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Vincent AJ, Johnston-Ataata K, Flore J, Kokanović R, Hickey M, Boyle JA, Teede HJ. A qualitative study of work and early menopause: 'On-the job' experiences and career trajectories. Maturitas 2024; 182:107920. [PMID: 38280355 DOI: 10.1016/j.maturitas.2024.107920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 11/18/2023] [Accepted: 01/17/2024] [Indexed: 01/29/2024]
Abstract
OBJECTIVES Early menopause or premature ovarian insufficiency (POI), menopause occurring before age 45 and 40 years respectively, occur at the age when most women are establishing or consolidating their careers. Studies of older postmenopausal women indicate an adverse bidirectional relationship between menopause and work. However, data are lacking regarding the work experiences of women with early menopause or POI. We explored the experiences of women with early menopause or POI in relation to work. STUDY DESIGN Using maximum variation sampling, 30 women (median age 44 years and 38 years at menopause diagnosis) of diverse backgrounds and menopause causes (16/30 iatrogenic) participated in qualitative interviews to explore experiences of early menopause/POI in the context of their overall lives, work and career. Dual thematic (themes identified across interviews) and thematic narrative (themes identified within individual interviews) analysis was done using NVivo 12 software. MAIN OUTCOME MEASURES Themes related to work experiences and influencing factors. RESULTS Two major themes were identified: 'on-the-job' experiences (work performance, bodily presentation and disclosure) and career trajectories (intact and altered). Factors impacting the interaction between work and early menopause/POI included: career (type of work, environment, working conditions), personal (age, socio-economic background, family arrangements, migration history) and menopause experience (spontaneous versus iatrogenic, treatment complexity). CONCLUSIONS Early menopause/POI has multiple impacts on women's work experiences and career trajectories. As with older postmenopausal women, career and personal factors influence younger women's work experience. However, this research highlights differences associated with menopause occurring at an earlier, often unexpected age compared with menopause at the usual age.
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Affiliation(s)
- Amanda J Vincent
- Monash Centre for Health Research and Implementation-MCHRI, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia; Department of Endocrinology, Monash Health, Clayton, Victoria, Australia.
| | - Kate Johnston-Ataata
- School of Global, Urban and Social Studies, RMIT University, Melbourne, Victoria, Australia; Women's Health Victoria, Melbourne, Victoria, Australia.
| | - Jacinthe Flore
- School of Historical and Philosophical Studies, University of Melbourne, Melbourne, Victoria, Australia.
| | - Renata Kokanović
- School of Global, Urban and Social Studies, RMIT University, Melbourne, Victoria, Australia.
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne and the Royal Women's Hospital, Flemington Road, Parkville, Victoria, Australia.
| | - Jacqueline A Boyle
- Monash Centre for Health Research and Implementation-MCHRI, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia; Department of Obstetrics and Gynaecology, Monash Health, Clayton, Victoria, Australia.
| | - Helena J Teede
- Monash Centre for Health Research and Implementation-MCHRI, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia; Department of Endocrinology, Monash Health, Clayton, Victoria, Australia.
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Bai S, Jiang H, Wang T, Yang D, Liu Y, Xu C, Zhang L, Zhang Y. An acceptability study of the introduction of total online or partial online PBL in a large classroom setting in biochemistry. BMC MEDICAL EDUCATION 2023; 23:912. [PMID: 38037047 PMCID: PMC10691088 DOI: 10.1186/s12909-023-04767-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/12/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Traditional problem-based learning (PBL) relying on tutored learning in small groups is very resource-intensive. Little is known about the benefits of PBL in a large classroom setting. This paper introduced a PBL case into the traditional didactic biochemistry course and investigated the acceptability of total online or partial online PBL in a large classroom setting introduced during the coronavirus pandemic. METHODS The students were allocated into either total online Group 1, partial online Group 2, or partial online and with poorer academic performance Group 3. A questionnaire comprising of 8 closed-ended questions and 2 open-ended questions and final exam performances were used to evaluate the acceptability of total online or partial online PBL in a large classroom setting. The 8 closed-ended questions were analysed by the Kruskal-Wallis test or chi-square tests. The word cloud analysis of the 2 open-ended questions were conducted by Wenjuanxing. Students' performances in the final examination were analysed by One-way Anova. RESULTS Both total online and partial online PBL were rated highly by the students. Overall, there were no significant differences in the effectiveness evaluation of PBL between Group 2 and Group 3. There were no significant differences in final exam performances between Group 1 and Group 2. However, Group 1 rated the effectiveness of PBL much higher than Group 2 and 3. Word cloud analysis of the 2 open-ended questions showed students' positive perspectives of PBL. In biochemistry teaching, from the perspective of the students, the expected optimal number of useful PBL cases might be 2. CONCLUSIONS Both total online and partial online PBL in a large classroom setting were widely accepted as a beneficial supplement to traditional biochemistry classes.
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Affiliation(s)
- Suyun Bai
- Department of Biochemistry and Molecular Biology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Hanming Jiang
- Department of Biochemistry and Molecular Biology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Tao Wang
- Department of Biochemistry and Molecular Biology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Duxiao Yang
- Department of Biochemistry and Molecular Biology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Yizhi Liu
- Department of Medical Statistics, School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Changqin Xu
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Limin Zhang
- Department of Rheumatology and Immunology, Shandong Provincial Hospital, Shandong First Medical University, Jinan, China.
| | - Yuanying Zhang
- Department of Biochemistry and Molecular Biology, School of Clinical and Basic Medical Sciences, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China.
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Kelly BS, Kirwan A, Quinn MS, Kelly AM, Mathur P, Lawlor A, Killeen RP. The ethical matrix as a method for involving people living with disease and the wider public (PPI) in near-term artificial intelligence research. Radiography (Lond) 2023; 29 Suppl 1:S103-S111. [PMID: 37062673 DOI: 10.1016/j.radi.2023.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 04/18/2023]
Abstract
INTRODUCTION The rapid pace of research in the field of Artificial Intelligence in medicine has associated risks for near-term AI. Ethical considerations of the use of AI in medicine remain a subject of much debate. Concurrently, the Involvement of People living with disease and the Public (PPI) in research is becoming mandatory in the EU and UK. The goal of this research was to elucidate the important values for our relevant stakeholders: People with MS, Radiologists, neurologists, Registered Healthcare Practitioners and Computer Scientists concerning AI in radiology and synthesize these in an ethical matrix. METHODS An ethical matrix workshop co-designed with a patient expert. The workshop yielded a survey which was disseminated to the professional societies of the relevant stakeholders. Quantitative data were analysed using the Pingouin 0.53 python package. Qualitative data were examined with word frequency analysis and analysed for themes with grounded theory with a patient expert. RESULTS 184 participants were recruited, (54, 60, 17, 12, 41 respectively). There were significant (p < 0.00001) differences in age, gender and ethnicity between groups. Key themes emerging from our results were the importance fast and accurate results, explanations over model performance and the significance of maintaining personal connections and choice. These themes were used to construct the ethical matrix. CONCLUSION The ethical matrix is a useful tool for PPI and stakeholder engagement with particular advantages for near-term AI in the pandemic era. IMPLICATIONS FOR PRACTICE We have produced an ethical matrix that allows for the inclusion of stakeholder opinion in medical AI research design.
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Affiliation(s)
- B S Kelly
- School of Medicine, UCD, Belfield, Dublin 4, Ireland; Department of Radiology, St Vincent's University Hospital, Dublin 4, Ireland; School of Computer Science and Insight Centre, UCD Belfield, Dublin 4, Ireland.
| | - A Kirwan
- Multiple Sclerosis Ireland National Office, 80 Northumberland Road, Dublin 4, Ireland
| | - M S Quinn
- School of Computer Science and Insight Centre, UCD Belfield, Dublin 4, Ireland
| | - A M Kelly
- School of Education, Trinity College Dublin, Dublin 2, Ireland
| | - P Mathur
- Department of Radiology, St Vincent's University Hospital, Dublin 4, Ireland
| | - A Lawlor
- Department of Radiology, St Vincent's University Hospital, Dublin 4, Ireland
| | - R P Killeen
- School of Medicine, UCD, Belfield, Dublin 4, Ireland
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In vitro maturation of immature oocytes for fertility preservation in cancer patients compared to control patients with fertility problems in an in vitro fertilization program. Radiol Oncol 2021; 56:119-128. [PMID: 34957736 PMCID: PMC8884857 DOI: 10.2478/raon-2021-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/25/2021] [Indexed: 11/20/2022] Open
Abstract
Background The aim of this study was to determine whether in vitro maturation (IVM) of immature oocytes after controlled hormonal stimulation of the ovaries could be important in cancer patients to improve their chances of conception in the future. Patients and methods After ovarian stimulation in cancer patients, the number of oocytes and their quality and maturity were compared to control patients with fertility problems in the in vitro fertilization (IVF) program. In both groups of patients, immature oocytes at the developmental stage of germinal vesicle were matured in vitro and the proportion of oocytes that matured in vitro was compared between groups. In a subset of women with fertility problems, intracytoplasmic sperm injection (ICSI) was performed on IVM oocytes to assess their ability to be fertilized and develop into an embryo compared to vivo matured oocytes in the same cycles and consider the procedure in cancer patients. Results In patients with different cancers, the disease did not affect the number and quality of retrieved oocytes. In cancer patients, there was even a significantly lower proportion of immature oocytes than in patients with fertility problems (30.0% vs. 43.6%; P < 0.05). However, in patients with cancer, fewer oocytes per patient matured in vitro than in patients with fertility problems (1.39 ± 1.04 vs. 2.48 ± 1.83; P < 0.05). After ICSI, the proportions of fertilized oocytes and fertilized oocytes developing into an embryo did not differ between oocytes matured in vitro and in vivo in the same cycles. Conclusions Oocyte IVM is proving to be a reliable procedure for resolving immature oocytes after controlled ovarian stimulation in cancer patients.
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Abstract
BACKGROUND The unprecedented pandemic presented new stresses and challenges in nursing education impacting the mental health of nursing students. PURPOSE The purpose of this study was to evaluate the relationship between virtual learning and the mental health of nursing students. METHOD This study used a descriptive, cross-sectional design with a convenience sample of 256 nursing students enrolled in a baccalaureate program. Data were collected through an online survey using 2 screening tools for stress, anxiety, and depression. RESULTS Mean sum Patient Health Questionnaire-4 scores and subscale scores suggest that more than 40% of students experienced mild to moderate levels of psychological distress. Mean sum Perceived Stress Scale-10 scores indicate 84% of students experienced moderate levels of stress, and 14% experienced high levels of stress. CONCLUSIONS During periods of societal crisis, faculty must be hypervigilant to the mental health needs of students.
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Johnston-Ataata K, Flore J, Kokanović R. Women's Experiences of Diagnosis and Treatment of Early Menopause and Premature Ovarian Insufficiency: A Qualitative Study. Semin Reprod Med 2021; 38:247-255. [PMID: 33472244 DOI: 10.1055/s-0040-1721463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Early menopause (EM) and premature ovarian insufficiency (POI) affect an estimated 10% of women and can precipitate a wide range of physiological and personal impacts. Receiving a diagnosis of EM/POI and navigating treatment can be complex experiences for women; however, qualitative research exploring these aspects of the condition is limited. Our study aimed to increase understanding of women's lived experiences of EM/POI encompassing its medical, social, and emotional dimensions. We conducted narrative interviews with 30 women aged 28 to 51 years with spontaneous and iatrogenic EM/POI and menopausal symptoms resulting from ovarian suppression therapy, and analyzed transcripts thematically. This article examines the prominent and under-researched themes of women's experiences of navigating "diagnosis" and treatment. Diagnosis emerged as a complex and changeable process wherein women had to negotiate a diagnosis of spontaneous EM/POI and grasp the meaning and probability of iatrogenic EM/POI. Navigating treatment entailed further complexity as women grappled with the risks and efficacy of hormonal and non-hormonal medications. The findings underline the intricacies of EM/POI as a biomedical phenomenon and highlight the need for health practitioners to recognize and respond to the challenges women face in coming to terms with the condition and managing its embodied effects.
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Affiliation(s)
- Kate Johnston-Ataata
- Social and Global Studies Centre, School of Global, Urban and Social Studies, RMIT University, Melbourne, Victoria, Australia
| | - Jacinthe Flore
- Social and Global Studies Centre, School of Global, Urban and Social Studies, RMIT University, Melbourne, Victoria, Australia
| | - Renata Kokanović
- Social and Global Studies Centre, School of Global, Urban and Social Studies, RMIT University, Melbourne, Victoria, Australia
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