Drug problems and social exclusion : the development of heroin careers in risk environments

The location-specificd rug scenesi dentified in Ireland and the UK in the 1980s indicated that problem drug use had a particular social and spatial focus in urban working-class communities, particularly those affected by unemployment and deprivation. This thesis explores localised drug problems in a number of disadvantaged neighbourhoods of Dublin by locating the perspective and experience of heroin users within the context of the social and economic contexts in which they live and operate. Taking a critical interpretivist methodological approach, the concepts of social exclusion and risk environments are used as heuristic devices for understanding the context in which problematic drug careers develop in marginalised areas. Using a multi-method research design, the study draws on secondary demographic, socioeconomic and policy data to provide a contextual framework of risk environments. The study then explores the development of heroin careers and the lived experience of social exclusion through in-depth qualitative interviews with sixty-one heroin users and an ethnographic study of the five socially excluded Dublin neighbourhoods in which they lived. An inductive analysis of the themes arising from the data describes the interactive dynamics at play in which social and structural processes are seen to both facilitate, and be facilitated by, local drug problems. The multiple and interconnected risks that drug users are seen to encounter at both a micro and macro environmental level contributes to our knowledge of localised drug problems and their relationship with social exclusion, and leads to the development of the concept of a risk environment for drug problems with consequent potential for informing grounded policy interventions.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Associations between maternal physical activity in early and late pregnancy and offspring birth size: remote federated individual level meta-analysis from eight cohort studies.

OBJECTIVE: Evidence on the impact of leisure time physical activity (LTPA) in pregnancy on birth size is inconsistent. We aimed to examine the association between LTPA during early and late pregnancy and newborn anthropometric outcomes. DESIGN: Individual level meta-analysis, which reduces heterogeneity across studies. SETTING: A consortium of eight population-based studies (seven European and one US) comprising 72,694 participants. METHODS: Generalised linear models with consistent inclusion of confounders (gestational age, sex, parity, maternal age, education, ethnicity, BMI, smoking and alcohol intake) were used to test associations between self-reported LTPA at either early (8-18 weeks gestation) or late pregnancy (30+ weeks) and the outcomes. Results were pooled using random effects meta-analyses. MAIN OUTCOME MEASURES: Birth weight, Large-for-gestational age (LGA), macrosomia, small-for-gestational age (SGA), %body fat and ponderal index at birth. RESULTS: Late, but not early, gestation maternal moderate-to-vigorous physical activity (MVPA), vigorous activity and LTPA energy expenditure were modestly inversely associated with BW, LGA, macrosomia and ponderal index, without heterogeneity (all: I-square=0%). For each extra hour/week of MVPA, RR for LGA and macrosomia were 0.97 (95% CI: 0.96, 0.98) and 0.96 (95%CI: 0.94, 0.98) respectively. Associations were only modestly reduced after additional adjustments for maternal BMI and gestational diabetes. No measure of LTPA was associated with risk for SGA. CONCLUSIONS: Physical activity in late, but not early, pregnancy is consistently associated with modestly lower risk of LGA and macrosomia, but not SGA. This article is protected by copyright. All rights reserved.Includes MRC, Wellcome Trust and NIHR

Illicit drug use in Dublin.

Preliminary data are presented from a two-year qualitative study on the development of problematic drug use, which has been found to be spatially concentrated in the most marginalized areas of Dublin city. The study will assess the relationship between problem drug use, unemployment and socio-economic deprivation in these areas. Initially defined trends and patterns in the drug-using careers of Dublin's young adult population are described here, and the data is placed in the context of social and economic trends and policy responses to drugs. Uneven geographical development of visible drug problems mirrors the uneven geographical development of socio-economic disadvantage

Understanding the social exclusion-problem drug use nexus.

A social exclusion approach is the most appropriate framework for examining the nature of the link between drug use and deprivation. This study focuses on the process of exclusion that forms the background to drug use rather than the individual user's behaviour. The research methodology employed a variety of data collection techniques to deal with the complexities of the phenomena involved. These included interviews, enthographic studies, and analyis of existing indicators, and a review of related social policy. Multiple data sources were used and this helped to locate individual experiences within social processes and structural forces. The social exclusion approach to the study of drug use allows the researcher to make the environmental context of drug use apparent

Overview of research on drug misuse among the homeless in Ireland.

Problematic drug use, mainly regarding the use of opiates, has been identified as a major social problem in Ireland. Such problematic drug use has been found to be concentrated in Dublin's inner city areas and outer estates where poverty, multi-generational unemployment, high population density (particularly of young adults), and poor facilities are the norm. Policy responses, although acknowledging the environmental context of the drug problem, have tended to focus on the medical treatment of the individual, rather than tackling the wider social and economic issues

Illicit drug use in Ireland: An overview of the problem and policy responses.

This paper looked at the development of problematic illicit drug use and the responses of policy makers and local communities. It drew on existing research and on the initial results from a study of the environmental aspects of problematic drug use. The author stated that such drug use, and in particular the misuse of opiates, had been identified as a major social problem in Ireland. It was found to be concentrated in Dublin's inner city areas and outer estates where poverty, multi-generational unemployment, high population density and poor facilities were the norm. The author suggested that policy responses to the issue tended to focus mainly on the medical treatment of the individual, rather than on wider social and economic factors