Women, self-harm and borderline personality disorder : a search for understanding

Adopting a case study approach (Yin, 1984; Stake, 1995;) this study aims to explore the experiences of 'self-harm' by women who have been given a diagnosis of 'borderline personality disorder' (BPD) within one area of a Mental Health NHS Trust. By taking a material-discursive-intrapsychic approach (Ussher, 1999; 2000) this research explores the accounts that have been constructed around 'self-harm' and 'BPD' by mental health professionals working with women and women themselves. This research looks at the ways in which 'self-harm' and the diagnosis of 'BPD' are operationalised by professionals and the implications arising from these constructions and discourses when delivering services to women. The study also explores the narrative accounts of women who access the mental health care arena in relation to their experiences of 'self-harm' and 'BPD', and in particular how they have constructed and experienced such responses in their everyday lives. The process of data gathering for this project was organised in two phases. In the first phase of data gathering eight mental health professionals participated in conversational interviews (Nichols, 1991; Conrad and Schober, 1998). These professionals worked for the Mental Health NHS Trust and each of them aimed to provide care, support and treatment for individuals accessing mental health services. The second phase of the research involved the participation of four women, living in the locality of the NHS Trust, in lengthy narrative interviews (Reissman, 1993). Data analysis for phase one drew upon the guidelines developed by Willig (1999; 2001) and for phase two Reissman's (1993) thematic narrative analysis and Langellier's (1989) personal narrative guided the analytical process. 5 Unlike previous research that has explored 'self-harm' and 'BPD' the present study draws upon social constructionism, critical realism and post-modern thinking. This approach has made it possible for an alternate way of considering 'self-harm' and 'BPO'. Individual women at material, discursive and intrapsychic levels experience this phenomenon. It's meaning to women, and to the mental health care professionals, has to be understood in relation to the specific historical and cultural contexts in which both are positioned and the dominant cultural discourses that exist at these times. By drawing upon a critical realist epistemological standpoint and adopting a materialdiscursive- intrapsychic analysis the present study has been able to incorporate these different layers of the women's subjective experience, and the different types of expert knowledge about 'self-harm' and 'BPO', into one framework. The present study has been able to explore 'self-harm' and 'BPO', both as discursive constructs and a set of symptoms experienced by individual women.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

A contemporary reflection on feminist criminology: whose side are we on?

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Co-located Heroin Assisted Treatment within primary care: A preliminary analysis of the implications for healthcare access, cost, and treatment delivery in the UK.

The UK is experiencing its highest rate of drug related deaths in 25 years. Poor and inconsistent access to healthcare negatively impacts health outcomes for people who use drugs. Innovation in models of care which promote access and availability of physical treatment is fundamental. Heroin Assisted Treatment (HAT) is a treatment modality targeted at the most marginalised people who use drugs, at high risk of mortality and morbidity. The first service-provider initiated HAT service in the UK ran between October 2019 and November 2022 in Middlesbrough, England. The service was co-located within a specialist primary care facility offering acute healthcare treatment alongside injectable diamorphine. Analysis of anonymised health records for healthcare costs (not including drug treatment) took place using descriptive statistics prior and during engagement with HAT, at both three (n=15) and six (n=12) months. Primary outcome measures were incidents of wound care, skin and soft tissue infections (SSTIs), overdose (OD) events, unplanned overnight stays in hospital, treatment engagement (general and within hospital care settings) and ambulance incidents. Secondary outcome measures were costs associated with these events. A shift in healthcare access for participants during HAT engagement was observed. HAT service attendance appeared to support health promoting preventative care, and reduce reactive reliance on emergency healthcare systems. At three and six months, engagement for preventative wound care and treatment for SSTIs increased at the practice. Unplanned emergency healthcare interactions for ODs, overnight hospital stays, serious SSTIs, and ambulance incidents reduced, and there was an increase in treatment engagement (i.e. a reduction in appointments which were not engaged with). There was a decrease in treatment engagement in hospital settings. Changes in healthcare utilisation during HAT translated to a reduction in healthcare costs of 58% within six months compared to the same timeframe from the period directly prior to commencing HAT. This exploratory study highlights the potential for innovative harm reduction interventions such as HAT, co-located with primary care services, to improve healthcare access and engagement for a high-risk population. Increased uptake of primary healthcare services translated to reductions in emergency healthcare use and associated costs. Although costs of HAT provision are substantial, the notable cost-savings in health care should be an important consideration in service implementation planning. [Abstract copyright: Copyright © 2024. Published by Elsevier B.V.

Acceptability and feasibility pilot randomised controlled trial of medical skin camouflage for recovery of women prisoners with self-harm scarring (COVER): the study protocol

Self-harm in prison is a major public health concern. Less than 5% of UK prisoners are women, but they carry out more than a fifth of prison self-harm. Scars resulting from self-harm can be traumatising and stigmatising, yet there has been little focus on recovery of women prisoners with self-harm scarring. Medical skin camouflage (MSC) clinics treat individuals with disfiguring skin conditions, with evidence of improved well-being, self-esteem and social interactions. Only one community study has piloted the use of MSC for self-harm scarring. We describe an acceptability and feasibility pilot randomised controlled trial; the first to examine MSC for women prisoners who self-harm. We aim to randomise 20-25 women prisoners to a 6-week MSC intervention and 20-25 to a waitlist control (to receive the MSC after the study period). We aim to train at least 6-10 long-term prisoners with personal experience of self-harm to deliver the intervention. Before and after intervention, we will pilot collection of women-centred outcomes, including quality of life, well-being and self-esteem. We will pilot collection of self-harm incidents during the intervention, resources used to manage/treat self-harm and follow-up of women at 12 weeks from baseline. Data on recruitment, retention and dropout will be recorded. We aim for the acceptability of the intervention to prison staff and women prisoners to be explored in qualitative interviews and focus groups. Ethical approval for COVER has been granted by the North East-York Research Ethics Committee (REC) for phases 1 and 2 (reference: 16/NE/0030) and West of Scotland REC 3 for phases 3 and 4 (reference: 16/WS/0155). Informed consent will be the primary consideration; it will be made clear that participation will have no effect on life in prison or eligibility for parole. Due to the nature of the study, disclosures of serious self-harm may need to be reported to prison officials. We aim for findings to be disseminated via events at the study prison, presentations at national/international conferences, journal publications, prison governor meetings and university/National Health Service trust communications. NCT02638974; Pre-results. [Abstract copyright: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.

A genetic variation map for chicken with 2.8 million single-nucleotide polymorphisms

We describe a genetic variation map for the chicken genome containing 2.8 million single-nucleotide polymorphisms ( SNPs). This map is based on a comparison of the sequences of three domestic chicken breeds ( a broiler, a layer and a Chinese silkie) with that of their wild ancestor, red jungle fowl. Subsequent experiments indicate that at least 90% of the variant sites are true SNPs, and at least 70% are common SNPs that segregate in many domestic breeds. Mean nucleotide diversity is about five SNPs per kilobase for almost every possible comparison between red jungle fowl and domestic lines, between two different domestic lines, and within domestic lines - in contrast to the notion that domestic animals are highly inbred relative to their wild ancestors. In fact, most of the SNPs originated before domestication, and there is little evidence of selective sweeps for adaptive alleles on length scales greater than 100 kilobases