Yes / Background: The role of medical imaging in the investigation of suspected child abuse is well documented. However, the role of the radiographer as an instigator of such concerns is less well understood. The fast-paced development of related technology and the evolution of the profession into new areas of work is argued to have impacted upon the traditional interaction between patient and professional; thus requiring a contemporary analysis of current practice. Objective: As part of a wider multimethod thesis, this qualitative study sought to fill a gap in the literature with regard the role of the radiographer in child safeguarding by exploring their knowledge of, attitude towards and practical experience of the phenomenon. Participants and setting: Online, semi-structured interviews were conducted with n=12 radiographers from across England between 2020 and 2021. Recruitment occurred via an initial survey and interviews were conducted online. Methods: Verbatim transcripts were analysed using a framework analysis approach to create initial codes which led to themes for discussion. Results: The framework analysis approach resulted in the identification of three constituent themes: (1) Patient, (2) Examination and (3) Radiographer. Each constituent themes were built from a comprehensive coding of the data. Analysis of these themes are presented in terms of quotes and diagrammatic depiction. Conclusion: For radiographers to be able to identify child safeguarding concerns, alignment of these constituent themes is necessary with the radiographer being the theme that can be greater controlled in terms of knowledge and attitude. Conceptually, this analysis could be extended to other professionals. Contemporary practice within medical imaging has made it more challenging to assess some physical and social signs of child safeguarding concern, and thus for the alignment to occur, as compared with previous generations. To maximise the contribution, education needs to account for wider paediatric practice and the imaging modality utilised by the radiographer. A case study approach demonstrating the potential that exists for the profession to contribute would be beneficial. Interprofessionally, greater involvement of radiographers in the assessment and escalation of any concerns could provide benefit to the patient. / This research was undertaken as part of internally funded PhD at University of Bradford, UK.

Yes / Child safeguarding and the appropriate identification of suspected victims represents a global phenomenon. Diagnostic imaging is acknowledged as a contributory diagnostic service but the role of the radiographer in the identification and escalation process is less well understood. Method: A Knowledge, Attitude and Practice (KAP) survey was constructed to evaluate knowledge base in the context of the patient–radiographer interaction, the shaping of attitude towards child safeguarding and attitudes held towards their role plus the actual practical experiences of managing child safeguarding concerns. Results: Respondents demonstrated a inconsistent knowledge base with respect to physical, social and radiographic signs and symptoms of child safeguarding concern. A positive attitude towards the role of the radiographer in child safeguarding was demonstrated but one that was shaped more by experience than pre-registration education. Assessment of concerns was chiefly influenced by clinical history and appreciation of aetiology. Practically, radiographers have infrequent involvement with the identification and escalation of concerns. Whilst some statistically significant relationships between responses and demographics did exist, these were either sporadic or argued to be a result of natural variation. Conclusion: Assessment of physical and social signs of child safeguarding concern are argued to be becoming more challenging. Radiological signs continue to be visible to radiographers but with increasing use of other imaging modalities these signs are becoming more varied in nature and are providing new challenges. Radiographers are capable of escalation when required to do so. Implications for practice: To maximise the contribution of the profession, education needs to account for imaging modality worked with, in combination with an understanding of related aetiology. Previously existing concerns with respect to escalating processes are no longer in evidence and radiographers are both willing and able to contribute to that process.

Research over the past 30 years suggests that sport can provide a context in which children are subjected to several forms of maltreatment. Various countries, regions, sports and individual organisations have responded to this evidence, causing a proliferation of methods used to safeguard children from harm. However, one approach that is yet to be considered is the safety culture approach. This is despite its potential to address all of the potential risk factors of child maltreatment in sport, and its evidenced ability to tackle a wide range of safety concerns in fields as far-reaching as healthcare, aviation and energy production. Based on this, the aim of this thesis was to conceptualise safety culture in sport from a child safeguarding perspective. A total of 45 interviews and 7 focus groups were conducted with participants from five organisations which differed on the grounds of size, mission and geographical location. Data was analysed using thematic analysis. Findings suggested that safety culture in sport is influenced by the presence and nature of; safety management systems, committed leadership and stakeholder engagement. Findings also suggested that these factors have an interconnected relationship, which influences the nature and strength of the safety culture. These factors and their subsequent safety culture were also found to be influenced by a multitude of internal and external contextual factors. Therefore, the findings of this thesis are used to present the Safety Culture Model for Safeguarding Children. This is the first of its kind as both a model of safety culture in sport, and a safety culture model that specifically relates to safeguarding children. Practical implications and avenues for future research are also presented.

Background- Diagnostic radiography is an established method of investigating child safeguarding concerns. The role of the radiographer in identifying signs that represent safeguarding concerns and acting as a conduit between the patient and other professionals is less well understood. Aims- To evaluate the role of the radiographer in child safeguarding. Establish the contributory factors that influence that role and identify the measures that can be taken to maximise the contribution that could be made to protect patients. Methods- A multimethod approach of two studies (KAP survey and semi-structured interviews) was implemented sequentially to permit the second study to be influenced by the results of the first. Results - An inconsistent knowledge base in terms of child safeguarding exists. A positive attitude towards the profession’s role was identified and an inference that the profession does contribute to the escalation process, albeit only exceptionally. Conclusion- Those in the earlier stages of their career are most in need of recognising suspicious appearances. Radiographic appearances are commensurate with the modality utilised and needs accounting for within education. Contemporary practice makes assessment of more abstract appearances of child safeguarding concerns challenging. The systems of escalating concerns are known, and the profession is willing and able to contribute. Recommendations- Educational focus on the recognition of pathognomonic signs of abuse and aetiology to permit recognition of occasions when injury and clinical history disagree. Education should also include child safeguarding concerns commensurate with the modality utilised and as part of image reporting. Further research is needed to promote the role of the profession and to evaluate the impact of technological advancement on the profession’s capability to contribute effectively.

Yes / ... Sustaining a sport-related concussion (SRC) has been associated with negative consequences to emotion and cognition in recent years,4,5 and head impacts are no different.1 Moreover, there is a consistent link reported with neurodegenerative diseases such as motor-neuron disease, Parkinson’s disease, and dementia. Although this is well-known within the scientific community, and becoming so in the general population, we still place children at risk. Promoting attitude change toward SRC and head impacts in sport is difficult enough with adults as many are accustomed to the way their contact sports are played and spectated. However, a redeeming feature for many researchers is that the evidence is there, and the rhetoric is being discussed in the mainstream media across the world.

An existing body of research indicates that peer-on-peer abuse, involving the physical, sexual and/or emotional abuse of young people by their peers, is an issue of serious concern within the UK. Whilst a range of studies have explored the individual and familial vulnerabilities associated with this phenomenon, there is an increasing recognition of the need to also consider the relationship between young people‟s peer groups, and other pertinent social fields, to their experiences of such abuse. This thesis offers an original contribution to the field by explicitly seeking to develop this contextual approach. It applies an age-specific and gendered interpretation of Bourdieu‟s constructivist structuralism (and specifically the concepts of field, habitus and symbolic violence) to the analysis of nine cases where young people raped or murdered their peers. In doing so, it offers a unique, in-depth, exploration of the interaction between individuals and the social fields that they navigate, in the context of nine abusive incidents. This methodological approach demonstrates how harmful norms underpinning these incidents are informed by a multi-way interplay between various social fields and young people‟s reflexive engagement with this process. It is through this interplay that motives and power hierarchies are established, and gender, age, consent, culpability, vulnerability and ultimately safety, are socially constructed and experienced.

Safeguarding adults is a priority in adult social care, and training is one of the main ways in which policy and guidance around it is implemented. Training transfer refers to the use of new learning on the job, and while the transfer literature is well developed, it does not extend to safeguarding adults training. This research aimed to identify, develop and refine a programme theory of safeguarding adults training transfer by identifying factors that facilitate or inhibit the use of safeguarding adults training in practice, and the impact that the training has. A cross sectional mixed methods realist synthesis approach was used to evaluate two safeguarding adults training programmes provided in Cornwall, UK between 2009 and 2011. Realist synthesis aims to uncover what works, for whom, in which circumstances and how, and develops policy makers’ programme theories of interventions using evidence. A systematic review of training transfer generally, and then of health and social care transfer specifically led to a revision of the policy makers’ programme theory of training. Empirical research in the form of a factorial survey and narrative analysis of qualitative interviews was then undertaken, to further revise the programme theory to be specific to safeguarding adults training. Findings emphasise the importance of considering the effect of the training culture and transfer climate on safeguarding adults training effectiveness. Factors such as opportunity to use learning and supervisor support are important to transfer and the conflict between adult learning principles and mandatory training was explored. Safeguarding adults-specific supports were also highlighted, emphasising the importance of supporting practice using mechanisms other than training. Recommendations are provided regarding how the safeguarding related transfer climate can be improved. Limitations of the study include a high likelihood of sampling bias. The limitations of individual methods and problem of generalising findings obtained from a case study of Cornwall were reduced using the realist synthesis approach.

This case study of the use of hospital accident and emergency records to safeguard children was triggered by Lord Laming’s inquiry into the care of Victoria Climbié, his follow up report, and government legislation since 1948. Research on the use of documentation for safeguarding children is limited, although serious case reviews consistently indicate, that across agencies, record keeping, and the sharing of pertinent information to identify patterns of maltreatment is poor. The social constructed meaning people place on hospital documentation relating to children’s safety and the perceived intentions of conveying that information within and between social environments are the focus of this research. A hermeneutic framework was used to identify how staff in A&E and other agencies perceive the use of A&E child records (birth -16 years). The investigation was in three stages (a) analysis of a purposive sample of 378 A&E children’s records, (b) a focus group with twelve A&E staff on the case study site and (c) another group with twelve members of the Local Operational Child Protection group. Colaizzi’s approach and the hermeneutic circle were the methods utilised to provide a rich description of the essential structure of the phenomenon. The results reveal that although written records are good tools for communication, records are not sufficiently child focused and risks factors are not always recognised. Consequently, the ability of the professional to provide information to safeguard children is limited. The data also highlights professional communication as the central theme, because this seemed to describe and unify the participants’ practices in a way that made sense. The findings of this study indicate that the behaviour of staff plays a crucial role in recording information. They are influenced by factors that are multi-faceted with the complexities of meanings that include social, economic, emotional, cultural, political and technical elements. A new theoretical framework to understand the complex interaction of professional perspectives within the varied situations that occur in clinical practice is proposed. This is underpinned by a constructivist epistemology. This provides an efficient method for evaluating the overall behaviour of the major components that affect documentation and communication, and highlights the recurring problems that arise from these areas when safeguarding children. Hence, this study provides an original contribution to knowledge concerning information sharing in the field of child protection. As a result of the findings of this study A&E records have been redesigned locally.

This study analysed the strategies of selected National Governing Bodies (NGBs) and voluntary sport clubs (VSCs) in the process of policy implementation of Sport England s generic Clubmark (a quality mark accreditation framework). Within the overarching Clubmark framework, other policies (safeguarding and increasing membership and/or participation) adopted by VSCs working towards the accreditation (or re-accreditation) standard were also examined. Policy-makers are predominantly centrally located, often a distance from the point of delivery where, it is argued; the environment is highly variable, pressured and political, often requiring negotiation and interpretation during the process of implementation. Traditionally, implementation analysis assumed two distinct approaches: top-down theorists (e.g. Hogwood & Gunn, 1984) suppose a perfect rational, systematic process as the starting point, with the focus placed on central policy-makers. The top-down theorists acknowledge that the ideal is unattainable but use the perspective to establish generalisable descriptive policy advice; in contrast, bottom-up theorists (e.g. Lipsky, 1980) argued that to gain a more realistic understanding of implementation the role of street-level bureaucrats (e.g. VSC members at the point of delivery) should be the focus for analysis and seek to offer prescriptive advice. More recently, a number of theorists have developed hybrid implementation models, which offered a synthesis of the two contrasting approaches, such as Matland's (1995) Ambiguity-Conflict model. The combination of these three approaches coupled with Kingdon's (1997) Multiple Streams framework, used to help organise and set a context for the understanding of implementation during analysis, established the theoretical framework that guided this study. The research adopted a qualitative approach using case studies for the three sports of boxing, swimming and rugby union. Data collection consisted of 29 semi-structured interviews from VSC members, NGB officials, a senior Sport England official and a County Sports Partnership officer. The interview data were combined with document analysis (from VSCs, NGBs and Sport England), which included policy documents, guidance templates, electronic communications and various website content. Two clubs from each sport were examined (one urban, one rural). VSC member selection was based on positions of authority within the committee who had some prior knowledge of Clubmark. Three to four NGB officials from each sport provided data for the top-down perspective of policy implementation. Analysis of the data revealed that policy implementation is not straightforward; NGBs had to be flexible with their strategies and be willing to modify criteria to deal with the varying nature and capacities of VSCs. Available NGB capacity to offer VSC support proved to be pivotal for implementation success in addition to the ability of the NGBs recognising the range of contextual constraints, which limited VSCs in the implementation process. At the club-level, motivation and willingness of VSC compliance for the three main policy strands varied across sports and clubs, which demonstrated how the role of the VSC members, as implementing agents, was fundamental in the policy process. At the NGB-level, the urgency or importance placed on the three policies and the variable capacity (to offer support) affected implementation. Application of the theoretical framework that guided the research proved effective in developing the understanding of implementation in this particular sport context. Furthermore, this research has provided a contribution to the literature by demonstrating how the complex and heterogeneous nature of VSCs affects the implementation process in community sport, which provides a useful point of reference for future comparative studies analysing NGBs and VSCs in different contexts.

Abuses and sexual misconduct have been present in the aid sector for decades. In 2013, a UN investigation declared sexual exploitation and abuse the most significant risk to UN peacekeeping missions. Nevertheless, the culture of impunity and hypocrisy still prevails in the aid sector. A recent report supports that one in three UN workers has been sexually harassed over the last two years. In the momentum of the #MeToo movement and of timely disclosures of various cases of sexual abuses and harassment in the international aid sector, people soon started to use the hashtag #AidToo on social media to highlight the prevalence of sexual harassment and misconduct within the industry. This study examines the major trends and the findings of an analysis conducted on the use of the hashtag #AidToo on Twitter over a ten-month period. As of the creation of the hashtag at the end of November 2017 and until the end of September 2018, over 13,000 tweets have used #AidToo in their content. Aid workers, journalists, NGOs, as well as news media compose the primary contributors of #AidToo tweets. Although limited to the political sphere and of limited reach, the movement has been sustainable and constant over its first year. Survivors and whistleblowers are the first to acknowledge that #AidToo has created a new safe space for discussion and has incited additional victims to speak up and share their experience. Aid organisations are now under constant scrunity, along with their values, integrity, and funding. However, the online campaign has mainly been a Northern conversation, and one can wonder if the use of the hashtag on Twitter failed to include the Global South and to give a voice to the actual victims of sexual exploitation and abuse. The #AidToo campaign represents a real and welcomed opportunity as a wake-up call for the aid sector, although it is too soon to observe the long-lasting impacts.