Re-working biographies: Women's narratives of pregnancy whilst living with epilepsy.

This paper explores the multiple ways experiences of pregnancy and early motherhood come to 'rework' the biographies of women living with epilepsy. Pregnancy is explored as a temporarily concurrent status alongside the long-term condition of epilepsy. Narrative interviews were conducted with 32 women from across the UK. Analysis of these narratives suggests that biographical disruption and continuity are both useful in the conceptualisation of women's diverse experiences of pregnancy and epilepsy. Such findings challenge the notion that the presence of a condition over a long period of time leads to the normalisation of illness. Participants' narratives demonstrate that, for some, pregnancy and early motherhood may be disruptive and can raise concerns regarding an ever present condition that may previously have been taken for granted. Findings also indicate the need for a greater consideration of gender and care responsibilities, as well explorations of concomitant conditions, in the theorising of biographies and chronic illness

Rights and Rebuilding in El Salvador: A Case Study in Two Parts

In January 2007, on the 15th anniversary of the signing of the peace accords that ended 12 years of civil war and grave human rights violations in El Salvador, UN Secretary General Ban Ki-moon praised El Salvador as a model for other countries emerging from conflict: “The groundbreaking accords signed in Mexico City in January 1992 not only set El Salvador on a new course. They also provided precedents and experiences that continue to inspire others who are striving to rebuild their societies following conflict. And they continue to be a point of reference for the United Nations, as we assist others on their path to peace.” © Elaine K. Denny & Susan Waltz. All rights reserved. This paper may be freely circulated in electronic or hard copy provided it is not modified in any way, the rights of the author not infringed, and the paper is not quoted or cited without express permission of the author. The editors cannot guarantee a stable URL for any paper posted here, nor will they be responsible for notifying others if the URL is changed or the paper is taken off the site. Electronic copies of this paper may not be posted on any other website without express permission of the author

Teaching Notes: Rights and Rebuilding in El Salvador

We have prepared this two-part case study with two pedagogical purposes in mind: (1) To develop an understanding of the concept (and political meaning) of human rights. (2) To facilitate discussion about processes of reconciliation and reconstruction and the importance of holistic conceptions of rights and security for future stability. © Elaine K. Denny & Susan Waltz. All rights reserved. This paper may be freely circulated in electronic or hard copy provided it is not modified in any way, the rights of the author not infringed, and the paper is not quoted or cited without express permission of the author. The editors cannot guarantee a stable URL for any paper posted here, nor will they be responsible for notifying others if the URL is changed or the paper is taken off the site. Electronic copies of this paper may not be posted on any other website without express permission of the author

How to do qualitative research?

Qualitative research begins with one or more relatively broad research questions that may be revised iteratively as the research is carried out to narrow the research aim or purpose. This is different from quantitative research, where a narrow research question is set at the start and remains fixed. For example, the aim of a study may be to explore the experiences of women who are pregnant while living with epilepsy. The initial research question may be ‘How do women with epilepsy experience pregnancy?’ However, from preliminary findings this may change to ‘How do women manage their epilepsy during pregnancy?

Men, chronic illness and healthwork: accounts from male partners of women with endometriosis

Currently dominant in medical discourse, the concept of self‐management sees the responsibility for health and illness shift from the state to the individual. However, while this emphasis on individual responsibility and management has burgeoned, the role and status of partners and other family members in the management of chronic illness remains under‐theorised. While self‐management privileges individual responsibility for the management of chronic illness, the role of partners remains unclear. This paper utilises data from a study of heterosexual couples’ experiences of living with the chronic gynaecological condition endometriosis to explore how male partners engage in its day‐to‐day management. In all, 22 couples participated in in‐depth, semi‐structured interviews with each partner interviewed separately (n = 44). Data were analysed thematically and dyadically, informed by an interpretivist relational approach. The paper utilises the concept of healthwork to describe the illness work, everyday life work, biographical work and emotion work men engaged in. The paper demonstrates how the conceptual value of healthwork is enhanced by incorporating an analysis of the emotional effort required in managing chronic illness. The paper illustrates the value of investigating the role of partners in managing chronic illness to provide a fuller account of the distributed and relational nature of healthwork

Barriers and facilitators to healthcare practitioners providing care for pregnant women with epilepsy : A systematic review and narrative synthesis

We acknowledge the contribution of Helen Ryba, subject specialist librarian who contributed to our search strategy and Joy Orpin, research fellow, who contributed to the extraction of survey data. Registration of the review Prospero CRD42023450252Peer reviewe

Barriers and facilitators to healthcare practitioners providing care for pregnant women with epilepsy:A systematic review and narrative synthesis

Purpose: Despite published guidelines for managing pregnant women with epilepsy, their care is sub-optimal. We undertook a review to establish the barriers and facilitators to healthcare practitioners providing optimal care. Methods: A systematic search of ASSIA, CINAHL complete, MEDLINE, SCOPUS, and the Cochrane database of systematic reviews between 2013 and 2023 and narrative synthesis. Results: From 580 potential papers, we included 16 studies. There were a total of 2045 participants across all studies, who consisted mostly of obstetricians/gynaecologists (n=447) and neurologists (n=765) but also included midwives/nurses (n=70), general practitioners (n=107) and pharmacists (n=156) with the others being mixed groups of physicians, advanced practitioners or unspecified. Thirteen studies were questionnaire surveys and three used qualitative methods. Nine tested or asked about practitioners’ knowledge. Although knowledge was generally adequate, practitioners found it difficult to apply in challenging or complex cases. Other barriers included challenges to joint working (between primary and secondary care and between different specialist groups), communication with women and environmental factors such as lack of time and guideline availability. Practitioners expressed the importance of providing good care for pregnant women with epilepsy. Conclusion: More qualitative studies are needed to understand the challenges and needs of practitioners caring for pregnant women with epilepsy. To address this, based on studies available we suggest joint (neurology and obstetrics) clinics, the availability and dissemination of guidelines, a risk evaluation tool and guidelines in the content and nature of communication with women

Outpatient versus inpatient uterine polyp treatment for abnormal uterine bleeding: randomised controlled non-inferiority study.

OBJECTIVE: To compare the effectiveness and acceptability of outpatient polypectomy with inpatient polypectomy. DESIGN: Pragmatic multicentre randomised controlled non-inferiority study. SETTING: Outpatient hysteroscopy clinics in 31 UK National Health Service hospitals. PARTICIPANTS: 507 women who attended as outpatients for diagnostic hysteroscopy because of abnormal uterine bleeding and were found to have uterine polyps. INTERVENTIONS: Participants were randomly assigned to either outpatient uterine polypectomy under local anaesthetic or inpatient uterine polypectomy under general anaesthesia. Data were collected on women's self reported bleeding symptoms at baseline and at 6, 12, and 24 months. Data were also collected on pain and acceptability of the procedure at the time of polypectomy. MAIN OUTCOME MEASURES: The primary outcome was successful treatment, determined by the women's assessment of bleeding at six months, with a prespecified non-inferiority margin of 25%. Secondary outcomes included generic (EQ-5D) and disease specific (menorrhagia multi-attribute scale) quality of life, and feasibility and acceptability of the procedure. RESULTS: 73% (166/228) of women in the outpatient group and 80% (168/211) in the inpatient group reported successful treatment at six months (intention to treat relative risk 0.91, 95% confidence interval 0.82 to 1.02; per protocol relative risk 0.92, 0.82 to 1.02). Failure to remove polyps was higher (19% v 7%; relative risk 2.5, 1.5 to 4.1) and acceptability of the procedure was lower (83% v 92%; 0.90, 0.84 to 0.97) in the outpatient group Quality of life did not differ significantly between the groups. Four uterine perforations, one of which necessitated bowel resection, all occurred in the inpatient group. CONCLUSIONS: Outpatient polypectomy was non-inferior to inpatient polypectomy. Failure to remove a uterine polyp was, however, more likely with outpatient polypectomy and acceptability of the procedure was slightly lower