Views from women and maternity care professionals on routine discussion of previous trauma in the perinatal period: A qualitative evidence synthesis.

BACKGROUND: Over a third of pregnant women (around 250,000) each year in the United Kingdom have experienced trauma such as domestic abuse, childhood trauma or sexual assault. These experiences can have a long-term impact on women's mental and physical health. This global qualitative evidence synthesis explores the views of women and maternity care professionals on routine discussion of previous trauma in the perinatal period. METHODS: Systematic database searches (MEDLINE, EMBASE, CINAHL Plus, APA PsycINFO and Global Index Medicus) were conducted in July 2021 and updated in April 2022. The quality of each study was assessed using the Critical Appraisal Skills Programme. We thematically synthesised the data and assessed confidence in findings using GRADE-CERQual. RESULTS: We included 25 papers, from five countries, published between 2001 and 2022. All the studies were conducted in high-income countries; therefore findings cannot be applied to low- or middle-income countries. Confidence in most of the review findings was moderate or high. The findings are presented in six themes. These themes described how women and clinicians felt trauma discussions were valuable and worthwhile, provided there was adequate time and appropriate referral pathways. However, women often found being asked about previous trauma to be unexpected and intrusive, and women with limited English faced additional challenges. Many pregnant women were unaware of the extent of the trauma they have suffered, or its impact on their lives. Before disclosing trauma, women needed to have a trusting relationship with a clinician; even so, some women chose not to share their histories. Hearing trauma disclosures could be distressing for clinicians. CONCLUSION: Discussions of previous trauma should be undertaken when women want to have the discussion, when there is time to understand and respond to the needs and concerns of each individual, and when there are effective resources available for follow up if needed. Continuity of carer should be considered a key feature of routine trauma discussion, as many women will not disclose their histories to a stranger. All women should be provided with information about the impact of trauma and how to independently access support in the event of non-disclosures. Care providers need support to carry out these discussions.

Prec(ar)ious knowledge and the neoliberal academy: Towards re-imagining epistemic justice and critical psychology.

This epilogue is written in the ink of gratitude and provocation, reflecting on the essays that constitute the special issue on precarity. I briefly review the key gifts of the essays and then try to imagine how a social psychology of precarity could be theorized and engaged otherwise, with commitments to epistemic justice, designed with decolonizing methodologies and organized in solidarity with movements for social justice.

Dissident women's letter writing as decolonial plurilogues of relational solidarities for epistemic justice.

Braiding our words, "dissi-dance," and desires, this article engages how various social actors, and communities-which we are a part of and belong to-challenge structural violence, oppression, inequity, and social, racial, and epistemic injustice. We thread these reflections through our written words, in subversive letters which we offer in the form of a written relational conversation among us: a plurilogue that emerges in response to our specific locations, commitments, and refusals, as well as dissents. Our stories and process of dissent within the various locations, relationships, and contexts that we occupy served as the yarn and needle to thread our stories, posed questions and reflections. Braiding, threading and weaving together, we animate deep decolonial inquiries within ourselves, and our different cultural contexts and countries. Refusing individualism-the illusions of objectivity as distance, the academic as expert, and the exile of affect and emotion on academic pages-we choose to occupy academic writing and ask: What if academic writing were stitched with blood and laughter, relationships and insights, rage and incites? What if, at the nexus of critical psychology and decolonizing feminism, we grew an "embodied praxis?" Unlike academic writing, traditionally designed to camouflage affect, connection, relationality and subjectivity, these letters are unapologetically saturated in care and wisdom toward a narrative-based embodied practice: decolonial plurilogues of relational solidarities for epistemic justice. Our plurilogue of dissent offers a view to advance community research and action with goals of liberation, decoloniality, and community wellness.

Critical participatory action research: Methods and praxis for intersectional knowledge production.

Building on the conceptual foundation of articles published in the 2005 volume of the Journal of Counseling Psychology on the qualitative turn in Counseling Psychology, we write to introduce and reflect on Critical Participatory Action Research (CPAR) as an intersectional approach to knowledge production by psychologists researching alongside individuals, communities, and movements dedicated to social justice. We open with a brief review of the origins of CPAR and the epistemological commitments of this approach to inquiry. We then explore why and how participation matters, and the delicate dynamics of CPAR through various phases of research: putting together a research team, crafting research questions and design, selecting methods, sampling, participatory analyses of qualitative and quantitative material, and figuring out how to produce and circulate findings in ways accountable to the community/movement of interest. The second half of the article offers a slow journey into one CPAR project, What's Your Issue?, a multigenerational, national, participatory survey designed by and for LGBTQIA+ youth, with an emphasis on the participation and representation of youth of color. We write this article for scholars, practitioners, activists, educators, and students to make visible why participation is so crucial to social justice research; that "no research on us, without us" is both scientifically and ethically valid, and how mixed methods research with LGBTQIA+ and gender-expansive youth can open new horizons for theory, methods, and action. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The public psychology for liberation training model: A call to transform the discipline.

Written against the backdrop of the 2020 twin pandemics of a global health crisis and greater national awareness of structural racism, this article issues a call for psychology to invest in training all psychologists to respond to the social ills of racial and other forms of oppression. We introduce a public psychology for liberation (PPL) training model. Essentially, the model reflects a science, a pedagogical commitment, and practice of, by, and with the people who have been most marginalized in society. The PPL consists of five foundational domains or cross-cutting areas of expertise (e.g., facilitate human relationships; generate reciprocal knowledge and translation) and 10 interrelated lifelong practices (e.g., cultural humility; care and compassion) that foster healing and equity. The model centers the perspectives of the Global Majority, focuses on radical healing and equity, and emphasizes a developmental, culturally grounded, strengths-based approach to training. Various training initiatives consistent with a public psychology for liberation approach are presented. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Efficacy and Safety of Direct Oral Anticoagulants for Atrial Fibrillation Across Body Mass Index Categories.

Background Direct-acting oral anticoagulants are now the preferred method of anticoagulation in patients with atrial fibrillation. Limited data on efficacy and safety of these fixed-dose regimens are available in severe obesity where drug pharmacokinetics and pharmacodynamics may be altered. The objectives of this study were to evaluate efficacy and safety in patients with atrial fibrillation taking direct-acting oral anticoagulants across body mass index (BMI) categories in a contemporary, real-world population. Methods and Results We performed a retrospective study of patients with atrial fibrillation at an integrated multisite healthcare system. Patients receiving a direct-acting oral anticoagulant prescription and ≥12 months of follow-up between 2010 and 2017 were included. The primary efficacy and safety outcomes were ischemic stroke or systemic embolism and intracranial hemorrhage. We performed Cox proportional hazards modeling to compute hazard ratios (HRs) adjusted for CHA2DS2-VASc score to examine differences by excess BMI categories relative to normal BMI. Of 7642 patients, mean±SD age was 69±12 years with a median (interquartile range) follow-up of 3.8 (2.2-6.0) years. Approximately 22% had class 1 obesity and 19% had class 2 or 3 obesity. Stroke risks were similar in patients with and without obesity (HR, 1.2; 95% CI, 0.5-2.9; and HR, 0.68; 95% CI, 0.23-2.0 for class 1 and class 2 or 3 obesity compared with normal BMI, respectively). Risk of intracranial hemorrhage was also similar in class 1 and class 2 or 3 obesity compared with normal BMI (HR, 0.64; 95% CI, 0.35-1.2; and HR, 0.66; 95% CI, 0.35-1.2, respectively). Conclusions Direct-acting oral anticoagulants demonstrated similar efficacy and safety across all BMI categories, even at high weight values.

Minority Stress, Activism, and Health in the Context of Economic Precarity: Results from a National Participatory Action Survey of Lesbian, Gay, Bisexual, Transgender, Queer, and Gender Non-Conforming Youth.

Lesbian, gay, bisexual, transgender, queer, and gender non-conforming (LGBTQ & GNC) youth experience more economic hardship and social stress than their heterosexual and cisgender peers. However, the ways that LGBTQ & GNC youth resist these damaging social factors and the corresponding implications for their health have not been addressed. Data were analyzed from a national participatory survey of LGBTQ & GNC youth ages 14-24 (N = 5,860) living in the United States. Structural equation models indicated that economic precarity was associated with experiences of health problems. This association was mediated by the negative influence of minority stress on health as well as by activism, which had a positive association with health. Findings suggest that minority stress explanations of health inequalities among LGBTQ & GNC youth can benefit from including a focus on economic precarity; both in terms of its deleterious impact on health and its potential to provoke resistance to structural oppression in the form of activism.

Tolvaptan for Volume Management in Heart Failure.

Volume management in acute decompensated and chronic heart failure (HF) remains a significant challenge. Although progress has been made in the development of mortality-reducing neurohormonal regimens in the reduced ejection fraction population, no clinical trial has yet demonstrated anything more than symptomatic relief or biomarker reduction with pharmacotherapeutic volume-based interventions made in the acutely decompensated individual or those with evolving outpatient congestion. As the number of patients with HF continues to grow, in addition to HF-related hospitalizations, identifying therapies that have the potential to aid in diuresis more safely and efficaciously is paramount to decreasing inpatient length of stay and preventing unnecessary admissions. More recently, a significant amount of research has been dedicated to the use of vasopressin antagonists, specifically tolvaptan, as adjunctive therapy to loop and thiazide diuretics. Although these agents do not seem to have a pervasive role in fluid management in the acute decompensated and chronic HF populations, they are effective tools to have available for specific clinical situations. This review summarizes the literature surrounding the use of tolvaptan for volume management in congestive HF, as well as offering practical guidance for use of this agent.

Outcomes With Novel Oral Anticoagulants in Obese Patients who Underwent Electrical Cardioversion for Atrial Tachyarrhythmias.

The efficacy of novel oral anticoagulants (NOACs) in severely obese patients is uncertain as volume of distribution is related to weight, and few such patients were enrolled in the pivotal trials. As the month after direct-current cardioversion (DCCV) for atrial fibrillation and atrial flutter is a high-risk period for stroke, we sought to evaluate the safety of performing DCCV in obese patients on NOAC. All patients who underwent DCCV after ≥3 weeks of NOAC or therapeutic warfarin treatment without a previous transesophageal echocardiogram over a 3-year period at a single center were included. Obesity groups were defined as normal (body mass index [BMI] < 25), overweight (BMI 25 to <30), class 1 obesity (BMI 30 to <35), class 2 obesity (BMI 35 to <40), and class 3 or severe obesity (BMI ≥ 40). The primary end point was stroke at 30days. Of 761 patients, 73 were severely obese, 78 class 2 obese, 197 class 1 obese, 254 overweight, and 159 in the normal weight group. Average age 66.4 ± 10.3years and 32.5% women. Mean CHA2DS2-VASc score was 2.6 ± 1.6, and 78.9% were on NOACs with no differences in groups. There were no strokes in the severely obese group, and 1 each in class 2 obesity and normal weight (p = 0.3). In conclusion, there was a low rate of stroke in all weight classes after DCCV in patients taking NOACs and warfarin. NOAC use in severely obese patients who underwent DCCV appears safe even in the absence of transesophageal echocardiogram.

Participatory action research (par) with LGBTQ+ & GNC youth in the United States: an interview with Michelle Fine, Maria Torre, and Allison Cabana / Pesquisa-ação participativa com juventude LGBTQ e "Gênero não conforme" nos Estados Unidos: uma entrevista com Michelle Fine, Maria Torre e Alisson Cabana

Entrevista com Michelle Fine, Maria Torre e Allison Cabana sobre Pesquisa-ação participativa com jovens LGBTQ e outros gêneros.

Interview with Michelle Fine, Maria Torre and Allison Cabana about Participatory action research with LGBTQ & GNC youth in the USA.

Just methods in revolting times.

This article takes up the challenge of critical methods in "revolting times," as we conduct qualitative research on (in)justice festering within repulsive inequality gaps, and yet surrounded by the thrill of radical social movements dotting the globe. I introduce a call for "critical bifocality," a term coined by Lois Weis and myself, to argue for research designs that interrogate how history, structures, and lives shape, reveal, and refract the conditions we study. Borrowing from critical researchers long gone, W. E. B. Du Bois in his text The Philadelphia Negro and Marie Jahoda in her stunning case study Marienthal, I offer up a set of epistemological muddles and methodological experiments, hoping to incite a conversation about our responsibilities as critical psychologists in deeply contentious times, refusing downstream analyses and resurrecting instead what Edward Said called "lost causes."

Leadership in Solidarity: Notions of Leadership Through Critical Participatory Action Research With Young People and Adults.

The authors trace the connections between multigenerational participatory action research and relational approaches to shared leadership, illustrating how the collective production of knowledge through research builds youth leadership capacity.

Echoes of Bedford: a 20-year social psychology memoir on participatory action research hatched behind bars.

Responding to Martin Luther King Jr.'s 1968 address at the American Psychological Association calling for a psychology that would educate Whites about racial injustice, this article challenges the widening epistemological gap between those who suffer from inequality and those who conduct social policy research on inequality. In this 20-year memoir on the echoes of a single piece of participatory policy research, Changing Minds: The Impact of College in a Maximum-Security Prison (Fine et al., 2001), readers are invited to explore how deep critical participation by a collaborative team of university and prisoner researchers has facilitated theoretical and methodological complexity, enhanced contextual and construct validity, thickened commitments to ethics and action, and fueled the political sustainability and generalizability of the findings over time and space.

Attention deficit/hyperactivity disorder blame game: a study on the positioning of professionals, teachers and parents.

Attention deficit/hyperactivity disorder is currently the most debated childhood psychiatric diagnosis. Given the circulation of competing perspectives about the 'real' causes of children's behaviour and the 'best' way to treat them, we aim to analyse the interactions of the central social actors' discourses about attention deficit/hyperactivity disorder children within the Italian context. Adopting a multi-method approach, we focus on the polyphonic chorus of voices surrounding the child, studying the discourses of mental health professionals, teachers and parents. These actors are representative of three contexts that are deeply engaged with attention deficit/hyperactivity disorder: medical institutions, schools and families. Our theoretical and methodological approach integrates positioning theory, the Bakhtinian notion of dialogical thinking and discourse analysis to study stakeholders' reflexive and interactive positioning in terms of the attribution of rights, duties, responsibilities and power issues. The results show that mutual blame is a constitutive element of relational dynamics among the key adults surrounding attention deficit/hyperactivity disorder children. We argue that these conflicting relationships are not merely related to the debate regarding the validity of the attention deficit/hyperactivity disorder diagnosis. Rather, the mutual blame centres on questions of compliance, recognition of authority and morality. Through the blame game, adults negotiate their own and others' subjectivity in ways that simultaneously (re)produce power relationships and resistance efforts.

Exploring dual identification among Muslim-American emerging adults: a mixed methods study.

This mixed methods study explored dual identification among Muslim-American emerging adults of immigrant origin. A closer look was taken at the relationship between American and Muslim identifications and how this relationship was influenced by experiences of discrimination, acculturative and religious practices, and whether it varied by gender. Data were gathered from 97 Muslim Americans (ages 18-25) who completed a survey and produced identity maps, a pictorial representation of hyphenated identities. The findings showed that young people found a way of allowing their Muslim and American identities to co-exist, and only a small minority of the participants seemed to experience identity conflict. While religiosity was the only predictor of Muslim identification, young peoples' identification with mainstream United States culture was predicted by discrimination-related stress and acculturative practices. Gender moderated the relationship between Muslim and American identities in both survey measures and identity maps.

The power of the Brown v. Board of Education decision: theorizing threats to sustainability.

Interviews with African American and White American elders capture the immediate power of the Brown v. Board of Education (1954) decision and the biography of its impact over time. This article reviews the lived experience of the decision and theorizes 3 threats to sustainability that ruthlessly undermined the decision over time: (a) the unacknowledged and enormous sacrifice endured by the African American community in the name of desegregation; b) the violent and relentless resistance to the decision by government officials, educators, and many White community members; and (c) the dramatic shrinkage of the vision of Brown from the dismantling of White supremacy to a technical matter of busing. Implications are drawn for the study of desegregation and for the study of sustainability of social justice more broadly.