Footprints of Birth: An Innovative Educational Intervention Foregrounding Women's Voices to Improve Empathy and Reflective Practice in Maternity Care.

INTRODUCTION: A global movement on respectful maternity care has arisen because of widespread accounts of dehumanized maternity care. This article considers the use of a transformative learning approach to highlight patient agency and personhood in health care. An educational intervention using patient narratives was introduced in a maternity unit to foster a culture of listening and responsiveness to women's voices. This article reports the impact on staff and student learning, empathy, and reflective practice. METHODS: A total of 245 interprofessional providers participated in 14 workshops over a 16-month period. Participants represented a range of health professions including medicine, midwifery, nursing, and allied professions. Senior management, administrators, and peer support volunteers also attended. Session sizes ranged from 5 to 60 attendees. The format included documentary-style videos of patient feedback followed by audience discussion. Discussion points were collected and qualitatively analyzed for participants' critical reflection, emotional engagement, cognitive dissonance, and perspective transformation. RESULTS: Learners reflected on the client-caregiver relationship and care provision. Staff and students showed empathy for the women sharing their stories. Learners were disturbed by failings in care and wished to improve services. All provider groups highlighted the importance of communication, compassion, and patient autonomy as key elements of maternity care. DISCUSSION: Multiprofessional learners engaged emotionally with women's narratives and reflected critically on their roles in maternity care. Learners' responses showed evidence of transformative learning. Staff and students recognized the value of providing respectful, empathic care. Educational interventions highlighting patients' voices may promote patient autonomy by reducing dehumanization in health care.

Evaluating the association of allergies with multiple sclerosis susceptibility risk and disease activity in a pediatric population.

BACKGROUND: Multiple sclerosis (MS) and allergies are both considered to be related to imbalanced Th1 and Th2 immune responses. Previous studies evaluating the relationship between MS and allergies provide conflicting results. OBJECTIVE: To assess allergies and asthma as risk factors for MS and as predictors of MS relapses in a pediatric cohort. METHODS: The environment and genetic risk factors for pediatric MS study is a national case-control project with 16 participating US sites. An environmental questionnaire is used that includes history of allergies in the first five years of life. Case-control data are entered in the pediatric MS Network database and cases at 12 of the 16 sites enter relapse data prospectively. Annualized relapse rate was calculated for patients with follow-up and adjusted for age at disease onset, gender, race, ethnicity, and use of disease-modifying therapy (DMT). RESULTS: We included 271 cases (mean age at disease onset of 15.7years and 62% female) and 418 controls. Relapse data were available for 193 cases. There was no difference in prevalence of allergies or asthma between cases and controls. Patients with food allergies had fewer relapses compared to patients without food allergies (0.14 vs 0.48, p=0.01). CONCLUSIONS: While allergies and asthma are not associated with pediatric MS, cases with food allergies have fewer relapses compared to those without food allergies.