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In England the macro context of adoption practice is characterised by radical change across administrative, political and organisational systems. The adoption regionalisation programme is underpinned by a policy commitment to speed up 'matching' processes. The Adoption and Children (Coronavirus) (Amendment) Regulations 2020 states that adoptions should 'proceed swiftly' and some agencies are pioneering online and virtual introductions between children and prospective adopters. This paper offers a timely contribution to practice debates and scholarship in this area. Drawing on a collaborative doctoral study, 'everyday' practices are considered through an emergent theoretical framework, the 'liminal hotspot'. The analysis hones in on the transformative practices generated in the early matching stages and the role of the social worker in their mediation and management. This paper supports findings from other studies that suggest that when matches are rushed necessary processing of complex dynamics is by-passed, creating unnecessary vulnerabilities in the fabric of new families. [ABSTRACT FROM AUTHOR]

Aims: This paper focuses on the reasons for the under-representation of British South Asians in substance use services. Based on a small-scale evaluation of a substance use service that delivers targeted outreach support within two predominantly Pakistani and Bangladeshi communities in the north west of England, this paper contributes to the debate around how substance use services can best engage with young British Pakistani and Bangladeshi substance users. Methods: Semi-structured interviews (with six staff members, 18 young Pakistani and Bangladeshi service users, and 18 stakeholders and partner agencies), a detailed ethnographic observation of the service, and an analysis of routinely collected quantitative monitoring data. Findings: The paper highlights the importance of what Fountain terms low threshold/open access services. Alongside this, the paper argues that the building of trust and confidence in a substance use service is a key when it comes to engaging with young Pakistani and Bangladeshi substance users. Yet this necessary process takes time: something that is at odds with the current trend towards short-term funding regimes and 'quick wins'. Conclusions: The paper concludes by advocating the need for, not only a diverse range of engagement strategies, but also a longer term approach when it comes to developing and delivering substance use services aimed at successfully engaging with this particular group of substance users. [ABSTRACT FROM AUTHOR]

The past two decades have seen an increasing role for the UK community and voluntary sector (CVS) in health promotion in disadvantaged areas, largely based on assumptions on the part of funders that CVS providers are better able to engage ‘hard-to-reach’ population groups in services than statutory providers. However, there is limited empirical research exploring CVS provider practices in this field. Using ethnographic data, this paper examines the experiences of a network of CVS providers seeking to engage residents in health-promoting community services in a disadvantaged region in the North of England. The paper shows how CVS providers engaged in apparently contradictory practices, fluctuating between an empathically informed response to complex resident circumstances and (in the context of meeting externally set targets) behavioural lifestyle approaches to health promotion. Drawing on concepts from figurational sociology, the paper explains how lifestyle drift occurs in health promotion as a result of the complex web of relations (with funders, commissioners and residents) in which CVS providers are embedded. Despite the fact that research has revealed the impact of targets on the work of the CVS before, this paper demonstrates more specifically the way in which monitoring processes within CVS contracts can draw providers into the neoliberal lifestyle discourse so prevalent in health promotion. [ABSTRACT FROM PUBLISHER]

This paper explores public health policy implementation through partnership working at the local level by examining how local actors from public health, and the wider workforce make sense of and work on social inequalities in health. An ethnographic case study was used to examine policy implementation in one local strategic partnership in north-west England during a period of significant resource constraint. Semi-structured interviews were the primary method of data generation. Sensitising concepts from figurational sociology were used to develop a theoretical account of how local policy implementation directed at narrowing social inequalities in health tended to give rise to relatively fragmented and short-term services, projects and practices, which focused on lifestyle factors and behaviour change. Theorising partnership work as figurations goes some way to explaining the apparent paradox among participants who expressed a relatively detached appreciation of wider social influences, alongside emotional involvement in their work. This process of individualisation explains how local professionals tended to conceptualise health inequality and the social determinants of health as personal troubles. Individualisation meant that the social reality of working in partnerships on difficult issues was simplified. Thus, any scope for working on the social determinants of health tended to be overlooked. The extent to which this was intentional or a matter of struggling to see opportunities, or a mixture of the two, was difficult to discern. Although the policy landscape has changed, the findings give some insight into understanding how local collaborative processes reproduce local public health work underpinned by lifestyle choices. [ABSTRACT FROM AUTHOR]

This paper discusses the strengths of using ethnographic research methods in cross-national comparative research. It focuses particularly on the potential of applying such methods to the study of migrants and minority ethnic youth in education, where large-scale quantitative studies or single-sited ethnographies are currently dominant. By linking findings and methodological reflections from a research study into the schooling experiences and life projects of migrants and minority ethnic youth in England and Spain, the paper shows how cross-national comparative ethnographies enable researchers to (1) contextualise and compare topics identified by research participants in the course of the fieldwork, (2) analyse topics, which only appear in one research setting and (3) explore and challenge how concepts and categories are employed by research participants in different settings. This, it is argued, makes such research methods particularly well placed to identify issues, which young people themselves find important to their schooling, and explore how these interlink with local practice. [ABSTRACT FROM PUBLISHER]

This empirically informed ‘opinion paper’ reflects upon the use of observant participant as a qualitative research method during an applied, multilocal, ethnographic study of street-based injecting drug use (conducted throughout the south of England during 2006–2011). Throughout these studies, participant observation took place with frontline service personnel and observant participation occurred with people who inject drugs. As participant observation typically involves the acquisition of a new role in an unfamiliar setting for a given person, observant participation prioritises existing roles in order to conduct research within familiar/unfamiliar settings. In this study, the method of observant participation is compared and contrasted with participant observation as both methods were conducted in the aforementioned ethnographic study of street-based injecting drug use. This experience-based comparison is followed by a discussion that offers a theoretically informed explanation for the various success and outcomes attached to the study (and, specifically, to those obtained from the applied use of observant participation with people who inject drugs). The paper concludes that observant participation may be best used as a ‘synergising’ component within a wider qualitative research toolkit especially when dedicated to inquiries of sensitive issues or ‘hard-to-reach’ populations (such as those affected by drug dependence). In addition, the synergistic effect of observant participation may contribute towards a combined understanding of social problems that is perhaps greater than the sum of findings obtained from separate, disconnected methods of social research. [ABSTRACT FROM PUBLISHER]

This paper explores the interpretative practices of the police when carrying out stops and searches. Drawing on ethnographic research carried out in England and Wales, a conceptual framework is developed to understand how officers become suspicious and decide to initiate encounters. It is argued that officers use tacit knowledge to make sense of new situations and determine what action to take, and base their suspicions on signals they come across on patrol. In examining these social processes, the paper shows that categories and stereotypes are central to decision-making which result in a police focus on the socially marginal. Looking beyond the immediate influences on officer action, the paper also explores the role played by the law in regulating police practice. [ABSTRACT FROM PUBLISHER]

Cemeteries garner considerable academic attention as anthropologists, landscapers, archaeologists, sociologists, geographers and historians examine their layout, purpose and use. Emerging from these studies is a body of literature that considers cemetery and burial ground design, memorialisation, mourning behaviour and ‘dark tourism’. Beyond interdisciplinary journals such as Mortality and edited multi-disciplinary books however, the insight generated in this literature can be fragmented through publication in discipline specific periodicals. As a result cemeteries are often analysed and presented as places that contain, for example, design or tourism and heritage or emotion and mourning. Framed by concerns over the sustainability of cemeteries nationwide, this paper considers the contemporary English cemetery as a simultaneous space of emotion, commerce and community. Using data from an ethnographic case study of a cemetery in East London, it illustrates the contestation that can result from these concurrent contrasting interpretations. The paper concludes that care needs to be taken when implementing initiatives and policy to balance the varying demands and expectations of a cemetery's purpose and use. [ABSTRACT FROM AUTHOR]

This paper focuses on the diversity in patients' experience of biomedicine and contrasts it with the normative view characteristic of health professionals. Ethnographic fieldwork among Polish migrant women in London, Barcelona and Berlin included interviews about their experiences with local healthcare and health professionals. Themes drawn from the narratives are differences between the cities in terms of communication between patients and health professionals, respect for patients' choices and dignity, attitudes to pregnancy and birth (different levels of medicalization), and paediatric care. It is argued that patients continuously negotiate among their own views and expectations based on previous experiences and knowledge from personal communication; internet forums and publications; and the offer of medical services in the countries of their settlement. Patients experience pluralism of therapeutic traditions within and outside bio-medicine. In turn, representatives of bio-medicine are rarely aware of other medical practices and beliefs and this leads to various misunderstandings. By highlighting the pluralism of medical practices in European countries and the increasing mobility of patients, this case study has useful implications for medical anthropologists and health professionals in a broader Western context, such as raising sensitivity to different communication strategies and a diversity of curing traditions and expectations. [ABSTRACT FROM AUTHOR]

Objectives:The burden of informal caregivers might show itself in different ways in different cultures. Understanding these differences is important for developing culture-specific measures aimed at alleviating caregiver burden. Hitherto, no findings regarding such cultural differences between different European countries were available. In this paper, differences between English, Finnish and Greek informal caregivers of people with dementia are investigated. Methods:A secondary analysis was performed with data from 36 English, 42 Finnish and 46 Greek caregivers obtained with the short form of the Burden Scale for Family Caregivers (BSFC-s). The probabilities of endorsing the BSFC-s items were investigated by computing a logit model with items and countries as categorical factors. Statistically significant deviation of data from this model was taken as evidence for country-specific response patterns. Results:The two-factorial logit model explains the responses to the items quite well (McFadden's pseudo-R-square: 0.77). There are, however, also statistically significant deviations (p< 0.05). English caregivers have a stronger tendency to endorse items addressing impairments in individual well-being; Finnish caregivers have a stronger tendency to endorse items addressing the conflict between the demands resulting from care and demands resulting from the remaining social life and Greek caregivers have a stronger tendency to endorse items addressing impairments in physical health. Conclusion:Caregiver burden shows itself differently in English, Finnish and Greek caregivers. Accordingly, measures for alleviating caregiver burden in these three countries should address different aspects of the caregivers’ lives. [ABSTRACT FROM AUTHOR]

In England, health inequalities policy shifted during the Labour term (1997–2010) from initially strong commitments to tackling the ‘upstream’ social determinants of health to a technically-driven emphasis on lifestyle risk factors and healthcare access. This multi-sited study, based in and around Westminster (2006–2007), extends our understanding of how political context influences policy-making by drawing from anthropological studies of policy. Qualitative material from central government is put into conversation with theory concerning policy as zones of practices. The paper explores the bristly process through which public health, healthcare and corporate interests vied to shape the political agenda for health inequalities; the selective use of evidence by civil servants in accordance with their perceptions of what politicians conceive to be electorally palatable; the silencing of critique of the dominant narrative about evidence-based policy; and how technical aids developed a life of their own – as a result of which, health inequalities policy ended up being depoliticised. [ABSTRACT FROM PUBLISHER]

It is now widely accepted that context matters in evaluations of the health inequalities impact of community-based social initiatives. Systems thinking offers a lens for uncovering the dynamic relationship between such initiatives and their social contexts. However, there are very few examples that show how a systems approach can be applied in practice and what kinds of evidence are produced when this happens. In this paper, we use data from ethnographic fieldwork embedded within a multi-site mixed method evaluation to demonstrate how a systems approach can be applied in practice to evaluate the early stages of an area-based empowerment initiative – Big Local (funded by the Big Lottery Fund and delivered by Local Trust). Taking place in 150 different local areas in England and underpinned by an ethos of resident-led collective action, Big Local offers an illustration of the applicability of a systems approach to better understand the change processes that emerge as social initiatives embed and co-evolve within a series of local contexts. Findings reveal which parts of the social system are likely to be changed, by what mechanisms, and with what implications. They also raise some salient considerations for knowledge generation and methods development in public health evaluation, particularly for the evaluation of social initiatives where change does not necessarily happen in linear or predictable ways. We suggest future evaluations of such initiatives require the use of more flexible designs, encompassing qualitative approaches capable of capturing the complexity of relational systems processes, alongside more traditional quantitative methods. [ABSTRACT FROM PUBLISHER]

This paper looks at the role of Bangladeshi families in the provision of care and help seeking: the burden on family members but also their presumed role in the causation of illness. It deploys data deriving from an interview study examining understandings and health-related practices among British Bangladeshis with mental and physical illness and their carers. While families generally support the mentally ill, the emotional and physical burden on them can be extensive. Conflicts between individuals may result in accusations of sorcery, especially when envy is suspected. Regular travel betweendeshandbideshattempts to maintain family unity and continues traditional understandings of serious sickness and disability. [ABSTRACT FROM AUTHOR]

This paper analyses data from a focus group conducted with a group of female pupils aged 13–14 to re-examine the assumption that pupils' negative assessments of sex and relationship education (SRE) should be understood only as a reflection of inadequate teaching. Focusing on the emotional aspects of their accounts, and the inconsistencies in their efforts to present a collective story of SRE, findings suggest that there are other ways in which such accounts can be read. Drawing on insights from psychoanalytic theory concerning the emotional aspects of learning and the teacher–pupil relationship, it is suggested that these accounts can also be understood as a result of transference. Using psychoanalytic understandings of the role of sexual learning in adolescence, findings reveal that pupils' relationships to SRE are complex and need to be understood as being tied up with internal struggles and anxieties about their own sexual development. This reading is presented as an additional perspective for teachers and is one that would benefit from further exploration. [ABSTRACT FROM PUBLISHER]

A way forward in the emerging societal structures is to engage in cross-cultural research for enhanced understanding of multi-ethnic sites in national and international contexts. (Shah, 2004, p. 549) In the course of a small-scale research project with an expatriate Indian community two Western researchers at a British university have reflected on the international dimensions of their work. This paper presents the experience and the thoughts of the researchers about their work on this project, reflecting some of the challenges of working globally in higher education. The researchers comment upon how the work reported might impact their future practice as teachers and researchers in higher education, working in an increasingly international context. Reflecting on the impact of engagement with the project, implications for teaching and learning in higher education are discussed. [ABSTRACT FROM PUBLISHER]

This article focuses on the relationship between volunteering and socio-economic status, suggesting that the insights provided by social organization theory can contribute to explanations of low levels of volunteering in areas exhibiting high levels of deprivation. The piece aims to provide a complementary framework to work alongside existing theories of inequalities in voluntary action, to reach towards an account which elucidates the role of structural factors in affecting the likelihood of volunteering in deprived areas. The article illustrates value of such an approach through an account of ethnographic research in a deprived neighbourhood in England, suggesting that by paying close attention to the configurations of social life in such areas it is possible to shed new light on the relationship between deprivation and volunteering. [ABSTRACT FROM AUTHOR]

The English child protection system continues to be the focus of national commentary in light of several high-profile deaths and the recently published reports from the Review of Children's Social Care, and the Child Safeguarding Practice Review Panel. Whilst narratives of 'failure', 'betrayal', and 'scandalous incompetence' perpetuate, these forgo consideration of the complexity of child protection work, nor do they acknowledge that during the COVID-19 'lockdowns', social workers remained one of the few professional groups visiting vulnerable families at home. Moreover, of the recent accounts of the lived experience of social workers, these have omitted a specific overview of what it means to be a child protection practitioner. Drawing from an original ethnography of a statutory child protection team and supplemented by follow-up interviews, the article seeks to elucidate the long-standing lived experience of a cohort of child protection social workers. It highlights a 'tendency' to be the target of threats and intimidation and identifies other costs in the context of health and personal relationships. The article concludes that these findings could help us better understand child protection workforce instability and the system's reliance on agency staff – both of which continue to be identified as contributory in child death tragedies. [ABSTRACT FROM AUTHOR]

Purpose: To explore how speech-language pathologists and nurses share information about the communication support needs of stroke patients through structured information-sharing routes and to consider how the two disciplines view their roles and interdependencies in addressing these needs. Method: Speech-language pathologist and nurse information-sharing was explored in context using ethnography. Ethnography has been used by researchers from other disciplines to understand the context of inpatient care, but the methodology has rarely been adopted within speech-language pathology. Fieldwork (357 hours) was carried out on three stroke wards in England for 40 weeks from 2015 to 2017. Data included fieldnotes, interviews with 43 members of speech-language pathology and nursing staff, and the patient records of 19 patients. Result: The findings provide a thematically organised explanation for how information about communication travelled through structured routes on the wards (meetings, the patient record, bedside signs, education, and nursing handover). Limitations were identified that appear underpinned by disciplinary differences in (1) how speech-language pathologists and nurses engaged with the wards in time and space, and (2) perceptions of roles and interdependencies. Speech-language pathologists routinely used meetings and the patient record to share communication information, however these formal structures were not easily accessible during nurses' caregiving roles. In addition, both speech-language pathologists (SLPs) and nurses were ambivalent about the usefulness of signage SLPs sometimes left at the bedside for supporting communication. There was little interdependency between SLP and nursing roles in meeting the communication support needs of patients. Conclusion: In-depth exploration of the context within which SLPs and nurses share information has revealed limitations in the capacity of structured routes to enhance collective knowledge about patients' communication support needs. [ABSTRACT FROM AUTHOR]

When making decisions about whether to transfer residents to hospital, care home staff consider the possible benefits and risks of different courses of action. However, to date, an in-depth and theoretically informed engagement with these decision-making processes and their associated behaviours has been lacking. We conducted an ethnographic study of care home staff's decision-making about resident hospital transfers in England between May 2018 and November 2019. We combined staff interviews at six care home sites, with 30 members of staff, with 113 hours of ethnographic observation at three care homes sites. 'Risk' and risk management emerged as important overarching themes. In this article we conceptualise staff decision-making about potential hospital transfers for residents as a form of risk work. In doing so, we identify the different forms of risk knowledge that staff used to conceptualise risk and explore the ways staff navigated tensions between different forms of risk knowledge. We highlight the ways individual understandings of risk were influenced by social interactions with others, both at an interpersonal and organisational level, before identifying strategies that staff use to manage risk. By understanding transfer decisions explicitly in terms of the different forms of risk that care home staff manage, our analysis provides new insights into hospital transfers from care homes and contributes to the wider literature around risk work, demonstrating the utility of this concept in researching organisations that fall under the umbrella of social care, which have been previously neglected in academic research. [ABSTRACT FROM AUTHOR]

UK policy for adults with intellectual disabilities no longer supports state-provided building-based day care but promotes personalised care and support under individuals' control with choice of community-based opportunities. The research explored experiences of this new terrain and the informal learning involved. An initial scoping review was followed by interviews with key service providers in one urban and one rural area in England and one of each in Scotland. Next, ethnographic fieldwork with people with intellectual disabilities involved a flexible mix of observations, interviews, focus groups, and participant-generated visual data. Thematic analysis involved an iterative mix of deductive and inductive coding. Findings showed informal peer learning ranged from ad hoc to structurally supported. Though learning was often tacit, support was valued and agency developed. The availability of local supportive people and schemes and time spent in them to develop new skills and identities was vital to people self-building community lives. This research looked at the experiences of people with intellectual disabilities, as they and their friends and family respond to policy change bringing in more personalisation and individual choice. Often people with intellectual disabilities and those supporting them do not recognise their everyday learning. Learning outside schools/colleges gets little research attention. We looked at the learning involved in people managing their own daily lives in their communities. Staff and volunteers are helping people to learn from each other in organisations, and this can become more formal peer learning, peer mentoring and peer support programmes. Advocacy groups create a sense of belonging and shared purpose, encouraging peer learning through the sharing of knowledge, experiences and problem solving. When new projects start up or traditional day services change, the staff or volunteers may not involve people with intellectual disabilities in the planning. This means people with intellectual disabilities miss opportunities to learn. [ABSTRACT FROM AUTHOR]

The perspective of domiciliary workers is needed to recruit a high-quality workforce and meet growing demand. An English ethnographic study yielded extensive insights. To structure analysis of the study data, we apply a method developed by political theorists Boltanski and Thévenot that identifies key variables in different values systems. This "orders of worth" framework is used to map out the distinctive features of the subjective world of home carers. The results can be drawn on to formulate recruitment and retention policies, to design reward strategies or to ensure that training and education opportunities engage effectively with the workforce. [ABSTRACT FROM AUTHOR]

Engaging the community in initiatives to improve health and inequalities is a prominent feature of contemporary public health approaches. Yet, how ‘community’ might be differently interpreted and experienced through mechanisms of engagement is little understood, with potential implications for how the pathways of effect of such initiatives, and their impacts on health inequalities, might be evaluated. This study sought to explore how community was enacted through the delivery of an area-based, empowerment initiative underway in disadvantaged areas of England. An ethnographic approach was used to identify enactments of community arising around the core activities and decision-making processes of the resident-led initiative in two sites. Enactments comprised ‘boundary work’: the ongoing assertion and negotiation of boundaries around who or what was, and was not, eligible to contribute to decision-making, and / or benefit from the initiative. Boundary work arose around practices of connecting with and consulting residents, protecting locally defined interests and autonomy, negotiating different sets of interests, and navigating representation. The multiple, shifting enactments of community and its boundaries highlight implications for understanding processes of inclusion and exclusion inherent to community engagement, and for interpreting pathways between collective empowerment and improved health. The study also raises questions for evaluating similar complex, community initiatives, where community cannot be taken as a fixed analytical unit, but something continually in process through the interplay between the initiative and the wider context. This must inform interpretations of how, and for whom, community engagement might – or might not – improve health. [ABSTRACT FROM PUBLISHER]

This ethnographic project explored the lives of women with learning disabilities on three locked wards. Aspects of these women’s lives were regulated by the service; in particular, relationships with family outside the unit, and peer relationships inside the unit. The women in this study valued these relationships, but they were treated with ambivalence by the service. Success in future community integration and accessing community resources can be dependent on the nature and quality of relationships with others, and therefore services should acknowledge that service-users need to forge relationships of their own choosing. [ABSTRACT FROM PUBLISHER]

Background: Since 1990, health policy in England has stressed the importance of user involvement in shaping and delivering services. Aims: To explore mental health service user-led organisations (ULOs) in England, as they interact with decision-makers to bring about change desired by them with a focus on institutional norms behaviour and specialised knowledge impacting service users' relationships with services. Method: An ethnography of five ULOs in two provider organisations (NHS Trusts) including observing their meetings and interactions with decision-makers, conducting in-depth interviews and collecting reflective diaries kept by two members of each group. Results: During the study, one group ceased to operate. This was a group which refused to adopt the institutional rules and norms of managerial discourse. The other four groups survived by navigating the changing environment which existed at the time of the study, although often at some cost. Themes of autonomy and leadership were also identified. Conclusion: The current environment is one of the organisational complexity and change and the place of ULOs is an ambiguous one as they strive to maintain autonomy whilst at the same time being an acceptable voice to managers. [ABSTRACT FROM AUTHOR]

This article challenges the dominance of a rupture model for understanding how we live day-to-day with life-threatening illness and the prospect of death. It argues that this model acts as a key interpretive framework for understanding dying and its related experiences. As a result, a rupture model upholds a normative and inherently crisis-based view of severe ill-health that reifies dying as an experience which exists outside of, and somehow transformatively beyond, everyday matters of ordinary life. These matters include the minutiae of daily experience which inform and shape our lived identities – as individuals and as relational selves. Drawing primarily on interview data from two family case studies that have contributed to an ethnographic project exploring family experiences of living with life-threatening illness, it will show how mundane, daily life is integral to understanding the ways in which families are produced and able to maintain a sense of continuity during circumstances of impending death. The analysis presented here moves analytical understanding of dying experience towards a theory of how individuals and families ‘know’ and engage with so-called ‘big’ life events and experiences. In this way, my study helps generate a novel and more inclusive way of understanding living with life-threatening/limiting illness. [ABSTRACT FROM PUBLISHER]