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A system was developed to automate the analysis of video images of polyphagous carabid predators searching for aphid prey. The system uses the following novel techniques: 1. large-scale foraging by predators across an arena of area in excess of 3 m squared. 2. automated collection of data on the movements of predators while searching within any sub-area of the arena (patch). An HVS VP112 tracking unit is used to analyse video images in real-time. A software system ('Predtrack') was developed on the BBC `B' micro-computer to analyse data generated by the tracker after storage, and has the capability to be entirely automatic. Predators are video-filmed as they search within a patch of prey centered in the arena. The output of the analysis programs is a set of means and standard errors for the following parameters of predator `tracks' (the trace of a single predator as it crosses the cameras field of view): 1. Duration of each track 2. Length of each track 3. Time spent moving per track 4. Time spent stopped per track 5. Number of stops per track 6. Average speed per track 7. Total angle turned through per track 8. Average rate of angle turned per unit distance per track 9. Average rate of angle turned per unit time per track The analysis method firstly isolates and identifies data belonging to each track in experimental data files and then uses a regression technique to convert this raw data into a set of representative lines from which angles of turn can be measured. Sample points are then taken along each line and timed relative to the raw data from which they are based. Statistics of movement as described above can be generated for any sub-period of an experiment. The system was used to investigate the response to spatial heterogeneity in populations of the aphid prey species Acyrthosiphon pisum, by the carabid predator Agonum dorsale. Preliminary results show that A. dorsale has the ability to aggregate to regions of high prey density, although the total response curve estimated for A. dorsale suggests that it cannot act in a regulatory manner upon populations of this prey species. Future experiments using two patches of different prey species at varying ratio's of each of their patch populations should be performed to investigate the possibility that, through the mechanism of prey switching, the total response of A. dorsale to aphid prey in the field could be such that a regulatory role is likely.

The importance of innovation as an academic research field and for society in general is stated, and existing definitions of the concept discussed. A new definition is proposed emphasizing the social nature of innovation and distinguishing it from creativity and non-innovative change. The innovation research literature is reviewed in relation to the two main approaches: 'antecedent factors' and 'process'. Conclusions from these reviews, and from a preliminary study of experiences of innovation, guide the design of the main research program. Three field studies are described. The first, carried out in two Homes for the Elderly, examines the sequence of the innovation process, influences on it, and staff attitudes towards it. Data are collected through semi-structured interviews, incorporating verbally administered questionnaires. Findings regarding the effect of involvement in the innovation process upon attitudes towards innovations are followed up in the second study, again in two Homes for the Elderly. A longitudinal questionnaire design is used. The third study is in a psycho-geriatric ward, using a participant observation methodology to follow the development of innovations as they occur. An overview of all the findings is presented in the final discussion chapter. Three areas are highlighted. (1) Attitudes to innovation: the primary importance of involvement in change processes is emphasized. (2) Influences on the innovation process: differences in perceptions according to phase of the process, and between staff groups, are interpreted in terms of individual and group role in the process. Possibilities of attributional bias are also raised. (3) The development of the process: the problems in identifying discrete stages are discussed and variations in the process for different innovation types are described. Building on these findings, especially in the third area, a general model of the innovation process is proposed. Its implications for future research are outlined.

Background: This PhD research sets out to qualitatively explore the cancer survivorship experiences of support and care continuity among UK Black African and Caribbean (BAC) cancer survivors and their family caregivers to understand their experiences of support and care continuity following the completion of initial cancer treatment in response to evidence of low support service uptake among them. Aim: The overall aim of this PhD research is to explore in depth the experiences of support and care continuity among UK BAC cancer survivors and their family caregivers following the end of initial cancer treatment; and examine the challenges UK cancer care providers face in supporting BAC cancer survivors and their family caregivers. Objective 1: To examine the experiences of support and care continuity among UK BAC groups and how they navigate to available cancer support services following the end of initial cancer treatment. Objective 2: To identify and analyse the support networks used by UK BAC cancer survivors and their family caregivers; and examine if their support networks and needs change over time. Objective 3: To explore the challenges faced by UK BAC family cancer caregivers and stakeholders. Objective 4: To inform UK cancer care stakeholders about study one's findings and consider the potential implications of such findings for practice and policy for UK BAC cancer survivors and their family caregivers. Methods: Study One involved 10 participants (five UK BAC cancer survivors and one family caregiver for each of them) recruited from community and religious support groups in the North of England. Data collection employed audio-recorded face-to-face semi-structured interviews involving a visual elicitation method (Pictor technique). The recorded interview data was transcribed and analysed using the Template Analysis approach. Content dyad analysis was applied on the Pictor charts. Study Two involved eight UK cancer survivorship stakeholders in an audio-recorded focus group discussion; data was transcribed and analysed thematically. Findings: Study One identified a variety of similar themes for both survivor and caregiver participants illuminating cancer survivorship experiences among a subset of UK BAC population. The top-level themes are: Feeling ambivalent with cancer support and social services; Accepting the new self; My family- my pillar; My culture - my identity; and My faith played a key part. The dyadic analysis of the Pictor charts highlights the similarities and differences within and between dyads, and the individual differences within their support networks. Study Two identified five main themes: Perceived cultural challenges, challenges with supporting BAC family cancer caregivers, lack of information, identified existing good practices, and strategies to improve support service uptake. Conclusions: The present research offers some significant contributions to knowledge and provides insight into UK BAC cancer survivorship experiences after initial cancer treatments, which they expressed as 'feeling abandoned', 'uninformed', and the lack of signposting and navigation to support services. Study One demonstrated the value of the Pictor technique which is a new approach to data collection among UK BAC groups. Study One participants' support networks were made up of mostly family, church, and friends. Caregivers' narratives shed light on the challenges of supporting BAC cancer survivors. Study Two highlights the challenges faced by UK cancer care providers in supporting BAC cancer survivors and their family caregivers, and points towards strategies for addressing them. Implication for policy and practice. Overall findings from both studies provide insights which may contribute to address some of the inequalities in cancer care and support. The identified impacts of religion/faith and culture on participants' cancer survivorship experiences suggest the need to consider the cultural dimension of cancer care in the UK; to improve cultural awareness with increased Black representation among UK cancer support providers. The findings also highlight the need for signposting and navigation services, for the involvement of religious leaders and inclusion of faith-based activities when designing cancer support services and support packages that target UK BAC cancer survivors and their family caregivers.

Critical Review of the Literature: Autistic children's social skills do not always align with those of their neurotypical peers and research suggests that this can negatively impact quality of life. This review aimed to assess the effectiveness of Extended Reality interventions in helping autistic children to enhance their social skills. Five electronic databases were systematically searched and twenty-one studies were identified. The majority targeted social-emotional reciprocity and were of relatively low quality. There was insufficient evidence to determine whether effects were generalisable, sustained or important to autistic people. Research in this field is in its infancy and evidence of effectiveness should be viewed with caution. Future studies should aim for high-quality, theory-driven research, and involve autistic people to ensure meaningful outcomes. PROSPERO ID: CRD42021229442. Service Improvement Project: 'Patient activation', defined as a patient's knowledge, skills and confidence in managing their health condition, is essential for collaborative neurorehabilitation. It is therefore in the interest of neurorehabilitation services to monitor and seek to improve this. The process of increasing patient activation at a Community Neurorehabilitation Service in Buckinghamshire (CNRS) was hereby explored. This research used a mixed methods design to investigate whether patient activation increases throughout intervention with CNRS and if so, what factors contribute to this. Quantitative analysis showed that activation did increase significantly and this was not impacted by demographic factors. Qualitative interviews with eight former patients and four therapists suggested that the nature of the therapeutic relationship and wider social support may have been important in contributing to the change. Negative past experiences of services and cognitive difficulties seemed to be associated with lower activation. As a result, CNRS embedded a number of service improvements including increased opportunities for peer support and greater consideration of the patient's wider health journey and emotional difficulties. Future research should seek to measure the impact of these improvements, as well as investigating the potential causal role of the factors identified in this qualitative research. Theoretically Driven Research Project: Understanding cognitive impairment and emotional difficulties after stroke are key priorities for research and clinical practice. However, cognitive screening tools are not always sensitive to impairments after stroke, and psychological distress in this population remains poorly understood, despite high prevalence and secondary implications. Part one of this research aimed to determine the sensitivity and clinical validity of a new stroke-specific, cognitive screening tool, the OCS-Plus, compared with the MoCA, a more established screening tool. Part two sought to better understand why cognitive impairment is associated with greater psychological distress after stroke, by exploring the role of illness appraisals. Eighty participants were consecutively recruited from Oxfordshire stroke wards over a 15-month period and completed a battery of assessments of mood, cognition and illness appraisals which were analysed cross-sectionally. The OCS-Plus was found to have good convergent validity and sensitivity when compared with the MoCA. Cognitive impairment significantly predicted depressive symptoms but was not predictive of anxiety when controlling for depression. The relationship with low mood was shown to be mediated by perceptions of control in this sample. Specifically, this research showed that higher levels of cognitive impairment were significantly associated with lower perceived control and accounted for the relationship between cognitive impairment and mood. Perceptions of threat and illness coherence were also predictive of low mood but were not predicted by degree of cognitive impairment. Illness appraisals may therefore be a target for intervention in the early stages after stroke, although prospective research is required to establish causality.

Systematic Review of the Literature: Multiple Concussions and Later-Life Cognitive Functioning: A Systematic Review Aims: This study aimed to review the evidence relating to the possible association of multiple concussions with later-life cognitive decline. Method: A systematic search was performed across five databases: Medline, Embase, Web of Science, PsycINFO, and SportDISCUS. Studies were included if they were original research investigating later-life cognitive function in individuals with multiple concussion histories, in any setting, using at least one neuropsychological measure. Data on study design, participant characteristics, exposure and outcome assessment, and key findings were extracted from included studies. Risk of bias was assessed using the Newcastle-Ottawa scale. Findings were qualitatively synthesised, due to the heterogeneity of included studies, for the domains of complex attention, learning and memory, executive function, language, and perceptual-motor function. Results: Twenty-three cross-sectional studies were identified (conducted with former football, rugby, and ice hockey players, and military veterans). The strongest evidence was for a subtle effect of multiple concussions on verbal learning and memory, and language. Evidence with regards to executive function was mixed, and the evidence did not support effects in the domains of complex attention or perceptual-motor function. Discussion: This review found no conclusive evidence of a relationship between multiple concussions and later-life cognitive decline; however, the findings should be interpreted with consideration of significant methodologic limitations in the literature. Further high-quality, powered, longitudinal research is needed, which includes a wider range of populations known to sustain multiple concussions, in order to draw firm conclusions about any associations between multiple concussions and later-life cognitive decline. Clinical implications of the findings are discussed. Service Improvement Project: "When You're on a Machine, You Want Some Kind of Humanity Around You": An Exploration of the Psychological Needs and Experiences of Patients with End-Stage Renal Disease Treated with Haemodialysis within a Regional Renal Service. Aims: This study aimed to provide a descriptive exploration of the psychosocial needs and experiences of patients receiving hospital-based haemodialysis treatment in a regional renal service, in order to inform meaningful developments in the provision of emotional and psychological support within the service. Design: A qualitative study using semi-structured interviews and questionnaires was conducted between September and December 2020. Method: A sample of 34 patients receiving hospital-based haemodialysis treatment participated in the study. Interviews were conducted with seven participants about their experiences of living with haemodialysis and receiving support from the service. To maximise the proportion of unique patient perspectives that could be included, interview data were supplemented with open-ended written feedback from a further 27 participants. Both datasets were combined and analysed using thematic analysis. Results: Four themes were developed from the qualitative data: 'a restricted life', 'the psychological impact', 'coping', and 'meeting patient needs.' Discussion: The findings demonstrated a considerable impact on quality of life for patients living with haemodialysis and highlighted the need for an integrated approach to providing renal care. Identified needs are discussed and recommendations are made to the service to guide future developments in the emotional and psychological support offered to patients receiving haemodialysis treatment. Theoretically Driven Research Project: Thought-Action Fusion as a Mediator of the Relationship Between Mental Imagery and Obsessive-Compulsive Symptoms. Aims: The purpose of this study was to extend research about the cognitive-behavioural model of obsessive-compulsive disorder (OCD), as it relates to intrusive mental images. It aimed to do this by investigating one mechanism potentially theorised to mediate the relationship between mental imagery and OCD symptoms, namely thought-action fusion (TAF), a cognitive bias relating to exaggerated beliefs about the morality of having certain thoughts or the likelihood that they will come true. Method: Participants (n=131) completed online measures relating to mental imagery use, TAF, and OCD symptoms. Mediation analyses were conducted using a percentile bootstrapping method. Participants were also asked questions about their lived experience of intrusive obsessional imagery. Secondary analyses (using a mix of quantitative and qualitative methods) compared the responses of participants who scored high for OCD, to those who scored low for OCD. Results: The proposed model of TAF mediating the relationship between mental imagery use and OCD symptom severity was supported in this sample. When likelihood- and moral-TAF were included in the model separately, only likelihood-TAF was a significant mediator. Also, participants scoring high for OCD reported more frequent, vivid, uncontrollable, and distressing intrusive images, and stronger likelihood- and moral-TAF appraisals of idiosyncratic intrusive images, than low scorers. Discussion: Overall, these results are in line with the key assumptions of cognitive-behavioural models of OCD. Findings are discussed, and the strengths and limitations of the study are considered.

A stroke is a brain attack caused when the blood supply to the brain is cut-off, killing brain cells. More people are surviving stroke than ever before, although many are left with physical disabilities, cognitive impairment, and report poor mood outcomes. The "Y-Shaped" process model suggests that as stroke survivors develop an awareness and understanding of the impact of these post-stroke changes on their functioning, they may experience a discrepancy between their 'pre-stroke' and 'post-stroke' identities, which may cause heightened distress. In line with this, evidence has suggested that those with greater post-stroke cognitive impairment had reduced awareness of these changes and reported 'normal' levels of anxiety and low mood. However, a subgroup of stroke survivors with mild post-stroke cognitive impairment had 'hyper-awareness' of these changes and reported high levels of anxiety and low mood. Impairments in cognition often improve in the months following stroke, as the brain recovers. The "Y-Shaped" process model may suggest that cognitive improvement could lead those with more severe cognitive impairment to develop a greater awareness of the discrepancy between their 'pre-stroke' and 'post-stroke' identities, which may be associated with greater emotional distress. This study thus aims to investigate whether the extent of cognitive impairment in the days following stroke impacts the relationship between cognitive change and emotional distress at 6-months post stroke. Research Questions: 1. What is the relationship between cognitive impairment at 6-months post stroke and awareness of cognitive impairment at 6-months post stroke? 2. What is the relationship between awareness of cognitive impairment at 6-months post stroke and emotional distress at 6-months post stroke? 3. Does severity of post-stroke cognitive impairment in the days following stroke moderate the relationship between cognitive change and emotional distress in the months following stroke? Methods: Participants were recruited from an inpatient stroke ward. One-hundred and fortythree stroke patients (74 men and 69 women) aged between 18 and 93 years (M = 73.33, SD = 13.73) were assessed within the first 3-weeks (T1) and at 6-months (T2) post stroke. Participants' cognition was assessed using the Oxford Cognitive Screen (OCS) at both T1 and T2. At T2, participants were also asked to complete the Hospital Anxiety and Depression Scale (HADS; a measure of emotional distress), the Cognitive Failures Questionnaire (CFQ; a measure of subjective cognitive impairment), and the Barthel Index (BI; a measure of disability relating to activities of daily living (ADL)). NIHSS score (a proxy of stroke severity) and stroke hemisphere were extracted from participant medical records. The difference between participants' objective and subjective cognitive impairment scores constituted their awareness score. Participants were divided into a 'moderate-severe cognitive impairment' group and a 'mild-no cognitive impairment' group according to their scores on the OCS at T1, then mean awareness scores were compared between groups. Participants were assessed as a pooled sample for subsequent analyses. Key Findings: In line with previous research, the 'moderate-severe cognitive impairment' group had significantly lower awareness of their cognitive impairments than the 'mild-no cognitive impairment' group at T2, when controlling for disability relating to ADL. Greater awareness of cognitive impairment and lower levels of disability relating to ADL were significant predictors of greater emotional distress at T2. Greater awareness was associated with an increased likelihood of reporting clinically significant symptoms of anxiety and depression. Reduced levels of disability relating to ADL was associated with a reduction in the likelihood of reporting clinically significant symptoms of anxiety and depression. Findings suggest that cognitive improvement over the first 6-months post stroke is associated with lower reported emotional distress. Moreover, this effect is largest for those most cognitively impaired in the days following stroke. On one hand, this is not in line with what we expected to find based on the "Y-Shaped" Process model. However, this finding may suggest that awareness of cognitive impairment is not the most important factor in determining emotional distress in the months following stroke. Research Implications: To the best of the authors' knowledge, this is the first observation that emotional outcomes in the months following stroke depend, partially, on the interaction between cognitive change and the severity of cognitive impairment in the days following stroke. Future research could investigate the causal mechanisms underlying this relationship, by exploring the role of 'psychological threat', coping, and adjustment. Repeating this study with a sample of patients with moderate-severe strokes (as scored by the NIHSS) would also be warranted to determine whether findings can be generalised to other stroke samples. Investigating additional factors, including access to neurorehabilitation, pre-morbid mental health, and social support may further understanding of the factors that contribute to emotional distress in the months following stroke. Clinical Implications: Findings emphasise the importance of clinicians considering the relationship between biological, psychological, and social factors following stroke, including monitoring stroke patients' cognitive deficits and their capacity to be self-aware. Although reduced awareness appears to be protective against emotional distress at 6-months, our findings suggest that cognitive improvement over the first 6-months post stroke is associated with lower reported emotional distress, particularly for those most cognitively impaired in the days following stroke. Targeting this subgroup of patients with psychoeducation regarding cognitive changes whilst providing strategies to manage these, alongside emotional support in the early stages post stroke may have a positive impact on their long-term emotional adjustment. In contrast, cognitive improvement over the first 6-months appears to have a much smaller impact on the emotional wellbeing of those less severely cognitively impaired in the days following stroke. Psychological interventions such as cognitive behavioural therapy may be better suited to this group, to support them with long-term adjustment to stroke.

Background: Dementia is a public health issue and a life-limiting condition. Compared to patients with other life-limiting diseases such as cancer, people living with dementia (PLWD) generally receive poor care at the end of life (EoL). Person-centred and culturally responsive end of life care (EoLC) supports individuals to die well and helps their families and carers. Currently, there is no cure for dementia, and most recent evidence suggests increasing prevalence within UK black, Asian and minority ethnic (BAME) groups. Despite this, there is little current UK-based evidence on EoLC for BAME communities with dementia. Within the wider UK BAME community, the voice of black African and black Caribbean PLWD and their families is rarely heard in EoLC research in the context of dementia. Aim: To explore EoLC among community-dwelling older people from black African and black Caribbean backgrounds who are living with dementia. Methods: Three, inter-related, qualitative studies were conducted, guided by van Manen's hermeneutic phenomenological approach. The first study involved two focus groups with older African-Caribbean PLWD (n=13) in ascertaining what, if any, would be significant at the EoL, drawing on their lived experiences. The second and third studies involved in-depth phenomenological interviews with bereaved family caregivers (n=6) and family carers (n=7). All participants (n=7 African and n=19 Caribbean) identified as African-Caribbean. The recruitment strategy involved establishing trust with 'gatekeepers' and prospective participants. Purposive sampling was used in all studies. Template Analysis was applied alongside van Manen's phenomenological data analysis approach to make sense of participants' experiential material. Findings: Three core themes and subthemes emerged from the analysis: • 'I don't want to die in old people's home': Negotiating preparedness for the EoL, A journey through the undergrowth; Yearning for quality of life at the EoL. • Making sense of unfolding events by faith to God: 'living in fear of making wrong EoLC decisions'; Two sides of the coin. • Living with uncertainty and continuous change: 'God knows what He is doing'; Suffering in silence; Anticipatory loss; At the crossroads. PLWD and family carers drew extensively on their religious and cultural understandings of dementia and EoLC. For all the participants, their Christian faith formed the basis on which understandings, perceptions, hopes and wishes concerning EoLC were made. There was a shared understanding that it is God who gives and takes life, so planning was not perceived as necessary. There was a lack of understanding of how dementia progresses as an illness, and reluctance to recognise signs of early dementia appeared to be associated with lost opportunities for early discussions regarding future care needs. For many, religion was not merely a set of beliefs or common faith in God, but rather, it was a phenomenon embedded within their everyday living practices. Methodologically, the study demonstrates the potential of van Manen's hermeneutic phenomenological approach in psychological healthcare research. It also reinforces focus groups as a suitable data collection approach in research involving PLWD. Conclusion: The research programme highlights a need to avoid being dissuaded by the term 'hard to reach' but to develop appropriate research methodologies for BAME groups. When working with BAME groups, considerations of their religious and cultural beliefs could help to encourage them to access dementia and EoLC services. More UK based research on EoLC is urgently needed to ascertain what if any would be significant for minority ethnic PLWD.

Though the understanding of the problem of intimate partner abuse (IPA) has grown over the years, limited focus has been given to the voices of minority women and their perception of IPA. The present research aim was to understand how Iranian women in the UK perceive IPA by men towards women, and what influences such perceptions. It was decided that a more comprehensive understanding of the construction of Iranian women's perception of IPA can be sought through mixed-methods research. Therefore, the present research took an explanatory mixed-method approach where the quantitative data helped to guide a purposeful sampling for the qualitative phase. An explanatory sequential mixed methods design was taken in which the quantitative study (phase one) used questionnaires to identify the predicting socio-demographic variables that influenced women's perception of IPA before comparing the Iranian and non-Iranian sample together. Phase one was subsequently followed by the qualitative study (phase two) where 16 Iranian women were purposefully selected to be interviewed about a vignette using semi-structured interviews. The regression analysis showed that the socio-demographic characteristics of marital status, education, religion, income, and ethnicity are able to predict the perception of IPA amongst Iranian and non-Iranian women in the UK. Furthermore, Iranian women have significantly better legal knowledge of IPA than non-Iranian women in the UK. However, Iranian women also have significantly more accepting attitudes towards male violence than non-Iranian women in the UK. Phase two of the research indicated that Iranian women who endorsed the traditional gender roles minimised IPA and had victim blaming attitudes. The findings from phase one and phase two suggest that although certain socio-demographic variables are able to predict the perception of IPA, Iranian women's attitudes towards traditional gender roles have a fundamental role in shaping their understanding of IPA. The mandate of this research is not to ostracize women of other cultures or to cast judgement for or against beliefs, but to better understand how culture and social interactions can influence the perception of IPA. This understanding is critical for identifying women who are at most risk of IPA in the UK. Future implications for practice and research are outlined in the present research.

Despite the scientific and technological progress made in coping with disasters, many lives are still lost due to gaps in warning communication. There is an overrepresentation of women in the disaster death toll, particularly in the tsunami death toll, which highlights women's poor capacity for response and lack of access to Tsunami Early Warning (TEW). For instance, according to the latest tsunami statistics, in the tsunami in Central Sulawesi in Indonesia on Friday 28 September 2018, 2,077 casualties were recorded, with women being overrepresented. The Great East Japan Earthquake and Tsunami in 2011 killed more women than men in the worst affected areas, including the Iwate, Miyagi, and Fukushima regions. Consequently, 8,363 female and 7,360 male casualties were recorded. In the Indian Oceanic tsunami of 2004, in the tsunami-affected areas of Indonesia, India, and Sri Lanka, approximately two-thirds of the dead were confirmed as being female. The lack of access to TEW and women's poor ability to respond resulted in the overrepresentation of women in tsunami death tolls. This is despite the Sendai Framework for Action (SFDRR) emphasising the importance of Early Warning Systems (EWS) in meeting the needs of the end-user considering the gender aspects. Another aspect in TEW is the gender-based internet interaction that also provides space for rescuing gender-based potentials. For example, social media facilitates online interaction for women, which transforms them into informed decision-makers in TEW. Therefore, in the present research, the research problem was identified as the need to improve gender equity within TEW using the internet. The overall research aim was established as the critical examination of the impact of internet-enabled digital technology on gender equity within TEW. In this research, multiple case studies were conducted in Sri Lanka, where an overall TEW framework with gender equity and internet interaction aspects is absent. The case studies were conducted in three tsunami-affected municipal council areas, namely Galle, Batticaloa, and Hambantota. In addition, semi-structured interviews were conducted with 11 experts. Consequently, 38 semi-structured interviews and questionnaire surveys were conducted with 290 respondents. Thematic analysis and computer software N Vivo 11 and SPSS 24 were adopted to organise and analyse the data. A triangulation technique was used to validate the findings. As per the findings, four critical components were identified in a gender-sensitive, internet-enabled, people-centred TEW system, such as risk knowledge for preparedness, monitoring and warning service for preparedness, dissemination and communication using the internet, and community responding capacity with the gender equity perspective. It is in this context that a framework of strategies was developed as the main research outcome. In conclusion, the identification of women as key actors in TEW at the strategic level - catering to men's and women's strategic and practical needs in TEW and recognising the usefulness of social media networks, smartphones, mobile internet, and digital risk information for non-hierarchical decision-making - has become important and instrumental in making the TEW system effective. The present research will have a vital impact on the national, regional, and global scale, enabling policymakers, academics, researchers and practitioners, and the communities at risk to make informed decisions for saving lives. The present thesis is organised into eight chapters: introduction, literature review, conceptual framework, methodology, case study analysis and discussion, expert interview analysis and discussion, findings, and conclusions.

Pathways in education, academic success, and stability can act as protective factors in the future life outcomes of children in care. However, official statistics and previous research within the UK suggest that the prospects of young people who have been in care, particularly within education, are significantly lower than those of their non-care peers. Furthermore, research suggests a concern for times of transition for these young people. Thus, within this developing body of research, a gap in the literature remains; care leavers' experience of the transition to higher education. The doctoral research aimed to investigate care leavers' transition to university, with a focus on how care leavers manage times of transition. The doctoral research was twofold, consisting of an initial exploratory study which aided the formation and development of the main doctoral research. The exploratory study involved a retrospective approach to experiences of nine care leavers' transition to higher education. All participants participated in a semi-structured interview. The interviews were recorded, transcribed, and analysed using interpretative phenomenological analysis. Several themes emerged; 'care leaver identity', 'lack of positive care leaver role models', and 'corporate versus normal parenting'. Through the findings of the exploratory study, the main study developed. The main study adopted a longitudinal approach to care leavers' transition to university, to explore care leavers' transition to higher education, as it occurred, through a series of three interviews at three stages throughout their initial transition to university and the majority of their first year. Seven care leavers from four local authorities in Northern England participated in this study. The participants' ages ranged from 18 to 21, and in total, 20 semi-structured interviews were carried out, with only one participant not participating in the final interview. Each participant was at a different university across the UK. The main empirical study adopts a pluralistic approach to analysis, through two methods; template analysis and narrative case studies. First, using a hermeneutic phenomenological framework, the interview transcripts were analysed through template analysis. Two key themes were identified: exercising agency and regaining control, and modes of transition to university life, and two integrative themes: identity and stability versus instability. Secondly, three narrative case studies were carried out to capture the longitudinal data from the interview transcripts. The case studies highlight the themes and integrative themes of the template and offer an in-depth exploration of some of the participants personal stories of the transition to higher education. The potential lessons from this research for theory, practice, and policy will be discussed.

UK Undergraduate students are increasingly expected to undertake Work Integrated Learning (WIL) as part of their studies. The inclusion of formal work experience in the curriculum of study is often driven, from the University perspective, by a need to prove the ‘value’ of a degree by demonstrating employability in graduates. As a result, research into the impact of WIL often involves quantifying its effect on areas such as employment rates or academic attainment leaving students overlooked and the opinions of academics or employers taking priority. This thesis aims to redress the balance by exploring students’ views of how they change in the work role as they experience WIL. A constructivist approach to understanding the lived experiences of the students was adopted, informed by Kelly’s Personal Construct Theory. The longitudinal study involved a group of students from two English universities, with three separate stages of data collection taking place. Stage 1 consisted of a questionnaire survey of first year undergraduates (n=644) from ten programmes across both institutions exploring their current and anticipated future views of a number of personal characteristics related to literature on employability. Fifteen of these students then completed self-characterisation sketches and semi-structured interviews at Stage 2 (second year). Eleven (of the fifteen) completed a second sketch and were interviewed again in Stage 3 (final year), and so were followed across the entire course of their studies. The Stage 1 analysis indicated areas for exploration in Stages 2 and 3, with the qualitative data from the sketches and interviews being analysed using Template Analysis and Longitudinal Qualitative Analysis (LQA). Template Analysis identified key themes about what was important to the participants, while LQA captured the changes which they felt were taking place and the conditions influencing these. Additional analysis of the sketches using Kelly’s protocol resulted in case studies of individual participants and their journeys. Stage 1 findings showed that social work students, in particular, rated themselves lower in a number of areas. It was also notable that all participants rated themselves highly already on the survey characteristics and expected these to increase further by graduation. Findings from Stages 2 and 3 uncovered a complex interplay of reasons underlying how participants felt about their workplace identity and how they thought it changed through WIL. For some, it was exposure to people and situations that they would not otherwise have encountered that was important while in others it was the opportunity to experiment in a safe place that promoted change. This thesis finds that participants thought WIL had changed their views about their workplace role in two dimensions. Firstly, experiencing WIL might have changed their ideas about themselves and what type of job they were best suited to. Secondly, they might have changed their view about what the job was and what it involved. This demonstrated that WIL could help participants develop clearer ideas about who they were and what they wanted. Subsequently, this might have led to some temporary uncertainty and a change in career direction, which is in contrast to previous research which tends to see one of the purposes of WIL as being to encourage a steady rise in career decidedness across the course of a degree. This uncertainty may ultimately be helpful to the participants as it could lead to a better ‘fit’ with a job in the long term, even though it would be regarded as a ‘failure’ in university terms. Finally, this thesis contributes to the development of knowledge about WIL’s influence on construal of self and job-role through the presentation of a new theoretical model.

This research project explored how children with additional needs experience interaction with animals. The value of animals in therapy, and related 'green care' approaches in health,is gathering evidence in the literature, however the use of qualitative methods is lacking. Exploring this phenomenon by gathering data directly from the children participating, rather than parents or healthcare providers, offers insight into how these practices can be adapted to suit children, especially those with additional needs. A descriptive phenomenological approach was adopted, and the project used observations to collect data. Colaizzi's seven step process of analysis was used, in keeping with the methodological stance. Twenty-three parents and thirty-one children participated in the study, which comprised four animal encounter experiences. Sessions were audio recorded and later transcribed, with observation notes included to add further context. The participant group was recruited from a local charity offering outdoor activities for children with additional needs. Husserl's descriptive phenomenology was the approach used, which enabled the researcher to delve into the lived experience of the children participating and describe the phenomena in detail, as perceived by the children under study. The findings showed the children were inspired by the animal interaction to ask questions, communicate with each other and the session leader. The animals provided a sensory experience and encouraged bonding with parents. Some children experienced some difficulties with following rules and becoming distracted at times. Excitement about the animals attending was a prominent feature of the day, although some children also presented some anxiety about some of the creatures. Sharing knowledge and previous experiences, and opinions on their favourite animals, highlighted the social element of the interaction. This research provided a useful opportunity to explore what it is about contact with animals that, according to the literature, can offer therapeutic benefits for children with additional needs. Previous research in this area has found improvements in social behaviours, communication and positive social interaction. Some physical improvements have also been found such as improved motor skills. The current study built on these findings; similar improvements were noted in the social domain, with additional findings including shows of empathic behaviour, the importance of a varied sensory experience and how including the family and others to provide a 'shared experience' alters the dynamic for the children participating. Using qualitative methods and exploring the phenomena predominantly from the children's perspective is unique in this area of research and offers a valuable contribution to substantive and methodological knowledge in this field.

Existing literature suggests that numerous factors influence cancer survivors' physical activity (PA) levels, for example receiving specific PA information from health care professionals. Interestingly. research also suggests that health care professionals fail to promote PA to cancer patients due to a variety of reasons. However, qualitative research exploring how these factors impact or influence PA levels amongst cancer survivors and PA promotion amongst health care professionals is sparse. In addition to this, no known research has utilised an interpretative phenomenological approach which includes both breast cancer survivors and breast cancer nurses. This research study utilises an interpretative phenomenological approach to explore breast cancer survivors' lived experiences of physical activity (PA) and breast cancer nurses' perspectives and experiences of promoting PA. By utilising a phenomenological approach and involving both groups, I aim to illuminate the multiple perspectives of PA and understand the meanings of the participants' experiences of either participating in PA or promoting PA. This research involved two separate phases. During Phase One, I interviewed ten breast cancer survivors individually, using semi-structured interviews; exploring their individual lived experiences of PA. The findings were analysed using interpretative phenomenological analysis (IPA) approach; the aim here was to illuminate the participants' individual experiences and meanings of PA. The themes identified were: 'losing and regaining control of the body', 'experiences and perceptions of support', 'the meaning of PA' and 'the importance of being with other people who were in the same boat'. During Phase Two, I interviewed five breast cancer nurses individually, using semi-structured interviews; exploring their perspectives and experiences of promoting PA. Template analysis was the method chosen to analyse the findings, the main themes identified were: 'Perceived responsibility for promoting PA', 'External services and resources', 'Nurse-survivor relationship' and 'Perceptions of breast cancer survivors' characteristics'. In Phase One: Varied experiences and meanings of PA amongst the breast cancer survivors are illuminated; however, it appeared that they utilised PA as a tool to help make sense of and adapt to their 'new normal'. In Phase Two: Differences amongst the breast cancer nurses with regards to their attitudes and perceptions of their roles and PA promotion were identified; it appeared that these differences caused inconsistencies with PA promotion. The findings from both phases of the research study were synthesised and explored further. The key findings which emerged across the two phases were: utilising PA as a tool to make sense of and adapt to a 'new normal', the importance of relationships and limited PA advice. The key findings illuminate the differences between the breast cancer survivors' and the breast cancer nurses' perceptions and attitudes. For example, the breast cancer survivors' meanings of PA were related to gaining a sense of 'normality' and control over their overall health and well-being. Whereas, the majority of the breast cancer nurses' focused on the medical benefits of PA, rather than focusing on the benefits of PA holistically. The unique insight into both sample groups, provides a deeper understanding of their experiences and meanings of PA and promoting PA. These findings may support and improve future research and PA promotion within oncology. It is recommended that more research is needed to develop further understanding of this phenomena which a) utilises interpretative phenomenological methods b) includes both sample groups, c) involves diverse sample groups such as; age, ethnicity, job roles etc. Further, it is suggested that specific education and training for breast cancer nurses with regards to their role and responsibility to promote PA, should be available as it may overcome specific issues relating to perception of their roles and PA promotion.

This research focuses upon the exploration of cancer survivors' lived experiences of long-term consequences following cancer and its treatment. The sample consists of members from the Macmillan 'Cancer Voices' online support group. This was carried out through two studies with the following overall aims being of focus throughout: Aim 1: To identify any prevalent long-term consequences of cancer and its treatment that are experienced within a diverse sample of cancer survivors. Aim 2: To investigate in depth, the lived experiences of a diverse sample of cancer survivors in regards to long-term consequences of cancer and its treatment. Aim 3: To provide healthcare professionals who support cancer survivors with insights for practice. The preliminary study consisted of an online survey using open-ended and closed questions and was completed by 84 participants. In addition to demographic and cancer history questions the participants completed the Quality of Life in Adult Cancer Survivors Scale and the Health Anxiety Inventory. Four open-ended questions enabled individuals to share anything they wished to, in regards to their experienced long-term consequences that had not already been addressed. Statistical analyses were conducted to identify relationships between selected variables. Template Analysis was used for the open-ended responses. Statistical analysis found in contrast to much previous literature that cancer type was not associated with quality of life. Template Analysis identified a rich variety of themes shedding light on the experience of long-term consequences. These analyses helped inform the selection of participants for the main study. The main phenomenological study used e-mail interviews with 16 individuals. The data were analysed using Template Analysis, which identified six main themes within the participants' responses; Changes in Selfhood, Support, Engagement in the Social World, Feeling Understood, Managing of Consequences, Research Impact and The Impact of Cancer Voices. A Narrative analysis was then performed upon the data of three participants, using the Listening Guide. This enabled the research to explore and identify how individuals narrated and structured their lived experiences. The present research provides a number of key contributions to knowledge. First, it utilises a relatively new data collection method; e-mail interviewing and in doing so, identifies the advantages it holds. The richness of the responses and of the relationships built with the researcher demonstrates that this method can provide in-depth data. Pragmatically, it enables a wider range of participants to be included than would often be possible for face-to-face interviews. The participants also expressed they found their participation to have a therapeutic quality. Secondly, the research gave some detailed insights, providing alternative ways of looking at both the 'changes in selfhood' and the concept of 'feeling understood', that occur through the longterm consequences of cancer and its treatment. Finally, the use of the online e-interviewing method showed how issues such as incontinence, fatigue and eating/digestive issues might be more prominent in the everyday concerns of cancer survivors than the fear of cancer reoccurrence.

This qualitative research explores the lived experience of nineteen bisexual women from all across the UK who are in monogamous relationships or who are single but desire a future monogamous relationship. The research has three broad aims 1) To explore the lived experience of bisexual women who identify as monogamous. 2) To understand the ways in which women who identify as bisexual and monogamous maintain their identity. 3) To explore the ways in which bisexual women in 'same-gender' and 'different-gender' relationships construct their identity. The research was carried out in three phases with each stage using a different data collection technique. The first stage required participants to keep a written diary for a period of four consecutive weeks, detailing thoughts and events that were related to their sexual identity. In the second stage participants took part in a semi-structured telephone interview. The interview used participants’ diary entries as a starting point to explore the research questions. The final stage involved a subset of participants taking part in a photo-assisted telephone interview. Participants in this stage were supplied with disposable cameras and were asked to take up to twelve photographs of places, objects and people who were significant in relation to their sexuality. Five participants completed this stage and took part in a photo-assisted telephone interview where they discussed the photographs they had taken. The research as a whole and the approach to analysing data was underpinned by the hermeneutic phenomenology of Ricoeur. Two different but complementary approaches were taken in the analysis of the data. Firstly, Template Analysis (King, 2004) was used to analyse the data from diaries and telephone interviews. This approach provides an opportunity to explore the data as a whole and identify themes and sub-themes relevant to the research questions. In order to complement this cross-case approach the photo-assisted interviews were analysed using a within-case approach (Hermeneutic Phenomenological Analysis) developed specifically for this research. Some of the findings support existing research which demonstrated that some bisexuals do experience ‘invisibility’ and misappropriation in relation to their sexual identity (Monro, 2015; Hayfield, Clarke & Halliwell, 2014; Savin-Williams, 2005; Blackwood, 2000; Angelides, 2001). Other findings point to aspects of bisexual monogamous women’s experience that appear to have been neglected by researchers. In particular, the gender of a participant’s partner seems to present different challenges in relation to their sexual identity. Participants in different-gender relationships appear to utilise more strategies related to displaying their same-gender attractions and keeping their bisexuality alive than those in same-gender relationships. Participants in same-gender relationships choose feminine appearance markers that are more likely to signify a heterosexual identity in contrast to participants in different-gender relationships who choose ‘traditional’ lesbian appearance markers. Women in different-gender relationships articulated a sense of longing or reminiscence for relationships or sex with women. Women in same-gender relationships did not express the same sentiment for sex and relationships with men. Identifying a community which provided support for their bisexual identity was of particular importance to all participants. The LGBT+ community seemed to be important in the early stages of participants’ struggles with the development of their sexual identity. However, over time participants experienced various forms of hostility from the LGBT+ community and one of the ways they coped with this was to disengage from it and turn to smaller network of friends.

The research presented in this thesis aims to explore people’s current relationships with nature and how these relationships develop throughout their life time. It does so by taking a constructivist perspective. In-depth interviews, involving three different tasks, were carried out with sixteen participants. Participants with a variety of different relationships with nature were recruited. The use of the Personal Construct Psychology (PCP) methods Rivers of Experience (RoE), Construct Elicitation and Laddering in the interviews allowed me to gain an understanding of both how people construe nature at present, as well as exploring how this construal of, and relationship with, nature has developed throughout their lives. The key contributions to knowledge were that participants created narratives which drew upon the idea of nature being of higher importance than them, creating a narrative of spiritual relationships with nature. The findings also suggested the importance of learning and mental engagement with nature, in both people’s development of a relationship with nature, as well as their current relationship. The effect of nature on well-being was also discussed as part of the process of developing a relationship with nature. The level of human impact on nature was also of central importance to participants in the construction of different environments. Finally, the research provides a look at the different structures which the stories of their relationships with nature developing took. In relation to the methods used, this research offers a contribution the literature by providing an example of approaches which can be taken to the analysis of RoE data. The analysis of the laddering data provides some support for viewing people’s construct systems as nests of meaning rather than hierarchical structures.

Children and young people’s physical activity levels are of continuing concern as the health implications for both childhood, and later on in adulthood, may be determined by their experiences of physical activity whilst growing up. Although many attempts have been made to increase physical activity levels relatively little attention has been paid to listening to the voices of children and how they experience physical activity. The publications presented in this thesis provide evidence to support the tenets of the Self Determination Theory. The results of three studies, one mixed methods, one literature review and one qualitative, have been synthesised to provide a commentary on why children engage with physical activity. The original contribution to knowledge arises from collecting evidence directly from active children and young people, many of whom have been previously disengaged from activity, to inform future interventions. For some children and young people being forced to be active is counterproductive as they associate activity as something that has to be ‘got out of the way’ or avoided where possible. If they are to take part in physical activity of their own volition it has to be enjoyable. The results of this thesis suggest that for it to be enjoyable participation should be in activities of their choice, where they feel competent and in control of their bodies whilst exercising. They want to be supported by parents and peers and respected, but not controlled, by teachers/instructors. Many children, in particular obese children, lack confidence in both their physical and social skills to interact with their peers in a physical activity setting. In providing separate activity sessions, which promote a caring and supportive climate, and a variety of non-traditional activities, children can develop competencies which enable them to enjoy being physically active. These findings need to be understood and further developed if we are to engage all young people in physical activity.

This study critically explores how Bourdieu’s (1985; 1989) concept of social space impacts on the experiences of medical and nursing students in the primary care setting when non-formal work based learning (WBL) is used as a model for interprofessional education (IPE) (Moore, 2012). Current ways in which professionals conduct their relationships with each other are also examined and factors that impede collaboration are also explored using Bourdieu’s theory of social life (1979; 1985; 1989; 1992; 1996; Bourdieu & Wacquant, 1992) as a theoretical lens. Bourdieu (1979) uses the concept of social space as a means of exploring power and hierarchical relationships arguing that social space influences relationships so that whilst groups of people can be located in the same physical space, they can remain socially distant (Bourdieu & Wacquant, 1992). In the United Kingdom (UK) different professions are now located together, within GP (General Practitioner) Practices, in the belief that it will enhance CP (DH, 2005; Hudson, 2007). However, there are a number of factors influencing how doctors and nurses work together and these include the powerful position of the doctor in relation to the nurse (for example: Coombs & Ersser, 2004; Davis, 2003; Fagin & Gaerlick, 2004, Malloy et al 2009, Vogwill & Reeves 2008). Therefore, students placed in this environment are likely to be immersed into practices where power relationships occur and supervised by those who are involved in them. As such it is likely that they learn the implicit, hierarchically influenced, rules of engagement that are practiced by their qualified counterparts (Collin et al., 2011). The study drew on critical ethnographic principles and took place in a city in the north of England. Participants were selected purposively and were comprised of the staff from three GP Practices, as well as medical and nursing students who were on or had recently completed a clinical placement at one of the three Practices. Data were collected predominantly through uni-professional focus groups alongside a selection of observations. Field notes were made at the time of the observations and a reflexive diary kept throughout. I transcribed the focus groups verbatim and uploaded them into NVIVO8 with analysis undertaken using template analysis (King, 2004). Whilst CP is now accepted as a fundamental part of contemporary health care (Barr et al., 2005; Dickinson & Sullivan, 2014) there is little clarity regarding either its meaning (Haddara & Lingard, 2013; Lingard et al., 2012) or of how it should be achieved (King et al., 2013) and could be the reason that measurements of its effectiveness are limited (Barr et al., 2005; Zwarenstein & Reeves, 2006). Exploration of CP within an emancipatory discourse ii however suggests a multitude of interplaying influences on how professions engage (Ansari et al. 2001; Haddara & Lingard, 2013). Indeed, findings from this study showed that whilst staff groups perceived CP to be positive, there remained a complex interplay of factors that impacted on how it occurred. In particular the dominant position of the doctor remained problematic influencing how, when and if it occurred. Physical space, elusiveness, communication methods, titles, language and tasks performed were all found to be significant in relation to the level and type of capital held and therefore the social space between professions. However, these were frequently masked by the physical space and distance between the staff groups. Bourdieu (1985; 1986) argues that the habitus of the individual is also influential in relation to social relationships as it is an inherent element of who a person is: influencing how they think as well as what they say and how they say it. The individuals’ habitus will ultimately manifest itself as a set of ‘tastes’ which shape their identity (Bourdieu, 1979) and how they engage with their environment (Bourdieu & Wacquant, 1992). The socialization of students into uni-professional practices resulted in their becoming indoctrinated into the epistemological norms of the profession to which they aspired: adopting similar tastes to their qualified counterparts. In this way the official criteria of WBL became lost in the unofficial criteria of social compliance to the hierarchical position held by their qualified counterparts (Billet, 2001a). The conclusions from this study argue that collaboration is complex and that greater recognition is required of those factors that impact on it: and in particular the power imbalance between doctors and nurses. Equally, current assumptions regarding students’ learning in this setting need also to recognize the complexities of CP, rather than simply relying on the experiences into which they are immersed to enable them to attain the goals of IPE and become ‘collaborative practice ready’ (WHO, 2010) at the point of qualification.

The main aim of this study was to explore student nurses and lecturers’ perceptions of directed study time (DST) within an undergraduate nursing curriculum. Previous research pertaining to the phenomenon has predominantly focused on how students approached learning, and the pedagogical preferences of lecturers and students. A wealth of quantitative literature demonstrates attempts to measure students’ preparation for self directed learning (SDL). Whilst a substantial amount of research has identified that students are unprepared to study independently and direct their own learning; no research has explored the underlying reasons behind this, nor has any research explored the perceptions of DST within undergraduate nursing curricula. A hermeneutic phenomenological approach was used to understand and interpret the participants’ perceptions of DST. The research was undertaken in two phases. In Phase One three focus group interviews were undertaken with student nurses on an undergraduate adult branch nursing course at an English university. In Phase Two, individual semi-structured interviews were carried out with nurse academics from the same university. Template Analysis was used to analyse the data and to determine key themes. Significant findings revealed that both groups perceived DST to be owned by student nurses, who controlled DST. The identities of the groups was not reflective of their roles and resulted in a lack of belonging to the university; this led to limited levels of engagement by both parties with academic activities. Many student nurses did not engage with SDL during DST and the majority of lecturers did not value academia. The culture was influenced by the ‘hidden curriculum’ within which nurse lecturers lacked authority and relied on traditional pedagogical methods to regain a sense of control. The participants also described how some students’ mentors did not value academia and did not always recognise the importance of linking theory to practice. The implications of this research study emphasise the need for a multi-faceted approach to promote the value and importance of academia within the nursing profession.

This thesis documents a qualitative study investigating common patterns that cut across the behaviours of white, heterosexual, working and middle-class men. Previous literature has reported that men’s behaviour during their micro social relations is often risky and potentially harmful. This study provides an important contribution to knowledge regarding the motivation behind these patterns of behaviour. The research is rooted within a critical realist philosophical perspective. Of key importance are the concepts of a dominant masculine norm, as a pre-established representation of social reality, common patterns of men’s behaviour, as occurring during relations between men, and social class dynamics, specifically amongst the working and middle-class. Data were gathered from four focus groups, two with working-class men and two with middle-class men, and from one to one interviews with the same respondents. Template analysis was used to thematically organize and analyse the recorded accounts. Masculinity emerged in the data as a dominant, socially pre-established representation which establishes the transcendence of vulnerability as an esteemed form of men’s behaviour. Following the data, masculinity constitutes but one of a multitude of men’s social identities; with men gravitating to the dominant masculine norm within those contexts when they perceive their status as ‘masculine’ to be under threat. In this sense, men and masculinity emerged as separate constructs, with some men and women having the freedom to gravitate to both masculine and feminine gender norms. Men, during relations between men, police one another’s gravitations to the dominant masculine norm, ostracising those who expose vulnerability. As such, all-male domains emerged as the main context in which men demonstrate their masculinity. The data suggested that patterns of subordination and domination are common among groups of white, heterosexual men with similar social and material resources. The subordination of women and less valued varieties of masculinity emerged as being a by-product, rather than a direct objective.

This thesis examines older (60-75 years) African Caribbean migrant women‟s experiences of health and the extent to which these connect with identity across the life-course. It draws on their accounts to consider how gender, migrant and ethnic identity are produced and constructed in later life. The thesis considers the religious experiences of older African Caribbean women and how these influence health and well-being. The relationship between past and present homeland experiences, traditions and homeland produce such as food and medicine, is further examined. The aim here is to identify how the maintenance of ethnic and cultural identities influences their perceptions of health, western healthcare and medical practices. The key theories examined relate to identity construction and how identity categories are inter-dependant, constantly changing and made up of boundaries that are not totally fixed. In addition to this, the formation of religious identity is examined to see the extent to which religion and its practices are contained within certain parameters and constraints which can structure the nature of both self-representation and subjectivity. The gendered nature of knowledge is also examined to ascertain how knowledge influences individual power and how power can influence the connections between the body, surveillance and health. A qualitative and in depth interpretative analysis guided by feminist epistemological and ontological thought is used. A methodological aim was to deconstruct the universal categories of women‟s experiences, in order to enable insight into the different types of regulation that define the individual experiences of older migrant African Caribbean women living in the UK. A second aim within the research process was to explore how the researcher‟s biography influences and is influenced by the biographies of the research participants. The key findings suggest past experiences have impacted on the health and well-being of African Caribbean women in later life. For instance, life-course inequalities had a direct impact on their health and life-fulfilment as they grew older. The experiences of older African Caribbean women link to the construction of both their ethnic and cultural identity, and these identities are constructed in such a way as to maintain the self and identity boundaries. Religion and its practices are of immense importance to older African Caribbean women. It is through such activities that many were able to cope with hardship and the effects of multiple oppressions. These have influenced how older African Caribbean women perceive and maintain their health and well-being. In understanding the lives of older African Caribbean women, it is important to consider the ways in which cultural, migratory and social experiences shape their experiences of health and well-being in later life; in order to acknowledge diversity through the recognition and acceptance of difference.

People living with advanced disease face challenges to their being-in-the world; these are attributable to both the nature and progression of their illness and the level and variability of their care needs. Recent policy initiatives and literature promote community care for patients with advanced disease, and there are a plethora of different health services that may be involved in care provision for people in the last year of their lives. The current research takes a phenomenological approach, informed primarily by the work of van Manen, to explore the lived experiences of patients and their spousal-carers in relation to the multiple services that are involved in their care. In-depth, semi-structured interviews with twelve patients with advanced disease, and eight spousal-carers were conducted. These interviews employed the Pictor technique to support people in reflecting on, and communicating, their experiences of care situations. Pictor is an innovative technique that is used with lay-participants for the first time in this research. The technique encourages people to reflect on relationships and personal experiences, and then to communicate these through the creation and discussion of a visual chart. The digitally recorded data were transcribed verbatim and analysed using interpretive phenomenological methods, supported by Template Analysis, which allowed the hierarchical coding of themes. The research findings indicate that advanced disease affects people in many different ways; participants’ perceived meaning of illness is instrumental in how they view and engage with health care services. The lived experience of this phenomenon is discussed as an ‘unhomelike-being-in-the-world’, and ‘striving for poise’. The varied experiences of participants are illuminated and further explored with a focus on key relationships with health care providers. Here, it is argued that consideration of ‘authentic relationships’ is a valuable resource in supporting people affected by advanced disease.

The principle aim of this study was to uncover and produce a phenomenological description of the experiences involved when reading and discussing with others a book about death and dying. Although fictional literature is frequently used within bereavement services, there is a dearth of research to support evidence based practice. The methodological design was based on the work of Edmund Husserl, in particular his transcendental phenomenological approach to enquiry. The participants for the study consisted of 11 bereaved young people, four of whom had Down’s syndrome. A therapeutic bereavement session was attended by the group, during which a member of staff read Michael Rosen’s SAD BOOK (Rosen, 2004). Afterwards a series of questions guided and stimulated discussion, gradually leading onto an exploration of their unique experiences. The participants listened, discussed, debated and shared stories, not only about reading the book but of their own grief. The main therapeutic session was video recorded and provided data that included verbal and non-verbal language, together with details of the context in which the interactions took place. The analysis uncovered findings that included: 1) a connection to other bereaved people 2) discussion of crying and sadness 3) a focus on prose and illustrations, especially one page which read: This is me being sad Maybe you think I’m being happy in this picture Really I’m being sad but pretending to be happy I’m doing that because I think people won’t like me if I look sad The findings were transformed to produce a phenomenological description of the experience when reading and discussing with others a book about death and dying. It is anticipated that this research will be of benefit to a wide range of multi-professional staff working with bereaved young people, some of whom may have a learning disability.

The research presented in this thesis aims to explore the lived experience of participating in consensual bondage, discipline, dominance & submission and sadism & masochism (BDSM). Traditionally, psychologists have researched this phenomenon from an external perspective, conceptualising it as pathological. By employing a phenomenological approach, I aim to understand this multifaceted phenomenon from the inside, by listening to the voices of those who engage in BDSM. The research is separated into two stages. For the first stage of empirical work I interviewed five practitioners of consensual BDSM about their experiences. This stage was designed to be particularly broad and exploratory with the aim of understanding more about the subcultures associated with BDSM, and also to inform the second, more focused stage of research. The findings were analysed using the descriptive phenomenological approach. The subsequent stage involved interviews with nine practitioners; including four that were previously interviewed for stage one. The aim here was to elucidate the specific constituents of BDSM that held erotic significance for participants. The template approach was utilised as the method of analysis. The complexity of BDSM is illustrated by the subtle variations in the erotic scripts of participants. The co-creation of fantasy was of central importance to the experience, as were measures employed in order to maintain the fantasy and ensure its success. The notion of authenticity was fundamental to the experience, which ensured all participants were invested in the erotic scene and allowed immersion into the bubble of fantasy and the exclusion of the ‘real’ world. A sense of care, trust and partnership were vital in order to achieve the erotic atmosphere, concepts that appear contrary to the kinds of sexual activities involved. This research presents an exciting account of the lived experience of BDSM, illuminating the erotic diversities and nuances related to this phenomenon. It is also the aim that this research contributes to the increasing body of work that investigates and reports BDSM from non-pathologising perspectives.

This thesis is concerned with understanding the challenges faced by individuals living with Parkinson's disease. The first section comprises a literature review of 26 studies examining the predictive relationship between patients' symptoms and the level of burden reported by caregivers. Analysis of results suggests that whilst patients' motor, psychiatric and cognitive symptoms are associated with caregiver burden, there is less evidence of a direct predictive relationship. A critique of studies' methodologies highlights inconsistent measurement of caregiver burden and participant recruitment strategies that question the ecological validity of results. Clinical implications and directions for future research are addressed. The second section presents a qualitative study examining patient and caregiver perceptions of a neurosurgical procedure (deep brain stimulation) which aims to alleviate Parkinsonian motor symptoms. Through semi-structured interviews, this longitudinal study explores 8 patients' and 6 respective caregivers' expectations of surgery and their subsequent evaluations of its impact. Using Template Analysis, the study investigates whether participants' evaluations of surgery overlap with themes deemed salient prior to surgery, and whether patients and carers differ in their accounts. Findings suggest some consistency in pre- and postsurgical discussions, with change in motor symptoms and quality of life deemed important. However, unanticipated difficulties with fluctuating symptom change and side effects impacted on satisfaction. Participants also evaluated the manner in which treatment was delivered. Patients and caregivers did not differ substantially in the themes discussed. Clinical implications of these findings are discussed as well as a critique of the study's methodology, with directions for future research proposed.

This qualitative study takes an interpretative phenomenological approach to understand the experience of whiplash injury from the different perspectives of patient and doctor. This was carried out in order to identify what psycho-social consequences might be experienced by patients as a result of that injury and to identify any implications for healthcare provision. The research was conducted in two phases. During Phase One, eight patients were recruited through GP practices using a combined approach of retrospective and prospective sampling. Three semi-structured interviews and one telephone interview were carried out with each participant over a twelve month period. In keeping with phenomenological methodology, data were analysed using Template Analysis (King, 2004) and a set of themes relating to healthcare experience were identified: „embodiment‟ „experience of pain‟ „disruption to lifestyle‟, „making sense‟, „patient as expert‟ and „whiplash: a minor injury?‟. During Phase Two, one semi-structured interview was carried out with eight doctors who worked in either the primary or secondary care settings. Data were analysed using Template Analysis and a set of themes relating to their experiences of treating patients was identified: „expectations regarding what patients will experience‟, „what patients do about their whiplash injury‟, „what doctors do‟ and „blame if things go wrong‟. These findings show how the patient participants‟ physical and psychological experiences of their malfunctioning body had consequences for maintaining their sense of self and their ability to carry out their normal everyday activities at home and work. The doctors‟ own expectations of treating patients with whiplash injury and whether or not they trust the patients‟ account have illustrated three approaches: dismissive, reactive or proactive that have different implications for patients‟ experiences of healthcare. The study shows how the notion of „compensation‟ is implicated in whether or not the doctor feels able to trust the patient‟s account. The implications of these findings can be seen in terms of methodological focus, general practice and policy formulation. Methodologically interpretative phenomenology provides a theoretical foundation that is, at the very least, equal to and able to challenge more „traditional scientific foundations‟ through its focus on meaning. In terms of practice and policy formulation, the findings have provided a unique insight that might prove to be beneficial for understanding the health care experience and assist in the provision of guidelines aimed at the treatment of whiplash injury. Indeed it is advocated that doctors adopt a subjective approach and that this is taken into account in training.

Since the 1960s contemporary art has seen a paradigm shift occur that has rejected the individual perspectives of modernity and begun to consider the value of connective and participatory aesthetics. New process-led and technologically-based practices have shifted the emphasis away from the art object and onto the art process, rendering the approach to making art a much more connected and relational one. In parallel, the curatorial role has radically shifted since it was first popularised in the 1970s. With less emphasis on the archival and more on the mediation and dissemination of practices, the role has risen to the forefront of the contemporary art arena, yet the actual methods of curation have not evolved in relation to the practices they curate, revealing an acute lack of curatorial convention for exhibiting and disseminating process-led practices. Employing the term Social Practice to actively define this ever-evolving body of process-led works, this research is situated at the juncture between the social outputs of reciprocal artworks and the curator’s role in exhibiting them. In establishing curation as a practice and situating it at a well-founded and clear point of perspective, this thesis argues that a clearer understanding of curatorial practice will in turn formulate an active and more integrated way of working. Focussed on the curation of media and performative practices specifically, and through four practical case studies: Becoming Electric, Fast and Slow Networks, Scatter Projects and Turnstile, in curatorial and exhibition practice, a dynamic form of curatorial practice is made manifest. This Social Curation seeks to contextualise fully the potential of exhibitions as structures of communication and exchange, maximising social interaction and engagement across curatorial approach, process and outcome. This thesis engages performative and participative approaches in its development of a research bricolage, revealing through practice how curation can function in an open and relational way. It contributes to methodical innovation through its use of a real-life initiative to test and ground the research strategies, and to the fields of artistic and curatorial research through original and responsive strategies towards evolving exhibition formats. Overall it has sought and revealed the means to both situate and question new ways of thinking and methods of working within the dynamic of the everyday.

This research project sets out to explore the lived experience of Being and caring for a child with a Life Limiting Condition. This research uses van Manen’s (1990) conceptualisation of hermeneutic phenomenology that is both a research methodology and a method. The first empirical work is a preliminary study using focus groups with professionals. The findings of this work acts as a backdrop to the further two studies that involve interviewing, in-depth, twenty eight parents and five children. The second study details the parents’ lived experiences and the final study looks at five parent-child dyads and their combined lifeworlds. In keeping with the phenomenological methodology, data was analysed using Template Analysis (King, 2004). It is a rare opportunity to observe and speak with children with Life Limiting Conditions and so gain insight into their lives. Their vulnerability is often characterised by rare and difficult-to-diagnose conditions, significantly shortened life spans with compromised quality of life. For the participants, the experience of Life Limiting illness was not only personal, but was also transactional, communicative and profoundly social. The challenge is one of Being thrown into an abnormal unready world which compels one to consider the paradoxical temporality of the here and now. This brings recognition of being the same as others in a lived space, but also being different in a fundamental way that has a significant impact. The challenge is met by adapting to the environment to find new ways of Being. This research encourages readers to thoughtfully reflect on what is it like for these families and those involved in their care, and to consider practice improvements that address the triadic experience (of child, parent and professional). The full significance of such reflection will ideally promote further questioning and inquiry, in keeping with the always provisional nature of phenomenological inquiry.

The aim of this research has been the examination of the long term psychological consequences of admission to the Intensive Care Unit (ICU) for critical illness. The major objectives were first, psychometric assessment at specified intervals post-discharge, using the General Health Questionnaire, Rosenberg Self Esteem scale, and the Impact of Event Scale, and secondly identification of ICU related variables which influence psychological wellbeing and recovery. The design was prospective and used survey methods. Seventy-two patients were recruited from the ICU at St James's University Hospital in Leeds. Data were collected at six weeks, six months and twelve months post-discharge. The initial analysis produced evidence of discrimination between subgroups, in particular age, length of stay in ICU, admission severity, indication for admission, communication, pre-existence of cancer, and the use of muscle relaxant drugs. Further analysis by way of a logistic regression identified four factors which may have predictive properties - age, admission severity, trauma and pre-existence of cancer. Patients from younger age groups reported more post traumatic stress symptoms than older patients; patients with pre-existing cancer also reported fewer post traumatic stress symptoms. Patients admitted following trauma reported poorer psychological outcome. Admission severity was negatively associated with psychological dysfunction, with those who were sickest on admission reporting fewer problems. Symptoms of post traumatic stress disorder were found in a number of patients; at final follow-up 27% of the surviving sample had medium levels, and 27% high levels of post traumatic stress symptoms. ICU patients form a fragile group to study and sample attrition was considerable. Nevertheless the findings are of interest to this developing research area and suggestions are made regarding their utilisation.