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This paper reflects on a practitioner-grounded metaphor -- the mosaic -- as a means to think the relationship between health and the environment in two policy initiatives, a walking and a conservation group. These were both part of Thames Chase Community Forest, a UK-based nature program to combat ill-health, poverty and social exclusion for those on the fringe of large urban conurbations. Using multiple research methods, the paper questions the simple, literal, equal-but-separate notions of the two pre-set policy parameters to show how the solidarity that mattered could not be fixed in advance. It was a mosaic-in-the-making, that came to life along the way, within the shifting ground of patterned regularities, people and happenings that often escape the net of rapid approaches to ethnographic policy research. Such reflections might usefully offer fresh soundings for policy-makers to contemplate, not merely a blueprint to be followed. [ABSTRACT FROM AUTHOR]

Abstract: This paper explores perceptions of health, the environment, and the relationships between them, in a programme of community forestry. Drawing on qualitative data generated within a multi-disciplinary project, the paper discusses the difficulties of conceptualising the key variables utilised in research on the links between green space and health. Health and the environment were not discrete entities that could be mapped on to one another, but fluid and contested concepts. A simple model of the ‘impact’ of environment on health could not do justice to the ways in which ‘use’ of outdoor space is a process, not an event. [Copyright &y& Elsevier]

In this paper we report on how a group of general practitioner (GP) educators, a medical sociologist and an educationalist learned to construct a shared understanding of ethnographic case study and how their different perspectives could be used to strengthen the investigative gaze of the study. We examine how our research traditions shaped what we understand research to be and how to use it. This examination identifies the key understandings we needed to develop to enable us to work sensitively and effectively in evaluating the contribution a Balint approach has to offer in the vocational training of GPs. Selecting one from seven ethnographic case studies documented, we illuminate both the learning processes within small groups and the contribution ethnography has to make. The case study selected brings us inside the research process and to the nub of the learning and teaching issues of small group work. It reflects the contribution ethnographic case studies may offer learner, teacher and those with responsibility for professional preparation and development. [ABSTRACT FROM AUTHOR]

The onset of a chronic illness such as Parkinson's Disease (PD) demands an urgent response to life's fundamental questions. General practitioners (GPs) who care for people with PD may also face anxieties, but these affect their professional rather than their personal lives. However, uncertainty at whatever level requires managing. Both patients and GPs adopt various strategies to resolve their difficulties. One aspect of this process concerns coming to understand, and explaining what to expect of the disease. Using data from in-depth interviews with people with PD and a separate group of GPs, this paper explores how the differing experience and management of uncertainty by both parties may, if unappreciated by doctors, hinder effective communication between them. Conversely, an imaginative understanding of what PD means may help transform people's experience of the illness. Training GPs to develop skills in understanding the special uncertainties of PD is considered. [ABSTRACT FROM AUTHOR]

This paper tussles with the policy question, that of integrating people with arthritis into employment, in terms of a dialectic between trouble and trust. It suggests that disability theorists' emphasis on the 'social model of disability' as the definitive explanation for disabled people's unfavourable position in the labour market is limited without an understanding of the body as a set of relationships linking self and outer world together. For disabled people, longterm illness in a public domain such as work may profoundly disrupt expectations about biographical and social integrity, and normative order. Using an in depth qualitative approach, this paper focuses on the differing employment experiences of two informants disabled by rheumatoid arthritis. Their accounts illustrate some tensions between the breakdown of trust, its constitution as trouble, and attempts to restore 'business as usual' in the workplace. The wider social and cultural significance of illness in the workplace, and the need to adopt a more discriminating approach to 'discrimination' are discussed. [ABSTRACT FROM AUTHOR]

This paper describes part of a qualitative project on patient doctor communication in the management of Parkinson's Disease. It explores how a group of general practitioners conceptualised the task of diagnosing patients with PD and the impact of diagnosis on a separate group of patients in terms of coherence and incoherence. My argument is that for GPs diagnosis represented a point of maximum theoretical coherence, whereas for patients it was a time of maximum experiential incoherence - a tension sharpened by reference to an analagous distinction: that between knowledge by description and knowledge by acquaintance. The paper further examines how GPs considered their own experiential knowledge helped patients by way of three key assumptions they held about PD and PD patients: namely, age, the comparatively protracted nature of the disease course and the availability of treatment. It asks how far patients found such notions helpful in their initial efforts to accept the diagnosis. I see this meeting point between two worlds simultaneously as tragic and potentially creative, with implications for more sensitive and effective interaction between patient and GP in this and other chronic illnesses. [ABSTRACT FROM AUTHOR]

In this article, the author responds to the paper by Tom Shakespeare and Nicholas Watson defending the social model in its wider context. Disability study critiques have emphasised the way in which medical sociologists' work on the experience of illness have often underplayed the influence of structures; and simultaneously how, in their desire to move away from the individualised "tragedy" model of disability, much of their own work has concentrated on structures, and rather less on the subtleties and complexities of lived experience. The Leeds Conference "Exploring the Divide" in March 1996 was organised precisely to address these issues and to see if a more sensitive rapprochement might be found between the two. Shakespeare has argued elsewhere that one of the achievements of the Disability Movement has been to separate impairment from disability. Whilst author appreciate the force of these arguments, and their grounding in disabled people's experience of marginalisation and exclusion from mainstream society, his two papers argue that attempts to treat the two as discrete entities glosses over the complexity of individual lives.

Presents a letter to the editor about doctors and medical students with disabilities.

This report is of a study of small group work in general practice vocational training schemes (GPVTS) in the London area, by a group of Baling-orientated general practitioner (GP) educators. It is part of a larger study which examines the educational processes of small group work. In this report, we focus on the `insider research' contribution of the Baling GP educators who identify the prevalence of small group teaching of different styles (established by a postal questionnaire) describe visits to some schemes offering Balint groups and some that used case discussion groups with other aims consider what was found and discuss the place of case discussion groups within a GPVTS for encouraging work based reflection. [ABSTRACT FROM AUTHOR]