"I want to become someone!" gender, reproduction and the moral career of motherhood for women with sickle cell disorders.

In Sierra Leone, motherhood is being transformed into a moral career for women with sickle cell disorders. This qualitative participatory study, conducted in 2018, involved thirty-six semi-structured interviews with female care-givers and women with sickle cell disorders. Mothers argued that medical models of disease, combined with caring practices, are means to morally manage ideas of 'spoiled identity' and rethink the sick role, disability and life-outcomes of a potentially serious condition. Mothers encourage their children with sickle cell to stay in education as a route to access formal employment and careers that will not tax their bodies and ensure reproductive timing. Education and employment are framed temporally to ensure a delay so that girls can develop caring relationships and access motherhood safely. Understanding and encouraging the development of motherhood as a moral career, involving embodied hyper-vigilant caring practices, is valuable for the self-identity of mothers, allowing them to see a future for themselves and their children.

Assessing the amount of unscheduled screening ("contamination") in the control arm of the UK "Age" Trial.

UNLABELLED: The UK Age Trial of mammographic screening from age 40 has reported a nonsignificant 17% reduction in breast cancer mortality calculated on an "intention to treat" basis. High levels of ad hoc screening in the control arm could potentially have diluted the estimated effect. OBJECTIVES: To estimate the level of unscheduled mammography in the control arm of the UK Age Trial. METHODS: Data were obtained from questionnaires sent to a random sample of 3,706 women at five centers in the control arm of this trial. Questions included in the Office for National Statistics Omnibus Surveys about the timing of and reasons for any breast screening provided comparable data. The overall response rate was 58.8%. RESULTS: Overall, 24.9% (95% confidence interval, 23.0-26.8) of Age Trial controls responding reported ever having had a mammogram, 18.2% reported a mammogram for symptomatic reasons, and 8.4% reported unscheduled mammography. Overall, 4.0% and 1.8% of women reported symptomatic and unscheduled mammography, respectively, within the previous 12 months. Results from the Omnibus surveys were similar, 14.2% of women reported previous mammography for symptomatic reasons or follow-up after breast cancer and 6.8% reported unscheduled mammography. CONCLUSIONS: The level of contamination due to mammographic screening in the control arm of the Age Trial was low and will have had a minimal effect on the estimated reduction in mortality from breast cancer. IMPACT: Estimating the extent of screening in the control arm in randomized trials of screening is important to inform interpretation of the results.