Aimee Grant | Cardiff University (original) (raw)
Papers by Aimee Grant
Pregnancy and motherhood are increasingly subjected to surveillance. Research has highlighted tha... more Pregnancy and motherhood are increasingly subjected to surveillance. Research has highlighted that public breastfeeding is difficult to navigate within existing constructs of acceptable femininity, but at the same time, mothers who formula feed are often located within discourses of the failed maternal subject. This article draws on intergenerational research with six mother/grandmother pairs from marginalised urban Welsh locales, which involved elicitation interviews around the everyday artefacts that participants presented to symbolise their experiences of motherhood and infant care. We examine the negotiation of acceptable motherhood in relation to the intrusive policing of lifestyle choices, consumption and infant feeding from family, friends and strangers. The article argues that the moral maze of surveyed motherhood renders infant feeding a challenging, and challenged, space for women. key words breastfeeding • infant formula • infant feeding • morality • motherhood • surveillance • stigma • visual methods • participatory research • qualitative research
This paper explores some of the tensions in conducting research using naturally occurring online ... more This paper explores some of the tensions in conducting research using naturally occurring online data. With reference to two public health research studies using data extracted from Twitter and one UK online news site (Mail Online), comparisons will be made with participant present research. Specifically the paper focuses on questions three issues. First, quality in terms of meaning, completeness and appropriateness of sample. Second, the emotional impact for researchers of researching challenging topics online, where offensive opinions are readily reported. Finally, the ethical issues encountered in undertaking participant absent online research are described. It will be concluded that, like participant present research, it is essential for participant absent research projects to be developed robustly.
Social Policy & Administration, 2015
Social Policy & Administration, 2015
Journal of human lactation : official journal of International Lactation Consultant Association, 2016
Stigma is a significant barrier to breastfeeding. Internationally, mothers have reported stigma s... more Stigma is a significant barrier to breastfeeding. Internationally, mothers have reported stigma surrounding public breastfeeding. In the United Kingdom, the Equality Act 2010 gives women the right to breastfeed in public, including within private businesses. In April 2014, a woman who was breastfeeding in a UK sports shop was asked to leave, resulting in a localized protest by breastfeeding mothers. This resulted in the issue of public breastfeeding being highlighted in local, national, and social media. To examine online opinion regarding breastfeeding in public and protesting about the right to breastfeed in public within the context of a single case. Online user-generated content relating to the case of Wioletta Komar was downloaded from Twitter and the comments section of a UK online news source, Mail Online. Data comprised 884 comments and 1210 tweets, collected within 24 hours of the incident. Semiotic and thematic analysis was facilitated by NVivo 10. Comments from Twitter we...
PLOS ONE, 2016
Despite cigarette-like adverse health outcomes associated with waterpipe tobacco smoking and incr... more Despite cigarette-like adverse health outcomes associated with waterpipe tobacco smoking and increase in its use among youth, it is a much underexplored research area. We aimed to measure the prevalence and patterns of waterpipe tobacco use and evaluate tobacco control policy with respect to waterpipe tobacco, in several universities across the UK. We also aimed to measure stop smoking practitioners' encounter of waterpipe tobacco smoking. We distributed an online survey to six UK universities, asking detailed questions on waterpipe tobacco. Multivariable logistic regression models, adjusted for age, gender, ethnicity, graduate status, university and socioeconomic status (SES) assessed associations between waterpipe tobacco smoking (single use and dual use with cigarettes) and sociodemographic variables. SES was ascertained by average weekly self-spend on non-essentials. We also descriptively analysed data from a 2012 survey of stop smoking practitioners to assess the proportion of clients that used waterpipe regularly. f 2217 student responses, 66.0% (95% CI 63.9-68.0%) had tried waterpipe tobacco smoking; 14.3% (95% CI 12.8-15.8%) reported past-30 day use, and 8.7% (95% CI 7.6-9.9%) reported at least monthly users. Past-30 day waterpipe-only use was associated with being younger (AOR 0.95, 95% CI 0.91-0.99), male (AOR 1.44, 95% CI 1.08-1.94), higher SES (AOR 1.16, 95% CI 1.06-1.28) and belonging to non-white ethnicities (vs. white, AOR 2.24, 95% CI 1.66-3.04). Compared to less than monthly users, monthly users were significantly more likely to have urges to smoke waterpipe (28.1% vs. 3.1%, p<0.001) report difficulty in quitting (15.5% vs. 0.8%, p<0.001), report feeling guilty, and annoyed when criticised about waterpipe smoking (19.2% vs. 9.2%, p<0.001). Nearly a third (32.5%) of respondents who had tried waterpipe had violated the UK smokefree law and a quarter (24.5%) reporting seeing health warnings on waterpipe tobacco packaging or apparatuses. Of 1,282 smoking cessation practitioners, a quarter (23.4%, 95% CI 21.5-26.1%) reported having some clients who regularly use waterpipes, but 69.5% (95% CI 67.0-72.0%) never ask clients about waterpipe use. Three quarters (74.8%, 95% CI 72.4-77.1%) want more information about waterpipe tobacco smoking. While two thirds of university students have ever tried waterpipe tobacco, at least monthly use is less common. Regular users display features of waterpipe tobacco dependence, and a substantial minority of SSS practitioners encounter clients who regularly use waterpipe. The lack of training on waterpipe for SSS practitioners and reported violations of smokefree laws for waterpipe highlight the need for regular surveillance of and a coordinated tobacco control strategy for waterpipe use.
Archives of Disease in Childhood - Fetal and Neonatal Edition, 2014
BioMed Research International, 2015
Background. Despite the rise in prevalence of waterpipe tobacco smoking, it has received little l... more Background. Despite the rise in prevalence of waterpipe tobacco smoking, it has received little legislative enforcement from governing bodies, especially in the area of health warning labels. Methods. Twenty regular waterpipe tobacco smokers from London took part in five focus groups discussing the impact of waterpipe tobacco pack health warnings on their attitudes towards waterpipe smoking. We presented them with existing and mock waterpipe tobacco products, designed to be compliant with current and future UK/EU legislation. Data were analysed using thematic analysis. Results. Participants felt packs were less attractive and health warnings were more impactful as health warnings increased in size and packaging became less branded. However, participants highlighted their lack of exposure to waterpipe tobacco pack health warnings due to the inherent nature of waterpipe smoking, that is, smoking in a café with the apparatus already prepacked by staff. Health warnings at the point of consumption had more reported impact than health warnings at the point of sale. Conclusions. Waterpipe tobacco pack health warnings are likely to be effective if compliant with existing laws and exposed to end-users. Legislations should be reviewed to extend health warning labels to waterpipe accessories, particularly the apparatus, and to waterpipe-serving premises.
Sociology of Health & Illness, 2015
Aims and objectives: To understand nurses' views and experiences of four-hour treatment targets ... more Aims and objectives: To understand nurses' views and experiences of four-hour treatment targets in the emergency department and how this impacts clinical decision-making throughout acute secondary care hospitals.
Background: In many countries, national treatment targets in the emergency department have been introduced. However, research and a recent enquiry into poor clinical care in one hospital in the UK have highlighted that patient care may be compromised by the need to meet these targets.
Design: Qualitative descriptive study as part of a case study approach.
Methods: Semi-structured interviews were conducted with 31 nurses working in UK secondary care hospitals which had an emergency department. Nurses were purposively sampled from three specialties: emergency arenas (emergency department, n = 5; medical assessment n = 4 surgical receiving n = 2) (n = 11), surgical wards (n = 11) and medical wards (n = 9).
Results: Nurses in emergency arenas reported considerable burden, in terms of a very high workload and pressure from senior staff to meet the target. Respondents reported that negative impact on patient care for the majority of patients, excluding the most sick, for whom emergency arena nurses reported that they ensured received appropriate treatment, regardless of breaching treatment targets. Around half of the nurses working outside emergency arenas felt pressure and amended their work practices to enable colleagues in emergency arenas to meet treatment targets.
Conclusions: Four-hour targets were not viewed as clinically helpful by the majority of nurses, some of whom questioned their appropriateness for patient care.
Relevance to clinical practice: Policy makers and senior managers should consider the suitability of treatment targets in the emergency department, particularly in relation to working conditions for nurses and other health professionals and its potential for negative impacts on patient care. While targets remain in place, senior nurses and managers should support nurses who breach the target to provide optimum clinical care.
Qualitative Health Research, 2014
Background Maternal smoking is a key cause of poor outcomes for mothers, babies and children and... more Background
Maternal smoking is a key cause of poor outcomes for mothers, babies and children and
Wales has higher rates of smoking in pregnancy than any other UK country. Despite various
improvements within the NHS Stop Smoking Service to strengthen the intervention for
pregnant women, referrals and successful quit attempts for this group have continued to
remain extremely low. A key element of UK national guidance for smoking cessation during
pregnancy is to provide a flexible and tailored service to help increase levels of engagement.
This study aims to test the effectiveness of three different models of service delivery to
address the gap in the evidence base about how to deliver a flexible, tailored smoking
cessation service to pregnant women.
Methods
This study will adopt a quasi-experimental design over a 12 month period. The setting is four
of Wales’ seven Health Boards using an integrated approach between maternity services,
local public health teams and the NHS Stop Smoking Service. Core recommendations from
UK public health guidance are being implemented across intervention and usual care sites.
Stop smoking support for pregnant women in intervention sites is being delivered more
flexibly than in usual care sites. Both qualitative and quantitative approaches will be adopted
to capture important contextual information and consider multiple perspectives. A health
economic analysis will be undertaken using a cost-consequences analysis approach. The primary outcome measure is engagement with stop smoking services (defined as having at
least one face-to-face therapeutic contact with a clinician).
Discussion
Supporting pregnant women to stop smoking is a challenging area of public health. The
proposed study will address several areas where there are key evidence gaps relating to
smoking cessation interventions for pregnant women. Specifically, how best to encourage
pregnant women to attend a specialist stop smoking support service, how to deliver the
service and who should provide it.
Health professionals have adopted proactive testing for early evidence of disease. Researchers ha... more Health professionals have adopted proactive testing for early evidence of disease. Researchers have identified that this leads to enumerated understandings and shapes behavior in productive ways. Smoking-cessation advisors regularly test clients for carbon monoxide (CO), but client views of this had not previously been explored. We interviewed 23 clients of a United Kingdom-based stop-smoking service regarding their experiences of CO testing. The majority of participants were successful quitters. We used ATLAS.ti 7 as a data-management tool during structured qualitative analysis. Our findings reveal that clients believed the results of their CO tests. Many became enumerated in their understanding, and thus placed themselves in a hierarchy with other members of their group. Almost all clients found that knowing their CO test score was motivating. We conclude that additional research is needed to understand the experiences of CO testing among clients who do not quit.
INTRODUCTION: We assessed the prevalence and frequency of waterpipe smoking among adults (aged 18... more INTRODUCTION:
We assessed the prevalence and frequency of waterpipe smoking among adults (aged 18+ years) in Great Britain (GB) and determined demographic factors associated with use.
METHODS:
We used cross-sectional representative population surveys conducted online in 2012 and 2013. A total of 12,436 adults in 2012 and 12,171 in 2013 were recruited from a commercial online survey panel.
RESULTS:
The prevalence of ever use of waterpipe across both survey years combined was 11.6% (95% confidence interval [CI] = 11.0-12.1). Frequent use (at least once or twice a month) was 1.0% (95% CI = 0.8-1.2) and was similar in both 2012 and 2013. There was some suggestion of increased ever but not frequent use among 18-24-year-olds between survey years. After adjustment for covariates, females had lower odds of ever waterpipe use than males (odds ratio [OR] = 0.71, 95% CI = 0.63-0.79), those in the lowest social grade had lower odds of use compared to those in the highest social grade (OR = 0.43, 95% CI = 0.35-0.54), older people were at much lower odds of ever use than younger people, ever having smoked cigarettes increased odds of ever waterpipe use, and being Asian (OR = 1.84, 95% CI = 1.39-2.45) or of mixed ethnicity (OR = 2.36, 95% CI = 1.64-3.40) increased likelihood of ever use compared to White ethnicity.
CONCLUSIONS:
Frequent waterpipe smoking was relatively rare in these representative samples of the GB adult population, and prevalence was similar between 2012 and 2013. Continued monitoring and targeted interventions are appropriate.
Introduction One strand of New Labour’s welfare reform agenda was introducing the Condition Manag... more Introduction
One strand of New Labour’s welfare reform agenda was introducing the Condition Management Programme (CMP), a service to support Incapacity Benefit claimants to return to productive roles. In many areas of the UK, occupational therapists took a leading role in service delivery. This paper examines occupational therapists’ use of discretion within the Programme, and its effect on their professional identity.
Method
In-depth face-to-face interviews were undertaken with 13 staff employed by the Condition Management Programme, the majority of whom were occupational therapists (6) or occupational therapy assistants (2). Interview transcripts were analysed thematically using Atlas ti. 6 as a data management tool.
Findings
Within CMPs, managers had a large amount of freedom in service design and created a service underpinned by occupational therapy. Whilst some decisions were made as part of a multi-disciplinary team, staff were allowed considerable clinical autonomy in delivering the service. The impact on professional identity is discussed.
Conclusion
As a central part of the CMP service, occupational therapists were allowed considerable freedom. Combined with low case loads, occupational therapy appeared to flourish within the CMP. There is a need for further research within mainstream National Health Service (NHS) services to examine how discretion affects professional identity.
Pregnancy and motherhood are increasingly subjected to surveillance. Research has highlighted tha... more Pregnancy and motherhood are increasingly subjected to surveillance. Research has highlighted that public breastfeeding is difficult to navigate within existing constructs of acceptable femininity, but at the same time, mothers who formula feed are often located within discourses of the failed maternal subject. This article draws on intergenerational research with six mother/grandmother pairs from marginalised urban Welsh locales, which involved elicitation interviews around the everyday artefacts that participants presented to symbolise their experiences of motherhood and infant care. We examine the negotiation of acceptable motherhood in relation to the intrusive policing of lifestyle choices, consumption and infant feeding from family, friends and strangers. The article argues that the moral maze of surveyed motherhood renders infant feeding a challenging, and challenged, space for women. key words breastfeeding • infant formula • infant feeding • morality • motherhood • surveillance • stigma • visual methods • participatory research • qualitative research
This paper explores some of the tensions in conducting research using naturally occurring online ... more This paper explores some of the tensions in conducting research using naturally occurring online data. With reference to two public health research studies using data extracted from Twitter and one UK online news site (Mail Online), comparisons will be made with participant present research. Specifically the paper focuses on questions three issues. First, quality in terms of meaning, completeness and appropriateness of sample. Second, the emotional impact for researchers of researching challenging topics online, where offensive opinions are readily reported. Finally, the ethical issues encountered in undertaking participant absent online research are described. It will be concluded that, like participant present research, it is essential for participant absent research projects to be developed robustly.
Social Policy & Administration, 2015
Social Policy & Administration, 2015
Journal of human lactation : official journal of International Lactation Consultant Association, 2016
Stigma is a significant barrier to breastfeeding. Internationally, mothers have reported stigma s... more Stigma is a significant barrier to breastfeeding. Internationally, mothers have reported stigma surrounding public breastfeeding. In the United Kingdom, the Equality Act 2010 gives women the right to breastfeed in public, including within private businesses. In April 2014, a woman who was breastfeeding in a UK sports shop was asked to leave, resulting in a localized protest by breastfeeding mothers. This resulted in the issue of public breastfeeding being highlighted in local, national, and social media. To examine online opinion regarding breastfeeding in public and protesting about the right to breastfeed in public within the context of a single case. Online user-generated content relating to the case of Wioletta Komar was downloaded from Twitter and the comments section of a UK online news source, Mail Online. Data comprised 884 comments and 1210 tweets, collected within 24 hours of the incident. Semiotic and thematic analysis was facilitated by NVivo 10. Comments from Twitter we...
PLOS ONE, 2016
Despite cigarette-like adverse health outcomes associated with waterpipe tobacco smoking and incr... more Despite cigarette-like adverse health outcomes associated with waterpipe tobacco smoking and increase in its use among youth, it is a much underexplored research area. We aimed to measure the prevalence and patterns of waterpipe tobacco use and evaluate tobacco control policy with respect to waterpipe tobacco, in several universities across the UK. We also aimed to measure stop smoking practitioners' encounter of waterpipe tobacco smoking. We distributed an online survey to six UK universities, asking detailed questions on waterpipe tobacco. Multivariable logistic regression models, adjusted for age, gender, ethnicity, graduate status, university and socioeconomic status (SES) assessed associations between waterpipe tobacco smoking (single use and dual use with cigarettes) and sociodemographic variables. SES was ascertained by average weekly self-spend on non-essentials. We also descriptively analysed data from a 2012 survey of stop smoking practitioners to assess the proportion of clients that used waterpipe regularly. f 2217 student responses, 66.0% (95% CI 63.9-68.0%) had tried waterpipe tobacco smoking; 14.3% (95% CI 12.8-15.8%) reported past-30 day use, and 8.7% (95% CI 7.6-9.9%) reported at least monthly users. Past-30 day waterpipe-only use was associated with being younger (AOR 0.95, 95% CI 0.91-0.99), male (AOR 1.44, 95% CI 1.08-1.94), higher SES (AOR 1.16, 95% CI 1.06-1.28) and belonging to non-white ethnicities (vs. white, AOR 2.24, 95% CI 1.66-3.04). Compared to less than monthly users, monthly users were significantly more likely to have urges to smoke waterpipe (28.1% vs. 3.1%, p<0.001) report difficulty in quitting (15.5% vs. 0.8%, p<0.001), report feeling guilty, and annoyed when criticised about waterpipe smoking (19.2% vs. 9.2%, p<0.001). Nearly a third (32.5%) of respondents who had tried waterpipe had violated the UK smokefree law and a quarter (24.5%) reporting seeing health warnings on waterpipe tobacco packaging or apparatuses. Of 1,282 smoking cessation practitioners, a quarter (23.4%, 95% CI 21.5-26.1%) reported having some clients who regularly use waterpipes, but 69.5% (95% CI 67.0-72.0%) never ask clients about waterpipe use. Three quarters (74.8%, 95% CI 72.4-77.1%) want more information about waterpipe tobacco smoking. While two thirds of university students have ever tried waterpipe tobacco, at least monthly use is less common. Regular users display features of waterpipe tobacco dependence, and a substantial minority of SSS practitioners encounter clients who regularly use waterpipe. The lack of training on waterpipe for SSS practitioners and reported violations of smokefree laws for waterpipe highlight the need for regular surveillance of and a coordinated tobacco control strategy for waterpipe use.
Archives of Disease in Childhood - Fetal and Neonatal Edition, 2014
BioMed Research International, 2015
Background. Despite the rise in prevalence of waterpipe tobacco smoking, it has received little l... more Background. Despite the rise in prevalence of waterpipe tobacco smoking, it has received little legislative enforcement from governing bodies, especially in the area of health warning labels. Methods. Twenty regular waterpipe tobacco smokers from London took part in five focus groups discussing the impact of waterpipe tobacco pack health warnings on their attitudes towards waterpipe smoking. We presented them with existing and mock waterpipe tobacco products, designed to be compliant with current and future UK/EU legislation. Data were analysed using thematic analysis. Results. Participants felt packs were less attractive and health warnings were more impactful as health warnings increased in size and packaging became less branded. However, participants highlighted their lack of exposure to waterpipe tobacco pack health warnings due to the inherent nature of waterpipe smoking, that is, smoking in a café with the apparatus already prepacked by staff. Health warnings at the point of consumption had more reported impact than health warnings at the point of sale. Conclusions. Waterpipe tobacco pack health warnings are likely to be effective if compliant with existing laws and exposed to end-users. Legislations should be reviewed to extend health warning labels to waterpipe accessories, particularly the apparatus, and to waterpipe-serving premises.
Sociology of Health & Illness, 2015
Aims and objectives: To understand nurses' views and experiences of four-hour treatment targets ... more Aims and objectives: To understand nurses' views and experiences of four-hour treatment targets in the emergency department and how this impacts clinical decision-making throughout acute secondary care hospitals.
Background: In many countries, national treatment targets in the emergency department have been introduced. However, research and a recent enquiry into poor clinical care in one hospital in the UK have highlighted that patient care may be compromised by the need to meet these targets.
Design: Qualitative descriptive study as part of a case study approach.
Methods: Semi-structured interviews were conducted with 31 nurses working in UK secondary care hospitals which had an emergency department. Nurses were purposively sampled from three specialties: emergency arenas (emergency department, n = 5; medical assessment n = 4 surgical receiving n = 2) (n = 11), surgical wards (n = 11) and medical wards (n = 9).
Results: Nurses in emergency arenas reported considerable burden, in terms of a very high workload and pressure from senior staff to meet the target. Respondents reported that negative impact on patient care for the majority of patients, excluding the most sick, for whom emergency arena nurses reported that they ensured received appropriate treatment, regardless of breaching treatment targets. Around half of the nurses working outside emergency arenas felt pressure and amended their work practices to enable colleagues in emergency arenas to meet treatment targets.
Conclusions: Four-hour targets were not viewed as clinically helpful by the majority of nurses, some of whom questioned their appropriateness for patient care.
Relevance to clinical practice: Policy makers and senior managers should consider the suitability of treatment targets in the emergency department, particularly in relation to working conditions for nurses and other health professionals and its potential for negative impacts on patient care. While targets remain in place, senior nurses and managers should support nurses who breach the target to provide optimum clinical care.
Qualitative Health Research, 2014
Background Maternal smoking is a key cause of poor outcomes for mothers, babies and children and... more Background
Maternal smoking is a key cause of poor outcomes for mothers, babies and children and
Wales has higher rates of smoking in pregnancy than any other UK country. Despite various
improvements within the NHS Stop Smoking Service to strengthen the intervention for
pregnant women, referrals and successful quit attempts for this group have continued to
remain extremely low. A key element of UK national guidance for smoking cessation during
pregnancy is to provide a flexible and tailored service to help increase levels of engagement.
This study aims to test the effectiveness of three different models of service delivery to
address the gap in the evidence base about how to deliver a flexible, tailored smoking
cessation service to pregnant women.
Methods
This study will adopt a quasi-experimental design over a 12 month period. The setting is four
of Wales’ seven Health Boards using an integrated approach between maternity services,
local public health teams and the NHS Stop Smoking Service. Core recommendations from
UK public health guidance are being implemented across intervention and usual care sites.
Stop smoking support for pregnant women in intervention sites is being delivered more
flexibly than in usual care sites. Both qualitative and quantitative approaches will be adopted
to capture important contextual information and consider multiple perspectives. A health
economic analysis will be undertaken using a cost-consequences analysis approach. The primary outcome measure is engagement with stop smoking services (defined as having at
least one face-to-face therapeutic contact with a clinician).
Discussion
Supporting pregnant women to stop smoking is a challenging area of public health. The
proposed study will address several areas where there are key evidence gaps relating to
smoking cessation interventions for pregnant women. Specifically, how best to encourage
pregnant women to attend a specialist stop smoking support service, how to deliver the
service and who should provide it.
Health professionals have adopted proactive testing for early evidence of disease. Researchers ha... more Health professionals have adopted proactive testing for early evidence of disease. Researchers have identified that this leads to enumerated understandings and shapes behavior in productive ways. Smoking-cessation advisors regularly test clients for carbon monoxide (CO), but client views of this had not previously been explored. We interviewed 23 clients of a United Kingdom-based stop-smoking service regarding their experiences of CO testing. The majority of participants were successful quitters. We used ATLAS.ti 7 as a data-management tool during structured qualitative analysis. Our findings reveal that clients believed the results of their CO tests. Many became enumerated in their understanding, and thus placed themselves in a hierarchy with other members of their group. Almost all clients found that knowing their CO test score was motivating. We conclude that additional research is needed to understand the experiences of CO testing among clients who do not quit.
INTRODUCTION: We assessed the prevalence and frequency of waterpipe smoking among adults (aged 18... more INTRODUCTION:
We assessed the prevalence and frequency of waterpipe smoking among adults (aged 18+ years) in Great Britain (GB) and determined demographic factors associated with use.
METHODS:
We used cross-sectional representative population surveys conducted online in 2012 and 2013. A total of 12,436 adults in 2012 and 12,171 in 2013 were recruited from a commercial online survey panel.
RESULTS:
The prevalence of ever use of waterpipe across both survey years combined was 11.6% (95% confidence interval [CI] = 11.0-12.1). Frequent use (at least once or twice a month) was 1.0% (95% CI = 0.8-1.2) and was similar in both 2012 and 2013. There was some suggestion of increased ever but not frequent use among 18-24-year-olds between survey years. After adjustment for covariates, females had lower odds of ever waterpipe use than males (odds ratio [OR] = 0.71, 95% CI = 0.63-0.79), those in the lowest social grade had lower odds of use compared to those in the highest social grade (OR = 0.43, 95% CI = 0.35-0.54), older people were at much lower odds of ever use than younger people, ever having smoked cigarettes increased odds of ever waterpipe use, and being Asian (OR = 1.84, 95% CI = 1.39-2.45) or of mixed ethnicity (OR = 2.36, 95% CI = 1.64-3.40) increased likelihood of ever use compared to White ethnicity.
CONCLUSIONS:
Frequent waterpipe smoking was relatively rare in these representative samples of the GB adult population, and prevalence was similar between 2012 and 2013. Continued monitoring and targeted interventions are appropriate.
Introduction One strand of New Labour’s welfare reform agenda was introducing the Condition Manag... more Introduction
One strand of New Labour’s welfare reform agenda was introducing the Condition Management Programme (CMP), a service to support Incapacity Benefit claimants to return to productive roles. In many areas of the UK, occupational therapists took a leading role in service delivery. This paper examines occupational therapists’ use of discretion within the Programme, and its effect on their professional identity.
Method
In-depth face-to-face interviews were undertaken with 13 staff employed by the Condition Management Programme, the majority of whom were occupational therapists (6) or occupational therapy assistants (2). Interview transcripts were analysed thematically using Atlas ti. 6 as a data management tool.
Findings
Within CMPs, managers had a large amount of freedom in service design and created a service underpinned by occupational therapy. Whilst some decisions were made as part of a multi-disciplinary team, staff were allowed considerable clinical autonomy in delivering the service. The impact on professional identity is discussed.
Conclusion
As a central part of the CMP service, occupational therapists were allowed considerable freedom. Combined with low case loads, occupational therapy appeared to flourish within the CMP. There is a need for further research within mainstream National Health Service (NHS) services to examine how discretion affects professional identity.
Pregnancy and motherhood have come to be increasingly subjected to surveillance, by medical profe... more Pregnancy and motherhood have come to be increasingly subjected to surveillance, by medical professionals, kin and also strangers. Rates of breastfeeding in developed countries vary significantly but research with mothers in countries with low breastfeeding rates has highlighted that public breastfeeding is difficult to navigate within existing constructs of acceptable femininity, due to the sexualisation of the breast in contemporary society. This paper draws on indepth qualitative reserach with six mother/grandmother pairs, where the mothers' infants were aged under 25 months. Data production involved eliciation interviews around the everyday artefacts that participants presented to symbolise their experiences of motherhood and infant care. Participants who were new mothers described the ways in which their behaviours were monitored by those around them, including service-sector employees, friends, family and, to a lesser extent, health professionals. The intergenerational nature of the study allowed a focus on the ways in which surveillance of infant feeding, and mothering more generally, has changed over time, and grandmothers reported considerably lower levels of scrutiny. Drawing on Foucauldian concepts of surveilance, the paper examines the negotiation of acceptable motherhood in relation to the intrusive policing of lifestyle choices, consumption and infant feeding. The paper argues that the moral maze of surveyed motherhood acts to close down mothers agency and situate them in a psychological impasse where ideas of choice and ownership become restricted.
• There was not a direct intergenerational relationship between mothers' and daughters' feeding p... more • There was not a direct intergenerational relationship between mothers' and daughters' feeding practices. • Maternal support for feeding decisions were central in participants' accounts.