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The impact of chronic pelvic pain and bowel morbidity on quality of life in cervical cancer patients treated with radio (chemo) therapy. A systematic literature review
Get PDFRadiotherapy, administered with or without chemotherapy is the gold standard treatment for cervical cancer with both curative and palliative intent. However, the treatments often result in adverse events, mainly chronic pelvic pain and bowel morbidity, which can negatively impact quality of life. To systematically appraise peer reviewed evidence regarding chronic pelvic pain and bowel morbidity and their impact on quality-of-life of cervical cancer patients treated with radiotherapy with or without chemoradiation therapy. A systematic review of original peer-reviewed research evidence. A systematic search conducted between April and May 2021, and updated in September 2024, using PubMed, Hinari, CINAHL and Google Scholar, for peer reviewed papers published between 2008 and 2019. Data were extracted using a structured checklist designed to capture key elements about the methods and findings of the research. There were 245 articles retrieved with 29 meeting the inclusion criteria. 11 studies were conducted in Europe, eight in Asia, one in North America, three in Africa, while six were multinational/multicontinental. 13 of the papers were longitudinal, 10 cross-sectional, three literature reviews, one open randomised controlled trial, and two retrospective studies of prospectively collected data. Studies reported disruptions in nearly all domains of quality-of-life, including global, physical, emotional/psychological, financial, sexual, social, role functioning as a result of being treated with radiotherapy or radio-chemotherapy. Chronic pelvic pain and bowel morbidity are common adverse events experienced by cervical cancer patients receiving, or who have received, pelvic radiotherapy or radio-chemotherapy. Symptoms occur to varying degrees and exert a negative toll on the quality-of-life of women. Clinicians should be more aware and prioritise thorough assessment and management of symptoms before, during and after treatment. There is limited population-based and longitudinal research about the topic, and on chronic pelvic pain in general, which limits generalisability. Longitudinal studies with more extended periods of follow-up are needed. [Abstract copyright: © 2025 Natuhwera and Ellis.
William Stukeley and the exploration of Paradise
Get PDFThis article examines the writings of eighteenth-century antiquarian William Stukeley. It argues that Stukeley conceived of the megalithic monuments of England as portals into a transfigured, paradisiacal landscape in which matter was spiritualized and spirit materialized. Throughout, the piece draws on Henry Corbin’s discussion of imagination as a mode of super-sensory perception and its revelation of a visionary geography which in turn mirrors back the truth of imaginative perception in endless co-creation. However, Stukeley, it goes on to argue, believed that the spiritualized landscape was being destroyed by a new materialism, so that he had to rely less on the presence of a divine landscape and more on personalized imagination as a way of accessing Paradise. The article also briefly examines Stukeley’s influence on poets, artists, antiquarians and the wider English public, particularly in the way they conceived of and experienced the relationship between imagination and divinized landscape
Blood pressure cutoffs at 11-13 weeks of gestation and risk of preeclampsia
No full textBackground
A parallel has been drawn between first-trimester placental vascular maturation and maternal cardiovascular adaptations, including blood pressure. Although 140/90 mm Hg is well-accepted as the threshold for chronic hypertension in the general obstetric population in early pregnancy, a different threshold could apply to stratify the risk of adverse outcomes, such as preeclampsia. This could have implications for interventions, such as the threshold for initiation of antihypertensive therapy and the target blood pressure level.
Objective
We evaluated the relationship between various blood pressure cutoffs at 11–13 weeks of gestation and the development of preeclampsia, overall and according to key maternal characteristics.
Study Design
This secondary analysis was of data from a prospective nonintervention cohort study of singleton pregnancies delivering at ≥24 weeks, without major anomalies, at 2 United Kingdom maternity hospitals, 2006–2020. Blood pressure at 11–13 weeks of gestation was classified according to American College of Cardiology/American Heart Association categories (mm Hg) as (1) normal blood pressure (systolic <120 and diastolic <80), (2) elevated blood pressure (systolic ≥120 and diastolic <80), stage 1 hypertension (systolic ≥130 or diastolic 80–89), and stage 2 hypertension (systolic ≥140 or diastolic ≥90). For blood pressure category thresholds and the outcome of preeclampsia, the following were calculated overall and across maternal age, body mass index, ethnicity, method of conception, and previous pregnancy history: detection rate, screen-positive rate, and positive and negative likelihood ratios, with 95% confidence intervals. A P value of <.05 was considered significant.
Results
There were 137,458 pregnancies screened at 11–13 weeks of gestation. The population was ethnically diverse, with 15.9% of Black ethnicity, 6.7% of South or East Asian ethnicity, and 2.7% of mixed ethnicity, with the remainder of White ethnicity. Compared with normal blood pressure, stage 2 hypertension was associated with both preterm preeclampsia (0.3% to 4.9%) and term preeclampsia (1.0% to 8.3%). A blood pressure threshold of 140/90 mm Hg was good at identifying women at increased risk of preeclampsia overall (positive likelihood ratio, 5.61 [95% confidence interval, 5.14–6.11]) and across maternal characteristics, compared with elevated blood pressure (positive likelihood ratio, 1.70 [95% confidence interval, 1.63–1.77]) and stage 1 hypertension (positive likelihood ratio, 2.68 [95% confidence interval, 2.58–2.77]). There were 2 exceptions: a blood pressure threshold of 130/80 mm Hg was better for the 2.1% of women with body mass index <18.5 kg/m2 (positive likelihood ratio, 5.13 [95% confidence interval, 3.22–8.16]), and a threshold of 135/85 mm Hg better for the 50.4% of parous women without a history of preeclampsia (positive likelihood ratio, 5.24, [95% confidence interval, 4.77–5.77]). There was no blood pressure threshold below which reassurance could be provided against the development of preeclampsia (all-negative likelihood ratios ≥0.20).
Conclusion
The traditional blood pressure threshold of 140/90 mm Hg performs well to identify women at increased risk of preeclampsia. Women who are underweight or parous with no prior history of preeclampsia may be better identified by lower thresholds; however, a randomized trial would be necessary to determine any benefits of such an approach if antihypertensive therapy were also administered at this threshold. No blood pressure threshold is reassured against the development of preeclampsia, regardless of maternal characteristics
Finding and using information: A guide for nursing, health and social care
No full textFinding and Using Information is an accessible textbook for nursing, health and social care students seeking to improve their information skills.
Starting with a self-assessment checklist and through clear explanations, examples and activities, the book will help you to develop a toolkit for dealing with information throughout your studies and beyond. You will learn:
* How to identify what information you need and how to find the best sources
* About browsing the web and how to work effectively with web-based information tools
* How to identify and evaluate trustworthy sources of information
* Ways of managing and keeping track of the information you find so that you can retrieve it when you need it
About the importance of acknowledging, citing and referencing information
* How to use academic databases
* How to plan and carry out an advanced literature search
Written by a highly experienced learning and research librarian, this book will help you to develop the information skills you need for your studies and to achieve the standards of proficiency required to practise your health and care profession effectively
Knowledge translation in Anglo-American paramedicine: a scoping review.
Get PDFTo map what is currently known about knowledge translation (KT) in Anglo-American paramedicine. The review focuses on reported barriers and facilitators to the implementation of new knowledge, and the use of models, theories and frameworks to guide implementation practice. Scoping review reported as per both the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews reporting guidelines. CINAHL (EBSCO Host) and Medline (OVID interface) were searched from January 2000 to May 2023. Reference lists of all included papers were reviewed, and several key professional journals were hand-searched. Primary sources that focused on KT models, theories or frameworks, or barriers and facilitators to KT implementation, involving paramedics or Emergency Medical Technicians (Paramedic in America) working in an out-of-hospital, Anglo-American Emergency Medical Service (EMS) system were eligible for inclusion. One reviewer used a data extraction template developed for this review and 10% of the papers were checked by the second author. Findings were summarised in tables and synthesised both quantitatively and qualitatively. The search yielded 1268 primary sources, of which 48 were included in the review. Thirty-two papers examining KT interventions and 16 papers examining the barriers and facilitators to KT were found. Only one randomised controlled trial was found, and only one paper made explicit use of any KT framework. Overall, eight themes describing barriers and facilitators to KT arose from the qualitative literature, with clinicians' perception of the evidence being the dominant theme. All 32 papers describing KT interventions included some form of educational intervention. Overall, there is little depth and breadth in the literature, with many papers focusing on trauma and airway management. There are large gaps in the evidence surrounding the use of KT theories and frameworks in Anglo-American EMS. Further research is needed to identify appropriate KT models and frameworks that are contextualised to EMS to ensure that paramedic-led research finds its way to the clinicians needing to use it. [Abstract copyright: © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
“It's that feeling that you can't get away”: Motherhood, gender inequality and the stress process during extreme events
Get PDFThe impacts of extreme events can intersect with pre-disaster systemic inequalities and deficiencies, exacerbating distress. This paper contributes to the existing literature by exploring the psychosocial processes through which stressors become traumatic during an extreme event. It does so by focusing on how mothers of children and/or adolescents in the United Kingdom experienced the COVID-19 pandemic. First, qualitative interviews (N = 15) showed that participants experienced a cluster of stressors stemming from their workplaces, partners, children's behaviours and homeschooling, which caused a sense of overload and captivity, reducing their quality of life. However, individual, interpersonal and collective forms of coping were reported. Second, quantitative survey data (N = 621) showed that the relationship between stressors and perceived stress was mediated by feelings of overload due to excessive identity-related tasks and caregiving responsibilities. Moreover, community identification was associated with reduced overload and perceived stress. Overall, during extreme events, people can experience distress due to being overloaded by and trapped in particular identities and identity-related tasks, unable to perform other aspects of their social selves. We argue that social psychological analyses can be useful in tracing the complex impacts of extreme events across a range of systems and levels of analysis
The enchantment of the creative consciousness
No full textIsland of innovation conference 2025 asynchronous activity.
In this session, participants will immerse themselves in a playful exploration of creative consciousness. Using the metaphor of intertwining coloured yarns to represent creative threads, the workshop invites attendees to share countercultural and imaginative ideas that spark joy and inspiration. The interactive art form encourages vulnerability, connection, and collaboration as participants weave their ideas into a collective tapestry. The session challenges traditional linear thinking by emphasising the beauty of playful rebellion and alternative modes of knowing, ultimately encouraging reflective and transformative creative expression
What is a School Chaplain?
No full textThis Report is from the Consolation and Hope in a Time of Crisis, Phase 2 project.
The chaplain is the embodiment of the Christian school ethos, the authentic witness that lives their faith boldly, yet communicates the language of faith and spirituality respectfully and in a way that connects appropriately with the context and situation they operate in. That said, there is no one-size fits all when it comes to defining the school chaplain. Their role within the school context is diverse and they are often called upon to address the various facets of the school community’s needs. The ability to be adaptable and responsive to the needs of others is an essential character trait to possess. Creating and fostering an environment where a climate of hope exists and relationships can develop, built on trust, underpin a chaplain’s role. Furthermore, chaplaincy is at its very core relational by nature. A chaplain needs to be able to connect with students, staff and families in a way that fosters trust and offers accompaniment.
What this report sets out is an understanding of the school chaplain seen through the lens of the chaplains, students, and staff that we have encountered during our two phased research projects
