, a concept that examines the ways in which environments contribute to health and wellbeing. Building upon work that acknowledges the relational and contingent nature of health-in-place, I argue that the Games are a therapeutic landscape of social relations for transplant recipients in three ways: providing a landscape of belonging , a landscape of hope , and a landscape of motivation. Through this therapeutic landscapes perspective, the Transplant Games are presented as a peer-to-peer clinic – a care space where individuals are more actively involved in their health on a reciprocal level than in the traditional hospital clinic. In turn, this paper emphasises the crucial role of affective peer support in producing health-promoting environments. This research seeks to make a practical contribution to the wider transplant community by promoting the Games as an environment which may positively contribute to both physical and mental wellbeing. • The Transplant Games function as a therapeutic landscape for organ recipients. • They provide a peer-to-peer clinic where participants are active in their health. • The Games provide a landscape of belonging, acceptance, understanding and family. • In showing you can still lead a healthy life, the Games become a landscape of hope. • As a landscape of motivation, the Games improve both physical and mental health. [ABSTRACT FROM AUTHOR]

This paper reports on an exploratory study, which gathered LGBT+ young people's (aged 15–22) experiences and perceptions of hate crime. Two design-led workshops were conducted in the North East of England, with the aim of identifying the reporting needs of LGBT+ young people. Participants in the first workshop were asked what types of 'hate' scenarios they would report to the police. Participants in the second workshop were asked to design hate crime reporting devices. Young people were ambivalent about reporting their experiences to the police as their victimization was intimately tied to people they were connected with (parents, school peers, and acquaintances). They highlighted a variety of response needs when reporting victimization. This article argues that acts of bullying and acts of antiLGBT+ hate crime are symmetrical in their tangibility. LGBT+ youth victimization is currently framed, within scholarly discourse, as a bullying issue involving peer victimization. However, the criminological discourse on LGBT+ adult victimization is framed as hate crime. The data provided bridges this gap by conceptualizing youth victimization as a form of hate crime, an important contribution in recognizing the report needs of young LGBT+ people. [ABSTRACT FROM AUTHOR]

There is a growing evidence base that recovery is contagious and its primary mechanism of spread is through peer champions and groups. This paper examines a model of peer-based recovery support services from Cumbria, England, that uses a hub and spoke method to create visible recovery while actively engaging with and supporting community growth. Three case studies are used to illustrate how peer engagement, using the principles of community connection and assertive linkage, can offer core resources to a local community. The key conclusion is that sustainability of recovery communities rests on effective community engagement and meeting the needs of those communities. [ABSTRACT FROM AUTHOR]

Background and context: Breastfeeding peer support is valued by women, but UK trials have not demonstrated efficacy. The ABA feasibility trial offered proactive peer support underpinned by behaviour change theory and an assets‐based approach to women having their first baby, regardless of feeding intention. This paper explores women's and infant feeding helpers' (IFHs) views of the different components of the ABA intervention. Setting and participants: Trained IFHs offered 50 women an antenatal meeting to discuss infant feeding and identify community assets in two English sites—one with a paid peer support service and the other volunteer‐led. Postnatally, daily contact was offered for the first 2 weeks, followed by less frequent contact until 5 months. Methods: Interviews with 21 women and focus groups/interviews with 13 IFHs were analysed using thematic and framework methods. Results: Five themes are reported highlighting that women talked positively about the antenatal meeting, mapping their network of support, receiving proactive contact from their IFH, keeping in touch using text messaging and access to local groups. The face‐to‐face antenatal visit facilitated regular text‐based communication both in pregnancy and in the early weeks after birth. Volunteer IFHs were supportive of and enthusiastic about the intervention, whereas some of the paid IFHs disliked some intervention components and struggled with the distances to travel to participants. Conclusions: This proactive community assets‐based approach with a woman‐centred focus was acceptable to women and IFHs and is a promising intervention warranting further research as to its effect on infant feeding outcomes. [ABSTRACT FROM AUTHOR]

Food insecurity in the UK is a pressing concern that is associated with poor health outcomes. Research to date has focused on the challenges for adults in providing food for families. However, there is little evidence showing how children and young people experience food insecurity, particularly outside of the home and school. This paper, drawing on 14 months of ethnography in a youth club in the North of England, explores how young people manage food insecurity. In this youth club, the circulation of takeaway food is part of an informal network where boys purchase, share and receive food. This practice allows the boys to participate meaningfully within their peer groups whilst also providing stable access to food. This peer practice, however, was not available to everyone. This was a gendered practice that for the girls held little benefit due to their concerns about eating and pressure to provide for others. Instead, some girls depend on romantic relationships for food provision that is equated with affection and care. The findings will be discussed through a 'materialities of care' perspective to explore the complex ways in which food as a practice of care is part of everyday routines embedded within local places. [ABSTRACT FROM AUTHOR]

Relationships between peers are often considered central to the therapeutic process, yet there is relatively little empirical research either on the nature of peer-to-peer relationships within residential treatment or on how those relationships generate positive behaviour change or facilitate recovery. In this paper, we explore relationships between peers in residential addiction treatment, drawing upon the concept of social capital to frame our analyses. Our study was undertaken during 2015 and 2016 in two English residential treatment services using the same therapeutic community-informed model of treatment. We conducted 22 in-depth interviews with 13 current and 9 former service residents. All interviews were audio-recorded, transcribed verbatim, coded in MAXQDA, and analysed using Iterative Categorisation. Residents reported difficult relationship histories and limited social networks on entry into treatment. Once in treatment, few residents described bonding with their peers on the basis of shared experiences and lifestyles. Instead, interpersonal differences polarised residents in ways that undermined their social capital further. Some senior peers who had been in residential treatment longer acted as positive role models, but many modelled negative behaviours that undermined others' commitment to treatment. Relationships between peers could generate feelings of comfort and connectedness, and friendships developed when residents found things in common with each other. However, residents more often reported isolation, loneliness, wariness, bullying, manipulation, intimidation, social distancing, tensions and conflict. Overall, relationships between peers within residential treatment seemed to generate some positive but more negative social capital; undermining the notion of the community as a method of positive behaviour change. With the caveat that our data have limitations and further research is needed, we suggest that residential treatment providers should more routinely open the 'black box' of 'community as method' to consider the complex and dynamic nature of the relationships and social capital inside. [ABSTRACT FROM AUTHOR]

This paper draws on findings from an analysis of interviews with young people aged 14–18 years, to explore the peer influences in young people's informal social networks which can affect their access to sexual health services. The research focuses on the social meanings of a C-Card condom distribution scheme in North East England. Such schemes are widespread in the UK as a way of providing access to condoms and sexual health advice for young people in health and community settings. Focusing on one aspect of a broader study, the paper outlines the important social, emotional and practical resources provided by young people's chosen friendship groups in the process of acquiring a C-Card, which offers a route to accessing sex and relationships advice and condoms. Informal peer networks inform attitudes and expectations which can influence gendered patterns of behaviour. Through a focus on the educational possibilities of the C-Card scheme, the study suggests a need to revisit the dynamics of young people's peer relationships and harness their potential to influence sexual attitudes and behaviour in positive ways, rather than simply seeing these always as a source of negative pressure. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Group suicidal behaviour can be devastating for all concerned., There is an absence of research on adolescent suicidal group behaviour., The perspectives of practitioners' experiences of these groups are largely lacking from research literature., What this paper adds to existing knowledge? Practitioners work regularly with suicidal behaviour in adolescent peer groups., Practitioners identify peer relationships in groups as complex, including elements that are both suicide encouraging and preventing., Practitioners identify a range of ways in which young people become involved in suicidal behaviour in groups, including indirectly through risk taking and care-seeking as well as directly suicidal or self-harming., What are the implications for practice? Assessments of young people should routinely include a focus on the qualities of peer relations, including those in the online/digital realm., Assessments and interventions need to consider the complexity of group relationships and roles, and the multiplicity of factors that can contribute to suicidal behaviour in groups., Interventions that sustain therapeutic connectedness are helpful for taking dynamic/fluctuating risks into account., Abstract Introduction Group suicidal behaviour by young people can have harmful effects; it may be increasing, influenced by online media and reported increasing self-harm rates; new knowledge and understanding to inform interventions is required. Aim To explore how practitioners experience group suicidal behaviour amongst adolescents, how they assess risks/needs, and how these insights inform understanding about these groups. Method Ten practitioners, including Mental Health Nurses, were interviewed in one multidisciplinary CAMHS, in England. Data analysis was by Thematic Analysis (Braun & Clarke 2006). Results Participants described frequently working with suicidal groups. Roles in groups include suicide encouraging and preventing. Practitioners identify risky and protective connections between young people, online and offline. Clinical tensions include living with suicidal risks, emotional and positional challenges, and getting to grips with digital media. Discussion Peer groups appear to have a larger role in adolescent suicide than recognized to date. Practitioners need to assess young people's roles in groups, their diverse motivations and to understand constantly changing digital media. Implications for practice Assessments of suicide risk for young people should routinely include focus on peer relations including the online/digital realm. Maintaining relationships with vulnerable young people facilitates managing fluctuating risks and understanding different group dynamics. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper describes a project undertaken by family centre staff, drawing on the ideas of the Marlborough Family Service in using multi-family groups as part of their parenting assessments. Child protection assessments are complex and have a far reaching effect on the lives of vulnerable children; practitioners can carry the burden of assessing parents' capacities to meet their children's needs without adequate supervision or support. Our project was developed following the implementation of a new policy, the Public Law Outline, requiring parenting assessments to be completed within a 40-week time frame. We were concerned that this would not afford the opportunity to develop a sufficient relationship with families to provide a thorough assessment. The paper describes the incorporation of multi-family days into the parenting assessments and the effect of this work on clients and practitioners. This paper is a practice paper, rather than a formal evaluation, and describes a project in which family centre workers sought to provide a model of assessment based on working as part of a team, managing uncertainty and valuing the opportunity to develop a relationship with clients in order to make an assessment. [ABSTRACT FROM AUTHOR]

This paper draws on focus group and interview data from 45 young men from the north of England to explore the barriers to effective sex and relationships education (SRE). Recent policy debates in relation to establishing statutory SRE in schools provide an opportunity to revisit how it is currently delivered to, and received by, young men. The paper considers the central role played by masculinities and how this role is mediated by social exclusion and poor engagement; it is suggested that addressing masculinities directly should be a priority for future SRE. In conclusion, some tentative approaches to addressing the issues are suggested. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to explore negative peer interactions in foster care. Looked after children and young people have highlighted the impact of negative peer interactions, and especially peer violence and intimidation, on their care experiences. However, to date, no specific fostering research has addressed this important issue. In response to this gap, we undertook focus groups with 32 foster carers in the South West of England. Group discussions were semi-structured based around the issue of negative peer interactions in foster care. The analysis revealed five main associated themes: the impact on the carers' birth children; a lack of placement planning; inadequate referral information; a negative view of social work support; and insufficient external interventions. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Messages Negative peer interactions, particularly violence, were a major concern for foster carers, especially if they negatively impacted on the welfare of carers' birth children., An absence of pre-placement referral information on negative peer interactions was commonly reported and placed all children in the fostering household at risk., Associated social work support and external interventions were often perceived as lacking and inadequate., Fostering procedures, review and decisions need to recognise the impact of peer violence on all members of the fostering household. [ABSTRACT FROM AUTHOR]

Football can bring people together in acts of solidarity and togetherness. This spirit is most evocatively illustrated in the world renowned football anthem 'You'll Never Walk Alone' (YNWA). In this paper, we argue that this spirit can be effectively harnessed in nursing and mental health care. We draw on data from qualitative interviews undertaken as part of evaluating a football and mental health project to explore the nature of supportive social relations therein. We use some of the lyrics from YNWA as a metaphor to frame our thematic analysis. We are especially interested in the interactions between the group facilitators and group members, but also address aspects of peer support within the groups. A contrast is drawn between the flexible interpersonal boundaries and self-disclosure evident in the football initiative, and the reported, more-distant relations with practitioners in mainstream mental health services. The findings suggest scope for utilizing more collective, solidarity-enhancing initiatives and attention to alliances and boundaries to maximize engagement and therapeutic benefits within routine practice. [ABSTRACT FROM AUTHOR]

New peer worker roles are being introduced into mental health services internationally. This paper addresses a lack of research exploring issues of risk in relation to the role. In-depth interviews were carried out with 91 peer workers, service users, staff and managers. A grounded analysis revealed protective practice in minimising risk to peer worker well-being that restricted the sharing of lived experience, and a lack of insight into how peer workers might be involved in formal risk management. Alternatively, analysis revealed potential new understandings of risk management based on the distinctive, experiential knowledge that peer workers brought to the role. [ABSTRACT FROM AUTHOR]

Background: Simulation within nurse education has been widely accepted as an educational approach. However, this is mainly led by the facilitator with the student maintaining a passive role in the learning. Objectives: This paper describes a study that was undertaken to analyse the effectiveness of peer-led simulations in the undergraduate nursing programme. Design: A mixed-method approach was used for this study design. Settings: This study took place in a simulation suite within a university in the Midlands. Participants: Twenty four second-year child branch students were purposively selected to take part. Methods: Students designed and facilitated a simulation based on the care of a critically ill child. Formal assessment of the learning was collected via the use of a structured clinical examination. Students completed an evaluation of their perceived confidence and competence levels. Results: There was 100% pass rate in the assessment of students' clinical competence following the simulation. Thematic analysis of the evaluation highlighted the learning achieved by the students, not only of their clinical skills but also their personal development. Conclusions: The use of peer-led simulation promotes new learning and is a valuable educational approach. [ABSTRACT FROM AUTHOR]

Breastfeeding peer support has been identified as a key intervention to help improve breastfeeding and exclusive breastfeeding rates. The World Health Organization, and, in the UK, the National Institute for Health and Clinical Excellence, recommend the implementation of sustainable peer support programmes. As part of an evaluation into a comprehensive breastfeeding peer support service in north-west England, in-depth interviews were conducted with 47 women who had received a breastfeeding peer support service. In this paper, we have drawn upon the work of Morse and colleagues to interpret the data in relation to behavioural manifestations of hope, together with insights into the strategies used by the peer supporters to augment hopefulness for women's breastfeeding goals. These theoretical and practice-based findings offer insights into how the breastfeeding peer supporters provided realistic assessments across varying situational contexts, formed strategies and plans to help women overcome any obstacles, made women aware of any negative outcomes, mobilised external and personal resources to facilitate goal attainment, provided evaluations and feedback on women's (and infants') progress, and through praise, reassurance and instilling calm, the peer supporters helped women to focus their energy to achieve their breastfeeding goals. Practice-based implications are considered. [ABSTRACT FROM AUTHOR]

banner d., miers m., clarke b. & albarran j. (2011) Women's experiences of undergoing coronary artery bypass graft surgery. Journal of Advanced Nursing 68(4), 919-930. Abstract Aim. This paper is a report of a study of women's experiences of coronary artery bypass graft surgery. Background. Worldwide, coronary heart disease is the leading cause of morbidity and mortality. It has traditionally been viewed as primarily affecting men. However, a growing body of literature exploring gender differences in this area is challenging accepted beliefs, particularly in relation to outcomes. Despite this, awareness of how women interpret and respond to the experiences of cardiac surgery remains limited. Methods. At regional cardiothoracic centres in England and Wales, during 2003 to 2006, data were collected from 30 women preoperatively and at 6 weeks and 6 months postoperatively using semi-structured interviews. A constructivist grounded theory approach was adopted and data were analysed using extensive coding and constant comparison techniques. Results. A substantive theory of the public-private dialogue of normality emerged demonstrating that participants faced lifestyle disruptions as they attempted to privately normalize and integrates limitations, while minimizing a public display of illness. During the preoperative period, participants experienced difficulties recognizing and acting on symptoms and endured physical and emotional distress while waiting for surgery. Following surgery, women experienced functional limitations which forced them to relinquish normal activities and roles. As recovery progressed, women came to accept their changed health status and renegotiated state of normality. Conclusion. The findings increase understanding about the adjustments which women undergoing cardiac surgery make as part of living with a long-term condition and support the need to develop innovative gender-sensitive health education and services. [ABSTRACT FROM AUTHOR]

Abstract: Background: Previous research identifies positive and negative effects of being a sibling in a family which includes a disabled child. Short break services (also known as respite) provide families with a break from caring and offer disabled children the chance to participate in various activities. This paper investigates the effects that these short breaks have on siblings. Methods: The research consists of a qualitative analysis of data collected as part of a survey of families using short break services. Data from 239 parent–carers (mostly biological parents) and 84 siblings are included in the analysis. Data are written responses to open questions about use of services and the effects they have. Results: The effects of short breaks on siblings are described as being mostly positive. Short breaks have the potential to ameliorate some of the negative impacts of being a sibling in a family with a disabled child whilst also promoting the positive impacts of having a disabled brother or sister. However, some siblings also report some adverse effects of short breaks. Conclusion: Short breaks have a significant role to play in promoting the wellbeing of siblings; however, their role currently seems to be largely unrecognised and consequently undervalued. [Copyright &y& Elsevier]

Purpose - This qualitative study considers the roles of service user consultants (SUCs) in six of the original 11 Department of Health (DH) Community Personality Disorder (PD) pilot services; how these roles differ from the active participation traditionally encouraged in therapeutic communities (TCs) around responsibility for self and others; how a service user (SU) becomes a SUC; what responsibilities they hold; the views of both staff members and SUCs on the role and the benefits and difficulties it creates; and how the role could be developed in a service-specific and general way. It is of particular interest to consider the amount of time for which the SUC role is seen to be beneficial, and what support a SUC would need to leave the role.Design/methodology/approach - Two qualitative interview schedules were developed to investigate issues highlighted in previous literature, one designed to be answered by staff members, another developed with a SUC from Cumbria for SUCs and administered by telephone. The research questions were designed to look at four main themes: How SUs become SUCs; SUC responsibilities within the service; views on the benefits and difficulties of the SUC role; and developing the role and moving forward. The context of each service was explored to reflect the uniqueness of each SUC role and service philosophy.Findings - The SUC role continues to develop and is seen as having value, particularly as a "bridge" between SUs and staff members, and as a transitional stage in which the work of therapy can be consolidated. Problems remain in respect to: optimal levels of disclosure between other staff members and SUCs; the level and type of support needed to carry out the work and to remain well; acceptance of the role by professionals in other teams; and the extent to which SUCs are felt able to engage, or not, in direct clinical work.Research limitations/implications - This is a qualitative study in which only just over half of the pilot services agreed to take part and in which fewer SUCs were put forward to take part as compared to other staff members. There are therefore potential problems in generalising these findings to other services which employ SUCs.Practical implications - Within personality disorder services there is a perceived optimal level of disclosure and information sharing between other staff members and SUCs, and between SUCs and SUs, but this remains undefined. SUC responsibilities do not always include direct clinical work because of concerns to maintain their well being. There is evidence from a number of services that SUCs can safely and creatively engage in direct clinical work given suitable support and supervision. Staff members from other teams without experience of employing SUCs may not always understand the SUC role, may denigrate the experience of SUCs, or feel threatened by their incursion into training and clinical work. SUCs seem enthusiastic to work in other areas within their wider service to promote understanding of mental health and personality difficulties. In-service supervision/mentoring can help to monitor and alleviate SUC distress.Originality/value - The paper extends knowledge about the SUC role, as it has developed and diversified during the development of the DH Community PD Pilot Sites. Novel semi-structured interview schedules have been developed. [ABSTRACT FROM AUTHOR]

Factors that contribute to sexual decision-making among young people are varied, and several determinants have been identified as contributing to the process. However, the influential role of music preference has been sidelined both in the literature and by sex and relationships educators. The research outlined in this paper explores the normative impact of music preference, and highlights the importance of influences drawn from teen culture. A preliminary study had indicated that representations of sex and relationships within lyrics were found to be genre specific. The main study comprised six single-sex focus group discussions on music and sex with young people aged between 14 and 19 years. Thematic analysis revealed that preferred genre and artists were found to be associated with all aspects of participants' lives and culture generally, with music functioning specifically as an educational tool for adult relationships. The findings from these studies indicate that the norms portrayed by young people's preferred genres reinforce (oftentimes inappropriate) beliefs about sex and adult relationships. [ABSTRACT FROM AUTHOR]