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Integration is widely considered to be difficult to define and even harder to facilitate. Whist the integration of migrants to the United Kingdom (UK) remains a ‘hot topic’ in policy, politics and public opinion it is also the subject of numerous attempts to conceptualise and measure it. In this article we draw on empirical research undertaken with a wide range of organisations working between refugees and powerful national organisations which perform everyday ‘integration work’. We present a possible framework for operationalising and enriching the day-to-day work of the integration of refugees. We explore this work through the lens of the Equality Act 2010. In so doing, we aim to demonstrate that more closely aligning ‘integration work’ within the framework of the Equality Act provides both greater conceptual and operational clarity about how to enhance the integration of refugees in the UK.
Empirical studies have the potential to both inform and transform cyber peace research. Empirical research can shed light on opaque phenomena, summarize and synthesize diverse stakeholder perspectives, and allow causal inferences about the impact of policymaking efforts. However, researchers embarking on empirical projects in the area of cyber peace generally, and cybersecurity specifically, face significant challenges – particularly related to data collection. In this chapter, we identify some of the key impediments to empirical cyber research and suggest how researchers and other interested stakeholders can overcome these barriers.
As discussed in Chapter 1, corpus representativeness depends on two sets of considerations: domain considerations and distribution considerations. Domain considerations focus on describing the arena of language use, and operationally specifying a set of texts that could potentially be included in the corpus. The linguistic research goal, which involves both a linguistic feature and a discourse domain of interest, forms the foundation of corpus representativeness. Representativeness cannot be designed for or evaluated outside of the context of a specific linguistic research goal. Linguistic parameter estimation is the use of corpus-based data to approximate quantitative information about linguistic distributions in the domain. Domain considerations focus on what should be included in a corpus, based on qualitative characteristics of the domain. Distribution considerations focus on how many texts should be included in a corpus, relative to the variation of the linguistic features of interest. Corpus representativeness is not a dichotomy (representative or not representative), but rather is a continuous construct. A corpus may be representative to a certain extent, in particular ways, and for particular purposes.
This study explored how a subsection of Canadians perceive older adults’ vaccines through a qualitative analysis of comments posted in response to national online news articles. We used reflexive thematic analysis to analyse 147 comments from 31 news article comments sections published between 2015 and 2020 from five different national online news sources (CBC, National Post, Global News, Globe & Mail, and Huffington Post Canada) that focused on three older adults’ diseases and vaccines: influenza, pneumococcal pneumonia, and herpes-zoster. Three themes encompassed the similarities and differences in how these three diseases were discussed: (1) the importance of personal experiences on stated stance in vaccine uptake or refusal, (2) questioning vaccine research and recommendations, and (3) criticisms of the government’s unequal vaccine opportunities across different Canadian provinces. Our findings identified that perceptions regarding older adult vaccination were dependent on the vaccine type, and, therefore, we make suggestions for future researchers to build on our findings, particularly the need not to treat the research subject of “older adults’ vaccines” as one entity. Gaining a better understanding of how older adults’ vaccines are perceived in Canada will enable public health professionals to develop effective communication strategies that should ultimately improve vaccination rates for older adults.
Training plays a central role in the pursuit of conservation goals, and it is vital to know if it is having the desired effect. However, evaluating the difference it makes is notoriously challenging. Here, we present a practitioner's perspective on overcoming these challenges and developing a framework for ongoing evaluation of a conservation training programme. To do this, we first created a theory of change, describing the pathway of change we expect from training delivery to conservation impact. This provided the clarity and structure needed to identify indicators of change in the short, medium and long term. For data collection, we utilized both quantitative and qualitative methods to provide a more complete understanding of the change expected and capture any that might be unexpected. However, the more time that passes since a training event, the more difficult it becomes to attribute results; in response, we shifted predominantly to the use of qualitative methods to understand the long-term results achieved. After 3 years of implementation, this framework has enabled us to measure the difference our training makes to individuals and their work, and to provide evidence for the contribution it makes to achieving conservation impact. We believe that the lessons learnt can be used to improve the evaluation of training activities across the conservation sector and maximize the impact they achieve.
When followed, there is evidence that social distancing measures play a major role in reducing the transmission of viruses such as COVID-19. However, not all individuals follow the guidance. We explored barriers and facilitators to compliance with UK social distancing guidelines during the COVID-19 pandemic through semi-structured interviews with 116 adults. Data were analysed using reflexive thematic analysis and themes mapped to the Capability, Opportunity and Motivation Model of Behaviour (COM-B). Barriers to compliance included inconsistent rules, caring responsibilities, fatigue, unintended consequences of control measures, and the need for emotional support. Facilitators were informational support and social responsibility. Six themes were both a barrier and a facilitator: lived environment, beliefs about consequences of non-compliance, influence of others, practical support, and trust in government. Reflective motivation, psychological capability, and social opportunity were important drivers for compliance. Measures that enable social support alongside strategies to maintain motivation to comply, provide clear guidance and optimise social cohesion should be promoted.
Perinatal depression and anxiety account for a high burden of perinatal morbidity and poor psychosocial functioning. There is a growing interest among mental health professionals, to devise interventions to prevent this condition. This review synthesizes evidence for the effectiveness of psychological and psychosocial interventions aimed at the prevention of perinatal depression and anxiety. We also explore qualitative evidence to understand the acceptability and feasibility of these interventions. Using a mixed-methods approach, data from a total of 21 studies were collated to inform the evidence for preventive interventions for perinatal depression and anxiety. Based on their theoretical orientations, these interventions were described by authors as cognitive-behavioral (n = 7); psychoeducational (n = 6); mindfulness (n = 2); and interpersonal psychotherapy (n = 2). These also included psychosocial approaches such as social support (n = 1) and multicomponent interventions (n = 3). For depressive symptoms, these interventions yielded moderate to strong effect sizes in favor of the intervention group [standardized mean difference (SMD) = −0.59; 95% confidence interval (CI) −0.95 to −0.23]. For anxiety symptoms, a strong effect size was estimated in favor of the intervention group (SMD = −1.43, 95% CI −2.22 to −0.65). Preventive interventions significantly reduce the severity of perinatal depressive and anxiety symptoms. These interventions are also acceptable and feasible in many settings.
This study aimed to examine the intrapersonal, interpersonal, environmental and macrosystem influences on dietary behaviours among primary school children in Singapore.
A qualitative interpretive approach was used in this study. Focus group discussions guided by the socio-ecological model (sem), of which transcripts were analysed deductively using the sem and inductively using thematic analysis to identify themes at each sem level.
Two co-educational public primary schools in Singapore.
A total of 48 children (n 26 girls) took part in the semi-structured focus group discussions. Their mean age was 10·8 years (sd = 0·9, range 9–12 years), and the majority of the children were Chinese (n 36), along with some Indians (n 8) and Malays (n 4).
Children’s knowledge of healthy eating did not necessarily translate into healthy dietary practices and concern for health was a low priority. Instead, food and taste preferences were pivotal influences in their food choices. Parents had a large influence on children with regards to their accessibility to food, their attitudes and values towards food. Parental food restriction led to some children eating in secrecy. Peer influence was not frequently reported by children. Competitions in school incentivised children to consume fruits and vegetables, but reinforcements from teachers were inconsistent. The proximity of fast-food chains in the neighbourhood provided children easy access to less healthy foods. Health advertisements on social media rather than posters worked better in drawing children’s attention.
Findings highlighted important factors that should be considered in future nutrition interventions targeting children.
Independent mobility is an important component of healthy ageing. Public transit may be an affordable way to achieve independent mobility, and yet little is known about older adults’ transition to public transit. This paper addresses this research gap by providing an exploration of older adults’ experiences transitioning to public transit use, and by comparing these experiences to those of older people who have always travelled using transit. Twenty-four older adults (65+) living in Hamilton, Canada, who use public transit completed semi-structured interviews during which they discussed their experiences when they first began to use transit. These experiences are framed herein with the concept self-efficacy, i.e. how one's belief in their ability to complete a task shapes their ability to complete said task. Results indicate that most older adults acquire skills to transition to public transit, such as trip planning, boarding, knowing where to sit and exiting the bus. These skills are developed through practice. As one gains experience, one becomes more confident in their ability to meet their daily travel needs using transit. Therefore, the transition to public transit as an older adult can be more challenging for those with little experience using public transit. This paper highlights the danger of assuming all older adults will effortlessly take up transit and stresses the importance of older adults gaining experience using public transit.
Across the globe, long-term care has been under increased pressure throughout the COVID-19 pandemic. This is the first study to examine the experiences and needs of long-term care staff and management during COVID-19, in the Canadian context. Our group conducted online survey research with 70 staff and management working at public long-term care facilities in central Canada, using validated quantitative measures to examine perceived stress and caregiver burden; and open-ended items to explore stressors, ways of coping, and barriers to accessing mental health supports. Findings indicate moderate levels of stress and caregiver burden, and highlight the significant stressors associated with working in long-term care during the COVID-19 pandemic (i.e., rapid changes in pandemic guidelines, increased workload, “meeting the needs of residents and families”, fear of contracting COVID-19 and COVID-19 coming into long-term care facilities, and concern over a negative public view of long-term care staff and facilities). A small subset (13.2%) of our sample identified accessing mental health supports to cope with work-related stress, with most participants identifying barriers to seeking help. Novel findings of this research highlight the significant and unmet needs of this high-risk segment of the population.
The involvement of citizens in the production and creation of public services has become a central tenet for administrations internationally. In Scotland, co-production has underpinned the integration of health and social care via the Public Bodies (Joint Working) (Scotland) Act 2014. We report on a qualitative study that examined the experiences and perspectives of local and national leaders in Scotland on undertaking and sustaining co-production in public services. By adopting a meso and macro perspective, we interviewed senior planning officers from eight health and social care partnership areas in Scotland and key actors in national agencies. The findings suggest that an overly complex Scottish governance landscape undermines the sustainability of co-production efforts. As part of a COVID-19 recovery, both the implementation of meaningful co-production and coordinated leadership for health and social care in Scotland need to be addressed, as should the development of evaluation capacities of those working across health and social care boundaries so that co-production can be evaluated and report to inform the future of the integration agenda.
The COVID-19 pandemic initially doubled the rates of food insecurity across the USA and tripled rates among households with children. Despite the association among food insecurity, chronic disease and psychological distress, narratives depicting the experiences of already food insecure populations are notably underrepresented in the literature. The current study assessed the impact of COVID-19 on clients of a food pantry who were also enrolled in the Supplemental Nutrition Assistance Program (SNAP).
A qualitative study probing the effects of the pandemic on daily living, food needs, food buying and food insecurity. Interview transcripts were analysed using a combined deductive and inductive approach.
Interviews were conducted via telephone between May and June of 2020.
Equal numbers of English- and Spanish-speaking clients (n 40 total).
Three main findings emerged: (1) the pandemic increased economic distress, such as from job loss or increased utility bills due to sustained home occupancy and (2) the pandemic increased food needs, food prices and food shortages. In combination with economic stressors, this led to greater food insecurity; (3) increased economic stress and food insecurity contributed to increased psychological stress, such as from fear of infection, isolation and children being confined at home.
Despite federal legislation and state and local programmes to alleviate food insecurity, COVID-19 exacerbated economic hardship, food insecurity and psychological distress among urban SNAP and food pantry clients. Additional research is needed to identify the most effective policies and programmes to ameliorate the short- and long-term health and economic inequities exacerbated by the pandemic.
The on-going rise in demand experienced by voluntary and community organisations (VCOs) providing emergency food aid has been described as a sign of a social and public health crisis in the UK (Loopstra, 2018; Lambie-Mumford, 2019), compounded since 2020 by the impact of (and responses to) Covid 19 (Power et al., 2020). In this article we adopted a social practice approach to understanding the work of food bank volunteering. We identify how ‘helping others’, ‘deploying coping strategies’ and ‘creating atmospheres’ are key specific (and connected) forms of shared social practice. Further, these practices are sometimes suffused by faith-based practice. The analysis offers insights into how such spaces of care and encounter (Williams et al., 2016; Cloke et al., 2017) function, considers the implications for these distinctive organisational forms (the growth of which has been subject to justified critique) and suggests avenues for future research.
Stringent social restrictions imposed during 2020 to counter the spread of the COVID-19 pandemic could significantly affect the wellbeing and quality of life of people with dementia living in the community and their family carers. We explored the impact of COVID-19 restrictions on people with dementia and family carers in England and considered how negative effects might be mitigated. We conducted semi-structured telephone interviews with 11 people with dementia and 11 family carers who were ongoing participants in the IDEAL cohort during the initial ‘lockdown’ period in May and June 2020, and follow-up interviews with five people with dementia and two carers as restrictions were eased in July. We analysed interview data and triangulated the findings with issues raised in dementia-specific online forums. Findings showed some people with dementia were coping well, but others experienced a range of negative impacts, with varying degrees of improvement as restrictions were eased. The need for clear personalised information relating to COVID-19 and the value of support in the form of regular ‘just checking’ phone calls was emphasised. This exceptional situation provides a natural demonstration of how social and psychological resources shape the potential to ‘live well’ with dementia. While some support is recommended for all, a personalised approach to determine needs and coping ability would ensure that further practical and emotional support is targeted effectively.
We explored the ‘coping reflections’ of elderly couples living alone (without any other family members) during the COVID-19 pandemic in urban Odisha, India.
Evidence worldwide suggests that older people are at increased risk from COVID-19 adverse outcomes and experience greater stress. In our previous community-based study urban dwelling, particularly elderly participants, and living alone reported higher pandemic-associated health care challenges than their rural and residing-with-family counterparts. We intended to explore how the elderly couples living alone coped through this challenging yet stressful situation during the COVID-19 pandemic and what were their key strategies adopted toward this.
We conducted telephonic in-depth interviews (IDIs) with 11 urban elderly couples living alone in Bhubaneswar city of Odisha, India using a semi-structured interview guide. All IDIs were digitally recorded, transcribed into the original language, and translated to English. We used a thematic approach for analysis.
Four themes emerged: (1) Risk appraisal and feeling vulnerable; (2) Safeguarding against COVID-19; (3) Managing routine health care and emergency; and (4) Pursuing mental and psychological well-being. Although fear, anxiety, and loneliness were continuing stressors, many of them learnt to adapt and emerge resilient with the evolving situation. Various elements at the individual, family, community, and organizational levels were conducive to better coping. The companionship and complementary support of spouse, self-health literacy, and digital efficacy, virtual connectedness with family and friends, availability of community pharmacy and diagnostic services in the vicinity, support of neighbors, reengaging with creative leisure time activity, and assurance of a responsive administration at the time of emergency helped them to cruise through the pandemic. Furthermore, watching the re-telecast of prime time serials made these elderly fondly remember their own youth time memories. Self-health monitoring, indoor physical exercise, spiritual practices, continuation of previous prescription, telephonic advice of physicians were add-on strategies that facilitated their physical and psychological well-being during the pandemic.
This research adds to scarce literature regarding adolescent experiences of traumatic brain injury (TBI). Retrospective accounts of young adults who had sustained a TBI in adolescence were analysed to explore the perceived impact this had on their lives and forming identities during this important developmental stage.
Thirteen adults (aged 20–25 years; mean 23 years) who sustained a mild or moderate TBI during adolescence (i.e. aged 13–17 years at injury), approximately 7.7 years (range = 6.7–8.0 years) prior, participated in the research. Semi-structured individual interviews, analysed using thematic analysis, explored participants’ experiences following their TBIs.
Thematic analysis of interview data produced two categories of themes: (1) Impacts on Important Areas of Life, which included: schoolwork suffered, career opportunities became limited, struggling with work and missing out socially; and (2) Impacts on Identity: with themes including feeling ‘stupid’, feeling self-conscious, loss of social identity and being dependent.
TBI sustained during adolescence can have broad impacts on important areas of life and on developing identity.
The coronavirus (COVID-19) pandemic and mandated physical distancing requirements significantly impacted volunteer programs for older persons with many long-standing programs either ceasing altogether or pivoting to connecting through virtual technologies. In this study, we collected qualitative interview data from 23 clients and 33 volunteers to investigate their experiences during the COVID-19 pandemic and the effects on the volunteer–client relationship. Three themes were identified: pandemic emotions, negotiating social interactions, and growing through the COVID-19 pandemic. These findings provide important insights into the experiences of hospice organizations and their volunteers and clients during the COVID 19 pandemic, further highlighting the importance of acknowledging both older persons’ vulnerability and their resilience, of building in compassionate community approaches to care, and of finding innovative ways to foster volunteer–client relationships during times when physical visiting is not possible.
To investigate the experiences of significant others when their loved one with a severe acquired brain injury (ABI) is being discharged from an ABI-specific rehabilitation unit.
Significant others of loved ones with an ABI participated in interviews close to their loved ones being discharged from inpatient ABI rehabilitation.
Semi-structured interviews were conducted, and thematic analysis applied. Additionally, the drawing method was also used which involved participants drawing what it was like for them as their loved one was going home. Image analysis was then combined with the interview data.
Eight significant others participated in interviews on discharge and completed a drawing describing their experience. Five themes were identified (Change, Mixed feelings, Support of family and friends, Journey and Staff interactions).
The experience of having a loved one with a severe ABI in rehabilitation is an emotional event. Compassionate communication, consistency of information and thorough discharge planning practices were cornerstones to enhancing the experience of significant others, empowering them to undertake their new role.
Measurement-based care (MBC) in mental health improves patient outcomes and is a component of many national guidelines for mental healthcare delivery. Nevertheless, MBC is not routinely integrated into clinical practice. Several known reasons for the lack of integration exist but one lesser explored variable is the subjective perspectives of providers and patients about MBC. Such perspectives are critical to understand facilitators and barriers to improve the integration of MBC into routine clinical practice.
This study aimed to uncover the perspectives of various stakeholders towards MBC within a single treatment centre.
Researchers conducted qualitative semi-structured interviews with patients (n = 15), family members (n = 7), case managers (n = 8) and psychiatrists (n = 6) engaged in an early-psychosis intervention programme. Data were analysed using thematic analysis, informed by critical realist theory.
Analysis converged on several themes. These include (a) implicit negative assumptions; (b) relevance and utility to practice; (c) equity versus flexibility; and (d) shared decision-making. Providers assumed patients’ perspectives of MBC were negative. Patients’ perspectives of MBC were actually favourable, particularly if MBC was used as an instrument to engage patients in shared decision-making and communication rather than as a dogmatic and rigid clinical decision tool.
This qualitative study presents the views of various stakeholders towards MBC, providing an in-depth examination of the barriers and facilitators to MBC through qualitative investigation. The findings from this study should be used to address the challenges organisations have experienced in implementing MBC.
A value reinforcement hypothesis expects that governance structures reinforce the values of the representative governments they serve. If a political system embraces pluralism and collective rationality as process values, its governance structures will enhance those process beliefs. If a government faces strong electoral accountability, its governance structures will emphasize accountability values, making identifiable managers likely to face sanctions for their performance. Correlations such as these would be observed if the hypothesis has potential for guiding a positive research agenda. The value reinforcement hypothesis has both institutional and behavioral mechanisms behind it.