Recent calls have been made to investigate the lived experience of migrant sex workers, to broaden the scope and inclusivity of macro-level conceptualizations, and to develop contextually grounded forms of understanding. Our ethnographic study sought to explore the lived perspectives of an under-researched occupational group: migrant women working as irregular streetwalkers in a European city. Nineteen Nigerian Edo women working as prostitutes and Madams in Spain participated in an ethnographic, longitudinal study spanning five years of data collection. In this article, we focus on some of the key challenges, including ethical considerations, of undertaking ethnographic work in a hazardous fieldwork setting that presents psychological and physical dangers to both participants and researchers, including threats of violence, and researcher burnout.

Objective: To establish whether poor parental supervision is associated with head injury and self-reported reactive aggression (ie, aggression in response to perceived provocation or threat) in adolescents in a Young Offender's Institute, by examining correlations between these variables. Understanding this population is important, as they are at a key pivotal age for intervention to prevent lifelong reoffending. Methods: Ninety-six male participants aged 16 to 18 years were recruited from a UK Young Offender's Institute. Self-report measures of remembered parenting, reactive aggression, and head injury history were administered during individual interviews. Results: Seventy-four percent of participants reported having experienced a lifetime traumatic brain injury (TBI), and 46% of participants reported experiencing at least 1 TBI leading to a loss of consciousness (LOC). We found that poor parental supervision, length of LOC following TBI, and self-reported reactive aggression were all positively correlated. Conclusions: Findings show that there are correlational relationships between poor parental supervision, length of LOC following lifetime TBI, and higher levels of self-reported reactive aggression. This suggests there may be pathways resulting from poor parental supervision leading to both TBI with LOC, and reactive aggression. We advocate for future research with longitudinal designs and larger samples to examine the nature of these interactions, and to establish whether poor parental supervision is a prospective risk factor for more TBIs leading to LOC, and reactive aggression. This is key to understanding whether parenting interventions could help to reduce the disabling effects of TBI in adolescents, and help to prevent contact with the law.

Abstract Purpose: Paediatric traumatic brain injury (TBI) can have resultant ongoing significant impairments which can impact life outcomes. The primary aim of this research was to explore whether TBI contributes to the relationship between poor educational outcomes and offending trajectories. Materials and methods: Through analysis of a dataset consisting of self-reported health, educational, and offending histories of 70 incarcerated young males, structural equation modelling was used to explore the mediation of educational outcomes and patterns in offending behaviour by chronic symptoms following TBI. Results: Symptoms related to TBI significantly mediated the relationship between decreased educational attainment and more frequent convictions. It did not mediate any relationships involving age at first conviction. Conclusions: Traumatic brain injury appears to have more influence over frequency of offending patterns than age at first conviction. However, TBI remains a pervasive factor in both higher rates of offending and poorer educational attainment. In order to tackle this effect on adverse social outcomes, greater attention to the impact of TBI is required in education and criminal justice systems. IMPLICATIONS FOR REHABILITATION Highlights traumatic brain injury as a contributory factor in some education to offending pathways, suggesting that greater focus on rehabilitation within the education and criminal justice systems is required. Reinforces that greater understanding of educational pathways post-injury is needed to better facilitate rehabilitation within the school system.

1 Murdoch Children’s Research Institute, Melbourne, Australia; 2 Department of Sociological Studies, University of Sheffield, Sheffield, UK; 3 Department of Social Policy, Sociology and Criminology, University of Birmingham, Birmingham, UK; 4 Department of Psychology, University of Exeter, Exeter, UK; 5 Carmarthen Community Team for Learning Disabilities, Hywel Dda University Health Board, Carmarthen, UK.

The internet is a potentially promising medium for delivering weight loss interventions. The current study sought to explore factors that might influence primary care patients’ initial uptake and continued use (up to four-weeks) of such programmes to help inform the development of novel, or refinement of existing, weight management interventions.

Multiple sclerosis (MS) is typically associated with life-long adjustment to wide-ranging, changeable symptoms and psychosocial disruption as all relationships are changed or lost. Despite accumulating evidence, the therapeutic impact of harnessing social group factors in MS management and rehabilitation remains largely unexplored. We investigated their role specific to adjusting to MS. A qualitative approach was used with thematic analysis to induce a rich and developing account of the impact of social groups on adjustment for 15 individuals with MS. An adjustment questionnaire was used to provide a framework for its organisation and discussion. The analysis revealed three themes associated with loss, change and social processes that influenced adjustment. These features distinguished between those who were more or less able to adjust, and resonated well with processes previously identified as central to identity loss and change. Social factors enhanced adjustment through easing transition between pre- and post-MS diagnosis lives. Notably, maintenance of pre-existing social roles and relationships was critical in providing a meaningful basis for integrating the old with new senses of self. The capacity to join new social groups was as key in adjustment as was awareness of having access to multiple social groups to avoid being solely defined by MS. These concepts provided a more stable grounding upon which to nurture value systems and employ collective support to counter the negative consequences of living with MS.

ABSTRACTThis article presents an analysis of long-term care-workers' work motivation that examines the way this is shaped by the social contexts in which they operate. We conducted a thematic analysis of 19 in-depth interviews with care-workers. Three core themes were identified as underpinning their motivation: those of ‘fulfilment’, ‘belonging’ and ‘valuing’, and together these contributed to a central theme of ‘pride’. We also found an overarching theme of ‘shared experience’ to be integral to the way in which care-workers made sense of their motivation and work experience. We draw on the social identity approach to provide a conceptual framework through which to understand how this shared experience shapes care-workers' motivation and the quality of care they deliver. In particular, we note the importance that care-workers' attach to their relationships with clients/patients and highlight the way in which this relational identification shapes their collective identification with their occupation and organisation and, through this, their motivation.

BACKGROUND:Cognitive behavioral therapy-based alcohol treatment programs have been widely used to break the link between alcohol and crime. While evidence exists on the connection between alcohol and crime, there is little data that demonstrate the effectiveness of different alcohol treatment programs in reducing criminal behavior. We tested whether male offenders who participate in alcohol treatment programs show lower rates of recidivism than a matched offender group who did not participate in an alcohol prevention program.METHODS:This is an observational matched case-control study. Participants were 564 male offenders with an alcohol problem related to offending. Participants were assigned by the courts to 1 of 3 alcohol treatment programs (141 offenders per treatment): Low Intensity Alcohol Program (LIAP), Alcohol Specified Activity Requirement, and Addressing Substance-Related Offending. A fourth matched group (n = 141) was not assigned to a program and served as a control group. Survival analysis was used to calculate participants' charged and reconviction rates over 4 time periods (0 to 3, 4 to 6, 7 to 9, and 10 to 12 months after completion of program or order).RESULTS:Offenders who did not participate in a program were more than twice as likely to be charged compared to offenders who participated in a program. Furthermore, offenders who did not participate in a program were over 2.5 times more likely to be reconvicted. Among the 3 alcohol treatment programs evaluated, the LIAP was the most cost-effective.CONCLUSIONS:Offenders enrolled in an alcohol treatment program showed a significant reduction in being charged with or reconvicted of a crime. With costs of keeping offenders in prison per year reaching close to £40,000 per offender per year (Mulheirn et al., 2010, www.smf.co.uk), assigning offenders to alcohol preventive programs-such as LIAP-are a promising way to reduce recidivism and reduce cost.

Background. Research on eHealth applications is growing fast, but little is known about people’s experiences with internet-based weight loss interventions. The current study explored experiences with these interventions to provide a better understanding of the facilitators and barriers to adherence. Method. Semi-structured recorded interviews were conducted with 20 primary care patients who were offered lifestyle advice and access to three free internet-based weight loss programmes. The interviews focused on experiences with the interventions during a 4-week period. Transcripts were analysed by two separate coders using Thematic Analysis. Findings. The accessibility and novelty of using the internet for weight loss was the initial motivation of engagement. Barriers to adherence included time, effort and excessive reminders. Ongoing engagement was facilitated by face to face contact and perceived success of changes. Discussion. This study identified facilitators and barriers to adherence that can inform the development of new eHealth behaviour change interventions and highlights the potential for use of eHealth alongside weight management advice within primary care settings.

PurposeThe present research aims to investigate parental attitudes towards using either cloth or disposable nappies, to better understand whether and how pro‐cloth initiatives might impact parental decisions.Design/methodology/approachFocus groups were conducted with both cloth and disposable nappy users to gain a better understanding of the factors that underlie their choice. Interviews were analyzed using thematic analysis.FindingsThe paper finds that parents using disposable nappies believed they were marketed as offering a popular, efficient, healthy, good value system. They acknowledged the environmental impact but rationalised this by referring to the equivocal nature of these consequences, and the ability to off‐set this by engaging in other pro‐environment behaviours. Parents choosing cloth nappies did so initially because they were more environment‐friendly and cost‐effective and disposables were disliked. Once using cloth, parents noted additional benefits: performance, fashion, formation of bonds with other users, and getting a buzz out of using them. This reinforced their reasons for continued use.Practical implicationsCloth nappies are unlikely to gain mass appeal, but findings suggest a bigger take up if parents are better informed, and subsidies are provided to reduce set‐up and laundering costs to tackle the “ease of use” barrier. The positive aspects of cloth nappies should be better promoted.Social implicationsMarketing initiatives need to buy into the current “designer parents” trend and play to the aspirational, fashionable aspects of cloth nappies.Originality/valueThis paper, the first to report on parental attitudes and decisions regarding both nappy types, could inform public policy and marketing decisions.

In contrast to everyday use of the term discrimination, we propose that discrimination can be appraised as either illegitimate or legitimate, and a comprehensive analysis of responses to discrimination needs to account for both ways of experiencing discrimination. We examine how perceived pervasiveness of discrimination and legitimacy appraisals affect group commitment among women in academia (Study 1) and tobacco smokers facing an upcoming smoking ban (Study 2). We found support for our hypothesis that legitimacy of discrimination appraisals moderates the effect of pervasiveness of discrimination. In both studies, group identification and collective action intentions were undermined most when the ingroup claimed that discrimination against them was legitimate and discrimination was perceived as pervasive. In both studies, group identification mediated the effects on collective action intentions. The results highlight the important role of legitimacy appraisals in understanding disadvantaged group members' responses to discriminatory treatment. Copyright (C) 2010 John Wiley & Sons, Ltd.

Questionnaire research was carried out to identify factors that may encourage problem debtors to take the first steps towards getting out of debt. Consumers with debt problems were identified with the aid of creditor organisations and Her Majesty’s Court Service for England and Wales. Responses were also sought from non-debtors from the same consumer groups as the debtors. Response rates from debtors were very low, but results confirmed the existence of a group of chronically poor consumers with widespread and long-lasting debt and also confirmed the demographic differences between this group of debtors and non-debtors found in previous research. These debtors showed marked attitudinal differences from non-debtors, with reduced optimism and financial self-esteem, and a less internal economic locus of control. They also showed a distinct social identity, identifying with fellow debtors and feeling stigmatised both generally and personally. Within the debtor group, engagement with creditors was higher in people reporting lower debt levels, but seeking advice was more frequent in those reporting higher debts. Engagement was associated with a stronger attitude of financial self-efficacy and with a perception of the debtor identity as more permeable. Neither demographic nor psychological factors significantly predicted which debtors would seek advice.

BACKGROUND Sickness certification poses challenges and problems for the GP. Patient factors may influence the sick leave period. OBJECTIVE To explore how sickness certification occurred based on patients' reports of medical consultations for a new episode of low back pain. METHODS A qualitative study using semi-structured interviews with 16 employees who were currently or had recently been off work with an episode of low back pain. RESULTS We present a preliminary typology of sickness certification responses by medical practitioners comprising four response types: 'process', 'cued', 'consultative' and 'laissez-faire'. All but the process response allows the patient some influence in the sickness certification decision. It is possible that certain types of response may occur at specific stages of recovery. CONCLUSIONS Doctors may allow patients input into the sickness certification process for a number of reasons. As yet, we do not know if this helps or hinders the return to work process.

Background: TBI can lead to cognitive, behavioural and emotional difficulties. Previous studies suggest that TBI is relatively elevated in offender populations. In this study the aims were to establish the rate of TBI of various severities in a representative sample of adult offenders and patterns of custody associated with TBI. Methods: A self-report survey of adult, male offenders within a prison. Of 453 offenders, 196 (43%) responded. Results: Over 60% reported ‘Head Injuries’. Reports consistent with TBI of various severities were given by 65%. Of the overall sample, 16% had experienced moderate-to-severe TBI and 48% mild TBI. Adults with TBI were younger at entry into custodial systems and reported higher rates of repeat offending. They also reported greater time, in the past 5 years, spent in prison. Conclusions: These findings indicate that there is a need to account for TBI in the assessment and management of offenders.

Adolescence is a risk period for offending and for traumatic brain injury (TBI) and TBI is a risk factor for poor mental health and for offending. TBI has been largely neglected from guidance on managing the mental health needs of young offenders. We sought to determine the rate of self-reported TBI, of various severities, in a male, adolescent youth offending population. We also aimed to explore whether TBI was associated with number of convictions, violent offending, mental health problems and drug misuse. Young male offenders aged 11 to 19 years were recruited from a Young Offender Institute, a Youth Offending Team and a special needs school. A total of 197 participants were approached and 186 (94.4%) completed the study. They completed self-reports on TBI, crime history, mental health and drug use. TBI with loss of consciousness (LOC) was reported by 46% of the sample. LOC consistent with mild TBI was reported by 29.6%, and 16.6% reported LOC consistent with moderate to severe TBI. Possible TBI was reported by a further 19.1%. Repeat injury was common - with 32% reporting more than one LOC. Frequency of self-reported TBI was associated with more convictions. Three or more self-reported TBIs were associated with greater violence in offences. Those with self-reported TBI were also at risk of greater mental health problems and of misuse of cannabis. TBI may be associated with offending behaviour and worse mental health outcomes. Addressing TBI within adolescent offenders with neurorehabilitative input may be important for improving well-being and reducing re-offending.