The Changing Narratives of Death, Dying, and HIV in the United Kingdom

Death and infection were closely linked from the start of the HIV epidemic, until successful treatments became available. The initial impact of mostly young, gay men dying from HIV was powerful in shaping UK responses. Neoliberal discourses developed at the same time, particularly focusing on how citizens (rather than the state) should take responsibility to improve health. Subsequently “successful ageing” became an allied discourse, further marginalising death discussions. Our study reflected on a broad range of meanings around death within the historical UK epidemic, to examine how dying narratives shape contemporary HIV experiences. Fifty-one participants including people living with HIV, professionals, and activists were recruited for semistructured interviews. Assuming a symbolic interactionist framework, analysis highlighted how HIV deaths were initially experienced as not only traumatic but also energizing, leading to creativity. With effective antiretrovirals, dying changed shape (e.g., loss of death literacy), and better integration of palliative care was recommended

A novel photodiode array for astronomical spectroscopy

Imaging arrays can be constructed from photodiode sensor elements using integrated circuit fabrication techniques. Such imaging arrays have proved to be useful in the field of observational astronomy, chiefly because of their linearity and good spectral response in the near infra red region. A photodiode array has been developed by the Plessey Co. Limited, in collaboration with the Royal Greenwich Observatory. This array incorporates certain novel techniques, including an "on-chip" charge amplifier on each element, and a multiplexing scheme that allows correlated double sampling and non-destructive readout. The array was originally designed to be used in an electron counting mode, installed in an electronographic tube. The Nuclear Instrumentation Group of Durham University has investigated the application of this array to direct optical imaging, in particular for astronomical spectroscopy. The characteristics of the array when used in the photon integration mode have been investigated, and measurements have been made of responsivity, thermal leakage, linearity, noise components, and other properties. A CAMAC based computer control system has been designed and constructed, and the required software developed, to operate the array as an observing instrument. The array has been used in observational tests at the Coudé spectrograph of the 30 inch telescope of the Royal Greenwich Observatory, and a quantity of spectral data has been obtained

Navigation and Positioning Requirements for Marine Survey Operations

The commercial Marine Survey industry, particularly in the North Sea and UK continental shelf areas, does not make as extensive use of satellite navigation systems as its investment in such might seem to show. This paper attempts to set out what are the requirements of the Marine Survey user, how these requirements are currently fulfilled, and what future satellite-based systems must provide in order to become competitive. Examples of typical survey operations are provided. The viewpoint is inevitably biased somewhat towards the requirements of the commercial survey contractor operating for the oil and gas industries, but as this is by far the largest sector of expenditure on navigation and positioning services in the UK Marine Survey sphere, the author feels that such bias is justified. This paper, then, examines not so much what the user’s expectations are from satellite navigation, but what his navigation requirements are in general, and what facilities satellite navigation must offer, and at what price, to provide a real service. In order to illustrate the requirements, let us first examine the systems currently in extensive use, with regard to cost, coverage and accuracy

Pharmacological studies of the involvement of hypothalamic prostaglandins in the regulation of thyrotropin secretion.

A case is made for the involvement of pituitary prostaglandins (PGs) in the regulation of thyrotropin (TSH) secretion by citing recent evidence that TSH release in vivo and in vitro is enhanced by treatment with exogenous PGs and is inhibited by drugs (e.g., indomethacin) that block PG synthesis. Pharmacological studies were then performed to test the hypothesis that hypothalamic PGs also affect TSH secretion indirectly via the appropriate hypothalamic hormones that regulate pituitary secretion. The inhibition of thyroidectomy-induced TSH secretion was used as an endpoint in choosing the best of several drugs purported to inhibit PG synthesis. The established effectiveness of indomethacin and aspirin were used for reference in testing the following drugs: naproxen, mefenamic acid, tranylcypromine, and phenelzine. Only naproxen was found to be effective, but since it was no more potent than indomethacin, the latter drug was used for subsequent work. Indomethacin was stereotaxically implanted into several hypothalamic regions known to regulate TSH secretion, and sequential plasma samples were analyzed for TSH by radioimmunoassay. Bilateral implants of indomethacin in the anterior hypothalamic area increased TSH secretion throughout the 72 hr period of study. Sham inplants at this site and indomethacin implants in other nearby sites were ineffective. These findings suggest that endogenous PGs play an inhibitory role in the hypothalamic regulation of pituitary secretion

Factors modulating the secretion of thyrotropin and other hormones of the thyroid axis.

The first portion of this paper is devoted to an overview of the normal function of the hypothalamo-pituitary-thyroid axis. This section emphasizes areas of current research interest and it identifies several sites and mechanisms that are potentially important interfaces with toxins or toxic mechanisms. We then describe an in vitro technique for the continuous superfusion of enzymatically dispersed pituitary cells; this approach is particularly valuable in studying the dynamics of the TSH responses to the factors known (or suspected) to regulate TSH secretion in vivo. Using this technique, we have found that 10(-5)M prostaglandin (PG)I2 stimulates TSH secretion without altering the response to TRH (10(-8)M), and that this stimulation is not due to its rapid conversion to 6-keto PGF1 alpha. In contrast PGs of the E series (PGE1 and PGE2, 10(-5)M) increase responsiveness to TRH but have no effect alone. We found no effects of any of the other prostanoids tested (PGs A2, B2, F1 alpha, F2 alpha, thromboxanes A2 and B2, and the endoperoxide analog, U-44069. Somatostain (10(-9)M inhibits TRH-induced TSH secretion, but does not alter the responsiveness to PGI2. These findings suggest that somatostatin blocks TSH secretion at a point that is functionally prior to the involvement of the PGs, and perhaps does so by blocking synthesis or limiting availability of selected PGs

How Patient Educators Teach Students: “Giving a Face to a Story”

Patient Educators are persons with specific pathologies that have participated in an education program in which they learn how to instruct students on physical examinations. The aim of this study was to explore the impact of graduate student experiences with Patient Educators during coursework on occupational therapy clinical internships. A phenomenological design was used to explore the lived experiences of students through a qualitative interview. As participants described their experiences with the Patient Educators, three primary themes emerged: (a) self-awareness, (b) confidence, and (c) empathy. The quotes from the transcriptions were organized into four sequential plot categories: (a) Before the Interaction, (b) During the Interaction, (c) Immediate Change, and (d) Impact on Clinical Internship. The results reveal a narrative of the learning process experienced by students from before the Patient Educators lab through clinical internships. These results suggest that incorporating Patient Educators in the classroom could be a critical component in preparing students for clinical internship and future clinical practice

HIV-related stigma in the UK then and now: to what extent are we on track to eliminate stigma? A qualitative investigation

Background The introduction of effective antiretroviral treatment in the late 1990s led to the perception that HIV was a chronic but manageable condition. Nevertheless, stigma remains one of the major hurdles for people living with HIV (PLWH) to accessing healthcare and biomedical preventions. Thus, Fast Track Cities has set a target of zero HIV discrimination by 2030 as part of its strategy to end HIV transmission. Methods Fifty-three participants from the United Kingdom, including PLWH (n = 21, 40%), health and social care workers (n = 24, 45%), and charity workers and activists (n = 13, 25%), were recruited. Semi-structured interviews investigated stigma and discrimination, focusing on both before and after the widespread use of effective antiretroviral treatment in the late 1990s. Data were analysed using a thematic approach. Results Before effective antiretroviral treatment narratives were shaped by two main themes: 1) the media’s role in influencing public opinion and contributing to misunderstandings of HIV transmission; and 2) personal experiences of HIV-related stigma, which for PLWH included incidents of physical violence and aggression, as well as fears of their HIV status being publicised. Contemporary narratives on stigma experiences were organised around four themes: 1) discrimination in healthcare settings; 2) stigma amongst men who have sex with men (MSM); 3) stigma towards African and Afro-Caribbean PLWH; and 4) the limits of change in public HIV-related knowledge and attitudes. Contemporary narratives indicated a reduction in enacted stigma, but continued anticipation of discrimination and self-reported shame, particularly in MSM and African and Afro-Caribbean PLWH. Conclusion The nature of stigma against those with HIV has evolved. The intersection of PLWH and minority groups (e.g. MSM and African and Afro-Caribbean persons) may enhance anticipatory and internalised stigma, with some suggestion that this may contribute to reduced engagement in HIV care and prevention services. Our findings indicate the need for further research in this area, as well as proactive interventions with community groups to enhance knowledge of HIV

Apiaceae subfamily Apioideae in Madagascar

An account of the Apiaceae (Umbelliferae) for the Flore de Madagascar et des Comores (Paris) has recently been completed and submitted for publication (Sales and Hedge 2004). The flora account deals with 15 genera and 31 species in the subfamilies Hydrocotyloideae, Saniculoideae and Apioideae; some of the species are globally widespread and/or doubtfully native. Five new species will be described in Peucedanum (2), Phellolophium (1) and Pimpinella (2). Here, we concentrate on subfam. Apioideae, draw attention to some features of special interest and provide a checklist of the native 11 genera and 20 species currently known to occur in Madagascar