“We’re Talking About You, Not to You”:Methodological Reflections on Public Health Research With Families With Young Children

In this article, we critically reflect upon the experience of public health research involving children and contribute to existing conversations about the methodological and ethical facets of research in this field. Drawing on two phases of a study that sought to explore the lived experiences of families with young children who have had a recent common childhood illness (gastrointestinal infection), we address the research process, from inception of the studies, to fieldwork and the resultant material obtained. We argue that when researching with families about a child-centered experience, it is important to look beyond the individual adult as “participant” and to conceptualize dependents either as, or “like” participants—what we suggest as a “family-centered approach.” Theoretically, this strategy best addresses the lived reality of relationality and responsibility of parent/carers for dependent children; while improving the ease and safety of data collection for the researcher and participants alike

Negotiating the fertile body:women's life history experiences of using contraception

British women experience a conundrum in the context of contraception. Despite knowledge about and free access to myriad methods Britain currently has high rates of unintended pregnancy (estimated as high as 2/3 in some cases). This thesis uses a feminist approach and Foucauldian theory to explore this phenomenon by addressing the gaps in current understanding namely the situated and subjective experiences of contraception use over the life course. Using a qualitative life history method and map-making, this research used Listening Guide analysis to understand 15 British women’s contraceptive life histories. Three substantive chapters situate these narratives within the political and social landscape of neoliberal Britain over the last 30 years. The first presents 4 individual life stories and drawing on the concept of ‘stratified reproduction’ indicates how many women’s contraceptive choice is not free but is shaped by structural inequalities. The second exposes the meaningful-ness of hormonal contraceptive ‘side effects’, namely the consequence to their sense of self, and argues for a departure from the typically reductive perspectives on the impacts of contraception use. The third chapter highlights the changes over time, or lack thereof, in contraceptive practice as experienced by the women participants and demands a shift from the rhetoric of ‘contraceptive choice’ towards a lived reality of supportive women-centred provision. Finally, these findings are conceptualised as ‘disconnections’ of a woman from both herself and from contraceptive providers and are theorised in relation to competing neoliberal (masculine) and female subjectivities. I argue that the current circumstances create an impossible position for contracepting women to successfully occupy. In conclusion, the narratives in this thesis compel us to adopt instead a model that approaches contraception use as more than an individual experience and to recognise and address the contextual factors that undermine women’s contraceptive choice and compromise sustainable use

(Re)thinking about self-harm and autism : findings from an online qualitative study on self-harm on the autism spectrum

Autistic people experience a higher prevalence of self-harming behaviours than do the general population. Self-harm remains a stigmatised topic, and until recently, self-harming behaviours in autism were considered to be limited to self-injurious behaviours experienced by intellectually impaired autistic children and not to be experienced by cognitively able autistic adults. Because of the belief held by many professionals that many mental health-related problems are inherently part of autism and immune to treatment or help, many autistic people are left unable to access the help and support that they desperately need. This study adopts an online qualitative methodology to explore this under-researched phenomenon, thematically analysing online forum posts from autistic adults to determine what forms of self-harm are described, what precipitates the self-harm and how forum users support each other. The findings reveal that self-harming behaviours are nuanced and complex, highlighting the connections between sensory overload, meltdowns, stimming and impulsive repetitive blunt trauma seen as autistic self-injurious behaviours. When seeking help, barriers include navigating misdiagnoses of other mental illnesses and being misunderstood or disbelieved by professionals. Online forum users offer help in the form of emotional empathy, as well as practical solutions, providing an example of valuable peer support. Lay abstract There is a higher prevalence of self-harming behaviours within the autistic community than is experienced by the general population, in addition to co-occurring mental health conditions such as anxiety and depression. To date, research has focused on quantifying and categorising the numbers of autistic people self-harming, what types of harming they are engaging in and what functions the harming performs. Autism research has historically focused on the opinions and experiences of parents, carers and clinicians, with a belief that autistic people are unable to present their own experiences and thoughts accurately. This study adopted a qualitative method to develop themes arising from online forum discussions, using the words of autistic adults talking about how they experience and understand their self-harming behaviours. The analysis discovered that self-harming behaviours are used by autistic people as a way of coping with anxiety and depression and to relieve the build up of stress and sensory or mental overload that can otherwise lead to a meltdown. Repetitive behaviours such as stimming are also used to relieve the buildup of sensory over-stimulation and anxiety, but both stimming and meltdowns can also be self-harming behaviours if they cause tissue damage, and are believed to be childhood presentations which are stigmatised if expressed by an autistic adult. Many autistic adults find it hard to get help with self-harming behaviours because they are not taken seriously by professionals, as it is seen as part of autism and cannot be helped, or the professionals do not have enough knowledge of autism

“Honestly, transwomen just look out for ourselves’’ Experiences of HIV Care in Sexual Health Clinics

This thesis presents two papers exploring the experiences of transwomen within healthcare systems: a meta-synthesis of the literature on the perceptions of physical healthcare providers of transwomen; an interpretive phenomenological analysis of the experience of 5 transwomen accessing sexual health services in the UK for HIV healthcare. In the first section, the meta-synthesis is presented, which reviewed 17 papers exploring on the perceptions of physical healthcare providers of transwomen. Four main themes were identified: (1) Healthcare providers' perceptions exist in the context of a cisnormative system, (2) The acceptability of transphobic and marginalising attitudes among healthcare providers, (3) Expected ways for Transwomen to exist, and (4) Education and Communication. The review also discussed clinical implications and the widespread nature of transphobia in healthcare settings. The empirical section of this thesis presents the experiences of 5 transwomen accessing sexual health services in the UK for HIV healthcare. Four main themes emerged during analysis: (1) Interpersonal Experiences of accessing healthcare for HIV, (2) The Practicalities of Accessing Healthcare for HIV, (3) “Honestly, transwomen like kind of just look out for ourselves.’’: The importance of connection to the community, and (4) Political and systemic influences on HIV healthcare. The final section offers a critical appraisal of the similarities and differences between the papers and the strengths and limitations of this thesis. The researcher’s motivations and place within the research are also discussed alongside suggestions for future research

Paradoxical family practices: LGBTQ+ young people, mental health and wellbeing

This article will explore how LGBTQ+ young people sustain, and in some cases survive, family relationships. We develop the concept of ‘paradoxical family practices’ and use this to demonstrate the ways in which LGBTQ+ young people manage family life through everyday emotion work. This highlights: (1) how families ordinarily navigate heteronormativity and ‘issues’ of gender/sexuality; (2) the efficacy of ‘paradoxical family practices’ as a conceptual tool; (3) the value of emotion-centred multiple qualitative methods to explore the lives of LGBTQ+ young people and mental health. Findings derive from a small-scale UK study funded by the Wellcome Trust (UNS39780) and were generated through a two-stage methodology comprising digital/paper emotion maps and qualitative interviews with LGBTQ+ young people aged 16–25 (n = 12) followed by diary methods and follow-up interviews (n = 9). Interviews were also completed with ‘family members’ (n = 7)

Family Trouble: Heteronormativity, emotion work and queer youth mental health

Conflict with the family about sexual orientation and gender diversity is a key risk factor associated with poor mental health in youth populations. Findings presented here derive from a UK study that employed an interdisciplinary critical mental health approach that de-pathologized emotional distress and conceptualised families as social and affective units that are created through everyday practices. Our aim was to explore how family relationships foster, maintain or harm the mental health and wellbeing of LGBTQ+ youth. Data were generated through exploratory visual, creative and digital qualitative methods in two phases. Phase 1 involved digital/paper emotion maps and interviews with LGBTQ+ youth aged 16-25 (n=12) and family member/mentor interviews (n=7). Phase 2 employed diary methods and follow-up interviews (n=9). The data analytic strategy involved three stages: individual case analysis; cross-sectional thematic analysis; and metainterpretation. We found that family relationships impacted on queer youth mental health in complex ways that were related to the establishment of their autonomous queer selves, the desire to remain belonging to their family and the need to maintain a secure environment. The emotion work involved in navigating identity, belonging and security was made difficult because of family heteronormativity, youth autonomy and family expectations and had a stark impact on queer youth mental health and wellbeing. Improving the mental health of LGBTQ+ youth requires a much deeper understanding of the emotionality of family relationships and the difficulties negotiating these as a young person

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Education from sexual pleasure workshops with self-defining women:a commentary

In this commentary, we reflect critically on the experience of delivering community-based sexual pleasure workshops for self-defining women in order to share lessons from our practice with others working in sex and sexualities education in higher education or in practice settings. Our discussion about facilitating these workshops in informal learning spaces contributes to the literature on pleasure inclusive sex and sexualities education. Specifically, it highlights the demand for spaces which women can think critically about sexuality and pleasure, and shares women’s perspectives on these workshops. We begin by addressing the context in which we delivered the sexual pleasure workshops and describe what we did and why. Next, we share reflections on what we have learned from delivering these workshops, before concluding with suggestions about what this may mean for pleasure inclusive sex and sexualities education more broadly