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People living with dementia have the same right to well-being as anyone else, including physical activity. Yet, physical activity levels among people with dementia are lower than in the general population, and while the physical activity health benefits are well established, little is known about how people living with dementia experience physical activity. To explore these physical activity experiences, we visited six community settings in one English county and conducted informal interviews with 18 people who were either living with dementia and community dwelling (n = 4), caring for or who had cared for someone with dementia (n = 10), or providing a support service for people living with dementia and their carers (n = 4). Findings highlight both the challenges and facilitators presented by organized groups, service provider skills and qualities, and environmental factors. Additionally, these factors were influential in shaping the physical activity experience of people living with dementia. The findings may be relevant for people providing or planning support services, commissioners, policymakers, and researchers. [ABSTRACT FROM AUTHOR]

Purpose: The traditional understanding of how coaches plan for sporting performance is rooted in the assumption that coaches create periodized plans underpinned by physiological principles, thereby providing scientific credibility to their work. In contrast, there remains a paucity of literature exploring how coaches understand or think about their planning practices. The purpose of this study was to generate new knowledge regarding what information coaches actually consider within their planning processes and how they actually approach the task of planning. Method: Using rigorous, in-depth interviews, this study examined athletics coaches' understandings of their everyday planning practices, in an attempt to contribute to narrowing the gap between academic research and real-world application. Twenty-eight highly experienced, high-performance track-and-field coaches based in England (female, n = 1; male, n = 27) were recruited. The coaches were from the throwing disciplines (n = 10) and endurance running (n = 18). Coaches were interviewed about their planning process, using a maximum of 3 semistructured interviews per coach, spaced across a full athletics season. In total, this generated 68 hours of data. Results: The analysis demonstrated that, while the participant coaches utilized the principles of periodization, their planning activities were not limited to this issue. The findings highlighted how the coaches conceptualized successful athletic performance in a holistic way; that is, planning is multifaceted in nature. Conclusion: This study presents a holistic picture of the complexity of coaches' planning, detailing the considerable time and attention given to planning for athletes' psychological, personal, and social development, to enhance athlete performance and development. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether menstrual-cycle symptoms are associated with sleep in elite female athletes. Methods: Sleep was assessed for a minimum of 25 nights (range = 25–31) using activity monitoring and sleep diaries. Menstrual-cycle symptoms were collected over the same duration in 12 elite female professional soccer players. Generalized estimating equations were used to examine the relationship between the day of the menstrual cycle (from day 1) and total menstrual-cycle symptoms on sleep characteristics. Results: There was a significant relationship between sleep duration and the day of the menstrual cycle (P =.042) and total symptoms reported that day (P <.001), with sleep duration increasing by 21 minutes for every symptom reported. There was a negative day × symptom interaction on sleep duration (P =.004), indicating that with increased symptoms, the day of the menstrual cycle had a smaller relationship with sleep duration. Sleep efficiency (P =.950), wake after sleep onset (P =.217), and subjective sleep quality (P =.080) were not related to the day of the menstrual cycle. The total symptoms reported had no relationship with sleep efficiency (P =.220), subjective sleep quality (P =.502), or sleep latency (P =.740) but did significantly relate to wake after sleep onset (P <.001), with a significant day × symptom interaction (P <.001). Conclusions: Sleep duration increased from day 1 of the menstrual cycle and was associated with the number of menstrual-cycle symptoms reported. All other sleep metrics remained unchanged; however, total symptoms reported were related to wake after sleep onset. Monitoring and managing menstrual-cycle symptoms should be encouraged due to a potential relationship with sleep characteristics. [ABSTRACT FROM AUTHOR]

Dementia-friendly communities (DFCs) are a policy-endorsed approach to community engagement in England that promotes social inclusion to enable people affected by dementia to live well. Research suggests that physical activity is beneficial in encouraging social connection and improving health. A mixed method sequential study design in England involving a national survey (n = 31) and semistructured interviews (n = 65) in three DFCs was carried out. The aim was to understand how DFCs enable people affected by dementia to participate in physical activities. An evaluation framework for DFCs was used to organize and interpret the data, and analysis was informed by the inclusive (social) citizen lens. Findings showed that DFCs offered a range of adapted dementia-inclusive and dementia-specific activities; however, people were not routinely offered information at time of diagnosis. Local authorities (councils) were key to enable access to information and infrastructure change to support sustainable inclusion within their local community. [ABSTRACT FROM AUTHOR]

Background: Integrated curriculum interventions have been suggested as an effective means to increase physical activity (PA) and health. The feasibility of such approaches in children living in deprivation is unknown. This study sought to pilot an integrated curriculum pedometer intervention in children living in deprivation on school-based PA, body fatness, resting blood pressure, motor skills, and well-being. Methods: Using a pilot cluster randomized intervention design, children (6–7 y old, n = 64) from 2 schools in central England undertook: (1) 10-week integrated curriculum intervention or (2) control (regular school-based activity). School-based PA, body fatness, resting blood pressure, motor skills, and well-being were assessed preintervention and postintervention. Results: For the intervention group, PA was higher on school days when children had physical education lessons or there were physically active integrated curriculum activities. Body fatness significantly decreased, and well-being and perceived physical competence increased, pre–post for the intervention group compared with the control group. Accelerometer-derived PA, motor skills, and resting blood pressure were not significantly different pre–post for intervention or control groups. Conclusions: A 10-week integrated curriculum PA intervention is feasible to conduct and can positively impact aspects of health in 6- to 7-year-old children in England. [ABSTRACT FROM AUTHOR]

Purpose: Whole-of-school approaches to physical activity (PA) promotion are recommended internationally, but there remains little descriptive research detailing the implementation of such approaches, especially at the secondary level. The purpose of this case study, which drew upon a social-ecological perspective, was to examine a whole-of-school approach used by one secondary school in England. Method: Participants (N = 30) included three members of the school's senior leadership team, eight teachers, 15 students, and four parents. Data were collected during 5 months using open-ended questionnaires that all participants completed, 14 staff interviews with staff, three focus groups with students, six observations, and attendance records from various PA opportunities. Results: Thematic analysis identified five key PA opportunities and uncovered four themes in relation to these opportunities: Student Autonomy, Support from Leadership, New School, and Physical Education Time. Discussion/Conclusion: This study highlights the importance of targeting multiple levels of influence when implementing whole-of-school PA programming. [ABSTRACT FROM AUTHOR]

Although guilt is often considered the most prevalent emotional outcome of work–family conflict (WFC), most work–family research focuses on family‐related guilt stemming from work interference with family, rather than job‐related guilt stemming from family interference with work (FIW). In addition, there is little understanding of how different employee social groups experience the implications of FIW in their daily lives. To address these research gaps, this study explores the relationship between daily FIW and job‐related guilt, and its subsequent impact on job satisfaction. It also investigates variation in these relationships by (1) gender and (2) the intersection of gender and ethnicity. Bayesian multilevel structural equation modeling using data from 5‐day diary surveys from 210 solicitors in Britain shows daily FIW is associated with higher job‐related guilt and subsequently lower job satisfaction. The relationship is stronger for women than men in general, but is also stronger for South Asian women than white British women (and men), and for South Asian men than white British men. This suggests that studies focusing on single social group characteristics (e.g., gender) are likely to obscure intersectional effects that might produce significant within‐group variation. The findings also highlight the importance of integrating workplace inequality arguments into theorization of WFC. [ABSTRACT FROM AUTHOR]

Background: Between 2018 and 2025, a national implementation programme is funding more than 500 new mental health support teams (MHSTs) in England, to work in education settings to deliver evidence-based interventions to children with mild to moderate mental health problems and support emotional wellbeing for all pupils. A new role, education mental health practitioner (EMHP), has been created for the programme. Aims: A national evaluation explored the development, implementation and early progress of 58 MHSTs in the programme's first 25 'Trailblazer' sites. This paper reports the views and experiences of people involved in MHST design, implementation and service delivery at a local, regional and national level. Methods: Data are reported from in-depth interviews with staff in five Trailblazer sites (n = 71), and the programme's regional (n = 52) and national leads (n = 21). Results: Interviewees universally welcomed the creation of MHSTs, but there was a lack of clarity about their purpose, concerns that the standardised CBT interventions being offered were not working well for some children, and challenges retaining EMHPs. Conclusions: This study raises questions about MHSTs' service scope, what role they should play in addressing remaining gaps in mental health provision, and how EMHPs can develop the skills to work effectively with diverse groups. [ABSTRACT FROM AUTHOR]

Introduction: Workplace trauma in mental health settings is defined as exposure to verbal and physical aggression, witnessing self-harm or hearing about patients' histories of abuse. Support for workplace trauma is important for staff well-being, staff retention and ultimately patient care. Assessing the extent and adequacy of staff support for workplace trauma in mental health settings is important in identifying areas of need and good practice. Aim: To determine what staff support systems are in place for workplace trauma in mental health services across England. Methods: Freedom of Information Act requests were sent to all 57 National Health Service Trusts providing mental health care in England to identify policies on the support to mental health staff after traumatic incidents that they have experienced in the course of their clinical duties. Results: Fifty-five Trusts provided usable data. Only half provided evidence of a psychologically informed incident response that went beyond a fact-finding exercise and only a fifth of Trusts used an established model for the response process. A small proportion of policies acknowledged workplace traumas related to staff discrimination on the basis of protected characteristics. Conclusion: There is insufficient attention to supporting mental health staff with the effects of workplace trauma. [ABSTRACT FROM AUTHOR]

The paper presents a comparative mixed methods study of the accessibility and usability for disabled people of four video conferencing tools, Zoom, MS Teams, Google Meet and Skype. Useable responses were obtained from 81 disabled people with diverse characteristics, mainly in the UK, though some groups had low representation. None of the tools was considered fully accessible and useable. Zoom was both the most commonly used and the most frequently preferred (56.1%) tool, with MS Teams second in usage and a trailing second in preferences (15.9%). It was considered to have better captioning, but otherwise to generally be a poor second to Zoom. Skype was the most commonly used before lockdown, but was considered dated and its limited use was mainly social, whereas the other tools were also used in work and education. The results were used to draw up separate lists of recommendations for developers and meeting organisers and hosts, as the study also identified actions for organisers and hosts to improve meeting accessibility. Developer recommendations include several easy to set customisation and user friendly interface features, involving disabled people and specific accessibility features, including compatibility with assistive technology, keyboard shortcuts for all functions and automatically-on high quality captions. [ABSTRACT FROM AUTHOR]

Objectives The National Health Service in England funds 12 months of weekly s.c. tocilizumab (qwTCZ) for patients with relapsing or refractory GCA. During the coronavirus disease 2019 (COVID-19) pandemic, some patients were allowed longer treatment. We sought to describe what happened to patients after cessation of qwTCZ. Methods Multicentre service evaluation of relapse after stopping qwTCZ for GCA. The log-rank test was used to identify significant differences in time to relapse. Results A total of 336 GCA patients were analysed from 40 centres, treated with qwTCZ for a median [interquartile range (IQR)] of 12 (12–17) months. At time of stopping qwTCZ, median (IQR) prednisolone dose was 2 (0–5) mg/day. By 6, 12 and 24 months after stopping qwTCZ, 21.4%, 35.4% and 48.6%, respectively, had relapsed, requiring an increase in prednisolone dose to a median (IQR) of 20 (10–40) mg/day. 33.6% relapsers had a major relapse as defined by EULAR. Time to relapse was shorter in those that had previously also relapsed during qwTCZ treatment (P  = 0.0017), in those not in remission at qwTCZ cessation (P  = 0.0036) and in those with large vessel involvement on imaging (P  = 0.0296). Age ≥65 years, gender, GCA-related sight loss, qwTCZ treatment duration, TCZ taper, prednisolone dosing and conventional synthetic DMARD use were not associated with time to relapse. Conclusion Up to half our patients with GCA relapsed after stopping qwTCZ, often requiring a substantial increase in prednisolone dose. One-third of relapsers had a major relapse. Extended use of TCZ or repeat treatment for relapse should be considered for these patients. [ABSTRACT FROM AUTHOR]

The article discusses the 2024 Nursing Ethics Conference held at Brunel University in London, UK, focusing on the theme "Ethics, Care, and the Workforce Crisis." It mentions that students from Brunel University and the University of Genoa shared reflections on the conference, highlighting key topics such as the importance of education in addressing workforce crises, the role of ethical leadership, and the impact of technology and Artificial Intelligence (AI) in healthcare.

Aims: People with a learning disability are at increased risk of becoming homeless, but little is known about how learning disability is viewed by people accessing homeless services. This study aimed to obtain the views of people experiencing homelessness about learning disability, in the context of a project that was exploring how to increase identification of learning disability. Methods: A qualitative approach was used, and 19 adults were interviewed who were receiving support from homeless services in the North-East of England. Information from the interviews was analysed using thematic analysis. Results: Four themes were identified relating to understanding of learning disability, the role of identification, day-to-day challenges, and experiences of services. Conclusion: There is a need to: promote better understanding of learning disability; for early identification processes that involve the person in a meaningful way; and the provision of support that is non-stigmatising, practical and which addresses health concerns. [ABSTRACT FROM AUTHOR]

Similar to a number of arts and cultural sector industries, the COVID-19 pandemic deeply affected the performing arts sector. Whilst research has focused on the impact on the industry and on freelance workers and performing artists during the lockdowns, this article investigates how the COVID-19 pandemic affected the resilience of permanently employed workers in the performing arts industry (not performers or performing artists) based in England, UK as the performing arts industry re-opened in 2021/22. Utilising a qualitative approach (via semi-structured interviews), this paper establishes the factors that affected the resilience of these workers in England and explores the effect of the COVID-19-related closures and subsequent re-openings on the resilience of the performing arts workers. The study finds that the participants reported maladaptive or coping behaviours rather than resilience behaviours and described a discomfort at having to be personally resilient in the absence of organisational resilience. [ABSTRACT FROM AUTHOR]

During the late-twentieth century there was a significant increase in the number of museums in the UK. Apart from the polemic heritage debates of the 1980s and 1990s, the boom in museums was not much investigated. Our project "Mapping Museums" collected and analysed data on over 4000 UK museums that were open in the period from 1960 to 2019. Here we present our findings. We show that the number of museums increased from around 1000 to a highpoint of 3360 in 2016, that the sector continuously expanded for 55 years, but that the rate of growth and closure varied depending on the museums' size, governance, subject matter, and location. Small and medium museums proliferated, as did independent museums; growth in the South of England far out-paced that in the North; local history museums multiplied and new subjects came on stream. The museum boom re-shaped the sector. [ABSTRACT FROM AUTHOR]

In England and Wales, Approved Mental Health Professionals (AMHPs) have the ultimate responsibility, based on doctors' medical recommendations, for deciding to detain a person, without consent, under the Mental Health Act (1983). The work can be traumatic, yet its emotional impacts are often unacknowledged. Consistent themes include erratic levels of supervision and an overdependence on peer support, despite the longstanding recruitment and retention difficulties arising from high levels of stress and burnout. This article draws on findings from two research projects with AMHP services: one a national study using questionnaires and focus groups, and the other a doctoral research study using ethnography. Findings suggest that a lack of peer support, teamwork and debrief opportunities, exacerbated during the COVID-19 pandemic, intensified stress and burnout ('buckling under') as well as undermining socialising opportunities for trainees. AMHPs used metaphoric language to articulate their difficult experiences. Workplace environments including hot-desking and lone working may undermine casework discussions, social relations, informal peer support and supervision. Overall, AMHPs perceive their teammates as an essential source of support (a 'safety net') without which there are negative implications for practice. Ultimately, stress is exacerbated when there is no space to reflect and no team to do this with. [ABSTRACT FROM AUTHOR]

There is recognition that teams act as a locus for the sensemaking activity that underpins social workers' judgement. Research has highlighted that teams also provide emotional support for practitioners. Although sensemaking involves emotional and social processes, there has been limited examination of how emotional support in teams interacts with sensemaking. This article uses the Team as Secure Base (TASB) model as a framework for presenting findings from an ethnographic study of four social work teams in England. Data comprise interviews with social workers and supervisors (n = 22) and fieldnotes from observations (n = 23). Teams exhibited behaviour consistent with the domains of TASB, creating a space for safe exploration of social workers' thoughts and feelings. However, while a strong sense of team membership contributed to participants' sense of safety and self-efficacy, this impacted on sensemaking in other ways, such as giving less weight to the views of those who were not team members. [ABSTRACT FROM AUTHOR]

This paper provides an exploration of a non-hierarchical model of discipline observed in one Secondary School in the North-East of England, that employed the whole-school use of Restorative Practice enhanced by vertically structured Coaching Groups. This model supported a school community characterised by working restoratively with others to achieve an environment of high challenge-high support (Wachtel, 2013). Drawing on an original evaluation of Embedding Restorative Practice in Schools (Warin & Hibbin, 2020), the 'Distributed Network of Relational Accountability' (Hibbin & Warin, 2021) that this school created was based on relationship over authority and collective accounts of responsibility over individualised notions of blame. This model is described and unpacked, to understand how such a relationship-centred approach to behaviour that disrupts traditional ways of engaging with discipline in school, can be implemented and sustained over time. Key themes in relation to the modelling and practice of pro-social skills within the context of Coaching, and the democratization of the disciplinary system through discernment and knowing the child, are explored. It is suggested that such practice that is based on notions of Relational Responsibility (McNamee & Gergen, 1999) alongside a whole school ethos of care (Warin, 2017) fosters commitment, pro-social ability and ultimately leads to more democratic versions of Restorative Practice. In addition, it supplies both students and teachers with important opportunities for community building and disclosure, through exposure to diversity within the secure family base of the Coaching Group. [ABSTRACT FROM AUTHOR]

In Spring Term 2021 following the second school closure and third lockdown in England, educational recovery and catch-up were key concerns for secondary schools. Following teacher interviews regarding wellbeing in secondary school teaching practice in Winter 2020–21, teachers from 10 schools (n = 18) took part in focus groups and interviews to explore their understandings of practice for wellbeing in the classroom, and how the circumstances of the school return were impacting these understandings and experiences, mid-pandemic. Teachers reported their perspectives for reflexive thematic analysis. As with other reports of school recovery post-disaster, re-establishing the safety of normality and routine was considered key. Yet promises of a 'new normal' sensitive to the already concerning landscape of youth wellbeing and mental health in the UK were soon re-prioritised as a focus on 'catch up' and re-establishing performance goals within-subject disciplines. Accounts of challenging student behaviour and teacher stress were elevated but met with a response that focused on the role of teacher as purveyor of subject knowledge rather than care-givers. The duty of schools in providing trauma-informed cultures was also under-recognized, though relevant to the needs articulated by teachers in this study. [ABSTRACT FROM AUTHOR]

Based on a longitudinal and ethnographic study, this research examines how women experience the emotional aspects of their maternal foodwork in England across social classes. Maternal foodwork is linked to guilt and anxiety due to intense gendered and class-related ideals of proper feeding within the context of responsibilising discourses. This article contributes to the literature by introducing a temporal perspective, exploring how emotions beyond anxiety transform as caregiving arrangements evolve over time. It reveals that middle-class mothers adopt a downscaling strategy to counter maternal guilt when maintaining the standards set by intensive feeding ideology proves to be challenging with time. Working-class mothers adopt the same strategy to counteract feelings of inadequacy tied to persistent institutional surveillance and the challenge of embodying middle-class dispositions. The study underscores women's capacity to cultivate agentic responses, albeit within the boundaries of their class habitus, crafting pockets of resistance against intensive feeding ideals. [ABSTRACT FROM AUTHOR]

The 2021 Census of England and Wales was one of the first in the world to ascertain the gender identity of an entire population. This article argues that its results are implausible with regard to geography, language, education, ethnicity, and religion. The results contradict data on referrals to gender clinics and signatures on a pro-transgender petition. The results are also internally inconsistent when the various categories of gender identity are correlated across localities, and when compared with sexual orientation. The spurious results were produced by a flawed question, which originated with a transgender campaigning organization. The question evidently confused a substantial number of respondents who erroneously declared their gender identity to differ from their natal sex. Confusion is manifested in the overrepresentation of people lacking English proficiency in the most suspect gender categories. These findings demonstrate how a faulty question can distort our apprehension of the social world. [ABSTRACT FROM AUTHOR]

The rise in students entering higher education in England with vocational qualifications, or a blend of academic and vocational qualifications, has sparked debate about the correlation between qualifications and degree outcomes. Focusing on Sport and Exercise Science students and mobilising Bourdieu's theory of practice, this paper explores 'misrecognition' of the problem alongside intersectional explanations of differential attainment. Students' concerns about independent study and levels of support, different modes of delivery, and assessment types, exemplify misalignment between their cultural capital and habitus and the tacit demands of the university. Yet these misalignments are not explained merely by the Level 3 qualification they studied. We argue that the institutional culture (habitus) of sixth form colleges is better aligned with universities than is the culture of Further Education colleges. This alignment facilitates a smoother transition and leads to improved degree outcomes. So, it is partly the context in which students study, and not simply the qualification type, that matters. This problem of variable alignment of learning cultures at the transition to university is more relevant that ever given the introduction of T-Levels and the proposed Advanced British Standard. [ABSTRACT FROM AUTHOR]

Community‐based intensive home treatment (IHT) is delivered as an alternative to psychiatric hospital admission as part of crisis resolution services. People receiving IHT present with complex mental health issues and are acutely distressed. Home treatment options are often preferred and there is evidence of service fidelity, although less is known about psychosocial care in this setting. Underpinned by a critical realist epistemology, this study aimed to explore psychosocial care in the context of home treatment from the perspectives of staff, service users and family carers. Data were collected using individual interviews and focus groups in two NHS organisations in England. An inductive qualitative thematic analysis resulted in five themes focused on (1) the staffing model and effective care provision, (2) the organisation of work and effective care provision, (3) skills and training and service user need, (4) opportunities for involvement and personal choice, and (5) effective communication. Findings suggest that co‐production may improve congruence between IHT service design, what service users and carers want and staff ideals about optimal care. Service designs that optimise continuity of care and effective communication were advocated. Staff training in therapeutic interventions was limited by not being tailored to the home treatment context. Evidence gaps remain regarding the most effective psychosocial care and related training and supervision required. There is also a lack of clarity about how carers and family members ought to be supported given their often‐crucial role in supporting the person between staff visits. [ABSTRACT FROM AUTHOR]

Background and Aims: Pathways of transitioning from tobacco smoking to vaping after receiving an e‐cigarette‐based smoking cessation intervention have been minimally explored. Study aims: 1) identify pathways between intervention delivery and final follow‐up; 2) describe baseline and post‐intervention statistical data in relation to smoking/vaping behaviour of the different pathway groups; 3) explore qualitative participant perspectives contextualising pathway groups. Design: Embedded mixed‐methods analysis of data collected for the Cessation of Smoking Trial in the Emergency Department (COSTED) randomised controlled trial. Setting: Recruitment from 6 Emergency Departments (5 in England and 1 in Scotland) between January and August 2022. Participants: 366 adult smokers who were randomised to receive the COSTED intervention and provided data at 6‐month follow‐up. Qualitative subsample of 24 participants interviewed after follow‐up. Interventions: Brief smoking cessation advice, provision of an e‐cigarette starter kit and referral to the local Stop Smoking Service. Measurements: Descriptive statistical reporting of identified pathways and smoking/vaping behaviour at baseline and 6‐month follow‐up. Semi‐structured phone/video interviews analysed thematically. Findings 13.4% (n = 49) of participants quit smoking within 1 month of receiving the intervention, 19.1% (n = 70) quit between 1 and 6 months, 24.9% (n = 91) reduced cigarettes per day (CPD) by at least 50%, and 42.6% did not experience a significant smoking reduction. Approximately a third of participants who quit reported not vaping at follow‐up. Reporting dual use was associated with a reduction in CPD. Appoximately a third reported experimenting with a different device to the one provided as part of the intervention. Quitters reported themes of satisfaction with vaping, changes in environment facilitating quitting and motivation to quit. Conclusions: Dual use of cigarettes and e‐cigarettes can result in a reduction of smoking and may prelude quitting smoking. Sustained e‐cigarette use is not always necessary for quitting success. Success depends on personal context as well satisfaction with vaping. [ABSTRACT FROM AUTHOR]

The Office for Standards in Education, Children's Services and Skills (Ofsted) inspects and reports on the quality and effectiveness of educational provision in England. This research explores the extent to which non-mandatory curricular outdoor learning was recognised and reported by Ofsted in their inspections of state-maintained English primary schools (3–11 years) between September 2019 and February 2020. The data obtained from published reports (n = 629) using key word searches indicate mainly positive outcomes for pupils who have opportunities for outdoor learning (42% of reports). Seventy-two percent of comments related to the Early Years Foundation Stage (3–5 years) where access to an outdoor environment or planned daily outdoor activities is a statutory requirement. Inspectors reported on learning and enjoyment outcomes although some identified the need to develop quality outdoor space and learning. The data provide a proxy measure for the extent, nature and status of outdoor learning at a national level. [ABSTRACT FROM AUTHOR]

The article presents letter to the editor focuses on the increasing pressure faced by general practice (GP) in England, exacerbated by a growing workload and diminishing workforce. Topics include the rise in the number of GP appointments, the increasing complexity of patient care, and the rise of remote consultations that, while improving productivity, pose safety risks for patients.

This paper presents quantitative and qualitative findings from an interdisciplinary research project exploring student teachers' positive perceptions of people on the autism spectrum. The set of findings reported in this paper asked 704 student teachers from one university in England (n = 191), Finland (n = 251) and Sweden (n = 262) to write down the first three words they thought of to identify the characteristics of people on the autism spectrum. Data was analysed using a multi-layered, deductive co-rated coding approach. Through this approach repeated words were extracted as were negative and undetermined words, leaving only positive words. Examination of the positive words identified found differences in the manner student teachers focus on the positive characteristics of people on the autism spectrum as this is an understudied area of research. Finnish student teachers more frequently used language to describe the positive characteristics of people on the autism spectrum that reflected their perception of learning being their primary professional role. However, English and Swedish student teachers used language that showed they perceived their role as encompassing the social and emotional development of their pupils, with little reflection about the positive characteristics of people on the autism spectrum as learners. [ABSTRACT FROM AUTHOR]

Aim(s): The aim of this study is to understand factors that challenge retention and support nurses to stay in general practice. Background: One in four general practice nurse positions in England expected to be left unfilled within the next 10 years. Cultural and structural issues associated with working in general practice have been linked with nurses leaving general practice, re‐evaluating their professional futures, adjusting work‐life balance and bringing forward retirement. This has implications for the future of the general practice nursing workforce and patient care more broadly. Design: Exploratory qualitative interview study funded by the General Nursing Council Trust for England and Wales. University of York ethics approval (Ref: HSRGC/2023/586/A) was gained in September 2023. The study will be conducted between September 2023 and August 2024. Methods: Qualitative interviews will be conducted with a range of nurses working in, or who have worked in, general practice as well as nurse leaders associated with general practice across England and Wales. Recruitment will be via professional and social media networks and snowballing techniques. We aim to purposively recruit 30–40 participants for maximum variation. Cultural and structural influences which may contribute to retention decisions will be explored. Data will be analysed following framework analysis. Discussion/Conclusion: This study will explore how underpinning cultural and structural issues may impact on retention of this highly skilled professional group and identify factors to support retention. Implications for the Profession and/or Patient Care: By exploring factors that support or discourage nurses to remain in general practice, retention strategies can be better planned on order to address the general practice nursing workforce crisis. Impact: What problem did the study address? This study will address the retention crisis in nursing in general practice by exploring how cultural and structural issues may impact on retention of this highly skilled professional group and identify factors to support retention. Where and on whom will the research have an impact? From the study findings, recommendations will be developed to inform future policy and practice. Key factors to address attrition will be generated to support employers and policy makers in future primary care workforce planning, as well as supporting nurses, at an individual level, in negotiating their roles in practice. Reporting Method: Standards for Reporting Qualitative Research (O'Brien et al., 2014). Patient or Public Contribution: As this is a workforce study protocol, there is no patient or public contribution. [ABSTRACT FROM AUTHOR]

Research to date has focused on the potential issues arising from chemsex and often seeks to uncover what is 'wrong' with those who are motivated to engage in chemsex. Critical chemsex studies reaches beyond this harm-orientated focus and instead adopts a social justice approach that recognises chemsex participants as legitimate sexual citizens. The present study – comprising eight interviews with gay men living in Ireland – is situated within this critical research praxis. Using a critical discursive psychology framework, our analysis demonstrates how participants draw on various interpretative repertoires to discursively negotiate chemsex identities in a bid to position themselves in a culturally intelligible manner. Participants deployed three key repertoires, centred around (i) harm, (ii) essentialism, and (iii) ethics. These repertoires are deployed in an interweaving manner to ultimately construct a dynamic, hierarchal continuum of chemsex participants – from flourishing, to flailing. Our analysis demonstrates how chemsex participants construct 'other' chemsex users as 'flailing' towards the bottom of the continuum by mobilising repertoires that draw upon prevailing moralistic notions of 'good' sexual citizenship. We argue that the mainstream construction of chemsex as inevitably harmful is restrictive and produces a deficit understanding of chemsex participants, and discuss the possibilities for discursively reimagining chemsex participation. [ABSTRACT FROM AUTHOR]

Background: An earlier study in a school in England found that a series of brief values affirmation writing exercises, performed over the course of a school year by students aged 11–14, increased the mathematics attainment of students of low socioeconomic status (SES). Aims: This pre‐registered follow‐up of the original study aims to investigate the long‐term effects of values affirmation on low‐SES students' attainment. Sample: The sample consisted of all students in the analytical sample of the original study who remained at the school and for whom the necessary data were available, N = 409 (95 low‐SES). Methods: The students' results in high‐stakes national standardized assessments at age 16, taken two to four years after the affirmation, were analysed. Results: The evidence did not support the pre‐registered hypotheses that values affirmation would raise the attainment of low‐SES students in mathematics and English. However, exploratory analyses suggested that for low‐SES students in two of the three‐year groups, the intervention increased Attainment 8, a broad policy‐relevant measure of academic attainment, and increased the attainment of boys in English (in particular English Literature) but reduced the corresponding attainment of girls. Conclusions: The results suggest that the benefits of values affirmation can differ by student cohort and by school subject and that they might be time‐limited in some circumstances. This suggests a set of hypotheses that future research could test in order to advance understanding of when values affirmation is, and is not, successful for school students over a sustained period. [ABSTRACT FROM AUTHOR]

This paper presents the first spatial analysis of racial disparities in the UK welfare sanction regime. As part of their austerity programme, the UK government tightened the conditionality of welfare programmes and intensified the use of financial penalties against welfare claimants who failed to demonstrate compliance with these conditions. Analysing Jobseeker's Allowance (JSA) data from the Department of Work and Pensions (DWP) and the Office for National Statistics between 2012 and 2019 we draw attention to the spatially uneven and highly racialised geography of welfare sanctions in England. Claimants from racially minoritised backgrounds are consistently more likely to be referred for a sanction by Jobcentre caseworkers and receive an adverse decision at the hands of institutional decision‐makers. Within this, however, there are important scalar and spatial differences that warrant critical attention. In rural England, the risk of being sanctioned is substantially higher for all groups, but especially for Mixed heritage and Black/Black British claimants who in some areas are over twice as likely to be sanctioned as their White counterparts. Since ethnicity data have not been published for Universal Credit sanction decisions, the presented evidence offers critical insight into the potential persistence of racial injustice in applying welfare sanctions. We identify 'hotspots' of racism in the sanction regime, most of which are in rural areas, before offering three interpretative frameworks through which spatial and racial disparities might be explained. Any suggestion that such disparities simply derive from the behaviour of DWP staff fails to adequately account for deeply entrenched histories of welfare racism, rural racism and the role of welfare sanctioning in dynamics of racial capitalism: that is, disciplining and impoverishing racialised populations in ways that generate conditions for capital accumulation. By contributing new empirical and theoretical insights to the often neglected study of rural austerity and welfare, the paper calls for scholarship to investigate the variegations of welfare, austerity and racial capitalism in diverse rural contexts. [ABSTRACT FROM AUTHOR]

Drawing upon archival research and documentary analysis, this article offers the first in-depth critical account of the prison modernisation narrative in England and Wales. By closely examining the claims behind the UK Government's current prison building policy, the article reveals that prison modernisation is severely undermined by a lack of supporting evidence as well as arguments which indisputably serve to contradict the government's claims. In concluding that modernisation is a seductive and elusive concept which has been deployed to legitimate and support investment in the prison estate, the article offers new and important insights that contribute to critical research agendas around the endurance, survival, and growth of the prison, despite irrefutable and overwhelming evidence of its failure. The analysis presented here should encourage and embolden academics, policy makers, practitioners and politicians in England and Wales, as well as those in jurisdictions where modernisation is also used to legitimate prison expansion, to engage more critically with the claims behind prison modernisation. [ABSTRACT FROM AUTHOR]

Achieving successful multi‐stakeholder collaboration for sustainable outcomes is complex. This paper provides key principles for future co‐design projects aimed at fostering an inclusive approach to research. These have been developed based on a novel methodology that co‐designed the essential components of a long‐term, collaborative agreement for a nature recovery scheme in England. Using an assortment of iterative, deliberative participatory methods, this research engaged a wide variety of stakeholders to produce a template agreement for an agri‐environmental policy. We demonstrate that a flexible, highly reflective approach resulted in positive engagement with previously marginalised stakeholders. The approach also successfully navigated the unequal power dynamics seen both within and between groups. Finally, multiple feedback loops allowed participants to continually build on previous interactions as they developed and reviewed the agreement. By drawing out the complexities of the co‐design process, this paper explains how co‐design efforts can produce potentially transformative outputs. We hope that the principles introduced here offer a useful starting point for those planning to undertake multi‐stakeholder co‐design. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject: Secondary traumatic stress (STS) is the indirect traumatisation of a person through the stress of helping or knowing about other's trauma. Burnout is gradual exhaustion in response to long‐term work‐related stress. Both have negative psychological, physiological and/or organisational consequences; however, the existing research in forensic health care professionals (FHCPs) is limited.One study explored STS in FCHPs and found that lower psychological flexibility (ability to adapt) was a predictor of greater STS. Existing research on burnout in FHCPs suggests that individual differences, such as the ways in which we cope (talking to people vs. using substances), may predict burnout levels. What the paper adds to existing knowledge: Prevalence findings add to the recent evidence base, which also found moderate levels of burnout. However, this study is the first to find high levels of secondary traumatic stress in FHCPs.Similar to existing literature, the study's findings suggest that FHCP's with lower levels of psychological flexibility and more maladaptive coping strategies may experience greater STS and burnout symptoms, while staff who use more adaptive coping strategies may experience less burn‐out.Unexpectedly, staff who reported a more anxious attachment style were burnt‐out; however, there are limitations to this finding. What are the implications for practice: Policies and practices in forensic settings should reflect the risk of STS and burnout.Practices or interventions should enhance adaptive coping strategies and psychological flexibility, such as Resilience Enhancement Programmes or Acceptance and Commitment Therapy (ACT). Introduction: Secondary traumatic stress (STS) and burnout literature in inpatient forensic health care professionals (FHCPs) is limited, despite the psychological, physiological and organisational consequences. Aims: This study aimed to further this limited evidence base, investigating predictors of STS and burnout in FHCPs. Method: 98 healthcare professionals working in two UK forensic inpatient settings completed measures assessing: burnout, STS, psychological flexibility, coping style, attachment style and a demographic questionnaire recording length of service and the sex of staff. Results: Results indicated high STS and moderate burnout levels. The main predictors of STS and burnout were poorer psychological flexibility and greater maladaptive coping styles, whereas lower burnout was predicted by greater adaptive coping styles and an anxious attachment style. Discussion: This study has contributed towards a limited evidence base and indicates poorer psychological flexibility and greater maladaptive coping may be risk factors for STS and burnout in FHCPs, whereas greater maladaptive coping may be a protective factor. Implication for Practice: The findings suggest that interventions such as Acceptance and Commitment Therapy (ACT) and coping skills interventions, may offer protective benefits to inpatient forensic healthcare professionals. [ABSTRACT FROM AUTHOR]

Background: Coproduction is a fast‐developing approach to patient involvement. It entails health and social care services users working as equals in partnership with providers and other public institutions to produce novel research and information, usually aimed at the improvement of service planning and delivery. Methods: This paper presents two real‐life examples of attempted coproduction with a group of men with learning disabilities in England. The first case study concerns the piloting and assessment of a 'user‐friendly' version of a local authority's 'vision statement'. The second explores an attempt to secure funding to develop and evaluate a community intervention with and for people with learning disabilities. Findings: Together, these portraits capture two important and intertwined problems that afflict the field of coproduction: namely, the drive to create fast results and the challenges of time and resource allocation that service users and professionals face whenever they attempt to coproduce work in a meaningful way. Conclusions: The paper concludes with some suggestions for how policy and practice might seek to address these issues in the future. Accessible summary: Nowadays, people with learning disabilities are starting to work together with health professionals and people in universities. This is called service user involvement.In this article, we talk about a special kind of involvement: it is called coproduction, and it means that service users and professionals should work together as equal teammates.People with learning disabilities can tell professionals what services they need and how they should be cared for. They can help to create user‐friendly policies and publications. They can also make their own choices about what research should be done and how to go about it.Here, we talk about two coproduction projects which involved a community group for men with learning disabilities.We show how these two projects excluded the men and put some of them off the idea of coproduction.At the end, we give some ideas on how we might make coproduction work better. [ABSTRACT FROM AUTHOR]

Background: Children with established kidney failure may have additional medical conditions influencing kidney care and outcomes. This cross-sectional study aimed to examine the prevalence of co-existing diseases captured in the electronic hospital record compared to UK Renal Registry (UKRR) data and differences in coding. Methods: The study population comprised children aged < 18 years receiving kidney replacement therapy (KRT) in England and Wales on 31/12/2016. Comorbidity data at KRT start was examined in the hospital record and compared to UKRR data. Agreement was assessed by the kappa statistic. Associations between patient and clinical factors and likelihood of coding were examined using multivariable logistic regression. Results: A total of 869 children (62.5% male) had data linkage for inclusion. UKRR records generally reported a higher prevalence of co-existing disease than electronic health records; congenital, non-kidney disease was most commonly reported across both datasets. The highest sensitivity in the hospital record was seen for congenital heart disease (odds ratio (OR) 0.65, 95% confidence interval (CI) 0.51, 0.78) and malignancy (OR 0.63, 95% CI 0.41, 0.85). At best, moderate agreement (kappa ≥ 0.41) was seen between the datasets. Factors associated with higher odds of coding in hospital records included age, while kidney disease and a higher number of comorbidities were associated with lower odds of coding. Conclusions: Health records generally under-reported co-existing disease compared to registry data with fair-moderate agreement between datasets. Electronic health records offer a non-selective overview of co-existing disease facilitating audit and research, but registry processes are still required to capture paediatric-specific variables pertinent to kidney disease. [ABSTRACT FROM AUTHOR]

Introduction: In 2016, the UK government identified the need for counselling services in schools to be evidence‐based (Department for Education, 2016). While there is more empirical evidence on counselling and improvement in mental health (Daniunaite et al., Counselling and Psychotherapy Research, 2015, 15, 251; Finning et al., European Child & Adolescent Psychiatry, 2022, 31, 1591), less is known about the associations of counselling with children's academic attainment and progress. Method: The aim of the paper was to provide more pieces of evidence on the possible associations between school‐based individual counselling and the academic attainment and progress of primary school–aged children. The academic outcomes of children receiving one‐to‐one counselling were compared with those of children who did not receive counselling, but who had similar background characteristics. Coarsened exact matching method was used to match similar children for these comparisons based on national data sets available in England. Data were analysed with inferential statistics and multilinear regression. Findings: Before matching the samples, analyses revealed children attending Place2Be's counselling services were significantly more likely to be boys (56.6% vs. 51.1%), of ethnic minority origin (46.4% vs. 21.5%), eligible for free school meals (FSM; 52.7% vs. 16.9%) and have special educational needs and disabilities (SEND) status (43.1% vs. 21.1%) than the comparison group. They also had lower academic attainment than children who were not in counselling. However, after a coarsened exact matching on relevant background characteristics, the Place2Be sample was found to have similar levels of academic progress to the matched national sample, suggesting they did not fall behind similar children. Conclusions: Findings indicate that individual school‐based counselling may be helpful as a potential intervention for supporting vulnerable children's (defined as those identified by schools or parents as in need of individual counselling) academic progress in primary schools, as well as socio‐emotional outcomes; however, further research is needed. [ABSTRACT FROM AUTHOR]

In common understanding, nostalgia is a past-oriented attitude that makes people turn their backs on the present and glorify former times. It leads to a self-indulgent 'ossification' of one's thoughts and results in escapism and the break with contemporary reality. Jonathan Coe's Middle England, one of the first English Brexit novels, is deeply steeped in the past and in certain forms of nostalgia that greatly contribute to the novel's overall atmosphere. One of these forms, the hankering after England's glorious past and the lost Empire, may easily be related to Brexit. This type of nostalgia, however, which contributed to England's leaving of the European Union, is only one form of nostalgia which Coe makes use of. What I want to show is that there is another type of nostalgia in the novel that is future-oriented and filled with positive social and psychological energies. It is this type of nostalgia that characterizes most of Coe's protagonists and that is responsible for the structure of his novel. [ABSTRACT FROM AUTHOR]

The restraint of patients is one of the important aspects of the regime in psychiatric hospitals. It has been an issue in hospitals over the years because it interferes with the personal freedom of patients. Most recently it was one of the matters raised in X NHS Foundation Trust v RH [2024] EWCOP 150. This paper aims to add to the awareness of it by looking at what it means, the forms it may take and the justifications for it. It is concluded that restraint of patients is controversial but reasonable and necessary at times in the interests of the patient's own health/safety or that of others. [ABSTRACT FROM AUTHOR]

We study the long-term effects on hospital activity of a three-year national integration programme. We use administrative data spanning from 24 months before to 22 months after the programme, to estimate the effect of programme discontinuation using difference-in-differences method. Our results show that after programme discontinuation, emergency admissions were slower to increase in Vanguard compared to non-Vanguard sites. These effects were heterogeneous across sites, with greater reductions in care home Vanguard sites and concentrated among the older population. Care home Vanguards showed significant reductions beginning early in the programme but falling away more rapidly after programme discontinuation. Moreover, there were greater reductions for sites performing poorly before the programme. Overall, this suggests the effects of the integration programme might have been lagged but transitory, and more reliant on continued programme support. [ABSTRACT FROM AUTHOR]

Deemed consent legislation for deceased organ donation was introduced in England in 2020, and is considered a vital part of the new UK NHS Blood and Transplant's 10-year strategy to increase consent for organ donation. Despite the legislation containing safeguards to protect the public, the introduction of deemed consent creates ethical, psychological and social un/certainties for healthcare professionals in their practice. In this paper, we offer insights into healthcare professionals' perspectives on deemed consent, drawn from interview data with 24 healthcare professionals in an NHS Trust in England, prior to the introduction of the legislation. Whilst participants supported deemed consent in principle, they were concerned that it would present a threat to the nature of donation as a 'gift'; the notion of informed consent (or non-consent); and the autonomy of donors, their relatives, and their own roles as health professionals, posing dilemmas for practice. We argue that healthcare professionals present themselves as guardians of potential (non)donors and thus as having ethics and integrity in their own practice. We draw conclusions around the values and principles that matter to healthcare professionals when contemplating consent in deceased donation which will be useful for organ donation committees and ethics forums. [ABSTRACT FROM AUTHOR]