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This commentary discusses the methodological utility of ethnography within the medical space. Whilst a general consensus affirms that ethnography aligns with qualitative approaches, as identified within the existing medical literature, here, we demonstrate how quantitative [positivist] methods can also be incorporated. This paper begins by contextualising ethnographic approaches within medical contexts by demonstrating its empirical value within the existing literature. Next, we discuss the interconnection between the practice of 'doctoring' and ethnographic research, whereby doctors themselves use forms of inductive and deductive reasoning to treat and manage patients in their everyday context. This philosophical discussion not only links to the everyday practice of medical practitioners, but also critically reflects on the role of the first author, as a diagnostic radiographer. Lastly, this paper identifies the virtues of ethnographic research for medical students and/or medical doctors whereby the combination of qualitative and quantitative methods (within an ethnographic methodology) can lead to new empirical and methodological insights, enabling the creation of alternate research strategies and evidence. This methodological strategy may be best considered amongst medical students and/or early career medical researchers, but we also anticipate it to resonate and open further discussion with experienced medical practitioners and researchers transnationally. [ABSTRACT FROM AUTHOR]

Background: Sex workers in South Africa face various forms of structural and interpersonal violence, including police violence, exclusion from health services, and stigmatization and marginalization within their communities. In an attempt to counteract the harmful health effects of criminalization and exclusion, risk-reduction workshops are a key component of HIV prevention programs globally. This paper offers a critical investigation of Creative Space workshops – a South African model of risk-reduction workshops for sex workers – taking place in Soweto, Johannesburg. Drawing on Paulo Freire's work, the paper explores the potential of these workshops to contribute to the empowerment, health and well-being of sex workers. Objectives: The aim of this paper is to investigate the social and psychological effects of peer-led risk-reduction workshops for sex workers in Soweto, South Africa, with a particular focus on the ways in which they might contribute to community empowerment. Methods: This paper is based on in-depth interviews and focus group discussions with 32 sex workers conducted as part of a 20-month ethnographic study (December 2015 to July 2017). Data was analyzed combining inductive thematic analysis with a theoretical frame based on Freire's theory of community empowerment. Results: Peer-led risk-reduction workshops can serve as a 'safe space' for sex workers and distribute empowering forms of knowledge, particularly regarding health issues and rights. However, divisions between different groups of sex workers and between sex workers and non-sex workers counteract the potential benefits of the workshops. Conclusions: Peer-led sex worker programs are likely to be more empowering when they are committed to raising critical consciousness and creating solidarity, and embedded in community action, focusing on common issues such as institutionalized racism, livelihood insecurity, and lack of access to safe and secure housing. Such actions would have positive outcomes on health and well-being. [ABSTRACT FROM AUTHOR]

Background:Quantitative research suggests that medical students' empathy declines during their training. This meta-ethnography asks: What new understanding may be gained by a synthesis of interview-based qualitative research on medical students’ views and experiences of empathy? How can such a synthesis be undertaken? Methodology:A meta-ethnography synthesizes individual qualitative studies to generate knowledge increasing understanding and informing debate. A literature search yielded eight qualitative studies which met the inclusion criteria. These were analyzed from a phenomenological and interpretative perspective. Results:The meta-ethnography revealed a conceptual confusion around empathy and a tension in medical education between distancing and connecting with patients. Barriers to empathy included a lack of patient contact and a strong emphasis on the biomedical over the psycho-social aspects of the curriculum. A number of influences discussed in the paper lead students to adopt less overt ways of showing their empathy. Conclusion:These insights deepen our understanding of the apparent decline in empathy in medical students. The lessons from these studies suggest that future curriculum development should include earlier patient contact, more emphasis on psycho-social aspects of care and address the barriers to empathy to ensure that tomorrow’s doctors are empathetic as well as competent. [ABSTRACT FROM PUBLISHER]

In the past twenty years, Australia has re-directed efforts to diversify the recruitment of temporary labour and students, attracting middle-class migrants from new sources, such as Latin America. This paper explores how structural, political and socio-economic contradictions in countries of origin and destination shape Argentine migrants' everyday experiences of trying to create a new home. Drawing on ethnographic research, this paper builds on work on temporary middle-class migration to show how a 'homing' lens contributes to refining our understanding of how precarity can become protracted for middle-class migrants moving from the Global South to the Global North. The findings demonstrate that feelings of detachment from their past home but difficulty planning a future due to their temporary status exclude such migrants from the ontological stability necessary for homing. Using metaphors of 'walls' and 'skidding', we show how spatial and temporal precarity discourage emotional and material investment in their present homes. [ABSTRACT FROM AUTHOR]

Across the world, economic interests and state-making interventions have converged in dispossessing rural and urban dwellers. Drawing on literature on rural transformation, precarity, and life after dispossession, this paper explores how lifeworlds are constructed after dispossession. Based on ethnographic research in an Afro-descendant village in agro-industrial Colombia, I analyse five income-generating activities that together point to rural precarity, characterised by uncertain labour relations, fragile conditions of life, ecological dependence, and reconfigured rural relations. While villagers construct their lifeworlds around community, autonomy, and recognition, the constant search for income and reconfigured rural relations uphold and deepen inequalities in the agro-industrial margin. [ABSTRACT FROM AUTHOR]

Research in the field of Global Mental Health has stoked hopes that 'task-shifting' to community workers can help fill treatment gaps in low-resource settings. The fact that community workers inhabit the same local moral worlds as their clients is widely framed as a boon, with little consideration of the social and ethical dilemmas this might create in the care of chronic, stigmatized conditions. Drawing on 14 months of ethnographic research focused on psychosocial interventions in Nepal, this paper traces how the multiple roles community workers occupied with respect to their clients - clinician, neighbour, and at times kin - came to bear on the care they provided. In-depth case studies are used to explore two divergent logics of care informing Nepali community workers' practice. While formal psychosocial care guidelines emphasized clients' autonomy, calling for non-judgmental and non-directive forms of emotional support, everyday efforts to 'convince' neighbours and relatives in distress often involved directive guidance oriented toward the restoration of moral personhood and social relations. These approaches could be mutually supportive, but tensions arose when community workers invoked moral standards linked with mental health stigma. This analysis highlights the challenge of mobilizing communities' strengths and resources without inadvertently reproducing their exclusions. It suggests the deployment of community workers to address psychosocial care gaps may entail not only leveraging existing relationships within communities, but also reconfiguring the very terms of relatedness. [ABSTRACT FROM AUTHOR]

Background: This paper draws on a longitudinal ethnographic study of music-making with "post-verbal" people: those with stroke, learning difficulties, acquired brain injury, dementias or autism. Methods: Using embedded observation, arts workshops, interviews with families and carers and focus groups with Music Leaders, the project traced how inclusive music-making happens with "post-verbal" people. It used post-human theory to illuminate and explore processes and benefits. Results: This paper fuses the practical and theoretical aspects of making music with post-verbal people, to understand both how it happens, and, what it signifies. It shows how post-verbal people use music to communicate and demonstrate their capacities, and analyses how those working with them use music to foster a sense of inclusion and belonging. Conclusions: By writing in collaboration across academia and community music practice the paper makes new and important contributions to both post-human thinking and capacities in learning, arts and health. [ABSTRACT FROM AUTHOR]

When trying to understand childhood obesity, policymakers and healthcare professionals most often make use of behavioural sciences and biomedical perspectives. This approach assumes that fatness is unhealthy and caused by people making 'bad choices' about their diet and physical activity. Increasingly not only parents, but also children, are considered to be individually responsible for their weight, their health, and through that, for the 'obesity epidemic'. Drawing on critical obesity/weight studies and practice theory, this paper challenges the individualistic and weight-based view of health, and the heuristic of 'individual food choice', and through that such a framing of childhood obesity. It does so by focusing on the experiences of young people medically identified as overweight, who are trying to lose weight. Looking at two domains of children's lives, their family and peers, the paper demonstrates how young people experience and negotiate the individualized health advice, and what sort of consequences this has for their daily lives, and their mental and physical wellbeing. The article is based on observations of interactions between families and healthcare professionals, conversations with children and parents, as well as participant observation at youth summer weight loss camps, which were part of a larger ethnographic research project conducted in 2018–2019 in Poland. The paper concludes by proposing to reframe how we think about childhood obesity, and consider young people's knowledge and lived experiences when re-designing policy interventions and wellbeing promotion programmes, that is, to work with, and not on, children. [ABSTRACT FROM AUTHOR]

In this era of personalisation a patient's molecular profile plays an increasingly central role in development and delivery of personalised medicine. This paper sets out to explore the sociocultural implications of mainstreaming BRCA genetic testing in the treatment of advanced ovarian cancer patients, who carry a BRCA1 or BRCA2 gene mutation. It draws on ethnographic research conducted by between April-June 2016 in a large tertiary London hospital. Participant observation was conducted across two sites. For the first two weeks participant observation was conducted in the traditional genetic testing setting in two separate clinics. From thereon, participant observation was conducted in the clinical encounters of treating patients in the ovarian cancer clinic. In addition, face-to-face interviews were conducted with medical oncologists who worked in the clinic. Contributing to the fields of cancer genetics, personalised medicine and medical material culture studies in medical anthropology the paper seeks to further discussions about the interactions and relationships unfolding between medical objects and subjects across the landscape of cancer care. It highlights the importance of clinic-based ethnography to examine the complexities of identities and technologies as they intersect with the themes of suffering and hope in new and contradictory ways for BRCA-positive patients with late-stage disease. The paper argues that a BRCA mutation is not only central to the political economy of hope but takes on a more materialist nature as it becomes an embodied practice that moves in and beyond the clinic. [ABSTRACT FROM AUTHOR]

Drawing on critical theoretical perspectives and ethnographic field research related to HIV/AIDS in northern India, this paper argues for a cultured-centered approach to stigma reduction interventions and communication practices that are based on an assessment of larger social and structural processes on the one hand and the lived experiences and narratives of people living with HIV (PLWH) on the other. This paper suggests that while the complex nature of stigma, particularly as it relates to HIV/AIDS, makes it difficult to understand and respond to, this problem is further exacerbated by a largely individual and behavior-centered research that still dominates the field of Health Communication. Such research sees human cognition as the main source of stigma and underplays issues of power, structure, domination, and control. More specifically, and with concrete examples from the everyday lived experiences of PLWH – such as their experiences within family and health-care settings, this paper demonstrates how power and structure deeply impact their lives and remain central to their experience of (and resistance to) stigma, thus opening up space for alternative theorizing and practices in Health Communication. [ABSTRACT FROM AUTHOR]

Conceptually anchored on lived religion, this paper explores the meanings and experiences of health, illness, and healing among Filipino migrant women in Japan as they intersect with their religion. Likewise, it explores the functions and limitations of religion as migrant women face physical and mental health problems caused by work, marital status, and/or dislocation. Using biographical interviews and ethnography, this paper suggests that religion serves as a material and symbolic resource for making sense of health, illness and healing. As a material resource, it offered tangible, informational, and emotional support. It can however become limiting when personalised meanings and practices of religion frame illness based on morality, promote health misinformation, and delay healing and other health-seeking behaviours. Nonetheless, healing as perceived and experienced by Filipino migrant women involves lived religion in their complex meaning making and negotiated in terms of its physiological, spiritual and emotional effects. [ABSTRACT FROM AUTHOR]

This article discusses local expressions of crisis in Beed district, central Maharashtra. Both in public and academic discourse crisis has become the term of choice for the many structural deficiencies which make agriculture an increasingly precarious livelihood in India. While most voices subscribe to the explanation that the current state of distress can be attributed to the unprofitability of agriculture, a wide range of structural explanations are suggested as to why this might be the case. Consequently, in some debates agricultural crisis runs the risk of moving the experiences, agency and postionalities of those imagined to be living through its consequences to the background. This paper counterbalances such causal explanations by empirically delving into the imaginaries of agricultural crisis as they are articulated, negotiated and employed by farmers in Maharashtra. Based on twelve months of ethnographic research, the paper examines how ideas of crisis are entangled with colloquial understandings by taking experiences of 'tension', an Anglicised term used to express feelings akin to stress, as object of inquiry. I argue that by claiming crisis through invoking feelings of tension farmers mobilise a plurality of meanings, narratives and moral evaluations about what is wrong with agriculture in this part of India. [ABSTRACT FROM AUTHOR]

Purpose: Stuttering is a chronic communication disorder resulting in challenging life experiences for many individuals. This review aimed to integrate qualitative findings on the lived experiences of people who stutter and identify implications for rehabilitation. Materials and methods: A systematic literature search of electronic databases for studies published since 2000 was completed to identify research papers that used qualitative methods to explore the lived experiences of adults who stutter. Forty-five papers were read in full and a final seventeen papers were synthesised using a meta-ethnographic approach. Results: Five themes are described: (i) Avoidance is used to manage stuttering; (ii) Stuttering unfavourably impacts employment experiences; (iii) Stuttering shapes self-identity; (iv) Stuttering leads to negative reactions; and (v) Stuttering impacts relationships adversely. Conclusions: This review identifies the profound and predominantly negative impact that stuttering has on individuals' experiences. Avoidance is a commonly used strategy to manage stuttering with further negative consequences for the individual. To promote person-centred care and enhance treatment outcomes, clinicians should be cognizant of the profound impact of stuttering on the individual's life experience and incorporate targeted goals to reflect this when intervening. Clinicians should be aware of and understand the extent of the impact of stuttering on an individual's life which is typified by various forms of avoidance and challenges in a number of domains including employment, identity formation, relationship development and others' perceptions of the person who stutters. An impairment-based approach to stuttering treatment with adults focusing on the overt aspects of stuttering (i.e., speech behaviours) is not holistic and does not do justice to the spectrum of covert features such as avoidance, and internalised thoughts and feelings that are associated with the condition. Therefore, the adoption of a holistic approach to stuttering intervention is recommended. An understanding of adults' lived experience of stuttering has the potential to inform programme developments for children and adolescents with the same condition and thus employ preventative strategies to reduce the development of negative life experiences at an earlier age. Clinicians should engage with the field of disability studies to strengthen their practice and consider their role in addressing socially-imposed barriers such as negative attitudes impacting on people who stutter. [ABSTRACT FROM AUTHOR]

In this paper, we outline a critical reparative justice/care approach to adolescent reproductive health as an alternative to the standard public health response to 'teenage pregnancy'. Joining an increasing body of critical scholarship that calls for nuance in understanding reproduction amongst young people, we draw, in this paper, on data generated from an ethnographic study conducted in antenatal care units in an Eastern Cape township in South Africa. To illustrate the approach we propose, we home in on five case studies that highlight the variability of young women's lives, the multiple injustices they experience, and the agency they demonstrate in negotiating their way through pregnancy and birth. Injustices evident in these cases centre on sexual violence, rape myths, education system failures, health system failures, shaming and stigmatising practices, socio-economic precariousness, absent male partners, and denial of services. We outline how the reparative justice approach that highlights repair and support for social and health injustices at the individual and collective level as well as at the material and symbolic level may be taken up to ensure reproductive justice for young pregnant women. [ABSTRACT FROM AUTHOR]

Eldercare is often regarded as "dirty work" due to its association with dysfunctional, decaying, and diseased bodies. This paper focuses on eldercare work, and studies how current practices and organization of eldercare have been justified and legitimized in different and sometimes conflicting ways. Drawing on ethnographic fieldwork with workers in nursing homes for the elderly and homecare service, this paper examines eldercare work through the theoretical lens of "orders of worth." The concept of orders of worth affords a moral political analysis of eldercare work that helps to explain those dilemmas and situations which eldercare workers encounter and negotiate. Through the analysis, the moral entanglements between individual practices, institutional logics, and the political economy of care labor are systematically revealed. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work 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.)

Throughout the history of bareback sex (condomless sex between men), 'subjects' have been created, particularly through scientific literature, to characterise the men who engage in the sexual practice. For example, a gay man who does not use a condom may be framed as a pathologised subject. This paper first presents this history. Afterwards, by relying upon ethnographic data such as interviews collected from fieldwork research done in Toronto in 2014 with young gay men who have bareback sex, it shows exactly how these young gay men related themselves to those subjects. Then, it focuses on the pre-exposure prophylaxis (PrEP) Truvada as a new HIV prevention technology. Although PrEP can allow condomless sex to occur while diminishing the risk of HIV transmission, at the time of the research, none of the young gay men were interested in using this tool despite being the subjects for whom the drug is tailored. This paper argues that PrEP and subjectivity are coproduced and can have conflicting meanings. This contradiction of meanings is a result of the various representations and symbols of bareback sex and the men who engage in the practice that have been produced throughout the history of bareback sex. [ABSTRACT FROM AUTHOR]

Mathematical memes are an Internet phenomenon with an epistemic potential noteworthy for the teaching and learning of mathematics. The aim of this paper is to conceptualize this phenomenon on an empirical base, elucidating its educational potential. To pursue this goal, a two-year ethnographic research study has been conducted in a selection of social media communities that exchange mathematical memes. In the paper, a twofold theoretical lens is used to investigate the phenomenon from a memetic perspective focused on the general characteristics of Internet memes, and from a cultural perspective considering the Web 2.0 environment. Analysis tools derived from the memetic and cultural theoretical background are applied to an instrumental case study, to reconstruct how mathematical memes activate the interaction among members of an online community. The investigation elicits key characteristics of the phenomenon, provides grounds to conceptualize mathematical memes as hybrid representations of mathematical statements, and sheds light on the traits of the epistemic culture they establish in the community. [ABSTRACT FROM AUTHOR]

Background: Visibility of the transgender community has increased, particularly in the media. Trans teachers face a challenge, as their professional roles are both public and private. In an effort to seek personal and professional support, trans teachers have turned to social media outlets. Additionally, current research does not always encompass intersectional experiences of trans BIPOC teachers. Aim: This paper presents an autohistoria-teoría, or autoethnographical case study account of the author's experience coming out in the workplace as a trans teacher in Texas. Methods: Guided by Slavin et al. multicultural model of the stress process coupled with intersectionality, this paper attempts to describe how a trans teacher of color navigates the workplace. The data for this study are a collection of all of the author's social media posts from 2005 to 2015. Results: Findings reveal that allies provided some support, and that this trans teacher used deflection as a coping strategy in posts. Conclusion: The results suggest that administrative and peer support can impact transgender workers' mental well-being. In this paper, autohistoria-teoría is used as a powerful way for a trans BIPOC teacher's narrative to be told, which contributed to cultural healing. [ABSTRACT FROM AUTHOR]

Global tourism competition has entered home and family space. Drawing upon ethnographic research in Guatemala, this paper investigates the postcolonial gendered politics that shape (and are shaped by) global tourism competition, homestays, and mothering labour. It shows how Guatemalan women turn to hosting as an economic strategy and, in doing so, become part of a complex power relationship between Spanish schools and their (primarily Western) language tourists (or ‘students’). Spanish schools only work with ‘host-mums’ deemed capable of meeting their students’ needs, desires, and expectations of homestays as affordable, enjoyable, pedagogical experiences of ‘real’ family. To achieve this, Guatemalan women become cosmopolitan, competitive subjects who devise and enact strategies to commodify, transform, and perform their mothering labour and homes/families in ways that appeal to their Western students. Far beyond creating desirable touristic experiences, the everyday competitive mothering of tourists is having widespread consequences at the personal, local, and global levels. [ABSTRACT FROM AUTHOR]

The concept of pluriversal politics, which encompasses the vast array of alternatives to ecologically destructive and colonial capitalism, is crucial for envisioning emancipatory futures. However, the diversity of the initiatives composing the pluriverse poses obstacles to the unity necessary to dismantle interconnected systems of oppression, thus creating an intrinsic dilemma between diversity and unity. This paper explores the navigation of this challenge within emancipatory and pluriversal projects, drawing on material from ethnographic research on the Neapolitan Commons movement. The case study illuminates how social movement actors achieve simultaneous unity and diversity through the grassroots-developed concept of ‘hegemony of non-hegemony.’ In the Neapolitan context, this framework allows diversity to thrive while maintaining essential unity, crucial for confronting economic and political powers. The findings underscore how grassroots, autonomous, and pluriversal degrowth practices can challenge capitalist growth dynamics through unity in diversity, hence suggesting the unnecessary nature of state-led, top-down, or uniformizing approaches. [ABSTRACT FROM AUTHOR]

AbstractIn recent decades, policy makers around the world have been working on implementing various technologies into healthcare, and the Covid19 pandemic fueled this process. The specialized technological solutions for telecare – the use of technologies for care at a distance – are often adopted by users in different ways than intended, or are abandoned if the users cannot find applications that are meaningful to them. However, beyond specialized healthcare technologies, people are incorporating mundane digital technologies into their (health)care practices. In this paper, we draw on ethnographic research on the use of everyday digital technologies in Indian families where migrating children who are professional nurses care for their aging parents at a distance. Our findings show that 1) remote elder care is enacted through frequent calling which further fosters trust, necessary to provide healthcare remotely; 2) the motivation for older adults to engage with digital technologies is grounded in the value of family and affect which is consequential also for health; 3) technologies, too, require care-work in the form of everyday maintenance; and 4) in-person visits from children remain important, indicating that hybrid interaction is optimal for good care at a distance. We conclude that taking these findings into account may contribute to a more successful implementation of formal telecare systems. [ABSTRACT FROM AUTHOR]

State authorities in Europe invest immense resources in what the EU insists on calling the ‘fight against illegal migration’. Based on ethnographic research in two German cities, this paper shows that a tough approach towards illegalised migration can only be implemented through state practices that operate at the margins of, or even cross, the boundaries of what is legally permissible. This argument is developed through an analysis of informal practices that frontline staff in registry offices and migration administrations deploy to prevent, or at least disturb, illegalised migrants’ attempts to regularise their status by becoming the parent of child that is entitled to German citizenship. Drawing on the autonomy of migration approach, I use migrants’ struggles within and against Germany’s migration and citizenship regime as an epistemic device to expose three kinds of informally institutionalised counter-tactics of street-level bureaucrats that qualify as unlawfare. The analysis shows that officials, in their attempts to forestall migrants’ practices of self-legalisation, frequently resort to practices that are legally questionable or outright unlawful themselves. Ultimately, not only a tough stance on illegalised migration, but the very production of migrant illegality emerges as contagious as it implicates an illegalisation of state practices. [ABSTRACT FROM AUTHOR]

Several shifts in physiotherapy treatment of patients with rheumatoid arthritis (RA) have occurred over time. This paper aims to identify shifts in physiotherapy practice for patients with RA based on the author's work experiences from the 1980s until today at two Norwegian rheumatism hospitals, and to explore why shifts may have happened. A narrative was developed by describing events making a difference, categorizing, and ordering them with the help of narrative analysis and a sensitizing analytic lens on discourses. The storyline from the 1980s to approximately the turn of the millennium is called 'Shifts determined mainly by clinical context-driven events' which occurred in response to medical advances and physiotherapists' clinical experiences. These shifts were later justified by physiotherapists' research in the clinical context. The other storyline covers mainly the 2000s and is called 'Shifts increasingly determined by events beyond clinical physiotherapy context.' They include adjustments to further medical advances and implementation of biopsychosocial understanding of disease at the hospital, and to external research-based recommendations, health reforms, and economy. These processes have moved physiotherapy practice at the hospital from mainly providing individualized remedial and rehabilitative physiotherapy for the purpose to normalize physical function to an increasing focus on generic health measures for the purposes of health promotion and cardiovascular disease prevention. However, this shift may not fully match the complex needs presented by patients in disease remission with unrelenting fatigue and work inability and those who have multiple functional challenges and comorbidities. [ABSTRACT FROM AUTHOR]

The precarity of journalistic labour has received significant scholarly attention globally, leading to a plethora of studies that attempt to theorise changing journalistic roles, practices, and norms. Whereas precarity in newswork is formulated as the "new normal" in the Global North, the precarious situation of marginal(ised) newsworkers in the Global South has been simply normal. Based on ethnographic research in two small-town formations in South India, this article presents how stringers working in Indian-language newspapers have developed a complex professional identity and shared norms through journalistic and extra-journalistic practices to survive in the field. In doing so, we develop, in a novel way, Bourdieu's concept of illusio to understand the formation of a professional identity that spans adjacent fields. This paper's critical engagement with the difficult working lives of stringers and their invisible labour has learnings for analysis of precarity in journalism across the Global North and South. [ABSTRACT FROM AUTHOR]

Drawing on empirical research this paper explores how gendered discourses position emotions and emotion practices in social work environments characterised as 'macho'. It highlights the intersection of traditional emotion-reason dualism and gendered constructions of emotions with dominant hegemonic organisational and professional norms. This ethnographic study in an English Children's Service explored how emotions were understood and used in practice. It identified essentialist negative beliefs and a paradoxical positioning of practitioners' emotions alongside their constructive use. Problematic perceptions of professionalism fed into notions of conformity, heroism and transgression, devaluing engagement in agile emotion practices which underpin relationship-based systemic practice. Institutionalised dynamics created scope for differential impacts given practitioners' status and social locations such as, gender, race, age, sexuality or status. These findings contribute new knowledge, relevant to humane social work, professionalism and workforce retention. [ABSTRACT FROM AUTHOR]

How do scientists construct the meaning of science as oppositional to politics? How do the institutional contexts of scientists' work environment, training processes, and peer-group interactions reflect scientists' understanding of scientific practices, rules of the scientific field, and themselves as scientists? I argue that scientists' practice of boundary-work between science and politics is institutionally nurtured by a series of processes, which I call boundary-training. Drawing on ethnographic research at a molecular biology laboratory, this article reveals various tactics of boundary-training. Scientists are trained to routinely consume material infrastructure and produce massive scientific data. They internalize productivity-oriented academic life and valorize controllability in science labs to achieve this goal. Individuals' self-reliance and survival become core virtues of scientific enterprise. All combined, scientists are trained to believe that their works are irrelevant to social and political circumstances. This mundane depoliticization of science contributes to the consequence that the scientific field becoming a more efficient apparatus of political and economic powers. [ABSTRACT FROM AUTHOR]

In the post-conflict Nepali society, death is discussed in subjective terms. The Maoists equated death with sacrifice. The dead person was seen as a sacrificing revolutionary and the dead was discussed in the pretext of a political and social movement. Consequently, while the security forces used the notion of death to protect the nation state, the Maoist revolutionary used it to defeat the existing power structures, the reactionary and feudal forces. In this paper, while drawing from ethnography carried out during 2009–2010 and a followup in 2018 in Nepal, I explore various narratives that seek to frame death as a concept of 'martyrology' - liberation from socio-cultural and political inequality. Martyrdom occupy a significant place in the Maoist revolutionary ideology Death – mrytu is exalted as 'the image' that revolutionaries adhere to, as a by-product of the process of revolution and to place oneself in a category of the self-actualised being. The Maoists framed this within the ideology of 'martyrology' where death and destruction were seen as creative strategies for revolution to continue and dying for social cause was a means to self-actualisation. Death during Maoists conflict was thus argued meaningful in terms of political martyrdom. [ABSTRACT FROM AUTHOR]

Intergenerational programs that bring the young and old together are known to facilitate social connections. However, benefits of intergenerational programs cannot be achieved by simply bringing the two generations together. We need to understand the factors which enhance intergenerational engagement. This paper specifically explores barriers and enablers for improving engagement of older people in an intergenerational program conducted within four research sites in South East Queensland and New South Wales, Australia. Video ethnography was used to examine the intergenerational environment and observe patterns of engagement between older people and children. Findings reveal the type of activity, group structure and length of activity to increase engagement of older people in an intergenerational program. [ABSTRACT FROM AUTHOR]

For human services professionals, safety is a practical and professional commitment. However, so far the human service community has made little use of the safety science literature. Using qualitative methods this paper tracks how the introduction of a safety science model to the human service organizations in two states resulted in shifts in talk about accidents and work. This in turn led to insight and positive change in these human service organizations and for their clients. [ABSTRACT FROM AUTHOR]

This paper discusses how online practices relate to empowering outcomes at individual and community levels. To understand the phenomenon in a natural setting, a virtual ethnography approach to Indonesian online domestic migrant workers' communities was adopted to explore the empowerment of migrant domestic workers. The findings show that, at an individual level, migrant domestic workers need to engage in various practices, which contribute to their well-being. The well-being of migrants can be assessed in terms of their self-efficacy, self-esteem, reduced loneliness and reduced stress, all of which enhance their capabilities to take control over migration processes. But, as a community, they can conduct online practices that contribute to their ability to improve their communal external engagement. Community's external engagement contributes to the awareness of their power and abilities to take action towards change. Online communities enable migrant domestic workers, who live in an isolated workplace, to penetrate the boundaries and engage in various practices that empower them as individuals and community as a whole. [ABSTRACT FROM AUTHOR]

This discussion paper provides an introduction and overview of Ethnography as a qualitative research methodology and outlines its usefulness in understanding the experiences of patients and service users during their healthcare journey. Ethnographic research provides an insight into the group being studied. In this paper that author suggests that ethnography can provide an insight into the behaviours, thoughts and feelings of a patient group. Research methods used in ethnographic research have been outlined and discussed along with some of the possible methodological and ethical issues that might occur when carrying out an ethnographic study with a group of patients. This paper discusses some of the potential results of an ethnographic study with patients and how ethnographic research can be used to study the experiences of patients. the author draws together some lessons that can be learnt and some possible applications of ethnographic research in healthcare settings with patients. Implications for rehabilitation are also proposed. Ethnography is a simple and effective qualitative research methodology for studying groups of people with a common enterprise or experience, ethnography studies the culture, behaviours and norms of the group. Ethnography is a useful research methodology to understand the experiences of patients and service users during their healthcare journey. It can provide information about what it is like to have a particular medical condition or diagnosis and the norms and behaviours of patients with this condition. Ethnographic data allows the patient's voice to be heard. Data from ethnographic studies of patient groups can be used for service improvement within health and social care. [ABSTRACT FROM AUTHOR]

Using ethnographic data from Providence County, Rhode Island, this paper explores yoga as a bodywork practice that is part of everyday health and wellbeing routines in middle class households. In this context, participants define their bodywork practices as individual activities that answer health and wellbeing needs, but notably discuss bodywork in terms of their everyday social experience. Along with other bodywork activities, yoga emerges as a shared social practice that links participants to their partners, children, and other intimates, facilitating a sense of togetherness by allowing time and space for autonomy. By giving atmospheric and sensory attention to the ethnographic data, the paper further reveals how domestic intimacy is cultivated via the generation of bodily heat and positive energies and that yoga may tacitly facilitate such atmospheres. In this way, yoga can help households meet an American need for self-development and autonomy while still facilitating a far more enduring human need for intimate connection. Ultimately yoga is characterized as a pragmatic bodywork practice that blends self-development and social intimacy through shared energetic encounters. [ABSTRACT FROM AUTHOR]

In this paper, I use insights from extensive ethnographic research with evangelicals in Colorado Springs, Colorado to investigate how competing ethical understandings of time and the future underpin conceptions of and responses to ecological collapse. It argues that a dominant apocalyptic chronotope in US evangelicalism makes the future earth redundant, an understanding that Christian Right leaders have linked to decreased interest in environmental issues. This dominant evangelical view looks to the future with anticipation when a promised and ever-close apocalypse and rapture will signal the end of the earth. The temporal structure of climate change clashes with this narrative about time and the future of the planet. In contrast, a new theological understanding is emergent among younger evangelicals, where Christ's return is understood as involving a remaking of the earth, and not an ejection from it. This contrasting view makes the care of the planet a crucial Christian priority. [ABSTRACT FROM AUTHOR]

What are the challenges entangled with co-curatorial processes developed with highly heterogeneous, minoritised communities? Why do these exhibitions, even when co-created with community members, often emphasize community homogeneity over diversity? I address these questions by focusing on the Science Museum, London. I look back at a past project, What Makes Your Gender? (2014): a pivotal step in the Museum's treatment of gender diversity co-curated with trans young people and activists associated with Gendered Intelligence, a trans-led charity aiming to improve trans people's lives. Drawing on my exhibition analysis and ethnographic research of this co-creation project, I discuss why the heterogeneity and divisions within the curatorial team were overlooked in the co-curatorial process and final display. The discussion then shifts towards more recent debate surrounding the Museum's treatment of trans/gender people in the Who Am I? permanent gallery (2000 to present). The paper shows how inclusive curatorial projects attempting to validate minoritised communities, which are subject to discriminatory discourse in the media and wider public realm, can privilege homogenizing and easily 'consumable' representations of trans people at the expense of more accurate portrayals. It argues for greater attention to intersectionality and community diversity in curatorial projects co-created with heterogenous minoritised groups. [ABSTRACT FROM AUTHOR]

This study explores the adoption of mobile and wearable technology in the physical activity of older adults. The data arose from qualitative ethnographic observations and interviews (N = 7). Findings led to the conceptualization of a model describing interviewees' decision-making processes for adoption. The model outlines these phases: awareness; attitudes; appraisals; initial use, which could lead to abandonment or adoption; and post-trial abandonment, which could lead to rejection or probable adoption through redeveloping awareness and attitudes, and reappraising the technology. The findings highlight the need to consider for age-specific barriers to adoption and to understand adoption as a stage-wise process with intricate layers. Certain well-formed habits and the lack of understanding of the parameters provided by these technologies can lead to older adults' rejection of tools that are potentially useful for physical activity motivation. The paper suggests practical ways for promoting mobile and wearable technology to older adults. [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]

It is usually emphasized that the relationship between migrants and the domestic objects from their home countries is essential for migrants' maintenance of their various identities. It is presumed that migrants need familiar objects to feel at home in new surroundings. This study focuses on the domestic material culture of transnational well-educated middle-class European women living in Belgrade. The aim of the paper is to discover what role domestic objects from their home countries play in their homemaking practices and everyday lives in Serbia. Ethnographic research was conducted for the most part in 2018. Levitt and Glick Schiller's theoretical framework on transnational 'ways of belonging' and 'ways of being' and Anthias' concept of 'translocational positionality' were applied. Furthermore, Pérez Murcia and Boccagni's framework on homemaking practices among migrants was discussed. Contrary to some similar studies of affluent migrants, the findings show that domestic objects from native countries evoke neither ethnic nor national sentiments. In some cases, they do not need them to feel 'at home' in new surroundings. [ABSTRACT FROM AUTHOR]

'Comfort women' refers to the estimated 80,000 to 200,000 women who were forced to serve the Japanese imperial army sexually, physically, and mentally during WWII in and beyond the Asia-Pacific region. Drawing on ethnographic research that I conducted on the protests for comfort women called 'the Wednesday Demonstration' from September 2019 to August 2020, this intervention traces both how sexually violated women and their bodies are represented in ways that comfort Minjok (Korean ethnicity) and how discomfort can function as a starting point of alternative feminist knowledge production and transformative praxis. This intervention interrogates how the comfort women narrative draws on paternal metaphors of colonial history—the 'raped daughter (comfort woman)' and 'weak father (colonized Korea)'—and how it reinforces the savior fantasies of Korean men. It then illustrates how this narrative creates an ethnic comfort zone in which the sense of the 'we, Koreans' fueled by ethnic victimhood is strengthened and a unified Korea (victim) is re-imagined in opposition to Japan (perpetrator) as the other. By introducing activist Jung Ah-lim's case, this paper examines how her feelings of discomfort revealed forms of epistemic injustice in which Korean ethno-nationalist leaders determine forms of knowledge regarding comfort women and control the direction of political acts for their nationalist purposes. In doing so, this intervention shows how discomfort enables Jung Ah-lim to pursue her own knowledge and transformative praxis for the comfort women issue. [ABSTRACT FROM AUTHOR]

The Munro Review called for reform of the English child protection system so that practicing social workers were better able to exercise their discretion in the best interests of the individual child. This paper reports on the results of a multiple qualitative methods case study of a local authority child protection team. Utilising observation, documentary analysis, focus group, questionnaire, interview and 'Critical Realist Grounded Theory', the study explored the extent to which practicing social workers identified discretionary space within their practice. The main findings were that social workers had discretionary space in a de facto, de jure and entrepreneurial sense, and that this runs counter to assertions of 'curtailed' and 'eroded' discretion previously reported. The research does offer some evidence in favour of Munro's image for discretion within a 'child-centred' system. However, it also suggests that further reform may be required to better imbed formally granted discretionary space into local policy and procedures, so that discretion becomes less 'risky' for the practitioner, and so social workers can more consistently employ their discretion in the interests of the individual child. [ABSTRACT FROM AUTHOR]

Purpose: Routinized activities create security for persons with dementia (PWDs) and help care staff manage everyday tasks, but care staff also assist PWDs with constructing routines during their leisure time. This paper investigates how a PWD negotiates how to use the common room in a dementia ward as a social space with co-present staff members, other residents, and a visiting researcher. Methods: Based on ethnographic observations and video recordings and using conversation analytical methodology, the paper presents sequential analyses of video recorded data collected at a dementia unit in a Danish care facility. Results: Detailed analyses of selected instances indicate that the PWD treats care staff as being in charge of the social organization of common room, and they show how the PWD is routinely guided to sit calmly, minding his own business. The analyses also show that the PWD relies on ritualized action and routine activities when managing co-presence and interaction with the visiting researcher. Moreover, they show that a previous non-routine joint activity is used by the PWD to take initiative and thereby re-establish it later. Conclusions: We argue that routine and ritual both provide constraints but also resources for PWDs to actively co-co-create new shared activities with co-present others, and we suggest that PWDs' possibilities for taking initiatives for activities during leisure time among other things rely on the routines that have already been established in interaction with care staff and others or on non-routine activities which PWDs may turn into routines as they re-establish them. [ABSTRACT FROM AUTHOR]

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

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]

Opioids, a set of potent pain medications, have numerous known deleterious side effects, ranging from constipation to respiratory depression and death, and yet they are routinely prescribed and administered in biomedical settings. Situated against the backdrop of the US opioid epidemic, this paper examines how the iatrogenic and inadvertent harms and complications caused by opioid administration in clinical settings are experienced by clinicians as forms of moral injury. 'Moral injury' describes a moral agent's experience of perpetrating or being unable to prevent events that are at odds with their moral beliefs and social expectations. This concept powerfully extends Illich's notion of clinical iatrogenesis, which refers to harms experienced by patients; instead, 'moral injury' indexes forms of harm that extend beyond patients to those providing them care. Using an analytic auto-ethnographic approach based on more than a decade of clinical practice in urban hospitals in the Midwestern and Northeastern United States, the authors describe interactions with patients on opioids whose treatment trajectories are fraught with iatrogenic complications, and explore how biomedical institutions and systems further harm vulnerable patients who receive and are addicted to opioids. Though anxious to avoid harming their patients, clinicians are disempowered by hierarchical systems of medical decision-making, which hinder their ability to always act in what they feel are the patient's best interests. This paper highlights the emotional/affective distress and ambivalence experienced by physicians when making decisions about whether to administer or prescribe opioids. Ultimately, the paper demonstrates how iatrogenesis and moral injury are concomitantly produced through cascades of decision-making and local health systems, rather than individual clinical decisions alone. [ABSTRACT FROM AUTHOR]

This paper explores how poor health outcomes in the HIV/AIDS and opioid epidemics in the United States are undergirded by iatrogenesis. Data are drawn from two projects in Southern California: one among men who have sex with men (MSM) engaging with pre-exposure prophylaxis to HIV (PrEP) and the other in a public hospital system encountering patients with chronic pain and opioid use disorder (OUD). Ethnographic evidence demonstrates how efforts to minimize risk via PrEP and opioid prescription regulation paradoxically generate new forms of risk. Biomedical risk management paradigms engaged across the paper's two ethnographic field sites hinge on the production and governance of deserving patienthood, which is defined by providers and experienced by patients through moral judgments about risk underlying both increased surveillance and abandonment. This paper argues that the logic of deservingness disconnects clinical evaluations of risk from patients' lived, intersectional experiences of race, class, gender, and sexuality. This paper's analysis thus re-locates patients in the context of broader historical and sociopolitical trajectories to highlight how notions of clinical risk designed to protect patients can in fact imperil them. Misalignment between official, clinical constructions of risk and the embodied experience of risk borne by patients produces iatrogenesis. [ABSTRACT FROM AUTHOR]

This paper aims to examine the spatial attributes in the hospital ward environment and their impact on medical students' learning and experience of the clinical workplace. An ethnographic study was conducted in a Scottish teaching hospital, combining observations and interviews over a period of 10 months. Two teaching wards served as the field-sites where approximately 120 h of non-participant observations took place sequentially. In addition, 34 individual interviews were conducted with identified key informants that included medical students, junior doctors, postgraduate trainees, consultant supervisors, ward nurses and hospital pharmacist. A combination of Actor-network Theory (ANT) and Social cognitive theory (SCT) was applied to analyse data pertaining to spatial attributes and their relevance to clinical teaching and learning. Analysis of the observational and interview data led to generation of the following themes: spatial attributes in the clinical workplace can enable or constrain teaching and learning opportunities, inadequate spaces impact students' and junior doctors' sense of value, short clinical rotations influence a sense of ownership of doctors' spaces, and contested nature of space in the clinical environment. Several illustrations of the field-sites help to contextualise the themes and aid in understanding the participants' experiences and perceptions. Our findings suggest a complex entanglement of space with medical students learning and wellbeing in the clinical workplace. Provision of suitable spaces needs to be a core consideration to realise the full potential of work-based learning in medicine. [ABSTRACT FROM AUTHOR]

Done well, ward rounds (WRs) promote effective, safe care and collaboration; but WR quality varies. An improvement-focused appreciative inquiry (AI) into a large intensive care unit's WR practices identified a pivotal axis of collaboration between the most senior medical role (the consultant) and the bedside nurse (BSN). This paper examines that axis of interprofessional collaboration (IPC) to deepen understanding of its implications. Data included ethnographic observations, interviews, and co-constructed AI with groups of staff. Four key concepts emerged from cyclical interpretive analysis: "need," "presence," "ability" and "willingness." BSNs and consultants needed the interprofessional WR to enable their work; WR effectiveness was affected by whether they were both present, then able and willing to participate in IPC. BSN presence was necessary for effective and efficient IPC between these key roles. Indirect contributions, based on prior exchanges with colleagues or through written notes, reduced the joint problem-solving through discussion and negotiation that characterizes IPC to less efficient asynchronous interprofessional coordination. Factors affecting "presence," "ability" and "willingness" are discussed alongside potential mitigations and acknowledgment of asymmetric power. Appreciative examination of interprofessional WRs identified mechanisms supporting and undermining effective WR IPC and the centrality of consultants' and BSNs' collaboration. [ABSTRACT FROM AUTHOR]

The focus of this paper is to report the findings of a qualitative study whose purpose was to analyse the experiences of adult learners pursuing evening postgraduate degree programmes at the university level in Tanzania. Using ethnographic research combined with multiple case research design, together with in-depth interviews and documentary review, data were generated from 20 postgraduate students from one school within a university in Tanzania. The resulting qualitative data were subjected to thematic analysis. The study found that university adult learners in these evening programmes combined learning with their full-time employment, family, and social responsibilities as well as extra income-generating activities. Inevitably, these multiple responsibilities, as the study established, adversely affected their academic performance and duration for programme completion. In fact, completion on a part-time basis depended on dispositional factors such as individual learner's efforts and strategies adopted to cope with the situation, with many others either delaying completion or dropping out altogether. This scenario invites rethinking the modus operandi of programmes to facilitate postgraduate students' completion rates amid widening participation in higher education. [ABSTRACT FROM AUTHOR]

Purpose: Aboriginal and Torres Strait Islander People with a disability continue to experience barriers to service engagement such as mistrust of government services, lack of culturally appropriate support, marginalisation and disempowerment. This meta-synthesis reviews current literature regarding these experiences to explain why services are underutilised. Methods: The meta-synthesis was conducted using a meta-ethnographic approach to synthesise existing studies into new interpretive knowledge. The approach was supported by a search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: Ten original research papers utilising a qualitative methodology were extracted. Synthesis of the articles revealed four concepts that were developed into a conceptual model. These include:1) History Matters; 2) Cultural Understanding of Disability Care; 3) Limitations to Current Service Provision; and 4) Delivery of Effective Services. Conclusions: Disability services do not adequately consider the cultural needs of Aboriginal and Torres Strait Islander People or communicate in a culturally appropriate manner. There are expectations that Aboriginal and Torres Strait Islander People acknowledge their disability in alignment with western definitions of disability in order to access services. More work is needed to align disability services with culturally appropriate support to provide better health outcomes. Aboriginal and Torres Strait Islander people with a disability continue to experience barriers to service engagement which must be addressed. An essential gap that must be filled in providing disability services to Aboriginal and Torres Strait Islander people is the acknowledgment of culture as a resolute influence on all client interactions with providers. A cultural model of disability may better align with the experiences of Aboriginal and Torres Strait Islander people than current medical and social models used in healthcare. Disability services need to align better with culturally appropriate support to provide better health outcomes for Aboriginal and Torres Strait Islander people. [ABSTRACT FROM AUTHOR]

Community housing services adopt care models such as rehabilitation, recovery-oriented care and person-centered planning to improve the quality of life of service users with an intellectual or psychiatric disability. However, the way these care models are implemented and practiced can negatively impact service users' experience with the service as their complex needs go unmet. In this paper, we conceptualize these experiences through developing the counternarrative of burdens of support. For this we draw on burden of treatment theory. We conducted ethnographic fieldwork in a community service organization in the Netherlands. This included participant observation (84 h), interviews with service users (n = 20), experts-by-experience (n = 8), family members (n = 10) and photovoice workshops. Our analysis identifies four burdens of support: burden of self-determination; re-identification; responsibilisation and re-placement. The results show that burden of support is very much a relational concept: through their support, professionals can aggravate or alleviate burden. People with intellectual or psychiatric disabilities often receive support with living in the community. Good support fits people's needs (e.g. person-centered planning), builds on people's strengths and contributes to recovery and community participation. Even when support is practiced or organized with such aims, service users can have negative experiences. In this research we call this: 'burden of support'. Examples of burden of support identified include: Clients' needs and wishes are sometimes not sufficiently attended too when working with a personal care plan. Too much responsibility is sometimes shifted to clients, which results in feelings of failing or abandonment. The focus on strengths and recovery sometimes leaves too little room for clients to voice support needs. Having to move to a different home or neighborhood as part of becoming more independent can result in many difficulties including loneliness. The research recommended that those who improve services should also alleviate these burdens. [ABSTRACT FROM AUTHOR]