This article investigates the lived experience of hybrid working and the impact this has on knowledge workers’ psychosocial health and wellbeing. Specifically, we focus on how the workplace can promote or hinder wellbeing and how hybrid working is experienced after the pandemic. We draw on salutogenic theory – which considers the factors that support and enhance health and wellbeing – in the context of workplaces, to help us understand individual's experiences of hybrid working spaces. This draws attention to new critical insights into the relationship between workspaces and wellbeing. This article is based on empirical, visual data gathered from a case study of university academic and professional services staff, who were asked to take photographs of their hybrid working practices. Our findings highlight the paradox that individual curation of workspaces represents both personalisation and depersonalisation as employees seek to anchor self-identity and a sense of belonging to the workspace. We offer three contributions in this paper. First, little is known of the experiences of those attending hybrid work environments following the pandemic; therefore, our research contributes to this by using salutogenic theory to emphasise the importance of individuals having control over how they shape their environments to promote personal wellbeing. Second, we demonstrate how the use of visual methods to explore hybrid working highlights how individuals mobilise resources within their workspaces to develop a self-responsibility for health. Third, we highlight the importance of how organisations should recognise individual circumstances when developing hybrid working policies.

Background: Firsthand accounts by autistic people describe a need for regular time alone. However, there is little in the literature that explores (1) why time alone is desired, (2) how that time is spent, or (3) where that time is spent. This article describes a neurodiversity-informed, qualitative study that demonstrates the importance and purpose of "alone-time" for autistic adults.Methods: We interviewed 16 autistic adults living in the United Kingdom about how and where they spent their "alone-time" and the benefits experienced from this time. We conducted the interviews online, some using a video link, and some using a synchronously accessed text-based document, according to the participants' preferences.Results: We used Reflexive Thematic Analysis with the interview data to generate four qualitative themes as follows: (1) reacting to social and sensory overwhelm; (2) retreating from social and sensory overwhelm; (3) regulating, recovering, and recharging; and (4) ready to reconnect with others.Conclusions: These themes highlight a need for balancing social activities and spaces with time and space alone and the benefits of creating or protecting spaces, which encourage recovery from overwhelm. Community Brief Why is this an important issue? Autistic people often talk and write about how they need regular time alone for their well-being, but there is very little in the academic literature on the importance of "alone-time" or what "alone-time" might look like. What was the purpose of this study? We wanted to explore why autistic people might want time alone, how autistic people like to spend time alone, and where autistic people like to spend time alone. What did the researchers do? We interviewed 16 autistic adults living in the United Kingdom about how and where they spent their alone-time and what they felt the benefits of alone-time were. Then we analyzed what was said in the interviews using Reflexive Thematic Analysis. What were the results of the study? Four themes help describe what the autistic adults talked about: (1) reacting to social and sensory overwhelm; (2) retreating from social and sensory overwhelm; (3) regulating, recovering, and recharging; and (4) ready to reconnect with others. These themes highlight how social and sensory environments can be overwhelming, how finding quiet spaces and/or engaging with intense interests can be helpful, and how socializing can be made less overwhelming. What do these findings add to what was already known? This study is the first to explore why autistic people might choose to spend time away from social spaces, how they choose to spend this time, and where they choose to spend this time. The findings support previous research on sensory and social overwhelm and on well-being strategies that autistic people use to support their own well-being. What are potential weaknesses in the study? All the participants lived in the United Kingdom, had access to the internet, and were able to give informed consent, and most of the participants were White and female. We do not know if the findings are true for autistic people who are not represented by this sample (e.g., people who are further marginalized by not living independently). How will these findings help autistic adults now or in the future? This study shows the importance for autistic adults in balancing social activities and spending time in social spaces, with alone-time. It also shows the benefits of finding/creating and protecting spaces that are not overwhelming for autistic adults. These findings may help autistic adults explain their need for alone-time, which is useful information for people who support, live with, and work alongside autistic adults.

Background: Emergency department nurses and paramedics have contact with millions of people and could use these contacts as opportunities to help people improve their health. These two professional groups could identify people with modifiable risk factors and provide information, brief interventions, and signposting to locally provided services. This study aimed to investigate if and how health promotion is delivered by emergency department nurses and paramedics, and its acceptability to both the staff and patients in these settings. Methods: A mixed methods study consisting of an online survey with paramedics and emergency department nurses and semi-structured telephone interviews with staff and patients. The setting was the emergency departments in three NHS Hospital Trusts and four Ambulance Service Trusts in England. Results: Three hundred and thirty-one online survey responses, 21 virtual interviews with staff and 14 virtual interviews with patients were analysed. Three main themes emerged from the data: (1) role and relevance of health promotion provision; (2) needs and support for health promotion provision; (3) trust and receptiveness for health promotion provision. Conclusions: The findings of this study indicate that staff often refrain from engaging in health promotion activities due to uncertainty about whether it falls within their job responsibilities and a lack of confidence in their ability to perform these activities. Further research is needed to identify effective strategies to encourage, empower, and support staff in integrating health promotion activities into their daily routines in ways that are acceptable to both patients and staff.

BACKGROUND:Emergency departments (EDs) afford 'teachable moments' for health behaviour change, but staff may not see themselves as public health practitioners and it can be challenging to undertake health promotion activities in emergency care settings. Furthermore, the evidence on health promotion in these settings is limited.AIM:To investigate the views and experiences of emergency nurses and ambulance service paramedics regarding health promotion in emergency care settings.METHOD:A convenience sample of emergency nurses (n=3) and ambulance service paramedics (n=3) was recruited. An inductive and descriptive qualitative study design using semi-structured interviews and thematic analysis was employed.FINDINGS:The participants understood health promotion and were willing to have conversations about it with patients. However, they cited several barriers to health promotion, including understaffing, a lack of understanding of the relevance of health promotion among staff, a lack of training and information, and the sensitivity of topics such as body weight and sexual health. Lack of time was not cited as a barrier.CONCLUSION:There are opportunities for developing the health promotion aspect of practice in emergency care settings, where staff and patients would benefit from a more structured, system-wide approach to health promotion.

Background Frontline NHS staff can recognise appropriate times and situations in which to engage with individuals and help them on the pathway to improving their health and wellbeing. Urgent care and emergency department staff are tasked with exploring opportunities for health promotion to be an integral function of their care planning. Emergency care and public health are naturally intertwined although emergency care staff may not identify themselves as public health practitioners. Whilst these clinical settings can prove challenging when considering health promotion activities, it is also these precise environments that affords an opportunity for a 'teachable moment' for health behaviour change. Methods We used direct enquiry targeting a convenience sample of staff (emergency department nurses and ambulance service paramedics). We conducted six one-to-one semi-structured interviews exploring the attitudes of staff about health promotion. The virtual interviews were audio-recorded, transcribed, and analysed thematically. Findings Two main themes were determined: health promotion as part of the role of emergency care staff; barriers to health promotion in the emergency care setting. The study findings indicate that staff working in emergency care have the time to engage with health promotion activities and see it as part of their job. They reported understaffing and lack of knowledge in the breadth of topics they may have to engage with as barriers. Conclusions A system-wide approach to health promotion in these clinical settings could provide staff with the training and framework (educational support, support from clinical managers, resources for in-house education and dissemination of information e.g., leaflets/apps) that they need to support their patients by incorporating health promotion activities into the routine processes of care. The findings of this qualitative scoping study underpin the promotED study (funded by the NIHR) to explore barriers to health promotion advice delivered by staff working in urgent care and emergency departments.

Christ and Rasputin number among the many folk healers in history. The practice is both ubiquitous and unique. It is at once a familiar and shared socio-cultural phenomenon, but it also evokes something magical and other, distant and irrational, and it is seen as deeply antithetical to ‘modern’ ways of thinking and being. And therein we can locate the complexity of addressing a subject both familiar and alien in a modern society which is assumed to be in the process of shedding the ‘last vestiges’ of such non-scientific and premodern beliefs and practices. In sharing the topic of this book with colleagues, we have noted that a similar theme emerges, in which the mention of ‘folk cures’ brings to light other people’s sometimes remarkable experiences and memories of relatives and extended kin who have been ‘blessed’ with the ability to cure or, at least, to offer solace and comfort to those in need. Unlike the many and varied complementary and alternative health practitioners in Britain and Ireland, folk healers are not easily discovered, and it is this undefined, unrefined and incomplete picture that we have of folk healing practices in these regions that further complicates, but also enriches, our narrative. Many of us, and not just the contributors to this book, have witnessed a folk cure, or have overheard a story revealing a folk wisdom,

Purpose Androgen deprivation therapy (ADT) for Prostate Cancer (PCa) is associated with side effects that could lead to negative body image and low masculine self-esteem of survivors. We compared a group of PCa survivors following ADT with ADT-naive patients, expecting the ADT group to show lower masculine self-esteem. We also expected patients with hegemonic masculinity ideals to show poorer masculine self-esteem and we hypothesized that ADT would moderate this relationship, expecting PCa patients on ADT with stronger hegemonic ideals to show the worst masculine self-esteem scores among study participants. Methods We compared 57 PCa survivors on ADT (M-age = 64.16 (7.11)) to 59 ADT-naive patients (M-age = 65.25 (5.50)), on the Masculine Self-Esteem Scale (MSES), Body Image Scale (BIS), and Hegemonic Masculinity Ideals Scale (HMIS). Results While the two groups did not significantly differ on masculine self-esteem (F [1, 115] = 3.46, p = 0.065, eta(2)(p) = 0.029) and body image (F [1, 115] = 3.46, p = 0.065, eta(2)(p) = 0.029), younger age was significantly associated with higher body image issues (F [1, 115] = 8.63, p < 0.01, eta(2)(p) = 0.071, beta = -0.30). Hegemonic masculinity significantly predicted more masculine self-esteem related issues (t (2, 114) = 2.31, beta = 0.375, p < 0.05). ADT did not moderate this relationship. Conclusions The results suggest that endorsing hegemonic masculinity could represent a risk factor for low masculine self-esteem regardless of ADT status and that younger age is associated with negative body image among PCa survivors. Implications These results suggest the importance of inclusion of topics related to hegemonic masculinity when providing support to PCa survivors, both when discussing treatment side effects, as well as in the later phases of survivorship. This pilot also suggests that younger PCa survivors might benefit from body-image focused support regardless of treatment plan.

BACKGROUND:There are potential health gains such as reducing early deaths, years spent in ill-health and costs to society and the health and care system by encouraging NHS staff to use encounters with patients to help individuals significantly reduce their risk of disease. Emergency department staff and paramedics are in a unique position to engage with a wide range of the population and to use these contacts as opportunities to help people improve their health. The aim of this research was to examine barriers and facilitators to effective health promotion by urgent and emergency care staff.METHODS:A systematic search of the literature was performed to review and synthesise published evidence relating to barriers and facilitators to effective health promotion by urgent and emergency care staff. Medical and social science databases were searched for articles published between January 2000 and December 2021 and the reference lists of included articles were hand searched. Two reviewers independently screened the studies and assessed risk of bias. Data was extracted using a bespoke form created for the study.RESULTS:A total of 19 papers were included in the study. Four themes capture the narratives of the included research papers: 1) should it be part of our job?; 2) staff comfort in broaching the topic; 3) format of health education; 4) competency and training needs. Whilst urgent and emergency care staff view health promotion as part of their job, time restraints and a lack of knowledge and experience are identified as barriers to undertaking health promotion interventions. Staff and patients have different priorities in terms of the health topics they feel should be addressed. Patients reported receiving books and leaflets as well as speaking with a knowledgeable person as their preferred health promotion approach. Staff often stated the need for more training.CONCLUSIONS:Few studies have investigated the barriers to health promotion interventions in urgent and emergency care settings and there is a lack of evidence about the acceptability of health promotion activity. Additional research is needed to determine whether extending the role of paramedics and emergency nurses to include health promotion interventions will be acceptable to staff and patients.

For many living in rural areas, the loss of traditional community assets and increased social fragmentation are a common feature of everyday life. The empty village church is a poignant symbol of these challenges; yet, these are sites that hold considerable potential for new placemaking solutions that respond to the needs of communities today. This means looking beyond "the traditional village church" to recognise a longer history of church adaptation and resilience within the lives of communities. In this paper we ask: how can co-design, projected through a Wicked problems and Clumsy solutions lens, help imagine new futures for communities and their historic churches today? Clumsy solutions consider a plurality of different perspectives on the nature of problems and their resolution to deliver more effective solutions with broad appeal. In the search for clumsiness, we turn to 'long history' and 'slow technology' for inspiration, uncovering deeper resonance with historical communities of place and anchoring that continuity within church sites themselves. Our paper demonstrates how Wicked/Clumsy thinking can account for the challenges faced by rural communities today, bootstrap co-design activities in the development of clumsy solutions, and uncover clumsiness in long history and slow technology dimensions-together laying the foundation for new placemaking strategies.

Purpose This paper aims to provide critical insight into the impact of locally embedded, community business-related approaches internationally to health and social care on users’ outcomes, in particular exploring their effectiveness in delivering outcomes for users. Design/methodology/approach The study used a robust systematic review methodology. It carefully identifies relevant studies that have been conducted on the impact of community business-related approaches, rigorously evaluates how well these studies have been carried out and combines the results from these studies to address that particular topic. Findings Health and social care-related community businesses deliver on a range of health and well-being outcomes and impacts positively on local residents’ satisfaction with their community/local area. Existing research into community businesses uses mostly qualitative methods, but a few studies have also used quantitative survey and mixed methods and demonstrate the challenges of conducting methodologically rigorous real-world research within local community settings. Research limitations/implications The review was limited to papers published in English language and may have missed relevant studies published in other languages which could have influenced the overall findings. Only one reviewer screened the titles and abstracts of the identified papers. Having multiple reviewers would have strengthened the validity of the screening process. Originality/value Community businesses offer a positive contribution to health and well-being, and highlight the significance of engaging local communities in promoting health, reducing health inequalities and addressing the wider determinants of health. This paper provides a baseline of evidence about community business’ broad impacts on health and well-being to help inform new and emerging evidence

Objective: This study explored stroke survivors' experiences of altered body perception, whether these perceptions cause discomfort, and the need for clinical interventions to improve comfort. Design: A qualitative phenomenological study. Setting: Participants' homes. Participants: A purposive sample of 16 stroke survivors were recruited from community support groups. Participants (median: age 59; time post stroke >2 years), were at least six-months post-stroke, experiencing motor or sensory impairments and able to communicate verbally. Interventions: Semi-structured, face-to-face interviews were analysed using an interpretive phenomenological approach and presented thematically. Results: Four themes or experiences were identified: Participants described (1) a body that did not exist; (2) a body hindered by strange sensations and distorted perceptions; (3) an uncontrollable body; and (4) a body isolated from social and clinical support. Discomfort was apparent in a physical and psychological sense and body experiences were difficult to comprehend and communicate to healthcare staff. Participants wished for interventions to improve their comfort but were doubtful that such treatments existed. Conclusion: Indications are that altered body perceptions cause multifaceted physical and psychosocial discomfort for stroke survivors. Discussions with patients about their personal perceptions and experiences of the body may facilitate better understanding and management to improve comfort after stroke.

Background: Evidence from a range of major public health incidents shows that neighbour-based action can have a critical role in emergency response, assistance and recovery. However, there is little research to date on neighbour-based action during the 2020 coronavirus pandemic. This article reports on a survey of people engaged in supporting their neighbours in weeks three and four of the UK COVID-19 lockdown. Methods: Members of area-based and community of interest COVID-19 support groups in the Bristol conurbation were invited to complete an online survey. Of 1,255 people who clicked on the survey link, 862 responded; of these, 539 responses were eligible for analysis. Results: Respondents reported providing a wide range of support that went beyond health information, food and medical prescription assistance, to include raising morale through humour, creativity and acts of kindness and solidarity. A substantial proportion felt that they had become more involved in neighbourhood life following the lockdown and had an interest in becoming more involved in future. Neighbour support spanned all adult age groups, including older people categorised as being at-risk to the virus. With respect to most measures, there were no differences in the characteristics of support between respondents in areas of higher and lower deprivation. However, respondents from more deprived areas were more likely to state that they were involved in supporting certain vulnerable groups. Conclusions: As with previous research on major social upheavals, our findings suggest that responses to the viral pandemic and associated social restrictions may increase existing social and health inequalities, and further research should explore this issue in more depth.

Background: Evidence from a range of major public health incidents shows that neighbour-based action can have a critical role in emergency response, assistance and recovery. However, there is little research to date on neighbour-based action during the 2020 coronavirus pandemic. This article reports on a survey of people engaged in supporting their neighbours in weeks three and four of the UK COVID-19 lockdown. Methods: Members of area-based and community of interest COVID-19 support groups in the Bristol conurbation were invited to complete an online survey. Of 1,255 people who clicked on the survey link, 862 responded; of these, 539 responses were eligible for analysis. Results: Respondents reported providing a wide range of support that went beyond health information, food and medical prescription assistance, to include raising morale through humour, creativity and acts of kindness and solidarity. A substantial proportion felt that they had become more involved in neighbourhood life following the lockdown and had an interest in becoming more involved in future. Neighbour support spanned all adult age groups, including older people categorised as being at-risk to the virus. With respect to most measures, there were no differences in the characteristics of support between respondents in areas of higher and lower deprivation. However, respondents from more deprived areas were more likely to state that they were involved in supporting certain vulnerable groups. Conclusions: As with previous research on major social upheavals, our findings suggest that responses to the viral pandemic and associated social restrictions may increase existing social and health inequalities, and further research should explore this issue in more depth.

Abstract Aim: To explore parents’ experiences of using child health services for their pre-school children post-migration. Background: Migrating between countries necessitates movement and adjustment between systems of healthcare. Children of migrants are known to have poorer health than local children on some measures and are less likely to access primary care. In the United Kingdom (UK), children are offered a preventive Healthy Child programme in addition to reactive services; this programme consists of health reviews and immunisations with some contacts delivered in the home by public health nurses. Methods: Five focus groups were held in a city in South West England. Participants were parents of pre-school children (n = 28) who had migrated to the UK from Romania, Poland, Pakistan or Somalia within the last 10 years. Groups selected included both ‘new migrants’ (from countries which acceded to the European Union in the 2000s) and those from communities long-established in the UK (Somali and Pakistani). One focus group consisted of parents of Roma ethnicity. Interpreters co-facilitated focus groups. Findings: Participants described profound differences between child health services in the UK and in their country of origin, with the extent of difference varying according to nationality and ethnic group. All appreciated services free at the point of delivery and an equitable service offered to all children. Primary care services such as treatment of minor illness and immunisation were familiar, but most parents expected doctors rather than nurses to deliver these. Proactive child health promotion was unfamiliar, and some perceived this service as intruding on parental autonomy. Migrants are not a homogenous group, but there are commonalities in migrant parents’ experiences of UK child health services. When adjusting to a new healthcare system, migrants negotiate differences in service provision and also a changing relationship between family and state.