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Technology has been lauded as a solution to range of challenges presented by ageing population internationally. While the lion-share of scholarship has focussed on high-fi, digital technologies, there has been a recent shift to exploring the contributions mundane, low-fi technologies make to older people's daily lives and our understandings of health, illness and care more broadly. Drawing from serial narrative interview data collected with 19 married couples aged 70 and over living in the U.K., this article explores the way one medical technology-the dosette box-was taken-up and deployed in their end-of-life caring process. Informed by actor-network theory and critical feminist scholarship, this article considers how the dosette box played an active role in structuring relationships, scheduling daily care activities and enforcing medical compliance. In doing so, we suggest that the dosette box provided an unexpected companion and 'weapon of the weak' for older partner's attempting to assert their expertise and power while caring. We also explore how the dosette box demanded an even higher level of regular, vital care from older partner's once introduced into the home, thus entrenching the physical and emotional demands of dispensing care., (© 2022 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL (SHIL).)

Objectives: "Attachment difficulties" is an umbrella term often used to describe various forms of non-secure attachment. Differentiating "attachment difficulties" from autism spectrum disorder (hereafter autism) and attention deficit hyperactivity disorder (ADHD) has been characterized as challenging. Few studies have explored how this happens in practice, from the perspective of professionals., Design: Qualitative study., Methods: We conducted in-depth semi-structured interviews with ( n = 17) healthcare professionals from five NHS Foundation Trusts in the United Kingdom. Participants were recruited using a combination of snowballing, convenience and purposive sampling. Data were analyzed using a thematic approach., Results: We identified six interrelated themes that might reflect difficulties with differential conceptualization. These include: a clinical lexicon of attachment; approaching attachment with caution; contextual factors; perceived characteristic behaviors; assessing attachment and adjacent supports; spotlighting intervention and dual conceptualization., Conclusion: Our results indicate some of the ways suspicions around attachment are raised in practice. We advocate for more dialogue between research and practice communities on issues of differential conceptualization. We call for collaboration between a panel of experts consisting of attachment and neurodevelopmental orientated practitioners and researchers, to clarify issues around differentiating between attachment difficulties, ASD, and ADHD., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Coughlan, van IJzendoorn, Woolgar, Weisblatt and Duschinsky.)

Attachment theory and research are drawn upon in many applied settings, including family courts, but misunderstandings are widespread and sometimes result in misapplications. The aim of this consensus statement is, therefore, to enhance understanding, counter misinformation, and steer family-court utilisation of attachment theory in a supportive, evidence-based direction, especially with regard to child protection and child custody decision-making. The article is divided into two parts. In the first, we address problems related to the use of attachment theory and research in family courts, and discuss reasons for these problems. To this end, we examine family court applications of attachment theory in the current context of the best-interest-of-the-child standard, discuss misunderstandings regarding attachment theory, and identify factors that have hindered accurate implementation. In the second part, we provide recommendations for the application of attachment theory and research. To this end, we set out three attachment principles: the child's need for familiar, non-abusive caregivers; the value of continuity of good-enough care; and the benefits of networks of attachment relationships. We also discuss the suitability of assessments of attachment quality and caregiving behaviour to inform family court decision-making. We conclude that assessments of caregiver behaviour should take center stage. Although there is dissensus among us regarding the use of assessments of attachment quality to inform child custody and child-protection decisions, such assessments are currently most suitable for targeting and directing supportive interventions. Finally, we provide directions to guide future interdisciplinary research collaboration.

Introduction: On average, aspects of mental health improve following behavioural weight management programmes, yet this is not the case for all participants. It is important to identify those at risk of harm to provide more effective psychological support. We aimed to identify participant characteristics associated with changes in depression and anxiety in participants of a behavioural weight management programme., Methods: In the Weight loss Referrals for Adults in Primary care trial, 1,267 adults with body mass index ≥28 kg/m2 were randomized to brief intervention, or WW (formerly weight watchers) for 12-weeks or 52-weeks and followed for 5 years. We used linear and multinomial regression to explore the association between participant characteristics and changes in depression and anxiety (measured by the hospital anxiety and depression scale). Where possible, the impact of missing data was investigated using multiple imputation., Results: Higher baseline anxiety was associated with decreases in anxiety symptoms and increases in depression symptoms from baseline to follow-up. Higher baseline depression was associated with decreases in depression symptoms and increases in anxiety symptoms from baseline to follow-up. The magnitude of the associations was small. No further characteristics were consistently associated with changes in mental health., Discussion: Evidence suggests that baseline depression and anxiety may indicate how depression and anxiety symptoms change during and after attending WW. Measurement of depression and anxiety at the start of a behavioural weight management programme and subsequent monitoring may facilitate timely psychological support if a deterioration in mental health is identified. Further research in large and diverse participant samples is required to clarify the findings., (© 2022 The Author(s). Published by S. Karger AG, Basel.)

Discourses about the dangers of spoiling children and images of grandparents came together in nineteenth-century literature, with the literary figure of the spoiling grandmother emerging as familiar cultural currency. From there, it would become a concern for the generation of psychoanalysts after Freud, for whom the grandmother represented a dangerous supplement to the importance of the mother for a child's psychological development. The literary and the psychological uses of the figure of the spoiling grandmother then intersected in scientific and popular guidance for parents in the battle for authority regarding the right way to engage in childcare., Competing Interests: Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

For Vicedo, 'putting attachment in its place' seems to entail two aspects. The first is working to understand the rise of attachment theory and its place within the history of knowledge practices. The second is to criticize the validity of attachment theory. In this reply, we appraise three criticisms made by Vicedo of attachment theory, chosen as points for sustaining a dialogue. Our main point in this reply is that, in excluding the work of attachment researchers after Ainsworth from consideration, Vicedo's work is not yet able to properly 'put attachment in its place', in either sense of the phrase. At most, she puts Bowlby in the 1950s-1960s in his place, but without speaking effectively to subsequent attachment research. In our view, not just the validity, but the very meaning of attachment as a scientific research programme cannot be understood outside of its temporal context, and the relationship this entails between theory and research, past and future.

Background: Self-management support can improve health and reduce health care utilization by people with long-term conditions. Online communities for people with long-term conditions have the potential to influence health, usage of health care resources, and facilitate illness self-management. Only recently, however, has evidence been reported on how such communities function and evolve, and how they support self-management of long-term conditions in practice., Objective: The aim of this study is to gain a better understanding of the mechanisms underlying online self-management support systems by analyzing the structure and dynamics of the networks connecting users who write posts over time., Methods: We conducted a longitudinal network analysis of anonymized data from 2 patients' online communities from the United Kingdom: the Asthma UK and the British Lung Foundation (BLF) communities in 2006-2016 and 2012-2016, respectively., Results: The number of users and activity grew steadily over time, reaching 3345 users and 32,780 posts in the Asthma UK community, and 19,837 users and 875,151 posts in the BLF community. People who wrote posts in the Asthma UK forum tended to write at an interval of 1-20 days and six months, while those in the BLF community wrote at an interval of two days. In both communities, most pairs of users could reach one another either directly or indirectly through other users. Those who wrote a disproportionally large number of posts (the superusers) represented 1% of the overall population of both Asthma UK and BLF communities and accounted for 32% and 49% of the posts, respectively. Sensitivity analysis showed that the removal of superusers would cause the communities to collapse. Thus, interactions were held together by very few superusers, who posted frequently and regularly, 65% of them at least every 1.7 days in the BLF community and 70% every 3.1 days in the Asthma UK community. Their posting activity indirectly facilitated tie formation between other users. Superusers were a constantly available resource, with a mean of 80 and 20 superusers active at any one time in the BLF and Asthma UK communities, respectively. Over time, the more active users became, the more likely they were to reply to other users' posts rather than to write new ones, shifting from a help-seeking to a help-giving role. This might suggest that superusers were more likely to provide than to seek advice., Conclusions: In this study, we uncover key structural properties related to the way users interact and sustain online health communities. Superusers' engagement plays a fundamental sustaining role and deserves research attention. Further studies are needed to explore network determinants of the effectiveness of online engagement concerning health-related outcomes. In resource-constrained health care systems, scaling up online communities may offer a potentially accessible, wide-reaching and cost-effective intervention facilitating greater levels of self-management., (©Sagar Joglekar, Nishanth Sastry, Neil S Coulson, Stephanie JC Taylor, Anita Patel, Robbie Duschinsky, Amrutha Anand, Matt Jameson Evans, Chris J Griffiths, Aziz Sheikh, Pietro Panzarasa, Anna De Simoni. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 11.07.2018.)

Main and Solomon were the first to create a formal infant Strange Situation classification of attachment disorganization. Bowlby's reflections on the underlying psychological processes of such behaviors, however, began early in his career, including the term "disorganization." Most of these remained unpublished but are available through the John Bowlby Archive. Bowlby saw affective experiences as the source of the attachment behavioral system's organization and regulation, and he introduced the term "effector equipment" to describe the emergent organization of attention, expectation, affect, and behavior to orchestrate responses to the environment. In his thinking, disorganization results from threat conflict, safe haven ambiguity, and/or activation without assuagement, which interfere with coordination and integration across a behavioral system. Bowlby's unpublished writings also amplify his published work on segregated systems and defensive exclusion. Bowlby's insights are relevant today and can provide greater background and clarity to current work, as researchers and clinicians consider the origins, manifestations, and meaning of disorganization.

In this short-term longitudinal study, 30 preschool-aged children with autism were first observed in Ainsworth's Strange Situation Procedure and, separately, interacting with the primary caregiver in the home. One year later, each child completed both a developmental assessment and an observational assessment of empathic responding. Behaviors typical for children with autism were distinguished from behaviors suggestive of relationally based attachment disorganization. Forty-five percent of the children were classified as securely attached. The secure group demonstrated language skills superior to those of the insecurely attached group, concurrently and during the follow-up. Compared to parents of children who were insecurely attached, parents of securely attached children were rated as more sensitive. Compared to both organized insecure and disorganized children, secure children were rated as more responsive to an examiner's apparent distress during the follow-up relative to their ratings at intake, whereas empathy ratings of children with insecure classifications did not increase. Importantly, attachment security was associated with empathy above and beyond the contribution of children's language level. These results indicate that the sequelae of attachment security in autism may be similar to those documented for typically developing children.

Since its introduction by Main and Solomon in 1990, the infant disorganised attachment classification has functioned as a predictor of mental health in developmental psychology research. It has also been used by practitioners as an indicator of inadequate parenting and developmental risk, at times with greater confidence than research would support. Although attachment disorganisation takes many forms, it is generally understood to reflect a child's experience of being repeatedly alarmed by their parent's behaviour. In this paper we analyse how the infant disorganised attachment classification has been stabilised and interpreted, reporting results from archival study, ethnographic observations at four training institutes for coding disorganised attachment, interviews with researchers, certified coders and clinicians, and focus groups with child welfare practitioners. Our analysis points to the role of power/knowledge disjunctures in hindering communication between key groups: Main and Solomon and their readers; the oral culture of coders and the written culture of published papers; the research community and practitioners. We highlight how understandings of disorganised attachment have been magnetised by a simplified image of a child fearful of his or her own parent., (Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Aims and Objectives: To explore nursing home nurses' experiences and views of work identity., Background: Nursing home nurses are in a unique position as they work at the interface of health and social care. Little is known about nursing home nurses' perceptions and experiences of working within this context. Evidence suggests that using the concept of work identity can support understanding of how workers make sense of their work., Design: Hermeneutic phenomenological study., Methods: The study was carried out in seven nursing homes in North East England. Findings are based upon literary analysis of multiple episodic interviews with 13 nursing home nurses., Results: Participants' responses suggested that nursing "residents" is different to nursing "patients," and nursing home nurses are required to modify their care activities to account for these differences. Participants also proposed that they are isolated and excluded from the rest of the healthcare workforce group. These issues led participants to feel uncertain about work identity. Many participants attempted to strengthen their work identity by aligning their role with what they perceived the "nurse identity" to be., Conclusion: Nurses' work activities and professional group identity influence their work identity. When work activities and professional group identity do not align with role expectations, as can be the case for nursing home nurses, work identity may be compromised. These nurses may attempt to change work practices to strengthen their work identity., Relevance to Clinical Practice: Health- and social care providers need to account for work identity factors in the organisation of care, and planning and implementation of integrated health- and social care initiatives., (© 2017 John Wiley & Sons Ltd.)

In 1990, M. Main and J. Solomon introduced the procedures for coding a new "disorganized" infant attachment classification for the Ainsworth Strange Situation procedure (M.D.S. Ainsworth, M. Blehar, E. Waters, & S. Wall, 1978). This classification has received a high degree of interest, both from researchers and from child welfare and clinical practitioners. Disorganized attachment has primarily been understood through the lens of E. Hesse and M. Main's concept of "fright without solution," taken to mean that an infant experiences a conflict between a desire to approach and flee from a frightening parent when confronted by the Strange Situation. Yet, looking back, it can be observed that the way Hesse and Main's texts were formulated and read has generated confusion; there have been repeated calls in recent years for renewed theory and clarification about the relationship between disorganization and fear. Responding to these calls, this article revisits the texts that introduced the idea of fright without solution, clarifying their claims through articulating more precisely the different meanings of the term fear. This clarified account will then be applied to consideration of pathways to infant disorganized behaviors., (© 2018 The Authors. Infant Mental Health Journal published by Wiley Periodicals, Inc. on behalf of Michigan Association for Infant Mental Health.)

Background: It is estimated that nearly 600,000 cancer cases in the UK could have been avoided in the past five years if people had healthier lifestyles. A number of theories of behaviour change suggest that before people will change health behaviours, they must accept that a risk applies to them. This study aimed to explore the views of the public on receiving personalised cancer risk information and the potential for that information to motivate behaviour change., Methods: We conducted 27 interviews with members of the public (mean age 49 ± 23 years). Each participant completed a questionnaire to allow calculation of their risk of developing the most common cancers (10 for women, 8 for men). During the interviews we presented their risk using a web-based tool developed for the study and discussions covered their views on receiving that information. Each interview was audio-recorded and then analysed using thematic analysis., Results: Participants generally viewed the concept of personalised cancer risk positively. The first reaction of almost all when presented with their 10-year risk of an individual cancer without any further context was that it was low and not concerning. Views on what constituted a high risk ranged widely, from 0.5 to 60%. All felt seeing the impact of changes in lifestyle was helpful. For some this led to intentions to change behaviour, but reductions in risk were not always motivating as the risks were considered low and differences small., Conclusions: Provision of personalised cancer risk was well received and may be a useful addition to other cancer prevention initiatives. Further work is needed in particular to develop ways to present cancer risk that reflect the general perception of what constitutes a risk high enough to motivate behaviour change and help patients contextualise a less well known health risk by providing a frame of reference.

Disorganized/Disoriented (D) attachment has seen widespread interest from policy makers, practitioners, and clinicians in recent years. However, some of this interest seems to have been based on some false assumptions that (1) attachment measures can be used as definitive assessments of the individual in forensic/child protection settings and that disorganized attachment (2) reliably indicates child maltreatment, (3) is a strong predictor of pathology, and (4) represents a fixed or static "trait" of the child, impervious to development or help. This paper summarizes the evidence showing that these four assumptions are false and misleading. The paper reviews what is known about disorganized infant attachment and clarifies the implications of the classification for clinical and welfare practice with children. In particular, the difference between disorganized attachment and attachment disorder is examined, and a strong case is made for the value of attachment theory for supportive work with families and for the development and evaluation of evidence-based caregiving interventions.

This article examines the construct of disorganized attachment originally proposed by Main and Solomon, developing some new conjectures based on inspiration from a largely unknown source: John Bowlby's unpublished texts, housed at the Wellcome Trust Library Archive in London (with permission from the Bowlby family). We explore Bowlby's discussions of disorganized attachment, which he understood from the perspective of ethological theories of conflict behavior. Bowlby's reflections regarding differences among the behaviors used to code disorganized attachment will be used to explore distinctions that may underlie the structure of the current coding system. The article closes with an emphasis on the importance Bowlby placed on Popper's distinction between the context of discovery and the context of justification in developmental science.

Lack of clarity regarding the infant disorganized attachment classification has caused confusion in the clinical, forensic, and research contexts in which it is used. This article offers distinctions to clarify the concept with the goal of increasing understanding and identifying potential misapplications. In particular, attention is drawn to the fact that there are many indices used to code “disorganized attachment,” and that so far they have been validated as a set rather than individually; and it is noted that the construct validation of disorganization in naturalistic settings is partially finished. Clinicians and social workers should be cautious in their interpretations of such behavior.

Liotti proposed that interactions during infancy with a parent suffering unresolved loss could lead to vulnerabilities to altered states of consciousness. Hesse and van IJzendoorn provided initial support for Liotti's hypothesis, finding elevated scores on Tellegen's Absorption Scale - a normative form of dissociation - for undergraduates reporting that their parents had experienced the loss of family members within two years of their birth. Here, we replicated the above findings in a large undergraduate sample (N = 927). Additionally, we investigated mother's and father's losses separately. Perinatal losses, including miscarriage, were also considered. Participants reporting that the mother or both parents had experienced loss within two years of their birth scored significantly higher on absorption than those reporting only perinatal, only father, or no losses. While not applicable to the assessment of individuals, the brief loss questionnaire utilized here could provide a useful addition to selected large-scale studies.

Research on attachment is widely regarded in sociology and feminist scholarship as politically conservative - oriented by a concern to police families, pathologize mothers and emphasize psychological at the expense of socio-economic factors. These critiques have presented attachment theory as constructing biological imperatives to naturalize contingent, social demands. We propose that a more effective critique of the politically conservative uses of attachment theory is offered by engaging with the 'attachment system' at the level of ontology. In developing this argument we draw on Deleuze and Guattari, making use of the common language of ethology which links their ideas to that of attachment theory. The attachment system can and has been reified into an image of the infant returning to their caregiver as an image of familial sufficiency. This has offered ammunition for discourses and institutions which isolate women from health, social and political resources. Yet Deleuze and Guattari can help attachment theory and research to be recognized as a powerful ally for progressive politics, for reflection on the movement of human individuation, and for arguing for the meaningful resourcing of those who care for someone else.

Sociologists and feminist scholars have, over many decades, characterised attachment as a social construction that functions to support political and gender conservatism. We accept that attachment theory has seen use to these ends and consider recent deployments of attachment theory as justification for a minimal State within conservative political discourse in the UK since 2009. However, we contest that attachment is reducible to its discursive construction. We consider Judith Butler's depiction of the infant attached to an abusive caregiver as a foundation and parallel to the position of the adult citizen subjected to punitive cultural norms and political institutions. We develop and qualify Butler's account, drawing on the insights offered by the work of Lauren Berlant. We also return to Foucault's Psychiatric Power lectures, in which familial relations are situated as an island of sovereign power within the sea of modern disciplinary institutions. These reflections help advance analysis of three important issues: the social and political implications of attachment research; the relationship between disciplinary and sovereign power in the affective dynamic of subjection; and the political and ethical status of professional activity within the psy disciplines.

The difficulties faced in the recruitment and retention of nursing staff in nursing homes for older people are an international challenge. It is therefore essential that the causes of nurses' reluctance to work in these settings are determined. This paper considers the influence that multiple-source care funding issues have on nursing home nurses' experiences and views regarding the practice and appeal of the role. The methodology for this study was hermeneutic phenomenology. Thirteen nurses from seven nursing homes in the North East of England were interviewed in a sequence of up to five interviews and data were analysed using a literary analysis method. Findings indicate that participants are uncomfortable with the business aspects that funding issues bring to their role. The primary difficulties faced are: tensions between care issues and funding issues; challenges associated with 'selling beds'; and coping with self-funding residents' changing expectations of care. The findings of the study suggest that multiple-source care funding systems that operate in nursing homes for older people pose challenges to nursing home nurses. Some of these challenges may impact on their recruitment and retention., (© 2014 John Wiley & Sons Ltd.)

This article examines the emergence of the concept of infant disorganized/disoriented attachment, drawing on published and archival texts and interviews. Since this new classification was put forward by Main and Solomon (1986), "disorganized/disoriented attachment" has become an important concept in clinical and social intervention contexts. Yet whereas Main and Solomon have often been misunderstood to have introduced disorganized/disoriented attachment in order to produce an exhaustive, categorical system of infant classifications, this article will suggest quite a different account. Attention will be paid to the emergence of disorganized attachment as a classification out of results and reflections in the late 1970s regarding the limits of an alarmed infant's capacities for maintaining behavioral and attentional avoidance. In contrasting this interpretation of Main and Solomon's work with current, widespread misunderstandings, the article will critically examine tendencies that have supported the reification and misapplication of the concept of disorganized/disoriented attachment., (PsycINFO Database Record (c) 2015 APA, all rights reserved.)

As Main (1999) noted in her obituary for Mary Ainsworth, 'she was interacting weekly by letter and manuscript with her mentor and friend, John Bowlby, and their academic correspondence formed an important part of her, and implicitly our, life.' These letters of Ainsworth to John Bowlby during the 1980s, available in the Wellcome Trust Library in London, contain valuable reflections on the work of her pupils to extend her system of classifying infant behaviour in the Strange Situation Procedure. Mary Main proposed a D classification and interpreted such behaviour as a breakdown in an ABC strategy caused by a conflict between a disposition to approach and flee from the caregiver. Patricia Crittenden extended the subtypes of A and C, using a developmental model of information processing, and observed that they could be used together in A/C combinations. These letters offer insight into Ainsworth's intellectual rationale for encouraging both Main and Crittenden in their conflicting endeavours.