Farmers, farm workers and work-related stress

This research explores the ways in which stress affects farming communities, how this has changed in recent years, and the degree to which work-related aspects of stress may be assuaged by support interventions. A qualitative case study research approach was employed to address these issues, involving 60 interviews in five locations across England and Wales.In examining farming stress, a distinction is made between its intrinsic, extrinsic and workrelated dimensions. Whileinterviewees tended to associate day-to-day worries and acute stress with farming’s intrinsic demands (such as disease and adverse weather conditions), external causes of tension (such as competition and regulation), together with worries about finances and family, were associated with more sustained anxieties. By contrast, work-related aspects of farming stress, such as workload issues and farming practices, involved a combination of physical and mental health effects.Notably, work-related and extrinsic dimensions of stress have increased in recent years in relation to organisational and policy shifts, price fluctuations, mounting paperwork demands, workload intensification, and changes in agricultural regulation. These have prompted an escalation in the aspects of their work that farming communities feel powerless to control, and represent a major area for policy intervention. Principal farmers displayed the most visible manifestations of stress, linked at once to the intrinsic, extrinsic and workrelated dimensions of their work. By contrast, family farm workers and labourers often lacked autonomy over the way they worked, and work-related aspects of stress concerning workload and organisation made up a greater part of their experience. Increased paperwork demands emerged as a major cause of stress among interviewees, particularly forfarmers and their wives, who struggled to balance these with traditional farming priorities. Differences between farmswere also influential in explaining stress. Livestock farming embodied intrinsic pressures relating to stock crises and the unpredictability of animals, but more recently has come under intense economic pressure, prompting a rationalisation of working practices. Arable farmers found the organisation of activities, such as harvesting and planting, in a context of reduced and increasingly contractual workforces particularly challenging. Mixed farmers faced the dual stresses of balancing work activities with conflicting timetables, and the paperwork demands of a complex portfolio of farming. Smaller farms were struggled with intensified workloads, while larger enterprises had to comply with the demands of more inspection regimes.Support agencies need to overcome the stigma attached to asking for help among farming communities and offer a rangeof responsive and proactive services. Locally based support was more likely to be used and trusted, although concernsabout client confidentiality might deter those most in need from seeking help. Where existing local networks wereestablished, there was a strong argument for providers to plug into these and work towards publicising their efforts to ensure that support is provided most effectively. Critically, support must be multidimensional, reflecting the wide range of stressors and their impacts among farming communities

Changing Priorites, Transformed Opportunities?

In addressing why some people work after state pension aage, this paper draws upon recent qualitative research to argue tht work decisions reflect long-standing dispositions and priorities, and are critically informed by opportunity structures. drawing upon a typolgy distinguishing between 'workers' and 'professionals' and creatives', and within these subgroups pf 'entrepeneurs' and 'portfolio workers', which relfect particular patterns of self-employment tha paper illustrates that qualitatively different meanings are associated with work, nd agrues tht class distinctions form the basis of particular sets of priorites and practices. Work orientations are considered against the context of opportunity structures, including work intensification, restructuring nd the decline of traditional industries, and shifts in health nd care responsibilities, which may revise people's options at state pension age. Revisiting the traditional relationshop between class and work, examining both cultural and economic factors, new conceptual insight may be gained into the reproduction nd persistence of social inequalities over the life course.

Renegotiating Identity and Relationships: Men and women’s adjustments to retirement

Retirement is frequently a period of change, when the roles and relationships associated with individuals’ previous labour market positionings are transformed. It is also a time when personal relationships, including the marital relationship and relationships with friends and family, come under increased scrutiny and may be realigned. Many studies of adjustment to retirement focus primarily on individual motivation; by contrast, this paper seeks to examine the structure of resources within which such decisions are framed. The paper examines the contribution that gender roles and identities make to the overall configuration of resources available to particular individuals. It draws upon qualitative research conducted with older people in four contrasting parts of the UK, looking at the combination of labour market and non-labour market activities they are involved in prior to reaching state retirement age, as they withdraw from paid work. It explores how older people invoke a range of gendered identities to negotiate change and continuity during this time. The paper argues that gender roles and identities are central to this process and that the reflexive deployment of gender may rank alongside financial resources and social capital in its importance to the achievement of satisfying retirement transitions. Amongst those interviewed, traditional gendered roles predominated, and these sat less comfortably with retirement for men than for women.

Fifty at fifty: long term patterns of participation and volunteering

Fifty at Fifty (50 at 50) combined longitudinal quantitative data from the 1958 British Birth Cohort Survey, i.e. the National Child Development Study (NCDS), with qualitative biographical interview data from the associated Social Participation and Identity Study (SPIS) to investigate long term patterns of participation and volunteering

How to communicate with patients about future illness progression and end of life: a systematic review

Background: Conversation and discourse analytic research has yielded important evidence about skills needed for effective, sensitive communication with patients about illness progression and end of life. Objectives To: Locate and synthesise observational evidence about how people communicate about sensitive future matters; Inform practice and policy on how to provide opportunities for talk about these matters; Identify evidence gaps. Design: Systematic review of conversation/ discourse analytic studies of recorded interactions in English, using a bespoke appraisal approach and aggregative synthesis. Results: 19 publications met the inclusion criteria. We summarised findings in terms of eight practices: fishing questions - open questions seeking patients’ perspectives (5/19); indirect references to difficult topics (6/19); linking to what a patient has already said — or noticeably not said (7/19); hypothetical questions (12/19); framing difficult matters as universal or general (4/19); conveying sensitivity via means other than words, for example, hesitancy, touch (4/19); encouraging further talk using means other than words, for example, long silences (2/19); and steering talk from difficult/negative to more optimistic aspects (3/19). Conclusions: Practices vary in how strongly they encourage patients to engage in talk about matters such as illness progression and dying. Fishing questions and indirect talk make it particularly easy to avoid engaging — this may be appropriate in some circumstances. Hypothetical questions are more effective in encouraging on- topic talk, as is linking questions to patients’ cues. Shifting towards more ‘optimistic’ aspects helps maintain hope but closes off further talk about difficulties: practitioners may want to delay doing so. There are substantial gaps in evidence

Fifty at fifty: long-term patterns of participation and volunteering among the 1958 NCDS cohort at age 50

Fifty at Fifty (50 at 50) combined longitudinal quantitative data from the 1958 British Birth Cohort Survey, i.e. the National Child Development Study (NCDS), with qualitative biographical interview data from the associated Social Participation and Identity Study (SPIS) to investigate long term patterns of participation and volunteering. Fifty interview transcripts were abstracted for analysis from the SPIS. These related to individuals who presented three distinct, and intrinsically interesting, patterns of participation within the NCDS data – nonparticipants, perennial participants, and frequent participants at age 50. At odds with most previous findings on the characteristics of participants vis-a-vis non-participants, quantitative data records indicated that these individuals shared numerous demographic traits. The SPIS data seemed potentially well placed to illuminate why these relatively similar individuals demonstrated noticeably different patterns of participation. The study’s major contribution is to the debate around data triangulation, in terms of the role methods play in defining and measuring participation and volunteering, and the potential for certain methods to ‘miss’ particular forms or levels of these activities. Comparing between the datasets, at times noticeably different narratives of participation emerged with alignment being poorest for those individuals identified in the quantitative data as non-participants. For these individuals, the SPIS often revealed a diverse range of occasional, past and informal involvements. Religious participation, too, produced divergent stories in the datasets. Further, the qualitative transcripts revealed a greater number of associational affiliations than the quantitative data while, conversely, trade union and political activity was rarely mentioned in the qualitative interviews, even though the quantitative data indicated that it was widespread. Several factors might explain the ‘gap’ between the datasets. Key amongst these are: (1) the timing of key life events, and the consequences of these transitions upon subsequent participation, (2) the way the NCDS appears to privilege ‘joining in’ with associations over other forms of participation, and (3) the pathways through participation that were picked up in the qualitative interviews, and those that were not pursued. Multiple forms of participation and volunteering were identified amongst the 50 interviewees while multiple motives drove these activities. There were similarities in motive between the three types of participant but, notably, relevant to the frequent and nonparticipants, altruistic motivations played a more central role in perennials’ long-term commitment. Triggers, both people and events, were important in providing opportunities for individuals to participate in desired and unfamiliar ways, but these were not equally accessible. Conversely, workplace factors, such as shift work and self-employment, had a major impact upon an individual’s ability to get and stay involved. Future research investigating the precise impact and mechanisms of these catalysts will provide further valuable insight into participation and volunteering pathways.<br/

‘The long arm of the household’ : Gendered struggles in combining paid work with social and civil participation over the lifecourse

Successfully combining paid work and various forms of social and civil participation is commonly assumed to be beneficial to both individuals and society. However, integrating these aspects can be difficult, partly because they can be connected through relationships that operate in opposing directions. Combining paid work and participation over the long-term can be especially challenging, as the factors informing each continuously evolve. This balancing act may be particularly difficult for women who, relative to men, often manage greater caring responsibilities alongside work. To build understanding of these matters, we weave together the participation and work-related content of the UK’s National Child Development Study and the associated 2008 Social Participation and Identity Study. We unpack a bidirectional relationship between these items and highlight the importance of household dynamics and gender. Paid work’s flexibility, autonomy, predictability and intensity also emerge as important elements in achieving a sustainable work-participation balance

The Druids, a Celtic study

My concern is with a select group of religious leaders known as "the Druids" who were affiliated to "the Celtic" peoples. I am particularly interested in the parallels that can be drawn with other religious leaders of Indo-European heritage. I will show how this description of the Druids as religious leaders is altered with a changing mythological context, with my emphasis on religion as a process involving both content and context. [Foreword

Defining novel regulators of inflammatory signalling in pancreatic cancer

Pancreatic ductal adenocarcinoma (PDAC) remains a cancer with few effective therapeutic options and, for patients with this disease, the prognosis remains extremely poor. In recent years immunotherapy has emerged as a promising treatment modality for a number of different tumour types but so far its impact in treatment of PDAC has been limited. Examining the molecular pathways that determine the immune response to cancer cells in PDAC will enable development of new therapeutic strategies to target this response. Focal adhesion kinase (FAK) is a non-receptor tyrosine kinase that is elevated in human PDAC tissues and correlates with high levels of fibrosis and poor CD8+ T cell infiltration. The Serrels Laboratory has already demonstrated a role for FAK in promoting tumour evasion by inducing an immunosuppressive microenvironment, specifically by regulation of cytokines. This has led to trials of the FAK inhibitor (defactinib) in conjunction with immunotherapy. I proposed that FAK was likely to regulate further chemokine/cytokine and ligand receptor networks and that by understanding more about these networks it may be possible to target potential pathways to modify this response and provide therapeutic benefit. I used CRISPR, Forward Phase Protein Arrays (FPPA) and ELISA on mouse and human PDAC cell lines to examine relative expression of chemokines and cytokines and how this expression was regulated by FAK. I identified CXCL16 as one of the most abundantly expressed cytokines in both mouse and human cell lines and one of the most significantly increased cytokines upon FAK depletion. PDAC FAK null cell lines +/- CXCL16 were then orthotopically implanted into the pancreas of C57BL/6 mice and I demonstrated that CXCL16 depletion resulted in a re-programming of the immune cell tumour infiltrate with reduced tumour growth. These findings identify a FAK dependent CXCL16-CXCR6 paracrine signalling axis that may represent a mechanism of resistance to FAK inhibition and thus an important potential therapeutic target

Communication practices that encourage and constrain shared decision making in health-care encounters: Systematic review of conversation analytic research

© 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd Background: Shared decision making (SDM) is generally treated as good practice in health-care interactions. Conversation analytic research has yielded detailed findings about decision making in health-care encounters. Objective: To map decision making communication practices relevant to health-care outcomes in face-to-face interactions yielded by prior conversation analyses, and to examine their function in relation to SDM. Search strategy: We searched nine electronic databases (last search November 2016) and our own and other academics' collections. Inclusion criteria: Published conversation analyses (no restriction on publication dates) using recordings of health-care encounters in English where the patient (and/or companion) was present and where the data and analysis focused on health/illness-related decision making. Data extraction and synthesis: We extracted study characteristics, aims, findings relating to communication practices, how these functioned in relation to SDM, and internal/external validity issues. We synthesised findings aggregatively. Results: Twenty-eight publications met the inclusion criteria. We sorted findings into 13 types of communication practices and organized these in relation to four elements of decision-making sequences: (i) broaching decision making; (ii) putting forward a course of action; (iii) committing or not (to the action put forward); and (iv) HCPs' responses to patients' resistance or withholding of commitment. Patients have limited opportunities to influence decision making. HCPs' practices may constrain or encourage this participation. Conclusions: Patients, companions and HCPs together treat and undertake decision making as shared, though to varying degrees. Even for non-negotiable treatment trajectories, the spirit of SDM can be invoked through practices that encourage participation (eg by bringing the patient towards shared understanding of the decision's rationale)