A sense of connectedness in reproductive donation. Contrasting policy with donor and donor kin lived experience

This article asks how well new developments in family life are reflected in law and policy, with a particular focus on donor conception. There has been an unprecedented ‘opening up’ of family life in recent decades; this increased diversity is, at least in part, linked to developments in reproductive technologies, including gamete donation. In family lives touched by donation, genetic relations with ‘donor connections’ take genetic connectedness beyond traditional notions of kinship. There is not yet an established social script for how to understand what constitutes meaningful connectedness in reproductive donation. Focussing on the UK context specifically, where assisted conception is highly regulated, this article examines on the one hand, how UK law and policy portray meaningful connectedness in the context of donation, and, on the other hand, how well this fits with connectedness as experienced within egg and sperm donor communities. Drawing on original data from UK law and policy analysis, and empirical interview data with egg and sperm donors and their kin, our analysis shows important disparities between law and policy, and the empirical evidence, suggesting a need for an overhaul of UK donor conception law and policy

The use of reported speech in children's narratives: a priming study

This study investigated the long-term effects of structural priming on children’s use of indirect speech clauses in a narrative context. Forty-two monolingual English-speaking five-year-olds in two primary classrooms took part in a story re-telling task including reported speech. Testing took place in three individual sessions (pre-test, post-test1, post-test2) and the priming phase was conducted in 10 group priming sessions. During the priming phase the two classrooms were randomly allocated to one of two conditions where, over the course of two weeks, the children heard 10 different stories that included 30 tokens of either indirect or direct speech. In the pre-test session we collected measures of receptive vocabulary (BPVS-3) and expressive grammar (Formulated Sentences sub-test, CELF4-UK). There was a significant effect of input manipulation that was maintained for up to ten weeks after the training. Expressive grammatical skills were positively correlated with the likelihood of using indirect speech one week after the end of the language intervention

"I am your mother and your father!": In vitro derived gametes and the ethics of solo reproduction

In this paper, we will discuss the prospect of human reproduction achieved with gametes originating from only one person. According to statements by a minority of scientists working on the generation of gametes in vitro, it may become possible to create eggs from men’s non-reproductive cells and sperm from women’s. This would enable, at least in principle, the creation of an embryo from cells obtained from only one individual: ‘solo reproduction’. We will consider what might motivate people to reproduce in this way, and the implications that solo reproduction might have for ethics and policy. We suggest that such an innovation is unlikely to revolutionise reproduction and parenting. Indeed, in some respects it is less revolutionary than in vitro fertilisation as a whole. Furthermore, we show that solo reproduction with in vitro created gametes is not necessarily any more ethically problematic than gamete donation—and probably less so. Where appropriate, we draw parallels with the debate surrounding reproductive cloning. We note that solo reproduction may serve to perpetuate reductive geneticised accounts of reproduction, and that this may indeed be ethically questionable. However, in this it is not unique among other technologies of assisted reproduction, many of which focus on genetic transmission. It is for this reason that a ban on solo reproduction might be inconsistent with continuing to permit other kinds of reproduction that also bear the potential to strengthen attachment to a geneticised account of reproduction. Our claim is that there are at least as good reasons to pursue research towards enabling solo reproduction, and eventually to introduce solo reproduction as an option for fertility treatment, as there are to do so for other infertility related purposes

Unsettling lesbian motherhood: Critical reflections over a generation (1990-2015)

This article explores how advancements in equality rights combine with attitudinal changes in UK society and LGBTQ communities to impact on the experience of lesbian mothers over a generation. The author reflects on ordinary moments where sexuality and relationships become meaningful and situate emotions at the heart of analytical enquiry because it is through emotional interactions that micro–macro networks of relations intersect. Autobiography is combined with original data from empirical research to provide analytical entry points, which aims to advance understanding and also facilitate reflection on how we understand and come to know queer parenthood. Whilst there are now many routes into lesbian motherhood and the stigma of queer kinship is diminishing, this article demonstrates the need to problematize the prevailing narratives of coupledom that are emerging and tease apart the conflation of temporal progression, progressive rights and narratives of progress

Reincentivizing – a new theory of work and work absence

<p>Abstract</p> <p>Background</p> <p>Work capacity correlates weakly to disease concepts, which in turn are insufficient to explain sick leave behavior. With data mainly from Sweden, a welfare state with high sickness absence rates, our aim was to develop an explanatory theory of how to understand and deal with work absence and sick leave.</p> <p>Methods</p> <p>We used classic grounded theory for analyzing data from >130 interviews with people working or on sick leave, physicians, social security officers, and literature. Several hundreds of typed and handwritten memos were the basis for writing up the theory.</p> <p>Results</p> <p>In this paper we present a theory of work incentives and how to deal with work absence. We suggest that work disability can be seen as hurt work drivers or people caught in mode traps. Work drivers are specified as work capacities + work incentives, monetary and non-monetary. Also, people can get trapped in certain modes of behavior through changed capacities or incentives, or by inertia. Different modes have different drivers and these can trap the individual from reincentivizing, ie from going back to work or go on working. Hurt drivers and mode traps are recognized by driver assessments done on several different levels. Mode driver calculations are done by the worker. Then follows employer, physician, and social insurance officer assessments. Also, driver assessments are done on the macro level by legislators and other stakeholders. Reincentivizing is done by different repair strategies for hurt work drivers such as body repair, self repair, work-place repair, rehumanizing, controlling sick leave insurance, and strengthening monetary work incentives. Combinations of these driver repair strategies also do release people from mode traps.</p> <p>Conclusion</p> <p>Reincentivizing is about recognizing hurt work drivers and mode traps followed by repairing and releasing the same drivers and traps. Reincentivizing aims at explaining what is going on when work absence is dealt with and the theory may add to social psychological research on work and work absence, and possibly inform sick leave policies.</p

Usefulness and engagement with a guided workbook intervention (WorkPlan) to support work related goals among cancer survivors

Background: Returning to work after cancer is associated with improved physical and psychological functioning, but managing this return can be a challenging process. A workbook based intervention (WorkPlan) was developed to support return-to-work among cancer survivors. The aim of this study was to explore how participants using the workbook engaged with the intervention and utilised the content of the intervention in their plan to return-to-work. Methods: As part of a feasibility randomised controlled trial, 23 participants from the intervention group were interviewed 4-weeks post intervention. Interviews focussed on intervention delivery and data was analysed using Framework analysis. Results: Participants revealed a sense of empowerment and changes in their outlook as they transitioned from patient to employee, citing the act of writing as a medium for creating their own return-to-work narrative. Participants found the generation of a return-to-work plan useful for identifying potential problems and solutions, which also served as a tool for aiding discussion with the employer on return-to-work. Additionally, participants reported feeling less uncertain and anxious about returning to work. Timing of the intervention in coordination with ongoing cancer treatments was crucial to perceived effectiveness; participants identified the sole or final treatment as the ideal time to receive the intervention. Conclusions: The self-guided workbook supports people diagnosed with cancer to build their communication and planning skills to successfully manage their return-to-work. Further research could examine how writing plays a role in this process

Costs of shoulder pain and resource use in primary health care: a cost-of-illness study in Sweden

<p>Abstract</p> <p>Background</p> <p>Painful shoulders pose a substantial socioeconomic burden. A prospective cost-of-illness study was performed to assess the costs associated with healthcare use and loss of productivity in patients with shoulder pain in primary health care in Sweden.</p> <p>Methods</p> <p>The study was performed in western Sweden, in a region with 24 000 inhabitants. Data were collected during six months from electronic patient records at three primary healthcare centres in two municipalities. All patients between 20 and 64 years of age who presented with shoulder pain to a general practitioner or a physiotherapist were included. Diagnostic codes were used for selection, and the cases were manually controlled. The cost for sick leave was calculated according to the human capital approach. Sensitivity analysis was used to explore uncertainty in various factors used in the model.</p> <p>Results</p> <p>204 (103 women) patients, mean age 48 (SD 11) years, were registered. Half of the cases were closed within six weeks, whereas 32 patients (16%) remained in the system for more than six months. A fifth of the patients were responsible for 91% of the total costs, and for 44% of the healthcare costs. The mean healthcare cost per patient was €326 (SD 389) during six months. Physiotherapy treatments accounted for 60%. The costs for sick leave contributed to 84% of the total costs. The mean annual total cost was €4139 per patient. Estimated costs for secondary care increased the total costs by one third.</p> <p>Conclusions</p> <p>The model applied in this study provides valuable information that can be used in cost evaluations. Costs for secondary care and particularly for sick leave have a major influence on total costs and interventions that can reduce long periods of sick leave are warranted.</p

Searching for ‘relations’ using a DNA linking register by adults conceived following sperm donation

This paper considers how sperm donor-conceived adults registered with a voluntary DNA linking register, UK DonorLink, constructed identity and relatedness by examining two areas: how their identity was affected by becoming aware that they were donor-conceived; and the process of searching for their donor and donor-conceived siblings. The views and experiences of donor-conceived adults has, until recently, been a neglected area. This study is the first to consider the experiences of those searching through a DNA-based register, and contributes to the growing literature on searching. This paper presents qualitative data from a questionnaire-based study with 65 adults conceived following sperm donation. It examines emerging linkages by investigating how ideas of relatedness, kinship and identity were enacted and how narrative certainties were moved and removed by opening up new conceptions of what it means to be ‘related’. Their knowledge of being donor-conceived was both a powerful disrupter and a consolidator of family relationships. No single story of being donor-conceived emerged – with competing narratives about the effects and implications for respondents’ kinship relationships and sense of identity. This study sheds light on how kinship relationships are negotiated and managed in adulthood by those conceived following sperm donation and how this can change over the life-course