“I don’t know if I understood the whole process from the beginning”: A photo-elicitation exploration of the experience of mastectomy and breast reconstruction decision making

Objectives: Policy and guidance assume that reconstruction following mastectomy will have physical and psychological benefits, however research has disputed whether this is always the case. This study aimed to explore mastectomy experiences and reconstruction decision making. Methods: Semi-structured interviews about self-curated participant photographs of the breast cancer experience were analysed using interpretative phenomenological analysis (IPA). Results: Three themes were developed: ‘Life before mastectomy’; ‘I don’t know if I understood the whole process from the beginning’; and getting back to ‘normal’. Conclusions: Decisions regarding reconstruction were influenced by needs of others, and surgeons’ communication and behaviour and negative experiences were prominent. Over time participants came to terms with physical and psychological impacts of mastectomy reporting re-finding themselves alongside acceptance of their post mastectomy bodies. However, participants were living with the fear that their cancer may one day return. Communication skills training for healthcare professionals should be a priority to ensure decisions made result in the best possible outcomes for patients. Innovation: Photo-elicitation is a novel research method enabling rich investigation of mastectomy experiences. Self-curation of images enables patient-led discussions about mastectomy experience and illustrates the importance of life context. Photographs may have value within clinical training to facilitate understanding of patient experiences

Pneumovirus in Dogs with Acute Respiratory Disease

To determine which respiratory viruses circulate among confined dogs, we analyzed nasal and pharyngeal swab specimens from shelter dogs with acute respiratory disease. An unknown virus was isolated. Monoclonal antibody testing indicated that it was probably a pneumovirus. PCR and sequence analysis indicated that it was closely related to murine pneumovirus

Hif-1α-Induced Expression of Il-1β Protects against Mycobacterial Infection in Zebrafish.

Drug-resistant mycobacteria are a rising problem worldwide. There is an urgent need to understand the immune response to tuberculosis to identify host targets that, if targeted therapeutically, could be used to tackle these currently untreatable infections. In this study we use an Il-1β fluorescent transgenic line to show that there is an early innate immune proinflammatory response to well-established zebrafish models of inflammation and Mycobacterium marinum infection. We demonstrate that host-derived hypoxia signaling, mediated by the Hif-1α transcription factor, can prime macrophages with increased levels of Il-1β in the absence of infection, upregulating neutrophil antimicrobial NO production, leading to greater protection against infection. Our data link Hif-1α to proinflammatory macrophage Il-1β transcription in vivo during early mycobacterial infection and importantly highlight a host protective mechanism, via antimicrobial NO, that decreases disease outcomes and that could be targeted therapeutically to stimulate the innate immune response to better deal with infections

Uranium mobility in organic matter-rich sediments: A review of geological and geochemical processes

Uranium (U) is of enormous global importance because of its use in energy generation, albeit with potential environmental legacies. While naturally occurring U is widespread in the Earth's crust at concentrations of ~1 to 3 ppm, higher concentrations can be found, includingwithin organicmatter (OM)-rich sediments, leading to economic extraction opportunities. The primary determinants of U behaviour in ore systems are pH, Eh, U oxidation state (U(IV), U(VI)) and the abundance of CO3 2– ions. The concentration/availability and interrelationships among such determinants vary, and the solubility and mobility of ions (e.g. OH-, CO3 2–, PO4 3-, SiO4 4-, SO4 2-) that compete for U (primarily as U(VI)) will also influence the mobility of U. In addition, the presence of OM can influence U mobility and fate by the degree of OMsorption to mineral surfaces (e.g. Fe- and Si- oxides and hydroxides). Within solid-phase OM, microbes can influence U oxidation state and U stability through direct enzymatic reduction, biosorption, biomineralisation and bioaccumulation. The biogenic UO2 product is, however, reported to be readily susceptible to reoxidation and therefore more likely remobilised over longer time periods. Thus several areas of uncertainty remain with respect to factors contributing to U accumulation, stability and/or (re)mobilisation. To address these uncertainties, this paper reviews U dynamics at both geological and molecular scales. Here we identify U-OMbond values that are in agreement, relatively strong, independent from ionic strength and which may facilitate either U mobilisation or immobilisation, depending on environmental conditions. We also examine knowledge gaps in the literature, with U-OM solubility data generally lacking in comparison to data for U sorption and dissolution, and little information available on multi-component relationships, such as UOM-V (V as vanadate). Furthermore, the capability ofOMto influence the oxidation state of U at near surface conditions remains unclear, as it can be postulated that electron shuttling by OM may contribute to changes in U redox state otherwise mediated by bacteria. Geochemical modelling of the environmental mobility of U will require incorporation of data from multi-corporation studies, as well as from studies of U-OM microbial interactions, all of which are considered in this review

Taylor Slough Hydrology

Taylor Slough, in Everglades National Park, has experienced an evolution of water management infrastructure since drainage activities arrived in South Florida. This has included the excavation of canals, installation of large capacity pump stations, and a variety of operational strategies focused on resolving the conflict between managing the water level for developed areas while providing water supply for Everglades National Park. This study provides a review of water management practices and the concurrent hydrologic conditions in the Taylor Slough basin and adjacent canal system from 1961 through 2010. Analyses of flow, water level and rainfall data were divided into time periods that correspond to significant changes in structural features and operational plans. In the early 1960s, Taylor Slough was disconnected from the greater Everglades system by the construction of levees upstream. As water supply for Taylor Slough became more urgent, the Slough was connected to the regional water supply system via a network of canals and pump stations to relieve over-drained conditions. The increased water supply and pump capacity succeeded in raising water level and increasing flow and hydroperiod in the marsh

The Matrix of Change: A Tool for Business Process Reengineering

Business process reengineering efforts suffer from low success rates, due in part to a lack of tools for managing the change process. The Matrix of Change can help managers identify critical interactions among processes. In particular, this tool helps managers deal with issues such as how quickly change should proceed, the order in which changes should take place, whether to start at a new site, and whether the proposed systems are stable and coherent. When applied at a medical products manufacturer, the Matrix of Change provided unique and useful guidelines for change management.

A photo-elicitation exploration of UK mothers’ experiences of extended breastfeeding

In this qualitative study we explored the experiences of women breastfeeding children over 12 months of age. Data were collected from 24 participants using semi-structured photo-elicitation interviews and photo-prompted online surveys. Participants took photographs of their extended breastfeeding experiences over one week and reflected on how the events depicted made them feel, and what they represented in terms of their experience. Data were analysed using interpretative phenomenological analysis. Four themes were developed; parenting through breastfeeding: meeting the needs of my child, my body is not my own, social influences on the breastfeeding experience, and thinking about stopping: my choice or theirs? Findings highlight that extended breastfeeding was experienced as beneficial for both mother and child, promoting closeness, and bonding, and providing a valued parenting tool. However, some mothers reported conflict between their desire for child-led extended breastfeeding and the need to regain autonomy and control of their own bodies. The dangers of negative societal responses to extended breastfeeding and risks to mental health posed by cultural constructions of ‘ideal’ motherhood are discussed