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  • Context matters: Problematizing the policy‐practice interface in the enactment of gender equality action plans in universities

    Ní Laoire, C.; Linehan, C.; Archibong, Uduak E.; Picardi, I.; Udén, M. (John Wiley & Sons Ltd, 2021)
    This study argues for recognition of the constitutive role of context in shaping the dynamics of the policy‐practice interface in the field of gender equality in universities. Using a comparative and reflective case‐study approach, we draw on our experiences, as action‐researchers, of developing and implementing Gender Equality Action Plans (GEAPs) in four universities in four different European countries and we explore the role of national and local context in the mediation and translation of the GEAP model. Drawing on the concepts of gendered organizations, dialogic organizational change, and policy mobilities, we argue for the need to be critical of approaches to gender equality in higher education (HE) that presume policy measures and good practice models transfer unproblematically to different HE organizations in different international contexts; instead, we draw attention to the contingent ways in which uneven gender relations articulate and manifest in different contexts, shaping possibilities for, and obstacles to, gender equality intervention. Thus, we argue that context plays a crucial constitutive role in the interpretation, enactment, and impact of gender equality policy in HE.
  • Teacher Perceptions of Fundamental Movement Skills and their Assessment in Primary Schools

    Eddy, L.H.; Hill, L.J.B.; Mon-Williams, M.; Preston, N.; Daly-Smith, Andrew; Medd, G.; Bingham, D.D. (2021)
    Evidence suggests that children struggle to acquire age-appropriate fundamental movement skills (FMS), despite their importance for facilitating physical activity. This has led to calls for routine school-based screening of children’s FMS. However, there is limited research exploring schools’ capacity to conduct such assessments. This study investigated what factors might affect the adoption and implementation of FMS assessments in primary schools. School staff (n=853) completed an online questionnaire developed using the Capability, Opportunity, Motivation and Behaviour (COM-B) model. A majority reported that knowledge of pupils’ FMS ability would be beneficial (65.3%), and 71.8% would assess FMS if support was provided. Barriers included: Capability – few possessed knowledge of FMS (15%); Opportunity – teachers reported 30-60 minutes as acceptable for assessing a class, a substantially shorter period than current assessments require; Motivation – 57.2% stated FMS assessments would increase workload stress. Solutions to these issues are discussed using the COM-B theoretical framework.
  • Point-of-care lactate measurement for suspected sepsis in the prehospital environment: are we missing the point at the sharp end?

    Lightowler, Bryan (Mark Allen Group, 2020-04-02)
    Expecting ambulance clinicians to dependably differentiate the life-threatening organ dysfunction caused by sepsis from an inflammatory response to a non-infectious aetiology, relying upon vital signs and a physical examination of the patient alone, must be considered unrealistic. Although lactate measurement has been integrated into numerous prehospital sepsis screening tools, it is not yet measured routinely within UK ambulance services. Research has generally focused on whether handheld point-of-care lactate measurement devices are as accurate as laboratory analysis of venous or arterial samples. The weight of literature has concluded negatively in relation to this. However, there is potential for handheld devices to be used independently to monitor trends in lactate elimination or accumulation to inform decisions on the efficacy of prehospital interventions, or simply to report categorical data in terms of whether lactate levels are elevated or not. This offers UK paramedics the opportunity to improve sepsis care through the enhanced assessment of risk and acuity, the identification of patients with cryptic shock, more aggressive fluid resuscitation and advanced notification to receiving units.
  • The “weanling’s dilemma” revisited: Evolving bodies of evidence and the problem of infant paleodietary interpretation

    Kendall, E.; Beaumont, Julia; Millard, A.M. (2021)
    Breastfeeding is known to be a powerful mediator of maternal and childhood health, with impacts throughout the lifecourse. Paleodietary studies of the past thirty years have accordingly taken an enduring interest in the health and diet of young children as a potential indicator of population fertility, subsistence, and mortality patterns. While progress has been made in recent decades towards acknowledging the agency of children, many paleodietary reconstructions have failed to incorporate developments in cognate disciplines revealing synergistic dynamics between maternal and offspring biology. Central to this understanding has been heavy reliance on the “weanling’s dilemma”, in which infants are thought to face a bleak choice between loss of immunity or malnutrition. Using a review of immunological and epidemiological evidence for the dynamic and supportive role that breastfeeding plays throughout the complementary feeding period, this paper offers context and nuance for understanding past feeding transitions. We suggest that future interpretative frameworks for infant paleodietary and bioarchaeological research should include a broad knowledge base that keeps pace with relevant developments outside of those disciplines.
  • Competition and Collusion among Criminal Justice and Non-State Actors in Brazil’s Prison System

    Macaulay, Fiona (Palgrave Macmillan, 2021-02)
    This chapter examines competition and collusion among criminal justice institutions and non-state actors in imprisonment in prisons in Brazil to analyse how both formal and informal dispositions and practices have created and sustain the mass incarceration that is a pre-condition for extensive prisoner self-governance. The chapter thus looks from the outside-in, examining how relationships between extra-mural institutions have created and sustained such an enormous prison population in Brazil. It also analyses these institutions and organisations as intra-mural actors that, through their action or inaction, exercise a key role in shaping the carceral experience for inmates. It highlights the competition between the different actors involved in the penal arena for control of the carceral space and of prisoners, driven by a variety of motives – rent-seeking, moral/philosophical, and territorial.
  • Transforming State Responses to Feminicide: Women’s Movements, Law and Criminal Justice Institutions in Brazil

    Macaulay, Fiona (Emerald Press, 2021-01)
    Global concern about feminicide -- the killing of girls or women for reasons related to gender roles – started in Latin America with the epidemic of sexualised murders and disappearances in Central America and Mexico. There, the killers walked free due to state indifference and an incompetent criminal justice system. But this book tells a more positive story from the region. Brazil has high numbers of feminicides, mostly committed by intimate partners. Yet, the state’s responses to this crime have been transformed in recent years. This is the first country study to examine in detail how strategic action by the women’s movement has resulted in significant improvements in the investigation, prosecution and prevention of domestic violence and of feminicide. This study traces the interaction between the main contributory factors to that transformation. Innovation and capacity-building in the criminal justice system has been driven by the development of norms and protocols at the inter-American level, by changes in Brazilian law and jurisprudence, and by policy entrepreneurs within the police and justice sector. Executive branch investment since the early 2000s in tackling gender-based violence created a propitious political environment. Coalitions of interest involving feminist academics, NGOs, local campaigners, bureaucrats within the state machineries for women, politicians, journalists, and criminal justice professionals were able to identify, create and use institutional spaces for change and diffuse good practices.
  • Princípios e práticas de formação de policiais para o atendimento às mulheres em situação de violência

    Macaulay, Fiona; Martins, J. (Brazilian Forum on Public Safety, 2020-10)
    This training manual on gender-based violence is intended for use by all those who train the police and other actors in the local protection networks. It outlines the principles of effective training based on the integrated competencies of knowledge, attitudes and skills, and emphasises the use of appreciative inquiry, group learning and dynamic techniques such as dramatisation and case-based learning
  • Practitioner-based research and qualitative interviewing: Using therapeutic skills to enrich research in counselling and psychotherapy

    McVey, Lynn; Lees, J.; Nolan, G. (2015-06)
    The researcher’s reflexive use of self forms part of a well-established tradition in counselling and psychotherapy research. This paper reviews that tradition briefly, with particular reference to an approach known as ‘practitioner-based research’ that has developed from it. In this approach, researcher-practitioners use their therapeutic skills and judgement and thereby enrich their understanding of research participants, themselves and their relationship. Aim: The paper aims to contribute to the practitioner-based approach by showing how it can impact on data collection, using an example from a qualitative interview. Methodology: A moment of interaction between a participant and a therapy researcher in a qualitative interview is examined, framed within psychotherapeutic intersubjectivity theory. The researcher’s reflexive awareness of micro-aspects of the relationship with the participant is reviewed, captured in their language and the split-second daydreams or reveries that arose as they interacted. Findings: The authors argue that the approach enhanced this small-scale study by intensifying the researcher’s engagement with the participant and enriching her understanding of their relationship and the subject under investigation. Implications: The paper highlights the unique value and contribution that this approach offers to therapy research and practice.
  • Reflective‐verbal language and reverie in a qualitative interview

    McVey, Lynn; Lees, J.; Nolan, G. (2016-06)
    Background: in contrast to dominant approaches to therapy research that look at outcomes and focus on large samples, another primary strand of research considers microphenomenal processes and focuses on small samples. This paper contributes to the latter genre in regard to the implicit impact of language. Aim: this paper aims to apply relational psychotherapeutic thinking about empathic dialogue, specifically the concepts of reflective-verbal language and reverie, to qualitative interviewing. Methodology: an example from a small-scale study about emotionally-evocative language is reviewed in detail, focusing on the interviewer’s phenomenological experience of her conversation with a participant in a qualitative interview. Findings: the authors argue that the interviewer’s reflexive awareness of her reveries and the reflective-verbal nature of the research dialogue, gave her an alternative perspective on the participant’s (and her own) experience. Implications: the paper highlights the value within research and practice of maintaining awareness of language at a microphenomenal level, using techniques based on the principles of psychological therapy.
  • The predictive moment: reverie, connection and predictive processing

    McVey, Lynn; Nolan, G.; Lees, J. (2020-07)
    According to the theory of predictive processing, understanding in the present involves non-consciously representing the immediate future, based on probabilistic inference shaped by learning from the past. This paper suggests links between this neuroscientific theory and the psychoanalytic concept of reverie–an empathic, containing attentional state–and considers implications for the ways therapists intuit implicit material in their clients. Using findings from a study about therapists’ experiences of this state, we propose that reverie can offer practitioners from diverse theoretical backgrounds a means to enter the predictive moment deeply, making use of its subtle contents to connect with clients.
  • Pilot cluster randomised trial of an evidence-based intervention to reduce avoidable hospital admissions in nursing home residents (Better Health in Residents of Care Homes with Nursing - BHiRCH-NH Study)

    Sampson, E.L.; Feast, A.; Blighe, Alan; Froggatt, K.; Hunter, R.; Marston, L.; McCormack, B.; Nurock, S.; Panca, M.; Powell, Catherine; et al. (2020-12)
    Objectives To pilot a complex intervention to support healthcare and improve early detection and treatment for common health conditions experienced by nursing home (NH) residents. Design Pilot cluster randomised controlled trial. Setting 14 NHs (7 intervention, 7 control) in London and West Yorkshire. Participants NH residents, their family carers and staff. Intervention Complex intervention to support healthcare and improve early detection and treatment of urinary tract and respiratory infections, chronic heart failure and dehydration, comprising: (1) ‘Stop and Watch (S&W)’ early warning tool for changes in physical health, (2) condition-specific care pathway and (3) Situation, Background, Assessment and Recommendation tool to enhance communication with primary care. Implementation was supported by Practice Development Champions, a Practice Development Support Group and regular telephone coaching with external facilitators. Outcome measures Data on NH (quality ratings, size, ownership), residents, family carers and staff demographics during the month prior to intervention and subsequently, numbers of admissions, accident and emergency visits, and unscheduled general practitioner visits monthly for 6 months during intervention. We collected data on how the intervention was used, healthcare resource use and quality of life data for economic evaluation. We assessed recruitment and retention, and whether a full trial was warranted. Results We recruited 14 NHs, 148 staff, 95 family carers and 245 residents. We retained the majority of participants recruited (95%). 15% of residents had an unplanned hospital admission for one of the four study conditions. We were able to collect sufficient questionnaire data (all over 96% complete). No NH implemented intervention tools as planned. Only 16 S&W forms and 8 care pathways were completed. There was no evidence of harm. Conclusions Recruitment, retention and data collection processes were effective but the intervention not implemented. A full trial is not warranted.
  • Dying to Talk? Co-producing resources with young people to get them talking about bereavement, death and dying

    Booth, J.; Croucher, Karina T.; Bryant, Eleanor J. (2020-09-29)
    The Dying to Talk project in Bradford, UK aimed to build resilience in young people around the topic of death, dying and bereavement. Starting conversations early in life could buttress people’s future wellbeing when faced with bereavement and indeed their own mortality. Research indicates that a key feature in young people’s experience of bereavement is ‘powerlessness’ (Ribbens McCarthy, 2007). Drawing on the principles of co-production, young people led the development of the project aimed at encouraging young people to talk about death, using archaeology as a facilitator to those conversations. The partnership between the University of Bradford, the voluntary sector and the young people proved to be a positive and empowering one. It laid the foundations for future collaboration and developed a framework for engaging young people in talking about death, building their resilience for dealing with death and dying in the future – a step towards building a ‘compassionate city’ for young people (Kellehear, 2012)
  • Involvement in meetings and events: Tips for good practice

    Mason, Clare; Quinn, Catherine; Andrews, Michael; Parveen, Sahdia; Litherland, R. (2020-11)
    When face-to-face meetings and events resume, there is likely to be a renewed commitment to involving people with dementia and carers. Clare Mason and colleagues reflect on what they have learnt from their own experience and provide some tips for good practice.
  • Non-medical prescribing and advanced practice in children's hospices

    Tatterton, Michael J. (Together for Short Lives, 2021)
    In recent years, as the prevalence of prescribers has increased, there has been discord and confusion around exactly how to refer to prescribers who are not doctors (Nuttall and Rutt-Howard, 2020). Professional regulators continue to define prescribers by specific profession, using terms such as ‘nurse prescriber’ (Nursing and Midwifery Council, 2018a), ‘pharmacist prescriber’ (General Pharmaceutical Society, 2018) and ‘allied health professional prescriber’ (Health and Care Professions Council, 2016). However, there is a broader range of literature using the collective term of ‘non-medical prescribers’ (All Wales Medicines Strategy Group, 2017; Department of Health Northern Ireland, 2020; NHS England, 2020; Scottish Government, 2020), highlighting the multidisciplinary nature of contemporary prescribing practices across the UK, and the shared responsibility of prescribers for assuring safe and effective practice. Within this chapter, we refer to prescribers collectively, as non-medical prescribers. Although this chapter has been written with the four countries of the UK in mind, it is important that you consider any country-specific, and profession-specific guidelines.
  • Independent non-medical prescribing in children's hospices in the UK: a practice snapshot

    Tatterton, Michael J. (2017-08)
    Background: Non-medical prescribing is well established within the British health service, with increasing numbers of nurses practicing within children’s hospices. Aim: To identify the context of non-medical prescribing in children’s hospices in the UK, focusing on the perceived benefits and challenges. Method: Internet-based questionnaires were sent to 55 UK children’s hospices, exploring the practice and context of prescribing. Results: Of the 55 invited, 20 children’s hospices responded to the questionnaire, 14 of which employed a total of 39 non-medical prescribers (NMPs). Sixteen individual NMPs responded, of which half (50%) prescribed to enable the continuation of existing medicines, 37.5% prescribed independently surrounding symptom management and control and 31.3% in end-of-life care. Perceived benefits of prescribing included timely access to medicines, increased efficiency and accuracy in the admissions process and medicine reconciliation and the increased ability to offer choice in the place of palliative and hospice care. Perceived barriers to prescribing surrounded opportunities to develop confidence, defining the scope of practice and the time required to assess, diagnose and treat. Conclusion: NMPs are making a significant contribution to the prescribing workforce within hospices; however, a number of challenges need to be addressed to enable hospices to realise the benefits.
  • How Grandparents Experience the Death of a Grandchild With a Life-Limiting Condition

    Tatterton, Michael J.; Walshe, C. (2019-02-01)
    Traditionally, family-focused care extends to parents and siblings of children with life-limiting conditions. Only a few studies have focused on the needs of grandparents, who play an important role in the families of children with illness and with life-limiting conditions, in particular. Interpretative phenomenological analysis was used as the methodological framework for the study. Seven bereaved grandparents participated in this study. Semistructured, individual, face-to-face interviews were conducted. A number of contextual factors affected the experience of bereaved grandparents, including intergenerational bonds and perceived changes in role following the death of their grandchild. The primary motivation of grandparents stemmed from their role as a parent, not a grandparent. The breadth of pain experienced by grandparents was complicated by the multigenerational positions grandparents occupy within the family. Transition from before to after the death of a grandchild exacerbated the experience of pain. These findings about the unique footprint of grandparent grief suggest the development of family nursing practice to better understand and support grandparents during the illness of a grandchild, in addition to bereavement support.
  • The prevalence of nonprescription cannabinoid-based medicines in British children's hospices: results of a national survey

    Tatterton, Michael J.; Walker, C. (2019-10)
    Background: Almost 50,000 children and young people are affected by life-limiting conditions in the United Kingdom, around a third of which use children's hospices. Anecdotal evidence suggests that cannabinoid-based medicines (CBMs), specifically cannabis oil (CO), are being used by families with increasing frequency to manage distressing symptoms. The use of most nonprescription CBMs in the United Kingdom remains illegal. Objective: The objective of the study was to identify the prevalence of CO use by families who use children's hospices in the United Kingdom, and the approaches taken by those services to manage it. Design: An electronic survey was sent to each of the 54 children's hospices in the United Kingdom between May and July 2018, comprising 10 questions. Results: Forty children's hospices from across the four countries of the United Kingdom responded to the survey, representing 74% of British children's hospices. About 87.5% of hospices knew of children who use CO therapeutically. Sixty-nine percent of those hospices have received requests to administer CO during an episode of care. Approaches by organizations around CO management varied across the sectors, including arrangements for storage, administration, and recording of its use. Hospices highlighted how the lack of available guidance made decision making more challenging. Only a third of responding organizations routinely questioned families about the use of cannabis when prescribing medicines. Conclusion: CO is used extensively by children who use children's hospices. Despite recognizing the use of CO, many hospices are unable to support it. There is a need for clear guidelines on how hospices should approach the care needs of children, allowing hospices to meet the needs of children who use CO, and families in a safe, consistent, and relevant way, safeguarding all children, families, and professionals within the organization.
  • Meaning making And Generativity In Children and Young people with Life limiting conditions (MAGICYL)

    Watts, L.; Rodriguez, A.; Tatterton, Michael J.; McSherry, W.; Smith, J. (2019-04-02)
  • Understanding the bereavement experience of grandparents following the death of a grandchild from a life-limiting condition: A meta-ethnography.

    Tatterton, Michael J.; Walshe, C. (2019-07)
    To increase understanding of grandparental grief following the death of a grandchild from a life-limiting condition. Meta-ethnography. Academic Search Complete CINHAL, Embase, psycINFO, PubMed and Web of Science, supplemented by manual search strategies (in 2015, updated 2018). Studies were appraised and synthesized using the principles of meta-ethnography. Three superordinate themes were identified: 'influence of the relationship with their grandchild', 'influence of the relationship with the grandchild's family' and 'pain'. The simultaneous, multigenerational position of grandparents meant individuals experience emotional pain from witnessing the experience of family members. Many factors that contribute to the bereavement experience of grandparents are outside of their control. The roles, positions, and support needs of grandparents need to be acknowledged to better meet their needs as parents, grandparents, and individuals who have experienced a child death.

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