The aim of this systematic literature review was to determine whether social vulnerability is associated with frailty in older people. Databases were searched for literature from January 2001 to March 2022. Hand searches of reference lists of the selected articles were also used to identify other relevant studies. Studies that met the inclusion criteria were selected. Two independent reviewers assessed the methodological quality using an established tool. Eleven eligible studies from Canada, Europe, USA, Tanzania, Mexico, and China were selected. The level of social vulnerability measured by the Social Vulnerability Index (SVI) from a meta-analysis was 0.300 (95% CI: 0.242, 0.358), with the highest SVI in Tanzania (0.49), while the lowest level of SVI was reported in China (0.15). The highest frailty level of 0.32 was observed in both Tanzania and Europe, with the lowest frailty reported in a USA study from Hawaii (0.15). In all studies, social vulnerability was a significant predictor of mortality for both sexes at subsequent data collection points. The association between SVI and frailty was high in Tanzania (r = 0.81), with other studies reporting stronger correlations for females compared to males, but at small to moderate levels. In one study, an increase of 1SD in SVI was linked to a 20% increase in frailty score at a subsequent evaluation. Additional study is warranted to determine a potential causality between social vulnerability and frailty.

Foot health and wellbeing in the UK are often overlooked in healthcare. Foot health outcomes are strongly interlinked to the social determinants of health, in that the way these determinants intersect can impact an individual's vulnerability to foot pain and disorders. In this commentary we explore some social determinants that hinder individuals from improving their foot health behaviour and ultimately reducing foot pain and foot disorder vulnerability. We focus on socioeconomic status, gender, disability, age, culture and ethnicity, and footwear quality; we also highlight the potential impact of the Covid‐19 pandemic and the cost‐of‐living crisis on foot health inequities; rises in inflation have resulted in footcare becoming less affordable among vulnerable groups, like those with intellectual disabilities and chronic illness, older people, those living in rural and inner‐city communities, and the ethnically and linguistically diverse population living in the UK. There is an urgent need to raise awareness of the social determinants of foot health, their intersectionality, and their impact on foot pain and disorder vulnerability. Despite the Black Report and both Marmot Reviews, little progress has been made in raising this awareness. It is recommended to widen the range of foot health interventions, by including it in GP consultations, developing cultural sensitivity within foot health services, creating more comprehensive educational foot health programmes, and developing a more sustainable footwear industry.

This paper presents findings from a cross-sectional study into the motivational factors of students who chose nursing and midwifery as a career. 189 students from the University of Bedfordshire (UoB) and 223 students from Canterbury Christ Church University (CCCU) completed a questionnaire at the start of their studies in 2018. The findings are generated from the first stage of the Placement, Impact, Experience and Destination (PIED) study into student belongingness on placement and the influence of practice on the first career destination of newly qualified nurses and midwives. An in-class questionnaire was administered to 1st year pre-registration adult, child and mental health nursing and midwifery students to identify the intrinsic and extrinsic factors that influenced their motivation to choose nursing or midwifery as a career. A mix methods study design was adopted for the PIED study where participants completed a survey that collected quantitative and qualitative data and administered during the course induction period. Motivation scores were found to be high in both cohorts, with students at both sites endorsing intrinsic motivational factors over extrinsic at statistically significant levels. The strongest intrinsic factors appeared to be a desire to help and care for people and play a useful role in society, whereas the strongest extrinsic factors were career stability and the ability to work in different regions and countries. The study suggests that the influence of family and friends continues to exert a strong intrinsic motivational influence on the career choices of students, particularly those under the age of 25. Identifying the motivational factors of first year nursing and midwifery students presents employers with an opportunity to tailor strategies to recruit apprentices, enable placement partners to enculturate prospective employees into the workforce and understand the relationship between extrinsic factors and practice learning to successfully recruit graduates.

This opening chapter attempts to introduce the reader to the nature of practice learning as a living landscape of key features that determine supervisors’ and learners' engagement with learning, including the nature of knowledge, boundaries and terrains that characterise the learning journey. It is argued that practice and work-based learning need to be understood as similar but distinct fields by supervisors, assessors and educators who need to be committed to the wellbeing of students and apprentices through the provision of a compassionate practice learning environment. <!----> <!----> <!----> <!---->

This chapter highlights the transformative impact of Higher Education Apprenticeships in the health and social care sector. Through a collaboration between local authorities, hospitals, wider care providers, and universities, apprentices gain hands-on experience alongside academic study, earning qualifications while contributing to service user and client interventions and care. This innovative approach not only addresses skills shortages but also enhances the quality of service delivery, demonstrating the vital role Higher Education Apprenticeships play in advancing health and social care and improving outcomes for those who use their services. The apprenticeship curriculum emphasises real-world clinical and practice-focused skills, critical thinking, and compassionate care, preparing apprentices to meet the evolving needs of local communities. In this chapter, we take a case study approach to explore apprentices’ learning experience within the health and social care setting when viewed through the lens of the Iterative Learning Model proposed by Lewis. This model is ideal because, instead of viewing apprenticeship learning as solely the result of either lecturer/practice educator guidance or self-determination by the learner, it acknowledges the combined roles of both parties in a partnership where responsibility is mutually defined. The model articulates several key stages in the acquisition of knowledge and skills within health and social care environments, which are themselves dependent upon development opportunities by which the learner may reinforce knowledge and skills through repeated engagement and application over the length of their apprenticeship.

The theme of compassionate practice learning continues in this chapter, as we consider the role of quality enhancement processes within learning environments and how supervisors, assessors and educators can work collaboratively through partnership approaches. The experiences of dissatisfied learners are explored from the perspective of a constellation of factors that require students and apprentices to be supported, particularly when raising their concerns. <!----> <!----> <!----> <!---->