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Patients with functional stroke can present with functional speech, language or swallowing symptoms, which are managed by speech and language therapists (SLTs). The aim of this study was to explore SLTs' views and experiences of working with patients with functional stroke. Constructivist grounded theory approach was used. Semi-structured interviews were the method of data collection. Constant comparative analysis was used to analyse data. Participants were eligible if they were SLTs who thought they had experience of working with functional stroke. 12 participants were interviewed. Patients with functional stroke were a common occurrence on participants' caseloads; yet they felt patients do not receive optimum care. All participants wanted to help their patients, yet felt they were working within a multitude of barriers to effective input. These included: stigma about the diagnosis, lack of pre-qualification training, quick discharge from inpatient settings, lack of access to mental health services and lack of clinical guidelines and care pathways. As healthcare professionals, participants were keen to help their patients. However, they felt they did not have the skills or knowledge to help which caused professional turmoil. Reducing stigma and increasing awareness and knowledge of functional stroke are required to improve patient outcomes. [ABSTRACT FROM AUTHOR]

Objective: Family-based multi-component weight management programmes are recommended for adolescents with obesity in England and Wales, however, these programmes suffer from poor uptake and high attrition rates. This study aimed to gather the views of professional stakeholders in a UK weight management programme to identify potential areas to target to improve engagement and success for such programmes. Results: Semi-structured interviews were conducted with those involved in the commissioning, referral, coordination or delivery of a weight management programme (n = 11). Interviews were analysed using qualitative content analysis. Three main categories developed: professional support, tailoring and intervention content. Participants recognised the importance of support from experienced professionals, as well as family and peers. There was agreement that longer-term support was needed for adolescents with obesity; suggestions included integrating follow-up support with schools and leisure services. Emotional and psychological support must be prioritised. Having a variety of delivery modes, such as group and one to one, particularly in the home environment, were recommended. Stakeholders agreed that weight management programmes for adolescents need to be more proactive at incorporating technology. By acting on the views of those that work closely with adolescents, engagement with weight management programmes may be improved. [ABSTRACT FROM AUTHOR]

The notion of inclusion has gained momentum worldwide, with most countries around the world embracing inclusive policies in their educational systems. However, there is still an ongoing debate as to what is inclusion and hence, the consequent challenge of coming up with an agreed definition, which could then be used to plan for and subsequently, evaluate, inclusion. This study adds to our understanding of inclusion by contrasting objective (i.e. School Census Statistics) and subjective (i.e. self-report questionnaire) measures of inclusivity in three mainstream secondary schools in England and by comparing the perceptions of school inclusivity of different groups of educational practitioners and pupils. The results of this study indicate that inclusion is a 'slippery' construct as the perception of inclusion of educational practitioners was found to be affected by their role at school while pupil perception on this matter depended upon their SEND category. However, despite these subjective differences in the way inclusion is perceived, there was also substantial agreement across the different categories of participants with regard to the relative ranking of inclusivity across the three schools suggesting that coming up with overarching themes on what is inclusion is achievable. The article ends with explaining the benefits of reaching an agreed definition at a national level. [ABSTRACT FROM AUTHOR]

Objective: Little is known about how first episode bipolar disorder (BD) is managed in early intervention for psychosis services (EIS). We aimed to investigate the knowledge and views of EIS staff on the assessment and treatment of BD. Methods: A 27-item anonymised online questionnaire was distributed to EIS mental health professionals in England. Descriptive data analysis was undertaken. Results: Responses were received from 117 EIS staff. Most were 'fairly confident' in their knowledge about causes, presentations and relapse indicators of BD, but less confident on pharmacological and psychological treatments. Eighty five percent expressed the view that more BD training was necessary in this area with 78% reporting no clear care packages within the service. Seventy two percent believe early BD should be treated within EIS only if patients have psychosis. Conclusions: Clearer care packages and staff training are needed for EIS staff to optimise care for BD. [ABSTRACT FROM AUTHOR]

While child protection social workers (CPSWs) make decisions about which children with an injury need a medical examination, we do not know how they make these decisions. We aimed to ascertain the knowledge, attitudes and training of CPSWs in regards to assessing childhood bruising. Paediatricians' views on the bruising knowledge and training of CPSWs were also explored, as well as the relationship and communication between the two professions. Semi-structured, face-to-face interviews were conducted with 39 CPSWs and 16 paediatricians across South Wales and South West England. Interviews were recorded and transcribed until data saturation was reached. Using NVivo, two independent assessors conducted a thematic analysis, identifying themes emerging from the data with group comparisons where appropriate. CPSWs lack confidence in assessing bruising with knowledge gaps regarding bruise patterns and the lack of evidence for ageing bruises. This appears to be linked to an almost complete lack of training. An important theme was that CPSWs regard the clinician's view as paramount, yet paediatricians feel that there is an over-expectation of what a child protection medical can conclude; this exemplified some of the communication issues between the professions. Evidence-based training of CPSWs is needed jointly by health and social care professionals, including an understanding of the respective roles. Copyright © 2017 John Wiley & Sons, Ltd. Key Practitioner Messages CPSWs lack confidence in assessing bruising characteristics associated with physical abuse, largely due to their lack of training., CPSWs' decisions to refer for medical examinations are strongly influenced by an exploration of history and key social factors, including chastisement strategies and the home environment., Paediatricians are unaware of CPSWs' training or knowledge, and thus have unrealistic expectations of their assessment of bruising characteristics., Communication between professionals could be improved by joint professional training in this area, providing current scientific evidence relating to bruises and an explicit explanation of the role of each in this assessment. [ABSTRACT FROM AUTHOR]

Background: Increasing numbers of people are living with, and beyond, cancer. They are at risk of long-term morbidity and premature mortality due to the consequences of their disease and its treatment. Primary care can contribute to providing ongoing care.Aim: To determine the current practice and views of GPs in England regarding cancer survivorship care.Design and Setting: Online survey of a sample of 500 GPs, stratified by NHS region in England.Method: The survey included questions adapted from prior surveys assessing physician knowledge and attitudes regarding care of patients with cancer.Results: In total, 500 GPs responded; approximately half reported often providing care to people living beyond cancer for treatment-related side effects (51%), psychological symptoms (65%), and lifestyle advice (55%). Only 29% felt very confident managing treatment-related side effects compared with 46% and 65% for psychological symptoms and lifestyle advice respectively. Half reported usually receiving cancer treatment summaries and survivorship care plans but most of the sample felt these would improve their ability to provide care (76%). Only 53% were convinced of the usefulness of cancer care reviews. Although most felt that primary and specialist care should share responsibility for managing bone (81%) and cardiovascular (77%) health consequences, fewer than half reported often taking previous history of cancer or cancer treatment into consideration when assessing bone health; only one-fifth did this in relation to cardiovascular health. Most responders were interested in receiving education to improve their knowledge and expertise.Conclusion: GPs have a potentially important role to play in caring for people following cancer treatment. This study has highlighted areas where further support and education are needed to enable GPs to optimise their role in cancer survivorship care. [ABSTRACT FROM AUTHOR]

In 2004, the author carried out a small scale study to find out the views of those living and working in private care homes in England about a range of issues connected to inspection, regulation and ways to better protect older people. This study reports on views from 19 managers and 19 residents about their understanding of abuse, their perceptions of the different forms of abuse and the possible action to deal with offending care staff. Although there was some consensus about the seriousness of certain types of abuse and how managers would investigate the allegation, the findings indicate that mandatory training for registered care home owners and managers is necessary to clarify their responsibilities in relation to their actions and the reporting of certain offences to relevant agencies. Residents' views also need to be taken seriously if they are to voice their opinions about life in a care home. [ABSTRACT FROM AUTHOR]

Background: Older adults are at increased risk of falls due to ageing, decreased muscle strength and impaired balance. Clinical trials have demonstrated the efficacy and effectiveness of the Falls Management Exercise (FaME) programme in improving functioning and preventing falls. However, programme completion is often low, impacting the potential benefits of FaME., Objective: To explore the barriers and facilitators for participation and completion of the FaME programme from an instructor and participant perspective., Methods: Semi-structured interviews were conducted with 20 FaME users and seven Postural Stability Instructors from the East Midlands region of England, UK. Interviews were conducted using a topic guide and explored their views of the programme, intended benefits, reasons for participating, instructor's approach and venue facilities. Data were transcribed verbatim and analysed using thematic analysis. Written informed consent was obtained from all participants and instructors., Results: Common themes identified by participants and instructors for adherence related to perceived health benefits, psychological well-being, intervention characteristics, cost, instructors' qualities, opportunity to socialise, venue accessibility and facilities. Further factors such as maintaining independence, discipline, relationship with peers and caring responsibilities influenced participants' engagement with the programme. Instructor factors such as progression were also reported as important predictors., Conclusions: Instructor and participant factors influence uptake, attendance and adherence of FaME. The findings from this study can inform the development and improvement of additional falls-prevention programmes. It can also guide marketing strategies to promote uptake of exercise-based falls-prevention programmes among older adults., (© The Author(s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Provision of contraception to women in the immediate postnatal period has been endorsed by professional bodies, to reduce the incidence of short inter-pregnancy intervals. This study examined the views of postnatal women and practising midwives regarding provision of contraceptive advice and contraceptive methods by midwives, in a region of the United Kingdom., Methods: A mixed-method approach using qualitative interviews with midwives, and a postnatal survey followed by qualitative interviews with postnatal women, in five hospitals in the East of England. Twenty-one practising midwives and ten women were interviewed. Two hundred and twenty-seven women returned a survey. Survey data was analysed descriptively, augmented by Student's t-tests and Chi-squared tests to examine associations within the data. Interviews were recorded, transcribed and analysed guided by the phases of thematic analysis., Results: Midwives and women supported the concept of increased midwifery provision of contraceptive advice, and provision of contraceptive methods in the postnatal period. Convenience and an established trusting relationship were reasons for preferring midwifery provision over visiting a doctor for contraception. The best time for detailed discussion was reported to be antenatal and community visits. The Progesterone-only-pill (POP) was the method, in which women indicated most interest postnatally. Concerns for midwives included the need for increased education on contraceptive methods and training in supplying these. Structural barriers to such provision were time pressures, low prioritisation of contraceptive training and disputes over funding., Conclusions: Women reported interest in midwives supplying contraceptive methods and expressed the view that this would be convenient and highly acceptable. Midwives are supportive of the concept of providing enhanced contraceptive advice and methods to women in their care, and believe that it would be advantageous for women. Institutional support is required to overcome structural barriers such as poor access to continuous professional development, and to allow contraceptive provision to be fully recognised as integral to the midwifery role, rather than a marginalised addition.

Objectives: Over the last decade, technological advances, market competition and increasing pressures for efficiencies across healthcare systems have resulted in changes to the processes and policies involved in medicines prescribing and dispensing. The aim of this study was to explore the views of family practice staff, including GPs, on the perceived impact of changes associated with remote dispensing and the increasing availability of distance-selling pharmacies., Methods: Exploratory mixed-methods study using qualitative focus groups and an online cross-sectional survey distributed to a non-probability sample of staff from family practices across England. Survey items were developed based on existing literature and initial thematic analysis from the focus groups and adapted using cognitive interviewing techniques., Key Findings: Findings suggest that family practice staff believe that where and how prescriptions are dispensed impacts on their practice and patients. Frequent contact with distance-selling pharmacies is not common; however, highlighted concerns included patient safety issues and the potential threat to the loss of valued elements and sustainability of community pharmacy and dispensing practices. Identified concerns and experiences are unlikely to be routinely discussed within or between practices, limiting opportunities for shared learning and consideration of the potential impact of changes to dispensing processes and policies., Conclusions: Further research is needed to confirm these exploratory findings, due to the low response rate and sample size. Findings, nevertheless, highlight how wider changes in dispensing processes may have unintended consequences on other aspects of the healthcare system., (© 2019 Royal Pharmaceutical Society.)

Focuses on the panoramic view of Scarbourough in England and Mont Blanc in Italy. Background information about Osbaldelston who owned the title as "squire of England; Awards receive by Osbaldelston; Description of Mont Blanc.