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A growing interdisciplinary literature examines the role of hair textures and styles in Black and mixed‐race women's identity performances. Through an analysis of travel narratives, this paper extends and complements research on the context‐dependency of racialized identity performances. This paper presents an analysis of 24 qualitative interviews with Black and mixed‐race women in England and Germany. The question it seeks to answer is: 'How do changes in context alter Black and mixed‐race women's hairstyling practices as a performance of identity?' Navigating a novel context could lead the women to (1) conform to local standards of beauty and femininity, (2) resist external expectations, (3) try out novel performances and (4) negotiate the complex performance of belonging. All in all, this paper shows that Black and mixed‐race women dialogically re/negotiated and performatively re/created how they identify and how they are identified by others as they moved from one context to another. [ABSTRACT FROM AUTHOR]

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]

The present paper explores psychological processes that underpin the success of community change in the context of urban regeneration schemes. We adopt a social identity approach to develop an understanding of the ways in which social identity dynamics may impact upon peoples' experiences of regeneration, and what influence these identity processes have on the creation of new communities. Qualitative interviews, using thematic analysis as an analytic technique, were conducted with community members (n = 14) in a recently (2001–2011) regenerated area in the South‐West of England. Three overarching themes were identified: Patterns of identification, willingness to engage, and the notion of regeneration as an event. The research overall highlights the central role of group‐based identity in understanding the processes of regeneration and how this is experienced by different community members. Findings are discussed in relation to the impact regeneration schemes have on community members' sense of collective self, unity, and engagement. The research highlights the pivotal role of social identity processes in delivering successful and sustainable strategies of urban regeneration. [ABSTRACT FROM AUTHOR]

This paper reports upon the learning that emerged from a development project which aimed to facilitate improvements in multiagency work in domestic abuse and safeguarding children. The two-year project (2011-13), funded by the Department for Education and led by WomenCentre, a specialist voluntary sector organisation based in West Yorkshire, was undertaken in nine local authorities in the north of England. Activities undertaken during the project included case mapping, service user and professional engagement exercises, observation of local multiagency meetings and provision of training. An evaluative research study examined the work of the project and the learning that emerged. Drawing upon data from telephone interviews with project participants, analysis of case mapping and project reports, this paper discusses some critical issues which emerged from this project. The paper draws attention to the different understandings and priorities which shape interprofessional practice in relation to safeguarding children and domestic abuse, and the complexities of the wider interagency environment including coordination, resources and expertise. Recommendations for improving multiagency work to achieve better outcomes for women and children experiencing domestic abuse are discussed. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Messages Multiagency working in domestic abuse and safeguarding children is complex and could be improved., The impact of professional differences in how cases are understood and managed, particularly in relation to 'risk', as well as different professional priorities and approaches to working with families should be recognised and considered within the multiagency context., Practitioners may want to consider whether 'case mapping' is pertinent to their own safeguarding practices and processes. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper presents findings from qualitative interviews with 24 young people (11-17 years) who have been referred to Children's Social Care Services in England. The paper explores young people's experiences of help seeking and their experiences of receiving help for maltreatment through statutory agencies. A central finding is the importance of relationships for young people when seeking and receiving help. It is through trusting relationships with professionals that young people are most likely to disclose maltreatment and/or engage with services. The paper concludes that young people's expectations and needs are not always met by the current safeguarding system and that the system needs to become more child-centred if it is to address the concerns maltreated young people have consistently voiced through research. [ABSTRACT FROM AUTHOR]

The social positioning and treatment of persons with dementia reflects dominant biomedical discourses of progressive and inevitable loss of insight, capacity, and personality. Proponents of person-centred care, by contrast, suggest that such loss can be mitigated within environments that preserve rather than undermine personhood. In formal organisational settings, person-centred approaches place particular responsibility on 'empowered' direct-care staff to translate these principles into practice. These staff provide the majority of hands-on care, but with limited training, recognition, or remuneration. Working within a Foucauldian understanding of power, this paper examines the complex ways that dementia care staff engage with their own 'dis/empowerment' in everyday practice. The findings, which are drawn from ethnographic studies of three National Health Service ( NHS) wards and one private care home in England, are presented as a narrative exploration of carers' general experience of powerlessness, their inversion of this marginalised subject positioning, and the related possibilities for action. The paper concludes with a discussion of how Foucault's understanding of power may help define and enhance efforts to empower direct-care staff to provide person-centred care in formal dementia care settings. [ABSTRACT FROM AUTHOR]

Child welfare removals of children are among the most invasive decisions a state can make toward its citizens, and typically it is the courts that make these decisions. These interventions are regularly exposed to criticism. In this paper, we examine if and how care order proceedings could be improved in England, Finland, Norway, and California, USA. We have asked the judiciary decision‐makers about their view on what should be improved. Our findings show that the organization of the proceedings, including time and staff, are identified as issues in all four systems. Furthermore, the preparations by the child welfare agency are also mentioned as an issue, for English, Finnish, and Californian decision‐makers. Very few decision‐makers indicate features related to the individual, situational, and contextual dimensions, which is interesting since this would be expected from organization theory. The strong call for change in the way proceedings are organized indicates a need for modernization as well as better use of available competency from child development experts. The respondents focus on the elements that a decision‐maker has direct experience with and knowledge about, and this is indeed worth noting for policymakers in the four systems. [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]

ABSTRACT Popular representations of crowd behaviour in disasters are often characterised by irrationalist discourses, in particular 'mass panic' despite their rejection by current scientific research. This paper reports an analysis of four survivors' accounts of the 1989 Hillsborough disaster to investigate if and how they used the term 'panic'. Reference to 'panic' occurred frequently, but more detailed analysis found that their accounts did not match the classic criteria for 'mass panic' (e.g. uncontrolled emotion and selfish behaviour). Indeed, participants referred to 'orderly' behaviour, and cooperation, even when they said the threat of death was present. 'Panic' was therefore being used as a description of events that was not consistent. A discourse analysis of usage suggests that participants used 'panic' not only to convey feelings of fear and distress but also to apportion culpability towards the actions of the police who they considered responsible for the tragedy (as indeed recent independent research has confirmed). It is concluded that the term 'panic' is so deeply embedded in popular discourse that people may use it even when they have reason to reject its irrationalist implications. Alternative discourses that emphasise collective resilience in disasters are suggested. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

In the literature on work-family balance, role and boundary issues are commonly discussed in relation to parents who work outside of the home. Work and family are considered as two different spheres of activity, with different role identities and cultural meanings. For foster carers, however, in very significant ways, their family is their work and their work is their family - so roles are not so clearly separated and boundaries are not so clearly defined. This paper reviews theoretical approaches to the work-family interface and draws on qualitative data from 40 interviews with long-term foster carers. It provides an analysis of their accounts of their roles as professional carers and/or committed parents to explore how they manage different and potentially contradictory role identities. The study found that foster carers primarily identified as carers or as parents, but that some foster carers could move flexibly between these roles while others could not. For foster carers who could be flexible, the two roles enriched each other rather than causing stress and role conflict. Implications for supporting professional foster carers who can also meet the parenting needs of long-term foster children are discussed. [ABSTRACT FROM AUTHOR]

Medical Education 2011: 45: 1251-1261 Objectives Professional status and working arrangements can inhibit doctors from acknowledging and seeking care for their own ill health. Research identifies that a culture of immunity to illness within the medical profession takes root during training. What happens when trainee doctors become unwell during their formative period of education and training? What support do they receive and how do they perceive that the experience of ill health affects their training trajectory? These research questions were developed by a multidisciplinary team of researchers and health professionals, who adopted a qualitative approach to investigate the experiences of personal illness among trainees in their Foundation Programme (FP) years. Methods Semi-structured interviews were conducted with eight FP trainees from the Severn Deanery in southwest England who had experienced significant illness. Interpretative phenomenological analysis was used to conduct and analyse the interviews, resulting in a comprehensive list of master themes. This paper reports an interpretative analysis of the themes of Support, Illness Experience, Crossing the Line, Medical Culture, Stigma and Disclosure. Results Ineffective communication within the medical education and employment system underpins many of the difficulties encountered by trainees who are unwell. Coping style plays a key role in predicting how trainees experience support during and after their illness, although this may be influenced by their particular diagnoses. The barriers to disclosure of their illnesses are discussed within the context of mobilising and maintaining support. Concern about the impact of missing training as a result of ill health appears to be significant in the transmitting of an ethos of invulnerability within the medical culture. Conclusions Suggestions to improve support procedures for trainees who are unwell include the provision of greater flexibility within the rotation system along with independent pastoral support. Promoting the importance of disclosing significant illness as early as possible might go some way towards challenging the culture of invulnerability to illness that prevails among doctors. [ABSTRACT FROM AUTHOR]

Introduction: The social and economic consequences of COVID‐19 have the potential to affect individuals and populations through different pathways (e.g., bereavement, loss of social interaction). Objective: This study adopted a solicited diary method to understand how mental health was affected during England's first lockdown. We also considered the experiences of diary keeping during a pandemic from the perspective of public participants. Methods: Fifteen adults older than 18 years of age were recruited from northwest England. Diarists completed semistructured online diaries for 8 weeks, which was combined with weekly calls. A focus group captured participants' experiences of diary keeping. Findings: Four key factors influenced mental health, which fluctuated over time and in relation to diarists' situations. These concerned navigating virus risk, loss of social connections and control and constrictions of the domestic space. Diarists also enacted a range of strategies to cope with the pandemic. This included support from social networks, engagement with natural environments, establishing normality, finding meaning and taking affirmative action. Conclusion: Use of diary methods provided insights into the lived experiences of the early months of a global pandemic. As well as contributing evidence on its mental health effects, diarists' accounts illuminated considerable resourcefulness and strategies of coping with positive effects for well‐being. While diary keeping can also have therapeutic benefits during adversity, ethical and practical issues need to be considered, which include the emotional nature of diary keeping. Public Contribution: Members of the public were involved in interpretation of data as well as critiquing the overall diary method used in the study. [ABSTRACT FROM AUTHOR]

Background: Parents of disabled children report poorer inpatient experiences when they stay in hospital, and some staff report finding communicating with disabled children challenging. This study tested the feasibility of implementing a training package for staff on paediatric wards to improve communication with disabled children, especially those with communication difficulties, and their families. The package was developed with parent carers and clinicians, and comprises a manual, a video of parent carers talking about real experiences, discussion points and local resources. The 50‐minutes training is intended for in‐house delivery by local facilitators. Methods: Thirteen training sessions were delivered in paediatric wards across four hospitals in England, totalling 123 staff who took part. Participants completed questionnaires before (n = 109) and after (n = 36) training, and a sample of champions (senior clinicians) and facilitators were interviewed at the end of the study. Results: Facilitators found the training easy to deliver, and participants felt they took away important messages to improve their practice. After the training, further changes were reported at an organizational level, including offering further training and reviewing practices. Conclusions: This study provides supporting evidence for the implementation of a low‐cost, minimal‐resource training package to support staff communication with children and their families in hospitals. It provides promising indication of impact on behavioural change at the individual and organizational level. Patient and public contribution: Parent carers identified the need and helped to develop the training, including featuring in the training video. They were also consulted throughout the study on research design, delivery and reporting. [ABSTRACT FROM AUTHOR]

Based on a three-year ethnographic study of four UK National Health Service (NHS) organizations, we explore the everyday cultural experience of managing clinical and administrative workforces. Although NHS organizations claim to function as enlightened HRM employers, we argue that the inflexible application of metrics-based target systems to clinical and administrative tasks, including HRM operations, can result in dysfunctional outcomes for patient care and workforce morale. Reminiscent of the recent Mid Staffordshire health care scandal, the priorities attached to NHS personnel meeting the demands of performance management systems can prove incompatible with them also meeting the fundamental 'human' needs of patients. The everyday experience of health care organization becomes one of employees reconciling competing logics of business efficiency and integrity of care. Trapped metaphorically between shrinking resources and expanding targets, the inclination-on the frontline and at mid-management level-is to extend the integrity of care, although this is sometimes impossible and can prove problematic in terms of system accountability. In response to such organizational tensions the behavior of many frontline and mid-management staffs ultimately reflects a form of 'street-level bureaucracy'-a situation in which traditional professional norms are reasserted informally in ways that often transgress prescribed performance systems. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Early help or early intervention is increasingly recommended for safeguarding children living with domestic violence, but little is known about what is effective. This article discusses findings from an evaluation of a pioneering early help service in North West England. This new service aimed to improve the safety and wellbeing of families (mothers and children) who were assessed as below the level of 'high risk' domestic violence and below the threshold for a child protection order. Between January 2014 and March 2015, families (473 mothers and 541 children) were identified within multiagency safeguarding hubs and referred to the early help service. The service that emerged was somewhat different to the service expected. This article discusses findings from qualitative data gathered from 39 participants (mothers, children and service providers) involved in the programme. Three main issues emerged as themes from the interviews: the benefits of having any service at all for children living with domestic violence who slip off the agendas of professionals working with child protection and high‐risk domestic violence; the importance of flexibility of key worker‐led service delivery; and the suitability of current group work and therapeutic models for meeting the varied needs of families affected by domestic violence. Key Practitioner Messages: Children, mothers and service providers reported both a perceived need for early help and a positive impact from domestic violence early help services on child health and emotional wellbeing.The ability of services to flex their delivery model in response to the needs of families is important for supporting engagement of, and fostering a sense of control for, families receiving support.Confidentiality, reliability, respect and trust are key factors in developing an effective key worker‐family relationship. 'Discusses findings from an evaluation of a pioneering early help service in North West England' [ABSTRACT FROM AUTHOR]

Background: It is widely acknowledged that inadequate handovers are associated with putting patients at risk in clinical settings; however, handover practices have received little attention in other 24‐hr settings such as long‐stay residential care facilities. Aim: This study aimed to explore the perceived purpose and organisational processes involved in the handover of information between shifts of staff caring for older residents in five care homes in England. Methods: The study took an ethnographic approach to fieldwork, undertaken between February and June 2016. It consisted of observations of handovers (n = 12) and interviews with managers, Registered Nurses (RNs) and care assistants (n = 27) working day and night shifts. Interview transcripts and observation notes were analysed within NVivo using a matrix approach. Results: Handovers were highly variable in all five care homes in relation to their timings, locations, content and participants. Managers and RNs highlighted handovers as an opportunity for risk assurance, supervision, team building, staff education and monitoring of residents' clinical status. In comparison, care assistants considered the purpose of handovers to be prepared for the responsibilities of working a shift. The discussion addresses implications of these findings, particularly consideration of how best use can be made of RN skills and knowledge in handovers. Conclusion: Research is needed to identify whether care home resident safety can be linked to handover practices and how the presence of RNs in handovers in care homes affects this. Implications for practice: Care home managers, RNs and care workers may find this research useful in practice when considering how best to organise handovers and deploy staff in care homes for older people. [ABSTRACT FROM AUTHOR]

Background: Person‐centredness is important in delivering care for long‐term conditions. New models of care aim to co‐ordinate care through integration of health and social care which require new ways of working, often remotely from the patient. Objective: To describe how person‐centred care is enacted within multidisciplinary groups (MDGs) created as part of a new service, integrating health and social care for older people. Methods: We followed the implementation of eight neighbourhood MDGs, observing and interviewing staff from three MDGs at different phases of programme implementation using semi‐structured topic guides. Results: Thirty‐four MDG meetings were observed and 32 staff interviewed. Three core themes were identified which impacted on enactment of person‐centred care: the structural context of MDGs enabling person‐centred care; interaction of staff and knowledge sharing during the MDG meetings; and direct staff involvement of the person outside the MDG discussion. Conclusions: This study provides new insights into attempts to enact person‐centred care within a new model of service delivery. Teams did what they could to enact person‐centred care in the absence of the "real" patient within MDG meetings. They were successful in delivering and co‐ordinating some aspects of care (eg prompting medication reviews, referring to social worker, health improvement and arranging further multidisciplinary team meetings for complex cases). This "absence of patients" and time pressures within the MDGs led to reliance on the "virtual" record, enhanced by additional "soft" knowledge provided by staff, rather than ensuring the patient's voice was included. [ABSTRACT FROM AUTHOR]

Objective: To explore and understand approaches to user engagement through investigating the range of ways in which health care workers and organizations accommodated the introduction of computerized physician order entry (CPOE) and computerized decision support (CDS) for hospital prescribing.Study Setting: Six hospitals in England, United Kingdom.Study Design: Qualitative case study.Data Collection: We undertook qualitative semi-structured interviews, non-participant observations of meetings and system use, and collected organizational documents over three time periods from six hospitals. Thematic analysis was initially undertaken within individual cases, followed by cross-case comparisons.Findings: We conducted 173 interviews, conducted 24 observations, and collected 17 documents between 2011 and 2015. We found that perceived individual and safety benefits among different user groups tended to facilitate engagement in some, while other less engaged groups developed resistance and unsanctioned workarounds if systems were perceived to be inadequate. We identified both the opportunity and need for sustained engagement across user groups around system enhancement (e.g., through customizing software) and the development of user competencies and effective use.Conclusions: There is an urgent need to move away from an episodic view of engagement focused on the preimplementation phase, to more continuous holistic attempts to engage with and respond to end-users. [ABSTRACT FROM AUTHOR]

Caring is a positive social act, but can it result in negative attitudes towards those cared for, and towards others from their wider social group? Based on intergroup contact theory, we tested whether care workers' (CWs) positive and negative contact with old-age care home residents (CHRs) predicts prejudiced attitudes towards that group, and whether this generalises to other older people. Fifty-six CWs were surveyed about their positive and negative contact with CHRs and their blatant and subtle attitudes (humanness attributions) towards CHRs and older adults. We tested indirect paths from contact with CHRs to attitudes towards older adults via attitudes towards CHRs. Results showed that neither positive nor negative contact generalised blatant ageism. However, the effect of negative, but not positive, contact on the denial of humanness to CHRs generalised to subtle ageism towards older adults. This evidence has practical implications for management of CWs' work experiences and theoretical implications, suggesting that negative contact with a subgroup generalises the attribution of humanness to superordinate groups. Because it is difficult to identify and challenge subtle prejudices such as dehumanisation, it may be especially important to reduce negative contact. © 2016 The Authors. Journal of Community & Applied Social Psychology Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Objective: The objective of this analysis was to explore the healthcare-seeking behaviours and experiences of maternity care among women from different socio-economic groups in order to improve understanding of why socially disadvantaged women have poorer maternal health outcomes in the UK.Design: Secondary analysis of a national survey of women conducted 3 months after they had given birth.Setting: England.Sample: A total of 5332 women.Methods: Logistic regression analysis to investigate differences in outcomes among different socio-economic groups, classified by the Index of Multiple Deprivation (IMD).Main Outcome Measures: Healthcare-seeking behaviours, outcomes and experiences of maternity care.Results: With each increase in IMD quintile (decrease in socio-economic position), women were shown to be 25% (adjusted odds ratio [aOR] 0.75; 95% confidence interval [95% CI] 0.63-0.90) less likely to have had any antenatal care and 15% (aOR 0.85; 95% CI 0.80-0.90) less likely to have had a routine postnatal check-up. They were 4% (aOR 1.04; 95% CI 0.99-1.10) more likely to have had an antenatal hospital admission, 7% (aOR 1.07; 95% CI 0.99-1.16) more likely to have been transferred during labour and 4% (aOR 1.04; 95% CI 0.99-1.09) more likely to have had a caesarean birth, although these results were not statistically significant. With decreasing socio-economic position women were more likely to report that they were not treated respectfully or spoken to in a way they could understand by doctors and midwives.Conclusions: This analysis suggests the need for a focusing of professionals and services towards pregnant women from lower socio-economic groups and more targeted maternal public health education towards socially disadvantaged women. [ABSTRACT FROM AUTHOR]

Background: Involving service users in the systematic review process is seen as increasingly important. As systematic reviews often include studies from diverse settings and covering a time span of several decades, involving service users in consideration of applicability to specific populations or settings might make reviews more useful to practitioners and policymakers. Objectives: To test and contextualize the findings of a systematic review of qualitative studies looking at patient and carer experiences of diagnosis and treatment of dementia. Methods: Results from the systematic review were discussed in focus groups and semi‐structured interviews with patient, public and professional participants in the South East of England. Analysis was guided by coding frameworks developed from the results of the systematic review. Participants: We recruited 27 participants, including three people with dementia, 12 carers, six service providers and five older people without dementia. Results: Findings from the focus groups and interviews were consistent with those from the systematic review and suggest that our review findings were applicable to the local setting. We found some evidence that access to information and diagnostic services had improved but, as in the systematic review, post‐diagnosis support was still often experienced as inadequate. Conclusions: Focus groups and interviews with service users and their representatives can provide useful contextual information. However, such strategies can require considerable investment of the part of the researcher in terms of time and resources, and more work is needed to refine strategies and establish the benefits for patients and the organization of services. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to explore the patients' and health professionals' experiences and perceptions on the management strategies for insomia in primary care. The researchers detail the study design, participants and setting, data collection procedure and outcomes. The study provides a better understanding on the approaches and difficulties in the therapeutic options and management of insomnia in primary care setting.

The article presents a study which aims to explore the acceptability of antenatal enquiry for domestic abuse from the perspective of women using maternity services. The researchers detail the multimethod approach in data collection procedure and outcomes. It implies that women patients support and have positive views of antenatal enquiry for domestic abuse in healthcare settings.

Background: Uptake of colorectal cancer screening programmes needs to be improved or at least maintained in order to achieve projected reductions in mortality and morbidity. Understanding the origins of non‐participation in screening is therefore important. Objective: To explore the beliefs and experiences of individuals who had not responded either to their screening invitation or reminder. Design: A qualitative study using in‐depth interviews with non‐participants from England's population‐based colorectal cancer screening programme. Data collection and analysis were carried out using a grounded theory approach, with an emphasis on the constant comparison method, and continued until saturation (27 interviews). Findings: The interviews provided an in‐depth understanding of a range of reasons and circumstances surrounding non‐participation in screening, including contextual and environmental influences as well as factors specific to the screening test. Non‐participation in screening was not necessarily associated with negative attitudes towards screening or a decision to not return a kit. Reasons for non‐participation in screening included not feeling that participation is personally necessary, avoiding or delaying decision making, and having some degree of intention to take part but failing to do so because of practicalities, conflicting priorities or external circumstances. Beliefs, awareness and intention change over time. Discussion and conclusions: A range of approaches may be required to improve screening uptake. Some non‐participants may already have a degree of intention to take part in screening in the future, and this group may be more responsive to interventions based on professional endorsement, repeat invitations, reminders and aids to making the test more practical. [ABSTRACT FROM AUTHOR]

Research examining antecedents to sibling relationship quality have explored factors such as parenting and temperament (Brody, 1998); however, there has been no previous research on the topic of the current study. The present study used a cross-informant approach to examine parent-child and marital relationships as potential mediators of links between parents' gendered attitudes and behaviours and sibling relationship quality. One hundred and twenty-four families with older ( M = 7.4 years) and younger ( M = 5.2 years) siblings were assessed. Parents reported on division of household labour, gender-role attitudes and marital satisfaction. Each child reported on sibling relationship quality and parental warmth and hostility. Results revealed a link between more egalitarian division of household labour and more positive sibling relationship quality. Furthermore, this association was not mediated by the marital nor parent-child relationship. We conclude that families with a more egalitarian division of household labour may model positive interactions for siblings. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim Osteoarthritis (OA) is one of the most common musculoskeletal conditions and a major cause of chronic pain and disability. Self-management of OA through education and exercise are recommended as core treatments. Current research has demonstrated the effectiveness of these approaches, but most trials tailor interventions for specific joints. The aim of the present study was to explore healthcare professionals' views on a group-based exercise intervention designed to facilitate the self-management of OA in the lower limbs and/or lower back. Methods Individual semi-structured interviews were conducted with 20 healthcare professionals (nine general practitioners, ten physiotherapists and one community-based rheumatologist). The interviews were audio-recorded, transcribed and analysed using thematic analysis. Results Three themes were identified: 1) Patient understanding of osteoarthritis; 2) Multiple-joint approach and 3) Practical aspects of the intervention. Healthcare professionals stated the usefulness of the intervention in improving patients' knowledge about their condition and self-management. They commented on including patients affected with OA in multiple or different lower limb sites in the intervention. They considered this a positive move, as they viewed self-management techniques as applicable to more than one affected joint in the lower body. Consideration of the practical aspects of the intervention included thoughts on an appropriate facilitator, the need to ensure accessibility to patients and ways to exercise once the intervention had ended. Conclusion Healthcare professionals saw the intervention as an acceptable and feasible approach to facilitate the self-management of OA. This study has implications for developing and implementing cost-effective interventions in primary care settings. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim To identify shared patterns of views in young people relating to the influence of industry-driven alcohol marketing (price, promotion, product and place of purchase/consumption) on their reported drinking behaviour. Design Q methodology harnessed qualitative and quantitative data to generate distinct clusters of opinions as follows: 39 opinion statements were derived from earlier in-depth qualitative interviews with 31 young people; by-person factor analysis was carried out on 28 participants' (six previous interviewees and 22 new recruits) rank orderings of these statements (most-to-least agreement); interpretation of the factor arrays was aided by 10-15-minute debriefing interviews held immediately following each Q-sort. Setting Northeast England Participants Young people aged 14-17 years purposively recruited from high schools, higher education colleges, youth centres and youth offending teams. Findings Centroid factor extraction and varimax rotation of factors generated three distinct accounts: factor one ('autonomous, sophisticated consumers') illustrated a self-defined sense of individuality and autonomy in alcohol choices; factor two ('price-driven consumers') appeared price-led, choosing to drink what was most accessible or cheapest; and factor three ('context-focused consumers') described drinking practices where products were chosen to serve specific functions such as being easy to carry while dancing. Conclusions Considering young people's views on alcohol marketing, different perspectives can be identified. These include perceived imperviousness to maketing, responsiveness to price and affordability and responsiveness to marketing focusing on youth lifestyles. [ABSTRACT FROM AUTHOR]

Aims To explore attitudes towards, and experience of, illicit tobacco usage in a disadvantaged community against a backdrop of austerity and declining national trends in illicit tobacco use. Design Qualitative study using 10 focus groups. Setting Multiply disadvantaged community in Nottingham, United Kingdom. Participants Fifty-eight smokers, ex- and non-smokers aged 15-60 years. Measurements Focus group topic guides. Findings There was high awareness and use of illegal tobacco sources, with 'fag houses' (individuals selling cigarettes from their own homes) being particularly widespread. Rather than being regarded as marginal behaviour, buying illicit tobacco was perceived as commonplace, even where products were known to be counterfeit. Smokers' willingness to smoke inferior 'nasty' counterfeit products may be testament to their need for cheap nicotine. Illicit tobacco was seen to be of mutual benefit to both user (because of its low cost) and seller (because it provided income and support for the local economy). Illicit tobacco sellers were generally condoned, in contrast with the government, which was blamed for unfair tobacco taxation, attitudes possibly heightened by the recession. Easy access to illicit tobacco was seen to facilitate and sustain smoking, with the main concern being around underage smokers who were perceived to be able to buy cheap cigarettes without challenge. Conclusions National strategies to reduce illicit tobacco may have limited impact in communities during a recession and where illicit trade is part of the local culture and economy. There may be potential to influence illicit tobacco use by building on the ambivalence and unease expressed around selling to children. [ABSTRACT FROM AUTHOR]

People's just world beliefs are related to how they feel and behave towards others: the stronger people hold beliefs that the world treats them fairly, the more they feel and act pro-socially towards others. It is conceivable, therefore, that pro-social feelings and behaviours towards others can strengthen people's personal belief in a just world, especially when people expect these positive feelings to be returned. Because mimicry enhances pro-social feelings towards others, we argue that mimicry may strengthen peoples' personal just world beliefs via positive feelings for the mimicked person and the expectation that these positive feelings are returned. Moreover, we expect these effects to be more pronounced for men because men have stronger reciprocity beliefs than women. The results of three studies supported this line of reasoning, showing that mimicry made men believe more strongly that the world is personally just to them. Further support for our line of reasoning was obtained by positive feelings for the (non)mimicked person (Study 2) and reciprocity beliefs (Study 3) mediating the effects. Taken together, the findings suggest that mimicry makes men view the world as more just. [ABSTRACT FROM AUTHOR]

Context: Performance measures are increasingly widely used in health care and have an important role in quality. However, field studies of what organizations are doing when they collect and report performance measures are rare. An opportunity for such a study was presented by a patient safety program requiring intensive care units (ICUs) in England to submit monthly data on central venous catheter bloodstream infections (CVC-BSIs). Methods: We conducted an ethnographic study involving ∼855 hours of observational fieldwork and 93 interviews in 17 ICUs plus 29 telephone interviews. Findings: Variability was evident within and between ICUs in how they applied inclusion and exclusion criteria for the program, the data collection systems they established, practices in sending blood samples for analysis, microbiological support and laboratory techniques, and procedures for collecting and compiling data on possible infections. Those making decisions about what to report were not making decisions about the same things, nor were they making decisions in the same way. Rather than providing objective and clear criteria, the definitions for classifying infections used were seen as subjective, messy, and admitting the possibility of unfairness. Reported infection rates reflected localized interpretations rather than a standardized dataset across all ICUs. Variability arose not because of wily workers deliberately concealing, obscuring, or deceiving but because counting was as much a social practice as a technical practice. Conclusions: Rather than objective measures of incidence, differences in reported infection rates may reflect, at least to some extent, underlying social practices in data collection and reporting and variations in clinical practice. The variability we identified was largely artless rather than artful: currently dominant assumptions of gaming as responses to performance measures do not properly account for how categories and classifications operate in the pragmatic conduct of health care. These findings have important implications for assumptions about what can be achieved in infection reduction and quality improvement strategies. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Patients can play an important role in reducing health care harm. Finding strategies to encourage patients to take on an active role in issues related to the quality and safety of their care is therefore essential. The aim of this study was to examine patients' and health care professionals' attitudes towards a video aimed at promoting patient involvement in safety-related behaviours. Method A within-subjects design was used where participants were required to complete a questionnaire pre and post screening of a patient safety video. Participants are 201 patients aged 19-103 years (mean 52) and 95 health care professionals aged 23-48 years (mean 32). Main outcome measures include (i) patients' willingness to participate and perceived importance in participating in safety-related behaviours; and (ii) health care professionals' willingness to support patient involvement. Results After watching the video patients elicited more positive attitudes towards asking doctors and nurses if they had washed their hands and notifying them about issues to do with personal hygiene. No significant effects were observed in relation to patients notifying staff if they have not received their medication or if they were in pain or feeling unwell. In relation to health care professionals, doctors and nurses were more willing to support patient involvement in asking about hand hygiene after they had watched the video. Conclusion Video may be effective at changing patients' and health care professionals' attitudes towards patient involvement in some, but not all safety-related behaviours. Our findings suggest video may be most effective at encouraging involvement in behaviours patients are less inclined to participate in and health care professionals are less willing to support. [ABSTRACT FROM AUTHOR]

We propose that the perceived continuity between a group's past and present can be a psychological resource that provides confidence in the group's future vitality, thereby reducing the need to preserve identity. In two studies, English participants were told that there was continuity or discontinuity between England's past and present. Both studies showed that higher identifiers (but not lower identifiers) experienced more collective angst (i.e., concern for the group's future) and were more opposed to immigration when English history was presented as discontinuous compared with continuous. Importantly, collective angst mediated the effect of the historical continuity manipulation on opposition to immigration. We conclude that, particularly among those higher in group identification, perceived discontinuity of the group's past can undermine the perceived vitality of the future, thereby increasing the need to preserve current collective identity. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Rates of obesity among black African and black Caribbean women in the UK are consistently higher than among white women. Cultural, attitudinal and behavioural differences may contribute to ethnic variation in weight, and the present study aimed to explore attitudes towards weight and weight control among black and white British women using a qualitative approach. Methods: Ethnically homogeneous focus groups were carried out with 25 white women [mean (SD) body mass index (BMI, kg m-2) = 26 (7.2) kg m-2] and 24 black women [mean (SD) BMI = 29 (6.6) kg m-2]. Women were recruited from London boroughs (Lambeth, Southwark and Croydon) and Guildford, Surrey, and focus groups were conducted in London. Focus groups were recorded and transcribed verbatim, and were analysed using thematic analysis. Results: All participants had fairly good knowledge of the causes, consequences and treatment of being overweight. However, black women primarily emphasised the health consequences of being overweight, whereas white women were more likely to focus on the perceived social and emotional consequences. White women associated being overweight with negative character traits, whereas black women had a broadly positive attitude towards larger body sizes. Conclusions: Black women were as well-informed about the causes and health risks of obesity as white women in this sample of mainly educated, working women, although they were more accepting of larger body sizes and experienced less social pressure to be slim. [ABSTRACT FROM AUTHOR]

Background Women with one previous caesarean section must decide which mode of delivery they would prefer in their next pregnancy. This involves a choice between attempted vaginal birth and elective caesarean section. Objective To explore women's mode of delivery preferences and the values placed on the outcomes of decision making. Greater insight into these issues could benefit both clinical care and future research. Design Observational study using longitudinal data collected within a randomized controlled trial. Setting and Participants Seven hundred and forty-two women with one previous caesarean section recruited at four antenatal clinics in South West England and Scotland. Main outcome measures Mode of delivery preference recorded at 19 and 37 weeks' gestation and visual analogue scale ratings of health and delivery outcomes. Results Comparison of mid and late pregnancy preferences and actual mode of delivery shows that 57% of women hold the same mode of delivery preferences at both times and 65% of women actually have the birth they prefer. The visual analogue scale ratings show variation in the way women value the outcomes of the decision. Discussion and Conclusions Understanding the way women's mode of delivery preferences change, how these relate to actual mode of delivery and how women value the outcomes of their decision will be beneficial to health professionals who wish to support women both during pregnancy and after birth. In addition, the visual analogue scale ratings provide evidence that may improve the development of population-level and economic models of decision making. [ABSTRACT FROM AUTHOR]

Background Despite the policy rhetoric, patient involvement in health service decisions remains limited. Highlighted barriers include a concern that most patients are unable to see beyond personal aspects of their care in order to contribute meaningfully to health service development, and a perception that professionals do not welcome patient involvement. Objectives We aimed to explore respiratory patients' awareness of changes in local health service provision and provide insight into health professionals' attitudes to engaging patients. Methods Nested within an ethnographic study of health service reconfiguration, we recruited 31 patients with a range of respiratory diseases from four case study areas in England and Wales. Data from telephone interviews, illness diaries and focus groups with patients, and interviews with health professionals and managers were transcribed and analysed using the Framework approach. Results Participants were not only aware of trends in health service provision (e.g. emergence of new professional roles, shift from secondary to primary care) but interpreted changes in the light of local and national events. Despite this awareness, none of the patients was formally involved in service development, though some contributed to local voluntary groups. Professionals generally welcomed the need for patients' views to be heard. Discussion and conclusions Our data give grounds for optimism. Patients are aware of and interested in a broad range of health-related issues. Professionals' motivation to involve patients in service development may be underestimated. Although practical obstacles remain, our findings should encourage the ongoing search for effective models of promoting patient engagement in health-care services. [ABSTRACT FROM AUTHOR]

Objectives. Formulation is argued to be of central importance in most psychotherapeutic approaches, yet little is known about client's experience of this. This study sought to explore the client experience of receiving cognitive analytic therapy (CAT). It aims to gain a better understanding of the use of specific CAT tools (e.g., reformulation letters and diagrams) and how these tools relate to clients' understanding of change. Design. Grounded theory methodology utilizing a three-stage analysis process was used to explore client's retrospective accounts of change in CAT. Methods. Fifteen semi-structured interviews were conducted with nine participants who had received CAT. Data analysis involved initial coding of transcripts and further theoretical sampling and interviewing followed. This led to the production of a model that was then taken to three further participants for exploration in further interviews. An audit was conducted of the analysis process. Results. A core conceptual framework of 'doing with' the therapist emerged from the analysis and represented clients' experience of receiving CAT and participating in the reformulation process. This framework subsumed four interrelated themes; 'being with the therapist', 'keeping it real', 'understanding and feeling', and 'CAT tools'. Conclusions. CAT was seen as an active and emotional experience facilitated by a trusting and collaborative therapeutic relationship. The CAT reformulation was seen as important but only when embedded within this context. Whilst, this was a small study theoretical generalizations are discussed about the process of change and further clinical and research recommendations are presented. [ABSTRACT FROM AUTHOR]

The UK National Health Service (NHS) is regularly restructured. Its smooth operation and organisational memory depends on the insights and capability of managers, especially those with experience of previous transitions. Narrative methods can illuminate complex change from the perspective of key actors. We used an adaptation of Wengraf's biographical narrative life interview method to explore how 20 senior NHS managers (chief executives, directors and assistant directors) had perceived and responded to major transitions since 1974. Data were analysed thematically using insights from phenomenology, neo-institutional theory and critical management studies. Findings were contextualised within a literature review of NHS policy and management 1974-2009. Managers described how experience in different NHS organisations helped build resilience and tacit knowledge, and how a strong commitment to the 'NHS brand' allowed them to weather a succession of policy changes and implement and embed such changes locally. By synthesising these personal and situated micro-narratives, we built a wider picture of macro-level institutional change in the NHS, in which the various visible restructurings in recent years appear to have masked a deeper continuity in terms of enduring values, norms and ways of working. We consider the implications of these findings for the future NHS. [ABSTRACT FROM AUTHOR]

When people occupy different social positions within a cooperative task they experience discrepant role and situation demands and thus have divergent perspectives. The reported research predicts that exchanging social positions within a cooperative task can overcome divergences of perspective. This prediction was tested in two experiments using the Communication Conflict Situation. The first experiment ( n = 88) found that position exchange increased the ability of dyads to solve a communication conflict arising through discrepant perspectives. The second experiment ( n = 120) found that the effect of position exchange exceeds that of purely cognitive perspective taking, thus suggesting that it cannot be reduced to a purely cognitive process. Exchanging social positions is a newly identified and powerful social mechanism through which perspective taking, within a cooperative task, can be enhanced. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective To determine the preferred means by which participants in a study of cardiac rehabilitation wish to be informed of the study’s results. Design Postal questionnaire survey of participants in a randomized controlled trial. Setting Cornwall, southwest England. Participants Patients recruited to the Cornwall Heart Attack Rehabilitation Management Study (CHARMS). Method Participants recruited to CHARMS who were alive 3 years and 9 months after the trial was completed were contacted by letter and invited to return a reply slip with four short questions indicating how they would prefer to be informed about the published results of the study. Results In March 2008, 191/230 participants originally recruited to CHARMS were still alive. General practitioners deemed 166/191 (88%) survivors medically appropriate to be contacted through a postal survey, and 154/166 (93%) participants responded to the invitation to participate in the follow-up survey. 86% (143/166) of participants indicated that they wished to be informed about the results: 115 (80%) of these elected to receive information by letter and 25 (18%) of these preferred to attend a meeting. Men older than 65 years predominated in this latter group. Women respondents preferred to receive the study results by letter; none preferred communication by email or the web. Conclusion Survivors of acute myocardial infarction who participated in a RCT of cardiac rehabilitation wanted to receive a summary of the aggregate study results. Participants had preferences regarding how they would wish to be informed about the results of the study. Most participants preferred to be informed by letter or email, but some preferred the interaction of a group or a meeting. [ABSTRACT FROM AUTHOR]