Explaining the social gradient in smoking and cessation: the peril and promise of social mobility

Smoking in high-income countries is now concentrated in poor communities whose relatively high smoking prevalence is explained by greater uptake but above all by lower quit rates. Whilst a number of barriers to smoking cessation have been identified, this is the first paper to situate cessation itself as a classed and cultural practice. Drawing on ethnographic research carried out in a working class community in the North of England between 2012 and 2015, I theorise smoking cessation as a symbolic practice in relation to the affective experience of class and social mobility. I show that ambivalence about upward mobility as separation and loss translated into ambivalence about smoking cessation. The reason for this was that the social gradient in smoking operated dynamically at the level of the individual life course i.e. smoking cessation followed upward mobility. A serious health problem was an appropriate reason to quit but older women continued to smoke despite serious health problems. This was linked to historical gender roles leading to women placing a low priority on their own health as well as the intergenerational reproduction of smoking through close affective links with smoking parents

Making sense of violence: a study of narrative meaning

Dramatized violence has been a feature of entertainment in western civilization throughout history. The function of film violence is explored and compared to violence encountered in real life. The role of narrative in individuals' meaning-making processes is also investigated. Six adults were individually interviewed using a semi-structured schedule and narrative analysis was implemented. The findings revealed that real life violence is experientially distinct from film violence but narrative was found to be central to participants' quest for the meaning of violence in both contexts. The narrative framework of violence and whether it is justifiable were fundamental to participants' understanding. The function of violent film was found to be multifaceted: it can teach viewers about the consequences of violence; it allows them to speculate about their own and others' reactions to violence; and it provides an opportunity to experience something which is ordinarily outside of our experience in order to satisfy our human existential needs

Contemplating workplace change

Drawing on topical life histories of physicians in a particularly volatile public health sector environment, we build theory around the contemplation of workplace change. Overall, our study provides evidence as to why single or multiple independent factors, such as pay or job structure, may fail to predict or explain individual decisions to stay in or change workplaces. Instead, the contemplation process we argue is a complex, evolutionary, and context-dependent one that requires individualized interventions. Our findings reveal the prevalence of episodic context-self fit assessments prompted by triggering stimuli, two mechanisms by which thought processes evolved (reinforcement and recalibration), and four characteristic story lines that explain why the thought processes manifested as they did (exploring opportunities, solving problems, reconciling incongruence, and escaping situations). Based on our findings, we encourage practitioners to regularly engage in story-listening and dialogic conversations to better understand, and potentially affect the evolving socially constructed realities of staff members

The lived experience of breathlessness and its implications for care: a qualitative comparison in cancer, COPD, heart failure and MND

<p>Abstract</p> <p>Background</p> <p>Breathlessness is one of the core symptoms, particularly persistent and frequent, towards the end of life. There is no evidence of how the experience of breathlessness differs across conditions. This paper compares the experience of breathlessness in cancer, COPD, heart failure and MND, four conditions sharing heavy symptom burdens, poor prognoses, high breathlessness rates and palliative care needs.</p> <p>Methods</p> <p>For this qualitative study a purposive sample of 48 patients was included with a diagnosis of cancer (10), COPD (18), heart failure (10) or MND (10) and experiencing daily problems of breathlessness. Patients were recruited from the respective clinics at the hospital; specialist nurses' ward rounds and consultations, and "Breathe Easy" service users meetings in the community. Data were collected through semi-structured, in-depth interviews and participant observation. Breathlessness was compared according to six components derived from explanatory models and symptom schemata, first within groups and then across groups. Frequency counts were conducted to check the qualitative findings.</p> <p>Results</p> <p>All conditions shared the disabling effects of breathlessness. However there were differences between the four conditions, in the specific constraints of the illness and patients' experiences with the health care context and social environment. In cancer, breathlessness signalled the (possible) presence of cancer, and functioned as a reminder of patients' mortality despite the hopes they put in surgery, therapies and new drugs. For COPD patients, breathlessness was perceived as a self-inflicted symptom. Its insidious nature and response from services disaffirmed their experience and gradually led to greater disability in the course of illness. Patients with heart failure perceived breathlessness as a contributing factor to the negative effects of other symptoms. In MND breathlessness meant that the illness was a dangerous threat to patients' lives. COPD and heart failure had similar experiences.</p> <p>Conclusion</p> <p>Integrated palliative care is needed, that makes use of all appropriate therapeutic options, collaborative efforts from health, social care professionals, patients and caregivers, and therapies that acknowledge the dynamic interrelation of the body, mind and spirit.</p

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Der Konflikt in Afghanistan : Historischer und gesellschaftlicher Hintergrund, Evolution und Lageentwicklung – ein Positionspapier

This study is part of a larger project, the aim of which is to elucidate “mental health nurses” attitudes towards their patients'. In this study, nurses' and patients' attitudes are described from the perspective of both parties using a qualitative approach. The informants were selected from a rehabilitation unit for young adults, below 40, suffering from psychosis at a psychiatric clinic that provides acute psychiatric care. The informant group consisted of three dyads: three patients with various diagnoses and three nurses with primary responsibility for the patients' daily care. The aim of this particular study was to extend our preliminary understanding of nurses' attitudes towards psychiatric patients in the context of psychiatric in-patient care, by elucidating the patient's “inner” picture of her/his past, present and future and the nurse's picture of the same patient's past, present and future. Data were collected and analysed using a phenomenological-hermeneutic approach and the narrative picturing technique. For each picture and group, 15 related sub-themes emerged, on the basis of which six themes were formulated. The findings show that the nurses overrate their own importance when it comes to the patient's well-being on the ward. All the nurses emphasize confirmation and safety as the basis of their nursing care, while in the patient's picture the nurses represent a replication of childhood demands, which probably means that nursing care risks becoming a continuation of the patient's childhood estrangement

Qualitative interviews in psychology: problems and possibilities

This paper distinguishes a series of contingent and necessary problems that arise in the design, conduct, analysis and reporting of open-ended or conversational qualitative interviews in psychological research. Contingent problems in the reporting of interviews include: (1) the deletion of the interviewer; (2) the conventions of representation of interaction; (3) the specificity of analytic observations; (4) the unavailability of the interview set-up; (5) the failure to consider interviews as interaction. Necessary problems include: (1) the flooding of the interview with social science agendas and categories; (2) the complex and varying footing positions of interviewer and interviewee; (3) the orientations to stake and interest on the part of the interviewer and interviewee; (4) the reproduction of cognitivism. The paper ends with two kinds of recommendation. First, we argue that interviews should be studied as an interactional object, and that study should feed back into the design, conduct and analysis of interviews so that they can be used more effectively in cases where they are the most appropriate data gathering tools. Second, these problems with open-ended interviews highlight a range of specific virtues of basing analysis on naturalistic materials. Reasons for moving away from the use of interviews for many research questions are described

How non-native English-speaking staff are evaluated in linguistically diverse organizations: A sociolinguistic perspective

The aim of this paper is to examine the effects of evaluations of non-native speaking staff?s spoken English in international business settings. We adopt a sociolinguistic perspective on power and inequalities in linguistically diverse organizations in an Anglophone environment. The interpretive qualitative study draws on 54 interviews with non-native English-speaking staff in 19 UK business schools. We analyze, along the dimensions of status, solidarity and dynamism, the ways in which non-native speakers, on the basis of their spoken English, are evaluated by themselves and by listeners. We show how such evaluations refer to issues beyond the speaker?s linguistic fluency, and have consequences for her or his actions. The study contributes to the literature on language and power in international business through offering fine-grained insights into and elucidating how the interconnected evaluative processes impact the formation and perpetuation of organizational power relations and inequalities. It also puts forward implications for managing the officially monolingual, yet linguistically diverse organizations