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Cancer is a disease that is imbued with notions of risk, with individuals expected to avoid 'risky' behaviours and act swiftly when symptoms indicating a risk of cancer emerge. Cancer symptoms, however, are often ambiguous and indicative of a number of other conditions, making it difficult for people to assess when symptoms may, or may not, be the result of cancer. Here, we discuss interview data from a study examining the symptom appraisal and help-seeking experiences of patients referred for assessment of symptoms suspicious of a lung or colorectal cancer in the North-East of England. We explore how individuals draw upon ideas about cancer risks to assess whether cancer may be a possible explanation for their symptoms and to inform their decisions about help-seeking. In our analysis, we applied the concept of candidacy to the data, to highlight how lay epidemiology shapes people's perceptions of cancer risk, and their subsequent responses to it. We found that participants appraised their symptoms, and the likelihood that they may have cancer, in light of relevant information on risk. These sources of information related to lifestyle factors, family history of cancer, environmental factors, and importantly, the symptomatic experience itself, including the absence of symptoms that participants associated with cancer. The importance of experienced, and absent, symptoms was a core element of participants' everyday constructions of the 'cancer candidate', which informed symptom appraisal and subsequent help-seeking decision-making. [ABSTRACT FROM AUTHOR]

Background In October 2009, NHS County Durham and Darlington introduced a single point of access telephone number for people requiring out-of-hours health care. We evaluated users' views and experiences of the service. Methods We used a validated questionnaire adapted for use in telephone interviews, with open-ended questions added to allow people to express their views. Interviews were carried out with 493 people who had used the urgent care line between April and July 2010 of 1626 telephone calls made, a response rate of 30.3%. SPSS 17.0 was used to analyse the quantitative data and Framework analysis the qualitative data. Results We found that (i) regardless of age or gender people who used the call line were satisfied with the service they received, (ii) the call line advised most cases to go to an urgent care centre, (iii) people who received advice other than that expected were still satisfied with the service. Criticisms of the service related to confusion about accessing the service and which number callers should use. Conclusions We found very high levels of satisfaction across all groups for a single point of access telephone number for urgent care. Clear information about the service, in particular that it will involve telephone triage and that access to a doctor or nurse is not immediate, may also resolve some instances of dissatisfaction. It appears that the service is effective in directing people to places where they can be dealt with appropriately. [ABSTRACT FROM PUBLISHER]

Retreat and advance of shoreline position occurs naturally, and also as a result of defences which are constructed to prevent erosion and flooding. Retreat more commonly manifests itself down-drift of defences due to a sediment deficit causing the coast to become 'set-back'. Advance normally develops due to sediment accumulation up-drift of a barrier inhibiting longshore drift, resulting in the coast becoming 'set-forward'. Many examples of set-backs and set-forwards are recorded, but their location, number and cause is not known on a national scale. Using the Futurecoast aerial photographs, approximately 200 localities were identified as set-back or set-forward in England and Wales, with half situated in the Eastern and South East regions of England. Half of the total set-backs or set-forwards were on cliffed coasts, and half on low-lying coasts. Without local knowledge it is difficult to distinguish between set-backs and set-forwards. Set-backs often indicate higher retreat rates, thus threatening cliff-top infrastructure which requires defence upgrade and extensions, as well as raising maintenance costs. Monitoring set-backs is important for shoreline management, because as retreat continues, set-backs evolve and artificial headlands form and grow. This is reinforced by the shift from hard defence policies towards softer engineering approaches, managed realignment and limited intervention. [ABSTRACT FROM AUTHOR]

A line of flight is essentially a movement of creativity, a practical act or a way of living that wards off or inhibits the formation of ‘centres’ and stable powers in favour of continuous variation and free action. This article supports the arts-based practice of a documentary film, Lines of Flight, which uses free solo rock climbing in the Pennine region of northern England, to give access to a range of ‘intensely lived experiences’ that can offer a route out of the social, economic and cultural conditions that often subjugate modern society and back to life in its free and wild state. The documentary becomes a presentational line of flight in itself, as it looks to find the conditions for a novel experience in the making, under which a new filmic affect is produced in the here and the now. [ABSTRACT FROM AUTHOR]

Objectives To investigate the causes of unintended pregnancies and, in particular, reasons for non-use of contraception among young women attending a day unit for surgical abortion. Methods Women between the ages of 16 and 20 attending a day unit at a hospital in the north of England who were due to have, or had recently had, a surgical abortion were interviewed about their knowledge of and views on contraception, sex education, and sexual health services. Twenty-four young women were interviewed, 22 on the day unit, one in her home and one over the phone, after the abortion. Interviews were recorded with the consent of the interviewees and fully transcribed. Transcripts were analysed using a grounded theory approach. Results The most common reasons for non-use of contraception related to forgetting or ‘not thinking’, being ‘in the moment’ (i.e., being ‘in the mood’, not wishing to ‘break a spell’), the influence of alcohol, and pressure from young men not to use condoms. Lack of knowledge was rarely cited as a reason. Conclusions Young people are aware of the need to use contraception, and knowledgeable about its availability; however, they often do not think about using it, especially where sex is unplanned. Alcohol and being ‘in the moment’ are key factors which diminish the likelihood of contraceptive use. [ABSTRACT FROM AUTHOR]

Purpose: The National Health Service (NHS) Local Improvement Finance Trust (LIFT) programme was launched in 2001 as an innovative public-private partnership to address the historical under-investment in local primary care facilities in England. The organisations from the public and private sector that comprise a local LIFT partnership each have their own distinctive norms of behaviour and acceptable working practices - ultimately different organisational cultures. The purpose of this article is to assess the role of organisational culture in facilitating (or impeding) LIFT partnerships and to contribute to an understanding of how cultural diversity in public-private partnerships is managed at the local level., Design/methodology/approach: The approach taken was qualitative case studies, with data gathering comprising interviews and a review of background documentation in three LIFT companies purposefully sampled to represent a range of background factors. Elite interviews were also conducted with senior policy makers responsible for implementing LIFT policy at the national level., Findings: Interpreting the data against a conceptual framework designed to assess approaches to managing strategic alliances, the authors identified a number of key differences in the values, working practices and cultures in public and private organisations that influenced the quality of joint working. On the whole, however, partners in the three LIFT companies appeared to be working well together, with neither side dominating the development of strategy. Differences in culture were being managed and accommodated as partnerships matured., Research Limitations/implications: As LIFT develops and becomes the primary source of investment for managing, developing and channelling funding into regenerating the primary care infrastructure, further longitudinal work might examine how ongoing partnerships are working, and how changes in the cultures of public and private partners impact upon wider relationships within local health economies and shape the delivery of patient care., Originality/value: To the authors' knowledge this is the first study of the role of culture in mediating LIFT partnerships and the findings add to the evidence on public-private partnerships in the NHS.

Objectives: To test the effectiveness of a typical magnetic wrist strap for reducing pain and stiffness, and for improving physical functioning amongst patients with osteoarthritis., Design: A randomised double-blind placebo-controlled crossover trial. Each participant wore four devices over a 16-week period., Setting: Forty five patients with osteoarthritis were recruited from general practices in rural and urban areas of Yorkshire., Interventions: Experimental device: a commercially available magnetic wrist strap. Control devices: a weak magnetic wrist strap, a demagnetised wrist strap, and a copper bracelet., Main Outcome Measures: The WOMAC Osteoarthritis Index, the McGill Pain Questionnaire-Pain Rating Index (PRI), a pain visual analogue scale (VAS), and medication use., Results: No difference was observed between devices in terms of their effects on pain as measured by the primary outcome measure (WOMAC A), the PRI and the VAS. Similar results were obtained for stiffness (WOMAC B), physical function (WOMAC C), and medication use. Further analyses of the PRI subscales revealed a statistically significant difference between devices (P=0.025), which favoured the experimental device. Participants reported lower sensory pain after wearing the standard magnetic wrist strap, than when wearing control devices. However, no adjustment was made for multiple testing., Conclusions: Our results indicate that magnetic and copper bracelets are generally ineffective for managing pain, stiffness and physical function in osteoarthritis. Reported therapeutic benefits are most likely attributable to non-specific placebo effects. However such devices have no major adverse effects and may provide hope.

The Intensive Care Society (1998) developed Guidelines for Bereavement Care in Intensive Care Units. In response to the guidelines, a group of nurses from the intensive care units at Glenfield Hospital in Leicester have developed a bereavement after-care service for relatives and staff. So far, the service has evaluated well from the feedback received from both relatives and staff, but evaluation is ongoing and the service is being continually developed.