Item Metadata onlyObstetric and neonatal outcomes in pregnant women with and without a history of specialist mental healthcare: a national population-based cohort study using linked routinely collected data in England.(Lancet, 2023-08-14) Langham, J.; Gurol-Urganci, I.; Muller, P.; Webster, K.; Tassie, E.; Heslin, M.; Byford, S.; Khalil, A.; Harris, T.; Sharp, H.; Pasupathy, D.; van der Meulen, J.; Howard, L.; O'Mahen, H.Background: Pregnant women with pre-existing mental illness have increased risks of adverse obstetric and neonatal outcomes. We estimated these difference in risks according to the highest level of pre-pregnancy specialist mental healthcare, defined as psychiatric hospital admission, crisis resolution team (CRT) contact, or specialist community care only, and the timing of the most recent care episode within 7 years before pregnancy. Methods: Hospital and birth registration records of women with singleton births between 2014 and 2018 in England were linked to records of babies and records from specialist mental health services, provided by the English National Health Service, a publicly funded healthcare system. Composite indicators captured neonatal adverse outcomes and maternal morbidity. We calculated odds ratios (ORs), adjusted for maternal characteristics. Outcomes: Of 2,081,043 included women (mean age 30.0 years; range 18 to 55 years; 77.7% White, 11.1% South Asian, 4.7% Black and 6.2% other ethnic background), 151,770 (7·3%) had at least one pre-pregnancy specialist mental healthcare contact. 7,247 (0·3%) had been admitted, 29,770 (1·4%) had CRT contact, and 114,753 (5·5%) had community care only. With a pre-pregnancy mental healthcare contact, risk of stillbirth or neonatal death within seven days was not significantly increased (0·45% to 0·49%; OR 1·11, 95%CI 0·99–1·24). Risk of preterm birth (<37 weeks) increased (6·5% to 9·8%; OR 1·53, 1·35–1·73) as did risk of small for gestational age (birthweight <10th percentile) (6·2% to 7·5%; OR 1·34, 1·30–1·37), and neonatal adverse outcomes (6·4% to 8·4%; OR 1·37, 1·21–1·55). With a pre-pregnancy mental healthcare contact, maternal morbidity increased slightly from 0·9% to 1·0% (OR 1·18, 1·12–1·25). Overall, risks were highest for women who had a psychiatric hospital admission any time or a mental healthcare contact in the year before pregnancy. Interpretation: Information about level and timing of pre-pregnancy specialist mental healthcare contacts can support identifying pregnant women at increased risk of adverse obstetric and neonatal outcomes, most likely to benefit from integrated perinatal mental health and obstetric care. Item Metadata onlyAccessing care services after sexual violence: A systematic review exploring experiences of women in South Africa(AOSIS, 2023-10-25) Hinsliff-Smith, Kathryn; McGarry, Julie; Griffiths, Sarah; Randa, MoreoagaeBackground: Sexual violence against women is a global phenomenon. This is a particular issue in South Africa, where it is estimated with evidence provided that up to half of all women will encounter gender-based and/or sexual violence from a partner during their lifetime. Therefore, evidence suggests that addressing the needs of women in South Africa is a priority. Objective: This qualitative review aimed to explore the experiences of women seeking care from first contact healthcare facilities in South Africa after sexual violence and during follow-up care. Method: This systematic review was conducted using the PRISMA checklist for systematic reviews and in line with a published protocol (PROSPERO, CRD42019121580) and searched six relevant databases in 2022. A total of 299 sources were screened, with 5 forming the overall synthesis. Results: Two synthesised themes of women’s experiences emerged at the time of reporting and during attendance at follow-up healthcare services. Conclusion: South Africa does have an established legal framework for prosecution and can provide support for survivors of sexual violence through established Thuthuzela Care Centres (TCCs). The review identifies that survivors’ needs are not clearly established when seeking medical attention initially nor identifying support or appropriate pathways. Contribution: The review has the potential to characterise the support available for women, the type and nature of sexual violence and interventions that may be used by healthcare professionals to support survivors especially during follow-up care. Item Metadata onlyIdentifying and Managing Frailty: A Survey of UK Healthcare Professionals(Sage, 2023-10-20) Hinsliff-Smith, Kathryn; Gordon, Adam; Frost, Rachael; Gavin, James; Gaiolla, Paula; Robinson, Katie; Caldeira De Melo, Ruth; Villas Boas, Paulo J. F.Frailty is a common condition that leads to multiple adverse outcomes. Frailty should be identified and managed in a holistic, evidence-based and patient-centered way. We aimed to understand how UK healthcare professionals (HCPs) identify and manage frailty in comparison with UK Fit for Frailty guidelines, their frailty training, their confidence in providing support and organizational pathways for this. An online mixed-methods survey was distributed to UK HCPs supporting older people through professional bodies, special interest groups, key contacts, and social media. From 137 responses, HCPs valued frailty assessment but used a mixture of tools that varied by profession. HCPs felt confident managing frailty and referred older people to a wide range of supportive services, but acknowledged a lack of formalized training opportunities, systems, and pathways for frailty management. Clearer pathways, more training, and stronger interprofessional communication, appropriate to each setting, may further support HCPs in frailty management. Item EmbargoEnd-of-Life Care in The Patient’s Home: Experiences of Nursing Staff Caring for Patients from the ethnic minorities in the United Kingdom(Mark Allen Group, 2023) Manyimo, Pretty; de Vries, KayBackground Providing end-of-life care in the patient’s home is challenging, especially if the nurse is from a different ethnic background from the patient. Evidence shows that Black, Asian Minority Ethnic background people often experience poorer end-of-life care due to care providers not understanding their care needs. Aim To describe the experiences of the United Kingdom nursing staff caring for community ethnic minorities patients at the end-of-life. Methods Using a qualitative descriptive approach, 16 semi-structured interviews were conducted, and the data was thematically analysed. Findings Participants dealt with large tight-knit families, paternalism and controlling behaviours. There was mistrust of Western palliative medicine. Language barriers and challenges were faced by the nursing staff, resulting in difficult conversations with the families. Different levels of the nursing staff’s spiritual/cultural competencies were also identified. The COVID-19 pandemic intensified the challenges. Conclusion This research has shed light on the challenges of individualising end-of-life care in a culturally diverse community in the United Kingdom. The nursing staff’s cultural/spiritual competencies were challenged. Item EmbargoExploring nurses’ well-being and strategies to support self-care(Royal College of Nursing, 2023-10-01) Tremayne, P.; De Bourg, L.Nurses experience a range of challenges in their practice that can adversely affect their well-being, for example work-related stress and workforce issues. These challenges may have been intensified by various factors, such as the coronavirus disease 2019 (COVID-19) pandemic and shift working. This article considers the concept of well-being and explores nurses’ well-being in the context of ongoing stressors and workforce issues. It also examines some of the effects of shift work on nurses’ well-being and how these could be mitigated. The authors outline a range of self-care practices that nurses could engage in and consider how they may be supported in this by their line managers and healthcare organisations Item Open AccessFacilitators and barriers to early diagnosis of malignant mesothelioma (FILMM): a qualitative study of patient experiences living in England, UK(16th International Conference of the international Mesothelioma interest group, 2023-06-26) Oviasu, Osaretin; Coleby, Dawn; Padley, Wendy; Hinsliff-Smith, KathrynBACKGROUND Partly due to late presentation and diagnosis of malignant mesothelioma (MM), UK’s survival rate is below the European average . To date, there has been little attention given to patients’ experiences prior to MM diagnosis as available studies have focused on their lived experiences after diagnosis , . Therefore, to improve survival through earlier diagnosis, there is an urgent need to understand decision-making points prior to patients’ MM diagnosis. OBJECTIVES This UK based study aims to explore patients’ experiences from the moment they notice the first symptom until they receive a MM diagnosis. Primary objective • To explore the factors which affect mesothelioma patients’ diagnosis pathway from their first symptom to confirmed diagnosis from their perspective. Secondary objective • To explore patients’ understanding of the development of their symptoms, reasons for seeking medical help and the process of interaction with health care professionals METHODS This is a qualitative study using one-to-one interviews and was conducted with participants who live in England, UK. Recruitment was via two regional specialist MM outpatient clinics using a purposive sample. A total of 17 patients were recruited, consented and interviewed. The data from the interviews were analysed using framework analysis. We utilised a model of pathway to treatment  as a conceptual framework for conducting the interviews and for the analysis of the findings. This model identifies four stages/intervals where delay can occur in the pathway to diagnosis - Appraisal, Help-seeking, Diagnostic, and Pre-treatment intervals and provides a useful framework to describe the participants’ journey to diagnosis and clinical interventions. RESULTS Preliminary findings indicates that there were barriers and facilitators within each interval identified along the MM patients’ journey to diagnosis. Within the appraisal and diagnostic intervals, the presentation of vague symptoms that were mistaken for a less serious illness were found to be a barrier. Both the patients that presented with these symptoms and their health care professional (HCP) failed to investigate for MM at the onset thereby leading to a delayed diagnosis. CONCLUSION Our findings identify, from the patients’ perspective, areas for improvement in the interactions and decision points along the clinical pathways to confirmed MM diagnosis. Earlier symptom recognition by both patient and HCP including GPs can be used to target significant and avoidable delays along patients’ MM diagnosis pathway, thereby promoting earlier diagnosis and treatment options. REFERENCE LIST  Cancer Research UK, “Mesothelioma statistics,” Statistics by cancer type, 2018. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/mesothelioma (accessed Feb. 24, 2020).  A. Arber et al., “A research study exploring the patient’s experience during the first three months following a diagnosis of Malignant Pleural Mesothelioma,” Surrey, 2010. [Online]. Available: s.surrey.ac.uk/id/eprint/2517.  C. Warnock, K. Lord, B. Taylor, and A. Tod, “Patient experiences of participation in a radical thoracic surgical trial: Findings from the Mesothelioma and Radical Surgery Trial 2 (MARS 2),” Trials, vol. 20, no. 598, 2019, doi: 10.1186/s13063-019-3692-x.  F. Walter, A. Webster, S. Scott, and J. Emery, “The Andersen Model of Total Patient Delay: a systematic review of its application in cancer diagnosis,” J Heal. Serv Res Policy, vol. 17, no. 2, pp. 110–118, 2012, doi: 10.1258/jhsrp.2011.010113. Item Metadata onlyTransitioning to trauma care: A phenomenological study of non-trauma foreign-trained nurses(Elsevier, 2023) Al-Sheikh Hassan, Mohammed; de Vries, Kay; Rutty, JaneBackground: The increasing global nursing workforce shortage creates higher demands for recruiting foreign-trained nurses, especially in high-income countries that depend on them to fill their nursing workforce gaps. Specifically, Saudi Arabia, a high-income country that possesses one of the highest trauma rates globally, recruits two-thirds of its total nursing workforce from other foreign countries. However, a significant number of newly recruited foreign-trained nurses are allocated to major trauma care settings without gaining previous trauma care experience in their home countries. This exposes them to intolerable workloads and higher rates of dissatisfaction affecting their transition and integration into their new care settings. Aim: To explore and describe the lived experiences of moving to major trauma care in Saudi Arabia as non-trauma foreign-trained nurses. Methods: The study employed a descriptive phenomenological approach guided by Husserl's phenomenology. In-depth, unstructured one-to-one interviews were conducted to gather data about the participants' transition journeys through real-life examples and stories from their own lived experiences. A total of nine foreign nurses were recruited to the study. The nurses were interviewed twice on two different occasions. The data were analysed using Colaizzi's descriptive phenomenological method. Findings: Three main themes were identified, (1) facing a new reality, (2) adjusting towards growth, and (3) achieving belonging. The themes depict the nurses' journey from their arrival in a foreign country as novice trauma nurses through to attaining a higher-level proficiency. Moreover, the themes highlight the phenomenon behind the significant transition the nurses went through at the personal, emotional, and professional levels. Conclusion: Extreme cultural, social, and religious differences and the need to provide nursing care in a challenging practice area were significant factors in the nurses' transition, which exposed them to culture and practice shocks. However, by practising emotional labour throughout their transition, the nurses moved forward and achieved belonging within the care setting. Therefore, the study provides practice and future research recommendations for enhancing foreign-trained nurses' recruitment and retention, which can lead to improvements in the pre-and post-arrival experiences of other nurses in similar contexts. Item EmbargoThe impact of Covid-19 on the mental health of professional footballers(Taylor and Francis, 2021-01-25) Souter, Gary; Tonge, Alan; Culvin, AlexThe Covid-19 pandemic has had huge ramifications on professional football. This commentary focuses on the impact of the pandemic on the mental health of professional footballers. Specifically, footballers within the English Premier League, English Football League, FA Women’s Super League and FA Women’s Championship. This commentary considers a holistic approach to mental health, the environment of professional football, and the impact of career transitions and critical moments on mental health. The intention is to stimulate discussion and further research of mental health and wellbeing within professional football. This paper considers the impact of Covid-19 and makes recommendations for professional football clubs to develop a holistic mental health strategy. We recommend that professional clubs increase the level of emotional support for professional footballers, and that this should not be a temporary measure due to the pandemic. Clubs should develop a long-term strategy to encourage players to seek emotional support. Item Open AccessInduction of labour at 39 weeks and adverse outcomes in low-risk pregnancies according to ethnicity, socioeconomic deprivation and parity: a national cohort study in England.(PLOS Medicine, 2023-07-20) Muller, P; Karia, A M; Webster, K; Carroll, F; Dunn, G; Frémeaux, A; Harris, T; Knight, H; Oddie, S; Khalil, A; van der Meulen, J; Gurol-Urganci, IBackground: Ethnic and socioeconomic inequalities in obstetric outcomes are well established. However, the role of induction of labour (IOL) to reduce these inequalities is controversial, in part due to insufficient evidence. This national cohort study aimed to identify adverse perinatal outcomes associated with IOL with birth at 39 weeks of gestation (“IOL group”) compared to expectant management (“expectant management group") according to maternal characteristics in women with low-risk pregnancies. Methods and Findings: All English National Health Service (NHS) hospital births between January 2018 and March 2021 were examined. Using the Hospital Episode Statistics (HES) dataset, maternal and neonatal data (demographic, diagnoses, procedures, labour, and birth details) were linked, with neonatal mortality data from the Office for National Statistics (ONS). Women with a low-risk pregnancy were identified by excluding pregnancies with pre-existing comorbidities, previous caesarean section, breech presentation, placenta previa, gestational diabetes, or a baby with congenital abnormalities. Women with premature rupture of membranes, placental abruption, hypertensive disorders of pregnancy, amniotic fluid abnormalities, or antepartum stillbirth were excluded only from the IOL group. Adverse perinatal outcome was defined as stillbirth, neonatal death or neonatal morbidity, the latter identified using the English composite neonatal outcome indicator (E-NAOI). Binomial regression models estimated risk differences (with 95% confidence intervals) between the IOL group and the expectant management group, adjusting for ethnicity, socioeconomic background, maternal age, parity, year of birth, and birthweight centile. Interaction tests examined risk differences according to ethnicity, socioeconomic background, and parity. Of the 1 567 004 women with singleton pregnancies, 501 072 women with low-risk pregnancies and with sufficient data quality were included in the analysis. 3.3% of births in the IOL group (1 555/47 352) and 3.6% in the expectant management group (16 525/453 720) had an adverse perinatal outcome. After adjustment, a lower risk of adverse perinatal outcomes was found in the IOL group (risk difference -0.28%; 95% confidence interval -0.43%, -0.12%; p=0.001). This risk difference varied according to socioeconomic background from 0.38% ( 0.08%, 0.83%) in the least deprived to -0.48% ( 0.76%, -0.20%) in the most deprived national quintile (p value for interaction =0.01), and by parity with risk difference of -0.54% (-0.80%, -0.27%) in nulliparous women and -0.15% (-0.35%, 0.04%) in multiparous women (p-value for interaction = 0.02). There was no statistically significant evidence that risk differences varied according to ethnicity (p=0.19). Key limitations included absence of additional confounding factors such as smoking, BMI, and the indication for induction in the HES datasets, which may mean some higher risk pregnancies were included. Conclusions: IOL with birth at 39 weeks was associated with a small reduction in the risk of adverse perinatal outcomes, with 360 inductions in low-risk pregnancies needed to avoid one adverse outcome. The risk reduction was mainly present in women from more socioeconomically deprived areas and in nulliparous women. There was no significant risk difference found by ethnicity. Increased uptake of IOL at 39 weeks, especially in women from more socioeconomically deprived areas, may help reduce inequalities in adverse perinatal outcomes. Item Open AccessA Qualitative Exploration on Perceived Socio-Cultural Factors Contributing to Undernutrition Among Under-Fives in the Southern Highlands of Tanzania(Frontiers, 2023-07-21) Frumence, Gasto; Jin, Yannan; Kasangala, Amalberga; Mang’enya, Mary; Bakar, Saidah; Ochieng, B.Objective: Under nutrition especially among under-fives is a major public health challenge in Tanzania. However, the contribution of cultural practices to child under nutrition is often overlooked. This study aimed to explore the perceived socio-cultural factors contributing to the persisting under nutrition among under-fives in Tanzania. Methods: The study applied focus group discussion (FDGs) with forty practitioners to examine the sociocultural factors contributing to under nutrition during early childhood. The study participants were purposively selected and thematic analysis was used to identify themes within the data. Results: This study revealed that, under nutrition for under-fives is caused by a number of socio-cultural factors including existence of gender inequality related to dietary practices and qualities, women’s excessive workload, patriarchy social-norm, excessive alcohol use and cultural taboos prohibiting women and girls from eating certain types of nutrient dense foods. Conclusion: The study highlights the multiplicity of factors including socio-cultural perspectives contributing to under nutrition among under-fives, and calls for a concerted efforts in developing and implementing issue-specific and culturally sensitive strategies towards elimination of child under nutrition. Item Open AccessA Case Study of a Pilot Smart Home Monitoring System with Older Adults Living Alone in East Midlands(Athens Institute for Education & Research, 2023-06-16) Chaudhry, Ismail; Chamley, Carol; Nijhof, Dewy; Ochieng, Rebecca; Rogerson, Louise; Wong, Richard; Prasad, Rishabh; Ochieng, B.The aim of this project was to examine older adults and their next-of-kins’ experiences of using smart home technology. The technology unobtrusively monitors the older adult’s physical functional ability to undertake their daily activities at home. Using a case study approach, the participants comprised three family units: three older adults with a history of long-term co-morbidities and who lived alone, along with their next-of-kin (n=4). The older adults were all female aged between 72- 82 years of age, while the four next-of-kin were all females aged between 40 and 55 years of age. Participants experiences of using the smart home technology was evaluated at three- and eight-months post installation via in-depth one-to-one interviews with the older adults and their next-of-kin. The older adults described how the smart home sensors reduced their levels of anxiety because they were ‘not feeling alone’. Likewise, their next-of-kin described how the sensors gave them an insight to their older relatives’ activities of daily living, as well as the challenges they experienced. The findings highlighted the benefit of smart home technologies in terms of helping older adults and their next-of-kin monitor their daily activities, reduce social isolation, and adopt positive health and behavioural changes. Item Open AccessEmotional labour in nursing: the fine line between support and stress(University Hospitals of Leicester NHS Trust, 2023-05-24) Al-Sheikh Hassan, MohammedN/A Item Metadata onlyIntimate Partner Violence. Gender-Based Violence: A Comprehensive Guide(Springer, 2023-06-01) Hinsliff-Smith, K.; McGarry, JulieThis chapter provides a foundation for the understanding of what is termed intimate partner violence. Intimate partner violence is a global phenomenon affecting all genders and relates to acts by a current or ex-partner to another person. Such acts may be physical, emotional, psychological or financial but in most cases will have a detrimental effect on the survivor. It is now much better understood that such acts can directly affect a survivor’s physical and mental health and have long-lasting, life-changing impacts. In this chapter, we aim to provide some context to the issues of intimate partner violence, which are often experienced by women and can occur across all age ranges. We provide the context for intimate partner violence as well as background about the known prevalence, which leads to changes in policy and how different authorities may deal with instances of intimate partner violence. Finally, we provide a case study that shows the complexity of intimate partner violence. Item Open AccessAddressing health inequalities, assumptions and barriers in meeting the hygiene needs of the transgender population(Nursing Standard, 2023) Layton, Helen; Tremayne, Penny; Norton, WendyThis article originates from the preparation of study resources for first year undergraduate nurses prior to them participating in an introductory simulation session related to patient hygiene (NMC, 2018a Annex B, 3.4,4.1,4.3 and 4.5). The lecturing team had prepared theoretical material and on reflection was acknowledged that it was overtly cisnormative. Content, both theory and simulation need to ensure that all protected characteristics of the Equality Act (2010) are addressed. This deficit influenced a need to expand knowledge and to influence and enhance care that student nurses would deliver to trans individuals who are in a healthcare setting and require assistance, support and care with their hygiene needs. Stonewall (2018) highlights that nursing schools should review curricula standards and training to ensure that it reflects LGBT-inclusive care including specific information on providing trans-inclusive care. This article considers some of the wider issues relating to this educational development and identify inequalities, assumptions and barriers in addressing the hygiene needs of trans patients. Ill-informed assumptions can lead to thoughtless care that can leave the patient feeling marginalised and discriminated against. The Nursing and Midwifery Council (2018b) stipulate the need to provide culturally competent care. There are many ways that a nurse can offer an even better care experience in promoting hygiene in a healthcare setting for these individuals. Item Open AccessDementia and comorbid cancer: challenges and implications for nursing practice.(RCNI., 2023-03-21) de Vries, Kay; Chaâbane, Fiona; Harrison Dening, KarenData regarding the prevalence of dementia and the prevalence of cancer suggest that a relatively large number of older people living with dementia may also have unsuspected comorbid cancer. Research into dementia and comorbid cancer is limited. The existing literature shows that people living with dementia have much lower cancer survival rates than people who do not have dementia, perhaps due to advanced age and cancer being diagnosed at a late stage or not at all. In people with dementia, investigating and managing cancer is complicated by cognitive impairment, atypical presentation, communication difficulties and potential behavioural issues – all of which may deter healthcare professionals from conducting patient assessments and screening tests. In this article, the authors use a case study to illustrate the challenges that can arise when a person living with dementia develops cancer, particularly in relation to diagnosis, pain assessment, decision-making and carer involvement. Item Embargo“Like an unbridled horse that runs away with you”: A study of older and disabled people during the COVID-19 pandemic and their use of digital technologies.(Taylor and Francis, 2023-05-31) Clayton, David; de Vries, Kay; Clifton, Andrew; Cousins, Emily; Norton, Wendy; Seims, MelissaThis study explored the uses of digital technologies by older and disabled people who were social distancing and shielding during the early Covid-19 pandemic lockdowns. The study considers the benefits, difficulties, and technical support needs of these groups of people during this time. Using a case study methodology, in-depth interviews were undertaken with 11 older and disabled people recruited from a local digital support service, and their support workers. Five main themes were identified by the research team. These were: technology was a mixed blessing and caused frustration; technology use increased during lockdown; technology supported resilience and contributed to identity through “stimulation, knowledge and friendship”; technology needs to be accessible, and support was required to facilitate technology use. Understanding these experiences will enable policymakers, commissioners, and providers to develop better and more responsive digital support for older and disabled people in the future. Item Metadata onlyBlood stream infections in NHS Maternity and Perinatal Care for women and their babies: a feasibility report of linking maternity, neonatal and infection datasets in England. London: RCOG; 2023(Royal college of Obstetrics and Gynaecology, 2023-02-27) Webster, K; NMPA Project TeamThe aim of this report was to link datasets that contain information about mothers, their babies, and infection data. The NMPA has been unable to obtain linked datasets within the timeframe of the audit programme contract, which ended on 31 December 2022. Therefore, this report focusses on how important it is to join together the datasets that hold different information about infections during and after pregnancy in women and birthing people and their babies. For example, data collected about pregnancy, labour and birth, information about infections and data about admissions to hospital. Had the joined dataset been available, this could have been used to look at aspects of maternity care and outcomes specifically for women and birthing people who had a bloodstream infection during pregnancy or in the six weeks after birth; and for babies who had a bloodstream or CSF infection in the first 3 days of life. Ongoing linkage of these datasets could be used for longer term surveillance of infection and antimicrobial use in women and birthing people, and babies Item Open AccessDeveloping a Clinical Academic Career Pathway in a Community and Mental Health NHS Trust(Sage, 2022-02-22) Bernhardt, Lizelle; Baillon, Sarah; Corr, Susan; de Vries, KayBackground: Despite growing evidence of the impact that clinical academic staff have on patient care and clinical practice, there are disproportionately low numbers of nurses, allied health professionals and other healthcare professionals in clinical academic joint roles, compared to their medical colleagues. Aim: To describe the initial development of a clinical academic career pathway for nurses, allied health professionals and other healthcare professionals in a community and mental health NHS Trust. Methods: Kotter’s Model for Change was used to expand opportunities and research culture across an NHS Trust. Results: A variety of capacity and capability initiatives at different academic levels were created to support clinical academic development and to complement those available externally. These opportunities were underpinned by a research and development strategy, senior leadership buy-in, manager and clinical staff support, and targeted organisation-wide communication. Conclusion: The ongoing development of innovative clinical academic opportunities in the Trust, alongside greater support for staff interested in pursuing clinical academic careers, has resulted in a growing number of individuals successful in developing as clinical academic. This has led to a growth in research culture in the organisation and a greater understanding of what clinical academic staff can bring to patient care, the clinical service, and the wider organisation. Item Open Access‘We went from understanding, to disappointment, resentment and often grief all in the space of 6 months’ A qualitative study of the stories of family carers of care home residents during COVID-19 pandemic in 2020. East Midlands Research into Ageing Network (EMRAN) Discussion Paper Series(EMRAN, 2023-03-03) Hinsliff-Smith, K.; de Vries, Kay; Padley, Wendy; Brown, Jayne; Griffiths, Sarah EllenWhen the WHO announced a global pandemic in response to COVID-19, individual countries reacted in a similar way with care homes closing their doors to visits, including visits from family members. The UK was no different, initially they closed to protect care home residents during a period of uncertainty, particularly as many were frail, with complex health needs and classed as vulnerable to the virus. This did however, create a sustained period of uncertainty for family members as well as the wider UK care home community. During 2020, 13 family carers in the UK shared their experiences through this period of COVID related enforced lockdowns, in total 27 interviews were conducted. Our findings and three themes narrate to time points when we were conducting interviews and were often linked to key changes in policy, often in the wider society but not conveyed into care home practices or visiting policies. Three overarching themes are described: Understanding and Acceptance, Disappointment and Resentment, Grief and Sense of Loss Item Open AccessEngaging in research with care homes(NIHR-ARC, 2023-02-10) Hinsliff-Smith, K.; Devi, Reena; Chadborn, Neil; Horne, Jane; Gordon, AdamCare homes are a key part of health and social care provision within the UK, and research is needed to help develop solutions to challenges faced in practice. Care homes might want to get involved in research but might not know where to start, and likewise, researchers might not know how best to engage care homes in their work. A team of academics with first-hand experience of conducting research and working with care homes have produced a tool, with public and patient input, to help care homes get more involved in research, and researchers wanting to involve care homes in research. The tool is freely available and is a 2-sided infographic hand out which aims to help guide discussions about engaging in research from the perspectives of both the research community and the care homes.