Search

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]

Journalism has been suffering a crisis of trust in recent years and in order to re-engage with disconnected audiences, media organisations have turned to creative forms of communication. Some of these draw on the concept of "live journalism", where both journalists and their stories are presented to a live audience. Various examples in the US and Europe have already been examined; this paper looks at the emergence of live journalism in the UK, and its potential in creating engagement in the public sphere. The authors reflect on two online events they produced as part of their "News on Stage" project during the Covid-19 pandemic, in which journalists presented previously unpublished stories, using dramatic techniques such as verbatim theatre, stand-up comedy, and soundscapes. Using creative, practice-based research, considered relevant to the study of journalism today, they discuss the experience of staging these events to analyse themes of dramatisation, truthfulness, and connection. The authors use ethnographic research, supplemented with audience and participant feedback, to show that this kind of fusion of journalism and theatre can increase interest and trust in journalism and build closeness with audiences. [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]

Copyright of Social & Cultural Geography is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

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]

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 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]

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]

Background: This paper draws on new research exploring community-based, participatory arts practice in Northern England and Mexico City to discuss contextual influences on artists' practice, and whether a common practice model can be identified. The international comparison is used to interrogate whether such a practice model is transnational, displaying shared characteristics that transcend contextual differences.Methods: The study used multi-site ethnography to investigate the participatory practice of more than 40 artists. Participant observation and extended individual and group dialogues provided data on practice in a diverse range of art forms and settings, analysed using open coding and grounded theory principles.Results: Findings locate differences in practitioners' motivations, and perceptions of the work's function; however, key similarities emerge across both sites, in practitioners' workshop methodologies and crucially in their creative strategies for catalysing change. A model is presented distilling the key elements of a common practice methodology, found across the study and across art forms.Conclusions: The discussion notes where divergences echo nationalities of contributors, drawing inferences about the level of influence of national context in this work, and concludes with the implications of these findings for potential international collaboration, to face challenges within the community arts and health sector globally. [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]

This article explores the foundation of a joint research project between social work (SW) colleagues at Hope Africa University in Burundi, and Oxford Brookes University in the United Kingdom (UK). It considers the destructive impact of colonialism on indigenous SW practices in Burundi setting out an argument for decolonisation of the SW curriculum both in Burundi and the UK. Drawing on the work of Mbembe and the traditional concepts of Ikibiri and Ubuntu, the article sets out a framework for cross-cultural collaboration not dominated by western colonial ideas and works towards the Global Agenda for SW. Potential barriers, and solutions to collaborative working are identified and discussed. [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]

This paper reports on a feasibility study and evaluation of a new type of cultural consultation service (CCS). This multi-component and systemic complex intervention was offered over 18 months to specialist mental health providers in one of the poorest regions of the UK. The service received 900 clinically related contacts and 99 in-depth consultations. Service users who were referred to the CCS had high levels of clinical needs with an average score of 15.9 on the Health of the Nation Outcomes Scale. Overall, Global Assessment of Function scores improved and there were trends for improvements in symptoms. The level of routine care (and by implication associated costs) significantly reduced after CCS intervention, due to a reduction in use of accident and emergency (A&E) services, psychiatrists and community psychiatric nurses (CPNs)/case managers. Cost analysis indicates that savings amounted to £497 per patient. The cost of intervention was no greater than usual care, and may reduce spend per patient over a 3-month follow-up and perhaps longer. More specifically, clinicians felt the cultural consultation service helped to improve the treatment plan (71%), engagement (50%), medication compliance (21%) and earlier discharge (7%). [ABSTRACT FROM AUTHOR]

This paper presents the results of the qualitative phase of Healthy Foundations, a study that groups people according to their motivations to live healthily or otherwise, their lifestyles, and the circumstances that affect this. These segments are ‘Health Conscious Realists’, ‘Balanced Compensators’, ‘Live for Todays’, ‘Unconfident Fatalists’ and ‘Hedonistic Immortals’. The aim was to explore people’s attitudes and motivations to live healthily or otherwise and the targeted healthcare interventions appropriate for each segment. The qualitative phase involved two strands: (i) focus groups and immersion in-depth interviews and (ii) video ethnographic ‘pen portraits’. It provides robust insight into the five segments’ motivations and behaviour and how these are constructed within and influenced by the wider environment. It also enabled the segments to give their views of and design appropriate interventions aligned to their individual requirements, lifestyles and structural environments. It demonstrates the usefulness of the qualitative approach to health segmentations and enhances the case for methodological pluralism, and a critical perspective, to enable development of health-related behaviour change interventions and policy more widely. [ABSTRACT FROM PUBLISHER]

Institutional racism became a potent mobilising concept in police reform in the UK following the publication of the Stephen Lawrence Inquiry in 1999. Yet while it continues to be used to highlight problematic police/community relationships, little attention has been paid to whether it actually works as a conceptual instrument for change. The explanatory value of the concept has long been contested due to its inherent ambiguities. However, reflecting the noted lack of empirical research in this area, there has been little exploration of how the concept is interpreted and applied by those charged with responding. Drawing on ethnographic research in the aftermath of the Inquiry, this paper puts in question the continuing use of the concept as a lever for reform. Empirical exploration reveals that the conceptual limitations of the term have important operational implications. While the concept provoked an urgent reaction, its central ambiguities confronted police services with profound difficulties in responding. At the same time, it inadvertently focused attention on internal police culture. Consequently, despite the Inquiry's intention that the term would divert attention away from a preoccupation with overt racism among police staff, this is precisely where reform activity was directed. Moreover, the concept not only failed to direct attention to the dynamics of institutional discrimination but, through the activity it elicited, in fact sustained them. However, despite these limitations, the mobilising power of the concept may have instigated a more subtle and pervasive series of shifts in organisational norms. A new approach grounded in practice and giving primacy to conceptual accuracy is now needed. [ABSTRACT FROM AUTHOR]

It has been suggested that asset-based strategies could provide an opportunity to rethink the approach to public health; however, this may not be a viable option unless there is clear recognition of specific individual assets. Although there has been some consideration of assets within a child health context, this is limited and previous studies have not sought to identify assets from the perspective of the child. This paper reports on a study that drew on an ethnographic approach, using a photo-elicitation method, to facilitate the mapping of children’s internal and external assets from the viewpoint of children themselves. Two primary schools in the South-East of England were used to recruit 20 year five children (aged 9–11 years of age). The participants, 10 boys and 10 girls, were given disposable cameras and asked to take photographs of the activities that they enjoyed. The children’s photographs were used as prompts during individual semi-structured interviews. A constant comparative analysis facilitated the mapping of the children’s assets as the children described them; this process revealed one overall stabilising asset (‘My Family’) as well as eight internal and three external assets. All of the assets are presented within an original model, ‘I’m good’: the children’s asset wheel [CAW], which was developed from the findings. It is suggested that the CAW could complement previous asset-based work to facilitate the rethinking of approaches to the enhancement of children’s public health. [ABSTRACT FROM PUBLISHER]

Since 2001, community cohesion has become central to discussions, policies and practices concerned with encouraging interaction between different ethnic groups in the UK. Discursively at least, it has signalled a shift from earlier race relations policies aimed at promoting multiculturalism. This paper examines policies of community cohesion alongside an exploration of interethnic and intercultural encounters within everyday spaces. Drawing upon two pieces of ethnographic research in the North of England, we draw attention to the ways in which ‘mixing’ is gendered and consider this in terms of the opportunities created for meaningful interactions. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to explore the meanings of outdoor physical activity in the natural environment for parentally-bereaved young people. It draws on data generated from a two-year ethnographic study that focused on the experiences of those involved with the Rocky Centre, a childhood bereavement service in the UK. Data was collected via extended periods of participant observation and semi-structured interviews with both staff and service users. One of the key themes to emerge from the analysis was that of physical activity in different environments. The meanings that the parentally-bereaved young people attributed to outdoor physical activity clustered around four sub-themes. These were: sense of freedom; distraction/escapism; retaining memories; and family cohesion. Each of these are considered in detail and their implications for future practice and research are discussed. [ABSTRACT FROM PUBLISHER]

Behavioral and psychological symptoms of dementia (BPSD) are considered to cause ambivalent feelings in caregivers that may contribute to understanding their depressive symptoms. Transnational research is needed in order to increase our knowledge about the cross-cultural equivalence of theoretical models to understand caregivers' mental health. The aim of this study was to cross-culturally analyze the association between BPSD, ambivalent feelings and depressive symptoms in two samples of family caregivers of people with dementia from Spain and the UK. Participants in this study were 432 caregivers who completed measures of BPSD, ambivalent feelings and depressive symptoms. The association between the assessed variables was tested through path-analysis, with differences between countries tested through multigroup analysis. The results suggest that the influence of BPSD on caregivers' depressive symptoms is indirect, through ambivalent feelings. The observed associations were equivalent between countries and explained a significant percentage of the variance of depressive symptoms. The findings of this study provide, for the first time, evidence of equivalent cross-cultural paths analyzing the role of ambivalent feelings for understanding caregivers' depressive symptoms. The practical implications of these results are discussed. [ABSTRACT FROM AUTHOR]

This study investigates the impact of the perceptions of antisocial behaviour on the use of the social media platform Twitter. We extend the Unified Theory of Acceptance and Use of Technology (UTAUT) with the Perception of Antisocial Behaviour as a risk factor, and two supporting constructs: Strategic Self-Presentation and Protective Self-Presentation. We call this extended model Technology Acceptance and Use under Risk (TAUR). We investigate two groups via an online questionnaire, contrasting Anglophone countries (the UK, USA, and Canada, 200 responses), with Saudi Arabia (540 responses). In both cases the data shows that the Perception of Antisocial Behaviour impacts Twitter use, but not directly, rather it negatively impacts the influence of other factors such as Behavioural Intention – it also shows that this affects Anglophones more than Saudis. This indicates that future work should differentiate between different cultural groups, and different solutions may be needed to assuage users' fears in different parts of the world. [ABSTRACT FROM AUTHOR]

Converging visual behavioural and attentional allocation studies within neuroscience have shown culture influences the processing of visual information obtained from the visual field. While attending (reviewing) a visual scene, individuals from a collectivist culture attend more to the context (background) compared to those from an individualist culture who view more the focal object. This highlights the effect of cultural conditioning in terms of holistic and analytical processing of visual information. This study aimed to demonstrate these principles in the context of an assistive product, a wheelchair, highlighting the key visual elements of the form; and, how a congruent background (hospital room) or incongruent (athletics track) influenced cultural bias during visual processing and assigned meaning. A combination of research methods (Semantic Differential Scale and eye-tracking) was used to triangulate the results. A total of 126 adult student participants, (Pakistani/collectivist, n = 57) and the (UK/individualist, n = 69), viewed a visual presentation of a wheelchair with semantically congruent and then an incongruent background and responded via an online questionnaire. A sub-sample completed the survey whilst monitored via eye-tracking. Pakistani respondents used shorter and less frequent fixations on the foreground compared to the responses of their counterparts (UK respondents). The wheel of the wheelchair was highlighted as the prominent form by both groups. Results demonstrate a culture-influenced pattern of visual processing even when the product was displayed against a semantically incongruent background. The findings from this study also validate and extend the outcomes of similar studies revealing a more specific, yet consistent, cultural effect on individuals' visual perception. Finally, the efficacy of triangulated research methods in their relationship to exploring the AT product's semantics was discussed. The knowledge of AT products' semantics will be significant to investigate, for their improved social acceptance, particularly when considered from a diverse cultural standpoint. A model of best practice, focussing on semantics manipulation, will provide AT product designers, practitioners, and those involved in their marketing, Internationally, with a suitable process/tool to positively reframe the perception of these devices. Finally, this research will help product and industrial designers to consider cultural cognitive styles in the design of products for the better adoption of products within the global marketplace. [ABSTRACT FROM AUTHOR]

As the COVID-19 pandemic hit, Orthodox Christians globally reacted to the possibility of contagion and risk in dialogue with theological positions about materials, their own long history which includes surviving previous pandemics and plagues, governmental and civil expectations and edicts, and pious – but often unofficial – understandings about protection and the sacrality of religious artefacts and the space of the temple. This article draws upon primary ethnographic research amongst Orthodox Christians in the UK, Serbia, Greece and Russia, as well as news articles about and primary ecclesiastical documents from Orthodox Churches more widely, to highlight commonalities and divergences in Orthodox Christian responses to the pandemic. Examining both the theological basis, and socio-political differences, this article considers how the Orthodox theology of apophaticism and relationality impacts wider discourses of contagion (both positive and negative), and consequently compliance with public health initiatives. Comparison across diverse Orthodox settings suggests that Orthodox Christians are concerned with the neighbour – both in terms of who may be watching (and reporting) them, and who may fall sick because of them. [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 present study used parent-report data to explore cross-cultural similarities and differences in tic severity and reactions to tics across 223 children with Tourette's disorder (TD) from the United States, United Kingdom, and Netherlands/Norway. Psychometric properties of the TARS-PR and PTQ were also examined and results indicated that both measures may be suitable for assessing tic severity and the consequences of tics in these countries. No differences in parent-reported tic severity were found. However, parents of children with TD from the United Kingdom reported significantly more reactions to their child's tics than parents from the United States and Netherlands/Norway. [ABSTRACT FROM AUTHOR]

Britain was the first country in the world to prescribe diamorphine (pharmaceutical-grade heroin) to heroin users as a treatment for opioid dependency. Known and admired internationally as the British System, Britain has a somewhat more ambivalent relationship to its own invention. Where patients were once prescribed diamorphine and other injectable opioids on an unsupervised basis, new patients are no longer initiated in this way and those existing 'old system' patients are under threat. Carrying out ethnographic research at an advocacy service for people who use drugs, I explore this threat as an onto-epistemological concern and the advocates' work to sustain these 'old' ways of knowing and being with diamorphine as a collective matter of care and action. Accounting for advocacy as a non-objective 'emboldening' of the individual to speak, the advocates draw our attention to the inequity of knowledge production and the collective act of speaking in an environment that is increasingly hostile towards these patients. As neoliberal political economies interact with stigmatising forces against people who use drugs, the article highlights the advocate's work as essential in allowing these patients' concerns to be heard where a threat to their prescription becomes a threat to their very way of living. [ABSTRACT FROM AUTHOR]

This article explores concepts of gender difference for nurses working in Child and Adolescent Mental Health Nursing. Inspired by the author's own experiences he emerged ethnographic research data to explore how male nurses replicate a problematic performance sited between representing 'similarity' and yet 'difference' to their female colleagues. In this article, the author discusses how typical dichotomies of sexuality, gender and transformation are troubling for child and adolescent nursing discourses because they privilege particular representations of maleness, narratives of sexual multiplicity and disguise how the equity gaze is a persistent reminder in the minds of many male nurses that theirs is sometimes a prescribed performance of metaphorical sexless, gender nakedness and quietened voice which is disrobed and left like their sex in the locker room. [ABSTRACT FROM AUTHOR]

Home modification or adaptation is an important global issue, especially for older people living with disabilities in ordinary housing of varying ages, and pre-dating concerns about accessibility in design. Comparisons of research from five developed nations identify common themes: variation in integrated service development; public and private financial investment; deferred health costs; workforce expansion and training; and the value of the user perspective. Further discussion identifies the importance of retrofitting alongside new build, and argues for sustainable housing that recognizes population aging but also issues of climate change and the need for more inclusive design of housing for all ages. [ABSTRACT FROM AUTHOR]

Existing research suggests the provision of communication aids for children with complex communication needs can have significant positive impacts on health and quality-of-life. The process of clinical decision-making related to the recommendation of high-tech communication aids is not well documented or evaluated, and research evidence related to the provision of these aids remains limited. This study aimed to understand the factors that specialized AAC professionals in the UK consider when recommending high-tech communication aids. Purposive sampling was used to recruit teams to six focus groups, each of which centred on a team's recent recommendation process (i.e. a discussion following a real-time assessment session, where the team attempted to arrive at an agreed recommendation for a specific child). Thematic network analysis was used to interpret data from the focus group discussions. Participants identified a wide range of child characteristics, access features, and communication aid attributes in weighing up decisions for individual children. Findings suggest that specialized AAC professionals in the UK prioritize access features over language considerations in their communication aid recommendations. An explanatory model was developed to illustrate the interaction effect that several competing considerations may have on decision-making. Implications for clinical practice and future research are discussed. [ABSTRACT FROM AUTHOR]

High-tech communication aids are one form of augmentative and alternative communication (AAC) intervention offered to children following an assessment process to identify the most appropriate system based on their needs. Professional recommendations are likely to include consideration of child characteristics and communication aid attributes. Recommendations may be influenced by contextual factors related to the cultural work practices and service context of professionals involved, as well as by contextual factors from the child's life including their family environment and wider settings. The aim of this study was to explore the influence of cultural and contextual factors on the real-time decision-making processes of specialized AAC professionals in the UK. A total of six teams were recruited to the study. Each team carried out an assessment appointment related to a communication aid recommendation for a child and family. Following the appointment, each team participated in a focus group examining their decision-making processes during the preceding assessment. Inductive coding was used to analyse the transcribed data, and three organizing themes emerged relating to the global theme of Cultural and Contextual Influencers on communication aid decision-making. An explanatory model was developed to illustrate the funnelling effect that contextual factors may have on decision-making, which can substantially alter the nature and timing of a communication aid recommendation. Implications for clinical practice and future research are discussed. [ABSTRACT FROM AUTHOR]

While the organisation of work in maternity care has historically witnessed boundary work between midwives and obstetricians, modern service provision has posed many challenges to professional boundary work, with increasing litigation and risk management practices fuelling the social construction of a ‘risk discourse’ within maternity care. Drawing upon observational and interview data of an ethnographic study conducted in a UK obstetric-led maternity unit during 2013, this article explores the professional experiences of contemporary ‘risk work’ and the impact of such ‘risk work’ upon the professional role boundaries of obstetricians and midwives. Midwives and obstetricians expressed concern regarding risk in childbirth. Obstetricians and midwives perceived control over the childbirth process as a means of promoting risk minimisation, so that risk management was central to the perceived rational management of uncertainty in maternity care. Anxiety over uncertainty, error and blame was associated with dominance of the biomedical model of care in translating and managing risk and a perceived increase in the medicalisation of childbirth. Such ‘risk discourse’ had consequently provoked boundary work tension, with the perceived shifting of professional role boundaries of obstetricians and midwives within maternity care. As a consequence of contemporary risk work and reconfiguration of role boundaries, the role of the midwife in the twenty-first century was perceived to be in a state of flux. I note that contemporary risk work and the reconfiguration of professional boundaries in maternity services potentially places the midwifery profession ‘at risk’ of deprofessionalisation, raising concerns for the future role and professional status of midwives. [ABSTRACT FROM AUTHOR]

Many studies of blood donation have looked at the motives of donors, their relationship with the wider society and corresponding values such as gift-giving, altruism and responsibility. These underpin a rhetorical representation of person-to-person donation that neglects the many technical processes that take place between donation and eventual use and the material nature of blood itself. This ethnographic study, conducted in four UK blood donation sites, describes the various practices involved in routine sessions, rather than the motives or values or donors or staff. It focuses on the procedures and equipment that not only ensures blood is collected safely and efficiently, but the extent to which they determine the nature of the collected blood itself. Taking our cue from posthuman approaches, we argue donated blood as something that is ‘made’ only when it leaves the body; in other words, it is not simply extracted, but is constructed through specific practices. We illustrate how, as blood is separated from the body, it is increasingly depersonalised and reconstituted in order to have biomedical value. In this way, rather than reproducing the essentialist claim that blood is what social scientists often described as a ‘special kind of substance’, we point to the ways in which donated blood alters as it moves in time and space. We argue that such transformations occur in both symbolic and material realms, such that the capacity of blood to have both cultural meaning and clinical value is dependent on the fact that it is never stable or singular. [ABSTRACT FROM PUBLISHER]

The substitution of clinical with non-clinical staff to triage and manage calls in the NHS urgent care services is one of the number of measures designed to meet growing health services demand. The deployment of a Computer Decision Support System ‘NHS Pathways’ to support this work has created a new type of health worker and a new form of risk work. In this article, we examine how call handlers manage, experience and respond to risk in their everyday practice of telephone assessment. We draw on data from an ethnographic study of 5 NHS 111 sites involving 356 h of observation plus 6 focus groups with 47 health services staff in 2011–2012. We found that there was a ‘risk problem’ involving balancing the competing demands of assessing patients safely against rationing limited health resources. The new service used technology to support risk management but this technology also created risk work for call handlers, clinicians and patients. We found that call handlers engaged in risk work that involved interpretation, judgement and flexibility in using NHS Pathways. Call handlers also deferred some risk work to both clinicians and patients/callers. Risk work now involves ‘making the technology work’ and much of this work has been delegated to non-clinical call handlers. These new healthcare workers are interpreters of risk. Risk work creates a sense of responsibility (and sometimes anxiety) for these non-clinical call handlers. [ABSTRACT FROM AUTHOR]

Research with young people suffering from a long-term illness has more recently incorporated the use of visual methods to foster engagement of research participants from a wide age range, capture the longitudinal and complex factors involved in young people’s experiences of care, and allow young people to express their views in multiple ways. Despite its contributions, these methods are not always easy to implement and there is a possibility that they might not generate the results or engagement initially anticipated by researchers. We hope to expand on the emerging discussion on the use of participatory visual methods by presenting the practical issues we have faced while using this methodology during different stages of research: informed assent/consent, data collection, and the dissemination of findings. We propose a combination of techniques to make sure that the research design is flexible enough to allow research participants to shape the research process according to their needs and interests. [ABSTRACT FROM AUTHOR]

In recent years research into child sexual offending has highlighted “grooming” as an important part of the offence chain. Topics that have come to dominate the research agenda have focused on the offenders' perspectives, psychological models of offending behaviour and how child sex offenders (CSOs) are managed and treated in local communities (for example through Multi-Agency Public Protection Arrangements). Whilst these studies are extremely important, one area that has suffered from a lack of research and visible debate is how victims, their families and local communities experience grooming in situ and on a day-to-day basis. Using observational, interview and document data collected from an ethnography of a south-east coast community that houses a number of CSOs, this article examines the strategies used by strangers and acquaintances when grooming the local environment, significant others and children. Importantly, these grooming experiences are articulated from the perspective of the victims and their families. In doing so, the article discusses the implications that these experiences have for understanding offender–victim behaviours. [ABSTRACT FROM AUTHOR]

Objective: To explore what factors influence student-doctors' learning of clinical communication on ward-rounds and how such learning can be enhanced. Methods: Adopting a qualitative ethnographic approach, the author audio recorded and observed 63 bedside episodes within 18 ward-rounds on four different wards over an 8-week period. Nine fourth year student-doctors and four clinicians also participated in semi-structured interviews. The combination of observations, audio-recordings, transcriptions, field notes, and interview data allowed us to produce a detailed description of the case. Results: Each bedside episode offered opportunities for learning about clinical communication. However, the student-doctors did not always recognise that they were learning about clinical communication, since in this context, they were not being explicitly taught about communication. Student-doctors were rarely invited to participate in the ward-round and clinicians overlooked opportunities for learning. Some student-doctors questioned the educational value of ward-rounds and did not always attend. Conclusions: Ward-rounds are a rich site for learning clinical communication but opportunities for learning are often overlooked. Practice implications: By being alert to the power of role modelling and the importance of inclusion and participation, student-doctors' learning of clinical communication can be enhanced even on busy ward rounds. [ABSTRACT FROM AUTHOR]

This article revisits the critical realist ethnographic process that was adopted in my doctoral thesis, which was concerned with the experiences of ethnic identity of white British and Pakistani British children as they started kindergarten in the northwest of England. The article focuses on the ethnography that emerged from the visits that I carried out alongside staff to children's homes before they started kindergarten and on the way in which these were portrayed and analysed in the final thesis. I conclude that the process of observation, writing field notes and then producing a fuller ethnography produced a very partial representation of the empirical world. This was problematic in that, in critical realism, what is observed in the world of the ‘empirical’ and considered in the world of the ‘actual’ forms the basis for understanding the underlying causal tendencies which point to the underlying explanatory concepts in the world of the ‘real’. I argue, however, that more careful critical realist ethnography has the potential to be a powerful methodological framework which accepts the contested nature of reality but which, unlike postmodernism, provides a means of addressing possibilities and of moving beyond ‘undecidability’. [ABSTRACT FROM PUBLISHER]

This article considers the implications of the varied social meanings and values practitioners give to aid and the logics they use to make sense of Aidland's inequitable economy. The author draws on experience as an aid practitioner, as well as on ethnographic research in Cambodia to propose that dominant economic approaches to assessing the value for money delivered by aid risk overlooking the values and varied interpretive logics aid workers use to make sense of aid allocations and exchanges. The article highlights dilemmas experienced by aid workers living and working in an inequitable socioeconomic system produced by aid flows that constantly have to be negotiated, reconciled or ignored. A case study from Cambodia shows how the interpretive lenses aid workers use to evaluate the use of aid money influence their relationships and practice in ways that have material effects. This suggests they deserve further study, likely to be aided by reference to ideas from economic sociology and anthropology. [ABSTRACT FROM PUBLISHER]

In this article, we examine the ways in which risk is categorised in childbirth, and how such categorisation shapes decision-making in the risk management of childbirth. We consider the ways in which midwives focus on and highlight particular adverse events that threaten the normality of childbirth and the life of the mother and/or her baby. We argue that such a focus tends to override other elements of risk, especially the low probability of such adverse events, resulting in ‘an ever-narrowing window of normality’ and a precautionary approach to the management of uncertainty. We start our analysis with a discussion of the nature of childbirth as a fateful moment in the lives of those involved, and consider the ways in which this fateful moment is structured in contemporary society. In this discussion, we highlight a major paradox; although normal childbirth is both highly valued and associated with good outcomes in countries like the UK, there has been an apparent relentless expansion of ‘the birth machine’ whereby birth is increasingly defined through the medicalised practices of intensive surveillance and technocratic intervention. We explore the dynamics that create this paradox using ethnographic fieldwork. In the course of this work, the lead author observed and recorded midwives’ work and talk in four clinical settings in England during 2009 and 2010. In this article, we focus on how midwives orientate themselves to normality and risk through their everyday talk and practice; and on how normality and risk interact to shape the ways in which birth can be legitimately imagined. We show that language plays a key role in the categorisation of risk. Normality was signified only through an absence of risk, andhad few linguistic signifiers of its own through which it could be identified and defended. Where normality only existed as the non-occurrence of unwanted futures, imagined futures where things went wrong took on a very real existence in the present, thereby impacting upon how birth could be conceptualised and managed. As such midwifery activity can be said to function, not to preserve normality but to introduce a pathologisation process where birth can never be categorised as normal until it is over. [ABSTRACT FROM PUBLISHER]

Background: User-generated content in an online environment has significant implications in both education and health. Instead of a model of knowledge being something transferred from the expert to the student or to the patient, Web 2.0 technologies offer the hope of making learning, and healthcare delivery, a more collaborative and participative process. However, some evidence suggests that this supposed democratisation of production is not entirely democratic and, in an educational context, many students are uncomfortable about sharing material they create with their peers. Aim: To understand students' affective and other experiences of generating content to be shared online with peers (e.g. in online discussions). Methods: Online interviews, face-to-face focus groups and further methods with two student groups in medical education, one undergraduate and one postgraduate. Results: Students were broadly positive about creating and sharing material online, but were also quite anxious about doing so. Many practical issues, including around course design, student workload and assessment pressures, were barriers to students creating and sharing material. Group size is also important, with self-sustaining activity less likely in small groups. Conclusion: Successfully introducing user-generated content into medical education requires attention to practical details and an awareness of the student anxiety that can arise. [ABSTRACT FROM AUTHOR]

The study of social defences against anxiety used within institutions has a long history, beginning with the seminal work of Isobel Menzies Lyth, who examined the reasons for the high rate of nursing students dropping out of their professional training within a large London teaching hospital. She identified a range of social defences used by nursing staff to manage the anxieties inherent within their work, including ritual task performance, reducing the weight of responsibility by checks and counterchecks and reduction of the impact of responsibility by upward delegation. British social work is haunted by the memories of children known to social services who have died. The anxieties experienced by child protection social workers derive from a variety of sources, ranging from daily exposure to powerful emotions within the families and other professionals that they work with to an awareness of a history of public inquiries and media coverage that has influenced public perceptions of their profession. Menzies Lyth's study is over 50 years old and this article will provide a critical analysis of whether this theoretical framework is useful for understanding contemporary child protection social work. Preliminary data from an on-going ethnographic study of local authority childcare teams are used to illustrate the discussion, indicating that similar defences are used within current child protection practice. The implications for the organisational culture in child protection social work and for changes proposed by the Munro Review will be explored, particularly the emotional aspects of organisational change. [ABSTRACT FROM AUTHOR]

This article highlights some considerations emerging from an ongoing ethnographic research I am carrying out at the local gurdwara of Fiumicino, in the outer edges of Rome, and in two ashrams owned by Italian converted Sikhs, which are also hosting some Sikh migrants. These sites seem to question the separation of urban from rural contexts, since they both act as community centres for Sikhs living in the town and neighbouring villages and as places of residence from where people commute for professional purposes. In this perspective, the 'Sikh case' is a good example to further reflect on the changing urban shape of Rome, which appears to have been constantly transforming itself over the last decades with the increasing expansion of the suburban areas; such restructuring has also influenced the way migrants choose where to work and live. [ABSTRACT FROM AUTHOR]

This article reports findings from an ethnographic study of the arts curriculum and pedagogy in a British primary school. The policy context for the study is the school's involvement in promoting creative partnerships between teachers and artists. The pedagogies of three different artist-led projects are analysed, using a Bernsteinian framework, and are characterised in relation to notions of 'competence' and 'performance' pedagogies. These characterisations are then used to consider the impact of the artists' pedagogies on teachers in the school, and the extent to which the different pedagogies promote inclusion. Broad conclusions are drawn about the relative difficulty of adopting competence pedagogies in the current educational culture of British schools; more specific conclusions are drawn about the importance of time, text, discourse and interpretation in arts pedagogies. [ABSTRACT FROM AUTHOR]