8 results
LO45: Women's perspectives on early pregnancy complications and supportive care needs: a qualitative multi-site study
- K. Dainty, B. Seaton, V. Rojas-Luengas, S. McLeod, M. Tunde-Byass, E. Tolhurst, C. Varner
-
- Journal:
- Canadian Journal of Emergency Medicine / Volume 22 / Issue S1 / May 2020
- Published online by Cambridge University Press:
- 13 May 2020, p. S23
- Print publication:
- May 2020
-
- Article
-
- You have access Access
- Export citation
-
Introduction: Women experiencing early pregnancy loss or threatened loss frequently seek care in emergency departments (ED) or early pregnancy clinics (EPC). The dearth of existing qualitative studies has left understudied questions about how these women perceive their healthcare and which strategies best meet their supportive care needs, particularly in the Canadian context. The objective of this study was to deepen our understanding of these women's experiences and gain insight into how clinicians and healthcare services can lessen the impact of this traumatic event on patients and their families. Methods: We conducted a descriptive qualitative study of women who presented to the ED or EPC at an urban tertiary care hospital and an urban community hospital for early pregnancy loss or threatened loss. Purposive sampling was used to recruit patients for in-depth, one-on-one telephone interviews conducted 4-6 weeks after the index visit. Data collection and analysis were concurrent and continued until thematic saturation had occurred. Data analysis was led by two qualitative researchers with support from a multi-disciplinary research team following standard thematic analysis techniques. Results: Interviews were completed with 59 women between July 2018 and August 2019. Participants ranged in age from 22 to 47 years and reflect the diversity of the multicultural city where the study occurred. Our analysis revealed that the medicalization and normalization of early pregnancy complications among ED and EPC clinicians is at odds with women's general lack of knowledge about the frequency, personal risk, causation, duration, and physical intensity of the miscarriage experience. Women identified the value of rapid access to appointments, point of care ultrasound, detailed care plans, and knowledgeable advice as key to lessening the physical and emotional trauma related to early pregnancy loss. Conclusion: This research highlights the physical, emotional, and psychological complexity of a medical situation frequently minimized within the current healthcare system. The results impart important knowledge about which aspects of ED and EPC care are most valued by women experiencing early pregnancy loss or threatened loss and demonstrate the clear need for women and their families to be provided with more education about the totality of the early pregnancy experience, including the possibility of pregnancy complications and loss.
P133: Why the emergency department is the wrong place for patients with early pregnancy complications: A qualitative study of patient experience
- V. Rojas-Luengas, B. Seaton, K. Dainty, S. McLeod, C. Varner
-
- Journal:
- Canadian Journal of Emergency Medicine / Volume 21 / Issue S1 / May 2019
- Published online by Cambridge University Press:
- 02 May 2019, p. S112
- Print publication:
- May 2019
-
- Article
-
- You have access Access
- Export citation
-
Introduction: Women experiencing complications of early pregnancy frequently seek care in the emergency department (ED), as most have not yet established care with an obstetrical provider. The objective of this study was to explore the lived experiences and perceptions of care of women treated for early pregnancy complications in the ED and early pregnancy clinic (EPC). Methods: We conducted an interpretive phenomenological qualitative study of women who presented to the ED or EPC of an urban tertiary care hospital with early pregnancy loss or threatened loss. We employed purposive sampling to recruit participants for in-depth, one-on-one telephone interviews conducted approximately 6 weeks after the index visit. Data collection and analysis were concurrent and continued until thematic saturation had occurred. Our research team of two qualitative researchers, a clinician, a clinical researcher, and a research student performed a phenomenologically-informed thematic analysis including three phases of coding to identify essential patterns of lived experience and meaning across the sample. Results: Interviews were completed with 30 women between July and August 2018. Participants ranged in age from 22 to 45 years and reflected the diversity of the multicultural city where the study occurred. Four key themes of patient experience were identified: tensions between what is known and unknown by women and ED staff about early pregnancy complications and care in hospital, stigmatization of early pregnancy complications and ED use, normalization of a chaotic experience, and the overwhelm of unexpected outcomes during the ED visit. Conclusion: The perspectives of women attending the ED or EPC for early pregnancy complications highlights the ways in which the current health care system minimizes and medicalizes early pregnancy complications in this setting and fails to adequately support these women. The emotional complexity of this medical situation is often overlooked by ED staff and can produce encounters that are traumatic for patients and families. However, the participants’ negative experiences occurring in the ED were often mitigated with their care in their follow-up with the EPC.
37 - Grand Tour
-
- By A. V. Seaton, University of Limerick.
- Edited by Charles Forsdick, Zoë Kinsley, Kathryn Walchester
-
- Book:
- Keywords for Travel Writing Studies
- Published by:
- Anthem Press
- Published online:
- 13 July 2019
- Print publication:
- 22 April 2019, pp 108-110
-
- Chapter
- Export citation
-
Summary
The Grand Tour flourished in the seventeenth and eighteenth centuries. It was a European tour lasting one to three years for young men of good birth or fortune, nominally aimed to complete their education in classical and renaissance civilization. They were commonly escorted by older custodians, clerics or schoolmasters, charged with directing their educational sightseeing, and restraining them from worldly temptations, particularly in Venice, a placenotorious for its promiscuous pleasures and vices. They were nicknamed ‘Bear leaders’, and the philosopher Locke briefly acted as one (Lough 1953).
The term ‘Grand Tour’ had first been used in 1670, but only achieved wide currency in the eighteenth century, notably after 1749 when a four-volume guide by Thomas Nugent first made the term the title of a book, claiming to provide ‘an exact description of most of the cities, towns and remarkable places of Europe’, including the distances and costs of travel involved. Nugent's work described nine countries but one took precedence over all the rest – Italy, where, among its many ancient towns and cities, Rome was the supreme goal: ‘No place in the universe affords so agreeable a variety of ancient and modern curiosities as this celebrated city. In fact, one cannot walk fifty paces within the town without observing some remains of its ancient grandeur’ (III, 21). Nugent devoted 67 pages to Rome and its environs, inventorying the sights that the Grand Tourist should seek out. They comprised ‘churches, palaces, villas, colleges, hospitals, piazzas, columns, obelisks, paintings, bridges, aqueducts and fountains, pagan temples, theatres and amphitheatres, triumphal arches, baths, […] and circus's (sic)’ (III, 213–14). The word ‘Grand’ did not just describe the tour but the status of the tourists. Though ostensibly meant to round off a classical education, the tour was also a social rite of passage intended to convert the sons of patrician families from schoolboys into urbane men of the world, who would return to manage country estates, or enter careers in politics, the professions or the church. Nugent's guide addressed these broader aims, offering, in addition to sightseeing information, ‘remarks on the present state of trade, as well as the liberal arts and sciences’ as part of its title.
36 - Ghosts
-
- By A. V. Seaton, University of Limerick.
- Edited by Charles Forsdick, Zoë Kinsley, Kathryn Walchester
-
- Book:
- Keywords for Travel Writing Studies
- Published by:
- Anthem Press
- Published online:
- 13 July 2019
- Print publication:
- 22 April 2019, pp 105-107
-
- Chapter
- Export citation
-
Summary
Ghosts feature widely in literary travel and tourism because, like football teams and cheeses, they are necessarily, sometimes eponymously, linked to specific places (see also death). Underwood's (1992) ghost gazetteer includes topographical details of 236 haunted sites in Britain, including three famous, eponymous ones: the Cheltenham Ghost, the Cock Lane Ghost in London and Borley Rectory, once ‘the most haunted house in Britain’ (Price 1940 and 1946; Chambers 2006; Collins 1948; Grant 1965; Underwood 1992). A broad consensus has existed from Dr Johnson to modern Oxford lexicographers on what ghosts are: ‘spirits appearing after death’, ‘incorporeal beings’, ‘the souls of men’ (Johnson 1785, no pagination; Oxford English Dictionary). The Society for Psychical Research, however, discriminates more precisely, dividing ghosts into four categories (Tyrell 1953): ‘experimental ghosts’, who appear present to others at a distance from where they are physically at the time; ‘crisis ghosts’, who appear at times of individual or collective trauma, such as war, or bereavement; ‘post-mortem ghosts’, who appear soon after death to those whom they have loved or known; and ‘true ghosts’, who appear unexpectedly to strangers, years, even centuries, after their death, ‘usually restricted to one locality’ (Haining 1999 [1982], 100; and Tyrell 1953, 33–48).
Another way of exploring the nature of haunting is through three near synonyms: apparition, appearance and presence. An apparition is a disturbing, visual encounter with an alien figure or shape, or a familiar one horribly transformed, for example, the vampiric forms of Dracula's victims, or Jacob Marley as he appeared to Scrooge. An appearance is a less disturbing encounter with an apparently human figure, rendered extraordinary by the knowledge or discovery that s/he was elsewhere, dying or dead at the time. The appearance of Christ three days after the Crucifixion is a pre-eminent instance.
‘Presence’, unlike the others, is non-visual, a feeling that the dead have not gone away, but can be sensed in places associated with them. ‘Presence’ is often claimed by writers and broadcasters describing the homes or gravesides of the famous, where it valorizes the auratic authenticity of a site and their sensitivity as observers in responding to it, suggesting that both effects might be replicated by visitors. Westover (2012) has explored the literary fashion during the Romantic period for visiting graves of dead writers, particularly poets, to experience ‘real presence’, and then returning home to compose poetic testimonies.
23 - Death
-
- By A. V. Seaton, University of Limerick.
- Edited by Charles Forsdick, Zoë Kinsley, Kathryn Walchester
-
- Book:
- Keywords for Travel Writing Studies
- Published by:
- Anthem Press
- Published online:
- 13 July 2019
- Print publication:
- 22 April 2019, pp 66-68
-
- Chapter
- Export citation
-
Summary
Although death may not be the main thing on the mind of tourists, it is regularly encountered intentionally and incidentally on journeys and tours. Understanding these encounters involves recognizing two of death's defining features. The first is its unknowability. Though dying can be observed and tracked, death cannot since the dead never report back. Death has, therefore, mainly been defined by lexicographers as deficit rather than content – ‘the extinction of life’ (Johnson 1785, no pagination; emphasis added), or ‘the state of being no longer alive’ (Webster's Third New International Dictionary 1971, 581). Medical practitioners identify death by multiple physiological deficits – for example, without breathing, without pulse, without brain activity
Its second feature is that, since death is unknowable, it can only be apprehended through representations and narratives, including those in myths, religious beliefs, paintings, memorials and funerary ceremonies, which constitute the symbolic imaginary of death that travellers may encounter in travel. Until recently these were hardly explored in thanatology studies, a multidisciplinary field that greatly expanded from the 1970s, largely stimulated by the pioneering work of Philippe Aries (1974, 1981 and 1985). His work opened up a flood of studies on death in different cultures (Farrell 1980; Gittings 1984; Jalland 2002; Merridale 2000) and over different time periods (Cecil 1991; Laderman 1996; Tenenti 2002), as well as general overviews that included other factors such as medical and ethical aspects of dying (Watkins 2013; Spellman 2014). None examined connections between death and travel. This linkage came about in the 1990s with the inauguration of a tourism studies subset, variously known as ‘Dark Tourism’ (Lennon 1996) or ‘thanatourism’ (Seaton 1996). The two terms are synonymous in substance, but not in their connotations or their acceptance by some sectors of the tourism industries (see Seaton and Lennon 2004; and Seaton et al. 2015, for a discussion of the debate about the names).
Social and economic influences on infant and child feeding practices in a Marshallese community
- Britni L Ayers, Marilou D Shreve, Allison L Scott, Victoria A Seaton, Kelly V Johnson, Nicola L Hawley, Brett Rowland, Ramey Moore, Pearl A McElfish
-
- Journal:
- Public Health Nutrition / Volume 22 / Issue 8 / June 2019
- Published online by Cambridge University Press:
- 22 February 2019, pp. 1461-1470
-
- Article
-
- You have access Access
- HTML
- Export citation
-
Objective
The present study aimed to examine the key influences on infant and child feeding practices among a Marshallese community at each social ecological level. It is the first study to examine the key influences on infant and child feeding practices with Marshallese immigrant women in the USA and helps fill a gap in the previous literature that has included other immigrant women.
DesignCommunity-based participatory research design with twenty-seven participants taking part in four qualitative focus groups.
SettingThe study took place within the Marshallese community in Arkansas, USA.
ParticipantsParticipants included Marshallese women with children aged 1–3 years and/or caregivers. Caregivers were defined as someone other than the parent who cares for children. Caregivers were often older women in the Marshallese community.
ResultsThere were five primary themes within multiple levels of the Social Ecological Model. At the intrapersonal level, mothers’ and caregivers’ autonomy emerged. At the interpersonal level, child-led and familial influences emerged. At the organizational level, health-care provider influences emerged; and at the policy level, the Special Supplemental Nutrition Program for Women, Infants, and Children emerged as the most salient influence.
ConclusionsMarshallese immigrant women’s infant and child feeding practices are influenced at intrapersonal, interpersonal, organizational and policy levels. Understanding these multidimensional influences is necessary to inform the creation of culturally tailored interventions to reduce health disparities within the Marshallese community.
Plasmoid Ejection at a Solar Total Eclipse
- M. Faurobert, C. Fang, T. Corbard, S. Koutchmy, C. Bazin, D. Berghmans, A. De Groof, M. Druckmüller, E. Tavabi, A. Engell, B. Filippov, L. Golub, Ph. Lamy, J. Linker, Z. Mikic, J. Mouette, Ch. Nitschelm, D. Seaton, V. Slemzin
-
- Journal:
- European Astronomical Society Publications Series / Volume 55 / 2012
- Published online by Cambridge University Press:
- 27 June 2012, pp. 223-226
- Print publication:
- 2012
-
- Article
- Export citation
-
The existence of coronal plasmoids has been postulated for many years in order to supply material to streamers and possibly to the solar wind (SW). The W-L SoHO C2 Lasco coronagraph observations were made under the 2.2 solar radii (R0) occulting disk to look at the ultimate sources of the SW; EUV imagers are preferably devoted to the analysis of the corona on and very near the solar disk. Here, in addition to eclipse white-light (W-L) snapshots, we used the new SWAP space-borne imager designed for the systematic survey of coronal activity in the EUV lines near 17.4 nm, over a field of view (FOV) up to 2 R0. Using summed and co-aligned images, the corona can then be evaluated for the 1st time up to the limit of this FOV. At the time of the July 11, 2010, solar total eclipse a 20h continuous run of observations was collected, including images taken during eclipse totality from several ground observing locations where W-L data were collected. A plasmoid-like off-limb event was followed using the SWAP summed
Linkage scan of nicotine dependence in the University of California, San Francisco (UCSF) Family Alcoholism Study
- I. R. Gizer, C. L. Ehlers, C. Vieten, K. L. Seaton-Smith, H. S. Feiler, J. V. Lee, S. K. Segall, D. A. Gilder, K. C. Wilhelmsen
-
- Journal:
- Psychological Medicine / Volume 41 / Issue 4 / April 2011
- Published online by Cambridge University Press:
- 01 July 2010, pp. 799-808
-
- Article
- Export citation
-
Background
Nicotine dependence has been shown to represent a heritable condition, and several research groups have performed linkage analysis to identify genomic regions influencing this disorder though only a limited number of the findings have been replicated.
MethodIn the present study, a genome-wide linkage scan for nicotine dependence was conducted in a community sample of 950 probands and 1204 relatives recruited through the University of California, San Francisco (UCSF) Family Alcoholism Study. A modified version of the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) with additional questions that probe nicotine use was used to derive DSM-IV nicotine dependence diagnoses.
ResultsA locus on chromosome 2q31.1 at 184 centiMorgans nearest to marker D2S2188 yielded a logarithm (base 10) of odds (LOD) score of 3.54 (point-wise empirical p=0.000012). Additional peaks of interest were identified on chromosomes 2q13, 4p15.33-31, 11q25 and 12p11.23-21. Follow-up analyses were conducted examining the contributions of individual nicotine dependence symptoms to the chromosome 2q31.1 linkage peak as well as examining the relationship of this chromosomal region to alcohol dependence.
ConclusionsThe present report suggests that chromosome 2q31.1 confers risk to the development of nicotine dependence and that this region influences a broad range of nicotine dependence symptoms rather than a specific facet of the disorder. Further, the results show that this region is not linked to alcohol dependence in this population, and thus may influence nicotine dependence specifically.
![](/core/cambridge-core/public/images/lazy-loader.gif)