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Qualitative research methods are increasingly used in nutrition and dietetics research. Ethnography is an underexploited approach which seeks to explore the diversity of people and cultures in a given setting, providing a better understanding of the influences that determine their choices and behaviours. It is argued that traditional ethnography, that is, the methodology of living within participant communities, is a dated practice, with roots in colonialism, accessible to only researchers with the means, connections and status to conduct such research, typically white, privileged males. This paper proposes a formal interpretation of 'patchwork ethnography', whereby research is carried out in situ around existing modern‐day commitments of the researcher, thus enabling more researchers within health, nutrition and dietetic practice to benefit from the rich data that can be discovered from communities. This review proposes the concept that pragmatic patchwork ethnography is required, proposing a framework for implementation, providing researchers, particularly within the fields of human nutrition, dietetics and health, the accessibility and means to deploy a meaningful client‐centric methodology. We present pragmatic patchwork ethnography as a modern method for use within multiple healthcare settings, thus adding a progressive brick in the wall of qualitative research. Key points: Ethnography in health research allows professionals to gather rich qualitative data such as lived experiences of participants.However, undertaking traditional ethnography can be demanding, costly and time‐consuming, consequently rendering it inaccessible and challenging to undertake.Pragmatic patchwork ethnography is underpinned by guiding principles of traditional ethnography, enabling researchers to weave the method into existing life and health practice commitments.This paper sets out the seven steps required to deploy pragmatic patchwork ethnography enabling and empowering public health, nutrition and dietetic researchers to undertake valuable qualitative research in a contemporary research landscape. [ABSTRACT FROM AUTHOR]

Building upon ethnographic research conducted among participants in UK-based initiatives in Jewish-Muslim dialogue, the paper contributes to anthropological literature on the essentialising nature of state-sponsored constructions of minoritised groups. More specifically, I put forward two sets of arguments. Firstly, I suggest a concept of simultaneity that challenges colonially inflected conceptualisations of the relationship between communities and their respective traditions. Activists of Jewish-Muslim inter-community work subvert dominant conceptualisations of intergroup commonalities and divergencies by developing a theorisation of Jewish-Muslim relations that acknowledges group similarities and differences as overlapping categories. Secondly, I contribute to John Jackson's (2005) theorisation of racial sincerity, a notion offering a conceptual challenge to the notion of authenticity. I argue that the complexity of my interlocutors' thematisations of Jewish-Muslim relations underpinned by the diversity of the sources of knowledge that they rely on could be best understood as an example of this analytic. On a broader theoretical plane, the paper proposes a framework that underscores the agentive power of minority communities and pays close attention to the way they define their positionalities vis-à-vis the majorities and each other in ways that go beyond binaries-based theorisations. [ABSTRACT FROM AUTHOR]

Purpose: Serious case reviews remind us that there is much to learn about inter-agency activity. Professional identity is a key phenomenon influencing work behaviour, especially during inter-agency activity. Yet, this link is complex and not well understood within the context of UK children's services. With an agenda of improving outcomes for children and their families, The purpose of this research paper is to conduct a systematic literature review on this topic to develop a conceptual model aimed at informing how practitioners mobilise their professional identity during inter-agency activity. Design/methodology/approach: This paper used meta-ethnography to synthesise the available research. This method is suitable for researchers who are interested in conceptual or theoretical understandings of a particular phenomenon as opposed to describing individual accounts or experiences. Findings: The findings support postmodern accounts of identity and show the construct as fluid, contingent and constituted within interaction. Professional identities are mobilised through the sharing of professional knowledge, which is underpinned by the performative nature of language. Mobilisations can lead to both positive and negative consequences, which can act as a barrier to and facilitator of inter-agency activity. Originality/value: Inter-agency working is integral to the function of children's services but remains an undertheorised concept, and this had led to a dearth of guiding theory on inter-agency practice. By drawing on relevant psychological theory, the proposed model provides a unique psycho-social perspective that articulates the important role of identity during inter-agency activity, which would be of interest to professionals working in children's services. [ABSTRACT FROM AUTHOR]

Background Given the globally ageing population, care homes have an important role in delivering palliative and end-of-life care. Advance care planning (ACP) is promoted to improve the quality of end-of-life care in this setting. While many professionals can be involved in ACP, little is known about what influences multi-professional involvement and how multi-professional working impacts the ACP process in the UK. This study investigated multi-professional practice in relation to ACP in nursing homes. Design and methods An ethnography was undertaken in two UK nursing homes using multiple methods of data collection: observations, interviews and document review. Participants included the following: nursing home residents (n  = 6), relatives (n  = 4), nursing home staff (n  = 19), and visiting health and social care professionals (n  = 7). Analysis integrated thematic analysis, mapping of resident ACP trajectories and documentary analysis. Findings This paper suggests that multi-professional and relatives' involvement in ACP was disjointed. Continuity and coordination were disrupted by misalignment of visiting professional and nursing home organisational structures. Findings show a 'knotworking' approach to teamwork and power imbalance between nursing home staff and visiting professionals, such as general practitioners. While residents wished their relatives to be involved in their ACP, this was not formally recognised, and limited support existed to facilitate their involvement. Conclusion The structure and organisation of multi-professional and relatives' involvement in ACP led to fragmentation of the process. This marginalised the voice of both the resident and nursing home staff, thereby limiting ACP as a tool to enhance quality of end-of-life care. [ABSTRACT FROM AUTHOR]

This paper seeks to explore how professionals in the financial sector understand the challenge that climate change presents to economy and society. It is a case study into how 'climate-related financial risk' is understood in a particular area of expertise – within the actuarial profession. There is an increasingly prominent claim among financial regulators that climate change should be considered as an issue of financial risk and stability; it is argued that this will drive capital towards green ends, and an orderly low carbon transition. Responding to this, actuaries are seeking to establish climate-related risk as part of their professional jurisdiction. Yet they are struggling to do so because of their relationship to the investment chain and because the tools they employ for risk management, mostly drawn from financial economics, are fundamentally failing to consider, quantify and financialise climate risks. Instead, the profession is moving toward scenario-based tools for managing climate-related uncertainty that incorporate narratives about policy interventions and market reaction. The paper draws on interviews and ethnographic research conducted with members of the UK-based Institute and Faculty of Actuaries (IFoA) to explore these established and emerging risk management tools and perspectives. [ABSTRACT FROM AUTHOR]

Qualitative research has long critiqued a simplistic association between youth parenting and poor outcomes. Despite this, the UK youth parenting policy continues to view young parents through a narrow deficit lens, focused on assumed risk rather than structural inequalities. The paper brings together the direct accounts of young parents' experiences, with ethnographic observation of practice, to argue that discrimination is the critical issue associated with being a young parent. This is then set within a wider critique of the policy framework which, it is argued, perpetuates and normalises negative ideas about young parents prevalent in political, societal and cultural processes. An integrative theoretical approach is used to highlight how a deficit lens at a policy level upholds, rather than undermines, young parents' intersectional experiences of discrimination and has ethical implications for practitioners working with them. The paper calls for a reorientation of policy which addresses and disrupts discrimination. [ABSTRACT FROM AUTHOR]

Negotiating the relationships influenced by a combination of identity markers during fieldwork is an important aspect of qualitative data co-creation. Based on ethnographic research with the canal boating and enthusiast communities in the UK, this paper focuses on the mundane power dynamics and hierarchies in research situations. The paper discusses the role of humour in negotiating the interpersonal dynamics and argues for the consideration of power (im)balances in the field beyond assumptions of the researcher as definitely the advantaged side. Joking plays an important role and is used by both research participants and researchers to level the researcher–participant hierarchies as well as to reproduce and reaffirm them. This takes place on a conceptual continuum: first, in terms of their relative rigidity, whereby certain norms, opinions or value systems are reinforced; and secondly, flexibility, whereby the notions about norms and preconceived ideas might shift during the research encounter. [ABSTRACT FROM AUTHOR]

This article traces the career, scientific achievements, and emigration of the Berlin-born physician, psychoanalyst, and psychosomatic researcher Eric Wittkower. Trained in Berlin and practicing internal medicine, he became persecuted by the Nazi regime and, after fleeing Germany via Switzerland, continued his professional career in the United Kingdom, where he turned to psychosomatic medicine and worked in the service of the British Army during World War II. After two decades of service in the UK, Wittkower joined McGill University in Canada. His increasingly interdisciplinary work contributed to the establishment of the new research field of transcultural psychiatry. Finally the paper provides a detailed history of the beginning of the section of transcultural psychiatry at the Allan Memorial Institute. [ABSTRACT FROM AUTHOR]

The word "Buddhism" conjures up a variety of images and connotations: monks meditating on hilltops, mindfulness, cheerful Buddha caricatures. It is unlikely that these depictions suggest engagement with societal issues. And yet, this is precisely what many Buddhist communities and traditions are involving themselves in around the world. Often referred to as "engaged Buddhism", this development in the Buddhist tradition refers to the application of Buddhist principles and practices to situations of social and environmental suffering. Nevertheless, there are critics of this emerging trend who contend that Buddhists should refrain from engaging in societal issues, believing that such involvement contradicts the teachings of the Buddha and distracts from the ultimate goal of liberation. Built on two years of ethnographic research, this paper explores the ways in which a particular environmentally engaged Buddhist group known as "Extinction Rebellion Buddhists" adapt their religious beliefs and practices in response to the challenges posed by the Anthropocene, where concerns for our collective world have resulted in increasing interest in the ways in which humans actively care for the environment. In reformulating Buddhist principles and meditation as a "politics of care", care becomes a tool for change, with the group not only confronting the pressing issues of the Anthropocene but also disrupting Buddhism's traditionally inward-looking, other-worldly tendencies, carving out space for autonomy and transformation within the broader landscape of UK Buddhism. [ABSTRACT FROM AUTHOR]

Controlled Organ Donation after Circulatory Death (DCD) was re-introduced in the UK in 2008, in efforts to increase rates of organs for transplant. Following reintroduction there were debates about the ethics of DCD, leading to production of legal and ethical guidelines. Today, DCD makes up 40% of deceased organ donors, leading to claims that the UK has 'overcome' its ethical challenges. However, there is little understanding of how DCD works in practice and the ethical implications of making DCD routine in the context of the NHS. This paper draws on data from an ethnographic study examining the practices of DCD in two acute NHS Trusts in England. Interviews with Intensive Care staff and Specialist Nurses in organ donation, observations of organ donation committee meetings and analysis of Trust documents were conducted. Findings reveal that the routinisation of DCD has created new ethical issues relating to interactions between organisational timeframes for DCD and (under)resourcing for, and de-prioritisation of, donation within an NHS subject to austerity. They include: the perceived burden on families and implications for consent when there are delays in the donation process, due to theatre space and retrieval team shortages; family and staff distress when death does not happen 'on time'; and the problem of where to take patients who do not die in time to donate. I argue these temporal-ethical issues are likely to become heightened as potential donor rates increase with the new opt-out legislation, unless the resourcing required to deal with these problems are also addressed. [ABSTRACT FROM AUTHOR]

Laboratory animal science represents a challenging and controversial form of human-animal relations because its practice involves the deliberate and inadvertent harming and killing of animals. Consequently, animal research has formed the focus of intense ethical concern and regulation within the UK, in order to minimize the suffering and pain experienced by those animals whose living bodies model human diseases amongst other things. This paper draws on longitudinal ethnographic research and in-depth interviews undertaken with junior laboratory animal technicians (ATs) in UK universities between 2013 and 2015, plus insights from interviews with key stakeholders in laboratory animal welfare. In our analysis, we examine four key dimensions of care work in laboratory animal research: (i) the specific skills and sensitivities required; (ii) the role of previous experiences of animal care; (iii) the influence of institutional and affective environments and (iv) experiences of killing. We propose that different notions of care are enacted alongside, not only permitted levels of harm inflicted on research animals following research protocols, but also harms to ATs in the processes of caring and killing animals. Concluding, we argue for greater articulation of the coexistence of care and harms across debates in geography about care and human-animal relations. [ABSTRACT FROM AUTHOR]

Background: Migrant and ethnic inequalities in maternal and perinatal mortality persist across high‐income countries. Addressing social adversity and inequities across the childbirth trajectory cannot be left to chance and the good intentions of practitioners. Robust, evidence‐based tools designed to address inequity by enhancing both the quality of provision and the experience of care are needed. Methods: An inductive modelling approach was used to develop a new evidence‐based conceptual model of woman–midwife relationships, drawing on data from an ethnographic study of relationships between migrant Pakistani women and midwives, conducted between 2013 and 2016 in South Wales, UK. Key analytic themes from early data were translated into social–ecological concepts, and a model was developed to represent how these key themes interacted to influence the woman–midwife relationship. Results: Three key concepts influencing the woman–midwife relationship were developed from the three major themes of the underpinning research: (1) Healthcare System; (2) Culture and Religion; and (3) Family Relationships. Two additional weaving concepts appeared to act as a link between these three key concepts: (1) Authoritative Knowledge and (2) Communication of Information. Social and political factors were also considered as contextual factors within the model. A visual representation of this model was developed and presented. Conclusions: The model presented in this paper, along with future work to further test and refine it in other contexts, has the potential to impact on inequalities by facilitating future discussion on cultural issues, encouraging collaborative learning and knowledge production and providing a framework for future global midwifery practice, education and research. Patient or Public Contribution: At the outset of the underpinning research, a project involvement group was created to contribute to study design and conduct. This group consisted of the three authors, an Advocacy Officer at Race Equality First and an NHS Consultant Midwife. This group met regularly throughout the research process, and members were involved in discussions regarding ethical/cultural/social issues, recruitment methods, the creation of participant information materials, interpretation of data and the dissemination strategy. Ideas for the underpinning research were also discussed with members of the Pakistani community during community events and at meetings with staff from minority ethnic and migrant support charities (BAWSO, Race Equality First, The Mentor Ring). Local midwives contributed to study design through conversations during informal observations of antenatal appointments for asylum seekers and refugees. [ABSTRACT FROM AUTHOR]

Introduction: This paper explores doctor–patient and companion communication about care decisions in a UK emergency department (ED). Doctors interface between patients and healthcare systems and facilitate access to care across a range of encounters, drawing on information and authority to make and communicate clinical care decisions. Materials and Methods: We explored characteristics of communication through ethnographic observation of 16 video‐recorded case studies of ED consultations (average length: 1 h) collected over 6 months. Companions were present in 10 cases. We conducted a framework analysis to understand the roles of doctors, consultants, patients and companions in relaying ED care decisions. Findings: We present two cases to reflect companion roles and their effect on the consultation. The urgency for care and scarcity of resources means clinicians justify decisions and strategize to move patients along ED pathways. Discussion: Everyday care interactions between patients and doctors are goal‐oriented and companions participate by providing case information, querying decisions and advocating for care. Our findings reflect how doctors justify decisions made in communicating the next steps in ways that characterize the clinical encounter. Conclusion: By exploring everyday interactions our study contributes to a growing understanding of patient–clinician and companion communication in the ED. Patient or Public Contribution: Patients and caregivers voluntarily participated in data collection and consented to video recordings being conducted of ED consultations between them and junior doctors. There was extensive consultation with all grades of staff about the acceptability of the work and the best way to conduct it to minimize the impact on patients and staff. Through this manuscript, we have demonstrated the presence and important role of companions. On reflection it would have been valuable to have included patients and companions in discussions about the work; however, this project was conducted with very limited funding and no resources were committed to patient and public involvement. Given the setting and scope of the study, it was not feasible to involve patients or members of the public in other stages of the research or preparation of the manuscript. We recognize this as a potential limitation of the work. [ABSTRACT FROM AUTHOR]

To explore how the information-sharing context influences how speech and language therapy (SLT) and nursing staff interact on stroke units and what they discuss. Ethnographic methodology was used, with data collected during 40 weeks of fieldwork across three inner city stroke units in the UK. Data comprised field notes collected during 357 h of participant observation and 43 interviews. Interviews were conducted with 14 SLTs, 1 SLT assistant, 24 registered nurses and 4 nursing assistants. This paper is focused on informal information-sharing. SLTs and nurses had different experiences of time and space (the temporal-spatial context) with respect to ward presence and proximity to patients, influencing how they interacted, the content of their talk and their relationships. Most interactions had the quality of interruptions, in which SLTs seized moments in between nursing tasks. Conditions were less suited to sharing information about communication than swallowing and SLTs felt more allied to other therapists than nurses. The temporal-spatial context impeded information-sharing, particularly about patients' communication needs. Consideration should be given to developing relationships between SLTs and nurses as key partners for patient care and raising the profile of communication information in ways that are relevant and useful to nursing work. Strategic waiting for opportunities to interrupt nurses and gain their attention is central to how speech and language therapists manage their need to share information informally with nurses. The small "windows in time" available for interaction influence information-sharing, with a limiting effect on information about patients' communication. There is potential to improve information-sharing between speech and language therapists and nurses by considering how the relevance of information for patient care could be made clearer. [ABSTRACT FROM AUTHOR]

Social work in the United Kingdom is preoccupied with what social workers cannot do due to having limited time to spend with service users. Yet remarkably little research has examined what social workers actually do, especially in long‐term relationships. This paper draws from an ethnographic study of two social work departments in England that spent 15 months observing practice and organizational life. Our findings show that social work some of the time has a significant amount of involvement with some service users and the dominant view that relationship‐based practice is rarely achieved is in need of some revision. However, families at one research site received a much more substantial, reliable overall service due to the additional input of family support workers and having a stable workforce who had their own desks and were co‐located with managers in small team offices. This generated a much more supportive, reflective culture for social workers and service users than at the second site, a large open plan "hot‐desking" office. Drawing on relational, systemic, and complexity theories, the paper shows how the nature of what social workers do and culture of practice are shaped by the interaction between available services, office designs, and practitioners', managers', and service users' experiences of relating together. [ABSTRACT FROM AUTHOR]

All secondary schools in England have been required to teach Relationships and Sex Education (RSE) since 2019, which has raised particular challenges for – and confrontations with – religious minorities. This paper draws on ethnographic research to centre analysis on the fraught moral binds felt by Jewish parents and educators as they struggle to decide when and how to equip children with knowledge while needing to conform to institutional positions on what protection means. Bodily knowledge is redacted across religious/state models of education, which propagates the maintenance of social boundaries and definitions of sexual transgression, but do not stop the quests and questions that adolescents harbour during puberty and development. The paper draws attention to the use of bracketed words in feminist scholarship to convey how terms are projected as having universal meanings or connotations, which are, in reality, socially situated or at least used in socially sanctioned ways. [ABSTRACT FROM AUTHOR]

Global health donors increasingly embrace international non-governmental organisations (INGOs) as partners, often relying on them to conduct political advocacy in recipient countries, especially in controversial policy domains like reproductive health. Although INGOs are the primary recipients of donor funding, they are expected to work through national affiliates or counterparts to enable 'locally-led' change. Using prospective policy analysis and ethnographic evidence, this paper examines how donor-funded INGOs have influenced the restrictive policy environments for safe abortion and family planning in South Sudan and Malawi. While external actors themselves emphasise the technical nature of their involvement, the paper analyses them as instrumental political actors who strategically broker alliances and resources to shape policy, often working 'behind the scenes' to manage the challenging circumstances they operate under. Consequently, their agency and power are hidden through various practices of effacement or concealment. These practices may be necessary to rationalise the tensions inherent in delivering a global programme with the goal of inducing locally-led change in a highly controversial policy domain, but they also risk inciting suspicion and foreign-national tensions. [ABSTRACT FROM AUTHOR]

A deeper understanding of care demands the methodological finesse of qualitative research: we must observe, listen, and witness to expose what matters to care recipients. In this paper, we – a team of three: one early-career researcher and two supervisors – reflect on our experiences of designing and then seeking ethics approval for ethnographic research on care for older adults, many of whom demonstrate a lack of capacity to consent to research. Viewing experiences of well-being and dignity as embedded within interpersonal negotiations, this study privileges care home residents' daily life, looking to stories and observations of daily life to reveal the complexities of well-being in the care home setting. This paper emphasizes the importance of using qualitative research methods to gain a deeper understanding of care practices, particularly in the context of care for older adults with varying cognitive capacities. By privileging the daily life experiences of care home residents and employing the logic of process consent, we aim to include the voices of all participants, not just those who can provide written informed consent. However, obtaining ethics approval for this type of research presents several challenges, requiring careful negotiation and the inclusion of consultee advice. This paper highlights the tensions between procedural ethics and the need for better inclusion of vulnerable populations in ethnographic research on care. By addressing these challenges, we can move towards a more context-sensitive and humanised approach to research ethics that values the lived experiences of care recipients. • This paper reflects on the experiences of a UK-based ethnographic research study with older adults in residential care. • We examine the formalised ethics process in UK-based research and the need to include older adults in ethnographic research. • Viewing well-being as embedded within interpersonal negotiations, this study uses the humanisation of care framework (HCF). • The HCF can help understand further and develop ethnographic research methods with older adult participants. [ABSTRACT FROM AUTHOR]

Although breastfeeding is known to improve health, economic and environmental outcomes, breastfeeding initiation and continuation rates are low in the United Kingdom. The global WHO/UNICEF Baby Friendly Hospital Initiative (BFHI) aims to reverse declining rates of breastfeeding by shifting the culture of infant feeding care provision throughout hospital maternity settings. In the United Kingdom, the global BFHI has been adapted by UNICEF UK reflecting a paradigm shift towards the experiences of women and families using maternity services. This research used a critical ethnographic approach to explore the influence of the national UNICEF UK Baby Friendly Initiative (BFI) standards on the culture of one typical maternity service in England, over a period of 8 weeks, across four phases of data collection between 2011 and 2017. Twenty‐one staff and 26 service users were recruited and engaged in moderate‐level participant observation and/or guided interviews and conversations. Basic, organising and a final global theme emerged through thematic network analysis, describing the influence of the BFI on providing, receiving and leading infant feeding care in a hospital maternity setting. Using Antonovsky's sense of coherence construct, the findings discussed in this paper highlight how the BFI offers 'informational' (comprehensible), 'practical' (manageable) and 'emotional' (meaningful) support for both staff and service users, strengthened by effective, local leadership and a team approach. This is juxtaposed against the tensions and demands of the busy hospital maternity setting. It is recommended that ongoing infant feeding policy, practice and leadership balance relational and rational approaches for positive infant feeding care and experiences to flourish. [ABSTRACT FROM AUTHOR]

Background: The United Kingdom has the highest incarceration rate in Western Europe. It is known that women in prison are a vulnerable female population who are at risk of mental ill-health due to disadvantaged and chaotic life experiences. Accurate numbers of pregnant women held in UK prisons are not recorded, yet it is estimated that 6%–7% of the female prison population are at varying stages of pregnancy and around 100 babies are born to incarcerated women each year. There are limited published papers that document the departure of the researcher following closure of fieldwork with women in prison. This article identifies the dilemmas and challenges associated with the closure of prison fieldwork through the interwoven reflections of the researcher. Departure scenarios are presented which illuminate moments of closure talk with five women, supported by participant reflections regarding abandonment and loss, making pledges for the future, self-affirmation, incidental add-ons at the end of an interview and red flags, alerting the researcher to potential participant harm through ill health or self-injury. Objectives: The primary intention of the study was to observe the pregnant woman's experience with the English prison system through interviews with pregnant women and field observations of the environment. Research design: Ethnographic design enabled the researcher, a practising midwife, to engage with the prisoners' pregnancy experiences in three English prisons, which took place over 10 months during 2015–2016. Data collection involved semi-structured, audio-recorded interviews with 28 female prisoners in England who were pregnant or had recently given birth while imprisoned, 10 members of staff and a period of non-participant observation. Follow-up interviews with 5 women were undertaken as their pregnancies progressed. Computerised qualitative data analysis software was used to generate and analyse pregnancy-related themes. Ethical considerations: Favourable ethical opinion was granted by National Offender Management Services through the Health Research Authority Integrated Research Application System and permission to proceed was granted by the University of Hertfordshire, UK. Findings: Thematic analysis enabled the identification of themes associated with the experience of prison pregnancy illuminating how prison life continues with little consideration for their unique physical needs, coping tactics adopted and the way women negotiate entitlements. On researcher departure from the field, the complex feelings of loss and sadness were experienced by both participants and researcher. Discussion: To leave the participant with a sense of abandonment following closure of fieldwork, due to the very nature of the closed environment, risks re-enactment of previous emotional pain of separation. Although not an ethical requirement, the researcher sought out psychotherapeutic supervision during the fieldwork phase with 'Janet', a forensic psychotherapist, which helped to highlight the need for careful closure of research/participant relationships with a vulnerable population. This article brings to the consciousness of prison researchers the need to minimise potential harm by carefully negotiating how to exit the field. Reflections of the researcher are interlinked with utterances from some participants to illustrate the types of departure behaviours. Conclusion: Closure of fieldwork and subsequent researcher departure involving pregnant women in prison requires careful handling to uphold the ethical research principle 'do no harm'. [ABSTRACT FROM AUTHOR]

Abstract Since Wil Gesler's earliest articulation (Gesler, 1992; Gesler, 1996) key thinkers in the field of therapeutic landscapes have sought to emphasise the embodied, contextual and wholly relational nature of the relationship that exists between people and place. However, the extant research has tended to focus on the relational healing experience as this occurs 'in the moment' and with reference to a specific location or site of healing, with less attention being paid to what happens to people when they return to their ordinary or everyday places. In this paper, we reflect on findings from visual ethnographic work (including photography and film) that explored the therapeutic landscape experiences of people with intellectual disabilities engaged in care farming interventions for health and wellbeing. The study also recruited farm staff and family members or carers to take part, and comprised 20 participants in total. Having identified a gap in our understanding, consideration is given to wider impact that engaging in these sorts of activities had on the everyday lives of the participants in this study. We argue that this study has identified two types of therapeutic journey that broadly fit the experiences of study participants. The first type of journey denotes landscape experiences that are transformative. Here the therapeutic power of the care farm landscape resides in the ability of activities conducted on care farms to influence other aspects of participants' lives in ways that promote wellbeing. By contrast, there is another type of journey where the therapeutic power of the care farm resides in its ability to ameliorate challenging or harmful life situations, thus offering people a temporary site of respite or refuge. We conclude that these findings denote an important development for this sub-field of health geography, not only because they draw attention to the transformative power of the therapeutic encounter, but also the broader socio-spatial environments in which people live and ways in which these can limit that power. Highlights • A visual ethnographic study on the role of care farms as therapeutic spaces. • Focuses on the experiences of people with intellectual disabilities. • Utilises the concept of therapeutic landscapes as a theoretical framework. • Draws critical attention to the transformative power of the therapeutic encounter. [ABSTRACT FROM AUTHOR]

Cross-regional correlations between average IQ and socioeconomic development have been documented in many different countries. This paper presents new IQ estimates for the twelve regions of the UK. These are weakly correlated (r=0.24) with the regional IQs assembled by Lynn (1979). Assuming the two sets of estimates are accurate and comparable, this finding suggests that the relative IQs of different UK regions have changed since the 1950s, most likely due to differentials in the magnitude of the Flynn effect, the selectivity of external migration, the selectivity of internal migration or the strength of the relationship between IQ and fertility. The paper provides evidence for the validity of the regional IQs by showing that IQ estimates for UK nations (England, Scotland, Wales and Northern Ireland) derived from the same data are strongly correlated with national PISA scores (r=0.99). It finds that regional IQ is positively related to income, longevity and technological accomplishment; and is negatively related to poverty, deprivation and unemployment. A general factor of socioeconomic development is correlated with regional IQ at r=0.72. [ABSTRACT FROM AUTHOR]

There has been a shift towards social workers in many areas of the UK being based in large open plan offices and working more flexibly and remotely in space. This approach is commonly referred to as ‘agile working’. The paper explores the impact of agile working on social workers' practices and experiences in office spaces. It discusses data from an ethnographic study of children's safeguarding social work teams in two locations. One team was based in a large open plan office and was engaged in agile working, the other team was located in a much smaller office and was not using this approach. Data from observations of practice, analysis of material spaces, and interviews with social workers and those responsible for planning office space are examined. The paper concludes that there are qualitative differences between such spaces which are due to agile working arrangements and which are likely to impact significantly on social workers' experiences of practice, interactions with colleagues and development of practice knowledge. The data also suggest a lack of understanding in social work of the spatial requirements of practitioners and the significance that private and open space has for children's social work in the current UK context. [ABSTRACT FROM AUTHOR]

Prescribing is the most common healthcare intervention, and is both beneficial and risky. An important source of risk in UK general practice is the management of 'repeat prescriptions', which are typically requested from and issued by non-clinically trained reception staff with only intermittent reauthorisation by a clinical prescriber. This paper ethnographically examines the formal and informal work employed by GPs and receptionists to safely conduct repeat prescribing work in primary care using Strauss's (1985, 1988, 1993) concept of 'articulation work' across eight UK general practices. The analytical lens of articulation work provided an investigative framing to contextually map the informal, invisible resources of resilience and strength employed by practice team members in the achievement of repeat prescribing safety, where risk and vulnerability were continually relocated across space and time. In particular, the paper makes visible the micro-level competencies and collaborative practices that were routinely employed by both GPs and receptionists across different socio-cultural contexts, with informal, cross-hierarchical communication usually considered more effective than the formal structures of communication that existed (e.g. protocols). While GPs held formal prescribing authority, this paper also examines the key role of receptionists in both the initiation and safe coordination of the repeat prescribing routine. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this paper was to highlight the importance of cultural infl uence in understanding hearing-help seeking and hearing-aid uptake. Design: Information on audiological services in different countries and ' theories related to cross-culture ' is presented, followed by a general discussion. Study sample: Twenty-seven relevant literature reviews on hearing impairment, cross-cultural studies, and the health psychology model and others as secondary resources. Results: Despite the adverse consequences of hearing impairment and the significant potential benefits of audiological rehabilitation, only a small number of those with hearing impairment seek professional help and take up appropriate rehabilitation. Therefore, hearing help-seeking and hearing-aid uptake has recently become the hot topic for clinicians and researchers. Previous research has identified many contributing factors for hearing help-seeking with self-reported hearing disability being one of the main factors. Although significant differences in help-seeking and hearing-aid adoption rates have been reported across countries in population studies, limited literature on the infl uence of cross-cultural factors in this area calls for an immediate need for research. Conclusions: This paper highlights the importance of psychological models and cross-cultural research in the area of hearing help-seeking and hearing-aid uptake, and consequently some directions for future research are proposed. [ABSTRACT FROM AUTHOR]

Accessible summary Current UK mental health nursing policy is critiqued for neglecting the storied complexities of recovery-survival., Within a critical framework, creative non-fiction is used in a relational auto-ethnographic design to produce two short stories that demonstrate the utility of narrative re-storying in recovery-survival., New insights emerge for mental health nurse practice and research. These are: that narrative re-storying may help the recovery process for individuals and communities; that hybrid transcultural writing positively undermines barriers between professionals and consumers of mental health; and that all of this constitutes contemporary methodological innovation in narrative inquiry and related practice., Abstract Some of the complexities of recovery and survival are arguably relatively neglected in current UK mental health nursing policy and, by association, clinical and research practice. In order to redress this, this paper, part of larger research project, will present two short stories, contextualized in a critical theoretical and methodological position. The overall significance of the argument in the paper is in its emerging benefits and implications for users of mental health services, practitioners and researchers. The central, orienting principle in the paper, cohering with all of its strands, is 'narrative re-storying'. Organized in three parts, the first reviews selected relevant background policy and related literature, the contextual and theoretical bases of the paper, and related methodological and ethical issues. The second presents the two stories, and the third brings the paper to a close. It does so in discussing specific and global emerging implications for mental health nursing practice and research, around narrative re-storying as a recovery tool and methodological innovations that include 'hybrid' writing. [ABSTRACT FROM AUTHOR]

Aim: To explore the role of UK district nurses in providing care for adult patients with a terminal diagnosis by reviewing qualitative research. Design: Meta-ethnography was used to conduct the synthesis. Data sources: CINAHL, MEDLINE and British Nursing Index (BNI) were searched comprehensively for primary research relating to the role of UK district nurses in palliative care. Review methods: The abstracts and titles of 700 papers were screened against inclusion criteria, of these 97 full papers were appraised. Some 24 studies reported in 25 papers were selected for inclusion in the synthesis. Findings: In total, five key themes were identified: valuing the role; practical role; relationships with patients and families; providing psychological support; and role uncertainty. Further synthesis yielded two ‘lines of argument’. The concept of the ‘expert friend’ argues that the atypical relationship district nurses cultivate with patients underpins district nurses’ provision of palliative care and profoundly influences the nature of psychological support given. Secondly, the concept of ‘threat and opportunity’ encapsulates the threat district nurses can feel to their traditional role in palliative care through changing health and social policy, while recognising the benefits that access to specialist knowledge and better training can bring. Conclusion: The findings have implications for understanding the motivators and barriers experienced by district nurses delivering palliative care in a time of unprecedented change to community health services [ABSTRACT FROM AUTHOR]

Although there is much written on the emotional labour of nursing, there is little research grounded in the experience of so-called ‘unqualified’ care assistants. This paper is drawn from an ethnographic study conducted with care assistants on three dementia care wards in one mental health trust within the United Kingdom National Health Service (NHS). We describe the emotional labour carried out by care assistants in their attempts to provide personalised care for people whose cognitive degeneration renders conventional relationship-building very difficult, produces unpredictable ‘challenging behaviour’ and calls into question the notion of ‘feeling rules’. This context requires the ability to strike a balance between emotional engagement and detachment, and it is the complexities of this relationship that are the focus of this paper, arguing that a degree of detachment is a prerequisite to engagement in this context. In conclusion, we argue that the contribution of care assistants in this context needs to be better acknowledged, supported and remunerated. [ABSTRACT FROM PUBLISHER]

The need to focus on patient safety and improve the quality and consistency of medical care in acute hospital settings has been highlighted in a number of UK and international reports. When patients on a hospital ward become acutely unwell there is often a window of opportunity for staff, patients and relatives to contribute to the ‘rescue’ process by intervening in the trajectory of clinical deterioration. This paper explores the social and institutional processes associated with the practice of rescue, and implications for the implementation and effectiveness of rapid response systems (RRSs) within acute health care. An ethnographic case study was conducted in 2009 in two UK hospitals (focussing on the medical directorates in each organisation). Data collection involved 180 h of observation, 35 staff interviews (doctors, nurses, health care assistants and managers) and documentary review. Analysis was informed by Bourdieu's logic of practice and his relational concept of the ‘field’ of the general medical ward. Three themes illustrated the nature of rescue work within the field and collective rules which guided associated occupational distinction practices: (1) the ‘dirty work’ of vital sign recording and its distinction from diagnostic (higher order) interpretive work; (2) the moral order of legitimacy claims for additional help; and (3) professional deference and the selective managerial control of rescue work. The discourse of rescue provided a means of exercising greater control over clinical uncertainty. The acquisition of ‘rescue capital’ enabled the social positioning of health care assistants, nurses and doctors, and shaped use of the RRS on the wards. Boundary work, professional legitimation and jurisdictional claims defined the social practice of rescue, as clinical staff had to balance safety, professional and organisational concerns within the field. This paper offers a nuanced understanding of patient safety on the front-line, challenging notions of the ‘quick fix’ safety solution. [ABSTRACT FROM AUTHOR]

In the UK, food poverty has been associated with conditions such as obesity, malnutrition, hypertension, iron deficiency, and impaired liver function. Food banks, the primary response to food poverty on the ground, typically rely on community referral and distribution systems that involve health and social care professionals and local authority public health teams. The perspectives of these key stakeholders remain underexplored. This paper reports on a qualitative study of the health and wellbeing challenges of food poverty and food banking in London. An ethnographic investigation of food bank staff and users was carried out alongside a series of healthcare stakeholder interviews. A total of 42 participants were interviewed. A Critical Grounded Theory (CGT) analysis revealed that contemporary lived experiences of food poverty are embedded within and symptomatic of extreme marginalisation, which in turn impacts upon health. Specifically, food poverty was conceptualised by participants to: firstly, be a barrier to providing adequate care and nutrition for young children; secondly, be exacerbated by lack of access to adequate fresh food, food storage and cooking facilities; and thirdly, amplify existing health and social problems. Further investigation of the local government structures and professional roles that both rely upon and serve to further embed the food banking system is necessary in order to understand the politics of changing welfare landscapes. [ABSTRACT FROM AUTHOR]

Abstract: Recent UK welfare reforms have been less successful than expected by the Government in supporting unemployed people with long‐term illness into work. Frontline workers remain a core element of the new welfare‐to‐work machinery, but operate within a changed organisational and policy landscape. These changes raise important questions regarding whether and how claimants’ health‐related barriers to work are considered. This paper examines the UK welfare‐to‐work frontline worker's role with claimants who have long‐term illness. Fieldwork observations in three not‐for‐profit employment support services and semi‐structured interviews with 29 participants (claimants, frontline workers, healthcare professionals and managers) were conducted between 2011 and 2012. Participant observation of the wider welfare‐to‐work arena was initiated in 2009 and continued until 2013. A qualitative methodology drawing on ethnographic principles was adopted. Thematic analysis of the data was carried out. The findings show that the frontline worker plays a key role in assessing and addressing claimants’ health‐related barriers to work. Two important health‐related role dimensions were identified: a health promoter role which involved giving health promotional advice to claimants about their general health; and a health monitor role which involved observing and questioning claimants about their general health. Frontline workers’ practice approaches were shaped by organisational and individual factors. Integration between the National Health Service and employment support services was limited, and the findings suggested improvements were required to ensure an adequate response to claimants’ health‐related needs to support their journey into work. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies using the WHOQOL measures have demonstrated that the relationship between individual items and the underlying quality of life (QoL) construct may differ between cultures. If unaccounted for, these differing relationships can lead to measurement bias which, in turn, can undermine the reliability of results.Methods: We used item response theory (IRT) to assess differential item functioning (DIF) in WHOQOL data from diverse language versions collected in UK, Zimbabwe, Russia, and India (total N = 1332). Data were fitted to the partial credit 'Rasch' model. We used four item banks previously derived from the WHOQOL-100 measure, which provided excellent measurement for physical, psychological, social, and environmental quality of life domains (40 items overall). Cross-cultural differential item functioning was assessed using analysis of variance for item residuals and post hoc Tukey tests. Simulated computer-adaptive tests (CATs) were conducted to assess the efficiency and precision of the four items banks.Results: Splitting item parameters by DIF results in four linked item banks without DIF or other breaches of IRT model assumptions. Simulated CATs were more precise and efficient than longer paper-based alternatives.Discussion: Assessing differential item functioning using item response theory can identify measurement invariance between cultures which, if uncontrolled, may undermine accurate comparisons in computer-adaptive testing assessments of QoL. We demonstrate how compensating for DIF using item anchoring allowed data from all four countries to be compared on a common metric, thus facilitating assessments which were both sensitive to cultural nuance and comparable between countries. [ABSTRACT FROM AUTHOR]

Context The National Institute for Health and Care Excellence ( NICE) has an explicit mandate to include patient and public involvement in the appraisal of medicines to be available for funding on the NHS. NICE involves an appraisal committee who are required to take on board experiential evidence from patient experts alongside population-based evidence on clinical and cost-effectiveness when making a decision whether to fund a drug. Objective This paper considers how NICE Single Technological Appraisal ( STA) committees attempt to incorporate the views of patients in making decisions about funding medicines on the NHS. Methods A prospective design was employed to follow three pharmaceutical products involving three different appraisal committees. Three data collection methods were used: analysis of documentary evidence sent by NICE, non-participant unstructured observations of the open and closed sessions of meetings and qualitative interviews. Settings and participants Unstructured non-participant observations were carried out at nine STA meetings, and 41 semi-structured interviews were undertaken with committee members from NICE's STA committees, patient experts, analysts from NICE's project team and drug manufacturers. Results Our analysis showed how the committees displayed a preference for an ideal-type of patient representative, disagreement among the committee when weighing-up patient statements in the STA process and more pre-preparation support for patient involvement. Conclusions Although NICE has attempted to adopt an approach flexible to patients and carers through formal decision-making arrangements that incorporate patient views, nonetheless, the processes of the STAs can in fact undermine the very evidence collected from patient representatives. [ABSTRACT FROM AUTHOR]

Aim: To more fully understand the experiences of seclusion in a learning disability service for women. Background: This paper reports on one of the analytical themes, seclusion, from an ethnographic study exploring the lives of learning disabled women on locked wards. Method: Participant observation was used on three locked wards for women in a learning disability secure (forensic) unit in the United Kingdom. Themes from the analysis of field-notes were used to construct an interview schedule. Sixteen detained women and ten staff participated in interviews. Results: The thematic analysis produced four areas of relevance: the seclusion room environment, reasons for using seclusion, termination of seclusion and alternatives to seclusion. Conclusion: Detained women's descriptions of seclusion portrayed a bewildering, distressing experience which violated their privacy. Alternative practices such as providing a space for anger and resolve, and time for discussion with staff were identified. [ABSTRACT FROM AUTHOR]

In July 2015, a new statutory duty was sanctioned in the UK for a range of professional practitioners, including social workers, to pay ‘due regard to preventing terrorism’. The duty has contributed to a shifting of social work practice and decision-making from the fields of advocacy and promotion of ethics, social justice and human rights, towards risk-work more analogous to that of the security services. Social workers are caught up in pre-emptive risk work, operating in a pre-crime space. Further, an ‘ethic of silence’ has emerged because social workers are not speaking back or challenging the duty due to the ensnared nature of the dominant securitised discourses, which prevent counter-discourses from emerging. Utilising an autoethnographic approach, this paper shows that the new duty is reorganising and rearranging new networks of practitioners with securitisation a dominant feature, and this significantly affects practice decisions. Latour’s actor network theory (ANT) helps us to examine the ethical and practical implications for decision-making. Shifting notions of ethics, rights and as yet unforeseen consequences of PREVENT concern us. This being said, humane and socially just social work practice within the duty is possible; strengths-based risk practices provide practical and ethical ways forward and these are discussed. [ABSTRACT FROM PUBLISHER]

Since 2005, health trainers and other lay public health workers ( LPHWs) have been increasingly active in the UK. Although elsewhere in the world LPHWs are expected to come from the communities within which they work and know that their knowledge is valued, neither is the case for LPHWs in the UK. This study sought to discover the lay knowledge of health trainers and other LPHWs, aiming to ascertain how this knowledge might more effectively be utilised within UK public health services. This paper describes a participatory and ethnographic case study research project undertaken on an anonymised urban estate in North East England. Findings were generated by a range of means including by participant observation and semi-structured interviews. Seven LPHWs took part, as did 32 other community members. This study found that the lay health knowledge of an individual UK LPHW is determined primarily by his or her position within, or in relation to, the community within which he or she works. Insider LPHWs possess an embodied knowledge and incomer LPHWs possess an experiential knowledge which, although different from one another, are essentially interpersonal in nature. Lay health knowledge can take different forms, and different LPHWs can provide different forms of lay health knowledge. Public health structures and services in the UK should make better use of all forms of LPHW knowledge, and should seek from LPHWs training on how to engage the most 'hard-to-reach' or 'difficult-to-engage' groups. Services recruiting LPHWs should decide whether they are seeking embodied insider LPHW knowledge, experiential incomer LPHW knowledge or a mixture of both. [ABSTRACT FROM AUTHOR]

Background This paper explores the nature of food and plants and their meanings in a British Bengali urban context. It focuses on the nature of plants and food in terms of their role in home making, transnational connections, generational and concepts of health. Methods An ethnographic approach to the research was taken, specific methods included participant observation, focus group discussions and semi-structured interviews. Thirty women of Bengali origin were mostly composed of "mother" and "daughter" pairs. The mothers were over 45 years old and had migrated from Bangladesh as adults and their grown-up daughters grew up in the UK. Results Food and plants play an important role in the construction of home "here" (London) while continuing to connect people to home "there" (Sylhet). This role, however, changes and is redefined across generations. Looking at perceptions of "healthy" and "unhealthy" food, particularly in the context of Bengali food, multiple views of what constitutes "healthy" food exist. However, there appeared to be little two-way dialogue about this concept between the research participants and health professionals. This seems to be based on "cultural" and power differences that need to be addressed for a meaningful dialogue to occur. Conclusion In summary, this paper argues that while food is critical to the familial spaces of home (both locally and globally), it is defined by a complex interplay of actors and wider meanings as illustrated by concepts of health and what constitutes Bengali food. Therefore, we call for greater dialogue between health professionals and those they interact with, to allow for an enhanced appreciation of the dynamic nature of food and plants and the diverse perceptions of the role that they play in promoting health. [ABSTRACT FROM AUTHOR]

Background and Purpose This paper draws on empirical fieldwork data of naturally occurring UK physiotherapy placement education to make visible how education is actually carried out and suggest what students may be learning through their placement interactions. The data challenge everyone involved in placement education design and practice to consider the values and practices students are learning to perpetuate through placement education experiences. Methods The researcher undertook an ethnomethodologically informed ethnographic observation of naturally occurring physiotherapy placement education in two UK NHS placement sites. This study adopted a social perspective of learning to focus on the minutiae of placement educator, student and patient interaction practices during student-present therapeutic activities. Two days of placement for each of six senior students were densely recorded in real-time focussing specifically on the verbal, kinesics and proxemics-based elements of the participants' interaction practices. Repeated cycles of data analysis suggested consistent practices irrespective of the placement, educators, students or patients. Results The data suggest that placement education is a powerful situated learning environment in which students see, experience and learn to reproduce the physiotherapy practices valued by the local placement. Consistently, placement educators and students co-produced patient-facing activities as spectacles of physiotherapy-as-science. In each setting, patients were used as person-absent audiovisual teaching aids from which students learnt to make a case for physiotherapy intervention. Discussion The paper challenges physiotherapists and other professions using work-placement education to look behind the rhetoric of their placement documentation and explore the reality of students' learning in the field. The UK-based physiotherapy profession may wish to consider further the possible implications of its self-definition as a 'science-based healthcare profession' on its in-the-presence-of-students interactions with patients. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper critically engages with a recent shift towards an emphasis on ‘resilience’ in policy and academic fields. The paper suggests that this shift is problematic for several reasons: that it supports normative value judgements; that it may overemphasize the ability of people to ‘bounce back’ and undervalue the hidden costs of resilience, especially those with gendered dimensions; and that it may be associated with policy prescriptions that shift responsibility for dealing with crisis away from the public sphere. The empirical illustration for this analysis is a qualitative study of the impact of economic decline in the Sussex town of Newhaven. [ABSTRACT FROM PUBLISHER]

Much work has been undertaken to publicize the plight of female rape survivors, but until recent years the rape and sexual assault of adult males received little research or public attention. The aim of this paper is to selectively review the literature on male survivors of sexual violence highlighting, where relevant, timely implications for policy and practice. First, changes in UK legislation relating to male rape are discussed, with cross-national comparisons made against United States, Australian and Canadian statute to overview developing definitions and legal good practice. Second, prevalence issues relating to the under-reporting and long-term consequences of male sexual victimization are outlined. Third, the current dearth of UK service provision for male rape survivors is reported. Finally, literature on how male rape myth acceptance, victim blaming and homophobia relate to the secondary victimization of male survivors is considered. Suggestions for continued research in this developing area of work are made. [ABSTRACT FROM AUTHOR]

In the UK there has been a widespread introduction of 'anticipatory prescribing' in community based palliative care. This involves general practitioners (GPs) writing prescriptions in anticipation of them being needed and has been encouraged to try to minimise the risk of patients suffering uncontrolled symptoms and distress; a key reason why terminally ill patients are admitted to hospital in contradiction of most people's preferences. This paper presents the findings from an ethnographic study of healthcare professionals across four care homes and four community sites in two regions (East Midlands and Lancashire/South Cumbria) of the UK. Data were collected from a range of community health professionals, resulting in 83 episodes of observation and 72 interviews. Findings highlight how essential good interdisciplinary communication is to the process of anticipatory prescribing and end-of-life care. This study found that when interdisciplinary communication worked well the anticipatory prescribing process could be carried out smoothly, optimising patient care. [ABSTRACT FROM AUTHOR]

Cyberbullying is a worldwide problem affecting mental health, education, safety and general well-being for individuals across the globe. Despite the widespread availability of the Internet, research into prevalence rates of cyberbullying in Qatar is lacking and legislating for the crime has been slow to develop. Recently there have been some positive initiatives in the country such as a Cybercrime Prevention Law, the development of a National ICT Strategy, and a website detailing safe practice guidelines for Internet usage. However, the implementation and usage of these initiatives are still limited and there is a lack of awareness of cyberbullying in Qatar. As a result, the risk factors and consequences among school-aged children are unknown. The current paper presents an evaluation of the legislative and public policy solutions to cyberbullying available in Qatar, and outlines the critical challenges that could potentially face educators in shaping best practice guidelines for the future. [ABSTRACT FROM AUTHOR]

This paper reports the results of a comparative investigation of attitudes to suicide and suicidal persons in 5,572 university students from 12 countries. Participants filled out two scales measuring attitudes towards suicide and suicidal persons, a measure of psychological distress together with the questions about suicidal behavior. Results showed that the highest suicide acceptance scores were observed in Austrian, UK, Japanese and Saudi Arabian samples and the lowest scores were noted in Tunisian, Turkish, Iranian and Palestinian samples. While the highest social acceptance scores for a suicidal friend were noted in Turkish, US, Italian and Tunisian samples, the lowest scores were seen in Japanese, Saudi Arabian, Palestinian and Jordanian samples. Compared to participants with a suicidal past, those who were never suicidal displayed more internal barriers against suicidal behavior. Men were more accepting of suicide than women but women were more willing to help an imagined suicidal peer. Participants with accepting attitudes towards suicide but rejecting attitudes towards suicidal persons reported more suicidal behavior and psychological distress, and were more often from high suicide rate countries and samples than their counterparts. They are considered to be caught in a fatal trap in which most predominant feelings of suicidality such as hopelessness or helplessness are likely to occur. We conclude that in some societies such as Japan and Saudi Arabia it might be difficult for suicidal individuals to activate and make use of social support systems. [ABSTRACT FROM AUTHOR]

mcinnes e., seers k. & tutton l. (2011) Older people's views in relation to risk of falling and need for intervention: a meta-ethnography. Journal of Advanced Nursing 67(12), 2525-2536. Abstract Aim. This paper is a report of a meta-ethnography of qualitative studies of older peoples' views on risk of falling and need for intervention. Background. Falls and falls-related injuries in older people are worldwide problems. A conceptual understanding of older people's views about falls risk and need for intervention is useful for understanding factors likely to impact on acceptance of risk and recommended interventions. Data Sources. Seven electronic databases were searched 1999-2009. Reference lists of included articles were screened for eligible papers. Review Methods. Assessment of quality was carried out. Themes and concepts were extracted using a meta-ethnographic approach to compare similarities and differences across the retrieved studies. A line of argument was developed to produce an explanatory framework of the extracted themes and concepts. Results. Eleven relevant qualitative research articles of reasonable quality were identified. Six key concepts were identified: beyond personal control; rationalizing; salience; life-change and identity; taking control and self-management. A line of argument synthesis describes how older people approach self-appraisal of falls risk and intervention need, and how they cope and adapt to falls risk and intervention need. Conclusion. In response to having an elevated risk status and perceived associations with frailty and impact on an independent life-style, some prefer to adapt to this reality by taking control and implementing self-management strategies. Healthcare professionals should take into account beliefs about risk and negotiate choices for intervention, recognizing that some individuals prefer to drive the decision-making process to preserve identity as a competent and independent person. [ABSTRACT FROM AUTHOR]

This paper examines the grid of sentiment that structures medical travel to India. In contrast to studies that render emotion as ancillary, the paper argues that affect is fundamental to medical travel's ability to ease the linked somatic, emotional, financial, and political injuries of being ill 'back home'. The ethnographic approach follows the scenes of medical travel within the Indian corporate hospital room, based on observations and interviews among foreign patients, caregivers, and hospital staff in Mumbai, New Delhi, Chennai, and Bangalore. Foreign patients conveyed diverse sentiments about their journey to India ranging from betrayal to gratitude, and their expressions of risk, healthcare costs, and cultural difference help sustain India's popularity as a medical travel destination. However, although the affective dimensions of medical travel promise a remedy for foreign patients, they also reveal the fault lines of market medicine in India. [ABSTRACT FROM AUTHOR]

Background Nursing involves caring for the ‘whole person’ and it is considered inappropriate for nurses to think or talk about patients in objectifying or dehumanising ways. Objectifying discourses can dominate within the arena of critical care, and critical care nurses can experience moral distress as they struggle to think about patients as persons. No previous study has examined the role played by ‘impersonal’ talk in the delivery of nursing care. This paper reports a study which examined the relationship between nursing practice and the way(s) in which critical care nurses think and talk about patients. Objectives The study objectives were to (1) identify and characterise the ways in which critical care nurses think and talk about patients; and (2) describe patterns of nursing practice associated with these different ways of thinking. Study design An ethnographic study was undertaken within one critical care unit in the United Kingdom. Data were collected over 8 months through 92 h of participant observation and 13 interviews. Seven critical care nurses participated in the study. Data analysis adopted the perspective of linguistic ethnography. Findings Analysis of these data led to the identification of seven Discourses, each of which was characterised by a particular way of talking about patients, a particular way of thinking about patients, and a particular pattern of practice . Four of these seven Discourses were of particular significance because participants characterised it as ‘impersonal’ to think and talk about patients as ‘routine work’, as a ‘body’, as ‘(un)stable’ or as a ‘medical case’. Although participants frequently offered apologies or excuses for doing so, these ‘impersonal’ ways of thinking and talking were associated with practice that was essential to delivering safe effective care. Conclusions Critical care practice requires nurses to think and talk about patients in many different ways, yet nurses are socialised to an ideal that they should always think and talk about patients as whole persons. This means that nurses can struggle to articulate and reflect upon aspects of their practice which require them to think and talk about patients in impersonal ways. This may be an important source of distress to critical care nurses and emotional exhaustion and burnout can arise from such dissonance between ideals and the reality of practice. Nursing leaders, scholars and policy makers need to recognise and legitimise the fact that nurses must think about patients in many ways, some of which may be considered impersonal . [ABSTRACT FROM AUTHOR]

Background The recognition, assessment and management of pain in hospital settings is suboptimal, and is a particular challenge in patients with dementia. The existing process guiding pain assessment and management in clinical settings is based on the assumption that nurses follow a sequential linear approach to decision making. In this paper we re-evaluate this theoretical assumption drawing on findings from a study of pain recognition, assessment and management in patients with dementia. Aim To provide a revised conceptual model of pain recognition, assessment and management based on sense-making theories of decision making. Methods The research we refer to is an exploratory ethnographic study using nested case sites. Patients with dementia ( n = 31) were the unit of data collection, nested in 11 wards (vascular, continuing care, stroke rehabilitation, orthopaedic, acute medicine, care of the elderly, elective and emergency surgery), located in four NHS hospital organizations in the UK. Data consisted of observations of patients at bedside (170 h in total); observations of the context of care; audits of patient hospital records; documentary analysis of artefacts; semi-structured interviews ( n = 56) and informal open conversations with staff and carers (family members). Findings Existing conceptualizations of pain recognition, assessment and management do not fully explain how the decision process occurs in clinical practice. Our research indicates that pain recognition, assessment and management is not an individual cognitive activity; rather it is carried out by groups of individuals over time and within a specific organizational culture or climate, which influences both health care professional and patient behaviour. Conclusions We propose a revised theoretical model of decision making related to pain assessment and management for patients with dementia based on theories of sense-making, which is reflective of the reality of clinical decision making in acute hospital wards. The revised model recognizes the salience of individual cognition as well as acknowledging that decisions are constructed through social interaction and organizational context. The model will be used in further research to develop decision support interventions to assist with the assessment and management of patients with dementia in acute hospital settings. [ABSTRACT FROM AUTHOR]

Recent scholarship on transnational immigration restriction have tended to frame British policies in opposition to those of white settler colonies, emphasising the frustration of British officialdom at the explicitly racist exclusions in South Africa, Canada, New Zealand and Australia. While acknowledging these, this paper interrogates the British position, by locating synergies between the deployment of examinations as a form of racial gatekeeping at the height of the empire, with reference to discourses of equity and access emanating from Britain, Australia and India. It reads British attempts to ameliorate the harsh exclusions of the White Australia policy – administered through the apparently neutral device of the Dictation Test – alongside remarkably similar constraints embedded in the exams for the Indian Civil Service that were designed to limit the numbers of Indians in the ICS. Race-based immigration restriction was consistent with – not repugnant to – imperial sensibilities, contrary to so many protestations. The prevalence of racially discriminatory immigration legislation in settler societies had the effect of projecting the worst forms of racism to the peripheries of empire, exposing the contradictions of the colonial project in India. [ABSTRACT FROM AUTHOR]

I explore the implications of example-making for both informants and ethnographers through an analysis of the history of the refoundation of the Anglican shrine at Walsingham during the twentieth century. I argue for an appreciation of distinctions between examples as 'models' and 'instances', but also for a focus on relations between the inchoate and the specific in processes of exemplification. The paper shows how an examination of the making of examples by actors in the field can speak to the creation of examples in writing and analysis, and may introduce elements of 'serendipity' more normally associated with encounters in the field. [ABSTRACT FROM AUTHOR]

Emergency foodbanks have become an increasingly prominent and controversial feature of austerity in Europe and the USA. In the UK, foodbanks have been called a ‘public health emergency’. Despite this, there has been no UK research examining the health of foodbank users. Through an ethnographic study, this paper is the first to explore the health and health perceptions of foodbank users via a case study of Stockton-on-Tees in the North East of England, UK during a period of welfare reform and austerity. Participant observation, field notes and interviews with foodbank users and volunteers were conducted over a seventeen month period (November 2013 to March 2015) inside a Trussell Trust foodbank. Foodbank users were almost exclusively of working age, both men and women, with and without dependent children. All were on very low incomes – from welfare benefits or insecure, poorly paid employment. Many had pre-existing health problems which were exacerbated by their poverty and food insecurity. The latter meant although foodbank users were well aware of the importance and constitution of a healthy diet, they were usually unable to achieve this for financial reasons – constantly having to negotiate their food insecurity. More typically they had to access poor quality, readily available, filling, processed foods. Foodbank users are facing the everyday reality of health inequalities at a time of ongoing austerity in the UK. [ABSTRACT FROM AUTHOR]