A qualitative study of parents' experiences using family support services: applying the concept of surface and depth

UK policy and practice endorses family support for child well-being. Achieving such support requires multi-agency approaches, that consider all aspects of parents’ and children’s lives and which offer practical, social and emotional help. The potential for services to make a positive impact on parents and their families will depend in part on the level and nature of engagement. In this paper a case is made for the application of the two-part ‘surface and depth’ concept for understanding how practitioners engage with families and how they might improve the chances of supporting sustainable differences for parents and families. To illustrate, qualitative data from a review of family centre support provided by a north of England local authority, are presented. The review was commissioned to explore why families often need to re-engage with intensive support services. Data are drawn from interviews with parents (n=18, recruited following a survey of all those registered with the service during April – May 2009) and discussions with family centre support workers (n=4) and following thematic analysis three dominant themes emerged: ‘resources available’, ‘staff approach’ and ‘real life’, were appraised in light of the ‘surface and depth’ concept. Much of the work with parents effectively dealt with pressing needs. This felt gratifying for both parent and worker and supported immediate service engagement. However, each noted that the more complex issues in parents’ lives went unchallenged and thus the sustainability of progress in terms of parenting practice was questionable. A ‘strengths focused’ approach by staff, that understood needs in the context of parents’ ‘real life’ circumstances was important to parent engagement. Thus, longer term benefits from family support requires practitioners to work with parents to problem solve immediate issues whilst also digging deeper to acknowledge and seek to resolve the more complex challenges parents face in their real lives

QICS work package 1: migration and trapping of CO2 from a reservoir to the seabed or land surface

Natural CO2 seeps can be used as analogues for studies into surface flux and impact resulting from leaking engineered geological CO2 reservoirs. However their long-lived nature often means that the local environment has either adapted or evolvedaround the seepage site. The ‘Quantifying Impact of carbon storage’ (QICS) experiment provides the solution to this issue by releasing CO2 into an environment previously untouched by CO2. Work Package 1 (WP1) of the QICS project is primarily concerned with the migration of CO2 in the subsurface and how to relate the results of the relatively shallow experiment to a full storage scale setting in the UK North Sea. The main objectives of WP1 are to investigate potential leakage pathways from the reservoir to the surface, determine possible leakage rates and assess the potential volumes of leaked CO2 that can reach the surface environment

An exploration into the experiences of health visitors delivering listening visits to women as an intervention for mild to moderate postnatal depression or anxiety

This study explored the experiences of health visitors carrying out listening visits, an intervention used to support women suffering from mild to moderate depression and anxiety in the postnatal period. Methods Thirty three health visitors from one single trust were surveyed using an online questionnaire. Follow up interviews were also carried out. Quantitative data from the questionnaires was analysed using descriptive statistics, answers to semi-structured questions within the survey were analysed using content analysis. Interview recordings were transcribed verbatim and analysed using the constant comparative method

Evaluating a telehealth intervention for urinalysis monitoring in children with neurogenic bladder

Telehealth as a community-monitoring project within children’s urology care is an innovative development. There is limited evidence of the inclusion of staff and parents in the early-stage development and later adoption of telehealth initiatives within routine urological nursing care or families’ management of their child’s bladder. The aim was to explore the experiences of key stakeholders (parents, clinicians, and technical experts) of the proof of concept telehealth intervention in terms of remote community-based urinalysis monitoring by parents of their child’s urine. A concurrent mixed-methods research design used soft systems methodology tools to inform data collection and analysis following interviews, observation, and e-surveys with stakeholders. Findings showed that the parents adopted aspects of the telehealth intervention (urinalysis) but were less engaged with the voiding diary and weighing. The parents gained confidence in decision-making and identified that the intervention reduced delays in their child receiving appropriate treatment, decreased the time burden, and improved engagement with general practitioners. Managing the additional workload was a challenge for the clinical team. Parental empowerment and self-efficacy were clear outcomes from the intervention. Parents exercised their confidence and control and were selective about which aspects of the intervention they perceived as having credibility and which they valued

Violence exposure and young people’s vulnerability, mental and physical health

Objectives To analyse the impact of being affected by domestic and/or relationship violence in early adolescence on indicators of health and wellbeing. Methods Secondary data analysis of a cross-sectional survey of 13-14 year-old pupils attending schools in north-west England; with variables relating to vulnerability, violence, mental and physical health. The sample of 9,626 represented 71% of the eligible population. Chi-squared tests and logistic regression were used to analyse demographic exposure to violence and outcomes. Results Pupils affected by domestic and/or relationship violence had significantly worse outcomes and experiences than non-affected peers. Odds ratios demonstrated higher risks of being lonely, being bullied or having deliberately self-harmed. They were also more likely to report an enduring health condition, poorer health practices and worse access to and experiences of health services. Conclusions Exposure to violence in domestic and/or relationships is detrimental to children and young people’s mental and physical health and vulnerability. Health risks and inequalities reported by CYP in this study provide compelling intelligence for renewed strategic policy level consideration in the design and delivery of young peoples’ health services

Making a difference for children and families: an appreciative inquiry of health visitor values and why they start and stay in post

The study aimed to develop an understanding of health visitor recruitment and retention by examining what existing staff and new recruits wanted from their job, their professional aspirations and what would encourage them to start and stay in employment. Following a period of steady decline in numbers, the health visitor workforce in England has recently been invested in and expanded to deliver universal child public health. To capitalise on this large investment, managers need an understanding of factors influencing workforce retention and continuing recruitment of health visitors. The study was designed using an interpretive approach and involved students (n = 17) and qualified health visitors (n = 22) from the north and south of England. Appreciative inquiry (AI) exercises were used as methods of data collection during 2012. During AI exercises students and health visitors wrote about ‘a practice experience you have felt excited and motivated by and briefly describe the factors that contributed to this’. Participants were invited to discuss their written accounts of practice with a peer during an audio-recorded sharing session. Participants gave consent for written accounts and transcribed recordings to be used as study data, which was examined using framework analysis. In exploring personal meanings of health visiting, participants spoke about the common aspiration to make a difference to children and families. To achieve this, they expected their job to allow them to: connect with families; work with others; use their knowledge, skills and experience; use professional autonomy. The study offers new insights into health visitors’ aspirations, showing consistency with conceptual explanations of optimal professional practice. Psychological contract theory illustrates connections between professional aspirations and work commitment. Managers can use these findings as part of workforce recruitment and retention strategies and for building on the health visitor commitment to making a difference to children and families

A Critical Analysis of the Conventionally Employed Creep Lifing Methods

The deformation of structural alloys presents problems for power plants and aerospace applications due to the demand for elevated temperatures for higher efficiencies and reductions in greenhouse gas emissions. The materials used in such applications experience harsh environments which may lead to deformation and failure of critical components. To avoid such catastrophic failures and also increase efficiency, future designs must utilise novel/improved alloy systems with enhanced temperature capability. In recognising this issue, a detailed understanding of creep is essential for the success of these designs by ensuring components do not experience excessive deformation which may ultimately lead to failure. To achieve this, a variety of parametric methods have been developed to quantify creep and creep fracture in high temperature applications. This study reviews a number of well-known traditionally employed creep lifing methods with some more recent approaches also included. The first section of this paper focuses on predicting the long-term creep rupture properties which is an area of interest for the power generation sector. The second section looks at pre-defined strains and the re-production of full creep curves based on available data which is pertinent to the aerospace industry where components are replaced before failure