Navigating shame to negotiate sexual agency in British born South Asian women: A grounded theory study

Sexual health relates to perceptions and experiences of sexual-based relationships and needs. It is viewed as a fundamental component of overall health. Positive sexual health is dependent upon various determinants which include communication, education and access to services. However, there are a number of barriers to positive sexual health due to its taboo nature. The sexual health needs of young people is a public health priority, in particular those from ethnic minority backgrounds. In the UK, the largest ethnic minority group is South Asian. Individuals from South Asian communities are socialised into the beliefs and norms of their culture through a process of enculturation. British born, South Asian women will also experience different levels of acculturation as they are influenced by the wider social context and cultures of the society they live in. Acculturation can influence their choices and beliefs where sexual health matters are concerned. Many South Asian religions emphasise the forbidden nature of pre-marital sexual relationships and may limit information about positive sexual health. However, within the British culture, young people generally have more permissible standards and beliefs surrounding sexual health. This may be particularly problematic for some British born, South Asian women who may be influenced by both the South Asian and British culture. Currently there is a lack of understanding into how young people navigate sexual health in these circumstances. My study aimed to explore the perceptions, awareness and experiences of sexual health among British born, South Asian women, aged 18-25 years: it was not limited to a particular South Asian group. I undertook a constructivist grounded theory study with purposive, snowball and theoretical sampling methods used within two recruitment phases. Both phases recruited females who were residing in the North West of England. Data collection methods involved focus groups and interviews and a total of 16 participants were recruited. Techniques of initial coding, focused coding, constant comparisons and theoretical sorting were used to analyse the data. Three main categories of ‘being influenced by religion, culture and the community’, ‘maintaining the secret relationship and acculturation’ and ‘accessing sexual health services, advice and awareness’ were identified. An overarching theory of ‘navigating shame to negotiate sexual agency’ was constructed – this theoretical interpretation draws on theories of shame and sexual agency depicted through a three stage interconnected model: ‘the grounding context of shame’, ‘connectedness with others’, and ‘finding their way’. Overall these findings highlight how women position themselves on a continuum where shame and sexual agency are concerned. This model provides a theoretical framework which identifies how some women may remain close to their encultured religious and cultural values and may be influenced heavily by shame. Whereas others adopt more Western values through acculturation in engaging in sex-based relationships. This model offers a unique theoretical interpretation which can be used by health professionals and young women to understand their position in relation to sexual health and to enhance knowledge of the issues faced. Implications for policy, practice and research are detailed

Hard Graft: Collaborative exploration of working class stories in shaping female educator identities

This empirical qualitative study investigates the ways in which working-class roots have shaped educator values and identity. Using collaborative autoethnography, we share an honest insight into the stories of seven female educators drawn together from a variety of health and social care disciplines. The five themes emerging from this research: Connection through differences and commonalities; graft; inner tensions; authenticity ‘I am who I am’ and the bigger picture are tightly interconnected, generating a complex and rich picture of contemporary female educator identity. This supportive and collaborative approach has been transformational in the realisation we are not alone, and it has provided a space to celebrate our ‘otherness’. As a result, we have embraced our collective responsibility to challenge inequalities and foster a more open, accessible and authentic HE future for all

Hard Graft: Collaborative exploration of working class stories in shaping female educator identities

This empirical qualitative study investigates the ways in which working-class roots have shaped educator values and identity. Using collaborative autoethnography, we share an honest insight into the stories of seven female educators drawn together from a variety of health and social care disciplines. The five themes emerging from this research: Connection through differences and commonalities; graft; inner tensions; authenticity ‘I am who I am’ and the bigger picture are tightly interconnected, generating a complex and rich picture of contemporary female educator identity. This supportive and collaborative approach has been transformational in the realisation we are not alone, and it has provided a space to celebrate our ‘otherness’. As a result, we have embraced our collective responsibility to challenge inequalities and foster a more open, accessible and authentic HE future for all

Hard Graft: Collaborative exploration of working class stories in shaping female educator identities

This empirical qualitative study investigates the ways in which working-class roots have shaped educator values and identity. Using collaborative autoethnography, we share an honest insight into the stories of seven female educators drawn together from a variety of health and social care disciplines. The five themes emerging from this research: Connection through differences and commonalities; graft; inner tensions; authenticity ‘I am who I am’ and the bigger picture are tightly interconnected, generating a complex and rich picture of contemporary female educator identity. This supportive and collaborative approach has been transformational in the realisation we are not alone, and it has provided a space to celebrate our ‘otherness’. As a result, we have embraced our collective responsibility to challenge inequalities and foster a more open, accessible and authentic HE future for all

Minoritised ethnic women’s experiences of inequities and discrimination in maternity services in North-West England: A mixed-methods study

Background: Minoritised ethnic perinatal women can experience judgemental and stigmatising care due to systemic racism. Discriminatory care contributes to increased risks of poor maternal and infant outcomes, including higher rates of mental ill-health. This study aimed to explore minoritised ethnic women’s experiences of maternity services, including maternity care and mental health support, within a North-West England locality. Here we use an equity lens to report the findings that describe if and how women’s personal, cultural, and spiritual needs were met, their experiences of discriminatory and prejudicial care, and to identify recommendations for service provision. Methods: A mixed-methods study was undertaken comprising an online survey, interviews, and community consultations. Questions explored access to and experiences of antenatal care and education; information, communication, and choice; experiences of (dis)respect and judgement; mental health needs and support; cultural/religious needs and support; and overall experiences of maternity care. Eligibility criteria were: women, 18+ years, from self-reported minoritised ethnic backgrounds, who had given birth in the previous 2 years and received maternity care in the locality. Surveys were available in seven languages and distributed via social media, mother-baby groups, and community locations. English-speaking survey participants were invited to take part in a follow-up interview. Community leaders/staff were approached to collect data on behalf of the study team. Quantitative data were analysed descriptively (n, %) and merged with qualitative data into descriptive themes. Results: Overall, 104 women provided data; most self-identified as Asian (65.0%) or Black (10.7%) and were aged between 30-34 (32.0%) or 25-29 years (23.3%). Four descriptive themes are reported: ‘accessing care’ details variations and barriers in accessing maternity care; ‘communication needs, and resources’ describes views on adaptions and resources for specific communication needs; ‘meeting religious and cultural needs’ outlines how various religious and cultural needs were met by maternity providers; ‘discriminatory or stigmatising care’ reports on experiences of pejorative and inequitable care. Conclusions: An equity lens helped identify areas of discriminatory and inequitable care. Key recommendations include cultural safety training for staff; service-user engagement and co-production of research and resources, and appropriate facilities and recording systems to facilitate individualised, needs-based maternity care

End-tidal carbon monoxide levels in prematurely born infants developing bronchopulmonary dysplasia

Bronchopulmonary dysplasia (BPD) is associated with an early inflammatory response that persists after the first week of life. Inflammatory mediators can induce hemoxygenase-1 with a consequent increase in carbon monoxide (CO) production. End-tidal CO (ETCO) levels would be elevated in infants developing BPD. Serial measurements of ETCO levels were attempted on d 3, 5, 7, 14, 21, and 28 in 50 prematurely born infants (median gestational age 29 wk). Fourteen infants developed BPD [oxygen dependent beyond 36 wk post-menstrual age (PMA)] and had higher ETCO levels compared with the rest of the cohort on d 7, 14, 21, and 28. On d 14, the mean (SD) ETCO levels of the BPD group were 3.19 (1.11) ppm and 1.43 (0.61) ppm in the non-BPD group (p 2.15 ppm had a sensitivity of 80% and specificity of 92% in predicting oxygen dependency at 36 wk PMA. Measurement of ETCO levels in prematurely born infants may be useful in the prediction of BP