Fear of devaluation : understanding the experience of intersexed women with androgen insensitivity syndrome

Objectives: We aim to provide an understanding of the psychological sequela of Androgen Insensitivity Syndrome (AIS) in phenotypic females in order to begin to inform psychosocial health care services. Design: Eight adult women with AIS were recruited through United Kingdom-Androgen Insensitivity Syndrome Support Group (UK-AISSG). Data was collected via two semi-structured interviews with each woman. Methods: Transcripts were analysed using grounded theory and a conceptual model was developed which suggests a way of understanding the AIS DISTRESS experienced by our participants. Results: The pivotal concept is a woman’s FEAR OF DEVALUATION. This is connected to her level of ADAPTATION and perception of having a COMPROMISED WOMANHOOD. These, in turn, are related to her MEDICAL MANAGEMENT and involvement with others (SUPPORT GROUP and TALKING ABOUT AIS). Conclusions: Participants showed a clear preference for open communication about their condition and we recommend sensitive, pacing of information in order to allow young women and their family to make informed decisions about treatment and a realistic adaptation to life with AIS

The swine flu alert: keeping Asia safe

After years of concern about H5N1 bird flu, the new flu causing global alarm is a pig virus of the H1N1 family. As influenza reports erupt around the world, inevitable questions are arising. Is this the big one? Are we prepared

Operational research to support equitable non-communicable disease policy in low-income and middle-income countries in the sustainable development era : a scoping review

Introduction Non-communicable diseases (NCDs) represent a growing health burden in low-income and middle-income countries (LMICs). Operational research (OR) has been used globally to support the design of effective and efficient public policies. Equity is emphasised in the Sustainable Development Goal (SDG) framework introduced in 2015 and can be analysed within OR studies. Methods We systematically searched MEDLINE, Embase, Scopus and Web of Science for studies published between 2015 and 2018 at the intersection of five domains (OR, LMICs, NCDs, health and decision-making and/or policy-making). We categorised the type of policy intervention and described any concern for equity, which we defined as either analysis of differential impact by subgroups or, policy focus on disadvantaged groups or promoting universal health coverage (UHC). Results A total of 149 papers met the inclusion criteria. The papers covered a number of policy types and a broad range of NCDs, although not in proportion to their relative disease burden. A concern for equity was demonstrated by 88 of the 149 papers (59%), with 8 (5%) demonstrating differential impact, 47 (32%) targeting disadvantaged groups, and 68 (46%) promoting UHC. Conclusion Overall, OR for NCD health policy in the SDG era is being applied to a diverse set of interventions and conditions across LMICs and researchers appear to be concerned with equity. However, the current focus of published research does not fully reflect population needs and the analysis of differential impact within populations is rare

The Kostolac horizon at Vučedol

Sustavnim istraživanjima Vučedola, jednog od važnijih eneolitičkih lokaliteta, potvrđeno je postojanje kulturnih horizonta badenske, kostolačke i vučedolske kulture. 2003. i 2004. godine kampanje su bile usmjerene upravo na istraživanje kostolačkoga kulturnog sloja, koji obiluje cijepanim litičkim nalazima i riječnim školjkama, što nam sugerira način privrede i prehrane. Istraživanjima je potvrđena gradnja nadzemnih objekata te kulture. U ovome radu obrađena je građa pronađena u nadzemnim objektima i jednoj otpadnoj jami.Systematic research at Vučedol, one of the more important Eneolithic sites, confirmed the existence of the Baden, Kostolac and Vučedol cultural horizons. The 2003 and 2004 seasons were dedicated to research of the Kostolac cultural stratum, which abounds in knapped lithics and river shells, suggesting modes of economic life and diet. Research has confirmed that this culture constructed above-ground structures. This work contains an analysis of materials found in such structures and a waste pit

The Kostolac horizon at Vučedol

Sustavnim istraživanjima Vučedola, jednog od važnijih eneolitičkih lokaliteta, potvrđeno je postojanje kulturnih horizonta badenske, kostolačke i vučedolske kulture. 2003. i 2004. godine kampanje su bile usmjerene upravo na istraživanje kostolačkoga kulturnog sloja, koji obiluje cijepanim litičkim nalazima i riječnim školjkama, što nam sugerira način privrede i prehrane. Istraživanjima je potvrđena gradnja nadzemnih objekata te kulture. U ovome radu obrađena je građa pronađena u nadzemnim objektima i jednoj otpadnoj jami.Systematic research at Vučedol, one of the more important Eneolithic sites, confirmed the existence of the Baden, Kostolac and Vučedol cultural horizons. The 2003 and 2004 seasons were dedicated to research of the Kostolac cultural stratum, which abounds in knapped lithics and river shells, suggesting modes of economic life and diet. Research has confirmed that this culture constructed above-ground structures. This work contains an analysis of materials found in such structures and a waste pit

Evolving power dynamics in global health: From biomedical hegemony to market dynamics in global health financing; A response to the recent commentaries

Correspondence

Black-faced Bunting Emberiza spodocephala on Taliabu Island, Sula Island group: The first record for Indonesia

No abstract availabl

Large-eddy simulation of a mildly curved open-channel flow

After validation with experimental data, large-eddy simulation (LES) is used to study in detail the open-channel flow through a curved flume. Based on the LES results, the present paper addresses four issues. Firstly, features of the complex bicellular pattern of the secondary flow, occurring in curved open-channel flows, and its origin are investigated. Secondly, the turbulence characteristics of the flow are studied in detail, incorporating the anisotropy of the turbulence stresses, as well as the distribution of the kinetic energy and the turbulent kinetic energy. Moreover, the implications of the pattern of the production of turbulent kinetic energy is discussed within this context. Thirdly, the distribution of the wall shear stresses at the bottom and sidewalls is computed. Fourthly, the effects of changes in the subgrid-scale model and the boundary conditions are investigated. It turns out that the counter-rotating secondary flow cell near the outer bank is a result of the complex interaction between the spatial distribution of turbulence stresses and centrifugal effects. Moreover, it is found that this outer bank cell forms a region of a local increase of turbulent kinetic energy and of its production. Furthermore, it is shown that the bed shear stresses are amplified in the bend. The distribution of the wall shear stresses is deformed throughout the bend due to curvature. Finally, it is shown that changes in the subgrid-scale model, as well as changes in the boundary conditions, have no strong effect on the result