Objectives To explore junior doctors’ knowledge about and experiences of managing patients with medically unexplained symptoms (MUS) and to seek their recommendations for improved future training on this important topic about which they currently receive little education. Design Qualitative study using in-depth interviews analysed using the framework method. Setting Participants were recruited from three North Thames London hospitals within the UK. Participants Twenty-two junior doctors undertaking the UK foundation two-year training programme (FY1/FY2). Results The junior doctors interviewed identified a significant gap in their training on the topic of MUS, particularly in relation to their awareness of the topic, the appropriate level of investigations, possible psychological comorbidities, the formulation of suitable explanations for patients’ symptoms and longer term management strategies. Many junior doctors expressed feelings of anxiety, frustration and a self-perceived lack of competency in this area, and spoke of over-investigating patients or avoiding patient contact altogether due to the challenging nature of MUS and a difficulty in managing the accompanying uncertainty. They also identified the negative attitudes of some senior clinicians and potential role models towards patients with MUS as a factor contributing to their own attitudes and management choices. Most reported a need for more training during the foundation years, and recommended interactive case-based group discussions with a focus on providing meaningful explanations to patients for their symptoms. Conclusions There is an urgent need to improve postgraduate training about the topics of MUS and avoiding over-investigation, as current training does not equip junior doctors with the necessary knowledge and skills to effectively and confidently manage patients in these areas. Training needs to focus on practical skill development to increase clinical knowledge in areas such as delivering suitable explanations, and to incorporate individual management strategies to help junior doctors tolerate the uncertainty associated with MUS.

A growing social science literature demonstrates that sleep is not merely a personal matter but also a political problem and a public health issue. Taking this as a point of departure, our article presents an analysis of sleeping practices amongst homeless drug users (HDUs) who make use of emergency hostels and night shelters in England. Data generated by way of qualitative interviews undertaken with 29 men and 11 women reveal that, as we might expect, securing sleep for this group is by no means easy. The strategies they pursue to find places to sleep are described, as are the threats and barriers to their sleeping. Emergency hostels and night shelters can afford a lifeline; providing warmth, water, food and access to support services. But if these are inadequately resourced they can be experienced as volatile environments and inimical to sleeping. It is argued here that although sleep is an essential prerequisite for health, for this population it can, somewhat ironically, be experienced as a risky behaviour. Vulnerable to both physical risks (e.g. inclement weather) and social threats (e.g. abuse and violence), falling asleep can exacerbate exposure to such dangers. These vulnerabilities are compounded by the social position of HDUs who live in socially and physically marginal places. It is this marginality that prevents them from being able to secure sleep that is both restful and restorative.

Research that has explored the lives of men and women recovering from heroin addiction has reported that users often claim that they ‘just want to be normal’. Working within a Foucauldian tradition, we argue in this article that the notions of ‘governmentality’ and the ‘norm’ are especially apposite to understanding the ubiquity of this aspiration. Here we focus not on the formal institutions of governance that encourage individuals to adhere to social, cultural and political norms, but rather seek to explore recovering users’ accounts of normality as they are envisaged and expressed. The reported empirical data were generated from interviews with 40 men and women in England at various stages of recovery from heroin use. The analytic focus is upon the accounts of normality articulated during the interviews in order to identify the ways in which being normal is presented by the participants. In keeping with the methodological tradition of discourse analysis we identify six discursive repertoires of ‘normality talk’ that transcend the accounts. It is concluded that the negotiation of normality is a precarious route for this social group. Articulations of a desire to be normal are replete with tensions; there are expressions of both resistance and resignation. Despite claims by some contemporary social theorists that diversity is the ‘new normality’, the accepted bounds of ‘difference’ are limited for those who have been addicted to heroin.

This article presents findings from an ethnography of fell running in the English Lake District. A provocative concept – existential capital – is proposed to underscore the profits acquired from fell running as an embodied technique, and as a means of defining the shared passions within the field. These gains are acquired through corporeal techniques that require sustained physical effort, embodied vigilance, and knowledge of an environment that is topographically challenging and aesthetically arresting. The visceral pleasures intrinsic to existential capital are appreciated by those within the field and this, in turn, means that this solitary sport gives rise to an intense sociality that ‘only a runner can understand’. Field analysis conventionally focuses on struggles; it is suggested here that a focus on what is shared allows us to understand how a field gains an identity. Thus the notion of existential capital highlights the field as passionately defined in ways that challenge the instrumentalism inherent to conventional modes of field analysis.

Throughout affluent societies there are growing numbers of people who survive severe brain injuries only to be left with long-term chronic disorders of consciousness. This patient group who exist betwixt and between life and death are variously diagnosed as in 'comatose', 'vegetative', and, more recently, 'minimally conscious' states. Drawing on a nascent body of sociological work in this field and developments in the sociology of diagnosis in concert with Bauman's thesis of 'ambivalence' and Turner's work on 'liminality', this article proposes a concept we label as diagnostic illusory in order to capture the ambiguities, nuanced complexities and tensions that the biomedical imperative to name and classify these patients give rise to. Our concept emerged through a reading of debates within medical journals alongside an analysis of qualitative data generated by way of a study of accounts of those close to patients: primarily relatives (N = 51); neurologists (N = 4); lawyers (N = 2); and others (N = 5) involved in their health care in the UK.