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

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?

Addressing Challenges in Endometriosis Pain Communication Between Patients and Doctors: The Role of Language

Introduction: In the context of the complex medical, social, and economic factors that contribute to endometriosis diagnosis delay and its consequent impact on quality of life, this report focuses on patient-practitioner pain communication and examines the role of language in doctor-patient communication. Our study explored what patients and doctors consider challenging and effective in endometriosis pain communication. It further examined what commonly used metaphors by patients could be suggestive, or not, of endometriosis to doctors. Method: A United Kingdom-based qualitative (open-ended question) survey with women with endometriosis (n131) and semi-structured telephone interviews with general practitioners (GPs) (n11). Survey and interview data were analyzed thematically. Results: Both women and GPs reported the Numeric Rating Scale (NRS) to be insufficient as a standalone tool for communicating endometriosis related pain. Both also found descriptions of the quality, location, and impact on daily life of pain to more effective means of communicating pain symptoms. When presented with common metaphorical expressions surveyed women used to describe their pain, not all GPs recognized such metaphors as indicative of possible endometriosis. Further, some GPs reported some of the expressions to be indicative of other pathologies. Conclusion: Findings reveal the importance of language in pain communication and the need for additional tools to help women and doctors find the most effective way to communicate the experience and elicit appropriate investigative care. They also show the need for further investigation into how metaphor can be effectively used to improve patient-practitioner communication of endometriosis related pain

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

Vaginal preparation with chlorhexidine at cesarean section to reduce endometritis and prevent sepsis: A randomized pilot trial (PREPS)

INTRODUCTION: Cesarean sections are the most common major operation worldwide. One in 10 women develops a surgical-site infection after cesarean section. The PREPS pilot trial was developed to assess the feasibility of a randomized controlled trial of vaginal cleansing with chlorhexidine before cesarean section, to reduce infectious morbidity. MATERIAL AND METHODS: A multi-center, open-label, parallel-group pilot randomized controlled trial across 4 UK maternity units. Women aged ≥16 years, undergoing elective or emergency cesarean section, ≥34 weeks of gestation, and able to give informed consent were eligible. Women were randomized 1:1 to chlorhexidine 0.05% or no cleansing and were followed up until 6 weeks after cesarean section. The feasibility of a larger randomized controlled trial was assessed by the pilot trial's recruitment, ability to use verbal consent in an emergency, adherence, follow-up and withdrawal rates. The main clinical outcome collected was Center for Disease Control and Prevention (CDC) classification of endometritis at 30 days. Trial registration number is ISRCTN33435996. RESULTS: A total of 320 women (128% of target) were randomized. Of these, 93% (95% CI 89%-95%) received their allocated intervention. Of the 88 women who had an emergency cesarean section, verbal consent was initially given by 32 (36%) women, with the remainder having sufficient time to give written consent. Endometritis (CDC definition) was collected from medical notes of 96% of women, 68% (95% CI 63%-73%) were followed up at both 14 and 30 days by telephone, and we were able to collect patient-reported outcomes. In the vaginal cleansing arm 2/152 (1.3%) women had endometritis compared with 1/155 (0.7%) in the no cleansing arm (RR 2.08, 95% CI 0.19-22.31). CONCLUSIONS: It is possible to perform a randomized controlled trial in women undergoing an elective or emergency cesarean section, using a verbal-followed-by-written consent process, while maintaining high adherence and retaining women in the trial

Girls, gifts, and gender : an ethnography of the materiality of care in rural Mpumalanga, South Africa

This thesis is based on ethnographic fieldwork carried out in Agincourt, South Africa, between 2009 and 2010. It examines social relations of care involving young people in the context of the country's AIDS epidemic and increasing economic inequality. The thesis focuses on three sets of care relations, which constitute gift exchanges involving young (orphaned and non-orphaned) people: 1) children's labour for guardian care; 2) girls' labour and sex for support from boys and men; and 3) the local manufacturing of 'orphans' for charitable gifts from tourist-philanthropists. The thesis further examines how the contested constructions of orphanhood, childhood and care are expressed through these three sets of relations. It theorises how Western and local constructions of care, childhood and orphanhood meet on the ground through orphan-targeted assistance. Evidence derives from ethnographic fieldwork carried out with two non-profit organisations serving 'Orphans and Vulnerable Children' (OVCs) in two separate villages, as well as with 14 households connected to the OVC organisations. Ongoing, semi-structured interviews were carried out with young people and significant adult caregivers from participant households. Participatory exercises, including a photography project and a 'Girls Club,' were also carried out with young participants. Interviews with key stakeholders involved in the OVC care scene were conducted. Stakeholders included local government workers and officials, faith-based leaders and staff from private tourist game lodges conducting community development projects involving young people in Agincourt. This thesis develops the concept of the 'materiality of care' to address the dearth of ethnographically informed theorisations of care involving young peopled affected by AIDS and poverty. It argues that understandings of care for and by young (orphaned) people must be placed within local, emic perspectives and practices of care, as well as within the broader, historical and political economic context shaping relations of care. Findings have implications for policies and interventions for young people people affected by AIDS and poverty. The thesis contributes to the growing body of evidence that is critical of orphan-targeted interventions in sub-Saharan Africa; interventions which fail to recognise the familial context of parentless children and the broader context of poverty and hardships caused by AIDS that cut across the lives of orphaned and non-orphaned young people

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Young people’s sexting is an area of increasing concern amongst parents, educationalists and policy makers, yet little research has been conducted with young people themselves to explore their perspectives on the support they need to navigate relationships in the new digital media landscape. To address this absence, an inter-disciplinary team of researchers undertook a participatory study with students, aged 13 to 15, in a UK secondary school. This paper outlines key study findings, including young people’s views on sexting, their recommendations for improved education around sexting in schools, their preferred sources of support, and their perspectives on the way adults should respond to young people’s sexting. Findings indicate that sexting education needs to be developed within the context of wider relationship issues, such as gender, power dynamics and trust between peers, and improved communication between students and teachers or other responsible adults. Findings may be used to consider ways of designing and communicating messages around sexting to young people within and beyond educational settings