Medicos, poultice wallahs and comrades in service: masculinity and military medicine in Britain during the First World War

The subject of British military medicine during the First World War has long been a fruitful one for historians of gender. From the bodily inspection of recruits and conscripts through the expanding roles of women as medical care providers to the physical and emotional aftermath of conflict experienced by men suffering from war-related wounds and illness, the medical history of the war has shed important light on how the war shaped British masculinities and femininities as cultural, subjective and embodied identities. Much of this literature has, however, focused on the gendered identities of female nurses and sick and wounded servicemen. Increasingly, however, more complex understandings of the ways in which medical caregiving in wartime shaped the gender identities of male caregivers are starting to emerge. This article explores some of these emerging understandings of the masculinity of male medical caregivers, and their relationship to the wider literature around the complex and sometimes contradictory relationship between warfare and medicine. It examines the ways in which the masculine identity of male medical caregivers from the ranks of the Royal Army Medical Corps, namely stretcher bearers and medical orderlies, was perceived and represented both by the men themselves and those they cared for. In doing so it argues that total war played a crucial role in shaping social and cultural perceptions of caregiving as a gendered practice. It also identifies particular tensions between continuity and change in social understandings of medical care as a gendered practice which would continue to shape twentieth-century British society in the war’s aftermath

Deciding Together?:Best Interests and Shared Decision-Making in Paediatric Intensive Care

In the western healthcare, shared decision making has become the orthodox approach to making healthcare choices as a way of promoting patient autonomy. Despite the fact that the autonomy paradigm is poorly suited to paediatric decision making, such an approach is enshrined in English common law. When reaching moral decisions, for instance when it is unclear whether treatment or non-treatment will serve a child’s best interests, shared decision making is particularly questionable because agreement does not ensure moral validity. With reference to current common law and focusing on intensive care practice, this paper investigates what claims shared decision making may have to legitimacy in a paediatric intensive care setting. Drawing on key texts, I suggest these identify advantages to parents and clinicians but not to the child who is the subject of the decision. Without evidence that shared decision making increases the quality of the decision that is being made, it appears that a focus on the shared nature of a decision does not cohere with the principle that the best interests of the child should remain paramount. In the face of significant pressures toward the displacement of the child’s interests in a shared decision, advantages of a shared decision to decisional quality require elucidation. Although a number of arguments of this nature may have potential, should no such advantages be demonstrable we have cause to revise our commitment to either shared decision making or the paramountcy of the child in these circumstances

Service planning and delivery outcomes of home adaptations for ageing in the UK

In response to the impact of demographic change on the healthcare system, ‘ageing in place’ was introduced as a national policy to support elderly people living independently in their homes. Housing adaptation is essential for successful independent living and has been given increased political priority. However, adaptation policies and practice vary regionally, reflecting statutory limits, policy choices and local planning. This study investigated the current status of adaptation provision in different regions in the UK and assessed the effectiveness of local service planning and management. A mixed-methods sequential explanatory research strategy was employed. In the first quantitative phase, a questionnaire survey was carried out involving all 378 local authorities in England, Scotland and Wales. This was followed by a second qualitative phase involving individual interviews with five professionals and two clients and a focus group meeting with six key stakeholders. The study found that the current number of adaptations was relatively small compared with potential demands in most local areas, as was funding for adaptations. On the operational side, the adaptation process was fragmented, involving different service groups in many local authorities. There were disconnections between these groups, which often caused inefficiencies and poor effectiveness. Moving forward, local authorities need to have a clear vision of the overall need for adaptations and allocate sufficient resources. Practical guidelines are also needed for better integrated working and performance management

Adaptations for aging at home in the UK: an evaluation of current practice

Housing adaptation is necessary to enable elderly people to live independently longer in their own homes. This study aims to review current housing adaptation practice in different parts of the UK and discuss the policy implications at national and local levels. It adopted a mixed-methods research strategy. First, a questionnaire survey was carried out with all 378 local authorities in England, Scotland, and Wales; 112 valid responses were received, representing a response rate of around 30%. Then, interviews and a focus group meeting were conducted with professionals involved in the adaptation process and older clients. The research findings showed that the current number of housing adaptations is relatively small in most local authorities, compared with the potential demand of an aging population. They also revealed some inconsistencies and deficiencies in the system, leading to ineffective and inefficient adaptation service process. These need to be addressed by local authorities in order to improve their adaptation systems and achieve better outcomes

The effects of adapting their home on the meaning of home for families with a disabled child

This article describes part of a mixed-method study investigating family and professional perspectives on home adaptations for disabled children. The methods were an online survey of staff involved in adaptations processes (n =39), semi-structured interviews with families with disabled children (n = 48) and an online survey for families (n = 16). One of the wider study’s recommendations was that families need to be enabled to engage with processes proactively. This article focuses on families’ experiences of the meaning attributed to adapting the home and highlights that, although satisfied with the completed adaptation, families were dissatisfied with the process they had been through. Thus, despite the need for the meaning of home being central to the adaptation process, families felt excluded from the process as it progressed. This had a negative impact on the continuing use of the adaptation and affected the meaning of home for families with a disabled child

Zemiology: reconnecting crime and social harm

This book challenges the given dichotomies between crime and harm, and criminology and zemiology. The main aim of the volume is to highlight the inexorable interconnectedness between systemically induced social harm and the corrosive flows of everyday crime both perpetrated and endured by those victimised by the capitalist system and its hegemonic vicissitudes. Drawing attention not only to various structurally imbedded harms, the chapters also outline the wider consequences of such harms, as they extend beyond immediate victims and contribute towards the further perpetuation of criminogenic and zemiogenic conditions. Comprising two parts, the first explores the relationship between crime and harm and criminology and zemiology, and the second explores the intersections of crime and harm through various lenses, including those trained on probation; global mobility; sexuality and gender; war and gendered violence; fashion counterfeiting; and the harms of the service economy. An exciting and wide-reaching volume written by world-renowned scholars, this collection is a must-read for students, academics, and policy makers in the fields of law, criminology, sociology, social policy, criminal justice, and social justice

The central role of the occupational therapist in facilitating housing adaptations/home modifications for disabled children

Introduction Six reviews/inquiries into housing adaptations/home modifications processes occurred in Wales between 2004 and 2015. One resulted in the removal of the means test for children's Disabled Facilities Grants. This research investigated families' and professionals' experiences of the adaptations/home modification process to gain an understanding of their views and experiences. Method Mixed methods of an online questionnaire for professionals, and semi-structured interviews or an online questionnaire for families (depending on their preference), were employed. Forty-eight families participated and an additional 16 families responded to an online questionnaire. Analysis of qualitative data identified emergent themes, which are discussed in this article. Findings The themes were: poor information and communication mainly aimed at older adults; negative experience of the process; and the positive impact of the completed adaptation. Additionally, whilst undergoing the process, families felt that they needed a contact to guide them through the process. This contact was often by default the community occupational therapist. Conclusion A single contact person should be made available for families; occupational therapists should consider their part in that role; more specific information on children's needs should be provided; families need to recognize the part they can play in adding to delays in the delivery of adaptations