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Early intervention is widely recommended for children at risk of difficulties with speech, language and communication. Evidence for effective practice remains limited due in part to inherent difficulties in defining complex interventions and measuring change. The innovative Language Environment Analysis (LENA) system has exciting potential for early intervention and for evaluating outcomes. LENA is used widely in the USA; however, there is little to guide the introduction of this new technology in the UK. Successful implementation of new technology is predicted by its perceived acceptability and usefulness. This qualitative pilot study aimed to explore the acceptability of LENA for UK families with a young deaf child. Four families used LENA to record for one day. They received and discussed LENA feedback reports with a specialist speech and language therapist. Using qualitative methodology with a pragmatic epistemology, semi-structured interviews were conducted and the data explored using thematic analysis. Three families were positive about using LENA; they identified benefits of the feedback, suggested important factors for future use and would recommend it to other families. One family chose not to complete the recording. Key to acceptability is parental understanding of LENA's purpose and the need for a trusted professional to facilitate interpretation and change. LENA is acceptable for some UK families with a young deaf child suggesting there is potential for successful implementation. Further study to explore LENA's usefulness is recommended.

Background: Management of pain is critical to improve the welfare of farmed livestock and meet consumer expectations. There is limited published information about the use of analgesic drugs in the sheep sector. Methods: A mixed‐method approach was followed. The range of analgesic drugs used on 52 Northern Irish sheep farms was determined through analysis of medicine purchase records. Through interview and discussion groups, with both farmer and veterinarian participants, attitudes towards the use and adoption of such medicines were explored. Results: The use of non‐steroidal anti‐inflammatory drugs (NSAIDs) was widespread and highly variable. One‐third of farmers in the sample did not purchase any NSAID. Meloxicam was the most commonly purchased NSAID by mass (72%) and standardised dose (73%). During interviews and discussions, farmers outlined the benefits they saw in using NSAIDs and how veterinarians influenced their uptake of these medicines. Use of corticosteroid was evidenced on 50% of the farms that supplied medicine records for analysis. Conclusions: Veterinarians can influence farmers to adopt NSAIDs for the provision of analgesia in their sheep and farmers observed the benefits they delivered. However, many farmers are still to be reached with this message, perhaps due to being largely self‐sufficient and rarely engaging with veterinarians. Veterinarians have the opportunity to challenge farmers about the provision of analgesia, especially when farmers seek antibiotics for painful conditions such as lameness. Currently, the lack of an authorised product in the UK, with associated treatment guidance and industry promotion, may limit veterinarians' confidence in prescribing drugs for pain control in sheep. [ABSTRACT FROM AUTHOR]

Methicillin-resistant "Staphylococcus aureus" (MRSA), commonly called a superbug, has recently been a major political issue in the UK, playing a significant role in debates over health policy in the general election held in 2005. While science recognizes the lack of evidence with regards to the effectiveness of existing measures implemented to control and prevent MRSA, the UK media coverage is dominated by articles that appeal to common sense and practical experience calling for more government interventions to combat the bug. In this paper we explore how uncertainty surrounding the origin and spread of MRSA is portrayed in debates within the media and policy-circles to particular political ends. Using established techniques of discourse analysis and corpus linguistics, we examine the assumptions, judgements, and contentions that structure two discourses of MRSA: according to one discourse MRSA is "not rocket science" and there are "simple" ways of coping with the risk of infection, whereas according to another discourse MRSA is a more complex matter and there is "no silver bullet". The analysis of different storylines through which specific ideas of "blame", "responsibility", and "urgency" are attributed helps to explain how different "constructions" of causes for the rise in MRSA emerged and led to discourses of blame and defence centred on cleanliness.

The landscape of mental health recovery is changing; there have been calls for a shift from the clinical expertise being the dominant voice within mental healthcare towards a more personalised and collaborative service that supports those in need of mental healthcare to define what recovery is for the individual. Within this new recovery movement, there has been a recognition of the importance of the social environment in which individuals are situated and the relationship of this to mental health and wellbeing. Included in this is the importance of an individual's role within society and the ways in which knowledge, such as experts by experience, can hold an important value. The argument then, is that social connectedness forms part of the recovery journey and that relationships can help us develop or re-connect with who we are in powerful ways. Such a view has only been strengthened by the recent and ongoing global COVID-19 pandemic. Within the UK, discussions of the importance of our wellbeing have become commonplace within the context of restricted social contact. With this heightened awareness of how the social contributes to wellbeing, it is important to consider the environments in which those in receipt of mental healthcare are situated. One of which is institutionalised care, where it is commonplace to restrict social contact. For example, by virtue of being within a locked environment, individuals' freedom of movement is often non-existent and thus contacts with those not residing or working within the institution is restricted. While such restrictions may be deemed necessary to protect the individual's mental health, such environments can be unintentionally toxic. Data are presented from an ethnography that was conducted within an inpatient forensic mental health hospital in the UK to highlight the problematic social environment which some individuals experience. Key interpersonal issues are presented, such as, trust, racism, the threat of physical violence and bullying that was experienced by staff and residents at the hospital. Consideration is given to the coping strategies enacted by residents and the pathologising of such behaviour. The consequences on interpersonal wellbeing are explored. [ABSTRACT FROM AUTHOR]

We analysed news articles published in national and local British newspapers between 2007 and 2015 to understand (1) how mental health and arts participation were framed and (2) how the relationships between participants in arts initiatives were conceptualised. Using corpus-assisted qualitative frame analysis, we identified frames of recovery, stigma and economy. The recovery frame, which emphasised that mental illness can be treated similarly to physical illness, positioned arts participation as a form of therapy that can complement or substitute medication. The stigma frame presented arts participation as a mechanism for challenging social conceptions that mentally ill individuals are incapable of productive work. The economy frame discussed the economic burden of mentally ill individuals and portrayed arts participation as facilitating their return to employment. Using thematic analysis, which paid attention to the representation of social actors, we found that service users were identified as the prime beneficiaries of arts initiatives, and arts participation was conceptualised as a way to bring people with mental health issues together. We discuss these findings against existing research on media representations of mental health and the concept of 'mutual recovery' and suggest what wider concurrent developments in the areas of mental health and the media may account for the uncovered frames and themes. [ABSTRACT FROM AUTHOR]

Aim To explore how Graduate Entry Nursing students present and position themselves in practice in response to anti-intellectualist stereotypes and assessment structures. Background A complex background turbulence exists in nurse education which incorporates both pro- and anti-intellectualist positions. This represents a potentially challenging learning environment for students who are recruited onto pre-registration programmes designed to attract graduates into the nursing profession on the basis of the specific attributes they bring known as 'graduateness'. Design A longitudinal qualitative case study conducted over 2 years. Methods Data were collected from eight Graduate Entry Nursing students at 6 monthly points between 2009-2011 via diaries, clinical assessment documentation and interviews. Forty interviews took place over 2 years. Additionally, three focus groups involving 12 practice assessors were conducted at the end of the study period. Data were analysed through a social constructivist lens and compared with a set of suppositions informed by existing empirical and theoretical debates. Findings Demonstrated the interplay of performance strategies adopted by Graduate Entry Nursing students to challenge or pre-empt actual or perceived negative stereotypes held by established practitioners to gain acceptance, reduce threat and be judged as appropriately competent. Conclusion Students interpreted and responded to, perceived stereotypes of nursing practice they encountered in ways which facilitated the most advantageous outcome for themselves as individuals. The data present the creative and self-affirming strategies which students adopted in response to the expectations generated by these stereotypes. They also depict how such strategies commonly involved suppression of the attributes associated with 'graduateness'. [ABSTRACT FROM AUTHOR]

Abstract: Resource considerations have meant that brevity in health care interventions is a high priority, and have led to a constant striving after ever more impressive time efficiency. The UK''s National Health Service may be described as a kind of ‘fast healthcare’, where everyone is task busy, time is money, bed spaces are frenetically shuffled so as to accommodate the most needy and there appears to be ‘no time to talk’. Indeed, a great many health care encounters are taking place in short ‘blips’ often of 5min or less across a range of sites and involving a vast number of practitioners. In this paper we explore how brief communication can both alienate and be therapeutic for patients. We theorise brief interactions by considering a number of traditions of work in anthropology, linguistics and sociology and conclude that health care providers need to invest much more in the skills and strategies for how best to communicate briefly if it to retain its core tradition of caring for others. [Copyright &y& Elsevier]

Politeness is of particular importance in health care contexts, where a number of international agreements and consensus statements formulated by policy makers demand that accord should be maintained, agreement should be solicited, and an attitude of respect be sustained especially when burdensome or intimate matters are being discussed. This paper explores the patterns of politeness in a corpus of material from a UK study of telephone encounters between NHS Direct health advisers and callers presenting with a need for advice over medication. In the opening sequences of interaction the questions that advisers asked the callers often included multiple politeness markers, for example through terms such as “may” and “just”, as in “may I just ask you?”. Politeness markers were often multiply layered, falling into three part structures which occurred when mundane information such as callers' names and telephone numbers were being elicited. Where more intimate matters were at stake, advisers minimized imposition and, arguably, undertook rapport building by means of preambles to the question such that the impending intrusion is accounted for, explained or mitigated. A potentially problematic question could also be followed up by further relational work and humour. There are important implications here for understanding politeness itself, especially where it is displayed by an institutionally more powerful or symbolically credentialed interactant towards one who is less advantaged. [ABSTRACT FROM AUTHOR]

This paper examines similarities and differences in media discourses relating to methicillin resistant Staphylococcus aureus (MRSA) at three important points in the development of the bacterium and its perception by the public over the last decade. We analyse three increasingly large sets of texts from the national media using a variety of complementary qualitative and quantitative methods. As such this paper exploits, develops and empirically assesses an emerging methodological trend in applied linguistics, namely the convergence of critical metaphor analysis, with corpus linguistics and science and technology studies. Using this, the study identifies a shifting media narrative that involves changes in dramatis personae over the decade. First, personified forces of nature, doctors and hospitals are engaged in a battle of evil against good, but also intelligence over stupidity. Second, we are presented with victims of personified bacterial forces and doctors and hospitals cast as perpetrators of crimes of omission by not cleaning hands or wards. Third, the malignant forces of politics try to exploit the evil forces of nature for their own ends while a mediator between the doctors and the potential victims of MRSA emerges and is given political and symbolic power: the modern matron. [ABSTRACT FROM AUTHOR]

The introduction of clinical governance policies in the UK offers an opportunity to explore the links between organizations, politics and language in health care. This paper attempts to theorise the links between symbolic and ideological formations and health care practitioners' accounts in one mental health care trust as a clinical governance initiative was implemented. Drawing on Fairclough, Foucault and Bourdieu, we attempt to situate the practices, formulations and identities of health care staff in a way that allows us to show the links between policy, professional identity and language. The data suggested that whilst there was widespread acceptance of the clinical governance concept this had resulted in little change in practice with clients. However, the major reconfigurations seemed to have taken place in personal and professional identity and the identities preferred amongst the clients. This had to do with 'feeling listened to' whilst the process of implementation was left to 'grow organically' and was what they were 'supposed to be doing anyway' whilst the clients were increasingly asked to be experts on their own care. The implementation of the policy thus involves reorganising symbolic capital so that adopting clinical governance represented a recapitalisation of the self with new experiences, skills, ideas and practices. This highlights the importance of drawing on critical theories and notions of identity and governmentality in doing applied linguistic analysis in health care institutions. [ABSTRACT FROM AUTHOR]

Health professionals have often been described as if they were in conflict with the new managerialist spirit in health care. However, because of their distributed and mobile sites of intervention, the work of community teams presents particular problems for traditional notions of management. In this UK study we identify how mental health team members are regulated by means of a subtle ‘deep management’. Team members point to a lack of management direction from senior colleagues, even though some of them participate in the management process themselves. However, the lack of overt management leads them to prioritise clients and foreground professional identities in performing their duties and much additional administrative work besides. This also meant that the organisational structure—the team—was defined in subjective terms. Participants had become self-regulating ‘deep managed’ subjects under a largely hands-off management regime. [Copyright &y& Elsevier]

This paper reports on an investigation of three interdisciplinary mental health teams. The discussion of the responses highlights the boundaries that exist between different professional roles and areas of responsibility. Whereas there is some evidence of role blurring, which was welcomed by a few respondents, others sought to preserve their own professional identity within the multidisciplinary environment. In a paradoxical sense, the lack of managerial direction and the encouragement of generic working seemed to make some respondents all the more insistent on separate professional identities. We conclude that, far from being a relic of the past or a product of ‘ingrained attitudes’, boundaries between professions are actively encouraged by the experience of interdisciplinary modes of working. [ABSTRACT FROM AUTHOR]

The article focuses on the legacy and personal vision of Irish Parliament Leader John Redmond. It discusses a eulogy of British Prime Minister David Lloyd George and the account of Redmond's political career in his 37 years in Parliament. According to the author, the centennial commemoration of Redmond's birth demonstrated an indication of a revitalize gratitude of his movements as the national leader.

In this article, the author argues for a compassionate design of health services to counterbalance the increasingly instrumental and bureaucratic culture of health care. A compassionate environment, he says, might result in services valuing staff who genuinely value and care for people with learning disabilities. He made the statements in response to "Undercover Care: The Abuse Exposed," a documentary on severe abuse of patients with learning disabilities at Winterbourne View Hospital, Bristol.

Background: There is a large literature suggesting that noise can be detrimental to health and numerous policy documents have promoted noise abatement in clinical settings. Objectives: This paper documents the role of noise in clinical environments and its deleterious effects with a particular focus on mental health care. Our intention however, is to go beyond the notion that noise is simply undesirable and examine the extent to which researchers have explored the meaning of sound in hospital settings and identify new opportunities for research and practice. Data sources and review methods: This is a narrative review which has grouped the literature and issues in the field into themes concerning the general issues of noise in health care; sleep noise and hospital environments; noise in intensive care units; implications for service users and staff; and suggestions for new ways of conceptualising and researching clinical soundscapes. Data sources comprised relevant UK policy documents and the results of a literature search of Pubmed, Scopus and Web of Knowledge using terms such as noise, health, hospital, soundscape and relevant additional terms derived from the papers retrieved. In addition the references of retrieved articles were scanned for additional relevant material and historical items significant in shaping the field. Results: Excess unwanted noise can clearly be detrimental to health and impede recovery, and this is clearly recognised by policymakers especially in the UK context. We use the literature surveyed to argue that it is important also to see the noise in clinical environments in terms of the meaning it conveys and rather than merely containing unwanted sound, clinical environments have a 'soundscape'. This comprises noises which convey meaning, for example about the activities of other people, the rhythms of the day and the nature of the auditory community of the hospital. Unwanted sound may have unwanted effects, especially on those who are most vulnerable, yet this does not necessarily mean that silence is the better option. Therefore it is our contention that it is important to begin thinking about the social functions of sound in the mental health environment. Conclusions: Whilst it can be stressful, sound can also be soothing, reassuring and a rich source of information about the environment as well. It may be used to secure a degree of privacy for oneself, to exclude others or as a source of solidarity among friends and colleagues. The challenge then is to understand the work that sound does in its ecological context in health care settings. [ABSTRACT FROM AUTHOR]

Sheep scab (psoroptic mange), which is endemic in the United Kingdom (UK) flock, has a significant, negative impact on sheep welfare. Nothing has previously been published about the distribution of sheep scab in Northern Ireland (NI), nor about Northern Irish farmers' knowledge and behaviours relating to the disease, its treatment, prevention and control. Between March and June 2021 an online questionnaire on the disease was completed by sheep farmers in NI. Forty-four respondents out of a total of 122 valid returns (36%) indicated that they had at least one outbreak of sheep scab in their flock within the previous five years. These flocks were spread throughout NI and included flocks grazing on common land. Farmers reporting sheep scab in their flock considered movements of sheep between flocks to be the main cause of flock infestation. Respondents demonstrated knowledge gaps in relation to the parasite biology, disease transmission, prevention and treatment options, as well as a lack of awareness of some of the relevant industry guidelines. We highlight that some farmers rely on clinical signs alone to rule out the possibility that newly purchased sheep are infested with sheep scab before mixing them with their flock. This activity poses a high risk for the introduction of sheep scab into previously uninfested flocks. The inadequacy of some farmers' quarantine rules, or their inability to follow them, was also reported by farmers as being the cause of their flock infestation. Sheep scab outbreaks were shown to result in significant financial cost, with some farmers reporting their most recent outbreak had cost over £2500 ($3329). The paper also highlights that in addition to the animal health and welfare impact and financial cost, sheep scab was reported to have a social cost: 94 respondents (79%) agreed that a sheep scab outbreak caused emotional stress to affected farmers. These findings have provided evidence of the widespread nature of sheep scab in the NI flock, and of the knowledge gaps and behaviours which need to be addressed to improve sheep scab control. This will require a combination of focused research, knowledge exchange between farmers, advisors, policy makers and regulators, and co-developed disease control plans at a flock and national level., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

The National Service Framework for Mental Health (1999) emphasizes the need for a culture of evidence-based practice (EBP) in mental health care. However, there is relatively little research addressing EBP from the perspective of community mental health nurses and we are still unsure of why the uptake of this style of working has been slow. This paper suggests that rather than thinking in terms of 'barriers' to the uptake of EBP, the issue may best be conceptualized as a form of praxis on the part of nurses, as they seek to manage the diversity of ideologies and practices in their working lives. From an interview and focus group study, we identify how practitioners' narrow definition of EBP itself, their formulation of how EBP was at odds with the nurse's professional activity and the organizational constraints within which they work were perceived to inhibit access to information and offer little time and managerial support for information seeking. Those who attempt to further the involvement of community mental health staff in EBP will have to reconceptualize the reasons why staff have yet to incorporate it fully, and acknowledge that this does not occur because staff are simply 'ignorant Luddites', but that this resistance enables them to retain a sense of control over their working lives and retain a focus on work with clients. Future EBP initiatives will have to address these ideological and organizational factors in order for uptake to be accelerated. This may involve changing organizational cultures and work roles and even encouraging activism on the part of the practitioners so as to enable them to learn from each other and educate and change their work environments.