Applied Social Sciences

Abstract The sociological literature pertaining to the nature of imprisonment has long documented the harm endured by the incarcerated. Such unease has led a range of commentators to challenge the over-reliance on imprisonment and the concomitant demotion of rehabilitative approaches, which have commonly been regarded as 'soft on crime' in a neoliberal populist punitive climate. However, recent economic and political changes have led to the promise of 'rehabilitation revolution' relying on collaboration between the state and third sector agencies. Whilst this new direction would appear to support the use of artistic and spiritual activities, which foster empathy, healing and transformation, the intention to make prisons places of 'hard work and industry' alongside 'Payment by Results' may eradicate all such prospects. The potential benefits of enrichment activities as part of a strengths-based rehabilitation model will be considered in this article, which will review the current state of artistic and spiritual initiatives in
prisons alongside empirical data gathered at a weekly yoga class in a UK adult male prison. By so doing, this paper discusses the potential impact of the proposed rehabilitation revolution on enrichment activities and considers whether their unique merits warrant a reconsideration of what should be valued in criminal justice responses.

Despite a growing literature on the value of relational data in studies of social phenomena, individuals still commonly constitute the basic unit of analysis in qualitative research. Methodological aspects of interviewing couples, particularly interviewing partners separately, and of conducting dyadic analysis have received scant attention. This article describes the experience of conducting separate interviews with both partners in 22 heterosexual couples (n = 44) in a study of the impact of the gynaecological condition endometriosis. In order to advance current methodological thinking regarding interviewing couples, we describe the dyadic, relational approach employed in designing the study and our specific method of dyadic analysis. We argue that utilising separate interviews with dyadic analysis rather than conducting joint interviews, while not without its ethical, practical and analytical challenges, offers considerable methodological benefits. Such an approach allows a unique...

Despite a growing literature on the value of relational data in studies of social phenomena, individuals still commonly constitute the basic unit of analysis in qualitative research. Methodological aspects of interviewing couples, particularly interviewing partners separately, and of conducting dyadic analysis have received scant attention. This article describes the experience of conducting separate interviews with both partners in 22 heterosexual couples (n = 44) in a study of the impact of the gynaecological condition endometriosis. In order to advance current methodological thinking regarding interviewing couples, we describe the dyadic, relational approach employed in designing the study and our specific method of dyadic analysis. We argue that utilising separate interviews with dyadic analysis rather than conducting joint interviews, while not without its ethical, practical and analytical challenges, offers considerable methodological benefits. Such an approach allows a unique...

While social science research into reproduction is a vibrant and growing field of scholarly activity, the majority of research is conducted with women and focuses on women’s lives. Reproduction research which does focus on men tends to overlook aspects such as pre-conception desires for parenthood and planning. Scholars have argued for a greater inclusion of men in reproduction research, yet there is a paucity of methodological literature addressing how best to do so. This article reports methodological reflections from a qualitative study into men’s perceptions and intentions regarding the ‘right time’ to have children. It does this in reference to Critical Studies of Men and Masculinities – which foregrounds men as gendered beings and comprises the study of the gendered nature of men’s lives – as both a theoretical position influencing study conception and design and as an explanatory framework for enhancing understanding of the research encounter. The first part of the article de...

In this paper we will consider the question of mutation as it is manifested in press coverage of MRSA in UK hospitals. This represents a fertile field of discourse which brings into focus issues relating to microbes, people and working practices as well as the concepts of risk and vulnerability. A regular feature of reporting has been the presence of explanations for drug resistance involving repeated random mutations of the microbe to achieve progressively greater resistance and versatility, largely through a Darwinian process which is 'clever' at overcoming human attempts at elimination. More recently a discourse has emerged which foregrounds also the vulnerability of patients who are very young, old or otherwise immunocompromised, or whose own genetic makeup might put them at risk from the microbe. The hospital is decentred as a source of infection, and attention is turned instead to nursing homes and gymnasia as sources of infection in the community. This latter development mitigates the responsibilities of hospitals and statutory healthcare providers and turns the risk back towards the individual as a responsible actor in an ecology of mutation.

Nicky Hudson is a senior research fellow in the School of Applied Social Sciences at De Montfort University. She is a sociologist with an interest in medicine, reproduction, gender and ethnicity. She has worked on a number of projects on the social aspects of infertility and reproduction, funded by the Economic and Social Research Council, the Department of Health and local NHS trusts. Nicky is also interested in the research process, particularly in elements of the researcher/researched relationship.

Cross-border reproductive care (CBRC) has attracted considerable attention in media and professional publications. The aim of this review is to present a critical narrative overview of the published evidence on CBRC. A systematic search of key academic databases was undertaken with no time restrictions set for publication. This was supplemented by additional searches of key websites, reference chaining and enquiries to people working in the field. A total of 54 items are included in the review, including both empirical research studies (18) and debate papers (36). The key themes discussed are: terminology and definitions; incidence; experiences; explanations; implications; and policy responses. Significant methodological limitations and gaps in the literature are identified. Evidence on incidence is scant, though it suggests that CBRC is increasing. The literature suggests legal, social and political drivers, which vary in importance geographically and between individuals. Limited findings on patient perceptions suggest a broadly positive patient experience. Suggested policy responses include prohibition, regulatory harmonization and harm minimization. There is a need for better international data collection tools and both quantitative and qualitative work which encompasses views of patients, donors, surrogates and professionals and which explores the implications for healthcare services in sending countries.

There is a wealth of research exploring the psychological consequences of infertility and assisted reproductive technologies (ARTs); a substantial body of sociological and anthropological work on ‘reproductive disruptions’ of many kinds, and a small but growing literature on patient perspectives of the quality of care in assisted reproduction.  In all these fields, research studies are far more likely to be focused on the understandings and experiences of women than those of men.  This paper discusses reasons for the relative exclusion of men in what has been called the ‘psycho-social’ literature on infertility, comments on research on men from psychological and social perspectives and recent work on the quality of patient care, and makes suggestions for a re-framing of the research agenda on men and ARTs. Further research is needed in all areas including perceptions of infertility and infertility treatment seeking; experiences of treatment; information and support needs; decisions to end treatment; fatherhood post-assisted conception; the motivation and experiences of sperm donors and of men who seek fatherhood through surrogacy or co-parenting. We argue for multi-method, inter-disciplinary research that includes broader populations of men which can contribute to improved clinical practice and support for users of assisted reproductive technologies.

Abstract

Background:  Endometriosis is a chronic condition affecting between 2-17% of women of reproductive age. Common symptoms are chronic pelvic pain, fatigue, congestive dysmenorrhoea, heavy menstrual bleeding, and deep dyspareunia.  Studies have demonstrated the considerable negative impact of this condition on women’s quality of life, especially in the domains of pain and psychosocial functioning. The impact of endometriosis is likely to be exacerbated by the absence of an obvious cause and the likelihood of chronic, recurring symptoms. The aims of this paper are to review the current body of knowledge on the social and psychological impact of endometriosis on women’s lives; to provide insights into women’s experience of endometriosis; to provide a critical commentary on the current state of knowledge; and to make recommendations for future psycho-social research.

Methods: The review draws on a method of critical narrative synthesis to discuss a heterogeneous range of both quantitative and qualitative studies from several disciplines. This included a systematic search, a structured process for selecting and collecting data, and a systematic thematic analysis of results.

Results: Forty-two papers are included in the review; 23 used quantitative methods, 16 qualitative methods, and 3 were mixed methods studies. The majority of papers came from just 4 countries: UK (10), Australia (8), Brazil (6) and the USA (5).  Key categories of impact identified in the thematic analysis were: diagnostic delay and uncertainty; ‘quality of life’ and everyday activities; intimate relationships; planning for and having children; education and work; mental health and wellbeing; and medical and self-management.
Conclusion: Endometriosis has a significant social and psychological impact on the lives of women across several domains. Many studies have methodological limitations and there are significant gaps in the literature especially in relation to a consideration of the impact on partners and children. We recommend additional prospective and longitudinal research utilising mixed methods approaches and endometriosis-specific instruments to explore the impact of endometriosis in more diverse populations and settings. Furthermore, there is an urgent need to develop and evaluate interventions for supporting women and partners living with this chronic and often debilitating condition.

Keywords: endometriosis, social, psychological, quality of life, chronic illness

Abstract
Background: There are few systematic studies of the incidence of cross border fertility care and even fewer reports of qualitative research with those undertaking treatment outside their country of origin. This paper reports findings from a qualitative study of UK residents with experience of cross border care: the socio-demographic characteristics of UK travellers; their reasons for seeking treatment abroad; the treatments they sought; the destinations they chose, and the outcomes of their treatment. 
Methods: Data regarding cross border fertility treatment were collected from a purposive sample of 51 people by means of in-depth, semi-structured interviews between May 2009 and June 2010. Data were analysed using a systematic thematic coding method and also subjected to quantitative translation. 
Results: Patient motivations for travelling abroad are complex. A desire for timely and affordable treatment with donor gametes was evident in a high number of cases (71%). However, most people gave several reasons including: the cost of UK treatment; higher success rates abroad; treatment in a less stressful environment and dissatisfaction with UK treatment.  People travelled to 13 different countries, the most popular being Spain and the Czech Republic. Most organised their own treatment and travel. The mean age of women seeking treatment was 38.8 years (range 29-46 years) and the multiple pregnancy rate was 19%.
Conclusions: UK residents have diverse reasons for, and approaches to seeking overseas treatment and do not conform to media stereotypes. Further research is needed to explore implications of cross border treatment for donors, offspring and healthcare systems.
Keywords:  cross border reproductive care; fertility tourism; reproductive tourism; treatment abroad, medical tourism.