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

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

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

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

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

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

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

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

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

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

Information studies have identified numerous needs and barriers to the integration of asylum seekers and refugees; however, little emphasis has been placed thus far on their need to keep their own culture, values, and traditions alive. In this work, we use ethnographic constructivist grounded theory to explore the place of heritage in the information experience of people who have sought asylum in the United Kingdom. Based on our findings, we propose to conceptualize heritage as an affective and meaningful information literacy practice. Such conceptualization fosters integration by allowing people to simultaneously maintain their own ways of knowing and adapt to local ones. Our research approach provides scholars with a conceptual tool to holistically explore affective, meaningful, and cultural information practices. This study also reveals implications for policymakers, third sector organizations, and cultural institutions working toward the more sustainable integration of asylum seekers and refugees. [ABSTRACT FROM AUTHOR]

Background and Aims: Communication is important in determining how patients understand the diagnostic process. Empirical studies involving direct observation of communication within diagnostic processes are relatively limited. This ethnographic study aimed to identify communicative practices facilitating or inhibiting shared understanding between patients and doctors in UK acute secondary care settings. Methods: Data were collected in acute medical sectors of three English hospitals. Researchers observed doctors as they assessed patients; semistructured interviews were undertaken with doctors and patients directly afterwards. Patients were also interviewed 2–4 weeks later. Case studies of individual encounters (consisting of these interviews and observational notes) were created, and were cross‐examined by an interdisciplinary team to identify divergence and convergence between doctors' and patients' narratives. These data were analysed thematically. Results: We conducted 228 h of observation, 24 doctor interviews, 32 patient interviews and 15 patient follow‐up interviews. Doctors varied in their communication. Patient diagnostic understanding was sometimes misaligned with that of their doctors; interviews revealed that they often made incorrect assumptions to make sense of the fragmented information received. Thematic analysis identified communicative practices that seemed to facilitate, or inhibit, shared diagnostic understanding between patient and doctor, revealing three themes: (1) communicating what has been understood from the medical record, (2) sharing the thought process and diagnostic reasoning and (3) closing the loop and discharge communication. Shared understanding was best fostered by clear communication about the diagnostic process, what had already been done and what was achievable in acute settings. Written information presents an underutilised tool in such communication. Conclusions: In UK acute secondary settings, the provision of more information about the diagnostic process often fostered shared understanding between doctor and patient, helping to minimise the confusion and dissatisfaction that can result from misaligned expectations or conclusions about the diagnosis, and the uncertainty therein. Patient/Public Contribution: A patient and public involvement group (of a range of ages and backgrounds) was consulted. They contributed to the design of the protocol, including the timing of interviews, the acceptability of a follow‐up telephone interview, the development of the interview guides and the participant information sheets. [ABSTRACT FROM AUTHOR]

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

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Mentoring has become a popular model of intervention to reduce the risk of offending, and has been proposed as an effective tool to tackle the risk of gang membership. This paper reviews the existing literature on mentoring and reports on a qualitative evaluation of a mentoring programme targeted at young people 'at risk' of gang membership in an English city. The study highlights important issues around these interventions. Although we found it a useful way to engage otherwise hard-to-reach families, important limitations remain: their potential labelling impact and their limited impact in isolation from other more ambitious measures. [ABSTRACT FROM AUTHOR]

Background and Purpose. Primary central nervous system (1° CNS) tumours represent 2% of cancers. They record the third highest mortality from cancer in the 18-35 age group in the UK today. Despite improving medical treatments, prognosis remains poor, with more patients experiencing residual complex functional deficits. Rehabilitation for these patients is scantily researched. Observational studies demonstrate improved function following inpatient and some outpatient multi-professional rehabilitation. Comparative recovery and functional improvement between patients with 1° CNS tumours and differing oncological and other neurological diagnoses is shown. Qualitative papers explore patient's values of medical treatment, demonstrating themes of hope and improved quality of life (QOL). No studies explore the significance of rehabilitation for these patients. The aim of this study was to discover the meaning of rehabilitation for people with this life-limiting illness through ethnographic enquiry. Methods. Fieldwork data, primarily written narratives, field notes and interviews, were collected from 10 patients with 1° CNS tumours receiving physiotherapy at a UK specialist cancer hospital. They were asked what they thought the purpose of rehabilitation was in the context of their disease. Thematic analysis explored this data. Results. Patient experience provided insightful perception of the beneficial role of rehabilitation in the context of their incurable disease. Main emergent themes included independence, confidence, 'professional talk' (the broader sense of communication through talk, touch and therapeutic handling) and hope. An analogy presents an analytical model of the themes. Incidental findings identified difficulty accessing services. Conclusion. Rehabilitation intervention offers positive contributions to patients with 1° CNS tumours improving QOL irrespective of the stage of their disease. With equal access to cancer services, a key aim advocated in national directives in health-care today, it is essential that patients receiving treatment for this life-limiting disease have timely access to rehabilitation services in conjunction with holistic medical management. Copyright © 2010 John Wiley & Sons, Ltd. Ethics The Royal Marsden Hospital Committee for Clinical Research (CCR) The Royal Marsden Hospital Research Ethics Committee (LREC) Central Office of Research Ethics Committee (COREC) COREC 05/Q0801/130 superseded by The National Research Ethics Service University of Surrey Ethics Committee. [ABSTRACT FROM AUTHOR]

Aims: This paper proposes that ethnography and auto‐ethnography can make important contributions to counselling and psychotherapy research. Auto‐ethnography is a recent methodological approach that focuses on the subjective experiences of the researcher. It is informed by anthropology, which encourages the researcher to journey alongside the persons being observed and to make meaning of complex symbolic systems in their lives. Method: Examples from a study of therapeutic processes in a mental health setting for women are examined. Discussion: If auto‐ethnography situates the researcher with the insider's perspective and ethnography is from the outsider's perspective, the researcher is caught 'in‐between' these two approaches. Acknowledging the concept of 'in‐between‐ness' can both cause discomfort and transform the experience of all who engage in the process and enhance the quality of the research. [ABSTRACT FROM AUTHOR]

Recent years have seen a renewed interest in integrating creative activities into statutory mental health practice in high‐income countries. In this article, we offer an exploratory analysis of an arts project delivered within UK mental health services, Creativity for Enablement and Wellbeing (CREW). Drawing on data collected for a process evaluation of the project, we suggest that conceptualising CREW as liminal and liminoid provides a helpful way to articulate the processes, atmospheres, relationships, and practices of the project. Through this theoretical lens, we identify CREW as a mode of engagement comprising looseness, possibility and collectivity, all brought together through a unique community event, the showcase. We explore CREW's mode of engagement through three themes: 'carving out a liminal space', 'looseness and experimentation,' and 'from liminal to liminoid'. Implications for service delivery are discussed, focussing on how CREW managed to create a transformative space of liminoid possibility rather than a recovery journey delineated by service‐defined imperatives. [ABSTRACT FROM AUTHOR]

Objective: This paper presents the results of a trans-cultural study looking at the possible differences in the symptomatology of Alzheimer’s disease (AD) in people from Manchester, UK and Rawalpindi, Pakistan. Methods: Two groups of people with AD (45 in each group) were recruited at the two sites. The participants and their carers were interviewed to investigate possible differences in demographics and symptomatology including cognition, depression, personality change and every day activities. The instrument used included the Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Cornell Scale for Depression in Dementia (CSDD), The Brooks and McKinlay Personality Inventory and Informant Questionnaire on Cognitive Decline in the Elderly (IQ CODE). Results: The data analysis showed that compared to people from Manchester the Pakistanis had lower literacy levels but similar cognitive deficits when MMSE scores were adjusted for education. They were however more depressed; they had a different profile of personality change since the onset of illness and their reported changes in activities of daily living were more severe. Conclusion: The study has shown a number of possible cultural differences in affective symptoms, personality changes and every day activities. It highlights the need for developing mental health services for older people in Pakistan and making UK services more accessible for this growing community. Further research on service and care needs along with developing culturally sensitive instruments for assessing cognition, psychiatric symptoms, personality changes and daily activities is needed. Copyright # 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

We present findings from a longitudinal ethnographic study of infertile couples seeking treatment following initial GP referral to specialist fertility services. Repeated observations and interviews were undertaken with the same 14 heterosexual participants over an 18‐month period. Heterosexual, non‐donor couples comprise the majority of fertility clinic patients; however, research interest in this group has dwindled over time as IVF cycles have increased. In the United Kingdom, IVF is presented as a logical response to involuntary childlessness, and as an entirely predictable, and linear, course of action. The market is well‐developed and often patients' first experience of privatised health care in the NHS. Our couples were challenged by this, and while they felt expected to move on to IVF, some wished to explore other options. While IVF is ubiquitous, the discomfort and challenge around fertility treatments remain; experiences are prolonged and characterised by recursive narratives and expressions of disequilibrium, which are rarely acknowledged and reflected in ongoing clinic‐patient interactions. Our findings develop understanding of the process of 'mazing' (Image ‐ The Journal of Nursing Scholarship, 1989, 21, 220), the pursuit of parenthood, by showing that the routine and normative status of IVF, at least in the current health care context, is at odds with the lived experiences of individuals. [ABSTRACT FROM AUTHOR]

An ethnographic study of health and wellbeing was undertaken in a deprived urban neighbourhood in the UK Midlands. Drawing on Bourdieu's concepts of habitus, capital and field, we discerned three different, even conflicting, ways of understanding and acting on health: (i) older adults discussed their wellbeing in relation to the local context or field, walking the dog, helping at the community centre and visiting the off licence, (ii) young professionals and students who lived in the neighbourhood were oriented towards leisure facilities, career opportunities and supermarkets outside of the neighbourhood, disdaining local facilities and (iii) community activists and carers discussed health in terms of providing for others but not themselves. Bourdieu is frequently used in medical sociology to highlight how poor people's lifestyle is constrained by their habitus; we suggest paying more attention to its both enabling and differentiating contradictions as well as the constraints it entails. Empirically and in terms of health promotion findings suggest that supposedly healthy activities, such as going to the gym, may also be a means of rejecting the local community; similarly, older people's pottering about in the neighbourhood, which is not usually recognised as a healthy activity, may enhance wellbeing in this context. [ABSTRACT FROM AUTHOR]

This article explores the professional project for an emergent subaltern specialist community of wound healing clinicians. Drawing on the literature on professions and boundary work, it examines how wound healing clinicians challenge the perception of their work as 'dirty' and seek its transformation into a specialism of 'woundology'. The article is based on an ethnography of a UK multidisciplinary team of doctors and nurses with an interest and expertise in wound healing, who work as clinical academics and provide wound care services in outpatient clinics. It demonstrates that wound healing clinicians vindicate their professional status by seeking to enthral the medical community in 'dirty wound care' as a focused clinical specialty of 'woundology'. Through training nurses to do medical wound care work, educating clinicians from other specialties about wounds and undertaking wound research, wound healing clinicians assert the professional boundaries of their specialism and its fit with mainstream medicine without embellishing the dirty aspects of their work. [ABSTRACT FROM AUTHOR]

Within health and social care, academic attention is increasingly paid to understanding the nature and centrality of body work. Relatively little is known about how and where body work specifically fits into the wider work relations that produce it in healthcare settings. We draw on ethnographic observations of staff practice in three National Health Service acute hospital wards in the United Kingdom to make visible the micro‐processes of patient care sequences including both body work and the work contextualising and supporting it. Our data, produced in 2015, show body work interactions in acute care to be critically embedded within a context of initiating, preparing, moving and restoring and proceeding. Shades of privacy and objectification of the body are present throughout these sequences. While accomplishing tasks away from the physical body, staff members must also maintain physical and cognitive work focussed on producing body work. Thus, patient care is necessarily complex, requiring much staff time and energy to deliver it. We argue that by making visible the micro‐processes that hospital patient care depends on, including both body work and the work sequences supporting it, the complex physical and cognitive workload required to deliver care can be better recognised. (A virtual version of this abstract is available at: https://www.youtube.com/channel/UC_979cmCmR9rLrKuD7z0ycA) [ABSTRACT FROM AUTHOR]

Over the last quarter century, non‐medical prescribing in the UK has grown significantly; eight non‐medical professional groups now have authority to prescribe a wide range of medicines, suggesting it could be a potent driver of pharmaceuticalisation. In this article, we present data from a case study of physiotherapists' prescribing practices. UK physiotherapists have had legal rights to prescribe medicines since 2005, but relatively little is known about the contribution they make to expanding patient access to medicines. We approached our study through a lens of governmentality to capture the mentalities and micro‐practices governing physiotherapist non‐medical prescribing. Ethnographic methods were used to gather data from an outpatient orthopaedic service in an NHS Trust in England employing physiotherapist prescribers. From the data, we identified a grid of intelligibility – an organising framework formulated by powerful discourses and technologies of government through which physiotherapist prescribing was acted into being. A primary effect of this grid was the constitution of new physiotherapist subjectivities, mostly as non‐prescribers of medicines contrary to policy intentions, underpinned by a familiar and enduring template of medical professionalism. [ABSTRACT FROM AUTHOR]

Coercive practices, such as physical restraint, are used globally to respond to violent, aggressive and other behaviours displayed by mental health service users.1 A number of approaches have been designed to aid staff working within services to minimise the use of restraint and other restrictive practices. One such approach, the 'REsTRAIN Yourself' (RYS) initiative, has been evaluated in the UK. Rapid ethnography was used to explore the aspects of organisational culture and staff behaviour exhibited by teams of staff working within 14 acute admission mental health wards in the North West region of the English NHS. Findings comprise four core themes of space and place; legitimation; meaningful activity; and, therapeutic engagement that represent characteristics of daily life on the wards before and after implementation of the RYS intervention. Tensions between staff commitments to therapeutic relations and constraining factors were revealed in demarcations of ward space and limitations on availability of meaningful activities. The physical, relational and discursive means by which ward spaces are segregated prompts attention to the observed materialities of routine care. Legitimation was identified as a crucial discursive practice in the context of staff reliance upon coercion. Trauma‐informed care represents a potentially alternative legitimacy. [ABSTRACT FROM AUTHOR]

Abstract: There is a significant amount of existing research exploring adoption policies, processes, and the experiences and safeguarding of children. However, although much research has children at the focus, little research has been conducted into the experiences of approved and waiting adopters. Where research has included adopters, focus tends to be on how adopters can aid an adoptive placement and what support they can provide to an adoptive child. In this article, the experiences of approved and waiting adopters are at the centre. This article reports on a digital ethnographic research project, which used unobtrusive methods to conduct a thematic analysis of over 600 posts made by waiting adopters on publically available UK online adoption forums in 2015. Online posts discussed the perceived over‐recruitment of adopters; the decision‐making behind adopters' initial preferences; and the negative emotional effects of the waiting period following approval. This article argues that more consideration needs to be given to the needs of and support for approved adopters whilst they wait for an adoptive child. [ABSTRACT FROM AUTHOR]

Abstract: The links between socioeconomic circumstances and health have been extensively studied in Britain but surprisingly few studies consider lay perspectives. This is problematic given popular efforts to reduce health inequalities appear to be based on assumption that public understanding is limited (this is evident in efforts to raise awareness of both ‘upstream’ causes of health inequalities and health‐damaging behaviours). The results of this meta‐ethnography, involving 17 qualitative studies, fundamentally challenge this assumption. We show, first, that people who are living with socioeconomic disadvantage already have a good understanding of the links between socioeconomic hardship and ill‐health. Indeed, participants’ accounts closely mirror the research consensus that material‐structural factors represent ‘upstream’ determinants of health, while ‘psychosocial’ factors provide important explanatory pathways connecting material circumstances to health outcomes. Despite this, people living in disadvantaged circumstances are often reluctant to explicitly acknowledge health inequalities, a finding that we suggest can be understood as an attempt to resist the stigma and shame of poverty and poor health and to (re)assert individual agency and control. This suggests that work to increase public awareness of health inequalities may unintentionally exacerbate experiences of stigma and shame, meaning alternative approaches to engaging communities in health inequalities discussions are required. [ABSTRACT FROM AUTHOR]

Accessible summary Essential Lifestyle Plans are a good way for people with learning disabilities and their support workers to tell people about things they like to do, such as listening to music., These plans also tell people about the things that they need, like what medicine they may need to take., Sometimes it is not easy to put the things we like to do at home into these plans because there are lots of things we do every day., People need to think carefully about how the things we choose to do at home can be put into Essential Lifestyle Plans that are written for us and with us., Abstract Background: Person-centred planning, which commonly becomes formalised within services for people with learning disabilities through an Essential Lifestyle Plan ( ELP), was intended to help place the choices of individuals at the forefront of service provision. However, beyond UK government policy rhetoric, scholars have raised issues regarding the capacity of person-centred planning to empower people with learning disabilities to make choices about various aspects of their lives. This article assesses these debates, paying attention to the relationship between ELPs and choices made in relation to leisure activities. Materials and Methods:To examine leisure activities and choice-making in depth, the article draws upon ethnographic research conducted with four adults living in a supported living scheme. It focuses upon their domestic musical activities, connecting data derived from participant observation with the contents of ELPs. Results:This study found that person-centred planning underplayed processes involved with articulations of musical choice and also the peculiarities of the settings in which choices were made. It also found that leisure preferences expressed in ELPs did not effectively convey the richness and sociocultural significance of everyday domestic musical activities within the supported living scheme. Conclusions:Person-centred planning should not be divorced from social context, relationships and differing degrees of dependency. Domestic leisure activities such as listening to music, while not necessarily 'meaningful' in the terms laid out in UK policy discourse, can become crucial resources for social bonding for people with learning disabilities. Thus, they should be considered carefully as part of a dynamic, socially situated and person-centred planning process. [ABSTRACT FROM AUTHOR]

Do children attribute mortality and other life‐cycle traits to all minded beings? The present study examined whether culture influences young children's ability to conceptualize and differentiate human beings from supernatural beings (such as God) in terms of life‐cycle traits. Three‐to‐5‐year‐old Israeli and British children were questioned whether their mother, a friend, and God would be subject to various life‐cycle processes: Birth, death, ageing, existence/longevity, and parentage. Children did not anthropomorphize but differentiated among human and supernatural beings, attributing life‐cycle traits to humans, but not to God. Although 3‐year‐olds differentiated significantly among agents, 5‐year‐olds attributed correct life‐cycle traits more consistently than younger children. The results also indicated some cross‐cultural variation in these attributions. Implications for biological conceptual development are discussed. [ABSTRACT FROM AUTHOR]

This research investigates how culture might influence loss aversion. Chinese were expected to be more loss averse than British because of cultural differences in regulatory focus. Study 1 reveals that compared with British participants, Chinese participants were less likely to give up gifts they had received in exchange for new gifts. In Study 2, Chinese and British participants imagined buying a computer which either had a high specification and a high price tag (high reference), or a basic specification and a low price tag (low reference). Participants were informed that the (reference) computer was unavailable, and they had to choose between two available computers, which were both cheaper and less powerful than the high reference computer, and more expensive and more powerful than the low reference computer. The results reveal that the difference in price tag between the two available computers had a bigger impact on Chinese buying decisions than on British buying decisions when it was viewed as a loss. Furthermore, both promotion focus and prevention focus mediated the influence of culture on buying decisions in the low reference condition. No cross-cultural difference was found in the high reference condition. [ABSTRACT FROM AUTHOR]

This study provides empirical data about shipboard practices in bridge operations on board a selection of platform supply vessels (PSVs). Using the theoretical concept of distributed situation awareness, the study examines how situation awareness (SA)- related information is distributed and coordinated at the bridge. This study thus favours a systems approach to studying SA, viewing it not as a phenomenon that solely happens in each individual's mind but rather as something that happens between individuals and the tools that they use in a collaborative system. Thus, this study adds to our understanding of SA as a distributed phenomenon. Data were collected in four field studies that lasted between 8 and 14 days on PSVs that operate on the Norwegian continental shelf and UK continental shelf. The study revealed pronounced variations in shipboard practices regarding how the bridge team attended to operational planning, communication procedures, and distracting/interrupting factors during operations. These findings shed new light on how SA might decrease in bridge teams during platform supply operations. The findings from this study emphasize the need to assess and establish shipboard practices that support the bridge teams' SA needs in day-to-day operations. [ABSTRACT FROM AUTHOR]

This feature explores the information behaviour of people infected with or affected by HIV/ AIDS. It investigates specifically the difficult issue of stigma and how this shapes the ways in which people interact with vital information. The study adopted an ethnographic whereby the researcher worked as a part-time volunteer at an HIV support centre in the North of England for over a year. This is the first time that such an approach has been reported in this feature and is interesting from this perspective alone. The very rich data which was gathered as a result of the approach is also instructive. The study formed part of a PhD thesis, which Robinah Kalemeera Namuleme completed at the University of Sheffield in March 2013. [ABSTRACT FROM AUTHOR]

Humans inhabit environments that are both social and physical, and in this article we investigate if and how social identity processes shape the experience and negotiation of physically demanding environmental conditions. Specifically, we consider how severe cold can be interpreted and experienced in relation to group members' social identity. Our data comprise ethnographic observation and semi-structured interviews with pilgrims attending a month-long winter Hindu religious festival that is characterized by near-freezing conditions. The analysis explores (1) how pilgrims appraised the cold and how these appraisals were shaped by their identity as pilgrims; (2) how shared identity with other pilgrims led to forms of mutual support that made it easier to cope with the cold. Our findings therefore extend theorizing on social identity processes to highlight their relevance to physical as well as social conditions. [ABSTRACT FROM AUTHOR]

Context 'Meaningful use' of electronic health records to improve quality of care has remained understudied. We evaluated an approach to improving patients' safety and quality of care involving the secondary use of data from a hospital electronic prescribing and decision support system (ePDSS). Methods We conducted a case study of a large English acute care hospital with a well-established ePDSS. Our study was based on ethnographic observations of clinical settings (162 hours) and meetings (28 hours), informal conversations with clinical staff, semistructured interviews with ten senior executives, and the collection of relevant documents. Our data analysis was based on the constant comparative method. Findings This hospital's approach to quality and safety could be characterized as 'technovigilance.' It involved treating the ePDSS as a warehouse of data on clinical activity and performance. The hospital converted the secondary data into intelligence about the performance of individuals, teams, and clinical services and used this as the basis of action for improvement. Through a combination of rapid audit, feedback to clinical teams, detailed and critical review of apparent omissions in executive-led meetings, a focus on personal professional responsibility for patients' safety and quality care, and the correction of organizational or systems defects, technovigilance was-based on the hospital's own evidence-highly effective in improving specific indicators. Measures such as the rate of omitted doses of medication showed marked improvement. As do most interventions, however, technovigilance also had unintended consequences. These included the risk of focusing attention on aspects of patient safety made visible by the system at the expense of other, less measurable but nonetheless important, concerns. Conclusions The secondary use of electronic data can be effective for improving specific indicators of care if accompanied by a range of interventions to ensure proper interpretation and appropriate action. But care is needed to avoid unintended consequences. [ABSTRACT FROM AUTHOR]

Background In the UK those paid to support adults with intellectual disabilities must manage two potentially conflicting duties that are set out in policy documents as being vital to their role: protecting service users (their duty of care) and recognising service users' autonomy. This study focuses specifically on the support of people with the genetically determined condition, Prader-Willi syndrome (PWS). Due to the behaviours associated with PWS, the support of this group of people vividly illustrates the tension between respect for autonomy and duty of care. This article explores how support workers working in a residential group home managed their competing duties of managing risk and promoting independence in practice. Methods An ethnographic study, comprising of qualitative observations, semi-structured interviews and documentary analysis, was undertaken to investigate the work of support workers in a UK residential group home specialising in the support of adults diagnosed with PWS. The study focused on how support workers attempted to reconcile the tension between protecting service users from the risks associated with the syndrome and acknowledging service users' autonomy by enabling independence. Results Findings demonstrate that risk was central to the structure of care delivery at the group home and support workers often adhered to standardised risk management procedures. The organisation also required support workers to promote service users' independence and many thought acknowledging service users' autonomy through the promotion of their independence was important. To manage tensions between their differing duties, some support workers deviated from standardised risk management procedures to allow service users a degree of independence. Conclusions There is a tension between the duty of care and the duty to recognise autonomy at the level of service delivery in residential homes. Support workers attempt to manage this tension; however, further work needs to be done by both residential services and policy makers to facilitate the reconciliation of the duty of care with the duty to recognise service users' autonomy in practice. [ABSTRACT FROM AUTHOR]

Relationships between nurses and older people within the home: exploring the boundaries of care. International Journal of Older People Nursing , 265-273 doi: 10.1111/j.1748-3743.2009.00192.x To explore the nature of relationships between nurses and older people within the home and to illuminate the nature and quality of caring boundaries within this setting. Older people are increasingly receiving nursing care in the home. There has been little exploration of the nature of the nurse-older patient relationship within this setting. An ethnographic approach using semi-structured interviews with 16 community nurses and 13 older patients (aged 65 years and over), were undertaken to explore the nature of care relationships within the home setting. The study has highlighted the centrality of the location of care and the concept of 'the home' in terms of geographical and metaphorical meanings. Moreover, the study has clearly illuminated the complex nature of relationships and boundary construction from a number of perspectives. As the location of care for older people continues to move closer to home it is crucial that the implicit qualities that are valued within nurse-patient relationships within this context of care, and which contribute to the quality of care, are recognized and made more explicit at the organizational and policy level. For nurses working within the home there is a clear impetus to clearly define and articulate the full breadth of their role, the nature of relationships and issues surrounding professional boundary construction within this environment. There is also a need for the core qualities that underpin the receipt of care within the home and the facets of the nurse-patient relationship valued by older people to be fully recognized and accounted for. [ABSTRACT FROM AUTHOR]

Aim. To explore the meaning of caring in a fertility unit and to present the findings and discuss their implications for practice. Background. Little research has been published internationally on the nature of nursing care in the fertility field. This study was intended to stimulate debate over the nature of care in fertility work. Methodology. An ethnographic approach, which included part-time participant observation and in-depth focused interviews with staff and patients. Data were also collected using a field and a research diary. Data were analysed using a modified thematic analysis. Findings. The data suggest that caring is strongly linked with nurses and that patients' expectations of nurses may be more practically than emotionally focused. I argue that the organization of nursing work, which I call 'nursing the clinic and the doctor', facilitated this practical approach to caring. I discuss two features of nursing the clinic and the doctor: hovering and being there. Conclusions. While there may be other factors that influence the practice of this form of non-intimate caring, nursing in this way may be what patients desire and may be congruent with managing emotions. The findings have implications for the discourse on intimacy and caring within fertility nursing as well as in different outpatient settings. [ABSTRACT FROM AUTHOR]

The article offers information on awards and fellowships related to anthropology in Great Britain. It highlights the Radcliff-Brown Memorial Fund for Social Anthropological Research Awards which are jointly funded by the Association of Social Anthropologists (ASA). It also offers details about the Arthur Maurice Hocart Essay Prize which was established in 1948 under the will of E. G. Hocart. Also highlighted is the Amaury Talbot Prize for African Anthropology.