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This paper seeks to contribute to the growing band of constructionist approaches within the field of identity studies (Wetherell & Moharty, 2010). First, it will review the developments that have taken place since the emergence of these approaches in the 1980s, identifying a state of fragmentation into local discursive, political-moral, and psychosocial levels of analysis. Second, and in order to challenge this fragmentation, it will present a rhetorical psychological (Billig, 1987, 1999a) analysis of the classic exchange of public letters between Israeli historian of Judaism Gershom Scholem and American political theorist Hannah Arendt in the wake of the latter's book Eichmann in Jerusalem (Arendt, 1994a). The analysis will proceed from local discursive action, through political-moral frameworks, to the nature of the writers' investment in these constructions. It will show that while the participants' implicitly occasioning of extreme identity categories (such as the 'Jewish anti-Semite' and the totalitarian-style religious Zionist ideologue) is a function of apparently incommensurable political-moral discourses, the nature of investment into such constructions may be understood in a mutual commitment to the absolute inalienability of Jewishness. Third, therefore, the paper will conclude that, rather than constituting separate 'levels', local discursive action, political-moral intelligibilities, and psychosocial qualities are mutually constitutive of each other. It is only through recognizing their inter-dependent nature that the complexity of identity may properly be addressed. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to summarize the work of the Court of Protection. Design/methodology/approach – The paper outlines the history and range of applications within the jurisdiction of the Court, drawing from the Mental Capacity Act and the Code of Practice. Reference is made to annual reports of the work of the court which profile its workload. Finally there is a review of a line of case law dealing with the question of media attendance and reporting of cases before the court. Findings – The Court in its current form was established under The Mental Capacity Act, 2005 and is a significant decision-making body in the UK within adult safeguarding practice concerning adults whose decision-making capacity is impaired. The implications of several specific cases are discussed. Originality/value – This paper provides a unique insight into the work of the Court of Protection and the implications of recent decisions by the Court for adult safeguarding. [ABSTRACT FROM AUTHOR]

Purpose – The Mental Capacity Act (MCA) was implemented in 2007 as a piece of legislation to empower and protect adults who require support making decisions. Many older adults in residential care homes will be in this position due to developmental disabilities associated with functional impairments of the mind and brain. This paper aims to evaluate the impact of MCA training within older persons' care homes within an East-Midlands local authority. Design/methodology/approach – Semi structured interviews were conducted with key informants who had strategic responsibility for implementation of MCA training as well as a focus group conducted with managers/deputy managers of care homes within the local authority. Findings – With a primary focus on training, data revealed issues surrounding the delivery and content of training, and the organisational factors relating to both training and the subsequent implementation of the knowledge learned. Research limitations/implications – The key informants for this paper are limited to management perspectives. Interviews and a focus group were conducted with stakeholders who either had direct responsibility for service delivery or managerial oversight for training and development. Practical implications – The paper suggests methods of delivery with the Mental Capacity Act which offer a tailored, engaging and cost effective alternative to conventional "away day" training sessions. Originality/value – The paper challenges and critiques conventional approaches to training the social care workforce. [ABSTRACT FROM AUTHOR]

In Britain, there has been an increased emphasis on the use of risk assessments in mental health services over the past 20 years. Mentally disordered offenders subject to Section 41 of the Mental Health Act 1983 (England and Wales) are defined as posing a serious risk of harm to others. They are thus dealt with by forensic mental health services, which are often seen as specialists in risk assessments. This paper is based on original research in three mental health trusts in the South of England which was carried out between March 2009 and September 2011. The paper examines mentally disordered offenders’ awareness and attitude to formal risk assessments in relation to theories of governmentality. Service users subject to Section 41 of the Mental Health Act 1983 were aware that their level of risk was being assessed by professionals caring for them but were commonly unaware of the content of these assessments. These risk assessments were viewed by participants as a means through which professionals measured and monitored behaviour. Although participants often referred to levels of risk, they did not view risk screening schedules as objective, but rather emphasised the need to persuade staff that their risk had reduced. Despite showing a limited awareness of the content of these risk assessments, participants generally identified more risks, in relation to their vulnerability, than did the professional assessments. However, participants generally identified fewer risks in relation to the dangers they posed to others than did professional staff. [ABSTRACT FROM PUBLISHER]

Purpose – This paper aims to detail the work of Nasa Begum in the disabled people's movement in the UK. Design/methodology/approach – The paper provides information on Nasa's background and her work as a social worker, researcher and activist in the disability movement. Findings – Nasa was a black disabled woman who used mental health services. This paper focuses particularly on how she brought the perspectives of black disabled people to the disabled people's movement and the health and social care field. Originality/value – The paper demonstrates that Nasa has left a clear legacy of principles that show how things can and should be done when policy makers and service providers want to work in an inclusive way. [ABSTRACT FROM AUTHOR]

This paper interrogates a concept at the core of a social policy agenda that has dominated thinking in the UK over the past decade. It argues that the notion of ‘community cohesion’ is based on a fundamentally flawed interpretation of the sources of tension and conflict in Britain’s towns and cities. It overly ethnicizes societal divisions and essentializes ethnicity. Examining the development of government policy since 2001 the paper shows that the result has been a predominantly culturalist agenda that obscures key sources of division, most notably those related to social class and material inequality. It is argued that the hegemonic status of this policy stream has also undermined the equalities agenda. The paper concludes with a reflection on the implications of the emergence of a Conservative-led coalition government in May 2010. [ABSTRACT FROM PUBLISHER]

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

Purpose – The Ageing Well programme is designed to improve life for older people and works with councils to help them make better places for people to grow old in. The purpose of this paper is to look at the programme and the work being carried out. Design/methodology/approach – The paper talks about the programme's origins and purpose, the work it has been doing, and the legacy it will leave for councils to work well in the future. Findings – The programme has shown different councils face different issues within the ageing agenda, and therefore need different solutions. Councils need to engage with older people to support them fully and to embrace the ageing agenda. Practical implications – The programme is aimed at improving provision for older people in many areas. This work needs to continue despite the challenge local authorities face with budgets. Support from the Ageing Well programme has helped councils identify innovative ways to look at the ageing agenda and this needs to continue. Social implications – The programme encourages councils and the wider public to see older people in a more positive light. It helps to show older people as an asset to society, whether the economy or through volunteering and life experience, and helps councils really embrace making their area a better place in which to grow old. Originality/value – This paper will help councils which are not already working with the Ageing Well programme see its value and access its support. [ABSTRACT FROM AUTHOR]

Purpose – The aim of this paper is to highlight the challenges in evaluating psychological input into acute wards using more traditional methods; and also to provide an example of how it is possible to evaluate such services capturing outcomes at multiple levels. Design/methodology/approach – Data were gathered from multiple levels including staff, patients and the wider organisation mainly using self report questionnaires. The paper looks at the impact on satisfaction, service utilisation, development of recovery principles, quality of therapeutic environment and alliance with treatment teams following the introduction of a dedicated psychology team. Findings – The results show positive trends in patient experiences of the ward environment, alliance with treating teams and staff recovery principles, along with reduced readmission rates and length of stay in hospital. Qualitative data demonstrate the value of the service to both staff and patients. Research limitations/implications – Much of the data do not meet the criteria for more sophisticated statistical analysis. Originality/value – The paper provides an example of evaluation of a contemporary model of service delivery for which there is currently a limited evidence base and looks to stimulate current thinking on the practice of mental health service delivery. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to explore the impact of domestic abuse on the health and lives of older women.Design/methodology/approach - A qualitative research design was used and data were collected using in-depth interviews with 16 older women who had experienced domestic abuse. The interviews varied between one and two hours in length and, with the participant's permission, all of the interviews were audio recorded and transcribed verbatim. Analysis was undertaken utilising an iterative approach. In the present study all data were manually indexed and coded.Findings - The findings of this study illustrate that the consequences of domestic abuse for older women are far reaching, impacting significantly on the long-term health and emotional wellbeing of those affected. This paper also highlights that there is currently little available data regarding older women and domestic abuse within the particular context of health. This is increasingly being recognised as a significant deficit in awareness and understanding within society as a whole and, more particularly, for those responsible for support and care provision. Existing policy in this field and the implications for service development are also considered.Research limitations/implications - This is a small scale study and therefore there are limitations in terms of generalisability.Originality/value - This paper discusses the specific issues that arise for older women who have experienced domestic abuse within the particular context of health. [ABSTRACT FROM AUTHOR]

mcinnes e., seers k. & tutton l. (2011) Older people's views in relation to risk of falling and need for intervention: a meta-ethnography. Journal of Advanced Nursing 67(12), 2525-2536. Abstract Aim. This paper is a report of a meta-ethnography of qualitative studies of older peoples' views on risk of falling and need for intervention. Background. Falls and falls-related injuries in older people are worldwide problems. A conceptual understanding of older people's views about falls risk and need for intervention is useful for understanding factors likely to impact on acceptance of risk and recommended interventions. Data Sources. Seven electronic databases were searched 1999-2009. Reference lists of included articles were screened for eligible papers. Review Methods. Assessment of quality was carried out. Themes and concepts were extracted using a meta-ethnographic approach to compare similarities and differences across the retrieved studies. A line of argument was developed to produce an explanatory framework of the extracted themes and concepts. Results. Eleven relevant qualitative research articles of reasonable quality were identified. Six key concepts were identified: beyond personal control; rationalizing; salience; life-change and identity; taking control and self-management. A line of argument synthesis describes how older people approach self-appraisal of falls risk and intervention need, and how they cope and adapt to falls risk and intervention need. Conclusion. In response to having an elevated risk status and perceived associations with frailty and impact on an independent life-style, some prefer to adapt to this reality by taking control and implementing self-management strategies. Healthcare professionals should take into account beliefs about risk and negotiate choices for intervention, recognizing that some individuals prefer to drive the decision-making process to preserve identity as a competent and independent person. [ABSTRACT FROM AUTHOR]

Home-care re-ablement or 'restorative' services are a cornerstone of preventive service initiatives in many countries. Many English local authorities are transforming their former in-house home-care services to provide intensive, short-term re-ablement instead. The focus of this paper is on the organisation and content of re-ablement services and the features of their organisation and delivery that have the potential to enhance or detract from their effectiveness. Qualitative data were collected from five sites with well-established re-ablement services. Data included semi-structured interviews with senior service managers in each site; observation of 26 re-ablement visits to service users across the five sites (four to six in each site) and a focus group discussion with front-line staff in each site (in total involving 37 front-line staff). The data generated from all three sources were analysed using the framework approach. All five services had developed from selective pilot projects to inclusive 'intake' service, accepting almost all referrals for home-care services. A number of features were identified as contributing to the effectiveness of re-ablement services. These included: service user characteristics and expectations; staff commitment, attitudes and skills; flexibility and prompt intervention; thorough and consistent recording systems; and rapid access to equipment and specialist skills in the team. Factors external to the re-ablement services themselves also had implications for their effectiveness; these included: a clear, widely understood vision of the service; access to a wide range of specialist skills; and capacity within long-term home-care services. The paper argues that re-ablement can be empowering for all service users in terms of raising their confidence. However, the move to a more inclusive 'intake' service suggests that outcomes are likely to be considerably lower for service users who have more limited potential to be independent. The paper discusses the implications for practice. [ABSTRACT FROM AUTHOR]

Objective: This paper seeks to highlight the need for employment relations academics and researchers to expand their use of research methodologies in order for them to enable the advancement of theoretical debate within their discipline. It focuses on the contribution that pragmatical critical realism has made to the field of perception and argues that it would add value to the subject of employment relations. Methods: It is a theoretically centred review of pragmatical critical realism and the possible contribution this methodology would make to the field of employment relations. Conclusions: The paper concludes that the employment relationship does not take place in a vacuum rather it is focussed on the interaction between imperfect individuals. Therefore, their interactions are moulded by emotions which can not be explored thoroughly or even acknowledged through a positivists' rigorous but limited acknowledgment of what constitutes 'knowledge' and development of theory. While not rejecting the contribution that quantitative data or positivism have made to the field, the study concludes that pragmatic critical realism has a lot to offer the development of the area and its theoretical foundations. [ABSTRACT FROM AUTHOR]

This paper reviews available UK evidence on (private sector) business attitudes to transport. It follows a 2008 review of public attitudes to transport, and provides an important frame of reference for considering business attitudes. Accordingly the current paper includes comparisons between public and business attitudes. There are some prima facie similarities between public and business attitudes in relation to congestion, the order of importance of transport attributes (especially reliability), stated conditions for support of road pricing, public transport, travel plans, telecommunications and some issues of reducing travel. There are, however, some differences also: transport concerns are less ubiquitous, less attention is given to the environmental concerns associated with road building and there is less attention to wider government goals such as equity, health, social welfare and the environment. However, both similarities and differences may be misleading, as research on business attitudes is less disciplined, and there are no well-established theoretical frameworks (such as exist for individual attitudes) for understanding attitudes, when applied to the corporate views of a commercial body. In essence, many of the business attitudes reports are framed as lobbying material yet, paradoxically, there can be considerable ambiguity attached to the meanings of business attitudes, that in turn can be partially attributed to doubts as to whether responses represent individual or corporate attitudes. As a result, it is very difficult, from the existing evidence, to interpret a clear and coherent view or set of views of business on transport issues. The authors suggest some protocols, with the aim of improving research methods that, if implemented, could help improve the credibility and clarity of claims to represent the 'voice (or, more realistically, voices) of business'. [ABSTRACT FROM AUTHOR]

Based upon the findings of a qualitative in-depth interview study with 23 women aged 23-72 years recruited from members of the general public and a psychosexual clinic, this paper explores participants understandings of the term 'sexuality'. The findings are set within the context of historical, prevailing and often contradictory perceptions of the term. Data were analysed thematically using the conventions of template analysis within a material discursive framework. This paper questions the assumption that sexuality is an altogether powerful and naturally occurring phenomenon. The ability to isolate and give credence to a definitive meaning of the term is, both for participants and academics alike, an arduous undertaking. Rather than focusing primarily on the material body, the extent to which ideology, culture and power intersect with the former indicate its multidimensional, constructed nature. Given the whole host of meanings evoked by the term, the paper asserts that it is more fitting to talk of multiple understandings of sexuality rather than a singular authoritative one whilst also contingent on social and historical practices. The findings have implications that should be considered when evaluating previous sexological research and conducting future research where this term is used throughout as a focus of academic enquiry. [ABSTRACT FROM AUTHOR]

During the last two decades the literature on public space has registered the emergence of alternative forms of pubic space provision that depart from the traditional model of direct state ownership and management. The picture that emerges is a complex one, not so much one of privatization, but instead one of complex redistribution of roles, rights and responsibilities in public space governance to a range of social actors beyond the state. This paper discusses an approach to understanding the forms of publicness implicit in alternative forms of public space governance. Issues of rights, access, accountability and control could be examined in public space governance arrangements based on contracts, legal agreements and performance management mechanisms involving private and voluntary entities instead of the traditional public sector processes of policy delivery and accountability. The paper proposes a framework for investigating how 'publicness' is constructed and maintained through these arrangements. [ABSTRACT FROM AUTHOR]

The world in 2010 is a very different place to 1987 when Bhugra's paper on homophobia was published. Huge shifts have occurred in society's attitudes to gender, sex, sexuality and identity - notably by the internet, changes in HIV treatment, media representation of homosexuality and feminism and the role of women in society. This paper updates the literature review on homophobia revisiting society's assumptions about homosexuals. Changes are discussed in the context of definitions of homophobia, socio-cultural and politico-legal perspectives and homophobia and medicine. New current assumptions are drawn up and offered as a way of understanding both development and limitations - whilst there has been a reduction in the fear associated with gay men and women, discrimination remains. Newer issues such as internalised homophobia, globalisation and mainstream representations of homosexuality add complexity to this ongoing concern. [ABSTRACT FROM AUTHOR]

This paper builds on previous work applying the concept of well-being to the field of housing. It uses the concepts of self-esteem, efficacy and social identity to explore the situations of a group of young homeless mothers. In particular, it focuses on the impact of well-being factors, among others, in understanding the uptake of education and training services. The paper concludes by arguing that well-being issues are crucial for housing agencies and others who want to engage with young homeless people. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: The experience of hearing distressing voices is commonly reported by service users with a diagnosis of first‐episode psychosis, but their access to formal conversations about voices in the form of psychological therapies can be limited.Service users within Early Intervention in Psychosis (EIP) services can benefit from informal opportunities to talk about their voice hearing experiences. However, they can be reluctant to engage with these conversations.Little is known about the experiences of EIP practitioners as they try to engage service users in conversations about their voices. What does the paper add to existing knowledge?: Despite EIP Services specializing in the treatment of the symptoms of psychosis such as voice hearing, practitioners can still be reluctant to initiate and continue informal conversations about voices. What are the implications for practice?: EIP practitioners may benefit from the introduction of interview guides and brief interventions to assist them with the initiation and continuation of conversations about voices. Introduction: Hearing voices is a common and distressing symptom of first‐episode psychosis. Formal and informal conversations about voices are helpful, but service users within Early Intervention in Psychosis (EIP) Services can be reluctant to discuss their voice hearing experiences. There is currently no literature that explores the experiences of EIP practitioners as they try to facilitate conversations about distressing voices. Aim/Question: A qualitative methodology was used to investigate how EIP practitioners work with service users who hear voices. Ten practitioners were interviewed, and interviews were analysed using template analysis. Results: Two themes that offer novel insights are presented: "starting a conversation about voices" and "continuing the conversation about voices." Discussion: Starting and continuing a conversation about voices was considered important but not all practitioners were confident in this respect. The initiation and continuation of these conversations may need to be systematically supported. Implications for practice: To support the initiation of informal conversations, a standardized interview guide for voice hearing could be introduced and systematically utilized. The continuation of these conversations could be supported by practitioners being given the opportunity to receive training in and the opportunity to deliver brief symptom‐specific therapies for distressing voices. [ABSTRACT FROM AUTHOR]

Purpose: Sexual transmitted infections (STIs) are associated with high stigma leading to poor sexual health-seeking behaviour and mental health problems. Although human immunodeficiency virus (HIV) prevention has generally been successful in many communities across the world, statistics for young people have remained relatively low, especially among most affected communities such as the black sub-Sahara African (BSSA) communities. This paper aims to explore the barriers to STIs and HIV testing among young BSSA communities living in the UK. Design/methodology/approach: The research study used an explorative qualitative approach. The study included 6 focus groups comprising 10 people each (N = 60), and 12 one-to-one follow-up interviews were held with the research participants. Two one-to-one follow-up interviews were held from each focus group (N = 12). Findings: The study found that perceived risk taking, perceived HIV test embarrassment, sexual health professionals' attitudes, perceived HIV as death sentence, limited educational awareness and general HIV stigma prevented research participants from testing and impacted on their mental health well-being. Originality/value: There is a need to increase sexual health and mental health education awareness among young BSSA communities. More importantly culturally sensitive interventions to reduce the impact of HIV stigma need to be rolled out in different diverse communities. This study is the first of its kind to look at the barriers affecting young BSSA communities in accessing sexual health testing services in the UK. [ABSTRACT FROM AUTHOR]

In healthcare settings, there is an emotional cost to caring which can result in compassion fatigue, burnout, secondary trauma, and compromised patient care. Innovative workplace interventions such as the Schwartz Rounds offer a group reflective practice forum for clinical and non‐clinical professionals to reflect on the emotional aspects of working in health care. Whilst the Rounds are established in medical health practice, this study presents an evaluation of the Rounds offered to mental health services. The Rounds were piloted amongst 150 mental health professionals for 6 months and evaluated using a mixed‐methods approach with standardized evaluation forms completed after each Round and a focus group (n = 9) at one‐month follow‐up. This paper also offers a unique six‐year follow‐up of the evaluation of the Rounds. Rounds were rated as helpful, insightful, and relevant, and at six years follow‐up, Rounds were still rated as valuable and viewed as embedded. Focus groups indicated that Rounds were valued because of the opportunity to express emotions (in particular negative emotions towards patients that conflict with the professional care‐role), share experiences, and feel validated and supported by colleagues. The findings indicate that Schwartz Rounds offer a positive application in mental healthcare settings. The study supports the use of interventions which provide an ongoing forum in which to discuss emotions, develop emotional literacy, provide peer support and set an intention for becoming a more compassionate organization in which to work. [ABSTRACT FROM AUTHOR]

In this paper we use a large UK survey of business angels (BAs) investing in two different publicly supported schemes to directly question the role that investment motivations play in shaping investors' appetite for risk. We dive deeper into the relationship between investment reasons and risk taking, by exploring the potential for a moderating effect derived from BAs' past experience (i.e. financial and entrepreneurial experience). Our analysis reveals that both investment reasons (for return and for passion) have substantial explanatory power in shaping angels' risk attitude, but their effect is moderated by the investors' prior experience. This key finding represents important empirical support for what has so far been anecdotal evidence concerning BAs' appetite for risk when investing. [ABSTRACT FROM AUTHOR]

Debates around the impacts of the UK's exit from the European Union ('Brexit') have exposed the limited critical attention given to how planning systems intersect with environmental protection. This is an important omission, especially given deregulatory pressures on both planning and environment in many countries. In response, this paper uses documentary, interview and focus group data, to conceptualise different regulatory styles governing the environment-planning interface, and assess UK planning practitioner attitudes to EU environmental legislation and scenarios for future change. The data show practitioners largely supporting the fixed standards and robust oversight characteristic of EU environmental regulatory styles, anxious about deregulation, and interested in procedural flexibility. More fundamentally, it also reveals the compromises struck in regulatory design, and the importance of concrete development-environment challenges in constructing arguments for change. Consequently, planning occupies a pivotal position within wider debates about new environmental policy fixes, warranting more extensive professional discussion. [ABSTRACT FROM AUTHOR]

Loneliness is a global public health concern linked to a range of negative health outcomes (Cacioppo & Cacioppo, 2018. The Lancet. 391(10119), 426). Internationally, this has led to the development of a number of interventions, but these are rarely implemented or evaluated on a large scale. This paper is one of the first of its kind to describe elements of an evaluation of a large‐scale national social prescribing scheme to reduce loneliness, deploying individual link workers to signpost people to community activities. Reporting on findings from interviews with staff (n = 25 of which 6 were repeat interviews) and volunteers (n = 9) between October 2017 and December 2018 in localities across the United Kingdom. We reflect on the complexities of the link worker role, the challenges of service delivery and the importance of community infrastructure. There was evidence that highly skilled link workers who had developed positive relationships with providers and service‐users were key to the success of the intervention. As well as providing an effective liaison and signposting function, successful link workers tailored the national programme to local need to proactively address specific gaps in existing service provision. For social prescribing services to be successful and sustainable, commissioners must consider additional funding of community infrastructure. [ABSTRACT FROM AUTHOR]

This paper reports on a study of the relationship between demographic, personality, and attitudinal variables and impulsive buying (a consumer's tendency to buy spontaneously, unreflectively, and immediately); using secondary analysis of data from common participants in two large national surveys of British adults: one survey contributing data on impulsive buying, demographics, and money attitudes; and the second, a Big Five personality trait measure. In particular, we focus on the attitudes characterized by the extent to which individuals associate money with security, freedom, power, and love. Younger females and those with higher household income were more likely to engage in impulsive buying. Correlational and regression analysis showed that those high on Neuroticism and Extraversion and those low on Conscientiousness were more likely to be impulse buyers. All four money attitudes were related to impulsive buying (Money as Security most strongly). A hierarchical regression indicated that demographic variables accounted for 3 percent, personality a further 9 percent, and money attitudes a further 13 percent of the variance, showing that these three sets of variables accounted for around a quarter of the variance. Implications are considered for educational and therapeutic interventions in reducing maladaptive impulsive buying. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: To date, improvements on U.K. acute mental health wards have been difficult to sustain. The barriers to change may be context dependent. Mental health wards are volatile workplaces with service user violence/aggression, frequent staff and patient changes, and ongoing service improvements.The evidence suggests that burnout affects staff perceptions of barriers to change, and ward climate affects burnout. As two potentially important, independent predictors of staff perceptions of barriers to change, the impact of ward climate and burnout on how staff regard changes should be considered. What the paper adds to existing knowledge?: Elements of ward climate such as high numbers of incidents and temporary staff independently worsened mental health staff perceptions of barriers to change, in addition to negative impacts from burnout and occupational status.How staff perceived ward climate was also linked their perceptions of barriers to change; however, burnout was no longer a significant consideration with these variables.Staff with low job satisfaction and high interaction anxiety also had low confidence regarding changes. Staff with low job satisfaction were also demotivated towards changes. What are the implications for practice?: Ward climate is clearly an important factor in how nurses view organizational changes. In this study, nurses' perceptions of barriers to change were worse if they viewed ward climate negatively, or if temporary staff and incident numbers were high.Staff perceptions of ward climate and barriers to change should be assessed, ahead of service changes.Developing change strategies based on such information is likely to produce better implementation outcomes. Specifically, targeting staff confidence and motivation (which are barriers to change) may improve how staff regard their ward climate. Introduction: To create successful change programmes for mental health wards, it is necessary to understand which aspects of ward climate prevent change. Question: Does ward climate influence mental health nurse's perceptions of barriers to change? Method: Random‐effects models were used to test whether the following ward climate variables influenced the outcome measure "staff perceptions of barriers to change" (VOCALISE) and its subscales (powerlessness/confidence/demotivation): (a) Perceptions of ward climate (VOTE: subscales included work intensity/job satisfaction/interaction anxiety). (b) Ward climate indicators (incidents/detention under the Mental Health Act (2007)/staffing/bed pressure). As known predictors of VOCALISE, burnout (Maslach Burnout Inventory) and occupational status were included in the models. Results: Perceptions of ward climate (VOTE), incidents, temporary staff, occupational status and burnout significantly and negatively affected perceptions of barriers to change (VOCALISE). Staff with low job satisfaction (VOTE) and high interaction anxiety (VOTE) also had low confidence (VOCALISE). Staff with low job satisfaction (VOTE) were also demotivated (VOCALISE). Discussion: Ward climate is an important predictor of how staff regard service changes in mental health wards. Implications for practice: Staff perceptions of ward climate and barriers to change should be assessed ahead of service changes to identify pressures that impede progress and lower morale. [ABSTRACT FROM AUTHOR]

Objectives: Little research has examined the discourses that shape therapists' sense‐making around heterosex. This paper explores the discourses of sexuality and gender underpinning therapists' and non‐therapists' responses to a sexual experimentation scenario in a heterosexual relationship. It also considers the value of the novel technique of story completion (SC), in which participants are asked to write a story in response to a hypothetical scenario, for qualitative psychology and psychotherapy research. Design: This research used a comparative SC design (Kitzinger & Powell, 1995). Participants were sequentially presented with and invited to complete two story stems: one in which a male character suggested 'trying something new' to his female partner and one in which the female character made the suggestion. The stems were otherwise identical. Methods: A total of 100 SCs were written by 49 (28 female; 21 male) therapists and 51 (29 female; 22 male) non‐therapists. Participants were recruited mainly via UK‐based email lists and Facebook groups, and therapeutic training organizations, and the data were analysed using a feminist post‐structuralist thematic analysis (Braun & Clarke, 2006). Results: Both groups of participants drew on heteronormative discourses of sexuality and gender to make sense of the stem. Engaging in sexual experimentation was often depicted as a demonstration of being normal. In some stories written by women, sex was framed as a site for negotiating 'equality' and reciprocity in relationships. Therapists were more likely than non‐therapists to frame 'difficulties' within relationships as opportunities for personal growth and increased emotional depth, and their stories included greater emotional complexity. Conclusion: These findings raise questions about practitioner training and whether it results in therapists drawing on narrow and restrictive discourses of heterosex in clinical practice. Practitioner points: Training on sexual issues is largely absent from non‐specialist practitioner training courses, which potentially means therapists are ill‐equipped to respond to clients' anxiety about sexual issues. Evidence from this and other research indicates that therapists' sense‐making around heterosexual sexual relationships is underpinned by narrow and restrictive discourses that entrench traditional gender relations and limit sexual agency. Psychologists are increasingly taking up positions of clinical leadership and are looked to for models of best practice. Drawing on theorizations of sexual difficulties, and of anxieties about sexual practice, that challenge traditional gender and heteronorms, and the commodification and medicalization of sex, is important for effective psychological leadership relating to the treatment of sexual issues and the furthering of social justice agendas. [ABSTRACT FROM AUTHOR]

Background: The lack of evidence for the effective management of carious lesions in children's primary teeth has caused uncertainty for the dental profession and patients. Possible approaches include conventional and biological management alongside best practice prevention, and best practice prevention alone. The FiCTION trial assessed the effectiveness of these options, and included a qualitative study exploring dental professionals' (DPs) experiences of delivering the different treatment arms. This paper reports on how DPs managed children with carious lesions within FiCTION and how this related to their everyday experiences of doing dentistry. Methods: Overall, 31 DPs from FiCTION-trained dental surgeries in four regions of the UK participated in semi-structured interviews about their experiences of the three treatment arms (conventional management of carious lesions and prevention (C + P), biological management of carious lesions and prevention (B + P) or prevention alone (PA)). A theoretical framework, drawing on social practice theory (SPT), was developed for analysis. Results: Participants discussed perceived effectiveness of, and familiarity with, the three techniques. The C + P arm was familiar, but some participants questioned the effectiveness of conventional restorations. Attitudes towards the B + P arm varied in terms of familiarity, but once DPs were introduced to the techniques, this was seen as effective. While prevention was familiar, PA was described as ineffective. DPs manage children with carious lesions day-to-day, drawing on previous experience and knowledge of the child to provide what they view as the most appropriate treatment in the best interests of each child. Randomisation undermined these normal choices. Several DPs reported deviating from the trial arms in order to treat a patient in a particular way. Participants valued evidence-based dentistry, and expect to use the results of FiCTION to inform future practice. They anticipate continuing to use the full range of treatment options, and to personally select appropriate strategies for individual children. Conclusions: RCTs take place in the context of day-to-day practices of doing dentistry. DPs employ experiential and interpersonal knowledge to act in the best interests of their patients. Randomisation within a clinical trial can present a source of tension for DPs, which has implications for assuring individual equipoise in future trials. [ABSTRACT FROM AUTHOR]

In recent years, tackling loneliness has become the focus of increased scholarly debate, social intervention and the development of international policy. One response to the 'epidemic of loneliness' has been the development of the compassionate communities model. The diversity of compassionate communities approaches has led to scholars such as Allan Kellehear (2005; 2017) to highlight a lack of a cohesive underpinning theory to support and drive policy development. In this paper, we propose the use of 'collective memory' as a novel approach to linking loneliness, memory and identity in a way that draws out conceptual links between the role compassionate communities play in tackling social isolation and loneliness. We suggest that the service-led approach that seeks to identify and transpose strategies from one community to another is ineffective; instead, we emphasise the need to develop bespoke community-centred models that can be used by community nurses. [ABSTRACT FROM AUTHOR]

The number of short trips by car is increasing. The objective of this paper is to look at why people use their cars for such trips. The paper draws upon the results of surveys carried out as part of a project for the Department of the Environment, Transport and the Regions (DETR) to investigate the potential for switching short car trips to other modes in Great Britain. The paper commences by considering the various approaches used to look at why people travel by car and, from these, concludes that there is a need to examine the behaviour underlying specific real trips by car. This is followed by a description of the survey methodology used in the project which forms the core of this paper. Then the evidence on why people used their cars for a set of real short trips identified in the surveys is presented. This is considered in terms of a number of dimensions including age, sex, and trip purpose. This is followed by a discussion of the alternatives to the car that drivers say that they might adopt and the factors which they say would make them consider switching to these alternatives. [ABSTRACT FROM AUTHOR]

This paper provides a development from previous conceptual frameworks related to the risk/pain/injury nexus in sporting subcultures (Hughes & Coakley, 1991; Maguire & Roberts, 1998; Nixon, 1992; Young, 1991). To do this, we have developed a model of factors contributing to injury risk in sport. In outlining our framework we seek to trace the enabling and coercive social forces that combine to act upon athletes and consequently promote participation to the extent of risking injury. This paper is grounded in a two-year study of female rowers in the United Kingdom. Several dimensions of sporting activities are mapped out, including the physical and structural settings, or "stage" upon which the sport takes place; preparation and participation in the sport itself; and the athletes' attitudes toward, and actions on, receiving an injury. The themes identified in the model are used to "make sense" of the substantive insights drawn from the rowers' stories. [ABSTRACT FROM AUTHOR]

This paper examines the central place of the list and the associated concept of an identifier within the scaffolding of contemporary institutional order. These terms are deliberately chosen to make strange and help unpack the constitutive capacity of information systems and information technology within and between contemporary organizations. We draw upon the substantial body of work by John Searle to help understand the place of lists and identifiers in the constitution of institutional order. To enable us to ground our discussion of the potentiality and problematic associated with lists we describe a number of significant instances of list-making, situated particularly around the use of identifiers to refer to people, places, and products. The theorization developed allows us to better explain not only the significance imbued within lists and identifiers but the key part they play in form-ing the institutional order. We also hint at the role such symbolic artifacts play within breakdowns in institutional order. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to investigate the most significant censorship issues faced by UK school librarians today and to determine what factors influence attitudes towards these issues.Design/methodology/approach A questionnaire was designed, closely based on that used for a previous survey of UK librarians in 2004. It was distributed online and 96 responses were received.Findings Overall, respondents were more likely to express support for intellectual freedom in theory than in practice. Statements that prompted the strongest pro-censorship responses related to access issues, namely, labelling and filtering. A number of librarians place significant emphasis on their personal ability, or right, to determine whether or not resources are included in the collection. There was evidence of a difference in practical application depending on whether librarians worked with pre-school children or were members of professional associations.Research limitations/implications The findings suggest a need for further research into the role of professional associations in supporting school librarians faced by censorship issues, especially those who support the youngest students.Originality/value The findings suggest that while school librarians hold strong pro-intellectual freedom views, they may need additional support to put these into practice. School librarians are undoubtedly in a challenging position, often being solo workers; they need support to find ways to uphold professional intellectual freedom principles within a school setting. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Difficulties with the recruitment and retention of qualified nursing staff have resulted in nursing shortages worldwide with a consequential impact on the quality of care. It is increasingly recommended that evidence-based staffing levels are central to the development of workforce plans. Due to a paucity of empirical research in mental health and learning disability services the staffing needs and requirements for these settings are undefined and the availability of tools to aid staffing decisions is limited., What this paper adds to existing knowledge? This paper provides a valuable insight into the practical uses of these tools as perceived by staff members with day-to-day experience of the requirements of mental health and learning disability wards. It reveals that while workload measurement tools are considered a valuable aid for the development of workforce plans, they are limited in their ability to capture all aspects of care provision in these settings. It further emphasizes the inapplicability of a one-shoe-fits-all approach for determining nurse staffing levels and the need for individual and customized workforce plans., What are the implications for practice? This study demonstrates that the development of tools for use in mental health and learning disability services is in its infancy, yet no tool that has been validated as such. It highlights the potential for workload measurement tools to aid staffing decisions; however, a more holistic approach that considers additional factors is needed to ensure robust workforce planning models are developed for these services., Abstract Introduction The critical challenge of determining the correct level and skill mix of nursing staff required to deliver safe and effective health care has become an international concern. It is recommended that evidence-based staffing decisions are central to the development of future workforce plans. Workforce planning in mental health and learning disability nursing is largely under-researched with few tools available to aid the development of evidence-based staffing levels in these environments. Aim It was the aim of this study to explore the experience of staff using the Safer Nursing Care Tool and the Mental Health and Learning Disability Workload Tool in mental health and learning disability environments. Method Following a 4-week trial period of both tools, a survey was distributed via Qualtrics online survey software to staff members who used the tools during this time. Results The results of the survey revealed that the tools were considered a useful resource to aid staffing decisions; however, specific criticisms were highlighted regarding their suitability to psychiatric intensive care units and learning disability wards. Discussion This study highlights that further development of workload measurement tools is required to support the implementation of effective workforce planning strategies within mental health and learning disability services. Implications for Practice With increasing fiscal pressures, the need to provide cost-effective care is paramount within the services of the National Health Service. Evidence-based workforce planning is therefore necessary to ensure that appropriate levels of staff are determined. This is of particular importance within mental health and learning disability services due to the reduction in the number of available beds and an increasing focus on purposeful admission and discharge. [ABSTRACT FROM AUTHOR]

This paper considers the contrasting ways in which disabled people seek to overturn socio-attitudinal, political and physical barriers to their mobility and access requirements in the built environment. In particular, the paper documents how disabled people are attempting to influence the form and content of local authority access practices and policies in the UK, through the context and contours of access groups. I begin by briefly outlining some of the key factors inhibiting and facilitating disabled people organising as effective political groupings, relating the material to access issues in the built environment. Then, using case studies of two contrasting access groups, the paper explores some of the practical barriers, problems and opportunities connected to disabled people's activities in seeking to influence local authority access policies and practices. I conclude by discussing how some of the wider structural and agency-level constraints on disabled people's political and policy interventions in access issues might be removed. [ABSTRACT FROM AUTHOR]

The paper analyses the contemporary rumour and hysteria which overlay much discussion of working-class opiate consumption. General middle-class fears arising from social dislocation, the reaction to the temperance movement, the sensational presentation of opium eating by the Romantics, the Indo-Chinese trade and the agitation against it; and the professional aspirations of pharmacists, all contributed to the irrationality with which much evidence was assessed. [ABSTRACT FROM AUTHOR]

This paper casts a critical eye on the 'race and class' debate in the British literature on race. It begins by arguing that 'race' derives its analytical status from its location within the wider category of 'ethnos'. An exploratory framework is provided that defines 'racism' and distinguishes it from 'race'. A number of central positrons on the links between race and class are then reviewed and their theoretical and empirical difficulties discussed. The paper concludes by arguing that race and racism cannot be located as emanating essentially from specific class interests. Racism is considered as a form of discourse and practice that can be harnessed to different political projects including those of class and nation building. Race on the other hand derives its ontological and analytical status from modes by which communal difference and identity are attributed and proclaimed. [ABSTRACT FROM AUTHOR]

Purpose: Although there is substantial evidence about the association between frailty and mental illnesses in older people, there is currently little evidence about how this is integrated into psychiatric clinical practice. The purpose of this paper is to explore the attitudes of a sample of psychiatrists in the UK about the concept and assessment of frailty in their clinical practice. Design/methodology/approach: This research used a qualitative approach with semi-structured interviews. Interview schedules and transcripts were analysed using thematic analysis. NVivo software and an audit trail were used for the data analysis. Findings: There were ten respondents (all psychiatrists) in this study. From the interviews, it appeared that some respondents were not be fully familiar with existing concepts of frailty. However, from their perspectives, frailty appeared to be multidimensional, reversible and for some could be enhanced by older people's ability. Negative stereotypes of being frail could undermine the accessibility to appropriate assessment and care. Existing multidisciplinary assessments, with some adjustments to the particular needs of psychiatric patients, can be used to establish a frailty index. Originality/value: The concept of frailty, especially those concerning its multidimensional and homeostatic nature, should be further examined to make it more applicable to psychiatric practice. Without much more effort, frailty could be assessed within current psychiatric practices. This could constitute a care plan tailored for frail people with a psychiatric illness, so as to improve the outcomes of their treatment and quality of life. [ABSTRACT FROM AUTHOR]

Purpose: Wales Applied Risk Research Network (WARRN) is a formulation-based technique for the assessment and management of serious risk (e.g. violence to others, suicide, etc.) for users of mental health services which has been adopted across most Child and Adolescent Mental Health Services (CAMHS) across Wales. The paper aims to discuss this issue. Design/methodology/approach: An online survey was disseminated to National Health Service clinicians in CAMHS to evaluate their perceptions of the use and effectiveness of WARRN. Data from 88 clinicians were analysed with both quantitative and qualitative methods. Findings: Clinicians reported increased clinical skills, increased confidence in their assessment and management of risk and in safety planning, the increased safety of service users and the general public, and a belief that WARRN had saved lives. The qualitative data showed that clinicians thought a common risk evaluation instrument across Wales and different agencies had created a common language and understanding that improved communication. Practical implications: WARRN appears well accepted in CAMHS services with the view that it is having a very positive effect on service user well-being and safety and could be implemented in other services. Originality/value: This is the first report of a formulation-based approach to the management of serious problem behaviours in CAMHS services. [ABSTRACT FROM AUTHOR]

International efforts to minimize coercive practices include the US Six Core Strategies© (6CS). This innovative approach has limited evidence of its effectiveness, with few robustly designed studies, and has not been formally implemented or evaluated in the UK. An adapted version of the 6CS, which we called 'REsTRAIN Yourself' (RY), was devised to suit the UK context and evaluated using mixed methods. RY aimed to reduce the use of physical restraint in mental health inpatient ward settings through training and practice development with whole teams, directly in the ward settings where change was to be implemented and barriers to change overcome. In this paper, we present qualitative findings that report on staff perspectives of the impact and value of RY following its implementation. Thirty‐six staff participated in semi‐structured interviews with data subject to thematic analysis. Eight themes are reported that highlight perceived improvements in every domain of the 6CS after RY had been introduced. Staff reported more positively on their relationships with service users and felt their attitudes towards the use of coercive practices such as restraint were changed; the service as a whole shifted in terms of restraint awareness and reduction; and new policies, procedures, and language were introduced despite certain barriers. These findings need to be appreciated in a context wherein substantial reductions in the use of physical restraint were proven possible, largely due to building upon empathic and relational alternatives. However, yet more could be achieved with greater resourcing of inpatient care. [ABSTRACT FROM AUTHOR]

Few conditions have sparked as much controversy as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Professional consensus has long suggested that the condition should be classified as psychiatric, while patients and advocacy groups have insisted it is a serious biological disease that requires medical care and research to develop it. This longstanding debate shifted in 2015, when U.S. governmental health authorities fully embraced medical classification and management. Given that some globally respected health authorities now insist that ME/CFS is a serious biological disease, this paper asks whether it can be ethical for the U.K. practice guideline now in development to characterize the condition as a mental health disorder. Following a brief history of ME/CFS controversy, I offer three arguments to show that it would be unethical for the U.K. to now characterize ME/CFS as a mental health condition, considering the relevance of that conclusion for ME/CFS guidelines elsewhere and for other contested conditions. [ABSTRACT FROM AUTHOR]

This paper reports findings from a study of the practical experiences of junior diagnostic radiographers in the UK when managing patients with dementia. Extended semi-structured interviews with six participants (mean experience in diagnostic radiography = 3.5 years) were analysed using interpretative phenomenological analysis. Findings highlight that participants' recurrently cited lack of confidence around their knowledge of dementia, and regular treatment of the condition as a 'generic' thing in practice, had sometimes damaged clinical interaction, particularly when the participant was feeling institutional time pressures. Education for new professionals was seen as lacking in both quantity and context-relevance, with implications for professional confidence and ethical practice. Carers and family members were viewed by participants as potentially positive and negative forces within an examination context, and technological advances in radiography were taken to be clinically advantageous but also actively detrimental to the effective interpersonal care of their patients. [ABSTRACT FROM AUTHOR]

Purpose Perinatal mental health (PMH) is acknowledged as a significant public health issue associated with significant personal, family, social and economic burden. Research demonstrates that healthcare practitioners lack knowledge and confidence in this area but there is likely to be a complexity of factors that may influence practitioner behaviours, including negative attitudes towards people with mental health and inaccurate illness perceptions. The purpose of this paper is to evaluate the psychometric properties of the Perinatal Illness Perceptions Scale (PIPS), a conceptual derivation of the Illness Perception Questionnaire – Revised.Design/methodology/approach A cross-sectional and exploratory instrument development design, using exploratory factor analysis, was employed.Findings The scale demonstrated good psychometric properties revealing three sub-scales: causes, consequences (mother); consequences (baby).Originality/value The findings implicate the PIPS as the first robust psychometric measure, which can be used to in the assessment of practitioner knowledge of the causes and consequences of PMH. The PIPS could offer the opportunity to assess these domains within both educational and training context and identify practitioner attitudes which may affect clinical decision making and referral decisions. [ABSTRACT FROM AUTHOR]

In this paper, we examine discourse in public deliberations in pre-development locales in the UK and US about advantages and disadvantages of future shale development ('fracking'). We aimed to understand how people anticipate potential health effects, broadly construed, of environmental toxicity and disturbance in the context of planned, but not yet implemented, energy development. In day-long deliberations with small, diverse groups in two cities in each country (London, Cardiff in the UK; Los Angeles, Santa Barbara in the US), participants discussed impacts on health and well-being using three main rubrics: 'It's money or health', 'Why take chances?' and 'Beyond the tipping point'. Throughout, participants framed health as an intrinsically moral issue, with collective responsibility as a dominant normative frame. We identify the concept of compound risk to underscore effects of multiple risks and hazards on people's sensibilities about anticipated future health and environmental harm. The findings demonstrate how and why diverse publics in pre-impact sites in both countries saw shale extraction as high stakes development that poses significant, often unacceptable, risks to human and environmental health and well-being. Risks extended beyond toxicity to broad threats to health, including, for some, the end of life as we know it on the planet. Overall, participants' discussions of health were more connected to social categories and their underlying moral principles than to technological details. This work contributes evidence of blurred boundaries between environment and health as well as the importance people place on social risks in the context of proposed energy system change. [ABSTRACT FROM AUTHOR]

Practitioners' preconceived ideas about service users can lead to prejudice and labelling, and ultimately may result in biased services. This paper reports on a UK‐based qualitative research study exploring the views and experiences of practitioners working with adult victims and perpetrators of domestic violence. It examines whether or not practitioners believe that childhood experiences of witnessing domestic violence indicate the likelihood of domestic violence in adulthood. It further explores practitioners' perceptions of factors contributing to the experiences of domestic violence amongst their service users. Twelve semi‐structured interviews were conducted with practitioners working in the domestic violence field, and thematic analysis was used to analyse their responses. The data did not indicate a general consensus on the matter of children becoming victims or perpetrators based on their childhood experiences of domestic violence. Participants' responses indicated that they thought the issue was more complex. Common themes that participants consider important to children's development of healthy/unhealthy relationships in this context were identified in the data. These included: an awareness of service users' individuality; the importance of meaningful support networks; and an understanding of the risk amongst their service users to normalise abusive behaviour. '[Explores] the views and experiences of practitioners working with adult victims and perpetrators of domestic violence' Key Practitioner Messages: Not all children witnessing domestic violence will inevitably become victims or perpetrators of abuse in adulthood.Perpetrating domestic violence in adulthood is often associated with a combination of various factors and circumstances, and can rarely be attributed to just one past experience.Assessments and holistic and judgement‐free services provided by practitioners are vital for children to develop positive and healthy future relationships. [ABSTRACT FROM AUTHOR]

In June 2016, the United Kingdom held a referendum on EU membership; 52% of those who voted, voted to leave, and 48% voted to remain. During the referendum campaign, two identities emerged: "Brexiter" and "Remainer," which remained salient post‐referendum. This study explores how the categories of Brexiter and Remainer were deployed by posters online. Data comprise comment threads collected from four online newspapers both during the campaign and after the vote, which focus on the Brexit campaign promise: "We send £350m a week to the EU. Let's fund our NHS instead." We draw on membership categorization analysis and discursive psychology to analyse when categories were made salient and what responses to the invocation of categories were. Analysis revealed that posters explicitly categorize the out‐group and in doing so implicitly define their group. Posters resisted other political identities when attributed to them in relation to the referendum. The analysis shows how Brexiter and Remainer are new, albeit contested, political categories and identities in their own right, with other political identities resisted when used. The paper highlights implications for the political system in the United Kingdom and for social divisions within U.K. society. [ABSTRACT FROM AUTHOR]

In this paper, we propose a culturalist interpretation of the outcome of the Brexit referendum. This interpretation is grounded on the analysis of the U.K.'s cultural milieu, which is part of a more general study of the cultural milieus of several European countries. Specific to the United Kingdom, our analysis is based on a questionnaire carried out on a representative sample of U.K. respondents stratified by sociodemographic variables and geographic region (NUTS1). Responses to the questionnaire were subjected to multidimensional analysis—a combination of multiple correspondence analysis and cluster analysis. Findings about the multicountry analysis show how cultural milieus are characterized by five basic, embodied, affect‐laden, generalized worldviews (defined as "Symbolic Universes"). Four out of five symbolic universes consist of a way of interpreting reality by a specific anchorage (i.e., the ethical norm, the institutional order, the emotional experience interpersonal bond, and the belongingness). One symbolic universe can be viewed as the anomic reaction to the failure of those anchorages. Focusing on Brexit, by means of a discriminant analysis, it is showed how the incidence of the symbolic universes (and of the underpinning basic dimensions of meaning within the 12 U.K. macroregions') enables to identify differentially the macroregions with high proportion of "leave" at the Brexit referendum against those with low proportion. More specifically, the high "leave" macroregion are characterized by higher relevance of cultural forms anchored on local identity/belongingness. Findings are discussed within the wider aims of the project and its implications for a cultural psychology informed policymaking. [ABSTRACT FROM AUTHOR]

In this paper, we look at the relationship between European identification and political support for (or opposition to) EU membership. First, we argue that conceptualizing political attitudes towards the EU as a direct product of European identification (a) neglects the distinction between the social reality of Europe and the political reality of the EU and (b) leads to psychological reductionism. We propose that the relationship should instead be conceptualized as mediated by legitimacy perceptions and as moderated by social‐level variables. Second, we look at three spheres of European integration and propose that their perceived legitimacy is appraised through the following principles: (a) normative solidarity for wealth sharing, (b) political authority for sharing political decisions, and (c) collective self‐realization for the sharing of practices. We illustrate the key mediating role of those principles by drawing on data from a survey ran across five European countries. Third, we argue that these meditational relationships are in turn moderated by social, political, and ideological realities and illustrate this point by looking at the case of United Kingdom in the context of the EU membership referendum. We point to an ideological assumption in the U.K. political landscape about the illegitimacy of EU supranational decision making and argue that this contributed to shape both the debate of the referendum campaign and its result. [ABSTRACT FROM AUTHOR]

This paper focuses on the moment of Brexit and its political aftermath in order to challenge dominant academic and popular conceptions of the political subject as singular and coherent. Instead, we suggest that there is an urgent political and analytical need for a view of the subject as multiple, contradictory, and dialogic. As interdisciplinary scholars working on the borders of policy studies and cultural studies, we think this is a critical site for transdisciplinary conversations about such conceptions of the subject. In the political field, such subjects are selectively and unevenly addressed and mobilized by political projects—such as Vote Leave—that invite them to recognize themselves as part of an imagined collective identity. In the twin disturbances of the European Union referendum and the 2017 general election, we suggest that it is possible to see that other voicings, other identifications, and other projects remain possible. Specific political mobilizations are neither singular nor stable. [ABSTRACT FROM AUTHOR]

Aims and objectives To test eight person-centred key performance indicators and the feasibility of an appropriate measurement framework as an approach to evidencing the patient experience. Background The value of measuring the quality of patient care is undisputed in the international literature, however, the type of measures that can be used to generate data that is meaningful for practice continues to be debated. This paper offers a different perspective to the 'measurement' of the nursing and midwifery contribution to the patient experience. Design Fourth generation evaluation was the methodological approach used to evaluate the implementation of the key performance indicators and measurement framework across three participating organisations involving nine practice settings. Methods Data were collected by repeated use of claims, concerns and issues with staff working across nine participating sites ( n = 18) and the senior executives from the three partner organisations ( n = 12). Data were collected during the facilitated sessions with stakeholders and analysed in conjunction with the data generated from the measurement framework. Results The data reveal the inherent value placed on the evidence generated from the implementation of the key performance indicators as reflected in the following themes: measuring what matters; evidencing the patient experience; engaging staff; a focus for improving practice; and articulating and demonstrating the positive contribution of nursing and midwifery. Conclusions The implementation of the key performance indicators and the measurement framework has been effective in generating evidence that demonstrates the patient experience. The nature of the data generated not only privileges the patient voice but also offers feedback to nurses and midwives that can inform the development of person-centred cultures. Relevance to clinical practice The use of these indicators will produce evidence of patient experience that can be used by nurse and midwives to celebrate and further inform person-centred practice. [ABSTRACT FROM AUTHOR]