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As elsewhere across the globe, for the past two decades doctoral education in the UK has been in the throes of change. This article seeks to describe and analyse developments in 1) the national framework for doctoral education, 2) institutional structures, 3) doctoral programmes, 4) doctoral candidacy, 5) doctoral supervision and 6) doctoral examination. Multiple sources of evidence, including official documentation and the results of investigations of the public-facing websites of the 150 institutions providing doctoral programmes, are used. The conclusion shows that these changes have been far-reaching, particularly for supervisors, and a call is made for greater recognition of their contributions to doctoral education.

Purpose: This paper examines how the COVID-19 pandemic has accelerated digital developments in apprenticeship and work-based learning in higher education (HE), focusing on practices that have ongoing value. Design/methodology/approach: A literature review was carried out on the theme of HE work-based and work-integrated learning during the pandemic, followed by minimally-structured interviews with UK university staff responsible for apprenticeship and other work-based programmes. Findings: The pandemic has accelerated adoption of online and digital methods to support work-based and apprenticeship learning. There has been progress from emergency measures to more pedagogically consistent ones. A blended approach is becoming common, with the learning and logistical benefits from digital methods ensuring their continuing use. Progress is uneven and there is still a need for improved digital pedagogy and better integration of theoretical and practical learning. Practical implications: More attention is needed to digital pedagogy and to effective use of online methods to support work-based learning with corresponding implications for staff development. There are institutional implications in terms of ensuring that systems and structures support what is, particularly for work-based learners, likely to be a permanent move towards digital, blended and online learning. Originality/value: There has been limited research on the impact of the pandemic on work-based learning, with most of the literature focusing on placements and projects. This paper presents findings at a point when universities are considering how technologically-supported methods will be employed on a more permanent basis.

Purpose: This paper examines architecture as an example of the evolving context of qualifying routes in UK professions. Design/methodology/approach: The background and current state of architectural education, qualifying routes and regulatory frameworks in the UK is presented as a case-study, and compared with practices in professional education and qualifying more generally including the use of Degree Apprenticeships. Findings: Architecture has since the 1960s maintained an entry-route that is premised on periods of full-time academic study plus full-time practice. While a minority part-time version of this route has always existed (and is now being expanded through Degree Apprenticeships), variations seen in other professions such as experienced practitioner entry and accelerated routes from cognate fields have so far been lacking. Pressures for reform are emerging both from external changes affecting the profession and from the high cost of qualifying in relation to median incomes in the sector. Practical implications: There is a need for more flexible and less expensive routes to qualifying as an architect, with substantial scope to use practices from other professions and areas of higher education to recognise existing levels of competence and improve crossover with other design and construction fields. Originality/value: This is the first review of architectural qualifying requirements that has been made in the context of professional entry more generally.

This article reports the findings of four separately commissioned evaluations of alternative provision (AP) undertaken in three local authorities in the UK. The evaluations were specifically predicated on the principles of children's rights and used a combination of qualitative research methods and documentary analysis to elicit the experiences of young people in conjunction with the viewpoints of key stakeholders. Data from each evaluation was gathered over a total period of 6 years. The sites and time scales for each evaluation varied from 6-month authority-wide strategic reviews to a 3-year evaluation of an AP free school and an evaluation of pupil referrals in a large school partnership. The evaluations involved 200 participant children and young people, 30 managers and stakeholders, 8 parents of non-attending pupils and local authority officers and school governors. The evaluations report the complexity of needs amongst children and young people; the continuing problem of unsuccessful transitions between key phases/stages of education and the profound consequences of this for young people; assumptions around mainstream reintegration and managed moves; and the curriculum challenges of vocationalism and academic emphasis. While the research data confirms the positive value of multi-agency approaches in AP, it also shows a more recent troubling increase in the number of young people now being referred to AP as a consequence of their exposure to performative school cultures.

While universities are increasingly focused on developing "green" practices on their campuses and integrating sustainability concepts into their curricula, few have considered the potential impact that their online learning programs may already be having on the environment. Online classes result in paper not printed, miles not driven and classrooms not lighted thereby reducing the carbon footprints of the sponsoring institutions. Yet, despite the growing enthusiasm of academic institutions to be recognized as "sustainable universities", most have overlooked the potential of their online learning operations to contribute to their long range goals for environmental stewardship. Consequently, the purpose of our paper is to present a proposed framework for measuring the sustainable impact of online learning which is currently being pilot tested at University of Dallas. We report results from the pilot data in the spring and summer semesters of 2009 and concludes with suggestions for establishing measurement models at other institutions where partnerships between university administrators, faculty and students hold promise for leveraging the sustainable impact of online learning. (Contains 4 tables and 3 figures.)

Purpose: The purpose of this paper is to describe a revised approach describing occupational competence, with particular reference to its application in two European countries at the level of specific occupational fields and in relation to the models used in national vocational education and training (VET) systems. Design/methodology/approach: An Erasmus+ project involved partners in five countries developing and trialling competence standards, following principles developed from approaches that have recently emerged in some British self-governing professions. Findings: The model used in the project avoids the narrowness that was characteristic of earlier British approaches to occupational competence. It provides a template that can be used for articulating the essentials of practice, including in emerging fields and those that cut across professions and occupations. It is also flexible enough to provide underpinnings for different types of VET system without making assumptions about the way that economies, labour markets and education systems are organised. Practical implications: A number of factors are outlined that improve the applicability of practice-based competence descriptions, including starting from occupational fields rather than job roles, focusing on the ethos and core activities of the field, and using concise and precise descriptions that are not limited to specific roles and contexts. Originality/value: A tested, practice-based model of competence is put forward that can be applied at the level of broad professional or occupational fields, is neutral in respect of national labour markets and educational systems, and offers a means of developing a common "language" of competence at a European level.

Purpose: The purpose of this paper is to discuss the problems of applying competence standards to professional-level work, noting limitations in functional approaches and drawing on developments in professions and on a recent Erasmus+ project to propose a more adequate alternative. Design/methodology/approach: An approach to describing competence based on previously reported developments in some self-governing, principally British professions was used to inform an Erasmus+ project that created competence standards for five higher-level occupations in different European countries. Findings: The original developments in professions and further work through the project both endorse a model of competence that is based on standards of practice, applies holistically to professional or occupational fields rather than focusing on work roles and functions, respects contextual factors in defining competent action, and necessitates situational interpretation and judgement. Practical implications: Descriptions of professional competence need to avoid being overly constrained by assumptions about the roles that practitioners might perform or the context in which practice takes place. They need to reflect the ethos and ethics of the field as well as more transversal aspects of professionalism. Descriptions of this type are likely to reflect factors that are also valued in higher education. Originality/value: The model of competence that is proposed appears to have a good level of validity for high-level professional work, and provides an approach to describing practice that is not limited to particular national contexts.

Purpose: The purpose of this paper is to review the use of "competence" as a concept and through the use of occupational competence standards in six European countries. Design/methodology/approach: Partners in an Erasmus+ project in each of the six countries prepared a review of the use of "competence" in their countries using a common template. The authors of this paper reviewed additional literature, summarised the individual country reviews and provided an analysis and commentary. Findings: "Competence" is becoming a widely used concept across Europe, but its interpretation and application both vary. Between them, the countries in the study illustrate the use of separate occupational standards, both as a national strategy and developed by self-governing professions; as well as competence embedded directly in qualification and training specifications. The use of separate standards as a mandatory component in national vocational education and training systems is questioned, while the use of appropriate standards for licensing and qualified status is largely endorsed. Research limitations/implications: The country reviews were conducted principally from the perspective of informing the developments taking place in the project, so were not comprehensive and also differed in emphasis between countries. Practical implications: The study points to the need to avoid promoting any particular model of occupational competence at a European level, as opposed to seeking common ground that will aid mutual recognition of qualifications. It also cautions against the uncritical transfer of models and policies from one national system to another. Originality/value: The paper provides additional evidence against "policy borrowing" without careful consideration of context, and contrasts the use of competence standards as part of a system-wide strategy with their tailored application for specific purposes.

The aim of this paper is to map the pattern of awards for research degree supervision in institutions in Australia and the United Kingdom. In particular, it explores the scope of such awards, their objectives, the criteria for nomination, the evidence required to be submitted, the composition of award panels, the criteria for award, and the rewards and conditions attached to success. Marked differences are found between these features in the two systems, which it is argued stem mainly from the fact that in Australia institution-led awards are the norm, while in the UK student-led awards are predominant. In conclusion, it is suggested that, while institution-led awards seem more likely to be effective in identifying, recognising and rewarding exemplary supervision, students can and should have an important role to play and, hence, that optimally all stakeholders should be involved in the awards process.

Purpose: The purpose of this paper is to discuss the benefits of reclaiming the idea of professional competence and challenges fragmented approaches to academic qualification and professional recognition. It is argued that academic programmes that are integrated with the requirements for professional recognition can resolve the potentially unhelpful differentiation between "theory" and "practice" and between "knowledge" and "competence". Design/methodology/approach: Three contextualised case studies are presented to demonstrate a range of possibilities for developing academic programmes that integrate professional competence in the fields of construction, aviation and management. Findings: It is argued that the examples described provide some evidence that where competence is conceived of as a matter of open on-going professional development, it can be effectively integrated and aligned with the intended outcomes of academic qualifications. Furthermore, that the examples described demonstrate that the idea of professional competence can operate to ground knowledge in practice contexts and ensure that professional values are positioned as a requirement of being qualified. Originality/value: The diversity of the examples provided across three distinct sectors illustrate the potential for wider curriculum development opportunities for higher education practitioners. The need to align professional body recognition with academic qualification for higher and degree apprenticeships may also indicate significant implications for policy in this area. The cases presented provide evidence that academic qualifications can be developed that are at the same time recognised by employers as delivering a professionally competent workforce. This kind of development activity can provide both an incentive for employers to pay for education and training and opening opportunities for career progression for those in work.

Competence frameworks and standards are increasingly used by professions in the UK, driven by pressures for professional accountability, and particularly by the trend towards assessing practice before fully-qualified status is granted. A review of 40 UK frameworks indicated that most are concerned primarily with the ability to undertake work activities and roles to an appropriate standard: i.e. they reflect a predominantly external or activity-based approach to competence. The better frameworks recognise that competence standards cannot provide prescriptions for practice, reflecting the need for practitioners to act intelligently and ethically, and to make judgements in complex and unpredictable situations. They also support valid, robust and consistent assessment, and are capable of being adopted in different practice contexts while remaining sufficiently precise. The overall standard of competence frameworks is, however, variable, with some being little more than adapted course curricula or simple lists of activities that rely on a high level of tacit agreement about what is needed in practice. The "project" of developing professional competence frameworks is a work in progress, with much to be learned from the best examples of the type.

In addition to the familiar occupational standards that underpin National Vocational Qualifications, the UK has a parallel if less complete system of competence or practice standards that are developed and controlled by professional bodies. While there is a certain amount of overlap between the two types of standard, recent research points to a distinct professional, as opposed to occupational, perspective on work competence. This can be characterised as focusing on ethics, professionalism and key standards rather than the detail of roles and functions; being designed to apply across the profession rather than having a core-and-options structure; and providing confidence in practitioners' abilities to act as a member of the profession rather than in a bounded occupational role. These factors are illustrated by reference to practices in professions with which the author has worked, suggesting that there is a spectrum of approaches from this archetypally professional one to a more utilitarian, occupationally oriented one.

Aims: Early intervention in people with an at‐risk mental state (ARMS) for psychosis can prevent the onset of psychosis. Clinical guidelines recommend that ARMS are referred to triage services, and then to Early Intervention (EI) teams in secondary care for assessment and treatment. However, little is known about how ARMS patients are identified and managed in UK primary and secondary care. This study explored patients' and clinicians' views of ARMS patients' care pathways. Methods: Eleven patients, 20 GPs, 11 clinicians from the triaging Primary Care Liaison Services (PCLS) and 10 EI clinicians were interviewed. Data were analysed thematically. Results: Most patients said their symptoms started in adolescence with depression and anxiety. Before being referred to EI teams, most patients were referred by their GP to well‐being services for talking therapies, which they had not found helpful. Some GPs said secondary care's high acceptance thresholds and scarce treatment availability made them reluctant to refer to EI teams. Triage in PCLS was influenced by patients' risk of self‐harm, and formulation of psychotic symptoms; only those without clear evidence of other pathology and not at high risk of self‐harm were referred to EI teams, the others being referred to Recovery/Crisis services. Although patients referred to EI teams were offered an assessment, only some EI teams were commissioned to treat ARMS. Conclusions: Individuals meeting ARMS criteria might not receive early intervention due to high treatment thresholds and limited treatment availability in secondary care, suggesting clinical guidelines are not being met for this patient group. [ABSTRACT FROM AUTHOR]

The article considers challenges faced in undertaking research work that examines issues of abuse and neglect, with young people acting in the role of co-inquirer. Based on a research process devised to support a qualitative study exploring why young people think they are frequently not believed when they report abuse and neglect, consideration is given to the issues encountered in facilitating the direct involvement of young people in research of this nature. Discussion is provided as to how young people were actively recruited to the co-inquirer role, the scope of the work they undertook and the strong ethical framework that had to be put in place to support their participation. It is argued that the involvement of young people as co-inquirers has to take account of their experiences, feelings and reactions to the demands of such work. It is also acknowledged that work of this nature can be extremely demanding especially when those involved have themselves been the victims of abuse and neglect. (Contains 1 table.)

The TRAVORS projects, supported by the European Union's Lifelong Learning Programme, ran between 2008 and 2012. Their object was to develop training programmes for disability employment practitioners across nine countries based on proven approaches both to vocational rehabilitation and to skills training. The second of the two projects aimed to trial and establish a European practitioner qualification, pitched at Level 5 of the European Qualifications Framework and emphasising skills-based training and workplace assessment. While the trials proved successful, they highlighted a generally poor level of understanding of assessment and certification based on workplace proficiency. The project resulted in a common "curriculum", a detailed qualification specification and a strengthened set of processes to guide implementation in different countries. However, the qualification can be considered a work-in-progress and wider uptake--sufficient to support sustainable central governance--needs to be achieved if a genuinely international certificate is to emerge.

The growth and evolution of professional doctorates in Australia, the UK and other parts of the English-speaking world has been widely reported and discussed. Recently, forms of doctorate have emerged that are not geared to specific professions or disciplines, and that are used by senior practitioners as vehicles for professional development and for addressing complex work issues. These transdisciplinary, candidate-centred, research-and-development programmes can collectively be referred to as work-based doctorates. Although stemming from more than one tradition, they are evolving towards a set of common practices that reflect the transdisciplinary model of work-based learning used in some UK and Australian universities. Evidence is beginning to indicate that these doctorates have significant value in terms of organisational benefit and individual professional development, and, although they still occupy disputed territory within the university, they are capable of being conceptualised and implemented in a way that is intellectually rigorous and robust.

National and transnational qualifications frameworks are an increasingly present feature of the education and training landscape. The United Kingdom can be regarded as one of the pioneers of qualifications frameworks, with partial frameworks appearing from the mid-1980s onwards. However, approaches in England if not in the whole of the UK have remained fragmented compared with the best examples from other countries. The recently-introduced Qualifications and Credit Framework (QCF) introduces partial innovations particularly in enabling credit for smaller achievements and allowing employers and practitioner communities to contribute content into the framework. However, the framework is largely limited to vocational qualifications outside of universities; it is not particularly well integrated with the higher education, professional, and at present, school sectors; and it lacks responsiveness to innovations in qualification design. The QCF has been described as a "strong" or regulated framework, although a more apposite term might be "brittle."

This article by Gordon Stan White, who is SENCo and Head of the Foundation Stage Resourced Provision at Lowerhouses CE School in Huddersfield, considers the role of resourced provisions or "units" within the present school system. Issues discussed include transition, the impact of children being transported out of their local communities, the social and academic benefits and tensions for the children, implications for mainstream teachers and support assistants, and the impact on school standards. The article also discusses the role of resourced provisions in the wider debate over inclusion, analysing whether they are an integral part of genuinely inclusive educational provision or simply make up deficiencies within a fundamentally flawed system. The author concludes that, in the absence of the political will and funding to create a truly inclusive system, although resourced provisions have significant limitations, the access to a mainstream environment with mainstream peer role-models coupled with specialist support provides the best opportunity within the present system for children with special educational needs to make academic, social and emotional progress.

Since the 1980s there has been significant growth in the engagement of higher education with workforce development, with among other things the emergence of a distinct if varied area of provision commonly referred to as work-based learning. Recent examination of practice and literature indicates a growing sophistication in the way that work-based learning is being theorised and facilitated in higher education, with its gradual emergence as a distinct field of practice and study supported by relevant pedagogies and concepts of curriculum. Tensions continue to exist between the demands and opportunities provided by the workplace and the need to develop capable practice, support personal development and maintain academic validity; however, universities are beginning to engage with these issues at a deeper level than that suggested by simple notions of employer engagement and skills development, and the evidence indicates that well-designed work-based programmes are both effective and robust.

There are three purposes for evaluation: evaluation for action to aid the decision making process, evaluation for understanding to further enhance enlightenment and evaluation for control to ensure compliance to standards. This article argues that the primary function of evaluation in the "Catherine Wheel" computer-based assessment (CBA) cyclic model is evaluation for action and secondary functions are evaluation for understanding and control. By studying segment and cyclic dependencies, conducting a risk analysis and identifying key stakeholders it is possible to identify where action evaluation has the most effect, what is required to be evaluated, who will perform the action and how it will be controlled. Each segment and cycle in the CBA model must therefore be monitored and the observations made must have meaning for the elimination or reduction of pedagogic, operational, technical non web-based, web-based and financial risks. It is important to consider stakeholders because they have differing views on what is most important in the evaluation process and inevitably will be involved in the evaluation process itself. CBA system stakeholders include management, academic, support and administrative staff together with external verifiers and students. The information gained from these stakeholders provides quality enhancement and assurance and forms the basis for change. (Contains 2 figures and 3 tables.)

The traditional role of the facilitator in outdoor education is frequently seen as outside the group of participants, either in a position of power over the participants or detached and passive. Following an ethnographic study at a residential outdoor centre, an in-depth analysis of the facilitation process was carried out, which revealed that the facilitator is always part of the group, and that the type of influence that the facilitators have on the outdoor learning process depends on the way that they approach their role within the group. For the purpose of this paper, the term "facilitator" is used to refer to both centre staff as well as visiting teachers accompanying the school groups. This paper addresses critical questions regarding the effectiveness of the outdoor learning process when a position of power is adopted. The paper will also show the impact that recognizing the facilitator as a member of the group has on the learning experience in the outdoor classroom. (Contains 12 notes and 1 table.)

In the UK fully qualified status in professional occupations is normally awarded by a professional association or registration body. Both the requirements and the routes for qualifying vary between professions, although the majority include an academic component combined with or followed by a period of assessed practice. In recent years there have been pressures on professions to broaden their entry routes while at the same time becoming more rigorous in the way that they sign off practitioners as fit to practise. A small-scale study undertaken in 2007 investigated how different professions operate entry routes and qualifying processes. The findings indicate a trend towards increased flexibility, more thorough assessment of the practising phase, and some movement away from defined routes towards frameworks with robust exit criteria. The pace of change is nevertheless uneven, and there is scope for professions to learn from one another and from recent developments in higher education. (Contains 1 table.)

Purpose: This paper sets out to examine whether the process of accrediting prior experiential learning (APEL) as used in UK universities is the most appropriate approach for providing academic recognition for work-based projects and learning. Design/methodology/approach: Work-based projects that had already been assessed in the context of a professional qualification were re-examined to identify how they might be used towards a master's degree and what if any additional work the candidates would need to complete. Findings: The study finds that in most cases it appeared that the candidates would be able in principle to gain a full master's degree based on their existing work and associated reflection and writing-up, without the need to carry out additional investigation or projects. Research limitations/implications: The findings are based on a small sample of individuals from a specific field (the conservation of cultural heritage), and while the findings are clear and appear to have wider applicability they can only be regarded as pointers for practical trialling and further investigation. Practical implications: The findings suggest that the current approach to APEL used in UK universities needs to be expanded so that awards can be made substantially on the basis of already-completed workplace projects. A trial of this approach is proposed using candidates from the cultural heritage sector. Originality/value: The paper proposes a basis for changes to credit practice that will provide better scope for individuals to use and build on workplace activities in gaining academic awards. (Contains 3 tables and 1 figure.)

This article discusses the research approach adopted by one higher education institution in the United Kingdom (UK) to explore employers' and employees' responses to local skills, recruitment and training issues and how these responses were used to develop a curriculum for Foundation degrees. The article discusses skills issues, the varying research methods employed, barriers to development and how specific problems were resolved. A brief discussion on reactions and attitudes towards Foundation degrees and responses from public and private sector organisations is also presented. The results of the research are currently being used to inform curriculum development processes.

Objectives: To understand how the delivery of dementia‐related social support services across the UK adapted during the pandemic. Methods: We devised a two‐part online and telephone longitudinal survey. Providers participated between March and June 2021, and again 3 months later. Information relating to services delivered and delivery methods employed was collected before and during the pandemic at two timepoints (T1 and T2). Results: A total of 75 participants completed the survey at T1, with 58 participants completing the survey at both timepoints. Thirty‐six participants had complete data at T1. Day care centres and support groups were the most delivered primary services. During the pandemic, services shifted from in‐person to remote or hybrid. While in‐person services started to resume at T2, most services remained hybrid. At T2, the frequency of service delivery increased, however, a decreasing trend in usage was observed across survey timepoints. The telephone was the most employed format to deliver remote and hybrid services, however, reliance on videoconferencing software significantly increased at T1. Videoconferencing software was often used alongside the telephone and emails to remotely deliver services. Conclusions: Services were able to adapt and provide support to some service recipients. Complementing novel approaches to service delivery with more traditional formats may facilitate access to service recipients with limited digital literacy. Following the easing of public health measures, many service recipients may be reluctant to engage with in‐person services. Thus, the provision of in‐person and remote services needs to be carefully balanced amidst the current hybrid landscape. Patient or Public Contribution: Two public advisors (a former unpaid carer and a person living with dementia) were involved in designing and piloting the tool, interpreting the results and disseminating the findings. Both public advisors have experience in delivering dementia‐related social support services before and or during the pandemic in the United Kingdom. [ABSTRACT FROM AUTHOR]

An interactive, computer-based assessment system implemented at the University of Luton (England) delivers end-of-module examinations, formative assessments, and self-assessment options. Student and faculty response to computer-based objective testing has been positive and suggests the approach is desirable both pedagogically and economically. Aspects of program design and implementation are discussed. (Author/MSE)

Background Little is known on whether associations between childhood autistic traits and psychotic experiences persist into adulthood and whether genetic confounding and childhood trauma influence them. Here we investigate the associations between childhood autistic traits and psychotic experiences until young adulthood and assess the influence of schizophrenia polygenic risk and childhood traumatic experiences, using the Avon Longitudinal Study of Parents and Children (ALSPAC) population-based birth cohort. Study design We used a measure of broad autistic traits (autism factor mean score), and four dichotomised measures of autistic traits capturing social communication difficulties (age 7), repetitive behaviours (age 5), sociability (age 3), and pragmatic language (age 9). Psychotic experiences were assessed at ages 18 and 24 using the semi-structured Psychosis-Like Symptoms interview (PLIKSi). Traumatic experiences between ages 5 and 11 were assessed with questionnaires and interviews administered to children and parents at multiple ages. Study results Broad autistic traits, as well as social communication difficulties, were associated with psychotic experiences that were distressing and/or frequent until age 24 (autism factor mean score, n = 3707: OR 1.19, 95%CI 1.01–1.39; social communication difficulties, n = 3384: OR 1.54, 95%CI 0.97–2.45). Childhood trauma mediated a substantial proportion of the identified associations (~28% and 36% respectively, maximum n = 3577). Schizophrenia polygenic risk did not appear to confound the associations. Multiple imputation analyses (maximum n = 13 105) yielded comparable results. Conclusions Childhood trauma may be an important, potentially modifiable pathway between autistic features and later onset of psychotic psychopathology. [ABSTRACT FROM AUTHOR]

Background: Psychological therapy assessments are a key point at which a person is accepted into a service or referred on. There is evidence of service users experiencing harm, dropping out of services and potentially experiencing poor outcomes because of inadequate assessment practices. Approaches to assessment tend to be developed by individual services, with a lack of research identifying what makes a good assessment. Methods: This survivor‐led study, based in England, aimed to generate guidelines for conducting trauma‐informed psychological therapy assessments. The study was guided by a Service User Advisory Group and a Clinician Advisory Group. The study was conducted in three key stages: (i) identifying, modelling and drafting guideline content (ii) modified Delphi study and (iii) guideline finalization. Stage 1 was informed by literature reviews, qualitative research, data workshops with Advisory Groups and an expert consultation. Fifty‐nine people with relevant experiences then participated in a single‐stage modified Delphi (Stage 2). The guidelines were finalized through an analysis of Delphi open comments and a final expert consultation (Stage 3). Results: The guidelines evolved through each stage of the process, and all items were deemed important by >90% of Delphi participants. The final trauma‐informed guidelines contain eight principles, including 'focus on relationships', 'from systems to people' and 'healing environments'. Conclusions: Experiential knowledge was key in generating the guidelines and conceptualizing content, with a consequent focus on areas, such as recognizing power differentials, understanding oppression as trauma and the relational aspects of assessments. Future research should focus on guideline implementation and investigate whether this impacts service user dropout, engagement with therapy, and outcomes. Patient or Public Contribution: This study is an example of survivor research, with several authors, including the study lead, identifying as survivors. We consider the ways in which our identities as survivor researchers impacted the study findings. [ABSTRACT FROM AUTHOR]

Objectives: Little is known about how community services and institutional care settings have adapted to providing support since the COVID-19 pandemic. The aim was to explore how these care services have adapted during the pandemic in the UK and are providing care to people living with dementia (PLWD) and carers. Method: Semi-structured telephone interviews were conducted in June and July 2020 with 16 purposefully sampled unpaid dementia carers. Participants were asked about their experiences of accessing care services since the lockdown, and whether they were beneficial, if accessed at all. Results: Three themes were identified: (1) Impacts of no activities; (2) Difficulties accessing care during the pandemic; (3) Remote vs. face-to-face support. Loss of access to previously enjoyed activities and having had to shield for many PLWD is suggested to have led to severe physical and cognitive deteriorations, advancing the dementia. Where remote support was available, this was helpful to some, but did not replace the benefits of face-to-face support. Where PLWD were residing in a care home, carers had very limited remote access. Conclusions: This is the first study to explore the impact on carers both from a community and institutionalised care angle. Few care services have adapted to providing remote support. With the vaccine taking time to be accessible to everyone, it is vital for organisations to work closely with carers and PLWD to adapt services to provide much needed support. [ABSTRACT FROM AUTHOR]

Self-stigma refers to the internalisation of negative societal views and stereotypes. Self-stigma has been well-characterised in the context of mental disorders such as schizophrenia but has received little attention in relation to post-traumatic stress disorder (PTSD). This work aimed to determine the prevalence of self-stigma in a sample of adults with PTSD and to establish factors associated with the internalisation of stigma in this population. Participants were 194 adults (mean age 46.07 (SD = 12.39); 64.4% female; 96.6% white Caucasian; residing in the UK), who self-reported a diagnosis of PTSD and currently screened positive for the disorder according to the PTSD Checklist for DSM-5 (PCL-5). Structured interviews and validated self-report questionnaires were used to ascertain clinical and sociodemographic information for analysis. The prevalence of self-stigma measured by the Internalized Stigma of Mental Illness Scale (ISMIS) was 41.2% (95% CI 34.24–48.22). There was no evidence of an association between self-stigma and gender (β = −2.975 (95% CI −7.046–1.097) p =.151), age (β = 0.007 (95% CI −0.152–0.165) p =.953), sexual trauma (β = 0.904 (95% CI −3.668–5.476) p =.697), military trauma (β = −0.571 (95% CI −4.027–7.287) p =.571). Self-stigma was associated with lower income and higher levels of anxiety (β = 5.722 (95% CI 2.922–8.522) p = <.001), depression (β = 6.937 (95% CI 4.287–9.588) p = <.000), and traumatic stress symptoms (β = 3.880 (95% CI 1.401–6.359) p =.002). The results indicate that self-stigma may be a significant issue among people with a diagnosis of PTSD. Further work is needed to understand the long-term impact and to develop interventions to address the internalisation of stigma in this population. The prevalence of self-stigma among a sample of participants with PTSD was 41.2%. There was no evidence of an association between self-stigma and gender, age or sexual / military trauma. Self-stigma was associated with lower income and higher levels of anxiety, depression, and traumatic stress symptoms. [ABSTRACT FROM AUTHOR]

Background: Patient and Public Involvement in research is important for citizenship, accountability and transparency, and has the practical benefit of helping to ensure its quality and applicability. Involving members of the public in research is becoming increasingly commonplace, in the UK and internationally. It is essential that public involvement is inclusive of individuals and their diverse life experiences, including challenging experiences that may be associated with stigma and social exclusion. The involvement of people with lived/living experience of substance use and homelessness in research is increasing in response to increased recognition of the importance of inclusion and the benefits conferred to research. Main body: In this commentary, we share our own experiences of being part of a Patient and Public Involvement group that was convened during a feasibility study of a peer-delivered harm reduction intervention. We are a diverse group but share experience of the field of substance use/homelessness, as people with lived/living experience, and as researchers and practitioners. We share our reflections and learning, as well as offer recommendations for researchers working in our field. Our group worked together to make a positive and deliberate contribution to the study. This did not happen by chance but required the development of mutual trust and respect, with each member having a commitment to support the group for its two-year duration. Short conclusion: It is important for researchers to appreciate that meaningful Patient and Public Involvement is very valuable but requires a commitment from all involved. Regarding our field of substance use and homelessness specifically, it is essential that people with these experiences have opportunities to contribute to research and can do so in a meaningful way. People with lived/living experience are able to bring to life the rich tapestry of others' experiences. However, the involvement must be neither tokenistic nor indifferent to the wider challenges common to these experiences. Plain English Summary: This article describes the activities and lessons learned from the involvement of an Experts by Experience group in a National Institute for Health Research (NIHR) study. The study was about peer support for people experiencing homelessness and substance use challenges. The Experts by Experience group was made up of research team members, and a range of individuals from across the UK who had experienced homelessness and/or drug use and/or alcohol use, and who were recruited from a range of services who currently worked with people experiencing homelessness and/or substance use. The purpose of the group was to 'sense check' the study throughout. The group was a requirement from NIHR who funded the project. These groups are usually known as PPI groups (Patient and Public Involvement), but members of the group felt that 'Experts by Experience' was a more accurate term to describe the membership. The lived/living experience members' knowledge of the topic, and experience of using the types of services and interventions involved in the study, helped to guide the study team. Study team members facilitated Experts by Experience group meetings, but everyone was equal. The group gelled and worked well together to oversee the study. This article describes the benefits of having Experts by Experience members as part of the project from the inception through to the end. Ensuring the group had autonomy enhanced the study and was a powerful and empowering experience for the lived/living experience members. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this national survey was to explore the impact of COVID‐19 public health measures on access to social support services and the effects of closures of services on the mental well‐being of older people and those affected by dementia. Methods: A UK‐wide online and telephone survey was conducted with older adults, people with dementia, and carers between April and May 2020. The survey captured demographic and postcode data, social support service usage before and after COVID‐19 public health measures, current quality of life, depression, and anxiety. Multiple linear regression analysis was used to explore the relationship between social support service variations and anxiety and well‐being. Results: Five hundred and sixty‐nine participants completed the survey (61 people with dementia, 285 unpaid carers, and 223 older adults). Paired samples t‐tests and X2‐tests showed that the mean hour of weekly social support service usage and the number of people having accessed various services was significantly reduced post COVID‐19. Multiple regression analyses showed that higher variations in social support service hours significantly predicted increased levels of anxiety in people with dementia and older adults, and lower levels of mental well‐being in unpaid carers and older adults. Conclusions: Being unable to access social support services due to COVID contributed to worse quality of life and anxiety in those affected by dementia and older adults across the UK. Social support services need to be enabled to continue providing support in adapted formats, especially in light of continued public health restrictions for the foreseeable future. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Traumatic brain injury (TBI) has been linked to poor outcomes in terms of mental health, specifically, PTSD, depression and alcohol abuse.A lack of research evidence exists relevant to exploring the presence and implications of TBI in the police in the UK and globally, despite the elevated risk of physical and emotional trauma specific to policing. What does the paper add to existing knowledge?: The rate of traumatic brain injury is highly prevalent in a small sample of police officers.Traumatic brain injury is a major source of post‐concussion symptoms (physical, cognitive and emotional deficits) in police officers, which, in general, are associated with greater mental health difficulties and drinking alcohol to cope. What are the implications for practice?: Traditional mental health treatments should be supplemented with elements of concussion care to address any cognitive, emotional and physical issues due to head injury.Interventions should be made more accessible to those suffering from a mild brain injury. This can be done through regular reminders of appointments, pictograms and by providing a concrete follow‐up. Introduction: Police officers have a high risk of injury through assaults, road traffic incidents and attending domestic calls, with many officers developing post‐traumatic stress disorder (PTSD) as a consequence. Traumatic brain injury (TBI) is a common injury in populations involved in conflict and has been extensively linked to mental health difficulties. However, current research has not explored the frequency and sequelae of TBI in police populations, despite the elevated risk of physical and emotional trauma specific to policing. Aim: To explore self‐reported TBI, PTSD, post‐concussion symptoms, depression and drinking to cope in a small sample of UK police, to determine the frequency of these conditions and their relationships. Method: Measures of TBI, mental health, and drinking alcohol to cope were administered to 54 police officers from a Midshire Police Constabulary. Results: Mild TBI with loss of consciousness was reported by 38.9% of the sample. TBI was associated with increased post‐concussion symptoms (PCS). PCS were associated with greater severity of PTSD, depression and drinking to cope. Discussion: Exploring TBI in the police could identify a major factor contributing towards ongoing mental health difficulties in a population where, based on previous research, the implications of TBI should not be overlooked, highlighting the need for further research in this area. Implications for Practice: This research spans to identify the importance of routine assessment and increasing awareness within mental health services. Mental health treatments should be made amenable to a population with potential memory, planning and impulse control deficits. Further work in mental health services is needed to understand the level of ongoing issues that are due to post‐concussion symptoms and those that are due to other mental health difficulties, such as PTSD, thereby educating patients on the association between TBI and emotional difficulties. A graduated return‐to‐work plan should be developed to enable a safe transition back to work, whilst managing any ongoing symptoms. [ABSTRACT FROM AUTHOR]

Background: In the UK, there has been a strong drive towards patient and public involvement (PPI) in health research. Its benefits include improvements in the quality, relevance and acceptability of research, and empowerment, self-respect and value for service users. Organisational context can significantly influence the operationalisation of PPI. Research has highlighted power asymmetries between clinicians, researchers and service users. A resistance to power sharing, tokenism and assimilation into the existing culture suggest that a consultative, technocratic form of PPI is operating within health research settings. The aim of the study was to explore the development of PPI within a London based mental health biomedical research centre (BRC) over a period of 10 years from its inception. Methods: This qualitative study compared data from 52 organisational documents and 16 semi-structured interviews with staff and service users associated with PPI within the Maudsley BRC. The data were analysed using inductive thematic analysis. Study design, data collection, analysis and write up were conducted by service user researchers. Results: Our analysis showed a picture of increasing activity and acceptance of PPI, its alignment with the broader BRC research agenda, progressive involvement of service users in governance, and the development of a collaborative culture in research processes. The presence of salaried service user researchers in the organisation was key to this progress. However, PPI remained localised and under resourced and there was a reluctance to change working practices which resulted in perceptions of tokenism. Service users faced conflicting expectations and were expected to assimilate rather than challenge the organisation's 'biomedical agenda'. Conclusions: Service user researchers may play a key role in establishing PPI in a scientific, hierarchical research environment. Adoption of a more democratic approach to involvement would build on the good work already being done and help to transform the culture and research processes. However, such an adoption requires considerable changes to the funding and policy environment orienting health research. [ABSTRACT FROM AUTHOR]

Analyses of investment banks acting as advisers for merger and acquisition transactions in the United Kingdom during 1992-2001 are used to examine the relationship between structural holes in a firm's network and its performance. We argue that the firms need two types of information--about new business opportunities and partners' cooperativeness--to pursue, respectively, two types of performance goals: status accumulation and market performance. Open networks facilitate access to information about new business opportunities, but at the same time, open ego networks limit access to information about partners' cooperativeness. We find that there is a positive and reciprocal relationship between status accumulation and market performance. We also find that structural holes increase firms' status accumulation but also dampen their market performance. [ABSTRACT FROM AUTHOR]

Quantitative palynofloral analysis of 42 core chip samples from upper Barremian and Aptian sediments of the Heslerton No. 2 shallow borehole (Speeton Clay Formation, Eastern England) and Gannet Field well 22/26a-2 (Valhall Formation, United Kingdom Sector, Central North Sea) has yielded very rich and diverse marine assemblages composed largely of dinocysts and acritarchs. The high biostratigraphic resolution achieved has allowed detailed correlation between the sections analysed and with third-party data from theWiechendorf 1/86 borehole (Lower Saxony Basin), a distance of approximately 700 km; the positions and extent of several hiatuses have been assessed within this framework. The Barremian/Aptian boundary has been discussed and "conventional" palynological criteria assessed with respect to contrary microfaunal and nannofloral evidence. Close spacing of samples has allowed some assessment of inter- and intra-species trends and, although palaeoenvironmental change profoundly influences assemblages, specific controls remain poorly understood. Over-prescriptive generic placement of taxa based on what are essentially subjective criteria is critically discussed. The zonation scheme proposed by Duxbury (2001) has been re-visited and significantly refined; recognition of additionalmarker events has allowed further sub-division of several zones to subzonal level, allowing a better understanding of late Barremian palynostratigraphy. Seventy-nine key palynofloral events have now been recognised between the late Barremian and "mid" Aptian, including many first occurrences. One genus, 23 species and 2 subspecies of dinocysts are described as new, nine new combinations have been effected and the diagnoses of two species have been emended; one species has been reduced to sub-species rank. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to review the history and current state of provision of homeless medical respite services in the UK, drawing first on the international context. The paper then articulates the need for medical respite services in the UK, and profiles some success stories. The paper then outlines the considerable challenges that currently exist in the UK, considers why some other services have failed and proffers some solutions.Design/methodology/approach The paper is primarily a literature review, but also offers original analysis of data and interviews, and presents new ideas from the authors. All authors have considerable experience of assessing the need for and delivering homeless medical respite services.Findings The paper builds on previous published information regarding need, and articulates the human rights argument for commissioning care. The paper also discusses the current complex commissioning arena, and suggests solutions.Research limitations/implications The literature review was not a systematic review, but was conducted by authors with considerable experience in the field. Patient data quoted are on two limited cohorts of patients, but broadly relevant. Interviews with stakeholders regarding medical respite challenges have been fairly extensive, but may not be comprehensive.Practical implications This paper will support those who are thinking of undertaking a needs assessment for medical respite, or commissioning a new medical respite service, to understand the key issues involved.Social implications This paper challenges the existing status quo regarding the need for a "cost-saving" rationale to set up these services.Originality/value This paper aims to be the definitive paper for anyone wishing to get an overview of this topic. [ABSTRACT FROM AUTHOR]

Research summary: We investigate how organizational adaptation to interdependence shifts is influenced by 'integrators.' These are formally mandated managerial roles meant to promote coordination across specialized but interdependent organizational subunits, yet they do so without relying on formal authority. While much has been learned about how integrators promote steady-state coordination within a known pattern of interdependence, less is known about their impact on organizational adaptation when the pattern of interdependence itself is unknown. We discuss mechanisms by which integrators may nonetheless aid organizational adaptation and learning processes in such situations, and test our hypotheses in the context of a regulatory change that affected the in vitro fertilization ( IVF) clinics sector in the United Kingdom using a differences-in-differences design. Managerial summary: Organizational structure can influence how an organization adapts to change. We investigate how a regulatory change in the provision of fertility treatments in the United Kingdom forced clinics to change their workflows, and whether the presence of integrator roles enabled clinics to adapt to these changes. It is well known that integrator roles in general are valuable in coordinating across specialized organizational units, but this research points to the surprising implication that their value may persist even when the workflow being coordinated changes suddenly, in ways that nobody necessarily comprehends. Our research highlights the fact that even in an intensively science-based work context, the 'technology of organizing' can have a significant role in shaping organizational performance. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Social work in the UK remains embroiled in concerns about child protection error. The serious injury or death of vulnerable children continues to evince much consternation in the public and private spheres. Governmental responses to these concerns invariably draw on technocratic solutions involving more procedures, case management systems, information technology and bureaucratic regulation. Such solutions flow from an implicit use of instrumental rationality based on a ‘means-end’ logic. While bringing an important perspective to the problem of child protection error, instrumental rationality has been overused limiting discretion and other modes of rational inquiry. This paper argues that the social work profession should apply an enlarged form of rationality comprising not only the instrumental-rational mode but also the critical-rational, affective-rational and communicative-rational forms. It is suggested that this combined, conceptual arsenal of rational inquiry leads to a gestalt that has been termed the holistic-rational perspective. It is also argued that embracing a more rounded perspective such as this might offer greater opportunities for reducing child protection error. [ABSTRACT FROM PUBLISHER]

The conditions under which people labour in mental health research affect how and what knowledge is produced – and who benefits or doesn't from involvement in health research systems. There has been, however, little sustained investigation of the uneven modalities of labour exploitation across what are increasingly financialised systems of mental health research. This theoretical paper advances conceptual and empirical investigations of labour in health research – outlining how material precarity and epistemic precarity often go hand in hand, and largely drawing on examples from the UK. The intertwining of labour relations and epistemic cultures can be understood by bringing together insights from two bodies of knowledge not commonly in contact with one another – survivor/service user research and critical research on universities and academic labour. The article addresses how mental health research makes significant use of the labour of (i) contract researchers (many of whom work on precarious and exploitative contracts); (ii) lay contributors (through 'patient and public involvement'); and (iii) research participants (where the conditions underpinning participation in various kinds of research increasingly blur the distinction between volunteering, and 'gig' work). Labour relations affect, and are affected by, efforts to change epistemic cultures and reduce epistemic inequalities, and epistemic and material precarity make efforts to improve research culture much more difficult. Those experiencing both material and epistemic precarity in health research systems need to be at the heart of efforts to combat both. • Labour conditions in mental health research affect how and what knowledge is produced. • Health research systems frequently rely on exploited labour. • Material and epistemic precarity frequently go hand in hand in mental health research. • Improving research cultures in mental health research demands addressing labour relations. • Those experiencing material/epistemic precarity should be core to improvement efforts. [ABSTRACT FROM AUTHOR]

The reducing cost of solar and wind energy together with the UK commitments to net-zero emissions will mean that UK energy systems for 2050 and similarly those in many other countries will be dominated by variable renewable supplies. Electricity systems are expected to be very reliable but renewable energy is inherently intermittent. We explore energy storage as a solution to this problem, considering the physics of the system to gain understanding of its needs, rather than using its economics, which may lead to less adequate designs. The scale and the periodic nature of the energy storage problem are crucial to system design. There are very different physical needs for storing energy for: days, weeks and years. Therefore a range of storage technologies with their differing characteristic will be required for these different periods. A UK energy system with three types of storage is modelled to both dimension and schedule these stores in light of the physical features and the cost parameters of potential storage technologies. The scale of the UK's energy storage need is large - more than a thousand times that of current storage systems - potentially increasing the energy costs of a 2050 energy system based largely on solar and wind, by a significant amount. Though the UK is considered as an example, the methods could be used for any country that is planning an energy system with a majority of variable renewables and a net-zero carbon target. [ABSTRACT FROM AUTHOR]