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This study explores policy makers’, health-care professionals’ and senior volunteers’ perceptions of senior volunteers. Two Norwegian government white papers regarding older adult care and welfare services, which were published over a period of 19 years, were selected for close examination. Furthermore, focus group interviews with a purposeful sample of five senior volunteers and 15 health-care professionals were conducted. The study explores the discursive formations of senior volunteers in the government white papers and how they are negotiated in the senior volunteers’ and the health-care professionals’ narratives. Two dominant discourses were presented in the white papers: a prevention discourse (in which volunteering was presented primarily as a means to prevent volunteers’ loneliness and need for care services) and a sustainability discourse (in which the volunteers were presented as instrumental in future sustainable care services). Both discourses echo a common overarching discourse about a capacity crisis due to the ageing population. The senior volunteers were positioned as partners and active agents in both their own narratives and the health-care professionals’ narratives. Their position as independent and as spokespersons for the less empowered were evident only in the senior volunteers’ own narratives. Only the health-care professionals referenced the prevention discourse and capacity issues. The senior volunteers presented themselves as competent, efficient political actors, and they resisted both the prevention and sustainability discourses. In the senior volunteers’ narratives, social and political participation were interrelated. The study demonstrates that new discursive landscapes must be created to capture the diversity among senior volunteers and their efforts. While senior volunteers must be meaningfully involved in decision making, planning and design, their positions as independent and active agents must also be ensured. Authentic partnerships between senior volunteers and public care services involve a balance between involvement and independence. [ABSTRACT FROM AUTHOR]

Given that the number of children and young people needing care keeps rising and fewer people are becoming foster carers, efforts to support carers and workers in foster caring are essential. This paper considers the experiences of carers and foster care agency workers involved in Australia's piloting of the Mockingbird Family. With a view understanding experience, data were collected via focus groups with carers and agency workers (n = 20) involved in piloting, implementation and evaluation. Deductive analysis applied the theory of experience to generate understanding of experience, as both intrinsic and extrinsic dimensions to capture strengths in the Mockingbird Family's foster caring networks. These dimensions of experience included collective passions of carers and workers; experiential change over time; collective experiences as a moving force; and experiences as transformational. Understanding of experience associated with the perceived strengths of the Mockingbird Family, including strategies to promote strong professional relationships between carers and workers, is an important element in strengthening environments of children and young people in care. Safe and stable environments are crucial for wellbeing. [ABSTRACT FROM AUTHOR]

What role do texts play in LGBTQ (lesbian, gay, bisexual, transgender, and queer) parents’ experiences of disability service systems? In interviews with 15 LGBTQ parents of disabled children in Toronto, Canada, participants selected documents to be used as a focus for discussion. Parents considered how LGBTQ identity and other intersectional identities influenced their experiences of institutional texts including adoption certificates, intake forms, and assessments. Findings suggest that documentation practices can operate as forms of systemic gatekeeping. LGBTQ identity was sometimes very significant in parents’ accounts, and sometimes less central than other aspects of their families' identities and experiences. [ABSTRACT FROM PUBLISHER]

This paper authentically represents the voices of non-verbal children with cerebral palsy using a case study design. Policy suggests that children should have the right to play and leisure opportunities, however non-verbal children with cerebral palsy have fewer choices. Additionally, children with communication, learning and mobility limitations are usually excluded from research. The aim of this research was to capture the voices of non-verbal children by exploring their well-being impact in terms of their experiences and choices about their level of participation in recreational activities. A qualitative case series study included interviews, observations, photographs and diaries. Where possible, the diaries were completed by both caregivers and children. Data were analysed thematically, and the lens of positioning theory applied. Seven children aged nine to sixteen years participated. The findings showed how equipment, people and environments enabled or hindered the children's participation. The children also advocated as champions for their own well-being. Positioning theory was applied across the data and was adapted offering a way to better understand the children's well-being responses. The findings demonstrate how these children were able to self-advocate, demonstrating their well-being by their intentional behaviours from their level of participation in a recreational activity. The voices of non-ambulant and non-verbal children are underrepresented in the literature. This study offers an innovative approach to highlight their voices using visual data. The images project the narrative about their choices for participation in recreational activities. The proposed kaleidoscope of well-being offers a way to demonstrate the fluctuations in their emotional responses from their participation. Choices for participation in recreational activities remains limited for non-ambulant and non-verbal children with cerebral palsy. Designers and policy makers should consider how equipment and environments can be adapted or created to increase the choices for non-ambulant and non-verbal children with cerebral palsy. Practitioners in health and social care should consider how to listen to the voices of non-verbal and non-ambulant children with cerebral palsy and their parents/guardians and work towards jointly setting participation goals to affirm their strengths. [ABSTRACT FROM AUTHOR]

The Kenyan Ministry of Health (MOH) and a consortium of nutritionists, researchers and communication, and design specialists developed a novel approach to create an evidence‐based recipe book promoting complementary feeding (CF) in Kenya. The ADAPT approach includes five steps: applied research (A), dialogue with stakeholders (D), adapted behaviour change communication (BCC) theories (A), purpose‐driven visual communication (P), and tailoring to priority audiences (T). Through this approach, the recipe book addresses key knowledge gaps using behaviour change theories and visual communication best practice to increase accessibility, acceptability, retention and motivation for behaviour change. The book addresses barriers to CF identified through formative applied research. Dialogue with stakeholders helped ensure cultural appropriateness and the book's alignment with MOH recommendations and key messages. The book uses behaviour change theories to approach the reader in a respectful way that motivates behaviour change. The use of consistent, purpose‐driven visuals helps ensure key messages are easily understood and accessible to all caregivers regardless of literacy level. The book's tone and content are tailored to its audiences’ attributes, needs and preferences. This five‐step process inspired the development of ADAPT, a novel approach that integrates behaviour change and visual communication for greater impact. This paper outlines how the consortium used the ADAPT approach to develop an evidence‐based book that thoughtfully and holistically addresses a wide range of barriers, provides practical solutions and increases self‐efficacy around CF. It offers a blueprint for public health practitioners from any field who are interested in using visual behaviour change communication to promote healthy behaviour. [ABSTRACT FROM AUTHOR]

Background: Empirical studies suggest that gratitude positively influence the quality of life of palliative patients and relatives. However, the literature is marked by a lack of conceptual clarity about what gratitude is and whether it can bring about individual and social benefits. Aim: This paper explores how palliative care patients and relatives understand gratitude, how discursive representations of gratitude may affect their positions, perceptions and relations, and how to conceptualise gratitude in the palliative context. Design: We examine 33 gratitude letters written by patients and relatives and 25 semi-structured interviews conducted as part of a pilot gratitude intervention study. We use a qualitative approach, thematic analysis, within a conceptual framework of discourse analysis. Settings/participants: Data were collected from 23 patients and 13 relatives recruited through three hospital palliative care services in French-speaking Switzerland. Results: Participants articulate gratitude in five ways: (1) appreciating others; (2) love; (3) need to reciprocate; (4) appreciating the little things; (5) solace amid serious illness. While some of these representations are sources of positive emotions and outlook, wellbeing and hope, others may confirm self-perceptions of powerlessness and burden. These results support a tridimensional conceptualisation of gratitude in palliative care as source of individual benefits, valuing closest relationships and moral obligation. Conclusion: Our study suggests that gratitude is a key to a good (end of) life, whilst highlighting potential negative effects. It could help healthcare professionals to better understand what gratitude means to patients and relatives, which may facilitate awareness and fostering of gratitude in palliative care. [ABSTRACT FROM AUTHOR]

Filipino psychologist Fr. Jaime C. Bulataosuggested that a shared collective consciousness allows for telepathy to occur. In the context of psychotherapy, telepathy may strengthen rapport between therapist and client, as well as enrich insight. This paper aims to describe and discuss a framework of Bulatao-inspired psychotherapy that integrates telepathy as part of the therapeutic practice. Thus, the paper asks the question: What does the Bulatao therapeutic process of telepathy look like? Descriptive phenomenology revealed four phenomenological structures: (a) Mental quietude and psychic openness; (b) Perceiving the client; (c) Receiving and reacting to telepathic stimuli; and (d) Anomalous insight. This paper has the potential to inspire a conversation with regard to the potential therapeutic uses of Bulatao's transpersonal world view. [ABSTRACT FROM AUTHOR]

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]

This article is based on a larger research project, which investigates the effectiveness of a culturally appropriate model, namely ūloa, when working with Tongan people. Ūloa is a communal method of fishing in Tonga, which includes all members of the community. A previous paper described the three phases of ūloa: presenting the concept to health providers and community groups; phase two amended the model based on phase one. This paper reports on phase three and findings related to the increased awareness of ūloa model within the mental health services and to raise awareness of how to work with Pacific people and adjust the health service to suit the needs of this population to test its effectiveness. Using reflexive thematic analysis, results highlighted a number of patterns both across the groups, described as napanapangamālie (harmony, balance), ngāue fakataha (working together/oneness), and toutai (fisher). These findings continue to support that the conventional biomedical approach employed in the mental health services overlooks elements of Tongan constructions of mental illness and the intersections between Tongan and biopsychosocial themes. Care that is based only on the 'medicine' rather than bringing the spiritual aspect into care planning (fake leaves) will not serve the needs of the Tongan community. [ABSTRACT FROM AUTHOR]

The seminal Lost in the Mall study has been enormously influential in psychology and is still cited in legal cases. The current study directly replicated this paper, addressing methodological weaknesses including increasing the sample size fivefold and preregistering detailed analysis plans. Participants (N = 123) completed a survey and two interviews where they discussed real and fabricated childhood events, based on information provided by an older relative. We replicated the findings of the original study, coding 35% of participants as reporting a false memory for getting lost in a mall in childhood (compared to 25% in the original study). In an extension, we found that participants self-reported high rates of memories and beliefs for the fabricated event. Mock jurors were also highly likely to believe the fabricated event had occurred and that the participant was truly remembering the event, supporting the conclusions of the original study. [ABSTRACT FROM AUTHOR]

Parental attachment refers to the protective and comforting role of parents toward their children. This role has been violated in cases of maltreatment. Understanding the attachment of parents who endanger their children can illuminate the psychological processes behind the harmful behaviour of parents. This paper proposes assessing parental attachment with the Adult Attachment Interview (AAI), classified according to the Dynamic‐Maturational Model of Attachment and Adaptation (DMM). We discuss meta‐analyses of the 'gold standard' Berkeley method for extracting AAI information. AAIs of maltreating adults classified with the Berkeley method have an improbably high rate of secure attachment, making it inadequate for family forensic applications. In contrast, the DMM uses a theory‐based, developmental expansion of Ainsworth's infant categories to describe a wide array of dimensionally related protective strategies for coping with danger across the lifespan. DMM‐AAIs, classified by trained, reliable professionals and integrated with data from other sources to create an individualised family formulation, meet evidentiary requirements. We call for a programme of research of court‐involved families comparing DMM‐AAI formulations to outcomes of usual methods for determining family services. 'This paper proposes assessing parental attachment with the Adult Attachment Interview, classified according to the Dynamic‐Maturational Model of Attachment and Adaptation (DMM)' Key Practitioner Messages: Childhood exposure to danger is crucial to understanding maltreating parents' behaviour.Adult Attachment Interviews, classified with the DMM method by authorised experts, can reveal motivating psychological processes that are not apparent in parental behaviour.Information about parents' attachment, together with other information, can help child protection personnel gauge the risk that parents pose to their children and organise personalised treatment plans to reduce that risk.ABCD Berkeley AAI classifications are not suitable for forensic use. [ABSTRACT FROM AUTHOR]

This study explores perceptions of child abuse and child protection matters involving staff working in the out‐of‐school‐hours care (OSHC) sector. Quantitative and qualitative data were collected through an online survey, focus group and interviews with staff and managers employed by one organisation that provided OSHC services in Sydney, Australia. This paper reports on their perceptions about implementing mandatory reporting requirements associated with the concepts of 'significant harm' and 'reportable conduct'. The aim of this paper is to engage OSHC stakeholders, including government, in reviewing child protection policies and practices to support educators in their work with children. Key findings indicate the inadequacy of available training, and the importance of relationships and communication between stakeholders, especially OSHC and school staff. This requires systemic change including raising the status of OSHC and the critical role that these educators have in supporting children's development, learning and wellbeing during the early years of school. Key Practitioner Messages: It is important that leadership supports educators to engage in respectful partnerships with families and schools to ensure child protection, and thereby child wellbeing and learning outcomesTraining in supporting children's safety and wellbeing in OSHC is critical.There is a need for a systems approach to OSHC services which places children's development, learning and wellbeing at the forefront of professional practice. 'Explores perceptions of child abuse and child protection matters involving staff working in the out‐of‐school‐hours care (OSHC) sector' [ABSTRACT FROM AUTHOR]

This paper uses the theory of mental health education to conduct an in-depth study and analysis of teachers' educational management, and based on this, it designs a survey method on teachers' status and analyzes its strategic methods based on the results of the survey. Using literature analysis, questionnaires, survey interviews, and statistical analysis, the analysis of mental health of primary and secondary school teachers in the city was made. The results of the survey and analysis of the questionnaire results were used to construct a compatible mental health evaluation model. It was found that the overall level of elementary school teachers' mental health is poor at present, and different levels of mental health were presented with school sections and ages. A total of 286 questionnaires were distributed, 278 valid questionnaires were returned, and statistical analysis was conducted using EXCEL tables based on the collected data. The data analysis results show that the mental health level of teachers in middle school is significantly lower than that of teachers in primary school, and the mental health level of teachers in primary and secondary schools decreases with the increase of age. Therefore, to prevent the small and the gradual, start from the source; do a good job in the publicity of mental health education in peacetime; popularize the knowledge of mental health, so that teachers have a correct understanding of mental health education; improve the professional level of teachers; set up professional teachers in professional positions; establish sound job system and evaluation system, etc. Promote the balanced development of school psychological counseling rooms, strengthen the construction of professional teachers in mental health education, improve various systems of mental health education, comprehensively popularize teachers' mental health education and training, and mobilize teachers' enthusiasm for scientific research on mental health education. Improve the understanding of mental health education in colleges and universities, and regard mental health education as the foundation of all education. [ABSTRACT FROM AUTHOR]

While recognition that some service users do not want social work involvement has grown in recent years, little research has explored what relationships between social workers and 'involuntary clients' look and feel like in practice and how they are conducted in real time. This paper draws from research that observed long-term social work practice in child protection and shows how relationships based on mutual suspicion and even hate were sustained over the course of a year, or broke down. Drawing on a range of psycho-social theories, the paper adds to the literature on relationship-based practice by developing the concept of a 'hostile relationship'. The findings show how hostile relationships were enacted through conflict and resistance – especially on home visits – and how anxiety and other intense feelings were often avoided by individuals and organisations. Much more needs to be done to help social workers recognise and tolerate hostility and hate, to not retaliate and to enact compassion and care towards service users. [ABSTRACT FROM AUTHOR]

This paper addresses the complex issue of the embodiment of grief. It explores how a theoretical shift to the body has influenced scholarly literature about grief and bereavement. Despite this shift, we argue that bodily interpretations and experiences are undertheorised in western psychological literature on bereavement. Specifically, we argue that linear stage models of grief have encouraged the view that grief needs 'working through' in the mind, and not necessarily the body. We draw on empirical data from interviews with bereaved people undertaken in England to illustrate aspects of the embodied experience of grief that differ from how psychological grief theories conceive of the bereaved person's body. Findings highlight the role of the bereaved person's body in managing grief and how the absence and continuing presence of the deceased person is managed through embodied practices. We conclude that understanding grief as an embodied experience can enable the development of grief theories that better capture the complex negotiation between the psychological processes of grief and the materiality of bodies. [ABSTRACT FROM AUTHOR]

Background: For the past 2 months the number of COVID-19 cases in Lebanon has been on the rise, while frontline nurses after the Beirut Blast of August 4th have been practicing through limited resources and a challenging context. Aim: This paper aims at exploring the psychological experiences of Lebanese frontline nurses serving at ground zero hospital during the current COVID-19 outbreak. Setting: This study was carried out in three main ground-zero hospitals in Beirut which are receiving COVID-19 cases. Method: This study have employed a phenomenological exploratory qualitative research design, where virtual interviews were conducted with 18 frontline nurses during the second week of January 2021. Results: Thematic analysis of the data expressed by the frontline nurses working in the approached ground-zero hospitals gave rise to five themes, namely 'helplessness and impending doom', 'increased mortality rates and depressive mood', 'fear of death and obsessive thinking', 'flashbacks, panic, and incompetence', and 'public recklessness, governmental responsibility, and anger'. Conclusion: The frontline nurses working at ground zero hospitals in Beirut are facing significant psychological challenges that should be mediated by the government and health policymakers in order to safeguard the quality of care and avoid higher mortality rates. [ABSTRACT FROM AUTHOR]

The biomedical aspiration of psychiatry has fundamentally reoriented clinical practice since the DSM-III in 1980 and reverberated in the public sphere. Over time, lay public understanding of the causes of mental suffering has increasingly endorsed biological conceptions. In this paper, I explore the sources from which a neurobiological model for mental suffering reaches ordinary people, and investigate its rhetorical appeal, personal appropriation, and consequences. Drawing on interviews and other data, I show that these sources—physicians, popular media, and advertising—share common ontological and moral assumptions. These assumptions, in turn, influence how people take up neurobiological explanation to account for their suffering, and how, paradoxically, they join it to their projects of self-determination. I conclude by considering how, from a phenomenological perspective, a neurobiological account fails to enhance self-knowledge or determination but leads to a hermeneutic dead end. [ABSTRACT FROM AUTHOR]

People with profound and multiple learning disabilities (PMLD) are some of the most marginalised in society and are perceived to lack agency. This paper contests such a narrative, presenting findings from an innovative project in Scotland, UK, exploring the impact of artists working collaboratively with people with PMLD and their formal carers. Art is conceived as a social practice, a process, an embodied aesthetic and sensory experience that takes place between individuals. Theoretically, the paper adopts an original approach, combining crip theory, the capability approach and social pedagogy to re-imagine and re-position people with PMLD. The year-long qualitative study used data from reflective diaries (n = 111) and semi-structured interviews (n = 9) with artists, carers and management of a day centre. An Interpretative Phenomenological Analysis of these shared experiences was used. The results reveal an unsettling of prevailing norms and creative ways of doing and experiencing social care that is relational. [ABSTRACT FROM AUTHOR]

This paper explores the intersection between migration, aging and lifelong learning with the aim of expanding our understanding of how lifelong learning enhances older migrants' active aging in a foreign land. Our study also offers insights into the learning activities of older immigrants in general. In 2002, the World Health Organization (WHO) proposed a conceptual framework of active aging, which has greatly influenced aging policies and seniors' everyday practices. Yet, there is a paucity of research that explicates and fully integrates lifelong learning into active aging discourse, and focuses on senior immigrants' lifelong learning in an aging society. Based on interviews, textual materials, and participatory observation in five Chinese seniors' immigrant associations in Toronto, we explore how Chinese senior immigrants' learning has been (re)shaped and practised through re-settling in Canadian society. Five categories of learning are explored, including a) learning language and computer skills, b) learning culture and history, c) learning civic engagement, d) learning leisure, and e) learning health. We argue that 'active learning' can be used as a dynamic conceptual framework that interacts with active aging theory, demonstrating how senior immigrants actively participate in the lifelong learning project for participation and integration in Canada. This paper provides insights to the understanding of culturally sensitive policy-making on integration, health, and lifelong learning of older immigrants in Canada and beyond. [ABSTRACT FROM AUTHOR]

This paper explores the moral implications of treatment of young people with functional somatic symptoms. Based on an ethnographic field study at a Danish pain clinic for youngsters (age 8 to 18), the paper seeks to unearth the cultural, moral values that clinical practice steers by and upholds, and the implications this has for the assessment and management of ill body-selves. Through an exposition of the general practice of the clinic and an investigation of two specific cases of youngsters, it is found that the assessment of symptoms and selves and the goals of treatment are informed by cultural ideals of 'the good self' and 'the good life' in which agency and work ethic – both pertaining to the notion of individual responsibility – figure as prevalent virtues. The study underpins the findings of other researchers who have found that ideals of individual autonomy and responsibility for own life and health permeate the Western health care system and the discourses of ill individuals. The contribution of this article is to portray in ethnographic detail how such a cultural ethics manifests in practice and what implications this have for the treatment of young people with functional symptoms at a specific location and in specific cases. The two cases illustrate that the underlying norms and values can give rise to very different moral assessments of symptoms and selves within the same diagnostic category. [ABSTRACT FROM AUTHOR]

The cultivation of equanimity has been emphasized in various indigenous philosophies and contemplative practices. This paper aims to develop an expansive understanding of equanimity as a distinct psychological construct. Thirty experts from various traditions such as Buddhism, Vedic studies, meditation, and yoga were interviewed on their understanding and insights into equanimity. The findings suggest equanimity as an even-mindedness towards the varied hedonic and affective experiences. The cognitive, affective, and conative mechanisms of equanimity such as increased distress tolerance, hedonic neutrality, and reduced reactivity are outlined. At the interpersonal level, equanimity entails impartiality and reduced bias towards others. The challenges one may face during the cultivation of equanimity have been suggested by the experts. The implications of cultivating equanimity have been examined in the context of adaptive coping and holistic wellbeing in the current pandemic situation, dealing with compassion fatigue, and the development of indigenous leadership practices. [ABSTRACT FROM AUTHOR]

The aim of this paper is to identify structural problems and challenges for the delivery of digital technologies for ageing in place to elderly with dementia. To that end, I conducted a case study in a Swedish municipality. The results showed that elderly with dementia are not exploiting their full potential of receiving help in the form of technology, since the four conditions of the Consumer Direction (Control and Direct services – Variety of digital technologies for ageing in place options – Information and Support – Participation in systems design) were met to a very low degree. I propose that the municipality in question creates a proper knowledge-sharing platform so that occupational therapists are well informed about digital technologies for ageing in place, to allow them to provide accurate information and support to elderly with dementia, resulting in a possible increase in use of technology and subsequently support the empowerment goal of Consumer Direction. I also believe, according to the findings of this study, that the module of Information and Support should be treated as the most important condition for achieving increased Consumer Direction. Elderly with dementia and their relatives do not receive sufficient information about digital technologies for ageing in place (DTAP). There is not enough information regarding the available options and their use. This often denies elderly with dementia and their relatives the services they are entitled. Occupational therapists knowledge about DTAP affects the variety of options presented to elderly with dementia and their subsequent use. Once a person is diagnosed with dementia, physicians tend to suggest medicinal solutions, overlooking the dissemination of DTAP information. Thus hindering their early access to DTAP. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper was to determine the attachment strategies of prospective adoptive parents and any correlation between attachment and the defensive strategies they used when talking about loss of fertility. The study also examined whether attachment strategy of the applicants had a bearing on the decision by the local authority to place a child. Design/methodology/approach: The sample was comprised of 48 respondents (21 couples) representing 84 per cent of all people who applied to one UK Social Services Department in a 12-month period. Placement of a child was reviewed two years following the assessment. The study used the dynamic maturational model version of the adult attachment interview (DMM-AAI), together with added questions on loss of fertility to assess the applicants' attachment strategies together with unresolved loss and trauma and the DMM modifiers. Findings: Unlike adoption studies using the Main and Goldwyn system, this study rated very few of the applicants' AAIs as secure (13 per cent), 48 per cent were in the normative low-risk range and 52 per cent of the AAIs were coded in the more complex DMM insecure strategies. There was a significant bias towards marriages where the partners deployed opposite low-risk/DMM strategies (13 (62 per cent) of couples). Compared with data on non-clinical populations the AAIs showed a high level of unresolved loss or trauma (58 per cent). Using a six-way distribution (A1-2, C1-2, B, A3-4, C3-6 and A/C) there was an 87 per cent correspondence between discourse about loss of fertility and that about attachment, thereby supporting the established proposition that reproduction is part of the attachment system. Twenty one per cent of the AAIs were coded as "disorientated" and this is discussed in terms of conflict for adoptive of parents concerning the raising of a child who carries their own genes or those of strangers. A case is made to conceptualise negative impact of infertility in terms of unresolved trauma rather than loss. Research - limitations/implications: This study adds to research showing that the DMM approach is more finely calibrated than the ABC+disorganised model with the latter likely over coding for security. The results emphasise that fertility and reproduction are legitimate subjects for attachment studies and that AAI discourse analysis is a valid methodology for future research. However coder agreement as to whether or not loss of fertility was resolved was only fair (64 per cent) κ. 0.25 (po0.33). More work is required in order to determine what constitutes unresolved loss of fertility and what impact, if any, this has on parenting an adopted child. Practical implications: The practice implications are considered in a separate paper. Social implications: The findings are contentious in that they suggest a significant number (48 per cent) of adoptive parents have needs not dissimilar to other clients of psychological services. Originality/value: This is the first DMM-AAI study with prospective adoptive parents and the findings show significant differences when compared with previous studies using the Main and Goldwyn AAI. It is also the first study to establish fertility as a legitimate area for attachment studies by using AAI discourse analysis. [ABSTRACT FROM AUTHOR]

The aim of this paper is to address risks young people in the late 20th and 21st century are exposed to with regard to political participation. Based on qualitative data and ordinary language interviews with 27 Norwegian pupils in upper secondary school, we address how the construction of the political space is understood by young people themselves. By analysing how young people define political interest and engagement, the findings indicate that a gap exists in the perception of 'own' and 'institutionalised' political participation. This paper concludes that exploring the understanding of politics among the young may reduce vulnerability of this particular group in their democratic participation as well as facilitate their political empowerment. [ABSTRACT FROM AUTHOR]

Aims: This paper focuses on the reasons for the under-representation of British South Asians in substance use services. Based on a small-scale evaluation of a substance use service that delivers targeted outreach support within two predominantly Pakistani and Bangladeshi communities in the north west of England, this paper contributes to the debate around how substance use services can best engage with young British Pakistani and Bangladeshi substance users. Methods: Semi-structured interviews (with six staff members, 18 young Pakistani and Bangladeshi service users, and 18 stakeholders and partner agencies), a detailed ethnographic observation of the service, and an analysis of routinely collected quantitative monitoring data. Findings: The paper highlights the importance of what Fountain terms low threshold/open access services. Alongside this, the paper argues that the building of trust and confidence in a substance use service is a key when it comes to engaging with young Pakistani and Bangladeshi substance users. Yet this necessary process takes time: something that is at odds with the current trend towards short-term funding regimes and 'quick wins'. Conclusions: The paper concludes by advocating the need for, not only a diverse range of engagement strategies, but also a longer term approach when it comes to developing and delivering substance use services aimed at successfully engaging with this particular group of substance users. [ABSTRACT FROM AUTHOR]

Introduction. Personality disorders are common mental health disorders, with an estimated lifetime prevalence of 4 to 15%. People living with personality disorders are extensively seeking mental health services, yet few papers focus on their unique occupational needs or effective rehabilitation interventions that may alleviate the occupational issues they face. Occupational therapists are encouraged to support engagement in socially valued occupations, while preventing engagement in damaging ones, despite a lack of evidence on the meaning and the lived experiences of people. Objectives. This paper describes the meaning attributed by people living with personality disorders to their main occupations and the underlying needs they strive to fulfill through occupational engagement, whether or not these occupations are sanctioned. Methods. This exploratory study rests on a descriptive interpretative methodology. The participants were ten men and women, aged between 18 and 35 years old and living with a Cluster B personality disorder. A semistructured interview guide allowed participants to build narratives on occupations that are important to them and discuss how these occupations shape their identity. A thematic content analysis fostered the development of a coding structure that reflected a first-account perspective. Results. The narratives provided by the participants depict a variety of meaningful occupations, many of which are socially disapproved. Many of these occupations serve as a coping strategy to deal with distressing situations, to connect with others who share similar life experiences, or to reestablish a fragile sense of control. Other occupations are socially disapproved due to the overinvestment of the participants' commitment. While participants described how this overinvestment allowed them to control destructive impulses, significant others perceived it as counterproductive and unnecessary. Participants perceived self-care occupations as painful and tedious chores or meaningless occupations. Engaging in productive occupations allowed some participants to gain recognition or to identify their competencies, but also confirmed their differences, creating some form of alienation or marginalisation. Conclusion. This exploratory study invites clinicians and researchers to develop a more responsive understanding of occupational engagement for this population. The results highlight the importance of situating occupations in their context, while endorsing a first-account perspective, to better understand the forces that shape occupational engagement. Ultimately, occupational therapists should critically appraise their assumptions around healthy and unsanctioned occupations, in order to respond with sensitivity to the needs and experience of their clients, without perpetuating the marginalisation and discrimination they face. [ABSTRACT FROM AUTHOR]

Abstract The concept of biographical disruption has now enjoyed nearly 40 years of use in medical sociology. This paper argues that taking an embodied approach to biographical disruption helps to explain the concept's enduring efficacy. Drawing on the work of Maurice Merleau-Ponty and contemporary theories of embodiment inspired by his phenomenology, this paper advances that biographical disruption involves, in the first instance, a disruption to the ability to enact an embodied orientation towards the world. Biographical disruption does not, from this perspective, result from illness as such, but from the ways that illness impinges on one's physical ability to engage with daily life. This paper examines the experiences of solid organ transplant recipients for the purpose of shedding light on the conditions under which biographical disruption arises in experience. The analysis includes interviews with 36 post-operative solid organ transplant recipients (heart, liver, lung, and kidney) living in British Columbia or Ontario, Canada. These participants exhibit a wide range of illness experiences, some of which manifest as biographical disruption and others that do not. Tracing the contours of these experiences, this paper argues that the efficacy of biographical disruption for describing the illness experience depends not only on the illness experience but also, fundamentally, on the content of embodiment prior to the onset of that experience. Highlights • The embodiment perspective improves the efficacy of biographical disruption. • The embodied context of an experience structures the illness experience. • Organ transplant recipients present variable experiences of biographical disruption. [ABSTRACT FROM AUTHOR]

Notions of 'participation' in sexuality education has gained considerable traction in recent years - with participation being regarded as a fundamental right and a critical means to empower young people. However, the notion has increasingly been subject of debate, with critics problematising the manner in which participation is operationalised, and questioning the assumed impact of participation in relation to sexuality education goals. This paper contributes to these debates by examining the under-researched gendered dimensions of participation of young people in sexuality education. It utilises data from a qualitative study conducted in 2015 on young women and men's (10-15 years old) perceptions of their participation in the dance4life programme, an in-school sexuality education programme in Jinja district in eastern Uganda. The paper highlights subtle but important differences between young men and women's participation in the programme, which are arguably reflective of existing gendered hierarchies. We conclude by providing recommendations on how to address gender differences in participation. [ABSTRACT FROM AUTHOR]

Dying alone is portrayed as undesirable in terms of policy, health and social care provision, the wishes of family and friends, and in popular culture. Despite this, people do often die alone, both in institutional and domestic settings. This paper reports findings from a study which explored ways of investigating individuals' perspectives on dying alone at home. It tested methods of recruitment and data collection, gathered preliminary data and explored the ethical issues involved. Interviews with 11 older people living alone and 7 hospice at home nurses are reported here. For the older people, the idea of dying alone was less problematic than the idea of needing care and support from others, and the perceived loss of independence that this would entail. Participants reacted in differing ways to threats to their independence, but all utilised a form of relational reflexivity when considering the effect their actions might have on others. The nurses would prefer no one to die alone, but believed they had seen patients managing their own dying so that they could be alone at the moment of death. The paper suggests that dying alone may be a problem for survivors, rather than for the person who is dying. [ABSTRACT FROM AUTHOR]

Preserving older pedestrians' navigation skills in urban environments is a challenge for maintaining their quality of life. However, existing aids do not take into account older people's perceptual and cognitive declines nor their user experience, and they call upon sensory modalities that are already used during walking. The present study was aimed at comparing different guidance instructions using visual, auditory, and haptic feedback in order to identify the most efficient and best accepted one(s). Sixteen middle-age (non-retired) adults, 21 younger-old (young-retired) adults, and 21 older-old (old-retired) adults performed a navigation task in a virtual environment. The task was performed with visual feedback (directional arrows superimposed on the visual scenes), auditory feedback (sounds in the left/right ear), haptic feedback (vibrotactile information delivered by a wristband), combinations of different types of sensory feedback, or a paper map. The results showed that older people benefited from the sensory guidance instructions, as compared to the paper map. Visual and auditory feedbacks were associated with better performance and user experience than haptic feedback or the paper map, and the benefits were the greatest among the older-old participants, even though the paper-map familiarity was appreciated. Several recommendations for designing pedestrian navigation aids are proposed. [ABSTRACT FROM AUTHOR]

This paper aims to examine consumer perception toward celebrity diagnoses of major depressive disorder (MDD) in Hong Kong and to provide insights into the effect of various factors on the persuasive effectiveness of MDD communication. A total of thirty-five interviews were conducted in April 2015. Interviewees in general are aware of celebrity MDD diagnoses, but they do not deem MDD as a threat to themselves. Hence, they are not motivated to learn more about the symptoms. Responses to celebrity MDD diagnoses are mixed. Many interviewees are sympathetic toward ill celebrities diagnosed with MDD, but some of the interviewees are dubious about the true intention behind disclosing their diagnoses to the public. Compared to non-fans, fans reported a greater increase in the level of knowledge of MDD after reading related media stories about celebrity MDD diagnoses. Source credibility is perceived as an important factor in MDD communication. This research suggests that the government or NGOs may use credible celebrities whose image can be associated with MDD and cooperate with fan clubs to spread health-related information. The paper represents the first attempt to investigate the effects of celebrity disclosure of MDD diagnoses on the mental disorder-related perceptions of the general public in Hong Kong. [ABSTRACT FROM AUTHOR]

Purpose Co-existing health conditions and frequent hospital usage are pervasive in homeless populations. Without a home to be discharged to, appropriate discharge care and treatment compliance are difficult. The Medical Respite Centre (MRC) model has gained traction in the USA, but other international examples are scant. The purpose of this paper is to address this void, presenting findings from an evaluation of The Cottage, a small short-stay respite facility for people experiencing homelessness attached to an inner-city hospital in Melbourne, Australia.Design/methodology/approach This mixed methods study uses case studies, qualitative interview data and hospital administrative data for clients admitted to The Cottage in 2015. Hospital inpatient admissions and emergency department presentations were compared for the 12-month period pre- and post-The Cottage.Findings Clients had multiple health conditions, often compounded by social isolation and homelessness or precarious housing. Qualitative data and case studies illustrate how The Cottage couples medical care and support in a home-like environment. The average stay was 8.8 days. There was a 7 per cent reduction in the number of unplanned inpatient days in the 12-months post support.Research limitations/implications The paper has some limitations including small sample size, data from one hospital only and lack of information on other services accessed by clients (e.g. housing support) limit attribution of causality.Social implications MRCs provide a safe environment for individuals to recuperate at a much lower cost than inpatient admissions.Originality/value There is limited evidence on the MRC model of care outside of the USA, and the findings demonstrate the benefits of even shorter-term respite post-discharge for people who are homeless. [ABSTRACT FROM AUTHOR]

Purpose Homeless people experience extreme health inequalities and high rates of morbidity and mortality (Aldridge et al., 2017). Use of primary care services are low, while emergency healthcare use is high (Mathie, 2012; Homeless Link, 2014). Duration of admission has been estimated to be three times longer for homeless patients who often experience poor hospital discharge arrangements (; ). This reflects ongoing and unaddressed care and housing needs (Blackburn et al., 2017). The paper aims to discuss these issues.Design/methodology/approach This paper reveals how GPs employed in secondary care, as part of Pathway teams, support improved health and housing outcomes and safe transfer of care into community services. It draws on published literature on role of GPs in working with excluded groups, personal experience of working as a GP in secondary care, structured interviews with Pathway GPs and routine data collected by the team to highlight key outcomes.Findings The expertise of GPs is highlighted and includes holistic assessment, management of multimorbidity or "tri-morbidity" – the combination of addictions problems, mental illness and physical health (Homeless Link, 2014; Stringfellow et al., 2015) and research and teaching.Originality/value The role of the GP in the care of patients with complex needs is more visible in primary care. This paper demonstrates some of the ways in which in-reach GPs play an important role in the care of multiply excluded groups attending and admitted to secondary care settings. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Risk assessment and management in mental health services are contested and perceived as problematic by both professionals and service users.There is substantial emphasis on risk as a core component of professional practice. However, recovery for people with mental health problems emphasizes self‐determination which seems to conflict with risk management.A critique is emerging of risk assessment and management. However, there is a lack of empirical evidence which seeks to explore how professionals manage the conflicts between recovery orientated practice and risk management. What the paper adds to existing knowledge?: The paper reports on qualitative research which highlights people with mental health problems are objectified and frequently associated with the potential for harm.Risk dominates the work of mental health professionals and undermines individualized care.Service users are subject to increased surveillance and medication as a result. What are the implications for practice?: Service users' subjective experiences need to be prioritized in mental health care by renewed focus on the relationship between professionals and service users.Mental health professionals should question the centrality of risk to their practice. Introduction: The emergence of recovery, alongside significant focus on risk management, creates potential for conflicting influences in mental health care. Although evidence has critiqued risk assessment, there is a lack of research that seeks to explore how professionals make decisions within these apparently incompatible agendas. Aim: To explore how practitioners, experience potential tensions arising from delivering recovery‐orientated care and enforcing containment. Method: This paper reports on a case study inquiry, using interviews with mental health professionals and observations in an acute ward and an assertive outreach team. Results: Risk governed the practice of mental health professionals to such an extent it defined how service users were understood and treated. Service users were constructed as objects of risk, first by being objectified and secondly by creating a link between that object and harm. Discussion: Hilgartner's (1992, Organizations, uncertainties and risk (pp. 39–53). Boulder, CO: Westview Press) theory of risk explains how risk dominates the identity of people with mental health problems at the cost of recovery. This results in increased monitoring, surveillance and medication to enact control. Implications for practice: To undermine the dominance of risk, professionals should reconnect with the subjective experiences of people with mental health problems and challenge the acceptance of risk as central to their role. [ABSTRACT FROM AUTHOR]

Summary This paper examines both the epistemological and practical limitations and challenges of data collection by reflecting on the experiences of a team of both junior and senior researchers engaged in such a longitudinal study. Findings This paper argues that longitudinal research with street youth challenges the boundaries and limits of the formal constructs of research and ethics that typically guide qualitative research by grappling with field issues such as navigating reciprocity, risk and authenticity within relationships with a vulnerable group. Application This paper calls for an explicit acknowledgement of the challenges researching populations such as street youth over time in our research ethics guidelines and encourages researchers to engage in dialogue leading to more reflective, transparent and accountable framing of how we collect data in the field with vulnerable youth populations. [ABSTRACT FROM AUTHOR]

This paper seeks to contribute to debates about how people's adult lives unfold after experiencing childhood adversity. It presents analysis from the British Chinese Adoption Study: a mixed methods follow-up study of women, now aged in their 40s and early 50s, who spent their infant lives in Hong Kong orphanages and were then adopted by families in the UK in the 1960s. Sixty-eight women participated via questionnaires and face-to-face interviews. The paper draws on both quantitative analysis (using standardised measures and systematically coded data on adult life events) and qualitative analysis of interview data to identify the context and subjective meaning of the quantitative findings. We found that most of the women lived largely positive, stable, well-supported lives although punctuated by challenging periods. Using regression analysis, two variables were significantly associated with poorer mid-life functioning over and above other potential influences: a) feeling unhappy about being adopted, and b) partnership adversity after age 25. No associations were found between childhood experiences and patterns of adult adversity. Illustrations are given, based on the interviews, of the women's multi-faceted perspectives on the long-term impact of being internationally adopted and on professional support. We conclude that when early orphanage care (of reasonable quality) was followed by a good quality adoption, most women were able to negotiate the majority of later difficulties successfully. The findings suggest two important implications for understanding mid-life outcomes: a) that experiences in both childhood and adulthood should be taken into account and b) individuals' subjective views on being internationally adopted may help explain divergent outcomes within groups with similar early experiences. [ABSTRACT FROM AUTHOR]

A distinction is often made between the “choice” of not having children and the claim that having children is “natural”. What disappears in this distinction is the fact that having children is most often a choice. This choice, however, is rendered invisible through the naturalisation of parenthood as a normatively expected aspect of adulthood. Whilst this argument is not new, the topic of how heterosexual couples come to decide to have children has received relatively little attention within the academic literature. This paper reports on findings from the first stage of a longitudinal interview study focused on Australian middle-class heterosexual couples planning for a first child. A thematic analysis of interviews conducted with 10 couples found that a paired contrast was often made between what were constructed as “childless others”, and a “natural” or “innate” desire to have children. The naturalisation of a desire to have children, however, was problematised when participants spoke about expectations from family members that participants should have children. The paper concludes by considering how the relationship between parenthood and adulthood may be a specifically class-based narrative. [ABSTRACT FROM AUTHOR]

Objective: In spite of the healthy immigrant effect, the prevalence of lifestyle-related chronic diseases among migrants is reported to approximate that of the host country with longer duration of stay. For example, higher rates of chronic diseases such as Type 2 diabetes and hypertension have been observed among Filipino migrants and these have been linked to acculturation. The aim of this study was to explore the experiences of Filipino-Australian migrants in managing their chronic health conditions in a Western host country. Design: This paper reports on qualitative findings of a mixed methods study that used an explanatory sequential design. Nine focus group discussions were undertaken with 58 Filipino-Australian migrants with chronic disease. Thematic analysis was undertaken using a five-stage general purpose thematic framework ensuring that themes closely identified key participants’ experiences. Results: Findings revealed that health benefits provided by the health system in Australia were considered advantageous. However, a lack of social and instrumental support compounded isolation and disempowerment, limiting self-management strategies for chronic illnesses. Cultural beliefs and practices influenced their knowledge, attitude to and management of chronic disease, which health service providers overlooked because of perceived acculturation and English language skills. Overall this study has clearly identified recognition of cultural beliefs, language needs and support as three core needs of Filipino-Australian migrants with the elderly the most vulnerable. Conclusion: This paper highlights that self-management of chronic disease among elderly Filipino immigrants may be adversely affected by host language difficulties, a lack of social support and cultural issues, impacting on access to services, health-seeking behaviours and participation in health promotion initiatives. Language, culture-specific health interventions and resources and enhancing social support are likely important strategies in promoting chronic disease self-management among the elderly. These interventions have the potential to empower and encourage individuals to take control and better manage their chronic disease. [ABSTRACT FROM AUTHOR]

This qualitative research paper discusses the importance of experiential learning in the creative writing process, the cognitive processing of difficult emotions that can result from writing creatively in both the first and third person, and the implications of this in therapeutic settings. It looks at the ways experiential learning can come not just first-hand from life experience, but also through interviewing others about their experiences, and the ways Interpretative Phenomenological Analysis can then be used to interpret the material and act as a stepping stone between fact and fiction. The study is based on the writer's 20-year databank of journalistic interviews, which represents hundreds of single case studies, and also on her experience of writing four published novels. It examines the significance of the overlap between creativity, psychology, and journalism, and the therapeutic implications of that overlap for journalists, authors, and psychologists and their patients. [ABSTRACT FROM AUTHOR]

Abstract: Background: Internationally, pharmaceutical policy has heightened expectations for community pharmacies to act as healthcare professionals, increasing the need to understand the health professional–retailer nexus. Literature suggests that pharmacy involves a dichotomy of roles including both retailing and healthcare provision, yet it is unknown whether pharmacists themselves perceive a tension between these roles and how such a tension might be managed. Aim: To explore whether there is tension between being retailers and healthcare providers in community pharmacy and to understand how any such tension is perceived and managed. Methods: Ten in‐depth semi‐structured interviews were conducted with pharmacist owners and managers of community pharmacies in New Zealand. General inductive thematic analysis was undertaken to gain insight from the data. Results: Pharmacists experienced tension between being healthcare providers and being retailers. In total, eight themes were derived from this study. Four themes emerged to describe the tension: (i) balancing roles; (ii) tension – what tension?; (iii) we give a lot for free; and (iv) too much bureaucracy and paperwork. Four themes for managing tension were identified: (i) imparting of owner beliefs; (ii) use of incentives; (iii) effective business management skills; and (iv) being entrepreneurial. Conclusion: This paper is expected to assist in helping policy‐makers and practitioners be aware of the role of tensions when policies are implemented to move pharmacists from a retailer role to healthcare provider. This paper aids in policy development and should inform professional practice and forthcoming business management training programs for community pharmacy. [ABSTRACT FROM AUTHOR]

Adolescents and youth with disabilities in South Africa still lack access to sexual and reproductive health and rights services including comprehensive sexuality education, which may increase their vulnerability to SRHR issues such as HIV and sexual violence. This is exacerbated for learners with intellectual disabilities whose educators often lack skills and tools to accommodate these learners in comprehensive sexuality education lessons. The following paper outlines the findings of a formative evaluation of an innovative sexuality training approach for educators of learners with diverse disabilities (Breaking the Silence approach). This approach was developed and piloted with educators across eight schools for learners with intellectual disabilities in KwaZulu-Natal, South Africa. The paper discusses the educators’ understanding and experiences of using this approach. The findings revealed that although educators were able to implement parts of the approach, contextual factors impacted the degree of implementation. These factors were related to perceptions of socio-cultural norms, interpersonal engagement with peers and management, the structural environment of school settings, and the wider community setting. Educators began to address cultural taboos related to talking about sexuality, but were challenged by untrained staff and the larger socio-cultural context, which includes a heighted risk of sexual violence against their learners. The paper concludes with recommendations for a further investigation of the approach within a whole school setting considering the needs of educators to not only acquire skills and knowledge but also to address their larger socio-cultural context in which they have to implement comprehensive sexuality education. [ABSTRACT FROM AUTHOR]

This paper explores the importance of hope as a determining factor for patients to participate in first-in-human trials for synthetic biology therapies. This paper focuses on different aspects of hope in the context of human health and well-being and explores the varieties of hope expressed by patients. The research findings are based on interview data collected from stable gout and diabetes patients. Three concepts of hope have emerged from the interviews: hope as certainty (H1); hope as reflective uncertainty (H2); hope as self-therapy (H3). The purpose of the paper is twofold. First, it aims to underline the significance of hope in patients’ medical decision-making, as well as the beneficence of hope for patients’ well-being, and for progress in research. Second, it shows how philosophical investigations—in particular Descartes—explore the phenomenon of hope and provide medical empirical research with profitable insights and tools. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to illustrate the hostility many young women who are also mothers experience within their everyday lives.Design/methodology/approach The paper will draw on qualitative research, incorporating a narrative approach, to illustrate the hostility many young mothers experience on a daily basis. The research design included a focus group, semi-structure interviews and participant observations.Findings The paper reports the findings of a study that explored the experiences of young women who are also mothers. The author presents the findings that indicate that many young women, who are also young mothers, experience hostile reactions and interactions as part of their everyday lives.Research limitations/implications The small sample size means that this study cannot be generalised, but it does contribute to the growing body of qualitative evidence in relation to young mothers.Practical implications The findings suggest that there needs to be more recognition and acknowledgement of the hostility young women experience. Such hostility could have deleterious consequences on the young women, their parenting ability and also on the children.Originality/value This paper documents the experiences of young women who are also mothers and how they experience hostility as a daily occurrence. The hostility ranged from verbal to non-verbal and how they felt they were being treated, inferences about their sexuality to stereotyping. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore keyworkers’ experience and perceptions working with people experiencing homelessness and the use of psychologically informed approaches in an Irish context.Design/methodology/approach In this paper a qualitative descriptive methodology was employed and face-to-face in-depth semi-structured interviews were conducted. Data collected were analysed using a thematic framework and transcribed by the researcher.Findings It was the view of the keyworkers psychological approaches allowed them greater understanding of psychological trauma and its effects promotes safe physical and emotional environments builds rapport between staff and clients and enables keyworkers to work more effectively with people with complex needs. There was also convincing evidence staff are quite receptive to training.Originality/value Given there is no research exploring the use of psychologically informed approaches in homelessness service settings, this study researched an area that has not yet been explored in Ireland. This qualitative descriptive research provides a platform from which further research can be conducted. It is hoped that highlighting the psychological issues of homeless people, the data obtained will help improve Irish homeless services, and the findings extracted beneficial in terms of future service developments, professional training and education. [ABSTRACT FROM AUTHOR]

Abstract: Aim: This article presents a discussion highlighting the relevance and strengths of using narrative inquiry to explore experiences of social networking site (SNS) use by adolescent mothers. Background: Narrative inquiry as a method reveals truths about holistic human experience. Knowledge gleaned from personal narratives informs nursing knowledge and clinical practice. This approach gives voice to adolescent mothers in relation to their experiences with SNS as a means of providing social support. Design: Discussion paper. Data sources: This paper draws and reflects on the author's experiences using narrative inquiry and is supported by literature and theory. The following databases were searched: CINAHL, Cochrane Library, Medline, Scopus, ERIC, ProQuest, PsychINFO, Web of Science and Health Collection (Informit). Key terms and Boolean search operators were used to broaden the search criteria. Search terms included: adolescent mother, teenage mother, “social networking sites”, online, social media, Facebook, social support, social capital and information. Dates for the search were limited to January 1995–June 2017. Implications for practice/research: Narrative research inherently values the individual “story” of experience. This approach facilitates rapport building and methodological flexibility with an often difficult to engage sample group, adolescents. Conclusion: Narrative inquiry reveals a deep level of insight into social networking site use by adolescent mothers. The flexibility afforded by use of a narrative approach allows for fluidity and reflexivity in the research process. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this paper was to use a storytelling approach to explore the role of a 5-day inclusive residential adapted sport and adventurous training (AS & AAT) programme in the recovery of military personnel diagnosed with PTSD. Design : Narrative storytelling approach. Method A first-person story was developed from the participant's own words taken verbatim from an in-depth semi-structured interview. A series of focus groups were conducted with members of the general public (n = 20) to reflect upon the story. Results The story provides a rich and holistic account of the participant's experiences and unique insight to the complex interaction between the social and psychological factors associated with illness and recovery. The story also highlights the value attributed to the AS & AAT in an individual's recovery journey. Conclusions This paper offers important insights into the personal meaning and value of participation in a bespoke 5-day AS & AAT programme. Feedback from the participant and focus groups with members of the general public who engaged with the story suggest judgement criteria appropriate for a creative non-fiction representation were achieved. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to describe the barriers and facilitators to an effective transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). It also presents a new entry into considering how the transition can be improved.Design/methodology/approach Insights into the transition from CAMHS to AMHS were gathered through eight semi-structured interviews with mental health professionals. Two methods of data analysis were employed to explore the emerging themes in the data and the observed deficit approach to organisational development.Findings The findings identified a vast volume of barriers in comparison to facilitators to the transition. Adolescents who transition from CAMHS to AMHS initially experience difficulty adapting to the differences in the services due to the short duration of the transition period. However, despite the established barriers to the transition, adolescents tend to adapt to the differences between the services. Findings also showed a negative framing towards the transition amongst the mental health professionals which resembles a deficit approach to organisational development.Originality/value This paper explores mental health professionals’ perspectives regarding the transition in Dumfries and Galloway, Scotland. The transition is increasingly recognised as an area in health care that requires improvement. This research provides a new way to consider the transition by exploring the perceived deficit approach to organisational development in the services. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? There is a growing body of evidence that many people with an autism spectrum condition suffer anxiety in their daily life and a realization among practitioners that admission to a mental health unit for this population is usually a negative anxiety-inducing experience., Anxiety is driven by the intolerance of uncertainty that is being unsure of what is going to happen, how long the uncertainty will exist and the insistence of sameness which, when compromised, can be anxiety provoking. Equally, confusion in understanding personal emotional responses and those of others is a source of anxiety., What this paper adds to existing knowledge? This paper builds upon existing understanding of anxiety as a causative factor of mental ill-health for people with an autism spectrum condition., Specifically, this paper explores the potentially anxiety-inducing experience of mental health unit admission; how anxiety is felt, triggered, expressed and managed., What are the implications for practice? As many different anxiety responses could be exhibited during hospitalization, including violent acts and self-harming, for mental health practitioners working in the inpatient units, it is essential that the thoughts, feelings and responses of the patient with an autistic spectrum condition (ASC) are better understood and that support offered during their stay in a mental health facility is from an informed position., Abstract Background This qualitative study explored how mental health inpatients with autistic spectrum conditions (ASCs) experience and cope with anxiety when admitted to an acute mental health inpatient facility in the United Kingdom. Anxiety is a common characteristic for people who live with ASCs and whilst a plethora of studies on anxiety in this population is published which correlate anxiety with mental health service experience, little is known about the actual triggers of anxiety and its manifestations. This study adds to a body of evidence which considers anxiety experienced by people with autism. The rationale for this study includes the need to heighten mental health practitioners' understanding, of the responses, motivations to engage and support required to overcome fears and anxieties when admitted to a mental health inpatient unit. Method The study used a qualitative naturalistic research design, to explore the emotional and psychological experiences of being a mental health inpatient living with an ASC. During 2015-2017. audio-recorded semistructured interviews captured the experiences of 20 adults from the east of England who were former psychiatric inpatients with an established diagnosis of ASC. Interpretative phenomenological analysis enabled the identification of broad themes which explained in rich detail, participant reflections regarding the situations and events within the acute care mental health facility that triggered their anxiety, manifestations of anxiety and responses to their anxiety. Findings Broad response patterns were identified that could be associated with their anxiety that is isolating themselves from others, including patients and staff, ceasing to eat and sleep adequately and all too often self-harming or exhibiting aggressive and violent responses. Conclusions The anxiety caused by the physical environment appears to be overlooked by mental health practitioners so attention to anxiety-inducing encounters is needed when planning acute care mental health service improvement and research is required to clearly understand the experiences of this vulnerable group. [ABSTRACT FROM AUTHOR]

‘Experiential knowledge’ is increasingly recognised as an important influence on reproductive decision-making. ‘Experiential knowledge of disability’ in particular is a significant resource within prenatal testing/screening contexts, enabling prospective parents to imagine and appraise future lives affected by disability. However, the concept of ‘experiential knowledge’ has been widely critiqued for its idiosyncrasy, its impermanence and consequently its perceived inferiority to (medical) knowledge. This paper explores some of these key critiques of experiential knowledge through an analysis of its constitution and uses in the context of reproductive decision-making. Seventeen UK-resident women with Spinal Muscular Atrophy (SMA), or with SMA in their family, took part in two in-depth interviews: one in 2007–9 and the other in 2013–4. By comparing and contrasting these women's accounts at two time points, this paper demonstrates the stark contrast between ‘lived experience’ of SMA (the visceral everyday realities of life with the condition) and the various way(s) this experience was transformed into, and presented as, ‘knowledge’ through the processes of making, and accounting, for reproductive decisions. The analysis highlights that multiple, distinct and sometimes competing experiential frameworks are used to conceptualise SMA across time and context. However, rather than evidence of its fallibility, this finding highlights that ‘knowledge’ is an inappropriate vessel with which to capture and transfer ‘experiential knowledge’. Rather, we need to consider how to value such insight in ways that harnesses its inherent strength without leaving it vulnerable to the epistemological critiques attracted by labelling it ‘knowledge’. [ABSTRACT FROM AUTHOR]

Public policies encourage the service system to work in new ways to promote health and increase social equality. This paper presents four categories that show the character of the low-threshold services in Norwegian family centres from the professionals' and parents' perspectives, focusing on accessibility and participation: easy access, low level of bureaucracy, collaborative competences and inclusive arena. This paper is based on an inductive study in three municipalities that have chosen to establish family centres as interdisciplinary co-located services that aim to offer low-threshold services for children and their families. Data were generated through a fieldwork, and participatory observation and interviews were the main source of data. The methodological framework for the analysis was grounded theory, in which the data generation and analysis interchanged throughout the study, and theoretical sampling set the focus for the fieldwork. Exploring the actor's perspective highlighted both strengths and challenges with the low-threshold services in the family centres. The four elements presented emphasize that the value of these low-threshold services are not found in one single hallmark; rather, the value depends on an interaction between different elements that must be addressed when establishing, evaluating and developing low-threshold services in family centres. [ABSTRACT FROM AUTHOR]