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Background: Social connections between medical students provide a key basis for learning and support. These connections, and associated social identity, may be patterned by ethnicity, and students often perform similarly academically to those they connect with. The mechanisms that underpin the formation of these connections and the role that they play are not fully understood. This study explored how medical students connect with each other, and the potential impact of this on their academic attainment and well‐being, with a focus on students with minoritised ethnic identities. Methods: A mixed methods study combining (1) a survey to establish the number and strength of connections formed by Years 1 and 2 medical students with both minoritised and non‐minoritised ethnicities and (2) semi‐structured interviews to understand how connections were formed, whether this was shaped by ethnicity and the role of connections in supporting students with their learning and well‐being. Results: One hundred fifty‐one students (15.5% response rate) completed the survey. Students connected regularly with three to four peers with the goal of supporting learning and 71.9% of students reported a sense of social identification with this group. There was no statistical difference between ethnically minoritised and White students on either of these measures (t = 0.1, p = 0.92, χ2 = 2.9, p = 0.56). Interviews with 19 students found that social connections were shaped by perceptions of their self‐identity and the need to find 'equilibrium' by forming relationships with compatible others. The education environment, including its ethnic diversity, impacted on the opportunities to make connections. Students who were ethnically minoritised reported encountering challenges, especially in the clinical environment, and described the burden of these for them. Discussion: Curriculum designers should consider the time and space that is afforded to student interaction during course development, as finding compatible others with whom students can socially connect is important to balancing well‐being with academic performance. Bull et al. analyze students' experiences to show that they seek individuals with whom they feel compatible to maintain 'equilibrium' and support both academic performance and wellbeing. [ABSTRACT FROM AUTHOR]

Purpose: Unaddressed hearing loss can adversely affect employment and day-to-day work-life. Efficient and effective audiology support can help optimise hearing in the workplace. This study explores the audiological rehabilitation experiences of workers with hearing loss (WHL). Materials and methods: Twenty-four WHL with experience of a wide range of audiology services across the UK participated in semi-structured interviews. Interviews were analysed using inductive thematic analysis. Results: Three main themes were generated: Theme 1: mixed experiences with audiology services (subdivided into two subthemes and four sub-subthemes). Theme 2: audiology role in work support (subdivided into three subthemes). Theme 3: "I think support could be improved if..." (subdivided into two subthemes). Conclusion: The audiological rehabilitation for working-age adults with hearing loss needs improvements to deliver sufficient support and quality care. Some of the barriers to having better-functioning hearing healthcare require fundamental standards in healthcare quality, such as access to services, staff (including audiologists) deaf awareness, information and technology support, and personalised care that considers work-life needs. Further research is required to evaluate the feasibility and cost-effectiveness of improvements, such as support that extends beyond hearing aid care, whether from audiology or non-audiology services. IMPLICATION FOR REHABILITATION: Workers with hearing loss need audiologists' support to address their work life needs beyond hearing-aids care. Improving audiologists' competencies, audiology departments' efficiency and developing relevant resources may promote better healthcare for workers with hearing loss. Audiologists, employers, workers, and the healthcare system need to collaborate in developing person-centred solutions to sufficiently assist workers with hearing loss. [ABSTRACT FROM AUTHOR]

The UK National Health Service (NHS) is one of the largest employers in the world and relies heavily on Black migrant women. Nonetheless, reports of (gendered) racism persist. This phenomenologically inspired qualitative study shares findings from empirical interview data with female Nigerian doctors and nurses working in the NHS, with a specific focus on how these women cope with the racism and gendered racism they experience in their everyday working lives. The analysis shows the extent to which they perceive the coping strategies available to them to be limited, with problem-based solutions focused on relocating themselves into geographical, professional, or organisational spaces where acute staffing shortages may curb employers' tendency towards discrimination in recruitment and advancement. Emotion-based strategies employed were often faith-based, or relied on their national identity and understandings of what it means to be Nigerian/a Nigerian woman. The article critically considers the power differentials endemic in employment that limit these women to individualised coping strategies which ultimately result in their isolation, a known stressor itself, creating a self-perpetuating vicious circle of gendered racism. [ABSTRACT FROM AUTHOR]

There is emerging evidence that post-traumatic growth is a relevant concept in addiction recovery. However, existing measures, such as the post-traumatic growth inventory, were designed to measure post-traumatic growth in general trauma populations. It is unclear if the post-traumatic growth inventory is suitable for individuals in recovery from substance-related addiction. The current study aimed to qualitatively assess the content validity of the post-traumatic growth inventory for individuals in addiction recovery. The think-aloud method was applied, and semi-structured interviews utilized, to collect data from 20 individuals in recovery from unhealthy alcohol and/or drug use. Reflexive thematic analysis was used to analyze data in relation to item interpretation and experience of post-traumatic growth. Qualitative assessment supported three out of five subscales on the post-traumatic growth inventory (new possibilities, personal strength and appreciation of life). Modifications were suggested on some items from the relating to others domain and responses to the spiritual change domain possibly reflected a cultural influence. There was an identified need to include items that account for positive changes in health behavior. The current study highlights domains of post-traumatic growth for those in addiction recovery and how the post-traumatic growth inventory may understate some forms of positive life change. Future research should focus on validating a revised version of the post-traumatic growth inventory for this population. [ABSTRACT FROM AUTHOR]

Hearing loss and dementia are common in long-term care home (LTCH) residents, causing communication difficulties and worsened behavioural symptoms. Hearing support provided to residents with dementia requires improvement. This study is the first to use the Behaviour Change Wheel (BCW) to identify barriers and propose interventions to improve the provision of hearing support by LTCH staff. Semi-structured interviews with 10 staff members were conducted. Transcripts were analysed according to the BCW's Theoretical Domains Framework alongside reflective thematic analysis. Relevant intervention functions and exemplar interventions were proposed. Staff believed hearing support to be beneficial to residents (Beliefs about Consequences) but lacked knowledge of hearing loss management (Knowledge). Poor collaborations between LTCHs and audiology (Environmental Context and Resources), led to despondency, and apprehension about traditional hearing aids for residents (Optimism). Despite feeling responsible for hearing support, staff lacked personal accountability (Social/Professional Role and Identity). Future interventions should include staff Training (on hearing support), Education (on the consequences of unsupported hearing loss), Enablement (dementia-friendly hearing devices), Incentivisation and Modelling (of Hearing Champions) and Environmental Restructuring (flexible audiology appointments to take place within the LTCH). Interventions should be multi-faceted to boost the capabilities, opportunities and motivations of LTCH staff. Hearing support for care home residents with dementia: Long-term care staff report inadequate knowledge and awareness of how to support residents' hearing needs and a lack of personal accountability for providing hearing support. They also report poor collaborations with audiologists and apprehension about traditional hearing aids. Barriers to hearing support stem from gaps in the capabilities, opportunities and motivations of staff, therefore, interventions should be designed to target all three constructs. Interventions to aid hearing support provision should target staffs' education, training, enablement, persuasion, modelling, incentivisation and environmental restructuring to boost staff capabilities, opportunities and motivations to provide hearing support. [ABSTRACT FROM AUTHOR]

Objectives: To explore how the use of, and trust in, different sources of advice and information on COVID-19 differed across the four UK nations and between different sociodemographic groups and their associations with COVID-19 vaccination status. Methods: We used a UK-wide representative survey conducted in July 2021, which included data on uptake of COVID-19 vaccination, trust in information sources, use of sources and geographical and sociodemographic variables. We used multivariate logistic regression to identify factors associated with completed or planned COVID-19 vaccination. Results: Trust in the NHS, followed by trust in scientists, were the strongest predictors of vaccination intention. NHS websites were the most used (56% across the UK); only the Scottish government website had a higher level of reported use (58%). Using either source was associated with a positive vaccination status as were use of the GP and television as sources of advice. Use of social media, family and friends, and 'none' of the sources enquired about, were all linked to a lower likelihood of being or intending to get vaccinated. Compared to those in England, respondents in other UK nations were less likely to trust the central UK government for advice on COVID-19. There was considerable variation by age in trust and use of some, but not all, sources of advice, with predicted probabilities ranging from 35% among the youngest age group to 62% among those aged 65 years or older. There were also significant differences by annual household income and by occupational class for trust in government, with higher incomes correlating with greater likelihood of trust. Conclusions: This study demonstrates high levels of trust in the key sources of public health advice and there was a positive association between using official sources of advice and vaccination intentions, even in the context of overall high vaccination rates. Our findings highlight the need for the UK and devolved governments to value the importance of public trust in the health system and take appropriate measures to avoid undermining such trust. [ABSTRACT FROM AUTHOR]

Collective nostalgia is an emotion experienced when one sentimentally recalls events or things related to a particular social identity. We investigated the relationship between collective nostalgia about the United Kingdom (UK) and UK citizens' desire to leave the European Union (EU). We collected data of UK citizens twice prior to the UK's official withdrawal from the European Union (N = 347 and N = 240) and once afterwards (N = 236). Cross‐sectional and longitudinal analysis, utilizing cross‐lagged panel models, supported the hypothesis that collective UK nostalgia increased the desire to leave the European Union. We additionally hypothesized that the relationship between these variables would be mediated positively by ties to UK citizens and negatively by ties to EU citizens. Exploratory and longitudinal analysis, however, indicated that strength of ties to UK and EU citizens predicts levels of collective UK nostalgia which, in turn, predicts desire to leave the European Union. Specifically, ties to UK citizens were associated with increased collective nostalgia and a desire to leave the EU and ties to EU citizens were associated with reduced collective nostalgia and a desire to re‐join the European Union. We discuss the implications of the findings as well as making suggestions for future studies. [ABSTRACT FROM AUTHOR]

The current study investigated meat‐reducers' (vegan, vegetarian, and flexitarian) dietary identities using an identity process approach. Drawing on identity development theories, we aimed to (i) classify meat‐reducers from the United Kingdom and United States (N = 375) based on their level of identity exploration and commitment, and (ii) examine the effect of dietary identity status on diet and group‐based behaviours. Findings demonstrated evidence for three identity clusters: achieved (high exploration and high commitment), foreclosed (lower exploration and higher commitment), and diffused (low exploration and low commitment) meat‐reducers. Vegans were more likely to display an achieved dietary identity, whereas the majority of flexitarians indicated a diffused identity. More importantly, identity status had significant effects on all outcome measures, with achieved meat‐reducers reporting greatest dietary strictness, greatest centrality and private regard, but lowest public regard, as well as most negative attitudes towards meat‐eaters and greatest activism. We discuss how investigating dietary identities with a 'process framework' may point to a more inclusive view of social identities among people who follow a plant‐based diet. [ABSTRACT FROM AUTHOR]

Background: A large number of deaths could be avoided by improving health behaviours. The degree to which people invest in their long-term health is influenced by how much they believe they can control their risk of death. Identifying causes of death believed to be uncontrollable, but likely to occur, may provide actionable targets for health interventions to increase control beliefs and encourage healthier behaviours. Method: We recruited a nationally representative online sample of 1500 participants in the UK. We assessed perceived control, perceived personal likelihood of death, certainty of risk estimation, and perceived knowledge for 20 causes of death. We also measured overall perceived uncontrollable mortality risk (PUMR) and perceived prevalence for each of the Office for National Statistics' categories of avoidable death. Findings: Risk of death due to cancer was considered highly likely to occur but largely beyond individual control. Cardiovascular disease was considered moderately controllable and a likely cause of death. Drugs and alcohol were perceived as risks both high in control and low in likelihood of death. However, perceptions of control over specific causes of death were found not to predict overall PUMR, with the exception of cardiovascular disease. Finally, our sample substantially overestimated the prevalence of drug and alcohol-related deaths in the UK. Conclusions: We suggest that more can be done by public health communicators to emphasise the lifestyle and behavioural changes that individuals can make to reduce their general cancer risk. More work is needed to understand the barriers to engaging with preventative behaviours and maintaining a healthy heart. Finally, we call for greater journalistic responsibility when reporting health risks to the public. [ABSTRACT FROM AUTHOR]

Background: Medicine is one of the most inaccessible professions in the United Kingdom (UK). The Plant a Seed (PAS) series was created to address this; it is an online pre-recorded three-part video series to "Inspire", "Educate" and "Motivate" pupils from widening participation backgrounds on Medicine. We explored the impact of PAS on pupils' knowledge, skills and attitude to Medicine. Methods: We conducted a national pretest-posttest study of Years 7–9 pupils in the UK. 503 schools were invited to PAS, following ethics approval. Consented pupils viewed all three episodes asynchronously and completed a pre-and post-series Likert scale confidence questionnaire, which evaluated their knowledge, skills and attitudes to a medical career. A Shapiro-Wilk test showed the lack of a normal distribution (p < 0.05); therefore, a Wilcoxon signed-rank test statistically compared pretest-posttest results of each pupil. Results: 70 pupils in Years 7–9 from 2 schools participated in this study. PAS was shown to significantly increase pupils' knowledge of the role and life of a doctor, medicine as a degree, admissions requirements, and careers in medicine (p < 0.05). There was a significant increase in pupils believing they could study medicine. The intervention did not significantly increase the desire for pupils to study medicine (p = 0.187). Conclusion: PAS significantly improved pupils' knowledge, skills and confidence demonstrating the need and benefit to enrolment of the programme at scale. It did not significantly increase the number of pupils wishing to study medicine. Analysis at scale is required to evaluate the effectiveness of PAS as a key intervention to break down barriers to medicine. [ABSTRACT FROM AUTHOR]

The term topical steroid withdrawal (TSW) refers to a condition widely discussed on social media, but rarely mentioned in the medical literature. It typically involves a patient with chronic eczema who abruptly discontinues topical corticosteroids (TCS) believing they are ineffective and damaging. Symptoms include an acute eruption, worse than the previous eczema, of painful erythema followed by oozing, crusting, desquamation and sometimes prolonged systemic weakness. Patients self-diagnose and often avoid healthcare professionals who dismiss the diagnosis and persist in offering TCS, leaving them unsupported. We analysed 121 responses to a survey of UK dermatologists' attitudes to TSW. Views on aetiology included relapsed eczema, erythroderma and a social construct. A total of 88.4% (107/121) agreed that TSW needs better understanding and more research. Respondents earlier in their careers are more cautious than senior respondents about prescribing TCS long term because of TSW, suggesting a trend that might lead to better understanding, communication and management. [ABSTRACT FROM AUTHOR]

Background: Societal beliefs about the seriousness of different addictions were assessed in the United Kingdom (UK). Methods: An online panel, conducted in 2021 and sampled to be representative of the UK general population 18 years and over (N = 1499), was conducted and asked participants their views regarding the seriousness of different societal problems, including various addictive behaviors. Results: Cannabis was ranked as the least serious of the addictive behaviors. Other illicit drug use (cocaine, amphetamine, heroin) was rated as the most serious of addictive behaviors. None of the addictive behaviors were rated as being as serious a problem to society as environmental damage, violent crime, poverty, and the COVID-19 pandemic. Conclusions: Ratings of cannabis use were not as expected and stand in contrast to the current UK policy on cannabis use. In addition, the UK policy on alcohol consumption contrasts with societal concerns about alcohol use. [ABSTRACT FROM AUTHOR]

Neurodivergent young people tend to struggle with building and maintaining their romantic relationships. Despite this, there appears to be a lack of appropriate sexuality education delivered to them. This review aims to present and discuss the most current literature (conducted between 2015 and current) on romantic relationships and sexuality education in young people with Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD), and ASD co-occurring with ADHD. Six internet-based bibliographic databases were used for the present review that followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Thirty-one studies were identified in this review. Twenty-six studies investigated the topic in the autistic young population. Four studies explored qualitatively and 11 quantitatively young people's perspectives of their romantic relationship experiences. One study investigated qualitatively and three quantitatively young people's perspectives on sexuality education. One study explored qualitatively and five quantitatively young people's romantic relationship experiences and two explored qualitatively and three quantitatively sexuality education from caregivers' perspectives. Five studies (all quantitative, self-reports) investigated romantic relationship experiences in the young population with ADHD. The studies conducted on the topic from the educational professionals' perspectives were absent in the literature. The literature was also non-existent on the topic in the population with ASD co-occurring with ADHD. To the researchers' knowledge, this is the first review exploring romantic relationships and sexuality education in three groups of neurodivergent young people (with ASD, ADHD, and ASD co-occurring with ADHD). [ABSTRACT FROM AUTHOR]

Celiac disease (CD) is an autoimmune condition managed by strict adherence to a gluten-free diet. Dietary choice has gendered connotations, and men with CD may face judgment from others when following a gluten-free diet. However, little is known about health-related stigma in men with CD. The study aim was to explore the health-related stigma and challenges faced by men with CD, and the influence of CD on their lives. Qualitative semistructured online interviews were conducted with men living with CD. Twenty adults (aged 18 years or older) identifying as men living in the United Kingdom, with self-reported CD, were recruited using social media and opportunistic sampling. Participants provided rich, detailed discussions about aspects of their experience of living with CD. Reflexive thematic analysis was used, with a critical-realist lens that enabled researchers to connect men's experiences within wider sociocultural constructs such as masculinity and social identity. Three themes were identified: CD threatens social inclusion; others' assumptions about CD and microaggressions have a psychological influence, and masculine norms, health-related stigma, and power dynamics influence men's health behaviors and everyday experience. Health-related stigma was found to be interconnected with these men's gendered social environment, suggesting that may be an important social and structural determinant of dietary, health-related, and health support-seeking behaviors in men diagnosed with CD. Contrary to prior assumptions, health-related stigma influences men with CD of all ages, particularly in social settings. The study unveils the complex interplay of individual beliefs, social norms, and power dynamics, in particular with other men, that influence individual beliefs and emphasize the performative aspect of food consumption. Internalized stigma and microaggressions influence men's well-being. To better support men with CD, health providers, charitable organizations, and the food industry should address the social influence of adherence to a gluten-free diet, in particular perceived threats to social status and inclusion, which may cause concern, influence food choice, and influence dietary adherence. [ABSTRACT FROM AUTHOR]

The article focuses on whooping cough (pertussis), detailing its history, transmission dynamics, diagnostic methods, complications, and the evolution of vaccination strategies. It highlights the resurgence of pertussis outbreaks, particularly affecting infants, and emphasizes the critical role of vaccination in controlling its spread, despite challenges such as vaccine hesitancy and waning immunity.

Background: With increased focus on people being supported to die at home, and increased numbers of people predicted to die in the coming years in the UK, it is recognised that domiciliary carers need to be trained and supported to give end-of-life care. Recent reports suggest that this is not happening. Aim: To introduce and evaluate a training programme to upskill unregulated domiciliary care agency staff and integrate them into the palliative care teams, supporting registered nurses in caring for end-of-life patients. Method: A training course was devised and implemented. This report covers the first 3 years of running the course, and evaluates the difference that it made to the first 210 recipients' ability and confidence in delivering end-of-life care, using a mixed-methods approach. Results: Pre- and post-course confidence questionnaires, evaluations, post-course testimonials, and managers' comments all identified improvements in knowledge, skills and attitudes following training. Agency policies were re-written with up-to-date guidance on how to respond to death in the community. Conclusion: This article demonstrates that this model is effective in achieving its aims. [ABSTRACT FROM AUTHOR]

Previous studies have revealed significant gaps in the UK public's knowledge about the welfare state and the economy. However, we know little about which groups of the population know more, and which less. Drawing on survey evidence, we confirm that many people overstimate both the size of unemployment provision and levels of benefit fraud, and also make mistakes when answering factual questions about finance, employment rights, and benefit entitlements. While men, older people and university degree holders demonstrate slightly better knowledge on average, substantial differences appear when we distinguish specific domains of knowledge. For example, women know more about benefits, but men more about finance. We argue that understanding patterns of economic knowledge requires more complex engagement than has been undertaken to date. This is important because we find that knowledge is linked to political attitudes, with those who are more supportive of the welfare state – and those who tend to emphasise the government's role in the delivery of public services – more likely to demonstrate greater levels of knowledge. [ABSTRACT FROM AUTHOR]

Diabetes is a non-communicable disease where the patient's glucose level in the blood is too high. Diabetes is prevalent among ethnic minority groups in the United Kingdom (UK). Type 2 diabetes is a major cause of premature mortality in England. Unfortunately, the lifestyle of these minority groups has become a barrier to diabetes healthcare treatment. The timely intervention of programmes targeting risk factors associated with diabetes may reduce the prevalence of diabetes among these ethnic minority groups. This review critically explores and identifies barriers that hinder specific African-Caribbean groups from accessing diabetes healthcare and how nurses can promote lifestyle changes in patients with prediabetes from African-Caribbean backgrounds. An extended literature review (ELR). The process consisted of a search of key databases and other nursing and public health journal articles with the keywords defined in this extended review (prediabetes, diabetes, lifestyle of Afro-Caribbean). Thematic analysis is then applied from a socio-cultural theoretical lens to interpret the selected articles for the review. Three main barriers were identified: (a) the strong adherence to traditional diets, (b) a wrong perception about diet management and (c) 'Western medication' as a key barrier that hinders effective diabetes management in ethnic minorities, including the African-Caribbean in the UK. To address these barriers, it is important for policymakers to prioritise well-tailored interventions for African-Caribbean groups as well as support healthcare providers with the requisite capacity to provide care. [ABSTRACT FROM AUTHOR]

Sexual assault is a global problem, with the risk highest among university students. Bystander intervention preventing sexual assaults has primarily been researched using quantitative methods to understand what factors influence it. However, both sexual assault and bystander intervention are complex with many subtle and overlapping issues that, when analyzed qualitatively, can offer new insights. The current study aimed to explore and develop a nuanced and comprehensive understanding of students' perceptions of sexual assault and bystander intervention across two universities, one in the United Kingdom and one in Australia. Thirty-nine university students (19 in the United Kingdom; 20 in Australia) took part in one-to-one semistructured interviews. Using inductive thematic analysis, two overarching themes were identified: (a) navigating the complex dynamics of sexual assault; and (b) decisions to intervene or not to intervene. Findings suggest that the complexity and ambiguity around sexual assault can forestall bystander intervention. As such, increasing education, awareness, and discussions around sexual assault and bystander intervention is vital to increase awareness of the problem and mobilize action from bystanders to prevent sexual assault. [ABSTRACT FROM AUTHOR]

Women with Tourette's syndrome (TS) continue to be under-researched, despite female sex being associated with increased tic-related impairment in adulthood. Existing literature indicates that individuals with TS are more likely than the general population to report self-stigma, but little is known about the subjective identities of women with TS and how this relates to psychological wellbeing. Semi-structured interviews were conducted via Zoom with a purposive sample of 11 females. All were diagnosed with TS and aged 18–28. Data was transcribed verbatim and thematic analysis applied. Five themes were established: "I'm not normal", "I just want to be me", I'm a "people pleaser", seeing oneself as an "outsider", and "it's just part of me...it's not going anywhere". Difficulties with self-acceptance and the autonomy to be one's true self were noted and appeared to be intensified by stereotypical gender roles and attempts to conceal tics. Findings also suggested that personal growth and feelings of mastery can be achieved through embracing TS as part of one's identity, or recognising it as just one aspect of the self. Psychological support focused on accepting and living with tics rather than reducing them may benefit this population and is currently difficult to access. Consideration should also be given to improving the availability of support groups where women with TS can meet others like themselves. [ABSTRACT FROM AUTHOR]

Mothers play a significant role in decision making about human papillomavirus (HPV) vaccination for their daughters and about cervical screening attendance for themselves. This study had three objectives, to explore: (1) mothers' knowledge and attitudes about HPV and HPV vaccination, (2) their knowledge and attitudes about cervical cancer and screening, and (3) whether their daughter's HPV vaccination invitation was an opportunity to nudge mothers to attend screening. 138 women from North Staffordshire completed a cross-sectional survey and 15 took part in follow-up focus groups. Despite high self-reported engagement with both the cervical screening and HPV vaccination programmes, relatively low levels of knowledge and some uncertainty were evident. There was mixed opinion about the potential of using the vaccination invite as an opportunity to nudge mothers to attend cervical screening. Even amongst women who do engage positively with the programmes, knowledge is not as complete and certain as it could be. Further research is needed with women who are less likely to accept the vaccination for their daughters. Women need to be better informed, which may go some way to reversing the decline in screening and maintaining high levels of vaccination. [ABSTRACT FROM AUTHOR]

The article highlights the transformative journey of a nurse-turned-activist who founded a not-for-profit organization, Her Heart, dedicated to addressing the alarming statistics and barriers faced by women in heart health. Topics include her diverse career trajectory, challenges in setting up the organization, and innovative solutions such as an online directory to connect women with female cardiologists and Australia's first online risk assessment tool tailored for women.

To attract and retain a more diverse workforce, organizations embrace diversity initiatives, expressed in diversity statements on their websites. While the explicit content of diversity statements influences attitudes towards organizations, much less is known about the effect of subtle cues such as emotions. In three pre‐registered studies, we tested the effect of positive emotionality in diversity statements on attitudes towards organizations. Study 1 focused on the degree to which 600 European organizations employed emotionality in their diversity statements, finding that although their statements differed in the level of emotionality, on average, organizations avoided highly emotional words. Study 2 (N = 220 UK participants) tested the effect of original diversity statements on readers' attitudes towards an organization, demonstrating that the level of emotionality in the existing statements did not influence positive attitudes towards the organization. In Study 3 (N = 815 UK participants), we thus modified the diversity statements so that they contained high levels of positive emotionality that triggered more positive emotions and resulted in more positive attitudes towards an organization. Taken together, highly emotional words (e.g. passionate; happy; wholeheartedly) are key in diversity statements if organizations wish to increase their attractiveness among potential employees. [ABSTRACT FROM AUTHOR]

In this perspective article we advocate community-based system change for people living with persistent pain. Our view is that greater use of the voluntary and community sector, in partnership with the clinical sector, creates the conditions for a "whole person" approach to pain management, leading to greater personalised care for adults living with long-term pain whilst having the potential to ease some of the pressures on General Practitioners and other clinical services. We advocate pain care that is socially connected, meaningful within socio-cultural contexts and aligned with the principles of salutogenesis. We provide an example of a UK National Health Service (NHS) commissioned pain service called "Rethinking Pain" that operationalises this perspective. Led by the voluntary and community sector, Rethinking Pain works in partnership with the clinical sector to provide a central holistic pathway of care for people experiencing persistent pain. This is the first time that this model of care has been commissioned for persistent pain in this area of England. The Rethinking Pain service is underpinned by core values to work with people to manage their pain holistically. The Rethinking Pain team proactively engage with people in the community, actively approaching and engaging those who experience the biggest health inequalities. In this article we provide an overview of the context of pain services in the UK, the rationale and supporting evidence for community-based system change, and the context, pathway, values, goals, and aspirations of the Rethinking Pain service. [ABSTRACT FROM AUTHOR]

Background: Current treatments for people with obesity emphasise the need for person-centred approaches that consider complex biopsychosocial factors and value the lived experience of people when attempting to lose weight. Methods: Narrative interviews (n = 20) were conducted with people living with obesity to explore the causes of their weight gain and their expectations and engagement with treatment at a Weight Management Clinic. A mixed inductive and deductive qualitative analysis identified utterances that represented psychological constructs used to understand self-appraisal and health behaviour. A narrative analysis was used to situate these findings in the context of a participant's life story. Results: Locus of control was a dominant construct evidenced through a person's attributional style and self-efficacy. Transcripts represented a heightened sense of self-understanding and shifts in control, and styles of attribution and efficacy resulted in either stasis or self-actualisation. The Stages of Change model could be applied to narratives to ascertain a patient's motivation to access treatment. Importantly, narrative interviews also allowed for the consideration of how a person's systemic context influenced their weight. Conclusion: Narrative interaction supports both self- and shared understandings of the causes and consequences of obesity for individuals, in a non-blaming or shaming manner. It provides an opportunity to enhance engagement through tailored, person-centred treatments. [ABSTRACT FROM AUTHOR]

Drawing on Elias's work on established-outsider figurations, stigmatisation and the civilising process, this study explores the narratives of women, who are mothers of children under the age of 18 years old, in one female prison in England, United Kingdom. We conducted 31 in-depth interviews as well as three focus groups with 26 different women, exploring their experiences of being an imprisoned mother as well as staying in contact with their children from prison. Moreover, we interviewed 15 members of staff. Our findings highlight the stigmatised 'outsider' nature that is ascribed to mothers in prison which is reinforced by the prison environment and figurations between mothers and prison staff. By highlighting the stigmatised and outsider positioning of mothers in prison, this research has significance for practice and policy. Improving support for imprisoned mothers and the development of non-stigmatising, more inclusive, compassionate institutions and compassionate responses are thus required. [ABSTRACT FROM AUTHOR]

The European Union and United Kingdom are in the process of establishing new regulation regarding the use of new genomic techniques in crop and animal breeding. As part of this process, consultations have been launched to understand the views of stakeholders towards the use of new genomic techniques in plant and animal breeding. The responsible research and innovation framework emphasises the importance of dialogue between technology developers and stakeholders, including the public, but what are the opinions of stakeholders towards the regulation of NGTs in Europe and do they view these consultations as opportunities to engage with technology governance? We conducted semi-structured interviews with experts from a range of agri-food stakeholder groups in the European Union and United Kingdom to understand current attitudes towards new biotechnology regulation, how they viewed the process of consultation in both places and what influence they felt they had in shaping regulations. We found that the discussion is similar in both EU and UK, with predictable and fixed opinions determined by attitudes towards the perceived risks associated with direct mutagenesis. Both UK and EU consultations were considered to have the same weaknesses and stakeholders discussed a desire for more dialogic forms of engagement. We highlight several options for new forms of involvement in biotechnology regulation by exploring relevant responsible research and innovation literature. [ABSTRACT FROM AUTHOR]

Autistic children and adolescents often have greater difficulty engaging in deception than their non-autistic peers. However, deception in autistic adulthood has received little attention to date. This study examined whether autistic and non-autistic adults differed in their inclination to lie in everyday situations and the factors that underpin this. Forty-one autistic and 41 non-autistic participants completed self-report measures relating to their inclination to lie, ability to lie and moral attitudes about the acceptability of lying. Participants also undertook a reaction-time test of lie-telling, as well as theory of mind and working memory measures. Autistic and non-autistic adults did not significantly differ in their inclination to lie in everyday situations. The degree to which lying was viewed as morally acceptable positively predicted both groups' inclination to lie. The remaining factors underpinning the inclination to lie differed between groups. Lower self-rated lying ability and slower lie speed predicted a reduced inclination to lie in autistic participants, whereas higher theory of mind and working memory capacity predicted a reduced inclination to lie in the non-autistic group. Implications for our understanding of deception in autistic and non-autistic adults are discussed. Differences in social communication and understanding others' mental states may mean that autistic adults are less likely to deceive others than non-autistic individuals. We investigated whether autistic and non-autistic adults differ in their inclination to lie and which psychological factors are involved in the inclination to lie. We found that autistic and non-autistic groups reported a similar inclination to lie, and the extent to which participants viewed lying as acceptable helped to explain their inclination to deceive others. However, the other underlying psychological factors associated with deception inclination differed between autistic and non-autistic groups. Autistic adults' belief about their ability to lie and also how quickly they could lie helped to explain whether they were more or less inclined to lie. For non-autistic adults, their memory and ability to understand others' mental states helped to explain their lie inclination. We discuss these findings and recommend areas for future research. [ABSTRACT FROM AUTHOR]

Secondary trauma arises through indirect exposure to trauma through engaging with first-hand accounts and narratives of traumatic events. While a significant amount of research has explored secondary trauma experienced by professionals who work with survivors of trauma, such as clinicians and front-line service providers, there is little research exploring the experiences of secondary trauma among violence researchers who routinely engage with traumatic first-hand accounts through their work. This study qualitatively explored violence researcher's professional experiences of secondary trauma and their perceptions of what enables and constrains their own coping and resilience. Participants were recruited using purposive sampling methods. Semi-structured interviews were conducted online with seven female violence researchers from the United Kingdom. Questions explored participant's experiences of secondary trauma symptoms related to their research, perceptions of their own coping and resilience, and experiences of organizational support that have enabled or constrained their resilience. Data were analyzed thematically using a coding framework applied reflexively across interview transcripts. All participants reported experiencing symptoms of secondary trauma from their work including cognitive disturbances; altered beliefs of themselves, others or the world; and challenges connecting with others. Participants' assessment of their own expertise in violence research did not generally impact their perception of their own resilience. Organizational support for violence researchers was rarely provided and participants felt generally unsupported—left to manage any resultant distress alone. Research organizations and universities should implement trauma-informed policies which positively transform workplace culture, provide peer support spaces, and conduct effective training in order to mitigate psychological harm and promote resilience among violence researchers. Support should be tailored to the requirements of violence researchers, and institutions should develop policies that are specifically attentive to the needs of researchers who also have lived experience of violence and abuse. [ABSTRACT FROM AUTHOR]

Given the importance of cultural continuity within the Indian culture, numerous studies have highlighted the challenges second-generation, Indian women endure, particularly in relation to decisions around romantic relationships. These challenges can have a psychological impact on the women, including an impact on their romantic relationship and with their families. The current study aimed to explore the lived experience of second-generation, Indian, Hindu (IH) women, living in the United Kingdom, who are in a heterosexual, cross-cultural, romantic (CCRR) relationship. Seven participants aged between 24 and 40 years were recruited. The participants were interviewed, and the data was analysed using Interpretative Phenomenological Analysis (IPA). From the data, three superordinate themes were identified: (1) "Predetermined Identity," (2) "The Two Worlds don't Meet," (3) "Enduring Challenges." Implications of the findings for clinical practice are discussed. The research explored the experiences of second-generation, Indian, Hindu women who were in a cross-cultural, romantic relationship. The results highlighted various tensions experienced by the women due to the opposing cultural systems they live in. The research adds to the limited research in the UK and can develop understanding in this area. [ABSTRACT FROM AUTHOR]

Introduction: Disparities in the uptake of routine and COVID‐19 vaccinations have been observed in migrant populations, and attributed to issues of mistrust, access and low vaccine confidence. Participatory research approaches and behaviour change theory hold the potential for developing tailored vaccination interventions that address these complex barriers in partnership with communities and should be explored further. Methods: This study used a theory‐informed, community‐based participatory research approach to co‐design a culturally tailored behaviour change intervention aimed at increasing COVID‐19 vaccine uptake among Congolese migrants in London, United Kingdom (2021–2022). It was designed and led by a community‐academic partnership in response to unmet needs in the Congolese community as the COVID‐19 pandemic started. Barriers and facilitators to COVID‐19 vaccination, information and communication preferences, and intervention suggestions were explored through qualitative in‐depth interviews with Congolese migrants, thematically analysed, and mapped to the theoretical domains framework (TDF) and the capability, opportunity, motivation, behaviour model to identify target behaviours and strategies to include in interventions. Interventions were co‐designed and tailored in workshops involving Congolese migrants. Results: Thirty‐two Congolese adult migrants (24 (75%) women, mean 14.3 (SD: 7.5) years in the United Kingdom, mean age 52.6 (SD: 11.0) years) took part in in‐depth interviews and 16 (same sample) took part in co‐design workshops. Fourteen barriers and 10 facilitators to COVID‐19 vaccination were identified; most barrier data related to four TDF domains (beliefs about consequences; emotion; social influences and environmental context and resources), and the behavioural diagnosis concluded interventions should target improving psychological capability, reflective and automatic motivations and social opportunities. Strategies included culturally tailored behaviour change techniques based on education, persuasion, modelling, enablement and environmental restructuring, which resulted in a co‐designed intervention comprising community‐led workshops, plays and posters. Findings and interventions were disseminated through a community celebration event. Conclusions: Our study demonstrates how behavioural theory can be applied to co‐designing tailored interventions with underserved migrant communities through a participatory research paradigm to address a range of health issues and inequalities. Future research should build on this empowering approach, with the goal of developing more sensitive vaccination services and interventions which respond to migrant communities' unique cultural needs and realities. Patient or Public Contribution: Patient and public involvement (PPI) were embedded in the participatory study design and approach, with community members co‐producing all stages of the study and co‐authoring this paper. An independent PPI board (St George's Migrant Health Research Group Patient and Public Involvement Advisory Board) comprising five adult migrants with lived experience of accessing healthcare in the United Kingdom were also consulted at significant points over the course of the study. [ABSTRACT FROM AUTHOR]

Mandatory standardized nutritional information on alcoholic drinks such as energy, or calorie labelling, is a population-level public health measure aimed at addressing obesity and alcohol consumption. In the UK, such measures are not a statutory requirement, but some alcohol brands do include references to calories on their products and in their marketing materials, as a marketing strategy to encourage sales and consumption. This article presents findings of semi-structured individual (N  = 43) and group (N  = 9) interviews with 78 women living in the UK that aimed to gain insight into their attitudes towards calorie-based alcohol brand marketing, and alcohol calorie labelling (ACL) as a health policy. Three themes are presented that outline how women rejected calorie marketing and labelling; the potential positive and unintended impact on alcohol consumption and dietary/eating practices; and how views on calorie labelling were intertwined with women's attitudes towards marketing that draws on calorie messaging. A feminist anti-diet discourse, as well as a discourse of pleasure through alcohol consumption, was at play in women's accounts, which may limit the intended aims of ACLs. It is concluded that ACLs should be considered within the wider commercial context of alcohol marketing that draws on calories to promote sales and consumption, consideration of the gendered factors that may lead some to reject ACLs as a health policy, and the potential for unintended consequences. [ABSTRACT FROM AUTHOR]

Identity loss and (re)construction forms a central debate in sociology of chronic illness. Living with chronic/persistent health conditions may raise questions about how disruptions can touch upon and further threaten the very roots of existence, by which people reflexively perceive a coherent and stable sense of 'being‐in‐the‐world'. Whilst medical sociologists have shown interest in 'existential loss' in chronic illness, this question remains largely underexplored. Adopting a qualitative study on Long COVID (LC) as an example, this article illuminates existential identity loss as a deeply painful experience of losing body as a fundamental medium to retain continuity and consistency of one's narratively constructed identity. Interviews with 80 LC sufferers in the UK revealed that living with persistent and often uncertain symptoms and disruptions can cause the loss of biographical resources and resilience, making it difficult to reflexively understand their own being within the world. Their dynamic responses to LC also highlighted how sufferers' longing for a narratively coherent self can profoundly shape the ongoing construction of their identity in chronic health conditions. These insights into the complicated and often hard‐to‐express existential pain of identity loss can also nurture more holistic understandings of and support for LC and chronic illness more broadly. [ABSTRACT FROM AUTHOR]

Identity has been empirically established as a recovery process from serious mental illness (SMI) yet is often overlooked within intervention evaluations. Community arts presents one such intervention with emerging evidence illustrating the potential for recovery to occur within this context. However, research indicates numerous mechanisms may be involved in the identity recovery process, making it difficult to determine what works, for whom and in what context. The current review aimed to generate new theories to explain how, why and in what context community arts enable the identity change recovery process for individuals with SMI. A realist review was conducted between January and September 2021, with 22 articles and reports reviewed and synthesised to develop a theory. A safe and empowering intervention context was found to be vital to activate three key mechanism pathways: (a) feeling in control of SMI through coping; (b) achieving acceptance through connectedness and (c) overcoming personal challenges. The outcome was the development of positive self‐awareness, which enables individuals to redefine identity beyond SMI through both social and personal identities. Novel insights are presented through theory development, utilising the Social Identity Approach to Health and Transformative Learning Theory to conceptualise the findings through a multi‐theoretical lens. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Organizational identification underpins a range of important outcomes in the workplace, including workers' well‐being. Drawing on the social identity approach to health (SIAH), here we explore whether certain organizational forms—specifically, organizational decentralization—can boost organizational identification and, in this way, employee well‐being. We test this possibility in four high‐powered samples of workers in the UK, US and Italy (N total = 1960). Results confirm that workers are more likely to identify with an organization when they perceive power to be decentralized. Importantly, we find the expected indirect effects between increased decentralization perceptions and ratings of improved well‐being (including job satisfaction, work engagement and reduced burnout) through organizational identification. These results were consistent across samples, proving the generality of the findings across different cultural contexts. Empirical and practical implications of shared decision‐making power to increase workers' well‐being are discussed. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Loneliness is a pernicious problem in older adulthood, associated with physical decline and isolation from valued social groups. However, the long‐term evolving experiences of ageing, identity and loneliness have yet to be elucidated. We use a Qualitative Longitudinal Research interview approach with nine vulnerable older adults (Agemean = 79.4 years), in which five participants were interviewed twice between 2019 and 2020, and four participants were interviewed at three‐time points from 2019 to 2021. This study aims to understand the unfolding experiences of ageing, social identity and loneliness during a prolonged period of social isolation during the Coronavirus pandemic. A theoretically guided thematic analysis highlights that participants initially experience 'Categorisation as Vulnerable and Loss of Agency' and 'Shrinking Social Worlds', leading to 'Undermining of Reciprocal Support' and 'Fears of Persistent Loneliness'. Findings suggest that interventions to ameliorate loneliness among older adults would benefit from addressing age‐based stereotypes and emphasising the value of reciprocal contributions that older adults can make to their networks, as well as scaffolding and enhancing social identification with new groups. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Wellbeing issues among international students in the UK higher education have been recognised as a crisis. To address this, we integrate social identity and felt understanding approaches to wellbeing and mental health, testing whether felt understanding (the belief that others understand oneself) is an important process through which social identity predicts better wellbeing, over and above other, more established mediators (social support, life meaning, and personal control). International university students (including both undergraduates and postgraduates, N = 301) completed an online survey that measured three sets of variables: social identity variables (ingroup identification, multiple identities, multiple identity compatibility); process variables (social support, felt understanding, life meaning, personal control); and wellbeing outcomes (e.g., depression, anxiety, stress). Path analyses confirmed that felt understanding predicted better wellbeing outcomes over and above the other mediators. Additionally, indirect effects from social identity variables to wellbeing via felt understanding were consistently significant, even when adjusting for the other mediators. The results are consistent with the idea that felt understanding is an under‐acknowledged resource through which social identities protect wellbeing. The findings contribute to "social cure" research and have implications for promoting wellbeing services from the perspective of group memberships. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

For people with social anxiety, ongoing exposure to feared situations is crucial for both treatment and the prevention of relapse. The COVID‐19 pandemic—with prolonged, often enforced, reductions in people's social contact—reduced such exposure and may thus have exacerbated social anxiety symptoms. In this three‐wave longitudinal study (N = 212) we explored whether people's membership in multiple groups could protect against anticipatory anxiety for, and avoidance of, social situations. In line with our predictions, pre‐pandemic multiple group memberships reduced anticipatory anxiety and avoidance at Waves 1 and 2 (June and August 2020). Controlling for participants' pre‐pandemic multiple group memberships, maintained group memberships (from pre‐pandemic to Wave 2) predicted lower Wave 2 anticipatory anxiety and avoidance, and lower Wave 2 anticipatory anxiety predicted reduced social anxiety symptoms at Wave 3. These findings are discussed with an emphasis on how social identity theorising and cognitive behavioural approaches to social anxiety can be successfully integrated. [ABSTRACT FROM AUTHOR]

COVID‐19 produced the largest mass mobilisation of collective helping in a generation. Currently, the impact of this voluntary activity is not well understood, particularly for specific groups of volunteers (e.g., new vs. existing) and for different amounts of voluntary activity. Drawing on social psychological work on collective helping, and work from the Social Identity Approach to Health, we seek to address this gap through an analysis of survey data from 1,001 adults living in the south of England (333 men; 646 women; age range = 16–85) during the first UK lockdown. Measures included time spent volunteering pre‐/post‐COVID, community identification, subjective wellbeing, and volunteering intentions. Those who volunteered during COVID‐19 reported higher levels of community identification than those who did not. However, subjective wellbeing benefits were only found for those volunteers who maintained the same level of volunteering (in terms of time) pre‐and post‐COVID lockdown. New volunteers showed significantly lower levels of wellbeing when they were undertaking 5 or more hours of volunteering a week. Our findings provide unique insight into the variable relationship with wellbeing for different groups of volunteers, as well as how the experiences and functioning of 'crisis' volunteering are different from volunteering during 'normal' times. [ABSTRACT FROM AUTHOR]

This article advances understanding of the relationship between (a) people's awareness of and (b) their attitudes toward the ways in which data about them is collected, analyzed, shared, and used. It draws on an online survey of 2000 adults in the UK, which found that people with greater awareness of data uses hold more negative attitudes toward them. This finding is important because it challenges the deficit model which underlies initiatives that seek to improve the public's attitudes toward and trust in institutional data uses through improved transparency or better data literacy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Research suggests that, following major changes in women's roles in developed societies, gender relations within heterosexual partnerships are entering a second stage, during which men's roles are the main source of change. Some scholars suggest that changes in gender roles occur differentially across social classes, as reflected in variation across educational groups. OBJECTIVE: We ask how variation in the educational level of both partners is related to: (1) gender role attitudes and housework contributions of each partner; and (2) consensus between partners on egalitarian gender role attitudes, and gaps between partners in housework hours. METHODS: Analyzing British Household Panel Survey and Understanding Society data on currently married, heterosexual partnerships in the United Kingdom (1992-2018) from a couplelevel perspective, we compare across four educational types defined by whether partners have a tertiary-level degree. RESULTS: We find that (1) it is not the male partner's but rather the female partner's tertiary education that is a key factor in understanding variation in partners' gender role attitudes and housework hours, as well as couple-level consensus on gender egalitarian attitudes and between-partner differences in housework hours; and (2) gender gaps in housework hours between partners are smallest among couples in which women are highly educated, primarily because highly educated women do substantially fewer hours than less educated women rather than because their partners do substantially more hours. CONTRIBUTION: Our results highlight that women's class status, as measured by their education (as distinct from their partner's), is related to meaningful variation within the household in terms of partners' values and day-to-day experiences of chores. [ABSTRACT FROM AUTHOR]

In the summer of 1939, Anglo-Japanese relations were extremely tense. A major change in the situation occurred with the signing of the Molotov-Ribbentrop Pact and the outbreak of World War Two. These events completely remodeled the existing system of alliances. Britain and Japan started to seek the possibility of rapprochement. However, due to a conflict of interests in China, the anti-Japanese attitude of the United States and general distrust in both countries towards each other, a reset in Anglo-Japanese relations could not be reached. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to report on the dynamics of "identity leadership" with a quality improvement project undertaken by an International Medical Graduate (IMG) from Sri Lanka, on a two year Medical Training Initiative (MTI) placement in the National Health Service (NHS) [Academy of Medical Royal Colleges (AoMRC), 2017]. A combined MTI rotation with an integrated Fellowship in Quality Improvement (Subedi et al., 2019) provided the driver to implement the HEART score (HS) in an NHS Emergency Department (ED) in the UK. The project was undertaken across ED, Acute Medicine and Cardiology at the hospital, with stakeholders emphasizing different and conflicting priorities to improve the pathway for chest pain patients. Design/methodology/approach: A social identity approach to leadership provided a framework to understand the insider/outsider approach to leadership which helped RH to negotiate and navigate the conflicting priorities from each departments' perspective. A staff survey tool was undertaken to identify reasons for the lack of implementation of a clinical protocol for chest pain patients, specifically with reference to the use of the HS. A consensus was reached to develop and implement the pathway for multi-disciplinary use of the HS and a quality improvement methodology (with the use of plan do study act (PDSA) cycles) was used over a period of nine months. Findings: The results demonstrated significant improvements in the reduction (60%) of waiting time by chronic chest pain patients in the ED. The use of the HS as a stratified risk assessment tool resulted in a more efficient and safe way to manage patients. There are specific leadership challenges faced by an MTI doctor when they arrive in the NHS, as the MTI doctor is considered an outsider to the NHS, with reduced influence. Drawing upon the Social Identity Theory of Leadership, NHS Trusts can introduce inclusion strategies to enable greater alignment in social identity with doctors from overseas. Research limitations/implications: More than one third of doctors (40%) in the English NHS are IMGs and identify as black and minority ethnic (GMC, 2019a) a trend that sees no sign of abating as the NHS continues its international medical workforce recruitment strategy for its survival (NHS England, 2019; Beech et al., 2019). IMGs can provide significant value to improving the NHS using skills developed from their own health-care system. This paper recommends a need for reciprocal learning from low to medium income countries by UK doctors to encourage the development of an inclusive global medical social identity. Originality/value: This quality improvement research combined with identity leadership provides new insights into how overseas doctors can successfully lead sustainable improvement across different departments within one hospital in the NHS. [ABSTRACT FROM AUTHOR]

The challenges of caring for children with early life adversity have been identified as contributing to feelings of compassion fatigue (CF)—an emotional disconnection resulting from repeated exposure to another's trauma. Although extensive studies have focused on contributors to trauma-inducing workplace stress and well-being, research on trauma-related stress in the home, especially in adoptive parent populations, is relatively underexplored. This study aimed to understand how adoptive parents make sense of their experiences of parenting adopted children, identify core components of CF, understand parents' perceptions of contributing factors and explore wider relational impacts. Parents were recruited from Adoption UK via email invite. Semi-structured interviews were conducted with twelve parents to form a holistic picture of adoptive parents' experiences. Data were analysed using Reflexive Thematic Analysis. Findings yielded three overarching and interrelated themes: (i) a parent not a therapist; (ii) strained connections; and (iii) support is a mirage. Findings support recent literature highlighting the reality of CF in adoptive parents and the need to develop more preventative structures and responsive systems of support adapted to the needs of adopted children but also the unique needs of their families to help prevent mental health crises across the family and adoption breakdowns. [ABSTRACT FROM AUTHOR]

Career research has focused on the changing structures of careers, mainly in the private sector. Recent literature on employment patterns in the public sector suggests that career structures are evolving, gradually moving away from their signature traditional structures to contemporary ones. However, empirical evidence of this change is scarce and inconclusive. This qualitative study examines the changes currently unfolding in the career structure of the civil service by eliciting the experiences and views of senior Foreign Offices (FOs) staff in four countries: 198 state ambassadors from the United States, the United Kingdom, Israel, and Denmark were interviewed about their career trajectories. The data were analyzed using a thematic analysis framework. The findings revealed a gradual breakdown of the structures and policies that support traditional careers, and the emergence of new principles and practices that characterize contemporary careers. However, as they were captured midway through the process of change, all FOs display a combination of traditional and contemporary career structures at this point. The findings offer unique insights into the drivers of this evolution and highlight some of the consequences. [ABSTRACT FROM AUTHOR]

The scholarly literature on US–UK relations has been marked by recurrent debate over the health and utility of the special relationship, recently enlivened by the policy tensions and political turbulence of the Trump presidency. The literature has also seen a social and cultural 'turn', with a growing focus on the broader linkages between the two countries' societies and cultures. However, there has been limited analysis of public opinion in Britain in recent scholarly research. This article examines the 'image of America' in British public opinion in the twenty-first century, across recent Republican and Democratic presidencies. It uses data from the annual Pew Global Attitudes survey series and Transatlantic Trends survey series to undertake systematic analysis of these quantitative data sources. It examines the following areas: the performance and policies of presidents from Bush to Biden, the US and its people, the state of bilateral relations, and NATO. It examines aggregate-level opinion and also pays close attention to views across different societal groups, based on demographic characteristics, party support and left–right ideology. The paper makes a significant and distinctive contribution to scholarly research into US–UK relations. [ABSTRACT FROM AUTHOR]

This article explores the experiences of some Black South African families affected by international migration. Historically, emigration from South Africa has occurred in waves, and has been associated with specific political moments. Such migration has often been perceived as a predominantly "White phenomenon", but recent trends reveal a more complex picture. Prior research on Black migration has focused primarily on internal labour migration, exilic migration and the "brain drain" phenomenon of medical professionals. So far, little research has been done on the impact of international outward migration on the Black family system. This article addresses this gap, drawing on a larger qualitative project exploring the impact of South African emigration on elderly family members staying behind. The findings highlight the significance of close relational ties in the Black South African family system. Familial separation through emigration brings feelings of loss and apprehension for the wellbeing of family members living abroad, including potential racism in destination countries. Migrants abroad highlighted the value of family and of maintaining a Black South African identity, despite separation from the country of origin and the extended family. Significantly, migration is often perceived as a temporary state, in contrast to White South African counterparts. Given increased international migration, the results shed light on the interplay between racial identity and emigration, and the impact of international migration by Black South Africans on family that they leave behind. [ABSTRACT FROM AUTHOR]

Purpose: This paper presents qualitative research findings from the evaluation of a Parkinson's Dance well-being venture in the UK. Methods: Qualitative data was gathered to see how bespoke dancing sessions helped people with Parkinson's (PwP) to manage their conditions and improve their lives and prospects. Principles of a participatory approach were incorporated and methods included semi-structured interviewing, researchers participant observation and an elicitation-based activity. Nineteen PwP, six carers, four dance artists and seven helpers participated in the study. Results: Participating in Parkinson's Dance sessions meant that PwP could experience the possibilities to dance, develop a "can do" attitude, experience fun, enjoyment, social connection, exercise, movement to music, improvement and/or maintenance of their balance, suppleness, coordination and confidence with movement, symptoms being pushed back and ability to learn new things. Conclusions: Our findings add to the evidence-base about the benefits of dance for people experiencing Parkinson's and through novel application of the Life-world based well-being framework of K. T. Galvin and Todres (2011) we propose a theoretical basis for Parkinson's Dance as a resource for well-being. There is scope to consider application of the well-being framework to other arts activities and as the basis of an arts and well-being evaluation tool. [ABSTRACT FROM AUTHOR]

To assess orthodontic clinicians' knowledge and attitudes towards dentogingival aesthetics and to explore characteristics that predict the knowledge of dentogingival aesthetics. Cross-sectional questionnaire On-line survey of members of the British Orthdontic Society. An 11-item online questionnaire was sent to orthodontic practitioners for completion. The questionnaire covered respondent demographics and questions relating to both knowledge and attitudes towards dentogingival aesthetics (six parameters). Descriptive statistics were calculated for study characteristics and summary values for the survey items. Responses to the eight knowledge-based questions were converted to a binary outcome (correct and incorrect answer). The maximum score that could be achieved was eight. Multivariable modelling was used in order to examine associations between the study characteristics and the aggregate score. A total of 252 responses were obtained resulting in a response rate of 17%. Within this cohort, the respondents were primarily women (52.8%) and aged 30–40 years (35.7%). The mean score for the eight knowledge-based questions was 3.8 ± 1.8 (range = 0−8). Knowledge of the ideal gingival margin position of the anterior teeth was high (92.4%). Knowledge of the other five dentogingival aesthetic parameters was variable. In the multivariable analysis, lower knowledge scores were predicated by respondents who did not have a special interest in dental aesthetics (−0.54; 95% confidence interval [CI] = −1.01 to −0.07; P = 0.02), who could not recall attending courses, lectures or seminars on dental aesthetics in the past five years (−0.80; 95% CI = −1.43 to −0.17; P = 0.01) and with increasing age (−0.43; 95% CI = −0.62 to −0.23; P < 0.001). Knowledge of ideal dentogingival parameters is generally suboptimal among orthodontists in the UK. The reported lack of knowledge of the ideal dentogingival parameters may also influence respondents' attitudes towards the importance of dentogingival aesthetics. Further teaching or courses related to dentogingival aesthetics is desired by orthodontic clinicians. [ABSTRACT FROM AUTHOR]

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