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Objectives: Prisoners use healthcare services three times more frequently than the general population with poorer health outcomes. Their distinct healthcare needs often pose challenges to safe healthcare provision. This study aimed to characterise patient safety incidents reported in prisons to guide practice improvement and identify health policy priorities. Design: We carried out an exploratory multi-method analysis of anonymised safety incidents from prisons. Setting: Safety incidents had been reported to the National Reporting and Learning System by prisons in England between April 2018 and March 2019. Participants: Reports were reviewed to identify any unintended or unexpected incident(s) which could have, or did, lead to harm for prisoners receiving healthcare. Main outcome measures: Free-text descriptions were examined to identify the type and nature of safety incidents, their outcomes and harm severity. Analysis was contextualised with subject experts through structured workshops to explain relationships between the most common incidents and contributory factors. Results: Of 4112 reports, the most frequently observed incidents were medication-related (n = 1167, 33%), specifically whilst administering medications (n = 626, 54%). Next, were access-related (n = 559,15%), inclusive of delays in patients accessing healthcare professionals (n = 236, 42%) and managing medical appointments (n = 171, 31%). The workshops contextualised incidents involving contributing factors (n = 1529, 28%) into three key themes, namely healthcare access, continuity of care and the balance between prison and healthcare priorities. Conclusions: This study highlights the importance of improving medication safety and access to healthcare services for prisoners. We recommend staffing level reviews to ensure healthcare appointments are attended, and to review procedures for handling missed appointments, communication during patient transfers and medication prescribing. [ABSTRACT FROM AUTHOR]

Indigenous women's health in low and middle-income countries continues to experience exclusions from the mainstream context and has remained underrepresented in health research, including qualitative research. Based on mixed methods research (comprising qualitative and quantitative methods) into Indigenous women in Bangladesh, this article addresses the reflexivity of a non-Indigenous researcher studying Indigenous women's health issues in the Chittagong Hill Tracts of Bangladesh. As reflexivity is a crucial strategy to ensure rigor in qualitative research, understanding how the characteristics and experiences of the study may influence the research process is of paramount importance. For non-Indigenous researchers working in an Indigenous context, the imperative to understand one's impact and position within the research becomes even more critical. Unfortunately, non-Indigenous researchers often avoid providing appropriate detail on reflexivity aspects in conducting research, particularly mixed-method research, among Indigenous communities in low- and middle-income countries like Bangladesh. In this reflexive evaluation, the researchers of this mixed method study evaluate the introspective reflexivity; reflect on the pre-research stage in developing collaborative and negotiated design and reflect on positionality during fieldwork and data analysis to consider interpersonal and collective dynamics during the research process. Strategies are offered to harvest the benefits of the researcher's familiarity with the subject and limit any unfavorable consequences. Directions for future research include integration of research methods, using qualified Indigenous researchers, engaging Indigenous community leaders, and collecting data using native language to respect and value the culture and voice of Indigenous communities. [ABSTRACT FROM AUTHOR]

Temporal aspects of child and adolescent time allocation in diverse cultural settings have been difficult to model using conventional statistical techniques. A new statistical approach, Egocentric Relational Event Modelling (EREM), allows for the simultaneous modelling of activity frequency, duration, and sequencing. Here, EREM is applied to a focal follow dataset of Congolese BaYaka forager child and adolescent play and work activities. Results show that, as children age, they engage in less frequent and extended play bouts and more frequent and extended work bouts. Bout frequency and duration were a more sensitive measure for early sex differences than overall time allocation. Sequential patterns of work and play suggest that these activities have short-term energetic trade-offs. This article demonstrates that EREM can reveal stable and variable patterns in child development. [ABSTRACT FROM AUTHOR]

Forager societies tend to value egalitarianism, cooperative autonomy, and sharing. Furthermore, foragers exhibit a strong gendered division of labor. However, few studies have employed a cross-cultural approach to understand how forager children learn social and gender norms. To address this gap, we perform a meta-ethnography, which allows for the systematic extraction, synthesis, and comparison of quantitative and qualitative publications. In all, 77 publications met our inclusion criteria. These suggest that sharing is actively taught in infancy. In early childhood, children transition to the playgroup, signifying their increased autonomy. Cooperative behaviors are learned through play. At the end of middle childhood, children self-segregate into same-sex groups and begin to perform gender-specific tasks. We find evidence that foragers actively teach children social norms, and that, with sedentarization, teaching, through direct instruction and task assignment, replaces imitation in learning gendered behaviors. We also find evidence that child-to-child transmission is an important way children learn cultural norms, and that noninterference might be a way autonomy is taught. These findings can add to the debate on teaching and learning within forager populations. [ABSTRACT FROM AUTHOR]

Summary This article considers the place of service-user knowledge and expertise within an evidence-based practice perspective. It makes a strong argument that client involvement is a core principle of Sackett et al.'s foundational approach in evidence-based medicine. In so doing, it draws on research on service-users' perceptions and experiences of evidence-based practice. Findings For service users, evidence-based practice lacks relevance and trustworthiness unless it explicitly factors in the expertise of service users themselves. Evidence-based practice is seen to have merit as a tool for enhancing accountability, but service users see a role for themselves at individual and representative levels in the process of evidence-based practice. They place a high value on the expertise derived from lived experience, and recognise that fluctuations in capacity and changes in circumstances of many service users require a flexible approach to their participation in decision making. A pragmatic approach to the conceptualisation of evidence is recommended, which not only maintains scientific rigour inherent in evidence-based practice but also more strongly emphasises the process of analysing evidence appropriate to a particular individual's preferences and circumstances. Applications For human service practitioners, this study emphasises the need to develop professional skills in assessing the capacities, circumstances and preferences of clients and analysing and applying evidence for practice in ways that conform to a client-centred approach. It also indicates a need for researchers and practitioners to recognise and value service-user expertise. [ABSTRACT FROM AUTHOR]

This article explores young people’s consumption of credit and the role of credit and debt in the distinction between youth and adulthood. The article engages with recent shifts in the nature of credit that have turned credit into an object of consumption in itself, as well as broader arguments about the financialisation of daily life, in order to understand the temporalities and moral distinctions enacted in different forms of credit and debt among youth. While it is well recognised that financialised capitalism operates and creates value from differences including gender, racialisation and class, the formation of youth subjectivities through credit and debt technologies remains unexplored in the literature despite an emerging crisis of consumer credit among young people. With this in mind, this article draws on a qualitative study of youth, credit and debt, to show that young people experience debt within contradictory temporalities and calculative logics, including the long-term ‘investments’ required to become an adult, and the logic of consumption attached to consumer credit which positions credit as a failure of self-responsible adulthood because it places future creditworthiness in jeopardy. In this way, the article suggests a future research agenda on the way that biographical distinctions are enacted through credit and debt, and how notions of youth and adulthood contribute to the qualification and consumption of credit. [ABSTRACT FROM AUTHOR]