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Background and Aims: Long‐acting injectable buprenorphine (LAIB) is a new treatment for opioid use disorder that is generating positive outcomes. Negative effects are typically mild and transient, but can occasionally be serious, resulting in treatment discontinuation/non‐adherence. This paper aims to analyse patients' accounts of how they felt during the first 72 h after initiating LAIB. Methods: Semi‐structured interviews were conducted (June 2021–March 2022) with 26 people (18 males and 8 females) who had started LAIB within the previous 72 h. Participants were recruited from treatment services in England and Wales and were interviewed by telephone using a topic guide. Interviews were audio‐recorded, transcribed and coded. The concepts of embodiment and embodied cognition framed the analyses. Data on participants' substance use, initiation onto LAIB and feelings were tabulated. Next, participants' accounts of how they felt were analysed following the stages of Iterative Categorization. Results: Participants reported complex combinations of changing negative and positive feelings. Bodily experiences included withdrawal symptoms, poor sleep, injection‐site pain/soreness, lethargy and heightened senses inducing nausea ('distressed bodies'), but also enhanced somatic wellbeing, improved sleep, better skin, increased appetite, reduced constipation and heightened senses inducing pleasure ('returning body functions'). Cognitive responses included anxiety, uncertainties and low mood/depression ('the mind in crisis') and improved mood, greater positivity and reduced craving ('feeling psychologically better'). Whereas most negative effects reported are widely recognized, the early benefits of treatment described are less well‐documented and may be an overlooked distinctive feature of LAIB. Conclusions: During the first 72 h after initiating long‐acting injectable buprenorphine, new patients report experiencing a range of interconnected positive and negative short‐term effects. Providing new patients with information about the range and nature of these effects can prepare them for what to expect and help them manage feelings and reduce anxiety. In turn, this may increase medication adherence. [ABSTRACT FROM AUTHOR]

In this paper, we report findings from a qualitative, multidisciplinary analysis of 20 Child Practice Reviews (CPRs) (previously Serious Case Review) in Wales. The reviews were analysed from three different disciplinary perspectives: law, criminology and practice (social work). The following cross‐cutting themes were identified from our coding of the reviews: (i) hierarchy of knowledge, where certain sources of knowledge were privileged over others; (ii) information sharing/recording, where deficiencies of sharing or recording of information were evident; (iii) partial assessment, where certain assessments were not always holistic; and lastly, (iv) voice of the child, where the experience or perspective of the child was not always considered. In addition, our analysis revealed a range of challenges to the CPR process as implemented. This paper is the first to explore themes emerging from (Welsh) CPRs and is also the first to do so from a multidisciplinary perspective. We conclude by highlighting the recommendations for practice, such as the need for greater learning pan‐Wales, regular publication of the major themes emerging from CPRs and the need for deposit of CPRs in a central repository to facilitate learning from reviews. 'Report[s] findings from a qualitative, multidisciplinary analysis of 20 Child Practice Reviews... in Wales' Key Practitioner Messages: There is an urgent need for multidisciplinary training on contemporary data protection requirements as per the General Data Protection Regulation for all safeguarding boards.Creative methods are required to disseminate the messages from Child Practice Reviews more widely.Child Practice Reviews should be deposited and indexed in a central repository to facilitate learning across Wales.Guidance and training for Child Practice Reviews should be revisited, so that the child is repositioned at the centre of the process and the voice of the child is heard. [ABSTRACT FROM AUTHOR]

Abstract: This paper discusses some key findings taken from a qualitative study conducted with gay and lesbian adopters and foster carers in England and Wales. The study examined the experiences of 24 self‐identified lesbians and gay men, who had been involved in adoption or fostering processes since the introduction of the Adoption and Children Act, 2002. This article will explore why participants chose to adopt or foster and their approach to relationships generated through these routes. Findings indicate that gay and lesbian applicants troubled dominant conceptualisations of family and kinship and revealed both heteronormative and nuclear constructions of parenting within adoption and fostering social work. In contrast, participants often demonstrated a reflexive and creative approach to caring for looked after children. This paper will therefore consider how professionals can recognise nuanced or complex relationships, situated beyond traditional frameworks, through drawing upon wider concepts within sociological literature. [ABSTRACT FROM AUTHOR]

Background: Trans‐identifying individuals experience unique barriers and challenges in negotiating health‐care systems due to the cisnormative attitudes and practices which obstruct the receipt of trans‐inclusive care. To date, there has been little exploration of older trans consumers' experiences of contemporary health‐care services when seeking to transition medically in later life. Objectives: Qualitative findings are presented from a study of trans ageing and trans‐related health and social care needs in Wales, UK (2016‐18). The objectives are to (1) examine supportive and obstructive points of interaction with health‐care professionals, and (2) identify key learning messages for improving trans‐related health care from the perspectives of trans‐identifying adults in later life. Design: Trans‐identifying participants self‐selected to take part in two interviews—a life‐history interview and a semi‐structured interview. Interview data were analysed thematically using the framework method approach. Setting and participants: This paper focuses on the accounts of 19 participants (50‐74 years of age) who identified as trans and were seeking to transition medically in mid‐ to later life. Results: Findings indicate how older trans patients are positioned as reluctant educators for GPs in primary care settings and illustrate the transphobic practices and cisnormative assumptions encountered across health‐care interactions and systems that impede their journey of transitioning in later life. Discussion and conclusions: Messages from this study speak to the importance of improving professionals' knowledge of gender identity diversity across the life course and making changes at a systemic level in redressing cisnormative assumptions and systems that reinforce inequities on the basis of gender identity. [ABSTRACT FROM AUTHOR]

Professional identities are important in defining workers' roles, and are concerned with attributes relating to those roles and how they are performed. Evidence shows mental health nurses undertake many different roles as part of their work. Yet, the roles of mental health nurses are insufficiently understood by healthcare staff, service users, and nurses themselves. Mental health nursing work has been deemed invisible and lacking in role clarity. Poor understandings about professional identity of mental health nurses result in difficulties recruiting to the profession, nurses lacking confidence articulating the value of their work, with misunderstandings apparent with service users about the specific role of mental health nursing in their care. The primary focus of this study, conducted in Wales, United Kingdom, was to examine how talk about mental health nursing was handled by participants from multiple perspectives. Data consisted of 17 individual interview transcripts with mental health nurses and 13 interview transcripts from mental health service users, and three focus groups with nursing students. Participants' talk was analysed using thematic analysis. This paper reports how participants described mental health nursing work to have significant role overlap with other multidisciplinary team members. Participants highlighted that mental health nurses often have an 'in the middle' label because the complexity of their work can be hard to describe. The implications are pertinent for nurses because if they are considered to be in a liminal position, they risk being perceived as neither one role nor another, resulting in nurses struggling with professional identities and role confidence. [ABSTRACT FROM AUTHOR]

Rationale: Prudent Healthcare is a strategy adopted by the Welsh Government in response to the challenge of improving health care during times of austerity and when needs and demand are rising. Four principles underlie Prudent Healthcare: to achieve health and wellbeing through co production; care for those with the greatest health needs first; do only what is needed; and reduce inappropriate variation. For Prudent Healthcare to be implemented in Wales, it is necessary for health professionals to adopt these principles in practice. Objective: This paper reports a qualitative evaluation of clinicians' awareness, experiences, and views about Prudent Healthcare, identifying barriers and enablers to implementation from the clinician's perspective. Methods: Semi‐structured interviews (n = 28) and five focus groups (with 23 participants) were undertaken with a diverse range of health professionals working in primary and secondary care. Analysis was underpinned by the COM‐B model which provides a framework to understand behaviour change in context using three domains, Capability, Opportunity, and Motivation. Results: Clinicians reported the importance and challenges of accessing and sharing information and evidence to inform practice (Capability). Reduced staffing levels and service availability were highlighted as possible barriers to Prudent Healthcare implementation while multidisciplinary working and reorganization of staff roles and services were considered enablers (Opportunity). Finally, although the principles of Prudent Healthcare were broadly welcomed (Motivation), a lack of awareness of the initiative and the management of patient expectations presented barriers. Conclusion: While there was a positive response and widespread support for the principles of Prudent Healthcare by clinicians, increasing awareness of the initiative and improvement to systems to enable information sharing and the monitoring of patient outcomes could improve the consistency of implementation. [ABSTRACT FROM AUTHOR]