University Women MacDonald, Sara Z
2021, 2021-11-15, Volume:
257
eBook
For the first generations of university women, higher education was a transformative experience, but these opportunities would narrow in the decades that followed. Examining the period between 1870 ...and 1930, University Women explores the processes of integration and separation that marked women's contested entrance into higher education.
High rates of alcohol consumption by midlife women, despite the documented risks associated with breast cancer, varies according to social class. However, we know little about how to develop ...equitable messaging regarding breast cancer prevention that takes into consideration class differences in the receipt and use of such information. To explore the heuristics used by women with different (inequitable) life chances to determine the trustworthiness of information regarding alcohol as a modifiable risk factor for breast cancer risk. Interviews were conducted with 50 midlife (aged 45-64) women living in South Australia, diversified by self-reported alcohol consumption and social class. Women were asked to describe where they sought health information, how they accessed information specific to breast cancer risk as it relates to alcohol, and how they determined whether (or not) such information was trustworthy. De-identified transcripts were analysed following a three-step progressive method with the aim of identifying how women of varying life chances determine the trustworthiness of alcohol and breast cancer risk information. Three heuristics were used by women: (1) consideration of whose interests are being served; (2) engagement with 'common sense'; and (3) evaluating the credibility of the message and messenger. Embedded within each heuristic are notable class-based distinctions. More equitable provision of cancer prevention messaging might consider how social class shapes the reception and acceptance of risk information. Class should be considered in the development and tailoring of messages as the trustworthiness of organizations behind public health messaging cannot be assumed.
Those with advanced heart failure (HF) experience high levels of morbidity and mortality, similar to common cancers. However, there remains evidence of inequity of access to palliative care services ...compared to people with cancer. This study examines patient, carer, and professional perspectives on current management of advanced HF and barriers and facilitators to improved care.
Qualitative study involving semi-structured interviews and focus groups with advanced HF patients (n = 30), carers (n = 20), and professionals (n = 65). Data analysed using Normalisation Process Theory (NPT) as the underpinning conceptual framework.
Uncertainty is ubiquitous in accounts from advanced HF patients and their caregivers. This uncertainty relates to understanding of the implications of their diagnosis, appropriate treatments, and when and how to seek effective help. Health professionals agree this is a major problem but feel they lack knowledge, opportunities, or adequate support to improve the situation. Fragmented care with lack of coordination and poor communication makes life difficult. Poor understanding of the condition extends to the wider circle of carers and means that requests for help may not be perceived as legitimate, and those with advanced HF are not prioritised for social and financial supports. Patient and caregiver accounts of emergency care are uniformly poor. Managing polypharmacy and enduring concomitant side effects is a major burden, and the potential for rationalisation exists. This study has potential limitations because it was undertaken within a single geographical location within the United Kingdom.
Little progress is being made to improve care experiences for those with advanced HF. Even in the terminal stages, patients and caregivers are heavily and unnecessarily burdened by health care services that are poorly coordinated and offer fragmented care. There is evidence that these poor experiences could be improved to a large extent by simple organisational rather than complex clinical mechanisms.
There is a GP workforce crisis, particularly in areas of high socioeconomic deprivation where levels of multimorbidity and social complexity are higher than in areas of low socioeconomic deprivation. ...How this impacts GP work, and how GPs manage workload has not been fully explored.
To explore GP work in areas of high socioeconomic deprivation and the strategies GPs employ, using Corbin and Strauss's framework on managing chronic illness as an analytical lens.
Secondary analysis of qualitative in-depth interviews with GPs working with populations experiencing high levels of socioeconomic deprivation.
Secondary analysis of in-depth interviews with GPs working in areas of high socioeconomic deprivation (
= 10).
All three types of work defined by Corbin and Strauss (everyday, illness, and biographical) were described, and one additional type: emotional (work managing GPs' own emotions). The context of socioeconomic deprivation, increased multimorbidity plus social complexity ('multimorbidity plus'), influenced GP work. Healthcare systems and self-management strategies did not meet patients' needs, which meant the resulting gap created extra everyday work, often unrecognised (which was a source of frustration). GPs also described taking on 'illness work' for patients who were either overwhelmed or unable to do it. Some GPs described biographical work, asserting their professional role against demands from patients and other professionals. Work aligning with personal values was important in sustaining motivation; for example, being part of a strong team and having outside professional interests appeared to build resilience.
GPs working in areas of high socioeconomic deprivation experience different types of work from those working in areas of low socioeconomic deprivation; much of which is unrecognised and not resourced. Current strategies to reduce burnout could be more effective if the complexity of different types of work was addressed. In addition, personal values, practice teams, and outside professional interests all need to be supported.
Evidence has shown for over 20 years that patients residing in rural areas face poorer outcomes for cancer. The inequalities in survival that rural cancer patients face are observed throughout the ...developed world, yet this issue remains under-examined and unexplained. There is evidence to suggest that rural patients are more likely to be diagnosed as a result of an emergency presentation and that rural patients may take longer to seek help for symptoms. However, research to date has been predominantly epidemiological, providing us with an understanding of what is occurring in these populations, yet failing to explain why. In this paper we outline the problems inherent in current research approaches to rural cancer inequalities, namely how 'cancer symptoms' are conceived of and examined, and the propensity towards a reductionist approach to rural environments and populations, which fails to account for their heterogeneity. We advocate for a revised rural cancer inequalities research agenda, built upon in-depth, community-based examinations of rural patients' experiences across the cancer pathway, which takes into account both the micro and macro factors which exert influence on these experiences, in order to develop meaningful interventions to improve cancer outcomes for rural populations.
We investigated demographic and clinical predictors of lower participation in bowel screening relative to breast and cervical screening.
Data linkage study of routinely collected clinical data from ...430,591 women registered with general practices in the Greater Glasgow & Clyde Health Board. Participation in the screening programmes was measured by attendance at breast or cervical screening or the return of a bowel screening kit.
72.6% of 159,993 women invited attended breast screening, 80.7% of 309,899 women invited attended cervical screening and 61.7% of 180,408 women invited completed bowel screening. Of the 68,324 women invited to participate in all three screening programmes during the study period, 52.1% participated in all three while 7.2% participated in none. Women who participated in breast (OR = 3.34 (3.21, 3.47), p < 0.001) or cervical (OR = 3.48 (3.32, 3.65), p < 0.001) were more likely to participate in bowel screening.
Participation in bowel screening was lower than breast or cervical for this population although the same demographic factors were associated with uptake, namely lower social deprivation, increasing age, low levels of comorbidity and prior non-malignant neoplasms. As women who complete breast and cervical are more likely to also complete bowel screening, interventions at these procedures to encourage bowel screening participation should be explored.
Combining a detailed study of Hegel's political philosophy with close readings of two important literary works that help clarify his thought, MacDonald traces the historical development of an ...enduring link between personal lives and stable political communities. While Sophocles' Antigone highlights the tension in states that deny the interests of their citizens, MacDonald shows that Shakespeare's A Midsummer Night's Dream offers an alternative image, one that sees freedom for all as essential to an ethical family and state and is consistent with Hegel's thought in both the Phenomenology of Spirit and The Philosophy of Right.
Increasing age is a risk factor for developing cancer. Yet, older people commonly underestimate this risk, are less likely to be aware of the early symptoms, and are more likely to be diagnosed with ...advanced stage cancer. Mass media are a key influence on the public's understanding health issues, including cancer risk. This study investigates how news media have represented age and other risk factors in the most common cancers over time.
Eight hundred articles about the four most common cancers (breast, prostate, lung and colorectal) published within eight UK national newspapers in 2003, 2004, 2013 and 2014 were identified using the Nexis database. Relevant manifest content of articles was coded quantitatively and subjected to descriptive statistical analysis in SPSS to identify patterns across the data.
Risk was presented in half of the articles but this was rarely discussed in any depth and around a quarter of all articles introduced more than one risk factor, irrespective of cancer site. Age was mentioned as a risk factor in approximately 12% of all articles and this varied by cancer site. Age was most frequently reported in relation to prostate cancer and least often in articles about lung cancer. Articles featuring personal narratives more frequently focused on younger people and this was more pronounced in non-celebrity stories; only 15% of non-celebrity narratives were about people over 60. Other common risks discussed were family history and genetics, smoking, diet, alcohol, and environmental factors. Family history and genetics together featured as the most common risk factors. Risk factor reporting varied by site and family history was most commonly associated with breast cancer, diet with bowel cancer and smoking with lung cancer.
Age and older adults were largely obscured in media representation of cancer and cancer experience. Indeed common risk factors in general were rarely discussed in any depth. Our findings will usefully inform the development of future cancer awareness campaigns and media guidelines. It is important that older adults appreciate their heightened risk, particularly in the context of help-seeking decisions.
Patients with chronic disease may experience complicated management plans requiring significant personal investment. This has been termed 'treatment burden' and has been associated with unfavourable ...outcomes. The aim of this systematic review is to examine the qualitative literature on treatment burden in stroke from the patient perspective.
The search strategy centred on: stroke, treatment burden, patient experience, and qualitative methods. We searched: Scopus, CINAHL, Embase, Medline, and PsycINFO. We tracked references, footnotes, and citations. Restrictions included: English language, date of publication January 2000 until February 2013. Two reviewers independently carried out the following: paper screening, data extraction, and data analysis. Data were analysed using framework synthesis, as informed by Normalization Process Theory. Sixty-nine papers were included. Treatment burden includes: (1) making sense of stroke management and planning care, (2) interacting with others, (3) enacting management strategies, and (4) reflecting on management. Health care is fragmented, with poor communication between patient and health care providers. Patients report inadequate information provision. Inpatient care is unsatisfactory, with a perceived lack of empathy from professionals and a shortage of stimulating activities on the ward. Discharge services are poorly coordinated, and accessing health and social care in the community is difficult. The study has potential limitations because it was restricted to studies published in English only and data from low-income countries were scarce.
Stroke management is extremely demanding for patients, and treatment burden is influenced by micro and macro organisation of health services. Knowledge deficits mean patients are ill equipped to organise their care and develop coping strategies, making adherence less likely. There is a need to transform the approach to care provision so that services are configured to prioritise patient needs rather than those of health care systems.
This article argues that a gap emerged after the Great War between the first deans of women and their students over the meaning of self-government for academic women. Early deans believed from their ...own undergraduate experience that self-government provided important training for women to perform public roles, and by doing so, to attack the gendered assumption that men alone could have full undergraduate rights. By contrast, women students of the post-war years embraced a different undergraduate identity, one which assumed a greater degree of personal liberty, and their conception of self-government entailed the right to determine and monitor their own rules of conduct. By examining Manitoba, Queen’s, Victoria, Toronto’s University College, Dalhousie, and Western, this study adds to the existing literature on moral regulation by exploring how deans were able to develop a new view of student government by incorporating a progressive emphasis on the role of graduate women in participa- tory democracy.
Résumé
Cet article démontre qu’un fossé est apparu après la Grande Guerre entre les premières Directrices des étudiantes et leurs étudiantes sur la signification de la gouvernance autonome des femmes universitaires. En raison de leur propre expérience au premier cycle, les premières directrices croyaient que cette autonomie offrait une formation importante aux femmes aspirant à occuper des fonctions publiques, tout en contredisant l’hypothèse suggérant que seuls les hommes pouvaient jouir des pleins droits étudiants au premier cycle. En revanche, les étudiantes de l’après-guerre ont adopté une identité différente pour les étudiantes de premier cycle ; une identité reposant sur une plus grande liberté personnelle, et une conception de l’autonomie assumant le droit de déterminer et de contrôler leurs propres règles de conduite. En étudiant les universités Manitoba, Queen’s, Victoria, University College (Toronto), Dalhousie et Western, cette étude s’ajoute à la littérature existante sur la réglementation morale en explorant la manière dont les directrices ont pu développer une nouvelle vision du gouvernement étudiant en incorporant progressivement un accent sur le rôle des diplômées dans la démocratie participative.
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