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The paper presents a comparative mixed methods study of the accessibility and usability for disabled people of four video conferencing tools, Zoom, MS Teams, Google Meet and Skype. Useable responses were obtained from 81 disabled people with diverse characteristics, mainly in the UK, though some groups had low representation. None of the tools was considered fully accessible and useable. Zoom was both the most commonly used and the most frequently preferred (56.1%) tool, with MS Teams second in usage and a trailing second in preferences (15.9%). It was considered to have better captioning, but otherwise to generally be a poor second to Zoom. Skype was the most commonly used before lockdown, but was considered dated and its limited use was mainly social, whereas the other tools were also used in work and education. The results were used to draw up separate lists of recommendations for developers and meeting organisers and hosts, as the study also identified actions for organisers and hosts to improve meeting accessibility. Developer recommendations include several easy to set customisation and user friendly interface features, involving disabled people and specific accessibility features, including compatibility with assistive technology, keyboard shortcuts for all functions and automatically-on high quality captions. [ABSTRACT FROM AUTHOR]

The impacts of the COVID-19 pandemic in the creative and cultural industries have been closely tracked by researchers, professional bodies, and arts organisations. In the period of recovery that has followed, emphasis has moved towards building a more inclusive and sustainable industry. Yet beyond the headline statistics, accounts of the support needs of creative workers – as identified in their own words – are less forthcoming. This paper reports on open responses collected during April-May 2021 as the United Kingdom began to lift lockdown restrictions. Thematic analysis of responses identified three overarching themes identified by respondents as central to sustainable recovery: (i) Financial Infrastructures; (ii) Artistic communities; and (iii) Future-proofed professional landscapes. The findings support previous research that has emphasised the need for recovery to prioritise supporting individual artists and the importance of freelance voices at all stages of policy and decision making to ensure equitable development for the future. [ABSTRACT FROM AUTHOR]

Background: This paper presents the findings from an exploratory study on alcohol and other drugs (AOD) nurses' views on current career opportunities and challenges and on how their role has been affected by clinical and structural changes in service delivery. Methods: The paper is based on qualitative interviews with a purposive sample of twelve AOD nurses in the UK. A narrative approach to interviewing aimed to encourage emergence of new insights and suggest theories for future examination. Interview domains were informed by the research team's knowledge of AOD nursing and by themes from published literature. Interviews were recorded, transcribed, and coded and a reflexive thematic analysis was conducted. Results: Key themes emerging focused on the growth, advantages, and challenges of non-medical prescribing (NMP), and the impact on AOD nursing of changes in workforce structures and environments. The findings indicate considerable doubts about career opportunities for nurses in AOD services although NMP may offer some limited routes to career advancement. Conclusions: Some long-standing issues around the identity and professional status of AOD nurses persist and current clinical and structural changes have created a "liminal space" within which the nursing role and AOD nurse identityare disrupted and in transition. [ABSTRACT FROM AUTHOR]

Background: During lockdown, I began exploring the use of response art while working with individual adult clients in private practice online. At times, the contributions it made to the therapy seemed significant and too pivotal to ignore. Context: Adult clients in private art therapy practice in the UK. Approach: An overview of the present discourse on response art is provided, followed by an exploration of related theories including Stern's 'attunement', Winnicott's 'holding' and Bion's 'container-contained'. An outline of how response art is integrated into a session is presented and illustrated with three vignettes. Outcomes: Response art was useful for the clients included in this paper when frozen emotionally or struggling to find words. It helped with restarting art making, trusting the therapist, reframing experiences, and encouraging emotional processing. Conclusions: Attunement was key in the decision-making and implementation of a creative response. The therapist's vulnerability in exposing their creative and mental processes appeared to be a valuable model for the client. The sounds (or silences) and gestures made during the making of the response art also appeared to be significant for the clients. Implications for research: Further research into benefits, risks and influencing factors when using response art would be instructive. Plain-language summary: Traditionally the art therapist observes the client making art. During lockdown, I began to explore making artwork at the same time as the client. I was working online with individual adult clients in private practice with the aim of responding to what they brought to the session. The contributions that the response artwork made to the therapy seemed significant and too important to ignore. An overview of the current discussion around response art is outlined. This is followed by looking at how it could relate to theory. An outline is given of how it was introduced and used within sessions, and three examples are offered to illustrate. Response art seemed to be useful when the clients included in this paper were stuck emotionally or could find no words. It helped them to restart their own art making and processing. Sometimes it appeared easier for the clients to trust what they saw in the response artwork, than it was for them to trust the therapist. Through the response art I hoped to offer another view point and encourage the clients towards alternate ways of thinking. Empathy is of key importance in art therapy. In the making of response artwork, I attempted to demonstrate my empathy for my clients. I became vulnerable in the process of artmaking, which appeared be a helpful model for the clients. The sounds (or silences) and gestures made by the therapist during the making of the response, also appeared to be significant for the clients. More research into the benefits, risks and influencing factors when using response art would be useful. It would be helpful to have a better understanding about the role of gender in response art and if there are any implications for practice or not. [ABSTRACT FROM AUTHOR]

Purpose: Understanding doctors' health beliefs is essential for developing effective and competent healthcare practices that benefit doctors and their patients. This study aimed to qualitatively explore doctors' perceptions of on-shift health-protective behaviours and their perceived effects on competence. Methods: The research applied theoretically driven Expanded Health Belief Model (EHBM) enquiry methods to explore beliefs and experiences through an occupational context survey, 14 individual depth interviews, and two focus groups. Semantic and deductive themes associated with EHBM domains were examined, and an inductive thematic analysis of the interviews was conducted. Results: Doctors' beliefs were strongly imbued by their perceived identity within the systemic context; they expressed impaired self-efficacy in reacting to their health needs on shift, and several disclosed harm to themselves and patients. Dominant themes included the psychosocial effects of the systemic culture and the influence of the situational occupational context in impacting health-protective behavioural action. The context and implications of experiences during the COVID-19 pandemic are discussed. Conclusions: This study presents key belief-oriented factors influencing doctors' health-protective behaviour at work and its implications for competent practice. Further doctor-led guidance on focus points for evidence-based theoretically driven health improvement solutions is provided regarding operational practice, formulating policies, developing interventions and further research. [ABSTRACT FROM AUTHOR]

Background: Cystic Fibrosis (CF) is a genetic life limiting disease that impacts upon quality of life. An aim of CF care is to preserve lung function, with physical activity (PA) being an important part of daily airway clearance. Ensuring children have opportunities to engage in PA at school should be an important part of their daily routine. It is important to gain parental perspectives on this, as they manage the daily care for their children. This study aims to explore parents' perceptions of school-based PA for their children with CF. Methods: Parents of children with CF (n = 10), from three regions of the UK (England, Wales and Northern Ireland) took part in online semi-structured interviews. Data were analysed using Interpretative Phenomenological Analysis (IPA). Results: Although parents recognized the benefits of school-based PA for their children, systemic barriers in the school setting often inhibit daily PA for children with CF, including teachers' misconceptions, emotional and physical barriers, and PA not being a priority. Conclusion: Recommendations for practice have been developed to help engage children with CF in daily school-based PA in an inclusive way, with the hope of maintaining health outcomes for children with CF. [ABSTRACT FROM AUTHOR]

This study assesses the influence of weather on Click & Collect (C&C) usage in England, examining differences between the day of order and day of collection, and how the weather influences the time taken to collect an order. Using sales and loyalty card data from a national retailer, we employ a series of gradient boosting models to analyse the influence of weather on daily order/collection totals, totals stratified by demographic group, and the time taken to collect an order. Weather is found to be consistently more influential on the day of order than the day of collection, however store location and thetiming of purchase have a higher relative influence than weather overall. The findings also evidence significant differences in influence between male and female customers and those aged above and below 65. Temperature and humidity are typically the most influential weather conditions, demonstrating a wide variation in effect on order totals. Temperature was also found to be significantly more influential than other weather conditions on the time taken to collect an order, with the highest temperatures leading to the longest collection times. Understanding the influences of different weather conditions on online consumption behaviours is of significant value to retailers, policy makers and associated stakeholders. However, it is an area that has been significantly under-researched compared to physical retailing, often due to a lack of reliable data. This study provides key insights into how different types of consumers behave on these platforms. [ABSTRACT FROM AUTHOR]

The global rise in adolescent self-harm and suicidal behaviours has intensified the demand for mental health services in the UK. This has further strained already underfunded and understaffed resources, resulting in longer waiting times and increased emergency department visits among teenagers. To address the overwhelming need for effective community-based emergency support, a brief psychodynamic crisis therapeutic intervention was developed within a CAMHS adolescent crisis team, inspired by child psychotherapist Ruth Schmidt Neven's work on time-limited psychotherapy with adolescents and their families. This 12-session intervention offers both individual therapy for the adolescent and sessions for their parents, along with regular family reviews. Two psychotherapists work closely together on each case – one with the young person, the other with the parents. The brief model views crises as opportunities for deeper understanding, moving beyond diagnostic and symptom-centred approaches, as well as standard risk management and safety-planning strategies, and underlines the centrality of parent involvement in adolescent crisis work. This paper outlines the intervention's theoretical foundation, guiding principles, and practical design, and presents preliminary findings from a pilot study of 22 cases, run over two and a half years. Early results suggest broad potential for this psychodynamic crisis approach in various adolescent crises, and merit further investigation. [ABSTRACT FROM AUTHOR]

Previous comparative research has revealed recent high and rising school exclusion rates in England and a contrasting picture of much lower and reducing rates in Northern Ireland, Scotland and Wales. In this paper, we examine findings from new research into school exclusion policies across the four countries of the UK. This interrogates for the first time how the problem of 'school exclusion' is framed within these four distinct policy contexts. We take up the question of how policy levers and drivers may shape patterns and trends in permanent exclusion and suspension/temporary exclusion. This analysis reveals that, despite broad agreement in policy on a need to reduce exclusion and increase equity across the UK jurisdictions, there are diverging policy stances on the purposes of exclusion, responsibilities of schools and the role of the state overall in bringing about change. We conclude that deeper critical engagement with policy contexts is a vital element in understanding the persistence of school exclusion itself but also the differential rates of exclusion across the UK. [ABSTRACT FROM AUTHOR]

This paper uses uniquely detailed large-scale commercial real estate investment data to examine how financial markets perceived the attractiveness of investing in UK regions during the last two decades. Our analysis demonstrates that prior to the 2008 Global Financial Crisis all regions of the UK were perceived similarly in terms of risks, whereas the crisis engendered a flight to safety of capital into London. Other UK regions shifted rapidly into junk bond territory, and have remained there ever since. These asymmetric capital shocks led up to a profound and adverse shift in the subsequent productivity growth of the UK regional economies. [ABSTRACT FROM AUTHOR]

Outcomes among acute kidney injury (AKI) patients are poor in United Kingdom (UK) hospitals, and electronic alerts and care bundles may improve them. We implemented such a system at West Suffolk Hospital (WSH) called the 'AKI order set'. We aimed to assess its impact on all-cause mortality, length of stay (LOS) and renal function among AKI patients, and its utilization. Retrospective, single-center cohort study of patients ≥ 18 years old with AKI at WSH, a 430-bed general hospital serving a rural UK population of approximately 280,000. 7243 unique AKI events representing 5728 patients with full data were identified automatically from our electronic health record (EHR) between 02 September 2018 and 1 July 2021 (median age 78 years, 51% male). All-cause mortality, LOS and improvement in AKI stage, demographic and comorbidity data, medications and AKI order set use were automatically collected from the EHR. The AKI order set was used in 9.8% of AKI events and was associated with 28% lower odds of all-cause mortality (multivariable odds ratio [OR] 0.72, 95% confidence interval [CI] 0.57–0.91). Median LOS was longer when the AKI order set was utilized than when not (11.8 versus 8.8 days, p <.001), but was independently associated with improvement in the AKI stage (28.9% versus 8.7%, p <.001; univariable OR 4.25, 95% CI 3.53–5.10, multivariable OR 4.27, 95% CI 3.54–5.14). AKI order set use led to improvements in all-cause mortality and renal function, but longer LOS, among AKI patients at WSH. [ABSTRACT FROM AUTHOR]

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We report on a case study using Positioning Theory as the basis for the design of a course to support Chinese international master's students understand and apply critical thinking (CT) within the context of higher education (HE) in the United Kingdom. Our aim was to understand the extent to which students found this helpful in their understanding and use of CT. Drawing on previous research, the retreat included direct teaching of positioning in relation to use of CT, as well as more general information on the conceptualisation and application of CT. One hundred and twenty-eight students took part in the retreat, and 14 agreed to be interviewed about their experiences. Thematic analysis of group interviews at the end of the retreat generated three themes related to the efficacy of this approach in supporting CT: early (mis)understanding of CT and self-positioning, pedagogical approaches and perceived teacher-positioning, student aspirations to be positioned as practitioners or critical researchers. Our findings support the limited calls in the literature for direct teaching of CT early in the master's degree, taking account of the pedagogical approaches used to support this. While our students reported a linguistic misunderstanding of the term CT, the broader role of culture was also evident in their approach to CT. [ABSTRACT FROM AUTHOR]

This paper uses disruption to norms of funeral attendance experienced in the UK during the COVID−19 pandemic as a lens to illuminate why and how funeral attendance can matter. It draws on an extensive qualitative dataset, gathered through semi-structured interviews with a diverse sample of 68 individuals who were bereaved and/or worked or volunteered in death care during the COVID−19 pandemic. It first examines interviewees' concerns about the insufficiency of funerals when gatherings were restricted. Second, it depicts the range of additional and alternative ways people found to pay tribute to the deceased and to offer and seek support when conventional funeral attendance was limited. Third, it explains why, for some, the smaller funerals necessitated by pandemic restrictions were welcome experiences. These findings support a development of Bailey and Walter's influential theorising concerning 'configurational eulogies': while a 'well-attended' funeral still matters to many, mourners contribute to configurational eulogies through a diverse and evolving range of activities. The shifts in funeral gatherings and activities prompted by the COVID−19 pandemic can be understood as part of dynamic processes of reconfiguring eulogistic repertoires in changing social contexts. [ABSTRACT FROM AUTHOR]

Military widow/ers can experience spousal death suddenly and in traumatic circumstances. Evidence shows that this experience often has a long-term effect on surviving family members, highlighting the unique experiences of loneliness and social isolation in the armed forces community. This study aimed to explore military widow/ers' lived experiences of social isolation and loneliness and unmet needs relating to social participation. This paper presents the qualitative findings of a sequential study in which Phase One utilized an online survey (N = 165) and Phase Two employed semi-structured interviews (N = 26). Almost all participants across both Phases discussed feeling lonely, socially isolated, or both. Findings highlight the complexity in transition from military spouse to military widow/er through the loss of a military community and geographical location. This was further compounded by language barriers and perceived hierarchy (through service life or circumstances of death) which created obstacles to help seeking. However, individuals who did join military widow/ers' associations valued peer support through shared connection and understanding. Peer support was particularly valued as, for many, existing relationships with friends or family members were often negatively impacted following bereavement. These changed relationships led to feelings of both vulnerability and loss. Consideration needs to be given to how access to appropriate support is gained and what provision needs to be in place. This study recommends the use of more inclusive language for the military bereaved to promote inclusive practices and broaden the availability of support, including that which would increase social participation, across the sector. [ABSTRACT FROM AUTHOR]

The quality of the UK’s doctorate training system plays a fundamental role in fostering vibrant research outputs and attracting global talent. However, while maintaining a consistently high standard of quality remains static and challenging, little is known about how the employability of international doctorate students is shaped and at what juncture it is opportune to support their employability during their research studies. This paper aims to understand the employability of international doctoral students within business schools at British universities, drawing on Urie Bronfenbrenner’s ecological systems theory as a framework. The qualitative study involves 15 international doctoral students from 9 business schools. The findings uncover various environmental systems impacting their employability. In addition, this study theoretically extends employability research by applying Bronfenbrenner’s ecological systems theory to provide a multi-layered understanding of international doctorate employability, offering a novel framework for targeted career support interventions. Further, the implications highlight the urgent need for tailored support to build industrial connections, promote departmental collaboration to scaffold a dynamic research environment, proffer multiple resource channels, and create employment opportunities both inside and outside of the university. [ABSTRACT FROM AUTHOR]

Between 30 and 40% of 18-year olds in England, Wales and Northern Ireland enter tertiary education (university) each year. Young adulthood (ages 15 to 25) is the usual period in which problems with alcohol, drugs or other behaviors begin to emerge, and yet these issues have received limited study in the UK. Government policy dictates that a full continuum of treatment and recovery services should be available in each area of the country, but uptake of these services by university students appears to be limited. In this discussion paper we describe the background to, and components of, the Collegiate Recovery Program (CRP), an initiative that has grown rapidly in the USA in the past decade. We then describe how the first UK University-led CRP was set up, before outlining what has been learnt so far and the potential challenges facing this approach. [ABSTRACT FROM AUTHOR]

Aim: To assess the knowledge, attitudes and practices of Registered Nurses working in residential aged care facilities pertaining to pain management for residents living with dementia. Background: Sub-optimal pain management continues for people living with dementia in residential aged care. Registered Nurses are the pivotal staff responsible for complex assessment and management of people residing in residential aged care facilities. Design and methods: :This integrative literature review was informed by Whittemore (2005). Searching and screening followed the PRISMA guidelines. Results: Thirteen papers were identified, the major themes identified were gaps in knowledge and skills, uncertainty of assessment, and delays in treatment. Conclusion: Registered Nurses require education on pain management for people living with dementia in residential aged care. Broader issues in residential aged care contribute to the problem and require examination. Research pertaining to Registered Nurses' roles pain management for residents living with dementia is required. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about how children learn to control eye-gaze technology, and clinicians lack information to guide decision-making. This paper examines whether typically developing 2–3 year olds can infer for themselves the causal mechanisms by which eye-gaze technology is controlled, whether a teaching intervention based on causal language improves performance and how their performance compares to the same task accessed via a touchscreen. Methods and materials: Typically developing children's (n = 9, Mean Age 28.7 months) performance on a cause and effect game presented on eye-gaze and touchscreen devices was compared. The game was presented first with no specific instruction on how to control the devices. This was followed by a subsequent presentation with explicit instruction about how the access methods worked, using a causal language approach. A final presentation examined whether children had retained any learning. Results: Performance in the eye-gaze condition without instruction (42.5% successful trials) was significantly below performance in the corresponding touchscreen condition (75%). However, when causal language instruction was added, performance with both access methods rose to comparable levels (90.7% eye-gaze and 94.6% touchscreen success). Performance gains were not retained post-intervention. Conclusions: Although 2–3 years in the study could make use of eye-gaze technology with support, this study found no evidence that these children could infer the causal mechanisms of control independently or intuitively. The lack of spatial contiguity and the comparative lack of feedback from eye-gaze devices are discussed as possible contributory factors. IMPLICATIONS FOR REHABILITATION: There are challenges in young children inferring for themselves the causal link between eye movements and control of an eye-gaze device. Explicit instruction may improve children's performance in a specific task, but it is debatable whether this translates to the establishment of causal mechanisms for control of the device. Clinicians should be cautious of making assumptions about what children are learning from activities claiming to teach cause and effect or other foundational eye-gaze control skills. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the review was to explore current factors affecting the use of a powered wheelchair for an adult person a with a disability. Materials and Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Information about the characteristics of the studies (type, setting) and perceived barriers and facilitators to powered wheelchair use were extracted using a data extraction sheet. Data synthesis was achieved using narrative synthesis. The quality of the included studies was assessed using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields (SQAC) and the CASP checklist (Critical Appraisal Skills Programme), Centre for Evidence-Based Medicine, SIGN (Scottish Intercollegiate Guidelines Network). Results: Fifteen studies qualified for inclusion in the review. The narrative synthesis produced a conceptual map of reported factors affecting the usability of a powered wheelchair. Conclusions: This review demonstrates that powered wheelchair use is a multifaceted and multidisciplinary phenomenon that is dependent on numerous interconnected factors including individual adjustment, stakeholder cooperation, societal attitudes, functional performance, and environmental features. Based on the review findings, there are several applied learning outcomes and practical applications to the powered wheelchair prescription and provision. IMPLICATIONS FOR REHABILITATION: The rejection, misuse or damage of a powered wheelchair can result in condition deterioration and loss of independence for the user. Adult powered wheelchair prescription, maintenance, and use is a multi-faceted process spanning social, individual, environmental, technical and functional, and organisational factors. Individuals in this stakeholder network should aim to account for these interdisciplinary factors when engaging with people who use powered wheelchairs. [ABSTRACT FROM AUTHOR]