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Men's emotions in intimate partner relationships have received little research attention. The current interpretive descriptive study included 30 Canadian‐based men to address the research question: What are the connections between masculinities and men's emotions in and after intimate partner relationships? Three inductively derived themes included emergent distressing emotions wherein participants' predominance for holding in abeyance their concerns about the relationship manifested varying levels of emotional stoicism. Within this context most men denied or downplayed and did not express their emotions. When the relationship broke, men were overwhelmed by mixed and weighty break‐up emotions comprising diverse and often‐times discordant emotions, including sadness, shame, anger, regret and guilt, calling into question men's rationality for deciphering and expressing what was concurrently but inexplicably felt. Shame and anger were prominent emotions demanding the participant's attention to all that happened in and at the end of the relationship. In the third theme, understanding and transitioning after‐burn emotions, participant's grief levered their efforts, including soliciting professional help for deconstructing, reframing and expressing their emotions in the aftermath of the partnership ending. The findings contextualise and in some instances counter claims about the utility of men's emotional stoicism by mapping participants' feelings in and after intimate partner relationships. [ABSTRACT FROM AUTHOR]

India and the global community are facing a critical crisis of antimicrobial resistance (AMR), significantly contributed to by on-going and increasing antimicrobial misuse. Information as to what drives misuse of antimicrobials within India is essential to inform strategies to address the crisis. This papers aims to identify perceived influences on antimicrobial use in Hyderabad, India. We conducted semi-structured qualitative interviews conducted with thirty participants (15 doctors, 15 pharmacists) around their experiences of antimicrobials in Hyderabad, India. Thematic analysis was performed and four themes identified around (1) Perceptions of the problem of resistance and antimicrobial use; (2) Social pressures to prescribe/dispense; (3) Financial pressures driving antimicrobial over-use; and (4) Lack of regulation around training and qualifications. We conclude that antimicrobial use within India is embedded with, and occurs as a result of, complex social and economic factors including issues of resource limitation, structural/governance limitations and social relationships. Strategies to address misuse without acknowledging and addressing the critical driving forces of use will be unlikely to induce significant change. [ABSTRACT FROM AUTHOR]

Men account for three‐quarters of suicide deaths in the UK, yet we know little about how at‐risk men construct their experiences of moving towards – and then subsequently stepping back from – suicide, nor the part played by relational factors therein. An inductive thematic analysis was used to examine narrative interviews with eleven UK men who self‐reported serious thoughts, plans and up‐to and including suicide attempts in progress, but who consciously decided against carrying out an attempt. Their accounts suggest a highly social process of movements towards and away from suicide (e.g. frustrated help‐seeking). Stepping back from suicide represents not a discrete issue, but a linked process in suicidality and wider recovery. Here, the use of military metaphors in particular (e.g. waging war, fighting back) highlights the gendered nature of the issue. Additionally, our article illuminates a range of social relations and forces that circulate in and around suicidality, which itself is embedded in varying forms of relationality, normativity and gendered practices. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is widely reported to be a rapidly escalating global health threat. Investigations into the social dimensions of AMR have tended to focus on economically wealthier nations, even though economically poorer countries are a site of considerable and often increasing antibiotic (mis)use. Understanding the global and local dynamics of antibiotic resistance, we propose, requires critical sociological investigation at the nexus of economic development, structural constraints, cultural norms, and infection-management practice. Here, to begin to unpack these intersections, we draw on qualitative interviews with physicians and pharmacists in Hyderabad to explore their accounts of the social dynamics of AMR in India. In particular, we focus on their accounts of practices of improvisation and self-medication with antibiotics; the nexus of informal and formal pharmaceutical economies and the vested interests therein; and the everyday brokering of antibiotics. We posit that responses to AMR need to be deeply embedded in the specificities of everyday practice, local market forces, and regulatory (im)possibilities with attention paid to the locally prevailing cultural norms. [ABSTRACT FROM AUTHOR]

While a significant health concern for sexual minority women, there is little qualitative research investigating their experiences of childhood trauma and suicidality. In this study, we used photovoice methods and an intersectionality framework. Drawing on qualitative interviews, we inductively derived three themes (a) Traumatized and discredited, (b) Cascading marginality, estrangement, and suicidality, (c) Reconstruction and reclaiming resilience. In Traumatized and discredited, we describe the sense of abandonment flowing from childhood trauma heightened by a lack of protection and neglect on the part of parents/guardians. The lack of support to deal with childhood trauma and the layering effects of marginality characterizes the theme Cascading marginality, estrangement, and suicidality. In the third theme, we discuss strategies for reconstruction and reclaiming resilience as participants worked to overcome these challenging experiences. Our study findings offer guidance to suicide prevention counseling programs for sexual minority women and affirm actions to address health inequities. [ABSTRACT FROM AUTHOR]

Although gay, bisexual, and two-spirit men (GBTSM) experience high rates of suicidality, there have been few empirical studies of prevention initiatives and policies that could address or reverse this major social problem. This article reports on a photovoice study of 29 GBTSM who had a history of suicidality or lost a fellow GBTSM to suicide. We focused our analysis on participants' perspectives on suicide prevention. Participants described four key considerations for GBTSM suicide prevention: (a) recognizing and addressing enduring homophobia, biphobia, and mental illness stigma; (b) provision of low-barrier, long-term, and GBTSM-affirming counseling; (c) de-isolation through peer support and community connection; and (d) fostering creativity and cultural resilience. By engaging GBTSM affected by suicide through photographs that depict their experiences and points of view, in this study, we offer concrete recommendations to reduce suicidality among GBTSM. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial therapy for intra‐abdominal infections is often inappropriately prolonged. An intervention addressing factors influencing the duration of intravenous antibiotic use was undertaken. This study reports the antibiotic prescribing patterns before and after the intervention and a qualitative analysis of the experience of the intervention. Methods: Quantitative: A retrospective audit of patients with complicated intra‐abdominal infection before and after a multifaceted persuasive intervention was performed. Qualitative: Semi‐structured interviews were performed to evaluate which elements of the intervention were perceived to be effective. Results: An intervention including collaborative inter‐specialty and inter‐professional educational meetings, and education of all professional streams was undertaken. Quantitative: Twenty‐three patients before and 22 patients after the intervention were included. The total duration of antibiotics decreased significantly following the intervention (9.2 versus 6.6 days P = 0.02). The duration of intravenous antibiotics did not change significantly (5.4 versus 4.5 days, P = 0.06). Qualitative: Eighteen health‐care professionals participated. Thematic analysis indicated that a collaborative approach between senior surgical and infectious disease specialists in the pre‐intervention stage led to perceived ownership and leadership of the intervention by the surgical team, which was thought critical to the success of the intervention. Conversely, the ability of nurses and pharmacists to influence antibiotic practice was considered limited and a poster promoting the intervention was perceived as ineffective. Conclusion: Consultant leadership and specialty ownership of the process were perceived to be critical in the success of the intervention. Antibiotic stewardship programs which address social factors may have greater efficacy to optimize antimicrobial prescribing. [ABSTRACT FROM AUTHOR]

Purpose: Surgical antibiotic prophylaxis (SAP) is a common area of antimicrobial misuse. The aim of this study was to explore the social dynamics that influence the use of SAP.Methods: 20 surgeons and anaesthetists from a tertiary referral hospital in Australia participated in semi-structured interviews focusing on experiences and perspectives on SAP prescribing. Interview data were analysed using the framework approach.Results: Systematic analysis of the participants’ account of the social factors influencing SAP revealed four themes. First, antibiotic prophylaxis is treated as a low priority with the competing demands of the operating theatre environment. Second, whilst guidelines have increased in prominence in recent years, there exists a lack of confidence in their ability to protect the surgeon from responsibility for infectious complications (thus driving SAP over-prescribing). Third, non-concordance prolonged duration of SAP is perceived to be driven by benevolence for the individual patient. Finally, improvisation with novel SAP strategies is reported as ubiquitous, and acknowledged to confer a sense of reassurance to the surgeon despite potential non-concordance with guidelines or clinical efficacy.Conclusions: Surgical-specific concerns have thus far not been meaningfully integrated into antimicrobial stewardship (AMS) programmes, including important dynamics of confidence, trust and mitigating fear of adverse infective events. Surgeons require specific forms of AMS support to enact optimisation, including support for strong collaborative ownership of the surgical risk of infection, and intra-specialty (within surgical specialties) and inter-specialty (between surgery, anaesthetics and infectious diseases) intervention strategies to establish endorsement of and address barriers to guideline implementation. [ABSTRACT FROM AUTHOR]

Although male suicide has received research attention, the gendered experiences of men bereaved by male suicide are poorly understood. Addressing this knowledge gap, we share findings drawn from a photovoice study of Canadian-based men who had lost a male friend, partner, or family member to suicide. Two categories depicting the men’s overall account of the suicide were inductively derived: (a) unforeseen suicide and (b) rationalized suicide. The “unforeseen suicides” referred to deaths that occurred without warning wherein participants spoke to tensions between having no idea that the deceased was at risk while reflecting on what they might have done to prevent the suicide. In contrast, “rationalized suicides” detailed an array of preexisting risk factors including mental illness and/or substance overuse to discuss cause–effect scenarios. Commonalities in unforeseen and rationalized suicides are discussed in the overarching theme, “managing emotions” whereby participants distanced themselves, but also drew meaning from the suicide. [ABSTRACT FROM AUTHOR]

India has undergone a considerable epidemiological transition in the past few decades. The rise of cancer and other chronic illnesses has, and will continue to have, a substantial impact on the overall burden of disease, as well as the lived experiences of illness in India. Little is known about the cultural inflection of cancer in the Indian medical, historical and religious/spiritual landscape, which is both highly varied and rapidly changing. Here, we explore some of the issues emergent from individuals’ experiences of illness including their understandings of cancer, its ‘origins’, its meanings and subsequent everyday experiences. Drawing on interviews with 40 people with cancer in Hyderabad, we focus on the cultural ontologies of cancer in India, the social moralities and evolving individual responsibilisation around cancer, and some of the affective dimensions of these interpretations of illness. [ABSTRACT FROM AUTHOR]

This study explored the social inclusion in high school of Australian students with vision impairment (VI). We sought to understand how students described school social inclusion, whether they felt included and what influenced these perceptions. As part of a larger mixed methods study, 12 students with VI, who had previously answered the Psychological Sense of School Membership (PSSM) questionnaire, were interviewed about the social aspects of school. These interviews were analysed thematically. Participants described social inclusion as about being noticed and not overlooked by others. While two-thirds of participants reported satisfactory social relationships in high school, one-third, including all those with additional disabilities, reported being teased or rejected by their school peers. Five themes encompassed the varying influences on school social inclusion. These were: (a) putting myself forward; (b) knowing me; (c) having control; (d) having a place to shine; and finally a negative influence (e) peer exclusion and rejection. These themes largely parallel those of competence, autonomy, and relatedness found in self-determination theory. This suggests that staff can enhance the social inclusion of students with VI by facilitating these students’ self-determination. In practice, this would require school staff to focus on enabling students with VI to explore and build on strengths, fully access the curriculum alongside their peers, and have time and opportunity to develop friendships with these peers. [ABSTRACT FROM AUTHOR]

Given the global crisis of antimicrobial resistance, the continued misuse of antibiotics is perplexing, particularly despite persistent attempts to curb usage. This issue extends beyond traditional “wastage” areas, of livestock and community medicine, to hospitals, raising questions regarding the current principles of hospital practice. Drawing on five focus group discussions, we explore why doctors act in the ways they do regarding antibiotics, revealing how practices are done, justified, and perpetuated. We posit that antibiotic misuse is better understood in terms of social relations of fear, survival and a desire for autonomy; everyday rituals, performances, and forms of professional etiquette; and the mixed obligations evident in the health sector. Moreover, that antibiotic misuse presents as a case study of the broader problematic of defensive medicine. We argue that the impending global antibiotic crisis will involve understanding how medicine is built around certain logics of practice, many that are highly resistant to change. [ABSTRACT FROM AUTHOR]

We are likely moving rapidly toward a post-antibiotic era, as a result of escalating antimicrobial resistance, rapidly declining antibiotic production and profligate overuse. Hitherto research has almost exclusively focused on doctors’ prescribing, with nurses’ roles in antibiotic use remaining virtually invisible. Drawing on interviews with 30 nurses, we focus on nurses as brokers of doctors’ antibiotic decisions, nursing capacity to challenge doctors’ decisions, and, “back stage” strategies for circumnavigating organizational constraints. We argue that nurses occupy an essential and conscious position as brokers within the hospital; a subject position that is not neutral, facilitates (short-term) cohesion, and involves the pursuit of particular (preferred) nursing outcomes. Illustrating how authority can be diffuse, mediated by institutionalized praxis, and how professionals evade attempts to govern their practice, we challenge the reification of physician prescribing power, arguing that it may work against the utilization of nurses as important stakeholders in the future of antibiotics. [ABSTRACT FROM AUTHOR]

The article discusses a study on the usefulness and usability of tools designed to assess the sexual knowledge of people with intellectual disability (ID). Topics covered include the limited sexual knowledge of people with ID serving as a barrier to sexual health, the preference by clinicians for using sexual knowledge assessment tools to support their work, and the concerns among clinicians about response bias and acquiescence associated with sexual knowledge assessment tools.

Home is frequently idealised as the preferred location for end-of-life care, while in-patient hospital care is viewed with suspicion and fear. Yet many people with a terminal illness spend their final days in some form of medicalised institutional setting, such as a specialist palliative care in-patient unit. Drawing on semi-structured interviews with in-patients at a specialist palliative care unit, we focus on their difficulties in finding a better place of care at the end of their life. We found that participants came to conceptualise home though a sense of bodily vulnerabilities and that they frequently understood institutional care to be more about protecting their family from the social, emotional and relational burdens of dying. For a significant number of participants the experience of dying came to be understood through what could be practically accomplished in different locales. The different locales were therefore framed around providing the best care for the patient and their family. [ABSTRACT FROM AUTHOR]

HIV is a significant social, political and economic problem in Zimbabwe. However, few researchers have explored peoples’ experiences of living with HIV in that country. Drawing on 60 qualitative interviews conducted with Zimbabweans living in Harare in 2010, this paper focuses on how people from four different urban communities cope with HIV-related social stigma. To provide theoretical context to this issue, we utilised the ideas of Erving Goffman for exploring the individual experience of stigma and the concept of structural violence to understand stigma as a social phenomenon. This paper considers the relevance and role of stigma in the context of a country undergoing significant social, political and economic crisis. We investigated the strategies adopted by the Zimbabwean state and the influence of traditional and religious interpretations to appreciate the historical roots of HIV-related stigma. We took into account the ways in which the articulation of HIV with gender has caused women to experience stigma differently than men, and more intensely, and how grassroots activism and biomedical technologies have transformed the experience of stigma. [ABSTRACT FROM PUBLISHER]

This article explores male perceptions and attitudes toward violence against women in Indonesia. It analyzes interview data from Indonesian men collected as part of a large multimethod Australian government–funded project on masculinities and violence in two Asian countries. Reluctance to talk about violence against women was evident, and the accounts of those men who did respond referred to three justificatory discourses: denial, blaming the victim, and exonerating the male perpetrator. The findings support continuation of government and nongovernmental organization (NGO) projects aimed at both empowering women and reeducating men. [ABSTRACT FROM PUBLISHER]

The proliferation of complementary and alternative medicine (CAM), and women’s high level of engagement with these practices, has presented sociology with a range of questions regarding gender, embodiment and identity work in the context of contemporary medical pluralism. The current study, drawing on 60 qualitative interviews with women from the Australian Longitudinal Study on Women’s Health (ALSWH), examines how a group of Australian women negotiate CAM and biomedicine in a range of health and illness contexts. Selected from the mid-aged cohort of this national study, here we explore their accounts of engagement with CAM and biomedicine, unpacking their logics underpinning, and rhetorical practices surrounding, their therapeutic engagement. The results provide significant insight into: the importance of ideas about nature, holism and strengthening; perceptions of the harshness and softness of medicines for women’s bodies; and, the relative importance of scientific proof vis-a-vis individual subjectivities. Ultimately, their accounts illustrate gendered and embodied strategies of strategic integration, and importantly, border crossing. We conclude that while women’s engagement with CAM and biomedicine may be indeed be gendered in character, we suggest a rethinking of gender-based resistance (to biomedicine) or gender-alignment (to CAM) arguments; the notion of women as designers would more adequately capture the landscapes of contemporary medical pluralism. [ABSTRACT FROM PUBLISHER]

Background: Specialist referral practices regarding palliative care are variable and their decision-making practices regarding timing and communication remains an under-researched issue. More effective referral practices have been shown to enhance patient and carer experiences at the end of life, reduce the burden on pre-palliative care services, and even extend life expectancy in some cases. Objective: The aim of this study was to examine the logics underpinning the timing of referral to palliative care according to a range of medical specialists in a regional center on the east coast of Australia, in order to facilitate improvements in referral practices. Methods: We conducted semi-structured, qualitative interviews with 20 medical specialists and carried out a thematic analysis of the interview data, utilising the framework analysis approach and NVivo 9 software. Key themes were tested for rigour through inter-rater reliability. Results: The major themes identified within this analysis of the interviews were: a) strategies for preparing for palliative care and the importance of planning timely referrals; b) perception of inter-professional variation and reasons for delayed or difficult referrals; and c) the importance of inter-specialty communication and cross-disciplinary dialogue. Conclusions: Significant barriers exist to the timely referral to palliative care, and, in order to improve patient and care quality of life and lessen clinical difficulties, further work is needed to develop streamlined practices that are sensitive to specialty needs and patient desires. [ABSTRACT FROM AUTHOR]

Drawing on qualitative interviews with patients near death, in this article we explore people’s experiences of living and dying in a hospice in-patient unit. The results illustrate the tensions and complexities of entering into the hospice environment and how its character (i.e. people, interactions and spaces) shapes experiences near death.The results illustrate the hospice in-patient unit as playing a vitally important role in supporting the end of life, but also, the unique challenges this environment presents to individual well-being. Key themes emergent from the interviews were: loss of self and identity nostalgia; liminality and the home/help dialectic; and the performative elements of dying. To explore and unpack these processes, we draw together different facets of previous conceptual work in sociology, working towards a more nuanced conceptualization of the in-patient hospice experience. [ABSTRACT FROM PUBLISHER]

Background: The end of life represents a therapeutic context that acutely raises cultural and linguistic specificities, yet there is very little evidence illustrating the importance of such dynamics in shaping choices, trajectories and care practices. Culture and language interplay to offer considerable potential challenges to both patient and provider, with further work needed to explore patient and caregiver perspectives across cultures and linguistic groups, and provider perspectives. The objective of this study was to develop a critical, evidence-based understanding of the experiences of people from Culturally and Linguistically Diverse (CALD) backgrounds, and their caregivers, in a palliative care setting. Methods: A qualitative study, using semi-structured interviews to explore key experiences and perspectives of CALD patients and caregivers currently undergoing treatment under oncology or palliative care specialists in two Australian hospitals. Interviews were digitally audio recorded and transcribed in full. A thematic analysis was conducted utilising the framework approach. Results: Sixteen patients and fourteen caregivers from a range of CALD backgrounds participated in semi-structured interviews. The research identified four prevalent themes among participants: (1) Terminology in the transition to palliative care; (2) Communication, culture and pain management; (3) (Not) Talking about death and dying; and, (4) Religious faith as a coping strategy: challenging the terminal diagnosis. Conclusions: CALD patients and caregivers' experiences are multifaceted, particularly in negotiating linguistic difficulties, beliefs about treatment, and issues related to death and dying. Greater attention is needed to develop effective communication skills, recognise CALD patients' particular cultural, linguistic and spiritual values and needs, and acknowledge the unique nature of each doctor-patient interaction. [ABSTRACT FROM AUTHOR]

An abstract of the study "Marginalization and Companionable Silence: CAM Practitioners' Perspectives of Their Interprofessional Relationships With Maternity Care Providers" by Amie Steel and colleagues is presented.