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This paper discusses the findings of two studies that critically analysed teachers' perspectives on the operation of the standards and inclusion agenda in primary schools in England. The studies were carried out in 2010–2011 and 2019, respectively. Through the application of Q methodology, the paper examines whether teachers' perspectives of standards and inclusion have changed over time. Analysis of the data strongly suggests that teachers have experienced significant difficulties including children with SEND while at the same time trying to operationalise the objectives of the standards agenda. The research concludes that there needs to be a focus on developing effective strategies to include children with SEND within the hostile environment of the standards agenda. Within such an environment it is suggested that focus needs to move away from concentrating on 'children with SEND having difficulties' to the creation of inclusive educational settings which welcome all learners. In addition, it is argued that Statutory Assessment Tests (SATs) should also be revised to consider the needs of all learners. [ABSTRACT FROM AUTHOR]

The paper referred to is ‘The Future of Data Analysis,’ published in 1962. Many authors have discussed it, notably Peter Huber, who in 1995 reviewed the period starting with Hotelling's 1940 article ‘The Teaching of Statistics.’ I extend the scope of Huber's remarks by considering also the period before 1940 and developments since 1995. I ask whether statistics is a science and suggest that to attract bright students to our subject, we need to show them the excitement and rewards of applied work. [ABSTRACT FROM AUTHOR]

The paper focuses on findings from research that investigated teachers' and key stakeholders' perspectives on the use of Reception Baseline Assessment. Data collection was carried out in 2021–2022, which was the year this assessment was introduced into Reception classes in England. In total, 70 teachers and key stakeholders from 47 Local Authorities were surveyed using a mixed methods approach. The findings highlight that most participants considered that the assessment was not beneficial to them and negatively impacted children and practice during the crucial first six weeks of Reception Year. Many participants in the study called to scrap this form of assessment. [ABSTRACT FROM AUTHOR]

In this paper, we present research into how leaders in early childhood education and care (ECEC) in England conceptualise and respond to sudden and challenging circumstances at organisational and personal levels. A distinction is made in this paper between critical incidents, such as a fire in the kitchen, and crises whereby leaders need to respond to unexpected, long term and evolving events. Although the impact of Covid-19 pandemic was uppermost in participants' minds, crises emerging from other issues were also investigated. The data informing this study were collected during the first half of 2021, nearly a year after the start of the Covid-19 pandemic, with ECEC leaders experiencing drastic changes which extended existing perceptions of crises. The research employed qualitative methodology using interviews with 16 accountable leaders in 13 different settings, with a further interview of a local authority officer with responsibility for advising and guiding multiple settings. [ABSTRACT FROM AUTHOR]

Care, management, and statute each mandate restraint-reporting in psychiatric settings in England. PROD-ALERT in this journal ("PA1") correlated log incidence of restraint, log institutional size, and log detention. The period was September 2020 to August 2021. It showed a clear trend among reporters. Restraint correlated with institutional size and use of legal detention. Some large detaining providers reported no restraints per month despite that trend. Inference from size suggested that non-complete reporters restrained 1,774 people per month. This paper "PA2" develops analysis repeating it for September 2021 to August 2022. PA2 shows how to count L-information, i.e., questionable information, added by null reports, by applying an L-test to data sets. PA2 uses illustrative vignettes about human height to ground L-information scores from English restraint reporting. In PA2, reported restraint again correlates with size and detention as in PA1. PA2 shows evolving data. Providers still follow a trend in restraint by size and detention. Providers which newly report restraint are on trend. Inference suggests that non-complete reporters restrained 1,305 people per month (536-3233), 95% CI, a large but reduced number since PA1. English restraint data have an L-test L-information score of increase in information by a factor of L = 145. This is as surprising as claiming that an average English man of 1.72 m is 2.64 m tall. Persons restrained per month is a robust measure continuing to log-correlate with size and legal compulsion. Providers over a certain size who report null restraint probably have some. Restraint remains underreported in England. Imputation of incomplete reporters shows a large shrinking cohort of patients detained by incomplete reporters. Knowledge of this may promote reporting. Improved reporting, and the infrastructure and integrity it demands, may help providers measure and reduce restraint. PA1 remains unrefuted. L-test can measure L-information in intuitively representable ways. The informational effect of nulls on the reliable data set is similar to a claim that an average-heighted man is as tall as people with clinical gigantism. [ABSTRACT FROM AUTHOR]

Background: When parents bring their child to appointments and then adhere to agreed speech and language therapy (SLT) recommendations, there is the potential to increase the intensity of the intervention, support generalization and improve outcomes. In SLT, however, little is known about factors that may promote attendance or adherence. Studies in other clinical areas such in medicine, psychology and physiotherapy have identified risk factors for non‐attendance or non‐adherence that are multifactorial and variable dependent on, for example, population and intervention. Aims: To identify rates of non‐attendance and non‐adherence, and to identify parent or child factors associated with parent involvement in intervention for children under 5 years of age receiving SLT. Methods: Parents completed questionnaires at two time points assessing the domains of parents' beliefs (problem perceptions, self‐efficacy), personal circumstances (socio‐demographics, family functioning), treatment experience and child factors. Predictors of parent attendance and adherence were identified through multiple regression analyses. Non‐attendance rates were identified via local health records and non‐adherence ascertained using a specific parent‐reported measure within the treatment experience domain. Results: Participants (N = 199) were predominantly mothers, and were ethnically and socio‐economically diverse, speaking a wide range of languages. Their children presented with a range of speech, language communication needs (SLCN). The rate of non‐attendance was 25% and the main predictors of non‐attendance were maternal age, education level and two factors within the parent beliefs domain. This model explained 40% of the variance in attendance. The rate of non‐adherence in this cohort was 26% with parental rating of the importance of a recommendation and self‐efficacy beliefs predicting adherence; this explained 56% of the variance in adherence to SLT recommendations at home. Conclusions & Implications: Our research has provided preliminary evidence of the influence of parents' beliefs, personal circumstances and treatment experiences on their involvement in their child's therapy. Speech and language therapists should consider factors impacting attendance and adherence to treatment and explore parental perceptions of their child's SLCN before embarking on an intervention, a foundation for collaborative practice. A possible limitation of this study is that the levels of attrition in our sample led to generally high measured rates of participation, which should be considered in future studies. Future research should explore adherence in treatments with varying doses, with different types of SLCN or interventions and in different settings. WHAT THIS PAPER ADDS: What is already known on the subject: It is acknowledged that parent involvement in their child's therapy, such as attending and adhering to recommendations, is important but little is known about the rates of involvement and what factors may be associated with attendance and adherence in SLT. Qualitative research has explored parental involvement suggesting that beliefs about an intervention may be pertinent. Extensive research in other clinical areas suggest multiple and varied factors are influential and further exploration of particular populations and interventions is necessary. What this paper adds to the existing knowledge: This study identified rates of parental non‐attendance and non‐adherence in a cohort of predominantly mothers of children under the age of 5 years. It is the first study to measure parent adherence in SLT and identify factors that are associated parental adherence to SLT recommendations. It adds to the small body of SLT specific research in understanding risk factors for non‐attendance. What are the potential or actual clinical implications of this work?: This study highlights the need for a speech and language therapist to consider and explore parents' perspectives of their child's SLCN as a part of achieving collaboration with a parent in order to achieve the best outcomes. It provides a foundation for further systematic research into parent involvement with the ultimate aim of enhancing outcomes for children with SLCN. [ABSTRACT FROM AUTHOR]

Hydraulic fracturing ('fracking') was a controversial issue in the United Kingdom that sparked national and community-led groups to organise protest mobilisations. To date, however, the social science literature has largely focussed upon general anti-fracking discourse rather than on the physical, community-led mobilisations that emerged from the frustrations of people directly affected at a local level by threats to their community. This paper develops and applies a novel conceptualisation of political opportunity structures at the nexus of the national and local levels to more fully explore the usually overlooked role of local-level structures in interaction with the national level in shaping protest. It uses protest event analysis with data derived from two key activist-specific sources. The analysis draws on data from over 1,400 protests occurring across 69 counties from 2011 to 2019. In so doing, this paper observes and accounts for variance in the form and frequency of community-led anti-fracking protest events within and between different areas of England across the life course of the protest episodes. This paper finds that trends in protest frequency and form over time correlate to shifts in opportunity structures, particularly regarding local and national-level interactions, and that this can be usefully conceptualised through a local-national-state-nexus. [ABSTRACT FROM AUTHOR]

This paper will explore the ways in which behaviour features in the accounts of 'off rolling' processes in schools in England volunteered by participants – senior school leaders, SENCos and parents, in an ongoing multi-stranded research project. In addition to analysing these accounts, this paper draws on contextual features and concepts such as parrhesia and authenticity in a probing of methodological considerations. The status of such accounts as data will also be considered given the high stakes accountability environment in which school principals strive to fulfil their legal remit in the field of inclusion. The trustworthiness of findings in qualitative research is more usually the focus of attention; however, our studies to date imply that some professionals carefully manage the image of their school and visibility of exclusionary practices to the detriment of students with mental health and behavioural issues. The methodological implications of conducting research in politicised and highly sensitive areas will be discussed. [ABSTRACT FROM AUTHOR]

Background: The Health of the Nation Outcomes Scales for people with Learning Disabilities (HoNOS-LD) is an 18-item measure which provides a structured and standardized approach to rating various clinical and psychosocial outcomes and has been in use nationally since 2002. Aims: To revise and improve the HoNOS-LD's utility in contemporary intellectual disability (ID) services whilst retaining its original objectives and five-point severity ratings. Method: ID clinicians were invited to complete an online survey, rating each item on the existing measure for being fit for purpose, identifying issues and suggesting improvements based on their experience of using the HoNOS-LD in practice. Scales were then assessed and revised sequentially; survey responses were used to inform discussion and revisions to the HoNOS-LD by the Advisory Board. Results: A total of 75 individuals replied. Respondents had used HoNOS-LD for an average of 8.0 years (S.D. 5.28 years) and 88% found the scale to be useful in their practice. On average, respondents used HoNOS-LD ratings to inform care 42.4% of the time (S.D. 33.5%). For each scale there was a significant negative correlation between the percentage of positive/very positive respondent ratings and the number of changes proposed. Common changes included simplifying terms, reducing ambiguity and replacing anachronistic language. Conclusion: The changes outlined in this paper are based on the advisory group's expert consensus. These changes are intended to improve reliability and validity but now need empirical testing as well as review by service users. [ABSTRACT FROM AUTHOR]

Background: Speech and language therapists and nurses need to work together to keep patients with swallowing difficulties safe throughout their acute stroke admission. Speech and language therapists make recommendations for safe swallowing following assessment and nurses put recommendations into practice and monitor how patients cope. There has been little research into the everyday realities of ongoing swallow safety management by these two disciplines. Patient safety research in other fields of healthcare indicates that safety can be enhanced through understanding the cultural context in which risk decisions are made. Aims: To generate new understanding for how speech and language therapists (SLTs) and nurses share information for ongoing management of swallows safety on stroke units. Methods & Procedures: An ethnographic methodology involving 40 weeks of fieldwork on three stroke wards in England between 2015 and 2017. Fieldwork observation (357 h) and interviews with 43 members of SLT and nursing staff. Observational and interview data were analysed iteratively using techniques from the constant comparative method to create a thematically organized explanation. Outcomes & Results: An explanation for how disciplinary differences in time and space influenced how SLT and nursing staff shared information for ongoing management of swallow safety, based around three themes: (1) SLTs and nurses were aligned in concern for swallow safety across all information‐sharing routes; however, (2) ambiguity was introduced by the need for the information contained in swallowing recommendations to travel across time, creating dilemmas for nurses. Patients could improve or deteriorate after recommendations were made and nurses had competing demands on their time. Ambiguity had consequences for (3) critical incident reporting and relationships. SLTs experienced dilemmas over how to act when recommendations were not followed. Conclusions & Implications: This study provides new understanding for patient safety dilemmas associated with the enactment and oversight of swallowing recommendations in context, on stroke wards. Findings can support SLTs and nurses to explore together how information for ongoing dysphagia management can be safely implemented within ward realities and kept up to date. This could include considering nursing capacity to act when SLTs are not there, mealtime staffing and SLT 7‐day working. Together they can review their understanding of risk and preferred local and formal routes for learning from it. What this paper adds: What is already known on the subject: It is known that information to keep swallowing safe is shared through swallowing recommendations, which are understood to involve a balance of risks between optimizing the safety of the swallow mechanism and maintaining physiological and emotional health. There is increasing appreciation from patient safety research, of the importance of understanding the context in which hospital staff make decisions about risk and patient safety. What this paper adds to existing knowledge: The paper provides new empirical understanding for the complexities of risk management associated with SLT and nursing interactions and roles with respect to ongoing swallow safety. What are the potential or actual clinical implications of this work?: Findings can underpin SLT and nurse discussion about how swallow safety could be improved in their own settings. [ABSTRACT FROM AUTHOR]

Primarily methodological in its orientation, this paper offers a presentation of 'research outcomes' in ways that challenge and disrupt commonplace notions of data and analysis. In an attempt to write against the grain of conventional qualitative research practice and to experiment with alternative encounters with data and analysis, I present 'data/analysis' in the form of a play (or imagined performance) that writes into being two Deleuzo-Guattarian principles – the critique of the self-conscious 'I' and desire. The play draws on a wider study that examined the potential of writing as a tool for learning for undergraduate student teachers in England. As such, the paper also contributes to debates on the practice and purpose of writing as a method of (professional) inquiry. [ABSTRACT FROM AUTHOR]

Introduction: The broader determinants of health including a wide range of community assets are extremely important in relation to public health outcomes. Multiple health conditions, multimorbidity, is a growing problem in many populations worldwide. Methods: This paper quantified the effect of community assets on major health conditions for the population of England over six years, at a fine spatial scale using a data analytic approach. Community assets, which included indices of the health system, green space, pollution, poverty, urban environment, safety, and sport and leisure facilities, were quantified in relation to major health conditions. The health conditions examined included high blood pressure, obesity, dementia, diabetes, mental health, cardiovascular conditions, musculoskeletal conditions, respiratory conditions, kidney and liver disease, and cancer. Cluster analysis and dendrograms were calculated for the community assets and major health conditions. For each health condition, a statistical model with all community assets was fitted, and model selection was performed. The number of significant community assets for each health condition was recorded. The unique variance, explained by each significant community asset per health condition, was quantified using hierarchical variance partitioning within an analysis of variance model. Results: The resulting data indicate major health conditions are often clustered, as are community assets. The results suggest that diversity and richness of community assets are key to major health condition outcomes. Primary care service waiting times and distance to public parks were significant predictors of all health conditions examined. Primary care waiting times explained the vast majority of the variances across health conditions, with the exception of obesity, which was better explained by absolute poverty. Conclusions: The implications of the combined findings of the health condition clusters and explanatory power of community assets are discussed. The vast majority of determinants of health could be accounted for by healthcare system performance and distance to public green space, with important covariate socioeconomic factors. Emphases on community approaches, significant relationships, and asset strengths and deficits are needed alongside targeted interventions. Whilst the performance of the public health system remains of key importance, community assets and local infrastructure remain paramount to the broader determinants of health. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine the influence of research evaluation policies and their interpretation on academics’ writing practices in three different higher education institutions and across three different disciplines. Specifically, the paper discusses how England’s national research excellence framework (REF) and institutional responses to it shape the decisions academics make about their writing.Design/methodology/approach In total, 49 academics at three English universities were interviewed. The academics were from one Science, Technology, Engineering and Mathematics discipline (mathematics), one humanities discipline (history) and one applied discipline (marketing). Repeated semi-structured interviews focussed on different aspects of academics’ writing practices. Heads of departments and administrative staff were also interviewed. Data were coded using the qualitative data analysis software, ATLAS.ti.Findings Academics’ ability to succeed in their career was closely tied to their ability to meet quantitative and qualitative targets driven by research evaluation systems, but these were predicated on an unrealistic understanding of knowledge creation. Research evaluation systems limited the epistemic choices available to academics, partly because they pushed academics’ writing towards genres and publication venues that conflicted with disciplinary traditions and partly because they were evenly distributed across institutions and age groups.Originality/value This work fills a gap in the literature by offering empirical and qualitative findings on the effects of research evaluation systems in context. It is also one of the only papers to focus on the ways in which individuals’ academic writing practices in particular are shaped by such systems. [ABSTRACT FROM AUTHOR]

This paper is a qualitative documentary analysis of six restorative justice reporting templates used by the Offices of the Police and Crime Commissioner in England for collecting restorative justice service data. Findings identify differences in the following areas: general presentation and format of templates; types of data recorded; areas of interest; definitions and use of descriptive language; methods and timing for counting data; and interpretation of restorative justice processes and outcomes. Conclusions highlight the need to standardise definitions and methods, outlining potential pitfalls when using data to draw further conclusions when equivalency is problematic, and further research avenues that could illuminate the use of data to evidence effectiveness, efficiency, impact and success. [ABSTRACT FROM AUTHOR]

This paper is concerned with the recent growth of the co-operative schools movement (CSM) in education in England. It provides a detailed description of the demography and distribution of co-operative schools and the motivations for becoming a co-operative school. Based on data provided by the Co-operative College (2014) the paper will identify schools' geographical distribution, the particular loadings in terms of primary and secondary institutions, the school populations they served, and the correlation between the political complexions of the local areas within which these schools were located and their decision to follow the co-operative route at that point in time. A key component of our research has been to explore the motivations which encouraged schools to affiliate with the Schools Co-operative Society (SCS) rather than with other forms of trusts and academies. We thus complement the statistical analysis of data with interview data from key figures in the CSM and a consideration of the values base within which the CSM is set. [ABSTRACT FROM AUTHOR]

Background: Looked after children and care leavers (denoted as LAC) are often described as a 'hard to reach' group of young people, and their voices are rarely sought to inform academic research. Methods: This paper reports on experiences and reflections of a group of children and young people and academic researchers who developed a Patient and Public Involvement (PPI) group that was set up in the context of an ongoing health service intervention trial with LAC. Setting and participants: Eighteen qualitative semi‐structured interviews were conducted with seven LAC, the participation officer within a North East Children in Care Council and the four researchers involved in developing and facilitating the PPI group. PPI sessions (n = 9) each approximately 1 hour in length were conducted over an 18‐month period. Analysis: The qualitative interviews were transcribed verbatim. Thematic analysis was used to analyse the data, and direct quotes are used within the paper. Main outcomes: The LAC used the PPI group to produce a 5‐minute video to highlight why they think young people should be involved in research. Overall findings suggested that it was feasible to develop a research‐related PPI group with LAC. Findings from the research were used to co‐develop 'top tips' of working with vulnerable young people such as looked after children. Conclusion: This paper has shown that PPI with LAC can be done if a co‐production approach to research is taken. It also suggests that assumptions regarding the capabilities of young people as researchers need to be re‐evaluated. [ABSTRACT FROM AUTHOR]

This paper examined relationships between area‐level deprivation, local authorities' social care expenditure and the rates of children entering care proceedings in England using a novel data linkage of de‐identified records provided by the Children and Family Court Advisory Service (Cafcass). Using structural equation modelling, the authors found strong positive relationships between socioeconomic area deprivation and high rates of children undergoing care proceedings in England between 2015 and 2019. Preventative social care expenditure is associated with lower child rates when adjusting for deprivation. Our findings suggest that deprived and underfunded local authorities respond to an increased need by prioritizing care arrangements. [ABSTRACT FROM AUTHOR]

Background: Medication errors regardless of the degree of patient harm can have a negative emotional impact on the healthcare staff involved. The potential for self-victimization of healthcare staff following medication errors can add to the moral distress of healthcare staff. The stigma associated with errors and their disclosure often haunts healthcare professionals, leading them to question their own professional competence. This paper investigates the negative emotions expressed by healthcare staff in their reported medication administration error incidents along with the immediate responses they received from their seniors and colleagues after the incident.Method: This is a retrospective study using a qualitative descriptive design and text mining. This study includes free-text descriptions of medication administration error incidents (n = 72,390) reported to National Reporting & Learning System in 2016 from England and Wales. Text-mining by SAS text miner and content analysis was used to analyse the data.Results: Analysis of data led to the extraction of 93 initial codes and two categories i.e., 1) negative emotions expressed by healthcare staff which included 4 sub-categories of feelings: (i) fear; (ii) disturbed; (iii) sadness; (iv) guilt and 2) Immediate response from seniors and colleagues which included 2 sub-categories: (i) Reassurance and support and (ii) Guidance on what to do after an error.Conclusion: Negative emotions expressed by healthcare staff when reporting medication errors could be a catalyst for learning and system change. However, negative emotions when internalized as fear, guilt, or self-blame, could have a negative impact on the mental health of individuals concerned, reporting culture, and opportunities for learning from the error. Findings from this study, hence, call for future research to investigate the impact of negative emotions on healthcare staff well-being and identify ways to mitigate these in practice. [ABSTRACT FROM AUTHOR]

This paper explores different conceptions of responsibility within and beyond neoliberal frames. Such exploration draws on the experiences and accounts of ‘Ashleigh’, a head teacher at a primary school in outer London that is part of an academy chain. Ashleigh and her school were key participants in a study that explored matters of accountability, performativity and equity. Through the presentation of interview data gathered from Ashleigh and six of her staff, the paper theorises ways of being a head teacher as aligning with the responsible neoliberal subject – a self-determined and rational actor who readily takes up the modes of regulation and measurement expected of them. It also highlights how this subjectivity sits within and alongside relations of care and concern for the welfare of students and teachers. The paper critically examines the implications of these different conceptions of responsibility in their production of different versions of professionalism. It also seeks to broaden current scholarly understandings of the responsible neoliberal subject and provide a counter-story to the tendency within public and political discourse for responsibility to be constructed in largely neoliberal terms. [ABSTRACT FROM AUTHOR]

New recruits within policing are involved in a process of negotiating and creating meaning within their newly shaped identities. Within this identity formation, members engage in both categorisation and comparison in an attempt to sustain the group and to enhance the self-image of the group member. The benefits of inclusion and enhanced group identity however must be analysed alongside the inevitable exclusion and 'othering' that also occur. Using the framework of social identity theories, this paper seeks to consider new police recruits in England and their perceptions of, and attitudes towards, victims and potential victims of crime. It does this through an analysis of qualitative data obtained through a piece of longitudinal, ethnographic research which focussed upon new police recruits to an English police force. The research followed the police recruits for four years and in doing so, attempted to produce a holistic description of their developing cultures. What emerged from the findings was an enthusiasm for assisting victims of crime but within the context of culturally defined notions of what a 'victim' might constitute. By sharply delineating between 'deserving' and 'undeserving' victims of crime, police officers are contributing to the 'diminishing status' of certain potential victims through privileging certain identities over others. Police officers are one of the key definers of victim status and through this process of 'informed neglect' are contributing to the discrimination and alienation of certain parts of the community. This has the potential to add to the exclusion of those who are already socially, educationally and economically ostracised. [ABSTRACT FROM AUTHOR]

Background: Very young children from lower socioeconomic status (SES) backgrounds often show poorer language development. Whilst there have been attempts to provide early intervention programmes, these sometimes miss the most disadvantaged groups. Aims: This report presents preliminary feasibility and effectiveness data for a novel language intervention designed for parents of toddlers in the United Kingdom. Methods and Procedures: In total, 43 UK families of 2–4‐year‐olds were recruited to the study, half of whom completed an 8‐week course (Tots Talking) focussed on parent interaction, and half of whom acted as wait‐list controls. Results and Outcomes: Results suggest that such programmes are feasible for families with 86% staying in the intervention. In addition, greater changes in underlying communication skills such as joint attention and gesture were evident compared to wait‐list controls. Conclusions and Implications: We conclude that pre‐verbal skills may be more important to measure as initial outcomes than language or vocabulary change in this population. What This Paper Adds: What is already known on the subject: Children from lower socioeconomic status (SES) backgrounds are at higher risk of communication difficulties and there is a need for community intervention programmes for very young children. What this study adds: This study suggests that such programmes can be feasible and effective, but that very early/basic communicative skills (such as joint attention) may be boosted first rather than language or vocabulary. What are the clinical implications of this work?: Children's centres and other community services could feasibly run short parent facing courses emphasising contingent communication in low SES families and other diverse groups. These may be more successful run with younger preschoolers. Joint attention may be a better focus of intervention before expecting vocabulary or language change. Community health professionals may find this information useful in referring and supporting families in need. [ABSTRACT FROM AUTHOR]

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Background: Many people with aphasia have word‐finding difficulties, with some showing particular difficulties with verbs. Picture‐naming therapy is often used to improve naming, but gains are usually limited to therapy items and do not transfer to conversation. Therapy where words are produced in sentences and in real‐life activities may be more effective. Aims: The current pilot study investigated whether an activity‐oriented therapy approach would be accepted and viable if implemented in a community setting, and whether communicating whilst cooking was more beneficial than using paper‐based activities. If successful, it would be expected that verb production would improve in structured and unstructured tasks in both naming and narrative tasks. Methods & Procedures: The study employed a case‐series repeated‐measures design, with testing of treated and control items. Seven adults with anomia participated, although only five completed the full programme. Participants were divided into two groups and each group completed both treatments, but in different orders. Each treatment was employed for six 2‐h sessions over a 3‐week period. Outcomes & Results: Naming of both treated and untreated verbs showed a statistically significant improvement following both treatments and this continued into the maintenance phase. There was a numerical but not statistically significant gain in the variety of verbs used in spoken narratives. Participants predominantly chose positive terms to describe their experience of the programme, but did not prefer one therapy over the other. Conclusions & Implications: Preliminary findings suggest that an activity‐oriented therapy approach, whether it involves carrying out tasks or paper‐based activities, can result in clinically meaningful improvements for people with chronic aphasia. Further research using a randomized control trial is required to determine whether cooking therapy alone is effective. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to evaluate the Supported Discharge Service as a case study of integrated care. The paper will critically evaluate integrated care with regard to patient outcomes, patient satisfaction and cost and productivity.Design/methodology/approach A retrospective mixed methods case study design was adopted utilising patient satisfaction questionnaires, therapy outcome measure and a performance dashboard to measure improvements in patient satisfaction, patient outcomes and cost and productivity.Findings Measured improvements were observed in the integrated discharge process and analysis of the findings demonstrated a statistically significant improvement in patient outcomes, high levels of patient satisfaction and improved productivity subsequently leading to financial savings.Research limitations/implications Due to convenience sampling, the small sample size and a short time frame when analysing patient outcomes, the generalisability of results is limited. Despite this, with integrated care being polymorphous the findings can be utilised to develop theoretical principles to make assertions about integration (Wikfeldt, 1993).Originality/value This paper draws on the importance of integration as the principal driver of reform within the healthcare system. Even though on a small scale, the case study provides evidence to support the use of integration to improve patient outcomes, patient satisfaction and financial savings. [ABSTRACT FROM AUTHOR]

Purpose Carers of people with mental health problems present with high levels of burden, poor mental well-being and feelings of disempowerment by mental health services. The purpose of this paper is to establish whether providing a psychoeducation skill programme for carers would lead to an improvement of mental well-being, reduce the levels of burden that carers sometimes feel while caring for someone with mental illness and also to increase empowerment. This paper provides a service evaluation study of an innovative carer-led psychoeducational intervention that was undertaken.Design/methodology/approach This programme was initiated and led by a carer who had experienced a lack of service provision to support carers and families in understanding and caring for a relative with severe and enduring mental health diagnoses. A model of co-production was adopted with the carer who led this initiative working closely with an occupational therapist and consultant psychologist in its development and delivery. Data were collected to measure the impact of the training at five different time points. The measures employed to measure outcomes were the Warwick-Edinburgh Mental Well-being Scale, the Burden Assessment Scale and Family Empowerment Scale.Findings Results indicated improved well-being, reduced burden and increased family empowerment in carers who completed this peer-led carer initiative psychoeducational programme.Research limitations/implications This service evaluation study was conducted in a single site and in the site in which it was developed. The carer consultant who led this evaluation and development of the intervention was also the peer worker who delivered the interventions. Hence, the authors are unable to ascertain if the results reported are unique to the individual peer worker. The transferability of this programme and generalisability of the result should therefore be treated with caution and further replication of this model and research is required. This would be beneficial to be conducted in an alternative site from where it was developed, delivered by different facilitators and include a control group.Practical implications The evidence from this study indicates that carers are able and willing to attend a group psychoeducational programme. A high number of referrals to the programme in a relatively short timeframe indicates that there is significant demand for such a service. The implementation of the programme is relatively straightforward. The key challenges for practical implementation are to have the right carer to lead and deliver the programme and the right support system in place for them (financial and supervision). Co-production also is not without challenges, the peer worker and occupational staff need to ensure that mutually valued and respected working relationship should develop.Originality/value This is the first evaluation of the impact of a carer-led psychoeducation intervention for carers of people with mental health difficulties in secondary mental health services. [ABSTRACT FROM AUTHOR]

Adult social care in England emphasises the service and support preferences of disabled and older people. Personal budgets play a central role in this development. Carers in England have also secured rights to assessment and support in their care-giving roles. However, these policies have developed largely separately, with little consideration of the interdependencies between disabled and older people and their carers. There is limited evidence detailing current practice. This paper explores current practice, particularly how far social care practitioners recognise and balance the needs and interests of service users and carers, especially those with cognitive and/or communication impairments. The paper reports findings from nine qualitative focus groups (forty-seven participants) conducted in 2012 with practitioners involved in service user personalisation and carer assessments from older people and learning disability teams across three English authorities. Findings indicate inconsistencies in practice. Although practitioners felt they sought to involve carers, practices varied between authorities, teams and colleagues in the same team. Clear and timely links between processes for service users and carers were absent. Practice was discussed most frequently around service user assessments; other stages of personalisation appeared ad hoc. Areas of confusion and tension are identified. Future policy and practice developments and challenges are also considered. [ABSTRACT FROM AUTHOR]

This paper is based on the first national qualitative study to examine diversity and progression within social work programmes in England, focusing on the experiences of disabled, black and ethnic minority and lesbian, gay and bisexual students. Data collected from ninety-five students and twenty-three social work education providers across eight higher education institutions (HEIs) suggested an institutional effect on rates of progression, linked to the degree of orientation towards systemic change. The study found that social work educators tended to place more emphasis on 'equality of access' than 'equality of outcomes', resulting in a lack of focus on other aspects of the student life cycle such as inter-group dynamics and rates of progression through the programme and into employment. This paper highlights the importance of a 'transformational' organisational change approach to creating an institutional culture where students from minority groups feel welcome and can thrive. Leadership, monitoring and an institution-wide sense of collective responsibility for diversity and equality policy implementation emerged as key to creating a more inclusive environment, alongside equipping staff to take a pro-active role in facilitating high-quality, respectful interaction between different members of the HEI community. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: The strength of a relationship between people with mental health difficulties and professionals has been linked to patients feeling suicidal. A relationship has been found between how defeated and trapped people with mental health difficulties feel and how suicidal they feel. What this paper adds to existing knowledge?: This study explored the relationship between alliance, suicidality, defeat and entrapment in people admitted to mental health wards as previous research has focused on people in the community. Patient‐rated defeat, entrapment and suicidality are related in this sample of people admitted to mental health wards. A relationship was found between how well nurses said they bonded with their named patient and how trapped the patients felt by their environment. What are the implications for practice?: Nurses should consider if patients are feeling defeated or trapped when helping people with mental health difficulties to feel less suicidal. Abstract: Introduction: Suicidality is prevalent worldwide, particularly in people who access mental health services. The quality of therapeutic alliance between people with mental health difficulties and staff has been associated with suicidality but only in community settings. Defeat and entrapment are correlated with suicidality and may mediate any relationship between alliance and suicidality. Therefore, this exploratory study explored these relationships in people admitted to mental health wards. Aim: To explore defeat, entrapment, suicidality and alliance between nurses and people admitted to mental health wards. Method: Fifty inpatient nurse–patient dyads completed questionnaires regarding demographics, defeat, entrapment, suicidality and alliance with their named nurse. Nurses completed questionnaires on demographics, alliance with their patient and the patients’ suicidality. Results: Defeat, entrapment and suicidality were correlated. A correlation between nurse‐rated bond and external entrapment was found, but no other correlations between alliance, defeat, entrapment and suicidality were statistically significant. Discussion and clinical implications: Ward‐based nurses should consider the relationship between defeat, entrapment and suicidality when developing interventions to improve suicidality. Although there was no evidence of a relationship between total alliance and suicidality, developing closer bonds with patients may reduce patients’ feelings of being trapped by their environment. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to share how the maturing value and impact model at The University of Sunderland is enabling the author to generate evidence and articulate the insights. The author draws from that evidence to inform and underpin the strategic service planning, resourcing and reporting.Design/methodology/approach The author will demonstrate how impactful articulation of these insights through data visualisation is enabling the author to employ thought leadership in the relationship management with stakeholders by increasing their understanding of the benefit of engagement with the service offers and demonstrating value for money and the value and impact of the role in achieving institutional objectives. The paper will give an overview of the key techniques of the model and will then demonstrate its practical applications using the following examples: how the model is underpinning the approaches to thought leadership in relationship management by enabling the author to effectively generate and articulate evidence to inform strategic faculty action plans; how the model has enabled the authors to develop a new graphical approach to annual reporting. By combining the variety of data sets generated by the model, the author is able to articulate the outputs and impacts of cross-service holistic service offers and clearly demonstrate how institutional strategic objectives are fulfilled.Findings The author will discuss the key findings including: the importance of embedding the model at the heart of the service culture – both in terms of involving staff in data generation and of developing an evidence-based culture of service planning; the benefit of meaningful data, analysis and insights in helping to inform and underpin strategic conversations and relationship management; the transferability of the model across service settings; the agility of a snapshot approach in enabling the authors to evidence and inform current strategic service priorities; the impact of a “rounded narrative” technique in articulating powerful human insights which demonstrate engagement, impact and value; and the importance of creative data-visualisation techniques in communicating the insights for maximum impact with the customers and stakeholders.Research limitations/implications This case study demonstrates the approach taken to fulfil a specific strategic need at one UK HE institution. Therefore, the readers are encouraged to consider the approach within that context.Originality/value This paper shares how a strategic approach to capturing and communicating value and impact evidence can contribute to thought leadership in articulating library impact. [ABSTRACT FROM AUTHOR]

Summary This paper reports on part of a research study carried out in three local authority adult social care departments in England, which explored links between adult safeguarding and personalisation. The study included statistical analysis of data on safeguarding referrals and the take up of personal budgets and qualitative interviews with managers, social workers, other staff working on safeguarding and with service users. The paper reports the findings from 16 interviews with managers and social workers, highlighting their perspectives and experiences. Findings Five main themes emerged from our analysis: contexts and risk factors; views about risks associated with Direct Payments, approaches to minimising risk; balancing risk and choice; and weaving safeguarding and personalisation practice. Social workers identified similar ranges and kinds of risks to those identified in the national evaluation of Individual Budgets. They described a tension between policy objectives and their exercise of discretion to assess and manage risks. For example, some described how they would discourage certain people from taking their personal budget as a Direct Payment or suggest they take only part of a personal budget as a Direct Payment. Application This exploratory study supports the continued need for skilled social workers to deliver outcomes related to both safeguarding and personalisation policies. Implementing these policies may entail a new form of ‘care and control’, which may require specific approaches in supervision in order to ensure good practice is fostered and positive outcomes attained. [ABSTRACT FROM AUTHOR]

Background: Geographical and cultural differences have been shown to affect public attitudes towards stuttering. However, increasingly for many individuals in the world one's birthplace culture (or home culture) and culture in their local geographical environment (or host culture) are not the same. Aims: The effects of home culture and host culture in shaping the attitudes towards stuttering among students with British, Arab and Chinese home cultures attending one British university were explored. The effects of host culture were investigated by considering the time lived in the UK for Arab and Chinese students. Methods & Procedures: The study used a descriptive survey design that included a standardized self‐delivered questionnaire: the Public Opinion Survey of Human Attributes—Stuttering (POSHA‐S). Purposive sampling was carried out thorough volunteer mailing lists, student societies and personal contact. The final sample of 156 university students included 51 British, 52 Arab and 53 Chinese students. Outcomes & Results: Overall stuttering score (OSS), which is indicative of attitudes towards stuttering, was highest for British participants (mean = 30) and lowest for Chinese participants (mean = 13), with Arab participants falling in the middle (mean = 21). The differences in attitudes between the three groups were statistically significant, suggesting that home culture is a contributor to attitudes towards stuttering. A post‐hoc item analysis of the POSHA‐S revealed numerous specific differences in attitudes towards stuttering between the three groups, including differences in the attribution of the aetiology of stuttering, their role in helping people who stutter (PWS) and sympathy toward PWS. Time lived in the UK—a proxy measure for the role of host culture—did not significantly influence the attitudes of Arab and Chinese respondents. Conclusions & Implications: To varying degrees, all three groups had evidence of stereotypical stuttering attitudes. Nevertheless, given similar ages and student status in the same university, observed respondent differences confirm previous research documenting geographical influences on stuttering attitudes in Western versus East Asian and Middle Eastern samples. The study also provides evidence that home culture was influential in shaping attitudes towards stuttering, but host culture was not a significant contributor. What this paper addsWhat is already known on the subjectPublic stereotypical beliefs towards stuttering are found across the world and hinder the quality of life among PWS. Different cultures have unique stereotypical beliefs towards PWS.What this study adds to existing knowledgeTo the best of our knowledge, no other study has investigated specifically if individuals who live in the same geographical location but have different home cultures, have similar or differing attitudes towards PWS. Results provide preliminary evidence that the home culture of an individual was influential in shaping attitudes towards PWS, but host culture, measured as the length of time living in the current geographical location, did not have a significant relationship with attitudes towards stuttering.What are the potential or actual clinical implications of this workThis study highlights that culturally sensitive clinical practice should not be based on just the culture of the region but should take home culture into consideration as well, and clinicians should discuss cultural perceptions of stuttering with clients in clinical practice. [ABSTRACT FROM AUTHOR]

After two decades of political interest in primary Physical Education (PE) and school sport, the London 2012 Games (and its promised legacy) ushered in a new wave of government investment. To date, the impact of this funding on new entrants to the profession is unknown. This paper draws upon findings from the first phase of a national study that gives insights into the opportunities of pre-service primary teachers (PSTs) to teach PE. A short online survey was administered to PSTs across England. Data were collected to identify how many lessons of PE were taught and who delivered the subject in schools. Nearly 50% of PSTs reported they had no opportunity to teach PE, largely due to curriculum outsourcing. We caution, that if a persistent pattern of outsourcing remains, this could continue the removal of PSTs from teaching PE and the exclusion of teachers from the subject altogether. [ABSTRACT FROM AUTHOR]

This paper reports on data from a qualitative case study of child protection social work in one local authority. Ethnographic methods were used and constructionist grounded theory employed to collect and analyse 329 pages of historical documents about the local authority child protection service, 246.5 hours of observations of social work practice and 19 interviews of social workers and their team managers. By interpreting the experiences of the social workers through the conceptual debates about the changes in the field of social administration, the social workers could be seen to want to perform a traditional form of social work but were required to perform a contemporary form of social administration. The aims and purposes of this form of practice could be considered to be distinct from those of social work as understood by the social workers, and as such, the social workers experienced the practice environment as constraining and often felt disillusioned. This paper conceptualizes these forms of practice, contributing to the debates about what practice is and how we are to analyse and categorize it for the purposes of influencing the institutions that create and maintain contemporary practice. [ABSTRACT FROM AUTHOR]

Background Deaths and injuries related to fires are largely preventable events. In the UK, a plethora of community-based fire safety initiatives have been introduced over the last 25 years, often led by fire and rescue services, to address this issue. This paper focuses on one such initiative—home safety assessments (HSAs). Cheshire Fire and Rescue Service (in England) implemented a uniquely large-scale HSA intervention. This paper assesses its effectiveness. Methods The impact of HSAs was assessed in relation to three outcomes: accidental dwelling fires (ADFs), ADFs contained and injuries arising from ADFs. A two-period comparison in fire-related rates of incidences in Cheshire between 2002 and 2011 was implemented, using Poisson regression and adjusting for the national temporal trend using a control group comprising the 37 other English non-metropolitan fire-services. Results Significant reductions were observed in rates of ADFs [incidence rate ratios (IRR): 0.79, 95% confidence interval (CI): 0.74–0.83, P < 0.001, 2002/03–2007/08 versus 2008/09–2010/11] and associated injuries (IRR: 0.49, 95% CI: 0.39–0.60, P < 0.001, 2002/03–2006/07 versus 2007/08–2010/11), but not in the proportion of fires contained to room of origin. Conclusions There is strong evidence to suggest that the intervention was successful in reducing domestic fires and related injuries. [ABSTRACT FROM PUBLISHER]

Over recent years, the credibility of public examinations in England has increasingly come to the fore. Government agencies have invested time and money into researching public perceptions of the reliability and validity of examinations. Whilst such research overlaps into the conceptual domain of trust, trust in examinations remains an elusive concept. Little is known about what itmeansto trust in examinations and on what individuals base their trust judgments. This paper reports the findings of research into key stakeholders’ perceptions of trust in the English A-level examination system through a series of focus groups comprising (separately) of examination board staff, students, higher education admissions tutors, teachers and the general public. Analysis of the data revealed a number of factors that are integral to the concept of trust in A-levels, including examination standards, the marking of examination papers, the syllabus, communication and provision of information, whether A-levels are fit for purpose and the mode of assessment. The fact stakeholders have different expectations and requirements of the A-level system, which are subject to change, means that it is difficult for the A-level system to engender the trust of all of its users all of the time. [ABSTRACT FROM AUTHOR]

This paper explores the impact for teachers’ identity of undertaking professional development designed to enhance provision for children identified as having dyslexia, in line with the recommendations made by the UK Government. In the paper the concept of ‘participation in communities of practice’ is taken as a departure point for investigating how reflective practice can inform professional identity. The data reported upon were gathered through focus groups and narrative life history interviews conducted with teachers on a Specialist Dyslexia Training for Teachers Programme. The paper identifies and investigates the ways in which teachers who work with dyslexic pupils view themselves as different from other teachers, as having distinct attributes and different motivations for pursuing their chosen career paths. These findings are reviewed, and it is argued that reflection can enable teachers to become better learners, develop their practice and feel integrated into a specific community of practice. However, tensions that arise from perceptions that these teachers have a distinct positioning in the school community are also explored. [ABSTRACT FROM PUBLISHER]

Purpose - This is the second of two papers which aims to describe the development of a sex offender assessment and treatment service for men with intellectual disability (ID) within a community ID service. The first paper by McBrien et al. in 2010 described the mapping of need, the assessment methods and results.Design/methodology/approach - This paper describes how decisions were made about whether or not to enrol 20 assessed men on group treatment and outlines the treatment group and outcomes.Findings - None of the seven men who completed treatment had committed a further sexual offence at 12-24 months follow-up. Other outcomes are discussed including the outcomes for the men who did not start or complete treatment. The available measures are not sufficiently sophisticated to detect change in individuals.Originality/value - This paper contributes to the literature that describes the assessment and treatment of men with an ID who have committed sexually harmful behaviours. It describes one community service's response to the complex needs of this client group. [ABSTRACT FROM AUTHOR]

The PISA Joint Industry Research Project was concerned with the development of improved design methods for monopile foundations in offshore wind applications. PISA involved large-scale pile tests in overconsolidated glacial till at Cowden, north-east England, and in dense, normally consolidated marine sand at Dunkirk, northern France. This paper describes the experimental set-up for pile testing, with unique features of load-application mechanisms and built-in fibre optic strain gauges. New procedures are described for the interpretation of pile loading data, and specifically for providing precise interpretation of pile displacements. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Research findings indicate the percentage of knowledge‐related errors in medicines management is high, accounting for approximately 75% of all errors, with insufficient knowledge levels one of the most significant contributors of medication errors. Patients should be able to trust nurses to engage therapeutically and actively listen to their needs and concerns, responding using skills that are helpful, providing information that is clear, accurate, meaningful and free from jargon. However, without knowledge of pharmacology, it is impossible for nurses to be able to provide adequate advice. What the paper adds to the existing knowledge?: This study has examined an area that had not yet been systematically examined previously, which draws together previous research findings on mental health nurses' knowledge of adverse events, including side effects and medication errors, related to antipsychotic medication within NHS inpatient settings. What are the implications for practice?: A recent study has found that almost three‐quarters (73%) of patients taking antipsychotic medication reported side effects to some degree. This high number of people experiencing antipsychotic medication side effects is likely to compromise care, especially in situations where nurses have inadequate knowledge of side effects and are unable to provide effective advice to patients.The findings from this study allow the mental health nursing profession an opportunity to reflect on the best means to increase knowledge and increase patient safety awareness and benefits for mental health service users. Introduction: Antipsychotic medications play a significant role in the treatment and recovery of people with several psychiatric disorders. However, research findings indicate mental health nurses are insufficiently knowledgeable about antipsychotic medication side effects. Aim: To assess practising mental health nurses' knowledge of antipsychotic medication side effects using a Multiple‐Choice Questionnaire (MCQ) across National Health Service (NHS) Trusts in England. Hypothesis: Knowledge of antipsychotic medication side effects amongst registered mental health nurses is related to their academic qualification, clinical banding and length of experience. Method: A national survey of registered mental health nurses was carried out using an online questionnaire which was disseminated by Research and Development departments. Results: A total of 504 questionnaires were returned, 245 of which had full data and further analysed. The mean score for the sample was 14.4 and only 21 participants attained a mark of >80%. Implications for Practice: Two out of three of our hypotheses (that length of experience and clinical banding are directly related to knowledge of antipsychotic medication side effects) were supported. Our study found many nurses have a suboptimal working knowledge of antipsychotic medication side effects which has the potential to compromise care. Strategies need to be put in place to enhance pharmacology knowledge. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to explore whether performance indicators in children's services can be used to predict the outcome of Ofsted inspections. Every local authority in England is inspected by Ofsted (the Office for Standards in Education, children's services and skills) and given a single, overall rating – outstanding, good, requirements improvement or inadequate. These ratings carry immense significance. Persistently inadequate authorities are liable to have legal responsibility for providing services outsourced to another organisation. Ofsted have been criticised in the past for focusing too much on procedure, and previous research has highlighted the importance of deprivation and spending levels. In this paper, we describe a new study using more recent Ofsted and local authority data to see what patterns there might be now between performance indicators and inspection results. Design/methodology/approach: We report an analysis of 45 variables in relation to children in need, children in care and young adults with care experience. Using statistical analysis, we consider to what extent performance measured by these variables differs between authorities based on their Ofsted ratings and which of the variables can be used to predict Ofsted inspection outcomes. Findings: We identified no consistent patterns of difference between local authorities in relation to Ofsted ratings. Deprivation was the best single predictor of Ofsted inspection outcomes. Originality/value: This study uses relatively recent Ofsted and local authority data and builds on previous research findings which are increasingly highlighting the significance of deprivation as a factor to help explain variable performance between different authorities. [ABSTRACT FROM AUTHOR]

The following paper outlines the findings from an exploratory analysis of the hostage and crisis negotiator deployment database that was piloted within Norfolk and Suffolk Constabularies prior to national rollout of a centralised and standardised online recording mechanism for negotiator deployments across the majority of police forces within the UK. The research utilised a descriptive research design, whereby the secondary data from an initial 24-month recording period was analysed using descriptive statistics. The findings provide a descriptive representation of (1) the socio-demographic characteristics of the subjects encountered by negotiators, (2) the typical situational characteristics/circumstances in which subjects present and the most frequently encountered subject impact factors and (3) how hostage/crisis incidents are typically resolved. The findings are discussed with relevance to the implications for negotiator practice and policy. An emphasis is placed on identification of recommendations for improving the discipline of hostage and crisis negotiation via the standardisation of deployment recording and targeted/focused training and continuing professional development of negotiators based on the characteristics of deployments observed. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to examine changes in the nature, form and range of commissioning arrangements for home care. Design/methodology/approach: Data from two discrete national surveys of English local authorities with social service responsibilities were used. In the first, undertaken in 2007, responses from 111 of the 151 local authorities (74%) were received; in the second, undertaken in 2017, responses from 109 local authorities (72%) were received. A combined data set of 79 complete cases, 52% of local authorities, was created. Percentage point differences across the two time periods were calculated and tested to identify significant changes and a systematic analysis of the free-text responses regarding intended changes to the commissioning process in each data set was undertaken. Findings: Findings identified substantial changes in some aspects of the commissioning of home care in the 2007-2017 decade. Collaboration between stakeholders had increased, particularly regarding the identification of future needs. Improved conditions of service and remuneration for home care workers were evident within the commissioning process. Standardised charges for home care (regardless of time and day) had also become more widespread. Initiatives to prompt providers to deliver more personalised care were more evident. Originality/value: This paper describes the evolution of commissioning arrangements for home care in localities in response to national policy initiatives. It provides guidance to commissioners in meeting the needs of current service users and emphasises the importance of collaboration with stakeholders, particularly providers, in securing future capacity. [ABSTRACT FROM AUTHOR]

One of the most problematic issues for researchers who conduct qualitative research using semi-structured, unstructured interviews or story telling data collection methods is the analysis of large quantities of rich data. In the past this has often led to fairly unmethodical approaches to analysis which in turn has led to qualitative business and management research being seen as insubstantial and unworthy of consideration. A relatively recent development in organisational research has been the application of Template Analysis to rich unstructured qualitative data following the primary data collection phase. Template Analysis appears to have emerged from the USA during the 1990s and academics familiar with the Grounded Theory approach to data analysis may see similarities in the techniques used. Nevertheless, it has gained credibility in the UK through the work of Nigel King and other colleagues researching in health and sociology related fields. This paper provides an overview of the origins of Template Analysis and discusses how it has been used to structure qualitative data. It then goes on to examine through the two case studies how Template Analysis has been extended and used by the authors in two different research projects. In the first case study the research team worked within a Primary Care Trust in the North East of England on a project that explored the Diffusion of Innovation of clinical and administrative computer systems across General Practice within the Trust. Seventeen Trust members were interviewed for approximately one hour and this led to over 85000 words of rich data. The second project focused on the NHS Secondary Care sector and examined IT project management practice related to the development of integrated pathology computing systems across eight separate laboratories in the North of England. Eight senior managers were interviewed and this, combined with participant observation and over 3 years of document collection, also resulted in a large volume of rich textual material. The use of template analysis, combined with a critical success factors methodology, resulted in a novel approach for learning about current IT project management practices. This paper critically examines these two case studies in terms of their particular research philosophy, epistemological approach and the lessons learnt from the techniques employed. The paper then provides a discussion of the principles and practicalities of template analysis and explores the benefits to the business and management research community at large. [ABSTRACT FROM AUTHOR]

The English healthcare sector underwent extensive system reform over the period from 2010 to 2015, aimed principally at improving technical efficiency. This paper examines the effect of the reforms on foundation trusts in England with particular emphasis on technical efficiency. By employing data envelopment analysis (DEA) and a second-stage regression, we found evidence of an overall improvement in efficiency, notwithstanding some fluctuations. Specifically, we found that bed utilization had positive and statistically significant association with the efficiency of acute foundation trusts; suggesting that better management of patient flows and bed utilization might be expected to improve hospital efficiency. We also found evidence to suggest that efficiency might also be improved through better management of staff numbers, optimizing liquidity, and better utilization of assets such as buildings and information technology. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine how the role in offender mental health for the probation service described in policy translates into practice through exploring staff and offenders' perceptions of this role in one probation trust. In particular, to examine barriers to staff performing their role and ways of overcoming them. Design/methodology/approach Qualitative secondary analysis of data from semi-structured interviews with a purposive sample of 11 probation staff and nine offenders using the constant comparative method. Findings Both staff and offenders defined probation's role as identifying and monitoring mental illness amongst offenders, facilitating access to and monitoring offenders' engagement with health services, and managing risk. Barriers to fulfilling this role included limited training, a lack of formal referral procedures/pathways between probation and health agencies, difficulties in obtaining and administering mental health treatment requirements, problems with inter-agency communication, and gaps in service provision for those with dual diagnosis and personality disorder. Strategies for improvement include improved training, developing a specialist role in probation and formalising partnership arrangements. Research limitations/implications Further research is required to explore the transferability of these findings, particularly in the light of the recent probation reforms. Originality/value This is the first paper to explore how staff and offenders perceive probation's role in offender mental health in comparison with the role set out in policy. [ABSTRACT FROM AUTHOR]

This paper describes some of the findings of a qualitative study into the health and illness beliefs of Greek Cypriots living in London. Data were collected through group and individual in-depth interviews and were analysed using the grounded theory approach of constant comparison and saturation. Two of the six themes which were identified are discussed in this paper. The findings provide the reader with important insights into Greek Cypriots' beliefs of health and illness. The paper argues that the understanding of such beliefs from a cultural perspective is vitally important for all those involved in the provision of health care to this group. [ABSTRACT FROM AUTHOR]

Aim To reflect on the use of photo elicitation as a data collection method when conducting research with primary school age children (nine to 11 years). Background There is recognition that children feel an affinity with the visual medium; as a result, visual methods can be useful when conducting research with children. Photo elicitation is one such method, but there has been little discussion of its use with primary school children within a health context. This paper considers the main issues that researchers should consider. Data sources This paper draws on a research study conducted by the author that used an ethnographic approach and photo elicitation to identify the assets underpinning children’s wellbeing. Review methods A reflective discussion is used to highlight issues relating to the use of photo elicitation to collect data from primary school children. Discussion Photo elicitation is not without its challenges: it creates additional ethical considerations, and can be more time-consuming and expensive. However, children value the opportunity to be involved in research and have their opinions sought, and photo elicitation provides a method of collecting data that is appropriate for children’s developmental and cognitive maturational stages. Conclusion Photo elicitation can be a positive experience for children, and one that is not only fun and engaging, but that is also empowering and valuing of their contributions. Implications for research/practice Research that uses photo elicitation needs to be carefully planned to ensure that the study is supported appropriately. The visual process can offer a unique insight into children’s lives that allows health professionals to deepen their understanding of children’s experiences. [ABSTRACT FROM AUTHOR]

Abstract: Many patients find using medicines burdensome. This paper reports the types of issues people experience with medicines, using a validated measure of medicines burden, and the factors associated with high burden. The cross‐sectional study involved patients presenting prescriptions at pharmacies or awaiting appointments at GP practices or outpatient clinics, during October 2015 to December 2016. Adults using at least one regular medicine were asked to complete the Living with Medicines Questionnaire V3 (LMQ‐3). The LMQ‐3 contains 41 statements rated on a 5‐point scale (strongly agree to strongly disagree), with higher scores indicating greater burden, plus a visual analogue scale for self‐reporting of overall perceived burden (VAS‐burden). For a subsample, access to their medication record was requested, facilitating calculation of the complexity of their medicine regimen using the Medicine Regimen Complexity Index (MRCI). Of 1,888 questionnaires distributed, 684 were returned (36.2%) and medication records obtained for 163. The median number of medicines respondents reported using was 4 (range 1 to 26). Two‐thirds (418; 67.0%) used medicines more than once daily, 67 (10.1%) required assistance with medicines and 189 (28.3%) paid a prescription charge. LMQ‐3 scores showed a strong positive relationship with VAS‐burden scores (r = .547; p < 0.001). LMQ‐3 and VAS‐burden scores were lower in older age groups, but both increased with increasing number of medicines and dosing frequency. LMQ‐3 score was positively related to MRCI score (n = 163; r = .217; p = 0.005), whereas VAS‐burden was not. Older respondents reported lower burden in most domains. Higher numbers and frequency of medicines, paying prescription charges, needing support and deprivation increased burden across multiple domains. Factors strongly associated with high LMQ‐3 scores were: needing support, high dosing frequency and unemployment. Interventions seeking to reduce medicines burden should consider targeting individuals who need support with using medicines, use at least four medicines, more than twice daily and/or pay prescription charges. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to investigate the operation of multidisciplinary team (MDT) meetings within a forensic hospital in England, UK.Design/methodology/approach Mixed methods, including qualitative face to face interviews with professionals and service users, video observations of MDT meetings and documentary analysis. Data were collected from 142 staff and 30 service users who consented to take part in the research and analysed using the constant comparison technique of grounded theory and ethnography.Findings Decisions taken within MDT meetings are unequally shaped by the professional and personal values and assumptions of those involved, as well as by the power dynamics linked to the knowledge and responsibility of each member of the team. Service users’ involvement is marginalised. This is linked to a longstanding tradition of psychiatric paternalism in mental health care.Research limitations/implications Future research should explore the nuances of interactions between MDT professionals and service users during the meetings, the language used and the approach taken by professionals to enable/empower service user to be actively involved.Practical implications Clear aims, responsibilities and implementation actions are a pre-requisite to effective MDT working. There is a need to give service users greater responsibility and power regarding their care.Originality/value While direct (video) observations were very difficult to achieve in secure settings, they enabled unmediated access to how people conducted themselves rather than having to rely only on their subjective accounts (from the interviews). [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to review the Mental Health Foundation’s experiences designing, implementing and evaluating peer-focused self-management programmes. Through a discussion of barriers and good practice, it outlines ways to be successful in making such projects work to improve mental health and wellbeing among at-risk populations.Design/methodology/approach A total of 11 Mental Health Foundation programmes implemented over the past ten years were reviewed through reading manuals and publications and interviewing programme managers. Key data were extracted from each programme to analyse trends in aims, outcomes and recommendations.Findings Through a focus on peer-work, programmes taught individuals from a variety of societal sectors self-management skills to effectively deal with life stressors. Through sharing in non-judgmental spaces and taking ownership of programme design and content, individuals realised improvements in wellbeing and goal achievement.Practical implications Good practice, barriers and recommendations can be taken from this review and applied to future peer-focused self-management programmes. By better embedding quantitative and qualitative evaluations into programme development and implementation, programmes can add to the evidence base and effectively target needs.Originality/value This review lays out valuable experience on an innovative community service paradigm and supports the evidence on effectiveness of peer-focused self-management programmes with a variety of group populations. [ABSTRACT FROM AUTHOR]