Sociocultural aspects of the medicalisation of infertility: a comparative reading of two illness narratives.

This paper is a comparative reading of variations in the medicalisation of infertility caused by sociocultural aspects, in two illness narratives by patients: Elizabeth Katkin's Conceivability (2018), a story of navigating a fertility industry with polycystic ovarian syndrome and antiphospholipid syndrome in America and Rohini Rajagopal's What's a Lemon Squeezer Doing in My Vagina (2021), a discussion from India of a growing awareness of medicalisation in treatment of unexplained infertility. For this purpose, it first charts scholarship on illness narratives and medicalisation, noting a historical association. Following this, it shows how infertility, a physiological symptom of reproductive incapacity or failure to show clinical pregnancy, is generally medicalised. This paper reads the texts as showing hitherto unaddressed sociocultural aspects of infertility's medicalisation. At the same time, drawing from existing sociological and anthropological scholarship, it shows how a reading of sociocultural aspects in medicalised infertility nuances understanding of it's medicalisation. This comparative reading attends to sociocultural values and norms within the texts, including pronatalism, fetal personhood, kinship organisation, purity/pollution, individual reliance, sacred duty and so forth. It draws from scholarship on embodiment, rhetorical strategies and the language of medicine. It also shows how a patient's non-medicalised, affective history of 'deep' sickness caused by the biographical disruption of infertility is not that of a 'poor historian'. In laying out the particularisation of such sociocultural values and norms across America and India, medicalisation's migration from its origins to the margins reveals subjectivised, stratified reproduction in infertility illness narratives. This paper is part of a turn in scholarship away from understanding the medicalisation of infertility as naturalised and decontextualised.

The role of meditation and mindfulness in the management of polycystic ovary syndrome: a scoping review.

Polycystic Ovary Syndrome (PCOS) presents multifaceted challenges affecting women's reproductive, metabolic, and psychological systems, consequently impacting their psychological and emotional well-being. The utilization of meditation and mindfulness interventions (MMIs) is found to be increasing for the management of PCOS. This scoping review systematically explored the current literature to identify the type and application of MMIs for PCOS management. A systematic search of literature was conducted using CINAHL, PsycINFO, Scopus, MEDLINE, and PubMed databases for identifying studies conducted on the usage of MMIs in women diagnosed with PCOS, irrespective of age. The comprehensive search identified 14 trials (comprising 17 citations) meeting inclusion criteria, involving 723 participants across various age groups. Among these, nine were randomized controlled trials (RCTs), while the remaining comprised non-RCTs. Several types of MMIs, including Rajayoga of Brahmakumaris, Yoga Nidra, OM cyclic meditation, unspecified forms of meditation, mindfulness-based stress reduction programs, mindful yoga, and mindfulness-based activities, were used. Outcomes were predominantly assessed in psychological domains (n=11), followed by anthropometric (n=9), quality of life (n=7), and metabolic metrics (n=7). The review findings suggest the integration of meditation with conventional treatment modalities. Preliminary data indicate that MMIs have the potential to improve psychosocial well-being and quality of life among PCOS-affected women. However, adequately powered studies with extended follow-up periods are required to investigate the mechanisms and therapeutic efficacy of MMIs, particularly concerning reproductive outcomes and weight management. Furthermore, diligent monitoring and reporting of adverse events and adherence are essential for a comprehensive understanding of MMI utilization in PCOS management.

Metabolic Effects of JAK1/2 Inhibition in Patients with Myeloproliferative Neoplasms.

Ruxolitinib is an FDA approved janus kinase (JAK)1/2 inhibitor used to treat myeloproliferative neoplasms (MPNs), including myelofibrosis and polycythemia vera. We aimed to determine the metabolic consequences of ruxolitinib treatment in patients with MPNs. We performed a retrospective single-center cohort study utilizing an electronic medical record based database of patients who began treatment with ruxolitinib for MPNs from January 2010 to March 2017. We also examined the effects of ruxolitinib on adipose tissue JAK/STAT signaling in a mouse model. 127 patients were identified, of which 69 had data available for weight, and at least one other parameter of interest before, and 72 weeks after starting ruxolitinib. Mean baseline weight was 73.9 ± 17.0 kg, and 78.54 ± 19.1 kg at 72 weeks (p < 0.001). 50% of patients gained >5% body weight. Baseline body mass index (BMI) was 25.8 ± 4.8 kg/m2, and 27.5 ± 5.5 kg/m2 at 72 weeks (p < 0.001). Patients treated with ruxolitinib had a higher systolic blood pressure, serum AST, and ALT at 72 weeks, compared with baseline (p = 0.03, p = 0.01, p = 0.04, respectively). In mice, ruxolitinib decreased basal and GH-stimulated STAT5 phosphorylation in adipose tissue. As pharmacological JAK1/2 inhibitors are being developed and used in clinical practice, it is important to understand their long-term metabolic consequences.

Improving operating room cleaning results with microfiber and steam technology.

Microfiber and steam technology is a novel cleaning method that has advantages for clinical applications. We describe its use in the operating room. The benefits include improved cleaning for every patient regardless of known or perceived risk, occupational health and safety advantages, and reduced cost of cleaning, allowing for expansion of cleaning activity without the need for additional human resources. Continuous surgical site infection surveillance demonstrated that infections remained at previously low levels.