Penny Curtis

The experiences of young people with obesity in secondary school: some implications for the healthy school agenda

In 1995, the World Health Organisation launched a Global School Health Initiative to reduce health risks among young people. In the UK, the National Healthy School Programme (HSP) developed as part of a wider government commitment to promoting social inclusion. One of the key issues to be tackled by the programme is childhood obesity, for obesity is widely argued to be a public health problem for which a solution needs to be found. However, the assumption that obesity is necessarily problematic and that a higher body weight leads to health problems and social exclusion, is not without challenge. Critics of anti-obesity campaigns question the significance of weight per se and highlight the potential implications of discrediting not only fatness, but also the people who are seen as fat. This paper therefore explores the experiences of young people with obesity within the secondary school environment in relation to areas of concern prioritised by the HSP. The paper draws upon data from a qualitative research study involving 18 children and young people, between the ages of 10 and 17. Data were generated in focus group discussions and individual interview with participants of a community-based obesity intervention programme in South Yorkshire, UK. Data collection took place in 2005, and thematic analysis of the data was undertaken. Findings suggest that the issues prioritised in the HSP, particularly physical exercise and healthy eating, present challenges to young people with obesity and can reinforce their vulnerability to bullying in schools and contribute to their social exclusion. It concludes that social exclusion is a process experienced by, and pertinent to, children and young people, which has meaning for their experiences of, and during, childhood and youth. The whole-school approach of the HSP may fail to adequately address the experiences of marginalised and vulnerable groups of young people within schools, challenging and undermining the social inclusion agenda in which the programme is grounded and contributing to the construction of undesirable, fat, young bodies.

Children's snacking, children's food: food moralities and family life

This work considers the construction of childrens food and childrens eating practices, in the narratives of children, aged 11–12, and their parents, and explores what these constructions reveal about child–adult relations and the nature of family life. It argues that, implicit to the differentiation of childrens and adults food and eating practices within families are generationally nuanced food moralities. We suggest that the day-to-day, ongoing negotiation and management of these generationally nuanced food moralities is integral to the constitution of intergenerational relations and generational identity and, indeed, the idea of ‘family’ itself.

Family Displays and Personal Lives

In this article we explore how Finch’s (2007) concept of display might illuminate the new sociology of personal life as set out by Smart (2007). Drawing on narratives of family life and eating practices, from both parents and children, the article considers how these work as tools of family display. For some families, displays are used to affirm an idiosyncratic sense of their family through drawing on particular cultural motifs of ‘family’. For other families, practices of display work to smooth over challenges from within. Displays can also be more normative, confirming wider hegemonic models of what the family is. Thus, while displays — and therefore ideas of family — do take different forms, nonetheless they also demonstrate that, as Smart suggests, people’s personal lives need always to be understood as embedded in particular social and cultural worlds, rather than a function of lone, autonomous individuals.

Negotiating Family, Negotiating Food: Children as Family Participants?

There has been a considerable resurgence of interest in families and food within English society, sparked in part by a concern that both family and food have, in some ways, undergone a process of detrimental decline over the last half of the twentieth century. Poised now at the start of the twenty-first century, critical eyes are being cast over rising levels of obesity among children as well as adults, the nutritional deficiencies of school dinners and the propensity for children and young people, as well as their parents, to consume ‘junk’ food. In respect of the family, observers have noted with alarm the rising levels of divorce, increasingly time-poor family life, the loss of ‘traditional’ parental authority, and the growing sequestration of children into separate institutionalised leisure spaces in which ‘the family’ plays a less prominent part (Qvortrup 1994). Taken together these twin trends are, within the popular press, held to account for many of the contemporary ills of English life, sparking waves of government initiatives designed to tackle these new social ‘problems’.1

‘She’s got a really good attitude to healthy food…Nannan’s drilled it into her’: Inter-generational Relations within Families

Over recent years, the UK tabloid press has been vociferous in highlighting a wide range of social issues, from an alleged decline in cooking skills among young people to the enthusiastic reporting of anti-social behaviour orders — all of which have, to a greater or lesser extent, been associated with the erosion of inter-generational relations. In July 2008, for example, The Daily Mail ran a headline, which asserted: Pushover parents to blame for generation of children who ‘lack discipline and moral boundaries’ (30 July 2008). It would seem from this that inter-generational relations are in crisis — a crisis characterised by adults’ failure to teach and to control children appropriately and by children’s lack of responsibility and failure to discriminate between right and wrong.

Children’s understanding of family financial resources and their impact on eating healthily

Socioeconomic inequalities in childhood are linked to childhood and adult health inequalities. They are particularly closely associated with inequalities in nutritional and consequently health status. Recent research links this to the high cost of nutrient-rich and low cost of nutrient-poor foods and explores how parents negotiate food purchase on a limited budget. However, we know little of childrens perspectives on the material and social realities of their lives and their involvement in health-relevant behaviour. This contrasts with a growing body of research which emphasises childrens active role in making sense of and participating in health practices while growing up and their potential to act in continuity with and as agents of change in family health cultures. This paper explores childrens understanding of family finances and how they perceive this to relate to eating healthily. It draws upon data from a qualitative study of 53 children aged 9-10 from two socioeconomically contrasting schools in the North of England during 2010 and 2011. Data were generated in friendship group interviews and debates at school and individual interviews in the home, and analysed thematically. Children incorporated a variety of media information into their understandings and sought explanations from their personal experience. They had sophisticated ideas about the interrelationships between diet, cost and health and were acutely aware of how family finances influenced food purchase. Children proposed different strategies to facilitate eating healthily on a budget, but prioritised state and corporate responsibility in ensuring that eating healthily is affordable. This contrasts with current health-related policy, which does not address cost as a potential barrier to eating healthily in the home. Children also consistently conflated healthy eating with eating fruit and vegetables, highlighting a need to reinforce other important nutritional messages.Socioeconomic inequalities in childhood are linked to childhood and adult health inequalities. They are particularly closely associated with inequalities in nutritional and consequently health status. Recent research links this to the high cost of nutrient-rich and low cost of nutrient-poor foods and explores how parents negotiate food purchase on a limited budget. However, we know little of children’s perspectives on the material and social realities of their lives and their involvement in health-relevant behaviour. This contrasts with a growing body of research which emphasises children’s active role in making sense of and participating in health practices while growing up and their potential to act in continuity with and as agents of change in family health cultures. This paper explores children’s understanding of family finances and how they perceive this to relate to eating healthily. It draws upon data from a qualitative study of 53 children aged 9–10 from two socioeconomically contrasting schools in the North of England during 2010 and 2011. Data were generated in friendship group interviews and debates at school and individual interviews in the home, and analysed thematically. Children incorporated a variety of media information into their understandings and sought explanations from their personal experience. They had sophisticated ideas about the interrelationships between diet, cost and health and were acutely aware of how family finances influenced food purchase. Children proposed different strategies to facilitate eating healthily on a budget, but prioritised state and corporate responsibility in ensuring that eating healthily is affordable. This contrasts with current health-related policy, which does not address cost as a potential barrier to eating healthily in the home. Children also consistently conflated healthy eating with eating fruit and vegetables, highlighting a need to reinforce other important nutritional messages.

Making Healthy Families

Certain geographical areas and neighbourhood types have come to symbolise patterns of ignorance, lack of opportunity and ‘poor lifestyle choice’ in public discussions of family food practices. The media, reporting recently on the activities of one of the UK’s ‘celebrity’ chefs announced: ‘Jamie Oliver to teach the poor how to cook ‘the basics’ in town [Rotherham] where mums opposed his school dinners campaign’ (The Daily Mail 28 March 2008). Concern about diet and about contemporary eating practices is therefore widespread. An increasing public focus on diet and health is not surprising: in England the number of obese children has tripled in 20 years. Ten per cent of six year olds are estimated to be obese, rising to 17% of 15 year olds (Zaninotto et al. 2006). While current concern about childhood obesity is usually expressed in terms of what children eat, implicit in contemporary discourses about health is also a critique of how they eat. While the ‘what’ is subject to scientific debate among for example, nutritionists and members of the medical profession, discussion of the ‘how’ has often been dominated by prejudice, myth and unquestioned assumptions which are grounded in notions of appropriate — and inappropriate — forms of parenting and family life.

Fathering through Food: Children’s Perceptions of Fathers’ Contributions to Family Food Practices

A few years ago, the BBC hosted a national competition for amateur chefs. The 2006 Masterchef title went to a man named Peter Bayless who charted his own experience of learning to cook in a book entitled My Father Could Only Boil Cornflakes — a sardonic title which serves to reaffirm Morgan’s observation that the ‘alleged incompetence of men in the kitchen is frequently the subject of considerable humour and right comment’ (1996:159). My Father Could Only Boil Cornflakes both emphasises Bayless’s expertise and implies incompetence in other men, particularly those of a different generation.

Supervision in clinical midwifery practice

In 1987, a community midwife practising in the Isle of Wight aroused considerable interest in the professional press (Flint, 1987; Hughes and Parker, 1987; Nursing Times, 1987), when she contested the right of her midwifery manager and supervisor of midwives to direct her clinical practice. Her supervisor of midwives had issued a memorandum directing all midwives who conducted hospital deliveries to administer syntometrine for the third stage of labour (unless the mother gave specific instructions to the contrary). The directive had been originated by a consultant obstetrician.

Jordanian perspectives on advanced nursing practice: an ethnography

AIM This study aimed to explore how different groups of participants perceived the concept of advanced nursing practice in Jordan. BACKGROUND In Jordan, there are postgraduate educational programmes offering a Masters degree in clinical nursing for registered nurses. Intended to prepare nurses to practise at an advanced level as potential clinical nurse specialists in critical care, community health nursing and maternal newborn nursing, little was known prior to this study about the development of advanced nursing roles for nurses in Jordan and the drivers behind their establishment. METHODS Using ethnographic design, narratives from semi-structured interviews and non-participant observation with participants from five Jordanian hospitals and two public universities were collected and analysed according to thematic analysis. FINDINGS AND DISCUSSION Four themes emerged from the data: core competencies, specific practice area vs. generic practice, beneficiaries of advanced nursing practice and drivers for educational change. The findings are similar to those found in other countries and highlight the need for a consensual understanding between nurse educationalists, professional bodies and employers about what advanced nursing practice in Jordan should be, so that a common framework can be identified. CONCLUSION Paralleling the lack of consistency in understanding of advanced nursing practice in the broader literature, participants described a number of different elements of advanced practice that are relevant to the specific context of contemporary Jordanian nursing.