Suchergebnisse

Across the globe, an estimated one billion people are on the move today, of whom 244 million are international migrants. Not only have global horizons expanded in the realm of work and study; global conflict and exploitation have resulted in forced migration. Migration is a political issue, which raises questions of identity, citizenship, diversity and integration and is utilised to play upon the fear of the stranger, the 'Other' and difference in contemporary society. Disabled migrants are a hidden population whose experiences are often overlooked or subsumed within wider debates around disability and ethnicity. This article considers the intersection of disability and migration in contemporary society through the lens of healthcare access. Reflecting on the impact of citizenship rights on the realisation of human rights in the context of contemporary migration, using health as an example, the article considers the implications for disabled migrants, focusing primarily on the European Union.

From Crossref journal articles via Jisc Publications Router ; Scholars are increasingly interested in and concerned with both the way various migrant populations are categorised, and the lived impacts of that categorisation. In this article, we examine how categorisation was experienced by people at various stages of the refugee journey during the biggest public health crisis for generations. We argue, using original interview data, that the way refugees are categorised, or politically bound, has material impacts on the way they experience their lives, and that this was evident in extremis during the Covid-19 lockdown in Scotland. As populations attempted to traverse public health messaging, this is shown to interact with longstanding state proclivities to control, marginalise and stratify. Consequently, how people experienced and managed the request to 'stay home and save lives' varied markedly by where they were in their refugee journey and how they arrived in the UK. ; Funder: Chief Scientist Office, Scottish Government Health and Social Care Directorate; FundRef: 10.13039/100011529; Grant(s): COV/GLA/20/12, COV/QMU/20/02 ; aheadofprint ; aheadofprint

Many migrant groups, particularly those that are politically and economically marginalised, such as asylum seekers and refugees (ASRs), face inequities in access to health care as well as poorer physical and mental health outcomes. The role of post-arrival experiences in contributing to these inequities is increasingly being explored, and it is suggested that being a migrant is itself a determinant of health outcomes. Drawing on the theoretical concept of structural vulnerability, this paper explores ASRs' experiences of health, wellbeing, and health practices in the context of their lived realities in Scotland. 24 semi-structured interviews were conducted with ASRs from Sub-Saharan Africa between January and December 2015. Data were explored using thematic analysis. Experience of the UK asylum system, both alone and in conjunction with other sources of vulnerability including racism, poverty, and language barriers had a negative and ongoing impact on the physical and mental health of ASRs. These impacts continued, even once refugee status was obtained. Efforts to engage ASRs in preventive health programmes and practices must take into account the ways in which the asylum system acts as a determinant of health, affecting both what it means to be healthy and what capacity individuals have to engage with their health. Political choices in how the asylum process is enacted have far-reaching implications for individual and population health.

Scholars are increasingly interested in and concerned with both the way various migrant populations are categorised, and the lived impacts of that categorisation. In this article, we examine how categorisation was experienced by people at various stages of the refugee journey during the biggest public health crisis for generations. We argue, using original interview data, that the way refugees are categorised, or politically bound, has material impacts on the way they experience their lives, and that this was evident in extremis during the Covid-19 lockdown in Scotland. As populations attempted to traverse public health messaging, this is shown to interact with longstanding state proclivities to control, marginalise and stratify. Consequently, how people experienced and managed the request to 'stay home and save lives' varied markedly by where they were in their refugee journey and how they arrived in the UK.

This article builds on the work of Michael Lipsky and develops an argument about the significance of interprofessional working for street‐level bureaucracy. It presents an ethnographic analysis of criminal justice social workers writing presentence reports for the Scottish courts. Social workers' report writing for judges brought into relief issues of relative professional status. Social workers were uncertain of their place within the legal domain and concerned about their credibility as criminal justice professionals. Reports were written, in part at least, as a way of seeking esteem and credibility in the eyes of judges—a motivation that undermined the policy objectives of social enquiry in sentencing. Applying the conceptual tools of Bourdieu to our findings, we argue that street‐level bureaucrats who have to work across bureaucratic "fields" may find, or fear, that the cultural and symbolic "capital" they retained within their own field is undervalued in the symbolic economy of new fields, putting them in a position of relative inferiority. This issue of relative professional status, and how officials respond to it, is significant for our understanding of street‐level bureaucracy.

This article draws on the findings of an ethnographic study of social enquiry and sentencing in the Scottish courts. It explores the nature of the practice of social enquiry (that is, of social workers preparing reports to assist sentencers) and explores the extent to which this practice is being reconfigured in line with the recent accounts of penal transformation. In so doing, we problematize and explore what we term the 'governmentality gap'; meaning, a lacuna in the existing penological scholarship which concerns the contingent relationships between changing governmental rationalities and technologies on the one hand and the construction of penality-in-practice on the other. The findings suggest that although policy discourses have, in many respects, changed in the way that these accounts elucidate and anticipate, evidence of changes in penal discourses and practices is much more partial. Drawing on Bourdieu, we suggest that this may be best understood not as a counter-example to accounts of penal transformation but as evidence of an incompleteness in their analyses which reflects the 'governmentality gap' and requires the development of more fully cultural penology drawing on ethnographies of penality.

This study was funded by the Scottish Government through the Primary Care Division and Health Improvement Scotland. ; Objective To synthesise international evidence for demand, use and outcomes of primary care out-of-hours health services (OOHS). Design Systematic scoping review. Data sources CINAHL; Medline; PsyARTICLES; PsycINFO; SocINDEX; and Embase from 1995 to 2019. Study selection English language studies in UK or similar international settings, focused on services in or directly impacting primary care. Results 105 studies included: 54% from mainland Europe/Republic of Ireland; 37% from UK. Most focused on general practitioner-led out-of-hours cooperatives. Evidence for increasing patient demand over time was weak due to data heterogeneity, infrequent reporting of population denominators and little adjustment for population sociodemographics. There was consistent evidence of higher OOHS use in the evening compared with overnight, at weekends and by certain groups (children aged 65, women, those from socioeconomically deprived areas, with chronic diseases or mental health problems). Contact with OOHS was driven by problems perceived as urgent by patients. Respiratory, musculoskeletal, skin and abdominal symptoms were the most common reasons for contact in adults; fever and gastrointestinal symptoms were the most common in the under-5s. Frequent users of daytime services were also frequent OOHS users; difficulty accessing daytime services was also associated with OOHS use. There is some evidence to suggest that OOHS colocated in emergency departments (ED) can reduce demand in EDs. Conclusions Policy changes have impacted on OOHS over the past two decades. While there are generalisable lessons, a lack of comparable data makes it difficult to judge how demand has changed over time. Agreement on collection of OOHS data would allow robust comparisons within and across countries and across new models of care. Future developments in OOHS should also pay more attention to the relationship with daytime primary care and other services. ; Publisher PDF ; Peer reviewed

peer-reviewed ; Objectives: Guidelines and training initiatives (G/TIs) are available to support communication in crosscultural consultations but are rarely implemented in routine practice in primary care. As part of the European Union RESTORE project, our objective was to explore whether the available G/TIs make sense to migrants and other key stakeholders and whether they could collectively choose G/TIs and engage in their implementation in primary care settings.

Objectives: Guidelines and training initiatives (G/TIs) are available to support communication in cross-cultural consultations but are rarely implemented in routine practice in primary care. As part of the European Union RESTORE project, our objective was to explore whether the available G/TIs make sense to migrants and other key stakeholders and whether they could collectively choose G/TIs and engage in their implementation in primary care settings. Setting: As part of a comparative analysis of 5 linked qualitative case studies, we used purposeful and snowball sampling to recruit migrants and other key stakeholders in primary care settings in Austria, England, Greece, Ireland and the Netherlands. Participants: A total of 78 stakeholders participated in the study (Austria 15, England 9, Ireland 11, Greece 16, Netherlands 27), covering a range of groups (migrants, general practitioners, nurses, administrative staff, interpreters, health service planners). Primary and secondary outcome measures: We combined Normalisation Process Theory (NPT) and Participatory Learning and Action (PLA) research to conduct a series of PLA style focus groups. Using a standardised protocol, stakeholders' discussions about a set of G/TIs were recorded on PLA commentary charts and their selection process was recorded through a PLA direct-ranking technique. We performed inductive and deductive thematic analysis to investigate sensemaking and engagement with the G/TIs. Results: The need for new ways of working was strongly endorsed by most stakeholders. Stakeholders considered that they were the right people to drive the work forward and were keen to enrol others to support the implementation work. This was evidenced by the democratic selection by stakeholders in each setting of one G/TI as a local implementation project. Conclusions: This theoretically informed participatory approach used across 5 countries with diverse healthcare systems could be used in other settings to establish positive conditions for the start of implementation journeys for G/TIs to improve healthcare for migrants. ; (VLID)6065982

Objectives: Guidelines and training initiatives (G/TIs) are available to support communication in cross-cultural consultations but are rarely implemented in routine practice in primary care. As part of the European Union RESTORE project, our objective was to explore whether the available G/TIs make sense to migrants and other key stakeholders and whether they could collectively choose G/TIs and engage in their implementation in primary care settings. Setting: As part of a comparative analysis of 5 linked qualitative case studies, we used purposeful and snowball sampling to recruit migrants and other key stakeholders in primary care settings in Austria, England, Greece, Ireland and the Netherlands. Participants: A total of 78 stakeholders participated in the study (Austria 15, England 9, Ireland 11, Greece 16, Netherlands 27), covering a range of groups (migrants, general practitioners, nurses, administrative staff, interpreters, health service planners). Primary and secondary outcome measures: We combined Normalisation Process Theory (NPT) and Participatory Learning and Action (PLA) research to conduct a series of PLA style focus groups. Using a standardised protocol, stakeholders' discussions about a set of G/TIs were recorded on PLA commentary charts and their selection process was recorded through a PLA direct-ranking technique. We performed inductive and deductive thematic analysis to investigate sensemaking and engagement with the G/TIs. Results: The need for new ways of working was strongly endorsed by most stakeholders. Stakeholders considered that they were the right people to drive the work forward and were keen to enrol others to support the implementation work. This was evidenced by the democratic selection by stakeholders in each setting of one G/TI as a local implementation project. Conclusions: This theoretically informed participatory approach used across 5 countries with diverse healthcare systems could be used in other settings to establish positive conditions for the start of implementation journeys for G/TIs to improve healthcare for migrants.