Experiences of Nursing Professionals Working With Women Diagnosed With Opioid Use Disorder and Their Newborns: Burnout and the Need for Support.

BACKGROUND: As the rate of opioid use in pregnancy escalates, there are a growing number of women diagnosed with opioid use disorder (OUD) and their newborns being cared for in inpatient settings. PURPOSE: In this study, we sought to better understand the experiences of nurses and nursing assistants working with women diagnosed with OUD and their newborns. By identifying the needs of nurses and nursing assistants, the findings from this study may contribute to reductions in stigma and improved patient care. METHODS: Nurses and nursing assistants were recruited from a postpartum unit at a large urban hospital in Utah. Participants (n = 30) attended up to 4 semistructured focus groups. We utilized Braun and Clarke's 6-phase approach to thematic analysis to analyze transcribed interviews. FINDINGS/RESULTS: Themes identified during the data analysis process included negative feelings and reactions toward patients; preferential concern for the newborn over maternal well-being; and identification of organizational and training needs to overcome these challenges. IMPLICATIONS FOR PRACTICE: These findings identify strategies for addressing challenges faced by nurses and nursing assistants in caring for women diagnosed with OUD and their newborns. IMPLICATIONS FOR RESEARCH: Future research should examine the effectiveness of approaches to reduce behaviors influenced by stigma among nurses and nursing assistants working with women diagnosed with OUD and their newborns, as well as employee and patient satisfaction, and long-term health outcomes.

"A condom is compulsory": A qualitative study of condom use and negotiation strategies among female sex workers in Nepal.

The objective of this qualitative study was to understand Nepali female sex workers' (FSWs) condom negotiation strategies. In 2016, we conducted 30 semi-structured, in-depth interviews with street- and brothel-based FSWs residing in Kathmandu, Nepal. Participants reported that their first entry into sex work typically occurred between the ages of 17-32, and the average duration of women's involvement with sex work was 8 years. FSWs reported high knowledge and awareness of condoms, and many women had used various sexual and reproductive health services. FSWs used three types of negotiation strategies: withholding or refusing sex, providing risk information, and direct request. While some FSWs believed that these strategies were useful and successful, we found that, for some women, condom negotiation strategies were difficult to implement due to fear of abuse and threats of violence by clients. Condom negotiation was further complicated by poverty and substance abuse, and several narratives revealed the influence of gender and social norms on safe sexual practices. The findings highlight the need for improved sexual health interventions that incorporate a range of negotiation strategies and techniques (e.g., nonverbal communication and reward strategies) and aim to mitigate harm and violence against FSWs.

"We want to offer you peace of mind": Marketing of transnational commercial surrogacy services to intended parents.

The purpose of this research study was to conduct a content analysis of commercial surrogacy websites to explore how surrogacy is marketed to intended parents. The researchers developed a template to code website data, and a total of 345 website pages were reviewed. Websites depicted surrogacy as a solution to a problem, privileged genetic parenthood, ignored the potential for exploitation, dismissed surrogates' capacity to bond with the fetuses they carry, emphasized that surrogacy arrangements are mutually beneficial, ignored structural inequalities, and depicted surrogates as conforming to strict gender roles. These framings introduce vulnerabilities to both intended parents and surrogate mothers.

'Total girlfriend experience': examining marketplace mythologies on sex tourism websites.

The purpose of this study was to conduct a systematic content analysis of sex tour websites to understand how sex tours are marketed to potential clients. A total of 380 web pages from 21 sex tour websites were reviewed. The sex tour websites sought to promote privacy and hassle-free travel with a local 'escort' and the opportunity for 'hooks-ups' with no strings attached. Three themes emerged around the description of sex workers: (1) enjoyment and complete acceptance, (2) a 'total girlfriend experience' and (3) exoticisation of the 'Third World' woman. The majority of the sex tourism websites used marketplace mythologies concerning racism, sexism and imperialism to appeal to sex tourists' desires for fantasy experiences, power and domination, and a renewed sense of identity. Legal and STI-related information was largely missing from the websites, and when it was included it was aimed at protecting sex tourists, not sex workers. It is of importance for researchers, social workers and others engaging with sex workers and sexscapes to recognise the power of language, cultural myths and framings and their ability to generate real-world social and health implications.

(De)criminalization of Survivors of Domestic Minor Sex Trafficking: A Social Work Call to Action.

Survivors of domestic minor sex trafficking (DMST) are failing to be identified and are frequently criminalized. Examining the linkages between DMST and the juvenile legal system is important, as many trafficked youths are only identified after entry into the child welfare or juvenile court system as a result of being arrested or detained on related delinquency charges. Due to legacies of structural violence, marginalized youths are reluctant to approach police officers for help. Therefore, social workers have an opportunity to identify, intervene, and advocate for trafficked youths. In this article, the author provides an overview of existing research related to the demographic profile of DMST, homelessness and survival sex, recruitment and entry, barriers to effective community response, and prevention and intervention strategies. This article represents a call to broaden our view of young people in the sex trade and supports the decriminalization of trafficked youths. Interventions and policies must be designed to fit their complex needs and experiences, resulting in empowerment, opportunity, and new beginnings.

Motherhood and assisted reproduction in a religious context: Genes, stigma and supports in Utah, United States.

Six percent of cisgender (i.e. not transgender) women aged 15-44 are considered infertile in the United States, and 12% are unable to carry a pregnancy to term. For those who yearn to create a family despite these circumstances, assisted reproductive technology (ART) is an often-utilised resource. Though faith-based institutions have been referenced as a source of support for involuntarily childless adults, it is unclear how religious doctrine, especially that which prizes 'traditional' gender roles and genetic parenthood, may be a catalyst for distress. More research is needed to understand how the socio-cultural environment affects those who are unable to conceive without assistance. Therefore, the purpose of this research study was to understand the lived experiences of women who have utilised assisted reproduction in a particularly pronatalist, religious cultural context in the United States. From March to September 2017, in-depth interviews were conducted with 10 cisgender women who had utilised ART. Data analysis was conducted in NVivo 10 and consisted of line-by-line analysis, identifying themes, coding categories and developing matrices to uncover relationships between themes and categories. The quest for motherhood was truly a journey for the study participants who experienced rumination and self-blame due to their inability to become pregnant. This was rooted in their socio-cultural context. Thus, the study findings suggest that culture and stigma are linked with women's distress regarding their inability to become pregnant and results in distancing from other women. Genetic parenthood was prized initially, but this desire decreased over time. While past research suggests that infertility strains relationships, our study found that the turmoil of infertility and assisted reproduction actually strengthened couple relationships. Counselling was described as particularly helpful, but it is needed throughout the assisted reproduction process. The inclusion of religion and spirituality, for those who identify as such, in counselling would be beneficial.

Unlocking the Door to Safety and Stability: Housing Barriers for Survivors of Intimate Partner Violence.

Housing has been identified as critical for survivors of intimate partner violence (IPV) to achieve long-term stability, but both individual- and system-level barriers hinder its obtainment. The purpose of this research study was to assess the challenges to service access and service delivery for survivors in Utah. In-depth, semistructured interviews and focus groups were conducted with 102 participants, including 43 survivors and 59 service providers. Data analysis consisted of line-by-line coding, identifying themes, coding categories, and developing matrices to uncover relationships between themes and categories. Overwhelmingly, participants communicated an immense need for emergency shelter upon exit from an abusive relationship, yet reported limited shelter space. Service providers reported that scarce funding coupled with grantor-imposed expectations impede their ability to serve all survivors in need. When turned away from shelter, survivors resorted to staying in a motel, car, homeless shelter, or even returning to the perpetrator. Barriers to obtaining permanent housing included unaffordability, landlord discrimination, and insufficient documentation. Indigenous and immigrant survivors encountered amplified barriers to housing stability. Despite the prominence of Housing First in Utah, survivors were unable to access much needed housing resources. Housing First programs can and should be tailored to meet the unique housing needs of survivors of IPV. Therefore, Housing First eligibility requirements should be adjusted, and a specific number of placements should be reserved for survivors and their children. IPV-related trauma must be understood as multifaceted, and services for survivors should simultaneously target this trauma while meeting basic needs. Future research should examine interventions such as rapid rehousing and permanent supportive housing on survivors' safety and stability in the long-term.

Substance Use as a Coping Mechanism for Survivors of Intimate Partner Violence: Implications for Safety and Service Accessibility.

This study examined substance use disorder (SUD) and mental health (MH) among survivors of intimate partner violence, with data collected from 102 participants. Both survivors and service providers emphasized SUD and MH as top priorities and reported a high prevalence of post-traumatic stress disorder (PTSD), depression, anxiety, and low self-esteem coupled with increasing rates of heroin, methamphetamine, and pharmaceutical abuse. Emergent themes included (a) trauma impacts functioning, (b) substances as coping strategy, (c) weighing safety against need, (d) lacking SUD and MH services, and (e) need for comprehensive and culturally specific resources. Scarcity of funding demands cross-sector collaboration to support survivors.

Client-Perpetrated Violence Toward Female Sex Workers in Kathmandu.

This qualitative study explores the experiences of client-perpetrated violence toward female sex workers in Kathmandu, Nepal. Individual interviews were conducted with 30 female sex workers. Data were analyzed using qualitative coding methods and thematic development. Two main themes emerged. Contexts in which client-perpetrated violence corresponded with (a) conditions associated with exchange of services, and (b) alcohol use. The first theme involved five factors: negotiating condom use, number of clients, requesting payment, length of service time, and negotiating sex acts. Alcohol use by clients and/or sex workers exacerbated violence. Implications for practice and research are discussed.

Exploring the relationship between domestic minor sex trafficking myths, victim identification, and service provision.

BACKGROUND: The onus of sex trafficking victim identification currently falls to professionals in youth-serving organizations. Accurate identification of domestic minor sex trafficking victims (DMST) and subsequent delivery of services can be impeded by common myths related to human trafficking. OBJECTIVE: Determine if human service professionals understand the difference between myths and facts pertaining to sex trafficking and if their knowledge affects subsequent service provision. PARTICIPANTS AND SETTING: Professionals (n = 69) represented youth-serving organizations from a large metropolitan city in the Southwestern United States. METHODS: Data was collected in a cross-sectional survey from March 2016 to April 2016. RESULTS: A minority of professionals working in youth-serving organizations believed DMST myths, though administrators most commonly believed the myth that force, fraud, or coercion are required in DMST. Most professionals could not provide an accurate number of victims identified and felt their organizations would benefit from further training. A statistically significant relationship (p < .05) was observed between the belief that "elements of physical force, restraint, bondage, and/or violence" must be present in DMST and participants' ability to identify victims served by their organizations in a given year. Organizations reported that they failed to provide services requested by DMST victims. CONCLUSIONS: The persistence of DMST myths likely hampers victim identification and tailored service delivery. Cross-sector collaborations are needed to ensure victims' needs are met. Trainings are needed that cover the legal definitions of domestic minor sex trafficking and victim identification and train on accurate identifiers. Training initiatives should include survivors to ensure practices are trauma-informed.

Commissioning Parents' Experiences with International Surrogacy: A Qualitative Study.

The purpose of this qualitative study was to explore the experiences of commissioning parents (CPs) who travel abroad for surrogacy, paying attention to motivations, processes, and sources of social support. The authors recruited 10 CPs and used semistructured, in-depth interviews to illicit storytelling. Data analysis revealed primary themes around CPs' experiences pre-surrogacy, during surrogacy, and post-surrogacy. International surrogacy was described as a long and arduous journey only undertaken after multiple failed attempts at "natural" conception. Prior to traveling abroad, CPs engaged in trade-off decision making, weighing their reproductive assistance options. CPs were primarily motivated to undertake international surrogacy by health complications and legal restrictions in their home country. CPs emphasized strenuous relationships in both the destination country and at home, and they worried about disclosure to family, friends, and children. The mental health and social needs of CPs were neglected throughout and should be incorporated in future interventions to address stigmatization.

Exploring Motivations, Awareness of Side Effects, and Attitudes among Potential Egg Donors.

This research study surveyed prospective egg donors at orientation to (a) understand women's motivations to donate eggs, (b) assess awareness and knowledge of egg donation prior to entry into the egg donation program, and (c) explore attitudes toward egg donation. Ninety-two women completed the questionnaire at one fertility clinic located in the Midwest between August 2011 and August 2012. Descriptive and inferential statistics as well as textual analysis were used to analyze the data. Three themes emerged regarding participant motivations: (1) altruistic, (2) financial, and (3) desire to pass on genetic material. The majority of participants were unconcerned with potential physical and psychological side effects; however, differences emerged based on motherhood status and educational level. Although potential donors felt recipients should receive some information about the donor, they tended to value privacy regarding information giving to resultant offspring. This research study has implications for social work practice, policy, and future research. It is crucial that women receive adequate procedural and side effect information prior to engaging in egg donation.