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This paper reports on a study of the views and experiences of 21 sperm donors and five egg donors registered with UK DonorLink (UKDL), a voluntary DNA-based contact register established to facilitate contact between adults who wish to identify and locate others to whom they are genetically related following donor conception. Specifically, the paper examines donors’ reasons for searching for, or making information about themselves available to donor-conceived offspring. Their expectations of registration with UKDL, experiences of being registered and finally, the experiences of those who had contacted donor-conceived offspring and other genetic relatives are investigated. While most respondents reported largely positive experiences of registration, the study found significant issues relating to concerns about donation, DNA testing, possible linking with offspring and expectations of any relationship that might be established with offspring that have implications for support, mediation and counselling. Research that puts the experiences, perceptions and interests of gamete donors as the central focus of study is a relatively recent phenomenon. This study contributes to this debate and highlights directions for future research in this area. [ABSTRACT FROM PUBLISHER]

Since the 1980s, the primary public health response to injecting drug use in the UK has been one of harm reduction. That is, reducing the harms associated with drug use without necessarily reducing consumption itself. Rooted in a post-Enlightenment idea of rationalism, interventions are premised on the rational individual who, given the right means, will choose to avoid harm. This lies in stark contrast to dominant addiction models that pervade popular images of the ‘out of control’ drug user, or worse, ‘junkie’. Whilst harm reduction has undoubtedly had vast successes, including challenging the otherwise pathologising and often stigmatising model of addiction, I argue that it has not gone far enough in addressing aspects of drug use that go beyond ‘rational’ and ‘human’ control. Drawing on my doctoral research with people who inject drugs, conducted in London, UK, this paper highlights the role of the injecting ‘event’, which far from being directed or controlled by a pre-defined individual or ‘body’ was composed by a fragile assemblage of bodies, human and nonhuman. Furthermore, in line with the ‘event’s’ heterogeneous and precarious make-up, multiple ways of ‘becoming’ through these events were possible. I look here at these ‘becomings’ as both stabilising and destabilising ways of being in the world, and argue that we need to pay closer attention to these events and what people are actually in the process of becoming in order to enact more accountable and ‘response-able’ harm reduction. [ABSTRACT FROM PUBLISHER]

The world in 2010 is a very different place to 1987 when Bhugra's paper on homophobia was published. Huge shifts have occurred in society's attitudes to gender, sex, sexuality and identity - notably by the internet, changes in HIV treatment, media representation of homosexuality and feminism and the role of women in society. This paper updates the literature review on homophobia revisiting society's assumptions about homosexuals. Changes are discussed in the context of definitions of homophobia, socio-cultural and politico-legal perspectives and homophobia and medicine. New current assumptions are drawn up and offered as a way of understanding both development and limitations - whilst there has been a reduction in the fear associated with gay men and women, discrimination remains. Newer issues such as internalised homophobia, globalisation and mainstream representations of homosexuality add complexity to this ongoing concern. [ABSTRACT FROM AUTHOR]

Employment for people with learning difficulties is considered key to their social inclusion. This contradicts the perceived un-employability of people with learning difficulties that has been part of their social identities throughout their history hitherto. The national rate of employment for people with learning difficulties remains extremely low and has barely changed in the 20 years between 1990 and 2010. This paper investigates links between learning disabilities and employment, drawing on interview-based research. It analyses the quality of experience of the minority in employment to consider whether employment can serve the inclusive purpose expected of it. [ABSTRACT FROM AUTHOR]

Experiences of autism-spectrum disorder are now increasingly studied by social scientists. Human-animal relations have also become a major focus of social inquiry in recent years. Examining horse-assisted therapy for autistic spectrum disorders, this is the first paper that brings these fields together. Drawing on participant observation and interviews at a UK horse therapy Centre, this article examines how staff and the parents of riders account for the successes and limitations of equine therapy. To the respondents, horses ‘open up’ autistic children and make possible interactions that seemed impossible before. Horses were regarded as facilitating the emergence of apparently social behaviours, which included eye contact, pointing, and speech. Three key explanations emerged for therapeutic success: the sensorial, embodied experience of riding the horse; the specific movements and rhythms of the horse; and, the ‘personality’ of the horse. Equine therapy can be regarded as enabling a form of multispecies intersubjectivity, with the resonance between rider and horse seeming to make possible a new attunement between humans. Practices of equine therapy, and perceptions of its efficacy, serve in turn to attune social scientists to a version of empathy constituted through lively and sensorial interactions, as opposed to one that is restricted to particular kinds of humans. [ABSTRACT FROM AUTHOR]

A questionnaire survey of drivers (n= 903) was conducted covering musculoskeletal symptoms, the vehicle seat, access to specific vehicle features, ingress/egress, driving performance and driving behaviours. Significantly, more discomfort was reported by older drivers (aged 65+) in the hips/thighs/buttocks and knees. Older drivers reported more difficulty parallel parking (p≤ 0.01), driving on a foggy day (p≤ 0.01), and turning their head and body to reverse (p≤ 0.001). They also reported that their reactions were slower than they used to be (p≤ 0.01). Dissatisfaction was found by all drivers with adjusting the headrest (height and distance), seat belt height and opening/closing the boot. There is a growing population of older people globally, and the number of older drivers is showing a parallel increase. Clearly, efforts are needed to ensure car design of the future is more inclusive of older drivers. Practitioner Summary:This paper describes a questionnaire survey of drivers on their driving experience – the vehicle seat, access to specific vehicle features, ingress/egress, driving performance and driving behaviours. Comparisons are made by age and gender. Issues with driving and vehicle design particularly for older drivers in the UK are identified. [ABSTRACT FROM AUTHOR]

In this paper, we examine why risk-based policy instruments have failed to improve the proportionality, effectiveness, and legitimacy of healthcare quality regulation in the National Health Service (NHS) in England. Rather than trying to prevent all possible harms, risk-based approaches promise to rationalise and manage the inevitable limits of what regulation can hope to achieve by focusing regulatory standard-setting and enforcement activity on the highest priority risks, as determined through formal assessments of their probability and consequences. As such, risk-based approaches have been enthusiastically adopted by healthcare quality regulators over the last decade. However, by drawing on historical policy analysis and in-depth interviews with 15 high-level UK informants in 2013–2015, we identify a series of practical problems in using risk-based policy instruments for defining, assessing, and ensuring compliance with healthcare quality standards. Based on our analysis, we go on to consider why, despite a succession of failures, healthcare regulators remain committed to developing and using risk-based approaches. We conclude by identifying several preconditions for successful risk-based regulation: goals must be clear and trade-offs between them amenable to agreement; regulators must be able to reliably assess the probability and consequences of adverse outcomes; regulators must have a range of enforcement tools that can be deployed in proportion to risk; and there must be political tolerance for adverse outcomes. [ABSTRACT FROM PUBLISHER]

A recent research study found that being more directly involved in medical abortion places greater demands on the nurses. The demands required by nurses working in abortion care may be increased by the stigma attached to such an antisocial action. This paper presents an application of stigma theory, as espoused by Goffman, based on a qualitative research study on abortion. It is argued that women attending for abortion are stigmatised and nurses, although 'wise', have an affiliate stigma through their close association with the procedure. It is proposed that the situation can be ameliorated by addressing stigma at policy, local and personal levels. Examples from other areas of practice are outlined for possible application to practice. [ABSTRACT FROM AUTHOR]

This is the first of two articles based on small-scale empirical research involving several hundred Muslim university students in Britain that was conducted between December 2003 and April 2004. In this paper first I will explain how the data was collected: a written survey concentrating on the West/Muslim world dialectic, followed by in-depth interviews with some of the survey respondents. Second, I delineate three strategies undertaken by British Muslims to express their religio-political identities: turning away from Islam by assimilating entirely into British society; subscribing to a culturally transcendental form of Islam by arguing that British cultural outputs are alien and threatening to Islam; and accepting that Islam is practiced differently in different contexts, and that British Muslims must understand their religion in light of their context. Finally, I discuss competing claims on the students' political loyalty: from the Muslim ummah and the British state. Part II of the research to be published in the next issue of the Journal of Muslim Minority Affairs , Volume 25, Number 3, will present the major survey findings including students' views of the events of September 11, 2001 and the influence of these events on the lives of Muslims in Britain as well as an analysis of their views of the West/Muslim world dialectic. [ABSTRACT FROM AUTHOR]

Evidence suggests that occupational prototypes have an impact on career decisions, through the mechanism of self-to-prototype matching, yet the literature provides scant information about the nature of these occupational prototypes. This study examines the prototypes of four common occupational choices of psychology students in the UK (social worker, primary school teacher, occupational psychologist and clinical psychologist). Data were gathered through four focus groups (N = 24) and were analysed with a quantitative content analysis to produce descriptions of the four occupational prototypes. It was found that the occupational prototypes were detailed and multi-dimensional, incorporating a wide range of features not directly related to the job itself including information about clothing, leisure activities and home décor. Implications for career development theory and career practice are discussed. [ABSTRACT FROM AUTHOR]

Objective: To understand the perspectives of healthcare professionals and interpreters in relation to working with and caring for non-English speaking families accessing National Health Service paediatric tertiary health care services. Design: Focus group and interview methods were used to elicit the views of healthcare professionals and interpreters at one tertiary paediatric hospital in the United Kingdom. Data were subjected to framework analysis. Results: Participants identified a number of factors affecting communication and their interaction with non-English speaking families in this setting, including time, role uncertainty, and interlinked dimensions of culture and gender. They also described how the nature of this communication could impact on both the delivery of care and the patient and family experience. These findings highlight gaps in services, training, and support for families, staff and interpreters. These need to be recognised and addressed by those in practice to improve care delivery and help tackle health inequalities. Conclusion: Our data show how significant the impact of language barriers can be, and the need to consider not only how communication can be improved, but also how this is situated in the specific context of tertiary paediatric care as well as a wider social context of inequity. [ABSTRACT FROM AUTHOR]

The youth-to-senior transition in professional soccer within the UK is challenging, yet previous work has focused on perspectives of a limited range of within-sport stakeholders. We conducted semistructured interviews with coaches (n =12), sport science support staff (n =10), and parents of players (n =6), exploring their perceptions of transition demands, resources, and barriers. Emergent themes highlighted role-specific support provision and that athletes progress through a period of adaptation, requiring a diverse set of characteristics and resources (e.g., knowledge of the transition process, social support), developed through a number of preceding transitions. [ABSTRACT FROM AUTHOR]

Many long-term care systems are seeking to address problems of growing demand, increasing expense, and higher user expectations. For many of them fostering care at home and private care arrangements are attractive options. The long-term care sector in England is typical of these systems. Over the last 2 decades, government policy in England has placed stronger emphasis on people’s choice and control when receiving care services. People with care and support needs may be eligible for public funds to employ care workers or to use them in other ways promote their well-being. These financial transactions are a major part of the policy of personalisation in adult social care, as confirmed by the Care Act 2014. Drawing on findings from life story interviews with 31 migrant care workers who had worked for disabled or older people in England, conducted 2011–2013, we note the potential for expanding the sociologically inspired concept ‘personalised risk’. This necessitates an appreciation of risks potentially faced by the multiple parties in the care relationship and a differentiated set of structural risks. Applying a multilevel analysis we highlight the potential risks of ‘informality’ of employment conditions experienced by directly employed care workers, the ‘emotional’ content of care worker-employer relationships, and ‘intimacy’ of employer/employee roles. In this article, we offer an empirical based contribution to the wider discussion of risks and risk theory derived from policy changes being adopted by many developed countries that increasingly emphasise individual responsibility for personal welfare within an uncertain and mobile social world. [ABSTRACT FROM PUBLISHER]

Objective: The objective of this survey was to explore the perceptions of implant users/carers and professionals across the UK about current and future cochlear implant service delivery and the challenges.Methods: Data were collected via an online questionnaire consisting of totally 22 questions. The questionnaire contained both open- and close-ended questions.Results: Totally, seven hundred and forty-eight responses were received. In spite of the wide range of respondents, there was a broad consensus of opinion across groups. The majority of participants were satisfied with the service they currently receive, but wanted some changes. They reported their current experience of implant services to be mainly driven by decisions made by the implant team. For the future, they preferred the service to be mainly driven by decisions made jointly by the team and the user and/or parent/carer. The majority of participants wanted the cochlear implant services to be integrated into local audiology and other services such as education. Restrictions on number of candidates funded and political decisions and issues were seen as major challenges. Qualitative analysis of the open-ended responses supported the questionnaire responses.Conclusions: This research highlighted the benefits and limitations of the current cochlear implant service delivery as well as the potential implications for the long term. While respondents were generally happy with the current cochlear implant service provision, they expressed some concerns about the long-term sustainability and management, wanting integration into the local services, and more involvement of parents and users in decisions. [ABSTRACT FROM AUTHOR]

The research aimed to investigate the national Improving Access to Psychological Therapies (IAPT) programme, from the perspective of ‘non-IAPT’ counsellors and psychotherapists working within IAPT services. Semi-structured interviews were carried out with therapists who were currently working within IAPT services, but had no formal ‘IAPT-compliant’ or ‘IAPT-accredited’ training. Foucauldian discourse analysis was used to analyse interview transcriptions and the study examined the various discourses used by participants to speak about IAPT. Findings indicated that participants drew upon dominant discourses in attempts to fit in or belong, yet paradoxically, the way in which the discourses were used seemed to create subject positions that were outside to, or excluded from, the IAPT services they worked at. IAPT and non-IAPT discourses emerged simultaneously – a possible indication of the discursive junction where different ideologies were in conflict with one another. Implications of the power relations that may be operating within this setting are discussed and suggestions made for further research. [ABSTRACT FROM PUBLISHER]

This article explores how Bourdieu's notion of habitus might be employed to shed light on the self-efficacy of primary teachers as they take on an additional specialism when modern foreign languages becomes statutory in primary schools in the new English National Curriculum in 2014. The article argues that Bandura's four principles of self-efficacy—mastery experiences, vicarious experiences, verbal persuasion and physiological and social affect—may be influenced by the operation of habitus in their various school contexts. Teachers with a heightened sense of agency appear more successful in harnessing self-efficacy to achieve either greater competence in a new area if they are generalists or to maintain their proficiency if they are specialists. The study was conducted in a small number of primary schools in the West Midlands using semi-structured interviews to illuminate the teachers' lived experiences. This article contributes to the debate on the necessity of having specialists teach foreign languages in primary schools by suggesting that the dualism of the specialist and non-specialist may be arbitrary and that developing teacher self-efficacy may be beneficial in preparing all primary teachers to meet the demands of the new curriculum. [ABSTRACT FROM AUTHOR]

The purpose of this case study was to understand the personal experience of a female athlete (aged 24 years) undergoing a significant change-event from a team sport (rugby) to an individual sport (weightlifting) at an elite level. Two in-depth informal interviews were conducted. A number of change-events were experienced in several contexts, including a change of sports, a change in academic status, and a reoccurring injury. The findings provided empirical support for the use of the scheme of change for sport psychology practice (Samuel & Tenenbaum, 2011a) for understanding the change process and the associated coping strategies athletes may adopt. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate health and social care professionals' perspectives on developing services for children with life limiting conditions at the end-of-life using issues identified by bereaved parents as priorities. The study adopted qualitative methodology using nominal group technique in focus groups (n = 5) to collect data from 35 health and social care professionals. Six issues were identified across professional groupings as particularly challenging within the context of caring for children at the end-of-life: truth telling; symptom management; communication with, and relationships between families and professionals; emotional impact, the withdrawal of feeding or treatment and sibling support. Strong resonance was noted between professionals and parents in the emphasis placed on issues related to talking about death (to child and siblings) and decision-making about the withdrawal of treatment. Conversely, late referral to hospice care and lack of services in the community dominated accounts of parents whose children had non malignant conditions, but were not prioritized by professionals. Although the latter focused on the need for and challenges associated with optimizing symptom management, most parents viewed symptom control as highly effective. Caring for a dying child is a multidimensional experience for both parents and professionals. Convergence of thinking carries three main implications for service development. Firstly, the need for 'joined up' palliative care services, particularly concerning timely referral to the range of support services. Secondly, more structured bereavement services. Third, within an ethos of family centered care, needs of siblings should be addressed effectively. [ABSTRACT FROM AUTHOR]

Background: The Revised Illness Perceptions Questionnaire (IPQ-R) is commonly used to measure illness perceptions. We tested whether the structure of the IPQ-R was appropriate for use with primary care musculoskeletal pain patients. Methods: Confirmatory (C) and exploratory (E) factor analyses (FA) were used to test whether the structure of the IPQ-R was supported for patients with knee pain (n = 393), hand pain (n = 2113) and back pain (n = 1591). CFA was used to test whether the timeline acute/chronic, timeline cyclical, consequences, personal control, treatment control, illness coherence and emotional representation dimensions of the IPQ-R were distinct; EFA was used to explore potential structure for patients’ views on the cause of their condition. Results: Goodness-of-fit indices for the CFA were below our criteria for good model fit. Removal of six items from the model improved model fit, but our criteria for good model fit was still not achieved. An interpretable factor solution could not be determined for the causal items on the questionnaire. Conclusions: Our data show limited evidence that the seven dimensions of the IPQ-R are distinct. A clear structure for the causal items was not determined. Further work is needed to develop the IPQ-R for use with primary care musculoskeletal pain patients. [ABSTRACT FROM PUBLISHER]

Aim: While little is known about how occupational therapists perceive the use of occupation-focused theory in their practice, evidence indicates that it has been called for in the profession. To date, the Model of Human Occupation (MOHO) is the most widely used model internationally. The aim of this study is to document practitioners' perceptions of how using MOHO impacted on their practice. Methods: A descriptive study using an Internet-based survey study design was conducted with 429 therapists in six National Health Service (NHS) trusts in the UK. Results: Of the 429 therapists, 262 completed the survey, for a response rate of 61.07%. Most were female (85.5%) with a varying range of years of experience. Most worked in community and/or inpatient mental health settings; 92.1% responded that they use MOHO as their primary model. Therapists reported using MOHO moderately to greatly improve their assessment, goal setting, and conduct of relevant interventions as well as professional identity as an OT in their mental health occupational therapy practice. Conclusion/Implications: This study examined therapists' perceived impact of using an occupation-focused model in mental health practice. The findings of this study provided promising results. Findings suggest that the utilization of MOHO increases service for clients and professional stature and identity for therapists. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this article was to describe socio-emotional themes in the stories of 16 Centenarians living in the United Kingdom. Methodology: Sixteen Centenarians were recruited and interviewed face-to-face by members of the research team. Participants were invited to tell the story of their lives in line with the principles of participatory action research (Koch and Kralik, 2006). The resultant story was returned to the Centenarian and their significant others for their validation and ownership. Stories were further analysed alongside verbatim interview transcripts. The first author wrote her psycho-social interpretation of the socio-emotional content in each person s life. These psycho-social interpretations were combined to provide commonalities in experience. Findings: These six common experiences or themes were: Engagement in the world, Happiness and describing a good life, Stoicism, Sources of support, Sources of frustration and Talking about death. All participants had strong interests. They reported their lives as having been ‘good’ or ‘happy’. They were resilient in the face of stress. Their frustrations pertained to visual or mobility impairments. While they were accepting the death of spouses, siblings and significant others, they were silent about the proximity of their own. In this article, we consider these themes in the light of previous empirical findings and theories. Conclusion: Centenarians indicated that life had been worth living and that it felt good to be 100 years of age. We explore the limitations of this study and discuss implications of the findings for those involved with the oldest old. [ABSTRACT FROM PUBLISHER]

Objective: This study investigated the impact of socio-cognitive factors (attitudes and norms), time perspective (TP), relationship status (RS), and past sexual behaviour on intended non-condom use in 104 Greek and 93 British university undergraduates. Method: Data were obtained by a self-report questionnaire. Data analysis included correlation, regression and ANOVA procedures. Results: Attitudes were the strongest predictors of non-condom use intentions for participants who had casual relationships or were single (i.e. unstable relationship context), and past behaviour was the strongest predictor of non-condom use intentions for those who perceived themselves to be in an exclusive relationship (i.e. stable relationship context). Past behaviour was the strongest predictorof intended non-condom use in relation to all the variables of this study. TP managed to predict non-condom use intentions and moderate the attitudes-intentions relationship. In terms of temporal influences, participants high in fatalistic TP were strongly inclined not to use condoms, irrespective of their attitudes, but TP did not differ as a function of culture. Conclusions: Our data revealed the value of considering the combined effects of relationship status, habit and attitudes, when investigating undergraduate non-condom use intentions and designing interventions. The construct of TP was introduced as a meaningful addition to sexual risk research. [ABSTRACT FROM PUBLISHER]

Background. From clinical work and research it is clear that people suffering from borderline personality disorder (BPD) often complain of psychotic symptoms including hallucinations, yet little is known about how service users experience these symptoms. Aims. The aim of this study was to examine the experience of psychotic symptoms in people with BPD and to establish how mental health professionals responded to reports of psychotic symptoms. Method. Seven semi-structured interviews were carried out with service users with BPD who had been known to present with psychotic symptoms. In parallel, medical case notes of these service users were analysed. Results were subjected to qualitative analysis using techniques of grounded theory. Results. Psychotic symptoms were often long standing and interfered with physical and emotional functioning. There were no clear distinctions from psychotic symptoms described by patients suffering from schizophrenia. Treating doctors had no common language to describe these symptoms. Furthermore, the language that was used had the implication that the symptoms were not real or true and could therefore be perceived as pejorative. Conclusions. It is suggested that the diagnostic category of BPD requires revision to include psychotic symptoms. Terminology such as pseudo- and quasi-psychotic symptoms are confusing and use of these terms should be revised. [ABSTRACT FROM AUTHOR]

The increase in exposure to sexually explicit material has been cited as a significant factor influencing adolescent sexuality and health. Concern about the negative impact of this material is increasingly prominent within policy, professional groups, and the media. Little research, however, has been conducted within this area. This article presents findings from my research, which is located at the intersection of public health, sociology, media and cultural studies. It explores young people's perspectives of sexuality, sexual identity and health within the context of sexualized culture and examines how young people discuss these issues, providing a critical account of young people's engagement with, and experiences of, sexualized culture as 'agents' in their own right. My findings are set against historical debates about the nature and impact of sexualized culture and the development of sexual health policy in the United Kingdom. [ABSTRACT FROM AUTHOR]

Correlates of disordered eating attitudes were examined with a mixed-sex sample of 347 young talented dancers aged 10-18 years from all UK Centres for Advanced Training. Equal proportions of females (7.3%) and males (7.6%) were symptomatic for disordered eating but correlates differed: for females, self-evaluative perfectionism, waking up > twice/night and hours of non-dance physical activity were predictive while for males, only the combination of self-evaluative and conscientious perfectionism was significant. Differences between menstrual status groups were evident, with young dancers (pre-menarcheal/within first year of menarche) reporting the least disordered eating attitudes and those with dysfunctional menses reporting the most. [ABSTRACT FROM AUTHOR]

Of the 293,600 cancers diagnosed annually in the UK, 11% occur in the 15- to 49-year age group. Fertility preservation options exist for those faced with the loss of fertility as a consequence of radiotherapy or chemotherapy. The aim of this study was to explore experiences, attitudes and perceptions of fertility advice and treatment among cancer survivors, and the subsequent impact upon their lives. Eighteen people aged 19–42 years with a diagnosis of cancer made more than 5 years earlier and, registered with general practices in North East England, were interviewed using a grounded approach. Survival was the universal focus of patients at the point of diagnosis and they commonly failed to appreciate the effect of treatment upon future fertility. A positive experience was linked to the quality of information about fertility preservation or action offered, but this needed to be tailored to the patients' age, stage in their life course, relationships and fears. Possible loss of future fertility only becomes important beyond survival but patients wanted their potential future fertility addressed sensitively at the time of diagnosis and backed up by access to written or web-based patient information, or a fertility specialist. [ABSTRACT FROM AUTHOR]

Schwartz Centre Rounds® aim to explore the human and emotional impact of everyday work by giving healthcare staff the opportunity to come together in a safe but open environment. We evaluated the experience of introducing Schwartz Centre Rounds in a UK hospice over 1-year using a mixed method approach. These rounds were reported as providing staff with a greater appreciation of the interprofessional approach. Individuals were more actively acknowledged by other colleagues as a result of contributions at rounds with an appreciation of a wider team, spanning the whole organisation. This appeared to relieve feelings of isolation and enhance a sense of shared purpose. Some staff chose not to attend but valued their contribution to the organisation without witnessing the emotional impact of hospice work. Our findings indicate that Schwartz Rounds offer staff the environment to explore the human element of their work and appear to improve interprofessional working. [ABSTRACT FROM AUTHOR]