'To be vigilant to leave no trace': secrecy, invisibility and abortion travel from the Republic of Ireland

Until 2018, abortion in the Republic of Ireland was banned in almost all circumstances under one of the most restrictive legal regimes in Europe. The main solution for Irish women and pregnant people seeking abortion services had been to pursue care abroad, typically in clinics in England. In this paper we focus on the hardships of waiting for abortion care experienced by Irish residents leading up to their travel for appointments in England in 2017 and 2018. Based on in-depth interviews with 53 Irish women collected at three British Pregnancy Advisory Services (BPAS) clinics in England we analyse women's experiences as they navigated an 'environment of secrecy' in Ireland. This included making specific secrecy efforts when navigating travel arrangements, conversations, movement, health records, and the travel itself. Despite the expansion of abortion access in Ireland in 2018, the need to travel abroad continues for many women. We argue that the continued need for secrecy when women have to travel abroad for care perpetuates this important phenomenon's invisibility. This argument also applies to other countries where abortion access is restricted, and women are forced to travel for care. We also caution against the presumption that all Irish residents are able to travel internationally for healthcare

French women's experiences and opinions with in-country versus cross-border abortion travel: a mixed-methods paper

ObjectivesThis is the first study contrasting the experience of women residing in France and travelling for abortion services inside and outside their country of residence. We compare travel reasons and costs as well as our study participants' opinions of abortion legislation. The article documents legal and procedural barriers related to accessing local and timely abortions and provides policy recommendations to broaden care options. MethodsThe study is based on a mixed-methods research design. Quantitative data were descriptively analysed using Stata and drawn from 100 surveys with in-country abortion seekers collected from 3 Parisian hospitals, and 57 surveys with French residents seeking abortion care in the Netherlands (42), Spain (10) and the UK (5). Qualitative data were thematically analysed using ATLAS.ti and drawn from 36 interviews with French residents (23 in-country abortion seekers and 13 cross-border abortion travellers). FindingsGestational age (GA) limits were the key reason for cross-border travel, while lack of close-by, timely and good quality abortion care was the main driver for in-country abortion travel. Unlike in-country travellers, cross-border abortion seekers faced significant financial costs and burdens related to such travel. Partners, family members and service providers offered important support structures to both cross-border and in-country travellers. ConclusionsLegal time limits appeared to be the key driver for abortion-related travel of French residents. Having passed or being at risk of exceeding the GA limit caused women to travel outside their country or department of residence for abortion care

What Works in Peer Support for Breast Cancer Survivors: a Qualitative Systematic Review and Meta-Ethnography

Breast cancer is associated with adverse physical and psychological consequences. Although research has identified the various benefits linked to psychosocial interventions, mixed results have been found in relation to peer support. The aim of the present systematic review and meta-ethnography is to explore the qualitative evidence on the experience of breast cancer survivors in peer support. A systematic search of the literature was conducted until June 2023, and a metaethnographic approach was used to synthesize the included papers. Eleven articles were included, collecting the experience of 345 participants. The following four core areas involved in peer support implementation were identified from the synthesis: Peer support can create understanding and a mutual therapeutic and emotional connection; peer support can facilitate an educational and supportive patient-centered journey; peer support should monitor group members for unpleasant emotional experiences; peer support should have professional supervision of recruitment and training to prioritize quality. These results can be used as patient-centered insights by healthcare professionals to provide evidence-informed peer support programs and address current limitations in the field

Influence of clinical and neurocognitive factors in psychosocial functioning after a first episode non-affective psychosis : Differences between males and females

Deficits in psychosocial functioning are present in the early stages of psychosis. Several factors, such as premorbid adjustment, neurocognitive performance, and cognitive reserve (CR), potentially influence functionality. Sex differences are observed in individuals with psychosis in multiple domains. Nonetheless, few studies have explored the predictive factors of poor functioning according to sex in first-episode psychosis (FEP). This study aimed to explore sex differences, examine changes, and identify predictors of functioning according to sex after onset. The initial sample comprised 588 individuals. However, only adults with non-affective FEP (n = 247, 161 males and 86 females) and healthy controls (n = 224, 142 males and 82 females) were included. A comprehensive assessment including functional, neuropsychological, and clinical scales was performed at baseline and at 2-year follow-up. A linear regression model was used to determine the predictors of functioning at 2-year follow-up. FEP improved their functionality at follow-up (67.4% of both males and females). In males, longer duration of untreated psychosis (β = 0.328, p = 0.003) and worse premorbid adjustment (β = 0.256, p = 0.023) were associated with impaired functioning at 2-year follow-up, while in females processing speed (β = 0.403, p = 0.003), executive function (β = 0.299, p = 0.020) and CR (β = −0.307, p = 0.012) were significantly associated with functioning. Our data indicate that predictors of functioning at 2-year follow-up in the FEP group differ according to sex. Therefore, treatment and preventative efforts may be adjusted taking sex into account. Males may benefit from functional remediation at early stages. Conversely, in females, early interventions centered on CR enhancement and cognitive rehabilitation may be recommended

Influence of clinical and neurocognitive factors in psychosocial functioning after a first episode non-affective psychosis: Differences between males and females

Background: Deficits in psychosocial functioning are present in the early stages of psychosis. Several factors, such as premorbid adjustment, neurocognitive performance, and cognitive reserve (CR), potentially influence functionality. Sex differences are observed in individuals with psychosis in multiple domains. Nonetheless, few studies have explored the predictive factors of poor functioning according to sex in first-episode psychosis (FEP). This study aimed to explore sex differences, examine changes, and identify predictors of functioning according to sex after onset. Materials and methods: The initial sample comprised 588 individuals. However, only adults with non-affective FEP (n = 247, 161 males and 86 females) and healthy controls (n = 224, 142 males and 82 females) were included. A comprehensive assessment including functional, neuropsychological, and clinical scales was performed at baseline and at 2-year follow-up. A linear regression model was used to determine the predictors of functioning at 2-year follow-up. Results: FEP improved their functionality at follow-up (67.4% of both males and females). In males, longer duration of untreated psychosis (β = 0.328, p = 0.003) and worse premorbid adjustment (β = 0.256, p = 0.023) were associated with impaired functioning at 2-year follow-up, while in females processing speed (β = 0.403, p = 0.003), executive function (β = 0.299, p = 0.020) and CR (β = -0.307, p = 0.012) were significantly associated with functioning. Conclusion: Our data indicate that predictors of functioning at 2-year follow-up in the FEP group differ according to sex. Therefore, treatment and preventative efforts may be adjusted taking sex into account. Males may benefit from functional remediation at early stages. Conversely, in females, early interventions centered on CR enhancement and cognitive rehabilitation may be recommended

The role of cognitive reserve and clinical symptoms in the association between genetic liability for educational attainment and functioning in first-episode psychosis: a mediation analysis

Background: Polygenic risk scores for educational attainment (PRSEA), cognitive reserve (CR), and clinical symptoms are associated with psychosocial functioning in first-episode psychosis (FEP). Nevertheless, the mechanisms underlying their complex interaction is yet to be explored. This study aimed to assess the mediating role of CR and clinical symptoms, both negative (NS) and positive (PS), on the interrelationship between PRSEA and functionality, one year after a FEP.Methods: A total of 162 FEP patients underwent clinical, functional, and genetic assessments. Using genome-wide association study (GWAS) summary results, PRSEA were constructed for each individual. Two mediation models were explored. The parallel mediation model explored the relationship of PRSEA with functionality through CR and clinical symptoms, NS, and PS. The serial mediation model tested a causal chain of the three mediators: CR, NS and PS. Mediation analysis was performed using the PROCESS function V.4.1 in SPSS V.22.Results: A serial mediation model revealed a causal chain for PRSEA > CR > NS > Functionality (β=-0.35, 95%CI [-0.85, -0.04], pConclusions: Both CR and NS mediate the relationship between PRSEA and functionality at one-year follow-up, using serial mediation analysis. This may be relevant for prevention and personalized early intervention to reduce illness impact and improve functional outcomes in FEP patients.</p

Influence of clinical and neurocognitive factors in psychosocial functioning after a first episode non-affective psychosis: differences between males and females

BackgroundDeficits in psychosocial functioning are present in the early stages of psychosis. Several factors, such as premorbid adjustment, neurocognitive performance, and cognitive reserve (CR), potentially influence functionality. Sex differences are observed in individuals with psychosis in multiple domains. Nonetheless, few studies have explored the predictive factors of poor functioning according to sex in first-episode psychosis (FEP). This study aimed to explore sex differences, examine changes, and identify predictors of functioning according to sex after onset.Materials and methodsThe initial sample comprised 588 individuals. However, only adults with non-affective FEP (n = 247, 161 males and 86 females) and healthy controls (n = 224, 142 males and 82 females) were included. A comprehensive assessment including functional, neuropsychological, and clinical scales was performed at baseline and at 2-year follow-up. A linear regression model was used to determine the predictors of functioning at 2-year follow-up.ResultsFEP improved their functionality at follow-up (67.4% of both males and females). In males, longer duration of untreated psychosis (β = 0.328, p = 0.003) and worse premorbid adjustment (β = 0.256, p = 0.023) were associated with impaired functioning at 2-year follow-up, while in females processing speed (β = 0.403, p = 0.003), executive function (β = 0.299, p = 0.020) and CR (β = −0.307, p = 0.012) were significantly associated with functioning.ConclusionOur data indicate that predictors of functioning at 2-year follow-up in the FEP group differ according to sex. Therefore, treatment and preventative efforts may be adjusted taking sex into account. Males may benefit from functional remediation at early stages. Conversely, in females, early interventions centered on CR enhancement and cognitive rehabilitation may be recommended

Adolescent psychopathology and alexithymia: a systematic review of the literature

Adolescence is a critical developmental period characterised by emotional, social and physical changes which can leave young people vulnerable to mental health difficulties. A wide body of research suggests that emotion regulation may be one of the central transdiagnostic constructs of adolescent psychopathology. Similarly, alexithymia, the term used to describe those who have difficulty expressing and identifying their own and others' emotions, has been cited as a developmental construct that emerges in adolescence. Although extensively researched in adulthood there has been less focus on the potential link between adolescent psychopathology and alexithymia. This review aims to address the gap in the literature by exploring this link. A systematic review was conducted according to the PRISMA guidelines. Eighteen studies were identified through a literature search of PubMed, Cochrane Trials Library, Sociological Abstracts and Google Scholar. All included studies investigated adolescent psychopathology and alexithymia. Specifically, seven studies reported on eating disorders, three on self-harm, two on post-traumatic stress disorder and two on borderline personality disorder. Of the remaining four studies one each investigated the link with depression, psychological distress, trauma and psychosis. The association between alexithymia and multiple psychopathologies in adolescence suggests that screening for alexithymia when treating these disorders may have important implications for both clinical practice and mental health intervention in this vulnerable population. Results are interpreted in the discussion. Future directions for research on adolescent psychopathology and alexithymia are also discussed.La adolescencia es un periodo crítico del desarrollo caracterizado por diversos cambios emocionales, sociales y físicos. Dichos cambios se convierten en factores de vulnerabilidad para la apariencia de problemas de salud mental. Un gran abanico de estudios empíricos destaca la regulación emocional como uno de los factores transdiagnósticos centrales de la psicopatología en la adolescencia. Asimismo, la alexitimia, el término utilizado a fin de describir a aquellas personas que tienen dificultades para expresar e identificar sus propias emociones y las de los demás, se ha citado como una característica del desarrollo que surge en la adolescencia. Aunque se investigó este vínculo de manera extensa en la población adulta, hay una carencia de literatura sobre este tema en la población adolescente. Por consiguiente, la presente revisión aborda esta brecha en la literatura al explorar dicho vínculo. Se realizó una revisión sistemática de acuerdo con las pautas de PRISMA. Dieciocho estudios fueron identificados mediante una búsqueda bibliográfica en PubMed, Cochrane Trials Library, Sociological Abstracts y Google Scholar. Todos los estudios incluidos en esta revisión investigaron la psicopatología en la adolescencia y alexitimia. Específicamente, siete estudios informaron sobre trastornos alimentarios, tres sobre autolesiones, dos sobre el trastorno de estrés postraumático y dos sobre el trastorno límite de la personalidad. Los últimos cuatro estudios investigaron el vínculo con depresión, angustia psicológica, trauma y psicosis. La asociación entre la alexitimia y múltiples psicopatologías en la adolescencia sugiere que la detección de alexitimia al tratar estos trastornos puede tener implicaciones importantes tanto para la práctica clínica como para la intervención de salud mental en esta población vulnerable. Se interpretan los resultados en la discusión. Es más, se proponen algunas futuras líneas de investigación relacionadas con la psicopatología adolescente y alexitimia.L'adolescència és un període crític del desenvolupament caracteritzat per diversos canvis emocionals, socials i físics. Aquests canvis es converteixen en factors de vulnerabilitat per a l'aparença de problemes de salut mental. Un gran ventall d'estudis empírics destaca la regulació emocional com un dels factors transdiagnósticos centrals de la psicopatologia en l'adolescència. Així mateix, la alexitimia, el terme utilitzat a fi de descriure a aquelles persones que tenen dificultats per a expressar i identificar les seves pròpies emocions i les dels altres, s'ha citat com una característica del desenvolupament que sorgeix en l'adolescència. Encara que es va investigar aquest vincle de manera extensa en la població adulta, hi ha una manca de literatura sobre aquest tema en la població adolescent. Per consegüent, la present revisió aborda aquesta bretxa en la literatura en explorar aquest vincle. Es va realitzar una revisió sistemàtica d'acord amb les pautes de PRISMA. Divuit estudis van ser identificats mitjançant una cerca bibliogràfica en PubMed, Cochrane Trials Library, Sociological Abstracts i Google Scholar. Tots els estudis inclosos en aquesta revisió van investigar la psicopatologia en l'adolescència i alexitimia. Específicament, set estudis van informar sobre trastorns alimentaris, tres sobre autolesions, dues sobre el trastorn d'estrès posttraumàtic i dos sobre el trastorn límit de la personalitat. Els últims quatre estudis van investigar el vincle amb depressió, angoixa psicològica, trauma i psicosi. L'associació entre la alexitimia i múltiples psicopatologies en l'adolescència suggereix que la detecció de alexitimia en tractar aquests trastorns pot tenir implicacions importants tant per a la pràctica clínica com per a la intervenció de salut mental en aquesta població vulnerable. S'interpreten els resultats en la discussió. És més, es proposen algunes futures línies de recerca relacionades amb la psicopatologia adolescent i alexitimia

IDEAS for Transforming Higher Education: An Overview of Ongoing Trends and Challenges

The recent unexpected impact of the global pandemic on higher education has caused universities, governments, students, and teachers to reexamine all components of existing systems, including how to become more effective and efficient in using technologies for education. We have seen that moving classes online—either blended or fully online—can be done rapidly, but early reports show huge variations in quality, acceptance, completion, and learning. Thus, it is important to examine the existing research literature on pedagogical innovations and practices that use technologies. To understand this complex situation, the present study examines the current technological, organisational, and pedagogical trends and challenges using an exploratory design carried out in three stages. In stage one, a literature review of the academic and grey literature was conducted, identifying 14 trends of interest. These trends were used in a workshop and interview discussion between leading experts in the higher education field. Stage two focused on identifying 108 initiatives that represent these trends. Finally, 30 of these were selected as cases for further exploration in stage three. Using thematic analysis, the 30 cases were condensed into 12 main themes that represent the innovative practices that led to development of the IDEAS framework as a signpost on the roadmap of next-generation pedagogy for transforming higher education. IDEAS is presented in the discussion alongside examples and ways to apply it in higher education contexts