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When unpaid female carers consider whether to pursue higher education (HE), they frequently experience decision-making uncertainties which stem from the structural and cultural challenges associated with their roles as carers. Reflexivity is a critical part of decision-making, as it empowers individuals to mediate between the present and future within the structural and cultural conditions which impact and guide their actions. To investigate the reflexive deliberation processes unpaid female carers engage in as part of their HE decision-making processes, this study analysed data from an in-depth, qualitative Australian study with 15 unpaid female carers who were considering higher education. Dialogic processes including narrative interviews and a card sort activity made visible the array of mental activities involved in reflexive decision-making by carers. Considering the more and less productive types of reflexive inner conversations which had been identified enabled participants to reflexively adjust the efficacy of some of their decision-making processes. This study contributes to the reflective and career counselling literature by theorising the cognitively and emotionally complex personal and structural demands of HE decision-making. By conceptualising reflexive decision-making anew, unpaid female carers and HE institutions can better identify and address the structural and cultural conditions which may be influencing their HE decision-making. [ABSTRACT FROM AUTHOR]

Introduction: Endometriosis is a common condition with average delays to diagnosis in New Zealand of almost 9 years., Methods: In total, 50 endometriosis patients participated in anonymous, asynchronous, online group discussions about their priorities, and their experiences with the development of symptoms, seeking a diagnosis, and receiving appropriate treatment., Results: Higher subsidy of care was the top change endometriosis patients wanted, followed by more research funding. When asked to choose whether research should be focused on improving diagnosis or improving treatment methods, the results were evenly split. Within this cohort, patients highlighted that they did not know the difference between normal menstrual discomfort and pathological endometriotic pain. If, upon seeking help, medical practitioners classified their symptoms as "normal," these dismissals could instill doubt in patients, which made it more difficult for them to continue to seek a diagnosis and effective treatments. Patients who did not express dismissal had a significantly shorter delay from symptom onset to diagnosis of 4.6 ± 3.4 years vs. 9.0 ± 5.2 years., Conclusion: Doubt is a frequent experience for endometriosis patients in New Zealand, which was reinforced by some medical practitioners who were dismissive of their pain and thus prolonged the patient's delay to diagnosis., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Ellis, Munro and Wood.)