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    ABSTRACT: BACKGROUND: Parenting and pregnancy in the context of drug use is a contentious topic, high on the policy agenda. Providing effective support to parents who are opioid dependent, through early intervention, access to drug treatment and parenting skills training, is a priority. However, little is known about opioid dependent parents' experiences and understanding of parenting support during the antenatal and postnatal periods. This paper focuses on the position and impact of opioid substitution therapy (OST) in the accounts of parents who were expecting, or who had recently had, a baby in the UK. METHODS: Semi-structured qualitative interviews were held with a purposive sample of 19 opioid dependent service users (14 female, 5 male). Longitudinal data was collected across the antenatal and postnatal (up to 1 year) periods, with participants interviewed up to three times. Forty-five interviews were analysed thematically, using a constant comparison method, underpinned by a sociologically informed narrative approach. RESULTS: Participants' accounts of drug treatment were clearly oriented towards demonstrating that they were doing 'the best thing' for their baby. For some, OST was framed as a route to what was seen as a 'normal' family life; for others, OST was a barrier to such normality. Challenges related to: the physiological effects of opioid dependence; structural constraints associated with treatment regimes; and the impact of negative societal views about drug-using parents. CONCLUSION: Parents' accounts of OST can be seen as a response to socio-cultural ideals of a 'good', drug-free parent. Reflecting the liminal position parents engaged in OST found themselves in, their narratives entailed reconciling their status as a 'drug-using parent' with a view of an 'ideal parent' who was abstinent.
    The International journal on drug policy 05/2013;
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    ABSTRACT: The general consensus in the research to date is that family meals are linked to healthier eating habits in children, compared to not eating with the family. Yet, few studies explore what it is about commensality which leads to better food choices among children. Using a representative Scottish sample of five-year-old children, this research explores the extent to which family meal occurrence, meal patterns regarding where, when and with whom children eat and perceived meal enjoyment predict the quality of children's diets after controlling for indicators of maternal capital that influence both meal rituals and taste preferences. Eating the same food as parents is the aspect of family meals most strongly linked to better diets in children, highlighting the detrimental effect in the rise of 'children's food'. Although theoretical and empirical work pointed to the important health advantage in children eating together with parents, the results suggested that eating together was a far less important aspect of family meals. In evaluating the importance of the family meal, this article redirects attention away from issues of form and function towards issues of food choice. Policy implications and the importance for public health to recognise the way eating habits are defined by and reproduce social and cultural capital are discussed.
    Sociology of Health & Illness 04/2013;
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    ABSTRACT: The role of pain in the practice of self-injury is not straightforward. Existing accounts suggest that self-injury does not cause 'physical' pain, however self-injury is also said to alleviate 'emotional' pain by inflicting 'physical' pain. This article explores these tensions using sociological theories regarding the socio-cultural and subjective nature of pain. Analysis derives from in-depth, life-story interviews carried out in the UK with people who had self-injured. Findings contribute to on-going debates within social science regarding the nature of pain. Participants' narratives about pain and self-injury both drew on and challenged dualistic models of embodiment. I suggest that self-injury offers a unique case on which to extend existing theoretical work, which has tended to focus on pain as an unwanted and uninvited entity. In contrast, accounts of self-injury can feature pain as a central aspect of the practice, voluntarily invited into lived experience.
    Sociology of Health & Illness 09/2012;
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    ABSTRACT: Child contact with a nonresident father who has perpetrated domestic abuse has gained policy and research attention. Both feminist social policy and family law research identify the role child contact centers can play in facilitating contact in these circumstances. Drawing from a literature review carried out by the authors, this article examines the priorities that underpin feminist social policy and family law disciplines and how these manifest in research on contact centers and domestic abuse.
    Violence Against Women 07/2012; 18(6):711-20.
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    ABSTRACT: The article reports qualitative research findings which explored the meanings of kinship and genetic knowledge of fifteen pre-1990 semen donors in the UK. This is presented in the context of public and academic debates about the regulation of access to genetic information, genetic information as intellectual property and kinship knowledge, and the multiple ownership of genetic information. Semen donors in the UK traditionally were expected to take no interest in what became of their donations and those who did were considered to be unsuitable as donors. However, the present research reveals that men who donated in the past hold varied attitudes, including curiosity about how donor offspring have fared and what they look like. Whilst some donors would welcome direct contact with donor offspring, there are practical and emotional obstacles to satisfying their curiosity. Donors' views reflect the varied understandings in the UK about the implications of genetic relatedness and the time and energy required to maintain and sustain relationships.
    Human Fertility 02/2012; 15(2):89-93.
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    ABSTRACT: People sexually abused in childhood are at higher risk than non-abused people of medically unexplained symptoms such as irritable bowel syndrome or chronic pain, with mental ill health and high healthcare use. Friction and frustration, with high, unproductive healthcare costs, can often develop between these patients and health-care professionals such as general practitioners and nursing staff. The aim of this integrative literature review was to seek a sound evidence base from which to develop helpful interventions, improve relationships and identify gaps in knowledge. It found some theories about interconnections among childhood sexual abuse mental health and medically unexplained symptoms, such as 'somatization' or 'secondary gain', were used prejudicially, stigmatizing survivors. Conflicting theories make more difficult the search for effective interventions. Researchers rarely collaborated with sexual abuse specialists. Emphasis on identifying key risk factors, rather than providing support or alleviating distress, and lack of studies where survivors voiced their own experiences, meant very few targeted interventions for this group were proposed. Recommendations to enable effective interventions include making abuse survivors the prime study focus; qualitative research with survivors, to assist doctors and nursing staff with sensitive care; case histories using medical records; prospective studies with sexually abused children; support for the growing field of neurobiological research.
    Journal of Psychiatric and Mental Health Nursing 06/2011; 19(3):211-20.
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    ABSTRACT: People with a learning difficulty are living longer. This increased longevity brings with it the conditions and illnesses of older age, such as dementia. It is known that amongst people in the general population who have dementia there is inadequate pain recognition and treatment. This report has identified similar trends in pain management amongst people with a learning difficulty and dementia. The report explores knowledge and practice in relation to pain recognition and management amongst direct support staff, members of community learning disability teams and general practitioners. It also examines the understanding and experiences of pain amongst people with a learning difficulty and dementia. It identifies the dilemmas and obstacles to effective pain management, and reports on examples of good practice. The authors make clear recommendations for practitioners and service providers. The report found that the pain experiences and management of people with a learning difficulty who have dementia mirrored findings in relation to people in the general population. It did, however, identify extra and compounding issues in relation to people with a learning difficulty. The findings in this report will be of interest to service providers and direct practitioners in health, housing, social care and social work.
    International Medical Review on Down Syndrome. 03/2011; 15(1).
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    ABSTRACT: This article presents a sociologically informed critique of a range of academic literatures relating to self-injury. It is noted how a lack of consensus on definitional issues, together with the inaccurate portrayal of the "typical self-injurer" in the clinical literature, has impeded the development of a sound understanding of self-injury. Some of the more problematic explanations for self-injury are explored. The individualistic focus of existing research is found to be inadequate, since it fails to account for the social context in which self-injury occurs. Social scientific approaches critically examine psychiatric and psychological constructions of self-injury, explore wider social and cultural meanings of the behavior, and examine its distribution across different social groups. The inclusion of social scientific perspectives into current debates will greatly improve understanding of self-injury.
    Suicide and Life-Threatening Behavior 02/2011; 41(1):98-109.
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    ABSTRACT: This paper revisits the concept of medicalisation and considers its value as a framework for understanding the ongoing development of new reproductive technologies, and their impact on women's reproductive decision-making. This evaluation is drawn from a qualitative discourse analysis of the public debate about the first extended cycle oral contraception (ECOC) to suppress menstruation in the United States of America in 2003/2004, and subsequent interviews with women living in Australia who had already extended their cycles without it being medically approved for widespread practice. Firstly, the debates about menstrual suppression are couched within a discussion of the ongoing usefulness of medicalisation as an analytical tool. It is posited that medicalisation occurs in a particular social and cultural moment, and is a dynamic process where dominant social relations can be both reproduced and challenged. Secondly, qualitative interviews with women about practices of menstrual suppression are used to explore the productive nature of agency in this particular medicalisation contest. Specifically, the ways in which these women engage with the discourses of 'risk', 'choice' and 'nature', as canvassed by menstrual suppression advocates, reveal accommodation and modification as much as resistance and contradiction. This paper suggests that if the concept of medicalisation is to have ongoing traction as a frame of analysis, such a critique must incorporate a generative discussion of agency.
    Social Science [?] Medicine 10/2010; 71(7):1324-31.
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    ABSTRACT: Attitude survey and interview data are mobilised to address neglect of men's contribution to low fertility and wider social change in families and relationships. Men's attitudes are as relevant as women's to understanding fertility behaviour. However, fertility behaviour can only be understood in the context of a package of changes in gender relations and family life. Data from a random sample of men aged 18–49 surveyed in the Scottish Social Attitudes (SSA) survey 2005/06 are combined with in-depth interviews conducted in 2007 with 75 men aged 25–44 identified through the Scottish Household Survey as not living in co-resident partnership arrangements. Both datasets encompass the age span conventionally associated with having children and men who were the potential partners of women delaying a first child until their 30s. They allow consideration of the impact of social contact with parents and children on men's fertility intentions and how the role of provider features in men's views about parenting. The interviews focus on men who have fallen out of, or have not entered, co-resident partnerships and examine the relationship between partnering and parenting. In combination the data suggest how men act as a complementary or contradictory downward drag on women's fertility and that their role has been underestimated in understanding the package of family change of which low fertility is a part.
    Sociological Review 07/2010; 58(3):463 - 485.
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