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Book review – “Challenging the Politics of Early Intervention: Who’s ‘Saving’ Children and Why”, by Val Gillies, Rosalind Edwards and Nicola Horsley.

I received a copy of this book from the publisher (Policy Press) in return for a fair and considered review. I approach this book from the perspective of a current practitioner (in health services), but with an academic/research background.

This is an excellent review of the underlying politics and interests underlying the prevailing social investment model of early intervention for children in the UK, and it is particularly excellent and thorough in dismantling the ‘Emperor’s New Clothes’ fetishisation of poorly interpreted neuroscience which forms the basis of much policy and current practice in early intervention. The historical roots of this approach provided fascinating background to what has become a largely cross-party consensus (though for differing reasons, depending on one’s political hue) that individual work with children and their primary caregiver (primarily the mother) is prioritised over the improvement of the social and material conditions in which children and their families live. The outlining of the various interest groups involved (political, business, philanthrocapitalist, and certain practitioner groups), as well as their problematic co-opting of poorly- (or over-) interpreted brain science, laid bare the underlying (not always entirely philanthropic) motivations for the development of this consensus, and paved the way for a blistering – and very timely – exposure of the overal social investment consensus as effacing gender, race and class factors impacting on children’s development. Further insights from practitioners highlighted indeed how, as the authors state on p.119, “Practitioners work in contexts where there is little internal questioning about the general endeavour of early intervention”, but instead accept the over-simplistic and poorly interpreted brain studies as a foundational evidence base and theoretical justification for their practice – a situation which arguably also applies to the policy makers and managers charged with developing and implementing these practices.

Whilst the book is specific to the UK context, in fact it is primarily England-focused, with just a couple of mentions of other policy initiatives (primarily the Named Person, currently contested and undergoing revision in the light of significant opposition and legal challenge) in Scotland. I would have liked to have seen a little more from parts of the UK other than England, whilst recognising that the underlying points and background apply to early intervention policy across the UK nations. Another concern echoes a previous Amazon reviewer*, which is that whilst this is an excellently argued and thorough academic critique of the current situation in policy, and in fact it does indeed end with a call for a collective rather than individualised response to social harm, moving away from an all-encompassing prioritisation of “risk” (a call with which I entirely agree), nevertheless as a practitioner I found I was looking for some practical suggestions of what to do in cases where individual responses and involvement with individual families is entirely justified, and required quickly. There may well be scope for further work in this area, if the authors are able to link with practitioners, academics, policy makers and service managers who share their concerns and misgivings. I would also have liked to have seen more input from professional bodies, as the bulk of those participating in the case study and interview part of the book were from the voluntary or non-statutory sector (it was unclear whether the FNP nurses interviewed were working within or outwith the NHS, although earlier the book had identified the decoupling of the FNP service from other statutory services in England). Perspectives from groups such as the Institute of Health Visiting, or other social work bodies, for example, would have been interesting and may have added a further layer of nuance to the authors’ arguments.

Overall though this has provided me with an immense amount upon which to reflect as a practitioner, and I recommend it wholeheartedly. It would be ideal not only for students of social policy and health/social work management, but also would offer valuable insights to practitioner training courses (social work, teaching, health visiting, etc).

Thank you very much to Policy Press for this opportunity!

* Simon Haworth on 29 September 2017 included in his amazon review the following, with which I absolutely agree: “One potential criticism is that, perceptive and value-based as the book is, it does at times seem to move too far way from the dilemma-laden nature of frontline practice, where difficult and emotive decisions do need to be made to protect children, even when it is evident that the system has failed the family.”

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New transcription and proofreading business

This month I have an exciting new venture to report. I have been looking for a while at how to be further involved in supporting research outwith academia. I am involved in some academic writing (more on that when it is published!), but the prospect of being a freelancer has appealed for a long time, as I seek both flexibility and portability in order to work around my family and other commitments. I have therefore set myself up as a freelance transcriber and proofreader and am now open for business! Please see the “Transcription and Proofreading Services” page on this blog for details of how to get in touch.

For transcription, I am primarily focusing on qualitative interviews and focus groups, but I am also happy to work with files from other scenarios such as seminars, meetings, or conference presentations amongst others. Whilst I expect the majority of my business to come from academia, if you are working elsewhere in the public or voluntary sectors and have sound files which need transcribing, then please do get in touch and we can discuss your requirements and my rates.

For proofreading, I am initially focusing on academic manuscripts, including providing a service for authors where English is not their first language. I am currently undertaking a proofreading and copy-editing course from Chapterhouse and hope that in the future this can also lead me to some freelance work within the publishing sector.

As someone who has previously marked student work as a tutor, I have for some time been concerned about the rise of companies ostensibly providing a “proofreading” service but in effect writing the work for the student. I will not be involved in this type of work, as I consider it highly unethical. In order to protect both myself and the student from this type of exploitative work, if you are a student wishing your work to be proofread then I would ask that you arrange for your supervisor to contact me first to discuss the requirements of the job.

Initially, due to the part-time nature of this venture (which I am undertaking alongside my regular health visiting post), I am primarily available to work on Tuesdays, with occasional other afternoons. My intention is that as I gain more work I will be able to extend the time I spend on this business, and hopefully on your work!

Please do get in touch if you are looking for transcription or proofreading services, and I will be happy to discuss your requirements further. I look forward to a fruitful working relationship!

REPOSE trial – final report

Earlier this year the final report came out for the REPOSE trial. This was the trial that I was working with while I worked at the University of Edinburgh; I was the Research Fellow involved in the qualitative study that was embedded in the RCT, looking at the experiences of patients and educators (nurses and dieticians) during the trial. Budget savings after I left meant that the team were also able to do a further qualitative piece of work looking at the close of the trial with the educators, which has also thrown up some really interesting findings.

The final report is titled “A cluster randomised trial, cost-effectiveness analysis and psychosocial evaluation of insulin pump therapy compared with multiple injections during flexible intensive insulin therapy for type 1 diabetes: the REPOSE Trial”, and is published by Health Technology Assessment, 21(20). The link to the downloadable version of the report is here.

New article

I have somewhat neglected this blog of late, but hopefully will return to it more regularly soon. I am now back in clinical practice, working as a health visitor in central Scotland, although still interested in and looking to be involved in research.

In the meantime however, another article from the qualitative research project I was involved in at the University of Edinburgh has now been published, and so I am delighted to be able to provide a link to it:

Lawton J, Kirkham J, Rankin D, White DA, Elliott J, Jaap A, Smithson WH, Heller S. (2016) “Who gains clinical benefit from using insulin pump therapy? A qualitative study of the perceptions and views of health professionals involved in the REPOSE (Relative Effectiveness of Pumps over MDI and Structured Education) Trial”, Diabetic Medicine, 33(2): 243-251. Link to article.

I really enjoyed the interviews I did with the diabetes educators working on this trial, and am delighted that we have (thus far) published two articles from these interviews.  My grateful thanks to all who participated.

 

Our recent articles

I am getting ready to leave my post at the University of Edinburgh, as my contract is finally ending (I am very grateful to the funders and to the University that I was able to see the contract through its final few months, after having to take time out for maternity leave. I know that not all researchers on fixed-term contracts are so lucky). I do intend to keep up with this blog, although it will probably change focus a little as I will be returning to clinical practice, at least in the short term, although I am not abandoning academia entirely and still hope to write a bit here and there.

I did want to provide links, though, to a couple of articles that have been published recently from the qualitative work that I have been involved in. I haven’t written about the project up till now, and won’t go into detail as the trial is still ongoing (with final clinical and statistical data due to be collected later this year), but this article in BMJ Open by my colleagues outlines the REPOSE trial, the qualitative sub-study of which has been my work over the last nearly 3 years. REPOSE is a randomised controlled trial which is seeking to compare two types of treatment for Type 1 diabetes (multiple daily injections of insulin, or MDI, and insulin pumps) alongside structured education (the DAFNE – Dose Adjustment for Normal Eating – course) for both sets of patients. The qualitative study involved interviewing both patients and DAFNE educators about their experiences, with the hope that our findings can help with interpreting the final trial findings and add value to the overall trial outcome, as well as potentially influence good practice in both diabetes care and in clinical trials more generally.

The first qualitative article we published is in Diabetes Research and Clinical Practice, and is titled “Perceptions and experiences of using automated bolus advisors amongst people with type 1 diabetes: A longitudinal qualitative investigation”. This article is open access.

The second article, also open access, was published in Trials journal last month and quickly became highly accessed, something of which we are very proud, as clearly we have tapped into a very pertinent and important issue in trials work. The article is titled “Uncovering the emotional aspects of working on a clinical trial: a qualitative study of the experiences and views of staff involved in a type 1 diabetes trial”.

2013

Happy New Year! I’m feeling a bit new year-ish (not hungover, but maybe a little bit slow!) so wanted to note down some aims for the year in order to hopefully slide gently into a good 2013.

I’m not going to particularly recap 2012 (though there is a blog on the ECRchat blog about the ‘my best of 2012’ chat I hosted in December – you can read that here), other than to say that there were lots of positives for me, not least getting my job and finding myself in a great team with supportive colleagues with whom I’m looking forward to working over the coming year.

Now that I feel a bit more established as an academic and in life in general, I do want to be a bit more focused both in work and in not-work. So here are a few, hopefully realistic, goals for the coming year:

1. Read more

This will relate to point 2. below, but I am hoping to read a lot more, both work-related and not. When I read something well-crafted it is energising and inspiring, and one day I hope that my own writing might have a similar effect. I’m not going to put specific goals (x journal articles and y books per week), but I think one of the things I learned from my failed #acwrimo was that without reading, the writing won’t happen, so I do want to increase the amount I read. For work I need to read more around diabetes, the body, technology and chronic disease (amongst others), and I also have a pile of post-PhD-related reading around gender, sexuality, reproduction and eastern Europe which will all be helpful for expanding my thinking ready to get seriously publishing from the PhD. Which leads me nicely onto:

2. Write more

Although #acwrimo didn’t work for me, it did show me that I need to incorporate writing more systematically into my working life. I have several articles in various states of being-written, and others in my head, so I have put in my diary space to try and get them finished over this year. I also need to write for my current project, something I am being encouraged to do (we are hopeful to have a couple of articles ready to submit in the next 2 or 3 months), so the reading and writing will be a big part of working life this year. I’m looking forward to that – I like writing, and I will have the new experience this year of joint-authoring articles, as well as continuing the single-authoring writing from my thesis. The first priority for me will be to write the papers on which I will be basing my talk for the BASEES conference in April.

3. Technology/internet

There are a few bits of technology/internet I’d like to get more up to speed with this year – I have found storify not particularly intuitive and so after hosting the #ECRchat end of year twitter chat (link above) I had to rely on somebody else to produce the storify, so one thing to do will be to play around with that and try and get my head round it. Another site which I think looks interesting is scoop.it, which I think will be a useful way of sorting out all the links, posts and videos I keep picking up and hopefully making my internet bookmarks a bit more manageable! There are other sites which I haven’t really connected with – LinkedIn and pinterest in particular – which other academics have found useful. I’m still to be convinced about them, but am happy to be persuaded otherwise. I’m thinking about buying an eReader of some description, which will hopefully help me with my aim of reading more. And I will try and blog a bit more frequently this year – so I will be thinking more carefully about my responses and reactions to issues with a view to writing more.

4. Teaching

My job is research-only, but I am also of course teaching with the Open University. I want to continue to learn what works well in both face to face and online learning environments, and hopefully see progress and good results in my students! I also want to start thinking about possibilities for teaching in future jobs – although I have over a year left on my current contract, and we are thinking about applying for other fellowships, so this is not an immediate requirement, I want to at least have a good plan so that should a position come up I am not taken by surprise!

5. Conferences

I have had a paper accepted for the BASEES (British Association of Slavonic and East European Studies) conference in April, so that will be a great chance to engage with the area studies community. I hope I’ll also have a chance to present some findings from the work project too, as up until now all of my conference presentations have been from my PhD, so it will be good to increase my experience outwith area studies conferences.

6. Relaxing

I’m not convinced that ‘work-life balance’ is quite the phrase I want – given that work is such a huge part of life – but I do want to get a better balance between work life and not-work life. I think the biggest key to this will be to be more efficient in my use of time, something I keep telling my students but which I need to be much better at doing myself! I will be rejoining the gym which is a good way (for me) of relaxing and feeling good, also spending time at the allotment, and hopefully getting in some non-work-related reading too. All that is relatively easy – the biggest challenge for me I think will be avoiding the temptation to procrastinate!

I think that will do for now – I will sit down and try and work out in a bit more detail (monthly) what to do when, and hopefully at the end of the year I can look back on this post and not be too shamefaced!