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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]

Despite a history of critique, concentrated discussion and improved assessment processes, neglect continues to be a major challenge for child protection services. This paper draws on findings from a government‐commissioned analysis of 'serious case reviews' (SCRs) in England, arising from incidents of serious child abuse in 2017–2019. There were 235 cases, for which 166 final reports were available. Alongside a quantitative analysis of the whole cohort, we undertook an in‐depth qualitative analysis of 12 cases involving neglect. A key challenge in responding to neglect in its different forms is that it can be so widespread amongst families that practitioners no longer notice its severity or chronicity – it becomes normalised. In this paper we explore two dimensions of the 'paradox of neglect' where it seems to be everywhere and nowhere simultaneously. The first is that neglect is so closely bound up with the prevalence of poverty that little action is taken to address it. The second is that the overwhelming nature of neglect can blind practitioners to other forms of maltreatment that may also be present within a family. Practitioners, now more than ever, need to recognise the dimensions of this paradox to protect children from neglect. [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 develops understandings of how being publicly identified and consequently labelled as 'looked after' can have damaging consequences for young people, particularly in how they are perceived by their peers in the context of schooling. Based on qualitative research in northern England utilising participatory approaches with young people and interviews with support staff, we explore barriers that inhibit young people's sense of belonging. We highlight how the very processes and practices set up to support the young people can often have unintended consequences by routinely positioning them as Other, before considering the implications for education and schooling in particular. [ABSTRACT FROM AUTHOR]

Having a good understanding of one's origins and history is known to be significant in identity development. Drawing on a large‐scale online survey of looked after children's subjective well‐being, this paper demonstrates that a significant number of children and young people (age 4–18 years) did not fully understand the reasons for their entry to care. The paper explores the effect of this lack of knowledge on children's well‐being and on their feelings of being settled in their current placement. The study reiterates the need for professionals to be honest and open with children in out‐of‐home care and the need to specifically address, perhaps repeatedly, why a child is not living with their birth family. [ABSTRACT FROM AUTHOR]

This paper adds to the limited evidence base around documentary representation of the wishes, feelings and views of children and young people involved in the child protection system. It presents the findings of a critical discourse analysis of 114 documents relating to 28 children and young people in the North of England who were the subject of a child protection conference (CPC) due to having experienced significant harm or the high likelihood of significant harm occurring. Three dominant and interlayering discourses were identified: a discourse of childhood, a discourse of participation and a discourse of professional social work practice. While some children and young people came to life in the reports and were afforded a unique identity, others were invisible and their views were marginalized. The findings support a dominant discourse of the unseen and unheard child, with participation normally mediated by power relationships between adults and children, and which marginalizes the experiences of children through a structurally constructed lens of risk and vulnerability. The findings signify the need to establish assessment practices and case reporting systems in which children are heard themselves as well as reported on by others. [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]

This study explores the ways in which African Caribbean families communicate with each other and the outside world in the context of post migration. The Big and Small Story in narrative inquiry was used to make sense of the data as it pays attention to the manner and style in which this story is told, and what identities are being claimed post migration. The key findings are set out using three archetypal positions: the trickster, passer/conformer and resister/revolutionary. These were used to capture different ways people responded to power and identities claimed within their daily life. Findings in part of reflect Du Bois' concept of double consciousness to consider the way black people carry out their negotiations with power. These African Caribbean participants were having to think about what is acceptable to the power base and how can this be negotiated. This paper is intended to be helpful to practitioners interested in indigenous knowledge of self and its clinical implications. [ABSTRACT FROM AUTHOR]

This paper examines the impact of disruptions to the organisation and delivery of healthcare services and efforts to re‐order care through emotion management during the COVID‐19 pandemic in the UK. Framing care as an affective practice, studying healthcare workers' (HCWs) experiences enables better understanding of how interactions between staff, patients and families changed as a result of the pandemic. Using a rapid qualitative research methodology, we conducted interviews with frontline HCWs in two London hospitals during the peak of the first wave of the pandemic and sourced public accounts of HCWs' experiences of the pandemic from social media (YouTube and Twitter). We conducted framework analysis to identify key factors disrupting caring interactions. Fear of infection and the barriers of physical distancing acted to separate staff from patients and families, requiring new affective practices to repair connections. Witnessing suffering was distressing for staff, and providing a 'good death' for patients and communicating care to families was harder. In addition to caring for patients and families, HCWs cared for each other. Infection control measures were important for limiting the spread of COVID‐19 but disrupted connections that were integral to care, generating new work to re‐order interactions. [ABSTRACT FROM AUTHOR]

Although breastfeeding is known to improve health, economic and environmental outcomes, breastfeeding initiation and continuation rates are low in the United Kingdom. The global WHO/UNICEF Baby Friendly Hospital Initiative (BFHI) aims to reverse declining rates of breastfeeding by shifting the culture of infant feeding care provision throughout hospital maternity settings. In the United Kingdom, the global BFHI has been adapted by UNICEF UK reflecting a paradigm shift towards the experiences of women and families using maternity services. This research used a critical ethnographic approach to explore the influence of the national UNICEF UK Baby Friendly Initiative (BFI) standards on the culture of one typical maternity service in England, over a period of 8 weeks, across four phases of data collection between 2011 and 2017. Twenty‐one staff and 26 service users were recruited and engaged in moderate‐level participant observation and/or guided interviews and conversations. Basic, organising and a final global theme emerged through thematic network analysis, describing the influence of the BFI on providing, receiving and leading infant feeding care in a hospital maternity setting. Using Antonovsky's sense of coherence construct, the findings discussed in this paper highlight how the BFI offers 'informational' (comprehensible), 'practical' (manageable) and 'emotional' (meaningful) support for both staff and service users, strengthened by effective, local leadership and a team approach. This is juxtaposed against the tensions and demands of the busy hospital maternity setting. It is recommended that ongoing infant feeding policy, practice and leadership balance relational and rational approaches for positive infant feeding care and experiences to flourish. [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]

Trauma‐informed practice has been developing for decades, though much remains unknown regarding how it is understood and practised. Drawing upon focus group data from an evaluation of a trauma‐informed approach (TIA) implemented by an organisation in Southeast England, this paper provides a unique perspective of 31 staff members and 18 young people. Results indicate how choice and control, key elements of a TIA, align with the Capability Approach (CA). The CA is then used as a novel analytic framework to examine the data. A 'Trauma‐Informed Capabilities Approach' is introduced as a holistic, person‐centred way of conceptualising young trauma survivors' well‐being. [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]

Background: The Healthy Child Programme is the universal public health system in England to assess and monitor child health from 0 to 19. Following a review of measures for closer monitoring at age 2 years, the Department of Health for England implemented the Ages & Stages Questionnaires®, Third Edition (ASQ‐3™; Hereon, ASQ‐3). Aim: The aim of this study was to evaluate the acceptability and understanding of the ASQ‐3 in England by health professionals and parents. Method: A mixed‐methods approach was used. This paper reports on the qualitative data drawn from interviews with 40 parents and 12 focus groups with 85 health professionals. The data were analysed using applied thematic analysis. Findings Overall, parents and health professionals found the ASQ‐3 acceptable and understandable and could use it as a measure at age 2 years. The ability to work in partnership was valued. Some limitations included potential to cause anxiety, concerns around the safety of some of the items, and use of Americanized language. Health professional's training in the use the ASQ‐3 was inconsistent. Conclusion: The ASQ‐3 is an acceptable and understandable measure to use as part of the 2‐year assessment with some adaptations to the English context and some standardized training for health professionals. [ABSTRACT FROM AUTHOR]

Nursing has a gendered and religious history where ideas of duty and servitude are present and shape its professional identity. The profession also promotes idealized notions of relationships with patients and of professional autonomy both of which are, in practice, highly constrained or even impossible. This paper draws on psychoanalytic concepts in order to reconsider nursing's professional identity. It does this by presenting an analysis of data from two focus group studies involving nurses in England and Australia held between 2010 and 2012. The studies gave rise to data where extremely negative talk about nursing work seemed to produce, or to be expressed with, a high degree of energy, and a particular kind of enjoyment. In our analysis, we focus on the nurses' apparent enjoyment derived from their expression of a position of powerlessness in which they describe themselves as 'slaves' or 'martyrs' in the health care system. We interpret this as jouissance and suggest that the positions of slave or martyr provide a possible response to what we argue is the impossibility of the nurse's role. We argue that a remnant of a quasi-religious ethic within the profession makes it acceptable for nurses to talk about self-sacrifice and powerlessness as part of their working subjectivity. We further argue that this analysis offers a new consideration of the issue of power and professional identity in nursing that goes beyond seeing nurses as simply overpowered by, or engaged in, a gendered power struggle with other professional groups. We suggest that powerlessness and victimhood hold particular attractions and advantages for nurses and are positions that are more available to nurses than to other occupational groups. This research shows how psychoanalytic theory can help produce new insights into the problems and complexity of nursing and extend existing study of the professions. [ABSTRACT FROM AUTHOR]

The question of where to locate teaching about the relationships between science and religion has produced a long-running debate. Currently, science and religious education (RE) are statutory subjects in England and are taught in secondary schools by different teachers. This paper reports on an interview study in which 16 teachers gave their perceptions of their roles and responsibilities when teaching topics that bridge science and religion and the extent to which they collaborated with teachers in the other subject areas. We found that in this sample, teachers reported very little collaboration between the curriculum areas. Although the science curriculum makes no mention of religion, all the science teachers said that their approaches to such topics were affected by their recognition that some pupils held religious beliefs. All the RE teachers reported struggling to ensure students know of a range of views about how science and religion relate. The paper concludes with a discussion about implications for curriculum design and teacher training. [ABSTRACT FROM PUBLISHER]

The present paper adopts a social identity perspective to examine the relationship between community-based identification and well-being, resilience and willingness to pay back in the context of urban regeneration. A sample of 104 residents across five deprived urban areas in the southwest of England that have recently undergone or are about to undergo regeneration projects completed a survey. The results demonstrate that areas where a more community-centred, bottom-up, approach to regeneration was taken (i.e., 'culture-led') showed higher levels of community cohesion than areas where the community dynamics were ignored (i.e., a 'top-down' approach to regeneration). Increased community identification was linked to greater perceived social support, community-esteem, personal self-esteem and self-efficacy. These psychological processes were, in turn, linked to increased resilience and well-being, as well as a stronger willingness to pay back to the community. The results are consistent with the social identity approach. Implications for urban regeneration strategies are discussed. [ABSTRACT FROM AUTHOR]

Accessible summary This paper stems from a pilot project offering residential experiences for young people with Autism., The project aimed to offer residential experiences to the young people and help them to develop life skills that would aid their transition to adulthood., The primary purpose of this paper is to analyse the viewpoints of the young people, their parents/carers and the educational and care professionals involved in order to understand the potential impact of projects of this nature., Summary Laying the foundations for an effective transition into independent adulthood is widely perceived as a key priority for practice with children/young people who have Autistic Spectrum Conditions. However, theory and research indicate that, for those children affected, autism often prevents the acquisition, development and expression of key life-skills which might assist their inclusion in the wider community. In exploring these issues, the authors of this paper report on the Phenomenographic analysis of a Residential Project, involving 16 children per young people who had Autistic Spectrum Conditions, at a Special School in the North West of England. The primary conclusion from this study is that provision for many children and young people with Autistic Spectrum Conditions is most meaningful if it is enabled by practice which: supports the wider human rights and needs of their family; realistically prepares the individual for a life outside of school and the home; and also enriches the unique lifeworld of each young person. [ABSTRACT FROM AUTHOR]

Using Ellen Herman's concept of 'kinship by design' ( KBD), this paper analyses recent efforts to reform adoption in England, arguing that they represent an attempt to curtail the powers of adoption professionals and their established practices of assessing and responding to risk. Examining policy contexts and relevant research, the paper looks at various facets of contemporary KBD in England as they relate to adoptable children, the treatment of adopters, matching, support and systemic governance of adoption within a mixed economy. From this analysis, it is suggested that the evidence base for many of the reforms is limited and that in important respects represents a 'manufactured crisis' used to justify radical changes, which, in turn, pose significant risks to wider policy and practice in child welfare. [ABSTRACT FROM AUTHOR]

Rationale People working in the health sector have been looking to complexity science to help them deal with the complex phenomena they encounter in their everyday working practice. While complexity science has assisted many in the field to look at the complex issues from a different viewpoint and explained the emergence of complex phenomena, however, practicable, pragmatic approaches and techniques have not been provided. Aims and objectives In this article, actual issues and challenges that these practitioners face and the needs they expressed during a workshop called 'Putting Complexity to Work - Supporting the Practitioners' are discussed. Conclusion As the nature of complexity offers no one single ultimate solution, the paper concludes that, for operationalizing the insights received from complexity science into their day-to-day work, practitioners in health care and other domains need to address a range of challenges that are outlined in the paper. [ABSTRACT FROM AUTHOR]

Three studies consider the implicit bystander effect in the light of recent advances in social identity approaches to helping. Drawing on the social identity model of deindividuation effects we argue that the implicit bystander effect is shaped not by the number of others imagined, but by who those others are imagined to be. Studies I and 2 demonstrate that, when group membership is primed, increasing group size can facilitate helping in line with the norms and values of the group. Study 3 explores mediation processes in group level helping. As group size increases, female participants react faster to words associated with communalism when others are imagined as women rather than strangers. The paper demonstrates that group size and helping behaviour is qualified by an implicit identity effect. [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 The activities and technologies of the psychology (Psy) disciplines, in the process of privileging professional understandings of distress, could be seen to be potentially facilitating corrosion in the capacity of the lay public to understand and ameliorate their distress. This paper draws on the experiences of people who use an Unemployed Centre Families Project in the South of England to provide an example of community mental health work that does not draw on the dominant discourses, institutions or practitioners of the Psy sciences. Through interviews with centre users, staff and volunteers, a picture emerges of a community space that provides a variety of services, projects and opportunities that have a very considerable positive impact on the mental well-being of the centre users. This picture highlights non-medical intersubjective processes that offer possibilities for recoveries from mental distress but that are often neglected and subordinated in the professional worlds of Psy and psychiatry. Such centres facilitate social networks and practical help, and transitions in identity can be beneficial for those experiencing mental distress. In so doing, they make prominent some of the key limitations of biomedical approaches to recovery. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper seeks to add to the literature on working with fathers by focusing on early intervention. It draws on research into fathers involved in a home visitation service delivered by the Family Nurse Partnership in England and evaluates the men's experiences of the intervention. The vulnerability of fathers was striking and many were helped to develop their practical skills and confidence in caring for their babies. The intervention was effective because of the quality time that was invested in developing relationships with fathers (as well as mothers), the focus on their strengths as well as areas for improvement and the skilled, therapeutically oriented, holistic approach through which the service was delivered. The 'early' nature of the help was crucial to its success because of how it so effectively tapped into the men's redefinition of themselves as caring fathers during pregnancy and following the birth. We argue that there is important learning here for social care and health services in general about how to engage men and promote fathers' capacities to care for their children. [ABSTRACT FROM AUTHOR]

Background: This article is about interactions that occur when someone with intellectual disabilities is engaged in everyday activities with a personal assistant (PA) or a support worker. Method: We examine the detail of nine hours of naturally occurring video‐recorded interactions, to explore how "relational autonomy" is done in practice. Nine people with ID and seven staff took part in the research, which took place in England from 2016–17. Results: We selected six extracts to illustrate different types of joint decision‐making. Informed by inclusive research with a drama group of people with intellectual disabilities, we focus on the ways in which (a) future plans are discussed; (b) choices are offered during an activity; (c) people reflect on their decisions. Conclusion: The article concludes with discussion about the teaching and learning content of choice‐making, on relational autonomy, and the practice learning for PAs, support workers and for people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

ABSTRACT 5 Boroughs Partnership NHS Foundation Trust, in the Northwest of England, has trained over 500 staff in the Knowledge and Understanding Framework, level 1 personality disorder awareness training. This is a 3-day nationally devised training programme delivered via an innovative co-production model (i.e. co-delivery and partnership working with service users who have lived experience). This paper provides quantitative and qualitative information on the effectiveness of training delivery and also serves to provide some insight into the impact of service-user involvement via such a co-production model. Information on 162 participants using the Knowledge and Understanding Framework bespoke questionnaire (Personality Disorder Knowledge, Attitudes and Skills Questionnaire) suggests that the training can be effectively delivered by and within a local NHS Mental Health Trust. Results immediately post-training suggest an improvement in levels of understanding and capability efficacy and a reduction in negative emotional reactions. Indications from a 3-month follow-up suggest that while understanding and emotional reaction remain improved, capability efficacy regresses back to pre-training levels, suggesting the need for ongoing supervision and/or support to consolidate skills. Discussion includes guidelines for the implementation of a truly integrated co-production model of training provision, as well as advice relating to the maximization of long-term benefits. Copyright © 2014 John Wiley & Sons, Ltd. [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]

Background Research on staffed housing for people with intellectual disability has identified the challenges in achieving postitive quality of life outcomes. However, a less well considered dimension of such services is that they are places of living and dying. This paper looks at the experiences of staff in dealing with issues of death and dying. Method In depth qualitative interviews were held with 22 staff in 5 different providers and who had experienced, in total, 27 deaths of people with intellectual disability. Results The data highlight that staff felt providing a good quality of care at the end of life was an important but unrecognised dimension of their work. This work could be broken down into several different phases, dying, death and beyond death. Bad deaths were felt to be those deaths which prevented staff from 'being there' with individuals over those phases. [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]

Background The speech and language therapy/pathology (SLT/SLP) profession is characterized by extreme 'occupational sex segregation', a term used to refer to persistently male- or female-dominated professions. Men make up only 2.5% of all SLTs in the UK, and a similar imbalance is found in other countries. Despite calls to increase diversity in the allied health professions more generally, research into the reasons for occupational sex segregation and gender as a potential key factor remains scarce. Aims This study aims to explore the potential role of gender/gendered discourses in people's decision to pursue a career in SLT/SLP. It seeks to illustrate how gendered assumptions/expectations/discourses continue to construct SLT as a 'gendered' profession, and to make some recommendations in this area for SLT recruitment and practice. Methods & Procedures The study adopted a qualitative design which elicited research participants' views, knowledge and experiences (in their own words) in relation to the research questions. Data collection involved two iterative phases: a preliminary data phase-which involved semi-structured interviews with newly qualified SLT graduates and practising SLTs, and the completion of questionnaires by undergraduate SLTs-and a main/focus group phase. In the focus group phase reported in this paper, six focus groups in total were held with SLTs, teachers of SLT, and careers advisors in London, UK. The data were analysed qualitatively using grounded theory principles, thematic analysis and discourse analysis. Outcomes & Results The findings extend our knowledge and understanding of gender as a parameter of people's motivations and perceptions, which can influence their choice of career (e.g. as regards pay and flexibility). The findings also show that discourses around women as carers, nurturers and communicators constitute key ways through which the SLT profession continues to be constructed as 'women's work'. The topic of structural gender inequalities in the profession was also discussed in the data. Some recommendations for change, with implications for SLT recruitment and practice, were made by the participants themselves. Conclusions & Implications Gender imbalance in SLT needs to be researched further in order to help address inequalities, re-evaluate professional practices and develop service delivery in the profession. This area also needs to be researched via analysis that goes beyond gender distribution in numerical terms to consider the complex perceptions or discourses around gender and work. Cross-disciplinary and comparative perspectives in future research would also be fruitful. [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]

Scand J Caring Sci; 2011; 25; 653-660 Paraprofessionals and caring practice: negotiating the use of self Responding to increasing concerns with the quality of care in both Sweden and England, this paper explores the way in which caring practice emerges out of the interplay between personal and social agency. Working from a socio-cultural perspective, results from an English and a Swedish study conducted independently of each other were used to explore the construction of caring practice. The English study drew on practice observations and four interviews conducted at monthly intervals collecting data on life history and critical incidents. The Swedish study drew on group interviews and two interviews with each participant - one at the beginning of an in-service recognition of prior learning process and one at the end. Interview data was transcribed and thematic analysis identified common themes. The findings from both studies suggest that caring practice involves the intentional use of self to build relationships, understand users and provide personalised interventions. Although practice presented as personal and individualistic, it took place within an organisational context requiring co-configured activity. The practitioners' negotiations with work teams were often conflictual or contested. It is argued that workplaces may enhance caring practice by enabling affordances for the use of self through the design of in-house training programmes, supervision and the organisation of teams. Reflexive practice may also be an important part of the effective use of self. [ABSTRACT FROM AUTHOR]

In this paper, we argue for a social psychological approach to citizenship which focuses on how social actors define competent and legitimate polity membership, together with the associated rights and responsibilities that this entails. A perspective based on the principles of rhetorical psychology is adopted in order to explore these issues in an analysis of a sample of young people's talk about issues of immigration to the UK. Analysis considers how matters of 'race', national identity and culture were oriented to and constructed during the interviews. We then explore how rights and responsibilities concerning cultural expression, interpersonal civility/courtesy and (implicitly acultural) legal frameworks were articulated as practical criteria for judgements about competent and legitimate polity membership. These findings are discussed in relation to existing social psychological work on issues such as racism and national identity, with a view to situating these matters within an overarching concern for the construction of polity membership. We conclude by briefly considering the implications of these findings for contemporary debates concerning citizenship education in the UK. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Increasingly research is being conducted on host community attitudes toward tourism. However, few studies have been conducted at a regional level and none have examined the attitudes of the host community towards both tourism and cultural tourism development. This paper outlines a study conducted in the Lewes District of southern England and notes that although residents are generally supportive of tourism development and cultural tourism development, there are differences in opinion concerning the perceived economic and social benefits. In particular, levels of income and proximity to the tourist centre were major influencing factors. Conclusions and recommendations are made concerning the need for tourism planners to distribute the benefits more widely and to engage residents from different socio-economic groups and localities in tourism planning and development activities. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper examines data on the racial composition and financial and sporting performance of professional English soccer teams between 1974 and 1993. In an earlier paper, Szymanski showed that teams with an above average proportion of black players would tend to perform better on average that would have been expected given the aggregate wage bills of these clubs. Since players are more or less freely traded in soccer this presents strong market-based evidence of discrimination. In the present paper we explore the source of such discrimination. In particular we are concerned to test the hypothesis that discrimination is attributable to the fans rather than the owners. If fans were racially prejudiced then the owners of a team might expect to generate a smaller marginal revenue product from a black player compared to an equally skilled white player. We assess the presence of fan discrimination by examining relationships between attendance, revenues, performance and the proportion of black players in the team. We also incorporate evidence regarding statements of racial prejudice (from the British Social Attitudes Survey) in particular regions. We find little evidence that the discrimination against black players has its source in fan discrimination. [ABSTRACT FROM AUTHOR]

Understanding how stroke sufferers experience their stroke and recovery is essential if the development of rehabilitation services is to be effective and appropriate. Previous research in this area has tended to be either cross-sectional or with a limited amount of informant follow-up, and consequently has limited utility. This paper describes a study underpinned by a phenomenological approach, which tracked the experiences of six patients admitted to a rehabilitation unit in the north-west of England. Informants were followed for at least 12 months after stroke, and a total of 73 interviews were undertaken during the study. The data demonstrate that recovery from stroke involved restructuring and adaptation in physical, social and emotional aspects of an individual's life. Two important features of recovery were highlighted. First, whilst aspects of pre-stroke life may be used to describe individual progress, no end-point to recovery was identified as informants described and anticipated life with stroke. Second, informants focused on the social context of recovery where engagement in the social world was emphasized over discrete physical function. Although no common path of recovery was found, it is recommended that stroke services are structured to take account of the long-term needs of stroke patients and their families in their home environment. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper reports an attempt to increase our understanding of adolescents who exhibit bullying behaviour, by focusing on their self-perceptions. The findings, which confirm those in the literature, establish that the typical bully has a relatively positive self-concept in the social domain and in self-esteem. It is proposed that these findings have implications for early preventative approaches to bullying. These may include an awareness of how temperament traits might interact with a child's environment to produce certain behaviours, including a tendency to bully. Parenting programmes may be a suitable vehicle, and it is also posited that parenting styles and basic elements of child development may be included in ante-natal care. [ABSTRACT FROM AUTHOR]

Aim: Nurse leaders influence workplace culture; however, little is known about ethnic cultural influences on nurse leader development. This research aims to identify personal strategies promoting effective leadership by nurse leaders from European small island countries. Design: Descriptive qualitative study. Methods: In 2017, nineteen semi‐structured interviews with nurse leaders from England, Greece, Republic of Ireland and Malta explored leadership journeys, strategies employed to support their growth and development, and how cultural identity played a role. Transcripts were analysed using reflexive thematic analysis. Results: Four main themes and 12 subthemes captured the strategies and approaches of the nurse leaders: (1) Influences, (2) Communication, (3) Process and (4) Relationships. These findings reflect and validate the five transformational leadership practices of the Exemplary Leadership Model. While cultural island identity was discussed, there was a shared cultural identity within the role of "nurse leader" that spanned all islands. Patient or Public Contributions: Nineteen nurse leaders contributed to this study. [ABSTRACT FROM AUTHOR]

Background: The inverse-care law suggests that fewer healthcare resources are available in deprived areas where health needs are greatest. Aims: To examine the provision of paediatric speech and language services across London boroughs and to relate provision to the level of deprivation of the boroughs. Methods & Procedures: Information on the employment of paediatric speech and language therapists was obtained from London boroughs by freedom-of-information requests. The relationship between the number of therapists and the index of multiple deprivation for the borough was examined. Outcomes & Results: Twenty-nine of 32 boroughs responded. A positive relationship between provision and need was obtained, suggesting that the inverse-care law does not apply. However, large inequalities of provision were found particularly among the more socially deprived boroughs. In some instances boroughs had five times as many therapists per child as other boroughs. Conclusions & Implications: The data reveal that large differences in speech and language therapy provision exist across boroughs. The reasons for these inequalities are unclear, but the lack of comparative information across boroughs is likely to be unhelpful in planning equitable services. The use of freedom of information in assessing health inequalities is stressed and its future availability is desirable. [ABSTRACT FROM AUTHOR]

We explored how employed university students experience their relationships with their work colleagues and with non‐employed students. Two research questions (RQs) were considered: RQ1: What experiences and conditions do employed students identify as contributing to a sense that they are a distinct and separate group from (1) their work colleagues and (2) non‐employed students? RQ2: What experiences and conditions do employed students feel facilitate and/or inhibit their social adaptation and integration at work and university? We interviewed 21 part‐time employed students in England, and analyzed the transcripts using reflexive thematic analysis. We adopted a deductive approach, using the Social Identity Approach as a theoretical framework. In relation to work colleagues, employed students identified a lack of empathy, being looked down upon, and experiencing hostility at the workplace as making them feel distinct from their work colleagues. In relation to non‐employed students, employed students identified differences in experiences and values as increasing intergroup differentiation, which then resulted in feelings of not fitting in at university or social exclusion. Identified conditions, which supported social integration in the workplace, were working with colleagues who held positive attitudes toward students, experiencing similar workplace circumstances and a sense of common fate. Employed students felt socially integrated when non‐workers had positive regard for them or by discussing their employment with other employed students. [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]

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]

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]

Absconding by patients from acute psychiatric wards is known to be linked to self harm and harm to others. Previous research has focused only on officially reported absconds, thus missing out many patients who although they abscond and pose a risk, are never officially processed. This paper reports the findings of a large prospective study of absconding in the East End of London using an objective definition of absconding not linked to official bureaucratic processes. Absconders are considered by staff to be high risk patients, and many have histories of violence and/or suicide attempts. Nevertheless nurses only request the aid of the police in returning patients on 47% of occasions. The actions of the police are very variable, and range from two policemen calling at the patient's house, to an entire team in riot gear appearing at the patient's door in the early hours of the morning. Most absconds result in no harm to anyone, and most absconders return by themselves. Relatives and carers also play a significant role in persuading the patient to return or bringing them back. Nurses should develop more sophisticated ways of working with the police and with relatives to maintain absconding patients' safety. [ABSTRACT FROM AUTHOR]

Absconding by patients from acute psychiatric care poses a significant problem to professional staff, and can involve significant risks for patients and others. This paper describes the methodology of a major prospective study of absconding recently completed in the East End of London, and reports the findings on why patients abscond from hospital. Interviews with 52 patients who returned to their wards showed that they abscond because they are bored, frightened of other patients, feel trapped and confined, have household responsibilities they feel they must fulfil, feel cut off from relatives and friends, or are worried about the security of their home and property. Psychiatric symptoms also contribute to the decision to leave, but in nearly every case patients can give additional and rational reasons for their abscond. Some patients leave impulsively and in anger following unwelcome news about delayed permission for leave or discharge. Others leave specifically in order to carry out some activity outside the hospital. In order to reduce absconding and rejection of care, nurses may need to carefully consider the meaning admission has for patients, and the impact it can have upon their everyday lives. [ABSTRACT FROM AUTHOR]

Information about how and when patients abscond from acute psychiatric wards may provide important clues to effective prevention strategies. This paper reports relevant findings from a large scale study of absconding conducted in the East End of London. In contrast to the findings in previous studies, the vast majority of absconders left from the ward directly, mostly via the front door. Some were known to be at risk of absconding, and although more than half had declared their intention to leave, they still succeeded in getting away. On some occasions they circumvented locked or guarded doors, or special nursing observation. Shift handovers were a peak time for absconds, possibly due to decreased nursing surveillance of the ward. Most absconds occur during the first few weeks of admission, and most absconders simply went home and engaged in normal, everyday activities. The findings indicate that physical security measures alone are not a sufficient answer to the problem of absconding, and nurses need to work harder to develop supportive alliances with patients. [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: Sustaining high‐quality, critical care practice is challenging because of current limits to financial, environmental, and social resources. The National Health Service in England intends to be more sustainable, although there is minimal research into what sustainability means to people working in critical care, and a theoretical framework is lacking that explains the social processes influencing sustainability in critical care. Aims and objectives: This study aimed to explain the concept of sustainability from the perspective of practitioners caring for critically ill patients. Design The qualitative research followed a Charmazian constructivist grounded theory approach, including concurrent data collection and interpretation through constant comparison analysis. Methods: In‐depth interviews were conducted online or by telephone with 11 health care professionals working in critical care in the South of England (8 nurses, 2 physiotherapists, and 1 technician). Schatzman's dimensional analysis and Straussian grounded theory techniques supplemented the data analysis. Results: Sustainability was defined as maintaining financial, environmental, and social resources throughout the micro, meso, and macro systems of critical care practice. The most pertinent social process enabling sustainability of critical care was satisficing (satisfaction of achieving a goal of quality care while sufficing within the limits of available resources). Increased satisficing enabled practitioners to fulfil their sense of normative, responsible, sustainable, and flourishing practice. Satisficing was bounded by the cognitive and environmental influences on decisions and an ethical imperative to ensure resources were used wisely through stewarding. Conclusions: An explanation of the concept of sustainability and significant social processes, in relation to critical care, are presented in a theoretical framework, with implications for how financial, environmental, and social resources for critical care practice can be maintained. Relevance to clinical practice: This theory offers clinicians, managers, educators, and researchers a definition of sustainability in critical care practice and provides a structured approach to addressing critical care sustainability issues. [ABSTRACT FROM AUTHOR]