• Factors influencing routine cognitive impairment screening in older at-risk drinkers: findings from a qualitative study in the United Kingdom

      Madoc-Jones, Iolo; Wadd, Sarah; Elliott, Lawrie; Whittaker, Anne; Adnum, Laura; Close, Ciara; Seddon, Jennifer L.; Dutton, Maureen; McCann, Michelle; Wilson, Fiona (Wiley, 2020-07-14)
      Cognitive Impairment (CI) screening is recommended for those engaged in harmful levels of alcohol use. However, there is a lack of evidence on implementation. This paper explores the barriers and facilitators to CI screening experienced across a service specifically for older drinkers. The findings draw on data gathered as part of an evaluation of a multilevel programme to reduce alcohol-related harm in adults aged 50 and over in five demonstration areas across the United Kingdom. It is based on qualitative interviews and focus groups with 14 service providers and 22 service users. Findings are presented thematically under the section headings: acceptability of screening, interpretation and making sense of screening and treatment options. It is suggested that engagement with CI screening is most likely when its fit with agency culture and its purpose is clear; where service providers have the technical skills to administer and discuss the results of screening with service users; and where those undertaking screening have had the opportunity to reflect on their own experience of being screened. Engagement with CI screening is also most likely where specific intervention pathways and engagement practices can be accessed to respond to assessed need.
    • Pathways of disadvantage: walking as a mode of transport among low-income mothers

      Bostock, Lisa (Wiley, 2000-09-09)
      Research shows that lack of car ownership is associated with poorer health. It is often assumed that the reason for this observed relationship is that access to a car ‹ or not ‹ reflects access to household assets. Consequently, lack of car ownership is used as a standard marker of low socio-economic status. However, little attention has been paid to the experience of carlessness in the context of disadvantaged lives. This paper argues that 'no access to a car' is not only an indicator of low socio-economic status but of walking as a mode of transport. These arguments are illustrated by data from a study of 30 low-income mothers with young children. Although walking is promoted as both an excellent and inexpensive form of exercise, these data suggest that reliance on walking can have negative effects on the welfare of families. The paper draws on qualitative data to describe the ways in which carlessness restricts access to health and social care resources such as food shops, health-care services and social networks. It also explores the impact of walking on the well being of mothers and their day-to-day relationships with children. This is compounded by walking through areas that are neglected and depressed. The paper concludes that strategies to reduce social exclusion must recognise the contradictory health effects of walking and aim to regenerate the physical fabric of social housing estates as well as improve public transport options.
    • Resurrecting the interval of need concept to improve dialogue between researchers, policymakers, and social care practitioners

      Willis, Rosalind; Channon, Andrew Amos; Viana, Joe; LaValle Masters, Maria Herica; Hutchinson, Aisha; University of Southampton; Akershus University Hospital; University of Bedfordshire (Wiley, 2019-05-29)
      Academics, social care practitioners, and policymakers speak different languages. If academic research is to have an impact on society, it must be understandable and convincing to the end users. We argue that the conceptualisation of social care “need” is different among these stakeholders, leading to poor  communication between them. Academics should use concepts that have more meaning to practitioners. We propose resurrecting a little‐used concept from the 1970s, “interval of need”, to help to bridge this gap. The interval of need concept identifies how often people require help, supplementing the usual data about types of tasks where assistance is needed. The history of the concept is described, followed by a test of its usefulness for today's researchers by applying it to data from the English Longitudinal Study of Ageing. An updated version of interval of need is proposed. Validation checks were conducted against mortality data, and through conceptual validation from a social work practitioner. The nature of the dataset limited comparability with previous studies. However, we conclude that the interval of need concept has promising scope to enhance communication of research findings, potentially leading to improved outcomes for service users. This paper strives to mark a turning point in the language and analysis of social care, ensuring that academic investigation in this field is convincing and clear to practitioners and policymakers.
    • What do we know about transgender parenting?: findings from a systematic review

      Hafford-Letchfield, Trish; Cocker, Christine; Rutter, Deborah; Tinarwo, Moreblessing; McCormack, Keira; Manning, Rebecca; Middlesex University; University of East Anglia; University of Bedfordshire; Gender Essence & Essence Arts, Belfast; et al. (Blackwell Publishing Ltd, 2019-04-14)
      Transgender issues are under-explored and marginalised within mainstream social work and social care professional practice. The experience of gender transition has a profound impact on the individuals who have diverse gender identities and their family members. We present findings from a systematic review of studies concerning the experiences of transgender parenting conducted during January–September 2017. We took a life course approach, examining the research studies that investigated the experience of people identifying as transgender, who were already parents at the time of their transition or who wished to be parents following transition. The review evaluated existing findings from empirical research on transgender parenting and grandparenting to establish how trans people negotiate their relationships with children following transition, and sought to consider the implications for professional practice with trans people in relation to how best to support them with their family caring roles. We used the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) method. Empirical studies published from 1 January 1990 to 31 April 2017 in the English language, and which had transgender parenting as a significant focus, were included in the review. Twenty-six studies met the criteria. Key themes reported are: how trans people negotiate their relationships with children following disclosure and transition; the impact of parental transitioning on children; relationships with wider families; trans people's desires to be parents; and the role of professional practice to support trans families. We discuss how the material from the review can inform social work education and practice, including to help identify future research, education and practice priorities in this area.