Bodies of concern? A qualitative exploration of eating, moving and embodiment in young mothers.

In some countries, including the United Kingdom, young mothers' pregnant and postnatal bodies remain an area of concern for policy and practice, with interventions developed to support improved health behaviours including diet and physical activity. This article explores what young women themselves think and feel about eating and moving during and after pregnancy. Semi-structured interviews with 11 young mothers were conducted within two voluntary organisations. Data were analysed using thematic analysis with the theoretical lens of embodiment, which provided an understanding of how young women's eating and moving habits related to how they felt about their bodies in the world. Four themes situated in different experiences of being and having a body were identified: pregnant body, emotional body, social body and surveilled body. Stress and low mood impacted eating habits as young women responded to complex circumstances and perceived judgement about their lives. Food choices were influenced by financial constraints and shaped by the spaces and places in which young women lived. Whilst young women were busy moving in their day-to-day lives, they rarely had the resources to take part in other physical activity. Holistic approaches that focus on how women feel about their lives and bodies and ask them where they need support are required from professionals. Interventions that address the structural influences on poor diet and inequalities in physical activity participation are necessary to underpin this. Approaches that over-focus on the achievement of individual health behaviours may fail to improve long-term health and risk reinforcing young women's disadvantage.

'You likes your way, we got our own way': Gypsies and Travellers' views on infant feeding and health professional support.

BACKGROUND: Gypsies and Travellers are known to have poor health status and access to health services, even in comparison with other ethnic minority groups. People from this stigmatized ethnic group are rarely consulted about their health needs or health service provision. Optimal infant feeding in the first year of life has the potential to improve lifelong health. OBJECTIVE: The aim of this study was to explore mothers and grandmothers' views on feeding in the first year of life, including the support provided by health professionals. METHODS: Semi-structured interviews were conducted with a purposively selected sample of 22 mothers and grandmothers of English Gypsy, Irish Traveller and Romanian Roma ethnicity between November 2011 and February 2012 in a city in south-west England. RESULTS: Few women perceived themselves as requiring help from health professionals in infant feeding, as acceptable and accessible support was available from within their own communities. Roma mothers described a tradition of breast-feeding and appropriately timed weaning, while English Gypsies and Irish Travellers customarily practised less healthy infant feeding. When mothers requested support, health service provision was often found inadequate. CONCLUSION: Exploring the views of Gypsies and Travellers is important to gain insight into the provision of health services for this marginalized ethnic group. This study has implications for policy and the practice of health professionals, in indicating the customary feeding behaviours of some Gypsy and Travellers, and highlighting areas meriting culturally sensitive health promotion.

An evaluation of the effectiveness of an educational programme promoting the introduction of routine antenatal enquiry for domestic violence.

OBJECTIVE: a feasibility study to evaluate the effect of an educational programme on midwives' knowledge, skills, attitudes and implementation of routine antenatal enquiry for domestic violence. DESIGN: pre-, post- and follow-up survey. SETTING: an acute Trust within the South West of England. PARTICIPANTS: 79 of the 82 community midwives (96%) working in the Trust participated in the training programme, with 70 (85%) participating at all three stages of the research. MEASUREMENTS: participating community midwives completed a 38-item questionnaire at three points during the study: before the educational programme to provide base-line data, post-test immediately after the programme, and at 6 months follow-up. The questionnaire was divided into the following categories: views of professional education, knowledge of domestic violence, attitudes to domestic violence, efficacy beliefs and issues of practice development. The aim of the study was to identify any differences between pre- and post-implementation test data in relation to all the areas identified. Repeated multivariate analysis of variance was used to examine changes between pre-, post- and follow-up measures of knowledge, attitudes and efficacy. Hierarchical regression was used to identify potential influences on post-training disclosure rates using pre-, post- and follow-up measures as predictors. FINDINGS: the programme was positively received by participants, particularly in relation to an increased awareness and confidence in dealing with domestic violence. It was also associated with improvements in knowledge, attitudes and efficacy at post-test. These changes declined but remained above pre-test levels at 6 months follow-up. Levels of current and previous experiences of abuse obtained by midwives were predicted by past experience of dealing with the issue and efficacy scores immediately after and at 6 months after programme delivery. Rates of enquiry after programme introduction were lower than anticipated, with midwives routinely asking only 50% of the time. However, the key barrier identified was the presence of a male partner. IMPLICATIONS FOR PRACTICE: the effect of routine enquiry for domestic violence on midwifery role development needs further exploration before universal introduction. Seeing women alone at least once during a pregnancy would clearly increase opportunities for directly asking about violence and allowing safe disclosure. Where enquiry is introduced, midwives should be given access to validated educational programmes and structured ongoing support if enquiry is to be sustained over time. Although further evaluations are necessary, it may be advisable to focus on skills-based programmes that increase midwives' confidence and prioritise support and safety aspects for midwives and women during enquiry about domestic violence.

A study exploring drug use and management of patients presenting to an inner city emergency department.

Patients who present to an emergency department (ED) with a problem related to illegal drug use can be difficult to identify and are perceived to generate a significant workload for staff. This study suggests that illicit drug use may be more common than previously reported and also that the impact on the ED is perceived by staff to be disproportionately high compared with the actual numbers of patients presenting with complaints related to illicit drug use. We conclude that the over estimation by staff is directly related to the challenges that staff working within the ED setting believe this group of patients pose.