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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]

This paper reports on doctoral research carried out in the UK into the experience of complexity in child protection work. The study explored what complexity meant for practitioners, and examined its significance for interprofessional working. A qualitative, case-based approach was adopted, drawing on the experiences of 17 practitioners working on two separate child protection cases. Participants were from a range of agencies, including children's social care, education, youth offending and child/adolescent mental health. Two rounds of semi-structured interviews were carried out over a period of four months. Interview transcripts were analysed using interpretative phenomenological analysis, a research methodology derived from qualitative psychology. The findings revealed complexity to be a multifaceted phenomenon, driven by the dynamics of cause and effect in open social systems. Practitioners' perception of unpredictability and volatility in these cases fed into various aspects of collaborative work: the experience of relationships, the process of assessment, efforts at intervention and concerns about risk. The paper concludes by exploring some implications for policy and practice in terms of how interprofessional networks are set up to manage the needs of vulnerable children and families. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Messages Complexity makes it hard for practitioners to understand cause and effect, predict outcomes and control the course of events., To manage complexity, the team around the child may need to operate as a strategic unit rather than a collection of tactical interventions., When complex cases become 'stuck', professional networks may need additional support and consultation from specialist agencies., 'Complexity makes it hard for practitioners to understand cause and effect, predict outcomes and control the course of events' [ABSTRACT FROM AUTHOR]

Background: Care home staff working during the COVID‐19 pandemic experienced higher levels of stress and increased workloads. People from diverse ethnic backgrounds were disproportionately affected by the COVID‐19 pandemic. This study explored the identity experiences of care home staff from diverse ethnic backgrounds in the context of working during the COVID‐19 pandemic. Methods: Fourteen semistructured interviews were conducted between May 2021 and April 2022 with ethnic minority care home staff in England, who worked during the pandemic. Participants were recruited using convenience and theoretical sampling. Interviews were conducted via telephone or online platforms. A social constructivist grounded theory methodology was utilised in analysing the data. Findings: Participants described five key processes which facilitated or hindered the impact that their experiences had on their identity: dealing with uncertainty and transitioning into a COVID‐19 world; difficult emotions; experiences of discrimination and racism; the response from the care home and societal systems; and the personal vs collective responsibility. When participants' physical and psychological needs went unmet by support structures within the care home and/or society, they experienced a sense of injustice, lack of control and being unvalued or discriminated against by others. Conclusions: This study highlights the importance of recognising the unique needs of staff from diverse ethnic backgrounds working in care homes and adapting working practices to improve impact on identity, job satisfaction and staff retention. Patient and Public Involvement: One care home worker was involved in developing the topic guide and helping to interpret the findings. [ABSTRACT FROM AUTHOR]