Search

Fieldwork encounters are not only contingent to biographical subjectivities, but are mediated by a confluence of identity, place and embodiment. This paper offers reflexive accounts of researchers with various socio-cultural and disciplinary backgrounds, who collaborated as a team to examine the varied funerary experiences and needs of established minorities and recent migrants in England and Wales. Focusing on the researchers' varied personal experiences with death and bereavement and on their performances of minority and majority ethnic and migrant identities, the paper highlights the mediated and embodied nature of fieldwork. It argues that reflection on the various aspects of intersectional researcher identity is necessary for a rigorous fieldwork practice that takes transparency and politics into account. This facilitates a deeper understanding of the positionality of both researchers and interlocutors, and the situated co-production of knowledge. In doing so, the paper illustrates that conducting research with a diverse team of researchers contributes to better understanding the complexity and multifacetedness of social phenomena. [ABSTRACT FROM AUTHOR]

Background and Aims: Long‐acting injectable buprenorphine (LAIB) is a new treatment for opioid use disorder that is generating positive outcomes. Negative effects are typically mild and transient, but can occasionally be serious, resulting in treatment discontinuation/non‐adherence. This paper aims to analyse patients' accounts of how they felt during the first 72 h after initiating LAIB. Methods: Semi‐structured interviews were conducted (June 2021–March 2022) with 26 people (18 males and 8 females) who had started LAIB within the previous 72 h. Participants were recruited from treatment services in England and Wales and were interviewed by telephone using a topic guide. Interviews were audio‐recorded, transcribed and coded. The concepts of embodiment and embodied cognition framed the analyses. Data on participants' substance use, initiation onto LAIB and feelings were tabulated. Next, participants' accounts of how they felt were analysed following the stages of Iterative Categorization. Results: Participants reported complex combinations of changing negative and positive feelings. Bodily experiences included withdrawal symptoms, poor sleep, injection‐site pain/soreness, lethargy and heightened senses inducing nausea ('distressed bodies'), but also enhanced somatic wellbeing, improved sleep, better skin, increased appetite, reduced constipation and heightened senses inducing pleasure ('returning body functions'). Cognitive responses included anxiety, uncertainties and low mood/depression ('the mind in crisis') and improved mood, greater positivity and reduced craving ('feeling psychologically better'). Whereas most negative effects reported are widely recognized, the early benefits of treatment described are less well‐documented and may be an overlooked distinctive feature of LAIB. Conclusions: During the first 72 h after initiating long‐acting injectable buprenorphine, new patients report experiencing a range of interconnected positive and negative short‐term effects. Providing new patients with information about the range and nature of these effects can prepare them for what to expect and help them manage feelings and reduce anxiety. In turn, this may increase medication adherence. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore interprofessional and multidisciplinary working between health and social care practitioners providing services to older people through the prism of how risk is assessed and managed. It proposes that whilst interprofessional and multidisciplinary working is a broad and commonly researched topic, there is a relative paucity of evidence specifically regarding how health and social care practitioners work together across structural, cultural and ideological divides. The study aims to expand the domain of integrated health and social care by including perceptions, understanding and use of the concept of risk by professionals from different disciplines. Design/methodology/approach: This paper is based upon an exploratory study using an interpretivist phenomenological perspective, including 23 semi-structured individual interviews with health and social care practitioners and 2 non-participant observations of multidisciplinary team meetings. Findings: The paper provides empirical insights around the complex dynamics of interprofessional and multidisciplinary working between health and social care practitioners, in particular the saliency of the interconnectedness of individual practitioner Personalities with the Process of interprofessional and multidisciplinary working under the auspices of relevant Policy drivers. Research limitations/implications: The research was conducted in Wales and, due to the increasingly divergent policy context within the UK, the research results may lack generalisability from a wider UK or international perspective. Therefore, researchers are encouraged to test the propositions of this research further. Practical implications: The paper includes implications for both interprofessional and multidisciplinary policy and practice with older people. With new models of integrated care being sought, the findings of this study may offer a timely and valuable contribution, particularly from the inclusion of a social care perspective and in better understanding the interconnectedness of practitioner personalities with process and policy. Originality/value: This paper fulfils an identified need to study the complex dynamics and interconnectedness between health and social care practitioners who work together to provide services to older people. [ABSTRACT FROM AUTHOR]

Domiciliary care workers (DCWs) continued to provide care to adults in their own homes throughout the COVID‐19 pandemic. The evidence of the impact of COVID‐19 on health outcomes of DCWs is currently mixed. The OSCAR study will quantify the impact of COVID‐19 upon health outcomes of DCWs in Wales, explore causes of variation and extrapolate to the rest of the UK DCW population. An embedded qualitative study aimed to explore DCW experiences during the pandemic, including factors that may have varied risk of exposure to COVID‐19 and adverse health and wellbeing outcomes. Registered DCWs working throughout Wales were invited to participate in a semi‐structured telephone interview. 24 DCWs were interviewed between February and July 2021. Themes were identified through inductive analysis using thematic coding. Several themes emerged relating to risk of exposure to COVID‐19. First, general changes to the role of the DCW during the pandemic were identified. Second, practical challenges for DCWs in the workplace were reported, including staff shortages, clients and families not following safety procedures, initial shortages of personal protective equipment (PPE), DCW criticism of standard use PPE, client difficulty with PPE and management of rapid antigen testing. Third, lack of government/employer preparation for a pandemic was described, including the reorganisation of staff clients and services, inadequate or confusing information for many DCWs, COVID‐19 training and the need for improved practical instruction and limited official standard risk assessments for DCWs. Pressure to attend work and perceptions of COVID‐19 risk and vaccination was also reported. In summary, this paper describes the risk factors associated with working during the pandemic. We have mapped recommendations for each problem using these qualitative findings including tailored training and better support for isolated team members and identified the required changes at several socio‐ecological levels. [ABSTRACT FROM AUTHOR]

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

During the COVID‐19 pandemic, first responders and health care workers faced elevated virus‐related risks through prolonged contacts with the public. Research suggests that these workers already experienced lower levels of psychological well‐being linked to occupational risks. Thus, the pandemic's impact might have particularly affected mental health in these groups. This paper analysed data from a large‐scale Welsh population study (N = 12,989) from June to July 2020. Levels of psychological distress were compared across various occupations, including police, fire and rescue, and NHS health care workers. Resilience was also indexed, and its role considered as a protective factor for psychological distress. Surprisingly, health care workers reported lower distress levels than the general population. Further, fire and rescue and police groups had lower distress than most groups and significantly higher resilience. Within police officers, higher resilience levels were protective for distress. Fire and rescue workers were half as likely as others to report distress, even accounting for demographic factors and resilience. The findings offer an optimistic view of psychological resilience in these critical occupations. They illustrate potential benefits to one's mental health of playing a crucial societal role during crises and reiterate the importance of enhancing resilience within groups who encounter high‐risk situations daily. Practitioner points: Our findings provide evidence that health care workers and first responders showed lower levels of psychological distress than the general population during the first period of lockdown due to the COVID‐19 pandemic in the United Kingdom. This may indicate that playing a critical role in society during an episode of crisis, and acting to help others, may be protective of one's own mental health.The research also provides an optimistic view of the psychological resilience of critical first responders and health care workers during a period early on in the COVID‐19 pandemic (June–July 2020). This highlights the benefits of fostering resilience in those working within high‐risk first responder and health care occupations. [ABSTRACT FROM AUTHOR]

Background and Objectives Arts activities can improve social connectedness and foster reciprocity between people living with dementia and their caregivers. The extent to which the arts can help shape attitudes towards dementia remains unclear. This paper explores the impact of a 12-week visual arts program "Dementia and Imagination" on the attitudes of family and professional caregivers through a mixed-methods longitudinal investigation, underpinned by a conceptual framework of the arts in dementia care. Research Design and Methods One hundred and forty-six family and professional caregivers were recruited across three settings in England and Wales (residential care homes, a county hospital, and community venues). Quantitative and qualitative data on caregivers' attitudes and perceptions of the impact of the arts program were collected through interviews at three time points. Results Thematic analysis identified four themes shared across the caregivers: (1) Recognizing capabilities , (2) Social connectedness , (3) Improvements to well-being , and (4) Equality and personhood. Two further themes were distinct to family caregivers: (5) Duration of the effects of the art program , and (6) Enriched perspective. The final theme Inspiring professional development was distinct to the professional caregivers. The quantitative analysis found no effect for caregivers' attitude change over time. Family caregivers scored significantly lower than professional caregivers at each of the three time points. Discussion and Implications Art programs have the potential to make visible the capabilities of the people living with dementia, enabling caregivers to see the person behind the condition. This study highlights practice implications for future implementation, such as the role of the arts in dementia care education. [ABSTRACT FROM AUTHOR]

Police community support officers (PCSOs) in England and Wales have become an integral part of neighbourhood policing since their national roll-out in 2008. The research reported here is based on the first-hand accounts of PCSOs from a four-month ethnographic study in a northern police force. Using Erving Goffman's theoretical framework and concept of performances, this paper argues that PCSOs still face ongoing pressures from inside the organisation to defend their position to police colleagues. PCSOs are still experiencing negative and bullying attitudes toward their existence and document the difficulties they face in being accepted. In response to this, some PCSOs have been known to conceal their status by modifying their uniform and using a current desire for increased visibility to enable presentational strategies in image management. [ABSTRACT FROM AUTHOR]

This paper centres on a neglected area of social work with older people--the social inclusion of older lesbian, gay and bisexual (LGB) adults in long-term care environments. The translation of equality law into the delivery of adult care services is a challenging endeavour for organisations, even more so in the morally contested terrain of sexual well-being. In this paper, we report findings from a mixed-methods study into the provision of long-term care for older adults who identify as LGB. Herein we present findings from a survey of care workers and managers (n = 121) and from focus groups with equality and LGB stakeholder representatives (n = 20) in Wales. Focusing on the current knowledge and understanding of staff, we suggest that affirmative beliefs and practices with sexual minorities are evident amongst care workers and managers; however, the inclusion of LGB residents needs to be advanced systemically at structural, cultural and individual levels of provision. There is a need for enhancing awareness of the legacy of enduring discrimination for older LGB people, for cultural acceptance in care environments of older people's sexual desires and relationships, and for a more explicit implementation of equality legislation. Social workers in adult care can advance this agenda. [ABSTRACT FROM AUTHOR]

This paper traces the evolution of Plaid Cymru's attitude towards Europe. It does so by focusing in turn on: the place of Europe in the ideas of Saunders Lewis, the dominant figure in the party between its foundation in 1924/25 and 1945; the more ‘northern’ or Nordic vision of Europe that gripped the party in the post -World War II era; and the waxing and waning of the party's most EU-enthusiastic phase between the mid -1980s and the present day. By adopting a longer timeframe than is normally the case, the paper argues that Europe has played a wider role in the thinking of the party than is often conceded; a role that was not at all or only tangentially related to actually existing institutions. The paper goes on to argue that it was in part the chastening impact of Plaid Cymru's eventual exposure to actually existing European institutions that led the party in 2003 to abandon its utopian commitment to a post-sovereign Europe in favour of an explicit commitment to ‘independence’ as its long-term aim. [ABSTRACT FROM AUTHOR]

Copyright of Folklore Studies / Tautosakos Darbai is the property of Institute of Lithuanian Literature & Folklore and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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. It has been gradually adopted as the risk evaluation and safety-planning technique for all seven health boards in Wales. The purpose of this paper is to examine the opinions of WARRN as used within these health boards. Design/methodology/approach: An online survey was disseminated to NHS clinicians in secondary mental health services to evaluate their perceptions of the use and effectiveness of WARRN. Data from 486 clinicians were analysed with both quantitative and qualitative methods. Findings: Results indicated that the overall impact of WARRN on secondary mental health care was very positive, with clinicians reporting increased skills in the domains of clinical risk formulation, safety-planning and communication, as well as increased confidence in their skills and abilities in these areas. Clinicians also reported that the "common-language" created by having all NHS health boards in Wales using the same risk assessment process facilitated the communication of safety-planning. Crucially, NHS staff believed that the safety of service users and of the general public had increased due to the adoption of WARRN in their health board and many believed that lives had been saved as a result. Originality/value: WARRN is perceived to have improved clinical skills in risk assessment and safety-planning across Wales and saved lives. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to compare the pharmacy services provided to people taking psychotropic and cardiovascular medications and examine the association between pharmacists’ attitudes towards mental illness and provision of pharmacy services. The paper also considers pharmacists’ opinions of the pharmaceutical care needs of people with mental illness including their physical health. Design/methodology/approach – A survey instrument was sent by facsimile to a random sample of community pharmacists in England and Wales. Findings – Community pharmacists had generally positive attitudes towards mental illness but provided significantly fewer pharmacy services (and were less comfortable providing them) to patients taking psychotropic medications than to patients taking cardiovascular medications. Awareness of the higher prevalence of physical health conditions among people with severe mental illness was not high. Provision of pharmacy services was associated with pharmacists’ attitudes towards mental illness and comfort providing pharmaceutical care. Other factors that may contribute to these disparities in service provision are discussed. Practical implications – The study findings indicate the need for enhanced mental health education for pharmacy students to improve attitudes, knowledge and confidence in mental health and the inclusion of mental health in pharmacy advanced services. Originality/value – Few studies have examined the relationship between attitudes towards mental illness and provision of pharmacy services. This was the first study to examine the attitudes of British community pharmacists towards mental illness. [ABSTRACT FROM AUTHOR]

This paper examines the ways in which older people's residential and nursing homes can constitute heteronormative environments – social spaces in which the same-sex attractions and desires of residents are disregarded in the provision of everyday care. The aim of this discussion is to examine the synergies and differences between older lesbian, gay and bisexual (LGB) adults' expectations for future care home provision and the expectations of care staff and managers in providing residential services to older people with diverse sexual backgrounds. We present qualitative evidence from research into the provision of care environments in Wales. In this paper, we present findings from two cohorts: first, from five focus groups with care and nursing staff and managers; and second, from 29 semi-structured interviews with older LGB adults (50–76 years) residing in urban and rural locations across Wales. We argue that residential care environments can constitute heterosexualised spaces in which LGB identities are neglected in comparison to the needs and preferences of other residents. To this extent, we discuss how care staff and managers can be more attentive and responsive to the sexual biographies of all residents and argue against the separation of care and sexual orientation in practice. [ABSTRACT FROM PUBLISHER]

This paper examines police officer understandings of and attitudes to the sex offenders’ register, Violent and Sex Offenders’ Register (ViSOR) and Child Sexual Offender Disclosure Scheme (CSODS) in England and Wales – an under-researched area in the management of sexual offenders in the UK. This research is an adaptation of an American study utilising a mixed-methods approach, combining an online questionnaire survey (N = 227) with a series of semi-structured interviews (N = 27). The study found that police officers, irrespective of role, were generally supportive of the register, ViSOR and CSODS in principle, but they thought that logistics, practicalities, infrastructure, multi-agency collaboration and public understandings had problematic impacts on the scheme in practice. The participants believed that greater investment was needed in terms of time and resource to make the register, ViSOR and CSODS easier to use and access and thus fit for purpose. [ABSTRACT FROM PUBLISHER]

This paper evaluates the Stern Review of rape in the context of public responses to rape, in England and Wales. The piece is based on an anti-rape feminist approach and so weighs a woman-centred approach to rape responses against the mainstream justice model. Overall, the argument made is that nothing much is really changing in public responses to rape. The work outlines problems with the Stern contention that the conviction rates for rape need to be calculated differently, and takes issue with the claim that the “policies are right”. Stern's call for greater support for women who have been raped is welcomed, but the effectiveness of the review process itself is questioned. These discussions illustrate the process of attrition as it is variously understood by feminists and by Baroness Stern. It is suggested that reviews themselves may be little more than a dampener, brought in when claims for change create a need to be seen to be doing something. A preferred alternative might be some form of ongoing body, reviewing and challenging practice and policy; however, it is recognised that this could be difficult to achieve amid the current spending cuts. The paper then turns to evaluate trends in support for survivors and notes that the more “professional” models of the Sexual Assault Referral Centre and the Independent Sexual Violence Advisers have held sway for some time. However, under the new coalition, government funding is also being directed towards women-only Rape Crisis centres, and this move is warmly welcomed here. The work concludes that much does indeed remain the same, despite positive signs in terms of respect for this survivor-centred model. [ABSTRACT FROM PUBLISHER]

This paper reports some of the findings from a study (Farmer et al., 2007), commissioned by an independent foster-care agency (IFA), to examine the support services offered to foster-carers and the young people in their care. In particular, this paper documents the use of a ‘team parenting’ approach within a ‘therapeutic’ fostering environment. Whilst there were some issues regarding the comprehensive assessments and the provision of therapy, foster-carers were positive about the support provided both to themselves and directly to the young people within the team parenting approach. On the other hand, communication and inter-agency working between the IFA and the local authority could be problematic, particularly in relation to funding decisions, which could limit the effectiveness of the team parenting approach. [ABSTRACT FROM PUBLISHER]

This paper reports findings from a qualitative research study of twenty-six core assessments, concerning thirty-two children, completed over a six-month period in one Welsh local authority. The data reported in the paper come from the twenty-six written assessment reports and interviews with the thirteen social workers who completed the assessments. The study was concerned with how social workers assess and report on children's identities. Identity is one of the seven developmental needs of children categorised in the Framework for the Assessment of Children in Need and their Families (National Assembly for Wales, 2001b). It is noted that practitioners display a broad understanding of identities when discussing their own identities in interview and report a practice commitment to learning about the details of children's lives in an attempt to ‘get to know’ the children. However, the assessment reports tend to convey only narrowly defined and negative aspects of the children's identities, with many descriptions standardised and replicated between reports. Similarities to findings from a study conducted by one of the authors prior to the introduction of the Assessment Framework are noted, and it is suggested that bureaucratic constraints, the need to argue a case and defensive practices may have impeded change. [ABSTRACT FROM PUBLISHER]

It cannot be assumed by healthcare providers that transgender people routinely receive care and treatment that is of the quality and sensitivity that should be expected. In particular there are concerns from within the transgender community that they experience discrimination and disrespect from both individual practitioners and the healthcare system as a whole. This causes an avoidance of contact that is undesirable for both users and providers of healthcare services. Older transgender people are vulnerable to a range of mental health problems and, like all elderly, increasingly to dementia; failure to access specialist services in a timely manner may result in unnecessary distress and potentially to crisis. This paper reports on the use of an appreciative inquiry approach towards identifying the opportunities for one health board in North Wales to work more closely with older members of the transgender community it serves. [ABSTRACT FROM PUBLISHER]

Purpose - Drawing findings from a large mixed-method study on perceptions of dignity, care expectations, and support in relation to older women from Black and minority-ethnic backgrounds, the purpose of this paper is to explore the interrelationships between life course events and the multiple roles adopted by women at different points in time that have shaped their perceptions of care and their care expectations in old age. Design/methodology/approach - In total, 32 semi-structured interviews were undertaken, allowing for the collection of data on the participants' understanding of growing old, and the meaning and attributes of care and what care with dignity "looked and felt like". The theoretical framework is guided by a life-course approach and grounded within an intersectionality perspective. The majority of the participants were migrants. Findings - Social markers such as ethnicity and cultural identity were found to influence the participants' understanding and expectations of care with factors such as gender identity and integration in the local community also of importance. How women felt they were perceived and "recognised" by others in their everyday lives with particular focus at the time of old age with the increased potential of loss of dignity due to declining capabilities, raised the importance of the family involvement in care provision, and perceived differences in the attributes of paid and non-paid care. The notion of "care from the heart" emerged as a key attribute of care with dignity. Care with dignity was understood as a purposeful activity, undertaken with intent to show respect and to acknowledge the participants' sense of worth and value. Practical implications - The implications of this study are relevant in the current debate taking place at the EU level about the lived experiences of ageing migrant groups and care expectations. Originality/value - The study highlights the importance of the social nature of dignity, how wider societal structures can impact and shape how care is understood for older women of migrant and minoritised backgrounds, and the need to explore migration and care across the life course. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy is a barrier to Covid-19 vaccine uptake and displays a social gradient, compounding health disparities. While social gradients are a vital concept in health, they flatten distinctions between types of disadvantaged community. This paper focuses on vaccine hesitance in post-industrial and de-industrialising coalfields. The social consequences of the decline of coal mining may present barriers to vaccine uptake. We ran parallel surveys in Wales (N = 4187) and US states overlapping with central Appalachia (N = 4864), to examine whether vaccine attitudes and uptake varied between areas with different coal mining histories. These surveys were accompanied by qualitative interviews of 36 residents of these coalfields to explore vaccination decisions and triangulate with survey data. Factor analysis identified four axes of attitudes in the survey data: vaccine confidence , covid scepticism , v accine individualism , and concerned confusion. These themes were echoed in the interviews. Vaccine confidence was lower; and covid scepticism, vaccine individualism, and concerned confusion higher, in residents of areas of Wales with greater mining extent and where pits closed during certain periods. Residents of former US coal counties had lower vaccine confidence and higher covid scepticism, while those in current coal counties had greater vaccine individualism and concerned confusion. In former US coal counties and Welsh areas where pits closed since 1980, vaccine uptake was lower. Differences could not be explained by respondents' income and education. In the interviews, norms of social solidarity were often invoked by vaccinated respondents, while unvaccinated respondents did not frame decisions in the context of the industrial history of their areas. The legacy of coal-mining's decline presents barriers to public health campaigns. We show evidence of this across two historically significant coalfields. Attention is needed to avert negative public health consequences of global energy transition. • Coalfields a distinct class of, often disadvantaged, community. • Industrial history may undermine trust in public health. • We find evidence of greater vaccine hesitancy on Welsh and Appalachian coalfields. • Coalfields may require specific public health campaigns. [ABSTRACT FROM AUTHOR]

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

Purpose – The purpose of this paper is to report on a qualitative exploratory study conducted in Wales to explore what dignity and care mean from the perspectives of men and women aged 50 years and older who self-identified as being either African-Caribbean/West Indian, or Black Welsh (third- or fourth-generation, with links to Africa or the Caribbean). Design/methodology/approach – Twenty-one semi-structured interviews were undertaken, allowing for the collection of data on the participants' understanding of dignity (what it is, and what it "looks and feels like") and of care. Findings – Dignity and respect for older people are revealed to be key aspects of the participants' personal value systems. The notion of care is understood as "caring about" and is seen to be a key indicator of dignity. Moreover, both care and dignity were understood and, for many of the participants, were both conceptualised on a personal basis and shaped by a sense of identity that was, in part and to varying extents, communally mediated and rooted in a cultural collectivistic value orientation. The findings also reveal the intersections of care and minority ethnicity, and how – to varying extents – these intersections shape the participants' perceptions of how they are recognised and acknowledged in encounters where dignity is especially important, such as in the receiving of care. With these perceptions come various levels of engagement, avoidance or acceptance of the need for extra care or support. Originality/value – Exploratory in nature, this study investigates the importance of paying attention to the impact that cultural and ethnic identity (and accompanying belief systems) may have on how notions of dignity and of care (both personal and communally mediated) are understood. It seeks to contribute to the body of evidence on ways of working with "seldom-heard" groups and the importance of building trust and establishing long-term, community-based research networks. [ABSTRACT FROM AUTHOR]

The article discusses various reports published within the issue including the barriers to meaningful communication with patients with dementia, the genes that contribute to the risk of developing Alzheimer's disease, and the deterioration of memory as people grow older.

Until recently, older lesbians and gay men were largely invisible within ageing research and, where it has been undertaken, a bias towards urban samples has occurred. As a result, less is known about the experience of living in a rural community as an older lesbian or gay man. This paper presents a discussion of a current research project that is taking place as one part a programme of research in the south-west of England and Wales under the umbrella of the UK's New Dynamics of Ageing Programme. The research projects in the south-west and Wales are broadly aimed at exploring how older people living in rural areas interact with their local communities. The Gay and Pleasant Land? project is focused on exploring sexuality, ageing and rurality in the south-west of England and Wales. The project uses multi-methods to explore connections between place, space and identity, which include visual ethnography, focus groups and interviews using the Biographic Narrative Interpretive Method (BNIM). The development and production of a short, professionally made film as the key dissemination tool are outlined. Performative Social Science and its philosophical grounding in Relational Aesthetics as the bedrock of the project are deliberated. Implications for research with marginalised groups in rural communities are discussed, alongside a consideration of multi-methods and the use of tools from the within social work research. [ABSTRACT FROM PUBLISHER]

Intermittent self-catheterization (ISC) is a recommended treatment for people with a neuropathic bladder due to spinal injury. The majority of the literature to date has focused on the safety and the complication rates of ISC and use of different catheters. The aim of this paper explores the lived experience of people with spinal cord injury carrying ISC and the impact of service provision on rehabilitation. A qualitative approach was used based on grounded theory. Fifteen users (11 men and 4 women) of ISC took part in semi-structured interviews during 2009. Ages ranged from 24 to 68 years. The sample was recruited from the regional spinal unit. Thematic analysis was used to analyse the emergent themes. The results of the core theme, the patients' journey, related to the patients' perspectives of health service provision. Incontinence was the biggest problem to impact on quality of life. Successful bladder management was considered crucial to independence. The services provided by professionals in relation to ISC impacted on the rehabilitation process and patients' journey through the care system and independence. Service provision during acute rehabilitation was excellent; however, follow-up support was poor and failed to meet expectations. The findings of this study have potential to help professionals to identify factors in relation to the service provision important to spinal cord injured patients when learning and living with ISC. The information could be used to help those who may be resistant to ISC or have difficulty complying with the treatment and to aid with the teaching, advice giving and ongoing care. [ABSTRACT FROM AUTHOR]

Purpose - This paper seeks to explore staff experiences of working in Crisis Resolution and Home Treatment (CRHT). There is a paucity of research in the area and a particular lack of in-depth qualitative accounts of staff experiences with most research focused on output and outcomes of CRHTs, including inpatient admission and bed-occupancy rates.Design/methodology/approach - Interpretative phenomenological analysis (IPA) was used to investigate participants' experiences of working in this service context. Five CRHT workers were interviewed about their experiences, including the aspects of their work that they found enjoyable and those that they found stressful, and how they coped with challenges related to the work.Findings - Three master themes, each with corresponding subordinate themes, emerged from the analysis. These were: "motivating factors", "stressors" and "coping". These findings indicated these subjective experiences emphasised the opportunities to make a difference and help service users and build therapeutic relationships. Perceived stressors were understood in the context of a complex service context, operational issues, responsibility for service users, and supervision and training needs.Research limitations/implications - The implications of the research for CRHT staff are discussed as well as the limitations of this study.Originality/value - This study offers a timely development in understanding the experiences of staff working in CRHTs. [ABSTRACT FROM AUTHOR]

A recent research study found that being more directly involved in medical abortion places greater demands on the nurses. The demands required by nurses working in abortion care may be increased by the stigma attached to such an antisocial action. This paper presents an application of stigma theory, as espoused by Goffman, based on a qualitative research study on abortion. It is argued that women attending for abortion are stigmatised and nurses, although 'wise', have an affiliate stigma through their close association with the procedure. It is proposed that the situation can be ameliorated by addressing stigma at policy, local and personal levels. Examples from other areas of practice are outlined for possible application to practice. [ABSTRACT FROM AUTHOR]

The increasing status and regard of indigenous minority languages across Europe, means the advantages of bilingualism for individuals and communities are now well established. We set out to elicit parents' and health professionals' views of the role of health visitors and midwives in promoting bilingualism in the family and to consider whether health professionals acknowledge the contribution that bilingualism makes to public health. A three-year study was completed to measure the impact of a language transmission initiative which depends on the input of midwives and health visitors with new parents and how its effect could be improved. This paper reports on one element of that study. A qualitative approach was used. Six focus group interviews were conducted with health visitors and midwives and 33 postnatal interviews were completed with parents across four counties in Wales. Thematic content analysis was undertaken by two researchers, a third trailed decision processes and scrutinised categories and themes. Findings suggest that health visitors and midwives perceive their roles relating to the promotion of bilingualism differently. Influences on their involvement include their language profile, contact with parents, personal experience, timing of the interaction and time in their workload. The relationship between promoting bilingualism and public health was accepted by some and denied by others. Data from the interviews with parents suggested that few health professionals discuss issues of language transmission with new parents. Some individual health visitors and midwives are willing to promote bilingualism with parents. However, there are challenges in enlisting the support of health visitors and midwives to discuss language transmission and bilingualism with parents. These findings challenge practitioners to consider their role in promoting bilingualism and its effect on public health and suggest the need for more defined responsibilities. [ABSTRACT FROM AUTHOR]

Background: Concerns have been raised about inpatient mental health care. An accreditation model can improve compliance with standards associated with improved quality of health care. Aims: To explore the effects of a standards-based, peer review, accreditation model on standards of care in acute inpatient wards and explore how staff achieved change. Method: Quality of care was assessed by independent peer review against evidence-based standards in an accreditation process. Staff from the 11 wards receiving subsequent accreditation were interviewed to find out what processes had enabled accreditation. Results: Sixteen wards enrolled: four achieved immediate and 11 subsequent accreditation. The most common reasons for initial failure of accreditation were lack of psychological therapies or 1:1 time for patients, and presence of ligature points. Ward staff perceived the accreditation process improved communication, gave power to negotiate for resources, clear guidance how to practice, rewarded good practice and led to additional unrelated improvements in care. Conclusions: Acute wards need to attend to basic safety and provide talking treatments (both formal psychotherapy and basic time spent with patients). An accreditation, peer-reviewed, standards-based process can enable staff to feel confident about improvements in the quality of care. [ABSTRACT FROM AUTHOR]

This paper examines the popular reaction to the implementation of licensing reforms in England and Wales in 2005. It characterises these events as an episode of moral panic and seeks an ideological explanation for this alarmist response. Utilising historical perspectives, the paper draws particular attention to the formative importance of the Nineteenth Century in terms of constructing contemporary public attitudes towards alcohol. This paper draws on existing sociology and social history to highlight an international and chronological pattern which suggests a connection between Victorian temperance movements and ascetic brands of Protestantism. Through a consideration of Max Weber, E.P. Thompson and a variety of primary sources, an interpretive explanation for this pattern is provided. Legal evidence, showing the growth of alcohol regulation and the partial enforcement of temperance codes of behaviour, is then used to illustrate the survival and secularisation of temperance views from the Nineteenth Century onwards. An interpretive analysis of public discourse surrounding licensing reform in 2005 provides empirical support for this argument. Attitudes to alcohol exhibited during this episode were found to bear qualitative similarities to Calvinist-inspired temperance beliefs. The paper argues that ascetic Protestant attitudes to alcohol have achieved a wide currency and now occupy a hegemonic position within secular British society. The public reaction to the implementation of the Licensing Act 2003 is thus reinterpreted as a moral panic largely constructed by ascetic Protestant beliefs. [ABSTRACT FROM AUTHOR]

This paper outlines the development process that took place for the production of assessment materials to be used by teachers in Wales now that statutory testing at the end of KS2 has been abolished. The aim was to provide teachers with a free, but rich, optional resource that would allow for assessment of pupils' abilities in a wide range of skills and competencies embedded in the English curriculum and demonstrate how teacher assessments could be used both summatively and formatively. [ABSTRACT FROM AUTHOR]

The two reclassifications of cannabis in England & Wales in 2004 and 2009 have been subjected to a series of academic analyses which have largely been centred on either the relationship to evidence, or in terms of the implications and realities of policing and health under the changes. However, despite the wealth of attention on this area, there have been relatively few attempts to understand these policy movements through broader criminological theoretical frameworks. One recent exception is Shiner's (2015) utilisation of Garland's (2001) concept of 'structured ambivalence'. This paper seeks to test this application through drawing upon an alternative source of evidence, namely, a series of 'elite' qualitative interviews, and using Kingdon's (1995) Multiple Streams model to make sense of the policy processes. In doing so, it largely corroborates Shiner's conclusions whilst also further illuminating particular agentic aspects and their intertwining with other structural and cultural forces which led to the reclassifications. These findings demonstrate the value of triangulating evidential sources and advances knowledge about the role of individuals in pursuing policy agendas within a broader shifting political climate. This provides greater scope to further test and understand how structured ambivalence manifests itself in other cultural contexts and policy domains. [ABSTRACT FROM AUTHOR]

Background: Health services research is expected to involve service users as active partners in the research process, but few examples report how this has been achieved in practice in trials. We implemented a model to involve service users in a multi-centre randomised controlled trial in pre-hospital emergency care. We used the generic Standard Operating Procedure (SOP) from our Clinical Trials Unit (CTU) as the basis for creating a model to fit the context and population of the SAFER 2 trial.Methods: In our model, we planned to involve service users at all stages in the trial through decision-making forums at 3 levels: 1) strategic; 2) site (e.g. Wales; London; East Midlands); 3) local. We linked with charities and community groups to recruit people with experience of our study population. We collected notes of meetings alongside other documentary evidence such as attendance records and study documentation to track how we implemented our model.Results: We involved service users at strategic, site and local level. We also added additional strategic level forums (Task and Finish Groups and Writing Days) where we included service users. Service user involvement varied in frequency and type across meetings, research stages and locations but stabilised and increased as the trial progressed.Conclusion: Involving service users in the SAFER 2 trial showed how it is feasible and achievable for patients, carers and potential patients sharing the demographic characteristics of our study population to collaborate in a multi-centre trial at the level which suited their health, location, skills and expertise. A standard model of involvement can be tailored by adopting a flexible approach to take account of the context and complexities of a multi-site trial.Trial Registration: Current Controlled Trials ISRCTN60481756. Registered: 13 March 2009. [ABSTRACT FROM AUTHOR]

Government exhortations for full community involvement in their locales in England and Wales have particular significance for rural elders as the literature suggests that they are amongst the most active in this sphere. But different people have different propensities to ‘join in’. A taxonomy of different degrees of involvement in community is derived: antagonising, absenting, being, belonging, bestowing and communing. Being, belonging and bestowing are explored empirically, because they are the elements of principal concern to policy, making use of surveys of rural elders in six locations in England and Wales. A minority of respondents undertook bestowing activity (actively assisting others or taking part in voluntary activity) but most felt there were benefits from being (just living in a place) or belonging (having an identity with place) to a community. Of those who did not join in, most claimed that this was because they did not want to. Education and qualifications had the strongest association with ‘joining in’, although income and wealth per se had little impact. Two lessons for government community policy are important. First, many older people do not wish to ‘join in’, and second, the variables that tended to be associated with participation may not be that easy to influence through community policy. [ABSTRACT FROM AUTHOR]

Copyright of Adeptus is the property of Polish Academy of Sciences, Institute of Slavic Studies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The British National Health Service (NHS) is undergoing possibly the most far-reaching set of changes in its sixty-five-year history.While some commentators (like Rudolf Klein) insist that little of substance is likely to change, others consider that the politics of reform may prove quite different on this occasion. The coalition government is committed to restructuring the welfare state and public services and to rolling back the state. The NHS as a popular monopoly public service runs counter to its neoliberal ideology. While (for now) remaining committed to a publicly funded system of health care that is largely free at point of use, the government wishes to encourage much greater diversity in the provision of care, including a much larger role for the for-profit private sector. Despite significant opposition to its proposals, few concessions have been forthcoming, and the legislation that passed onto the statute book in March 2012 remained essentially unchanged.Notwithstanding the lack of convincing evidence, the government is wedded to encouraging greater competition and choice. Those who believe the changes will amount to far less than its architects hope for are being too complacent and overlooking the strength of the government's ideological convictions. These threaten to dismantle the NHS and replace it with a more costly, fragmented, and less effective system of care that is driven by profit in place of the public interest. [ABSTRACT FROM AUTHOR]

Abstract: Increasingly policy for long term condition management is focussing on new technologies. Telecare is viewed as a means of making services more responsive, equitable, cost and clinically-effective and able to play a central part in mediating between service users, professionals, and service providers. It has also been identified as helping to establish patient self-management for long term conditions. In this paper we consider the social practices of the work of telecare integration and incorporation for patients, their interactions with professionals and the synergy or otherwise with policy makers’ expectations for how patients approach, use and interact with services. The research took place in England and in Wales and involved qualitative interviews with 31 individuals. Our research suggests that, telecare services provide both an adequate substitution for traditional services and additional benefits such as minimising the need to travel and the added reassurance of regular external surveillance. However, the nature of patient work involved is ‘low level’ rather than requiring higher level interpretation of readings and decision making commensurate with realising a policy vision of more independent and responsible self –managers. Indeed a paradox of the reliance and acceptance of telecare is the creation of new relationships and dependencies rather than the diminution of reliance envisaged by policy. The illumination of practices around telecare provides evidence for policy makers and others to adjust the predictions and presumptions about how telecare might enable and promote more effective long term condition management. [Copyright &y& Elsevier]

Accessible summary • As people frequently encounter others in mental distress, there is a need for appropriate knowledge and skills to provide support. Mental Health First Aid, a 12-h mental health promotion programme was developed to address this. • There has been little research into basic mental health training programmes generally, in terms of their usefulness. The views of instructors delivering these programmes are also important, as this may provide information about the most effective way of delivering mental health training programmes to a wide audience. • In this study, instructors delivering the Mental Health First Aid programme in Wales were asked to give their views and experiences of delivering the programme. • These instructors said it was important they had the necessary skills and support to enable them to deliver the programme effectively. Mental health literacy among the public is often poor, and although people frequently encounter others experiencing mental distress in their workplace, families and communities, they may be ill-equipped to provide appropriate support. ‘Mental Health First Aid’ (MHFA), a 12-h mental health promotion programme seeks to address this, training people in the knowledge and skills needed to engage with someone experiencing mental health problems. Research relating to the MHFA programme has centred on course attendees, with a paucity of research surrounding the delivery of basic mental health training programmes. Understanding experiences of instructors delivering such programmes is key to the success of future delivery. This study sought to identify the views and experiences of instructors delivering the MHFA programme in Wales. Fourteen MHFA instructors participated in semi-structured audio-recorded interviews, with the transcripts analysed to identify key themes. This paper explores two of the identified themes namely prerequisite skills and support required by instructors. The study highlighted that because of the ensuing emotional labour experienced by instructors, universal mental health training programmes must put in place a clear infrastructure to train, support and monitor those delivering them, for programme roll-out to be effective. [ABSTRACT FROM AUTHOR]

Aim: To identify factors influencing healthcare professionals' engagement in health behaviour conversations with patients. Design: Cross‐sectional survey. Methods: Between April and June 2019, an online survey of 1338 nurses, midwives and healthcare support workers was conducted. The survey assessed whether staff felt comfortable initiating health behaviour conversations with patients about five behaviours (reducing alcohol intake; stop smoking; being more active; reducing their weight; and improving their diet) and barriers to conversation initiation. Health professionals' own health‐related behaviours, self‐rated health and mental wellbeing, and socio‐demographic characteristics were recorded. Logistic regression models were built to assess factors associated with feeling comfortable initiating health behaviour conversations for each topic. Result: Less than 50% of respondents reported feeling comfortable initiating health behaviour conversations with patients. Female staff, young professionals (18 to 29 years), those in lower staff grades and those with poorer health and low mental wellbeing were less likely to report feeling comfortable having health behaviour conversations across all topics. Those who did not adhere to physical activity and dietary guidelines were less likely to initiate a conversation about being more active and having a healthy diet, respectively. Not having time to discuss the topic, suitable space to hold a conversation, and feeling worried about offending/upsetting patients were the main barriers reported. Conclusion: Around 6 in 10 members of the nursing, midwifery and healthcare support workforce in Wales potentially do not feel comfortable to initiate a health behaviour conversation with patients about health and wellbeing. Feeling less comfortable to initiate a conversation was associated with staff demographics and organizational factors. Impact: We identified those less likely to initiate health behaviour conversations as well as personal and organizational barriers to initiation. This will help to target and tailor interventions to ensure staff are equipped and enabled to hold health behaviour conversations with patients. [ABSTRACT FROM AUTHOR]

This study employs Jungian psychological type theory, as subsequently developed by various type measures, to interpret and to classify the expectations of cathedral visitors, as assessed by the Visitor Expectations Type Scales 2.0 (VETS 2.0). Data provided by 1,278 visitors to five cathedrals in England and Wales demonstrated the coherence and internal consistency of the eight measures of the VETS 2.0 (designed to access introvert expectations, extravert expectations, sensing expectations, intuitive expectations, feeling expectations, thinking expectations, perceiving expectations, and judging expectations) and drew attention to the particular emphasis placed by cathedral visitors on introvert expectations, feeling expectations, and perceiving expectations. The VETS 2.0 are commended as providing a more valid assessment of the psychographic segmentation of cathedral visitors than could be provided simply by the administration of a recognised measure of psychological type. Such assessment has implications for the marketing and management of cathedrals within the tourism industry. [ABSTRACT FROM AUTHOR]

Purpose: In January 2013, new court procedure rules were introduced in England and Wales, which resulted in significant changes to the instruction of expert witness psychologists (EWPsychs). This study aims to build on the results of previous survey studies of psychologists working as expert witnesses in identifying the current challenges faced by EWPsychs. Design/methodology/approach: Using a mixed-methods design, a sample 58 practicing psychologist expert witnesses were surveyed, and qualitative data was analysed using a thematic analysis approach. Findings: Six overarching themes emerged from the online survey data: training and knowledge, changes to procedure rules and Legal Aid Authority fees, quality of reports, pressures to change opinion, conflict with EWPsychs and expert witness feedback. Over a third of psychologists working as expert witness have not received specific expert witness training, with a quarter of respondents indicating that the capped legal aid fees are a determining factor in whether they accept instruction as an expert witness, and almost two-third of respondents believing that the legal aid rates do not accurately reflect the work that they do. Practical implications: There is clear demand for high-quality EWPsychs and a need to develop expert witness training programmes and guidance documents to better support the next generation of EWPsychs. Originality/value: These results inform existing policy, clinical practice and guidance documents in supporting psychologists working as expert witnesses. [ABSTRACT FROM AUTHOR]

The first section of the paper criticizes the concept of inconsistency between status ranks as an explanation of variations in attitudes and behaviour between different groups. The second section argues that the concept of relative deprivation may, if appropriately qualified, prove more useful and suggests a possible application of it to the topic of attitudes towards immigrants. The third section presents some findings from a sample survey carried out in England and Wales in 1962 which furnish a limited test of two proposed hypotheses. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, lymphoedema staff adapted services, providing care remotely, and worked in other NHS sectors. The impact on services and staff must be understood in order to safeguard patient care and foster workforce resilience. Aims: To evaluate the experiences of clinical and non-clinical lymphoedema staff in Wales during the COVID-19 pandemic. Methods: An anonymous online survey, based on scoping work, was sent out via the Welsh lymphoedema services mailing list. Findings: 71% (68/96) of eligible lymphoedema staff completed the survey. More than half supported lymphoedema services (40/68) with the remaining staff deployed elsewhere. Overall, staff and services felt prepared for new ways of working. Concerns about others and the future burden on services when life returned to normal were reported. Opportunities identified included education initiatives and virtual services. Conclusion: Lymphoedema services were well prepared to deliver virtually, enable effective care and share knowledge. Co-ordinated efforts to uphold patient advocacy will support virtual services to meet their needs. [ABSTRACT FROM AUTHOR]

In the United Kingdom, one‐in‐four individuals with mental health problems access mental healthcare with police involvement. However, little is known about police officers' perceptions of their role in pathways to services. The aim of this study was to examine UK police officers' views and experiences of their involvement in mental healthcare, focusing on decision‐making in emergency situations. Using volunteer sampling, we recruited 15 police officers from a large metropolitan conurbation in the North West of England. Semi‐structured interviews, including a vignette depicting a mental health emergency, were used to elicit data. Interviews were transcribed verbatim and analysed at the manifest level using thematic analysis, yielding three main themes: 'Doing What's Right', 'Challenges of Working Together' and 'Training versus Experience'. Our findings indicate that, while police officers believe they have a duty of care to protect people in mental health emergencies, they sometimes lack relevant knowledge, skills and confidence in decision‐making. Challenges associated with multi‐agency working were also perceived as impeding officers' ability to effectively manage these emergencies. Our findings suggest that strengthening multi‐agency working and improving training might positively influence police officers' views of their role and maximise their contribution to improving emergency mental healthcare. [ABSTRACT FROM AUTHOR]

Issues Addressed: To establish the views of clinicians on the feasibility and effectiveness of using a novel lifestyle prescription form (LRx) which requires co-signing by clinician and patient and is uniquely based on the design of the standard drug prescription form, in the primary and secondary health care settings.Methods: Thirty-six participants were issued with a "prescription" pad, of 20 LRx scripts, for 1 month and requested to issue an LRx prescription to patients they deemed suitable during their consultation, recording their reason for use of the LRx. Each clinician was then asked to complete a comprehensive feedback questionnaire.Results: Feedback of the LRx was overwhelmingly positive. The script was viewed as a more effective way to convey and support cardiovascular lifestyle advice, than usual care. Forty per cent (196 of 480) of the LRx scripts that were provided to primary and secondary care clinicians during the study period were issued. In most consultations, the LRx script was issued to reaffirm dietary advice. Nurses and health care assistants were more likely than doctors to use the LRx in response to a request for lifestyle advice from a patient.Conclusions: The LRx may be a useful addition to the clinician's communication toolkit to stimulate lifestyle behaviour changes in their patients. The main barrier to use in the study was lack of consultation time. SO WHAT?: Issuing the LRx is a method of solidifying lifestyle advice that clinicians could utilise, providing them with another tool in their behaviour change arsenal, particularly with familiarity with the tool. [ABSTRACT FROM AUTHOR]

Professional control in the selection of treatment options for patients is changing. In light of social and legal developments emphasising patient choice and autonomy, and restricting medical paternalism and judicial deference, this article examines how far patients and families can demand NHS treatment in England and Wales. It considers situations where the patient is an adult with capacity, an adult lacking capacity and a child. In all three cases, there is judicial support for professional autonomy, but there are also inconsistencies that have potential to elevate the importance of patient and family preferences. In combination, they may be perceived by healthcare professionals as an obligation to follow patient preferences, even where doing so conflicts with other professional obligations. It is argued that a more nuanced approach to shared decision-making could help clarify the boundaries of decision-making responsibility. [ABSTRACT FROM AUTHOR]

Young mothers under the age of 20 often have poor nutrition and low levels of physical activity, adversely affecting outcomes for themselves and their babies. The aim of this qualitative study was to explore the experiences of healthcare professionals in supporting young women around eating and moving during and after pregnancy. Seventeen semi‐structured interviews were conducted with midwives, family nurse practitioners and health visitors involved in the care of pregnant and post‐natal mothers under the age of 20 in England and Wales. Data were analysed using thematic analysis and coded within the theoretical framework of the COM‐B model to three areas of capability, motivation and opportunity. For capability, participants were broadly divided between those who had specialist knowledge and training in communication skills to support health behaviours in this population and professionals reliant on tacit knowledge. For opportunity, having enough time was seen as critical because young women's difficult social contexts meant supporting improved health behaviours required relationships of trust to be built. For motivation, participants reported that supporting young women with eating and moving was part of their role. However, the decision to prioritise this support sometimes related to perceived need based on BMI and this was complicated as young women were still growing. Motivation was additionally connected to professionals' own body experiences and health behaviours. Moving habits were less frequently discussed than eating as professionals described how young women tended to walk a lot in their daily lives or found that young women were not interested. Results suggest that to support eating and moving behaviours with young women, professionals need to be trained in communication techniques, enabled with the time to hold space for young women and be able to reflect on their own attitudes and beliefs to support a rounded model of health and wellbeing. [ABSTRACT FROM AUTHOR]

In the process of creating a care plan or finding a placement for children, assessment of their health and developmental needs will be undertaken. This can involve the interpretation of complex family history information and may also include undertaking and interpreting the results of genetic testing, when within professional guidelines. This study explores opinions, knowledge about and experiences of adoption professionals in relation to genetic information and testing in Wales. Semi-structured qualitative interviews were conducted with six social workers and seven medical advisers. The data were transcribed and thematically analysed. Themes included the challenges to collation of family history, how the willingness of professionals to undertake genetic testing in children awaiting adoption was altered by the availability (and non-availability) of family history information, and the uncertainty that genetic information can generate for professionals and prospective parents. Uncertainty for both professional groups emerged from apparent inconsistency in current practice and from concern over their own lack of genetic knowledge. As new genetic technologies increase the scope of uncertainty, there is a need for social workers and medical practitioners working in adoption to have a greater understanding of genetics alongside opportunities to discuss cases in a multidisciplinary setting when appropriate. [ABSTRACT FROM AUTHOR]