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The purpose of this paper is to investigate the operation of multidisciplinary team (MDT) meetings within a forensic hospital in England, UK.

Mixed methods, including qualitative face to face interviews with professionals and service users, video observations of MDT meetings and documentary analysis. Data were collected from 142 staff and 30 service users who consented to take part in the research and analysed using the constant comparison technique of grounded theory and ethnography.

Decisions taken within MDT meetings are unequally shaped by the professional and personal values and assumptions of those involved, as well as by the power dynamics linked to the knowledge and responsibility of each member of the team. Service users’ involvement is marginalised. This is linked to a longstanding tradition of psychiatric paternalism in mental health care.

Future research should explore the nuances of interactions between MDT professionals and service users during the meetings, the language used and the approach taken by professionals to enable/empower service user to be actively involved.

Clear aims, responsibilities and implementation actions are a pre-requisite to effective MDT working. There is a need to give service users greater responsibility and power regarding their care.

While direct (video) observations were very difficult to achieve in secure settings, they enabled unmediated access to how people conducted themselves rather than having to rely only on their subjective accounts (from the interviews).

This article draws upon our perspective as academic-practitioners working in the fields of food insecurity, food systems, and inequality to comment, in the early stages of the pandemic and associated lockdown, on the empirical and ethical implications of COVID-19 for socio-economic inequalities in access to food in the UK. The COVID-19 pandemic has sharpened the profound insecurity of large segments of the UK population, an insecurity itself the product of a decade of “austerity” policies. Increased unemployment, reduced hours, and enforced self-isolation for multiple vulnerable groups is likely to lead to an increase in UK food insecurity, exacerbating diet-related health inequalities. The social and economic crisis associated with the pandemic has exposed the fragility of the system of food charity which, at present, is a key response to growing poverty. A vulnerable food system, with just-in-time supply chains, has been challenged by stockpiling. Resultant food supply issues at food banks, alongside rapidly increasing demand and reduced volunteer numbers, has undermined many food charities, especially independent food banks. In the light of this analysis, we make a series of recommendations. We call for an immediate end to the five week wait for Universal Credit and cash grants for low income households. We ask central and local government to recognise that many food aid providers are already at capacity and unable to adopt additional responsibilities. The government's – significant – response to the economic crisis associated with COVID-19 has underscored a key principle: it is the government's responsibility to protect population health, to guarantee household incomes, and to safeguard the economy. Millions of households were in poverty before the pandemic, and millions more will be so unless the government continues to protect household incomes through policy change.

The role of dialogue has recently been identified as being important in generating impact in organisations, but the purposeful use of narrative or story-based approaches to effect organisational change and service improvement is still relatively innovative. The purpose of this paper is to document and examine two projects in health and social care settings which aim to generate organisational development and service improvement.

The paper evaluates and compares two case studies of story-based organisational development and service improvement projects in the UK. This involved developing an appropriate evaluation framework and assessing the impacts in each case using semi-structured interviews and thematic content analysis.

This paper reports the diversity of impacts and outcomes that were generated by the projects. Specifically, it is argued that there is a strong indication that story-based projects best achieve their objectives when clearly linked to key organisational strategic drivers or pathways, as evidenced by robust evaluation.

This paper recommends that researchers and practitioners, working with story-based methods, design credible and robust evaluative practices, in order to evidence how their work supports organisations to meet current sector challenges. The paper recommends a flexible evaluation framework for evaluating story-based projects in the workplace.

This paper offers new evidence and insight into the impacts and outcomes of using story-based approaches, and a new evaluation framework for these sorts of projects.

Older people living in nursing homes have complex care needs and frequently need specialists’ advice and support that can be challenging to deliver in a rural setting. The aim of this paper is to describe a model of integrated care in a rural area supported by a nurse case manager.

A real-world evidence study of people living in Ribes de Freser nursing home, was conducted between specific timeframes in 2019 and 2022, comparing the casemix and outcomes of a traditional care model with the integrated interdisciplinary model.

The integrated care model led to a significant reduction in transfers to the emergency department, hospitalisations, outpatient medical visits and a reduction in the number of medicines. In addition, the number of residents receiving end-of-life care at the nursing home showed a substantial increase.

This case study contributes valuable evidence supporting the implementation of an integrated model of nurse case manager support in nursing homes, particularly in the rural contexts, where access to specialist medical staff may be limited. The findings highlight the potential benefits of person-centred integrated care for older adults, addressing their complex needs and improving end-of-life care in nursing home settings.

There is substantial research on the experiences, needs and well-being of unaccompanied refugee adolescents, but less is known about existential aspects of their lives. The purpose of the current study is to explore existential meaning-making among unaccompanied refugee children.

The informants in this study are young unaccompanied refugees (n = 30) living in Norway, and young Norwegians (n = 46). The authors undertook a secondary analysis of in-depth qualitative refugee interview data and a quantitative analysis of questionnaire data from Norwegian informants.

Both the refugee youths and the Norwegian youths expressed that social relationships and connections to others were most important for meaning. Moreover, both groups emphasized the importance of relatedness and generativity, i. e. commitment to worldly affairs beyond one’s immediate needs. The main differences between the two groups were related to the significance attached to religion and to loneliness.

The comparison between the two groups is only possible to some degree. Secondary analyses have some limitations, as well as strengths.

The findings may be useful for supporting young refugees, as they provide insights into less-studied aspects of their lives.

The originality of this study lies in the focus on and broad interpretation of meaning, of secondary data analyses, and of comparisons between youths that are refugees versus non-refugees.

The study aims to analyse library user preferences in the willingness to read and pay for e-books, using a sample of both active readers (users of public library services) and non-users (the general population).

Two empirical surveys were conducted from August to November of 2019; the research sample consisted of 1,334 users from the Municipal Library of Prague and 1,101 non-users from the general Czech population. The research was focussed on e-book user preferences. The willingness to pay (WTP) for e-book services and the determinants that affect this willingness were also examined.

The results show the specific approach of Czech readers, whose main determinant of WTP is not the content, but the price and method of its payment (allocation). Some people prefer a cheaper annual lump sum, whereas others may prefer a charge of small regular fees. The decision to pay depends on their reading or payment habits.

This study also aims to clarify the demand for various types of digital media in Czech libraries and the preferred distribution models. Furthermore, the study determines the dependence of the preferences of library users in their WTP for e-books using different evaluation models. The originality of this study is in the evaluation of the determinants of WTP for e-books, which makes this study unique, and the findings should contribute to the expansion of existing knowledge in the field of information science.

The purpose of this paper is to document the results and the impact of the ESRC-funded High Street UK 2020 (HSUK2020), a project designed to take the existing academic knowledge relating to retail and high street change directly to UK High Streets, to improve local decision-making and, ultimately, their vitality and viability.

Through a systematic literature review, and by following the tenets of engaged scholarship, the authors identified 201 factors that influence the vitality and viability of town centres. Through the consensus-building Delphi technique, a panel of 20 retail experts identified the top 25 priorities for action.

Taking a place management approach led to the development of a more strategic framework for regeneration, which consisted of repositioning, reinventing, rebranding and restructuring strategies (4R’s of regeneration). Collaboration with the project towns resulted in identification of the strategy area that would add the most value, and the impact of the 4R’s and the top 25 priorities is demonstrated via numerous town examples.

Knowledge exchange projects, such as High Street UK2020, have an important contribution to make, not by developing even more theory that is unlikely to get utilised, instead their contribution is to bring existing theory into practical use.

It is widely believed that transgender individuals in Nepal inject silicone for face and body manipulation, a phenomenon thought to be common among transgender individuals globally. Therefore, this qualitative study conducted in Nepal explored: (1) awareness of silicone use and sources of information; (2) reasons for using silicone; (3) notion of cost and quality of these procedures; (4) reported negative aspects, including side effects and (5) health seeking behaviors of Nepali transgender women.

The authors carried out eight focus group discussions (FGDs) with transgender women at four different districts of Nepal, five in the capital Kathmandu and three in different rural areas. We also interviewed three transgender women who preferred not to participate in the FGD but were happy to be interviewed separately. Similarly, six interviews with stakeholders working for sexual and gender minority populations were also conducted.

Most FGD participants were young (mean age 23.06 ± 3.9 years) and the majority (55%; n = 34) completed grade six to high school level. Peer networks of transgender people and the Internet were the more popular sources of information about silicone. The decision to use silicone was largely influenced by the desire to look beautiful and more feminine. Often they appear not to follow the recommended procedures for silicone use. Their health seeking behavior regarding side effects or complications of these procedures was very poor.

Findings reflect that targeted interventions aimed at transgender individuals should educate them on the use of silicone, as well as explore safe and affordable approaches to meet gender-related appearance needs of Nepali transgender people.