“Patchy Patriarchy” and the Shifting Fortunes of the CCP's Promise of Gender Equality since 1921

The CCP's commitment to gender equality since 1921 has produced vast gains in employment and education for countless women while overlooking established gender hierarchies in family life. Long-term research in Beijing reveals that crossing class, sectoral and generational differences, there is an apparent paradox between women's increasing access to education and employment and their abiding attachment to ideas and practices associated with their roles as wives, mothers and daughters-in-law. A reconfigured “patchy” form of patriarchy is sustained by a dominant discourse of gender difference that naturalizes women's association with the domestic sphere. Unprecedented engagements with international feminism after 1995 introduced new approaches to gender equality. Recently, young feminists from diverse backgrounds have launched public protests targeting expectations of women in marriage and family life, marking a contestation of previous articulations of gender equality. Online platforms are flooded with exchanges about women's empowerment in a market environment that grants them considerable leverage to manage their marital and domestic relationships. The focus of this new generation of feminists on social reproduction signifies a radical departure from the classical Marxist principles underpinning earlier approaches to women's emancipation. Nevertheless, a “patchy patriarchy” continues to characterize widely held gender assumptions and expectations, spanning class and sectoral difference

The Official Construction of Female Sexuality and Gender in the People's Republic of China 1949-1959.

Issues of sexuality as expounded in the Chinese official press of the 1950s can be taken as an important indicator of the changing perception of female gender in the early People's Republic. This thesis explores the assumptions and attitudes concerning sexuality conveyed in the official media, and places particular emphasis on the projection of female attributes and responsibilities in sexual relationships. It analyses the different biological and social constructions of sexuality, and the means by which biologically determined sexual differences were inscribed with specific gender characteristics. In so doing, it offers a view of female gender not attainable from the study of women in other contexts in the same period. Simultaneously, the focus on the official media permits examination of the nature of the state's interests in sponsoring public discussion about sex-related issues. Official journals and educational materials on love, marriage and the family projected new norms and expectations of women's sexual behaviour which served both didactic and exhortatory functions. Norms expounded for women as fiancee, wife and mother, as represented in these materials, established a new conjugal relationship in which, ideally, both man and wife contributed in equal measure to marital and family stability and satisfaction. The new norms also suggested that women were attributed with certain biological characteristics which identified them as 'natural' providers of their husbands' needs and as principle mediators of marital harmony. Any female violation of the new sexual norms was interpreted as the generator and signifier of suffering, sickness and moral chaos. Women, therefore, were assigned primary responsibility for maintaining moral and social order. On this basis, it can be argued that female sexual conduct was appropriated by the state as an agent of moral and social order, in which the needs and interests of the male predominated over those of the female

Secondary analyses to test the impact on inequalities and uptake of the schools-based human papillomavirus (HPV) vaccination programme by stage of implementation of a new consent policy in the south-west of England

Objectives To test the impact on inequalities and uptake of the schools-based human papillomavirus (HPV) vaccination programme by stage of implementation of a new policy providing additional opportunities to consent.Setting Two local authorities in the south-west of England.Participants Young women (n=7129) routinely eligible for HPV vaccination aged 12–13 years during the intervention period (2017/2018 to 2018/2019 programme years).Interventions Local policy change that included additional opportunities to provide consent (parental verbal consent and adolescent self-consent).Outcomes Secondary analyses of cross-sectional intervention data were undertaken to examine uptake by: (1) receipt of parental written consent forms and; (2) percentage of unvaccinated young women by stage of implementation.Results During the intervention period, 6341 (89.0%) eligible young women initiated the HPV vaccination series. Parental written consent forms were less likely to be returned where young women attended alternative education provider settings (p<0.001), belonged to non-white British ethnic groups (p<0.01) or more deprived quintiles (p<0.001). Implementation of parental verbal consent and adolescent self-consent reduced the percentage of unvaccinated young women from 21.3% to 16.5% (risk difference: 4.8%). The effect was greater for young women belonging to the most deprived compared with the least deprived quintile (risk difference: 7.4% vs 2.3%, p<0.001), and for young women classified as Unknown ethnic category compared with white British young women (6.7% vs 4.2%, p<0.001). No difference was found for non-white British young women (5.4%, p<0.21).Conclusions Local policy change to consent procedures that allowed parents to consent verbally and adolescents to self-consent overcame some of the barriers to vaccination of young women belonging to families less likely to respond to paper-based methods of gaining consent and at greater risk of developing cervical cancer.Trial registration number 49 086 105

Impact of new consent procedures on uptake of the schools-based Human Papillomavirus (HPV) vaccination programme

BACKGROUND: Local policy change initiating new consent procedures was introduced during 2017–2018 for the human papillomavirus (HPV) vaccination programme year in two local authorities in the south–west of England. This study aims to assess impact on uptake and inequalities. METHODS: Publicly available aggregate and individual-level routine data were retrieved for the programme years 2015–2016 to 2018–2019. Statistical analyses were undertaken to show: (i) change in uptake in intervention local authorities in comparison to matched local authorities and (ii) change in uptake overall, and by local authority, school type, ethnicity and deprivation. RESULTS: Aggregate data showed uptake in Local Authority One increased from 76.3% to 82.5% in the post-intervention period (risk difference: 6.2% P = 0.17), with a difference-in-differences effect of 11.5% (P = 0.03). There was no evidence for a difference-in-differences effect in Local Authority Two (P = 0.76). Individual-level data showed overall uptake increased post-intervention (risk difference: +1.1%, P = 0.05), and for young women attending school in Local Authority One (risk difference: 2.3%, P < 0.01). No strong evidence for change by school category, ethnic group and deprivation was found. CONCLUSION: Implementation of new consent procedures can improve and overcome trends for decreasing uptake among matched local authorities. However, no evidence for reduction in inequalities was found. IMPLICATIONS AND DISCUSSION: The new consent procedures increased uptake in one of the intervention sites and appeared to overcome trends for decreasing uptake in matched sites. There are issues in relation to the quality of data which require addressing

Using Systemised Nomenclature of Medicine (SNOMED) codes to select digital pathology whole slide images for long-term archiving

The archiving of whole slide images represents a hurdle to digital pathology implementation largely because of the amount of data generated. The retention of glass slides is currently recommended for a minimum of 10 years, but it is for individual departments to determine how digital images are archived and for how long. In a retrospective study, we examined the combination of Systemised Nomenclature of Medicine (SNOMED) codes allocated to cases reported between July 2011 and December 2015 and recalled more than 12 months after diagnosis in comparison to non-recalled cases. Our results show that 0.2% of cases are recalled after 12 months, and SNOMED code combinations can be used to identify which cases are likely to be recalled and which are not. This approach could reduce the number of cases archived by 62% and still ensure all cases likely to be recalled remain in the archive

Delivery of a Mental Health First Aid training package and staff peer support service in secondary schools: a process evaluation of uptake and fidelity of the WISE intervention.

BACKGROUND: Improving children and young people's provision for mental health is a current health priority in England. Secondary school teachers have worse mental health outcomes than the general working population, which the Wellbeing in Secondary Education (WISE) cluster randomised controlled trial aimed to improve. The WISE intervention comprised a Mental Health First Aid (MHFA) training package delivered to at least 16% of staff, a short mental health awareness session to all teachers and development of a staff peer support service. Twenty-five schools were randomised to intervention or control arms. This paper reports findings regarding the extent of uptake and fidelity of the intervention. METHODS: Mixed methods data collection comprised researcher observations of training delivery, training participant evaluation forms, trainer and peer supporter interviews, peer supporter feedback meetings, logs of support provided, and teacher questionnaires. Quantitative data were summarised descriptively, while thematic analysis was applied to the qualitative data. RESULTS: In the 12 schools assigned to the intervention arm, 113 (8.6%) staff completed the 2-day standard MHFA training course, and a further 146 (11.1%) staff completed the 1-day MHFA for schools and colleges training. In seven (58.3%) schools, the required 8% of staff completed the MHFA training packages. A 1-h mental health awareness-raising session was attended by 666 (54.5%) staff. Delivery of the MHFA training package was achieved with high levels of fidelity and quality across schools. All schools set up the peer support service following training, with a majority adhering to most of the operational guidelines developed from the pilot study at the outset. Teachers reported limited use of the peer support service during follow-up. At the 1-year follow-up, only three (25.0%) schools indicated they had re-advertised the service and there was evidence of a reduction in support from senior leadership. CONCLUSION: The MHFA training package was delivered with reasonably high fidelity, and a staff peer support service was established with general, but not complete, adherence to guidelines. In some schools, insufficient staff received MHFA training and levels of delivery of the peer support service compromised intervention dose and reach. TRIAL REGISTRATION: ISRCTN 95909211 . Registered on 15 January 2016

Regulating services

No abstract available

Phase I Study of Ipilimumab Combined with Whole Brain Radiation Therapy or Radiosurgery for Melanoma Patients with Brain Metastases

Purpose: We performed a phase I study to determine the maximum tolerable dose (MTD) and safety of ipilimumab with stereotactic radiosurgery (SRS) or whole brain radiotherapy (WBRT) in patients with brain metastases (BM) from melanoma. Methods: Based on intracranial (IC) disease burden, patients were treated with WBRT (Arm A) or SRS (Arm B). Ipilimumab starting dose was 3 mg/kg (every 3 weeks, starting on day 3 of WBRT or 2 days after SRS). Ipilimumab was escalated to 10 mg/kg using a two-stage, 3+3 design. The primary endpoint was to determine the MTD of ipilimumab combined with radiotherapy. Secondary endpoints were overall survival (OS), IC and extracranial (EC) control, progression free survival (PFS), and toxicity. This trial is regis- tered with ClinicalTrials.gov, number NCT01703507. Results: Characteristics of the 16 patients enrolled between 2011 and 2014 were: mean age, 60; median BM, 2 (1 to \u3e10); number with EC disease, 13 (81%). Treatment included WBRT (n=5), SRS (n=11), ipilimumab 3mg/kg (n=7), 10 mg/kg (n=9). Median follow-up was 8 months (Arm A) and 10.5 months (Arm B). There were 21 grade 1-2 neuro- toxic effects with no dose-limiting toxicities (DLTs). One patient experienced grade 3 neurotoxicity prior to ipilimumab administration. Ten additional grade 3 toxicities were reported with gastrointestinal (n=5, 31%) as the most common. There were no grade 4/5 toxicities. Median PFS and OS, respectively, in Arm A were 2.5 months and 8 months, and in Arm B were 2.1 months and not reached. Conclusion: Concurrent ipilimumab 10 mg/kg with SRS is safe. The WBRT arm was closed early due to slow accrual, but demonstrated safety with ipilimumab 3 mg/kg. No patient experienced DLT. Larger studies with ipilimumab 10 mg/kg and SRS are warranted