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Why you should read this article: • To recognise that many women who receive inpatient mental healthcare have negative experiences • To update your knowledge of the importance of gender-sensitive and trauma-informed inpatient mental health services for women • To understand women’s experiences of care and support in an NHS mental health rehabilitation service. The importance of providing women who experience mental health issues with gender-sensitive and trauma-informed care has been emphasised in research and policy. However, the literature highlights that many women who receive inpatient mental healthcare have negative experiences including restrictive interventions, feeling coerced to take medicines, lack of empathy and re-traumatisation. It is important to continue exploring women’s experiences in inpatient mental health services to determine to what extent the care offered is gender-sensitive and trauma-informed. This article reports on a service evaluation conducted in 2023 at one mental health rehabilitation service in England to explore the experiences of female service users. Six women were interviewed and the data obtained were analysed thematically. Most participants reported positive experiences of the service but there were areas where care could be improved. [ABSTRACT FROM AUTHOR]

Research has shown that religion can play a protective role in diverse risky behaviors among young people. However, very little is known about the effect of religion in gambling, especially among young problem gamblers. A strong moral belief regarding gambling may prevent adolescents and young adults engaging in gambling and developing problems. Nevertheless, some evidence suggests that religion might have an influence on gambling cognitive distortions (i.e., some religious beliefs might influence the conceptions of chance and luck, which may contribute to an increase in gambling participation). The present study examined the different effects that religion can have on gambling behavior, in two different cultural contexts (i.e., Portugal and England), characterized by different religious affiliations. A sample (n = 725) comprising Portuguese (n = 312) and English (n = 413) adolescents and young adults completed an online survey. The findings indicated that Portuguese youth were more religious than their English counterparts. Moreover, religiosity was associated with lower gambling engagement among participants in both samples. Mediation analyses also showed that the cognitive distortion of illusion of control mediated the relationship between religiosity and problem gambling among the Portuguese participants, and the interpretative bias was a significant mediator in the English sample. The study's findings suggest that religion can have a protective role on gambling behaviors. However, further research is needed to explore the interactive role of religion and cognitive distortions. [ABSTRACT FROM AUTHOR]

Two experiments investigated the effect of sustained cognitive control engagement on syntactic ambiguity resolution. Participants heard (Experiment 1) or read (Experiment 2) garden path sentences like "Put the kiwi on the rectangle on the circle", in which "on the rectangle" could temporarily reflect either a destination of "Put" or modifier of "kiwi", and they viewed visual arrays with a kiwi on a rectangle and an empty rectangle and circle. Cognitive control was manipulated experimentally by interleaving sentence trials among either mostly incongruent or mostly congruent Stroop trials. Across both experiments, garden path mouse cursor movements to incorrect destinations were reduced when sentence trials were interleaved among mostly incongruent Stroop trials, and in Experiment 2, garden path reading time effects were also reduced in this condition. These results suggest that a high proportion of incongruent trials supports the sustained engagement of cognitive control and causally improves sentence comprehension across (i.e. spoken and written) modalities. [ABSTRACT FROM AUTHOR]

The Scottish Law Commission has recently confirmed in its Eleventh Programme of Reform, published in May 2023, the continuation of its medium-term project to examine the law of homicide. This includes a review of sexual infidelity killings and provocation as a partial defence to murder, or otherwise. It embraces a critique of whether and, if so, how any necessary proposals for modernising the law in this sensitive and important area should be made. A Discussion Paper has previously been published for examination. Against this backdrop, we analyse whether sexual infidelity ought to be retained in extant Scots law, as one of only two relationally relevant qualifying triggers. In November 2023, the Law Commission in England and Wales announced its forthcoming review of domestic homicide given contemporary understandings of the impact of domestic abuse. We provide novel insights into Anglo-Scottish law to seek to recalibrate the understanding of coercive/controlling behaviour in the contextualisation of sexual infidelity killings. Our review highlights the ways in which allegations of (actual or perceived) sexual infidelity may be symptomatic of coercive control through consideration of recent case law, and via the lens of Monckton-Smith's eight stages to femicide. A risk assessment is utilised to demonstrate the extent to which victims of coercive controlling behaviour have their capacity for action delimited, and how this should inform deliberations in cases where the coercively controlled individual kills in response. A novel and original new template is promulgated for provocation reform predicated de novo on qualifying triggers of domestic abuse and gross breach of trust and with a part-justificatory – part excusatory standardisation. It is suggested that a new nomenclature and typology is required as extant Scottish law on provocation is out of step with contemporary social mores, and the law in England and Wales does not adequately address contextual factors, such as, ethnicity, culture, religion, sexuality, disability, and migrant status, which impact on a domestic abuse victim's capacity for action. It is further propounded that a social entrapment lens, drawing on initiatives crystallised from New Zealand and Australian academician perspectives, ought to be enacted as part of urgently needed effective remedial legislation. [ABSTRACT FROM AUTHOR]

Context: A key task for countries around the world facing the COVID-19 pandemic was to achieve high vaccination coverage of the population. To overcome "vaccination inertia," governments adopted a variety of policy instruments. These instruments can be placed along a "ladder of intrusiveness" based on their degree of constraint of individual freedoms. The aim of this study is to investigate how the governments of three European countries moved along the ladder of intrusiveness and how the choice of policy instruments was influenced by contextual factors. Methods: The study draws on secondary data sources, including academic and gray literature, policy documents, and opinion polls, over an observation period from December 2020 to summer 2022. The study employs inductive logic to analyze data and identify the factors explaining similarities and differences across England, Germany, and Italy. Findings: The study identifies similarities and differences in how the three countries advanced along the ladder of intrusiveness. Contextual factors such as policy legacy, social acceptability, and ideological orientation contribute to explain the observations. Conclusions: Country-specific contextual factors play an important role in understanding the choice of policy instruments adopted by the three countries. Policy makers should carefully consider these factors when planning immunization strategies. [ABSTRACT FROM AUTHOR]

Previous research highlighted that a fundamental rethink of the measurement of domestic abuse was needed in the Crime Survey for England and Wales (CSEW). The research reported here aimed to develop and test new questions on domestic abuse for the CSEW to improve the headline prevalence measure, including frequency of abuse, to develop a way of measuring controlling or coercive behavior within the overall prevalence measure, and to develop a measure of the impact of abuse. The research included focus groups and interviews with victims (n = 27) to assess a set of draft questions and cognitive testing of revised questions with victims and the general public (n = 42). A final set of 24 questions was developed for use with victims of both intimate partner and family abuse, with an additional question for family abuse. The new questions were found to echo victim experiences and were deemed acceptable and reliable measures by victims and the general public for domestic abuse, including controlling and/or coercive behavior and impact. An analytical approach was recommended to improve the headline prevalence measure of domestic abuse by establishing 'high' and 'low' abuse profiles using measures of both behavior and impact. [ABSTRACT FROM AUTHOR]

A parenting style with high amounts of control combined with low caring or nurturing behaviour has been reported in association with mental disorders including schizophrenia. However, the association of parenting style with illness severity in individuals with schizophrenia has never been evaluated retrospectively or over a longitudinal time course. In a subset (n = 84) of the participants included in the AESOP (Aetiology and Ethnicity in Schizophrenia and Other Psychoses)-10 study, we evaluated participants' perceptions of their own parents' bonding style at the time of their first episode of psychosis using the parental bonding instrument (PBI). We then examined the association between different bonding styles, illness course and severity, and global functioning over a 10-year follow-up. Participants who perceived that their fathers had a more caring and less controlling parenting style showed better functioning at follow-up. However, in contrast to previous research, participants who reported having been subject to uncaring and controlling parenting styles were not found to have a notably worse course of illness or symptom severity over the follow-up period. These results indicate that more optimal parental bonding styles may be associated with better overall functioning in individuals with psychosis but not with other measures of illness outcome. [ABSTRACT FROM AUTHOR]

Purpose: In 2020 the England and Wales Office for National Statistics commissioned the research reported here to review the current questions on domestic abuse in the Crime Survey for England and Wales (CSEW) and to establish how better data for policy and practice might be produced. The CSEW is a representative population survey that since the early 2000s has provided ongoing measurement of domestic abuse via a dedicated domestic abuse module, with regular publication of headline prevalence and other descriptive data. At the same time the measurement of domestic violence in the CSEW has also been the subject of ongoing debate and critique, in particular whether it is appropriate to use catch-all prevalence measures in the context of policy, practice and commissioning of services. Method: The research included analysis of CSEW user survey data (N = 39), focus group and individual interviews with male and female victims/survivors (N = 11), consultation with core stakeholders (N = 18), and consideration of international surveys and recent legislation. Results: Current CSEW questions do not capture domestic abuse accurately or reflect lived experience, coercive control needs to be seen at the core of domestic abuse, and while physical assault is an important part of measuring domestic abuse establishing frequency through counting events is probably impossible. Conclusion: A fundamental rethink of the current CSEW self-completion module is required, with a wider set of questions about domestic abuse and impact. A revised module should identify and provide estimation of prevalence for different 'abuse profiles' that would complement improved headline measures and better inform policy and practice. [ABSTRACT FROM AUTHOR]

Developing from existing research in the field of hate studies, this article outlines a new approach to understanding repeated experiences of hate by perpetrators who live in close proximity as neighbours to those victimised. Building on previous work, a conceptual argument is made drawing parallels between what we call 'hate relationships' and coercive control in domestically abusive relationships. Empirical data from a hate crime advocacy service in the North East of England evidences these parallels through consideration of the home as central to the hate experienced and the cumulative impact of a pattern of hate-motivated behaviours. As with coercive control, our analysis shows that the apparent inaction of help providers exacerbates hate relationships and their impacts. We argue that the current reliance on a criminal justice system, incident-based, approach to understanding and responding to repeat reporting of hate incidents is inadequate. Rather, an approach identifying hate relationships and intervening early in a hate relationship might better preempt escalation and provide possibilities for those victimised to remain in their own homes. [ABSTRACT FROM AUTHOR]

Background County lines is used to describe the illicit drug supply model whereby drugs are transported from one area of the country to another, often by children believed to have been physically and psychologically coerced to do so. County lines is a serious threat to public health, with significant negative impacts on the physical and psychological health and wellbeing of children and families. Methods We conducted in-depth interviews with parents of children involved in county lines to understand their experiences and the impact of grooming and recruitment. Interviews were conducted between December 2019 and January 2021. Thematic analysis identified four primary themes: (i) out of nowhere behaviour change, (ii) escalation and entrenchment, (iii) impact of intervention failures and (iv) destructive lifestyle choices. Results Parents from across England all reported similar experiences, and so these data offer novel insight into potential grooming and recruitment indicators. All were frustrated by the prevailing vulnerable narrative, which they argued hindered understanding. A lack of consultation, and reports of numerous intervention failures was common. Conclusion The importance of giving parents a voice and involving them as a potential first line of defence, and how the current vulnerability narrative appears to be closing impactful education opportunities are discussed. [ABSTRACT FROM AUTHOR]

In 2015, legislation was enacted in England and Wales to criminalise coercive control. While there has been considerable debate on the merits of the law, there has been little empirical study of its use in practice. This paper presents findings from a focused ethnography conducted in two police forces in England. Field observations with first response officers and specialist investigators reveal structural and social-cultural contexts that mitigate against successful implementation of the law. Specifically, we identify officer knowledge and attitudes, resourcing and the framing of the legislation itself as impeding its wider use. While we did not observe the unintended consequences feared by some observers, we conclude that systemic change is required if the theoretical benefits of the legislation are to be fully realised. [ABSTRACT FROM AUTHOR]

Research on risk assessment for domestic abuse has focused primarily on the predictive validity of specific tools; less attention has been paid to implementation of risk tools by practitioners. This paper presents findings from a mixed methods study in England and Wales. Multi-level modelling reveals an 'officer effect' whereby victims' responses to the Domestic Abuse, Stalking and Harassment and Honour-Based Violence (DASH) risk assessment are influenced by the specific officer that completes the assessment. Specifically, this officer effect is strongest in relation to questions intended to capture elements of controlling and coercive behaviour, and least apparent in relation to identifying physical injuries. We further present findings from field observations and interviews with first response officers that corroborate and help explain the officer effect. We discuss implications for the design of primary risk assessments, victim safeguarding, and the use of police data for predictive modelling. [ABSTRACT FROM AUTHOR]

The Domestic Violence Disclosure Scheme (DVDS) was first introduced in England and Wales in 2014 and has since been reproduced across the world. Its aim is to empower victim–survivors by giving them access to a partner's criminal history and thereby helping them make informed decisions about their relationship. Yet the relationship between information and empowerment in this context remains contested and unexplored both theoretically and empirically. This paper draws on findings from the largest qualitative study of the DVDS to date as well as coercive control, to show that police are using disclosures to undermine perpetrators' 'monopolies on perception' and in doing so aiming to empower victim–survivors to redefine their own realities. The implications for practice-oriented models of empowerment and evaluation methodologies are explored. [ABSTRACT FROM AUTHOR]

An abused person who kills their abuser remains a conundrum for law and justice. How do we adequately deal with this issue using the current defences to murder? The Coroners and Justice Act 2009 legislated with such situations in mind, but the focus here was on physical abuse. As our understanding of the effects of coercive and controlling behaviour has grown, how fatal reactions to such behaviour might be dealt with by the courts has become an issue of particular interest. This article considers how the current parameters of the criminal law and our increased understanding of intimate partner violence are in conflict, and further legislation will most certainly be necessary to be inclusive of non-physical abuse. [ABSTRACT FROM AUTHOR]

People with care and support needs were often badly affected by Covid-19, although the impact on people employing Personal Assistants (PAs) has not been addressed. We aimed to explore the experiences of people employing PAs during the pandemic to inform care systems and social work practice. Remote qualitative interviews were conducted with seventy PA employers across England in 2021–2022. Data were analysed thematically to explore salient themes. The Covid-19 pandemic elucidated role tensions of PA employers: Navigating care arrangements during a time of unprecedented uncertainty reinforced participants' role as an employer, but exposed some aspects of employment responsibilities and legal obligations that participants felt ill-equipped to manage. Reports of contact with or by social workers were few and not perceived as helpful. The often-informal nature of PA arrangements and its blurred relational boundaries affected participants' expectations of their PAs. PA employers would welcome support from social workers in their employment role and flexibility with care plans, albeit with greater autonomy over their Direct Payment (DP) budget to enhance the potential of this arrangement. In the context of declining DP uptake in England, our study offers some potential explanations for this, with suggestions for systemic change and social work practice. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Sometimes someone needs to be in hospital because they are struggling with their mental health and need some extra support but being in hospital can also be a difficult experience.There are a lot of restrictions in place in hospital, like locked doors, rules to follow and not much choice about what happens to you.Other research has found that these restrictions can feel difficult and stressful for people and so more research is needed about this.We wanted to know what being in hospital felt like for women in particular. What the paper adds to existing knowledge?: We interviewed women who were in hospital because of their mental health about what it was like for them in hospital.The women told us that they felt powerless while they were in hospital. They sometimes felt like they were being punished and this could affect their mood and could lead to them hurting themselves.They also said that they were not always listened to by staff, and they found it difficult being away from their family and friends while they were in hospital.The women also told us that being in hospital could sometimes help them to feel safe. What are the implications for practice?: Women should be looked after in hospital in a way that helps them to feel in control of what happens to them.They should be supported to be able to go outside the hospital on leave, to keep in touch with their family and friends, and they should be listened to by staff.A project called "safewards" has suggested some ways for helping to make hospital wards safer. They have suggested that everyone should be clear about what the rules are when they go into hospital and ways that staff could communicate more clearly with the people they are working with. Our research supports using these techniques. Introduction: Inpatient care often involves restrictive interventions such as seclusion and restraint and restrictive practices that limit the person's freedom, rights and daily activities. Restrictive practice has not been the explicit focus in previous research; however, it often appears as an important theme, with participants identifying it can have a detrimental effect on their well‐being. More research specifically on this topic in an inpatient setting is, therefore, needed. Women might be particularly vulnerable to adverse effects of restrictive practices compared to men as women generally occupy less powerful positions in society and more often experience abuse. Aims: The study aimed to explore women's experiences of routine restrictive practices in mental health inpatient settings. Methods: Twenty‐two women who were currently inpatients on mental health wards were interviewed about their experiences of restrictive practices in hospital. Interviews were analysed using thematic analysis. Results: An overarching theme emerged of powerlessness. Four key sub‐themes were also identified: restrictions perceived as punitive, having no voice, impact of restrictions on relationships and restrictions providing safety and support. Discussion: Although restrictive practices were found to provide the women with a sense of safety, they were also found to impact upon the women's well‐being, leading to increases in self‐harm and over‐reliance on restrictions. Implications for practice: This research highlights the importance of gender‐informed inpatient services for women that foster independence, empowerment and allow women to have their voices heard. Safewards interventions such as clear mutual expectations and soft words could contribute to mitigating the impact of restrictive practices. [ABSTRACT FROM AUTHOR]

Background: Weight gain is inevitable during pregnancy. However, high prepregnancy body mass index and excessive gestational weight gain are associated with poor pregnancy outcomes. Understanding the experiences, social influences and decisions women make to maintain a healthy lifestyle during pregnancy are essential to consider how to improve services and interventions to help women engage in a healthy diet and physical activity (PA) behaviours. Objective: The study investigated women's opinions and lived experiences of engaging in a healthy diet, promoting optimal gestational weight gain and PA during and after pregnancy. Design and Methods: Twenty‐two pregnant women contributed to qualitative data collection for this Grounded Theory (GT) study. Nineteen women completed semi‐structured interviews and three patient and public involvement (PPI) representatives sought to validate the analysis and GT framework. Results: Two substantive categories were constructed: (1) Evolving from 'I' to 'we', as informed by two subcategories and (2) the power of information and guidance, as informed by three subcategories. These categories informed the core category, 'A navigational journey and evolution of the pregnant self'. The navigational journey involves constantly searching for knowledge and information to support and balance the interests of personal beliefs, the health of their unborn baby, their social circle and the wider world. A woman's psychological capability (e.g., their knowledge of a healthy lifestyle and confidence to implement such knowledge) is continuously tested. Conclusions: Pregnancy may create a 'teachable moment' but there is a need for appropriate guidance from professionals to assist with lifestyle choices during pregnancy. The findings showed a significant influence of online resources, and lack of guidance on behaviour during pregnancy and may highlight areas of focus for future research and intervention. Public Contribution: Three pregnant women were recruited to act as PPI representatives to assist with the validation of the analytical findings and aid the final theoretical saturation of the GT framework. Commentary from these PPI representatives was used to validate the analysis and support the interpretation of the data. In addition, these PPI representatives were also invited to provide commentary on the draft manuscript and those involved in this later process have been included as coauthors. [ABSTRACT FROM AUTHOR]

Prison settings have been neglected in the growing literature on drug-related deaths. This paper explores policy and practice issues regarding the governance of drug-related deaths in prisons in England and Wales from 2015-2021. Thematic documentary analysis was conducted on national level policy documents published between 2015-2021 (e.g. drug strategies, prison policy documents, Her Majesty's Inspectorate of Prisons and Prison and Probation Ombudsman (PPO) annual reports and guidance for staff). At the local (prison) level, all of the PPO fatal investigation reports and their associated action plans relating to 171 drug-related deaths from 2015-2021 were analysed thematically. Various modes of governance were identified using Head's 'wicked problems' conceptual framework including avoidance and denial, coercive controls, compartmentalised micro-management, incremental and pragmatic adjustment and technocratic problem-solving. There was strong evidence of the dominance of denial of the problem of drug-related deaths, coercive controls, micro-management and reliance on technological solutions in the early years (2015-2018). In some prisons, there developed a move towards the adoption of more pragmatic and incremental policies and push towards comprehensive policies over time. In others, remnants of denial and coercion remained. In our analysis, the focus on new psychoactive substances came to dominate attention, to the relative neglect of other substances and of the contribution of mental and physical illness to these deaths. Staff are not equipped, supported or resourced adequately to deal with the two 'wicked problems' of increasing rates of drug use and mental illness which collide in the prison setting. The PPO investigations repeatedly recommend reducing supply and improving monitoring and surveillance and the emergency response. There is less focus on prevention and reducing demand or improving the wider environmental context and culture in which the deaths occur. Policy needs to pay more attention to the fundamental issues driving the current deterioration in conditions in prisons. [ABSTRACT FROM AUTHOR]

Access to abortion care has been hugely affected by the COVID-19 pandemic. This has prompted several governments to permit the use of telemedicine for fully remote care pathways, thereby ensuring pregnant people are still able to access services. One such government is that of England, where these new care pathways have been publicly scrutinised. Those opposed to telemedical early medical abortion care have raised myriad concerns, though they largely centre on matters of patient safeguarding. It is argued that healthcare professionals cannot adequately carry out their safeguarding duties if the patient is not in the room with them. These concerns lack empirical support. Emerging evidence suggests that safeguarding processes may, in fact, be more effective within telemedical abortion care pathways. In this article, we address two specific safeguarding concerns: (1) that a remote consultation prevents a healthcare professional from identifying instances of abuse, and (2) that healthcare professionals cannot reliably confirm the absence of coercion during a remote consultation. We demonstrate that such concerns are misplaced, and that safeguarding may actually be improved in telemedical care pathways as victims of abuse may find it easier to engage with services. It is inevitable that some individuals will fall through the net, but this is unavoidable even with in-person care and thus does not constitute a strong critique of the use of telemedicine in abortion care. These safeguarding concerns set aside, then, we argue that the current approval that enables telemedical early medical abortion should be afforded permanence. [ABSTRACT FROM AUTHOR]

The offence of controlling or coercive behaviour came into effect in England and Wales in December 2015, and related offences have since been enacted in Scotland and Ireland. To date, there has been almost no empirical evaluation of the operationalisation of the new English and Welsh offence. This article fills that gap by analysing media reports relating to 107 individuals convicted of controlling or coercive behaviour, providing a profile of offenders and victims (gender and age), the types of abusive behaviours offenders engaged in and how the cases progressed through the criminal justice system (manner of conviction, sentencing outcomes). Media reporting of these cases is also discussed. The results suggest that the offence is (appropriately) operationalised in a highly gendered manner, that it has captured a diverse range of behaviours that would not previously have been considered criminal, and that media reports of this form of domestic violence have not demonstrated the negativity towards victims identified in previous studies. Further research of primary data is required to confirm these findings. [ABSTRACT FROM AUTHOR]

Research suggests that intimate relationship violence and coercive control are prevalent in young people's relationships. Furthermore, young people often fail to recognise such behaviour as abuse. While such findings indicate the normalisation of controlling and coercive behaviours amongst young people, there is little focus on how these behaviours are normalised. This paper presents findings from a study exploring young people's experiences and expectations of intimate relationships. Focus groups were conducted with young people (aged 13 to 18 years) in schools in the West Midlands, England. Young people talked of navigating precarious and competitive heterosexual relationships. Their expectations and negotiations of these relationships often upheld and reinforced gender double standards around dating practices. Young people's discussion also highlighted how they came to accept and rationalise controlling and coercive behaviours as 'love', 'care' and 'protection', legitimising these practices as reasonable. Heteronormativity remains a dominant discourse shaping young people's experiences and expectations of relationships with coercion and control being defining features of this discourse. Supporting young people to critically examine constructs of heterosexuality and gender norms should be a key component of England's forthcoming statutory Relationship and Sex Education. [ABSTRACT FROM AUTHOR]

Online abuse, facilitated via social media and mobile technologies, has recently attracted considerable academic attention. The nonconsensual sharing of intimate images—revenge pornography—can have a devastating effect on victims, is a global problem, and constitutes interpersonal violence. The national helpline in the United Kingdom has now received over 7,000 calls. In the United Kingdom, new legislation making revenge pornography a crime was introduced in 2014, yet the police do not always respond appropriately to victims. This article presents the findings of a national online survey of police understanding of revenge pornography, undertaken in the United Kingdom in March 2017. The study set out to investigate police knowledge of revenge pornography legislation, their confidence in responding to cases of revenge pornography, and what level of training they had received. A total of 783 members of the police force responded to the survey and, to the authors' knowledge, this the first study to seek to quantify the understanding of revenge pornography by police officers and staff in England and Wales. The findings suggest that the police in the United Kingdom have a limited understanding of revenge pornography legislation and lack confidence both in investigating cases and in effectively responding to victims. The implications of the study demonstrate that there is an urgent need for training across police forces to ensure that cases of revenge pornography are appropriately responded to, victims are safeguarded, and offenders brought to justice. [ABSTRACT FROM AUTHOR]

Some mother–child relationships become more strained and distant than others in domestic violence contexts, but the processes influencing this are little understood. Qualitative interviews with 15 mothers and 15 children were held to explore their experiences. Findings suggested that five interlinked factors influenced levels of closeness, distance, and strain in mother–child relationships: (1) perpetrator's/father's behavior toward children, (2) perpetrator's/father's use of domestic violence, (3) perpetrator's/father's undermining of mother–child relationship, (4) mother's ability to emotionally connect to children, and (5) children's views of mother and perpetrator/father. These findings have global significance for services and practitioners who work with domestic violence–experienced mothers and children and may help to tailor responses more effectively to mothers' and children's needs. [ABSTRACT FROM AUTHOR]

The onset of disability in bathing may be followed by disability in other daily activities for older adults. A bathing adaptation usually involves the removal of a bath or inaccessible shower and replacement with a level, easy access shower. The purpose is to remove the physical environmental barriers and restore older adults' ability to bathe safely and/or independently. The aim of this study was to explore the views and experiences of older adults and their carers who had received a bathing adaptation in order to examine how the adaptation had affected them and identify mechanisms of impact and outcomes from their perspectives. The study was nested within a feasibility Randomised Controlled Trial (RCT) (BATH‐OUT) conducted within one local authority housing adaptations service in England. Semi‐structured interviews were completed between 21 December 2016 and 19 August 2017 with 21 older adults and five carer participants of the feasibility RCT. Interview participants were purposively sampled on living arrangement and gender. Interviews were audio‐recorded, transcribed verbatim and analysed in seven stages using framework analysis. Findings were presented thematically. Five themes were identified: ease of use; feeling safe; feeling clean; independence, choice and control; and confidence and quality of life. The removal of the physical barriers in the bathroom led to older adults re‐mastering the activity of bathing, having an improved sense of physical functioning which gave a sense of 'freedom'. This appeared to impact a range of areas contributing to a wider sense of increased confidence consistent with constructs underpinning social care‐related quality of life. We suggest that future research should examine housing adaptations from a person–environment fit approach, and that timely restoration of bathing ability is especially important as it can affect confidence and perceived competence in other areas of daily living. [ABSTRACT FROM AUTHOR]

• Pre-morbid contexts may relate to the onset of central sensitisation in chronic low back pain. • Themes of developmental learning experiences and personal characteristics emerged. • Themes of physical and emotional sensitivities and traumas also emerged. • These four themes may be linked with autonomic stress responses and central sensitisation pain. Central sensitisation pain is a predominant mechanism in a proportion of individuals with non-specific chronic low back pain and is associated with poor outcomes. It is proposed that the pre-morbid experiences and contexts may be related to the development of central sensitisation. The objective of this study was to explore the pre-morbid experiences and personal characteristics of participants with central sensitisation pain from a non-specific chronic low back pain population. This was a qualitative, exploratory study, using a concurrent nested design within a mixed methods protocol. n = 9 participants were recruited purposively based on sensory profiles and trait anxiety-related personality types. Data were collected through semi structured interviews, managed using QSR NVivo 10 software and analysed using theoretical thematic analysis. Four themes emerged: developmental learning experiences, personal characteristics, sensitivity and trauma. Reported was lack of confidence, low esteem and a need to please others, physical hyper-sensitivities (smell, light, sound) and emotional sensitivity (anxiety) as well as physical hypo-sensitivity. Participants had also suffered emotional and/or physical trauma. Learning difficulties, sensory sensitivities and trauma are associated with autonomic stress responses, which in turn have been linked to physiological changes seen in central sensitisation pain. Central sensitisation pain developed in the context of sensory processing differences related to learning difficulties, sensitivities and trauma, and personal characteristics of low confidence and control, in a group of participants with non-specific chronic low back pain. The role of pre-existing sensory processing differences, as a component of altered central nervous system function, in relation to central sensitisation pain warrants further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Asset based approaches to dementia research and measurement emphasise the need to also assess the strengths and capabilities that people with dementia retain, rather than assessing only losses or deficits. The CASP-19 proposes wellbeing as the satisfaction of four 'needs' (control, autonomy, self-realisation and pleasure). The CASP-19 may reflect the asses-based approach and has been validated in over 20 countries. The aim of this study was to evaluate the CASP-19's psychometric properties in older adults with dementia. Methods: An observational study was conducted at five NHS trusts across England. Participants were asked to either complete the CASP-19 by interview or self-report, alongside four other measures to assess psychometric properties. Results: Internal consistency overall was good (α =.856) but the autonomy subscale fell below the acceptable. The CASP-19 was significantly correlated in the expected direction with measures of quality of life (r =.707), depression (r = −.707) and additional measures. It also remained moderately stable over a one-week period but factor analyses indicated a 12-item measure may be more robust. Conclusions: Despite some variations, the CASP-19 appears to have adequate psychometric properties for older adults with dementia and can be used in future research and practice. [ABSTRACT FROM AUTHOR]

This article suggests that the policy re-framing of the prostitution of children as a separate phenomenon from the prostitution of adults is obscuring the commercial nexus between men who buy sex with children and the third party profiteers (pimps) who frequently supply the children they buy. It suggests that this is making both groups of perpetrators invisible. It argues that coercion is endemic to the sex trade and explores the gendered strategies of coercive control used by pimps to entrap both children and women. The article suggests that the wider sex trade creates a 'conducive context' for the sexual commodification of children, and that the commercial sexual exploitation of children and adults can only be effectively challenged by policy and law aimed at reducing demand for all forms of prostitution. It focusses on law and policy in England and Wales, which differs from the rest of the UK. [ABSTRACT FROM AUTHOR]

Snacking is prevalent in adolescents and can have significant health impacts, but there is considerable individual and cross-country variation in determinants on adolescent snacking. The present study examined the role of eating styles (i.e. restrained eating, emotional eating, external eating, mindful eating) and the constructs of an extended Theory of Planned Behaviour (TPB) (i.e. attitudes, subjective norms, perceived behavioural control, habit strength) in predicting adolescent snacking, and the moderating effects of country. A survey was completed by adolescents aged 16–19 years from China (N = 182; mean age = 16.13, SD = 0.87) and England (N = 96; mean age = 17.04, SD = 0.74). Compared to British adolescents, Chinese adolescents showed higher restrained eating (p =.009), lower external eating (p =.004), less positive attitudes (p <.001) and subjective norms (p =.007) to, and less strong habit strength (p =.005) for unhealthy snacking. Mindful eating significantly predicted lower consumption of unhealthy snacks (p =.008) and beverages (p =.001), while restrained eating predicted higher consumption of fruit (p <.001) and vegetables (p <.001), regardless of country. Country showed significant moderating effects of TPB constructs on unhealthy beverages (p =.008) and fruit (p <.001) consumption, and effects on unhealthy snack (p =.023) and vegetable (p =.015) consumption approaching significance. Subjective norms predicted unhealthy snacking frequency regardless of country (p =.001). Habit strength predicted consumption of beverages (p <.001) and fruit (p <.001) only in English adolescents. Mindful eating may be a positive intervention approach to help reduce adolescent unhealthy snacking. TPB-based snacking interventions should carefully consider the country context. Acknowledging country-specific determinants of snacking are recommended. [ABSTRACT FROM AUTHOR]

A difficult birth experience can have long lasting psychological effects on both mother and baby and this study details four in-depth accounts of first time mothers who described their birth experience as traumatizing. Narrative analysis was used to record discrepancies between the ideal and the real and produced narrative accounts that highlighted how these mothers felt invisible and dismissed in a medical culture of engineering obstetrics. Participants also detailed how their birth experience could be improved and this is set in context alongside current recommendations in maternal health care and the complexities of delivering such care in UK health settings. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Community mental health staff and their service users have reported mixed views on the importance of talking about the content of voices. Community staff have reported feeling that they do not have the skills to explore voice content and worry about making things worse. Voice hearers experiencing extreme distress due to the content of their voices can access support through acute inpatient mental health services. No previous studies have focused on the experiences of staff who nurse voice hearers at a time of acute distress. What does this study add to existing knowledge?: MHNs and HSWs working with voice hearers in acute distress report feeling powerless and helpless, as they feel that they cannot lessen the distress experienced by the voice hearer. Despite these difficult feelings, staff report finding ways of coping, including using structured tools to help make sense of their service users' voice‐hearing experiences and accessing reflective practice forums. What are the implications for practice?: Due to the current context of increased acuity and limited resources in acute services, there may be a need to further protect time for staff to access reflective practice groups and supervision forums to help them manage the difficult feelings arising from their work with voice hearers. Abstract: Introduction: Mental health nursing (MHN) staff in acute settings work with voice hearers at times of crises when they experience high levels of distress. Previous research has focused on community mental health staff's experiences and their service users views on exploring the content of voices. No studies have explored this from an acute mental health service perspective. Aim: This study therefore sought to explore the experiences of staff working with voice hearers in an acute mental health service. Method: Due to the exploratory nature of the research, a qualitative design was chosen. Three MHNs and five healthcare support workers (HSWs) were interviewed. The data were analysed using Interpretative Phenomenological Analysis. Results: A group analysis elicited three master themes: “It's quite scary really, not unlike a horror movie;” “I can only influence what's in front of me;” and “Just chipping away”. Discussion: Staff working with voice hearers in acute settings experience feelings of powerlessness and helplessness, as they feel unable to reduce the distress experienced by voice hearers in their care. Staff employ coping strategies to help manage these difficult feelings, including using structured tools in their work with voice hearers and attending reflective practice forums. Implications for Practice: Acute mental health services may need to protect time for staff to access regular reflective practice and other supervision forums to help manage their feelings of powerlessness and helplessness arising from their work with voice hearers. [ABSTRACT FROM AUTHOR]

Background Two experiments investigated the contribution of conflict inhibition to pragmatic deficits in children with autism spectrum disorder (ASD). Typical adults' tendency to reuse interlocutors' referential choices (lexical alignment) implicates communicative perspective-taking, which is regulated by conflict inhibition. We examined whether children with ASD spontaneously lexically aligned, and whether conflict inhibition mediated alignment. Methods Children with ASD and chronological- and verbal-age-matched typically developing controls played a picture-naming game. We manipulated whether the experimenter used a preferred or dispreferred name for each picture, and examined whether children subsequently used the same name. Results Children with ASD spontaneously lexically aligned, to the same extent as typically developing controls. Alignment was unrelated to conflict inhibition in both groups. Conclusions Children with ASD's referential communication is robust to impairments in conflict inhibition under some circumstances. Their pragmatic deficits may be mitigated in a highly structured interaction. [ABSTRACT FROM AUTHOR]

Background Mental health nurses are exposed to patient aggression, and required to manage and de-escalate aggressive incidents; coercive measures such as restraint and seclusion should only be used as a last resort. An improved understanding of links between nurses’ exposure to aggression, attitudes to, and actual involvement in, coercive measures, and their emotions (anger, guilt, fear, fatigue, sadness), could inform preparation and education for prevention and management of violence. Objectives To identify relationships between mental health nurses’ exposure to patient aggression, their emotions, their attitudes towards coercive containment measures, and their involvement in incidents involving seclusion and restraint. Design Cross-sectional, correlational, observational study. Settings Low and medium secure wards for men and women with mental disorder in three secure mental health hospitals in England. Participants N = Sixty eight mental health nurses who were designated keyworkers for patients enrolled into a related study. Methods Participants completed a questionnaire battery comprising measures of their exposure to various types of aggression, their attitudes towards seclusion and restraint, and their emotions. Information about their involvement in restraint and/or restraint plus seclusion incidents was gathered for the three-month period pre- and post- their participation. Linear and logistic regression analyses were performed to test study hypotheses. Results Nurses who reported greater exposure to a related set of aggressive behaviours, mostly verbal in nature, which seemed personally derogatory, targeted, or humiliating, also reported higher levels of anger-related provocation. Exposure to mild and severe physical aggression was unrelated to nurses’ emotions. Nurses’ reported anger was significantly positively correlated with their endorsement of restraint as a management technique, but not with their actual involvement in restraint episodes. Significant differences in scores related to anger and fatigue, and to fatigue and guilt, between those involved/not involved in physical restraint and in physical restraint plus seclusion respectively were detected. In regression analyses, models comprising significant variables, but not the variables themselves, predicted involvement/non-involvement in coercive measures. Conclusions Verbal aggression which appears targeted, demeaning or humiliating is associated with higher experienced anger provocation. Nurses may benefit from interventions which aim to improve their skills and coping strategies for dealing with this specific aggressive behaviour. Nurse-reported anger predicted approval of coercive violence management interventions; this may have implications for staff deployment and support. However, anger did not predict actual involvement in such incidents. Possible explanations are that nurses experiencing anger are sufficiently self-aware to avoid involvement or that teams are successful in supporting colleagues who they perceive to be ‘at risk’. Future research priorities are considered. [ABSTRACT FROM AUTHOR]

Summary Research on self-directed care has focused on older people and adults with learning or mental health difficulties. This article reports physically disabled young adults’ experiences of self-directed care. Such work is important because young adults are a ‘minority’ group within adult social care. This, and their still developing life-skills and lack of life experience, may have a bearing on their experiences of self-directed care and associated support needs. An exploratory qualitative study using semi-structured interviews investigated this issue. Participants were 19–29 years with a range of congenital and acquired impairments. Findings Many aspects of interviewees’ experiences of self-directed care appeared to be influenced by their limited life experience, the fact they are still developing life-skills and are a minority group within adult social care. Interviewees identified their lack of life experience and self-confidence as making them cautious in assuming responsibility for their care arrangements and, typically, their desire for on-going parental support. They also believed their age and life stage contributed to difficulties managing carers and PAs. Preferences around characteristics of carers/PAs were influenced by their age and desire to integrate into mainstream activities. Information provided by statutory services did not (fully) acknowledge that some users were young adults. Applications Compared to other physically disabled users of adult social care, young adults’ under-developed life-skills and lack of life experience influences their experiences as users, and the support they needed to assume control of their care arrangements. Tailored information and support for this ‘minority group’ is required. [ABSTRACT FROM AUTHOR]

Children can sometimes find it difficult to articulate their experiences if they have to rely solely on words. Giving children the opportunity to use arts-based research approaches can support their participation in research and create a bridge that enables them to express their perspectives and feelings. This paper focuses on the ethical and practical considerations when using photo elicitation interviews (PEI) in research with children. The discussion and examples provided are drawn from an international study that used auto-driven PEI, where photographs are taken by children themselves, to explore children’s experiences of living with a chronic condition and the impact condition management may have on their everyday lives. In this paper we critically explore the issues arising from our use of PEI including children’s participation and engagement, balancing power and control, and keeping children safe. The main areas of focus for the paper are how PEI provided a means of shifting control; how setting photographic boundaries influenced our PEI study with children; and how we addressed risks associated with the method. Our experience shows that PEI is an engaging and valuable research method, providing a powerful medium for obtaining rich data with children. However, PEI is challenging and it requires researchers to conscientiously address ethical and practical aspects that extend beyond those inherent to standard (words-alone) interviews. [ABSTRACT FROM PUBLISHER]

Background/Aim The “asphalt identikit” theory suggests that driving cessation inevitably leads to feelings of incompetence and dependency. This article challenges this proposition by investigating the driving-related possible selves of British older adults living in West London. Methods Thematic analysis of data from 19 of 39 interviews in which older adults participating in a larger study talked about driving in the context of their grocery shopping. Results Three themes were evident: “I can drive – that makes a huge difference,” “Expecting to lose my license,” and “I gave up my license.” Discussion Driving cessation is not a dreaded possible self for all older adults. Older adults may use a variety of identity maintenance processes to retain their positive sense of self. Conclusions Mental well-being can be maintained during driving cessation by finding ways to compensate for the loss of a license and finding alternative ways of achieving hoped-for possible selves. [ABSTRACT FROM AUTHOR]

Purpose: Community Treatment Orders lack evidence of effectiveness. Very little is known about how they are used in practice and over time in terms of what it obliges patients to do and the judicial threshold for remaining on an order.Aims: To investigate CTO implementation in England in terms of the use of specified conditions, and judicial hearings; whether these change over time, and; the level of continued coercion.Method: 36-month observational prospective study of patients on CTO in the OCTET follow-up study.Results: The number of CTO conditions remained stable over time but consolidated around medication adherence and remaining in contact with services. Ten percent of Mental Health Tribunal Hearings and only 1 percent of Hospital Managers Hearings resulted in discharge. Twenty-seven percent of patients experienced more than one CTO episode and eighteen percent remained under compulsion until the end of follow-up.Conclusions: CTOs seem to be used primarily to oblige patients to take medication and stay in contact with services. There is agreement between clinical and legal judgements about their appropriateness and threshold for use. A pattern of continuous coercion for a significant group of patients raises concerns. If CTOs are to be continued to be imposed, their use should be carefully monitored with further cohort studies with long-term follow-up. [ABSTRACT FROM AUTHOR]

The introduction of supervised community treatment, delivered through community treatment orders ( CTOs) in England and Wales, contrasts with the policy of personalisation, which aims to provide service users autonomy and choice over services. This article draws upon findings from a primarily qualitative study which included 72 semi-structured interviews (conducted between January and December 2012) with practitioners, service users and nearest relatives situated within a particular NHS Trust. The article also refers to a follow-on study in which 30 Approved Mental Health Practitioners were interviewed. The studies aimed to develop a better understanding of how compulsory powers are being used in the community, within a policy context that emphasises personalisation and person-centred care in service delivery. Findings from the interview data (which were analysed thematically) suggest that service users were often inadequately informed about the CTO and their legal rights. Furthermore, they tended to be offered little, or no, opportunity to make choices and have involvement in the making of the CTO and setting of conditions. Retrospectively, however, restrictions were often felt beneficial to recovery, and service users reported greater involvement in decisions at review stage. Areas of good practice are identified through which person-centred care can be better incorporated into the making of CTOs. [ABSTRACT FROM AUTHOR]

Research suggests a link between being in care and eating problems. The present study compared the eating behaviour of looked after young people and their non-looked after peers with a focus on the role of their perceived early childhood attachments. Looked after young people completed questionnaires about their perceived and unresolved attachment to their main caregiver during early childhood (aged 0 to 5), their level of picky eating and food disgust and the meanings they ascribed to food. They then nominated a non-looked after friend to complete the same measures. The results showed that looked after young people reported poorer scores on all aspects of early childhood attachments and were more likely to be ‘picky eaters’ and to find food disgusting. Further, they rated food as less embedded with meanings relating to sexuality, family life, a treat and social interaction. In addition, although care status independently predicted picky eating, food disgust and a belief that food was central to family life and social interaction, unresolved attachment was a better predictor of these variables. Unresolved attachment also significantly predicted a belief that food was a means to take control over one’s life. Being brought up in care is associated with eating problems and a less engaged approach to food. Poor attachment is a powerful explanation of this association. Carers and other professionals are key to the development of trusting relationships with looked after young people. Such secure attachments with carers and other professionals may enable looked after young people to foster a more positive relationship with food. [ABSTRACT FROM AUTHOR]

There has been substantial research on the implementation of personal budgets across adult social care in England, but relatively little exploration of take-up within the field of mental health--and whether personal budgets are providing an effective mechanism for service users to exercise greater power, choice and control in their lives. Drawing upon in-depth interviews with fifty-two people using mental-health-related social care services and twenty-eight social work and other practitioners, undertaken for a national study in 2010-13, this paper explores experiences from their different perspectives. Inter-views were undertaken in three English local authorities which were at different stages of implementing personal budgets in mental health social care. Data were analysed using an Interpretive Framework Approach. The findings provide evidence of how personal budgets may deliver opportunities for people to take more power and control, sometimes collaboratively with practitioners, and also identify some of the barriers and challenges which can militate against such outcomes. A key factor in enabling personal budgets to support empowerment and recovery was reported to be the quality and continuity of the professional relationship--which raises particular implications for the organisation of mental health social work and the organisational cultures within which this is situated. [ABSTRACT FROM AUTHOR]

The article discusses the late retirement conditions by the older people prevailing in the western countries, stating that the working life has extended such decisions. It states that the reason behind such decisions are linked with the individual factors of health, wealth and physiological working conditions. In order to get the proper data, regression models were build for aged workers. The result concluded preferred time of retirement, exit from work and psychological efforts by the workers.

This article begins to build knowledge of how non-violent coercive controlling behaviours can be central to children's experiences of domestic violence. It considers how children can be harmed by, and resist, coercive controlling tactics perpetrated by their father/father-figure against their mother. Already, we know much about how women/mothers experience non-physical forms of domestic violence, including psychological/emotional/verbal and financial abuse, isolation and monitoring of their activities. However, this knowledge has not yet reached most research on children and domestic violence, which tends to focus on children's exposure to physical violence. In this qualitative study, 30 participants from the UK, 15 mothers and 15 of their children (most aged 10-14) who had separated from domestic violence perpetrators, participated in semi-structured interviews. All participants were living in the community. Using the 'Framework' approach to thematically analyse the data, findings indicated that perpetrators'/fathers' coercive control often prevented children from spending time with their mothers and grandparents, visiting other children's houses and engaging in extra-curricular activities. These non-violent behaviours from perpetrators/fathers placed children in isolated, disempowering and constrained worlds which could hamper children's resilience and development and contribute to emotional/behavioural problems. Implications for practice and the need to empower children in these circumstances are discussed. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Messages Children experiencing domestic violence may be affected by more than the physical violence perpetrated by one parent against the other., Children may be harmed by non-physical abusive behaviours inherent to coercive control-based domestic violence, including continual monitoring, isolation and verbal/emotional/psychological and financial abuses., Responsibility for the impacts on children of coercive control-based domestic violence should be placed with the perpetrator (usually fathers/father-figures) and not with the victimised parent (usually mothers). [ABSTRACT FROM AUTHOR]

In this article we discuss the Department of Health's Positive and Safe initiative in the context of one Inner London mental health trust. The goal of the initiative is to reduce the use of restrictive practice in mental healthcare settings and to eradicate the use of prone restraint. We discuss how we are addressing the recommendations of the guidance and the new Mental Health Act 1983: Code of Practice. Implementation of the core elements of the approach are considered: these are behavioural support planning, reducing the use of restraint and post-incident reviews. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of Community Treatment Orders (CTOs) has been examined previously. However, few studies have explored the significance of service user and practitioner understandings. Aims: The study explored the experiences of service users, practitioners and nearest relatives, to identify key factors and good practice in relation to CTOs. Method: A study of CTOs in a mental health NHS Trust in Southern England, including 72 semi-structured interviews, analysed thematically. Results: CTOs were perceived as helpful in certain circumstances for the 'right' service user. Factors influencing effectiveness included recognition of the containing elements of the CTO, a respect for its legal authority and an acceptance of conditions. Conclusions: The perceptions of service users have an important role in determining the value and potential effectiveness of CTOs. A consideration of these issues should be integral to the process of assessing whether a CTO is appropriate in individual cases. [ABSTRACT FROM AUTHOR]

This paper outlines the findings from an English research study using an Interpretive Phenomenological Analysis methodology with service users of the Unified Adolescent Team (UAT) that was carried out in 2009. The UAT worked with adolescents between the ages of twelve and twenty and who had complex needs which led them to be identified as a 'hard to reach group'. The research identifies three super-ordinate themes that reflect the their experiences of receiving services from the UAT: in crisis and out of control, new helping relationships and building new lives. This paper discusses these findings and contextualises the work of the UAT with in the existing literature on positive engagement with this client group. [ABSTRACT FROM AUTHOR]

Aim: To explore patients’ lived experience of undergoing laparoscopic colonic resection on an enhanced recovery programme. Method: Eleven patients were interviewed at home, between 14 and 16 days following discharge. The transcribed interview texts were interpreted with a hermeneutical-phenomenological method. Findings: Participants were keen to achieve their goals and participate actively in the enhanced recovery programme. They strived to return to full health as soon as possible after surgery, but all participants indicated that it was taking longer than they had expected. As they became more independent regarding their self-care needs during their hospital stay, participants noticed that the nursing presence became more distant, which could result in unmet psychological needs. Their recovery at home was perceived to be taking longer than it should and was often prolonged by symptoms. The minimally invasive approach associated with laparoscopic surgery led the participants to expect a lesser physical and psychological effect from this major surgery. Conclusion: Nurses need to acknowledge and attend not only to the physical but also to the emotional needs of patients on an enhanced recovery programme, right up until the point of discharge. Nurses also need to prepare patients more fully for what to expect after discharge. [ABSTRACT FROM AUTHOR]

Serious Case Reviews (SCRs) for adults are commissioned to examine the ways in which local professionals and agencies worked together to safeguard a vulnerable adult or take place following harm or death of a vulnerable adult where there are concerns about agencies' actions or engagement. There is no national system in England for their collation or analysis. This paper presents the results of a study investigating SCRs for vulnerable adults where the person who was at risk of harm, harmed or died had a learning disability. Eighteen SCRs were identified and a further three where there are grounds for considering that the victim may have had such a disability. Three themes are presented: staff relationships; family and carers; and biography and chronology to draw out material relevant to social work policy and practice. At a time when the English government has announced plans for SCRs for adults to move to a statutory basis, this paper draws attention to their potential as learning materials, but also the risks of seeing them as presenting a full picture of practice. The case for local flexibility is argued. [ABSTRACT FROM AUTHOR]

The aim of this paper is to reflect critically on the current health promotion initiatives targeting overweight individuals in Western countries. The paper’s methodological approach is to draw on analytical findings from my and other sociologists’ empirical work on how the problems of overweight people are being defined in various settings in Denmark, England, Australia and the US. I try to illustrate how health promotion targeting overweight individuals can not only be seen as a project aimed at securing longer lives and fewer illnesses for people carrying excess fat but also a moral project that, in a more general sense, aims to tell people how they ought to live their lives. I link this moral aspect of health promotion to a) the medicalization tendency in current Western society (e.g. a growing pharmaceutical industry and its economic interest in transforming the human condition of being overweight into a treatable disorder) and b) the strong focus on individual risk today. One of the main arguments in the paper is that health in relation to overweight is primarily defined from a biomedical perspective that praises certain physical measurements of the body, as well as dominant societal values such as  self-responsibility and self-control, and that a combination of biomedicine and these dominating values can lead to health promotion becoming a problematic moral endeavour. [ABSTRACT FROM PUBLISHER]

Purpose -- The purpose of this paper is to report on the introduction of individual personal budgets for older people and people with mental health problems in one local authority (LA) in 2011. Design/methodology/approach -- Jenny Weinstein is a Hon Senior Lecturer at Kingston University, Professor Ray Jones and Rick Hood are based at the Joint Faculty of Health and Social Care, St George's, University of London and Kingston University, London, UK.A qualitative study is described in which structured interviews were carried out with participants belonging to each service user group. The study aimed to explore the following issues: first, service users' experiences of the assessment process, second, whether service users wanted full control of their budgets and third, if personal budgets make a difference to quality of life. Findings -- xService users (n = 7 older people and carers; n = 7 people with mental health problems) found the personal budgets system and assessment process difficult to understand and its administration complex. Older people in particular were reluctant to assume full control and responsibility for managing their own personal budget in the form of a Direct Payment. Participants in both groups reported their continued reliance on traditional home care or day care services. These findings were reported back to the LA to help staff review the implementation of personal budgets for these two user groups. Research limitations/implications -- Study participant numbers are low due to difficulties recruiting. Several potential participants were not interviewed due to their frailty. Practical implications -- Studies of this type are important for constructing local knowledge about national policies such as the implementation of personal budgets in social care. Originality/value -- Studies of this type are important for constructing local knowledge about national policies such as the implementation of personal budgets in social care. [ABSTRACT FROM AUTHOR]

The goal of this article is to address three research questions that are important for understanding self-injuring behaviors among homeless women: (1) Do homeless women self-injure? (2) If so, do the correlates of self-injuring behavior among homeless women in our self-injuring group differ in type from stressors experienced by homeless women who do not self-injure? (3) Do women who have engaged in self-injuring experience a greater number of significantly stressful events than those who do not? To answer these questions, we draw on data from the 55 in-depth qualitative interviews conducted in Manchester and Liverpool, UK. What our research demonstrates is that self-injury occurs and, in our sample, is linked not only to age and length of homelessness, but also to experiences of childhood trauma. Women in our sample who have engaged in self-injuring behaviors were also found to have experienced three or more significant stressors over their life course. [ABSTRACT FROM AUTHOR]