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Objective: Increasing numbers of young people live with a chronic health condition. Much research to date has explored young people's self-management of their illness and related symptomatology. Relatively less is known about how young people manage their long-term condition in everyday social contexts. This paper reports on findings from a qualitative study examining the perspectives of university students with a chronic health condition, including how they negotiate their health (and experiences of ill health) while at university. Design: A qualitative interview study was conducted with 16 students with a medically diagnosed chronic health condition. Setting: The study was conducted at a major university in Australia. Methods: Data were collected via in-depth semi-structured interviews and analysed thematically and inductively. Results: Findings illustrate how young people sought to position themselves as being 'healthy' while simultaneously distancing themselves from labels of ill health and disability. The relative invisibility of their health conditions enabled participants to align with and enact a preferred health identity. Yet, this invisibility presented particular challenges for students when navigating university systems and processes. Indeed, the fluctuating nature of their (ill) health status prompted a felt need continuously to prove their ill health to the university in order to receive academic support. Inevitably, this illness identity was at odds with participants' own health narratives -- triggering additional anxieties and (academic and social) exclusions for these young people. Conclusion: These contradictory (ill) health positions carry a number of implications for how best to support young people living with chronic health conditions while at university.

As the culture of silence that once surrounded cancer has gradually given way to greater public awareness, normative visions of what cancer survivorship should entail have proliferated. These visions emphasise positivity and perseverance in pursuit of cure. While these visions provide comfort to many, for people with metastatic cancer, the emphasis on cure can undermine their sense of belonging to the broader collective of people living with cancer. Drawing on semi‐structured interviews with 38 Australian women living with metastatic breast cancer, we explore how incurable cancer inflects understandings of self and transforms interpersonal relationships. Extending ideas around biosociality and belonging, we explore the tenuousness of social bonds, revealing how (in)visibility, (in)authenticity and (in)validation circulate within the daily lives of women with metastatic breast cancer. We conceptualise accounts according to four social bonds: (1) threatened bonds where a relationship is strained by misunderstanding, (2) severed bonds where a relationship is ruptured due to misunderstanding, (3) attuned bonds whereby a relationship is based on shared identification and (4) flexible social bonds when a relationship is based on mutual understanding. More broadly, we illustrate the persistence of normative visions of cancer survivorship and their enduring effects on those whom such visions exclude. [ABSTRACT FROM AUTHOR]

Voluntary assisted dying laws have now been enacted in all six Australian States with reform being considered in the remaining two. While there is an emerging body of literature examining various aspects of regulation, there has been scant consideration of what these reforms mean for First Nations peoples, and to what extent their experiences have been considered in the process of developing legislation. This article provides a critical analysis of how Indigenous perspectives both contributed to, and were engaged with, during the law reform processes in Victoria and Western Australia, the first two States to grapple with this topic. Findings reveal the sophistication in how Indigenous organisations and individuals engaged with this issue and highlight the critical importance of not universalising Indigenous perspectives. Significantly, there was much greater engagement with Indigenous views in Western Australia than in Victoria. We conclude by considering how Indigenous voices can meaningfully influence Australian law reform processes. [ABSTRACT FROM AUTHOR]

Concepts and practices related to risk are central to people's experiences of the COVID-19 crisis and attempts to contain the spread of the novel coronavirus. Sociological perspectives and empirical research on risk and uncertainty have much to offer for insights into how people conceptualise and respond to health risks such those associated with this new pandemic: including identification of the geographical, political, socioeconomic and other contextual dimensions. In this article, we provide findings from a qualitative interview-based project on Australians' experiences of the first six months of the pandemic in 2020, including the national lockdown. A total of 40 adults from across Australia took part in a semi-structured telephone interview. Adopting a narrative analysis approach, we explored people's biographical, embodied, spatial and affective experiences in what we term their 'COVID-19 risk narratives'. We further identified the events and circumstances that contributed to people beginning to feel at heightened personal risk from COVID-19 or which helped them feel safe or less vulnerable. The findings highlight the roles of factors including media coverage, previous experiences with infectious disease, beliefs about personal health and immunity, the government's implementation of containment measures, observations of others' behaviours and experiences, interactions with healthcare providers, geographical location and concern for family members. We argue that surfacing the interplay of these dynamic complex and highly contextual forces and relationships is vital to understanding COVID-19 risk understandings and practices. [ABSTRACT FROM AUTHOR]

What does migrancy mean for personhood, and how does this flow through caring relations? Drawing on life history interviews and photo elicitation with 43 people who identify as migrants and live with cancer, here we argue for the significance of recognising complex personhood as it inflects illness and care. Drawing on social science theory around temporalities, moralities and belonging, we assemble a series of cross-cutting themes at the intersection of personhood and care; relations that transcend cultural origins yet are vividly illustrated in relation to migrant pasts. In seeking a multidimensional view of personhood, we attend to the intersecting layers of complexity that make up care in this context vis-a-vis an emphasis on forms of difference, vulnerability and otherness. In this way, we develop an approach to personhood and care that broadens the lens on migrancy and cancer, but also, one that speaks to the importance of recognition of complexity and how it shapes care more generally. [ABSTRACT FROM AUTHOR]

Historical simulations of models participating in the sixth phase of the Coupled Model Intercomparison Project (CMIP6) are evaluated over 10 Australian regions for their performance in simulating extreme temperatures, among which three models with initial‐condition large ensembles (LEs) are used to estimate the effects of internal variability. Based on two observational data sets, the Australian Water Availability Project (AWAP) and the Berkeley Earth Surface Temperatures (BEST), we first analyze the models' abilities in simulating the probability distributions of daily maximum and minimum temperature (TX and TN), followed by the spatial patterns and temporal variations of the extreme indices, as defined by the Expert Team on Climate Change Detection and Indices (ETCCDI). Overall, the CMIP6 models are comparable to CMIP5, with modest improvements shown in CMIP6. Compared to CMIP5, the CMIP6 ensemble tends to have narrower interquartile model ranges for some cold extremes, as well as narrower ensemble ranges in temporal trends for most indices. Over southeast, tropical, and southern regions, both CMIP ensembles generally exhibit relatively large deficiencies in simulating temperature extremes. We also confirm that internal variability can affect the trends of the extremes and there is uncertainty in representing the irreducible variability among different LEs in CMIP6. Furthermore, the evaluation based on Perkins' skill score (PSS) and root‐mean‐square error (RMSE) in the three LEs does not directly correlate with the ranges of the trends for extreme temperatures. The findings of this study are useful in informing and interpreting future projections of temperature‐related extremes over Australia. Key Points: The assessment on the probability distributions of daily maximum and minimum temperature makes the evaluation of extremes more robustTemperature extremes over Australia are broadly similar in CMIP5 and CMIP6There are differences in estimating internal variability across multiple CMIP6 models [ABSTRACT FROM AUTHOR]

An extensive body of scholarship focuses on cultural diversity in health care, and this has resulted in a plethora of strategies to "manage" cultural difference. This work has often been patient-oriented (i.e., focused on the differences of the person being cared for), rather than relational in character. In this study, we aimed to explore how the difference was relational and coproduced in the accounts of cancer care professionals and patients with cancer who were from migrant backgrounds. Drawing on eight focus groups with 57 cancer care professionals and one-on-one interviews with 43 cancer patients from migrant backgrounds, we explore social relations, including intrusion and feelings of discomfort, moral logics of rights and obligation, and the practice of defaulting to difference. We argue, on the basis of these accounts, for the importance of approaching difference as relational and that this could lead to a more reflexive means for overcoming "differences" in therapeutic settings. [ABSTRACT FROM AUTHOR]

Premised on the idea that setting goals motivates action and allocation of resources toward a desired future state, goal-setting has become a key component of self-management support. The notions that underpin goal-setting situate self-management firmly within the control and responsibility of individuals. Yet, we argue that goals are not solely individual pursuits to be achieved if individuals have the right knowledge and enough motivation; rather, they are social products, influenced by individual and collective subjectivities, which are structured over time. Drawing primarily on Bourdieu's concept of habitus, along with capital and field, we examine how goals are constructed in self-management support encounters. Seventeen patient-professional dyads comprising 15 patients and 11 health professionals were interviewed on up to three occasions. In total 64 semi-structured interviews were conducted between 2015 and 2017 in Sydney, Australia. Goals were manifested through patient participants' expressions of goal agency (as self-owned wants and opportunities; responsibilities to self and others; or necessities); goal-oriented dispositions (determined; responsible; or powerless); temporal orientations (past, present or future); and access to resources to support self-management. These characteristics were grouped into three typologies: 'Goals as opportunities'; 'From goals to responsibilities'; and 'Necessities when living precariously'. The way goals were constructed was structured over time by present experiences superimposed on past experiences and access to resources. These findings help broaden understandings of the tensions between patient and professionals' goals for living well with chronic conditions and draw attention to the need for structural change to support people to live well with their chronic conditions. • Goals for self-management are complex social products. • Goal orientations are shaped by dispositions, temporalities and resources. • People are differentially positioned in the field of self-management support. • Structural factors must be addressed for all to have opportunities for meaningful goals. [ABSTRACT FROM AUTHOR]

A person-centered approach to goal-setting, involving collaboration between patients and health professionals, is advocated in policy to support self-management. However, this is difficult to achieve in practice, reducing the potential effectiveness of self-management support. Drawing on observations of consultations between patients and health professionals, we examined how goal-setting is shaped in patient–provider interactions. Analysis revealed three distinct interactional styles. In controlled interactions, health professionals determine patients' goals based on biomedical reference points and present these goals as something patients should do. In constrained interactions, patients are invited to present goals, yet health professionals' language and questions orientate goals toward biomedical issues. In flexible interactions, patients and professionals both contribute to goal-setting, as health professionals use less directive language, create openings, and allow patients to decide on their goals. Findings suggest that interactional style of health professionals could be the focus of interventions when aiming to increase the effectiveness of goal-setting. [ABSTRACT FROM AUTHOR]

In this paper, we examine the intersections between place and healthcare choice, drawing on Bourdieu's concepts of distinction and social space, and engaging with data from interviews with 78 Australians living in varied geographic locations. We find the status of an area is used to judge the quality of its healthcare services. Areas with high status are assumed to have better quality health services than areas of disadvantage. Where people live shapes the choices they make and their judgements about the status of a place. Moreover, having less choice is not necessarily problematic. Participants in regional and remote areas with less choice tend to report positive experiences with healthcare providers. Place can constrain people's ability to make good healthcare choices, yet participants have differing capacities to mobilise resources to overcome the constraints of place. [ABSTRACT FROM AUTHOR]

Australia experienced much above average rainfall in association with strong, extended La Niña conditions during 2010-2012. Was the heavy Australian rainfall influenced by La Niña conditions and/or anthropogenic greenhouse gases? We investigate the relative contributions of anthropogenic climate change and natural climatic variability to the likelihood of heavy Australian rainfall using three distinct model datasets. Area-average rainfall anomalies for model simulations with natural forcings only were compared to simulations with both anthropogenic and natural forcings using 16 models participating in the Coupled Model Intercomparison Project Phase 5. Using fraction of attributable risk to compare the likelihood of unusual rainfall between the parallel experiments, we find attribution statements are uncertain, with FAR values sensitive to the attribution parameters considered, including thresholds, regions and seasons. When heavy rainfall probabilities were next investigated in ensembles of two atmospheric general circulation models, run with and without anthropogenically-induced sea surface temperature changes, results were model-dependent. Overall, the attribution of seasonal-scale heavy Australia rainfall to a particular cause is likely more complicated than for temperature extremes. As estimates of the greenhouse gas attributable change in rainfall risk may depend on the model datasets considered, it is also useful to consider model outputs from several datasets and using various estimates of counterfactual surface conditions to establish robust attribution statements for extreme rainfall events. In contrast, comparing the likelihoods of heavy rainfall during simulated La Niña years with El Niño/neutral years reveals a substantial La Niña influence on Australian rainfall during 2010-2012 that is robust to changes in the attribution framework. [ABSTRACT FROM AUTHOR]

In this article, we use the case study method to detail the experiences of five participants who reported living with pre-existing mental illness during COVID-19. We adopted a sociomaterial analytical approach, seeking to identify how human and nonhuman agents came together to generate states of wellbeing or distress during this challenging period. As the case studies show, feelings of anxiety, fear and risk were generated from the following sociomaterial conditions: loss of face-to-face contact with friends and family members; concerns about hygiene and infecting others; financial stress; loss of regular paid employment or volunteering work; public spaces; and the behaviour of unknown others in public spaces. The agents and practices that emerged as most important for opening capacities for coping and maintaining wellness during lockdown included: the space of the home; contact with a small number of intimate others; online therapeutic care; practising self-care skills learnt from previous difficult times; helping and supporting others; engaging in leisure activities; and the companionship of pets. Contributing to an affirmative approach to more-than-human assemblages of health, distress and recovery, these findings demonstrate what bodies can do in times of crisis and the agents and practices that can generate capacities for coping. • An analysis of how people with existing mental health conditions experienced COVID-19. • Draws on corpus of 30 indepth interviews with adult Australians. • Uses a sociomaterial theoretical framework. • Adopts an affirmative approach that highlights ways of coping. [ABSTRACT FROM AUTHOR]

Abstract: Obesity stigma exists within many institutions and cultural settings. Most studies suggest that stigmatising experiences have a negative impact on individuals’ health and social behaviours and outcomes. However, some studies indicate that obesity stigma can motivate individuals to lose weight. Limited research has examined weight-based stigma from the perspective of obese individuals, including their perceptions of, and responses to, the different types of weight-based stigma they face in their daily lives. This study advances knowledge about weight-based stigma by documenting how obese adults (mostly female) described the different types of obesity stigma that they faced, how they responded to this stigma, and how different types of stigma impact on health and social wellbeing. Semi-structured, qualitative interviews were conducted between April 2008 and March 2009 with a diverse sample of 141 obese Australian adults. Guided by categorisation of different types of discrimination, participants’ experiences could be grouped into three distinct types of stigma: 1) Direct (e.g. being abused when using public transport); 2) Environmental (e.g. not being able to fit into seats on planes); and 3) Indirect (e.g. people staring at the contents of their supermarket trolley). Participants described that more subtle forms of stigma had the most impact on their health and social wellbeing. However, it was the interaction between direct, environmental and indirect stigma that created a barrier to participation in health-promoting activities. Participants rarely challenged stigma and often blamed themselves for stigmatising experiences. They also avoided situations where they perceived they would be stigmatised and constantly thought about how they could find a solution to their obesity. [Copyright &y& Elsevier]

Choice is an imperative for patients in the Australian healthcare system. The complexity of this healthcare ‘maze’, however, means that successfully navigating and making choices depends not only on the decisions of patients, but also other key players in the healthcare sector. Utilising Bourdieu's concepts of capital, habitus and field, we analyse the role of gatekeepers (i.e., those who control access to resources, services and knowledge) in shaping patients' experiences of healthcare, and producing opportunities to enable or constrain their choices. Indepth interviews were conducted with 41 gatekeepers (GPs, specialists, nurses, hospital administrators and policymakers), exploring how they acquire and use knowledge within the healthcare system. Our findings reveal a hierarchy of knowledges and power within the healthcare field which determines the forms of knowledge that are legitimate and can operate as capital within this complex and dynamic arena. As a consequence, forms of knowledge which can operate as capital, are unequally distributed and strategically controlled, ensuring democratic 'reform' remains difficult and 'choices' limited to those beneficial to private medicine. [ABSTRACT FROM AUTHOR]

The media play a key role in promoting the thin ideal. A qualitative study, in which we used in depth interviews and thematic analysis, was undertaken to explore the attitudes of 142 obese individuals toward media portrayals of the thin ideal. Participants discussed the thin ideal as a social norm that is also supported through the exclusion of positive media portrayals of obese people. They perceived the thin ideal as an 'unhealthy' mode of social control, reflecting on their personal experiences and their concerns for others. Participants' perceptions highlighted the intersections between the thin ideal and gender, grooming and consumerism. Participants' personal responses to the thin ideal were nuanced e some were in support of the thin ideal and some were able to critically reflect and reject the thin ideal. We consider how the thin ideal may act as a form of synoptical social control, working in tandem with wider public health panoptical surveillance of body weight. [ABSTRACT FROM AUTHOR]

Hope can carry considerable allure for people facing imminent mortality and for those who care for them. Yet, how hope is variously and relationally (re)produced within end-of-life care settings, remains under-researched. In this study, we aimed to better understand hope as it circulates within palliative care, drawing on video recorded family meetings and pre- and post-meeting qualitative interviews, within two hospitals in Queensland, Australia. Our findings highlight family meetings as an important site for articulations of hope and hopefulness. The results illustrate how hope is recalibrated within the transition to and through palliative care, the tensions between hope and futility, and the work of hope in discussions of goals and expectations. Through our analysis we argue that hopefulness within family meetings, and in palliative care more broadly, is collectively produced and opens up discourses of hope to the lived experience of terminality. Attending to the nuances of hope, including moving beyond the determinative (hope for more life/hope for a quick death), can elucidate the possibilities and problems of the collective negotiation of hope at the end of life, including how hope can be drawn on to express support and solidarity. • Palliative care family meetings are important sites for the recalibration of hope. • Hope is collectively produced and relationally significant in palliative care. • Attending to hope helps recognise what matters to people nearing the end of life. • Hopefulness as a disposition reveals ways of tacitly knowing and doing living and dying. [ABSTRACT FROM AUTHOR]