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Developing resilience is vital for firefighters and other practitioners exposed to trauma as part of their day-to-day work in maintaining physical and mental resilience. However, further understanding of what factors facilitate and hinder the development of firefighter resilience and why is needed. The current study evaluates efficacy of support mechanisms currently in place and develops an evidence base for interventions to support development of firefighter resilience.

Semi-structured interviews were conducted with 12 firefighters from across two regions in the United Kingdom, the Northwest and Southeast of England. Thematic analysis was used to analyse transcripts, highlighting themes within, and across, services to identify what factors affect development of firefighter resilience and why.

Thematic analysis highlighted four key themes shared by firefighters across regions: “informal support”, “formal support”, “basic welfare measures” and “trust”. Importantly, how effective formal measures are perceived to be and the willingness for firefighters to access these resources was dependent upon the level of trust held in senior management. Firefighters across locations highlighted levels of trust were affected by industrial actions which created divides. Accordingly, one way firefighter resilience may be further promoted is by altering how formal support mechanisms are accessed.

Although existing research has found factors which promote resilience of firefighters, evaluation of specific services is lacking. The current research highlights areas among two UK services where resilience is effectively being promoted and areas for potential improvement.

THE beginning of a new volume is always a matter of concern both to its Editor and to its Readers. It is usual to be able to forecast some programme of work or at least policy, for the year then opening. At the moment what is usual is not here; we have the cessation of actual battle in Europe, it is true; but we are as involved in Asia as we have ever been and, in spite of the optimists, the end is not in view. It would be well, too, for us always to realize that while there is no battle here, there is conflict with disease, want, misery and homelessness on a scale never approached before. It is certain only that men of goodwill, amongst whom librarians hope they are numbered, are awake to the situation and anxious to help. Thus, in our pages we shall endeavour to keep open minds and ideas adapted to our changing world before our readers.

Health service effectiveness continues to be limited by misaligned objectives between policy makers and frontline clinicians. While capturing the discretion workers inevitably exercise, the concept of “street-level bureaucracy” has tended to artificially separate policy makers and workers. The purpose of this paper is to understand the role of social-organizational context in aligning policy with practice.

This mixed-method participatory study focuses on a locally developed tool to implement an Australia-wide strategy to engage and respond to mental health services for parents with mental illness. Researchers: completed 69 client file audits; administered 64 staff surveys; conducted 24 interviews and focus groups (64 participants) with staff and a consumer representative; and observed eight staff meetings, in an acute and sub-acute mental health unit. Data were analyzed using content analysis, thematic analysis and descriptive statistics.

Based on successes and shortcomings of the implementation (assessment completed for only 30 percent of clients), a model of integration is presented, distinguishing “assimilist” from “externalist” positions. These depend on the degree to which, and how, the work environment affords clinicians the setting to coordinate efforts to take account of clients’ personal and social needs. This was particularly so for allied health clinicians and nurses undertaking sub-acute rehabilitative-transitional work.

A new conceptualization of street-level bureaucracy is offered. Rather than as disconnected, it is a process of mutual influence among interdependent actors. This positioning can serve as a framework to evaluate how and under what circumstances discretion is appropriate, and to be supported by managers and policy makers to optimize client-defined needs.

Interventions to hasten patient discharge continue to proliferate despite evidence that they may be achieving diminishing returns. To better understand what such interventions can be expected to accomplish, the authors aim to critically examine their underlying program theory.

Within a broader study on patient flow, spanning 10 jurisdictions across Western Canada, the authors conducted in-depth interviews with 300 senior, middle and frontline managers; 174 discussed discharge initiatives. Using thematic analysis informed by a Realistic Evaluation lens, the authors identified the mechanisms by which discharge activities were believed to produce their impacts and the strategies and context factors necessary to trigger the intended mechanisms.

Managers' accounts suggested a common program theory that applied to a wide variety of discharge initiatives. The chief mechanism was inculcation of a sharp focus on discharge; reinforcing mechanisms included development of shared understanding and a sense of accountability. Participants reported that these mechanisms were difficult to produce and sustain, requiring continual active management and repeated (re)introduction of interventions. This reflected a context in which providers, already overwhelmed with competing demands, were unlikely to be able (or perhaps even willing) to sustain a focus on this particular aspect of care.

The finding that “discharge focus” emerged as the core mechanism of discharge interventions helps to explain why such initiatives may be achieving limited benefit. There is a need for interventions that promote timely discharge without relying on this highly problematic mechanism.

This chapter examines the associations between gender, social support, and health outcomes for individuals living with HIV disease. We include social integration and social isolation as structural measures of social support as well as perceived social support and social conflict as functional measures of social support. We include both mental health and physical health outcomes, which are too often studied in isolation of each other.

Data are from the Coping with HIV/AIDS in the Southeast (CHASE) study; this study reports on baseline data from 611 participants collected from 2001 to 2002. We first examined differences by gender and race, and then used blocked linear regression to determine the additive effects of the social support variables on both mental and physical health outcomes while controlling for potential confounders.

There were notable differences in the significance and strength of social support variables in health outcome models for men and women. Unlike men, social conflict was the strongest predictor of greater psychological distress and poorer physical health-related quality of life among women.

While the results from this study contribute to a greater understanding of gender differences in the relationships between social support and health outcomes, the data used for this study are limited to those living with HIV/AIDS in the Southeast.

Our findings suggest that social conflict may be more detrimental for the health of women than men.

The purpose of this paper is to provide a preliminary outline of the international presence, commonality and differences between Recovery Colleges.

This study used a short e-mailed survey to create a map of Recovery Colleges internationally and review Recovery Colleges outside the UK. Questions gathered descriptive and qualitative data to gain an overview of the mode of delivery and aspects respondents felt were noteworthy.

This paper identifies Recovery Colleges in 22 countries in five continents (including the UK). Participants described wide variance in their context. Despite adaptations, the operational models and inherent principles of each were closely aligned to those developed in the UK.

This paper provides the first baseline of Recovery Colleges on an international scale. It provides evidence of a high degree of commonality despite variance in setting and highlights the internationally valued transformational power of this model.

This qualitative study was an exploration on the process of self-reflection on identity. The purpose of this paper is to see how mirrors could be used as a therapeutic tool and a meta-physical bridge to one's inner consciousness.

An intergenerational expressive arts group (n=12) was organized around the question of identity. Following an open-discussion around the topic of identity, participants were asked to decorate a mirror with words, images, and/or symbols while reflecting on the question, “Who am I?” A post-session interview was conducted regarding participant's experiences during the creative process.

The results indicated that mirrors can be used to connect to one's inner thoughts and feelings on the question of identity. Three core themes in the process of self-reflection on identity were revealed which included introspection and self-concern, connection and attachment to something or someone other than self, and taking action to help others.

This study was limited not only in size, but also in cultural diversity and disparity of age range. Although this study was limited, it provided a useful indicator for identifying core themes in the process of self-reflection on identity.

While there have been no studies on the therapeutic use of mirrors as a tool for self-reflection and limited intergenerational studies with pre-adolescent and adolescent students and older adults, results from this study will add to the body of expressive arts literature by providing a new metaphor for mirrors as a therapeutic tool for self-reflection on identity.

Trans theory (also known as transgender studies) is a rapidly expanding interdisciplinary field in which activism, scholarship and lived experience are coalescing around questions of embodiment, personhood, and intersections of race/ethnicity/class/ability/gender/sexuality. Trans-themed research, whether explicitly located in trans theory or not, is a growing area of academic exploration. As a trans researcher and trans person, I am interested in two questions: how does autoethnography fit within trans and queer theory, and how can people who do not live in trans communities undertake ethical trans-related research? A symbolic interactionist perspective informs my understanding of trans theory and the social construction of identity and embodiment. I explore my own femme transmasculinity through autoethnography, and also consider my experience interviewing other trans people as part of researching masculinity. I suggest that researchers who are not trans (who are cisgendered, meaning they identify with the sex/gender they were assigned at birth) must accept that trans people have what Talia Bettcher (2009a, 2009b) terms First Person Authority over their embodiment, experience, and narratives. Having established this, I examine self-identification and intersubjective recognition in relation to my own experience of femme transmasculinity, asking what is femme incoherence and how does this relate to queer and trans theory/politics?

The term luxury and sustainability, within the fashion and textile industries are seldom seen as natural bedfellows. Recently however, the perception of luxury has begun to include a definition left behind in the twentieth century; beautifully hand crafted artefacts valued for the time, skill and design invested in them. It is possible though, for the concept of luxury textiles to embrace this definition and that of the sustainable credentials of a “Cradle to Cradle” (McDonough and Braungart, 2002) mindset (that of a life beyond original creation) and be fashionable. The paper aims to discuss these issues.

Utilising a variety of methodologies including case studies, reflective practice and a practice-based approach; this paper examines the use of pre-consumer waste in the creation of new luxury textiles. Several projects are cited, offering examples of collaboration between textile mills and designers in the creation of new fabrics made from luxury by-products. This luxury waste is routinely shredded for automobile seat filling or landfill, however current sustainable thinking encourages a more creative solution to this circumstance. Designers have a crucial role to play in converting an unwanted by-product to one that is highly desirable.

Traditional values of what constitutes a luxury item include the concept of time invested in making a unique handmade artefact. More recently, this premise has been overlooked in favour of branded goods. The slow fashion movement advocates the inherent value of craftsmanship coupled with the ethical use of sustainable and or local materials and processes. The traditional techniques of felting, weave and stitch are utilised to create beautiful, original textiles from discarded waste. By collaborating with local mills, designers provide solutions to something that could be perceived as a problem.

The embedded narrative within these layered textiles provides an original quality and added value, building on their Scottish heritage. The resulting textiles reflect their provenance; the landscape they come from and the people who created them. As a result of purchase, the story continues with the new custodian, adding to the ongoing history of the textile. The design work and collaboration that this paper outlines embodies a transferable model for sustainable upcycled luxury textiles.