A qualitative study examining UK female genital mutilation health campaigns from the perspective of affected communities.

OBJECTIVES: Female genital mutilation (FGM) is a worldwide problem associated with severe health risks. In the UK, preventative public health campaigns have been developed to eradicate FGM. The aim of the present study was to elicit the views about FGM public health campaigns from the perspective of a UK Somali community. STUDY DESIGN: Three focus groups and one interview were conducted with 16 community members. METHODS: Using posters and leaflets focused on UK FGM prevention, photo-elicitation was used to encourage participants to discuss the usefulness and implications for national public health messages aimed at eradicating FGM. Data were subjected to inductive thematic analysis. RESULTS: Participants were positive about the aims of the campaigns presented within the research, believing such campaigns were necessary and increased awareness of FGM. However, participants felt the campaigns also carried risks of enhancing stereotypes in terms of ethnicity, gender and religion. For example, some images were perceived to suggest that FGM was only relevant to Sub-Saharan women, although it is also prevalent in other populations. Some fathers reported feeling unfairly targeted in campaigns that focused on the role of mothers in protecting daughters from FGM. Participants were also concerned that some poster images may suggest that FGM was associated with Islam and perceived as a religious issue, rather than a cultural one. Fears were identified that this could lead to stigmatisation and hostility towards those affected. CONCLUSIONS: The research findings suggested that actively working with affected communities to develop messaging that counters negative stereotyping and associated hostility should be a priority.

Concerns and future challenges of health literacy in the Nordic countries - From the point of view of health promotion practitioners and researchers.

BACKGROUND: Health literacy is an essential social determinant for promoting and maintaining the health of a population. AIM: From a health promotion perspective, explore health literacy issues, concerns and future challenges among Nordic practitioners and researchers. METHODS: Data were collected in a workshop at the 8th Nordic Health Promotion Conference, and in a literature review, with articles from five databases. The search included title and abstract with the search terms health literacy* and health literacy as a MeSH term and all the Nordic countries. Qualitative and quantitative analysis were used. RESULTS: Twenty-five persons participated in the workshop. The discussions were summarized in six themes: concept of health literacy in national language; risk of victim blaming; measuring health literacy; content in school curricula on health literacy; new technologies for information and communication; communication and collaboration between different actors in support of health. Forty-three articles on health literacy were identified, mainly conducted within three fields: development, test and adaptation of instruments for measuring health literacy; measurement of health literacy among patients, or other defined target groups and on populations; and developing and evaluating methods/tools for the training of personnel groups or different target groups. CONCLUSIONS: There is a need for further studies providing a more in-depth understanding of the health literacy concept, knowledge on how to measure health literacy, ethical aspects, application in intersectoral collaboration as well as the adaptation to new technologies for information and communication in education supporting health literacy. As health literacy is an essential social health determinant, a concern and a future challenge must be, to make the health literacy concept familiar and visible in health promotion policies, research and practice such as health education.

Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews.

Maternal obesity is linked with adverse outcomes for mothers and babies. To get an overview of risks related to obesity in pregnant women, a systematic review of reviews was conducted. For inclusion, reviews had to compare pregnant women of healthy weight with women with obesity, and measure a health outcome for mother and/or baby. Authors conducted full-text screening, quality assurance using the AMSTAR tool and data extraction steps in pairs. Narrative analysis of the 22 reviews included show gestational diabetes, pre-eclampsia, gestational hypertension, depression, instrumental and caesarean birth, and surgical site infection to be more likely to occur in pregnant women with obesity compared with women with a healthy weight. Maternal obesity is also linked to greater risk of preterm birth, large-for-gestational-age babies, foetal defects, congenital anomalies and perinatal death. Furthermore, breastfeeding initiation rates are lower and there is greater risk of early breastfeeding cessation in women with obesity compared with healthy weight women. These adverse outcomes may result in longer duration of hospital stay, with concomitant resource implications. It is crucial to reduce the burden of adverse maternal and foetal/child outcomes caused by maternal obesity. Women with obesity need support to lose weight before they conceive, and to minimize their weight gain in pregnancy.

Third Prader-Willi syndrome phenotype due to maternal uniparental disomy 15 with mosaic trisomy 15.

We report on a boy with mosaicism for trisomy 15 and Prader-Willi syndrome (PWS) due to maternal isodisomy for chromosome 15. His phenotype is consistent with PWS and trisomy 15 mosaicism. Although our patient is unusual in having maternal isodisomy rather than the more common maternal heterodisomy, we think that his more severe PWS phenotype is due to his trisomy 15 mosaicism rather than to homozygosity for deleterious chromosome 15 genes. We propose that individuals with PWS have one of three similar but distinctive phenotypes depending on the cause of their condition. Patients with paternal deletions have the typical PWS phenotype, patients with maternal UPD have a slightly milder phenotype with better cognitive function, and those with maternal UPD and mosaic trisomy 15 have the most severe phenotype with a high incidence of congenital heart disease. These phenotype-genotype differences are useful to guide the work-up of patients with suspected PWS and to provide prognostic counseling for families.

Ovarian teratomas associated with the insertion of an imprinted transgene.

Ovarian teratomas are tumors that arise from female germ cells and are often a mixture of immature embryonal carcinoma cells and mature embryonic cells. Tissues derived from all three primary embryonic lineages (ectoderm, mesoderm, and endoderm) are typically found in the mature elements of a teratoma. In the case of the transgenic mouse line TG.KD, created with an imprinted transgene construct, malignant ovarian teratomas of a mixed germ cell tumor morphology occur in 15-20% of hemizygous female carriers of the transgene. The tumors frequently metastasize and can result in death of the mouse. Genetic analysis indicates that the tumors are associated with the transgenes integration site. Inbred FVB/N and female mice of other transgenic lines, also created in the inbred FVB/N strain with the same DNA construct as TG.KD, do not develop teratomas. In addition to teratomas, the integration of the transgene on Chromosome (Chr) 8 is associated with a perinatal lethality in homozygous transgenic carriers. The hemizygous genotypes of the teratomas suggest that they arise from early germ cells, prior to the completion of meiosis I.