Marcianna Nosek

Mycoplasma genitalium infection and persistence in a cohort of female sex workers in Nairobi, Kenya.

Objective: The objective of this study was to assess the risk factors for and persistence of Mycoplasma genitalium (MG) in a highly exposed female population in Kenya. Study Design: Two hundred fifty-eight sex workers in Nairobi, Kenya, 18 to 35 years of age, were enrolled. Every 2 months, cervical samples were collected for MG, Chlamydia trachomatis (CT), and Neisseria gonorrhoeae (GC) testing by polymerase chain reaction. Results: At enrollment, 16% were infected with MG. Seventy-seven subjects acquired 107 MG infections, giving an incidence of 22.7 per 100 women-years. Incident CT (adjusted hazard ratio [HR] = 2.4; 95% confidence interval [CI] = 1.5–4.0), GC (HR = 2.0; 95% CI = 1.2–3.5), and HIV infection (adjusted HR = 2.2; 95% CI = 1.3–3.7) were associated with an increased risk of MG. Seventeen percent, 9%, and 21% of MG infections persisted 3, 5, and ≥7 months, respectively. Conclusion: The high incidence of MG, greater than that for both CT (14.0%) and GC (8%), association with common sexually transmitted infection risk factors, and persistence in the female genital tract supports its role as a common sexually transmitted infection in Kenyan women.

The composite first person narrative: Texture, structure, and meaning in writing phenomenological descriptions.

This paper illustrates the use of composite first person narrative interpretive methods, as described by Todres, across a range of phenomena. This methodology introduces texture into the presently understood structures of phenomena and thereby creates new understandings of the phenomenon, bringing about a form of understanding that is relationally alive that contributes to improved caring practices. The method is influenced by the work of Gendlin, Heidegger, van Manen, Gadamer, and Merleau-Ponty. The methods applicability to different research topics is demonstrated through the composite narratives of nursing students learning nursing practice in an accelerated and condensed program, obese female adolescents attempting weight control, chronically ill male parolees, and midlife women experiencing distress during menopause. Within current research, these four phenomena have been predominantly described and understood through quantified articulations that give the reader a structural understanding of the phenomena, but the more embodied or “contextual” human qualities of the phenomena are often not visible. The “what is it like” or the “unsaid” aspects of such human phenomena are not clear to the reader when proxies are used to “account for” a variety of situated conditions. This novel method is employed to re-present narrative data and findings from research through first person accounts that blend the voices of the participants with those of the researcher, emphasizing the connectedness, the “we” among all participants, researchers, and listeners. These re-presentations allow readers to develop more embodied understandings of both the texture and structure of each of the phenomena and illustrate the use of the composite account as a way for researchers to better understand and convey the wholeness of the experience of any phenomenon under inquiry.

The Effects of Perceived Stress and Attitudes Toward Menopause and Aging on Symptoms of Menopause

INTRODUCTION As part of a longitudinal study of midlife women, the aim of this investigation was to describe the intensity of menopausal symptoms in relation to the level of perceived stress in a womans life and her attitudes toward menopause and aging. METHODS Data were collected on 347 women between 40 and 50 years of age in Northern California who began the study while premenopausal. Women self-identified as African American, European American, or Mexican/Central American. Data collected over three time points in the first 12 months were used for this analysis. An investigator-developed tool for the perception of specific types of stress was used. Attitudes toward menopause and aging were measured using the Attitudes Toward Menopause and Attitude Toward Aging scales. Attitudes toward aging and menopause, perceived stress, and income were related to intensity of symptoms. RESULTS There was no ethnic group difference in perceived stress or attitude toward menopause. However, European and African Americans had a more positive attitude toward aging than Mexican/Central Americans. DISCUSSION A lower income, higher perceived stress, a more negative attitude toward aging, and a more positive attitude toward menopause influenced menopausal symptom experience.

Silence, stigma, and shame: a postmodern analysis of distress during menopause.

Because of the complexity of a midlife womans life and the variation of the manifested symptoms of menopause, much remains inconclusive regarding the experience of distress during the menopause transition. The purpose of this narrative analysis study was to examine experiences of distress during the menopause transition using a postmodern feminist framework. Findings include experiences of shame related to symptom experience and prevailing social discourses on menopause and aging. Clinicians must be cautioned of the potential for silencing and withdrawal in women who may not be receiving adequate support, and must advocate for more choices for midlife women.

Distress During the Menopause Transition

In 2010, nearly 400 million women worldwide were of menopause age (45-54). Although many women transition through menopause with ease, some experience distress and a subsequent decrease in quality of life. The purpose of this qualitative study was to examine the experiences of distress in women during the menopause transition. A narrative analysis methodology was used maintaining participants’ complete narratives when possible. In-person interviews of 15 midlife women were digitally audio recorded and transcribed verbatim. Women shared narratives of distress related to menstrual changes, emotional instability, vaginal dryness, and decreased libido affected by their relationships with self, partners, work, and family. Some experiences were presented against a backdrop of the past and influenced by concerns for the future. Detailed stories illuminated the effect that distressful symptoms had on quality of life and captured how intricately woven symptoms were with the women’s interpersonal and social lives.

Nonviolent communication: A dialogical retrieval of the ethic of authenticity

Charles Taylor called for a retrieval of the ethic of authenticity that has been distorted in modern notions of autonomy and self-fulfillment. Via exchanges with others who matter to us, he proposed that human identities develop through the use of rich language draped in shared horizons of significance. The fostering of these dialogical ties beyond purely instrumental purposes, along with the recognition of the human dignity in all, may avert the fallen ideal of authenticity. Nonviolent communication affords the skillful dialogue with others cradled in a shared sense of significance and supports the development of a meaningful identity—one that is formed through the realization of what exists beyond the self. The purpose of this article is to argue that nonviolent communication facilitates the retrieval of the ethic of authenticity. Narratives from nursing students’ journals on the use of nonviolent communication skills will be used to support the argument.

‘Chaos, restitution and quest’: one woman’s journey through menopause

Menopause, a natural stage in a womans reproductive life, is not an illness; yet some women experience severe enough symptoms to cause a breakdown in the body similar to illness or other major health disruptions. As part of a larger narrative analysis investigation of distress during menopause, this case study presents one womans transformational journey through menopause, analysed through Franks health and illness narratives - chaos, restitution and quest. The narratives were retranscribed using Labovs elements of a true story and Gees poetic restructuring. This report of one womans experience of distress during the menopause transition describes a poetic chaos narrative of incessant night sweats resulting in a loss of physicality and a deep-rooted belief in self-healing; a restitution narrative of restored health that mandated the surrender to a new healing discourse, experienced simultaneously as a victory and a defeat; and a quest narrative of seeking meaning, insight and new-found values and identities.