Professionalising patient safety? Findings from a mixed-methods formative evaluation of the patient safety specialist role in the English National Health Service.

While safety-dedicated professional roles are common in other high-risk industries, in health care they have tended to have a relatively narrow, technical focus. We present initial findings from a mixed-methods evaluation of a novel, senior role with responsibility for leadership of safety in English National Health Service organisations: the patient safety specialist. We conducted interviews with those responsible for designing, developing and overseeing the introduction of the role.

Consensus-building to improve implementation of NICE guidance on planning for end-of-life treatment and care: a mixed-methods study.

Background: Despite the availability of guidance for the provision of good end-of-life care, there are significant variations across the UK in its delivery. This study sought to identify the influences on end-of-life treatment and care planning across several areas where deficiencies in evidence-based practice have been identified, and to develop consensus among healthcare providers and users for recommendations on how to address these deficits.

Methods: An online survey (106 responses), qualitative interviews (55 participants) and a consensus-building exercise (475 participants in the initial round) were undertaken.

Asked to be a sperm donor: disclosure dilemmas of gay men living with HIV.

Previous research has documented the various challenges people living with HIV face as they navigate intimate relationships, including what is often referred to as disclosure. In studies of gay, bisexual and other men who have sex with men, the issue of telling or not telling others about an HIV-positive status has been examined primarily in relation to communication with sexual partners, with few studies focusing on other aspects of intimacy. Drawing on interviews with gay men living with HIV, conducted in four clinics in London, this article explores the narratives of men who have been asked by female friends about the possibility of being a sperm donor.

Discussing parenthood with gay men diagnosed with HIV: a qualitative study of patient and healthcare practitioner perspectives.

Background: Research on HIV and reproduction has focused largely on women and heterosexual men. This article examines whether it is relevant to address parenthood in HIV care with gay men and what ways of doing so are most appropriate.

Methods: Qualitative interviews were conducted at four London clinics with 25 men living with HIV, aged 20-45, who did not have children, and 16 HIV clinicians.

Sexual identities and reproductive orientations: Coming out as wanting (or not wanting) to have children.

In the context of growing visibility, recognition and acceptance of lesbian motherhood and gay fatherhood in countries such as Britain, it is important to ask how younger generations of sexual minorities approach the possibility of becoming a parent. Drawing on interviews with lesbians and gay men who do not have children but may have them in the future, I explore how people become aware that having children is an option. By attending to how this consciousness manifests in conversations and how conversations shape the consciousness, I illuminate specific dynamics that raising the topic of parenthood creates in intimate interactions.

Can HIV-positive gay men become parents? How men living with HIV and HIV clinicians talk about the possibility of having children.

It is now established that people living with HIV who have an undetectable viral load and adhere to antiretroviral treatment cannot transmit HIV to their sexual partners. Previous research has shown that 'being undetectable' changes how HIV-positive gay men experience their sex lives. But how does it affect gay men's reproductive behaviours? And what influence does it have on views about parenthood at a time when gay fatherhood has become more socially accepted and publicly visible? Drawing on qualitative interviews with patients and clinicians at four HIV clinics in London, we identify differences in how interviewees talked about the possibility of having children for HIV-positive men.

Parenthood as intended: Reproductive responsibility, moral judgements and having children 'by accident'.

What does it mean to have a child 'by accident'? And why is parenthood so often described as happening 'accidentally', even when it is likely to involve at least some degree of intention? Drawing on interviews conducted in England and Wales with lesbians and gay men who do not have children but may have them in the future, this article explores the meanings of the notion that, as a same-sex couple, 'you can't have a child by accident' - a comment that interviewees frequently made unprompted when they were asked about the possibility of becoming parents. My data show that referring to 'accidental parenthood' is a common way of distinguishing one's experience of early adulthood from that of heterosexual people, especially among white, middle-class lesbians. As a closer reading of the data also suggests, parenthood that arguably happens by accident is often neither unforeseen nor unfortunate, and its currency as a point of reference reveals a powerful cultural narrative.

More Natural Does Not Equal More Normal: Lesbian, Gay, and Bisexual People's Views About Different Pathways to Parenthood.

Heterosexual reproduction is often seen as and , with the two descriptors commonly understood as mutually reinforcing. I argue that, despite their apparent similarity, the meanings of "normal" and "natural" are distinct in important ways-a distinction that questions the positioning of lesbian motherhood and gay fatherhood as inferior. Through an analysis of lesbian, gay, and bisexual people's ethical judgments about different ways of creating families, I show that pathways to parenthood that make a family appear "more normal" rely on means of reproduction that seem, in fact, "less natural.

Repro-sexual intersections: sperm donation, HIV prevention and the public interest in semen.

In the scientific literature on fertility and assisted reproduction, and in the corresponding area of clinical practice, increasing attention has been paid to two groups: people living with the human immunodeficiency virus (HIV) and gay men. However, research on fertility in the context of HIV focuses almost exclusively on heterosexual couples, whereas studies on non-heterosexual reproduction rarely mention HIV, despite the fact that, in many western countries, HIV prevalence among men who have sex with men is higher than ever before and men who have sex with men are the only group in which new HIV infections are on the rise. This review identifies links between reproduction, HIV and homosexuality, showing that, historically, they are closely intertwined, which has important implications for current issues facing HIV care and fertility services.