'Selling it as a holistic health provision and not just about condoms ?' Sexual health services in school settings: current models and their relationship with sex and relationships education policy and provision

In this article we discuss the findings from a recent study of UK policy and practice in relation to sexual health services for young people, based in - or closely linked with - schools. This study formed part of a larger project, completed in 2009, which also included a systematic review of international research. The findings discussed in this paper are based on analyses of interviews with 51 service managers and questionnaire returns from 205 school nurses. Four themes are discussed. First, we found three main service permutations, in a context of very diverse and uneven implementation. Second, we identified factors within the school context that shaped and often constrained service provision; some of these also have implications for sex and relationships education (SRE). Third, we found contrasting approaches to the relationship between SRE input and sexual health provision. Fourth, we identified some specific barriers that need to be addressed in order to develop 'young people friendly' services in the school context. The relative autonomy available to school head teachers and governors can represent an obstacle to service provision - and inter-professional collaboration - in a climate where, in many schools, there is still considerable ambivalence about discussing 'sex' openly. In conclusion, we identify areas worthy of further research and development, in order to address some obstacles to sexual health service and SRE provision in schools

Lesbian and bisexual women's human rights, sexual rights and sexual citizenship: negotiating sexual health in England.

Lesbian and bisexual women's sexual health is neglected in much Government policy and practice in England and Wales. This paper examines lesbian and bisexual women's negotiation of sexual health, drawing on findings from a small research project. Themes explored include invisibility and lack of information, influences on decision-making and sexual activities and experiences of services and barriers to sexual healthcare. Key issues of importance in this respect are homophobic and heterosexist social contexts. Drawing on understandings of lesbian, gay and bisexual human rights, sexual rights and sexual citizenship, it is argued that these are useful lenses through which to examine and address lesbian and bisexual women's sexual health and related inequalities

The shape of equality: discourses around the Section 28 repeal in Scotland

This article focuses on conceptualizations of equality in the discourses deployed in the campaign to repeal Section 28 in Scotland. I use the parliamentary debates and two newspapers: the Daily Record, which supported the campaign to Keep the Clause, and The Guardian, which supported repeal, to exemplify the different discursive articulations around equality and citizenship. I suggest that the Scottish example provides further evidence of the ways in which liberalism naturalizes heterosexuality as the standard for citizenship and thus bequeaths a hierarchy of 'equality' and citizenship in the realm of sexuality, wherein lesbian and gay citizenship is either rendered invalid or characterized as 'special rights'. However, within the narrow confines of the parliamentary debates, more expansive and differentiated notions of citizenship and equality are evident. Whilst I conclude that the 'shape' of equality achieved through the repeal has been moulded to support institutionalized heterosexuality - with Section 28 replaced by statutory guidelines on sex education which advocate marriage - I also suggest equality is contested, both through the recognition of transformations in heterosexual family forms and the appeal to non-discrimination as a democratic principle. It is possible, therefore, that current destabilizations of the heterosexual social order simultaneously destabilize the precepts of liberal democracy

‘Slappers like you don’t belong in this school’: the educational inclusion/exclusion of pregnant schoolgirls

Policy in England identifies pregnant schoolgirls as a particularly vulnerable group and emphasises the importance of education as a way of improving the life chances of those who become pregnant while young. This paper draws on repeat interviews conducted over a twelve-month period to compare and contrast the stories of four young women. The narratives show that despite a common policy framework, there is great variability between schools in staff attitudes towards and responses to pupil pregnancy which produce different accommodations and support for pregnant girls, and seem likely to produce very different outcomes. We mobilise Iris Marion Young’s five faces of oppression to conduct a second reading of the stories. This situates the specificity of the girls’ school experiences into a wider socio-cultural and economic framing and indicates what might be involved in actually initiating and implementing the kinds of changes that the first ‘face value’ reading suggests are necessary

Experiences and Outcomes of Preschool Physical Education: an analysis of developmental discourses in Scottish curricular documentation

This article provides an analysis of developmental discourses underpinning preschool physical education in Scotland's Curriculum for Excellence. Implementing a post-structural perspective, the article examines the preschool experiences and outcomes related to physical education as presented in the Curriculum for Excellence ‘health and wellbeing’ documentation. The article interrogates the ways in which developmental discourses are evident throughout this and related documentation and how these discourses might ‘work’ to produce specific effects on practitioners and children as they are deployed and taken up in Scottish preschool education contexts. This analysis involves speculating about potential consequences for practitioners' and children's experiences and subjectivities. In conclusion, it is suggested that practitioners should critically engage with the curriculum, as uncritical acceptance of the discourses underpinning it could lead to practices that may have negative consequences. Furthermore, the article proposes that future research should investigate the ways in which the discourses privileged in the Curriculum for Excellence ‘health and wellbeing’ documentation are taken up and negotiated in Scottish preschool settings

Sexuality and religion: from the court of appeal to the social work classroom

This paper critically reviews the case of a social work student whose professional training was terminated by his University. This followed the student’s expression of his religious views about homosexuality on a public social media platform. The student sought a judicial review of this decision on human rights grounds. The High Court dismissed the student’s challenge but the Court of Appeal overturned this decision to dismiss on the grounds of proportionality and referred the student back to the University to determine further action. This case is discussed in the context of the complicated positions taken up during the process leading to this legal Judgment, as they have implications for curriculum and pedagogical strategies, fitness to practice processes, and the experience of LGBTQ+ students. The discussion considers how, in light of this Judgment, social work educators can continue to address sexuality as a social justice issue. Critical and queer perspectives can support transformative learning where binary thinking about sexuality and religion is challenged and students can appreciate the impact of their values on others. Recommendations are made for addressing disparities in how sexuality, sexual, and gender diversity are addressed in professional education

Factors influencing preoperative stress response in coronary artery bypass graft patients

BACKGROUND: In many studies investigating measures to attenuate the hemodynamic and humoral stress response during induction of anaesthesia, primary attention was paid to the period of endotracheal intubation since it has been shown that even short-lasting sympathetic cardiovascular stimulation may have detrimental effects on patients with coronary artery disease. The aim of this analysis was, however, to identify the influencing factors on high catecholamine levels before induction of anaesthesia. METHODS: Various potential risk factors that could impact the humoral stress response before induction of anaesthesia were recorded in 84 males undergoing coronary aortic bypass surgery, and were entered into a stepwise linear regression analysis. The plasma level of norepinephrine measured immediately after radial artery canulation was chosen as a surrogate marker for the humoral stress response, and it was used as the dependent variable in the regression model. Accordingly, the mean arterial blood pressure, heart rate and the calculated pressure-rate product were taken as parameters of the hemodynamic situation. RESULTS: Stepwise regression analysis revealed that the oral administration of low-dose clonidine (mean dose 1.75 μg·kg(-1)) on the morning of surgery was the only significant predictor (p = 0.004) of the high variation in preoperative norepinephrine plasma levels. This intervention decreased norepinephrine levels by more than 40% compared to no clonidine administration, from 1.26 to 0.75 nmol·l(-1). There was no evidence for dose-responsiveness of clonidine. All other potential predictors were removed from the model as insignificant (p > 0.05). The use of beta-blocker, ace-inhibitors, ejection fraction, and body mass index were significant determinants for the hemodynamic situation (heart rate, mean arterial pressure, pressure rate product) of the patient during the pre-induction period. CONCLUSION: The oral administration of clonidine is the only significant predictor for the observed variation of norepinephrine levels during the preoperative period. Lack of significant dose responsiveness suggests that even a low dose of the drug can attenuate the preoperative stress response and thus is recommended in cardiovascular high risk patients

Influencing resilience: The role of policy entrepreneurs in mainstreaming climate adaptation

One way to make development pathways more resilient in the face of a changing climate has been through mainstreaming adaptation into government policies, planning and sectoral decision‐making. To date, many of the transferable lessons have taken the form of technical approaches such as risk assessments and toolkits. This article instead draws on evidence from South Asia to emphasise some of the more tacit and informal approaches used to influence adaptation policy. Despite their apparent significance in policy processes, such tactics are often neither planned for nor well reported in resilience‐building projects and programme documents. Using evidence to populate a typology of influencing strategies, this article looks particularly at the role of policy entrepreneurs who navigate the political complexity of both formal and informal governance systems to promote successful adaptation mainstreaming. It concludes with recommendations for adaptation and resilience programming that can more effectively harness the breadth of influencing strategies