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Theoretical perspectives (ATF, Lerner & Keltner, 2000, 2001) on emotion and risk- taking posit that differences in risk-propensity and risk choice between angry and anxious individuals can be predicted on the basis of the appraisal dimensions which define these emotions. The thesis aimed to test these predictions across three studies of trait emotions, incidental affective states and integral emotions. Study one examined differences in reported risk-taking between trait angry and trait anxious individuals. A large scale study (N = 1961) was conducted which saw the development and validation of the General Risk Accessibility and Behaviour scale (GRAB); differences between trait angry and trait anxious were then assessed in terms of current risk-taking behaviours. Findings indicated a reliable and stable factor structure as well as strong construct validity of the GRAB. Hypotheses were partially supported insofar as trait anger was found to be more strongly associated with risk- taking than trait anxiety. However, trait anxious individuals were found to take greater dietary risks than trait angry individuals and were also found to demonstrate positive associations with risk-taking with regards to health-threatening behaviours. Study two focused on the manipulation of immediate anger and anxiety during an emotional Stroop task in order to assess whether angry and anxious individuals differed in their attentional bias towards risk-related stimuli. No Stroop effect however, was demonstrated. Possible explanations were offered in terms of distraction effects caused by the manipulation techniques. Difficulties encountered with the emotion manipulations during study two, prompted the need for a more naturalistic method for inducing emotions. The final study therefore aimed to test ATF predictions in a more naturalistic context. The use of the Leeds Advanced Driving Simulator (LADS) enabled manipulations of immediate integral emotions based upon other driver behaviour. Findings from the final study demonstrated that angry drivers drove at faster speeds and demonstrated shorter time headway and shorter time to collision compared to fearful drivers during the lane drop and contraflow scenarios. However, fearful drivers were found to drive faster throughout the narrow lanes scenarios. Overall the thesis provides partial support for the Appraisal Tendency Framework (Lerner & Keltner, 2000, 2001) in predicting differences in risk-taking between angry and anxious individuals. Implications and directions for future research are discussed.

Despite the prevalence of mental health problems in the United Kingdom, there is a disparity between the number of individuals suffering with such difficulties and those that seek professional psychological help. Specifically, young adult men account for the least frequent users of psychological services. A wide body of literature has found that men's reluctance to seek help is associated with traditional masculine ideologies. The present research aimed to investigate this further by asking how a sample of young adult men from London and the surrounding boroughs constructed psychological helpseeking and masculinity, and the implications these had for their subject positioning and help-seeking practices. The research adopted a qualitative methodology, incorporating a social constructionist paradigm. Semi-structured interviews were conducted with ten men aged 18-25 years old. The participants were predominantly white British, and had no mental health problems or previous experience of psychological service use. An integrative form of discourse analysis was carried out, which drew on discursive and Foucauldian features to explore the different interpretative repertoires, ideologies and subject positions that were available for the participants to work up in their talk. It was found that the men in the sample drew on a number of interpretative repertoires in order to construct help-seeking, and also constructed particular masculine identities within which to position themselves and others. Specifically, psychological helpseeking presented some ideological dilemmas to the men in the sample, where they risked being positioned as abnormal within society or weak, feminine men. The participants discursively managed this by drawing on several discursive strategies and discourses of 'macho' men who are brave to seek help, and 'new' men who are comfortable with expressing their emotions. It was concluded that this enabled psychological help-seeking to become a legitimate practice. However, it was also discussed how the dominance of traditional hegemonic masculinity constrained the way in which these men were able to construct psychological help-seeking. The findings of the present study contribute to therapists' awareness of masculinity-related issues with their male clients, and also inform the way psychological services could be marketed to men. The findings also provide support to the literature that has criticised and extended Connel's (1995) theory of hegemonic masculinity.

This thesis is an exploration of the concepts of knowledge, sociality and relatedness amongst the Nivacle indigenous people of the Paraguayan Chaco, concentrating particularly on the community of Jotoicha in the Mennonite Colonies of the Central Chaco region. A central issue in this thesis is the concept of "knowledge" as a relational capacity and the ways in which knowledgeable behaviour can be constitutive of aesthetically pleasing forms of sociality. Such practices can be generative of increased similarity between individuals over time. The thesis begins with an exploration of Nivacle understandings of "knowledge" and shows it to be an eminently social concept that is created in an organ located in the stomach known as the cachi. "Knowledge" for the Nivacle is the basis for an individual's social conscience, their productive and reproductive skills, as well as their inter-personal relationships. "Knowledge" is also a central aspect of Nivacle understandings of relatedness. Rather than being based on a static genealogical structure, relatedness is best understood within the context of lived relationships that are constantly evolving. These relationships are generated through the practices of feeding and caring for one's "close" kin, with such practices also being generative of sociality itself. However,"close" relationships are neither static nor geographically bounded and are always open to the possibility of re-activation through visiting and gift giving. The Nivacle have been inserted into the market economy for several decades. Wage labour is conceptualised alongside other "subsistence activities" and productive activities are generative both of gender relations and sociality itself. In the final chapter I discuss Nivacle notions of reciprocity within the context of team-based sporting events. I show that whilst such community-based divisions appear to be premised on relations of "sameness" and "difference," they are best understood within the context of an overarching desire for people to generate similarity between different kinds of people in a variety of contexts.

Background: Polypharmacy has been defined as taking four or more daily prescription medicines. Reviews were introduced by the Scottish Government (2012) with the purpose of these reviews being to undertake a person centred seven step review to aim for optimal polypharmacy where the risks and benefits of medicines are assessed so that the process cannot be protocolised. Aim: This was a multisite ethnography to understand to understand patients, healthcare professionals and carers' perceptions and experiences of polypharmacy medication reviews for patients with multimorbidity. Methods: This multisite ethnography took place in two health boards and four GP practices across Scotland, who were early adopters of the policy on delivering polypharmacy reviews using a multidisciplinary team (MDT). The analysis draws on Abbotts (1988) theory of jurisdictional boundaries, sociological theories of professional boundaries (Fournier, 2000; Strauss 1978; Nancarrow and Borthwick, 2005) and how work is transferred and negotiated between professionals and Lipsky's (2010) concept of street level bureaucracy. Results: In both health boards, the drivers for the reviews were safety, quality and financial drivers and the priority of these changed over time and strongly influenced by medical or finance senior managers. Implementation of policy was felt to take time, because of the complexity of implementing new kinds of team working and so there was a view that policy should be in place for longer. When protocol led work is transferred from the more dominant profession there is horizontal transfer of the work. This research was to understand how autonomous work that provides professional status and prestige is transferred from one professional group to another in the context of polypharmacy reviews that requires autonomous decision-making. How policy was implemented in practice varied being adapted to address local issues, with GPs having more influence over this than other healthcare professionals. The reviews across the practice were always pharmacist led but there was variation in the autonomy given to pharmacists to make decisions and role of the geriatrician, GP and pharmacist MDT review depending on the patient group. The pharmacist doctor boundary is still evolving but has been accelerated in the local arena by workforce pressures to manage patients with complex medication issues and to work autonomously to make decisions for these patients despite the publically maintained position that the pharmacist undertakes routine reviews. Many doctors were inviting pharmacists to do the work, and while most of the work was transferred through horizontal substitution, some GPs tried to maintain supervisory activity so introducing the concept of "diagonal transfer" to explain the substitution. The conceptual models provide a framework to understand how autonomous work is being transferred between doctors and pharmacists leading to substitution of this work, accelerated by increased workload, as well as geriatricians and pharmacy technicians. Patients thought reviews were to address active medication-related problems rather than prevention of medication-related harm. The most important factor to patients was that they had a relationship with the professional doing the review, that they were listened to, and that there was continuity of care. GPs could influence public and cultural acceptance of pharmacists' role in some practices. Conclusion: The pharmacist doctor boundary is still evolving and is likely to change in both the local and public arena. The acceptance of the pharmacists' role in primary care changed after patients had seen the pharmacists and this may affect wider public and cultural acceptance of the pharmacists' role as the lead in the polypharmacy reviews with GPs and geriatricians adopting an advisory role.

Background: This thesis explores routine social care data collection and management processes resulting from the Scottish Government's strategic vision for 2020 and the formal implementation of health and social care integration. Key to this strategy is the initiative to use routinely collected social care data to evaluate services and also to combine these data with health care information in order to inform service access, use comparison and future planning. In stark contrast to healthcare information, social care data has not been formally evaluated to date. This thesis addresses the disparity in knowledge and understanding between the two organisations. The overall aims were to build a comprehensive understanding of how social care data materialises; how data are collected, coded, shared and managed. Method: A multiple-site ethnography incorporating semi-structured interviews, non-participation observation and supporting documentary analysis were used to capture routine practices of social care staff holistically and contextually from the perspective of the people themselves. Data were collected from 29 participants over an 18 month period then transcribed verbatim and uploaded to Nvivo© 11 software programme for coding, synthesising and data management. Analysis proceeded interpretively and in parallel with ongoing interviews and observations and was informed by drawing from the theoretical framework of actor-network theory and the sociology of the professions. Findings: Field sites revealed a broad but common framework of legislated mandates which authorised staff to gather information, although local variations in forms and procedures were noted across regions. Analysis revealed 4 overarching themes of influence (Data processes, IT Systems, Organisational Systems, Inter/intra-professional relations). From these, some overlapping concepts were recognised as having a significant bearing on day to day operations and practices: Leadership/Management, Philosophies and Standardisation. This intricate blend of inter-related issues highlights the messiness and multi-dimensional measures at force in complex organisations such as health and social care. Conducted on the cusp of health and social care integration formally going live during 2016, this thesis provides a new body of knowledge to data processes and is one of the first of its kind to evaluate social care data in the UK - from origins to output. In consideration of findings from this study, there are consequences with regard to policies, procedures, education and training that could serve as further stimuli to aid direction to absolute integration.

This research was undertaken to investigate Chinese herbal medicine for the treatment of impaired glucose tolerance and insulin resistance. The prevalence of diabetes is a rapidly growing with considerable social and economic costs to our community. It is desirable that progress from prediabetes to frank diabetes be stopped or delayed. There has been considerable research undertaken in lifestyle and pharmaceutical prevention or delay or diabetes but there is no cure, pharmaceutical interventions often have side effects and lifestyle interventions are not always achieveable. There have been a number of clinical trials of Chinese herbal medicine interventions in recent years but there has been no review undertaken of Chinese herbal medicine interventions. The objective of this research was to review the evidence for the treatment of prediabetes with traditional Chinese herbal medicine and examines the traditional Chinese medicine approach to the treatment of prediabetes. This involved two main pieces of research a systematic review to evaluate the efficacy and safety of Chinese herbal medicine for the treatment of impaired glucose tolerance or impaired fasting blood glucose; and a double blinded, randomised and placebo-controlled clinical trial to evaluate the effectiveness of a Chinese herbal formula, Jiangtang Xiaozhi for the treatment of impaired glucose tolerance and insulin resistance in persons with prediabetes and mild diabetes. In the preparation for the conduct of the clinical trial and systematic review an examination of the traditional Chinese medicine (TCM) patterns of disharmony and treatment principles was undertaken. An inter-rater reliability study of the TCM diagnosis of people with prediabetes using a subset of the clinical trial participants was also conducted. The findings of our inter-rater reliability study indicated that TCM practitioners diagnosing patients with prediabetes commonly selected one of three patterns: Qi and Yin deficiency, Spleen qi deficiency or Yin deficiency. There was a moderate level of inter-rater reliability between practitioners. The methodology of inter-rater reliability studies of TCM diagnosis would benefit from further refinement, building on research that has already been conducted. The continued improvement of the face and content validity of the TEAMSI-TCM instrument will result in a robust tool for the conduct of clinical trials.