Wicked futures:meaning, matter and the sociology of the future

Sociologists and futurists have come to see that 'fabrications' of the future as entirely open to being remade in the present have become more difficult to sustain in a complex and contingent world. Rather, new and more nuanced conceptualizations of the future are required. To contribute to that task, I draw inspiration from Rittel and Webber's 1973 paper in which they analyze social problems as 'wicked problems' to explore how sociologists have found the future to be difficult and tricky, both conceptually and empirically and have sought to overcome those difficulties through various analytical strategies. I discuss the onto-epistemological status of the future in sociology, tracing major shifts in theorizing of the future and suggest that what makes the future so wicked - so difficult and pernicious - is that it is an 'entanglement of matter and meaning'. In doing so, I draw on insights from STS (science and technology studies) and other fields of inquiry to propose a new conceptual language in which to do the sociology of the future

Revisiting digital technologies: envisioning biodigital bodies

In this paper the contemporary practices of human genomics in the 21st century are placed alongside the digital bodies of the 1990s. The primary aim is to provide a trajectory of the biodigital as follows: First, digital bodies and biodigital bodies were both part of the spectacular imaginaries of early cybercultures. Second, these spectacular digital bodies were supplemented in the mid-1990s by digital bodywork practices that have become an important dimension of everyday communication. Third, the spectacle of biodigital bodies is in the process of being supplemented by biodigital bodywork practices, through personal or direct-to-consumer genomics. This shift moves a form of biodigital communication into the everyday. Finally, what can be learned from putting the trajectories of digital and biodigital bodies together is that the degree of this communicative shift may be obscured through the doubled attachment of personal genomics to everyday digital culture and high-tech spectacle.Keywords: genomics, biodigital, bodies, spectacle, everyda

Gesture and Speech in Interaction - 4th edition (GESPIN 4)

International audienceThe fourth edition of Gesture and Speech in Interaction (GESPIN) was held in Nantes, France. With more than 40 papers, these proceedings show just what a flourishing field of enquiry gesture studies continues to be. The keynote speeches of the conference addressed three different aspects of multimodal interaction:gesture and grammar, gesture acquisition, and gesture and social interaction. In a talk entitled Qualitiesof event construal in speech and gesture: Aspect and tense, Alan Cienki presented an ongoing researchproject on narratives in French, German and Russian, a project that focuses especially on the verbal andgestural expression of grammatical tense and aspect in narratives in the three languages. Jean-MarcColletta's talk, entitled Gesture and Language Development: towards a unified theoretical framework,described the joint acquisition and development of speech and early conventional and representationalgestures. In Grammar, deixis, and multimodality between code-manifestation and code-integration or whyKendon's Continuum should be transformed into a gestural circle, Ellen Fricke proposed a revisitedgrammar of noun phrases that integrates gestures as part of the semiotic and typological codes of individuallanguages. From a pragmatic and cognitive perspective, Judith Holler explored the use ofgaze and hand gestures as means of organizing turns at talk as well as establishing common ground in apresentation entitled On the pragmatics of multi-modal face-to-face communication: Gesture, speech andgaze in the coordination of mental states and social interaction.Among the talks and posters presented at the conference, the vast majority of topics related, quitenaturally, to gesture and speech in interaction - understood both in terms of mapping of units in differentsemiotic modes and of the use of gesture and speech in social interaction. Several presentations explored the effects of impairments(such as diseases or the natural ageing process) on gesture and speech. The communicative relevance ofgesture and speech and audience-design in natural interactions, as well as in more controlled settings liketelevision debates and reports, was another topic addressed during the conference. Some participantsalso presented research on first and second language learning, while others discussed the relationshipbetween gesture and intonation. While most participants presented research on gesture and speech froman observer's perspective, be it in semiotics or pragmatics, some nevertheless focused on another importantaspect: the cognitive processes involved in language production and perception. Last but not least,participants also presented talks and posters on the computational analysis of gestures, whether involvingexternal devices (e.g. mocap, kinect) or concerning the use of specially-designed computer software forthe post-treatment of gestural data. Importantly, new links were made between semiotics and mocap data

Appraising the situation : a framework for understanding compassionate care

Background: Compassion in healthcare represents an ideal way of interacting with patients. It entails an active response to suffering, distress or discomfort that can be associated with people seeking health related support or treatment. However, reports from within healthcare highlight that compassionate care (CC) is not always achieved. It may be especially problematic when trying to work with a patient who seems unwilling or unable to engage with advice provided by a healthcare professional (HCP). Methods: We conducted a grounded theory study to understand the meaning of CC for HCPs working with patients with type 2 diabetes. Data were collected between May-October 2015 using focus groups and individual interviews; 36 HCPs took part in total. For the current paper, we used constant comparison to analyse data from transcripts where participants talked about working with a ‘non-adherent’ patient. Results: Analysis highlighted how appraisal of their encounter with a non-adherent patient could affect whether CC was seen as possible by participants. Therefore, we used a transactional model of emotions as a framework for understanding HCPs’ narratives. This involved a consideration of their primary appraisal of such encounters, which participants said often resulted in a sense of threat, failure and rejection. Their secondary appraisals, which centred on coping resources, included problem-focused approaches (e.g. supporting the patient to plan how to move forwards in managing their health) and emotion-focused approaches (e.g. recognising change was hard, appreciating it may not be the right time for the patient to change). These appraisals could be modified by: a) gaining experience as a HCP; b) altering what was seen as professional success; c) their connection with the patient; d) how much autonomy they had in their job. Conclusions: Our findings provide new insights and emphasise that CC in response to non-adherent patients is not determined solely by a HCP’s innate nature, but can be affected by an individual’s appraisal of this interaction and the resources he/she has available to cope. This has implications for the environment within which staff work

Measuring compassionate care : views of healthcare staff

Aim: To explore healthcare professionals' views of measuring compassionate care. Method: As part of a grounded theory study participants, who were healthcare professionals involved in the care of patients with type 2 diabetes, were invited to discuss the topic of compassionate care measurement through semi-structured interviews and focus groups. Results: Measuring compassionate care was regarded as problematic because of its complex nature. Categories identified in the data that reflect this difficulty include distinguishing compassionate care from other concepts, relying on informal indicators, making the subjective objective, incorporating external influences and putting a measurement tool to use. Conclusion: Findings highlighted the complexities associated with measuring compassionate care, and how attempts to do this by managers could be problematic

Participation in a trial in the emergency situation : a qualitative study of patient experience in the UK WOLLF trial

Background Patients can struggle to make sense of trials in emergency situations. This study examines patient experience of participating in the United Kingdom, Wound management of Open Lower Limb Fractures (UK WOLLF) study, a trial of standard wound management versus Negative Pressure Wound Therapy (NPWT). Methods The aim of the study was to understand the patient’s lived experience of taking part in a trial of wound dressings. Interviews drawing on Phenomenology were undertaken with a purposive sample of 20 patients, on average 12 days into their hospital stay from July 2012–July 2013. Results The participants were vulnerable due to the emotional and physical impact of injury. They expressed their trial experience through the theme of being compromised identified in categories of being dependent, being trusting, being grateful and being without experience. Participants felt dependent on and trusted the team to make the right decisions for them and not cause them harm. Their hopes for future recovery were also invested within the expertise of the team. Despite often not being well enough to consent to the study prior to surgery, they wished to be involved as much as possible. In agreeing to take part they expressed gratitude for their care, wanted to be helpful to others and considered the trial interventions to be a small component in relation to the enormity of their injury and broader treatment. In making sense of the trial they felt they could not understand the interventions without experience of them but if they received NPWT they developed a strong technological preference for this intervention. Conclusions Patients prefer to be involved in studies within the limits of their capacity, despite not being able to provide informed consent. A variety of sources of knowledge may enable participants to feel that they have a better understanding of the interventions. Professional staff need to be aware of the situated nature of decision making where participants invest their hopes for recovery in the team

Biosamples as gifts? How participants in biobanking projects talk about donation.

Funded by National Institute for Health Research (NIHR) Oxford Biomedical Research Centre based at Oxford University Hospitals NHS Trust University of Oxford Oxford Biomedical Research Centre FellowshipPeer reviewedPublisher PD

Patient experience of long term recovery after open fracture of the lower limb : a qualitative study using interviews in a community setting

Objectives Treatment of open fractures is complex and patients may require muscle and skin grafts. The aim of this study was to gain a greater understanding of patient experience of recovery from open fracture of the lower limb 2–4 years postinjury. Design A phenomenological approach was used to guide the design of the study. Interviews took place between October 2016 and April 2017 in the participants’ own homes or via telephone. Setting England, UK. Participants A purposive sample of 25 patients were interviewed with an age range of 26–80 years (median 51), 19 were male and six female, and time since injury was 24–49 months (median 35 months). Results The findings identified a focus on struggling to recover as participants created a new way of living, balancing moving forward with accepting how they are, while being uncertain of the future and experiencing cycles of progress and setbacks. This was expressed through three themes: (i) ‘being disempowered’ with the emotional impact of dependency and uncertainty, (ii) ‘being changed’ and living with being fragile and being unable to move freely and (iii) ‘being myself’ with a loss of self, feeling and looking different, alongside recreation of self in which they integrated the past, present and future to find meaningful ways of being themselves. Conclusion This study identified the long-term disruption caused by serious injury, the hidden work of integration that is required in order to move forward and maximise potential for recovery. Supportive strategies that help people to self-manage their everyday emotional and physical experience of recovery from injury are required. Research should focus on developing and testing effective interventions that provide support and self-management within a holistic rehabilitation plan

Flow of compassion in health care : moving beyond an individual towards a systemic focus

Background: Compassion is an underpinning construct in nursing and healthcare more generally, an ideal that is a motivating force for most of those working in this field. Nevertheless, delivering compassionate care (CC) is not always easy or achieved. Little research has investigated how it is enacted and what it means to healthcare professionals (HCPs)

Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb : UK wound management of open lower limb fractures (UK WOLFF)

Introduction: Patients who sustain open lower limb fractures have reported infection risks as high as 27%. The type of dressing applied after initial debridement could potentially affect this risk. In this trial, standard dressings will be compared with a new emerging treatment, negative pressure wound therapy, for patients with open lower limb fractures. Methods and analysis: All adult patients presenting with an open lower limb fracture, with a Gustilo and Anderson (G&A) grade 2/3, will be considered for inclusion. 460 consented patients will provide 90% power to detect a difference of eight points in the Disability Rating Index (DRI) score at 12 months, at the 5% level. A randomisation sequence, stratified by trial centre and G&A grade, will be produced and administered by a secure web-based service. A qualitative substudy will assess patients’ experience of giving consent for the trial, and acceptability of trial procedures to patients and staff. Patients will have clinical follow-up in a fracture clinic up to a minimum of 12 months as per standard National Health Service (NHS) practice. Functional and quality of life outcome data will be collected using the DRI, SF12 and EQ-5D questionnaires at 3, 6, 9 and 12 months postoperatively. In addition, information will be requested with regards to resource use and any late complications or surgical interventions related to their injury. The main analysis will investigate differences in the DRI score at 1 year after injury, between the two treatment groups on an intention-to-treat basis. Tests will be two sided and considered to provide evidence for a significant difference if p values are less than 0.05. Ethics and dissemination: Ethical approval was given by NRES Committee West Midlands—Coventry & Warwickshire on 6/2/2012 (ref: 12/WM/0001). The results of the trial will be disseminated via peer-reviewed publications and presentations at relevant conferences