Equity of access to adult hospice inpatient care within north-west England.

There is a growing debate about the question of equity of access to hospice and palliative care services. Even countries with relatively well developed palliative care systems are considered to have problems of access and inequity of provision. Despite these concerns, we still lack a relevant evidence base to serve as a guide to action. We present an analysis of access to adult hospice inpatient provision in the north-west region of England that employs Geographical Information Systems (GIS). Measures of the possible demand for, and supply of, hospice inpatient services are used to determine the potential accessibility of cancer patients, assessed at the level of small areas (electoral wards). Further, the use of deprivation scores permits an analysis of the equity of access to adult inpatient hospice care, leading to the identification of areas where additional service provision may be warranted. Our research is subject to a number of caveats�it is limited to inpatient hospice provision and does not include other kinds of inpatient and community-based palliative care services. Likewise, we recognise that not everyone with cancer will require palliative care and also that palliative care needs exist among those with nonmalignant conditions. Nevertheless, our methodology is one that can also be applied more generally

Theorizing through literature reviews : the miner-prospector continuum

While literature reviews play an increasingly important role in theory development, understanding how they contribute to the process of theorizing is lacking. This article develops the metaphor of a miner-prospector continuum, which allows review scholars to identify approaches taken in literature reviews to develop theory. We identify eight strategies located on a continuum ranging from miners—who position their contributions within a bounded and established domain of study alongside other researchers—to prospectors, who are more likely to step outside disciplinary boundaries, introducing novel perspectives and venture beyond knowledge silos. We explore the pathways between miner and prospector in terms of strategies followed, choices made, risks borne, and benefits gained. We identify the roles to be played by different stakeholders in balancing the mix between miners and prospectors. While respecting the need for both miner and prospector approaches, we suggest that collective efforts toward encouraging prospector reviews could assist management research in tackling, through reviews, the complex challenges facing organizations and society today

Academic motherhood and fieldwork: Juggling time, emotions and competing demands

The idea and practice of going ‘into the field’ to conduct research and gather data is a deeply rooted aspect of Geography as a discipline. For global North Development Geographers, amongst others, this usually entails travelling to, and spending periods of time in, often far-flung parts of the global South. Forging a successful academic career as a Development Geographer in the UK, is therefore to some extent predicated on mobility. This paper aims to critically engage with the gendered aspects of this expected mobility, focusing on the challenges and time constraints that are apparent when conducting overseas fieldwork as a mother, unaccompanied by her children. The paper emphasises the emotion work that is entailed in balancing the competing demands of overseas fieldwork and mothering, and begins to think through the implications of these challenges in terms of the types of knowledge we produce, as well as in relation to gender equality within the academy

Education in the working-class home: modes of learning as revealed by nineteenth-century criminal records

The transmission of knowledge and skills within the working-class household greatly troubled social commentators and social policy experts during the first half of the nineteenth century. To prove theories which related criminality to failures in working-class up-bringing, experts and officials embarked upon an ambitious collection of data on incarcerated criminals at various penal institutions. One such institution was the County Gaol at Ipswich. The exceptionally detailed information that survives on families, literacy, education and apprenticeships of the men, women and children imprisoned there has the potential to transform our understanding of the nature of home schooling (broadly interpreted) amongst the working classes in nineteenth-century England. This article uses data sets from prison registers to chart both the incidence and ‘success’ of instruction in reading and writing within the domestic environment. In the process, it highlights the importance of schooling in working-class families, but also the potentially growing significance of the family in occupational training

Uptake of Screening for Breast Cancer in South Lancashire

Study objective: To describe and explain variation among general practices in the uptake of screening for breast cancer. Design: Analysis of the variation in uptake of screening by general practice. Uptake rates are calculated and related to a social deprivation score created for each practice, and to the presence of at least one female general practitioner. Setting: South Lancashire Health Authority, England. Patients: All women aged 50–64 y registered with Lancashire Family Health Services Authority and resident in South Lancashire in 1988–1995. Main results: Variation in the uptake of screening for breast cancer during Round 1 of the national programme is explained partly by a deprivation score for each practice and by the presence of at least one female general practitioner. In Round 2 the deprivation index continues to explain variation, but the effect of a female GP has diminished. The number of hours worked by practice nurses has no effect on uptake of breast screening. Conclusions: Variation in the uptake of breast cancer screening is closely related to social deprivation. Results suggest that the presence of a female general practitioner has a beneficial effect on uptake

How is place of death from cancer changing and what affects it? Analysis of cancer registration and service data

We aimed to compare trends in place of cancer death with the growth of palliative care and nursing home services, and investigate demographic, disease-related and area influences on individual place of death, using registration data for 216404 patients with breast, lung, colorectal and prostate cancer and aggregate data on services in South East England. Between 1985 and 1994 there was a trend away from hospital death (67–44%), to home (17–30%) and hospice death (8–20%). After 1995, this partly reversed. By 2002, hospital death rose to 47%, home death dropped to 23%, hospice death remained stable and nursing home death rose from 3 to 8%. Numbers of palliative care services increased, but trends for hospice and nursing home deaths most clearly followed the beds available. Cancer diagnosis and treatment influenced individual place of death, but between 1998 and 2002, age and area of residence were associated with most variation. Older patients and those living in more deprived areas died more often in hospitals and less often at home. Despite more palliative care services the proportion of people dying at home has not increased. Variation by age, deprivation and area of residence is unlikely to reflect patient preference. More active surveillance and planning must support policies for choice in end of life care

Work, Parenting and Gender: The care-work negotiations of three couple relationships in the UK

Changes globally mean that there are now record numbers of mothers in paid employment and a reported prevalence of involved fathering. This poses challenges to mothers and fathers as they negotiate care-work practices within their relationships. Focusing on interviews with three heterosexual couples (taken from a wider UK qualitative project on working parents), the paper considers care-work negotiations of three couples, against a backdrop of debates about intensive mothering and involved fathering. It aims to consider different configurations of work and care within three different couple relationships. We found that power within the relationships was negotiated along differential axis of gender and working status (full or part time paid work) . We present qualitatively rich insights into these negotiations. Framed by a critical discursive psychological approach, we call on other researchers to think critically about dominant discourses and practices of working, caring and parenting, pointedly how couples situated around the world operationalise these discourses in talking about themselves as worker and carers

Relational practices and reflexivity: Exploring the responses of women entrepreneurs to changing household dynamics

This qualitative study explores how and why women, positioned as mothers, wives, or carers, navigate changing household dynamics, related to care and reproductive resources, and become entrepreneurial. Drawing on relational reflexivity, we show how women’s embodied, intimate relations with important others in the household form the focal point for entrepreneurial activities and offer evidence of their entrepreneurial agency. Our analysis reveals the emergence of three relational practices that result in a new venture as the entrepreneurial response of women. We critically evaluate normative analyses on gender, entrepreneurship, and household

Milk for a girl and bananas for a boy:recipes and reasons for sex-preference practices in a British Internet forum

Using postings from an internet forum, this paper explores the ways in which some women try to influence the sex of a future child. The extensive reproductive work involved give an indication of the women’s commitment to being able to choose a particular sex; in this case a preference for girls rather than boys. The findings revealed stereotypical views of masculinity and femininity at the heart of the preference. The presumption of fixed gendered identities helped to frame this desire as ‘natural,’ lessen the threat to maternal identities, and reinforce the logic of ‘choice,’ and support their reproductive work practices