Sexual health activism: the motivations of near-peer volunteer educators working to promote positive understandings of gender and sexuality in UK secondary schools.

This paper explores and theorises education-based workshops delivered in secondary schools in support of a relationships and sex education curriculum that aims to bring forth more positive understandings and experiences of gender and sexuality. We cast this work as a form of sexual health activism, with our paper deepening understanding of how the motivations of those engaged in this form of activism interface with the decision to invest time in this work. Based on interviews with 40 workshop facilitators in England and Wales we argue that this form of sexual health activism is motivated by facilitators' life experiences as well as the desire to make the world a better place. As such, this form of work can function as a means of 'caring for' both past selves and future generations, thus functioning simultaneously as a form of self-care and a form of 'societal care work'. Ultimately, these activities may be understood as a form of 'extra-clinical' healthcare practice, with leading gender and sexual health workshops serving as an important means of solidifying health students' identities as both healthcare providers and activists for social change.

Prehospital Comparison of the HEAR and HE-MACS Scores for 30-Day Adverse Cardiac Events.

OBJECTIVE: The History, Electrocardiogram (ECG), Age, and Risk factor (HEAR) and History and ECG-only Manchester Acute Coronary Syndromes (HE-MACS) risk scores can risk stratify chest pain patients without troponin measures. The objective of this study was to determine if either risk score could achieve the ≥99% negative predictive value (NPV) required to rule out major adverse cardiovascular events (MACE; a composite of all-cause death, myocardial infarction, or coronary revascularization) at 30 days or the ≥50% positive predictive value (PPV) indicative of a patient possibly needing interventional cardiology. METHODS: We performed a pre-planned secondary analysis of the prospective multisite PARAHEART (n = 462, 12/2016-1/2018) and RESCUE (n = 767, 4/2018-1/2019) trials, which accrued adults ≥21 years old with acute non-traumatic chest pain transported by emergency medical services (EMS). Paramedics prospectively completed risk assessment forms. Very low risk was defined by a HEAR score of 0-1 or HE-MACS probability <4%. The primary outcome was 30-day MACE, which was determined by adjudication (PARAHEART) or electronic record review (RESCUE). NPV and PPV with exact 95% confidence intervals (95%CI) for 30-day MACE were calculated for each risk score and compared using McNemar's tests. RESULTS: Among the PARAHEART and RESCUE cohorts, 30-day MACE occurred in 18.8% (87/462) and 6.9% (53/767) of patients, respectively. In PARAHEART, 7.8% (36/462) were very low risk by HEAR score vs. 7.8% (36/462) by HE-MACS (p = 1.0). The HEAR score had a NPV of 97.2% (95%CI 91.9-100.0) vs. 91.7% (95%CI 82.6-100.0) for HE-MACS (p = 0.15). The HEAR and HE-MACS PPVs were similar [46.4% (95%CI 28.0-64.9) vs. 33.3% (95%CI 13.2-53.5) (p = 0.26)]. In RESCUE, the HEAR score identified 14.2% (109/767) as low risk compared to 8.3% (64/767) by HE-MACS (p < 0.001). In this cohort, the HEAR and HE-MACS scores had similar NPVs [98.2% (95%CI 95.7-100.0) vs. 98.4% (95%CI 95.4-100.0) (p = 0.89)] and PPVs [16.2% (95%CI 6.2-32.0) vs. 22.6% (95%CI 12.3-36.2) (p = 0.41)]. CONCLUSIONS: In two prehospital chest pain cohorts, neither the HEAR score nor HE-MACS achieved sufficient NPV or PPV to rule out or rule in 30-day MACE.

Local Landscapes of Breastfeeding: A comparison of breastfeeding amongst mothers in low- and high-income neighborhoods in Bristol, UK.

This paper compares experiences of breastfeeding outside the home for women living in low-income and high-income neighborhoods of the same city. Our findings are based on an analysis of 22 interviews with breastfeeding mothers (11 in each of two study areas) undertaken in Bristol, UK in 2017. We extend existing scholarship by showing how experiences of breastfeeding vary not only at the regional level but between local areas of the same city, and outline how our findings can inform policy. We advance literature on maternal bodies by exploring how local "landscapes" of breastfeeding emerge as mothers encounter and negotiate different socio-material landscapes and locally-differentiated norms about "appropriate" maternal embodiment. We argue that these variegated interactions can lead to different orientations to space and forms of spatial practice on the part of breastfeeding mothers, as well as different kinds of maternal identities.

Affect, corporeality and the limits of belonging: breastfeeding in public in the contemporary UK.

The UK has some of the lowest breastfeeding duration rates in the industrialised world. This paper considers women's experiences breastfeeding in public as a factor in breastfeeding duration. Research is based on an analysis of: 11 interviews and a 46-person survey of new mothers in Southampton, Hampshire; 180 postings about breastfeeding in public on UK parenting website mumsnet; and a patent application for a 'portable lactation module'. I analyse these data through an engagement with the work of cultural theorist Sara Ahmed to argue that the 'limits of sociability' in public space in the UK can be marked through affective practice. This paper makes three unique contributions to scholarship. First, it increases understanding regarding an issue of direct importance to health policy by filling a gap in knowledge about women's experiences breastfeeding outside the home in the UK. Second, it contributes to the field of health geography by showing how affective environments can constrain health-promoting behaviours. Third, it extends conceptual work in human geography more broadly through an analysis of the relationships between affect, embodiment and urban subjectivity.

"The way to break the taboo is to do the taboo thing" breastfeeding in public and citizen-activism in the UK.

Like other forms of infant feeding, breastfeeding is a fundamental act of care. Yet despite being the recommended way of feeding babies, breastfeeding is not always easy to do. In addition to lack of support, bio-physical problems and the need to return to work; discomfort with breastfeeding in public is a factor shaping infant feeding choice (and the decision to stop breastfeeding specifically). With increased awareness of breast milk's health benefits in recent years, there has been a rise in efforts to make breastfeeding in public more commonplace and socially acceptable (including through lactation advocacy or "lactivism"). This paper considers breastfeeding in public and lactation advocacy in the UK through interviews with lactation activists, non-activist breastfeeding mothers, and participant-observation at two breastfeeding picnics held in 2009. Building on existing scholarship in Geography, I suggest that lactivism can be understood as an effort to expand the boundaries of where care-work is allowed to take place: thus constituting a form of "care-work activism".