Legitimating complementary therapies in the NHS:campaigning, care and epistemic labour

Questions of legitimacy loom large in debates about the funding and regulation of complementary and alternative medicine (CAM) in contemporary health systems. CAM's growth in popularity is often portrayed as a potential clash between clinical, state and scientific legitimacies and legitimacy derived from the broader public. CAM's 'publics', however, are often backgrounded in studies of the legitimacy of CAM and present only as a barometer of the legitimating efforts of others. This article foregrounds the epistemic work of one public's effort to legitimate CAM within the UK's National Health Service: the campaign to 'save' Glasgow’s Centre for Integrative Care (CIC). Campaigners skilfully intertwined 'experiential' knowledge of the value of CIC care with 'credentialed' knowledge (Rabeharisoa et al., 2014) regarding best clinical and managerial practice. They did so in ways that were pragmatic as well as purist, reformist as well as oppositional. We argue for legitimation as negotiated practice over legitimacy as a stable state, and as labour borne by various publics as they insert themselves into matrices of knowledge production and decision-making within wider health care governance

‘The biggest charity you’ve never heard of’:Institutional logics of charity and the state in public fundraising in Scotland’s NHS.

The boundaries between state and charitable activities within the NHS are set out in regulations but are also enacted, blurred, and contested through local practices. This article reports research on NHS Charities– charitable funds set up within NHS organizations to enhance statutory provision – in Scotland. We analysed financial accounts and conducted qualitative interviews with staff in 12 of the 14 NHS Charities in Scotland, where they are generally known as endowments. Our findings suggest that Scotland’s endowments are relatively wealthy in charitable terms, but that this wealth is unevenly distributed when population size and socio-economic deprivation are considered. We also identify two diverging organisational approaches to decisions, including those about appropriate and inappropriate fundraising. We argue that these approaches cohere with contrasting ‘state’ and ‘charitable’ institutional logics, which in turn imply different attitudes to potential inequalities, and to relationships with local publics

Plugging the Knowledge Drain: Strategies and Technologies for Acquiring Knowledge in Lean Organizations

Recent programs for organizational improvement (reengineering, downsizing, and outsourcing) have apparently resolved the productivity paradox by making organizations leaner and more efficient. However, these same programs have drained knowledge from organizations, threatening the future performance of lean organizations. Knowledge management, which focuses on the acquisition, internalization, and maintenance of an organization\u27s intellectual assets, is currently a popular approach used to plug the knowledge drain. Designed and managed properly, knowledge management programs can repair significant damage to organizations affected by work force reductions. In this paper, we analyze the process of organizational knowledge acquisition, which most directly addresses the problem of knowledge drain. We discuss strategies and technologies for acquiring knowledge by restocking from external sources and by regenerating from internal processes. We conclude that the technological infrastructure for knowledge acquisition must be complemented by an organizational culture that is committed to learning. A commitment to learning not only values the acquisition of new knowledge but also the preservation of old knowledge

Opening Real Science: Engaging primary teacher education students with science and mathematics

A project funded by the Federal Enhancing the Training of Mathematics and Science Teachers program that is working with scientists, mathematicians and educators to develop inquiry-based modules to build the competencies of teacher education students

Legitimating complementary therapies in the NHS: Campaigning, care and epistemic labour

Questions of legitimacy loom large in debates about the funding and regulation of complementary and alternative medicine (CAM) in contemporary health systems. CAM’s growth in popularity is often portrayed as a potential clash between clinical, state and scientific legitimacies and legitimacy derived from the broader public. CAM’s ‘publics’, however, are often backgrounded in studies of the legitimacy of CAM and present only as a barometer of the legitimating efforts of others. This article foregrounds the epistemic work of one public’s effort to legitimate CAM within the UK’s National Health Service: the campaign to ‘save’ Glasgow’s Centre for Integrative Care (CIC). Campaigners skilfully intertwined ‘experiential’ knowledge of the value of CIC care with ‘credentialed’ knowledge regarding best clinical and managerial practice. They did so in ways that were pragmatic as well as purist, reformist as well as oppositional. We argue for legitimation as negotiated practice over legitimacy as a stable state, and as labour borne by various publics as they insert themselves into matrices of knowledge production and decision-making within wider health care governance

‘The biggest charity you’ve never heard of’: Institutional logics of charity and the state in public fundraising in Scotland’s NHS

The boundaries between state and charitable activities within the NHS are set out in regulations but are also enacted, blurred, and contested through local practices. This article reports research on NHS Charities– charitable funds set up within NHS organizations to enhance statutory provision – in Scotland. We analysed financial accounts and conducted qualitative interviews with staff in 12 of the 14 NHS Charities in Scotland, where they are generally known as endowments. Our findings suggest that Scotland’s endowments are relatively wealthy in charitable terms, but that this wealth is unevenly distributed when population size and socio-economic deprivation are considered. We also identify two diverging organisational approaches to decisions, including those about appropriate and inappropriate fundraising. We argue that these approaches cohere with contrasting ‘state’ and ‘charitable’ institutional logics, which in turn imply different attitudes to potential inequalities, and to relationships with local publics

Genetic counselling and testing for inherited gene mutations in newly diagnosed patients with breast cancer: a review of the existing literature and a proposed research agenda

Many women newly diagnosed with breast cancer and with a strong family history of breast cancer are referred to a family cancer service for genetic counselling and for consideration of genetic testing for germline mutations in cancer predisposition genes following completion of their cancer treatment. However, there is growing evidence that mutation status may influence treatment recommendations, and that there may be benefits in having 'treatment-focused genetic counselling and testing' available shortly after cancer diagnosis. This article reviews the literature that could inform the development of treatment-focused genetic counselling and testing, including: the rationale for genetic testing to aid with treatment decisions; the potential benefits of using mutation or risk status to tailor management; the criteria that may be used to identify patients most likely to carry germline mutations; and the evidence regarding women's decision-making regarding treatment-focused genetic counselling and testing and the associated psychological impact