Prevention is better than cure, but...: Preventive medication as a risk to ordinariness?

Preventive health remains at the forefront of public health concerns; recent initiatives, such as the NHS health check, may lead to recommendations for medication in response to the identification of 'at risk' individuals. Little is known about lay views of preventive medication. This paper uses the case of aspirin as a prophylactic against heart disease to explore views among people invited to screening for a trial investigating the efficacy of such an approach. Qualitative interviews (N=46) and focus groups (N=5, participants 31) revealed dilemmas about preventive medication in the form of clashes between norms: first, in general terms, assumptions about the benefit of prevention were complicated by dislike of medication; second, the individual duty to engage in prevention was complicated by the need not to be over involved with one's own health; third, the potential appeal of this alternative approach to health promotion was complicated by unease about the implications of encouraging irresponsible behaviour among others. Though respondents made different decisions about using the drug, they reported very similar ways of trying to resolve these conflicts, drawing upon concepts of necessity and legitimisation and the special ordinariness of the particular dru

Young People, Biographical Narratives and the Life Grid: Young People's Accounts of Parental Substance Use

Research into potentially sensitive issues with young people presents numerous methodological and ethical challenges. While recent studies have highlighted the advantages of task-based activities in research with young people, the literature on life history research provides few suggestions as to effective and appropriate research tools for encouraging young people to tell their stories. This paper explores the contribution that may be made to such research by the life grid, a visual tool for mapping important life events against the passage of time and prompting wide-ranging discussion. Critical advantages of the life grid in qualitative research include: its visual element which can help to engage interviewer and interviewee in a process of constructing and reflecting on a concrete life history record; its role in creating a more relaxed research encounter supportive of the respondent’s ‘voice’; and facilitating the discussion of sensitive issues. In addition, the way in which use of the grid anchors such narratives in accounts of everyday life, often revealing interesting tensions, is explored. These points are discussed with reference to an exploratory study of young people’s experience of parental substance use

'The best thing for the baby': mothers' concepts and experiences related to promoting their infants' health and development

Mothers and pregnant women in contemporary western societies are at the centre of a web of expert and lay discourses concerning the ways they should promote and protect the health and development of their foetuses and infants. This article reports the findings from an Australian study involving interviews with 60 mothers. The findings explore in detail four topics discussed in the interviews related to pregnancy and caring for young infants: disciplining the pregnant body; promoting infants’ health; immunisation; and promoting infants’ development. It is concluded that the mothers were highly aware of their responsibilities in protecting their foetuses and infants from harm and promoting their health and development. They conceptualised the infant body as highly vulnerable and requiring protection from contamination. They therefore generally supported the idea of vaccination as a way of protecting their babies’ immature immune systems, but were also often ambivalent about it. The mothers were aware of the judgemental attitudes of others, including other mothers, towards their caring efforts and attempted to conform to the ideal of the ‘good mother’. The emotional dimensions of caring for infants and protecting their health are discussed in relation to the voluntary participation of mothers in conforming to societal expectations

Creating 'good' self-managers?: Facilitating and governing an online self care skills training course

<p>Abstract</p> <p>Background</p> <p>In chronic disease management, patients are increasingly called upon to undertake a new role as lay tutors within self-management training programmes. The internet constitutes an increasingly significant healthcare setting and a key arena for self-management support and communication. This study evaluates how a new quasi-professional health workforce – volunteer tutors – engage, guide and attempt to manage people with long-term conditions in the ways of 'good' self-management within the context of an online self-management course.</p> <p>Methods</p> <p>A qualitative analysis of postings to the discussion centre of 11 online classes (purposively selected from 27) run as part of the Expert Patients Programme. Facilitators (term for tutors online) and participants posted questions, comments and solutions related to self-management of long-term conditions; these were subjected to a textual and discursive analysis to explore:</p> <p>a) how facilitators, through the internet, engaged participants in issues related to self-management;</p> <p>b) how participants responded to and interacted with facilitators.</p> <p>Results</p> <p>Emergent themes included: techniques and mechanisms used to engage people with self-management; the process facilitators followed – 'sharing', 'modelling' and 'confirming'; and the emergence of a policing role regarding online disclosure. Whilst exchanging medical advice was discouraged, facilitators often professed to understand and give advice on psychological aspects of behaviour.</p> <p>Conclusion</p> <p>The study gave an insight into the roles tutors adopt – one being their ability to 'police' subjective management of long-term conditions and another being to attempt to enhance the psychological capabilities of participants.</p

Meals in western eating and drinking

Meals are a way of organizing eating into events that have a particular structure and form, and they play an indisputable and even self-evident role within the rhythms and routines of everyday life. In late modern societies, concern about the fate of meals has arisen in both public and academic discourse. It has been suggested that eating is characterized today by individualization, destructuration, and informalization and that communal meals are increasingly being replaced by snacks and solitary eating. This chapter focuses on meals in today’s affluent societies and reflects on why meals are considered important, how meals are defined, and what material elements and social dimensions they contain. It looks at how societal and cultural changes and ecological concerns may influence the organization and future of meals, and it suggests that the content of meals will change in response to the need to diminish the ecological burden of food production and consumption. In particular, plant-based options will at least partly need to replace meat and other animal-based foods. However, there is no reason to expect that the meal as a social institution will break down. Despite the fact that not all meals are characterized by conviviality and companionship, they continue to serve as a significant arena of human sociability and togetherness. Sharing food is, after all, an essential part of being human.Non peer reviewe

Tenure, gender and household structure

Starting with a review of recent literature on gender and housing, this paper goes on to develop a new theory of household structure, in which concepts of gender and generation play a key role. The utility of this theory is then demonstrated in the analysis of data from a survey of households in the City of Salford

Fathers Taking Leave Alone in the UK – A Gift Exchange Between Mother and Father?

Over the last decade there has been a gradual enhancement of British fathers’ rights in the workplace, even though the UK has one of the longest maternity leaves in OECD countries. From April 2003, for the first time, British fathers were given a legal right to take a 2 week paid paternity leave after the birth of a child, building on a 3 month unpaid parental leave entitlement available since 1999. In April 2011 a new right to allow fathers to take up to 6 months Additional Paternity Leave (APL) during the child’s first year, if the mother returns to work before the end of her maternity leave, was introduced. This chapter examines the experiences of six British fathers who were some of the first to take up this opportunity. The study as a whole explored couples’ negotiations and experiences of leave divisions, drawing on the proposition that intimacy is a mediating factor in gender and parenting roles. The accounts portray how, despite men’s lack of formal individual entitlement to leave, they tended to be positioned as the decision makers in taking leave. Women’s structural agency, as higher earners and as holders of the policy entitlement, was often underplayed. Drawing on Hochschild’s writings on the ‘gift economy’ of couples, we suggest that couple negotiations around APL can be conceptualised as a form of gift exchange