‘I feel so tired I could sleep for days’: discourse, gender and working parents in the UK

Situated in early twenty-first century UK, I critically review the work-family reconciliation policy landscape to illuminate embedded gendered discourses and practices of caring and working. I critically examine the historical, social and cultural context of these gendered working and caring practices. Drawing on semi-structured qualitative interviews with fourteen working parents (nine mothers and five fathers), with children under 5 years old, I adopt a discourse analysis approach to consider both the performative aspects of their interview talk and the influence of wider discourses of caring and working. The thesis culminates in the development of knowledge and understanding of the intricate constitutive network of, the individual parent, the caring and working practices in which they engage, the social structure within which they live and the discourses which frame these. Drawing on large scale studies of the participation of mothers and fathers in care and employment, this thesis responds to a need for research which connects the complex relationship of caring and working discourses and practices at the macrolevel of UK society and the micro-level of individual working parents’ talk. To do this I analyse data from semi-structured interviews with fourteen working parents. In these analytical chapters, I focus on the discourse practices and discourse resources the working parents mobilised to position themselves within caring and working discourses. This thesis contributes to knowledge and understanding of gender, discourse and working parents’ talk using a sophisticated blended approach to discourse analysis. Additionally, having become a first-time mother during this study, I reflexively detail how this presented me with a unique position of knowledge, understanding and experience as a full-time working mother and researcher. To summarise, I connect contemporary UK work-family reconciliation policy, feminist scholarship and empirical discourse analysis of working parents’ interview talk to reveal ways in which discourses of working and caring are inextricably linked both in language performance in working parents’ interview talk and wider work-family reconciliation policy discourses in early twenty-first century UK

Providing holistic end-of-life care for people with a history of problem substance use: a mixed methods cohort study of interdisciplinary service provision and integrated care

Harmful use of illicit drugs and/or alcohol is linked to life-limiting illness and complex health and social care needs, but people who use substances and have complex needs do not receive timely palliative care and fail to achieve quality standards for a good death. They and their families often require support from multiple health and social care services which are shown to be poorly integrated and fail to deliver interdisciplinary care. This study aimed to identify the existing barriers and facilitators within and between services in providing this population with a good death. Using a mixed methods approach of survey, focus groups and semi-structured interviews, we explored the perspectives of practitioner and management staff across a range of health and social disciplines and organisations in one combined authority in a large city in the north west of England. Our findings indicate that practitioners want to provide better care for this client group, but face structural, organisational and professional boundary barriers to delivering integrated and shared care. Differences in philosophy of care, piecemeal commissioning and funding of services, and regulatory frameworks for different services, lead to poor and inequitable access to health and social care services. Ways forward for improving care are suggested as bespoke hostel-based accommodation for palliative care for this client group, and specialist link workers who can transcend professional and organisational boundaries to support co-ordination of services and support. We conclude that it is no longer adequate to call for more training, better communication and improved joint working. Complex care at the end of life requires creative and cohesive systemic responses that enable multi-disciplinary practitioners to provide the care they wish to give and enables individuals using substances to get the respect and quality service they deserve

The use of anabolic androgenic steroids as a public health issue

In recent years there have been increasing calls for the use of anabolic androgenic steroids (AAS) and associated drugs to be recognized as a public health issue. In the domain of the competitive athlete and professional bodybuilder, recent decades have seen the diffusion of AAS from the hardcore gyms of the 1980s and 1990s to the mainstream exercise and fitness environments of the twenty-first century. Alongside the apparent increases in the use of these drugs, there is a growing evidence base in relation to harms – physical, psychological and (to some extent) social. But is this form of drug use a public health issue? What criteria should we use to make this judgement? What is the available evidence and has our understanding of the issue improved? By drawing on the authors' research in the United Kingdom and the wider international literature this chapter will explore these issues and attempt to answer the fundamental question – is the use of anabolic steroids a public health issue

Phosphorylation of ezrin on Thr567 is required for the synergistic activation of cell spreading by EPAC1 and protein kinase A in HEK293T cells

Recent studies have demonstrated that the actin binding protein, ezrin, and the cAMP-sensor, EPAC1, cooperate to induce cell spreading in response to elevations in intracellular cAMP. To investigate the mechanisms underlying these effects we generated a model of EPAC1-dependent cell spreading based on the stable transfection of EPAC1 into HEK293T (HEK293T–EPAC1) cells. We found that direct activation of EPAC1 with the EPAC-selective analogue, 8-pCPT-2′-O-Me-cAMP (007), promoted cell spreading in these cells. In addition, co-activation of EPAC1 and PKA, with a combination of the adenylate cyclase activator, forskolin, and the cAMP phosphodiesterase inhibitor, rolipram, was found to synergistically enhance cell spreading, in association with cortical actin bundling and mobilisation of ezrin to the plasma membrane. PKA activation was also associated with phosphorylation of ezrin on Thr567, as detected by an electrophoretic band mobility shift during SDS-PAGE. Inhibition of PKA activity blocked ezrin phosphorylation and reduced the cell spreading response to cAMP elevation to levels induced by EPAC1-activation alone. Transfection of HEK293T–EPAC1 cells with inhibitory ezrin mutants lacking the key PKA phosphorylation site, ezrin-Thr567Ala, or the ability to associate with actin, ezrin-Arg579Ala, promoted cell arborisation and blocked the ability of EPAC1 and PKA to further promote cell spreading. The PKA phospho-mimetic mutants of ezrin, ezrin-Thr567Asp had no effect on EPAC1-driven cell spreading. Our results indicate that association of ezrin with the actin cytoskeleton and phosphorylation on Thr567 are required, but not sufficient, for PKA and EPAC1 to synergistically promote cell spreading following elevations in intracellular cAMP

End of life care for people with alcohol and other drug problems. Secondary analysis of interviews with family members, friends and carers bereaved through a relative’s substance use.

This research presents findings from secondary analysis of qualitative interviews with adults bereaved through substance use. As the first half of a two-phase piece of work, this analysis aimed to: • explore how families of people with alcohol/drug use problems experience their relative’s end of life; • examine the extent to which services recognised or responded to the whole family’s needs; and • inform design and delivery of primary qualitative data collection (the second half of the two-phase piece of work). The research team accessed interview transcripts from an ESRC funded research project on Bereavement Through Substance Use, where 102 people talked about the deaths of 93 relatives/friends

Highlighting the palliative care needs of people using drugs

Letter to Collegian - The Australian Journal of Nursing Practice, Scholarship and Researc