Sarah Seymour-Smith

'My Wife Ordered Me to Come!': A Discursive Analysis of Doctors' and Nurses' Accounts of Men's Use of General Practitioners.

This study used a discursive approach to analysing doctors’ and nurses’ accounts of men’s health in the context of general practice. The analysis worked intensively with interview material from a small sample of general practitioners and their nursing colleagues. We examine the contradictory discursive framework through which this sample made sense of their male patients. The ‘interpretative repertoires’ through which doctors and nurses constructed their representations of male patients and the ‘subject positions’ these afforded men are outlined in detail. We describe how hegemonic masculinity is both critiqued for its detrimental consequences for health and paradoxically also indulged and protected. These constructions reflect a series of ideological dilemmas for men and health professionals between the maintenance of hegemonic masculine identities and negotiating adequate health care. Men who step outside ‘typical’ gender constructions tended to be marked as deviant or rendered invisible as a consequence.

‘What he hasn’t told you...’: Investigating the Micro-Politics of Gendered Support in Heterosexual Couples’ Co-Constructed Accounts of Illness

Research has demonstrated that heterosexual men receive enhanced health benefits from their relationships with women. Explanations for this gendered pattern often focus on women’s role as the main caregivers and arrangers of health care. However, what remains unclear is how these benefits are mediated. In this article, we describe the micropolitics evident in negotiations between 12 heterosexual couples as they discuss the serious illness of one of the pair with an interviewer. The interviews were transcribed and subsequently analysed using a synthetic approach to discursive psychology. We argue that in these co-constructed stories, women potentially trouble men’s identity performances. For instance, by interjecting emotional assessments, women supporters allow men the opportunity to discuss aspects of the illness experience that might be otherwise viewed as at odds with hegemonic masculinity. We suggest that women’s positioning of men is a form of complicity with hegemonic masculinity and urge that further research should follow this line of enquiry.

'Motivate': the effect of a Football in the Community delivered weight loss programme on over 35-year old men and women's cardiovascular risk factors

The purpose of this study was to examine whether an innovative, inclusive and integrated 12-week exercise, behaviour change and nutrition advice-based weight management programme could significantly improve the cardiovascular risk factors of overweight and obese men and women over the age of 35. One hundred and ninety-four men and 98 women (mean age = 52.28 ± 9.74 and 51.19 ± 9.04) attending a community-based intervention delivered by Notts County Football in the Community over one year, took part in the study. Height (m), weight (kg), fitness (meters covered during a 6 min walk) and waist circumference (cm) were measured at weeks 1 and 12 as part of the intervention. Changes in body weight, waist circumference and fitness for men and women were measured by a 2-way repeated measures ANOVA, with significance set to p < 0.05.Weight, waist circumference and fitness significantly improved over time in both men (4.96 kg, 6.29 cm, 70.22 m; p < 0.05) and women (4.26 kg, 5.90 cm, 35.29 m; p < 0.05). The results demonstrated that the FITC lead weight loss intervention was successful in significantly improving cardiovascular risk factors in both men and women. In particular, the weight loss reductions achieved were comparable to those seen in similar, more costly men-only programmes. This is the first study to demonstrate the efficacy of such an intervention in an inclusive, mixed gender programme and more specifically, in women.

A Qualitative Analysis of Offenders’ Modus Operandi in Sexually Exploitative Interactions With Children Online

Transcripts of chat logs of naturally occurring, sexually exploitative interactions between offenders and victims that took place via Internet communication platforms were analyzed. The aim of the study was to examine the modus operandi of offenders in such interactions, with particular focus on the specific strategies they use to engage victims, including discursive tactics. We also aimed to ascertain offenders’ underlying motivation and function of engagement in online interactions with children. Five cases, comprising 29 transcripts, were analyzed using qualitative thematic analysis with a discursive focus. In addition to this, police reports were reviewed for descriptive and case-specific information. Offenders were men aged between 27 and 52 years (M = 33.6, SD = 5.6), and the number of children they communicated with ranged from one to 12 (M = 4.6, SD = 4.5). Victims were aged between 11 and 15 (M = 13.00, SD = 1.2), and were both female and male. Three offenders committed online sexual offenses, and two offenders committed contact sexual offenses in addition to online sexual offenses. The analysis of transcripts revealed that interactions between offenders and victims were of a highly sexual nature, and that offenders used a range of manipulative strategies to engage victims and achieve their compliance. It appeared that offenders engaged in such interactions for the purpose of sexual arousal and gratification, as well as fantasy fulfillment.

‘It’s not a disease, it’s a nuisance’: controlling diabetes and achieving goals in the context of men with Type 1 diabetes

Despite a steady growth in research into men’s health, little is known about how men experience life with a chronic illness like Type 1 diabetes. To address this knowledge gap, we conducted an interview study with 15 men who have Type 1 diabetes. Following grounded theory analysis of the interview transcripts, we generated a number of inter-related themes which were then formulated as a theory of adjustment to life with Type 1 diabetes. This theory indicates that men reduce the seriousness of diabetes by defining it in ways other than a serious illness. By viewing diabetes in this way, men are then able to prioritise the pursuit of their personal goals over adherence to the diabetes regimen. Finally, men reassess their relationship with diabetes in light of diabetes-related complications. The goal of this process is to find the ‘best fit’ for diabetes in their lives – a place which will allow them to pursue and satisfy their personal goals. As men progress through life, personal goals may change and so too will their relationship with diabetes.

Our people has got to come to terms with that: changing perceptions of the digital rectal examination as a barrier to prostate cancer diagnosis in African-Caribbean men

African‐Caribbean men in the United Kingdom in comparison with other ethnicities have the highest incidence rate of prostate cancer. Psychosocial aspects related to screening and presentation impact on mens behavior, with previous studies indicating a range of barriers. This study explores one such barrier, the digital rectal examination (DRE), due to its prominence within UK African‐Caribbean mens accounts.

Straight Guys Do Wear Make-Up: Contemporary Masculinities and Investment in Appearance

Today’s men are less limited than previous generations and do things their fathers would have eschewed, including spending lots of time and money on ‘grooming’ products and services (moisturiser, body hair removal, even make-up). Our research with ‘metrosexual men’ and men on weight loss programmes shows that (heterosexual) men are indeed interested in their appearance, but also that appearance-related practices are glossed in conventionally masculine terms. While men do enact a greater range of attributes and activities than before, belying any notion of a ‘crisis’ in masculinity, we highlight the continued operation of orthodox masculinities which may work to marginalise other men and women.

PROCEE: a PROstate Cancer Evaluation and Education serious game for African Caribbean men

Purpose Prostate cancer is the most common cancer diagnosed in men in the UK. Black men are in a higher prostate cancer risk group possibly due to inherent genetic factors. The purpose of this paper is to introduce PROstate Cancer Evaluation and Education (PROCEE), an innovative serious game aimed at providing prostate cancer information and risk evaluation to black African-Caribbean men. Design/methodology/approach PROCEE has been carefully co-designed with prostate cancer experts, prostate cancer patients and members of the black African-Caribbean community in order to ensure that it meets the real needs and expectations of the target audience. Findings During the co-design process, the users defined an easy to use and entertaining game which can effectively raise awareness, inform users about prostate cancer and their risk, and encourage symptomatic men to seek medical attention in a timely manner. Originality/value During focus group evaluations, users embraced the game and emphasised that it can potentially have a positive impact on changing user behaviour among high risk men who are experiencing symptoms and who are reluctant to visit their doctor.

Co-design of a Prostate Cancer Serious Game for African Caribbean Men

Co-design is a process for creating interventions with representative participants of the target group. The co-design process ensures that the technologies are aligned with peoples needs and removes the designer subjectivity. This paper discusses the co-design methodology and evaluation of the Pro-CEE serious game, an innovative intervention which is aimed to raise the awareness of prostate cancer among African Caribbean men. The serious game provides information and risk evaluation based on the users profile and symptoms. Feedback from focus group evaluations of the serious game revealed that it is an effective tool which can potentially have positive impacts on changing user behaviour among those who are at high risk of prostate cancer and experience symptoms. The co-design approach adopted for the development of Pro-CEE ensured that an effective and culturally sensitive intervention was developed.

An Intelligent Serious Game for Supporting African and African Caribbean Men during Pre- and Post-Diagnosis of Prostate Cancer

Prostate cancer is the most common cancer diagnosed in men in the UK. Over 40, 000 men are diagnosed with prostate cancer every year and one in four Black men will develop prostate cancer at some point in their lives. High mortality rates among African and African Caribbean men exist due to the various barriers which prevent them from seeking advice and early treatment for prostate cancer. Such barriers include unawareness of risk, symptoms, and treatments for prostate cancer, and trust/mistrust of healthcare services. There is a need for understanding and developing culturally sensitive interventions to enhance knowledge and understanding of prostate cancer in African and African Caribbean men, and to encourage presentation as early as possible, as this could save lives. Serious games and computational intelligence can provide a supportive framework for patients at the pre- and post-diagnosis stages. We are proposing an intelligent serious game which can build a model of the patient via their user-profile and in game responses. This data is analysed by a computational intelligence layer, built beneath the game layer, which assesses the risk factors and feeds back to the patient, via the game layer, timely cues for action. This approach can overcome some of the existing barriers to timely presentation and diagnosis for this target population including their preferences in mining health information, previous negative experiences with health professionals and other barriers which prevent men at risk from seeking medical attention.