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This chapter examines the fathering narratives of British South Asian men with children aged three to eight years, in the context of their complex migration histories and experiences of socioeconomic marginalisation in contemporary Britain. It investigates men’s narratives about their memories of their own fathers and their legacy for own values and practices as fathers. The findings show that the fathering practices are shaped not just by the intergenerational replication of values and practices but also by the deep emotional legacy that children inherit from their fathers. Further, fathering is embedded in wider socioeconomic and racial hierarchies, which constrain men’s ability to father in new ways. Despite their efforts, many fathers consciously or unconsciously end up replicating their fathers’ parenting practices such as working long hours and absence from the day-to-day lives of their children.

Sionnadh Mairi McLean,1 Andrew Booth,2 Melanie Gee,3 Sarah Salway,2 Mark Cobb,4 Sadiq Bhanbhro,3 Susan A Nancarrow5 1Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK; 2School of Health and Related Research, University of Sheffield, Sheffield, UK; 3Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK; 4Therapeutics & Palliative Care, Sheffield Teaching Hospitals, Sheffield, UK; 5School of Health and Human Science, Southern Cross University, East Lismore, NSW, Australia Abstract: Missed appointments are an avoidable cost and resource inefficiency which impact upon the health of the patient and treatment outcomes. Health care services are increasingly utilizing reminder systems to manage these negative effects. This study explores the effectiveness of reminder systems for promoting attendance, cancellations, and rescheduling of appointments across all health care settings and for particular patient groups and the contextual factors which indicate that reminders are being employed sub-optimally. We used three inter-related reviews of quantitative and qualitative evidence. Firstly, using pre-existing models and theories, we developed a conceptual framework to inform our understanding of the contexts and mechanisms which influence reminder effectiveness. Secondly, we performed a review following Centre for Reviews and Dissemination guidelines to investigate the effectiveness of different methods of reminding patients to attend health service appointments. Finally, to supplement the effectiveness information, we completed a review informed by realist principles to identify factors likely to influence non-attendance behaviors and the effectiveness of reminders. We found consistent evidence that all types of reminder systems are effective at improving appointment attendance across a range of health care settings and patient populations. Reminder systems may also increase cancellation and rescheduling of unwanted appointments. “Reminder plus”, which provides additional information beyond the reminder function may be more effective than simple reminders (ie, date, time, place) at reducing non-attendance at appointments in particular circumstances. We identified six areas of inefficiency which indicate that reminder systems are being used sub-optimally. Unless otherwise indicated, all patients should receive a reminder to facilitate attendance at their health care appointment. The choice of reminder system should be tailored to the individual service. To optimize appointment and reminder systems, health care services need supportive administrative processes to enhance attendance, cancellation, rescheduling, and re-allocation of appointments to other patients. Keywords: attendance, cancellation, rescheduling, TURNUP

Drawing on both qualitative and quantitative data, the thesis describes and explains both the current patterns of \ud natural protection against pregnancy and the use of modern contraception in the period following childbirth in \ud two populations, one rural and one urban, in Bangladesh. \ud First, quantitative data gathered through demographic surveillance systems of the International Centre for \ud Diarrhoeal Disease Research, Bangladesh are used to explore the patterns and differentials in breastfeeding, \ud postpartum amenorrhoea and risk of pregnancy in the months following birth in the two study populations. \ud Next, the surveillance data are used to describe the patterns of adoption of contraception in relation to time \ud postpartum, breastfeeding and menstrual status for the two study populations. Extensive use is made of life \ud table methods, hazard models and logistic regression techniques in these analyses. \ud Qualitative data gathered through in-depth interviews with users of contraception are then used to identify key \ud themes of understanding that influence women's behaviour, including contraceptive uptake, in the period \ud following childbirth. The current knowledge, attitudes and practices of family planning providers in the two \ud study populations are next described using qualitative data collected through a series of in-depth interviews \ud and group discussions. \ud Findings from the quantitative and qualitative analyses are then integrated in order firstly, to explain the \ud current patterns and recent trends in contraceptive use and lactational protection against pregnancy following \ud childbirth, and secondly to explore their potential implications for birth intervals and fertility. Finally, \ud important issues are identified and recommendations made for improvements to postpartum family planning \ud programme approaches in Bangladesh.

This chapter reports on the experiences and lessons learned through the use of participatory, locality-based data generation methods to research the intersections between long-term illhealth and poverty among four different ethnic 'communities'.

This report forms part of the first triennial review of equality undertaken by the\ud Equality and Human Rights Commission; its aim is to provide a\ud comprehensive picture of the state of equalities and human rights within the\ud domains of Life Expectancy and Health.

Summary points\ud • Conducting research that appropriately and sensitively pays attention to ethnicity presents an important challenge to nursing researchers and demands particular competencies.\ud • Nursing research must recognise the multifaceted nature of ethnicity and the varied ways in which health-related experiences and outcomes may be associated with ethnicity.\ud • Ethnic identities are complex and fluid so that using fixed ethnic categories in research requires careful consideration.\ud • Describing and explaining differences between ethnic 'groups' demands careful attention to sampling, data generation and analysis so that partial or misleading interpretations are avoided.\ud • Researchers should be alert to the potential for research on minority ethnic groups to do more harm than good and should seek to ensure that their research focus and approach is informed by the experiences and priorities of these groups.

The aim of this project was to review and synthesise available evidence that could\ud throw light on: why Black and Minority Ethnic (BME) customers are less satisfied\ud with the Pension, Disability and Carers Service (PDCS); why BME individuals eligible\ud for the PDCS benefits are less likely to apply for them; what interventions might\ud be successful at raising levels of take-up and satisfaction with PDCS services; and\ud what important gaps exist in research evidence to answer these questions.

Government health policy has emphasised the\ud importance of understanding and tackling ethnic\ud disparities in health and healthcare for at least four\ud decades. Yorkshire & the Humber includes areas with\ud large, well-established minority ethnic populations.\ud In addition, most cities in the region, including those\ud that have in the past been dominated by the White\ud British majority, are now experiencing rapid migration.\ud Persistent patterns of health disadvantage among\ud established minority ethnic communities are now\ud compounded by the differing health needs of new\ud migrant populations.\ud NHS organisations in Yorkshire & the Humber have\ud begun to respond more systematically to the needs of\ud minority ethnic groups. However, there is still progress\ud to be made on establishing basic requirements for\ud effective commissioning, including effective ethnic\ud monitoring systems that provide high quality\ud intelligence to commissioners, service managers and\ud health professionals. While there are examples of\ud innovation and good practice, there is significant\ud variation across the region and a lack of sharing and\ud learning between organisations.\ud Here we report on a workshop that was convened by\ud the Strategic Health Authority in June 2009 as a first\ud step towards addressing this recognised area of need.\ud The Workshop Chair was John Chuter, Chair of NHS\ud Bradford & Airedale. The aims of the workshop\ud were to:\ud • Highlight the policy context and imperatives for\ud ethnic monitoring.\ud • Raise awareness of the current position with\ud regard to ethnic monitoring and use of data in\ud Yorkshire & the Humber.\ud • Share emerging good practice.\ud • Identify ways to move forward to improved\ud ethnic monitoring across the region.

In Briefing Paper 1 we set out the rationale for having an "Inequalities in health" theme as part of the CLAHRC (SY) activity. In this second briefing paper we show how research conducted under the aegis of CLAHRC (SY) can address issues of health inequality.