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Objectives: This paper considers home from the perspective of people living with dementia supporting ongoing discourse around ageing in place and the significance of creating more inclusive communities. Methods: Forty‐six home tour interviews led by people living with dementia were conducted in England and Scotland to better understand the connectivity between home and neighbourhood for people living with dementia. These interviews used a range of participatory and creative approaches including video, photographic images and in situ interviews. Data were analysed via reflexive thematic analysis. Results: Three themes were identified in data analysis. 1. Connected home and neighbourhood, where participants revealed the dynamic relationship between home and neighbourhood; 2. Practices of home, where participants discussed the everyday nature of their homes and routines; and 3. Displaying home and family, which reflected participant's biographical homes in the context of living with dementia. Discussion: The findings show that home holds multiple meanings for people living with dementia. For example, home is understood as a part of the neighbourhood and an extension of the home space into gardens and backyards, thus extending existing discourses that solely focus on the inside of people's homes. For people living with dementia, homes are also sites of negotiation and renegotiation where new meanings are created to reflect the changing nature and context of the home. There is not one fixed solution to these issues. Support and understanding for people living with dementia will need to evolve to adapt to the shifting dynamics and multiple meanings of home. Key points: Neighbourhoods begin within homes and are interconnected. This relationship has important implications for the discourse of ageing in place.'Home' for people living with dementia holds the same meanings for those without dementia, but with some notable differences. It is important to recognise the shifting dynamics of home and to recognise the complexity of home in the context of dementia. There is not a fixed solution to the challenges of ageing at home with dementia, but support and understanding need to evolve alongside people with lived experience.Homes are a site of renegotiation where new meanings are created to reflect the changing nature of home and the lived experience of home for those with dementia.The study has provided findings through innovation in the research design. The employment of creative methods enabled people living with dementia to participate in sharing their own narratives of home.The work provides evidence where there is a current gap in understanding 'what matters' about home for people living with dementia. [ABSTRACT FROM AUTHOR]

Background: Big data research requires public support. It has been argued that this can be achieved by public involvement and engagement to ensure that public views are at the centre of research projects. Researchers should aim to include diverse communities, including seldom‐heard voices, to ensure that a range of voices are heard and that research is meaningful to them. Objective: We explored how researchers involve and engage seldom‐heard communities around big data research. Methods: This is a qualitative study. Researchers who had experience of involving or engaging seldom‐heard communities in big data research were recruited. They were based in England (n = 5), Scotland (n = 4), Belgium (n = 2) and Canada (n = 1). Twelve semistructured interviews were conducted on Zoom. All interviews were audio‐recorded and transcribed, and we used reflexive thematic analysis to analyse participants' experiences. Results: The analysis highlighted the complexity of involving and engaging seldom‐heard communities around big data research. Four themes were developed to represent participants' experiences: (1) abstraction and complexity of big data, (2) one size does not fit all, (3) working in partnership and (4) empowering the public contribution. Conclusion: The study offers researchers a better understanding of how to involve and engage seldom‐heard communities in a meaningful way around big data research. There is no one right approach, with involvement and engagement activities required to be project‐specific and dependent on the public contributors, researchers' needs, resources and time available. Patient and Public Involvement: Two public contributors are authors of the paper and they were involved in the study design, analysis and writing. [ABSTRACT FROM AUTHOR]

Background: As digital tools are increasingly used to support COVID‐19 contact tracing, the equity implications must be considered. As part of a study to understand the public's views of digital contact tracing tools developed for the national 'Test and Protect' programme in Scotland, we aimed to explore the views of groups often excluded from such discussions. This paper reports on their views about the potential for contact tracing to exacerbate inequalities. Methods: A qualitative study was carried out; interviews were conducted with key informants from organizations supporting people in marginalized situations, followed by interviews and focus groups with people recruited from these groups. Participants included, or represented, minority ethnic groups, asylum seekers and refugees and those experiencing multiple disadvantage including severe and enduring poverty. Results: A total of 42 people participated: 13 key informants and 29 members of the public. While public participants were supportive of contact tracing, key informants raised concerns. Both sets of participants spoke about how contact tracing, and its associated digital tools, might increase inequalities. Barriers included finances (inability to afford smartphones or the data to ensure access to the internet); language (digital tools were available only in English and required a degree of literacy, even for English speakers); and trust (many marginalized groups distrusted statutory organizations and there were concerns that data may be passed to other organizations). One strength was that NHS Scotland, the data guardian, is seen as a generally trustworthy organization. Poverty was recognized as a barrier to people's ability to self‐isolate. Some participants were concerned about giving contact details of individuals who might struggle to self‐isolate for financial reasons. Conclusions: The impact of contact tracing and associated digital tools on marginalized populations needs careful monitoring. This should include the contact tracing process and the ability of people to self‐isolate. Regular clear messaging from trusted groups and community members could help maintain trust and participation in the programme. Patient and Public Contribution: Our patient and public involvement coapplicant, L. L., was involved in all aspects of the study including coauthorship. Interim results were presented to our local Public and Patient Involvement and Engagement Group, who commented on interpretation and made suggestions about further recruitment. [ABSTRACT FROM AUTHOR]

The "problem" of public resistance to hospital closure is a recurring trope in health policy debates around the world. Recent papers have argued that when it comes to major change to hospitals, "the public" cannot be persuaded by clinical evidence, and that mechanisms of public involvement are ill‐equipped to reconcile opposition with management desire for radical change. This paper presents data from in‐depth qualitative case studies of three hospital change processes in Scotland's National Health Service, including interviews with 44 members of the public. Informed by sociological accounts of both hospitals and publics as heterogeneous, shifting entities, I explore how hospitals play meaningful roles within their communities. I identify community responses to change proposals which go beyond simple opposition, including evading, engaging with and acquiescing to changes. Explicating both hospitals and the publics they serve as complex social phenomena strengthens the case for policy and practice to prioritise dialogic processes of engagement. It also demonstrates the continuing value of careful, empirical research into public perspectives on contentious healthcare issues in the context of everyday life. [ABSTRACT FROM AUTHOR]

This article examines the accounts given by child protection practitioners of how the current economic climate has impacted on their practice. We build our discussion on empirical findings emerging from a small but rigorous qualitative research project conducted by one of the authors. This original study examined Scottish and Finnish social workers' perceptions of their abilities to engage effectively with children and families in what many have described as an "age of austerity." It set out to explore challenges encountered in daily practice through a cross‐national comparative thematic analysis. The paper illuminates practitioners' shared reality of frontline practice in Scottish and Finnish contexts. Despite differing socio‐political environments, participating practitioners found austerity measures to impact negatively on both their professional resources and on the communities they work with. Significantly, practitioners regarded themselves as the key resource, taking individual responsibility to ensure families received a quality service. For many, austerity had resulted in greater empathy for families and awareness of the wider economic and structural impact on their lives. The increased centrality of social justice was pivotal to everyday practice. [ABSTRACT FROM AUTHOR]

There is renewed interest in the place of direct work and relationship-based practice in social work. This paper explores the day-to-day direct work that happens where children and young people are 'looked after' at home, from the perspectives of children, social workers and those supervising practice. It is based on interviews with eight children and 25 professionals about their experiences. In this paper, I highlight that despite barriers, direct work, which is characterized as meaningful by children and professionals, happens and that the relationships formed between children and social workers are an important precursor to and an outcome of direct work. The research was undertaken in Scotland, and although the legislation, policy and guidance differ from other jurisdictions, the messages about direct work are relevant for practice in other countries. [ABSTRACT FROM AUTHOR]

Social workers working to protect children face the prospect of making very finely balanced judgements, often on the basis of incomplete information. Based on doctoral research into sense‐making by social workers, this paper explores aspects of the tipping point, i.e. where the categorization of a child's situation changes, potentially leading to a very different response to their needs. Those aspects include identifying the triggers for, and consequences of, the tipping point, and being aware that the tipping point being reached may have to do with changes in the internal world of the worker as well as changes in the circumstances of the family. This paper stresses the need for a more nuanced understanding of the tipping point, and emphasizes the need to take account of the processes of decision‐making, and of looking at both inter‐ and intra‐personal components of those processes. Further, it is argued that a cautious attitude requires to be taken towards technical–rational solutions and that there is a real need to place professional judgement and consideration of the tacit dimension at the heart of the child protection process. [ABSTRACT FROM AUTHOR]

Abstract: E‐cigarettes are devices through which a nicotine solution is ‘vapourised’ and inhaled by the user. Unlike cigarettes, the process involves no tobacco combustion. However, the inhalation and exhalation of vapour is reminiscent of smoking and there is debate about the possible harms and benefits of e‐cigarette use, including the ‘renormalisation’ of smoking. Despite these debates, there has been little exploration into the embodied and semiotic similarities between smoking and vaping. This paper views the practices of vaping and smoking through the lens of performativity that is, the accumulation of meaning associated with the habits over time and space. Through in‐depth interviews, we explore how young adults from primarily disadvantaged areas in Scotland, understand the similarity in practices between smoking and vaping. Participants talked about financial barriers to using different types of e‐cigarettes, and how their use reflected their views on smoking cessation. They also discussed the embodied similarities between smoking and vaping, with divergent opinions on whether this continuance of habit was beneficial or not, revealing still developing and ambiguous norms around performativity. The norms of vaping were also frequently discussed, with participants’ experiences and views reflecting the contested position of vaping in an environment where cigarette smoking is denormalised. [ABSTRACT FROM AUTHOR]

Context Health care organisations are increasingly conceptualised as complex, indivisible entities made up of web-like networks of staff that connect to each other in changeable ways. This study draws on the theoretical framework of activity theory and the concept of knotworking to illustrate how health professionals improvise collaboratively to negotiate everyday challenges and contribute positively to patients' health priorities. Objectives The aim of this paper is to contribute to evolving ideas about collective learning, change and improvement in secondary care by exploring how health professionals work and learn together and how this compares with earlier findings from primary care. Methods This study applied a constructionist methodology within the research paradigm of interpretivism. Qualitative data were gathered through 26 hours of observations and 17 field interviews within the natural environment of a working hospital over a 3-month period. The research site encompassed a medical receiving ward, a chronic ward, an out-patient clinic and the connecting corridors. Staff participants included a range of clinical, nursing, ancillary and clerical staff. Results The study found a recurring pattern of spontaneous team forming and interprofessional shared learning to respond to care needs within the hospital as they arise. These are presented in four analytical themes: motion, flux and the unpredictability of 'team spirit'; adaptive, responsive learning through seeing, doing and asking questions; the collective learning gap between doctors and other staff; and frustration, compassion and the desire for improvement. Conclusions Health care professionals in the hospital setting both create and experience complex inclusion and exclusion behaviours that define who is empowered to act with professional authority in any given moment of care. This paper discusses issues of power, the particular exclusion of doctors from interprofessional knotworking, and the greater emphasis on questions as the pivotal aspect of shared collective learning when compared with primary care. [ABSTRACT FROM AUTHOR]

Children's participation in decision making of all kinds is of increasing interest across the world as more and more countries seek to comply with Article 12 of the United Nations Convention on the Rights of the Child. The participation rights of children who are in the care of the state are of particular concern. Recent research in England suggests that Independent Reviewing Officers (IROs) can play a crucial role in ensuring that looked after and accommodated children are able to participate in care planning and review processes. This paper outlines the findings of the first Scottish study to investigate the role of Reviewing Officers in encouraging children's participation in reviews. Surveys were collected from social workers, Reviewing Officers and young people after 69 review meetings as part of an action research study. Follow-up qualitative interviews were then completed with 10 young people and a focus group held with the five participating Reviewing Officers. The findings suggest that participation in looked after reviews can best be understood as a cyclical and relational process and that taking part in action research may enhance participation practices. While the role of the Reviewing Officer was found to be important, the findings suggest that everyone involved in the care and support of the young person needs to encourage participation processes that are individualized. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper draws on the findings of a research study that examined the factors that influence local decision-making in cases where a child or young person is being considered by residential workers, social workers and senior managers for placement in a secure unit. After outlining the research problem and case study approach taken, the paper focuses on explicating the findings of the study that relate to the impact of group membership, goals, roles and norms on group performance in such cases. The paper illustrates how attending to these four areas, and the way in which power relations impact on them, may help those developing and managing groups to improve decision-making practice. [ABSTRACT FROM AUTHOR]

Objectives This paper outlines a model developed by NHS Education for Scotland to pilot consultant appraiser training. The training was aimed at both new/inexperienced appraisers and experienced appraisers. A Course for New/Inexperienced Appraisers was held over 2 days and the Experienced Course over 1 day. Both are described, as is an initial tutor induction day designed to recruit consultant tutors who could contribute to delivering the courses. A thorough qualitative evaluation of the courses was undertaken and this is reported. The paper also discusses the desirability and implications of rolling out the pilot on a wider scale. Method A qualitative evaluation design using interviews to collect feedback from participants who had attended all three courses - the Induction event, the Inexperienced Appraiser Course and the Experienced Appraiser Course - was employed. Telephone interviews were transcribed and analysed using framework analysis and aided by NVivo 7. Results The response of those interviewed for this evaluation of the three courses was very positive. The content, organization, skills of the tutors and usefulness of the courses were commended. Suggested improvements were relatively minor and included: introducing more material on the requirements of revalidation, more small group discussions and making the course more secondary care-orientated. However, it was recognized that with the requirements for 'enhanced' appraisal and revalidation still uncertain, this created difficulties and the course would evolve to take account of further developments. Conclusions The training piloted represents an effective way to train consultants in appraisal skills. Interviewees were supportive of the pilot being continued: either nationally or cascaded down locally. Exactly what model is achievable and desirable will depend on the number of appraisers to be trained and the availability of resources to support 'enhanced' appraisal in secondary care. [ABSTRACT FROM AUTHOR]

Objective The focus of simulation-based education ( SBE) research has been limited to outcome and effectiveness studies. The effect of social and cultural influences on SBE is unclear and empirical work is lacking. Our objective in this study was to explore and understand the complexity of context and social factors at a surgical boot camp ( BC). Methods A rapid ethnographic study, employing the theoretical lenses of complexity and activity theory and Bourdieu's concept of 'capital', to better understand the socio-cultural influences acting upon, and during, two surgical BCs, and their implications for SBE. Over two 4-day BCs held in Scotland, UK, an observer and two preceptors conducted 81 hours of observations, 14 field interviews and 11 formal interviews with faculty members ( n = 10, including the lead faculty member, session leaders and junior faculty members) and participants ( n = 19 core surgical trainees and early-stage residents). Results Data collection and inductive analysis for emergent themes proceeded iteratively. This paper focuses on three analytical themes. First, the complexity of the surgical training system and wider health care education context, and how this influenced the development of the BC. Second, participants' views of the BC as a vehicle not just for learning skills but for gaining 'insider information' on how best to progress in surgical training. Finally, the explicit aim of faculty members to use the Scottish Surgical Bootcamp to welcome trainees and residents into the world of surgery, and how this occurred. Conclusions To the best of our knowledge, this is the first empirical study of a surgical BC that takes a socio-cultural approach to exploring and understanding context, complexities, uncertainties and learning associated with one example of SBE. Our findings suggest that a BC is as much about social and cultural processes as it is about individual, cognitive and acquisitive learning. Acknowledging this explicitly will help those planning similar enterprises and open up a new perspective on SBE research. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Internationally, health technology assessments ( HTAs) are ubiquitous drivers to health policy. Within Scotland, the Scottish Medicines Consortium undertakes the medicine review process. Input from clinical experts, involved in frontline care, is an integral component of the assessment process. This paper explores the relationship between the clinical experts and the HTA agency within Scotland to better understand what motivates expert clinicians to devote their time to the medicine review process with no remuneration. Methods Twenty-seven clinical experts from 16 different clinical specialties took part in one-to-one interviews at their place of work between October 2011 and March 2012. Data analysis was inductive and comprised the organization of data into a framework and a subsequent thematic analysis. Results Three distinct themes were identified: (1) recruitment, which identified two types of explanations for the experts' appointment: external justification (nominated by another) and internal justification (being recognized as an expert); (2) flexibility of the procedures, with experts able to determine their own response style and negotiate timelines; (3) health care systems, demonstrating that their affiliation to the health system underpinned the relationship and their motivation to be clinical experts. Conclusions The findings of this study provide insight into the elements important to clinicians who voluntarily contribute to HTA processes. Examination of these elements in the context of the organizational citizenship behavior literature provides a foundation on which to improve understanding of this relationship and sustain and improve clinical expert participation in an increasingly intensified clinical environment and within cash-limited HTA systems. [ABSTRACT FROM AUTHOR]

For migrant children, moving to a new country is marked by excitement, anxiety and practical challenges in managing this significant transition. This paper draws upon the concepts of social capital and social networks to examine migrant children's access to services post‐migration. Using data from a qualitative study with Eastern European families in Scotland, we identify a range of cumulative barriers that limit children's access to services and illustrate how their experiences are shaped by ethnicity, social class and place. The study shows that migrant children are often disadvantaged post‐migration and develop their own mechanisms to mitigate the impact of migration on their lives. We argue that migrant children's own social networks are relevant and they need to be analysed through a more individualised approach. [ABSTRACT FROM AUTHOR]

Background: As most young teenagers grow up in families, parents might be well situated to facilitate and support their weight management and thereby prevent or manage obesity prior to adulthood. Aim: This paper explores parents' perceptions of, and views about, their teenage children's weight and the factors that influence parents' weight management strategies. Design, setting and participants: We conducted two qualitative studies in Scotland, UK, involving in‐depth interviews with the parents of overweight/obese and ‘normal’ weight 13–15 year olds (n = 69). Findings: Parents' concerns about their own weight provided useful context for understanding their attitudes or actions with regards to their teenage child. Some parents described their teenager's weight as being of concern to them, although puberty often introduced confusion about a child's weight status. Genetic explanations were very often put forward as a way of making sense of teenage weight or body size. Frustration about advising teenagers about weight management was expressed, and some parents worried about giving their growing child a ‘problem’ if they directly raised concerns about weight with them. Discussion: Parents' views about their own weight as well as social and moral norms about labelling a teenager as overweight or as needing help with their weight could usefully inform patient‐centred service development. Parent/teenage partnerships and supporting parents to create a healthy home in which teenagers can make healthier choices are suggestions for intervention development. Conclusion: The study highlights the importance of taking parents' perceptions into account when developing family‐based interventions to address teenage overweight and obesity. [ABSTRACT FROM AUTHOR]

This paper presents some of the key findings of a study investigating the introduction of the Graded Care Profile (GCP) - a tool used in the assessment of child neglect - in one Scottish local authority where neglect is the primary reason for which nearly half of all children are placed on the Child Protection Register. The findings suggest that while there are some advantages to the use of the GCP there are also a number of significant questions about previous claims made about its objectivity and value-neutrality, its user-friendliness and its ability to generate good partnership working with parents, particularly where there are substantive disagreements about the quality of care. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Messages: The GCP is used to identify and respond to neglect., This study examined the perspectives of parents and practitioners about the GCP in one Scottish area., It found a favourable response to the way that the GCP breaks down the parenting task into more specific areas., Identified difficulties included the abstract language in the GCP and positive parental engagement where there were substantive disagreements about the quality of care. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper considers young people's perspectives of being parented and draws on a study that comprised secondary analysis of 112 qualitative interviews with teenagers who had either never offended or who had ceased to offend for at least a year. Young people's offending behaviour has traditionally been linked to parenting styles, but it is parenting practices that proved central to parental responses to revelations about their offspring's offending. During the interviews, desisters gave accounts of their upbringing and, in particular, the parenting they experienced in one critical situation, namely when their offending came to light. At this point, parents of desisters were reported to be more punitive, more emotional and less measured than they were customarily, and non-offenders anticipated similar reactions from their parents if they were to offend in the future. The relevance of the findings for professional interventions, especially parenting programmes, and for social workers in child protection is discussed, and suggestions for further research is made. [ABSTRACT FROM AUTHOR]

In Scotland, the Adult Support and Protection Act of 2007 mandates effective interagency policies and activities to prevent harm to individuals unable to safeguard their own well-being, property, and rights because they are affected by 'disability, mental disorder, illness or physical or mental infirmity.' In this paper, the author examined the high proportion of adult protection referrals that resulted in ' No Further Action' ( NFA) decisions (these are referrals that did not lead to a full adult protection investigation). The review involved examining police referral data from 15 areas in Scotland as well as referral reports received over a 3-month period in one representative area. Data sources were case files, national reports, and Freedom of Information requests. Interviews conducted with key personnel were supplemented with statistical data with a view to making recommendations. Screening criteria for referral, main contributory factors in referral, and reasons for NFA decisions were analyzed. It was found that, typically, more than 40% of adult protection referrals made by the police to adult protection teams resulted in NFA decisions. Variations in the interpretation of threshold criteria were observed, and there was a perception of overreporting. The high proportion of NFA outcomes has implications for Scottish policy and practice and may offer lessons for international applications. While overreporting of cases may have implications for resources and impact on the process, the dangers of underreporting may have more detrimental implications for adults with intellectual disabilities. More robust data and recording processes are needed to determine how effectively different systems are protecting adults who are most at risk. [ABSTRACT FROM AUTHOR]

Background A clear policy trend exists towards promoting the use of direct payments (DPs), including those for families with disabled children who use short breaks. However, uptake has been slow and use of DPs has been socially patterned. Recent programmes in England have dramatically increased investment in short break provision including breaks funded through DPs. This research examines the characteristics, circumstances and experiences of families who use DPs to fund short breaks with those who use short breaks funded in other ways. Method The paper draws on surveys totalling 348 parents and carers in families with disabled children using short breaks. We investigate associations between the use of DPs and a range of demographic, socio-economic, well-being, service use and satisfaction indicators. Logistic regression identifies which variables are most strongly associated with use of DPs. We also draw on open-ended survey responses which highlight important aspects of families' experience of using DPs. Results Characteristics significantly associated with increased use of DPs include the presence of main carers who are female, more highly educated and from White British backgrounds, younger children, lower levels of area deprivation, greater access to service and social networks and use of more hours of short breaks. Characteristics not found to be significantly associated with use of DPs include various health and well-being indicators, impairment characteristics of children and service satisfaction. A range of benefits of DPs are described along with problems accessing and using them. Conclusions Direct payments can have a number of benefits for families using short breaks, but access to them is currently problematic and socially patterned. If the uptake of DPs is to be increased and made more equitable, more attention must be paid to promoting and supporting their use in ways which meet the needs of individual families. [ABSTRACT FROM AUTHOR]

T olson D and S chofield I. Nursing Inquiry 2012; 19: 63-70 Football reminiscence for men with dementia: lessons from a realistic evaluation A major challenge of studies of non pharmacological dementia interventions is the likely modest intervention effect size and difficulties collecting data from individuals with behavioural, psychological and communicative symptoms. The reported Realist Evaluation is built around sets of contextually comparable case studies of Football Focussed Reminiscence for men with dementia. The study aim was to evaluate benefits of football related reminiscence for individuals and family carers. Four case studies were constructed; two community groups, one nursing home groups and individual sessions within their family home. Data was collected as field notes from non-participation observation of reminiscence sessions, notes of conversations with people with dementia, audio recorded interviews with family members, facilitators and dementia link workers. The analysis was framed around identification and extraction of data pertaining to Context-Mechanism-Outcome configurations within each data set, and patterns and threads were compared across the cases. An important finding was that anticipation of pleasure in tandem with a sense of continuity appeared to be important mechanisms triggering optimal benefit. The paper explores design considerations, project delivery experiences and the contribution that innovative theory driven research adds to the study of complex interventions including those with behavioural and communicative symptoms of dementia. [ABSTRACT FROM AUTHOR]

Medical Education 2011: 45: 995-1005 Context A particularly onerous aspect of the transition from medical student to practising doctor concerns the necessity to be able to rapidly identify acutely unwell patients and initiate appropriate resuscitation. These are skills in which many graduates feel poorly prepared and are considered by some to be best learned on the job. This constructivist study investigated the factors that influence the behaviour of junior doctors in this context and initiated the development of a framework that promotes understanding of this important area. Methods Focus groups involving 36 clinicians with a variety of clinical experience were conducted and analysed using a qualitative, grounded theory approach. The complex relationships between emergent themes guided the development of a framework that was refined and validated by further interviews with participants. Results Six main themes, grouped under three broad headings, emerged from the data: 'transferring knowledge into practice' and 'decision making and uncertainty' (cognitive challenges); 'acts and omissions' and 'identity and expectations' (roles and responsibilities), and, finally, 'the medical hierarchy' and 'performing under stress' (environmental factors). The framework presented within this paper illustrates the complex relationships between these factors. Conclusions Although the potential of metacognitive strategies to reduce medical error is acknowledged, the framework promotes looking beyond the individual to consider the contributions to patient safety of identity issues, role uncertainty and the hierarchical clinical environment. A more distributed approach to situation awareness may help junior doctors to better tolerate complexity and uncertainty. The efficacy of simulation as an educational strategy may be improved by finding ways to recreate the hierarchical and stressful environment in which junior doctors practise. Junior doctors should be aware of the impact of affect and emotion on behaviour, and clinical supervisors should strive to ensure that roles and responsibilities are explicitly discussed. [ABSTRACT FROM AUTHOR]

Unaccompanied asylum-seeking children are one of the most vulnerable groups of children and those who have been trafficked present with additional needs, posing new challenges for child protection professionals. Drawing on a research programme commissioned to inform policy and practice in Glasgow, this paper identifies issues emerging for practitioners working with separated children who have been trafficked. The commitment of frontline staff and increased multiagency working appear to be positive aspects of the work. Initial identification and assessment present a major challenge for reasons including cultural issues, the trauma and fear of children affecting engagement and the potential for ongoing contact with traffickers to compromise safeguarding. Trafficking is a particularly complex area of child protection work, made more problematic by the international dimensions to the trade and the absence of a clear definition and conceptual framework that can fully inform interventions and practice. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Context: This paper reports on a qualitative study looking at the perceptions of clients who use drugs and are on low income. Research suggests that counselling services can experience difficulties in reaching and retaining such clients, and outcomes of counselling can be disappointing. Aim: To learn from clients who had engaged in counselling for over six months what difference it had made to their lives. Method: Grounded theory methodology was used to analyse semi-structured interviews with six participants. Findings: Findings included changes in the clients' internal world, their connectedness with society, their familiarity with counselling, and their perception of the relationship with the counsellor. Factors within the counselling process which helped and hindered change were identified. The study documents how participants were able to use counselling to improve their lives. [ABSTRACT FROM AUTHOR]

In common with the rest of the UK, child care and protection practice in Scotland has undergone unprecedented change over the last ten years, including a wide-ranging three-year Child Protection Reform Programme. In 2006, The University of Dundee's Centre for Child Care and Protection and Barnardo's Scotland Research and Development team were commissioned by the then Scottish Executive to undertake a process review of the Child Protection Reform Programme (Daniel et al., ). Drawing on findings from the process review, this article considers the impact of the Child Protection Reform Programme. The process review concluded that, in the view of the respondents, the Child Protection Reform Programme made a substantive contribution towards the improvement and delivery of child protection services in Scotland, particularly in terms of raising awareness and increased multi-agency working. It was beyond the scope of the review to measure outcomes for children as a result of the reforms. Since the completion of the Child Protection Reform Programme, national policy emphasis has broadened from 'child protection' towards integrated support for children under the Getting it Right for Every Child reforms of children's services. The paper concludes with a discussion around where 'child protection' now fits within this context of universal support for children and argues that there is a need to ensure that the valuable work which was done to improve child protection services in Scotland under the Child Protection Reform Programme is not lost. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

There has been little research on social workers' views and experiences of managing contact for children in public care, and none focused in Scotland, where different institutional and legal features provide contrast with the rest of the UK. This study explored the views of 19 social work practitioners and managers and three Reporters to the Children's Hearing system regarding the management of contact for children in non-permanent placements, using semi-structured interviews and a focus group. The paper focuses on the themes of the supervision and assessment of contact, risks associated with contact and contact via ICT-e-mail and the internet. It suggests improvements in assessing contact are needed and concludes that while there are strengths in practitioners' current awareness of risks, a risk-based conception of contact, as exemplified by most respondents' views about the use of new technology, is in tension with the thrust of current legislation; conceptions of contact need to be flexible enough to embrace the variety of purposes contact might serve. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper reports the findings of a research project which explored the care factors that influence the educational achievement of looked-after children. The project was innovative because it focused on children looked after at home and away from home. A mixed-methods strategy was adopted to analyse data from two large Scottish local authorities. The project developed, what is to date, the largest dataset which includes variables for one-fifth of children discharged from care in Scotland over a 5-year period. The qualitative element of the project collected in-depth data on the care and education experiences of looked-after children and care leavers. The overall finding was that looked-after children perform less well academically than their counterparts in the general school population. The empirical data indicated that factors such as placement type, reason for becoming looked after and age on becoming looked after were significant in determining educational achievement. Empirical results further indicated that looked-after children suffered from discrimination and social exclusion in many areas of their lives, including school and where they lived. [ABSTRACT FROM AUTHOR]

This paper examines the development and consistency of children's (4, 7, 10, and 14 years) naíve concepts of inheritance using three tasks. A modified adoption task asked participants to distinguish between biological and social parentage in their predictions and explanations of the origins of different feature types (physical characteristics, disabilities, and personality traits). The causal mechanisms task asked participants to rate their preference for various mechanisms of inheritance for physical features. The family relatedness task required participants to provide judgements on the relatedness of family members and explain their understanding of kinship terms. Developmental trends were revealed in all three tasks. There was a trend towards increased consistency in judgements across tasks with age, but low correlations between explanations given in different task contexts. Findings are discussed with reference to the onset and variability of inheritance concepts and the implications for education and future research. [ABSTRACT FROM AUTHOR]

This study aimed to determine whether pharmacy customers are deterred from using a pharmacy that offers services to drug misusers. If patients are deterred, what are their specific concerns? The study was qualitative and three different groups were interviewed about their views on pharmacies providing services to drug misusers (i) pharmacy customers, (ii) local community councils and (iii) local drug forums. This paper focuses on pharmacy customer interview results. Interviews were conducted in 10 pharmacies, five in Aberdeen and five in Glasgow, both areas of high drug misuse. The pharmacy customers were attending pharmacies with high, medium and low involvement with drug misusers and were located in city centre, suburban and rural locations. Pharmacy customers were generally supportive of pharmacies offering services to drug misusers. However, their support was often qualified by a wish to see a private area provided for methadone consumption. Pharmacy customers were more knowledgeable of the rationale for and supportive of needle exchange services compared to methadone maintenance and supervised consumption. The results of the study demonstrate that the majority of pharmacy customers are supportive of drug misuse services, provided there is adequate privacy in the pharmacy. These results should be used to encourage more pharmacists to provide drug misuse services. [ABSTRACT FROM AUTHOR]