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Abstract: Teenage parenthood is problematised in the UK. Attention is increasingly falling on the potential or actual father yet we still know relatively little about young men’s experiences and attitudes in this area. This paper focuses on the experiences of, and attitudes towards, pregnancy and fatherhood amongst a sample of men incarcerated in a Scottish Young Offender Institute. In-depth interviews were conducted with 40 inmates, aged 16–20, purposively sampled using answers from a questionnaire administered to 67 inmates. Twelve men reported eighteen pregnancies for which they were, definitely or possibly, responsible. All but one of the pregnancies were unplanned. Five of the men were fathers: two were still in a relationship with the mother of their child and were in close contact with her and the child while incarcerated, three, all of whom had separated from their partner before the birth, had had patchy contact with mother and child before and/or during their sentence. All five of the men expressed a strong desire to be ‘a good father’. Amongst the interview sample as a whole, most said they did not feel ready to become fathers. The main reason given was being unable to fulfil what they regarded as the key role of financial provider. Most of the men had given little or no thought to the possibility of a sexual partner becoming pregnant. Contraceptive use was high, however, amongst the minority who reported thinking about this possibility. The paper concludes by considering the cultural context of the men’s attitudes and the potential for intervention development for incarcerated male young offenders in the areas of Sex and Relationships Education and parenting. [Copyright &y& Elsevier]

Abstract: Mitigation of the tuberculosis (TB) and HIV syndemic is undermined by critical clinical, operational and social challenges of which the social aspects have been least explored. This paper examines the lived experience of TB disease and HIV from the perspective of affected individuals to analyze how they may think about their dual illness; how they understand their illness with TB in relation to HIV, and vice versa; and how they characterize their (stigmatized) experiences in the context of their perceptions and identities. From February–August 2009, qualitative, semi-structured interviews were conducted with 40 adults with HIV and TB disease at three ambulatory clinics in KwaZulu-Natal, South Africa. Subjective meanings of illness experience were analyzed using modified grounded-theory. Emergent themes on illness perception and disclosure revealed how patients constructed dichotomous identities associated with TB and HIV through social constructs of moral susceptibility and (im)permanence. Each identity was associated with relatively disparate degrees of stigma as a product of labeling, negative stereotyping and discrimination. HIV bore the least desirable identity and invoked the greatest stigma. However, the confluence of the two epidemics rendered TB symbolic and symptomatic of HIV, and enhanced the visibility of AIDS. Dual illness thus introduced a paradox to patients'' identity constructions, and produced a unique, overlapping double stigma. This facilitated new forms of stigma against TB, and aggravated existing stigma against HIV. It also conferred visibility to some forms of extra-pulmonary TB. Patients managed their double stigmas through novel forms of information sharing that relied on segregating their dual illness identities. Patients deflected the dominant stigma of HIV through concurrent processes of HIV ‘othering’ – their symbolic distancing from persons affected by HIV, and ‘covering’ – their selective disclosure of illness (and identity associated) with TB over that of HIV. Findings call for greater consideration to the complex role of stigma in the delivery of TB/HIV healthcare. [Copyright &y& Elsevier]

Mental health services worldwide are under strain from a combination of unprecedented demand, workforce reconfigurations, and government austerity measures. There has been relatively little research or policy focus on the impact of staffing and skill mix on safety and quality in mental health services leaving a considerable evidence gap. Given that workforce is the primary therapeutic intervention in secondary mental health care this constitutes a major deficit. This study aimed to explore the impact of staffing and skill mix on safety and quality of care in mental health inpatient and community services. Exploratory, qualitative methodology; purposive sampling. Inpatient and community mental health services in the United Kingdom. 21 staff (including nurses, occupational therapists, psychiatrists, social workers, and care co-ordinators) currently working in mental health services. We conducted semi-structured telephone interviews with a purposive sample of staff recruited via social media. We asked participants to describe the staffing and skill mix in their service; to reflect on how staffing decisions and/or policy affected safety and patient care; and for their views of what a well-staffed ward/service would look like. We conducted thematic analysis of the interview transcripts. The participants in this study considered safestaffing to require more than having 'enough' staff and offered multiple explanations of how staffing and skill mix can impact on the safety and quality of mental health care. From their accounts, we identified how the problem of 'understaffing' is self-perpetuating and cyclical and how its features interact and culminate in unsafe care. We conceptualised the relationship between staffing and safety as a 'vicious cycle of unsafestaffing' which comprised: (1) understaffing (the depletion of resources for safe care provision); (2) chronic understaffing (conditions resulting from and exacerbating understaffing); and, (3) unsafestaffing (the qualities of staffing that compromise staff capacity to provide safe care). Continued policy focus on safestaffing is clearly warranted, especially in mental health as staffing constitutes both the principal cost and main therapeutic driver of care. This paper provides compelling reasons to look beyond regulating staff numbers alone, and to consider staff morale, burden and the cyclical nature of attrition to ensure the delivery of high quality, safe and effective services. Future research should investigate other mechanisms via which staffing impacts on safety in mental health settings. [ABSTRACT FROM AUTHOR]