Developing "The Health After Cancer Podcast" to amplify cancer survivors' voices through digital storytelling.

BACKGROUND: Cancer survivors experience complex medical and psychosocial challenges after a cancer diagnosis, leading to unmet informational and emotional needs. There is a paucity of cancer survivorship educational resources co-created by survivors and medical professionals. OBJECTIVE: Our aim was to create an educational resource for cancer survivors, caregivers, and medical professionals that would leverage digital storytelling to address survivorship topics. PATIENT INVOLVEMENT: Our content and production team included cancer survivors, clinicians, educators, and design experts. All content was co-created by cancer survivors and medical experts. METHODS: We conducted an environmental scan of existing cancer survivorship educational resources in academic and public domains. Applying human-centered design principles, we incorporated patient perspectives through advisory board meetings and focus groups and identified a podcast as the preferred medium. We selected content and speakers, produced the podcast, and developed a corresponding website. RESULTS: Based on patient recommendations, podcast episodes address mental health, fear of cancer recurrence, relationships, parenting, relating to a new body, care transitions for adult survivors of childhood cancer, disclosing health information, and financial burden of cancer. Podcast guests were invited based on lived or learned experience in these domains. Thirteen guests (survivors, experts) and four hosts (two cancer survivors, two oncologists) co-created 15 podcast episodes. Podcast guests found the storytelling experience to be powerful and therapeutic. DISCUSSION: Digital storytelling is a scalable and accessible educational tool for communicating complex survivorship concepts that can amplify survivors' voices and increase awareness among survivors and clinicians. Co-creation of educational resources for cancer survivorship by survivors and professionals is a feasible and innovative educational strategy. PRACTICAL VALUE: A podcast created by and for cancer survivors in partnership with medical experts highlights opportunities for peer-to-peer digital storytelling to foster community among survivors and caregivers. FUNDING: Podcast production was supported by the Stanford Comprehensive Cancer Center.

Dysphania schraderiana (Schult.) Mosyakin & Clemants - An overlooked medicinal and ritual plant used in Poland.

ETHNOPHARMACOLOGICAL RELEVANCE: The paper discusses the traditional ritual, medicinal and insect repellent use of Dysphania schraderiana in Poland, a plant with little ethnobotanical and phytochemical data. Our research suggests that its properties should be further studied comparing it with the related D. botrys and D. ambrosioides. AIM OF THE WORK: D. schraderiana is an aromatic and medicinal annual herb related to D. ambrosioides and D. botrys and practically absent from historical accounts of plant uses in Europe. The aim of this work is to characterise the current use of D. schraderiana in south east Poland on the background of historical Dysphania species use in Europe. MATERIALS AND METHODS: The data on D. schraderiana was collected in 2020, based on interviews with 42 people in rural areas of south-eastern Poland where the species is used today. A range of textual sources were searched including old medicinal herbals, pharmaceutical handbooks, ethnobotanical publications and culinary databases regarding all the uses of Dysphania species in Europe. RESULTS: In the study area D. schraderiana occurs in the whole spectrum of cultivation stages - from being intentionally cultivated to completely wild. The plant is used mainly as an apotropaic and insect repellent, blessed during Catholic church holidays (mainly Assumption Day), and sometimes used as incense in churches (and blessed on Epiphany Day). D. schraderiana rarely occurs in European historical sources, except sometimes classed as a false, inferior form of D. botrys, which has been known for centuries as a moth repellent and treatment for respiratory illness. We hypothesise that the plant was not easily distinguished from D. botrys and their uses strongly overlapped. For some unknown reason the use of D. botrys died out, whereas a relatively large semi-feral population of D. schraderiana exists in south-eastern Poland where it has remained a culturally important plant. CONCLUSIONS: D. schraderiana is a rare case of a non-native plant traditionally used within an area of Europe but previously nearly overlooked in European ethnobotanical literature. Historical uses of Dysphania spp. in other areas of Poland and former Poland (now western Ukraine) suggest that the genus was used more widely in regions beyond the one studied. However, a very compact distribution of use suggests that D. schraderiana may have been brought to SE Poland from a single source outside the study area. Its common name, and use as a holy incense plant, is associated it with the well-known biblical tree resin obtained from Commiphora myrrha (Nees) Engl.

Historical chemical annotations of Cinchona bark collections are comparable to results from current day high-pressure liquid chromatography technologies.

ETHNOPHARMACOLOGICAL RELEVANCE: Species of the genus Cinchona (Rubiaceae) have been used in traditional medicine, and as a source for quinine since its discovery as an effective medicine against malaria in the 17th century. Despite being the sole cure of malaria for almost 350 years, little is known about the chemical diversity between and within species of the antimalarial alkaloids found in the bark. Extensive historical Cinchona bark collections housed at the Royal Botanic Gardens, Kew, UK, and in other museums may shed new light on the alkaloid chemistry of the Cinchona genus and the history of the quest for the most effective Cinchona barks. AIM OF THE STUDY: We used High-Pressure Liquid Chromatography (HPLC) coupled with fluorescence detection (FLD) to reanalyze a set of Cinchona barks originally annotated for the four major quinine alkaloids by John Eliot Howard and others more than 150 years ago. MATERIALS AND METHODS: We performed an archival search on the Cinchona bark collections in the Economic Botany Collection housed in Kew, focusing on those with historical alkaloid content information. Then, we performed HPLC analysis of the bark samples to separate and quantify the four major quinine alkaloids and the total alkaloid content using fluorescence detection. Correlations between historic and current annotations were calculated using Spearman's rank correlation coefficient, before paired comparisons were performed using Wilcox rank sum tests. The effects of source were explored using generalized linear modelling (GLM), before the significance of each parameter in predicting alkaloid concentrations were assessed using chi-square tests as likelihood ratio testing (LRT) models. RESULTS: The total alkaloid content estimation obtained by our HPLC analysis was comparatively similar to the historical chemical annotations made by Howard. Additionally, the quantity of two of the major alkaloids, quinine and cinchonine, and the total content of the four alkaloids obtained were significantly similar between the historical and current day analysis using linear regression. CONCLUSIONS: This study demonstrates that the historical chemical analysis by Howard and current day HPLC alkaloid content estimations are comparable. Current day HPLC analysis thus provide a realistic estimate of the alkaloid contents in the historical bark samples at the time of sampling more than 150 years ago. Museum collections provide a powerful but underused source of material for understanding early use and collecting history as well as for comparative analyses with current day samples.

Lip service: Public mental health services and the care of Aboriginal and Torres Strait Islander peoples.

The failure of public mental services in Australia to provide care deemed culturally safe for Aboriginal and Torres Strait Islander people has persisted despite several national reports and policies that have attempted to promote positive service change. Nurses represent the largest professional group practising within these services. This article reports on a multisited ethnography of mental health nursing practice as it relates to this group of mental health service users. It explores the beliefs and ideas that nurses identified about public mental health services and the services they provided to Aboriginal and Torres Strait Islander people. During the fieldwork, mental health nurses described the constricting effect of the biomedical paradigm of mental illness on their abilities to provide authentic holistic care focused on social and emotional well-being. Despite being the most numerous professional group in mental health services, the speciality of mental health nursing appears unable to change this situation and in many cases maintain this status quo to the potential detriment of their Aboriginal and Torres Strait Islander service users.

Case-loading midwifery in New Zealand: bridging the normal/abnormal divide 'with woman'.

OBJECTIVES: to explore the way that case-loading midwives in New Zealand construct midwifery (and in so doing, the concepts of woman and childbirth). This paper illuminates the fundamental features of this construction (continuity and woman-centred care) and discusses this with regard to the role of midwives vis-à-vis normal/abnormal birth. DESIGN: semi-structured interviews and official publications constituted the 'text' which was analysed using a poststructural approach that was informed by theorists Foucault, Grosz and Braidotti. PARTICIPANTS AND SETTING: 48 case-loading midwives practising throughout New Zealand participated in this study. These included facility-employed and self-employed midwives and those from rural and urban settings. FINDINGS: many midwives follow women through their maternity experience providing continuity of care regardless of whether the experience is considered 'normal' or 'abnormal'. KEY CONCLUSIONS: continuity and woman-centred care are fundamental features of the construction of midwifery in New Zealand. IMPLICATIONS FOR PRACTICE: a focus on the midwifery concept of 'with woman' can bridge the divide between the polarising concepts 'normal' and 'abnormal' and enable a more fluid and dynamic reading of midwifery.

Case-loading midwifery in New Zealand: making space for childbirth.

OBJECTIVES: to explore the way in which case-loading midwives in New Zealand construct midwifery (and in so doing, the concepts of woman and childbirth) and, given these constructions, to examine their practice within the obstetric hospital. DESIGN: in-depth interviews were conducted with 48 case-loading midwives. Along with relevant professional, regulatory and contractual documents, transcripts of these interviews comprise the 'texts' which were analysed using a feminist, poststructuralist framework drawing, particularly on the work of Foucault and Grosz. SETTING: midwives practising throughout New Zealand participated in this study. PARTICIPANTS: case-loading midwives. FINDINGS: case-loading midwives in New Zealand work across various places as they move from community to primary or obstetric hospitals. They must also negotiate a variety of discursive spaces as they develop a plan of care with the childbearing woman. However, the biomedical discourse of childbirth is most dominant in the obstetric hospital. Therefore, midwives employ a number of strategies as they work to 'make space' for childbirth. These include re-constructing the maternal body as a competent body, re-positioning the woman at the centre of care, disrupting the obstetric gaze, and creating an oasis of privacy, calm and 'woman centeredness' within the birthing room. KEY CONCLUSIONS: midwives 'make space' for the childbearing woman. This space often, although not always, challenges obstetric constructions of childbirth and woman, creating an opportunity for alternatives that are less constraining and hopefully more enabling of an enjoyable and successful birth. IMPLICATIONS FOR PRACTICE: it is important to recognise and articulate the work that midwives do, to facilitate childbirth.

Re-discovering the material body in midwifery through an exploration of theories of embodiment.

The body is of central concern to midwifery yet, as a profession, we have largely failed to grapple with the corpus of feminist and other literature that deals with the body. This article provides an overview of the ways in which the body has been theorised, from the essential and biological through to postmodern theories of the body. We draw attention to the limitations of some of these approaches, suggesting that Elizabeth Grosz's schema of the Möbius strip (representing the inter-relationships between the inside and outside, culture and nature) provides a useful framework for thinking about the body; one that avoids a biological materialism that disregards the effect of culture, and a cultural determinism that neglects the corporeal body. Recognising the multiplicity and fluidity of women's experiences of pregnancy, their body and childbearing emancipates us from the limitations imposed by the masculinist Western philosophical traditions that we have inherited.