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Physical inactivity levels are rising globally. In response, public health investigators have sought to design and implement effective interventions to raise levels of physical activity in populations, communities and individuals. Usually, such interventions are built around theories of behaviour change in which notions of motivation and incentivisation loom large. Drawing on focus group evidence derived in the context of a cluster RCT aimed at increasing levels of physical activity in the workplace, this paper offers a critical look at the factors that seemingly stimulate and sustain that activity. In particular, using novel methods of data analysis we illustrate how motives and motivation – often interpreted as a driving force 'in' individuals – can be more usefully seen as distributed; as a property of systems (incorporating technologies, organisational structures, and social interaction) rather than of persons. In our discussion, we outline various theoretical as well as empirical grounds for making such claims and conclude by drawing out the implications of our work for public health policy and research. [ABSTRACT FROM AUTHOR]

In the light of the 'peak-car' thesis, this paper explores the driving-related desires and practices of adults aged 16-21 and their parents from the UK. Tropes of freedom and independence were commonly evoked; but were pragmatically framed by concerns of finance, utility and risk. Car ownership was prized only for instrumental reasons, and as one tool in a mixed, collective transport network: it had been decoupled from automobility. Environmental sustainability was notably absent from discussions. It may be too early to herald the end of automobility but, for these participants, its seductions have been rendered ironic, rather than aspirational. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate health and social care professionals' perspectives on developing services for children with life limiting conditions at the end-of-life using issues identified by bereaved parents as priorities. The study adopted qualitative methodology using nominal group technique in focus groups (n = 5) to collect data from 35 health and social care professionals. Six issues were identified across professional groupings as particularly challenging within the context of caring for children at the end-of-life: truth telling; symptom management; communication with, and relationships between families and professionals; emotional impact, the withdrawal of feeding or treatment and sibling support. Strong resonance was noted between professionals and parents in the emphasis placed on issues related to talking about death (to child and siblings) and decision-making about the withdrawal of treatment. Conversely, late referral to hospice care and lack of services in the community dominated accounts of parents whose children had non malignant conditions, but were not prioritized by professionals. Although the latter focused on the need for and challenges associated with optimizing symptom management, most parents viewed symptom control as highly effective. Caring for a dying child is a multidimensional experience for both parents and professionals. Convergence of thinking carries three main implications for service development. Firstly, the need for 'joined up' palliative care services, particularly concerning timely referral to the range of support services. Secondly, more structured bereavement services. Third, within an ethos of family centered care, needs of siblings should be addressed effectively. [ABSTRACT FROM AUTHOR]

The author reflects on the notion of finding worlds in a small square of wood essential to understand why an N of 1 can prove useful to scientific inquiry. He points out that research not entirely qualitative nor exclusively quantitative and neither entirely built on big N nor ignorant of small N and that what matters is the justification for choosing N and not the magnitude of N.

This paper reports on the routine decision making practices of health professionals working within a genetics service. Specifically the paper focuses on professionals' assessments of whether patients are at increased risk of inheriting a gene that predisposes the individual to developing cancer. By analysing professionals' talk and actions whilst assessing risk, the paper develops an understanding of both routine and complex decision making. Whilst some decisions were unproblematic, there were a number of situations in which geneticists appear to challenge the decision rules. Such situations occur when faced with a borderline case, an interesting case, when the patient appears particularly anxious or when the rules themselves are judged to be inadequate. Whilst decision support technologies are able to assist clinical decision making they are not relied upon by geneticists above and beyond their own knowledge. Thus, when knowledge is uncertain the decisions that clinicians make are not a consequence of the standard application of scientific protocols but are locally determined according to experience, circumstance and case. This suggests that the transfer of decision support technologies to general practice or to the general public are unlikely to be effective, given the importance of clinical experience to the risk assessment process. [ABSTRACT FROM AUTHOR]

Whilst analysis of 'risk' (in its many conceptual shapes) has loomed large in both medicine and social sciences over the past 25 years, detailed investigations as to how risk assessments are actually put together (in either lay or professional contexts) are few in number. The studies that are available usually focus on the use of words or everyday conversation in assembling risk. Talking about risk is, of course, important, but what tends to be ignored is the fact that risk can be and is often made visible. For example, it can be made visible through the use of tables, charts, diagrams and various kinds of sophisticated laboratory images. This paper concentrates on the role of such images in the context of a cancer genetics clinic and its associated laboratory. Precisely how these images are tied into the production of risk estimates, how professionals discuss and use such images in clinical work, and how professionals reference them to display facts about risk is the focus of the paper. The paper concludes by highlighting the significance of different kinds of visibility for an understanding of genetic abnormalities and how such differences might impact on the attempts of lay people to get to grips with risk. [ABSTRACT FROM AUTHOR]