ORCID Profile
0000-0002-7893-6998
Current Organisation
University of Adelaide
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Publisher: SAGE Publications
Date: 22-02-2022
DOI: 10.1177/19322968221079867
Abstract: The Environmental Determinants of Islet Autoimmunity (ENDIA) study is an Australia-wide pregnancy-birth cohort study following children who have a first-degree relative with type 1 diabetes (ACTRN1261300794707). A dedicated ENDIA Facebook page was established in 2013 with the aim of enhancing recruitment and supporting participant retention through dissemination of study information. To measure the impact of Facebook, we evaluated the sources of referral to the study, cohort demographics, and withdrawal rates. We also investigated whether engagement with Facebook content was associated with specific post themes. Characteristics of Facebook versus conventional recruits were compared using linear, logistic, and multinomial logistic regression models. Logistic regression was used to determine the risk of study withdrawal. Data pertaining to 794 Facebook posts over 7.5 years were included in the analysis. Facebook was the third largest source of referral (300/1511 19.9%). Facebook recruits were more frequently Australian-born ( P .001) enrolling postnatally ( P = .01) and withdrew from the study at a significantly lower rate compared with conventional recruits (4.7% vs 12.3% P .001) after a median of follow-up of 3.3 years. Facebook content featuring stories and images of participants received the highest engagement even though % of the 2337 Facebook followers were enrolled in the study. Facebook was a valuable recruitment tool for ENDIA. Compared with conventional recruits, Facebook recruits were three times less likely to withdraw during long-term follow-up and had different sociodemographic characteristics. Facebook content featuring participants was the most engaging. These findings inform social media strategies for future cohort and type 1 diabetes studies. Australia New Zealand Clinical Trials Registry: ACTRN1261300794707.
Publisher: Elsevier BV
Date: 09-2009
DOI: 10.1016/J.JPSYCHORES.2009.01.004
Abstract: The study aimed (a) to test a method of identifying patients who have been repeatedly referred (RR) from primary care to medical outpatient clinics where they have received multiple diagnoses of medically unexplained symptoms (MUS) and (b) to describe the prevalence and characteristics of these patients. RR patients with MUS (RRMUS) were arbitrarily defined as those with (a) five or more referrals in a 5-year period and (b) a specialist final diagnosis of MUS for at least three of these referrals. A two-stage method of identifying these patients was piloted in one primary care practice: Stage 1 used computerized health service data to identify RR Stage 2 used manual case note review to identify referrals that ended with specialist diagnoses of MUS. The RRMUS patients identified were asked to complete a questionnaire, a psychiatric diagnostic interview, and their GPs were asked to rate how "difficult to manage" they were. The process was feasible and reasonably accurate. From 6770 registered patients aged 18 to 65 years, 23 (0.3%) were identified as RRMUS. They accounted for 157 referrals over the 5-year period. Sixteen agreed to further assessment, and 8 (50%) had a current anxiety or depressive disorder. GPs rated only 8 (50%) as "difficult to manage." This two-stage procedure offers a practical method of identifying RRMUS patients in primary care as a first step in achieving more cost-effective care. These patients have substantial psychiatric morbidity.
Publisher: Hindawi Limited
Date: 20-04-2020
Publisher: Oxford University Press (OUP)
Date: 02-08-2010
Abstract: Patients with medically unexplained symptoms (MUS) are commonly referred to specialist clinics. Repeated referrals suggest unmet patient need and inefficient use of resources. How often does this happen, who are the patients and how are they referred? The design of the study is a case-control survey. The setting of the study is five general practices in Scotland, UK. The cases were 193 adults with three or more referrals over 5 years, at least two of which resulted in a diagnosis of MUS. The controls were (i) patients referred only once over 5 years and (ii) patients with three or more referrals with symptoms always diagnosed as medically explained. The measures of the study are SF-12 physical and mental component summaries symptom count and number of referrals, number of different GPs who had referred and number of specialist follow-up appointments. A total of 1.1% [95% confidence interval (CI) 1.0-1.2%] of patients had repeated (median 3, range 2-6) referrals with MUS. Compared to infrequently referred controls, they were older and more likely to be female, living alone and unemployed. Compared to controls with medically explained symptoms, their health status was comparable or worse: odds ratio for SF-12 physical component summary<40, 1.2 (95% CI 0.72-2.0) SF-12 mental component summary<40, 1.8 (95% CI 1.1-3.0) reporting eight or more physical symptoms, 2.2 (95% CI 1.2-3.8). They were referred by more GPs and received less specialist follow-up. A small proportion of primary care patients are repeatedly referred to specialist clinics where they receive multiple diagnoses of MUS. The needs of these patients and how they are managed merits greater attention.
Publisher: Informa UK Limited
Date: 12-04-2023
Publisher: Informa UK Limited
Date: 19-06-2014
Publisher: Cambridge University Press (CUP)
Date: 19-05-2010
DOI: 10.1017/S0033291710001017
Abstract: One third of referrals from primary to secondary care are for medically unexplained symptoms (MUS). We aimed to determine the association of depression and anxiety disorders with high use of specialist services by patients with MUS. We did this by comparing their prevalence in patients who had been repeatedly referred with symptoms for which they had received repeated specialist diagnoses of MUS with that in two control groups. We also determined the adequacy of treatment received. A case-control study in five general practices in Edinburgh, UK. Data collection was by case note review and questionnaire. Cases were 193 adults with three or more referrals over 5 years, at least two of which resulted in a diagnosis of MUS. Controls were: ( a ) patients referred only once over 5 years ( n =152) ( b ) patients with three or more referrals for symptoms always diagnosed as medically explained ( n =162). In total, 93 (48%) of the cases met our criteria for current depression, anxiety or panic disorders. This compared with 38 (25%) and 52 (35.2%) of the control groups odds ratios (95% confidence intervals) of 2.6 (1.6–4.1) and 1.6 (1.01–2.4), respectively. Almost half (44%) of the cases with current depression or anxiety had not received recent minimum effective therapy. Depression, anxiety and panic disorders are common in patients repeatedly referred to hospital with MUS. Improving the recognition and treatment of these disorders in these patients has the potential to provide better, more appropriate and more cost-effective medical care.
Publisher: Springer Science and Business Media LLC
Date: 02-10-2011
Publisher: Springer Science and Business Media LLC
Date: 22-04-2015
Publisher: MDPI AG
Date: 29-03-2023
Abstract: Background: We sought research experiences of caregivers and their children were enrolled in the Environmental Determinants of Islet Autoimmunity (ENDIA) study. Methods: ENDIA is a pregnancy–birth cohort investigating early-life causes of type 1 diabetes (T1D). Surveys were sent to 1090 families between June 2021 and March 2022 with a median participation of years. Caregivers completed a 12-item survey. Children ≥ 3 years completed a four-item survey. Results: The surveys were completed by 550/1090 families (50.5%) and 324/847 children (38.3%). The research experience was rated as either “excellent” or “good” by 95% of caregivers, and 81% of children were either “ok”, “happy” or “very happy”. The caregivers were motivated by contributing to research and monitoring their children for T1D. Relationships with the research staff influenced the experience. The children most liked virtual reality headsets, toys, and “helping”. Blood tests were least liked by the children and were the foremost reason that 23.4% of the caregivers considered withdrawing. The children valued gifts more than their caregivers. Only 5.9% of responses indicated dissatisfaction with some aspects of the protocol. The self-collection of s les in regional areas, or during the COVID-19 pandemic restrictions, were accepted. Conclusions: This evaluation identified modifiable protocol elements and was conducted to further improve satisfaction. What was important to the children was distinct from their caregivers.
Publisher: Hindawi Limited
Date: 04-05-2015
DOI: 10.1111/HSC.12249
Abstract: Parenting and family support are key prevention and intervention strategies for improving outcomes for children and families affected by parental drug misuse. However, little is known about the delivery of parenting support for drug-dependent parents, particularly within universal healthcare services. This study aimed to explore the way healthcare practitioners engage with this challenging agenda. Four multidisciplinary focus groups involving a purposive s le of 18 experienced healthcare professionals were conducted in Scotland. Participants included general practitioners, midwives, public health nurses and addiction staff who work together to provide care for vulnerable families. A focus group topic guide was developed to explore the views and experiences of these healthcare professionals in relation to providing parenting support for drug-using parents, predominantly those receiving opioid substitution therapy. Data were analysed using a constant comparison method and thematic approach. The overarching narrative which united the focus group discussions was about the 'burden of care' that these families pose for frontline healthcare professionals. Recurring themes centred on three key issues: the problematic nature of drug-using parents themselves clinical challenges in living up to the ideals of professional practice and the wider context in which current practice is governed. Professionals expressed ambivalence over their parenting support role anxiety over responsibility for intervening with this 'hard-to-engage' population and concern over 'dwindling' resources and lack of organisational support. Nevertheless, strategies and opportunities for providing parenting support were acknowledged and there was consensus about the need for further skills training. Despite a proliferation of policy and good practice guidance on the delivery of parenting support for drug-dependent parents, the findings of this study suggest that significant challenges remain. Notably, our findings raise questions about whose role it is to provide parenting support to drug-using mothers and fathers, especially those who are not involved in the child protection system.
Publisher: Springer Science and Business Media LLC
Date: 27-07-2021
DOI: 10.1186/S42523-021-00112-5
Abstract: The chicken gut microbiota passes through different stages of maturation therefore, strengthening it with well characterised probiotics increases its resilience required for optimum gut health and wellbeing. However, there is limited information on the interaction of Bacillus based probiotics with gut microbial community members in cage free laying chickens both in rearing and production phases of life. In the current study, we investigated the changes in the gut microbiome of free range hens in the field after Bacillus based probiotic supplementation. Overall, at phylum level, probiotic supplementation increased the populations of Bacteroidetes and Proteobacteria mainly at the expense of Firmicutes. The population of Bacteroidetes significantly increased during the production as compared to the rearing phase, and its higher population in the probiotic-supplemented chickens reflects the positive role of Bacillus based probiotic in gut health. Core differences in the beta ersity suggest that probiotic supplementation decreased microbial compositionality. The non-significant difference in alpha ersity between the probiotic and control chickens showed that the composition of community structure did not change. No Salmonella spp. were isolated from the probiotic supplemented birds. Egg internal quality was significantly higher, while egg production and body weight did not differ. Functional prediction data showed that probiotic supplementation enriched metabolic pathways, such as vitamin B6 metabolism, phenylpropanoid biosynthesis, monobactam biosynthesis, RNA degradation, retinol metabolism, pantothenate and CoA biosynthesis, phosphonate and phosphinate metabolism, AMPK signaling pathway, cationic antimicrobial peptide (CAMP) resistance and tyrosine metabolism. Overall, age was the main factor affecting the composition and ersity of gut microbiota, where probiotic supplementation improved the abundance of many useful candidates in the gut microbial communities. The generated baseline data in the current study highlights the importance of the continuous use of Bacillus based probiotic for optimum gut health and production.
Publisher: JMIR Publications Inc.
Date: 04-10-2021
Abstract: ecruitment and retention of research participants is challenging. Social media, particularly Facebook, has emerged as a tool for connecting with participants due to its high uptake in the community. The Environmental Determinants of Islet Autoimmunity (ENDIA) study is an Australia-wide prospective pregnancy-birth cohort following children who have a first-degree relative with type 1 diabetes (ACTRN1261300794707). A dedicated Facebook page was established for the ENDIA study in 2013 with the aim to enhance recruitment and support participant retention. he purpose of this investigation was to evaluate the long-term impact of Facebook as a recruitment and retention tool. The hypotheses were that (1) Facebook was an important source of referral to the ENDIA study, (2) the sociodemographic characteristics of participants recruited by Facebook would be different from those of participants recruited by other means (i.e., ‘conventional recruits’), and (3) recruitment by Facebook would be associated with long-term retention. We also evaluated the most effective types of Facebook content based on post engagement. ecruitment of 1511 ENDIA participants was completed in December 2019. Characteristics of participants recruited through Facebook were compared to conventional recruits using linear, logistic, and multinomial logistic regression models. A logistic regression model was used to determine the risk of study withdrawal. Data pertaining to 794 Facebook posts over 7.5 years from June 2013 until December 2020 were extracted using the Facebook ‘Insights’ function for thematic analysis. acebook was the third largest source of referral to the ENDIA study (300/1511 19.9%) behind in-person clinics (500/1511, 33.1%) and healthcare professional referrals (347/1511, 23.0%). The ENDIA Facebook page had 2337 followers at the close of recruitment. Approximately 20% of these could be identified as participating parents. Facebook recruits were more frequently Australian-born (P .001) enrolling postnatally (P=.01) and withdrew from the study at a significantly lower rate compared to conventional recruits (4.7% vs 12.3% P .001) after a median of follow-up of 3.3 years. acebook was a valuable recruitment tool for the ENDIA study and participants recruited through Facebook were three times less likely to withdraw during long-term follow-up. The sociodemographic characteristics of Facebook recruits were different to conventional recruits, but perhaps in unintended ways. Facebook content featuring stories and images of participants received the highest engagement despite the fact that most Facebook followers were not enrolled in the study. These findings should inform social media strategies for future cohort studies involving pregnant women and young families, and for type 1 diabetes risk studies. ustralia New Zealand Clinical Trials Registry: ACTRN1261300794707 R2-0.1186/1471-2431-13-124
Publisher: Hindawi Limited
Date: 07-01-2020
DOI: 10.1111/PEDI.12952
Abstract: Microbial exposures in utero and early life shape the infant microbiome, which can profoundly impact on health. Compared to the bacterial microbiome, very little is known about the virome. We set out to characterize longitudinal changes in the gut virome of healthy infants born to mothers with or without type 1 diabetes using comprehensive virome capture sequencing. Healthy infants were selected from Environmental Determinants of Islet Autoimmunity (ENDIA), a prospective cohort of Australian children with a first-degree relative with type 1 diabetes, followed from pregnancy. Fecal specimens were collected three-monthly in the first year of life. Among 25 infants (44% born to mothers with type 1 diabetes) at least one virus was detected in 65% (65/100) of s les and 96% (24/25) of infants during the first year of life. In total, 26 genera of viruses were identified and >150 viruses were differentially abundant between the gut of infants with a mother with type 1 diabetes vs without. Positivity for any virus was associated with maternal type 1 diabetes and older infant age. Enterovirus was associated with older infant age and maternal smoking. We demonstrate a distinct gut virome profile in infants of mothers with type 1 diabetes, which may influence health outcomes later in life. Higher prevalence and greater number of viruses observed compared to previous studies suggests significant underrepresentation in existing virome datasets, arising most likely from less sensitive techniques used in data acquisition.
Publisher: Elsevier BV
Date: 05-2023
Publisher: Springer Science and Business Media LLC
Date: 04-06-2021
DOI: 10.1186/S40104-021-00597-9
Abstract: Gut microbiota plays a key role in health, immunity, digestion, and production in layers. Factors such as environment, diet, diseases, stress, and flock management significantly affect gut microbiota however, it is not known how potential stressors such as intramuscular injections or feed withdrawal alter the composition of gut microbiota that result in increased the shedding level of foodborne pathogens. In the current study, the effects of intramuscular corticosterone injection and feed withdrawal were evaluated to understand their role in Salmonella Typhimurium shedding and changes in the composition of gut microbiota in layers. Salmonella shedding was observed for 8 weeks post-infection. There was a significant increase in Salmonella Typhimurium count after intramuscular injection and feed withdrawal. The Salmonella infected and the negative control groups showed significant differences in the abundance of different genera in gut microbiota at week 1 and up to week 7 post infection. The infected group showed a significant reduction in alpha ersity of gut microbiota. Firmicutes reduced significantly ( P 0.05) after intramuscular injection, while the feed withdrawal groups did not cause any significant changes in Proteobacteria-Firmicutes ratio. Furthermore, intramuscular injection resulted in a significant change in alpha ersity of gut microbiota. Exposure of chicks to relatively low dose of Salmonella Typhimurium can lead to persistent shedding in pullets. The Salmonella Typhimurium infection disrupted the gut microbiota composition immediately after infection. The potential stress of intramuscular injection and feed withdrawal significantly increased the Salmonella Typhimurium count in faeces. The intramuscular injection also resulted in a significant alteration of the Proteobacteria-Firmicutes ratio, which could increase the risk of dysbiosis.
Publisher: Wiley
Date: 02-2004
DOI: 10.1002/ART.20025
Abstract: To assess the reliability of physical examination of the osteoarthritic (OA) knee by rheumatologists, and to evaluate the benefits of standardization. Forty-two physical signs and techniques were evaluated using a 6 x 6 Latin square design. Patients with mild to severe knee OA, based on physical and radiographic signs, were examined in random order prior to and following standardization of techniques. For those signs with dichotomous scales, agreement among the rheumatologists was calculated as the prevalence-adjusted bias-adjusted kappa (PABAK), while for the signs with continuous and ordinal scales, a reliability coefficient (R(c)) was calculated using analysis of variance. A PABAK of >0.60 and an R(c) of >0.80 were considered to indicate adequate reliability. Adequate poststandardization reliability was achieved for 30 of 42 physical signs/techniques (71%). The most highly reliable signs identified by physical examination of the OA knee included alignment by goniometer (R(c) = 0.99), bony swelling (R(c) = 0.97), general passive crepitus (R(c) = 0.96), gait by inspection (PABAK = 0.78), effusion bulge sign (R(c) = 0.97), quadriceps atrophy (R(c) = 0.97), medial tibiofemoral tenderness (R(c) = 0.94), lateral tibiofemoral tenderness (R(c) = 0.85), patellofemoral tenderness by grind test (R(c) = 0.94), and flexion contracture (R(c) = 0.95). The standardization process resulted in substantial improvements in reliability for evaluation of a number of physical signs, although for some signs, minimal or no effect of standardization was noted. After standardization, warmth (PABAK = 0.14), medial instability at 30 degrees flexion (PABAK = 0.02), and lateral instability at 30 degrees flexion (PABAK = 0.34) were the only 3 signs that were highly unreliable. With the exception of physical examinations for instability, a comprehensive knee examination can be performed with adequate reliability. Standardization further improves the reliability for some physical signs and techniques. The application of these findings to future OA studies will contribute to improved outcome assessments in OA.
Publisher: Springer Science and Business Media LLC
Date: 04-2006
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1016/J.JPSYCHORES.2012.03.005
Abstract: Patients with a medical condition and co-morbid depression have more symptoms and use more medical services. We aimed to determine the prevalence of depression and the adequacy of its treatment in patients who had been repeatedly referred from primary to specialist medical care for the assessment of a medical condition. All patients who had at least three referrals to medical and surgical specialists for an assessment of symptoms attributed to a medical condition, over a five year period from five primary care practices in Edinburgh, UK were identified using a referral database and review of records. Participants were sent a questionnaire which included the PHQ-9 depression scale and additional questions about depression during the preceding 5years. Details of treatment for depression were obtained from primary care records. Questionnaires were sent to 230 patients and returned by 162 (70.4%). Forty-one (25.3%) had a PHQ-9 score of 10 or more and hence probable current depressive disorder. An additional 36 (22.2%) reported depression in the previous 5years. Only eight (19.5%) of those reporting current depression and 20 (26%) of the 77 patients reporting previous depression had received minimally adequate treatment for it. Whilst we know that patients with medical conditions are often depressed and that such co-morbid depression is often undertreated, we have found that it is undertreated even in patients repeatedly referred to medical specialists. Better assessment and management of depression in such patients could both improve patients' quality of life and reduce the cost of care.
Publisher: Springer Science and Business Media LLC
Date: 09-09-2021
DOI: 10.1038/S41598-021-97135-4
Abstract: Salmonella Typhimurium is a human pathogen associated with eggs and egg-derived products. In Australia, it is recommended that eggs should be refrigerated to prevent condensation that can enhance bacterial penetration across the eggshell. Except for the United States, the guidelines on egg refrigeration are not prescriptive. In the current study, in-vitro and in-vivo experiments were conducted to understand the role of egg storage temperatures (refrigerated vs ambient) on bacterial load and the virulence genes expression of Salmonella Typhimurium. The in-vitro egg study showed that the load of Salmonella Typhimurium significantly increased in yolk and albumen stored at 25 °C. The gene expression study showed that ompR , misL , pefA , spvA , shdA , bapA , and csgB were significantly up-regulated in the egg yolk stored at 5 °C and 25 °C for 96 h however, an in-vivo study revealed that mice infected with egg yolk stored at 25 °C, developed salmonellosis from day 3 post-infection (p.i.). Mice fed with inoculated egg yolk, albumen, or eggshell wash stored at refrigerated temperature did not show signs of salmonellosis during the period of the experiment. Data obtained in this study highlighted the importance of egg refrigeration in terms of improving product safety.
Publisher: Springer Science and Business Media LLC
Date: 02-08-2021
DOI: 10.1038/S41538-021-00103-5
Abstract: Chemical decontamination during processing is used in many countries to mitigate the C ylobacter load on chicken meat. Chlorine is a commonly used sanitizer in poultry processing to limit foodborne bacterial pathogens but its efficacy is limited by high bacterial loads and organic material. Acidified sodium chlorite (ASC) is a potential alternative for poultry meat sanitization but little is known about its effects on the cellular response of C ylobacter . In this study, the sensitivity of C. jejuni isolates to ASC was established. RNAseq was performed to characterize the transcriptomic response of C. jejuni following exposure to either chlorine or ASC. Following chlorine exposure, C. jejuni induced an adaptive stress response mechanism. In contrast, exposure to ASC induced higher oxidative damage and cellular death by inhibiting all vital metabolic pathways and upregulating the genes involved in DNA damage and repair. The transcriptional changes in C. jejuni in response to ASC exposure suggest its potential as an effective sanitizer for use in the chicken meat industry.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2007
DOI: 10.1007/S10350-006-0815-8
Abstract: Health-related quality of life has become an important outcome in cancer treatment. Detailed health-related quality of life measures were taken as part of a trial of follow-up of patients with colon cancer by general practitioners and surgeons. This study was designed as a longitudinal assessment of health-related quality of life after treatment for carcinoma of the colon and patient satisfaction with two different settings of follow-up (general practitioners vs. surgeons). A total of 338 patients were recruited into randomized (n = 203) and patient preference (n = 135) follow-up groups. Prospectively assessed physical and mental health-related quality of life measures and patient satisfaction are reported during two years. Elderly and less educated patients prefer follow-up by general practitioners over surgeons. Overall, physical health-related quality of life is reduced early after treatment however, this returns to normal levels at one year. Mental quality of life, anxiety, and depression are at or above population levels throughout the two-year follow-up period. There were no differences in physical or psychologic health-related quality of life measures between general practitioner and surgeon groups at any time during follow-up. Overall, more advanced Dukes stage is associated with a trend to improved mental health-related quality of life. Patients' ability to choose the setting of follow-up has no influence on health-related quality of life compared with random allocation to general practitioner or surgeon. Patients are equally highly satisfied with follow-up by general practitioner or surgeon. After recovery from treatment for colon cancer, health-related quality of life is similar to the general population. Good health-related quality of life outcomes and high patient satisfaction are as well provided by general practitioners in the community setting as by surgeon review.
Publisher: Oxford University Press (OUP)
Date: 06-2009
Publisher: Elsevier BV
Date: 07-2021
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1016/J.JPSYCHORES.2011.12.009
Abstract: Some patients are repeatedly referred from primary to secondary care with medically unexplained symptoms (MUS). We aimed to estimate the healthcare costs incurred by such referrals and to compare them with those incurred by other referred patients from the same defined primary care s le. Using a referral database and case note review, all adult patients aged less than 65 years, who had been referred to specialist medical services from one of five UK National Health Service primary care practices in a five-year period, were identified. They were placed in one of three groups: (i) repeatedly referred with MUS (N=276) (ii) infrequently referred (IRS, N=221), (iii) repeatedly referred with medically explained symptoms (N=230). Secondary care activities for each group (inpatient days, outpatient appointments, emergency department attendances and investigations) were identified from primary care records. The associated costs were allocated using summary data and the costs for each group compared. Patients who had been repeatedly referred with MUS had higher mean inpatient, outpatient and emergency department costs than those infrequently referred (£3,539, 95% CI 1458 to 5621, £778 CI 705 to 852 and £99, CI 74 to 123 respectively. The mean overall costs were similar to those of patients who had been repeatedly referred with medically explained symptoms. The repeated referral of patients with MUS to secondary medical care incurs substantial healthcare costs. An alternative form of management that reduces such referrals offers potential cost savings.
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.DRUGPO.2013.04.004
Abstract: Parenting and pregnancy in the context of drug use is a contentious topic, high on the policy agenda. Providing effective support to parents who are opioid dependent, through early intervention, access to drug treatment and parenting skills training, is a priority. However, little is known about opioid dependent parents' experiences and understanding of parenting support during the antenatal and postnatal periods. This paper focuses on the position and impact of opioid substitution therapy (OST) in the accounts of parents who were expecting, or who had recently had, a baby in the UK. Semi-structured qualitative interviews were held with a purposive s le of 19 opioid dependent service users (14 female, 5 male). Longitudinal data was collected across the antenatal and postnatal (up to 1 year) periods, with participants interviewed up to three times. Forty-five interviews were analysed thematically, using a constant comparison method, underpinned by a sociologically informed narrative approach. Participants' accounts of drug treatment were clearly oriented towards demonstrating that they were doing 'the best thing' for their baby. For some, OST was framed as a route to what was seen as a 'normal' family life for others, OST was a barrier to such normality. Challenges related to: the physiological effects of opioid dependence structural constraints associated with treatment regimes and the impact of negative societal views about drug-using parents. Parents' accounts of OST can be seen as a response to socio-cultural ideals of a 'good', drug-free parent. Reflecting the liminal position parents engaged in OST found themselves in, their narratives entailed reconciling their status as a 'drug-using parent' with a view of an 'ideal parent' who was abstinent.
Publisher: Hindawi Limited
Date: 09-06-2020
DOI: 10.1111/PEDI.13056
No related grants have been discovered for Kelly McGorm.