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BackgroundPreterm birth (PTB) is a global health epidemic, sub-Saharan Africa is severely impacted due to its limited healthcare resources. Pregnancy knowledge, cultural beliefs and practices play a role in the identification of risk and management of PTB. This study explored knowledge, understandings, cultural beliefs and attitudes to pregnancy and PTB, as well as cultural considerations for the introduction of an intravaginal device which could be used to identify PTB risk.MethodsQualitative research was conducted in South Africa and Kenya. In-depth interviews were conducted using semi-structured guides with women with a history of PTB (n = 10), healthcare providers (n = 16) and health systems experts (n = 10); and 26 focus group discussions with pregnant women seeking antenatal care (n = 132) and community male partners/fathers (n = 54). Interviews/discussions were transcribed, translated, and analysed thematically.ResultsPregnancy knowledge, especially for first time pregnancies was poor, with many reporting late entry to antenatal care. Knowledge about PTB was understood in terms of gestational age, weight or small size of baby, with concerns about long term health and stigma. Various risk factors for PTB were described, including those related to traditions and beliefs of witchcraft/curses. Cultural practices, such as the use of traditional medicines and pica, and religion and its impact on health seeking behaviour were also viewed as risk factors. Although insertion of intravaginal devices was not widely acceptable in traditional communities, especially during pregnancy, it was felt that the use of one to detect risk of PTB would be accepted if proven effective in reducing PTB risk.ConclusionsVarious culturally-informed beliefs exist which explain understandings of and attitudes toward pregnancy, pregnancy risk, and PTB. An inclusive exploratory process is critical to facilitate an understanding of the beliefs and traditions which could impact the introduction and design of a product to detect the risk of PTB.

This article presents a systematic review of a substantial body of literature that considers the ways in which the concept of teacher identity has been used to understand and explore teachers' professional lives. The aim of the review was to go beyond the limitations of specific areas of teachers' practice to explore the broad and rich field of teachers' professional lives. Drawing on 412 articles from 2000-2021, the review demonstrates the growth in teacher identity research, particularly since 2010. Results from the review are categorised into seven thematic groups that span key areas related to teachers' professional lives: (1) Models and frameworks of professional lives; (2) Narratives of professional lives; (3) Becoming a teacher; (4) Contexts; (5) Communities; (6) Change, transition and conflict; and (7) Subject specialisms. The review reveals gaps in teacher identity research, such as: few research studies from Global South countries; a limited number of studies focusing on non-core curriculum subjects, including arts, history, geography and physical education; fewer studies focusing on primary school and early years teacher identities; and a divide between identity scholarship and research, and policy and practice. The article concludes with a call for teacher identity research to be expanded and broadened with the aim to facilitate the progress of identity work in scholarship, policy and practice.

ObjectiveTo describe experiences with abortion counseling and access in patients with lethal or life-limiting fetal diagnoses in Texas after enactment of Senate Bill 8 (SB8).MethodsIn this qualitative study, we interviewed patients who obtained abortions after enactment of SB8, using semi-structured interviews to explore how restrictions affected abortion care. Two researchers coded all transcripts using an inductive technique and analyzed themes in an iterative approach.ResultsWe interviewed 16 participants who reported gestational durations from 13 to 29 weeks at the time of abortion. Participants described loss of the therapeutic patient-physician relationship and feelings of isolation while pursuing abortion due to the limitations imposed by SB8. For example, participants felt there was a physician "gag rule" regarding abortion ("the unspoken word of termination"), resulting in the need to find information about pregnancy options outside of the medical community and further highlighting the privilege of financial resources necessary to obtain an abortion on their own. Participants also expressed fears regarding confidentiality with their support systems and clinicians ("I would joke around and say, well don't sue me, but halfway mean it") and personal safety when self-referring for abortion ("…am I making the right choice on where I need to go? Is it safe?").ConclusionAbortion restrictions and bans such as SB8 erode the patient-physician relationship, evoking fear and safety concerns during a vulnerable time for those undergoing abortion for lethal or life-limiting fetal diagnoses. They force patients to shoulder the significant burden of understanding pregnancy options and navigating the process of abortion alone, which is likely to have greater effects on those with fewer resources.

THE COLLECTED WORKS OF THOMAS KYD Volume One BRIAN VICKERS, EDITOR 646pp. Boydell and Brewer. 145 [pounds sterling]. THE COLLECTED WORKS OF JOHN FORD Volume Four BRIAN VICKERS, EDITOR 512pp. [...]

BackgroundPrematurity and its complications are the leading cause of death and disability in children under five in Africa and North America, affecting as many as one in ten pregnancies. Screening tests to predict preterm birth (PTB) are insensitive, costly, and often unavailable in low resource settings. In parallel with early-stage U.S.-based testing of a novel self-placed intravaginal device to predict PTB risk, we elicited key stakeholder input from two sub-Saharan African countries to ensure local contextual factors inform future development of the device and its acceptability.MethodsA qualitative study was conducted in Kiambu County, Kenya and KwaZulu-Natal Province, South Africa. We conducted 26 focus group discussions with pregnant women (n = 132) and males from the community (n = 54); in-depth interviews with women who had a history of PTB (n = 10), healthcare providers (n = 16), and health system experts (n = 10). Interviews were transcribed and thematic analysis was performed using an iterative coding technique. In addition, we facilitated user-centered design sessions to generate prototype preferences.ResultsWomen with a personal history of PTB were almost unanimous in support of the proposed device, whereas those with no experience of PTB expressed the greatest degree of reservation. Healthcare providers anticipated that women with a history of PTB would accept the device. However, various potential challenges were identified, including potential discomfort with device insertion, hygiene, and sexual activity, as well as need for provider training, and attention to country-specific regulatory processes. Both community participants and providers expressed a preference for a provider inserted device. Design recommendations included preference for a small, soft, pliable device, with a shape that could facilitate easy removal.ConclusionsUse of an intravaginal device to detect risk of PTB was generally acceptable, however stakeholders expressed a notable preference for insertion by providers. This reflects the significance of end-user consultation in device design and use. Recommended device modifications as well as educational messaging and provider technical assistance may facilitate utilization.

This paper presents descriptive statistics from the first wave of the Syrian Refugee Life Study (S-RLS), which began in 2020. S-RLS is a longitudinal study that tracks a representative sample of approximately 2,500 registered Syrian refugee households in Jordan. It collects comprehensive data on sociodemographic variables, health and well-being, preferences, social capital, attitudes, and safety and crime perceptions. We use these data to document sociodemographic characteristics of Syrian refugees in Jordan and compare them to representative populations in the 2016 Jordan Labor Market Panel Survey (JLMPS). Our findings point to lags in basic service access, housing quality, and educational attainment for Syrian refugees relative to non-refugees. The impacts of the pandemic may partially explain these disparities. The data also show that most Syrian refugees have not recovered economically after Covid-19 and have larger gender disparities in income, employment, prevalence of child marriage, and gender attitudes than their non-refugee counterparts. Finally, mental health problems were common for Syrian refugees in 2020, with depression indicated among more than 45 per cent of the phone survey sample and 61 per cent of the in-person survey sample.

Globally, teacher educators work in contexts which are shaped and informed by persistent policy reform and global environmental crises which we argue, combine to create a professional life that is volatile, uncertain, complex and ambiguous (VUCA). Through a case study of geography teacher educators (GTEs) based in England, we explore the experiences, knowledge and professional growth of teacher educators. Our findings draw on data from responses to an online questionnaire (n = 51), a practitioner workshop and 11 semi-structured interviews. We find that GTEs have multi-faceted identities which are shaped by professional, social and personal realms through engagement with a diverse community of practice. The VUCA context of teacher education is visible in the professional identities of GTEs in both affirming and deleterious ways which we argue, are linked to perceptions of professional autonomy. We argue that the professional role of teacher educators is to bravely engage with policy making as part of their contribution to a socially and environmentally just future for all.