Diagnosing uncertainty, producing neonatal abstinence syndrome

The use of alcohol and other drugs during pregnancy is understood to be an important public health problem. One way in which this problem is expressed and responded to is via the identification and treatment of neonatal abstinence syndrome (NAS). In this article, we demonstrate how the processes of anticipating, identifying and responding to NAS are characterised by significant uncertainty among parents and health and social care practitioners. We draw on interviews with 16 parents who had recently had a baby at risk of NAS, and multidisciplinary focus groups with 27 health and social care professionals, held in Scotland, UK. NAS, and drug use in pregnancy, is a fraught and complex arena. Parents in the UK who use opioids risk losing custody of children, and must navigate a high degree of surveillance, governance and marginalisation. We suggest that considering NAS as a social diagnosis, further informed by Mol's political ontology of ‘multiple’ bodies/diseases, may help to produce clinical and social responses to uncertainty which avoid, rather than promote, further marginalisation of parents who use drugs. One such response is to develop a culture of relationship‐based care which empowers both service providers and service users to challenge existing practice and decision‐making.Output Status: Forthcoming/Available Onlin

How men step back – and recover – from suicide attempts: A relational and gendered account

Men account for three-quarters of suicide deaths in the UK, yet we know little about how at-risk men construct their experiences of moving towards - and then subsequently stepping back from - suicide, nor the part played by relational factors therein. An inductive thematic analysis was used to examine narrative interviews with eleven UK men who self-reported serious thoughts, plans and up-to and including suicide attempts in progress, but who consciously decided against carrying out an attempt. Their accounts suggest a highly social process of movements towards and away from suicide (e.g. frustrated help-seeking). Stepping back from suicide represents not a discrete issue, but a linked process in suicidality and wider recovery. Here, the use of military metaphors in particular (e.g. waging war, fighting back) highlights the gendered nature of the issue. Additionally, our article illuminates a range of social relations and forces that circulate in and around suicidality, which itself is embedded in varying forms of relationality, normativity and gendered practices. [Abstract copyright: © 2020 Foundation for the Sociology of Health & Illness.

Explaining the social gradient in smoking and cessation: the peril and promise of social mobility

Smoking in high-income countries is now concentrated in poor communities whose relatively high smoking prevalence is explained by greater uptake but above all by lower quit rates. Whilst a number of barriers to smoking cessation have been identified, this is the first paper to situate cessation itself as a classed and cultural practice. Drawing on ethnographic research carried out in a working class community in the North of England between 2012 and 2015, I theorise smoking cessation as a symbolic practice in relation to the affective experience of class and social mobility. I show that ambivalence about upward mobility as separation and loss translated into ambivalence about smoking cessation. The reason for this was that the social gradient in smoking operated dynamically at the level of the individual life course i.e. smoking cessation followed upward mobility. A serious health problem was an appropriate reason to quit but older women continued to smoke despite serious health problems. This was linked to historical gender roles leading to women placing a low priority on their own health as well as the intergenerational reproduction of smoking through close affective links with smoking parents

'I didn't want to pass that onto my child, being afraid to go to the dentist': Making sense of oral health through narratives of connectedness over the life course

While previous sociological research on oral health has identified the relevance of personal relationships, there is more scope to analyse the mouth through a lens of connectedness. Recent qualitative interviews with 43 older people (65+) in England and Scotland found that participants constructed relational narratives to make sense of their oral health practices. By drawing on ideas of family practices, family display and personal life, we illustrate how the mouth can be understood relationally. Participants presented their own embodied experiences as connected to the actions of their parents. Narratives also reflected how, as parents and grandparents themselves, participants tried to shape the experiences of others. In this way, oral health practices were conceptualised as being about family. This can be seen in self‐narratives that demonstrated how participants located themselves as embedded in webs of ongoing relationships. We highlight the importance of narrated practices of thinking and feeling, whereby participants imagined doing oral health, and indeed family, in different ways. We thereby demonstrate how oral health practices are constituted through family connectedness and at the same time how these practices contribute to the constitution of family. Policy should therefore pay attention to family relations when promoting improvements in oral health practices

Harnessing History: Narratives, Identity and Perceptions of Russia's Post-Soviet Role

Russian political elites have long been aware of the power of myths to forge national unity. However, the past six or seven years have seen core myths increasingly situated within a highly selective narrative of Russian history. This narrative is accepted as contextual information for policy discussion, and so sets cognitive parameters for evaluations of Russia's history, identity and role. This standard narrative of Russian history prioritises the state, supports gradualism and continuity, and dramatically reduces the potential for re‐conceptualising Russia's role in contemporary international relations

Athlete experiences of disordered eating in sport

To date, research into disordered eating in sport has focused on the prevalence and the identification of putative risk factors. Findings suggest that elite female athletes participating in sports with a focus on leanness or aesthetics are at greatest risk. A paucity of research remains as to the period after onset and how existing sufferers manage their illness over time. In line with the principles of interpretative phenomenological analysis (IPA), this study 'gives voice' to four athletes who have experienced disordered eating, documenting their personal accounts and interpreting these accounts from a psychological perspective. In‐depth, semi‐structured interviews were conducted and verbatim transcripts were analysed according to the procedures of IPA. Three superordinate themes emerged from the data: the struggle to disclose, social support needs and identity challenges. Athletes' stories provided rich descriptions of their subjective disordered eating experiences. Their accounts give critical insight into the impact of eating disturbance on the lives of athletes. Future research should continue to identify athletes with existing eating problems in order to improve understanding as to how such individuals can best be helped

Interrogating trans and sexual identities through the conceptual lens of translocational positionality

This article explores the confluence of trans identity and sexuality drawing on the concept of translocational positionality. In this discussion, a broad spectrum of gendered positionalities incorporates trans identity which, in turn, acknowledges normative male and female identities as well as non-binary ones. It is also recognised, however, that trans identity overlaps with other positionalities (pertaining to sexuality, for example) to shape social location. In seeking to understand subject positions, a translocational lens acknowledges the contextuality and temporality of social categories to offer an analysis which recognises the overlaps and differentials of co-existing positionalities. This approach enables an analysis which explores how macro, or structural, contexts shape agency (at the micro-level) and also how both are mediated by trans people's multiple and shifting positionalities. In this framing, positionality represents a meso layer between structure and agency. Four case studies are presented using data from a qualitative study which explored trans people's experiences of family, intimacy and domestic abuse. We offer an original contribution to the emerging knowledge-base on trans sexuality by presenting data from four case studies. We do so whilst innovatively applying the conceptual lens of translocational positionality to an analysis which considers macro, meso and micro levels of influence