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This paper reports on an innovative interprofessional education (IPE) initiative conducted in three care homes across Greater Manchester in the United Kingdom (UK). Students from a variety of professions including nursing, physiotherapy, social work, podiatry, counseling, and sports rehabilitation worked collaboratively in the homes to address the residents' individual goals. We found that care homes provided students with many opportunities for interprofessional working and learning. Through better understanding the dimensions of different perspectives and approaches, students improved their education and transformed their perceptions of aged care. Having a diverse range of professionals allowed staff to gain insight into the latest evidence-based practice and address the multiple needs of the residents more holistically. Residents gained an enriched sense of meaning and purpose in their daily life by engaging in fulfilling and meaningful activities. The complexities of undertaking an IPE initiative in this setting are also considered and we conclude by proposing important avenues for future research. [ABSTRACT FROM AUTHOR]

In 2023, the UK Government published its long-awaited reform strategy for England's children's social care system. Whilst the strategy set out planned reforms for several aspects of the wider system, an area requiring particular 'priority' was the purported workforce instability seen within child protection social work. However, the strategy has subsequently faced criticism on the basis that the suggested reforms were not satisfactorily informed by the testimonies of practicing social workers. This paper draws from a mixed-method study to report on the lived experiences of a sample of 201 child protection social workers practicing across England, in the context of better understanding the factors which they believed were impacting on workforce stability within England's child protection system. Implications that emerge are the need for an increase in the monetary commitment offered by the UK Government (especially in the context of tackling high caseloads, and improving local authority pay scales to reduce the allure of agency work); a targeted emphasis on challenging local cultures preoccupied with evidencing compliance over time spent with children; and the Government taking a more assertive role in tackling the often-counterproductive commentary perpetuated by politicians and media. [ABSTRACT FROM AUTHOR]

In this paper, we use a UK case study to explore how the COVID-19 pandemic affected the mental health (emotional, psychological, social wellbeing) of farmers. We outline the drivers of poor farming mental health, the manifold impacts of the pandemic at a time of policy and environmental change, and identify lessons that can be learned to develop resilience in farming communities against future shocks. We undertook a survey answered by 207 farmers across the UK, focusing on drivers of poor mental health and the effect of the COVID-19 pandemic. We also conducted 22 in-depth interviews with individuals in England, Scotland and Wales who provide mental health support to farmers. These explored how and why the COVID-19 pandemic affected the mental health of farmers. These interviews were supplemented by 93 survey responses from a similar group of support providers (UK-wide). We found that the pandemic exacerbated underlying drivers of poor mental health and wellbeing in farming communities. 67% of farmers surveyed reported feeling more stressed, 63% felt more anxious, 38% felt more depressed, and 12% felt more suicidal. The primary drivers of poor mental health identified by farmers during the pandemic included decreased social contact and loneliness, issues with the general public on private land, and moving online for social events. Support providers also highlighted relationship and financial issues, illness, and government inspections as drivers of poor mental health. Some farmers, conversely, outlined positive impacts of the pandemic. The COVID-19 pandemic is just one of many potential stressors associated with poor farming mental health and its impacts are likely to be long-lasting and delayed. Multiple stressors affecting farmers at the same time can create a tipping point. Therefore, there is a need for long-term support and ongoing evaluation of the drivers of poor mental health in farming families. [ABSTRACT FROM AUTHOR]

This paper examines how, in the midst of changing political times, some characteristics of HIV activism are changing, and suggests the relevance of these shifts for other fields of health activism. Despite the UK achieving UNAIDS's '90–90-90ʹ testing and treatment goals, many in the UK lack up-to-date HIV knowledge and retain stigmatising attitudes, and some areas of testing failure remain. In response, people with HIV and HIV organisations are generating imaginative, collaborative projects that indicate effective contemporary forms of health activism may, as other critical health research suggests, be decentred, participatory, multimodal, affective, and implicit. The paper describes a 2016 HIV NGO-run comedy event directed at HIV awareness which was researched via qualitative pre- and post-measures, and two-month follow-up interviews. Findings pointed to strong effects of comedy, as enjoyment and 'break' in HIV thinking, feeling, and action; of a one-off event's emotionality and particularity; and of performance in generating collectivity and HIV citizenship. The paper discusses the potential transferability of these findings to other health activisms, particularly around stigmatised conditions. It argues that such strategies of emotionality, multi-modality, and solidarity in a performance event can work as implicit activism for changing times, generating social change via a doubled politics of resistance and alterity. [ABSTRACT FROM AUTHOR]

Moral thinking and communication are critical competencies for confronting social dilemmas in a challenging world. We examined these moral competencies in 70 college students and graduates from Taiwan, the United Kingdom, and the United States. Participants were assessed through semi-structured written interviews, Facebook group discussions, and a questionnaire. In this paper, we describe the similarities and differences across cultural groupings in (1) the social issues of greatest importance to the participants; (2) the factors influencing their approaches to thinking about social issues and communicating with others; and (3) the characteristics of their moral functioning in terms of moral awareness, moral judgment, moral discourse, and moral decision-making. [ABSTRACT FROM AUTHOR]

This paper reports the initial findings from Contemporary Visual Art and Identity Construction—Wellbeing Amongst Older People: a two-year research project that aims to understand how the lives of older people can be improved by examining their use of contemporary visual art in the art gallery and museum. It will focus on data relating to lifelong learning for postretirement people. The paper investigates the impact of engaging with contemporary art on a sample of 43 participants aged 64+. [ABSTRACT FROM PUBLISHER]

A task carried out in error creates a latent condition that can result in a future undesirable outcome if the error is not detected later. The paper presents a study of the relatively under-researched phenomenon of post-task latent error detection. Focusing on UK naval aircraft maintenance, it was hypothesised that time, location and systems cues influence individual latent error detection amongst naval air engineers who experience the phenomenon. The systems view of human error is combined with a multi-process approach to post-task latent error research, for which findings suggest that distributed cognition across the entire socio-technical system may be influential in post-task latent error detection. Directions for future research will be of benefit to those interested in furthering safety resilience using a systems approach to minimise the consequences arising from latent error. Relevance to human factors/ergonomics theoryThe nature and extent of post-task latent error detection is explored using a systems approach, for which distributed cognition across the entire socio-technical system appears influential. The aim of current research is to develop interventions to further mitigate for latent errors and thus advance the systems application of ergonomics theory. [ABSTRACT FROM PUBLISHER]

ObjectivesHospital chaplaincy in the UK's National Health Service (NHS) is an allied profession that is emerging from its origins as an aspect of Anglican clerical organisation. This paper describes the perceptions and practices of hospital chaplains around end of life care and organ donation. DesignQualitative study involving 19 semi-structured exploratory interviews with hospital chaplains in five NHS Hospital Trusts across two regions in the UK. ResultsChaplains provided generic support for the family around death and in relation to end of life conversations. While chaplains were supportive of efforts to increase awareness of issues around deceased donation they held a range of views on organ donation and had limited knowledge of hospital processes and practices. ConclusionsThere is scope for greater training and involvement of hospital chaplains in hospital work on organ donation, and in developing new forms of community engagement to promote awareness and debate. [ABSTRACT FROM AUTHOR]

This paper reports and critically discusses, against the literature on culturally sensitive and cultural competency practices, the findings of a qualitative study which explored the needs and expectations of older people and their carers from eight different migrant communities and the white British majority. The study investigated the accessibility and acceptability of care and support services in Bradford, UK, a city with a large migrant population. A total of 167 study participants were recruited from February 2008 to October 2008; of these 134 were older people and 33 carers. The age ranged from 25 to 90 years. The study found that older migrants and their carers described expectations of services as complex constructions of ‘abstract expectations’, the study participants’ general beliefs regarding what services should be about, and ‘pragmatic expectations’, their specific views about how they would like to receive care and access services. All groups, irrespective of their ethnic background, expressed three ‘abstract expectations’: high standards of good practice; cultural understanding; and responsiveness to individual expectations. This similarity did not imply a similarity in their preferences for how services should provide for their ‘abstract expectations’. Dignity was a central expectation for all older people in the care of their bodies. However, a number of culturally specific ‘pragmatic expectations’ emerged in the practices that older people and carers associated with maintaining dignity in older age. Nevertheless, differences could not always be explained as an outcome of different cultural backgrounds, but were rather linked to individual characteristics and life experiences. This study indicates that whether and how older migrants’ knowledge systems inform their expectations of care and support should be objects of investigation rather than taken for granted, as implied in some literature on culturally sensitive practices. Exploration of older migrants’ knowledge systems may help us to understand if older migrants’ expectations differ with regard to what they expect to receive from a certain service, their ‘abstract expectations’, and/or how they expect to receive it, their ‘pragmatic expectations’. This information should help to identify if different communities require different culturally competent interventions and of what type: interventions at the organisational level, at the structural level or at the clinical level. [ABSTRACT FROM AUTHOR]

Bondage/discipline, dominance/submission, and sadism/masochism (BDSM; "kink") are frequently pathologized as derivatives of abuse. Although the link is unsubstantiated, some kink-identified people who happen to be survivors of trauma may engage in kink, or trauma play, to heal from, cope with, and transform childhood abuse or adolescent maltreatment. The present study sought a thematic model (Braun & Clarke, Qualitative Research in Psychology, 3(2), 77–101, 2006) of trauma recovery through kink using a critical realist, inductive approach to inquiry. Participants were eligible if they had experienced early abuse, were adults, and practiced kink. Six superordinate themes were generated from semi-structured interviews with 20 participants from five countries: cultural context of healing (e.g. using BDSM norms and previous therapy to reframe kink and trauma), restructuring the self-concept (e.g. strengthening internal characteristics which had been harmed or distorted), liberation through relationship (e.g. learning to be valued by intimate others), reclaiming power (e.g. setting and maintaining personal boundaries), repurposing behaviors (e.g. engaging in aspects of prolonged exposure), and redefining pain (e.g. transcending painful memories through masochism). Notably, participants only reported retraumatizing experiences prior to learning about the structural safeguards of BDSM. Research and clinical implications are discussed by drawing on general models of trauma recovery. [ABSTRACT FROM AUTHOR]

Social isolation within agricultural communities is prevalent within the United Kingdom (UK). Along with other social and economic determinants, social isolation is considered to be a contributing factor towards the high rates of mental health issues experienced among people working in agriculture. The livestock auction mart is one of the remaining spaces upon which many livestock farmers rely for consistent social interaction and to experience community, both determinants proven to improve physical and mental health. However, the importance of the social contribution of livestock auction marts to farmer wellbeing appears rarely in associated literature. The aims of this study, therefore, were i) to determine levels of isolation experienced by livestock farmers who attend auction marts and ii) to identify the role of the mart as a system of social support, with an emphasis on the informal support system attendees provide for one another. Findings from 90 qualitative interviews demonstrate that the auction mart is an important social site where occupational community and identity can be produced and reproduced for all attending stakeholders, positively impacting upon mental health and wellbeing. The strength of the occupational community among livestock farmers should be considered as a key element among a basket of options approach in the development of support interventions, and as a pathway to negotiating barriers to both help-seeking behaviors and reaching the hard-to-reach. [ABSTRACT FROM AUTHOR]

Supported self-management (SSM) is an important part of adapting to life after stroke however it is a complex concept. It is unclear what SSM in stroke consists of or how stroke survivors, families, and clinicians can most effectively work together to support person-centred self-management. In this study, we aimed to explore what was most important in making SSM work in community stroke rehabilitation. We conducted a Q-methodology study with stroke survivors (n = 20), community-based stroke clinicians (n = 20), and team managers (n = 8) across four health boards in Scotland, United Kingdom. Participants ranked 32 statements according to their importance in making SSM work. Factor analysis was used to identify shared viewpoints. We identified four viewpoints: (i) A person-centred approach to build self-confidence and self-worth; (ii) Feeling heard, understood, and supported by everybody; (iii) Preparation of appropriate resources; and (iv) Right thing, right place, right time for the individual. Important across all viewpoints were: a trusting supportive relationship; working in partnership; focusing on meaningful goals; and building self-confidence. Differing views exist on what is most important in SSM. These views could be used to inform quality improvement strategies to support the delivery of SSM that considers the preferences of stroke survivors. Clinicians should be aware of their own viewpoint of supported self-management and consider how their perspective may differ from stroke survivors' and colleagues' perspectives of what's important to support self-management. Working in partnership with stroke survivors plus developing a trusting and supportive relationship with them are core components of supporting self-management in the longer term after stroke. Building a sense of self-worth and self-confidence, a focus on meaningful goals, training and support for staff, and tailoring support to people's needs at the right time are important considerations for supporting longer-term engagement in self-management. [ABSTRACT FROM AUTHOR]

The aims of this study were to describe how and why adults with CP living in the UK and Ireland accessed and used physiotherapy services; to describe the type of physiotherapy accessed and satisfaction with physiotherapy services and to examine the associations between relevant factors. A cross-sectional semi-structured online survey was employed. Participants were adults with CP aged 18 and above living in the UK and Ireland; able to complete an online questionnaire in English independently or with technical or physical assistance. Data were collected from April 2019 to February 2020. Participants (n = 162) were aged 18–74 years. The majority were female (75%) and lived in the UK (83%). Ninety percent of participants reported a need for physiotherapy but only 35% received physiotherapy services. The most common reason for visiting physiotherapy was mobility decline (62%). Satisfaction with the availability and quality of physiotherapy services were 21% and 27%, respectively. Adults with scoliosis and mobility decline were less likely to report that they received the physiotherapy they needed. Adults with CP did not receive the physiotherapy services that they perceived they needed. There is a need to develop physiotherapy services in collaboration with people living with CP. Adults with cerebral palsy (CP) needed physiotherapy services, but were not receiving the physiotherapy services that they perceive they needed. Adults were not satisfied with the availability or quality of physiotherapy services received. Adults with scoliosis and mobility decline were less likely to report that they received the physiotherapy they needed. There is a need to develop physiotherapy services from a life-span perspective for adults living with CP. [ABSTRACT FROM AUTHOR]

To assess the benefits of the Ida Institute's Why improve my hearing? Telecare Tool used before the initial hearing assessment appointment. A prospective, single-blind randomised clinical trial with two arms: (i) Why improve my hearing? Telecare Tool intervention, and (ii) standard care control. Adults with hearing loss were recruited from two Audiology Services within the United Kingdom's publicly-funded National Health Service. Of 461 individuals assessed for eligibility, 57 were eligible to participate. Measure of Audiologic Rehabilitation Self-efficacy for Hearing Aids (primary outcome) scores did not differ between groups from baseline to post-assessment (Mean change [Δ]= −2.28; 95% confidence interval [CI]= −6.70, 2.15, p=.307) and 10-weeks follow-up (Mean Δ= −2.69; 95% CI= −9.52, 4.15, p =.434). However, Short Form Patient Activation Measure scores significantly improved in the intervention group compared to the control group from baseline to post-assessment (Mean Δ= −6.06, 95% CI= −11.31, −0.82, p =.024, ES=.61) and 10-weeks follow-up (Mean Δ= −9.87, 95% CI= −15.34, −4.40, p =.001, ES= −.97). This study demonstrates that while a patient-centred telecare intervention completed before management decisions may not improve an individual's self-efficacy to manage their hearing loss, it can lead to improvements in readiness. [ABSTRACT FROM AUTHOR]

The meaning and significance of gender is currently a focus of heated and, often, polarised debate in the UK and elsewhere. This article provides a new perspective in the gender debate through focused exploration of UK-based non-binary people's perceptions of legal gender status and reform. Binary gender/sex systems, such as the legal gender system in the UK, are underpinned by cisgenderism and are challenged by those whose identity falls outside of the binary of woman and man. In contrast to most lay participants in the Future of Legal Gender (FLaG) project, the majority of non-binary participants reported support for reform (85.5% (n = 165) in favour) to the current UK legal gender system. Over half (57%, n = 110) were in favour of abolishing legal gender (i.e. the state would no longer assign a legal gender status), although this was constructed as 'an impossible dream'. Situating non-binary people's perspectives at the heart of the debate about the certification of gender offers novel insight which could have significant ramifications for how societal structures could support undoing gender in the future. [ABSTRACT FROM AUTHOR]

To address the paucity of research on patient perspectives regarding return to driving after Total Hip and Total Knee arthroplasty (THA; TKA), and how this impacts on return-to-work. Employed participants, who had undergone THA or TKA, took part in semi-structured telephone interviews. They were asked about support received regarding driving, who provided this information, and the impact of this on their return to driving and consequently work. Thirty-eight people were interviewed. Although sources of information and advice were available, patients struggled to know who to approach. Interviewees reported variations and contradictions in the advice given on when they could safely return to driving after surgery. Of note, there was little difference in the advice given to those who had undergone THA compared to TKA. Many participants devised their own plan for returning to driving There is inconsistency in driving advice provided after THA and TKA. Consequently, patients make their own decisions about how and when to drive, and develop strategies to accelerate the process. Greater clarity is required from healthcare professionals on time frames for driving post-surgery and for advising patients on their responsibilities around informing the DVLA and insurance companies of their surgery. Healthcare professionals should be aware of medico-legal requirements when advising patients about their legal responsibilities regarding driving after joint arthroplasty. Given the pivotal role of driving in the resumption of work after joint arthroplasty, there needs to be greater importance placed on the provision of explicit advice and support on driving for those undergoing orthopaedic surgery. As driving is a complex skill, the advice given to patients should be individualised. Factors to be considered should be the type of vehicle driven e.g., automatic/manual transmission; height of the vehicle from the ground; the side of the surgery; any medication prescribed which might impact on driving, and consideration of any comorbidities. [ABSTRACT FROM AUTHOR]

Visual perceptual deficits are frequently underdiagnosed in stroke survivors compared to sensory vision deficits or visual neglect. To better understand this imparity, we evaluated current practice for screening post-stroke visual perceptual deficits. We conducted a survey targeted at professionals working with stroke survivors involved in screening visual perceptual deficits across the United Kingdom and the Republic of Ireland. Forty orthoptists and 174 occupational therapists responded to the survey. Visual perceptual deficit screening was primarily conducted by occupational therapists (94%), with 75∼100% of stroke survivors screened per month. Respondents lacked consensus on whether several common post-stroke visual deficits were perceptual or not. During the screening, respondents primarily relied on self-reports and observation (94%), while assessment batteries (58%) and screening tools were underutilised (56%) and selected inappropriately (66%). Respondents reported lack of training in visual perception screening (20%) and physical/cognitive condition of stroke survivors (19%) as extremely challenging during screening. Visual perceptual deficits are screened post-stroke at a similar rate to sensory vision or visual neglect. Underdiagnosis of visual perceptual deficits may stem from both reliance on subjective and non-standardised screening approaches, and conflicting definitions of visual perception held among clinicians. We recommend increased training provision and use of brief performance-based screening tools. Lack of agreement among clinicians on what constitutes as visual perceptual or sensory vision deficits may prove problematic, as precise and exact language is often required for clinical decision-making (e.g., referrals). Biases for more familiar visual (perceptual) deficits held among clinicians during the screening process may lead to other visual deficits being missed. To avoid problems being missed, clinicians should aim to use standardised assessments rather than stroke survivor self-report and observations of function when screening for visual perceptual difficulties. [ABSTRACT FROM AUTHOR]

This article examines the experiences of citizens with dementia who campaign for social change, with a particular focus on the effects of campaigning on citizenry identity and psycho-emotional well-being. In diary-interviews, 16 people with dementia recorded and described their experiences of campaigning. Findings revealed that although campaigning can be energising and reaffirming of citizen identity, because it (re)located a person within the realm of work, individuals may experience dementia-related fatigue and oppression linked to normative expectations about what someone with dementia ‘should’ be like. The discussion is linked to critical debates within disability studies about the psycho-emotional aspects of impairment and disability, and concludes that the struggle for citizenship has only just begun for people with dementia. [ABSTRACT FROM AUTHOR]

This study considered professional input into collecting personalized donor information for later release to donor offspring. Existing studies report the importance of such information for identity completion, to satisfy curiosity, and to allay anxiety about genetic inheritance. The study used a three-pronged approach: a literature search of professional practices in this and related fields; key informant telephone interviews with donor-conceived adults, sperm and egg donors, and professionals and a postal survey of UK clinics' practices and views. The literature revealed only one previous study, which suggested gendered approaches to pen portraits were used in commercial donor banks. Key informants agreed on the importance of information for offspring well-being and the need for support services in its compilation and on release. Donors reported inadequate professional assistance to date. The postal survey of clinics revealed variable practices in the process of acquiring and storing later life information and variable success in achieving its completion. Respondents identified factors that hinder completion (donor anxiety, lack of guidance, shortage of staff time) and factors that help (donor belief in the importance of later life information, staff belief, dedicated staff time). Further research, including intervention studies, is needed into the processes and skills involved in collecting later life information. [ABSTRACT FROM AUTHOR]

As the use of social media to mediate learning in the occupational therapy profession gains increasing recognition, calls for tangible guidance with concrete and platform-specific examples have also become prominent. This study aims to describe and analyse the various learning activities qualified occupational therapy practitioners engage with in professional communities known as 'groups' on the Facebook social media platform. Forty-nine (n = 49) practitioners eligible for registration with the Health and Care Professions Council in the United Kingdom completed online questionnaires to produce one-hundred and ten (n = 110) critical incident reports. Data were thematically analysed. Six learning activities were inductively identified: (1) Acquisition of New Ideas; (2) Reinforcement of Existing Knowledge; (3) Adjustments to Existing Knowledge; (4) Learning about Resources; (5) Learning related to Career Advancement; (6) Learning related to Hidden Curriculum. This study showcases the varied ways occupational therapy practitioners learn through Facebook Groups, evidencing the utility of this professional learning environment. Findings enable occupational therapy practitioners to better evaluate which activities to engage in on Facebook Groups for learning and development of higher-quality professional practice. Further research examining the utility of Facebook Groups for professional learning in contrast to other social media platforms is recommended. [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]

Objectives: The implementation of new health services is a complex process. This study investigated the first phase of the adaptive implementation of the Dutch Meeting Centres Support Programme (MCSP) for people with dementia and their carers in three European countries (Italy, Poland, the UK) within the JPND-MEETINGDEM project. Anticipated and experienced factors influencing the implementation, and the efficacy of the implementation process, were investigated. Findings were compared with previous research in the Netherlands. Method: A qualitative multiple case study design was applied. Checklist on anticipated facilitators and barriers to the implementation and semi-structured interview were completed by stakeholders, respectively at the end and at the beginning of the preparation phase. Results: Overall, few differences between countries were founded. Facilitators for all countries were: added value of MCSP matching needs of the target group, evidence of effectiveness of MCSP, enthusiasm of stakeholders. General barriers were: competition with existing care and welfare organizations and scarce funding. Some countries experienced improved collaborations, others had difficulties finding a socially integrated location for MCSP. The step-by-step implementation method proved efficacious. Conclusion: These insights into factors influencing the implementation of MCSP in three European countries and the efficacy of the step-by-step preparation may aid further implementation of MCSP in Europe. [ABSTRACT FROM AUTHOR]

There has been a considerable drive to encourage a wide range of professional groups to incorporate alcohol screening (or identification) and brief advice (IBA) into their everyday practice. This article aims to examine the role of training in promoting IBA delivery in contexts outside primary care and other health settings. The data are drawn mainly from a structured online survey supplemented by illustrative material from nine qualitative interviews and insights from an expert workshop. Findings support the results from other research that issues relating to role relevance and role security continue to act as barriers to professional change. Furthermore, issues of organisational commitment and organisational barriers are insufficiently addressed in strategy to promote wider use of IBA. The article concludes that development of appropriate training for alcohol IBA needs to take account of the role of IBA within a complex interactive system of related services and help seeking pathways and consider how training can contribute to changing both professional attitudes and behaviours and organisational approaches to implementing and sustaining IBA in everyday professional practice. [ABSTRACT FROM PUBLISHER]

Background: Whilst the scientific understanding of mild traumatic brain injury sequelae has advanced, the consequences of neurological insults sustained during football play in the form of multiple concussions and heading remains unclear. Method: To the authors’ knowledge, this is the first longitudinal prospective study to follow-up a group of footballers and controls over time. Thirty-two elite young professional footballers were recruited and 24 were identified at follow-up. Thirty-three controls were recruited and 17 identified at follow-up. Medical examination, MRI (brain) imaging and detailed neuropsychological data were collected on the footballers at baseline and 5-year follow-up. Medical examination and detailed neuropsychological data were collected on the controls at baseline and 5-year follow-up. Results: All participants had normal neurological examination at both time points. At baseline, 37% of the footballers had sustained minor neurological insults. Between baseline and 5 years, 66% of the footballers had sustained minor neurological insults. No MRI (brain) abnormalities were identified among the footballers at either time point. Regarding the neuropsychology, there was a 6-point IQ difference between footballers and controls, with the footballers being low. Test–re-test analysis on a range of carefully selected neurocognitive tests revealed a picture of good stability in cognitive functioning over this 5-year period. Conclusions: These longitudinal prospective data indicate no significant neurological, structural brain imaging or neuropsychological change among a sample of young elite professional footballers over the first 5 years of their professional career. [ABSTRACT FROM PUBLISHER]

Objective: This study explored the psychosocial experiences of adults with hearing loss using the self-regulatory model as a theoretical framework. The primary components of the model, namely cognitive representations, emotional representations, and coping responses, were examined. Design: Individual semi-structured interviews were conducted. The data were analysed using an established thematic analysis procedure. Study sample: Twenty-five adults with mild-moderate hearing loss from the UK and nine hearing healthcare professionals from the UK, USA, and Canada were recruited via maximum variation sampling. Results: Cognitive representations: Most participants described their hearing loss as having negative connotations and consequences, although they were not particularly concerned about the progression or controllability/curability of the condition. Opinions differed regarding the benefits of understanding the causes of one’s hearing loss in detail. Emotional representations: negative emotions dominated, although some experienced positive emotions or muted emotions. Coping responses: engaged coping (e.g. hearing aids, communication tactics) and disengaged coping (e.g. withdrawal from situations, withdrawal within situations): both had perceived advantages and disadvantages. Conclusions: This novel application of the self-regulatory model demonstrates that it can be used to capture the key psychosocial experiences (i.e. perceptions, emotions, and coping responses) of adults with mild-moderate hearing loss within a single, unifying framework. [ABSTRACT FROM AUTHOR]

Objective:Despite the benefits of physical activity (PA), only one-third of older adults meet the recommended levels. The present study focused on psychosocial determinants of PA following retirement. Social cognitive theory (SCT) was used to better understand pre- and post-retirement adults’ thoughts about PA, the reasons why some individuals are more active than others, and how PA is incorporated into daily life after retirement. Design:Seven focus groups of older adults (N = 37,M = 64, SD = 5.20; males = 20) representing a range of PA levels and retirement length participated in one of seven focus groups. Results:Aligned with SCT, self-efficacy beliefs along with perceptions about barriers and benefits of PA were among the major determinants of PA. Findings highlighted the importance of social support, positive outcome expectations and self-regulatory strategies as motivators. The lack of structure in retirement was a hindrance to incorporating PA into daily routine but, when incorporated, PA provided a sense of purpose in the lives of retired individuals. Conclusion:It is important to understand the meaning of retirement as a life transition and how it affects beliefs about PA to inform SCT-based health promotion interventions targeting individuals in retirement age. [ABSTRACT FROM PUBLISHER]

Objective:This pilot study investigated the use of patient drawings to explore patient experiences of symptoms of melanoma prior to health care use. Design:Patients (n = 63) with melanoma were interviewed within 10 weeks of diagnosis. Participants were asked to draw what their melanoma had looked like when they first noticed it, and to make additional drawings to depict changes as it developed. Main outcome measure:The size and features of the drawings were compared between participants and with clinical data (thickness of the melanoma; histological diameter; clinical photographs). Results:Eighty-four percent of participants were able to produce at least one drawing. This facilitated discussion of their lesion and recall of events on the pathway to diagnosis. Common features of the drawings related to the view, presence of shading, inclusion of sections and the shape and border of the lesion. There was potential for disparity between the details in awareness resources and the perceptions of patients. The drawings resembled the clinical photographs and the size of the drawings was positively associated with the histological diameter, but did not differ according to tumour thickness. Conclusion:Asking patients to make drawings of their melanoma appears to be an acceptable, inclusive, feasible and insightful methodological tool. [ABSTRACT FROM PUBLISHER]

Background: UK social firms are under-researched but are a potentially important vocational option for people with mental health problems. Aims: To describe the clinical profile, satisfaction levels and experiences of social firms employees with mental health problems. Method: Clinical, work and service use characteristics were collected from social firms' employees with mental health problems in England and Wales. Workplace experience and satisfaction were explored qualitatively. Results: Predominantly, social firms' employees (N = 80) report that they have a diagnosis of depression (56%) and anxiety (41%). People with schizophrenia (20%) or bipolar disorder (5%) were a minority. Respondents had low symptom and disability levels, high quality of life and job satisfaction and experienced reductions in secondary mental health service use over time. High-workplace satisfaction was related to flexibility, manager and colleague support and workplace accommodations. Conclusions: The clinical profile, quality of life and job satisfaction level of employees with mental health problems suggest social firms could be a useful addition to UK vocational services for some people. Current employees mainly have common mental disorders, and social firms will need to shift their focus if they are to form a substantial pathway for the vocational recovery of people currently using community mental health teams. [ABSTRACT FROM AUTHOR]

Interprofessional teamwork is seen in healthcare policy and practice as a key strategy for providing safe, efficient and holistic healthcare and is an accepted part of evidence-based stroke care. The impact of interprofessional teamwork on patient and carer experience(s) of care is unknown, although some research suggests a relationship might exist. This study aimed to explore patient and carer perceptions of good and poor teamwork and its impact on experiences of care. Critical incident interviews were conducted with 50 patients and 33 carers in acute, inpatient rehabilitation and community phases of care within two UK stroke care pathways. An analytical framework, derived from a realist synthesis of 13 'mechanisms' (processes) of interprofessional teamwork, was used to identify positive and negative 'indicators' of teamwork. Participants identified several mechanisms of teamwork, but it was not a subject most talked about readily. This suggests that interprofessional teamwork is not a concept that is particularly important to stroke patients and carers; they do not readily perceive any impacts of teamwork on their experiences. These findings are a salient reminder that what might be expected by healthcare professionals to be important influences on experience may not be perceived to be so by patients and carers. [ABSTRACT FROM AUTHOR]

Background: Individual placement and support (IPS) is an effective form of supported employment for people with severe mental illness. Little is known about service users' experiences of these programmes during economic recession. Aims: Obtain service users' views of an IPS programme implemented in the UK during recession. Method: Thirty-one service users enrolled in an IPS programme were interviewed using a semi-structured protocol. The questions covered several areas of their experience, including problems faced in seeking work, perceived barriers in returning to work and what they found helpful in employment support. Results: Unsurprisingly, a large number of service users had problems in finding work due to the number of appropriate jobs available. Nevertheless, many service users felt positively about the support they had received (90% were satisfied with IPS), and would advise others in their position to seek employment. Personal and practical support from employment specialists (ES) was the most useful aspect of the service. Conclusions: Despite economic recession, an IPS service was implemented and regarded as satisfactory to service users seeking work. Although many found obtaining employment difficult, they would still advise others that work is worthwhile, suggesting that the context of recession has not discouraged them. [ABSTRACT FROM AUTHOR]

Introduction: Widening participation in Medicine is a key policy priority as it helps promote a diverse and representative workforce and improves patient care. The selection process employed can influence the socio-economic composition of the student cohort and this study therefore evaluated whether Multiple Mini Interview (MMI) performance was influenced by school type or area-level Higher Education (HE) participation rates. Methods: MMI performance for all UK applicants was recorded and consent to link performance with socio-economic data was requested using an applicant questionnaire. Station-level and total MMI scores, and offer rates were compared between applicants from non-selective, non-fee-paying schools and from selective and/or fee-paying schools; and between applicants from each quintile of area-level HE participation. Results: 793 applicants were included in the analysis. MMI performance and offer rates were slightly higher for applicants from non-selective, non-fee-paying schools and/or from lower HE participation quintiles, but the effects were small and not statistically significant. Conclusions: The MMI did not favour applicants from selective and/or fee-paying schools, or from areas with high HE participation rates. Work to evaluate whether the relationship between MMI and medical school performance is the same for all sub-groups of students is now required. [ABSTRACT FROM AUTHOR]

Aims: Residential rehabilitation (RR) is relatively expensive and is received by a minority of drug users seeking treatment. It is perceived to be particularly effective, but those entering RR may be more amenable to treatment than those treated in other modalities. The objective of this study was to explore ways in which opiate users treated in a residential setting differ, at treatment entry, from those treated in a community setting. Methods: Opiate users ( N = 406) who received either RR or community substitute prescribing (CSP) were sampled from the UK Drug Treatment Outcomes Research Study (DTORS). A logistic regression analysis, controlling for Drug Action Team, was used to predict the occurrence of RR versus CSP for the treatment of opiate dependence. Measures included self-reported levels of drug use, offending, social measures and health. Findings: RR clients were different to CSP clients in a number of respects that may positively influence treatment outcome; most importantly, their reasons for seeking treatment were different and they were better motivated. Conclusions: Higher treatment motivation may be one factor that explains why RR is a more effective treatment for clients with complex drug-related problems. [ABSTRACT FROM AUTHOR]

Stroke is a leading cause of disability across the developed world, affecting an increasing number of younger people. In this article, we seek to understand the experience of stroke as a disabling life situation among young people and the strategies that they use to recover and cope. Directed content analysis was conducted from interviews with 17 community-dwelling stroke survivors aged 55 years and younger across the United Kingdom. The sample was drawn from a larger maximum variation sample of stroke survivors. Using the sociological concepts of biographical disruption and biographical repair as a guide, excerpts from the interviews pertaining to aspects of the patients' life that were interrupted, in addition to how they coped with the changes, were selected and analysed. All individuals described an ''altered sense of self,'' a theme that included loss of identity, family disruption, and/or loss of valued activities. Individuals sought to adapt their sense of self by seeking external support, by restoring normality, and/or through positive reflection. Despite the adapted self that emerged, most individuals continued to experience impairments. While young stroke survivors adapt to their illness over time, they continue to experience impairments and disruptions in their personal and work lives.Aholistic model of rehabilitation that helps individuals regain the capacity for everyday activities related to work, family life, and leisure can begin to address the emotional ramifications of diseases such as stroke, restore wellness, and work towards minimizing the burden felt by family caregivers and children. [ABSTRACT FROM AUTHOR]

Following its election in 2010 the UK’s Coalition Government has sought to implement radical restructuring of disability-related benefits justified by reference to the financial crises of 2007/08. In this article we examine how these changes have impacted on coverage of disability in the UK media comparing and contrasting coverage of disability in newspapers in 2010/11 with a similar period in 2004/05. Our analysis suggests that disabled people have become a ‘folk devil’ and that there has been a significant change in the way that disability is reported. Newspaper coverage in 2010/11 was less sympathetic and there was an increase in articles that focused on disability benefit and fraud, and an increase in the use of pejorative language to describe disabled people. An audience reception study suggests that this coverage is having an impact on the way that people think about disabled people. [ABSTRACT FROM PUBLISHER]

In resource-based models of job design, job resources, such as control and social support, are thought to help workers to solve problems. Few studies have examined this assumption. We analyzed 80 qualitative diary entries (N=29) and interviews (N=37) concerned with the in-role requirements of medical technology designers in the UK for problem solving. Four themes linked to using the resources of job control and social support for problem solving emerged. These were: (1) eliciting social support to solve problems; (2) exercising job control to solve problems; (3) co-dependence between eliciting social support and exercising job control to solve problems; and (4) using job resources to regulate affect. The results were largely supportive of the assumptions underpinning resource-based models of job design. They also indicated that the explanatory power of resource-based models of job design may be enhanced by considering interdependencies between various factors: how different job resources are used, workers' motivation to use resources, workers' knowledge of how to use resources and the use of resources from across organizational boundaries. The study provides qualitative support for the assumption that social support and job control are used to cope with demands. [ABSTRACT FROM AUTHOR]

Prescriptive authority has been extended in the UK to include non-medical healthcare professionals. However, uptake and use of prescribing by these professionals are inconsistent. Collaborative practice is key for its successful implementation, and such practice is a benefit of interprofessional education (IPE). This study explored the feasibility of IPE between nurse prescribers at Anglia Ruskin University and 3rd year medical students at the University of Cambridge. Three focus groups and three individual interviews were undertaken with nurse and medical prescribing students, following shared learning sessions on drug interactions, prescription writing and legal issues and accountability. Benefits included the opportunity for mutual understanding of prescribing training and role. Medical students valued the opportunity to be able to gain an insight into nurses' views about prescribing. The level and breadth of pharmacology knowledge of medical and nursing students differed. Location of sessions, scheduling of classes and balancing of students acted as barriers to learning. [ABSTRACT FROM AUTHOR]