Effective strategies for South Asian recruitment to clinical trials include: using multi-recruitment strategies; defining the demographic and social profiles of the population to be included; using focus groups to identify any potential barriers; consulting representative community members to provide assistance in the study; ensuring eligibility criteria are set as wide as possible; developing educational and recruitment approaches to attract ethnic minority health professionals; ensuring health professionals are adequately trained in culturally and ethnically orientated service provision; determining the most effective mass media to use in study promotion and recruitment; and targeting inner-city, single-handed practices likely to have high ethnic minority populations. Future research should consider: responses when invited to participate; the role of methodological and organisational barriers to recruitment; the complexities of recruitment from a health professional perspective; developing culturally sensitive research methods; the magnitude of the problem of under-recruitment; strategies to encourage inner-city, single-handed GP participation; and other factors affecting trial inclusion, such as age, gender, educational level and socio-cultural background.

Reflexivity is a key aspect of qualitative research. Considerable attention has been given to the ways in which gender mediates the production and analysis of qualitative data; however, much of this has been focused on qualitative interviews with women and the influence of the interviewer's gender in this specific context. Very little work has been done on comparing different interviewer-interviewee contexts such as male-to-female, male-to-male or female-to-male interviewing. Moreover, the interplay of gender with environmental, psycho-social and other biographical factors within the interview has received little attention. Drawing on four different studies on cancer care, work and family, and parenting, this article examines how each of these factors potentially mediate the collection of qualitative data in a range of interviewer-interviewee contexts. Moreover, it explores gender as both resource and delimiting factor, examining the use of impression management as a researcher tool to mediate potentially problematic interpersonal dynamics. It is concluded that greater attention should be paid to the complex intersectionality of gender, environmental, biographical and psychosocial factors in qualitative data analysis and write-up.

Objective To evaluate a training programme intended to improve the management of obesity, delivered to general practice teams. Design Cluster randomised trial. Setting Northern and Yorkshire region of England Participants 44 general practices invited consecutively attending obese adults to participate; 843 patients attended for collection of baseline data and were subsequently randomised. Intervention 4.5 hour training programme promoting an obesity management model. Main outcome measures Difference in weight between patients in intervention and control groups at 12 months (main outcome measure) and at 3 months and 18 months; change in practitioners' knowledge and behaviour in obesity management consultations. Results Twelve months after training the patients in the intervention group were 1 (95% confidence interval − 1.9 to 3.9) kg heavier than controls (P = 0.5). Some evidence indicated that practitioners' knowledge had improved. Some aspects of the management model, including recording weight, target weight, and dietary targets, occurred more frequently in intervention practices after the training, but in absolute terms levels of implementation were low. Conclusion A training package promoting a brief, prescriptive approach to the treatment of obesity through lifestyle modification, intended to be incorporated into routine clinical practice, did not ultimately affect the weight of this motivated and at risk cohort of patients.

The integration of complementary and alternative medicine (CAM) into cancer services is increasingly discussed as a potential part of UK health policy but as yet there has been little sociological research examining this process. This paper examines the results of a study on the provision of CAM to cancer patients in two distinct organisational contexts: the hospice and the hospital. It is based on interviews with medical specialists, nursing staff and CAM therapists. This paper focuses on how integration is managed in each organisation, examining professional boundary disputes and inter-professional dynamics. Discussion focuses on the rhetorical and practical strategies that are employed by a variety of differently positioned interviewees to negotiate the complexities of the interface of CAM and biomedicine. The results show significant differentiation in how differently positioned cancer clinicians view and utilise the biomedical hierarchy of evidence. We argue that the integration of CAM should not be conceptualised as a mere challenge to biomedicine, or, as resulting in a linear process of deprofessionalisation. Rather, it should be seen as producing a complex array of processes, including strategic adaptation on the part of medical specialists and NHS organisations.

Drawing on in-depth interviews with cancer patients, this article examines patients' perspectives on the nature of evidence and the degree to which different understandings of evidence inform decision-making about complementary and alternative medicine (CAM) and biomedical cancer treatments. Results illustrate the ways in which many cancer patients critically engage with questions about the nature of knowledge and the potential pitfalls of science.Their accounts can largely be characterized by a dialectical tension between individuation (espoused by many CAM therapies) and depersonalization (implicit in biomedical care); a tension mediated by individual cancer patient's prognosis and age. On the basis of the results we argue for a re-focusing of social theory to embrace an understanding of grass-roots ontological tensions seen in the experiences of individual cancer patients.The problematic nature of maintaining a narrowly defined 'evidence-base' policy on CAM and cancer is also discussed in light of the data. KEY WORDScancer / complementary medicine / evidence-based medicine