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The branding of ayurveda as a market strategy for the health consumer has become an important factor in the creation of 'New Age orientalist desire'. Using Vedic Village as a case, this paper shows how new age orientalism has been spread in modern India to middle class professionals, entrepreneurs and overseas health tourists. With this representation, ayurveda has become a wellness therapy instead of a means to restore health, and affluent people can now buy a package of 'ayurvedic healthy life' without changing their lifestyles. In addition to Euro-American health tourists, emerging middle class professionals and entrepreneurs in modern India have also become an integral part of the process of 'new age orientalization'. This paper concludes that the commodijied version of ayurveda, which has been developed in the West as part of 'wellness and spa culture', has become popular among the affluent middle class in India and abroad today, and through this the West has claimed and justifies authority over Eastern medicine. [ABSTRACT FROM AUTHOR]

This paper reports on a qualitative study of UK mental health practitioners' experiences of working with the contested condition, dangerous and severe personality disorder (DSPD). Our interviews focused on the issues of treatability, risk assessment and decision-making in multi-disciplinary teams. We discuss the approach of values-based medicine (VBM) as a useful framework for interpreting the data: respondents cited both explicit values (based on occupational training) and implicit values (based on personal beliefs and subjective perceptions). There was evidence of conflicting values -- within individuals, between occupational groups, and between individuals in occupational groups -- which led to widespread uncertainty and caution about whether and how those with 'dangerous' personality disorders could be treated. These disputes were resolved by a 'slide to pragmatism', whereby practitioners, reluctantly acknowledging their own empowerment in the process, sought to make whichever choice was least risky for their own professional reputation, and most pragmatic, given the resources available. [ABSTRACT FROM AUTHOR]

This paper reports on a case study which examined mental health service users and carers, public housing tenants and non-government organisations' (NGO) participation and representation within policy processes. A particular focus was influence upon policies aimed at achieving housing outcomes for people with a psychiatric disability. The research was a case study of a period of mental health system reform in South Australia (2000–2005) and involved primarily qualitative research; interviews, focus groups and participant observation, as well as document analysis. Participants (n = 92) included service user and carer representatives, public servants from across the health, housing and disability sectors, and NGO professionals from across sectors. The study found that the community participation that existed during the reform period was largely an end in itself rather than a means for groups to shape policy processes, including housing policy. A number of barriers to service users and NGOs influencing policy agenda setting and implementation were determined and described. A range of strategies and processes to enhance community participation, representation and accountability in policy processes are recommended. These include cross-sectoral policy development and accountability mechanisms, advocacy coalitions across sectors for policy agenda setting, public forums involving both service users and professionals, and challenging ‘consumerist’ discourses on participation. Such strategies could facilitate policy debates on housing for people with a psychiatric disability, counter dominant professional interests within policy networks, and help to address community stigma. [ABSTRACT FROM AUTHOR]

Healthy eating in schools is central to UK Government attempts to redress nutritional deficiencies and combat childhood obesity. However, there is little consideration of the local, contextual spatial factors that contribute to the ways in which particular policy initiatives are experienced at the school level. This paper presents findings from an evaluation of the 'Eat Well Do Well' programme in Kingston-upon-Hull, UK: an innovative scheme providing free, healthy food to all primary school children. Data is presented from an ethnographic study of two case study schools illustrating how notions of 'spatiality' augment our understanding of the ways policy intention is mediated. We consider the potential of primary school meals policy to address health inequalities using the concept of 'spatiality' to examine the interconnections between the aesthetic, temporal, social and spatial elements of school dining environments. We conclude optimistically, suggesting that an engagement by health policy developers with what we call the 'spatial imagination', might be useful in examining and developing factors that ensure the effectiveness of interventions addressing the determinants of ill health. [ABSTRACT FROM AUTHOR]

Collaborative approaches to knowledge translation seek to make research useful and applicable, by centring the perspectives and concerns of healthcare actors (rather than researchers) in problem formulation and solving. Such research thus involves multiple actors, in interaction with pre-existing ecologies of knowledge and expertise. Although collaboration is emphasised, conflict, dissonance, and other tensions, may arise from the multiplicity of perspectives and power dynamics involved. Our article examines knowledge translation in this space, as both empirical focus and research methodology. Drawing from practice theory and critical pedagogy, we describe knowledge translation as a situated and social process of transformative learning, enabled by reflexive dialogue about practice, and supported by care. With examples from five studies across two countries, we show that practice-based knowledge translation can be mediated by researchers, using video-reflexive ethnography. We describe the importance (and features) of practices of care in these studies, that created psychological safety for transformative learning. We argue that attempts to transform and improve healthcare must account for sustained and reciprocal care, both for, and between, those made vulnerable in the process, and that knowledge translation can, and should, be a process of capacity strengthening, with care as a core principle and practice. [ABSTRACT FROM AUTHOR]

By applying a posthuman perspective to the analysis of care for older people (COP), we analyse the agential cuts (together/apart) enacted by humans (mainly caregivers and older people) and more-than-humans (a camera intra-acting with other objects) whose agential entanglement configures and reconfigures the political economy of the caring apparatus. Our study identifies 'targeting', 'monitoring', and 'aligning' as interrelated caring practices, thus contributing to advance a posthuman understanding of welfare technology, and advancing a critical use of the possibilities enacted by technologies. [ABSTRACT FROM AUTHOR]

Clinical practice guidelines (CPGs) are a central technique within the evidence-based medicine (EBM) movement. General practice is an area of medicine that seems to be particularly resistant to the use of CPGs. This article contributes to the debates about GPs and CPGs by reflecting on three different Australian studies conducted by the authors in an attempt to better understand variations between GPs' practices and the recommendations found in relevant CPGs. These projects focused on dementia, chronic obstructive pulmonary disease and hypertension (high blood pressure). A common finding across the three studies was that GPs described how their focus on the whole person and their patients' priorities and needs meant that the recommendations found in CPGs were not always appropriate or easy to apply. In doing this, our study participants were describing tensions between the holistic/whole person and patient-centred approach of GPs and the narrow disease-specific focus of guidelines. Our work provides insight into the rationality of GPs and illustrates some of the ways that whole person care and patient-centred care create operational challenges to the application of EBM in the form of CPGs. [ABSTRACT FROM AUTHOR]

The authority relationship between medicine and the allied health professions has been conceptualised as one of subordination. The research that underpinned the subordination thesis was largely based on pre-1980 studies of inter-professional interaction and struggle. This article presents data from a comparative longitudinal case study analysis of Australian allied health professions employed in three distinct organisational models in urban acute care general hospitals during the 1990s. The article discusses the emergence of a distinct allied health 'profession community' subculture associated with the emergence of new organisational structures in Australia. A model to account for subculture development under different organisational conditions is proposed. A key concern is the way in which a 'profession community' is created, structured and maintained in the complex organisational settings of the acute-care hospital. The findings challenge the notion that subordination is an inevitable consequence of medical dominance and calls for a re-formulation of our understanding of the relationship between medicine and allied health professions in light of contemporary health service reforms. [ABSTRACT FROM AUTHOR]

A case study of twenty-nine midwives and nine obstetricians working in a regional, public sector Australian hospital demonstrates the plasticity of professional boundaries within a post-welfare state. Driven by new discourses of globalisation, marketisation, managerialism and consumerism, professional boundaries in health care are being blurred, reordered and reconstituted. Government policies that call for a new interdisciplinarity between maternity professionals may be seen as responses to the above pressures. However, there remain considerable barriers to achieving collaborative models including conflicting interpretations of risk, of women's bodies and of childbirth; the veto power of decision-making retained by obstetricians; questions of professional accountability; and diversity over appropriate styles of micro-interaction. Collaboration demands a new egalitarianism to eclipse the old vertical system of obstetric dominance and this means that midwives need to create a distinctive professional specialty, or new object of knowledge. Midwives' skill in 'emotion management' could provide this speciality in addition to their rational-technical knowledge and thus elevate midwifery to an equivalent professional status with obstetrics but as yet neither obstetrics nor midwifery have realised its professionalising potential. [ABSTRACT FROM AUTHOR]