ObjectivesTo explore the impact of eye clinic liaison officers (ECLOs, also known as sight loss advisors) on the processes, functions and quality of ophthalmology clinics through the experiences of ophthalmology staff in the UK.DesignQualitative study.SettingUK hospital ophthalmology clinics.ParticipantsHealth and social care professionals in the UK.ResultsECLOs who had a presence in hospital ophthalmology clinics were seen as valuable in streamlining processes within the clinic, particularly in relation to the certification of visual impairment process, and providing continuity of care for patients when they were discharged from medical treatment. ECLOs also saved staff time in the clinic, as they were often responsible for providing emotional and practical support for patients living with sight loss.ConclusionsECLOs are well placed in ophthalmology clinics. They can relieve pressure on clinical staff by taking on information giving and referring duties, allowing other staff to focus on their clinical responsibilities. The impact of ECLOs may depend on efficient communication with the clinical team, being trusted by other staff and having a good knowledge of local and national sight loss support services outside of the hospital setting. Further research could enhance our understanding of how much time and associated costs ECLOs substitute in the ophthalmology clinic.

Part 2 of Encountering Berlant amplifies the promise of Lauren Berlant's influential concept of 'cruel optimism'. Cruel optimism names a double-bind in which attachment to an 'object' holds out the promise of sustaining/flour ishing, whilst simultaneously harming. The lines between harming, sustaining, damaging and flourishing blur, sometimes collapsing entirely. By holding together opposites the concept exemplifies and performs the centrality of ambivalence to Berlant's thought, as well as their orientation to overdetermination and incoherence. Geographers and others have found in the concept a way of understanding the intersection between affective and political economies in the crisis-present following the 2008 financial crisis. Together with Berlant's linked concepts such as 'crisis ordinariness' and 'impasse', cruel optimism has offered a way of understanding why detachment can be so difficult and how damaging conditions endure. Contributors begin from these starting points, amplifying the concept's promise: a new way of researching and writing about the reproduction of ordinary damage and harm.

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This thesis tries to develop an understanding of the phenomenon of ‘Dementia Friendly Communities’ (DFCs), a policy initiative which has been pursued during the last decade in the nations and regions of the UK, and other parts of the world. In Wales, this has coincided with a radical shrinking of state budgets to deliver social care support, often called ‘austerity’, and rising interest in the policy and cultural implications of an ageing society, and how dementia has seemingly become more central in that demographic trend. This inquiry arises initially from a critical gerontology perspective but develops along lines which borrow from cultural geography and post-war, avantgarde literature. Such an interdisciplinary approach presents opportunities for using novel methods of collecting and analysing material. Though conventional ethnographic techniques such as participant observation, interviewing and photography were used throughout, I also introduce practises such as writing using spontaneous prose, collaging or cut-ups, as an alternative means of analysis. During fieldwork, I attended various events and meetings with those involved in developing DFCs, including ‘dementia activists’, and witnessed the development of ‘Meeting Centres’ as a chosen approach to support those with dementias and their carers in the market town of Brecon, south Wales. From this, a picture emerges of a phenomenon which seems contingent and difficult to grasp, but offers space for critical counter-conducts, glimpses of community-making and types of citizenship. Foucauldian concepts such as biopolitics, governmentality and pastoral power, alongside more non-representational and affective approaches, were used throughout. Writers such as William S. Burroughs, Georges Perec and others inspired ‘ways of doing and making that [could] intervene in the general distribution of ways of doing and making’ (Rancière, 2004, p13). Findings are presented as a series of fragments, including fictocritical and anecdotal writing, collages and cut-ups of materials generated. The main contribution of this study is to attempt to a more nuanced portrayal of DFCs as found, whilst developing methods which question epistemic boundaries, and may have practical potential for synthesising new materials across disciplinary borders.