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Attention deficit hyperactivity disorder (ADHD) is a paradigmatic case for childhood medicalisation. Critical studies of medicalisation have pointed to the increasing clinical role of schools, with teachers tending to rely on medical treatment of students with ADHD and are perceived as a primary source of diagnostic information. Based on 27 semi‐structured interviews with teachers working in two Israeli elementary and middle schools, this research explored how teachers mediate the medicalisation process and understand their responsibilities in the classroom amidst the emphasis on inclusion in contemporary Israel. We found that teachers offer a wide range of explanations of the disorder and its prevalence, and their attitudes to medication are ambivalent. We argue that teachers develop pedagogical (lay) expertise in the field of ADHD in parallel with and in opposition to medical solutions. Such expertise is based on practical experience and close interaction with students. A top‐down ideological imperative of inclusion, combined with uncertainty about ADHD, has generated a bottom‐up set of preformative practices of 'containment' of troubled students. Teachers' emerging knowledge and practices raise questions about the relationship between medicalisation, policy, expertise and the pragmatic value of medical categories when applied outside the medical establishment. [ABSTRACT FROM AUTHOR]

'Experiential knowledge' has been identified as a key epistemic resource used by lay people to contest medical authorities and build new knowledge related to health. The Internet has created unprecedented opportunities for such experience‐based epistemic projects. This article contributes to understandings of the as yet under‐theorised concept of experiential knowledge by analysing accounts of a group of Swedish women who claim that their use of contraceptive copper IUDs has led to systemic side effects not recognised by health care providers. Based on digital group interviews and written essays, we distinguish between three components or stages of experiential knowledge at work in the women's use of experience as an epistemic resource: somatic knowing, collective validation and self‐experimentation. Drawing on a critical realist framework, we defend a notion of experiential knowledge as crucially, while only partially, based on a bodily and practical access to aspects of reality organised by extra‐discursive principles. By providing theoretical complexity to the notion of experiential knowledge, we contribute resources for discriminating between and evaluating various experience‐based claims, something that is particularly needed in the current 'post‐truth' era where experience‐based knowledge claims pointing in divergent directions flourish. [ABSTRACT FROM AUTHOR]

Framed both as a solution to and as an additional part of the tobacco problem, e-cigarettes have been the subject of risk controversies since they were launched in 2006, followed by massive divergence in media, public health approaches and regulations across the world. This study explores vapers' risk perceptions and accounts of the public risk communication and regulation of e-cigarettes in a Norwegian context were nicotine-containing e-liquids are prohibited from being sold by domestic retailers. Based on analyses of semi-structured qualitative interviews (n = 30, 17 males) with adult vapers, I find that the participants emphasised three important dimensions related to risk. First, they perceived vaping as harm reduction by substituting for smoking. Second, they devalued much of the risk communication about e-cigarettes from Norwegian health authorities and media. Interlinked with their harm-reduction approach, they perceived the present regulation of nicotine e-liquid and vaporisers as increasing risk by decreasing their availability to smokers. Third, in general they preferred the lay expertise available online to the health authorities' information on e-cigarettes. The analysis displays a lack of trust among the participants in what can be labelled as top-down information. Based on these dimensions, I conclude that the dissonance between vapers risk perceptions and the regulation and mixed messages in risk communication of e-cigarettes has contributed to their preference for bottom-up expertise. From the vapers' point of view, e-cigarettes represent harm reduction, and the vaper community symbolises a bottom-up health movement where peer assistance compensates for a perceived lack of assistance from health authorities. [ABSTRACT FROM AUTHOR]

Peer support workers are now working with patients in a variety of settings, coming into close contact and even work alongside health professionals. Despite the potentially influential position peer support workers hold in relation to those engaged in support activities, their role, duties and their relationship to peers and health professionals lack clarity and is often defined by other actors. This study explores how peer support workers interpret and define the activities, responsibilities and knowledge associated with their work. Using methods of membership categorisation analysis, we analysed interview materials generated by conducting individual semi-structured interviews during the autumn of 2016 with prostate cancer peer support workers (n = 11) who currently volunteer as support workers in Finland. Although the peer support workers acknowledged the psychosocial aspects of the work, we argue that their interpretations extend far beyond this and encompass expertise, advocacy and activism as central features of their work. These can be used to strengthen their position as credible commentators and educators on issues relating to cancer and men's health; raise awareness and represent the 'patient's voice' and attempt to influence both policy and clinical practice. These findings suggest that by categorising their work activities in different ways, voluntary sector actors such as peer support workers can attempt to portray themselves as legitimate authorities on a range of issues and influence decision-making ranging from individual level treatment decisions all the way to health policy. [ABSTRACT FROM AUTHOR]

Although randomized controlled trials (RCTs) examine "objective" indicators of safety and efficacy of investigational drugs, participants may not perceive study medications as neutral entities. Some medications are imbued with social and cultural meaning, such as stigmatized medications for opioid use disorders. Such perceptions surrounding substance use treatments can extend to the research context and shape RCT participants' experiences with and adherence to study medications. Considering these complexities in substance use research, we conducted a nested qualitative study within a multi-site, pragmatic RCT in Canada testing two treatments (methadone versus buprenorphine/naloxone) for opioid use disorder. Between 2017 and 2020, we conducted 115 interviews with 75 RCT participants across five trial sites in British Columbia, Alberta, Ontario, and Quebec. Using an abductive coding approach, we characterized participants by their previous experience with medication for opioid use disorder and by their exposure to drug culture and drug scenes. Across these experience types, we identified systematic differences around participants' perceptions of the study medications, sources of information and expertise, and medication stigma. Our findings illustrate the critical importance of social context in shaping medication beliefs and study experiences among people who use drugs, with implications for the conduct of future RCTs in substance use. • Medications for opioid use disorder have social meaning that can influence research. • Participants' prior experiences shape medication beliefs and RCT participation. • Nested qualitative studies within RCTs provide robust data on research experiences. [ABSTRACT FROM AUTHOR]

Background: The impact of chronic diseases in our society is growing. The idea of self‐care generates understandable enthusiasm and is seen as a natural answer. It is important to develop an understanding of self‐care practices that goes beyond a clinical understanding of the disease and that acknowledges everyday practicalities, and the perspective of the patient. Objective: To shed light on some of the practicalities of everyday chronic self‐care, to expose to analysis the key role of lay expertise and to stress the importance of its recognition in future chronic care practices and technology. Design: Ethnomethodological investigations based on observations of a patient support group (10 months) and some shadowing sessions of everyday practices, semi‐structured interviews with individuals with type 1 diabetes (n = 14) and professional caregivers (n = 7). Analysis: The qualitative data analysis was inspired by grounded theory and aimed at ordering data under emerging categories and topics. Results: The patient's knowledge and expertise is critical to grounding, integrating and complementing technical‐medical/clinical knowledge in everyday chronic self‐care. To deal with the intricacies and difficulties of everyday chronic self‐care, individuals with type 1 diabetes develop different ways of knowing and dealing with the disease that need to be equally taken into account in the reorganization of care delivery, and in the design of the tools to support it. Conclusion: Rethinking the traditional separation between hard and soft data may be a possible first step towards rethinking the role of lay expertise in chronic care towards better supports for self‐care practices and patient empowerment. [ABSTRACT FROM AUTHOR]

Recent literature on the public understanding of science has focused on replacing the deficit model of public communication in which experts disseminate information with one that encourages public participation and dialogue. Situated within this call for increased participation, this study looks at self-care practices in which medical expertise is not passively consumed by the layperson, but shared and (re)produced through arenas of lay practice. This collective knowledge production is facilitated by the online environment, which provides access to mediated medical knowledge and the ability to form communities in which users can negotiate this expertise and share their experiences. The laypersons examined here are members of the Canadian online collective, Running Mania , highlighting how this negotiation of expertise occurs in a "wellness" community. Drawing from member interviews and website observations of the site's injury forum, the study examines collective injury management using two dominant theoretical discourses surrounding lay knowledge and participation in medical expertise: the lay expert whose knowledge arises from experience and the expert patient whose knowledge base parallels dominant biomedical discourse. Using the coproduction model and the related concepts of tinkering and logic of care from material semiotics, the research examines how these knowledge forms articulate to produce an intermediary discourse unique to this collective's articulation of running and caring practices, a discourse that is enacted in individuals' embodied negotiation of these multiple forms of medical expertise. It suggests that the logic of care has the potential to bridge the expert/lay boundary since the need for persistent, attentive tinkering applies across epistemological divides: in "good" care practices, multiple expertises are needed, both expert and lay, to hold the body together. • Online self-care collectives are sites of participation with medical expertise. • Multiple mediated medical expertises and lay expertise coproduce new knowledge. • Laypersons negotiate collective knowledge in the context of their own embodiment. • "Good" care requires attentive, persistent tinkering with multiple expertises. • Commitment to "good" care is a shared value that blurs the expert/lay boundary. [ABSTRACT FROM AUTHOR]