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What role do texts play in LGBTQ (lesbian, gay, bisexual, transgender, and queer) parents’ experiences of disability service systems? In interviews with 15 LGBTQ parents of disabled children in Toronto, Canada, participants selected documents to be used as a focus for discussion. Parents considered how LGBTQ identity and other intersectional identities influenced their experiences of institutional texts including adoption certificates, intake forms, and assessments. Findings suggest that documentation practices can operate as forms of systemic gatekeeping. LGBTQ identity was sometimes very significant in parents’ accounts, and sometimes less central than other aspects of their families' identities and experiences. [ABSTRACT FROM PUBLISHER]

This paper authentically represents the voices of non-verbal children with cerebral palsy using a case study design. Policy suggests that children should have the right to play and leisure opportunities, however non-verbal children with cerebral palsy have fewer choices. Additionally, children with communication, learning and mobility limitations are usually excluded from research. The aim of this research was to capture the voices of non-verbal children by exploring their well-being impact in terms of their experiences and choices about their level of participation in recreational activities. A qualitative case series study included interviews, observations, photographs and diaries. Where possible, the diaries were completed by both caregivers and children. Data were analysed thematically, and the lens of positioning theory applied. Seven children aged nine to sixteen years participated. The findings showed how equipment, people and environments enabled or hindered the children's participation. The children also advocated as champions for their own well-being. Positioning theory was applied across the data and was adapted offering a way to better understand the children's well-being responses. The findings demonstrate how these children were able to self-advocate, demonstrating their well-being by their intentional behaviours from their level of participation in a recreational activity. The voices of non-ambulant and non-verbal children are underrepresented in the literature. This study offers an innovative approach to highlight their voices using visual data. The images project the narrative about their choices for participation in recreational activities. The proposed kaleidoscope of well-being offers a way to demonstrate the fluctuations in their emotional responses from their participation. Choices for participation in recreational activities remains limited for non-ambulant and non-verbal children with cerebral palsy. Designers and policy makers should consider how equipment and environments can be adapted or created to increase the choices for non-ambulant and non-verbal children with cerebral palsy. Practitioners in health and social care should consider how to listen to the voices of non-verbal and non-ambulant children with cerebral palsy and their parents/guardians and work towards jointly setting participation goals to affirm their strengths. [ABSTRACT FROM AUTHOR]

Filipino psychologist Fr. Jaime C. Bulataosuggested that a shared collective consciousness allows for telepathy to occur. In the context of psychotherapy, telepathy may strengthen rapport between therapist and client, as well as enrich insight. This paper aims to describe and discuss a framework of Bulatao-inspired psychotherapy that integrates telepathy as part of the therapeutic practice. Thus, the paper asks the question: What does the Bulatao therapeutic process of telepathy look like? Descriptive phenomenology revealed four phenomenological structures: (a) Mental quietude and psychic openness; (b) Perceiving the client; (c) Receiving and reacting to telepathic stimuli; and (d) Anomalous insight. This paper has the potential to inspire a conversation with regard to the potential therapeutic uses of Bulatao's transpersonal world view. [ABSTRACT FROM AUTHOR]

The seminal Lost in the Mall study has been enormously influential in psychology and is still cited in legal cases. The current study directly replicated this paper, addressing methodological weaknesses including increasing the sample size fivefold and preregistering detailed analysis plans. Participants (N = 123) completed a survey and two interviews where they discussed real and fabricated childhood events, based on information provided by an older relative. We replicated the findings of the original study, coding 35% of participants as reporting a false memory for getting lost in a mall in childhood (compared to 25% in the original study). In an extension, we found that participants self-reported high rates of memories and beliefs for the fabricated event. Mock jurors were also highly likely to believe the fabricated event had occurred and that the participant was truly remembering the event, supporting the conclusions of the original study. [ABSTRACT FROM AUTHOR]

While recognition that some service users do not want social work involvement has grown in recent years, little research has explored what relationships between social workers and 'involuntary clients' look and feel like in practice and how they are conducted in real time. This paper draws from research that observed long-term social work practice in child protection and shows how relationships based on mutual suspicion and even hate were sustained over the course of a year, or broke down. Drawing on a range of psycho-social theories, the paper adds to the literature on relationship-based practice by developing the concept of a 'hostile relationship'. The findings show how hostile relationships were enacted through conflict and resistance – especially on home visits – and how anxiety and other intense feelings were often avoided by individuals and organisations. Much more needs to be done to help social workers recognise and tolerate hostility and hate, to not retaliate and to enact compassion and care towards service users. [ABSTRACT FROM AUTHOR]

This paper explores the intersection between migration, aging and lifelong learning with the aim of expanding our understanding of how lifelong learning enhances older migrants' active aging in a foreign land. Our study also offers insights into the learning activities of older immigrants in general. In 2002, the World Health Organization (WHO) proposed a conceptual framework of active aging, which has greatly influenced aging policies and seniors' everyday practices. Yet, there is a paucity of research that explicates and fully integrates lifelong learning into active aging discourse, and focuses on senior immigrants' lifelong learning in an aging society. Based on interviews, textual materials, and participatory observation in five Chinese seniors' immigrant associations in Toronto, we explore how Chinese senior immigrants' learning has been (re)shaped and practised through re-settling in Canadian society. Five categories of learning are explored, including a) learning language and computer skills, b) learning culture and history, c) learning civic engagement, d) learning leisure, and e) learning health. We argue that 'active learning' can be used as a dynamic conceptual framework that interacts with active aging theory, demonstrating how senior immigrants actively participate in the lifelong learning project for participation and integration in Canada. This paper provides insights to the understanding of culturally sensitive policy-making on integration, health, and lifelong learning of older immigrants in Canada and beyond. [ABSTRACT FROM AUTHOR]

This paper explores the moral implications of treatment of young people with functional somatic symptoms. Based on an ethnographic field study at a Danish pain clinic for youngsters (age 8 to 18), the paper seeks to unearth the cultural, moral values that clinical practice steers by and upholds, and the implications this has for the assessment and management of ill body-selves. Through an exposition of the general practice of the clinic and an investigation of two specific cases of youngsters, it is found that the assessment of symptoms and selves and the goals of treatment are informed by cultural ideals of 'the good self' and 'the good life' in which agency and work ethic – both pertaining to the notion of individual responsibility – figure as prevalent virtues. The study underpins the findings of other researchers who have found that ideals of individual autonomy and responsibility for own life and health permeate the Western health care system and the discourses of ill individuals. The contribution of this article is to portray in ethnographic detail how such a cultural ethics manifests in practice and what implications this have for the treatment of young people with functional symptoms at a specific location and in specific cases. The two cases illustrate that the underlying norms and values can give rise to very different moral assessments of symptoms and selves within the same diagnostic category. [ABSTRACT FROM AUTHOR]

The cultivation of equanimity has been emphasized in various indigenous philosophies and contemplative practices. This paper aims to develop an expansive understanding of equanimity as a distinct psychological construct. Thirty experts from various traditions such as Buddhism, Vedic studies, meditation, and yoga were interviewed on their understanding and insights into equanimity. The findings suggest equanimity as an even-mindedness towards the varied hedonic and affective experiences. The cognitive, affective, and conative mechanisms of equanimity such as increased distress tolerance, hedonic neutrality, and reduced reactivity are outlined. At the interpersonal level, equanimity entails impartiality and reduced bias towards others. The challenges one may face during the cultivation of equanimity have been suggested by the experts. The implications of cultivating equanimity have been examined in the context of adaptive coping and holistic wellbeing in the current pandemic situation, dealing with compassion fatigue, and the development of indigenous leadership practices. [ABSTRACT FROM AUTHOR]

The aim of this paper is to identify structural problems and challenges for the delivery of digital technologies for ageing in place to elderly with dementia. To that end, I conducted a case study in a Swedish municipality. The results showed that elderly with dementia are not exploiting their full potential of receiving help in the form of technology, since the four conditions of the Consumer Direction (Control and Direct services – Variety of digital technologies for ageing in place options – Information and Support – Participation in systems design) were met to a very low degree. I propose that the municipality in question creates a proper knowledge-sharing platform so that occupational therapists are well informed about digital technologies for ageing in place, to allow them to provide accurate information and support to elderly with dementia, resulting in a possible increase in use of technology and subsequently support the empowerment goal of Consumer Direction. I also believe, according to the findings of this study, that the module of Information and Support should be treated as the most important condition for achieving increased Consumer Direction. Elderly with dementia and their relatives do not receive sufficient information about digital technologies for ageing in place (DTAP). There is not enough information regarding the available options and their use. This often denies elderly with dementia and their relatives the services they are entitled. Occupational therapists knowledge about DTAP affects the variety of options presented to elderly with dementia and their subsequent use. Once a person is diagnosed with dementia, physicians tend to suggest medicinal solutions, overlooking the dissemination of DTAP information. Thus hindering their early access to DTAP. [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]

Notions of 'participation' in sexuality education has gained considerable traction in recent years - with participation being regarded as a fundamental right and a critical means to empower young people. However, the notion has increasingly been subject of debate, with critics problematising the manner in which participation is operationalised, and questioning the assumed impact of participation in relation to sexuality education goals. This paper contributes to these debates by examining the under-researched gendered dimensions of participation of young people in sexuality education. It utilises data from a qualitative study conducted in 2015 on young women and men's (10-15 years old) perceptions of their participation in the dance4life programme, an in-school sexuality education programme in Jinja district in eastern Uganda. The paper highlights subtle but important differences between young men and women's participation in the programme, which are arguably reflective of existing gendered hierarchies. We conclude by providing recommendations on how to address gender differences in participation. [ABSTRACT FROM AUTHOR]

Dying alone is portrayed as undesirable in terms of policy, health and social care provision, the wishes of family and friends, and in popular culture. Despite this, people do often die alone, both in institutional and domestic settings. This paper reports findings from a study which explored ways of investigating individuals' perspectives on dying alone at home. It tested methods of recruitment and data collection, gathered preliminary data and explored the ethical issues involved. Interviews with 11 older people living alone and 7 hospice at home nurses are reported here. For the older people, the idea of dying alone was less problematic than the idea of needing care and support from others, and the perceived loss of independence that this would entail. Participants reacted in differing ways to threats to their independence, but all utilised a form of relational reflexivity when considering the effect their actions might have on others. The nurses would prefer no one to die alone, but believed they had seen patients managing their own dying so that they could be alone at the moment of death. The paper suggests that dying alone may be a problem for survivors, rather than for the person who is dying. [ABSTRACT FROM AUTHOR]

Preserving older pedestrians' navigation skills in urban environments is a challenge for maintaining their quality of life. However, existing aids do not take into account older people's perceptual and cognitive declines nor their user experience, and they call upon sensory modalities that are already used during walking. The present study was aimed at comparing different guidance instructions using visual, auditory, and haptic feedback in order to identify the most efficient and best accepted one(s). Sixteen middle-age (non-retired) adults, 21 younger-old (young-retired) adults, and 21 older-old (old-retired) adults performed a navigation task in a virtual environment. The task was performed with visual feedback (directional arrows superimposed on the visual scenes), auditory feedback (sounds in the left/right ear), haptic feedback (vibrotactile information delivered by a wristband), combinations of different types of sensory feedback, or a paper map. The results showed that older people benefited from the sensory guidance instructions, as compared to the paper map. Visual and auditory feedbacks were associated with better performance and user experience than haptic feedback or the paper map, and the benefits were the greatest among the older-old participants, even though the paper-map familiarity was appreciated. Several recommendations for designing pedestrian navigation aids are proposed. [ABSTRACT FROM AUTHOR]

Objective: In spite of the healthy immigrant effect, the prevalence of lifestyle-related chronic diseases among migrants is reported to approximate that of the host country with longer duration of stay. For example, higher rates of chronic diseases such as Type 2 diabetes and hypertension have been observed among Filipino migrants and these have been linked to acculturation. The aim of this study was to explore the experiences of Filipino-Australian migrants in managing their chronic health conditions in a Western host country. Design: This paper reports on qualitative findings of a mixed methods study that used an explanatory sequential design. Nine focus group discussions were undertaken with 58 Filipino-Australian migrants with chronic disease. Thematic analysis was undertaken using a five-stage general purpose thematic framework ensuring that themes closely identified key participants’ experiences. Results: Findings revealed that health benefits provided by the health system in Australia were considered advantageous. However, a lack of social and instrumental support compounded isolation and disempowerment, limiting self-management strategies for chronic illnesses. Cultural beliefs and practices influenced their knowledge, attitude to and management of chronic disease, which health service providers overlooked because of perceived acculturation and English language skills. Overall this study has clearly identified recognition of cultural beliefs, language needs and support as three core needs of Filipino-Australian migrants with the elderly the most vulnerable. Conclusion: This paper highlights that self-management of chronic disease among elderly Filipino immigrants may be adversely affected by host language difficulties, a lack of social support and cultural issues, impacting on access to services, health-seeking behaviours and participation in health promotion initiatives. Language, culture-specific health interventions and resources and enhancing social support are likely important strategies in promoting chronic disease self-management among the elderly. These interventions have the potential to empower and encourage individuals to take control and better manage their chronic disease. [ABSTRACT FROM AUTHOR]

This qualitative research paper discusses the importance of experiential learning in the creative writing process, the cognitive processing of difficult emotions that can result from writing creatively in both the first and third person, and the implications of this in therapeutic settings. It looks at the ways experiential learning can come not just first-hand from life experience, but also through interviewing others about their experiences, and the ways Interpretative Phenomenological Analysis can then be used to interpret the material and act as a stepping stone between fact and fiction. The study is based on the writer's 20-year databank of journalistic interviews, which represents hundreds of single case studies, and also on her experience of writing four published novels. It examines the significance of the overlap between creativity, psychology, and journalism, and the therapeutic implications of that overlap for journalists, authors, and psychologists and their patients. [ABSTRACT FROM AUTHOR]

To date, little to no attempt has been made yet to describe how people experience agony, specifically, the elderly population in the penal setting and how exactly this experience of agony affects these marginalized communities. This grounded theory paper aspires to contribute to the understanding of the complexity of agony specifically, shedding light on what happens to incarcerated elderly when they experience this process of agonizing in prison. The Strauss and Corbin grounded theory method of analysis was utilized to generate theories from systematically obtained and analyzed data. A total of 25 respondents were selected using inclusion criteria and chosen through purposive sampling. Subsequently, a two-part data gathering tool was used consisting of a robotfoto and individual interviews. Lastly, the emerged themes were further subjected to member checking procedures to establish the credibility of the data collected. From the vertical and horizontal analyses of the verbalizations and sharings of a select group of elderly prisoners, the Splash Model of Agony has emerged which describes the Triggering, Escalating, and Plummeting phases of their agony while in prison. [ABSTRACT FROM AUTHOR]

It is timely to have this kind of study in South Africa as the country has an increasing number of people living with HIV and AIDS. While an extensive literature has documented factors associated with HIV and AIDS, psychosocial variables associated with the health of persons living with HIV (PLH) have only begun to receive attention recently. The objective of this paper was to explore the views of a group of people living with HIV and AIDS regarding HIV and AIDS and Self-Forgiveness. Theoretical base: To examine the role of self-forgiveness in people living with HIV and AIDS, George Engel's Biopsychosocial Model was adopted. Methods: Individual In-depth Interviews were conducted with 10 purposefully-selected participants in Ekurhuleni. Outcomes: Results showed that self-forgiveness has a huge role in the lives of people living with HIV and AIDS. For instance, it has been found that self-forgiveness leads to acceptance of HIV status, promote infected people to seek medical care, and eventually gain the confidence to disclose to friends and families. Work implications: In conclusion, self-forgiveness has micro, messo and macro implications as it promotes good health of people living with HIV and AIDS; enhance HIV status self-disclosure and adherence to HIV treatment. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to study and provide a framework for the motivations of women to engage in and maintain a nutritional program in Mexico. Focusing on a physician–dietician counseling program, 10 in-depth interviews were conducted with women age 30–60 engaged in the program. Two different sets of motivations for women were found, intrinsic and extrinsic, consistent with the self-determination theory. A model presents each set of motivations including subsets that explain specifically what makes women want to continue a nutrition program. Also, marketing implications from these motivations are discussed. [ABSTRACT FROM AUTHOR]

This paper provides ethnographic evidence on how coloniality shapes the making of Latin American psychologists. A critical ethnography was conducted at a psychology training institution in Ecuador, consisting of twelve months of participant observation; forty-one semi-structured interviews; and analysis of academic discourse, photos, videos and relevant social media content. The research was guided by the tradition of Critical Psychology – specifically Liberation Psychology – and Critical Discourse Analysis. Findings suggest the pervasiveness of coloniality in the making of Ecuadorian psychologists and, hypothetically, of others in Latin America and the wider Global South. Interpretations also highlight the non-essentialist, non-dichotomist, 'messy' nature of such processes, a consideration which may advance current ethical and analytical debates on decolonisation. Echoing ongoing critical arguments, authors suggest that a 'help-as-war' metaphor is a category with potential value to contribute to such advancement, an approach that has important theoretical and pragmatic implications for researchers and practitioners. [ABSTRACT FROM AUTHOR]

This paper uses practice theory to explore a poorly understood phenomenon with important health implications: How and why an increasing number of young Americans regularly use multiple tobacco products. Practice theory is a promising alternative to traditional public health frameworks for understanding everyday activities related to health. It broadens the analytic focus from characteristics of individuals to viewing practices as having lives of their own in competing for, winning, and losing practitioners. We drew from in-depth interviews with 21 young adults (ages 18–29; California) who regularly use cigarettes, electronic nicotine delivery systems (ENDS), and/or smokeless tobacco. Participants described their everyday routines. We examined the characterizing elements of each tobacco product use practice and the roles of each within participants' routines. We found that each product comprises a distinct substance use practice with different roles to play in different situations and contexts. Notably, many participants rotated between or modulated use of different products as a strategy for reducing perceived tobacco-related harms. Cigarettes are uniquely capable of aiding in the space-time organization of everyday activities and coping with crisis, while ENDS and smokeless tobacco open up times and spaces for nicotine consumption. This kind of approach aids our understanding and anticipation of the evolution of tobacco use practices as new products and regulations are introduced. [ABSTRACT FROM AUTHOR]

This paper will discuss examples of mental health training developed and co-produced in active partnership with two communities, one in Britain and one in Sri Lanka. This work has taken place in community settings, not within the consulting room. The learning had a bi-directional flow; through these partnerships, both partners/groups shared and developed their understanding of different cultures, idioms of distress, explanatory mental health models and ways of dealing with these. This expanded everyone's knowledge, understanding, and repertoires of practice. The work in Britain was audited through a range of psychometric tests and that in Sri Lanka through questionnaires. Semi-structured interviews also took place with both groups as did meetings with a range of key informants. Working beyond the clinic can benefit people, who have obliquely been labeled, as 'hard to reach' groups and who may find it difficult to access mental health services or who find services inappropriate. Therefore, community groups may be well-positioned to bridge this gap in non-stigmatizing, accessible and culturally appropriate ways. Evidence has begun to emerge suggesting that mental health services developed in conjunction with service users and the wider community may lead to better usage, more appropriate and accessible services, and to an improved sense of inclusivity. The implications of this for the global mental health debate will be briefly considered as will health pluralism and the importance of language and using a mother tongue. [ABSTRACT FROM AUTHOR]

Studies have shown burnout to be a significant problem in the mental health field, causing workers serious health problems and reducing quality of care provided to clients. Yet despite mental health practitioners' training in supporting others' emotional health, they may be reluctant to seek help for burnout symptoms. This paper addresses this paradox by showing how human cognitive processes could act as powerful blocks to the recognition of and response to burnout. Fifty-five mental health practitioners' beliefs and perceptions about burnout were examined using qualitative interview and survey data interpreted through a phenomenological perspective on attribution theory. The study identified four perceptual biases and identified professional identity and stress-induced cognitive deficit having influence on the recognition and response to burnout. [ABSTRACT FROM AUTHOR]

Purpose: Scholars agree that effective rehabilitation relies on a bedrock of reciprocity, relational trust, and authenticity. It is therefore essential for practitioners to develop insight into the complex dynamics within helping relationships. This study aims to provide an in-depth understanding of visually impaired students' experience of informal helping relationships. Methods: Ten visually impaired students at a South African university participated in one of two semi-structured focus group interviews (six and four in each group, respectively) wherein we explored their experience of informal helping relationships. Interpretive phenomenological analysis was used to make sense of the data. Results: Help, according to the participants, can militate against visibility and complete acceptance, and has the potential to cause helpers to feel entrapped. By contrast, some students found that help offered benefits to relationships by boosting the helper's self-esteem and affording disabled students the opportunity to make friends. Conclusion: Decisions whether to accept help were mediated more by relationship factors than by the need for help. These findings are important for rehabilitation professionals, as deep relationship can come into being during the course of a rehabilitation process. Although this study was conducted in an informal setting, the relational dynamics that we explore are also applicable to clinical relationships between disabled persons and rehabilitation professionals. In this paper, we provide an overview of the intricacies involved in care and helping relationships; In order for rehabilitation to be successful, these relationships should ideally be real, trusting, and authentic; Yet, authenticity and spontaneity often get lost in helping relationships, as help-recipients may deny help when they need it, and accept help when perfectly able to cope without it. These decisions are mediated more by relationship factors than by the need for help; In their daily practice, it is essential for health professionals to be mindful of these relational intricacies within care relationships; We recommend that professionals remain motivated to continuously reflect on their own actions and on the emotional investment they might have in their role as a helper; Our last recommendation is for rehabilitation professionals to spend energy on exploring, through open and transparent discussions with their disabled patients, the relational dynamics in their relationship. [ABSTRACT FROM AUTHOR]

Disability encompasses the limitations on an individual’s basic physical activities, and the consequent social oppressions such individual faces in society. In this regard, the limitation on the use of some parts of the genitals in a patriarchal system is considered a form of disability. This paper describes the perceptions of and the coping mechanisms employed by affected couples dealing with the consequences of female genital mutilation (FGM) as a form of sexual disability. Cultural Libertarianism was employed as a theoretical framework. The paper presents the results of a descriptive cross-sectional study conducted in Akure, Ondo State, Nigeria, with 10 male and 12 female respondents purposively selected through a snowball sampling for in-depth interviews. The findings present the justifications provided for the practice of FGM, and victims’ perceptions of how it affects their sexual relations. Furthermore, it highlights coping strategies employed by affected women and their spouses. The study shows that the disabling consequence of FGM is largely sexual in nature, leading to traumatic experiences and negative beliefs about sex, and requiring a myriad of coping strategies employed by the disabled women, and their spouses, which may have its own implications for marital and sexual bliss. [ABSTRACT FROM PUBLISHER]

This paper concerns children’s and young people’s accounts about the situation when one parent is misusing substances but the other parent is not. Earlier research on the other parent is scarce and fragmented. The aim of the paper is to discuss the role of the other parent from a child perspective. The results are based on qualitative analysis of interviews with 23 children who had one parent who misused substances while the other parent, according to public knowledge, did not. The main finding is that the other parent is a source of support, help and protection to some children, but difficulties may reduce the other parent’s ability to protect the children. Moreover, the challenges differ in the situations before and after the parents’ separation. The conclusion underlines the importance of taking a family perspective, working with the whole family and seeking solutions that take into account all persons of importance to the children’s welfare. It cannot be taken for granted that the other parent is able to protect the children. A careful assessment of the children’s living conditions is warranted and that assessment should include listening to the children. [ABSTRACT FROM PUBLISHER]

This paper reports on an action-oriented research study providing decision support to three local authorities in England on the prioritisation of public health investment and disinvestment decisions. We adopted a political science perspective, using the multiple streams framework to investigate the use of prioritisation tools in public health spending decisions at a time of severe financial constraints. The challenges and implications of their potential use in everyday practice were explored. Twenty-nine interviews were conducted before the targeted decision support occurred and 19 interviews after the decision support had been delivered. Interviews were held with locally elected politicians, officers and public health professionals based within local government, NHS commissioners and the local independent consumer watchdog for health and social care. Targeted workshops with local stakeholders were facilitated in each site by health economist members of the project team. Structured observational notes were recorded during these workshops and integrated with the interview data. Many respondents expressed an interest in prioritisation tools although some scepticism was expressed about their value and impact on decision-making. This paper analyses the enablers and barriers to adopting priority-setting tools in a local government environment that by definition is political. The findings suggest that the adoption of priority-setting tools in decision-making processes in public health poses some significant challenges within local government and that certain enabling factors have to be present. [ABSTRACT FROM PUBLISHER]

Objectives: To explore the discursive construction and social actions achieved by accounts given by men following a birth in which the mother developed life-threatening complications. Background: Existing qualitative research employing interpretative thematic analysis of men's accounts of births in which the mother developed life-threatening complications highlights men's expressions of distress and marginalisation. This paper extends this, adopting different epistemological and analytic approaches to those accounts. Methods: Audio recordings and transcripts of semi-structured interviews collected by Hinton et al. were re-analysed using an approach informed by narrative analysis, discursive psychology and the discursive action model. Participants were four white British men whose partners experienced a maternal 'near-miss' event. Results: This analysis illustrates how men in this study draw on cultural narratives of 'normal' birth to construct experiences. Narrative constructions highlight separation of health professionals from laymen. These men use a discourse of self-reliance within families to construct their path to recovery. Conclusion: The strength of available narratives of birth and limited accessibility of alternative ones may impact how men tell their experience. Men in this study discursively attend to issues of power, agency and male identity, re-establishing entitlement to speak about their experience, but construct emotional support as unavailable to them. [ABSTRACT FROM AUTHOR]

Medical science and other sources, such as the media, increasingly inform the general public's understanding of disease. There is often discordance between this understanding and the diagnostic interpretations of health care practitioners (HCPs). In this paper – based on a supra-analysis of qualitative interview data from two studies of joint pain, including osteoarthritis – we investigate how people imagine and make sense of the pathophysiology of their illness, and how these understandings may affect self-management behavior. We then explore how HCPs' use of medical images and models can inform patients' understanding. In conceptualizing their illness to make sense of their experience of the disease, individuals often used visualizations of their inner body; these images may arise from their own lay understanding, or may be based on images provided by HCPs. When HCPs used anatomical models or medical images judiciously, patients' orientation to their illness changed. Including patients in a more collaborative diagnostic event that uses medical images and visual models to support explanations about their condition may help them to achieve a more meaningful understanding of their illness and to manage their condition more effectively. Chronic musculoskeletal pain is a leading cause of pain and years lived with disability, and despite its being common, patients and healthcare professionals often have a different understanding of the underlying disease. An individual's understanding of his or her pathophysiology plays an important role in making sense of painful joint conditions and in decision-making about self-management and care. Including patients in a more collaborative diagnostic event using medical images and anatomical models to support explanations about their symptoms may help them to better understand their condition and manage it more effectively. Using visually informed explanations and anatomical models may also help to reassure patients about the safety and effectiveness of core treatments such as physical exercise and thereby help restore or improve patients' activity levels and return to social participation. [ABSTRACT FROM AUTHOR]

Just as in the field of general education, scholars within the field of teaching English to speakers of other languages (TESOL) have also struggled to come to a consensus as to how reflective practice should be operationalized with many different approaches suggesting a retrospective approach to questioning about practice. As a result, many of these approaches have led to a type of routinization of reflection. Worried about such routinization of reflection, Farrell developed a more holistic approach to reflective practice that recognizes the spiritual, moral, and emotional aspects of reflection, as well as the usual retrospective questions about practice. This paper outlines a case study of the reflections of one experienced TESOL teacher teaching in South Korea using Farrell's framework for reflecting on practice that included reflections on his philosophy, principles, theory, practice, and beyond practice. The results revealed three common themes of approachability, art-oriented conceptions, and curiosity that emerged in all aspects of his reflection as uniquely influential parts of a larger whole. Thus, Farrell's holistic framework for teacher reflection employed in this study provided multiple filters through which these various parts could be viewed. [ABSTRACT FROM AUTHOR]

In 2010, Vietnam established social work as a profession. As part of their strategic plan, the government aims to incorporate social work into existing hospitals and health care facilities in the country, including psychiatric hospitals and mental health care centers. This paper, based upon survey and focus group data from 194 people working in three major mental health facilities in Hanoi, explores direct care staffs' perceptions of this historic incorporation of social work, with a particular eye to the benefits and challenges of the transition. Results show most staff members thought social workers would provide great support to the many unmet needs of their largely underserved and impoverished patients. They also viewed social workers as a potential resource to the treatment team by reducing work overload. Existing staff, however, were less attuned to the clinical functions of social workers in mental health settings, often equating social work with community development and social movements. Some were concerned about social workers taking on their tasks; others about new social workers being hindered by the professional hierarchy in which doctors were placed at the top. Successful integration of social workers will hinge on strong support from policy-makers and leaders of mental health systems. [ABSTRACT FROM AUTHOR]

The mental health of migrant communities is an important public health concern. A growing body of literature suggests that social and cultural determinants of health significantly contribute to the mental health and wellbeing of older migrants in their host countries. Despite the increasing population of older Nepalese migrants in the UK, there is little research exploring the mental health needs of this community. This article explores older Nepalese women’s experiences of drivers of mental distress in London. Data was collected using in-depth interviews with 20 older Nepalese women living in the London Borough of Greenwich. Grounded thematic analysis of women’s narratives identified six overarching factors contributing to their emotional distress that pose potential risks to their mental health: absence of family, language barriers, housing problems, physical illness, lack of appropriate support, fears of death, and inadequate financial resources. In many cases, the impact of these factors was experienced in combination rather than isolation, often influenced by cultural dynamics. Findings highlight that re-settlement in the absence of family is at the heart of emotional challenges for older Nepalese women. The paper concludes with a series of recommendations for supporting processes of settlement to mitigate this risk among older Nepalese women in the UK. [ABSTRACT FROM AUTHOR]

This paper scrutinises the concepts of moral reasoning and personal reasoning, problematising the binary model by looking at young women’s pregnancy decision-making. Data from two UK empirical studies are subjected to theoretically driven qualitative secondary analysis, and illustrative cases show how complex decision-making is characterised by an intertwining of the personal and the moral, and is thus best understood by drawing on moral relativism. [ABSTRACT FROM AUTHOR]

This study examines the relationship between state policies, religion, reproductive politics, and competing understandings of embodied sexual and reproductive morality. Using ethnographic and life history interviews, this study looks at the lives of Filipino urban poor women and how they interpret, follow and resist Catholic Church doctrines and practices as these relate to sexuality and reproduction. Taking everyday morality as embedded in social practice, this paper argues that women’s subjective reinterpretations of Catholic teachings regarding contraception and abortion render religion pliant in a way that restores moral equilibrium in women’s lives. It is in this process of adjusting and re-adjusting this moral order that women are able to construct their moral worlds. Further, this article investigates how social class, gender and religion work in tension with one another in women’s everyday decisions and how the constraints and opportunities that poor women encounter in their everyday lives are enabled by the state and its institutions. [ABSTRACT FROM AUTHOR]

Young people's sexting is an area of increasing concern amongst parents, educationalists and policy makers, yet little research has been conducted with young people themselves to explore their perspectives on the support they need to navigate relationships in the new digital media landscape. To address this absence, an inter-disciplinary team of researchers undertook a participatory study with students, aged 13 to 15, in a UK secondary school. This paper outlines key study findings, including young people's views on sexting, their recommendations for improved education around sexting in schools, their preferred sources of support, and their perspectives on the way adults should respond to young people's sexting. Findings indicate that sexting education needs to be developed within the context of wider relationship issues, such as gender, power dynamics and trust between peers, and improved communication between students and teachers or other responsible adults. Findings may be used to consider ways of designing and communicating messages around sexting to young people within and beyond educational settings. [ABSTRACT FROM AUTHOR]

Background: Aphasia can have major consequences for participation. In line with other initiatives around the world, in the Netherlands aphasia centres provide support to people with aphasia and their relatives in the chronic phase to bridge the gap between therapy, rehabilitation, and participation in daily life. Although there is greater focus on participation in health care, the concept of participation is complex and not well-defined. Aims: The purpose of this paper is to understand the value and meaning of the aphasia centres in the Dutch context. We focus on the emic perspectives of people with aphasia and their relatives: how do aphasia centres contribute to building up a meaningful life with aphasia in the chronic phase and how do the centres support them to participate? Hence, this study also contributes to the understanding of the concept of participation and its meaning. Methods and procedures: This qualitative study used a naturalistic case study design in order to get an rich and multi-layered understanding of the context of aphasia centres. Within this context we focused on the experiences and perspectives of people with aphasia and their relatives. To secure involvement of people with aphasia themselves, research methods were attuned to their abilities to participate, and included participant observations, interviews, focus group meetings, and creative methods. Outcomes and results: Aphasia centres help people with aphasia to overcome isolation. They bring new goals and perspectives and help people find new meaning in life. They are experienced as a safe place to learn, overcome shame, and build self-confidence. Working in groups is a valuable element, providing a mutual sense of belonging. Also, people experience they can have a meaningful contribution by helping others. Relatives underscore these values and also feel supported in building up their life with their partner. Conclusions: Aphasia centres are a first step to overcome isolation and bear a first step towards participation in itself. They contribute to overcome barriers to relate to others by building self-confidence and overcome shame. This is a big step stone towards participation in the context outside the centre. From the perspectives of clients and relatives, participation is linked to the concept of being and belonging. At the same time, clients feel it is hard to meet societal norms of participation, framed as paid work, independency and self-reliance. This makes it harder to overcome shame. In this societal context, aphasia centres become even more relevant. [ABSTRACT FROM AUTHOR]

It is an oft-repeated trope that the recent medical advances in the field of assisted reproduction have radically transformed the ways in which we can achieve, practice and imagine parenthood. This development has enabled new forms of non-heterosexual family constellations, including same-sex nuclear families and solo-parents by choice, and as a result an increasing number of groups are mobilising politically for access to fertility treatments. Swedish transgender patients are one of these groups; after many years of political mobilisation, they are no longer required by law to go through sterilisation as a compulsory part of gender corrective surgery, and instead today, all transgender patients are offered fertility preservation through gamete freezing. This, in turn, has meant not only that Swedish fertility clinics have faced an entirely new patient group - the transgender fertility patient - but also that the cultural imagination of who can become a parent and what a family might look like is becoming further destabilised. Building on interviews with medical staff, LGBTQ-advocates and complementing qualitative data, this paper seeks to shed light on the very process by which these new rights are translated in the practical context of the fertility clinic, and also what it means, more generally, for cultural imaginations of parenting when a group whose reproductive futures were previously considered either impossible or undesirable are now 'anticipating infertility' and engaging in 'family planning' as central parts of their lifecourse and medical engagements. [ABSTRACT FROM AUTHOR]

This paper describes the implementation of an educational intervention to enhance sexual health among homeless people by including sexual and reproductive health and rights (SRHR) as a part of social work provision with this group. Adult service users in different forms of temporary accommodation were provided with the opportunity to participate in three group sessions. Seventeen sessions, six with women and eleven with men, took place at six different housing facilities in Gothenburg. The intervention implementation process (which involved preparation, creation, realisation and evaluation) is described, and factors of importance are identified. Service users appreciated the opportunity to receive information and discuss sexual health, rights and norms. The success of the work may be related to the fact that the project was anchored both in social services and among service users, constantly adjusted, and delivered using a respectful approach. Social work organisations and professionals have an important role to play in acknowledging and promoting service users’ sexual health and rights, especially among disadvantaged and socially excluded groups including homeless people. [ABSTRACT FROM AUTHOR]

This paper reports on a study that examined the grief and coping of 29 parents whose child has hypoplastic left heart syndrome using the Dual Process Model. The study employed a secondary thematic analysis of interviews at key times of treatment and recovery for the child. After the diagnosis, parents experienced intense loss (LO), but focused upon restoration-orientated tasks (RO) to support their child. Over time, most parents employed a healthy oscillation between LO coping and RO coping, with waves of grief and with some grieving suppressed. There are some specific grief and coping and gender patterns employed by parents. [ABSTRACT FROM AUTHOR]

Body image issues associated with eating disorders involve attitudinal and perceptual components: individuals’ dissatisfaction with body shape or weight, and inability to assess body size correctly. While prior research has mainly explored social pressures produced by the media, fashion, and advertising industries, this paper focuses on the effects of personal networks on body image, particularly in the context of internet communities. We use data collected on a sample of participants to websites on eating disorders, and map their personal networks. We specify and estimate a model for the joint distribution of attitudinal and perceptual components of body image as a function of network-related characteristics and attributional factors. Supported by information gathered through in-depth interviews, the empirical estimates provide evidence that personal networks can be conducive to positive body image development, and that the influence of personal networks varies significantly by body size. We situate our discussion in current debates about the effects of computer-mediated and face-to-face communication networks on eating disorders and related behaviors. [ABSTRACT FROM AUTHOR]

Objective: This paper investigated patients’ experiences of disease and self-care as well as perceptions of the general practitioner’s role in supporting patients with impaired self-care ability. Design: Qualitative interviews with 13 patients with type 2 diabetes, concurrent chronic diseases, and impaired self-care ability assessed by a general practitioner. We analyzed our data using systematic text condensation. The shifting perspectives model of chronic illness formed the theoretical background for the study. Results: Although most patients experienced challenges in adhering to recommended self-care activities, many had developed additional, personal self-care routines that increased wellbeing. Some patients were conscious of self-care trade-offs, including patients with concurrent mental disorders who were much more attentive to their mental disorder than their somatic diseases. Patients’ perspectives on diseases could shift over time and were dominated by emotional considerations such as insisting on leading a normal life or struggling with limitations caused by disease. Most patients found support in the ongoing relationship with the same general practitioner, who was valued as a companion or appreciated as a trustworthy health informant. Conclusion: Patient experiences of self-care may collide with what general practitioners find appropriate in a medical regimen. Health professionals should be aware of patients’ prominent and shifting considerations about the emotional aspects of disease. Patients valued the general practitioner’s role in self-care support, primarily through the long-term doctor-patient relationship. Therefore, relational continuity should be prioritized in chronic care, especially for patients with impaired self-care ability who often have a highly complex disease burden and situational context. Key points:   Little is known about the perspectives of disease and self-care in patients with a doctor-assessed impaired ability of self-care.   • Although patients knew the prescribed regimen they often prioritized self-care routines that increased well-being at the cost of medical recommendations.   • Shifting emotional aspects were prominent in patients’ considerations of disease and sustained GPs’ use of a patient-centred clinical method when discussing self-care.   • Relational continuity with general practitioners was a highly valued support and should be prioritized for patients with impaired self-care. [ABSTRACT FROM AUTHOR]

New York City (NYC) is considered to be one of the world’s most progressive cities and gender and sexuality diversity (GSD)-inclusive education departmental policies appear to reflect these values. However, even within such a context, NYC educators report challenges in their work to meet the needs of trans/gender-diverse students and the visibility of trans/gender diversity more generally within their pre-K - 12 school communities. This paper reports on interview data from 31 school staff members from nine public and independent schools located in the NYC metro region, with a specific focus on their framing of inclusivity and bullying, and reported support of trans/gender-diverse students. Based on educators’ representations of their schools, the nine schooling environments fell into two broad clusters: (1) those framing trans/gender inclusivity as an anti-bullying initiative and working at the minimum policy requirements, and (2) those working beyond bullying discourses and policy frameworks to conceptualise trans/gender inclusivity as integral to the school’s mission and as offering clear whole-community benefit. Findings support the constraints of bullying discourse on even supportive educators’ curricular ‘translation’ of GSD-inclusive policies, reinforcing the need for relevant policy reframing and targeted of professional development opportunities, particularly for school leaders. [ABSTRACT FROM AUTHOR]

The World Health Organization Regional Office for Europe (WHO EURO) and the German Federal Centre for Health Education (BZgA) published the Standards for Sexuality Education in Europe in 2010. The standards were developed to provide an overview of those sexuality education issues that should be addressed in school at various specific age levels. They were intended to guarantee that sexuality education teaching is age-appropriate and of uniformly good quality throughout Europe. In the context of the present survey, Austrian teachers and parents or guardians were asked about the importance of the topics covered by the WHO standards and about any aspects they would like to see for such sexuality education to be successful. The paper concludes that parents and teachers agree on the sexuality education topics they find important for coverage in Austrian primary schools, although teachers find sexuality education in general to be of greater importance than do parents. Teacher’ wishes for sexuality education in practice correlate highly with parents’ ideas of quality. Overall, qualifications and support for work in this field are viewed as essential, with survey respondents perceiving the need for high-quality initial training and continuing education and appropriate frameworks for implementation in school. [ABSTRACT FROM AUTHOR]

Experiences of autism-spectrum disorder are now increasingly studied by social scientists. Human-animal relations have also become a major focus of social inquiry in recent years. Examining horse-assisted therapy for autistic spectrum disorders, this is the first paper that brings these fields together. Drawing on participant observation and interviews at a UK horse therapy Centre, this article examines how staff and the parents of riders account for the successes and limitations of equine therapy. To the respondents, horses ‘open up’ autistic children and make possible interactions that seemed impossible before. Horses were regarded as facilitating the emergence of apparently social behaviours, which included eye contact, pointing, and speech. Three key explanations emerged for therapeutic success: the sensorial, embodied experience of riding the horse; the specific movements and rhythms of the horse; and, the ‘personality’ of the horse. Equine therapy can be regarded as enabling a form of multispecies intersubjectivity, with the resonance between rider and horse seeming to make possible a new attunement between humans. Practices of equine therapy, and perceptions of its efficacy, serve in turn to attune social scientists to a version of empathy constituted through lively and sensorial interactions, as opposed to one that is restricted to particular kinds of humans. [ABSTRACT FROM AUTHOR]

Blood transfusions belong to standard and commonly utilised biomedical procedures. Jehovah's Witnesses' transfusion refusals are often referred to in bioethical and medical textbooks. Members of this globally active religious organisation do not, however, challenge biomedical diagnosis and treatment as such. A result of both their trust in and their interpretation of the Bible, they question only this medical treatment. In spite of the global presence of this religious community and its uniformly practised teachings, including those pertaining to blood, experiences and choices of Jehovah's Witness patients have been understudied. Drawing on a nine-month fieldwork with Jehovah's Witnesses and physicians in Germany (mainly in Berlin) between 2010 and 2012, the paper addresses treatment choices made by Witness patients and their relationship with physicians. In light of the long tradition of 'medical heterodoxy' established in German culture and society, Germany constitutes an ideal point of departure for such a study. By utilising the concept of 'medical landscape' it is argued that Jehovah's Witnesses in my field site find themselves at the intersection of different medical landscapes: in the 'immediate' surroundings of the German healthcare system that is open to different 'treatment modalities', and that of the United States, which favours biomedicine. The paper also argues that Jehovah's Witnesses' position towards blood transfusions can further be used as a lens to shed light on the German (bio)medical landscape itself. [ABSTRACT FROM AUTHOR]

Village dwellers in Central Ukraine have access to various types of therapy that comprise diverse medical landscapes. Patients' movements within these landscapes are possible thanks to each person's web of relations. Medical landscapes are not fixed, but vary and dynamically change for each person, depending on their fluid and interchanging, hierarchical webs of mutual relations with other people, personal bodies, institutions, discourses, political powers, other non-human organisms, or objects such as medicines. This paper was inspired by the medicoscape concept (H€orbst and Krause 2004) as well as Ingold's idea of meshwork analyses of relations between various actors: in this case, patients, healers, a weak state, official healthcare providers, pharmacists and medicinal plants, in the context of patients' therapeutic choices. Self-medication based on herbal remedies is a very important feature of people's medical landscapes in Central Ukraine and usually the first therapy choice for most interlocutors. That is why this paper is focused on the presentation of the means through which people acquire knowledge about medicinal plants, and the ways they interact with plants and plants interact with them. In this way, showing the complexity of villagers' webs of relations is possible. The analysis is based on ethnographic research conducted between 2009 and 2013 in the Vinnytsia region (Central Ukraine). [ABSTRACT FROM AUTHOR]

This paper introduces the notion of 'risky encounters', referring to the way in which contacts with doctors are commonly perceived by the inhabitants of Bishkek, the capital city of Kyrgyzstan. The author's research conducted between 2011 and 2013 revealed that most people were extremely critical of biomedical personnel, despite positive assessments of healthcare reforms expressed by experts. Owing to the prevailing distrust of doctors, their interventions are often considered risky to one's health, which strongly influences people's health-related strategies in the context of medical diversity. This perception of risk is deeply embedded in feelings of uncertainty and anxiety, which should be viewed from the more general perspective of the political, economic and social uncertainties resulting from the difficulties of the period of post- Soviet transformation. It is evident that medical diversity in Bishkek provides people in need with many non-biomedical treatment options, and a distrust of doctors significantly contributes to the popularity of complementary medicine. Economic constraints and local concepts of health, illness and efficacy are among the many other factors that play a role in therapeutic choices. However, the current paper focuses on risk, uncertainty and trust, as emotions that are central to an understanding of the health-related strategies and tactics used by the inhabitants of present-day Bishkek. [ABSTRACT FROM AUTHOR]

Despite the increased diversification of Australian families, the nuclear family formed through reproductive heterosex continues to be treated as the norm. This paper argues that this norm impacts negatively upon families formed in other ways, by exposing them to increased scrutiny. Drawing on interviews with 60 participants from four cohorts (families formed through reproductive heterosex, intercountry adoption, long-term foster care, or surrogacy), a comparative thematic analysis is presented in which two key themes are elaborated: (1) the impact of government policies and practices, and (2) the degree to which families are treated as public property. Findings suggest that families formed through reproductive heterosex were the least regulated and scrutinised; families formed through either adoption or surrogacy received a considerable degree of regulation and scrutiny; and foster families were the most scrutinised and negatively impacted by government policies. The paper concludes by considering what is required to engender more inclusive and supportive responses to all families. [ABSTRACT FROM AUTHOR]

Broad and inter-disciplinary inquiry into disability is at a nascent stage in Sri Lanka. This paper looks at the intersectionality of disability and gender in the specific contexts of ‘the rural’ and the armed conflict-affected areas of the country, particularly the interaction with the law. In-depth interviews and focus group discussions were conducted among rural women with disabilities in the North Central and Eastern provinces, including women who acquired disabilities resulting from the internal conflict. Legal literacy, administrative discretion in disability-related welfare programmes, and transitional justice and reconciliation emerged as the most prominent themes in the interviews. We analyse these issues using a rights framework in an attempt to highlight some of the vulnerabilities of women with disability in the rural and war-affected contexts. The paper also reflects on a few instances where those vulnerabilities have been overcome through collective action. [ABSTRACT FROM AUTHOR]

This paper explores issues around stigmatisation and labelling as they pertain to pupils with SEBD. The paper draws upon an evaluative case study, conducted in two Scottish local authorities, of the implementation of support groups, and examines how the approach was experienced by pupils who participated within the intervention, drawing from a range of accounts. The study was implemented in upper primary (aged 10–12) and lower secondary (aged 12–14). It is principally qualitative and draws upon data generated from open questionnaires, interviews and focus group discussions. Pupil responses to intervention were largely positive, but there was evidence that a minority of children had experienced the intervention as stigmatising. Variables relating to the establishment of trusting and respectful relationships within the group, partnerships with parents, professional development for staff and the adoption of a whole-school approach emerged as key variables in determining how pupils experienced the intervention. [ABSTRACT FROM PUBLISHER]

Based on ethnographic fieldwork in a coastal village in south-eastern Tanzania, this paper examines how social inequalities and social suffering become embodied in the lived experiences of hunger. The paper explores local meanings of food, fertility and hunger and how these concepts interconnect and materialize on a landscape impacted by two large-scale conservation and development projects, the Mtwara Development Corridor and the Mnazi Bay Ruvuma Estuary Marine Park. Fourteen in-depth interviews Sinde villagers were conducted to elicit narratives about their food experiences in addition to 24 hour food recall and pile sort to explore local taxonomies of food. One focus group discussion with six women was also conducted. The study finds displacement from resources by the conservation and development projects has exacerbated existing food security issues of irregular rains, increasing food prices and malnourished bodies. The downward cycle of food insecurity has local villagers worried about the viability of their community's future, embodied in the health of local children and their performance in school. Increasing food insecurity is internalized within the community as infertility where the health of the landscape is connected to the health of society. [ABSTRACT FROM PUBLISHER]