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Paid carers play an important role in helping older adults with care needs to remain living in their own homes. This paper examines changes in the home care field, specifically the emergence of self‐employed care entrepreneurs ('microentrepreneurs'). To do this, it employs Bourdieu's concepts of field, capital and habitus. Drawing on 105 semi‐structured interviews with stakeholders working in home care, the paper describes how the interaction of changes to field structures, and altered practices of care have challenged the taken‐for‐granted acceptance of traditional, transactional forms of care provision. This process has been highly dependent on local state actors, their ability to mobilise relevant forms of capital and the factors which shaped their habitus. It should be seen within the context of changes to local field structures and the hierarchical classification processes which underpin them. These changes threaten the distribution of capital in the home care field in ways that are beneficial to microentrepreneurs. Bourdieu might categorise these developments as 'partial revolutions', which do not challenge the fundamental axioms of the field. However, for care entrepreneurs, formerly employed as low‐paid home‐care workers, a revolution that is only partial may be better than none at all. [ABSTRACT FROM AUTHOR]

In recent years, assistive technologies have gained acceptance as tools for supporting chronically ill patients in achieving improvements in physical activity. However, various healthcare and sociological studies show contradicting results regarding the physical and social impact of using such devices. This paper explores real‐time user appropriation of an assistive monitoring/tracking device, the pedometer, in a healthcare intervention, with a particular focus on the technology identities users attribute to the pedometer. The study site was a rehabilitation programme at a local Danish health centre supporting patients with chronic obstructive pulmonary disease. As part of this empirical study, six focus‐group interviews were conducted with patients before and after they used pedometers. The analysis of respondents' accounts shows that monitoring devices become part of users' complex socio‐technical ensembles in which the use of the device and its tracking of activity is constantly negotiated through experimentation with type and frequency of use; interpretation of knowledge and experience gained via the device; and negotiation of expectations, wellbeing, and the value of quantified knowledge for the management of chronic illness. On the basis of these findings the paper brings together and advances sociological scholarship on chronic illness, embodiment, the quantified self and technology adoption. [ABSTRACT FROM AUTHOR]

In the British NHS the principle of exceptionality involves assessing whether a patient is sufficiently different from the generality of patients to justify providing a treatment, such as an expensive cancer drug, not approved for routine funding. In England, individual requests for certain high‐cost treatments are considered by local panels that examine exceptionality alongside treatment efficacy and cost as the main criteria for funding. This was also the case in Wales until September 2017. Our paper draws on audio recordings of panel meetings and interviews in a Welsh Health Board to investigate how exceptionality was constructed in discussions. It focuses on the problematic combination of different decision criteria in meeting talk, particularly regarding the discourses associated with efficacy and exceptionality. Exceptionality is a fluid category that raised questions about the evidence‐based nature of panel decision making. In particular, the paper discusses the use of subgroup data from RCTs and the difficulty of deciding how small a subgroup of patients should be before it is deemed exceptional. Determining exceptionality has been an important mechanism for deciding that a minority of NHS patients can still receive high‐cost treatments not routinely provided for all. As a neglected rationing mechanism it warrants sociological examination. [ABSTRACT FROM AUTHOR]

The "problem" of public resistance to hospital closure is a recurring trope in health policy debates around the world. Recent papers have argued that when it comes to major change to hospitals, "the public" cannot be persuaded by clinical evidence, and that mechanisms of public involvement are ill‐equipped to reconcile opposition with management desire for radical change. This paper presents data from in‐depth qualitative case studies of three hospital change processes in Scotland's National Health Service, including interviews with 44 members of the public. Informed by sociological accounts of both hospitals and publics as heterogeneous, shifting entities, I explore how hospitals play meaningful roles within their communities. I identify community responses to change proposals which go beyond simple opposition, including evading, engaging with and acquiescing to changes. Explicating both hospitals and the publics they serve as complex social phenomena strengthens the case for policy and practice to prioritise dialogic processes of engagement. It also demonstrates the continuing value of careful, empirical research into public perspectives on contentious healthcare issues in the context of everyday life. [ABSTRACT FROM AUTHOR]

Digital technologies are increasingly embedded in clinical encounters, reconfiguring the basis on which health care is delivered. Thereby, the delivery of care shifts from territorial locations in clinics and temporal modes of co‐presence towards digital platforms. Drawing on a sociotechnical evaluation of digitised patient follow‐up in HIV care, this paper argues that the forms of interactivity practised in platform encounters cannot be adequately understood through traditional interaction frameworks such as Erving Goffman's interaction order. To conceptualise the new informational space and temporal mode of 'response presence' within which platform encounters are conducted, the paper draws on theoretical advances made by Karin Knorr Cetina who further developed Goffman's interaction order to describe interactions augmented by 'scopic media'. A comprehensive framework is presented to elaborate the distinct qualities of interactions occurring in face‐to‐face, tele‐interaction and platform encounters and to analyse their affordances based on doctor and patient experiences. This framework is intended to stimulate further research on how new interactional forms between doctors and patients will reconfigure roles and responsibilities as well as wider structures of digital society. Furthermore, it can also support practical guidance of when and how different forms of clinical encounters may be integrated in care pathways. [ABSTRACT FROM AUTHOR]

Over the last three decades, sociomaterial approaches to the study of health care practices have made an important contribution to the sociology of health care. Significant attention has been paid to the role of technology and artefacts in health care and the operation of actor‐networks but less space has been given to questions of ontological multiplicity in health care practices. In this paper, we draw upon our study of patient experience data in five acute hospitals in England to illustrate how treating patient experience data as 'singular‐multiples' can enable useful insights into patient experience data work in health care organisations. Our data was generated during 12 months of fieldwork at five participating hospitals and included organisational documents, field notes, informal and formal interviews with frontline and managerial staff and patient representatives at the study sites. We use the examples of the Friends and Family Test (FFT) and the National Cancer Patient Experience Survey (NCPES) in England to consider the multiple nature of data as it is enacted in practice and the work data does when coordinated as an entity in the singular. We argue that, and discuss how, the sociomaterial insights we discuss here are relevant to health care quality and improvement research and practice. [ABSTRACT FROM AUTHOR]

Despite an increased drive over the past two decades in Western societies to promote children's physically active play to improve their health, there are concerns that childhood has become less physically active. There are also fears that a previously naturally occurring aspect of childhood has become less authentically playful. Both trends highlight changes over time in the amount and type of play practiced by children and are often cited as consequences of generational shifts. Yet, research which analytically employs the concept of generation to connect changes to childhood with relevant social transformations is lacking. Inspired by Mannheim's conceptualisation of generations, this paper draws on life history interviews with 28 United Kingdom residents born between 1950 and 1994 to propose a fracturing of naturally occurring physical activity from childhood play. As shifts in childhood and parenting have become inextricably linked, this argument illustrates the impact of an intensification to parenting upon greater parental surveillance of increasingly organised forms of childhood physical activity at the expense of spontaneous play. Future physical activity policy should be sensitive to the social climate in which recommendations for children are made, as this places expectations upon parents due to how childhood is currently understood within neoliberal contexts. [ABSTRACT FROM AUTHOR]

The COVID‐19 crisis in the UK precipitated a sharp rise in the use of remote technologies to provide therapy during the lockdown. With mental health care services migrating to devices and video‐conferencing platforms, nearly all forms of therapy had become 'teletherapy'. Drawing on interviews with UK‐based practitioners, this paper explores how existing ideas of intimacy and presence are challenged when care is practiced at a distance. Against the background of concerns that remote technologies erode intimacy and degrade physical presence, the argument is made that presence, distance, intimacy and control are reconfigured within mediated therapy. Analysis of practitioners' experiences of teletherapy examines the material and expressive components of 'assemblages' characterised by their stable and fluid properties. Two assemblages are identified and discussed: emergency care assemblages and assemblages of intimacy, both of which are aligned with specific sectors of mental health care. Evidence that therapeutic encounters are constrained by technologies are considered alongside the material conditions and inequalities of vulnerable groups, while assemblages with relatively stable properties are generative of new ways of relating to clients online. These findings highlight the material and expressive components of human and nonhuman assemblages that create new kinds of affective relations in distanced care. [ABSTRACT FROM AUTHOR]

Currently dominant in medical discourse, the concept of self‐management sees the responsibility for health and illness shift from the state to the individual. However, while this emphasis on individual responsibility and management has burgeoned, the role and status of partners and other family members in the management of chronic illness remains under‐theorised. While self‐management privileges individual responsibility for the management of chronic illness, the role of partners remains unclear. This paper utilises data from a study of heterosexual couples' experiences of living with the chronic gynaecological condition endometriosis to explore how male partners engage in its day‐to‐day management. In all, 22 couples participated in in‐depth, semi‐structured interviews with each partner interviewed separately (n = 44). Data were analysed thematically and dyadically, informed by an interpretivist relational approach. The paper utilises the concept of healthwork to describe the illness work, everyday life work, biographical work and emotion work men engaged in. The paper demonstrates how the conceptual value of healthwork is enhanced by incorporating an analysis of the emotional effort required in managing chronic illness. The paper illustrates the value of investigating the role of partners in managing chronic illness to provide a fuller account of the distributed and relational nature of healthwork. [ABSTRACT FROM AUTHOR]

New medicines can transform routines and priorities in clinical practice, but how do clinicians think and feel about these changes, and how does it affect their work? In Australia, the HIV prevention regimen pre‐exposure prophylaxis (PrEP) has been rapidly rolled out, transforming the sexual cultures and practices of users, but less attention has been given to the ways PrEP has reconfigured clinical practice. This paper draws on 28 qualitative semi‐structured interviews conducted between 2019 and 2020 with PrEP‐providing doctors and nurses in Australia to consider how they have affectively engaged with PrEP and put it into practice. Through a reflexive thematic analysis, we explore how clinicians adapted to PrEP, how the field of HIV prevention has been transformed, and how these developments have changed how clinicians approach patients. While the introduction of PrEP was initially received with uncertainty and shock, clinicians described PrEP as enjoyable to prescribe, and better aligned with the moral duties of sexual health consultations than existing HIV prevention strategies like condoms. Through approaching clinical work as an 'affective practice', we argue for attending not only to how new interventions change expectations and practices, but also how these changes are felt and valued by clinicians. [ABSTRACT FROM AUTHOR]

Children and young people (CYP) with sickle cell disease (SCD) are a 'missing voice' in the debate on biography and sociology of chronic illness, meaning we know little about the social consequences of the illness for CYP. This paper examines the meaning of fatigue (a common symptom) for adolescents with SCD. Analysing 24 in‐depth interviews with adolescents aged 12–17 years in Ghana, we draw on the distinction proposed by Bury (1988) between 'meanings as significance' and 'meanings as consequence' to examine biographical aspects of fatigue. We argue that concepts of 'biographical disruption' and 'normal illness' do not easily accommodate the experience of CYP with congenital chronic illnesses like SCD, as their sense of (un)disruption and normality/continuity is contextualised relative to normative expectations about what it is to be a young person. At biographical transition points, illness/symptoms present from birth may evolve, shift and become experienced as 'new', 'different', or 'non‐normal'. They may become restrictive rather than continuous or disruptive. These experiences are influenced primarily by normative biographical expectations and the pursuit of identity affirmations. We propose that biographical restriction, biographical enactment, biographical abandonment and biographical reframing are more relevant concepts for understanding the experiences of CYP living with SCD. [ABSTRACT FROM AUTHOR]

Drawing on semi‐structured interviews with larger bodied patients (n = 20) and their healthcare practitioners (n = 22) in Canada, this paper combines micro and macro approaches in outlining a social justice approach to caring for larger patients in healthcare practice. Theoretically, we draw upon structural competency and critical consciousness to address the question of how social justice is enacted, experienced, and understood in interactions between clinicians and larger patients. Our findings highlight four key themes that provide a framework for integrating social justice into healthcare practice: (1) an awareness of one's simultaneous experience of marginalisation and privilege in the clinical interaction; (2) navigating between additive and interactive understandings of intersectionality; (3) micro and macro approaches to change; and (4) straddling the line between equity and equality. The synergies in participants' perspectives across social identities suggests that the cultivation of social justice awareness potentially mitigates some blinders of privilege. Furthermore, practitioners' social justice orientation positively impacted patient experience, with most patients expressing appreciation for having their various histories of trauma and social challenges handled compassionately during appointments. [ABSTRACT FROM AUTHOR]

This paper explores how young people who are living with a parent who is dying talk about the future. Drawing on a qualitative, interview study, I argue that young people are able to move imaginatively beyond the death of a parent, and in doing so, to maintain a sense of biographical continuity. While thinking about the future, most were able to generate an alternative to the 'harm story' typically associated with parental loss. Furthermore, the facility to engage with parental absence in the present enabled young people to make sense of living with dying, and gave meaning to their imagined futures. These findings suggest that young people's narratives of the future may act as a symbolic resource to draw on, albeit one requiring adequate material and social resources to construct. The paper extends the notion of continuing bonds derived from post‐bereavement accounts to suggest that relational experiences of the dead begin prior to bereavement, and may facilitate everyday living in anticipation of significant loss. Enabling young people to imaginatively explore the future may support them in getting by when they are living in these difficult family circumstances. [ABSTRACT FROM AUTHOR]

In recent years, increases in medical technologies in the critical care setting have advanced the practice of medicine, enabling patients to live longer while also creating dilemmas for end‐of‐life decision‐making. Clinicians have increasingly been called on to involve patients and family members in decision‐making through a process of shared decision‐making (SDM), yet less is known about how SDM plays out in the critical care setting and the ways in which clinicians engage in SDM. Using observational data from 14 months of ethnographic fieldwork in two intensive care units and interviews with 33 family members of 25 critically ill patients and 51 clinicians, I explore how clinicians refer to the choices available in medical decision‐making paradoxically as a 'buffet' of choice while they simultaneously recognise that such rhetoric is misaligned with complex and emotional decision‐making, often involving pain and suffering. Lastly, this paper considers the role of SDM and the ways in which clinicians push back on the 'buffet' rhetoric and engage in practices to guide families in end‐of‐life decision‐making by granting permission for families to make decisions and validating their decisions to decline treatment when there is an opportunity for more treatment. [ABSTRACT FROM AUTHOR]

Infertility is often recognised as a status that is medically identified in adulthood after unsuccessful attempts to conceive. This paper develops existing literature by illustrating how current conceptualisations of infertility do not incorporate a full range of experiences. Drawing on detailed, reflective diaries and in‐depth interviews with five participants, I explore how infertility is experienced and understood by women with variations of sex characteristics (VSCs) or intersex traits. I argue that greater consideration needs to be applied to intersex people and the circumstances of an infertility status that may be received in infancy, childhood or adolescence, before or outside of attempts to conceive, and without undergoing fertility treatment. Through discussions of time and futurity, this paper seeks to explore how visions of the future coalesce with an infertile status that is received in combination with an atypical sex status early in life. The paper indicates that early infertility can hinder some intersex children and young people's ambitions. However, infertility is not understood to be pathological or consistently prohibitive throughout the lives of everyone affected. Intersex women's conceptions of a potentially childless future are varied, complex, ambivalent and, in some cases, transitional throughout the life course. [ABSTRACT FROM AUTHOR]

Modern health‐care systems have customarily approached hepatitis C in ways that resemble the public health approach to HIV/AIDS known as 'HIV exceptionalism'. HIV exceptionalism describes the unusual emphasis on privacy, confidentiality and consent in approaches to HIV and was partly developed to address HIV/AIDS‐related stigma. In the case of hepatitis C, exceptionalist approaches have included diagnosis and treatment by specialist physicians and other 'boutique' public health strategies. The recent availability of highly effective, direct‐acting antivirals alongside goals to eliminate hepatitis C have heralded dramatic changes to hepatitis C health care, including calls for its 'normalisation'. The corollary to exceptionalism, normalisation aims to bring hepatitis C into routine, mainstream health care. This article draws on interviews with stakeholders (n = 30) who work with hepatitis C‐affected communities in policy, community, legal and advocacy settings in Australia, alongside Fraser et al.'s (2017, International Journal of Drug Policy, 44, 192–201) theorisation of stigma, and Rosenbrock et al.'s (1999, The AIDS policy cycle in Western Europe: from exceptionalism to normalisation. WZB Discussion Paper, No. P 99‐202) critique of normalisation to consider the perceived effects of hepatitis C normalisation. Stakeholders described normalisation as a stigma‐reducing process. However, they also expressed concerns about the ongoing stigma and discrimination that is not ameliorated by normalisation. We suggest that in centring normalisation, changes in health care may exaggerate the power of technological solutions to transform the meanings of hepatitis C. [ABSTRACT FROM AUTHOR]

A reticence on the part of women to disclose domestic abuse (DA) to family doctors, allied to front‐line responses that do not always reflect an understanding of the structure and dynamics of DA, hampers the provision of professional support. Using data from 20 qualitative interviews with women who have experienced DA, this paper explores their discourse about interacting with family doctors. It is the first study to explore firsthand accounts of these interactions through Dixon Woods' lens of candidacy. It finds disclosure to be inherently dynamic as a process and expands the candidacy lens by considering the: (i) conflicting candidacies of victims and perpetrators; (ii) diversionary disclosure tactics deployed by perpetrators and, (iii) the potential role of General Practitioner (GPs) in imagining candidacies from a structural perspective. By exploring the dynamics of disclosure through the concept of 'structural competency' it finds that in encounters with women who have experienced abuse GPs ineluctably communicate their views on the legitimacy of women's claims for support; these in turn shape future candidacy and help‐seeking. Greater GP awareness of the factors creating and sustaining abuse offers the potential for better care and reduced stigmatisation of abused women. [ABSTRACT FROM AUTHOR]

Given the considerable emphasis placed on informed choice, the management of health information has become an increasingly important part of living with chronic illness. This paper explores the intra‐familial dynamics of managing health information in the context of chronic illness. Drawing on 77 interviews with people affected by Multiple Sclerosis in the UK (patients, partners, family members and close friends), we show how families develop their own idiosyncratic information practices, including the careful, at times strategic, seeking, sharing and withholding of information. We describe how one individual, most commonly either the patient or their partner, often takes primary responsibility for managing growing quantities of health information. Doing this is a complex task, yet its dynamics within the family unit remain invisible and unacknowledged. In this paper we: (a) stress the importance of understanding information management in chronic illness as a collective process across all those affected, patients as well as carers; (b) conceptualise the process of managing health information in this context as 'health information work'; and (c) analyse it as part of the wider care practices families engage in and as a form of care in its own right. [ABSTRACT FROM AUTHOR]

The focus on patient autonomy in American and increasingly British medicine highlights the importance of choice. However, to truly honour patient autonomy, there must be both understanding and non‐control. Fifty‐eight semi‐structured in‐depth interviews were conducted with internal medicine physicians at three hospitals in the US and one in the UK. At hospitals where autonomy was prioritised, trainees equated autonomy with giving a menu of choices and felt uncomfortable giving a recommendation based on clinical knowledge as they worried that that would infringe upon patient autonomy. Employing Habermas's Theory of Communicative Action, this paper explores how physician trainees' communication practices of using purposefully graphic descriptions of resuscitation to discourage that choice prevent greater understanding and compromise non‐control. Central to this problem are also issues of colonisation of the life‐world by the system. Physicians are fully inculcated in their respect for autonomy but unintentionally resort to strategic forms of communication that prevent patients from adequately understanding their situation because trainees feel constrained against making recommendations. However, if the ideal of autonomy is to be realised, physicians might have to move towards practices that embrace a more authentic autonomy that fosters open communication that allows for co‐creation of consensus between doctors and patients. [ABSTRACT FROM AUTHOR]

This paper examines the impact of disruptions to the organisation and delivery of healthcare services and efforts to re‐order care through emotion management during the COVID‐19 pandemic in the UK. Framing care as an affective practice, studying healthcare workers' (HCWs) experiences enables better understanding of how interactions between staff, patients and families changed as a result of the pandemic. Using a rapid qualitative research methodology, we conducted interviews with frontline HCWs in two London hospitals during the peak of the first wave of the pandemic and sourced public accounts of HCWs' experiences of the pandemic from social media (YouTube and Twitter). We conducted framework analysis to identify key factors disrupting caring interactions. Fear of infection and the barriers of physical distancing acted to separate staff from patients and families, requiring new affective practices to repair connections. Witnessing suffering was distressing for staff, and providing a 'good death' for patients and communicating care to families was harder. In addition to caring for patients and families, HCWs cared for each other. Infection control measures were important for limiting the spread of COVID‐19 but disrupted connections that were integral to care, generating new work to re‐order interactions. [ABSTRACT FROM AUTHOR]

Genomic medicine has captured the imaginations of policymakers and medical scientists keen to harness its health and economic potentials. In 2012, the UK government launched the 100,000 Genomes Project to sequence the genomes of British National Health Service (NHS) patients, laying the ground for mainstreaming genomic medicine in the NHS and developing the UK's genomics industry. However, the recent research and reports from national bodies monitoring genomic medicine's roll‐out suggest both ethical and practical challenges for health‐care professionals. Against this backdrop, this paper, drawing on qualitative research interviews with general practitioners (GPs) and documentary analysis of policy, explores GPs' views on mainstreaming genomic medicine in the NHS and implications for their practice. Analysing the NHS's genomic medicine agenda as a 'sociotechnical imaginary', we demonstrate that whilst sociotechnical imaginaries are construed as collectively shared understandings of the future, official visions of genomic medicine diverge from those at the forefront of health‐care service delivery. Whilst policy discourse evokes hope and transformation of health care, some GPs see technology in formation, an unattainable 'utopia', with no relevance to their everyday clinical practice. Finding space for genomics requires bridging the gap between 'work as imagined' at the policy level and 'work as done' in health‐care delivery. [ABSTRACT FROM AUTHOR]

Amidst public health campaigns urging people to sit less as well as being more physically active, this paper investigates how older adults make sense of their sedentary behaviour. Using an accounts framework focusing on how people rationalise their sitting practices, we analysed data from 44 qualitative interviews with older adults. All interviewees had received information about sedentary behaviour and health, visual feedback on their own objectively measured sitting over a week and guidance on sitting less. Participants used accounts to position sitting as a moral practice, distinguishing between 'good' (active/'busy') and 'bad' (passive/'not busy') sitting. This allowed them to align themselves with acceptable (worthwhile) forms of sitting and distance themselves from other people whose sitting they viewed as less worthwhile. However, some participants also described needing to sit more as they got older. The findings suggest that some public health messaging may lead to stigmatisation around sitting. Future sedentary behaviour guidelines and public health campaigns should consider more relatable guidelines that consider the lived realities of ageing, and the individual and social factors that shape them. They should advocate finding a balance between sitting and moving that is appropriate for each person. [ABSTRACT FROM AUTHOR]

Analysing data from a nationally representative sample of 3442 interviews conducted in Egypt in 2020, this study examines the influence of four sets of factors in predicting compliance with the advice of healthcare professionals to combat the spread of COVID‐19: demographics, knowledge and values, fear of the disease and denial, and the pandemic as a foreign invasion. The findings show that a higher likelihood of compliance is linked to socioeconomic status, awareness of the pandemic, reliance on a plurality of information sources, adherence to liberal values, and fear of the disease, but being male, young, employed, religious, fatalistic, and in denial of the severity of the pandemic lower this likelihood – all consistent with the results reported in the literature. In addition, this study highlights the link between compliance and such attributes of nationalism as national identity, national pride, the perception of the pandemic as a national event, and the willingness to sacrifice one's human right to combat the spread of the disease. Drawing on these factors, this paper suggests building societal consensus around the theme of national unity against the microparasitic invasion is the key to an effective strategy to combat the spread of the virus. [ABSTRACT FROM AUTHOR]

Contemporary sociological work has emphasised that family is not static, but actively shaped by ideas of who and what makes family. Disclosure of an illness, including diagnosis of stigmatised infections such as HIV, hepatitis B virus and hepatitis C virus, can change the dynamics of family relationships. This paper draws on 61 qualitative semi‐structured interviews conducted between 2017 and 2019 with people in Australia with one or more of these blood‐borne viruses (BBVs) and their family members, to understand the experiences of serodiscordant (mixed viral status) families. Through a thematic analysis, we explore the family imaginaries that participants evoked when describing their disclosure practices in relation to (self‐defined) family members, revealing how some participants disclosed in ways that enabled them to shape their family, to maintain boundaries between self and family or to protect family from distress. Participants' accounts of disclosure to family revealed imaginaries of family as a precious web of connections to be nurtured or protected, but also as sites of ambivalent belonging and complex history. We conclude that BBV disclosure practices within families reveal important ideas about families that are imagined in response to the threat of loss, change and stigma. [ABSTRACT FROM AUTHOR]

Medically unexplained symptoms (MUS) are persistent bodily symptoms without known pathology. An unofficial term has recently emerged in Taiwan to accommodate MUS: autonomic imbalance (AI). AI literally refers to disturbances of the autonomic nervous system (ANS) that innervates vital organs. However, AI is variously conceptualised by different parties. This study intends to investigate what is in the name of AI. It draws on available databases and in‐depth interviews with AI sufferers and Western and Chinese medicine physicians. Some physicians research ANS functions through heart rate variability measurements. Research findings show that physicians regard AI as a convenient term for clinical communication and a euphemistic substitute for MUS or even psychiatric diagnoses. It is not a 'real thing'. However, AI sufferers treat AI as a bona fide disease, only that it has not been officially classified. AI is therefore an unfaithful translation, or an uncontrolled equivocation, of MUS. The paper concludes by discussing the implications of treating AI as an equivocation. These implications include the limitations of the current diagnostic criteria, the necessity to rethink the dichotomy of mind and body, and the underlying realities exposed or masked by 'diagnosis'. [ABSTRACT FROM AUTHOR]

The materialist thread within health sociology has observed a clear gradient linking inequalities in health with measures of social class and poverty. More recently, Bourdieu's approach to social class complemented the 'economic capital' of Marxist analysis with 'symbolic' capitals such as 'social' and 'cultural'. However, efforts to assess how symbolic capital interacts with health disparities reveal complex or contradictory effects. In this paper, we re‐materialise the study of health and social position via a new materialist focus on the interactions between humans and non‐human matter (NHM). We analyse empirical data to disclose the range of human/NHM interactions in daily life, and how these affect people's health status. These interactions establish physical, psychological and social opportunities and constraints on what human bodies can do, contributing to relative advantages and disadvantages. We argue for a revised materialist understanding of sociomaterial position as constituted by a 'thousand tiny dis/advantages', and suggest that health and wellbeing are inextricably linked to dis/advantage. [ABSTRACT FROM AUTHOR]

Mobile health (mHealth) technologies for HIV care are developed to provide diagnostic support, health education, risk assessment and self‐monitoring. They aim to either improve or replace part of the therapeutic relationship. Part of the therapeutic relationship is affective, with the emergence of feelings and emotion, yet little research on mHealth for HIV care focuses on affect and HIV testing practices. Furthermore, most of the literature exploring affect and care relations with the introduction of mHealth is limited to the European and Australian context. This article explores affective dimensions of HIV self‐testing using a smartphone app strategy in Cape Town, South Africa and Montréal, Canada. This study is based on observation notes, 41 interviews and 1 focus group discussion with study participants and trained HIV healthcare providers from two quantitative studies evaluating the app‐based self‐test strategy. Our paper reveals how fear, apathy, judgement, frustration and comfort arise in testing encounters using the app and in previous testing experiences, as well as how this relates to care providers and test materials. Attending to affective aspects of this app‐based self‐testing practice makes visible certain affordances and limitations of the app within the therapeutic encounter and illustrates how mHealth can contribute to HIV care. [ABSTRACT FROM AUTHOR]

Internationally, there has been substantial growth in temporary working, including in the medical profession where temporary doctors are known as locums. There is little research into the implications of temporary work in health care. In this paper, we draw upon theories concerning the sociology of the medical profession to examine the implications of locum working for the medical profession, healthcare organisations and patient safety. We focus particularly on the role of organisations in professional governance and the positioning of locums as peripheral to or outside the organisation, and the influence of intergroup relationships (in this case between permanent and locum doctors) on professional identity. Qualitative semi‐structured interviews were conducted between 2015 and 2017 in England with 79 participants including locum doctors, locum agency staff, and representatives of healthcare organisations who use locums. An abductive approach to analysis combined inductive coding with deductive, theory‐driven interpretation. Our findings suggest that locums were perceived to be inferior to permanently employed doctors in terms of quality, competency and safety and were often stigmatised, marginalised and excluded. The treatment of locums may have negative implications for collegiality, professional identity, group relations, team functioning and the way organisations deploy and treat locums may have important consequences for patient safety. [ABSTRACT FROM AUTHOR]

Research on patients' choice of healthcare practitioners has focussed on countries with regulated and controlled healthcare markets. In contrast, low‐ and middle‐income countries have a pluralistic landscape where untrained, unqualified and unlicensed informal healthcare providers (IHPs) provide significant share of services. Using qualitative data from 58 interviews in an Indian village, this paper explores how patients choose between IHPs and qualified practitioners in the public and formal private sectors. The study found that patients' choices were structurally constrained by accessibility and affordability of care and choosing a practitioner from any sector presented some risk. Negotiation and engagement with risks depended on perceived severity of the health condition and trust in practitioners. Patients had low institutional trust in public and formal private sectors, whereas IHPs operated outside any institutional framework. Consequently, people relied on relational or competence‐derived interpersonal trust. Care was sought from formal private practitioners for severe issues due to high‐competence‐based interpersonal trust in them, whereas for other issues IHPs were preferred due to high relationship‐based interpersonal trust. The research shows that patients develop a strategic approach to practitioner choice by using trust to negotiate risks, and crucially, in low‐ and middle‐income countries IHPs bridge a gap by providing accessible and affordable care imbued with relational–interpersonal trust. [ABSTRACT FROM AUTHOR]

Transitions into informal care roles are associated with various characteristics, for example gender and geographic proximity, but such associations are insufficient to explain role delegation, overlooking the interpersonal structure–agency nexuses that constitute role trajectories. This paper explores unequal role delegation within 7 families affected by dementia, presenting data from interviews with 7 people with dementia and 26 carers living in the community in the United Kingdom. Two key care roles are identified: the relatively un‐involved role of peripheral actors and the lynchpin role of main carers who take on most of the care tasks. These roles emerge from negotiations around a range of extraneous factors that collectively comprise cumulative baggage, including historic conflicts and childcare commitments. The unequal distribution of care reflects widely noted demographic associations with role delegation, but is enacted and justified through the interpersonal negotiation of personalised meanings regarding individual circumstances and suitability. Though deeply personal when taken at face value, these meanings imbibe sociocultural norms and political economies of care to structurally position family members in relation to each other and signpost appropriate candidates for caring roles, even before such care is required. [ABSTRACT FROM AUTHOR]

Students' use of prescription stimulants to enhance study performance is increasingly under the spotlight. Medical guidelines discourage general practitioners (GPs) from prescribing stimulants to students without a diagnosis; yet a considerable proportion of students acquire them from GPs. Building on Eisenberg's theoretical framework on clinical decision‐making and Conrad's sociological concept of biomedical enhancement, this study examined the social context of GPs' off‐label prescribing decisions for stimulants, using data from 21 semi‐structured interviews, including vignettes, undertaken with Flemish GPs. Results identified two groups of GPs: (1) hard‐liners who strictly follow medical guidelines and who would only prescribe in case of an appropriate diagnosis and (2) context‐dependent GPs who would prescribe stimulants depending on the patients' symptoms and extent of need. GPs' decisions depend on one‐on‐one doctor‐patient interactions (i.e. the extent of empathy from the doctor and the extent of assertiveness from the patient); the extent to which GPs define concentration problems as medical problems; GPs' interactions with fellow health care workers; as well as GPs' interaction with the wider community. By disentangling these influences, this paper advances both theoretical and practical understanding of the sociological context in which GPs' off‐label prescribing behaviour occurs. [ABSTRACT FROM AUTHOR]

Parkinson's disease ( PD) presents as an illness which predominantly affects older men. However older men's lived experiences of PD, including how they are influenced by age and gender relations has seen little empirical study. Drawing on Watson's male body schema, this paper explores how men engage with masculinities and ageing in order to make sense and meaning from PD. Data is presented from 30 narrative and semi structured interviews with 15 men of various ages who were living with PD. Findings suggest that PD threatens a visceral embodiment located in the body's basic movements and intimate functions; a pragmatic embodiment expressed through men's everyday occupations and an experiential embodiment concerned with emotions and sensations felt within and through the body. In addition, each dimension of men's embodiment also intersected with the ageing process, a process also shaped in turn by broader social and cultural concerns regarding the positions and possibilities of men's lives as they move through the life course. This paper concludes by discussing the implications of gender and ageing in understanding men's experiences of PD [ABSTRACT FROM AUTHOR]

When a baby is diagnosed with a condition needing surgery they, and their family, start down an uncertain and unknown path. Living with uncertainty underpins every stage of the journey from hospital to home. These journeys span the highly technical to the mundane. They are likely to involve, at crucial points, medicalised and specialised neonatal and surgical care in paediatric centres of excellence where parents are mere spectators. Yet ultimately parents are able to take their baby home, confident experts in their daily care. Drawing on narrative interviews with 42 UK parents whose baby underwent neonatal surgery, this paper explores how parents navigate this uncertainty through acquiring experiential and lay knowledge and developing expertise in their baby's condition and treatment options. These conditions are rare. Building on sociological understandings of the work of chronic illness, as well as more recent work on newborn screening, sharing information online and examinations of experiential knowledge, we explore lay knowledge and expertise as it intersects with biomedical and surgical frontiers. We demonstrate how the development of expertise is an emergent, three‐stage process supported by both biomedical and lay knowledge and elucidate this process of knowledge‐building as a scaffold through which to manage uncertainty. [ABSTRACT FROM AUTHOR]

The concept of biographical disruption has been used to explain the experience of a cancer diagnosis. Studies on cancer experience increasingly suggest that people diagnosed in older age may not have such disruptive experiences. Prostate cancer is diagnosed more often in older men and is often considered a disease of old age; furthermore, the signs of illness in prostate cancer and the signs of ageing might become convoluted. With this in mind, this paper aims to explore how 42 men with prostate cancer who participated in an interview study respond to and make sense of bodily changes. The sample was selected using a maximum variation strategy in order to describe a range of possible experiences with prostate cancer. Analysis was conducted thematically. The men's narratives tell of the constant process of dealing with ageing‐related and/or cancer‐related changes to both their bodies and their social interactions, and their struggle to disentangle the related effects of ageing and/or cancer on their bodies. We describe how men "muddle through" problems of urinary leakage, potency and loss of libido. We then identify how men attributed changes as part of ageing and/or cancer to (better) manage the experiences of loss. [ABSTRACT FROM AUTHOR]

The power of social actors to drive or block pharmaceutical uptake has been a concern in sociological debates on pharmaceuticalisation, including in the case of pandemic vaccination. We build on Steven Lukes' three‐dimensional view of power to explore the 2009 H1N1 pandemic vaccination in Sweden and Denmark – two similar countries that arrived at conflicting vaccination strategies. Drawing on interviews with members of each country's pandemic steering group and on document analysis, we explore three consecutive stages of pandemic vaccination response: planning, vaccine procurement and the vaccination campaign. The paper makes two contributions to studies of pharmaceuticalisation and pandemics. Conceptually, we advocate the suitability of Lukes' framework over the 'countervailing powers' framework repeatedly used to model power in the pharmaceutical field. Empirically, our study confirms that government‐appointed experts steered pandemic planning in both countries, but we show that the state, industry and the WHO also exerted power by enabling and constraining experts' decision‐making, including by keeping some information secret. Furthermore, we argue that mass vaccination in Sweden was a pervasive expression of state power, in Lukes' sense, since it rested on keeping latent the tension between many individuals' health interests and the state's interests in protecting social and economic functioning. [ABSTRACT FROM AUTHOR]

This paper draws on the work of Giorgio Agamben to understand how the social organisation of care transitions can reduce people to their 'bare' life thereby making harmful and degrading treatment seemingly legitimate. The findings of a 2‐year ethnographic study show how some people experience hospital discharge as undignified, inhumane and unsafe process, expressed through their lack of involvement in care planning, delayed discharge from hospital and poorly coordinated care. Our analysis explores how these experiences stem from the way patients are constituted as 'unknown' and 'ineligible' subjects and, in turn, how professionals become 'not responsible' for their care. The result being that the person is reduced to their 'bare' life with limited value within the care system. We suggest that the social production of 'bare life' is an inadvertent consequence of reconciling and aligning multiple disciplines within a complex care system. [ABSTRACT FROM AUTHOR]

In this article, I contribute to the literature around interagency collaboration, especially between law enforcement and health care, by reconciling the previous work of Sarah Charman (2014) with the interprofessional teamwork literature. Drawing upon a semi‐structured interview‐based study with 20 custody nurses working in English police custody suites (analysed using Framework Analysis), I explore the ways they are able to achieve interagency collaboration with a particular police officer, the Desk Sergeant. I argue that nurses accomplish interagency interoperability by interacting regularly with the Desk Sergeant, anticipating their needs and limiting their own goals to those that are commensurate with the Desk Sergeant's, notably providing information and avoiding deaths in custody. Such practices are similar to the strategies of 'Cultural Interoperability' noted by Charman (2014); however, this study also identifies that such strategies are only available once a successful working relationship has formed between Desk Sergeant and nurse, and as a result, similarly to the findings of interprofessional teamwork studies, the success or failure of attempts to collaborate across agencies is underpinned by interpersonal relations. The paper concludes by commenting on the importance of analysing both the interpersonal and organisation levels when studying collaboration. [ABSTRACT FROM AUTHOR]

Family carers affected by violent, abusive or harmful behaviour by the older person for whom they care face social and epistemic challenges in developing and sharing knowledge about their experiences. These difficulties have contributed to a situation in which there is a paucity of evidence and public discourse about how we understand violence and harm instigated by people who have care needs or are 'vulnerable'. This paper reports the findings of a qualitative study that involved 12 in‐depth interviews with female carers affected by violence, abuse or harm. The study was informed theoretically by Miranda Fricker's concept of epistemic injustice which was used as a framework for analysis. There were two principal findings: (1) Carers were sensitive to anticipatory stigma and loss of moral autonomy. As a result, they self‐censured what they shared and, at times, were met with subtle but powerful processes of silencing. (2) Carers had limited linguistic and conceptual resources to explain the emotional and social aspects of the harm they experienced, exacerbated by implicit social norms about the 'private' and gendered nature of familial care. To conclude, we discuss the implications of these findings for sociological research and health and social care practice. [ABSTRACT FROM AUTHOR]

Moving away from paternalism to more equal forms of interaction in the patient–doctor relationship has been seen in positive light by policymakers, patients' rights advocates and scholars alike. Nonetheless, against the background of commercialisation and consumerism, empirical research showcases how reduced asymmetries bring in tensions and friction between patients and doctors (Greenfield et al. 2012). This paper contributes to the discussion through the examination of the patient–doctor relationship in the niche setting of private transnational healthcare markets which involve patients travelling overseas for care and where commodification, consumerism and care go hand‐in‐hand. It is geographically focused on two large cities in South‐Eastern Europe as settings where health care is provided to foreign patients – Athens and Istanbul – and empirically draws on qualitative interviews with doctors who run small/medium practices. The findings highlight that, despite excessive consumerism, power asymmetries are not mitigated but patient vulnerability shapes the patient–doctor relationship. In the transnational context, the patient faces an additional source of vulnerability: a condition of foreignness. As such, the findings stress that one relationship model (the consumerist) does not, per se, replace an older one (e.g. the Parsonian). Instead, the consumer–provider dimension co‐exists with the client–expert, patient–doctor and, finally, host–guest relation. [ABSTRACT FROM AUTHOR]

This article uses a socio‐material approach, social practice theory, to provide new insights into the self‐management of chronic illness. It demonstrates how this theory can bridge arguments about the respective roles of social and individual influences, and how it can foreground an oft‐overlooked aspect of the issue – the demands of self‐care technologies and consequences for participation in social life. Drawing on interviews and focus groups with 25 young type‐1 diabetes outpatients in London, UK, the study points to the conflicts that occur when disease management technologies compete for time and space with the social practices of everyday life, and when self‐care tasks threaten to interrupt the flow of social life and make people feel 'left behind'. The paper concludes that young people are disabled by the contingent position of self‐care activities in daily life, which oblige them to compromise either their physical health or their immersion in the social world. This disabling effect would be mitigated if social practices were reorganised to make them more amenable to the time‐space requirements of disease management. A social practice theory lens can help throw light onto this issue and make a valuable contribution to the study of the self‐management of chronic illness. [ABSTRACT FROM AUTHOR]

This paper examines how people with chronic illnesses respond to absences of continuity and coordination of care. Little work has been done on how the ill person might mitigate flaws in a less than optimal system. Our qualitative research, carried out among 91 participants in Australia, reveals that people with chronic illnesses create strategies to facilitate the management of their care. These strategies included efforts to improve communication between themselves and their health care practitioners; keeping personal up-to-date medication lists; and generating their own specific management plans. While we do not submit that it is patients' responsibility to attend to gaps in the health system, our data suggests that chronically ill people can, in and through such strategies, exert a measure of agency over their own care; making it effectively more continuous and coordinated. Participants crafted strategies according to the particular social and bodily rhythms that their ongoing illnesses had lent to their lives. Our analysis advances the view that the ill body itself is capable of enfolding the health system into the rhythms of illness - rather than the ill body always fitting into the overarching structural tempo. This entails an agent-centric view of time in illness experience. A Virtual Abstract of this paper can be found at: [ABSTRACT FROM AUTHOR]

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

Using data collected through semi‐structured interviews and focus group discussions with 37 adult men living in Brunei Darussalam, this paper explores how masculinities and expectations about male roles across the life course influence men's perceptions, of and attitudes towards health and health help‐seeking behaviour. Bruneian men gave accounts that consistently spoke of a series of masculine roles and associated attributes and behaviours, which mapped across the life course. Men described health and the steps that they had taken to protect their health in terms of responsibilities associated with being a breadwinner, provider of support for parents, role model and leader of the family. Whilst adherence to Bruneian norms about masculinity could obstruct men's engagement with health help‐seeking, we also found that men mobilised their understanding of Bruneian masculinity such that it provided culturally legitimate way of engaging in health help‐seeking. We conclude by considering implications for further development of conceptualisations of masculinities, particularly responding to the call to consider Connell's theory of 'hegemonic masculinity' in the context of the Global South. We also consider the implications of the findings of this research for policy and practice in provision of health promotion and services in Brunei. [ABSTRACT FROM AUTHOR]

With the human papillomavirus (HPV) vaccine positioned as the "right tool" to protect girls' health and sexual health, public discourse positions parents as "responsible" if they vaccinate, "irresponsible" if they do not. The problem with this binary, however, is that it cannot account for the full spectrum of responsibilities and social norms that parents enact in vaccine decisions. In this paper, and in the context of low HPV vaccination rates, I confront this binary and encourage a fuller view of adolescent health and sexual health. Using data from qualitative semi‐structured interviews with 28 Canadian mothers tasked with consenting to the HPV vaccine, I examine the complexity of this responsibility. I find HPV vaccine‐consenting mothers have normative conceptualisations of responsibility aligned with dominant interpretations of public health. Rather than expressing irresponsibility, some non‐HPV vaccine‐consenting mothers articulated alternate responsibilities, aligned with broad efforts to manage their teens' sexual health and sexuality. They extend responsibility beyond cancer protection vis‐à‐vis vaccines to a general responsibility for daughters' sexual health and self‐esteem. In conclusion, I recommend the need for a broader public health approach to HPV, which includes, and goes beyond vaccination. Moreover, I suggest that some of these alternate responsibilities be viewed as complementary to vaccination. [ABSTRACT FROM AUTHOR]

Contributing to critical digital health research and the sociology of health consumption, this study investigates the phenomenon of self‐tracking and interpretation of consumer data via wearable technology and mobile fitness software applications (apps). It critically analyses qualitative data collected from members of running communities in the UK who are heavy users of apps and wearables. The study seeks to understand the meaning and practise of long‐term use of apps and wearables targeted at consumers interested in tracking fitness, and the collection of personal health information over time. The paper offers an interpretative perspective on runners as performance‐seeking fitness consumers engaged in long‐term self‐management of health. These consumers are driven by a profound motivation to visualise and embody a long‐term state of fitness. Participants were also hyper‐aware of advertising and promotional methods used to engage consumers. The findings raise concerns about the validity of personal fitness data, and how its collection promises improved personal health while visually promoting sought‐after fit bodies. Further research is required to understand the transformative impact of fitness‐tracking and how individuals negotiate personal classifications of health. [ABSTRACT FROM AUTHOR]

This study explores the social organisation of risk within online drug‐related communities. Drawing on in‐depth interviews with participants from two Norwegian Internet drug forums, the paper illustrates how participation in such forums influenced notions of risk, and how it supported notions of participants as being informed, responsible and empowered. First, the forums facilitated an easy exchange of user‐generated drug information, which helped members present themselves as informed and competent. Second, members used the communal resources on the forums to negotiate their drug‐using identities, in which they resisted stigma and argued for a responsible drug‐using identity. Third, the social inclusion and sense of community within the forums formed the basis for collective support, which helped empower those involved. Conceptualised as community‐consumerism, these findings highlight the social mechanisms involved in the information self‐sufficiency and decentralisation of authority on the Internet, in which members created an alternative frame of reference for drug use and associated health. The concept of community‐consumerism offers a perspective on the social organisation of risk within online communities and ought to be of relevance for future studies on online health‐related discourses, not only those related to drugs. [ABSTRACT FROM AUTHOR]

Tumour genetics is currently turning into a massive clinical approach. This paper is an enquiry into its practices as they expand beyond expert and experimental contexts and become routinised in clinical hospital settings. Studying a French university hospital, we unpack the content and everyday organization of diagnostic labour in this context. Exploring the sociotechnical frictions that arise in the process, we describe the ways in which they are collectively controlled, and stabilized through organizational fictions, that are instrumental in making tumour genetics doable in the hospital, at a large scale. We further show that the new role of external regulations in the production of clinical values for mutations has a strong impact on diagnostic work, making it possible to be performed locally without resorting to expert bioclinical collectives, and outside the professional jurisdiction of clinical geneticists. This division of labour appears as a necessary condition for the rise in clinical productivity required by a new function assigned to genetics: to guide the prescription of drugs for common diseases. This turn in the way genetics is embedded in the clinic calls for a thorough reassessment of its impacts on clinical discourses, practices and decisions. [ABSTRACT FROM AUTHOR]

The prescribing of high‐cost cancer medicines at the end of life has become a focus of criticism, due primarily to concerns about the safety, efficacy and cost‐effectiveness of these medicines in this clinical context. In response to these concerns, a number of interventions have been proposed – frequently focused on improving physician–patient communication at the end of life. Underpinning these strategies is the assumption that the prescribing of high‐cost cancer medicines at the end of life is primarily the result of poor communication on the part of cancer physicians. In this paper, we explore the factors perceived by cancer physicians to be driving the use of high‐cost cancer medicines at the end of life. Drawing on semi‐structured interviews with 16 Australian oncologists and haematologists, we demonstrate that these physicians believe that the use of high‐cost medicines at the end of life is driven by multiple factors – including individual, interpersonal, socio‐cultural and public policy influences. We conclude that these factors, and their interactions, need to be taken into account in the development of public policy and clinical interventions to address the use of high‐cost medicines at the end of life. [ABSTRACT FROM AUTHOR]

The MERIDIAN study examined whether in‐utero MRI (iuMRI) improves the accuracy of diagnosis of foetal brain abnormalities, when used as an adjunct to ultrasound anomaly scanning. A diagnostic iuMRI differs from routine ultrasound screening because of its infrequent use and scanning procedure. Nested within this trial, this sociological study explored the acceptability of iuMRI as a technology and its contribution to parental decision‐making. Our sociological interpretation of the role of iuMR images in prenatal diagnosis draws on narrative interviews with women (and some partners) who underwent MRI imaging at three different centres. Overall, participants found iuMRI helpful in decision‐making because it either confirmed or disconfirmed previous results, or provided additional information. Expectant couples experienced the iuMR imaging process as informative, but also as having emotive and practical value. Our paper extends the existing sociological literature on antenatal testing and visualising the foetus, by using iuMR diagnostic imaging to further explore the concept of the unborn entity. Our data suggest that alongside the iuMR images, the 'parental gaze' and accompanying commentary are used by parents to construct and transform foetal and parental identities despite ongoing uncertainties about, and shifting social contexts to their pregnancy. [ABSTRACT FROM AUTHOR]

Abstract: E‐cigarettes are devices through which a nicotine solution is ‘vapourised’ and inhaled by the user. Unlike cigarettes, the process involves no tobacco combustion. However, the inhalation and exhalation of vapour is reminiscent of smoking and there is debate about the possible harms and benefits of e‐cigarette use, including the ‘renormalisation’ of smoking. Despite these debates, there has been little exploration into the embodied and semiotic similarities between smoking and vaping. This paper views the practices of vaping and smoking through the lens of performativity that is, the accumulation of meaning associated with the habits over time and space. Through in‐depth interviews, we explore how young adults from primarily disadvantaged areas in Scotland, understand the similarity in practices between smoking and vaping. Participants talked about financial barriers to using different types of e‐cigarettes, and how their use reflected their views on smoking cessation. They also discussed the embodied similarities between smoking and vaping, with divergent opinions on whether this continuance of habit was beneficial or not, revealing still developing and ambiguous norms around performativity. The norms of vaping were also frequently discussed, with participants’ experiences and views reflecting the contested position of vaping in an environment where cigarette smoking is denormalised. [ABSTRACT FROM AUTHOR]