In sickness and in health: The strains and gains of caring for a chronically ill or disabled spouse.

Objectives To examine the subjective experiences of spousal carers, focusing on positive, negative, and relational aspects of this role. Methods Mixed-methods exploratory study involving questionnaires ( N = 40) and in-depth interviews ( N = 8) with spousal carers in the southwest of England. Results Participants used a combination of negative and positive terms to describe their experiences, with the cared-for spouse's mental acuity, behavior towards the carer, and amount of care required, impacting on carers' subjective experience.

Saving lives, preserving livelihoods: understanding risk, decision-making and child health in a food crisis.

The purpose of this paper is to analyse household decision-making regarding resource allocation in the aftermath of a food crisis in rural Niger. International attention had resulted in humanitarian agencies launching emergency nutrition programmes to alleviate persistently high levels of acute child malnutrition. We conducted participant observation, 93 in-depth interviews, 15 focus groups, 44 feeding and illness histories for children under 5, and debriefing sessions with local humanitarian staff.

Patients' explanatory models for irritable bowel syndrome: symptoms and treatment more important than explaining aetiology.

Background: Irritable bowel syndrome (IBS) is a common condition associated with no certain organic cause, though diet and stress are widely implicated. The condition is frustrating for both sufferers and doctors, and there are problems in diagnosing and treating the condition. Eliciting explanatory models (EMs) is a useful tool for understanding how individuals relate to their illnesses and their expectations for treatment, particularly for illnesses with uncertain aetiology like IBS.

GPs' explanatory models for irritable bowel syndrome: a mismatch with patient models?

Background: Inconsistencies in doctors' views about causes and treatment of irritable bowel syndrome (IBS) lead to frustration for doctors and in doctor-patient interactions. Diagnosis by GPs does not correspond well to established diagnostic criteria.

Objective: To understand GPs' explanatory models (EMs) and management strategies for IBS.

The social context of childcare practices and child malnutrition in Niger's recent food crisis.

In 2004-05, Niger suffered a food crisis during which global attention focused on high levels of acute malnutrition among children. In response, decentralised emergency nutrition programmes were introduced into much of southern Niger. Child malnutrition, however, is a chronic problem and its links with food production and household food security are complex.

Children's health and the social theory of risk: insights from the British measles, mumps and rubella (MMR) controversy.

Recent debates in the United Kingdom about the measles, mumps and rubella (MMR) vaccine and its alleged link with autism have centred on contested notions of risk. This paper presents findings from 87 parents' focus group and interview discussions of their decision-making about the vaccine in light of three streams of theoretical literature on risk (cultural theory, risk society, psychometric models of risk perception) and models of vaccination acceptance and resistance. In addition to the risks of infectious disease and autism, parents balanced other risk concerns-both biological and social-in making their decisions.

Restoring confidence in vaccines by explaining vaccine safety monitoring: is a targeted approach needed?

Public trust in childhood vaccines is crucial to achieving adequate immunisation coverage to ensure population-level immunity. However, in the UK, immunisation uptake has been adversely affected by vaccine safety scares, such as those surrounding whooping cough and measles, mumps and rubella (MMR). It is our belief that greater public awareness of safety surveillance schemes may play a key role in improving trust in vaccine safety.

Uncertainty, decision-making and trust: lessons from the MMR controversy.

Uncertainty about the likelihood of a particular child coming to harm is a chief concern for parents making decisions about the MMR vaccine, but little attention has been given to the ways that parents cope with this uncertainty. Social science frameworks may help practitioners to understand parental decision making and its implications for community practice. In focus groups and interviews involving 87 parents, three distinct strategies for dealing with uncertainty emerged: reducing complexity through trust, compromise strategies that embrace ambivalence and identifying vulnerable groups.

A survey of UK parental attitudes to the MMR vaccine and trust in medical authority.

Contested reports associating the MMR vaccine with autism have resulted in diminished confidence and uptake of the vaccine in the UK. This postal survey of parent's decisions, attitudes and use of information about MMR immunisation was constructed from questions derived from in-depth qualitative work. The setting was a Primary Care Trust in northeast England (N=996).