Fitting In: Young British Women's Reported Experiences of Body Modification

This thesis investigates female cultures of body modification in contemporary Britain. I begin from the premise that women in current UK society are concerned about their appearance and subjected to significant media pressures to engage in body modification. By body modification I mean the methods which women use in order to alter their physical body and appearance. All methods (invasive or non-invasive; self-administered or other-administered; permanent or temporary) are considered, provided the intention of their use is primarily to alter the user’s physical appearance. Based on qualitative life-history interviews with thirty university-educated British women aged between eighteen and twenty-five my research investigates the choices of, motives for, influences on and relationships of women to their practices of body modification. The analysis chapters of this thesis deal with three key stages in my participants’ development during which body modification emerged as important. These are the point when my participants went to school, their years at university and their entry into the world of work. The analysis chapters focus on these three stages. The first one explores participants’ initial engagement with and experience of body modification during the school years. The second centres on their use of body modification while at university, and the final analysis chapter explores their engagement with these practices in the world of work. I also discuss my participants’ expectation of their future engagement with body modification. Unlike third-wave feminist discourse, which frequently refers to body modification in terms of freedom and choice, my findings offer a completely different understanding of women’s engagement in these practices. In the life stages I focus on, sociality and taking cue from others emerged as the most important aspects of women’s body modification decisions

More that unites us than divides us? A qualitative study of integration of community health and social care services

From Springer Nature via Jisc Publications RouterHistory: received 2019-09-13, accepted 2020-05-17, registration 2020-05-18, pub-electronic 2020-05-29, online 2020-05-29, collection 2020-12Publication status: PublishedFunder: Collaboration for Leadership in Applied Health Research and Care - Greater Manchester; doi: http://dx.doi.org/10.13039/501100012358; Grant(s): NAAbstract: Background: The integration of community health and social care services has been widely promoted nationally as a vital step to improve patient centred care, reduce costs, reduce admissions to hospital and facilitate timely and effective discharge from hospital. The complexities of integration raise questions about the practical challenges of integrating health and care given embedded professional and organisational boundaries in both sectors. We describe how an English city created a single, integrated care partnership, to integrate community health and social care services. This led to the development of 12 integrated neighbourhood teams, combining and co-locating professionals across three separate localities. The aim of this research is to identify the context and the factors enabling and hindering integration from a qualitative process evaluation. Methods: Twenty-four semi-structured interviews were conducted with equal numbers of health and social care staff at strategic and operational level. The data was subjected to thematic analysis. Results: We describe three key themes: 1) shared vision and leadership; 2) organisational factors; 3) professional workforce factors. We found a clarity of vision and purpose of integration throughout the partnership, but there were challenges related to the introduction of devolved leadership. There were widespread concerns that the specified outcome measures did not capture the complexities of integration. Organisational challenges included a lack of detail around clinical and service delivery planning, tensions around variable human resource practices and barriers to data sharing. A lack of understanding and trust meant professional workforce integration remained a key challenge, although integration was also seen as a potential solution to engender relationship building. Conclusions: Given the long-term national policy focus on integration this ambitious approach to integrate community health and social care has highlighted implications for leadership, organisational design and inter-professional working. Given the ethos of valuing the local assets of individuals and networks within the new partnership we found the integrated neighbourhood teams could all learn from each other. Many of the challenges of integration could benefit from embracing the inherent capabilities across the integrated neighbourhood teams and localities of this city

The implementation of medical revalidation: an assessment using normalisation process theory

Abstract Background Medical revalidation is the process by which all licensed doctors are legally required to demonstrate that they are up to date and fit to practise in order to maintain their licence. Revalidation was introduced in the United Kingdom (UK) in 2012, constituting significant change in the regulation of doctors. The governing body, the General Medical Council (GMC), envisages that revalidation will improve patient care and safety. This potential however is, in part, dependent upon how successfully revalidation is embedded into routine practice. The aim of this study was to use Normalisation Process Theory (NPT) to explore issues contributing to or impeding the implementation of revalidation in practice. Methods We conducted seventy-one interviews with sixty UK policymakers and senior leaders at different points during the development and implementation of revalidation: in 2011 (n = 31), 2013 (n = 26) and 2015 (n = 14). We selected interviewees using purposeful sampling. NPT was used as a framework to enable systematic analysis across the interview sets. Results Initial lack of consensus over revalidation’s purpose, and scepticism about its value, decreased over time as participants recognised the benefits it brought to their practice (coherence category of NPT). Though acceptance increased across time, revalidation was not seen as a legitimate part of their role by all doctors. Key individuals, notably the Responsible Officer (RO), were vital for the successful implementation of revalidation in organisations (cognitive participation category). The ease with which revalidation could be integrated into working practices varied greatly depending on the type of role a doctor held and the organisation they work for and the provision of resources was a significant variable in this (collective action category). Formal evaluation of revalidation in organisations was lacking but informal evaluation was taking place. Revalidation had not yet reached the stage where feedback was being used for improvement (reflexive monitoring category). Conclusions Requiring all organisations to use the same revalidation model made revalidation easy to integrate into existing work for some but problematic for others. In order for revalidation to be fully embedded and successful, impeding factors, such as a lack of resources, need to be addressed

The implementation of medical revalidation: an assessment using normalisation process theory

Abstract Background Medical revalidation is the process by which all licensed doctors are legally required to demonstrate that they are up to date and fit to practise in order to maintain their licence. Revalidation was introduced in the United Kingdom (UK) in 2012, constituting significant change in the regulation of doctors. The governing body, the General Medical Council (GMC), envisages that revalidation will improve patient care and safety. This potential however is, in part, dependent upon how successfully revalidation is embedded into routine practice. The aim of this study was to use Normalisation Process Theory (NPT) to explore issues contributing to or impeding the implementation of revalidation in practice. Methods We conducted seventy-one interviews with sixty UK policymakers and senior leaders at different points during the development and implementation of revalidation: in 2011 (n = 31), 2013 (n = 26) and 2015 (n = 14). We selected interviewees using purposeful sampling. NPT was used as a framework to enable systematic analysis across the interview sets. Results Initial lack of consensus over revalidation’s purpose, and scepticism about its value, decreased over time as participants recognised the benefits it brought to their practice (coherence category of NPT). Though acceptance increased across time, revalidation was not seen as a legitimate part of their role by all doctors. Key individuals, notably the Responsible Officer (RO), were vital for the successful implementation of revalidation in organisations (cognitive participation category). The ease with which revalidation could be integrated into working practices varied greatly depending on the type of role a doctor held and the organisation they work for and the provision of resources was a significant variable in this (collective action category). Formal evaluation of revalidation in organisations was lacking but informal evaluation was taking place. Revalidation had not yet reached the stage where feedback was being used for improvement (reflexive monitoring category). Conclusions Requiring all organisations to use the same revalidation model made revalidation easy to integrate into existing work for some but problematic for others. In order for revalidation to be fully embedded and successful, impeding factors, such as a lack of resources, need to be addressed

Scottish toolkit for fair access: Interim report

This interim report provides a detailed methodology for the development of the Scottish Toolkit for Fair Access. It builds on and develops the method proposed in our response to the invitation to tender. The Fair Access Toolkit has two broad aims: - To provide an accessible summary of the evidence of impact for different interventions to allow practitioners and funders to select those that are most appropriate given their budget and target audience. - To provide guidance on selecting and implementing evaluation methods for practitioners to support the improved evaluation of widening access initiatives across Scotland. Our work will focus on the first aim as the necessary initial step to developing the Toolkit. We propose to initially consider interventions that relate to retention, progression and success, as topics where the Toolkit can most add value. In particular we will consider evidence in relation to the following activities: - Mentoring - Bursaries / scholarships - Attainment support - International opportunities - Employability guidance - Internships We will prioritise evaluations which test the activities with socio-economically disadvantaged learners and those with one of the nine protected characteristics. If a focus on these target groups alone does not identify sufficient material, we will widen the search to include evaluations of interventions that support all students. We will take a rapid evidence assessment (REA) approach to searching, identifying and assessing the evidence. Proposed search terms are included in Appendix 1. To assess and compare impact across different interventions we will calculate effect sizes and classify studies as having no, low, moderate, high or very high impact. We will aggregate all of the assessments to provide an overall assessment for each intervention