Ben Hughes

Purpose
Nearly half of 18–24-year-olds report drink spiking on themselves or someone they know. However, this is an under-researched topic and nearly all previous studies have focused on women. This study aims to help understand a possible spiking incident from a male perspective.

Design/methodology/approach
An individual case study methodology, using a reflective account from a young male university student, was used to provide a personal interpretation of an incident at the university.

Findings
Abnormal changes in behaviour and cognition were out of character and corresponded with spiking but were explained by paramedics and some friends as a result of excessive alcohol.

Originality/value
For the first time, this paper explores and helps understand the very personal and individual responses of a young male who was a likely spiking victim, providing the confusion, embarrassment and uncertainty of the situation. In addition, this situation highlights the need for personal vigilance while on a night out, as well as the training needs for emergency responders and nighttime staff and the understanding from friends and observers.

When a pet dies, owners can experience similar levels of grief as when a human dies. Previous research indicates the role of continuing bonds (CB) when a pet is alive. To understand the impact of these bonds after the pet has died, we conducted a systematic narrative synthesis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). Findings were heterogenous, yet there were still parallels in the literature. CB can sometimes aggravate and intensify grief experiences, particularly when pet grief is perceived as disenfranchised grief. However, identifying appropriate bonds can be useful to moderate the intensity of grief and be a valuable mechanism of support. CB can also help post-traumatic growth of owners.

Purpose: This paper - the final paper of a series of three - aims to discuss the implications of the findings from a service user needs assessment of people experiencing homelessness in the Northwest of England. It will expand on the previous paper by offering a more detailed analysis and discussion of the identified key themes and issues. The service user needs assessment was completed as part of a review of local service provision in the Northwest of England against the backdrop of the COVID-19 pandemic. Design/methodology/approach: Semi-structured questionnaires were administered and used by health-care professionals to collect data from individuals accessing the Homeless and Vulnerable Adults Service (HVAS) in Bolton. The questionnaires included a section exploring Adverse Childhood Experiences. Data from 100 completed questionnaires were analysed to better understand the needs of those accessing the HVAS. Findings: Multiple deprivations including extensive health and social care needs were identified within the cohort. Meeting these complex needs was challenging for both service users and service providers. This paper will explore key themes identified by the needs assessment and draw upon further comments from those who participated in the data-gathering process. The paper discusses the practicalities of responding to the complex needs of those with lived experience of homelessness. It highlights how a coordinated partnership approach, using an integrated service delivery model can be both cost-effective and responsive to the needs of those often on the margins of our society. Research limitations/implications: Data collection during the COVID-19 pandemic presented a number of challenges. The collection period had to be extended whilst patient care was prioritised. Quantitative methods were used, however, this limited the opportunity for service user involvement and feedback. Future research could use qualitative methods to address this balance and use a more inclusive approach. Practical implications: This study illustrates that the needs of the homeless population are broad and varied. Although the population themselves have developed different responses to their situations, their needs can only be fully met by a co-ordinated, multi-agency, partnership response. An integrated service model can help identify, understand, and meet the needs of the whole population and individuals within it to improve healthcare for a vulnerable population. Social implications: This study highlighted new and important findings around the resilience of the homeless population and the significance of building protective factors to help combat the multiplicity of social isolation with both physical and mental health problems. Originality/value: The discussion provides an opportunity to reflect on established views in relation to the nature and scope of homelessness. The paper describes a contemporary approach to tackling current issues faced by those experiencing homelessness in the current context of the COVID-19 pandemic. Recommendations for service improvements will include highlighting established good practices including embedding a more inclusive/participatory approach.

Purpose – The purpose of this paper – the second of three – is to report the findings from a service user needs assessment in those who have contact with a local homelessness service in the North-West of England.
Design/methodology/approach – Data were collected using a semi-structured questionnaire that included a section exploring Adverse Childhood Experiences. Aggregated data from a total of 100 completed questionnaires were analysed to understand the nature and scope of those accessing the Homelessness and Vulnerable Adults Service (HVAS).
Findings – Homeless people accessing HVAS face a number of challenges, which reflect their upbringing and chaotic and complex lifestyles. Reports of multiple disadvantage, social isolation, physical and mental health problems were common among the cohort.
Research limitations/implications – This was a small cohort study, and the authors accept that this may potentially limit the scope of the findings. Themes identified are, however, reflected in wider research and official data collection sources. Future research may seek to widen the data collection methods to offer a more representative cohort.
Practical implications – The provision of co-ordinated multi-agency support is essential to tackle health inequalities experienced by those who are homeless.
Social implications – The complex issues often experienced by those who are homeless can further compound the impact of social exclusion on health and well-being. The reduction of statutory support and increased emphasis on self-reliance can further impact those people on the margins of society.
Originality/value – This study identifies how multiple deprivations and social isolation impacts upon health and well-being, further compounding a person’s ability and willingness to engage with services. It raises the question of the systems failure to respond effectively

Capacity for death awareness and death anxiety in young people has been previously documented but the impact of Covid-19 is not currently known. Therefore, the aim of this study of this study was to explore young people’s experiences and responses to the Covid-19 pandemic. Qualitative data was collected from young people via a two-stage process across the United Kingdom: Stage One consisted of an online questionnaire; Stage Two comprised online semi-structured interviews. Responses for Stage One of the study totalled 120 young people; 9 of these were interviewed for Stage Two of the study. Thematic analysis of data identified four themes relating to young people’s experiences of the Covid-19 pandemic: death anxiety; mental health; normalising death; and identified support needs. Young people experienced heightened death anxiety due to the pandemic but death also became normalized for them and their mental health was negatively affected.

Capacity for death awareness and death anxiety in children and young people has been previously documented but the impact of Covid-19 and subsequent support needs are not currently known. Therefore, the aim of this study was to explore children’s and young people’s experiences and responses to the Covid-19 pandemic and to identify resulting support needs, which are long-lasting or ongoing. Qualitative data was collected from thirteen children aged 9–10 years old in a primary school in Northwest England and from over a hundred young people, including nine interviews, across the United Kingdom. Children were asked to draw their thoughts and feelings about the pandemic and write a short narration to accompany the drawing. A questionnaire and semi-structured interviews were used with young people aged 12-16. Thematic analysis identified four themes in the data: death anxiety; mental health; positive experiences of the pandemic; and support needs. Findings indicate the need for appropriate support and interventions with children and young people to facilitate safe spaces to express their emotions and share feelings around death, dying, and bereavement confidently in a non-judgemental setting.

Background:
A range of polices, documentation, and practices are associated with advance care planning. However, there is a shortage of research to understand advance care planning from a professional viewpoint.
Aims:
To explore the views and experiences of health professionals of the advance care planning process with children and young people.
Methods:
An online questionnaire was used to collect data, which were analysed thematically.
Findings:
Key findings related to barriers and facilitators to initiating and documenting advance care planning: understanding the process and the condition of the patient; how advance care planning works in practice; and access to relevant, affordable training options.
Conclusion:
Additional training and standardised documentation can help support the initiation and use of advance care planning, reduce misperceptions, and generate greater confidence in participating in the process. A larger multidisciplinary team, with better communication, will support improved relationships between professionals which will filter down to the families.

Purpose – This paper – the first of three – aims to explore some of the complex physical and mental health needs of those experiencing homelessness. It will act as a leader to the other articles by establishing the nature of the problem and offer a rationale for carrying out a service user needs assessment as part of a review of local service provision in the North West of England against the backdrop of the current COVID-19 epidemic.
Design/methodology/approach – There are a number of complex social and health inequalities often experienced by those who are homeless. Effectively tackling these requires a co-ordinated multi-agency response to both prevent and tackle the harms associated with being and becoming homeless.
Findings – Partnership working offers the best opportunity to meet the complex needs of those experiencing homelessness. The current delivery model being actioned in the North West of England highlights the importance of the links between statutory and non-statutory services. An ongoing service user needs assessment will further help to highlight contemporary issues faced by those experiencing homelessness and those providing services in the context of the COVID-19 epidemic.
Social implications – Future papers as part of this series of three will consider the implications of social exclusion and barriers to accessing services faced on a day-to-day basis by those experiencing homelessness.
Originality/value – The opportunity to reflect on established views in relation to the nature and scope of homelessness. It will consider the implications exclusion from society and service provision that this group face on a day-to-day basis. The paper will describe a contemporary approach to tackling current issues faced by those experiencing homelessness in the current context of the COVID-19 epidemic

The aim of this study was to explore children's experience and responses to the Covid-19 pandemic through their illustrations and short narrations. During October 2020 and January 2021 data was collected from thirteen children aged 9–10 years old in a primary school in the North-West of England. Children were asked to draw their thoughts and feelings about the pandemic and to write a short narration to accompany the drawing. Thematic analysis of data revealed that during the pandemic children at this age have an understanding of death, experience death anxiety and are able to use creative expression to facilitate meaning of the impact of lockdown on their lives such as feeling isolated, lonely, sad and bored. Creative expression also facilitated adaptive coping mechanisms derived from being able to spend more time with family. The data on primary school children is part of a larger study which involved surveys and interviews with children aged 12–16 years in secondary schools.

Objective: To understand the thoughts, feelings, and support needs of student nurses called into practice during a pandemic.
Methods: A descriptive narrative method was used as part of a collaborative approach with student nurses to help them explore their thoughts and feelings about working during the pandemic and also identify resulting support needs.
Results: Student nurses were excited about the opportunity to join the workforce and both develop new skills and use existing competencies. However, there was also nervousness about their readiness for practice and the financial and health implications for themselves and their families.
Conclusion: Students are an important part of the nursing workforce and the pandemic provided unique opportunities to learn key competencies in an unprecedented situation. Recognising the contribution of student nurses will enhance the response to future pandemics and providing clarity for the role of the student in these situations will ensure appropriate support is in place. Consequently, plans for student nurses to join the workforce should be put into place before another pandemic develops.