Peer support is well established in fields such as the disability movement and mental health and is increasingly recognised as one way of enabling support by and for people with a diagnosis of dementia and their immediate carers. It was central to the implementation of the National Dementia Strategy (NDS) for England, when 40 demonstration sites were established. This mixed-methods study included in-depth qualitative interviews with people living with dementia (n = 101) and staff/stakeholders (n = 82) at 8 of the 40 sites. Data analysis was a five-stage process: coding framework developed (using 25 transcripts); further development of the framework (using a further 70 transcripts); development of emerging themes; modelling of themes and verification of models based on the entire data set. Peer support had positive emotional and social impact that was rooted in identification with others, a commonality of experience and reciprocity of support. There was also a contrast between the quality of peer support and support from professionals. This emphasises the significance of lived experience and promoting a strength-based approach to interpersonal support that is enabling and challenges a deficit approach to understanding dementia.

( 2 0 1 0 ) Journal of Nursing and Healthcare of Chronic Illness 2, 102-112 Dementia and risk: contested territories of everyday life Aims. The project aimed to understand the construction of risk in dementia care from the perspective of the person with dementia, family carers and practitioners with the intention of developing negotiated partnerships in risk management. Background. This paper addresses a gap in the literature by embedding constructions of risk within everyday events and social contexts, and communicates such constructions through the voices of people with dementia, carers and practitioners. Method. This symbolic interactionalist study involved data collection by interview with 55 people with dementia (sometimes twice), and their nominated carer and practitioner. The sample was drawn from three regions of the United Kingdom. Data were collected during 2004. Conclusions. Five 'contested territories' of everyday living with dementia are outlined in this paper: friendships, smoking, going out, domestic arrangements, and occupation and activity. These contested territories are purposeful and allow for 102Ó 2010 Blackwell Publishing Ltd sense making, maintenance of self, claiming and relinquishing decision making, and creating purpose(lessness) in people's lives. Relevance to clinical practice. Assessing and managing risk in a way that respects the dynamics and purposes of contested territories will support care that is person centred, and moreover respectful of the relationships that contribute to maintaining the individual's sense of self and purpose.Key words: carer, contested territories, dementia, everyday life, risk, symbolic interactionism IntroductionThe paper addresses the complex area of risk management in dementia care. It described a qualitative study in which 55 people with dementia were interviewed, together with their nominated family member and carer. The findings demonstrate the everyday ways in which people with dementia experience risk and its impact on their sense-making, and their identity, purpose and control over their lives. As such, the paper contributes to a growing awareness of the critical importance of the ways in which the micro-dynamics of people's lives are affected by others and it offers a way of intervening to support the identity of the person with dementia.

Gynaecological malignancy has an immense impact on the well-being of women. For many women, however, treatment such as surgery is curative and healthcare intervention focuses on the physiological status of the women. The psychological, social and sexual consequences of the malignancy and its treatment have received little attention in research or in practice. The present study used a mixed quantitative and qualitative design to analyse a specialist nurse intervention (including psychosexual intervention), and to explain the impact of the illness on women's lives. The qualitative arm of the study collected interview data from 20 women and six partners. The randomized controlled trial sample consisted of 36 women, with data collected using a quality of life measure (the EORTC QLQ-C30) and the Lasry Sexual Functioning scale. This paper focuses on the randomized controlled trial data, which identified that sexual functioning and quality of life were improved in the active group who received specialist psychosexual counselling. However, the validity of the sexual functioning scale is challenged by the qualitative results of the study, which emphasize the social meaning of sexuality.

There has been little research that addresses the importance of place in enabling resilience and citizenship -most to date focussing on these as a characteristic of the individual. This paper reports on findings from a qualitative study that aimed to explore the everyday experiences of living with dementia within rural and semi-urban communities. Data collection included a sequence of four research diaries and interviews with 13 families living at home with dementia and interviews with service providers and commissioners (a total of 57 diaries, 69 interviews with people living with dementia and 6 interviews with service providers and commissioners). Key themes identified included: Others Knowing and Responding; Socially Withdrawing and Feeling Excluded; Sustaining and Changing Activities;Belonging and Estrangement from Place; Engaging Services and Supports.The study found that familiarity with people and place can be supportive, and these factors support a narrative citizenship in which people can tell a story of inclusion and feeling on the inside. However, this familiarity with place may also create a social barrier and a sense of estrangement, or being on the outside. Narrative citizenship allows us to explore how people with dementia position themselves in relation to others and in so doing, negotiate their own and other's understandings of dementia. It also allows for people to tell stories about themselves in relation to their sense of belonging in a social and physical place, which augment the personal and political approaches to citizenship and thus offers an approach that enhances individualised yet collective understandings of living with dementia.

Aim.  To report on a study which developed a knowledge of the experiences of South Asian people with diabetes in the UK in relation to socio-cultural and dietary practices, religion and ageing influences on the perception and understanding of risks. Background.  South Asian people have enhanced vulnerability to poor health as a result of diabetes. Risk perception and management is culturally mediated, yet imperative to the behaviour adjustments required for diabetes management. Method.  A grounded theory study with data collected by focus group with ethnic health development workers and individual interviews with 20 older people with diabetes. Where necessary, interpreters were involved in data collection. Findings.  A number of issues influence the perception of risk among South Asian older people with diabetes: beliefs about its cause, perceived severity and its visibility, food and its social function, religion and beliefs about external control over their life span and diabetes management. People weighed up the risks in making decisions about issues such as dietary management and the emphasis placed on diabetes as a pathology. Conclusion.  Good risk communication will maintain the current trend of improving patient's choice and self-management in health care, and there is a need for this to be sensitive to the particular issues faced by South Asians with diabetes in the UK.

Contemporary nurse education places a high value on learning in the clinical environment. Combined with increasing numbers of students there are unprecedented demands on clinical areas and staff. One response to this problem has been the development of the practice placement facilitator (PPF) role. This study aimed to evaluate, over 12 months, the impact of the PPF role on the provision of practice placements, student support during placement and professional development needs of staff as clinical supervisors/assessors. The evaluation focused on three areas: capacity to accommodate students; quality of placements in relation to the role of the PPF; and the evolution of the role of the PPF. Data‐collection methods included interviews, focus groups, questionnaires and secondary data analysis. The findings of the study demonstrated that: many different groups of learners are present in clinical environments; students need to have continuity of support; clinical staff derive benefits from an enhanced understanding of the needs of learners through the work of the PPF; and that if the role and function of the PPF post is unclear and/or poorly maintained there will be detrimental effects.

The filial piety model of family centred care has dominated Chinese society for thousands of years. The ways in which filial piety is presented are being modified and modernised as China undergoes social transitions. The study aims to understand the meaning of filial piety for people with dementia and family caregivers. Semi-structured interviews with people with dementia ( n = 10) and family caregivers ( n = 14) were conducted. Data were analysed using interpretative phenomenological analysis. Three themes emerged: (a) 'Being filial is a cultural continuity and my future investment'. (b) 'The changed perception and ways of being filial'. (c) 'Filial responsibility is a social and cultural convention, but not my personal choice'. This study highlights the importance of cultural values in family care decision making and in shaping filial responsibilities. It indicates that filial obligation can be maintained through social support, even though the nature of filial piety has been changed by social transitions.

As the world of work changes, UK pharmacists are increasingly required to recognise and articulate lifelong learning. College of Pharmacy Practice (CPP) portfolios were made available to 25 pharmacists in a single Workforce Development Confederation area. The evaluation reported here formed one strand of a larger study exploring CPD activity in the NHS. This strand aimed to describe and consider the ways in which pharmacists used the CPP portfolio as a vehicle to articulate their acquisition and use of practice based knowledge. Data were obtained through semi-structured interviews with nine pharmacists before and after using the portfolios (n ¼ 18 interviews) and were analysed using "framework technique". Key emergent themes were "socialised learning" and "learning amplification", in particular the findings emphasised the importance of recognising:. the advantages/disadvantages of work based (socialised) learning approaches; and . the environment in which learning takes place and ensuring that learning can be "amplified" for the individual and the organisation.