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Portfolios are used in midwifery education to provide students with a central place to store their accumulative evidence of clinical experience for initial registration in Australia. Portfolio formats can be paper-based or electronic. Anecdotal discussion between midwifery students in Queensland debated the best format to document the requirements for the Australian Nursing and Midwifery Accreditation Council (ANMAC) standard 8.11. Midwifery students using paper-based portfolios envisioned that an ePortfolio would be streamline, simple, safe to use, and able to be used anywhere with WIFI, while some students using an ePortfolio expressed a desire to have a paper-based portfolio as a hard copy. This situation called for evidence of a comparison to resolve the debate. The aim of this study was to investigate midwifery students' experiences of the benefits and challenges between paper-based and ePortfolios when compiling evidence to meet the requirements for initial registration as a midwife in Australia (ANMAC, 2014). • Each type of portfolio had challenges and benefits. • Portfolio completion is time consuming, and stressful due to the need for verification of evidence. • Students require early and regular feedback on portfolio development. • National standards are required for consistency in documentation across universities. [ABSTRACT FROM AUTHOR]

(1) To describe facilitators and barriers to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food shopping via electronic benefits transfer (eWIC) compared with paper vouchers. (2) To explore suggestions that WIC participants had for modifying the program to enhance their overall WIC experience. Qualitative, semistructured, in-depth interviews. WIC participants in East Tennessee. Twenty-four primary food shoppers of WIC-participating households aged at least 18 years were recruited using a purposive sampling strategy. Perceived facilitators and barriers to use of eWIC as compared with paper vouchers. Interview transcripts were analyzed using a grounded theory approach to identify emergent themes. Participants identified several ways eWIC has improved their food shopping experience, including ad hoc redemption of WIC benefits and a quicker, more discrete checkout. Participants' chief complaint about eWIC was transaction errors at checkout. Participants identified other barriers to shopping for WIC foods that cannot be addressed by the card alone, such as difficulty identifying WIC items in-store. Participants reported changes to their benefit tracking behaviors and provided suggestions to improve WIC further. The transition to eWIC was viewed favorably among WIC participants, although participants identified a need for additional support in addressing transaction errors. This finding presents an opportunity to modify messages delivered to WIC participants by WIC nutrition educators and enhance collaboration between WIC agencies, retailers, and e-commerce technology providers. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In Ukraine, women constitute a third of all new HIV infections, and injection drug use accounts for nearly half of HIV infections among women. Women who use drugs (WWUD) often have diminished access to drug use treatment, HIV care, and other health and social services or underutilize women-specific services such as maternal health services. While interpersonal and contextual factors diminish access to and utilization of services among WWUD, rules, processes, and bureaucratic structures also systematically exclude women from accessing services and resources. Institutions, bureaucratic processes, and instruments of legibility such as documents regulate who can and cannot access services and raise questions about "deservingness." In this paper, we use the lens of bureaucracy to explore paperwork as a form of structural violence through its production of "legible" citizens, often through reinforcement of gender stereotypes and moral narratives of deservingness. Between December 2017 and October 2018, we interviewed 41 medical and social service providers and 37 WWUD in two Ukrainian cities. Our analysis revealed that requirements for internal passports and residency permits—the primary state apparatus through which rights to services are granted in Ukraine—compelled participants to continually render themselves visible to the state in order to receive services, despite financial, logistical and other challenges that undermined women's ability to obtain documents. These requirements exposed them to new forms of stigma and exclusion, such as reduced opportunities for employment and losing custody of children. Nongovernmental organizations, due to funding cuts, curtailed direct services such as support groups but became liaisons between clients and the state. They enforced new narratives of deservingness, such as the ability to define "good" behavior or reward social relationships with agency staff. Ukraine's current reforms to social safety net institutions present an opportunity to interrogate underlying assumptions about spheres of responsibility for the country's most marginalized and stigmatized groups. • Access to services is essential to improve health outcomes for women who use drugs. • Bureaucratic structures systematically exclude some women from accessing services. • The bureaucratic process of document procurement is a form of structural violence. • NGOs impose new forms of moral scrutiny on vulnerable populations. [ABSTRACT FROM AUTHOR]

Objectives: To synthesize the findings of cognitive interview and usability studies performed to assess the measurement equivalence of patient-reported outcome (PRO) instruments migrated from paper to electronic formats (ePRO), and make recommendations regarding future migration validation requirements and ePRO design best practice.Methods: We synthesized findings from all cognitive interview and usability studies performed by a contract research organization between 2012 and 2015: 53 studies comprising 68 unique instruments and 101 instrument evaluations. We summarized study findings to make recommendations for best practice and future validation requirements.Results: Five studies (9%) identified minor findings during cognitive interview that may possibly affect instrument measurement properties. All findings could be addressed by application of ePRO best practice, such as eliminating scrolling, ensuring appropriate font size, ensuring suitable thickness of visual analogue scale lines, and providing suitable instructions. Similarly, regarding solution usability, 49 of the 53 studies (92%) recommended no changes in display clarity, navigation, operation, and completion without help. Reported usability findings could be eliminated by following good product design such as the size, location, and responsiveness of navigation buttons.Conclusions: With the benefit of accumulating evidence, it is possible to relax the need to routinely conduct cognitive interview and usability studies when implementing minor changes during instrument migration. Application of design best practice and selecting vendor solutions with good user interface and user experience properties that have been assessed in a representative group may enable many instrument migrations to be accepted without formal validation studies by instead conducting a structured expert screen review. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Estimates suggest that close to 3 million institutionalized children internationally have some family to whom they could go home. A proportion of these children is recruited from their communities under false pretenses and has false documentation that describes them as legal orphans. The orphanages where they live exploit them on the basis of their orphanhood. These children are known as paper orphans. The aim of the current article is to provide a profile of their origins and networks based on current available evidence, from an investigative interviewing perspective. Increased discussion and research of this problem will assist in supporting efforts towards reunification of children with families, investigations by law enforcement into orphanages, and successful prosecution of orphanage trafficking. The article provides an overview of the orphanage trafficking context, followed by a comparison of orphanage trafficking victims with other child trafficking victims from the perspective of investigative needs. Investigative needs are outlined with respect to two primary groups who would interview paper orphans and other involved parties (e.g., birth parents, orphanage staff)–law enforcement and reunification officers. In the final section of the article, we encourage further research on orphanage trafficking and provide initial guidance for interviewing in this unique context. This paper serves as a step to raise further awareness of paper orphans, orphanage trafficking, and the specific characteristics of their cases that affect research and planning into how to identify and interview them and others involved. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Medicalization represents an increasingly significant form of social control. Emergent evidence suggests that workplace managers take up medicalized practices and discourses to produce a compliant labor force, but this phenomenon has received limited sociological attention. This paper extends prior theories of medicalization to investigate therapeutic management in the low-wage workplace. I draw upon eight months of ethnographic fieldwork in Disability Works, a nonprofit job training program for people with mental illnesses, and interviews with other providers and advocates within this field. Disability Works harnesses therapy, psychiatry, and "softer" therapeutic practices such as mindfulness meditation, sleep hygiene, and positive affirmations to produce its workforce. This paper identifies two dimensions of therapeutic management: (1) it aims to inculcate work norms at the level of client-workers' embodied dispositions, and (2) it aims to transform structural problems into individual ones. Findings illuminate therapeutic management as an emergent workplace regime and may guide future research on its effects. • "Therapeutic management" is an emergent managerial style. • Ethnographic fieldwork and interviews illustrate practices of therapeutic management. • This style draws on therapy, psychiatry, and pseudo-therapeutic practices. • Therapeutic management aims to inculcate work norms at the dispositional level. • Therapeutic management aims to transform structural problems into individual ones. [ABSTRACT FROM AUTHOR]

The current staffing shortage across all disciplines of post-acute and long-term care (PALTC) settings is affecting the health and safety of residents, as well as the well-being of the current staff. The need to retain and recruit new talent to this challenging but fulfilling setting demands that we look to existing evidence-based strategies and identify ways to implement them quickly, effectively, and in a sustainable way. Using the 4 Ms Framework of the Age-Friendly Health System developed by the Institute for Healthcare Improvement and the John A. Hartford Foundation (What Matters, Medication, Mentation, and Mobility), we can build on successful strategies to address what matters to staff, mental health, career mobility, and the overall safety and wellness of our nation's careforce. This paper summarizes "More of a Good Thing: A Framework to Grow and Strengthen the PALTC Careforce," a series of 6 roundtable discussions held in 2022 that brought together clinicians, industry leaders, and change-makers to share strategies that have been researched and successfully implemented and discuss ways to scale and disseminate them to a broader audience. The role of PALTC leadership is highlighted, with key points from the final roundtable discussion outlined, and challenging leadership to think about what they can begin doing immediately to build trust with existing staff and lay the foundation for a stronger nursing home careforce. Next steps for "More of a Good Thing" include a survey of participants about what they have tried, what has been successful, and what barriers they face; a series of focused interviews with leaders; and potential collaboration with quality improvement organizations to help facilities build on and implement the strategies presented. [ABSTRACT FROM AUTHOR]

Presently, child-specific tools and instruments related to active school travel (AST) are lacking. This methodological shortcoming often contributes to suboptimal AST behaviour evaluations and intervention programming. The aim of this paper was to develop and validate a theoretically informed child-specific scale regarding multiple perceived barriers and enablers known to impact children's participation in AST. Mixed methods. A mixed-methods and multistudy scale development approach featuring the application of social-ecological theory, a validation pilot study (n = 80), and test-retest study (n = 96) was conducted in collaboration with children in Ontario, Canada. In tandem with completing cognitive interviews and online surveys, multiple analyses, including a qualitative thematic analysis, along with weighted Cohen's kappa, Cronbach's alpha, and confirmatory factor analysis were undertaken. Qualitative analyses of the developed tool addressed face validity concerns related to the response options and definitions of terms used. Following the reliability analyses of 40 items, two confirmatory factor analyses were run to assess the construct validation of perceived AST barriers and enablers, and resulted in the development of the 24-item Perceived Active School Travel Enablers and Barriers – Child (PASTEB-C) questionnaire. The developed PASTEB-C questionnaire may be used to inform the programming and development of AST interventions, as well as conduct child-specific AST research. [ABSTRACT FROM AUTHOR]

Gifts are a powerful way to acknowledge and strengthen interpersonal relationships. As with any relational space, gifting plays various roles in forming and maintaining relationships in political contexts, but its contribution to relationship-building has attracted little attention. This paper examines how politicians in Aotearoa New Zealand both engage with gifting and how they navigate the perceptions of others. Four current members of parliament (MPs) and six retired MPs participated in semi-structured interviews with questions on common practices and common understandings about political gifting. Their responses indicate their use of four different processes: formal processes are the guidelines provided by the government on gifting, but when these are insufficient, contextual processes regarding perceptions of the media, constituents or colleagues are used, or, alternatively, MPs rely on personal values or view gifting in terms of transactional processes with both parties receiving benefits. The paper explores perceptions and complexities of a sequence of gifts during events (event gifting). The authors recommend an improved awareness and understanding of the contribution of gifting practices to political relationship building. [ABSTRACT FROM AUTHOR]

The purpose of this study is to analyze how cultural difference plays a different role in overseas tourists of different age groups. It examines how perceived cultural differences affect the perceived value of tourists from different age groups, in their travel abroad and, consequently, their satisfaction. The paper is based on self-determination theory (SDT) and develops a structural equation model (SEM) between tourists' cultural needs, perceived cultural differences, perceived value and satisfaction. Through textual analysis, questionnaires and interviews, this paper conducts three studies to empirically analyze the relationship between cultural difference variables related to overseas tourism and tries to explore the influence mechanisms of the cultural differences. The effects of cultural SDT needs of autonomy, competence, and relatedness have different effects upon different age groups. Cultural factors play a significant role in influencing the experience of young tourists, but not in older tourists. The possible reasons why cultural differences play different roles in different groups of people are also explored. • The perceived cultural differences have no direct effect on perceived value in the context of overseas tourism. While the moderating effects of perceived cultural differences are confirmed. • Satisfaction of self-determination theory needs has no effects on the elderly groups. Conversely, among the younger group, the effects are significant. [ABSTRACT FROM AUTHOR]

Previous studies of service reconfiguration in healthcare have explored the influence of power on processes and outcomes. However, in these accounts the moral agency of managers is often underemphasised. This paper draws on the theoretical tools provided by the sociology of morality to help deepen understanding of the interaction between power and moral agency in service reconfiguration in healthcare. It presents results from a qualitative study of a pan-organisational service reconfiguration in the NHS in England, involving nineteen in-depth interviews with those leading the change and the analysis of twelve programme documents. We combine concepts of the moral background and epistemic governance to interpret participants' conviction that the service change was 'the right thing to do'. The paper shows how epistemic work carried out by service change regulations shaped the moral background within which participants worked. This, in turn, channelled their moral agency – specifically their commitment to patient care – in a way that also reflected central priorities. The paper adds to sociological understandings of service reconfiguration through considering the interaction of structure, agency and power, while also developing the concept of the moral background to show how power relations can influence moral beliefs. • Managers can show strong faith in uncertain evidence for healthcare service change. • The moral background explains this in a way which considers power and moral agency. • Confidence in evidence depends on background assumption of future as predictable. • Confidence also depends on premise that finances are not open to moral evaluation. • Service change regulations carry out epistemic work on background assumptions. [ABSTRACT FROM AUTHOR]

• UK law changed in 2018 to permit cannabis prescribing. Cannabis remains otherwise criminalised. Participants experienced benefits from cannabis across a broad range of conditions. • Most people who need a cannabis prescription in the UK still cannot access one. • Poor implementation of cannabis prescribing policy creates heath inequalities. • Intractable prohibition policy context continues to create social harms. This paper reports on the first qualitative study to interview people prescribed cannabis in the UK. Cannabis is a class B controlled substance under the 1971 Misuse of Drugs (MoD) Act, but a 2018 change to UK regulations provided for the prescription of cannabis for medical purposes. Relatively few people have been able to access a prescription, despite this policy change. This paper examines their experiences. Qualitative, semi-structured interviews were conducted with 24 people with a prescription for cannabis, or their carers. Data was analysed using a reflextive thematic analysis approach. The findings are discussed using a zemiology (social harms) perspective which provides a language for critical reflection on the current cannabis policy context. All participants reported that cannabis had significantly improved their mental and/or physical health, across a broad range of conditions. Many had been able to reduce their use of conventional medicines and reported that cannabis had relatively few side effects. Despite the potentially life-enhancing benefits of cannabis medicine, patients in the UK face multiple barriers to access. These include a lack of funding streams, bureaucratic supply problems, and a lack of training for doctors and police. Even for the few people able to obtain a prescription, the ongoing criminalisation of cannabis in the UK contributed to their experiences of stigmatisation. This often made it difficult and anxiety-inducing to take their medicine in public spaces. The UK government's lack of implementation of medical cannabis legalisation, combined with their ongoing prohibition position, is producing multiple harms to people who need cannabis medicine. The policy context is perpetuating stigmatising attitudes to cannabis which, as we demonstrate, contribute to social harms. We make recommendations on equality of patient access, and highlight the importance of education and policy change as means of combatting stigma. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Educator roles in medicine are expanding yet career paths and definitions of successful careers are not uniformly agreed upon. Educator success from their own perspective has not been broadly explored as these studies usually occur from the institutional or organizational viewpoint. This study examined the impact of a national educational faculty development program (FDP) for academic pediatricians on educators' self-description of their own professional and personal success. METHODS: This was a cross-sectional, qualitative study of FDP alumni between 2019-2021. Interviews explored participants perspectives on their professional success, and supports and barriers. Using an iterative process, thematic analysis of the data identified 6 themes. RESULTS: Fourteen scholars were interviewed. All felt they were successful citing both outcome and impact measures categorized into 6 themes: personal attributes, adequate resources and barriers, foundational skill development, experiencing strong mentoring and networking, engaging, and being connected to a community of practice and self-identifying as a medical educator. To view the data holistically, a model incorporating 3 frameworks was developed. CONCLUSIONS: These educators viewed themselves as successful academic educators. While papers, promotions and positions were important, educators viewed impact in mentoring and collaborations with others, along with acquired expertise and an expanded viewpoint of the field and themselves as equally important. Educators and leaders could use these elements for their own self-assessment and support, FDP development and enhancement, and for investment in programs and faculty educators. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

• Multiple search platforms (e.g. social media) are key to locating participants. • Quickly following up with missed interviews will increase the retention rate. • On-the-ground canvassing is a useful approach when all other methods have failed. • It is important to develop tailored approaches to track hard-to-reach participants. • The team facilitated 735 interviews compared to 370 interviews completed before. Retaining study participants over time is essential for longitudinal studies to prevent selection bias and to achieve their long-term goals. The present paper examines the extent to which participants can be retained in a 30-year longitudinal study when a multi-pronged approach is employed. The paper specifically describes the approach that was used to locate and interview participants of the Chicago Longitudinal Study (CLS), three decades after the study began. The CLS is a prospective cohort investigation that examines the effects of the Child–Parent Center (CPC) program, a school-based intervention for low-income children from preschool through 3rd grade. The original CLS sample included a complete cohort of 1539 children who were born in low-income areas in 1979–1980 and attended kindergarten in 1985–1986 at Chicago Public Schools. The CLS conducted a follow-up survey when participants were approximately age 35. After relatively slow initial progress, CLS researchers developed a comprehensive strategy to locate and interview participants, including: (a) adoption of detailed, manualized tracking protocol, (b) utilization of multiple search platforms, ranging from public search engines to social media, (c) assistance from state correctional facilities, and (d) neighborhood canvassing and in-person interviews. This tracking and interview process facilitated 735 completed interviews within 27 months, compared to 370 completed interviews in the 32 months prior to the launch of the comprehensive tracking protocol. Altogether, 1105 interviews were conducted, representing an effective completion rate of 76.5%. Recommendations for strengthening response rates in other longitudinal studies are discussed. [ABSTRACT FROM AUTHOR]

This paper focuses on the question of identity in relation to jocular interactional practices. The metapragmatic analysis is based on qualitative interview data where native speakers of Australian and British English were shown a number of videos with potentially jocular verbal behaviours. The main objective of this paper is to observe what role jocular verbal behaviours play in claims to identity as well as in the attribution of identity to others via their interactional behaviour. The results suggest that in the analysed data identity related to jocular verbal practices primarily manifests itself in three different, though sometimes overlapping, ways: via (1) perceiving oneself as part of a cultural context where particular preferences are shared by the majority of people (what is referred to here as 'collective identity'); (2) arguing that one's evaluations and reactions to jocularity depend on personal characteristics ('individual identity'); and (3) suggesting that the understanding of and reactions to humour are limited to a particular situation and the interactants involved ('situated identity'). • This paper explores the interplay between humour and identity construction. • The study focuses on metapragmatic comments in the interview data. • Three types of identity are explored: collective, individual and situated. [ABSTRACT FROM AUTHOR]

• Youth's juvenile justice involvement can lead to financial debt into adulthood. • Juvenile monetary sanctions propel youth into early adulthood, with negative effects. • Juvenile monetary sanctions hinder individuals' educational and work aspirations. • Juvenile monetary sanctions increase individuals' distrust of the legal system. Previous research has established the deleterious long-term effects of juvenile legal system involvement such as increased risk of criminal legal system involvement as adults. This paper examines retrospective accounts of how that process occurs by exploring the following research question: how does one's involvement in the juvenile legal system, which includes monetary sanctions, shape peoples' views of law and legal institutions and with what consequences? Based on 19 interviews with adults who have legal debt from both juvenile and criminal legal systems, the paper focuses on four aspects of the long-reaching effects of juvenile legal involvement and juvenile monetary sanctions: legal socialization, adultification, legal cynicism, and future aspirations. In all these aspects, we show the organizational constraints that shape individuals' perspectives about the law and the impact of monetary sanctions on their lives. In doing so, the paper shows how monetary sanctions associated with juvenile cases add to the cumulative disadvantage of legal system involvement. [ABSTRACT FROM AUTHOR]

Achieving sufficient COVID-19 vaccination coverage has been hindered in many areas by vaccine hesitancy. Many studies based on large survey samples have characterized vaccine refusal, but there are fewer in-depth qualitative studies that explore hesitant adoption: the middle-ground between vaccine acceptance and refusal, and how individuals may move across this continuum depending on their lived experience. For this paper, we use the narratives of 25 adults living in off-road, predominately Alaska Native communities to describe the complex decision-making processes undertaken by ' hesitant adopters', defined in our study as those who completed their initial COVID-19 series despite reporting hesitancy. Interviewees' stories help illustrate how hesitant adopters' decision-making processes involved making sense of information through interactions with trusted individuals, lived experiences, observations, emotions, and personal motivations. For the majority of these hesitant adopters' (n = 20, 80%) interpersonal interactions were key in helping to make the decision to get vaccinated. Over half of the interviewees (n = 14, 56%) described how conversations with individuals they trusted, including healthcare providers, family, friends, and interactions through their professional network made them feel safe. One third of the hesitant adopters (n = 7, 28%) attributed their decision to get vaccinated based on the influence of Alaska Native Elders including their knowledge, personal experiences, as well as being motivated by the desire to protect them. Independent research was also important to about a quarter of hesitant adopters (n = 6, 24%), and for these interviewees it was the process of gathering information on their own and learning from others, especially healthcare providers who could answer their questions and alleviate their concerns. This paper illustrates the temporality of vaccine decision-making: vaccine acceptance for those who are hesitant may be an ongoing process that is influenced by personal experience, relationships, and context. • Understanding hesitant adoption provides insights into increasing vaccine acceptance • In remote Alaska, Elders may influence the decisions community members make • Images and conversations reinforced narratives of safety and efficacy • Agency in information-seeking increased vaccine confidence [ABSTRACT FROM AUTHOR]

The changing organisation and governance of healthcare work represents a persistent focus of micro-politics. Whilst there is a developed literature describing the micro-political struggles that occur amongst healthcare occupations, there is little understanding about how, when and why actors become politically aware and active. Framed by research on political activation and the concept of identity work, this paper reports on a narrative interview study with 65 people, specifically doctors, nurses and managers, working in the English healthcare system. The narratives show that healthcare workers become increasingly aware of and engaged in micro-political activities through incremental stages based on their accumulating experiences. These stages are opportunities for identity work as actors make sense of their experiences of micro-politics, their occupational affiliations and their evolving sense of self. This identity work is shaped by actors' changing views about the morality of playing politics, the emotional implications of their engagement, and their deepening political commitments. The study shows that political socialisation and activation can vary between occupations and rather than assuming political affiliations are given or acquired the papers highlights the reflective agency of healthcare actors. • The study shows how healthcare workers become politically active. • Political activation develops through accumulated experiences of micro-politics. • Political activation involves identity work to construct a coherent sense of self. • Identity work centres on questions of morality, emotion and ideology. • Hybrid roles complicate political activation and affiliation. [ABSTRACT FROM AUTHOR]

According to popular understandings, children grow from a state of dependence to eventually become independent adults. Interdependence helps to disrupt the in/dependence binary and is a useful concept for making sense of the experiences young people with variations in sex characteristics in relation to healthcare. This study used semi-structured interviews with 32 health professionals, 33 caregivers and 12 young people recruited in the UK and Sweden. The analysis is guided by the questions: (1) how do young people, carers and health professionals position themselves in the adult/young person relationship in the context of healthcare? (2) how is the (in/ter)dependence of young people imagined when young people, carers and health professionals talk about healthcare? Our analysis shows how carers and health professionals might support dominant understandings about young people growing towards independence while providing little opportunity for young people's agency and voice. Interviews with young people gave clear examples of their negotiating relational ways of being, seeking agency in the context of healthcare and not simply becoming independent of adults. This analysis also draws attention to the ways young people might be silenced within healthcare contexts. The present paper is based on secondary analysis of data from the SENS. It works with concepts of relationality and interdependence to draw out the possibilities of voice and agency for young people with variations in sex characteristics in healthcare contexts. • Youth with variations in sex characteristics are sometimes silenced in the clinic. • There is sometimes too little room for youth agency in healthcare. • A relational approach could improve the healthcare experiences of young people. • Working towards interdependence, not simply independence, can support youth. • It is important to value knowledge that is based on intersex lived experience. [ABSTRACT FROM AUTHOR]

• There are distinct typologies of social support networks for children and youth in out-of-home care. These network structure provide differing types of social support. • Many children in out-of-home care experience low levels of social support, both in terms of number of available support providers and amount of social support activities received. • Among youth with higher levels of social support, social support activities are spearheaded by certain members, including cousins, aunts and uncles, grandparents, and fictive kin. This paper aims to examine the social support network structures of youth in out-of-home care and to delineate the type of social support activities provided by kin and fictive kin within the networks. Children in the child welfare system experience significant benefits from contact with non-custodial kin and fictive kin. However, little is known about the support activities they provide (e.g., childcare, transportation, etc.) and their relationship to the children (e.g., grandparents, godparents, etc.). Support provision and relationship to the child was measured through chart reviews and interviews with key stakeholders, allowing for a description of the amount of support provided by various types of kin and fictive kin. Latent Profile Analysis (LPA) was applied to the data to determine the presence of distinct profiles. A four-profile solution emerged: (1) Multigenerational Predominant Cousin, (2) Bigenerational Lower Involvement, (3) Bigenerational Predominant Fictive Kin, and (4) Multigenerational Predominant Aunt/Uncle), suggesting heterogeneity in the social support networks of children in foster care. Children in foster care experience varying levels of social support, which were spearheaded by specific categories of caregivers who provide distinct types of support. Thus, there is great heterogeneity in the social support networks of children and youth in care. The identified clusters suggest that "one-size fits all" policy practices may not be effective in engaging and maintaining social support for children in out-of-home care. This research indicates that child welfare practitioners need to appreciate the complexity of social support patterns available to children. [ABSTRACT FROM AUTHOR]

• Supportive housing can be combined with wraparound supports for teen families. • Collaborative partnerships are key to offering teen families supportive housing. • Supportive housing needs to balance structure with trauma-informed responsivity. Providing support to address the systemic barriers that teen families face is a logical step toward improving their health and well-being. One area where teen families face multiple obstacles is accessing safe, secure, affordable housing. This paper describes a unique, innovative model of supportive housing developed in combination with wraparound supports, provided to teen parents in Edmonton, Canada. As part of a larger community-based participatory research and evaluation project, we draw on qualitative data to describe the supportive wraparound housing model that was developed. In particular, we conducted individual interviews and focus groups with a total of 27 staff members from the partner agencies, who provided information about the Successful Families program model. Analysis of interview data resulted in five broad categories that have resonated with our community and academic team as a way to conceptualize and share the work of the program. Categories, which are described in terms of associated subcategories, include: Community, Partnership, Program Principles and Values, Successful Families Program Structures, and Skill and Knowledge Development. Through this work, we aim to promote awareness of considerations for service providers seeking to implement similar services, and expand the limited knowledge base regarding methods for supporting the diverse needs of teen families. [ABSTRACT FROM AUTHOR]

• Adverse childhood experiences (ACEs) screeners can be verbal or self-administered. • We used 2 contemporaneous surveys to compare prevalence of caregiver-reported ACEs. • The telephone survey had higher ACEs disclosure rates compared to paper/web survey. • Findings support the importance of verbal communication to identify ACEs exposure. Adverse childhood experiences (ACEs) are traumatic experiences that increase people's susceptibility to adverse physical health, mental health, and social consequences in adulthood. Screening for ACEs in primary care settings is complicated by a lack of consensus on appropriate methods for identifying exposure to ACEs. It is unclear whether self-report methods could increase disclosure of ACEs as compared to interview-based methods. This study compares data on the prevalence of ACEs from two publicly available surveys conducted on the same population of children's caregivers: the 2019 Ohio subsample of the web/mail-based National Survey of Children's Health and the telephone-based 2019 Ohio Medicaid Assessment Survey. We find higher disclosure of caregiver-reported child exposure to ACEs in the telephone interview survey, highlighting the importance of the role of verbal communication in developing a safe and trusting relationship in the disclosure of trauma. [ABSTRACT FROM AUTHOR]

• The lives of Black girls, femmes, transgender, and nonbinary (TGNB) young people who identify as LGBTQ + are punctuated by experiences of oppression-based, interpersonal, and systemic trauma. • Healing and creative resistance are strong driving forces facilitated by pride in one's identities, artistic expression, and mindfulness facilitated by time spent in nature and parks. • Individual and collective dreaming and futuring are central to the living of LGBTQ + identified Black girls, femmes, and TGNB young people. Black LGBTQ + girls, femmes, transgender and nonbinary youth and young adults experience high rates of sexual violence, and other forms of trauma, including oppression-based trauma related to racism, misogynoir, homophobia and transphobia. Black LGBTQ + girls, femmes, transgender and nonbinary young people, whose experiences are underexplored within social science research, also experience disparately harsh discipline and pushout within school settings while being disproportionately represented in the foster care and juvenile justice systems. However, they are also a community with a tremendous history of creative resistance, and legacies of activism and powerful healing practices. Within this paper we have disaggregated the interview data of 13 LGBTQ + identified participants from a larger qualitative study with 24 Black girls, femmes, transgender and nonbinary youth, aged 16–25, who reside in New York State. Data were analyzed using critical thematic analysis and three main themes emerged: 1) the significance of participants' experiences of childhood trauma, 2) participants' conceptualizations and experiences of healing and resistance, and 3) participants aspirations and dreams for their futures and the futures of their communities. [ABSTRACT FROM AUTHOR]

The factors that inhibit and promote professional interventions with young adults refer to social, formal-structural, and personal factors. Nevertheless, studies of these factors from social workers' perspective, and research of the inhibitors associated with the socio-cultural context of minority young adults, are few. The aim of the present study was to examine social workers' perceptions of the factors that inhibit and promote interventions in the socio-cultural and formal-structural context of at-risk young Arab-Palestinian women in Israel, who are at an intersection of marginal positions. Semi-structured in-depth interviews were conducted with 21 social workers. The findings revealed two themes: 1) Social workers' perceptions of the challenges in two dimensions, a) socio-cultural factors which include family centrality in the young women's life, and b) formal-structural inhibitors. 2) Promoting factors which include professional values and the need for cooperation between organizations themselves and with recipients of the services The findings were reviewed according to the intersectional invisibility model, and were based on the concept of institutional discrimination, which showed that at-risk young Arab women experience an intersectional invisibility of their identities and, at the same time, the social workers experience a conflicting situation within the wider context of intersectional discrimination. The paper concludes with recommendations to practitioners and policymakers. [ABSTRACT FROM AUTHOR]

Due to the global aging trend, the number of older people who will spend the last years of their lives in nursing homes is increasing. However, nursing homes have long confronted negative social and public discourses, including stigmas on dementia and life in such facilities. Nevertheless, the remaining time of residents with dementia holds significance, for them and their families, as they seek respect and the ability to make meaningful end-of-life decisions. To explore how nursing home nurses advocate for the remaining lifetimes of residents with dementia. A qualitative research design. Four nursing homes in Korea from January 2023 to February 2023. Twenty nurses who provide direct caregiving for residents with dementia and have a minimum of two years' experience in nursing homes were recruited. This study employed a critical discourse analysis. Twenty interviews conducted with nursing home nurses were examined to explore the connections between the grammatical and lexical aspects of the language used by the nurses to construct their identities as advocates for residents with dementia and the broader sociocultural context. Four discourses regarding nursing home nurses advocating for the value of life of residents with dementia were identified: (1) Bridging perspectives: I am a negotiator between medical treatment and residents' families with differing views; (2) Embracing a shared humanity: Residents are no different from me; they just need professional help; (3) Affirming belongingness: Residents still belong to their families, even when care has been delegated; and (4) Empowering voices for change: We are struggling to provide better care in a challenging reality. This paper highlights the importance of nursing advocacy in safeguarding the remaining time and dignity of individuals with dementia, challenging the stigma surrounding dementia and nursing homes and calling for greater societal and political recognition of the efforts nurses make to preserve the personhood and well-being of these older adults. [ABSTRACT FROM AUTHOR]

Australia's prisons have a high chronic hepatitis C (HCV) prevalence (8 %). Antiviral therapies and prison-based hepatitis services are available, but only a minority of those eligible are being treated. Improving the HCV public health literacy of the prison sector via targeted education may overcome key barriers to scale-up treatment. This paper describes the: i) HCV public health literacy of the prison setting; ii) barriers and solutions for HCV education and service engagement; iii) HCV education program co-design and development processes; and iv) HepPEd resources. A national needs assessment was conducted to analyse the HCV public health literacy of the target audience groups in the prisons (healthcare providers; custodial officers; people in prison) to inform development of a prison-specific HCV education program (HepPEd). Structured interviews were conducted with key informants (n = 40). Three National Steering Committees, one for each target group, were convened to co-design and develop HepPEd. Only healthcare providers involved with hepatitis care were considered to have 'good' to 'very good' HCV health literacy (including knowledge, attitudes, and capabilities), with all other groups considered less favourably. Key barriers identified included being time poor (healthcare providers), poor motivation (custodial officers) and stigma (people in prison). Peer education delivery was considered a key facilitator for custodial officers and people in prison. A suite of multi-modal resources addressing the perceived gaps in HCV health literacy was developed, with a broad theme of 'Let's talk about hep C'. Delivery of HepPEd was designed to overcome key barriers and utilise facilitators for each group. Significant gaps in HCV health literacy were perceived amongst the target audience groups. The comprehensive co-design and development processes utilised in HepPEd suggest the program will be well-placed to improve the HCV public health literacy of the prison sector and thereby enhance HCV testing and treatment rates amongst people in prison. [ABSTRACT FROM AUTHOR]

Assessing the internal dynamics of organizations has been shown to provide information that can help planners and policymakers improve service delivery. A good organizational climate, which in this study incorporates mission clarity, team cohesion, staff autonomy, communication, levels of stress, and openness to change has been shown to be of particular importance. Still, there is a dearth of evidence in this area, and while relationships between organizational factors have been identified, little is known about the mechanisms that might underpin these relationships, and there is little understanding of how to address deficits once they are identified. The objective of this study was to identify relationships between program factors that influence organizational climate and to explore which mechanisms might underpin these relationships. This paper reports on a cross-sectional, concurrent, mixed-methods study design, across twelve discrete community-based prescribing service providers (organizations) in Ireland. Data was obtained using a staff survey [ n = 132] which utilized measurements of organizational readiness to change and one-to-one interviews [ n = 12]. Quantitative data was analyzed using multivariate linear regression modeling which assessed relationships between variables, while interviews were analyzed using an abductive approach, both types of data were synthesized at the interpretation stage. A range of interdependent factors were considered to affect the climate of organizations. Surveys identified that specific types of resources, such as physical infrastructure, training, and staffing resources were important for supporting a good organizational climate, while programs with greater needs had a poorer climate. Opportunities for professional growth, the skill sets of staff, and having access to e-communication were also significant. Interviewees reported that rigid organizational hierarchies and bureaucracy, philosophical views of addiction, stress, and staff turnover were influenced by the provision of fewer resources. Interdependent factors such as leadership, supervision, staff relationships, and collective training, also thought to be influenced by resources, were considered to positively influence programs. Resources were not the only challenge identified, and practices within programs and how existing resources are used were also thought to contribute both positively and negatively to the internal dynamics of services. Key findings in this study identified that the organization of effective services is influenced by a range of specific factors, some of which can be addressed without additional resources. Overall, staff views of organizations can provide us with valuable information to support service improvement. Using a mixed methods approach can not only identify where relationships between organizational variables exist but can also help us to understand the mechanisms that underpin these relationships and, importantly, how to address deficits once they are identified. In order to improve how substance misuse services work, the need for a long-term systemic approach to program development, which incorporates some of the findings from this study, is required. • Resources: ie. staffing, training, and office resources will likely influence a treatment program's organizational climate. • Programs with higher identified needs were less likely to have a favorable organizational climate. • Having greater growth opportunities was positively associated with; mission clarity, autonomy, and communication. • There is a likely interdependence between organizational domains with no indication of a hierarchy of importance. • How resources are used, not just their availability, was thought to influence to the organizational climate. [ABSTRACT FROM AUTHOR]

High quality primary care is a foundational element of effective health services. Internationally, primary care physicians (general practitioners (GPs), family doctors) are experiencing significant workload pressures. How non-patient-facing work contributes to these pressures and what constitutes this work is poorly understood and often unrecognised and undervalued by patients, policy makers, and even clinicians engaged in it. This paper examines non-patient-facing work ethnographically, informed by practice theory, the Listening Guide, and empirical ethics. Ethnographic observations (104 h), in-depth interviews (n = 16; 8 with GPs and 8 with other primary care staff) and reflexive workshops were conducted in two general practices in England. Our analysis shows that 'hidden work' was integral to direct patient care, involving diverse clinical practices such as: interpreting test results; crafting referrals; and accepting interruptions from clinical colleagues. We suggest the term 'hidden care work' more accurately reflects the care-ful nature of this work, which was laden with ambiguity and clinical uncertainty. Completing hidden care work outside of expected working hours was normalised, creating feelings of inefficiency, and exacerbating workload pressure. Pushing tasks forward into an imagined future (when conditions might allow its completion) commonly led to overspill into GPs' own time. GPs experienced tension between their desire to provide safe, continuous, 'caring' care and the desire to work a manageable day, in a context of increasing demand and burgeoning complexity. • The non-patient-facing work of general practitioners is often invisible or hidden. • Hidden work is associated with complexity and uncertainty. • Behind-the-scenes work is care work, just as direct work with patients is care work. • Doctors face tensions between completing tasks and working a manageable day. • Combining practice theory with the Listening Guide embraces multi-vocality. [ABSTRACT FROM AUTHOR]

• Beneficial help relationships go beyond formal professional practice. • Peers and friends are central to youths' beneficial help seeking trajectories. • Family gestures and home practices are embedded in beneficial help relationships. The literature on help engagement of commercially sexually exploited youth has tended to focus on the challenges of such relationships and has been mostly grounded in studies of professional help relations from professional perspectives. This study is part of a large-scale study on help seeking and help related experiences from the perspectives of commercially sexually exploited youth (CSEY). This paper focuses specifically on the beneficial characteristics of help as seen by CSEY. Fifty commercially sexually exploited youths, in the present or in the past. In-depth semi-structured interviews, conducted and analyzed in accordance with the principles of Constructivist Grounded Theory. The study identified four characteristics of beneficial help that were salient both to help relations with professionals and in relations with peers and friends: Continuity and long-term ties; Sharing similarities; brokering help by others; "doing family," and "performing home." The significance of the various help experiences appeared to be more a function of how the help was provided and the nature of the relationship, rather than whether it was provided by formal or informal helpers. Nonetheless, the study underscores the critical importance of care and support by peers and friends and calls for further examination of the ways these might be integrated into services and programs for youths who are subject to commercial sexual exploitation. It also cautions not to "professionalize" informal friendships. [ABSTRACT FROM AUTHOR]

By drawing perspectives from the multi-level perspectives in sociotechnical transition and the normalisation process theory, this article explores how ongoing (i.e., incomplete) national level reforms in health information management (HIM) shape the normalisation of electronic medical records (EMRs) in Philippine rural health work. Based on document review, interviews, and observations, we argue that an ongoing HIM regime transition—transitioning from paper-based to an electronic HIM regime—may exert ambivalent institutional pressures on health workers through their institutions' implementation context. The ambivalence of the implementation context—one that accommodates both EMR and paper-based medical records—offers conflicting social, cognitive, and material resources for normalising EMRs. In such a context, we find that health workers performed selective participation and partial implementation in normalising EMRs in their routine healthcare work. In selective participation, select health workers—often, the technologically savvy—could actively participate in the EMR implementation while others focused on their clinical work. At the same time, since only a few could use the EMR in routine work, EMRs were implemented partially in particular instances where it is deemed more valuable and applicable. We emphasised in this article how complementing the idea of normalisation with sociotechnical transition may reveal the emergence of pressures from various institutions and stakeholders that advances (or impede) the normalisation of healthcare innovations. • The implementation process involves regime transition and normalisation work. • Institutional pressures from regime transition shape the implementation context. • The Philippines has an ambivalent health information management (HIM) regime. • Techy health workers participated in electronic medical record (EMR) implementation. • EMRs were implemented partially in select areas within the rural health units. [ABSTRACT FROM AUTHOR]

This paper explores the social connectedness experiences among older migrants from culturally and linguistically diverse (CALD) backgrounds in Australia. Data were collected via two rounds of semi-structured interviews and analysed using thematic and cluster analysis. Participants were 40 migrants aged 66-91 years, of German, Dutch, Romanian, Chinese, and Vietnamese origin. They identified a range of factors affecting their social connectedness experiences: personal preferences, individual efforts to connect with others, English language proficiency, driving ability, and length of residence. Data analysis also revealed four groupings of experience: the isolated, family, ethnic community, and multicultural cluster. These patterns of connectedness were experienced differently across the ethnic groups. The findings suggest the benefits of providing culture-specific social connection opportunities to help older migrants to stay socially connected. [ABSTRACT FROM AUTHOR]

Abstract Having a noticeable role in CO 2 sequestration and O 2 production, microalgae as precious sources of the third-generation biofuel, offer various advantages for energy efficient architecture. Although biofuel production from microalgae biomass has a considerable research background, integrating microalgae culture system with building façade is in its infancy. It is mainly due to the fact that there is only one real building named BIQ house adopting the bioreactor façade technology constructed in Germany, 2013. Hence, there are various challenges associated with this newly emerged technology. This paper aims to detect and estimate the probable causes of damage to microalgae photobioreactor panels integrated with building façade known as SolarLeaf. In order to realize the paper key objective, by comprehensively studying the literature review, surveying and interviewing with the experts, the factors causing damage to bioreactors were recognized and categorized. Based on the results, the main damages are classified as internal and external. Internal causes include bio/chemical and structural factors, while external ones involve climatic and operational/constructional ones. These are the fundamental damage categories of microalgae façade systems that architects and engineers should get familiar with in order to meet and consider the defects developed in the bioreactor panel structure during the design and construction process. Highlights • Microalgae as precious sources of the third-generation biofuel, offer various advantages for energy efficient architecture. • This paper aims to detect and estimate the probable causes of damage to microalgae photobioreactor panels integrated with building façade known as SolarLeaf. • The main damages are classified as internal and external. Internal causes include bio/chemical and structural factors, while external ones involve climatic and operational/constructional ones. • Architects and engineers should get familiar with in order to meet and consider the defects developed in the bioreactor panel structure during the design and construction process. [ABSTRACT FROM AUTHOR]

Human geography's varied engagement with the brain has involved considerations of the way people know and respond to their environments, and their place-based experiences with emotions, mental illnesses and disorders, intellectual disabilities and particular neurological conditions. This paper argues however that this scholarship could be augmented by, and existing expertise be directed towards, considering physical brain abnormalities and injuries. As a case in point it considers the spatial experience of living with Type 1 Chiari Malformation. Through interviews with four sufferers, the research articulates three domains that they have had to re-negotiate - home space, social space and medical space - emphasizing supportive and challenging aspects of each, as well as meaningful and affective qualities to encounters. The paper concludes with some pointers towards the future study of physical brain abnormalities and injuries and the kinds of knowledge it might create to increase awareness and inform care. • Extends a geographical research lens to structural brain abnormalities and injuries. • Shows how life spaces are negotiated by people with Chiari Malformation. • Exposes both meaningful and affective levels to their encounters with life spaces. [ABSTRACT FROM AUTHOR]

Major service change in healthcare – whereby the distribution of services is reconfigured at a local or regional level - is often a contested, political and poorly understood set of processes. This paper contributes to the theoretical understanding of major service change by demonstrating the utility of interpreting health service reconfiguration as a biopolitical intervention. Such an approach orients the analytical focus towards an exploration of the spatial and the population – crucial factors in major service change. Drawing on a qualitative study from 2011–12 of major service change in the English NHS combining documentary analyses of historically relevant policy papers and contemporary policy documentation (n = 125) with semi-structured interviews (n = 20) we highlight how a particular 'geography of stroke' in London was created building upon multiple types of knowledge: medical, epidemiological, economic, demographic, managerial and organisational. These informed particular spatial practices of government providing legitimation for the significant political upheaval that accompanies NHS service reconfiguration by problematizing existing variation in outcomes and making these visible. We suggest that major service change may be analysed as a 'practice of security' – a way of redefining a case, conceiving of risks and dangers, and averting potential crises in the interests of the population. • Foucault's work on biopolitics is applied to analyse major service change. • The reconfiguration of stroke services in London is explored. • Empirical and theoretical implications are discussed. [ABSTRACT FROM AUTHOR]

This paper examines how power and knowledge are involved in the workings of speech and language therapy and in the work of speech and language therapists (SLTs). The paper draws on Foucault for its conceptual frame, with reference to his exposition of governmentality, biopolitics and pastoral power. Based on interviews with thirty-three SLTs in the UK, the findings show that evidence-based practice (EBP) is ever-present in speech and language therapy, despite its apparent absence; and that its power circulates in a multitude of ways. EBP as a process, and not an outcome, was workable. When competent practice was at risk, however, the SLTs challenged the dominance of EBP by saying it needed to 'get real' but then were troubled when it did. Working the 'wise' - those people involved with the client, including the SLTs themselves - was key to speech and language therapy; as was the making of subjects into biopolitical objects. At its most rewarding, but also most personally challenging, the work of SLTs involves mediating between different ways of being in the world and reimagining life, personhood and citizenship; to capture this complex labour process, the paper introduces the term 'pastoral labour'. • Uses Foucauldian lens to examine how power and knowledge govern the work of SLTs. • Evidence-based practice discriminates against some clients, it needs to 'get real'. • Reflective practice can inhibit the sharing of clinical practice knowledge. • SLTs' work means working the 'wise' i.e. other professionals, family, and themselves. • Pastoral labour - labour mediates knowledges and knowing in the 'making' of citizens. [ABSTRACT FROM AUTHOR]

This paper explores how distinctions between 'intended' and 'side' effects are troubled in personal narratives of taking psychotropic medications. Grounded in interviews with 29 participants diagnosed with mental illness in Victoria, Australia between February and December 2014, we consider how people interpret pharmaceutical compounds beyond their desired or intended effects, and how such effects shape and transform subjectivity and their relationship with their bodies. This paper contributes to recent discussions of mental illness and medication effects, informed by feminist science studies. It emphasises the co-constitution of social, affective and material relations in the context of 'taking' psychotropic medication. This paper discusses three key themes as important to the phenomenology of the nexus of illness and psychotropic medication: movement, ambivalence, and sociality. Our analysis demonstrates how psychotropic drugs are productive of subjectivity through their promises and potential, their unexpected harms and the institutions from which they are inseparable. • Analyses accounts of mental illness using feminist science and technology studies. • Focus on experiences of taking psychotropic drugs and impact on subjectivity. • Moves beyond distinctions between 'therapeutic' and 'side' effects of drugs. • Unique contribution to understandings of experiences of taking psychotropic drugs. [ABSTRACT FROM AUTHOR]

Western therapeutic methods have increasingly been implemented in non-Western contexts as treatment for traumatic stress reactions. There is a growing awareness of the need for such implementations to incorporate cultural specificity, and discussions are needed on the suitability of Western psychological approaches and theories in different parts of the world. The objective of this paper is to explore the intercultural applicability of trauma treatment through a case study in Sudan. We look at how Western methods are applied and potentially modified in Sudan to fit social-cultural realities – and how specific contexts affects treatments. Such data from a non-Western context is invaluable to the discussion of transcultural aspects of mental health care. This paper presents interview data, where counsellors in a trauma centre in Sudan were asked how they are implementing Western methods, and how these treatments are negotiated and potentially modified to fit the context. The interviewed counsellors emphasise the contextual factors influencing the treatment and the need to modify therapeutic methods to the specific cultural setting. Three themes are discussed: stigma towards mental health and sexual assaults; the negotiation of treatment alongside traditional healers; and the modification of treatments to the cultural context. The findings suggest that although Western methods can be useful in non-Western settings, these need to be carefully modified to the context as well as to each individual client. The study offers valuable insights into such modifications. [ABSTRACT FROM AUTHOR]

Abstract Health systems around the world face financial pressures that can affect sustainability and patient outcomes, and there is a vast literature devoted to the allocation of scarce health care resources. Capital spending - for example on estates, equipment and information technology - is an important but often neglected area of this literature. This study explores the constraints on the allocation of capital budgets in health care, before addressing the question: what is the role of priority setting and rationing in responses to these constraints? The paper presents findings from interviews conducted with senior finance professionals in 30 National Health Service local provider organisations across England. Findings suggest a pervasive sense of impending crisis, with capital restrictions limiting investment in buildings, infrastructure and equipment. The paper applies a conceptual classification scheme from the classic rationing literature (the forms of rationing framework) and identifies widespread practices of 'selection', 'dilution' and 'delay', with 'denial' and 'termination' comparatively rare. Practices of 'deflection' and 'deterrence' are ascribed to national actors as a means of restricting the flow of capital resources to the system. The study suggests that there is little by way of tailored support for priority setting in capital spending, and a perception that decisions are often reactive and short term. It also suggests that wider system features and dynamics can preclude or constrain priority setting at the organisational level. The authors use these findings to suggest future conceptual development of the forms of rationing framework and make recommendations for research and practice in this area. Highlights • Respondents described capital budget deficits affecting quality and safety of care. • Most had adopted rationing and/or priority setting to help deal with this. • Service dilution, delay and selection were the most cited forms adopted. • Lack of tools and the system context impeded local decision-making. [ABSTRACT FROM AUTHOR]

Abstract The concept of biographical disruption has now enjoyed nearly 40 years of use in medical sociology. This paper argues that taking an embodied approach to biographical disruption helps to explain the concept's enduring efficacy. Drawing on the work of Maurice Merleau-Ponty and contemporary theories of embodiment inspired by his phenomenology, this paper advances that biographical disruption involves, in the first instance, a disruption to the ability to enact an embodied orientation towards the world. Biographical disruption does not, from this perspective, result from illness as such, but from the ways that illness impinges on one's physical ability to engage with daily life. This paper examines the experiences of solid organ transplant recipients for the purpose of shedding light on the conditions under which biographical disruption arises in experience. The analysis includes interviews with 36 post-operative solid organ transplant recipients (heart, liver, lung, and kidney) living in British Columbia or Ontario, Canada. These participants exhibit a wide range of illness experiences, some of which manifest as biographical disruption and others that do not. Tracing the contours of these experiences, this paper argues that the efficacy of biographical disruption for describing the illness experience depends not only on the illness experience but also, fundamentally, on the content of embodiment prior to the onset of that experience. Highlights • The embodiment perspective improves the efficacy of biographical disruption. • The embodied context of an experience structures the illness experience. • Organ transplant recipients present variable experiences of biographical disruption. [ABSTRACT FROM AUTHOR]

Abstract Summary Incorporating the voice of the child is essential for a holistic assessment that is used to guide social work interventions targeted at enhancing the well-being of children. In order to include children as key participants in understanding their worldview, social workers need to provide a space for children to voice out their subjective assessment of their current life experiences and conditions. This paper aims to bring attention to utilizing photo eliciting interviewing (PEI) as a means to access children's subjective well-being from low-income families. Findings By utilizing photoraphy and in-depth interviews sequentially to engage and gain access into children's worldviews, this study found that children from low-income families possessed agentic capabilities and are capable of contributing towards their well-being. Despite the financial constraints experienced by their families, children did not perceive their families to be poor. Instead, they took into account the family context and parental efforts in assessing the family's circumstances. Furthermore, children initiated strategies to create opportunities of happiness or to intervene in situations of sadness that stemmed from financial constraints. Application This study propose social workers to employ PEI as a complement to the objective measurement tools commonly utilized in social work assessments and interventions when working with children from low-income families. Other than constructing a holistic assessment of children's well-being, PEI also allows for the inclusion of children as integral partners in social work interventions and programme designs. Children possess the knowledge and ability to initiate and contribute solutions to problems, which when identified and tapped upon, promotes children's participation as change agents of their own lives. Highlights • This paper highlights the relevance of using Photo Elicitation Interviewing as a supplementary information gathering method for social work assessment in working with children. • Utilizing this method, this paper illustrates how it engaged children from low-income families by empowering them to use photography to express their views on their families' financial constraints. • From the results of using photos to elicit conversations, children were facilitated to voice their perspectives, world views and their sense of agency. • It is proposed that Photo Elicitation Interview can be a useful tool for social work assessment alongside with standardized assessment measurements and framework to access children's voice. [ABSTRACT FROM AUTHOR]

Abstract This paper aims to explore the challenges to youth work in capturing the voices of young people in a meaningful way within Meitheal and the Child and Family Support Networks model (Meitheal). This is a prevention and early intervention model for statutory and non-statutory agencies working with children, young people and families. This paper, within the context of Meitheal, will explore how best to achieve positive outcomes for young people, and identify what are the barriers which inhibit their full participation in this model. A total of 16 youth workers completed semi-structured interviews that were transcribed and analysed using inductive thematic analysis. The analysis identified three themes: 'Role of youth work in Meitheal', 'Barriers and facilitators of adolescent voices in Meitheal' and 'The young person'. The study found that youth workers recognise advocacy and support of young people as a key role for their profession within models of prevention and early intervention. Barriers to adolescents' active engagement in Meitheal were the formal structure and agenda, but also the need to achieve outcomes in exchange of professional validation. Youth workers are also concerned about the nature of young people's participation as being fully participatory and voluntary in the process, whilst questioning if their voices are truly being included in a meaningful way. Highlights • Youth workers' role within Meitheal is one of support and advocacy of the young person. • The structured and formal setting of Meitheal challenged the participation of young people. • Meitheal can be unsettling and difficult for young people, this limits their involvement as true partners. [ABSTRACT FROM AUTHOR]

Abstract Registered Nurses (RNs) are regulated health professionals who are educated and accountable for safe medication administration (MA). Binding their practice are standards, policies, procedure and legislation. MA competence is taught and assessed during professional pre-registration education programs. However, different philosophies, theories and models are used by education providers making curriculum content disparate and competency frameworks diverse. Additionally, healthcare contexts are increasingly complex and clinical environments unpredictable. Competency models must respect contemporary practice. This paper focusses on the outcomes of Australian PhD research that combined Appreciative Inquiry (AI) principles with a qualitative study to identify MA safety strategies. In this 2-phase descriptive study, twenty RNs were observed then interviewed about their MA experiences. This paper discusses the interview findings. The participants explained how they assessed patient's needs and implemented strategies to administer medications safely. They presented their actions as being underpinned by a desire to do 'the right thing for the patient' despite their practice going beyond traditional procedural frameworks and not reflecting organisational protocols. Instead, they developed common strategies to enhance safe MA. The participants' described using clinical reasoning and patient-centredness during MA. This study contributes to the knowledge needed for future practice development by highlighting what works. Highlights • Nurses apply professional knowledge, skills and attitudes that go beyond organisational protocols. • Nurses use clinical reasoning to facilitate safe MA. • Nurses practice person-centred care throughout all phases of MA. • The 5-rights framework that is ubiquitous in nursing programs does not reflect authentic practice. • Best practice models should be informed by what works well in practice. [ABSTRACT FROM AUTHOR]

Abstract Sciatica is a common form of low back pain (LBP) that has been identified as distinct both in terms of the persistence and severity of symptoms. Little research has explored individual experiences of sciatica, and none focuses on individuals with the most severe, long-lasting symptoms who may experience the most profound impact. This paper addresses this gap through proposing a theoretical framework for understanding such experiences, that of biographical suspension as a form of liminality of Self. Twenty semi-structured interviews were conducted with individuals with severe sciatic symptoms between January 2016‒March 2017, as part of the UK-based SCOPiC (SCiatica Outcomes in Primary Care) randomised controlled trial. Data were analysed thematically using the constant comparison method. The concept of 'biographical suspension', originally developed in LBP, emerged as one whereby individuals put life on-hold in the expectation of an eventual return to their former, pain-free selves. Deeper analysis extended this concept to a form of liminality, whereby individuals are caught between pre- and post-sickness selves, unable to fully identify with either. This liminality is underpinned by ongoing beliefs about sciatica as a temporary and fixable 'injury' rather than long-term 'illness', even among those with long-lasting symptoms. This led to a disjuncture between individuals' ongoing pain beliefs and experiences, resulting in longer-term psychological impacts. Biographical suspension is further conceptualised as an experiential stage giving rise to four distinct short-term trajectories: i) symptom resolution leading individuals to occupy a clearly post-liminal state; ii) remaining in suspended liminality; iii) ongoing symptoms leading to a post-liminal state of resignation; ix) a state of being both between sickness and wellness, and straddling hope and fear; thus exemplifying differing states of liminality experienced over time. Findings have implications for the support provided in clinical settings to individuals who may struggle to self-manage due to sustained liminality of Self. Highlights • First paper to explore lived experiences of individuals with most severe sciatica. • Individuals experience biographical suspension, conceptualised as liminality. • Liminality is underpinned by conceptualisation of sciatica as a fixable 'injury'. • Biographical suspension can give rise to four distinct experiential trajectories. • Differing forms of liminality identified throughout course of pain trajectory. [ABSTRACT FROM AUTHOR]

Abstract Targets and indicators set at the global level are powerful tools that govern health systems in low-income countries. Skilled birth attendance at a health facility is an important indicator for monitoring maternal mortality reduction worldwide. This paper examines how health workers negotiate policy implementation through the translation of clinical care into registries and reports. It does so by analysing the links between the global policy of institutional births and the role of documentation in the provision of birth care in primary health centres in Burkina Faso. Observations of health workers' practices in four primary maternity units (one urban, one semi-urban and two rural) conducted over a 12-week period in 2011–2012 are analysed alongside 14 in-depth interviews with midwives and other health workers. The findings uncover the magnitude of reporting demands that health workers experience and the pressure placed on them to provide the 'right' results, in line with global policy objectives. The paper describes the way in which they document inaccurate accounts, for example by completing the labour surveillance tool partograph after birth, thus transforming it into a 'postograph', to adhere to the expectations of health district officers. We argue that the drive for the 'right' numbers might encourage inaccurate reporting practices and it can feed into policies that are incapable of addressing the realities experienced by frontline health workers and patients. The focus on producing indicators of good care can divert attention from actual care, with profound implications for accountability at the health centre level. Highlights • Documentation is time consuming and diverts attention away from clinical care. • The drive for the 'right' numbers may encourage inaccurate reporting practices. • Inaccurate documentation practices misinform policymakers. • The focus on numbers and indicators stimulates top-down accountability. [ABSTRACT FROM AUTHOR]

The recent 50th anniversary of the 1967 Abortion Act provides the opportunity to revisit what has been termed the ‘remarkable authority’ this Act ascribes to doctors. This paper does so using as its starting point a seminal commentary on this question by the renowned medical sociologist Sally Macintyre, published in this journal in 1973 as ‘The Medical Profession and the 1967 Abortion Act in Britain’. We revisit themes from that paper through an analysis of the findings of interviews with 14 doctors who, throughout lengthy careers, have provided abortions and led the development of the abortion service in England and Wales. We contrast our findings with Macintyre's, and argue that our interviews highlight the shifting meaning of medical authority and medical professionalism. We show that those doctors most involved in providing abortions place moral value on this work; uphold the authority of women (not doctors) in abortion decision-making; view nurses and midwives as professional collaborators; and consider their professional and clinical judgement impeded by the present law. We conclude that medical sociologists have much to gain by taking abortion provision as a focus for the further exploration of the shifting meaning of medical authority. [ABSTRACT FROM AUTHOR]