Introduction: 'Changing Parenting Culture'

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Under the Influence? The Construction of Foetal Alcohol Syndrome in UK Newspapers

Today, alongside many other proscriptions, women are expected to abstain or at least limit their alcohol consumption during pregnancy. This advice is reinforced through warning labels on bottles and cans of alcoholic drinks. In most (but not all) official policies, this is linked to a risk of Foetal Alcohol Syndrome (FAS) or one of its associated conditions. However, given that there is little medical evidence that low levels of alcohol consumption have an adverse impact on the foetus, we need to examine broader societal ideas to explain why this has now become a policy concern. This paper presents a quantitative and qualitative assessment of analysis of the media in this context. By analysing the frames over time, this paper will trace the emergence of concerns about alcohol consumption during pregnancy. It will argue that contemporary concerns about FAS are framed around a number of pre-existing discourses including alcohol consumption as a social problem, heightened concerns about children at risk and shifts in ideas about the responsibility of motherhood including during the pre-conception and pregnancy periods. Whilst the newspapers regularly carried critiques of the abstinence position now advocated, these challenges focused did little to refute current parenting cultures.Foetal Alcohol Syndrome, Parenting Cultures, Media, UK

The ‘First Three Years’ Movement and the Infant Brain: A Review of Critiques

This article reviews a particular aspect of the critique of the increasing focus on the brain and neuroscience; what has been termed by some, ‘neuromania’. It engages with the growing literature produced in response to the ‘first three years’ movement: an alliance of child welfare advocates and politicians that draws on the authority of neuroscience to argue that social problems such as inequality, poverty, educational underachievement, violence and mental illness are best addressed through ‘early intervention’ programmes to protect or enhance emotional and cognitive aspects of children's brain development. The movement began in the United States in the early 1990s and has become increasingly vocal and influential since then, achieving international legitimacy in the United States, Canada, New Zealand, Australia, the UK and elsewhere. The movement, and the brain-based culture of expert-led parent training that has grown with it, has been criticised for claiming scientific authority whilst taking a cavalier approach to scientific method and evidence; for being overly deterministic about the early years of life; for focusing attention on individual parental failings rather than societal or structural problems, for adding to the expanding anxieties of parents and strengthening the intensification of parenting and, ultimately, for redefining the parent–child relationship in biologised, instrumental and dehumanised terms

Constructions of Parents in Adverse Childhood Experiences Discourse

In December 2017, the House of Commons Parliamentary Science and Technology Committee put out a call for submissions to an Inquiry which would consider the evidence-base for early intervention policies, with a particular focus on ‘Adverse Childhood Experiences’ or ACEs. This paper analyses those submissions and the transcripts of the Inquiry’s oral sessions in the belief that they constitute a useful window through which to explore the types of claims being made in ACEs discourse. Our aim is to assess whether the ACEs phenomenon represents a continuity with what has been termed the ‘first three years movement’ (Thornton, 2011a and b): social policy and philanthropic activism which focuses on the earliest years of life in the name of preventing social problems ‘down the line’. In particular, we consider constructions of parents as determinate of these social problems through their influence on their children and the ways in which these are gendered in new ways

Integrated care pathways in neurosurgery: A systematic review.

IntroductionIntegrated care pathways (ICPs) are a pre-defined framework of evidence based, multidisciplinary practice for specific patients. They have the potential to enhance continuity of care, patient safety, patient satisfaction, efficiency gains, teamwork and staff education. In order to inform the development of neurosurgical ICPs in the future, we performed a systematic review to aggregate examples of neurosurgical ICP, to consider their impact and design features that may be associated with their success.MethodsElectronic databases MEDLINE, EMBASE, and CENTRAL were searched for relevant literature published from date of inception to July 2020. Primary studies reporting details of neurosurgical ICPs, across all pathologies and age groups were eligible for inclusion. Patient outcomes in each case were also recorded.ResultsTwenty-four studies were included in our final dataset, from the United States, United Kingdom, Italy, China, Korea, France, Netherlands and Switzerland, and a number of sub-specialties. 3 for cerebrospinal fluid diversion, 1 functional, 2 neurovascular, 1 neuro-oncology, 2 paediatric, 2 skull base, 10 spine, 1 for trauma, 2 miscellaneous (other craniotomies). All were single centre studies with no regional or national examples. Thirteen were cohort studies while 11 were case series which lacked a control group. Effectiveness was typically evaluated using hospital or professional performance metrics, such as length of stay (n = 11, 45.8%) or adverse events (n = 17, 70.8%) including readmission, surgical complications and mortality. Patient reported outcomes, including satisfaction, were evaluated infrequently (n = 3, 12.5%). All studies reported a positive impact. No study reported how the design of the ICP was informed by published literature or other methods.ConclusionsICPs have been successfully developed across numerous neurosurgical sub-specialities. However, there is often a lack of clarity over their design and weaknesses in their evaluation, including an underrepresentation of the patient's perspective

‘After the ‘need for….a father’: ‘The welfare of the child’ and ‘supportive parenting’ in UK assisted conception clinics’

The law governing assisted conception in the United Kingdom (UK) (the Human Fertilisation and Embryology Act 1990) mandates through section 13(5) that clinicians make ‘child welfare’ assessments before proceeding with treatment. In the 1990 Act, section 13(5) stated that assessment should take into account ‘the need … for a father’, but in section 13(5) of a revised Human Fertilisation and Embryology Act in 2008 the words ‘a father’ were replaced with ‘supportive parenting’ in order to signal official recognition of same-sex parents. This article challenges the idea that this might be seen as an unequivocally progressive development through reference to a growing body of scholarship that critically evaluates the attention that policy makers have come to pay to ‘parenting’. It discusses the sociopolitical context that gave rise to section 13(5) and the pressures that led to its reform. Findings from an interview study with members of staff who work in assisted conception clinics in the UK are then discussed, focusing on staff’s perceptions of the new policy, the meanings they ascribe to the term ‘supportive parenting’ and their opinions about the responsibility they are given under law for child welfare. The article concludes that professionals’ understandings of their role resonate strongly with the wider realities of the oversight of parent–child relations considered characteristic of policies on parenting

The 1967 Abortion Act fifty years on: Abortion, medical authority and the law revisited

The recent 50th anniversary of the 1967 Abortion Act provides the opportunity to revisit what has been termed the ‘remarkable authority’ this Act ascribes to doctors. This paper does so using as its starting point a seminal commentary on this question by the renowned medical sociologist Sally Macintyre, published in this journal in 1973 as ‘The Medical Profession and the 1967 Abortion Act in Britain’. We revisit themes from that paper through an analysis of the findings of interviews with 14 doctors who, throughout lengthy careers, have provided abortions and led the development of the abortion service in England and Wales. We contrast our findings with Macintyre’s, and argue that our interviews highlight the shifting meaning of medical authority and medical professionalism. We show that those doctors most involved in providing abortions place moral value on this work; uphold the authority of women (not doctors) in abortion decision-making; view nurses and midwives as professional collaborators; and consider their professional and clinical judgement impeded by the present law. We conclude that medical sociologists have much to gain by taking abortion provision as a focus for the further exploration of the shifting meaning of medical authority

Supporting inclusive learning resource design with Designing for Diverse Learners

This brief communication introduces the regulatory and ethical requirements of accessible learning design, and the Designing for Diverse Learners project. This communication is a call to action, asking for educators to share, support and help develop the Designing for Diverse Learners guidance