Editorial

UID/SOC/04647/2013publishersversionpublishe

Features of a NeuroQueer existential-phenomenology

This paper provides a phenomenological description of what is being experienced, and encountered, at the intersections between queer and neurodivergent existence. The description includes an exploration of our emergent pluralities, non-linearity and immersion in existence. It further delves into our existing-being-worlds, and provides a more detailed articulation of the movements, positions and paradoxes that we encounter there. Finally, we offer implications for existential-phenomenological (critical) psychopathology and psychotherapeutic practice

Intergenerational feminism and media: a roundtable

This is the edited text of a roundtable held at City University London, UK in November 2014, organised by Alison Winch and Jo Littler. The event aimed to pay attention to the ways in which age and generation shape mediated conversation about feminist politics: to problematise the dominant media representations of intergenerational “cat fights,” or feminist bickering, while simultaneously interrogating the ways in which mediated conflicts and connections shape the potential to work together to enact feminist social change. It therefore aimed to explore a number of different questions in relation to this issue, including: what kind of shared conversations do women have across age groups, and how do these circulate in media cultures? How can intergenerational alliances be built while still remaining sensitive to differences of experience? How are feminist connections being formed by digital media, technology, and platforms? How is feminist conflict mediated, and how might it operate productively

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Rewriting the Rules: An Anti-Self-Help Guide to Love, Sex and Relationships [second edition]

We live in a time of uncertainty about relationships. We search for The One but find ourselves staying single because nobody measures up. We long for a happily-ever-after but break-up after break-up leave us bruised and confused. Rewriting the Rules: An Anti Self-Help Guide to Love, Sex and Relationships is a friendly guide through the complicated - and often contradictory - advice that's given about sex and gender, monogamy and conflict, break-up and commitment. It asks questions about the rules of love, such as which to choose from all the rules on offer? Do we stick to the old rules we learnt growing up, or do we try something new and risk being out on our own? And what about the times when the rules we love by seem to make things worse, rather than better? This new edition, updated throughout, considers how the rules are being 'rewritten' in various ways - for example in monogamish and polyamorous relationships, different ways of understanding sex and gender, and new ideas for managing commitment and break-up where economics, communities, or child-care make complete separation impossible. This book considers how the rules are being ‘rewritten’ in various ways, giving you the power to find an approach that best fits your situation

Depression and/or oppression? Bisexuality and mental health

The following paper is a write-up of the keynote talk which I presented at UK BiReCon in 2012, and then – in a revised form – at the first US BiReCon in 2013. My gratitude to Alex Iantaffi and Lauren Beach for enabling me to attend the latter, and to all the attendees for making me so welcome and for engaging so fully with our discussions around compassion and self-care. Given this paper’s origins, I hope that readers will forgive the tone for being somewhat more informal and polemic than that of a standard academic article in places, as well as the tendency to draw heavily on my own work over the years as expected in a keynote talk. Perhaps the most important, and consistent, finding in existing research on bisexuality is the fact that bisexual people are more prone to mental health problems than either heterosexual, or lesbian and gay, people. This finding has been replicated across many different countries and contexts, as readers of this journal will be well aware (e.g. Jorm et al., 2002; King & McKeown, 2003; Schrimshaw et al., 2013; Colledge et al., in prep)Therefore, in presenting a keynote talk on bisexuality it seemed appropriate – even essential – to focus on issues of mental health. My interest in this topic is threefold: First I am an academic who is interested in both sexuality and mental health, and has written on both areas over the last decade; secondly as a therapists I work with largely LGBTQ clients; and finally as an individual I have – perhaps inevitably given the aforementioned findings – struggled with these matters on a personal level, and within the bisexual and other sexual and gender communities that I am a part of. This paper considers bisexual mental health from both an individual, and a community, perspective. It asks how we, as individuals, generally understand mental health, and what ideas might be useful in relation to this. It also asks how the bisexual and wider LGBTQ communities that we are located in can relate to the ways in which we engage with mental health

Sexual Consent

Despite its obvious importance, sexual consent remains a remarkably under-researched and under-theorized topic. Sexual consent has important implications in the areas of: sexual violence and the law; sex education and sex advice; and LGBTQ studies, particularly in relation to drugs and sex, BDSM/kink/leather, and debates around age of consent for various sexual practices and identities. Reviews of the literature find a notable absence of studies and articles relating specifically to the topic of sexual consent: specifically, only 1-2% of the number of those relating to rape or sexual assault. Similarly, analyses of mainstream sex advice books, articles, and websites find that the topic of consent is rarely, if ever, mentioned, despite its pivotal role in ensuring that sex is not abusive. Frequently the only time consent is covered is in relation to BDSM or kinky sex, as a form of delineating such practices from ‘normal’ sex which is generally assumed not to require any strategies to ensure consent. This seems problematic given the consistently high level of incidents of sexual violence, and increasing awareness of the prevalence of sexual assaults and abuse across various contexts. This entry provides a brief overview of five of the main ways of understanding sexual consent which exist within the psychological and legal literature, and within feminist writings and writings from within BDSM communities. It starts with assumptions that consent is implicitly understood, moving onto definitions wherein it is assumed that consent has been given as long as nobody has explicitly refused or said ‘no’. It then moves on to the concept of ‘enthusiastic consent’, and consent as an ongoing communication between people, ending with a consideration of ‘consent cultures’: the idea that consent negotiations occur within a wider social context and are impacted by the power relations between those involved