3,631 research outputs found

    How does migration impact on mental health and emotional wellbeing of migrants? A case study of 25 Filipino migrants in the United Kingdom

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    This thesis presents findings from a qualitative case study to explore the experiences and perceptions of 25 Filipino migrants in the United Kingdom (UK) on how migration has impacted their mental health and emotional well-being. Through semi-structured interviews and participant observation, this study determined the factors Filipino migrants associated with their mental health and emotional well-being, and what coping strategies they have used to deal with the impacts of migration. Although migration is a well-researched phenomenon, little is known about how Filipino migrants conceptualise mental health, nor is there a great deal of qualitative research on how their mental health is impacted by the experience of migration. The main thesis of this study was the significance of culture in the migrants’ understanding of mental health and in making sense of their migration experiences.Guided by Bhugra’s framework (2004), this study found sociological and economic factors that were associated with mental health including loss of social support, loss of identity, discrimination and racism, and financial obligation to the family. This study showed that for economic migrants, the voluntary nature of their migration and their motivation to migrate factored in coping with the impact of migration. Culturally appropriate coping strategies that correspond to Filipino values and norms include faith, religion, social support, or togetherness, and fulfilling the obligation of providing economic support to the family. This study offers another way of understanding the role of the family of the migrants and challenges some concepts of the migrant behaviour model where sending remittances is seen as an intertemporal contractual arrangement. Instead, the study highlights the deeply rooted sense of obligation by the migrants to fulfil their provider role.Finally, this study showed how qualitative research using a case study design could investigate a sensitive topic such as mental health and provide a voice to research participants. Using participant observation proved effective in understanding the dynamics of relationships within social groups and how culture manifests in social interactions.<br/

    Information actors beyond modernity and coloniality in times of climate change:A comparative design ethnography on the making of monitors for sustainable futures in Curaçao and Amsterdam, between 2019-2022

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    In his dissertation, Mr. Goilo developed a cutting-edge theoretical framework for an Anthropology of Information. This study compares information in the context of modernity in Amsterdam and coloniality in Curaçao through the making process of monitors and develops five ways to understand how information can act towards sustainable futures. The research also discusses how the two contexts, that is modernity and coloniality, have been in informational symbiosis for centuries which is producing negative informational side effects within the age of the Anthropocene. By exploring the modernity-coloniality symbiosis of information, the author explains how scholars, policymakers, and data-analysts can act through historical and structural roots of contemporary global inequities related to the production and distribution of information. Ultimately, the five theses propose conditions towards the collective production of knowledge towards a more sustainable planet

    On Wondering: The Epistemology of A Questioning Attitude

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    An emerging trend in contemporary epistemology departs from the traditional preoccupation with the nature of knowledge, belief, evidence, justification, and the problems of skepticism. This trend focuses instead on the nature of inquiry itself and especially on the role of questions and questioning attitudes that arise in and define that activity. Naturally, this emerging trend calls for a philosophical exploration of the nature of questioning attitudes like curiosity and wondering, and of the various epistemological considerations pertaining to them. Consequently, this project primarily addresses two questions: what does it mean to wonder? And what is required to wonder well? The project is thus both descriptive and normative, aiming to pin down the place that wondering has in our ontology of epistemologically significant mental states and to determine what kinds of prescriptive norms it is subject to in the course of rational inquiry

    Genomic solutions for selective breeding towards increased disease resistance in sheep

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    Gastrointestinal parasitism is a global problem for grazing ruminants which can be addressed sustainably by breeding animals to be more resistant to disease caused by gastrointestinal parasites. This thesis sets out to estimate the genetic parameters of parasitic infection associated with natural nematode and coccidian infections, productivity and immunological phenotypes associated with immune responses including various cytokines and immunoglobulin A (IgA). The thesis sheds light on the genetic architecture of these traits and uses animal genomic and phenotypic data to identify candidate genes associated with resistance to disease. Individual animal phenotypic data on faecal egg counts from different nematode species (Strongyles (FECS), Nematodirus (FECN) and faecal oocyst counts (FOC) from coccidian parasites were collected on Scottish Blackface lambs together with a faecal soiling score in the breach area ‘dag’ score (DAG) and live weight (LWT). Data from 3,731 Scottish Blackface sheep lambs reared on one experimental farm at SRUC (Castlelaw) were used from 2011 to 2017. Parasitic infection traits (FEC, FOC and DAG) were shown to be heritable (0.09±0.02 to 0.17±0.03) exhibiting significant genetic variation among individuals to underpin a selective breeding programme with the goal of enhancing animal resistance. FECS was shown to be positively (genetically) correlated with FECN (0.74±0.09) and FOC (0.39±0.15). Additionally, DAG was negatively (genetically) correlated with LWT (-0.33±0.15). Significant and positive associations between FECS and FECN, and FECS and FOC at around 3 months of age show that co-selection for increased resistance to different parasites is feasible. Furthermore, selection for increased resistance is unlikely to adversely affect LWT, as no significant antagonistic relationship was found between faecal counts and LWT. Significant antagonistic phenotypic correlations between LWT and DAG, and LWT and FECS/FECN indicate that the expression of manifestation of disease in lambs via the DAG score may be a meaningful indicator of the impact of parasitic burden on productivity. Additionally, whole blood stimulation assays were used to characterise the adaptive immune response of 1,040 lambs measured in 2016-2017, with either pokeweed mitogen (PWM, a lectin that non-specifically activates lymphocytes irrespectively of their antigen specificity), and Teladorsagia circumcincta (T-ci) larval antigen to activate parasite-specific T lymphocytes. The type of adaptive immune response was determined by quantifying the cytokines interferon-gamma (IFN-Îł), interleukin (IL)-4, and IL-10, which relate to T-helper type 1 (Th1), Th2 and regulatory T cell (Treg) responses, respectively. T-ci specific IgA within serum was also quantified. Heritability estimates for each immune trait, and genetic and phenotypic correlations with parasitic infection and productivity phenotypes were estimated. Heritabilities of cytokine production varied from low to high (0.14±0.06 to 0.77±0.09), while IgA heritability was found to be moderate (0.41±0.09). A positive genetic correlation was found between FOC and PWM-induced IFN-Îł (IFN-Îł(PWM)) production (0.67±0.30) while a negative correlation was found between FOC and T-ci induced IL-10 (IL-10(T-ci)) (-0.84±0.31). Live weight was negatively, genetically correlated with IFN-Îł responses (-0.54±0.18 and -0.51±0.20). Overall, IFN-Îł and IL-4 responses were positively correlated (from 0.50±0.15 to 0.74±0.21), providing little evidence of cross-regulation of Th1 and Th2 immunity within individual sheep. The results show a negative correlation between IL-10(PWM) and IL-4(T.ci)ÂŹ, which might indicative of a regulatory function of IL-10 over IL-4. Furthermore, Immunoglobulin A was shown to be genetically correlated with IL-10(PWM) and IL-4(T-ci) (0.85±0.17 and 0.32±0.17, respectively). The results suggest that while selection for high IFN-Îł responsiveness may be beneficial for coccidian parasite control, selection for this trait may negatively affect productivity, which will need to be considered in genetic improvement programmes. DNA samples from a subset of 1,766 animals in the study were collected and whole genome sequenced. The genotypic effects on each one of the traits described above were quantified, including the additive and dominance effects as well as the proportion of additive genetic variance due to each SNP locus. A total of 15 SNPs were associated at least at a suggestive level with FECS, FECN, DAG, IgA, PWM-induced IFN-Îł and IL-4, and T-ci-induced IL-10. A total of 52 genes closely related to immune function were found to be in close proximity to these SNPs. While most of the SNPs were not significant beyond a suggestive level, this study was able to confirm the polygenic nature of both parasitic infection and immunological traits such as FEC and IgA. The results highlight several C-type lectins and killer cell lectin-like family members close to a SNP associated with FECN, and several genes encoding IL-1 cytokine family members associated with a SNP associated with IgA. There were also several potential candidate genes belonging to, or in close proximity to, the Major Histocompatibility Complex (MHC) which, due to its importance in the control of immune responses, could play important roles in resistance to such parasitic infections. These include HFE and butyrophilin coding genes, associated with IFN-Îł(PWM), and IL-17 coding genes associated with IgA. The results reveal a largely complex and polygenic genetic control on resistance to parasitic infection and immunological traits in this Scottish Blackface sheep population. Lastly, these results also suggested that the studied animal traits are amenable to improvement with genomic selection

    Finding an effective problem-solving heuristic instructional approach for circle geometry

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    Abstracts in English, Afrikaans and ZuluThis research study carried out an investigation into finding a contemporary problem- solving instructional approach that will be effective for teaching and learning of mathematics in South African schools, with specific focus on circle geometry. Prior to conducting this study, a retrospection was done into the mathematical practices implemented, in schools in South Africa, by researchers, educational practitioners and stakeholders such as Non-Governmental Organisations. The aforementioned unanimously identified the instructional approaches for teaching and learning of mathematics, particularly, the traditional teaching and learning approach, as problematic and counter-productive, and this might be contributing to poor learners’ performances. In a bid to replace the obsolete traditional approach, the researcher in this study recommended: “teaching thinking skills” and “teaching effective problem-solving instructional approaches” as more appropriate. With regards to teaching thinking skills, the infusion approach (teaching thinking skills, along with content instructions), was highlighted. For teaching effective problem-solving, Polya’s Problem-Solving Model, was investigated. To ensure an effective design and implementation of the proposed problem-solving instructional approach, the APOS theory (ACE teaching cycle) was adopted. Also, the teaching and learning of circle geometry was carried out in a collaborative classroom setting. This proposed instructional approach was tentatively, labelled as “IPAC mathematics problem-solving instructional model’’ or simply, the “IPAC model”. This was an acronym for the four elements of this new approach, namely - the infusion approach, Polya’s approach, and APOS theory in a collaborative learning classroom. Two groups of Grade 11 mathematics learners served as participants for this study: group 1 - 11A had 30 learners (the control group) and group 2- 11B had 32 learners (the experimental group). Data collected methods for this study were: observations of participants in their natural classroom settings, recorded videos, questionnaires, photograph of participants’ work (classwork/homework and standardized tests). This study followed a mixed-method research design, hence, both quantitative and qualitative data analyses procedures were implemented. The quantitative data was analysed by implementing inferential statistics and descriptive statistics, while the APOS theory analysis was used to analyse the qualitative facet of the collected data. During the APOS theory analysis, content analysis was done on participants’ written responses to each of the four standardized tests’ data. The content analysis was carried out on the written responses of participants, from both the control and the experimental groups. The research findings that emanated from this study were the following: that this new method of teaching and learning is valid, practical and effective; there was a statistically significant improvement in the test scores of participants who were taught by the new instructional approach; participants’ conceptual understanding, procedural fluency, strategic competence and mathematical reasoning skills were enhanced; participants’ problem-solving competence improved, during and after the intervention; the IPAC model guided the majority of the participants to operate at the object and schema levels in relation to the APOS theory mental conceptions. Lastly, the ACE teaching instructional approach significantly guided and enhanced participants’ cognitive engagement and development, which ultimately, optimized their problem-solving competence. Based on these research findings, the researcher recommended among others, that the new instructional approach - the IPAC model, should be implemented for teaching and learning of circle geometry in South African schools. The researcher also recommended that cultivation of thinking skills and implementation of effective problem-solving instructional approaches should be prioritized in mathematics classrooms in South Africa. The researcher established from this study that the developed IPAC model will serve as an effective and a reliable pedagogical tool which can address some of the teaching and learning challenges teachers and learners encounter in mathematics classrooms.Hierdie navorsingstudie het 'n ondersoek gedoen na die vind van 'n kontemporĂȘre probleemoplossende onderrigbenadering wat effektief sal wees vir onderrig en leer van wiskunde in Suid-Afrikaanse skole, met spesifieke fokus op sirkelmeetkunde. Voor die uitvoering van hierdie studie is 'n terugblik gedoen na die wiskundige praktyke wat in skole in Suid-Afrika geĂŻmplementeer is deur navorsers, opvoedkundige praktisyns en belanghebbendes soos nie-regeringsorganisasies. Die instruksionele benaderings vir onderrig en leer van wiskunde, veral die tradisionele onderrig-en-leerbenadering, is eenparig geĂŻdentifiseer as problematies en teenproduktief, en dit kan dalk bydra tot swak leerders se prestasies. In 'n poging om die uitgediende tradisionele benadering te vervang, het die navorser in hierdie studie aanbeveel: "onderrig van denkvaardighede" en "onderrig van effektiewe probleemoplossende onderrigbenaderings" as meer gepas. Met betrekking tot die onderrig van denkvaardig hede, is die infusiebenadering (onderrig van denkvaardighede, tesame met inhoudsinstruksies), uitgelig. Vir die onderrig van effektiewe probleemoplossing is Polya se probleemoplossingsmodel ondersoek. Om 'n effektiewe ontwerp en implementering van die voorgestelde probleemoplossende onderrigbenadering te verseker, is die APOS-teorie (GOS-onderrigsiklus) aanvaar. Die onderrig en leer van sirkelmeetkunde is ook in 'n samewerkende klaskameropset uitgevoer. Hierdie voorgestelde onderrigbenadering is voorlopig, gemerk as "IPAC wiskunde probleemoplossing instruksionele model" of eenvoudig die "IPAC model". Dit was 'n akroniem vir die vier elemente van hierdie nuwe benadering, naamlik - die infusiebenadering, Polya se benadering en APOS-teorie in 'n samewerkende leerklaskamer. Twee groepe graad 11-wiskunde-leerders het as deelnemers vir hierdie studie gedien: groep 1 - 11A het 30 leerders (die kontrolegroep) en groep 2- 11B het 32 leerders (die eksperimentele groep). Data wat ingesamel is metodes vir hierdie studie was: waarnemings van deelnemers in hul natuurlike klaskamerinstellings, opgeneemde video's, vraelyste, foto van deelnemers se werk (klaswerk/huiswerk en gestandaardiseerde toetse). Hierdie studie het 'n gemengde-metode navorsingsontwerp gevolg, dus is beide kwantitatiewe en kwalitatiewe data-ontledingsprosedures geĂŻmplementeer. Die kwantitatiewe data is ontleed deur inferensiĂ«le statistiek en beskrywende statistiek te implementeer, terwyl die APOS teorie-analise gebruik is om te analiseer die kwalitatiewe faset van die versamelde data. Tydens die APOS-teorie-analise is inhoudsontleding gedoen op deelnemers se geskrewe antwoorde op elk van die vier gestandaardiseerde toetse se data. Die inhoudsanalise is uitgevoer op die geskrewe reaksie van deelnemers, van beide die kontrole- en die eksperimentele groepe. Die navorsingsbevindinge wat uit hierdie studie voortgespruit het, was die volgende: dat hierdie nuwe metode van onderrig en leer geldig, prakties en effektief is; daar was 'n statisties beduidende verbetering in die toetstellings van deelnemers wat deur die nuwe onderrigbenadering onderrig is; deelnemers se konseptuele begrip, prosedurele vlotheid, strategiese bevoegdheid en wiskundige redenasievaardighede is verbeter; deelnemers se probleemoplossingsbevoegdheid het verbeter, tydens en na die intervensie; die IPAC-model het die meerderheid van die deelnemers gelei om op die objek- en skemavlakke te werk in verhouding tot die APOS-teorie se verstandelike opvattings. Laastens het die GOS-onderrigbenadering die deelnemers se kognitiewe betrokkenheid en ontwikkeling aansienlik gelei en verbeter, wat uiteindelik hul probleemoplossingsbevoegdheid geoptimaliseer het. Op grond van hierdie navorsingsbevindinge het die navorser onder andere aanbeveel dat die nuwe onderrigbenadering - die IPAC-model, geĂŻmplementeer moet word vir onderrig en leer van sirkelmeetkunde in Suid-Afrikaanse skole. Die navorser het ook aanbeveel dat die kweek van denkvaardighede en implementering van effektiewe probleemoplossende onderrigbenaderings in wiskundeklaskamers in Suid-Afrika geprioritiseer moet word. Die navorser het uit hierdie studie vasgestel dat die ontwikkelde IPAC-model sal dien as 'n effektiewe en betroubare pedagogiese hulpmiddel wat sommige van die onderrig- en leeruitdagings wat onderwysers en leerders in wiskundeklaskamers ondervind, kan aanspreek.Lolu cwaningo luqukethe uphenyo mayelana nokuthola ikhambi elingaxazulula ekutholeni indlela eqondile engaletha imiphumela ewusizo ekufundiseni nasekufundeni kwezibalo ezikoleni zaseMzansi Africa, ezophinde ibhekane ngqo ne circle Geometry. Ngaphambi kokuba kuqale lolu cwaningo, kube nolunye ucwaningo olunzulu olwenziwe ngezinye izindlela esezivele zikhona mayelana nezibalo, ezikoleni zaseMzansi Africa, lwenziwa ngabacwaningi, izifundiswa ezingo ncweti Kanye nezinhlangano ezizimele. Inhlangano ebizwa nge okushiwo ngenhla luhlonze indlela eqondile yokufundisa nokufunda izibalo, ikakhulukazi, indlela ejwayelekile yokwenza, njengezindlela eziyinkinga nezingahambisani, futhi lokhu ngungaba yimbangela ekungenzini kahle kwabafundi. Emkhankasweni wokushintsha lolu hlelo oludala lokwenza olungasasizi, uMhlaziyi kulolu cwaningo uncome ukuthi: “ikhono elufundisa ukuzicabangela” Kanye “nekhono lokufundisa elisebenzayo ukuzixazululela izinkinga” njengendlela okuyiyo efanele. Mayelana nekhono elifundisa ukuzicabangela, indlela eyiqophelo (ikhono elifundisa ukuzicabangela, elihambisana nemigomo equkethwe), luthintiwe. Mayelana nohlelo oluwusizo ekuxazululeni izinkinga, uhlelo luka Polya lokuxazulula izinkinga luphenyiwe. Ukuqinisekisa ukuthi uhlelo olusebenzayo futhi oluzosentsenziswa ekuphakamiseni indlela eqondile enemigomo ekuxazululeni izinkinga yokwenza, i APOS theory (ACE teaching cycle) iyona ekhethiwe. Okunye, uhlelo lokufundisa nokufunda i circle geometry lukhishiwe endleleni ehlanganisayo yokuhlala egunjini lokufunda. Okwamanje Lolu hlelo oluphakanyisiwe lokufundisa, lubekwe njenge “IPAC indlela yezibalo eqondile yokuxazulula izinkinga enemigomo” . Lokhu kuyigama elifinqiwe elakhiwe izinhlamvu ezine kule ndlela entsha ebizwa nge infusion approach, Polya’s approach, Kanye ne APOS theory egunjini lokufunda elihlanganisile. Amaqembu amabili ebanga le shuminanye labafundi bezibalo basentshenzisiwe ukubamba iqhaza kulolu cwaningo: iqembu lokuqala ibanga 11A ebelinabafundi abangu 30 (iqembu labaqondisi) bese iqembu lesibili ibanga 11B ebelinabafundi abangu 32 (iqembu elenzayo). Ucwaningo oluqoqiwe lwalendlela lube kanje: imibono yalaba ebekade bebambe iqhaza egunjini lokufunda obuhleliwe, baqophe amavidiyo, babhala imibuzo, bathatha izithombe zalaba ekade bembambe iqhaza lwalomsebenzi wokubamba iqhaza. (imisebenzi yasegunjini lokufunda/imisebenzi yasekhaya Kanye nokwenza uvivinyo). Lolu phenyo lulandele uhlelo oluxubile okuwuhlelo lokuphenya, yingakho zombili lezi zinhlelo zokuqukethwe nokuseZingeni zokuqoqa uphenyo olwenziwe zisentshenzisiwe. Uhlelo lokuqukethwe lemininingwane lusentshenzisiwe ukuhlaziya ngokusebenzisa uhlelo lokuqoqa okutholakele Kanye nohlelo lokwenza okutholakele, futhi kube kwenziwa ne APOS theory analysis ukuhlaziya okusezingeni eliphezulu zigxenye zonke lwemininingwane eqoqiwe. Ngesikhathi se APOS theory analysis, ukuhlaziywa kokuqukethwe okwenziwe ababambe iqhaza babhale okwenzekile ngesikhathi benza lezi zivivinyo ezine ezibekiwe. Uhlelo lokuhlaziya okuqukethwe lwenziwe labhalwa yilaba kade bebambe iqhaza, kuwo womabili amaqembu , elokuqondisa nelokwenza. Uphenyo olutholakele kulolu hlelo lunje: lolu hlelo lokufundisa nokufunda luyasebenza, luyenzeka, futhi lunomehluko: ngokwezibalo kube nomehluko omkhulu oncono ezibalweni zalabo ekade bebambe iqhaza besebenzisa indlela entsha yemigomo: bonke ekade bebambe iqhaza bathole ithuba lokuthi kuthuthuke amakhono abo ekwazini ukuqonda ukuzicabangela, ekwazini ukwenza izinto ezinomehluko eyinqubomgomo, ukumelana nezindlela eziningi eziphumelelisayo Kanye nekhono lokuqonda izibalo; ikhono lalabo ekade bebambe iqhaza ekuxazululeni izinkinga ngokusezingeni lithuthukile, ngesikhathi nangemuva kokwenza ucwaningo; I IPAC model ukwenzisa abaningi balaba ekade bebambe iqhaza kalula umsebenzi ngokuhlukana kwamazinga kusentsenziswa i APOS theory. Ekugcineni, indlela yokwenza ebizwa nge ACE teaching ikwazile okwenzisa kahle ngokusezingeni eliphezulu futhi yakhuphula labo ebekade bebambe iqhaza yaphinde yabathuthukisa, lokhu okwenze bakwazi ukuba sezingeni lokuphumelela ukuxazulula izinkinga. Ngenxa yalokhu okutholakale kucwaningo, umcwaningi uncome ukuthi kokunye, indlela entsha yokwenza ngemigomo – i-IPAC, kumele isentshenziswe ekufundiseni nasekufundeni i circle geometry ezikoleni zaseMzansi Africa. Umcwaningi uphinde waphakamisa ukuthi ukuthuthukisa ikhono lokuzicabangela nokwenziwa kwezindlela ezisebenzayo zokuxazulula izinkinga kumele zibekwe phambili emagunjini okufunda izibalo eMzansi Africa. Umcwaningi ubeke indlela eseqophelweni eliphezulu eyisisekelo kusukela kwisifundo esenziwe yokuthi i IPAC model iyona esebenza njenge ndlela eyithuluzi elibonakalayo futhi elinemiphumela emihle ethembekile, engakwazi ukubhekana nezinkinga futhi ixazulule izinqinamba zokufundisa nokufunda ezikoleni, lezi othisha nabafundi ababhekana nazo egunjini lokufundela izibaloEducational StudiesD. Phil. (Education

    Improving the provision of services in the community for people with a sexual attraction to minors, people at risk of and/or who have perpetrated sexual abuse against children

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    The aim of this mixed methods research was to understand how the current provision of community-based services in the UK for people who have a sexual attraction to minors, people at risk of committing and/or who have committed sexual abuse against children can be improved. This is essential to enhance the wellbeing of this population and safeguard children. This study's quantitative phase included an online survey of 318 members of the general public, while the qualitative phase consisted in interviewing 20 people who work or have worked with people who are sexually attracted to minors and/or have committed or are at risk of committing sexual offences against children. According to the survey results, the general public supports a programme like the German Dunkelfeld (free, confidential and widely advertised service for people sexually attracted to minors), despite an undecided/slightly negative attitude towards people who commit sexual offences against children. Although, there is some variance in their opinions. In turn, the thematic analysis of the interviews revealed six themes: the level of acceptability of the programme is influenced by the level of knowledge on the topic; various large-scale strategies need to be implemented to ease the public attitudes; Dunkelfeld's confidentiality approach provides unique benefits; all-round responsivity is required; employees must possess a unique set of aptitudes; funding is essential, but this should not fall onto the service users. This research showed that a policy and practise model for programmes in the UK must consider current best practises while also addressing current shortcomings. First, programmes must be widely accepted and advertised in the community, so that people are aware of them and may use/recommend them. Second, they must secure adequate funding to ensure that supply meets demand. Third, Dunkelfeld's approach to confidentiality is a delicate subject that needs to be clarified but can be beneficial. Finally, a sex-positive approach may aid an all-round responsive programme's ability to become normalised and welcoming to diverse clients

    The Struggle to Stay in Relation: How the Dominance of an Ideology of Certainty Marginalises Practical Judgment and Political Action, from the Perspective of a Senior Manager in the NHS

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    In this thesis I explore my everyday work as a director of research in an NHS mental health trust. I use collaborative narrative autoethnography to explore episodes where research activity and evidence is contested, questioned, and sometimes causes conflict. In a health and care environment such as the NHS, it is often assumed that producing evidence of a high quality puts an end to politics and dispute. Drawing on the complexity sciences, pragmatism, and process sociology, I claim that, in addition to the scientific and bureaucratic rationality of evidence-based medicine (EBM), undertaking and using research is a complex and relational process that involves contestation and working with conflicting notions of the ‘good’. Evidence may be (more or less) clear about an area of practice, but producing research and deciding what should be done with it involves human, social, and political activities characterised by strongly held values, contested meanings, and conflicts. Through the research I have done for this thesis, I found that the production and use of clinical research in healthcare is dominated by an ideology of certainty, which manifests as EBM, and bureaucratic rationality in health service management. This ideology of certainty closes down discussion in favour of bureaucratic or scientific ends. In turn, this may lead to conflict and the breakdown of working relationships. In the course of my research for this thesis, I found that it is impossible to run clinical research without exercising practical judgement, taking political action, and being immersed in the social melee of human relating. I have argued that navigating this ongoing and dynamic process in a way that might be less harmful requires practical judgment. My research contributes to the ongoing conversation that selves are social, and therefore, even the most scientifically rational research is also social, constrained and enabled through differing ideologies, thought styles, beliefs, and values. Even research that is described as objective (for example, Randomised Controlled Trials [RCTs]) involve processes that are relational, political, and processual, by nature of the everyday activities undertaken to ensure that the research takes place. By improving our understanding of the challenges that arise from the relational nature of research and by exercising practical judgement, it may be possible to help to sustain research activity, reduce the potential for conflict and harm, and, ultimately, make the research more useful. My thesis concludes that although EBM and RCTs are essential in how the health service operates, practical judgement (phronesis) and political action are important when managing research activity. Working with conflict, ambiguity, and uncertainty is not easy. However, engaging reflexively — in particular, with prior assumptions, differences of views and beliefs, and within a community of inquiry — can increase confidence of managers and clinicians in dealing with the complex everyday work that they are involved in when it comes to research activity
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