In order to advance our understanding of informal carer health, this mixed-method research was conducted amongst a large, general population of informal carers. Initially, a postal survey was carried out using the UK version of the Short-Form 36 (SF-36) health status questionnaire. The study population, which was composed of 578 participants, was drawn from the carer mailing lists of voluntary sector organisations in four geographically distinct areas in the North West of England. The participants' scores for SF-36 were compared with those of a small group of non-carets and UK normative data for this measure. These evaluations revealed that the participants' health was dramatically inferior to that of a normative population across all eight health dimensions addressed by the SF-36. Moreover, following the performance of a further evaluation, the health of the participants was shown to be comparable to or worse than that of patients with a variety of medically diagnosed conditions. A subsequent series of in-depth interviews with 28 of these participants validated and expanded upon the findings of the quantitative survey. Furthermore, data from these interviews demonstrated clear associations between the participants' health status and their social and political milieu. A coherent theory, which contributes to our current knowledge of caret health, was developed from these research findings.

No description available.

This is the first systematic large-scale study of lesbian health that has been conducted in the U.K. Its purpose is to provide data about lesbians' breast and cervical screening behaviour and experiences of health care. Comparable studies in the U.S.A. suggest that lesbians do not attend for routine screening tests and are less likely, than heterosexual women, to practise breast self examination. A questionnaire (the Lesbians and Health Care Survey) was distributed to 1066 lesbians in the UK. Four follow-up focus groups (n = 30) were used to explore some of the issues arising from the survey. The major quantitative survey findings include: 12 per cent of lesbians have never attended for a cervical smear; 20 per cent have never practised BSE, and only 11 per cent attend for a mammogram every three years. The qualitative survey data were content analysed in order to identify the reasons given by lesbians for their healthcare behaviour. In the follow-up focus groups, breast health is taken as a case study. This thesis contributes to defining a lesbian feminist health agenda by its valuing of lesbians' own perspectives; by providing alternative conceptions of lesbians' health that do not rely on biomedical, disease models; and it locates lesbians' health experiences within a socio-political framework. By providing a range of data about-lesbians' health, the findings may help to inform the understanding of health providers about lesbians' health needs, improve the practice of health care delivery for lesbians and be of value to lesbians in making decisions about their health care behaviour.

No description available.

No description available.

The thesis explores policy relevant issues within poverty debates with reference to Bangladesh. The core questions addressed include: what are the determinants of (income) poverty and income levels? Do these determinants vary according to the degree of poverty? Why is poverty reduced at different rates in different areas? What are the determinants of income inequality? What role has inequality had in the decline of poverty? These are addressedu sing a 1995 census survey in two sets of villages. These villages have experienced drastic declines in (income) poverty, but to very different degrees. The thesis aims to understand the underlying reasons and dynamics behind this difference. These villages are not representative of the country as a whole, but the conclusions are of interest in that they highlight issues pertinent to poverty reduction strategies in Bangladesh. Outcomes of the various analyses undertaken consistently point to certain conclusions as to why these sets of villages have evolved so differently. For the first, richer group, non-agricultural opportunities have boosted the economy and reduced poverty, despite widespread landlessness. The development of the agricultural sector (through irrigation and the use of High Yielding Varieties) has stimulated the emergence of a vibrant non-agricultural sector. Lower levels of irrigated land and High Yielding Varieties adoption and the resulting lower agricultural productivity in part explain the less impressive performance on poverty reduction of the second group of villages. The thesis also makes a contribution to poverty analysis by applying a very diverse range of techniques, the outcomes of which together provide a fuller picture of the processes at work.

No description available.

No description available.

In the autumn of 1997 it was announced that Radio 4's programmes were to be rescheduled and a commitment was given that disability would become a mainstream issue for the network. The new schedule and the mainstreaming initiative were implemented in April 1998. One of the immediate effects of rescheduling was the disappearance of Does He Take Sugar?, the network's weekly programme which presented in-depth treatment of general disability issues. By way of replacement, You and Yours, Radio 4's consumerist programme of longstanding, was given the remit to include regular coverage of disability issues in its content. It was intended that the outcome of these decisions would be that regular coverage of disability would emerge from a niche slot within the network and be positioned within the mainstream of the network's output. On the one hand, the implementation of the proposal to mainstream disability yielded the possibility of an increase in the coverage of disability issues on Radio 4 in an integrated way. On the other hand it could mean a loss of effective and focused treatment of disability issues and a qualitative shift in the nature of coverage. The proposal to mainstream disability issues on Radio 4 thus touched on central issues concerning the treatment of socially disadvantaged groups and the quest for equality. Its implementation took place at a time when the UK disability movement was growing in political power, and disabled people in Britain were becoming aware of the promise of potentially beneficial socio-cultural changes reflected by developments such as the introduction of the Disability Discrimination Act CDDA 1995). This thesis examines three aspects of the introduction of the mainstreaming initiative and the early years of its implementation: a) it draws on interviews with key players, conversations with others involved, participant observation reports and documentary evidence to examine the rationale behind the mainstream initiative and, in the light of the decision to drop the network's programme which focussed on general disability issues (Does He Take Sugar?), it examines the decision to retain In Touch, the network's niche programme for blind or visually impaired listeners; b) it presents a quantitative and qualitative comparative analysis of the network's pre and post-mainstreaming treatment of disability issues. This includes analysis of ten editions of Does He Take Sugar? the disability issues covered in You and Yours during the months of September 1998, 1999, 2000 and analysis of the series No Triumph, No Tragedy. presented by a former member of the Does He Take Sugar? team in the summer of 2000.

The National Health Service (NHS) holds an esteemed position within Britain's `welfare state'. Since its inception, however, it has been subject to near constant reforms, seemingly intended to balance public expectations with available resources. Successive governments have required professional collaboration to gain crucial popular support, and increasingly, general practitioners have been prioritised within reform initiatives. Sociologists assert that professionals' reactions to reforms are often shaped by estimations of such reforms' influence on claims to professional status. Professionals react particularly defensively when they estimate that reforms challenge the foundation of status based on professional identity. Indeed, professions perceived as having `weaker' professional claims may engage more diligently with such defensive work, and general practitioners have been particularly virulent opponents to reforms. I spent eighteen months conducting ethnographic research into the role of GPs in the implementation of the reform initiative, ‘The New NHS: modern, dependable' (1997). I explored the translation of policy ideas into `real' working structures, seeking to address a gap in the literature between considerations of the formulation of official policy rhetoric and evaluations of reform effectiveness. Data revealed `clinical governance' and `delegation of authority to local professionals' as key concepts in shaping local reform implementation. In particular, official policy rhetoric outlined initiatives as unproblematic, whereas the data illustrated their complexity. Furthermore, contrary to expectation, interaction between GPs and the state was not overtly confrontational. Rather, local actors engaged multiple strategies seemingly intending to maintain locally formulated co-operation. Policy implementation was shaped more by efforts to protect existing local networks, than by professional efforts to defend against any one reform initiative. Professionals' engagement with policy objectives to protect their privileged status served to facilitate the operationalisation of ideas. The influence of particular local actors being such that they were often able to mould policies to serve their own agenda.