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

Objectives: There is a growing consensus worldwide that palliative care needs to be both more inclusive of conditions other than cancer and to improve. This paper explores some common challenges currently faced by professionals providing palliative care for patients with either cancer or dementia across five countries. Method: One focus group (n = 7) and 67 interviews were conducted in 2012 across five countries: England, Germany, Italy, the Netherlands and Norway, with professionals from dementia, cancer and palliative care settings. Results: The interviews revealed five common challenges faced across the five countries: communication difficulties (between services; and between professionals, and patients and their families); the variable extent of structural/functional integration of services; the difficulties in funding of palliative care services; problematic processes of care (boundaries, definitions, knowledge, skills and inclusiveness) and, finally, time constraints. Conclusion: These are not problems distinct to palliative care, but they may have different origins and explanations compared to other areas of health care. This paper explored deeper themes hidden behind a discourse about barriers and facilitators to improving care. [ABSTRACT FROM AUTHOR]

• Survey respondents had their first suicidal thoughts, on average, at 13.6 years. • Forms of suicidal thoughts were passive, active and chronic suicidal ideation. • During and after leaving care, suicidal thoughts can re-occur and intensify. • English and German samples show similar occurrences of suicidal thoughts. • English participants judge their care experience to affect their attitude towards life. This paper investigates the range of suicidal ideation among people with care experience. People who grew up in care have an elevated risk of suicidal ideation, behavior and dying by suicide compared to people without care experience. However, a comprehensive and in-depth understanding of when suicidal ideation occurs and how care-experienced people experience suicidal thoughts, especially when leaving care in England and Germany, is currently not available but would help to inform suicide prevention tailored to care-experienced people across different ages. Aiming to address this gap, the current study applied a mixed-methods approach, combining an online survey and semi-structured interviews with young adults with care experience from England and Germany. The survey included 45 adults with care experience, age 18–40, and interviews were conducted with 13 care-experienced young adults from both countries. Descriptive statistical and significance tests were conducted to analyze the survey data with SPSS. Framework analysis was used to analyze the interviews. The findings show that many participants experienced suicidal thoughts from a young age and at different times up to adulthood. A range of suicidal thoughts and trajectories are identified with an increased risk of suicide for young people with care experience, especially during transitions such as when leaving care in early adulthood. The study underlines the need for a stronger recognition of suicide prevention in social work and the (leaving) care system across different countries. [ABSTRACT FROM AUTHOR]

Background: Integrative medicine (IM) is currently the most commonly used term to describe the integration of complementary and alternative medicine (CAM) into conventional medicine. In the definitions of IM the most important feature is the focus on evidence as crucial factor for therapeutic decision-making. However, there are discussions on the term “integrative medicine” with the most notable critique from within CAM that it describes the integration of complementary methods into conventional institutions and into a “conventional framework of thinking”. The aim of this qualitative study was to understand the thoughts of leading experts on IM and on the scientific debate in the field as well as their personal opinions about terminology in general.Methods: We have conducted semi-standardized interviews with ten leading experts in the field of CAM and integrative medicine in the USA, England, and Germany, who have had leading positions at medical schools or the NIH in 2010 and 2011. Interviews were recorded, transcribed and analyzed using content analysis with the qualitative analysis software max qda.Results: Overall the current terminology was seen as a problem, although most experts agreed that the term“integrative medicine” (IM) described well what they do or they think is useful for medical care. The terminology debate was discussed from four perspectives: 1) from the perspective of medical practice, 2) from the perspective of research, 3) from the perspective of public relations, and 4) from the perspective of health care delivery. These perspectives may be used to evaluate the appropriateness of different terms in use in the field. When intervieweesdiscussed the terminology question, they also discussed the type of health care system they envisioned. Such reflections led the interviewees to caution about too narrow a focus on the terminology question. The question of naming was one about influencing and changing medicine.Conclusion: The discussion of the experts demonstrated that the discussion about terminology is an important debate about the shaping of medicine. The experts discussed terminology in the light of "how health care systems"should look like in the future. [ABSTRACT FROM AUTHOR]