Marian Peacock

The role of social networks in the development of overweight and obesity among adults: a scoping review

BackgroundAlthough it is increasingly acknowledged that social networks are important to our understanding ofoverweight and obesity, there is limited understanding about the processes by which such networks shapetheir progression. This paper reports the findings of a scoping review of the literature that sought to identify the key processes through which social networks are understood to influence the development of overweight and obesity.MethodsA scoping review was conducted. Forty five papers were included in the final review, the findings of which were synthesised to provide an overview of the main processes through which networks have been understood to influence the development of overweight and obesity.ResultsIncluded papers addressed a wide range of research questions framed around six types of networks: a paired network (one’s spouse or intimate partner); friends and family (including work colleagues and people within social clubs); ephemeral networks in shared public spaces (such as fellow shoppers in a supermarket or diners in a restaurant); people living within the same geographical region; peers (including co-workers, fellow students, fellow participants in a weight loss programme); and cultural groups (often related toethnicity). As individuals are embedded in many of these different types of social networks at any one time, the pathways of influence from social networks to the development of patterns of overweight and obesity are likely to be complex and interrelated. Included papers addressed a diverse set of issues: body weight trends over time; body size norms or preferences; weight loss and management; physical activity patterns; and dietary patterns.DiscussionThree inter-related processes were identified: social contagion (whereby the network in which people are embedded influences their weight or weight influencing behaviours), social capital (whereby sense of belonging and social support influence weight or weight influencing behaviours), and social selection (whereby a person’s network might develop according to his or her weight).ConclusionsThe findings have important implications for understanding about methods to target the spread of obesity, indicating that much greater attention needs to be paid to the social context in which people make decisions about their weight and weight influencing behaviours.

Shaming Encounters: Reflections on Contemporary Understandings of Social Inequality and Health:

The idea that social inequality has deleterious consequences for population health is well established within social epidemiology and medical sociology (Marmot and Wilkinson, 2001; Scambler, 2012). In this article, we critically examine arguments advanced by Wilkinson and Pickett in The Spirit Level (2009) that in more unequal countries population health suffers, in part, because of the stress and anxiety arising from individuals making invidious or shame-inducing comparisons with others regarding their social position. We seek to extend their arguments, drawing on sociologically informed studies exploring how people reflect on issues of social comparison and shame, how they resist shame, and the resources, such as ‘collective imaginaries’ (Bouchard, 2009), which may be deployed to protect against these invidious comparisons. We build on the arguments outlined in The Spirit Level, positing a sociologically informed account of shame connected to contemporary understandings of class and neoliberalism, as well as inequality.

The discordant pleasures of everyday eating: Reflections on the social gradient in obesity under neo-liberalism

Despite widespread epidemiological evidence of a social gradient in obesity, there has been less attention focused on understanding this from a sociological perspective. Furthermore, whilst pleasure is an obvious feature of contemporary cultural representations of food and eating, this has not figured prominently in sociological understandings of the social gradient. Using qualitative data from biographical interviews conducted with adults living in materially deprived parts of South Yorkshire (UK) we introduce the idea of discordant pleasure in relation to everyday eating as a way of shedding light on the social gradient in obesity. We highlight in particular, the ways in which materially deprived individuals who were defined as obese described the tensions between the pleasures of eating and the struggles for bodily control, alongside the affective dimensions - frustration and shame - that this process engendered. We draw on Berlants work on lateral and interruptive agency to make sense of these accounts, suggesting that classed agency and discordant pleasure are important dimensions in understanding the social gradient in obesity under neoliberalism.

Palliative care in UK prisons : practical and emotional challenges for staff and fellow prisoners

Despite falling crime rates in England and Wales over the past 20 years, the number of prisoners has doubled. People over the age of 50 constitute the fastest growing section of the prison population, and increasing numbers of older prisoners are dying in custody. This article discusses some of the issues raised by these changing demographics and draws on preliminary findings from a study underway in North West England. It describes the context behind the rise in the numbers of older prisoners; explores the particular needs of this growing population; and discusses some of the practical and emotional challenges for prison officers, health care staff, and fellow prisoners who are involved in caring for dying prisoners in a custodial environment.

The Micropolitics of Obesity: Materialism, Markets and Food Sovereignty:

This article shifts focus from an individualised and anthropocentric perspective on obesity, and uses a new materialist analysis to explore the assemblages of materialities producing fat and slim bodies. We report data from a study of adults’ accounts of food decision-making and practices, investigating circulations of matter and desires that affect the production, distribution, accumulation and dispersal of fat, and disclose a micropolitics of obesity, which affects bodies in both ‘becoming-fat’ and ‘becoming-slim’ assemblages. These assemblages comprise bodies, food, fat, physical environments, food producers and processing industries, supermarkets and other food retailers and outlets, diet regimens and weight loss clubs, and wider social, cultural and economic formations, along with the thoughts, feelings, ideas and human desires concerning food consumption and obesity. The analysis reveals the significance of the marketisation of food, and discusses whether public health responses to obesity should incorporate a food sovereignty component.

BOTH SIDES OF THE FENCE: METHODOLOGICAL CHALLENGES IN UNDERTAKING RESEARCH INTO END OF LIFE CARE FOR PRISONERS

Introduction The number of older prisoners in the UK has more than doubled in the last decade, with the greatest increases amongst those over 70. Around 40% of older prisoners are sex offenders, many of whom are in prison for the first time due to historic abuse. Longer sentences and more stringent release criteria mean that increasing numbers of anticipated deaths in prison are predicted. Prison staff experience tensions between care and custody and demands for considerable emotional labour in delivering palliative care to such prisoners. Aim(s) and method(s) This paper presents some of the methodological challenges encountered during the early stages of the ‘Both sides of the fence’ study, which uses action research to develop a transferable model of integrated palliative care for prisoners. The first phase comprises a detailed situational analysis to explore current palliative care provision in one prison; then healthcare and custodial staff participate in action cycles to implement and evaluate changes to practice. Results A prison with a large population of older and disabled prisoners was identified as the research site, and access was granted following ethical and governance approvals. Engagement of diverse groups of staff in the research required multiple meetings, extensive networking and the visible on-site presence of the researcher; this engagement led to an important protocol amendment to include focus groups with prisoners who provide informal care to fellow prisoners. Conclusion(s) Establishing effective connections with a wide range of prison staff has been key to overcoming the methodological challenges and progressing the research.

‘We Call it Jail Craft’: The Erosion of the Protective Discourses Drawn on by Prison Officers Dealing with Ageing and Dying Prisoners in the Neoliberal, Carceral System:

The UK prison population has doubled in the last decade, with the greatest increases among prisoners over the age of 60 years, many of whom are sex offenders imprisoned late in life for ‘historical’ offences. Occurring in a context of ‘austerity’ and the wider neoliberal project, an under-researched consequence of this increase has been the rising numbers of ‘anticipated’ prison deaths; that is, deaths that are foreseeable and that require end of life care. We focus here on ‘jail craft’; a nostalgic, multi-layered, narrative or discourse, and set of tacit practices which are drawn on by officers to manage the affective and practical challenges of working with the demands of this changed prison environment. Utilising findings from an empirical study of end of life care in prisons, we propose that the erosion of jail craft depletes protective resources and sharpens the practical consequences of neoliberal penal policies.

Non-epileptic attack disorder: the importance of diagnosis and treatment

A 50-year-old woman was taken to hospital by emergency ambulance during her first seizure. She was admitted to hospital, treated with intravenous diazepam, diagnosed with epilepsy and started on antiepileptic drug (AED) therapy. This was ineffective so she was referred to a tertiary centre where she underwent video EEG and was diagnosed with non-epileptic attack disorder. Her experience of the diagnosis was positive; it allowed her to understand what was happening to her and to understand the link between her seizures, adverse childhood experiences and the death of her mother. She stopped taking AEDs and she was referred to a psychologist which led to a significant improvement in her functioning and quality of life. We present this case as a good example of the benefits of accurate diagnosis, clear explanation and access to specialist care.

Involving prisoners in action research to improve palliative care: findings from the ‘both sides of the fence’ study

Introduction With more than 12,000 older prisoners in the UK, deaths in custody are increasing ,1 as is the need for palliative care. The ‘Both sides of the fence’ study used action research methodology in one prison with a high population of older offenders. Interviews with staff and prisoners in Phase 1 provided the foundation for action cycles that took place in Phase 2; this paper reports action cycles directly involving older prisoners. Aim(s) and method(s) The aim was to engage with prisoners in making meaningful improvements to palliative care. First, an Older Prisoners Group (OPG) was established and facilitated by prison staff and researchers. The OPG met bi-monthly, with smaller groups of prisoners working on tasks between meetings. OPG members created an information leaflet on planning for the end of life in prison. They were also involved in the development of an Older Prisoners Unit (OPU) to reduce intimidation of vulnerable older prisoners by younger offenders. Results One thousand copies of the leaflet were produced for use by prisoners in the research site and other prisons. The OPU is a protected environment for prisoners over 50, with medication lockers in each room; prisoners in the OPU have reported feeling safer and less stressed. They also reported increased self-esteem through their involvement in the research. Conclusion(s) Involving prisoners in action research can have positive benefits for both prisoners and staff. Sustainability of these benefits will be achieved by the continuation of the OPG after the end of the study. Reference Prison Reform Trust.Bromley Briefings Prison Factfile, Autumn 2015. London: Prison Reform Trust; 2015.