Growing Well-beings: the Positive Experience of Care Farms

Objectives: Care farms enable people who are in some way vulnerable to engage with agricultural places and farming activities. This study investigates how this impacts on the health and well-being of service users and explores associated processes and outcomes. Design: A mixed methods design was adopted that allowed for the integration of quantitative measurements of change with qualitative descriptions of this change. A pragmatic approach provided sufficient flexibility to support the investigation of complex contexts. Methods: A total of 216 service users completed an initial questionnaire, and 137 (63%) of this number provided comparative data in a follow-up questionnaire. Questionnaires contained multiple choice and open-ended questions alongside standardized health and well-being measures requiring Likert-format responses. Semi-structured interviews with 33 service users allowed personal experiences to be detailed. Results: Statistical analysis of well-being measure scores identified significant positive relationships with the length of time people had been attending the care farm. Questionnaire and interview data presented health benefits as being enabled by the farm environment, the positive experience as supporting personal development, and associated social interactions as becoming increasingly influential as time progressed. Conclusions: The health and well-being outcomes that result from participating at a care farm influence multiple elements of the human condition and apply amongst vulnerable people with a wide range of personal needs. Care farms have access to a potentially unique range of resources that can support many service users in becoming happier and healthier individuals.

Myths and Realities of Inter-professional Working

Introduction: Childhood cancers are rare and community based health care professionals have limited experience in caring for these children and often even less experience in providing their palliative care. It is well recognised that the provision of palliative care falls beyond the remit of any one profession, thus inter professional working is the standard model. This qualitative study aims to examine the experiences of the range of health care professionals involved in providing palliative care at home for children with cancer, focusing on how knowledge is exchanged; the level of communication and support both interprofessionally and at the community/specialist interface. It also aims to examine interprofessional collaboration in palliative care; identifying healthcare professional's perceptions of problems involved, interprofessional boundaries, specific areas of the organisation or provision of care that could be enhanced through changes in practice, support issues and the educational needs of health professionals. Methods The study involves three types of data collection; in-depth interviews, facilitated case discussion (FCD) and field notes from up to 20 cases (a "case" refers to the provision of palliative care to one child). Cases are selected from children who were treated at one regional childhood caner centre. For each case the community based health care professionals (for example the GP, community nurse or health visitor) involved in the care of the child at home are invited to participate in a one-to-one tape recorded in-depth interview followed by a group discussion in the form of a FCD. Field notes are completed following each interview. Data analysis follows a grounded theory approach. The term "social worlds theory" (SWT) his used to define a type of social organisation with no fixed or formal boundaries (such as membership boundaries), for example the range of health professionals that work together to provide palliative care. The boundaries of SW's are determined by the interaction and communication between recognised organisations, such as community nursing teams and general practitioners. SWT examines encounters between different professional groups and can be used to extend knowledge in both the organisation (for example general practice) and the content of what is being provisioned (for example, palliative care). The use of SWT in the analysis of the data is through examining the ethos of the different professions and the associated individual approaches to palliative care, exploring how this determines their roles in the provision of palliative care. Results 10 cases have so far been completed: 47 1:1 interviews (with a range of between 2-7 health care professionals being involved in each case): ( 9 x GP, 19 x CCN, 4 x DN, 3 x HV, 1 x HV assistant 7 x paediatric palliative care nurses, 1 x home support worker, 1 x OT, 1 x physiotherapist, 1 x community paediatrician) and 5 x FCD. The range of participants in the FCDs reflected that of the individual interview sampler. Data obtained to date gives clear insight into the personal experience of the individual health care professional in providing palliative care. Two themes emerging from the data will be focused upon: the continuity of care provision throughout treatment and palliation and the emotional burden experiences by the health care professional. Conclusions SWT can provide a useful framework in examining the social worlds of a disparate group of health care professionals working together for the first and maybe, the only time. A wide variation in the continuity of care provision has been found not only between professions, but also within professions. The emotional burden is evident across the professions.

Identifying Risk Factors for Postpartum Mood Episodes in Bipolar Disorder – A UK Prospective Study

Background and Aims: Women with bipolar disorder are vulnerable to episodes postpartum, but risk factors are poorly understood. We are exploring risk factors for postpartum mood episodes in women with bipolar disorder using a prospective longitudinal design. Methods: Pregnant women with lifetime DSM-IV bipolar disorder are being recruited into the Bipolar Disorder Research Network (www.BDRN.org). Baseline assessments during late pregnancy include lifetime psychopathology and potential risk factors for perinatal episodes such as medication use, sleep, obstetric factors, and psychosocial factors. Blood samples are taken for genetic analysis. Perinatal psychopathology is assessed via follow-up interview at 12-weeks postpartum. Interview data are supplemented by clinician questionnaires and case-note review. Potential risk factors will be compared between women who experience perinatal episodes and those who remain well. Results: 80 participants have been recruited to date. 32/61 (52%) women had a perinatal recurrence by follow-up. 16 (26%) had onset in pregnancy. 21 (34%) had postpartum onset, 19 (90%) within 6-weeks of delivery: 11 (18%) postpartum psychosis, 5 (8%) postpartum hypomania, 5 (8%) postpartum depression. Postpartum relapse was more frequent in women with bipolar-I than bipolar-II disorder (45% vs 17%). 62% women with postpartum relapse took prophylactic medication peripartum and almost all received care from secondary psychiatric services (95%). Conclusions: Rate of postpartum relapse is high, despite most women receiving specialist care and medication perinatally. A larger sample size will allow us to examine potential risk factors for postpartum episodes, which will assist in providing accurate and personalised advice to women with bipolar disorder who are considering pregnancy.

The Perceived Benefits of an Arts Project for Health and Wellbeing of Older Offenders

Background: The increasing ageing prison population is becoming a pressing issue throughout the criminal justice system. Alongside the rising population, are a host of health and wellbeing issues that contribute to older offenders needs whilst in prison. It has been recommended that meaningful activities can have positive effects on this population and therefore this paper uniquely reviews older offenders accounts of taking part in an arts based project, Good Vibrations, whilst imprisoned. Objective and design: The Good Vibrations project engages individuals in Gamelan music making with an end of project performance. This study used independent in-depth interviews to capture the voices of older offenders who took part in an art based prison project. Analysis and Results: The interview data was analysed using thematic analysis, which highlighted themes that were consistent with other populations who have taken part in a Good Vibrations project, along with specific age relating issues of mobility, motivation, identity and wellbeing.

Social Capital in Jordan: Wasta in Employment Selection

Social capital has emerged as a concept of great interest and potential to help understand and explain how social structures and networks impact political, social and business practices at the collective and individual levels. The basic premise is: investment in social relations will yield expected returns. Extant research has largely focused on the West; our knowledge of how social capital plays out in the Middle East is limited. We marry social capital with ‘wasta’, the strong family and tribal based connections secured in networks in the Arab world, and investigate HR managers’ perceptions of wasta in employment selection in Jordan. Often use of wasta in employment selection is related to favouritism and nepotism and the many negative outcomes of not adhering to merit-based selection. Through in-depth interview data we reveal a more nuanced and multifaceted view of wasta in employment selection. When examined through the social capital lens six distinct themes emerge: (i) wasta as an enabler to get jobs, (ii) wasta as social ties/ solidarity, (iii) wasta as a method to transfer/ attain information, (iv) wasta as a guide in decision-making, (v) wasta as an exchange, and (vi) wasta as pressure. Our findings confirm that at times wasta grants individuals unfair access to employment that is beyond their qualifications, skills, knowledge and/ or abilities. However, organisational context is relevant. In banking, not all roles are open to wasta. Where the possible negative impact on the organisation poses too great a risk HR managers feel able to resist even strong wasta. Context also emerges as being of key importance with regards to the background and business model of an organisation. Family businesses tend to operate wasta more frequently and extensively using tribal connections, religious networks and geographical area based networks as a key source in hiring. Despite globalisation and international nature of banking, wasta and tribalism feature strongly in daily business conduct in Jordan. Our paper illuminates the positive effects of wasta, e.g.as a method to transfer information, together with discussion on the dangers of ‘cloning’, a (lack of diversity), and the dangers of an incompetent workforce .

Enhancing Student Learning Experiences in Sport Psychology Modules Using Practical Activities

The University of Worcester states in its most recent strategic plan (2013 – 2018) a set of enduring values that guide and direct the activities of the institution. The first listed, and perhaps the most important value is the striving to be “an outstanding university at which to be a student”. This is further supplemented by values such as “to inspire our students to reach their full potential through excellent, innovative teaching, scholarship and research” (University of Worcester 2013: p.4). One of the many ways in which the institution strives to provide this outstanding educational experience is through regular engagement, both formal and informal, with students at a number of points in each semester. Regular experiences of collating formal and informal feedback has led to the identification of a common theme amongst Higher National Diploma (HND) students in the Institute of Sport and Exercise Sciences (ISES), where they consistently request ‘more practicals’. The ISES modules however are designed to incorporate a high degree of interaction, practical activities and tasks. This is especially important for those studying at HND level as research suggests differences in learning preferences exist when compared to undergraduate students, the former preferring a more tactile style of learning (Peters et al. 2008). Using an introductory Sport Psychology HND module as an example, practical activities and tasks are fully embedded in the taught sessions to enable contextual links to be made between the learning outcomes and their subsequent use. Examples of these include: a. interviewing athletes to produce a performance profile (Butler & Hardy 1992); b. completing psychometric instruments such as the Competitive State Anxiety Inventory-2 (CSAI-2) to measure competitive anxiety in sport (Martens et al. 1990) and demonstrate data collection and construct measurement; c. performing relaxation interventions on the students to demonstrate how specific techniques (in this instance, decreasing somatic anxiety) might work in practice; d. demonstrating how observational learning facilitates skill acquisition by creating experimental conditions that the students participate in, in teaching a new skill. Nevertheless owing to the students' previously stated on-going requests for more practical activities, it became evident that assumptions about what students consider an effective means of experiential or active learning in the context of sport-related disciplines of study needed to be investigated. This is where the opportunity to undertake an action research project arose, this being a practical method commonly employed in pedagogical enquiry to aid reflection on teaching and assessment practice for the purposes of working towards continuous improvement.

The Development of Entrepreneurial Drive During the University Business School Experience

This research investigates changes in entrepreneurial drive (ED) between each of the three-year levels of students at an undergraduate UK university business school in order to test this measurement construct within a European context. The research adopted a quantitative approach to determine whether the ED measurement instrument could identify differences in the students’ ED dimensions and the overall ED across the three different years of undergraduate study. The data was subjected to principle component analysis to create factor scores for the ED components and the multivariate analysis of variance tests to determine whether different year groups exhibited different levels of ED. The research found that the total ED score increased at each successive year level. In addition, the achievement motivation, proactive disposition, and self-efficacy factors (dimensions) all increased during the university experience. As such, this research confirms the value of the ED measurement instrument in assessing the development of entrepreneurial drive within a European higher education setting.

Narratives of Variation in Teacher-Pupil Relationships Across a Career

This paper reports on the findings of a research study focused on teacher perceptions of their relationships with pupils over three phases of a career. Data collected from thirty primary school teachers using a critical event narrative approach were coded and compared across the three groups of teachers at different points in their careers; 0-7 years, 8-23 years, and over 24 years. The study, based in the United Kingdom, highlighted a complex development amongst teachers which centres on five key areas identified as differentiating between the three career phases; interaction, behaviour, expectations, proximity and control. Results indicate that teachers go through a series of relationship transitions in relation to these five areas, and that these transitions can often confront teachers with conflicting views of what positive teacher-pupil relationships are and create personal dissonance as they try to make sense of their role in these relationships. Based on empirical evidence, this paper argues that positive relationships with pupils are not necessarily associated with experience and that the transitions teachers experience through their career is of concern given the centrality of teacher-pupil relationships to effective teaching.

Understanding the Patient Experience Through the Power of Film: a Mixed Method Qualitative Research Project

Film is a highly attractive teaching instrument for the study of different terminal diseases, exploring bioethics (Beauchamp and Childress, 2009) and is a preferred medium over traditional lectures (Edmunds, 2013) to provide realistic examples for adult learners. It can tap into ethical issues; facilitate decision-making; and examine underlying issues such as euthanasia; assisted suicide; and professional responsibility. Contrast this with standard means of teaching, such as scenarios- although a useful pedagogic tool, these are limited because students must imagine the clinical scenario. Film can fill that imaginative gap (Volandes, 2007). It can be utilised as an active teaching strategy for a variety of topics in nursing (Edmunds, 2013) providing a unique way to promote active learning in nursing education (Herrman, 2006). The objectives of the study, aim to help pre registration student nurses from each year of study to engage with their role as health care professionals; provide open discussion and debate on how they view the personal experience of illness/disease/disability/death and to reflect on their role and provision of patient care. It is delivered in 3 tiers to provide a range of data for thematic analysis; 1) Film screening followed by a ‘5 minute reaction’ discussion and post screening questionnaire; 2) Pre screening guided activities for reflection and discussion; 3) Focus groups. This project meets identified aims from the UK Professional Standards Framework (UKPSF) by fostering creative and innovative approaches to teaching and learning; facilitating and supporting the design and delivery of continuing education development programmes and activities; and demonstrates professionalism that staff and institutions bring to teaching. Preliminary feedback and themes will be presented.