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Contextualising Menopause in Nigeria: A Qualitative Analysis From the MARiE Project
No full textObjective To explore Nigerian women's lived experiences of menopause and identify sociocultural, structural, and health‐system factors shaping symptom recognition, care‐seeking, and wellbeing, using in‐depth qualitative inquiry. Design Qualitative interview study. Setting Urban, peri‐urban, and rural communities across Nigeria. Participants Post‐menopausal women aged 40–66 years experiencing natural, surgical, or medical menopause. Methods As part of the Nigerian arm of the MARIE project, semi‐structured qualitative interviews were conducted with purposively sampled post‐menopausal women to capture diverse menopausal stages, socioeconomic positions, and geographic contexts. Interviews were analysed using thematic analysis informed by an equity‐centred, intersectional framework. Multiple researchers independently coded transcripts, with iterative discussion and triangulation to enhance analytic rigour and validity. Results Three interrelated themes characterised menopausal experiences in Nigeria. First, structural health‐system inequalities were evident, including limited anticipatory information, inadequate clinician training, fragmented care pathways, and restricted access to hormone replacement therapy and non‐hormonal treatments. Second, sociocultural and gendered norms shaped symptom interpretation and disclosure, with menopause often framed as a natural or inevitable life stage requiring endurance rather than care, compounded by stigma and silencing within families and communities. Third, women demonstrated adaptive coping and resilience, relying on peer networks, faith‐based practices, and self‐management strategies in the absence of formal support. Urban participants reported comparatively better access to information and services, while rural women described pronounced neglect and dependence on informal care. Conclusions This qualitative study provides the first in‐depth, context‐specific account of menopausal experiences among Nigerian women, revealing substantial inequities driven by sociocultural beliefs, economic constraints, and systemic gaps in healthcare provision. The findings underline the urgent need for culturally sensitive, equity‐oriented menopause care in Nigeria, including integration into primary healthcare, improved professional training, affordable access to evidence‐based treatments, and public health education to reduce stigma and unmet need
‘What Do People With Long Covid Want From Healthcare Services?’ A Qualitative Exploration From Lived Experience
Get PDFBackground
Long COVID (LC) is a chronic, multisystem condition affecting millions globally, with significant personal, social and economic consequences. Despite increasing recognition of its impact, healthcare services for LC remain inconsistent with patients frequently encountering fragmented services, scepticism and delays leading to patient-voiced frustration. Therefore, understanding patient priorities is crucial for optimising service provision.
Objectives
To explore what individuals with LC want from healthcare services—drawing on their lived experience and collaborative insights with clinicians and researchers, to inform principles for improving care delivery, barriers to access, expectations for service improvement, and the role of multidisciplinary care in managing LC.
Methods
A qualitative study using thematic analysis was conducted, incorporating multiple data sources, including semi-structured interviews, workshops, and a patient-led audit. Key themes were identified, focusing on healthcare access, clinical assessments, treatment options, and service organisation.
Study Participants
Twenty-seven LC sufferers from the LOCOMOTION Patient Advisory Group (PAG) and Patient Advisory Network (PAN), along with clinicians and researchers involved in LC service provision across the United Kingdom, participated in the study.
Results
Three major themes emerged: (1) Who the services are for: Equity of access for all those with LC. Barriers such as stigma, inequitable access and lack of clinician awareness need to be addressed. (2) What services should do: Consistent and standardised assessments and diagnostic clarity—particularly for modifiable conditions like autonomic dysfunction—and an emphasis on the need for early medical intervention, not just rehabilitation. (3) How services should operate: Care should be coordinated, proactive and adaptable to evolving evidence. Patients should not be discharged without ongoing review. Multidisciplinary collaboration should be patient-centred and informed by up-to-date research.
Conclusions
LC services should be designed to provide equitable, standardised and evidence-based care. Early intervention, appropriate medical testing and sustained follow-up are critical to improving patient outcomes. Patients emphasised the importance of being heard and the value of receiving timely care that reflects the latest scientific understanding and recognises their condition as real, treatable and deserving of ongoing clinical attention. Incorporating these insights into healthcare design may improve outcomes, service efficiency and trust between patients and providers.
Patient and Public Contribution
Patients led all phases of this study, including design, analysis and writing, through active co-production with the LOCOMOTION research team. The paper was born out of discussions within the LOCOMOTION study's Patient Advisory Group (PAG). It was taken forward by C.R., N.S. and R.M., all members of the PAG, working closely with N.B., H.d.K. and G.M
The epistemic space of digital education governance. An archaeological perspective on data, automation and the promise of perfection
No full textWe assist nowadays to the intensification across scales, sites, and times of data-based and evidence-driven forms of governance and management in education. This is coupled with a more and more pervasive role played by digital technologies in education governance. In this chapter I mobilise Foucauldian archaeology to interrogate both the ontology and epistemology of the contemporary digital education governance, discussing epistemic tensions in the production of the ‘subjects’ and objects’ of governance. The analysis focuses on (dis)continuities in: a) how specific governing subjects and objects are recognised and treated; b) what authorities are assigned to hold and care for them and can decide about them, and according to what criteria; c) what methods are employed to make distinct type of operations on/with/through them. I argue that the epistemic space of digital education governance, rather than being a radically new space, presents multiple points of continuity with the episteme of modern education governance and notably: a) the ontological definition of the educational (both as subject and object) as a paradoxical figure of knowledge that is knowable and predictable; b) the ethical radicalization of the promise of perfection; and c) the epistemological centrality of datafication. At the same time, the chapter emphasizes automation and the aspirations towards automated management as a key point of epistemic discontinuity that tends to decenter the ‘modern human’ as the reflexive subject of educational governance and creates the conditions of possibility for the emergence of digital subjects as radically heterogeneous entities
Centri e periferie nello Stato delle autonomie spagnolo
No full textAnalisi delle principali tendenze in atto nell'ordinamento autonomistico spagnolo, anche ricercando spunti di comparazione con l'esperienza regionale italian
Entering Self-employment as Opportunity-driven Entrepreneurship: Evidence from Ethnic Enclaves in the United Kingdom
No full textPurpose - This study examines the entry of ethnic minority groups into opportunity-driven self-employment in the United Kingdom (UK) through the lens of ethnic enclave theory. In doing so, it challenges the dominant view in this stream of inquiry, which posits that such entrepreneurship is primarily driven by necessity, by highlighting the role of ethnic enclaves in shaping entrepreneurial transitions.
Methodology - A quantitative approach using comprehensive UK household data is adopted to analyse the relationship between ethnic enclaves and self-employment transitions, thereby advancing the predominant case-study-based approach in this field.
Findings - The findings confirm that ethnic enclaves promote the transition of ethnic minorities into opportunity-driven self-employment in the UK; the degree of this impact varies across ethnic groups and depends on individual-level factors, such as prior entrepreneurial experience and skill sets. These results demonstrate that enclaves can serve as incubators for opportunity-driven ventures and highlight the interplay between ethnic actors and their immediate contexts.
Originality - By empirically identifying opportunity-driven self-employment within enclaves, this study extends the scope of ethnic enclave theory beyond survival-oriented venturing, reframing enclaves as contexts that can foster growth-oriented entrepreneurship. It offers new insights into the interplay between ethnic enclaves and entrepreneurial agencies, discussing how enclave structures can facilitate business entry for ethnic minorities under specific conditions
Peer Assisted Learning Strategies (PALS-UK) increases reading attainment, oral fluency and comprehension: A cluster randomized controlled trial
Get PDFPurpose
This study evaluates the impact of Peer Assisted Learning Strategies (PALS-UK) in developing pupils’ reading attainment, reading skills (comprehension and fluency) and affective factors (reading self-efficacy and motivation).
Method
All Year 5 pupils (9–10 years old, N = 4840, 49% female and 51% male) in 114 schools in England, took part in a two-armed, randomized controlled efficacy trial randomizing schools. The final analyzed sample included 53 treatment schools (N = 1907, 51% female and 49% male) and 50 business-as-usual control schools (N = 1721, 49% female and 51% male). In treatment schools, class-teachers were asked to deliver PALS-UK three times per week for 20 weeks.
Results
Pupils in treatment schools demonstrated higher curriculum-aligned reading attainment than pupils in business-as-usual control schools. A moderate effect size was found for this primary outcome. Exploratory subgroup analyses suggested that no groups were disadvantaged by treatment. In addition, analyses of secondary outcomes showed significant positive treatment effects for reading comprehension and reading fluency/rate – a measure based on speed/accuracy of reading connected text. The treatment effect was not significant for multidimensional fluency (measuring qualitative differences in expressive reading), reading self-efficacy or motivation to read.
Conclusion
This study is the most rigorous evidence to date that PALS-UK is effective in improving reading outcomes. It provides strong evidence in support of the use of this structured approach to paired reading. We conclude that the approach works, when implemented with fidelity, because it supports pupils to practice reading aloud and scaffolds use of reading comprehension strategies, which improve reading outcomes
A composite short self-report of adolescents’ out-of-school physical activity: enhanced validity, reliability, cross-cultural applicability and identification of psychological correlates
Get PDFQuestionnaires of adolescents’ moderate-to-vigorous physical activity (MVPA) often capture differing timeframes and lack cross-cultural comparability, limiting their utility in large-scale international research. This study evaluated the factorial, cross-cultural, incremental, criterion validity and reliability of a composite tool that integrates three widely used Short Self-Reports (SSRs) of out-of-school MVPA (OS-MVPA). Psychological correlates of PA and accelerometer-based MVPA were used as validation criteria. In Study 1, 9,435 adolescents (ages 10–18) from seven countries (France, Greece, Italy, Portugal, Spain, Turkey, UK) completed the PACE+, a one-item weekly MVPA measure (WHO-HBSC), and four items from the Youth Activity Profile (YAP). Structural equation modelling supported a hierarchical factor model with three lower-order and one higher-order factors, demonstrating strong structural validity and cross-cultural metric invariance. The composite measure showed greater predictive power, with psychosocial variables explaining 51% of its variance – substantially more than individual SRs (35%–42%). In Study 2, involving 2,907 adolescents from four countries, the composite measure demonstrated good test–retest reliability over a six-month interval, exceeding that of individual SRs. In Study 3, 188 adolescents from three countries wore accelerometers for seven days. The composite tool exhibited strong criterion validity, explaining a higher proportion of variance in accelerometer-assessed MVPA compared to previous studies. Incremental validity for the composite tool was supported both in Study 1 and 3. Overall, findings suggest that the composite SR measure offers a valid, reliable, and culturally robust approach for assessing youth out-of-school PA in large-scale, cross-national studies, outperforming single SR instruments across multiple psychometric criteria
Disruptive Journeys: multi-sited archives of ‘invasion’ and the everyday
Get PDFThis paper uses print and associated visual media to investigates the sensationalist reportage of and local responses to a transnational journey undertaken over a century ago. At the time referred to as the “German
Gipsy Invasion”, this was a widely reported and highly debated journey of German Roma and Sinti across the UK. The exploration of the media coverage of this event provides a way through which to geographically and narratively track the activities and local interactions undertaken within a temporary and high-profile migration. It also enables the exploration of domestic, locale specific discourses around migration, spectacle and the everyday. This paper seeks to explore how, and where, the event was documented in order to explore how, and in relation to what, it was documented situated, and later archived. It asks how a perceived spectacle, and the memory of that spectacle, is subsumed into the everydayness of place
