Zwischen Normalität, Scham und Tabu. Qualitative Interviews zur Bedeutung von Menstruation im Alltag.

„Periods are normal, showing them should be too“ dies ist der Slogan des Werbefilms „Blood normal“ (2017, 2:23min) des internationalen ‚Hygieneartikel‘-Herstellers Libresse, welcher viral diskutiert wurde. Der Grund dafür war das rote ‚Blut’, welches in dieser Werbung – anstelle von sonst üblicher blauer Flüssigkeit – gezeigt wurde. In aktuellen (Sozialen-)Medien und erfolgreichen, populärwissenschaftlichen Büchern findet die Thematisierung der Menstruation verstärkt Anklang. Das Sprechen über die eigene Menstruation im Alltag hingegen gilt immer noch als wahrgenommenes Tabu. Konzepte und Vorstellungen von Normalität spielen in der Auseinandersetzung mit dem Thema Menstruation eine ebenso große Rolle. Sie konstruieren eine soziale Wirklichkeit, in der Menstruation etwas ‚Natürliches’ und somit 'Normales' darstellt. Gleichzeitig werden große Ambivalenzen im Umgang mit der Menstruation deutlich. Einerseits wird die Menstruation als Notwendigkeit betrachtet, als Zeichen für die weibliche Reproduktionsfähigkeit und für Gesundheit, andererseits ist sie eng mit kulturhistorischen- und negativen Zuschreibungen, wie Ekel, Scham und Schmerzen verknüpft. Diese Ambivalenzen konnten auch in der qualitativen Forschung dieserMasterarbeit mit dem Titel „Zwischen Normalität, Scham und Tabu. Qualitative Interviews zur Bedeutung von Menstruation im Alltag.“ herausgestellt werden. In diesem Kontext wurden dreizehn Personen – vier Frauen, drei Männer und drei Paare (zwei Hetero-Paare und ein Geschwisterpaar) – in zehn Interviews zu ihren Erfahrungen mit Menstruation befragt. In vielen Aussagen der Interviewten ließen sich implizite - den Befragten eher unbewusste - Tabuisierungen im Umgang mit der Menstruation erkennen. Diese äußerten sich dabei nicht nur im Sprechen bzw. Nicht-Sprechen über die Menstruation, denn nur im privaten und vertrauten Umfeld, mit engen Freundinnen oder der Familie, scheint ein Austausch möglich. Die Dynamik dieses Tabus wurde auch im Nicht-Erinnern, Nicht-Beschäftigen und Nicht-Wissen, im heimlichen Austausch oder Kauf von Tampons, in Umschreibungen des Themas, beziehungsweise des Wortes Menstruation sowie in Formen der Scham und Fremdscham deutlich. Viele peinliche und schambesetzte Erinnerungen handelten vom Sichtbar-Werden der eigenen Menstruation und äußerten sich als Fremdscham in imaginierten Situationen im Interview, beispielsweise wenn es darum ging, dass eine Frau einen sichtbaren Blutfleck auf ihrer Kleidung hat. Kontexte der Tabuisierung ließen sich sowohl in Erzählungen aus der Vergangenheit der Interviewpartner*innen, besonders in der Schule, im Schwimm- oder Sportunterricht und in Mutter-Kind-Interaktionen, als auch im aktuellen Alltagserleben sowie in der konkreten Interviewsituation, etwa durch Nervosität oder häufiges Lachen wiederfinden. Dass die Normalität der (eigenen, aber auch fremden) Menstruation erst durch jahrelanges ‚Üben’ hergestellt werden musste, war eine zentrale Erkenntnis der Analys

Efficacy and safety of topical delgocitinib in patients with chronic hand eczema: data from a randomized, double‐blind, vehicle‐controlled phase II a study

Background: Management of chronic hand eczema (CHE) remains a challenge; effective topical treatment is limited to corticosteroids. Objectives: To assess the efficacy and safety of a novel, pan-Janus kinase inhibitor (delgocitinib) in patients with CHE. Methods: In this randomized, double-blind, phase IIa study, patients with CHE received delgocitinib ointment 30 mg g(-1) or vehicle ointment for 8 weeks. The primary end point was the proportion of patients achieving treatment success ['clear'/'almost clear' skin with ≥ 2-point improvement in the Physician's Global Assessment of disease severity (PGA)] at week 8. Secondary end points included Hand Eczema Severity Index (HECSI) score changes and the proportion of patients achieving treatment success on the Patient's Global Assessment of disease severity (PaGA). Results: Ninety-one patients were randomized. More patients receiving delgocitinib (46%) than vehicle (15%) [odds ratio 4 center dot 89, 95% confidence interval (CI) 1 center dot 49-16 center dot 09; P = 0 center dot 009] achieved treatment success (PGA). Adjusted mean HECSI score at week 8 was lower with delgocitinib (13 center dot 0) than with vehicle (25 center dot 8) (adjusted mean difference -12 center dot 88, 95% CI -21 center dot 47 to -4 center dot 30; P = 0 center dot 003). More patients receiving delgocitinib than vehicle achieved treatment success by PaGA, but this did not reach statistical significance. The incidence of adverse events was similar with delgocitinib and vehicle; none led to discontinuation of delgocitinib. Conclusions: Delgocitinib ointment was efficacious and well tolerated. As a plateau of efficacy was not observed, a longer treatment period may lead to increased efficacy. Further clinical studies are warranted to confirm these findings in patients with CHE

Itching in patients with chronic hand eczema: Data from the CARPE registry

BACKGROUND Itching is a leading symptom of chronic hand eczema (CHE) having a great impact on patients. The determinants of itching in CHE are unclear. OBJECTIVE We performed a cross-sectional analysis investigating factors associated with the presence and severity of itch in CHE patients from the CARPE registry. METHODS We present baseline data on itch in relationship with sociodemographic factors, severity of CHE, atopy, contact allergy, treatment and patient- reported outcomes including health-related quality of life (HRQoL). RESULTS Of 1,051 patients with CHE, 78.1% reported itching. Significant positive associations with itching were observed for younger age groups (17-25 and 26-45 years), for moderate, severe and very severe CHE and for small/moderate impairment in HRQoL. Atopic skin diathesis, hardly being able to realize treatment recommendations and very or extremely large impairments in HRQoL were associated with itch severity. CONCLUSION Taking the identified variables into account may help identify vulnerable groups most affected by (severe) itch

Study protocol; thyroid hormone replacement for untreated older adults with subclinical hypothyroidism - a randomised placebo controlled trial (TRUST)

Background: Subclinical hypothyroidism (SCH) is a common condition in elderly people, defined as elevated serum thyroid-stimulating hormone (TSH) with normal circulating free thyroxine (fT4). Evidence is lacking about the effect of thyroid hormone treatment. We describe the protocol of a large randomised controlled trial (RCT) of Levothyroxine treatment for SCH. Methods: Participants are community-dwelling subjects aged ≥65 years with SCH, diagnosed by elevated TSH levels (≥4.6 and ≤19.9 mU/L) on a minimum of two measures ≥ three months apart, with fT4 levels within laboratory reference range. The study is a randomised double-blind placebo-controlled parallel group trial, starting with levothyroxine 50 micrograms daily (25 micrograms in subjects <50Kg body weight or known coronary heart disease) with titration of dose in the active treatment group according to TSH level, and a mock titration in the placebo group. The primary outcomes are changes in two domains (hypothyroid symptoms and fatigue / vitality) on the thyroid-related quality of life questionnaire (ThyPRO) at one year. The study has 80% power (at p = 0.025, 2-tailed) to detect a change with levothyroxine treatment of 3.0% on the hypothyroid scale and 4.1% on the fatigue / vitality scale with a total target sample size of 750 patients. Secondary outcomes include general health-related quality of life (EuroQol), fatal and non-fatal cardiovascular events, handgrip strength, executive cognitive function (Letter Digit Coding Test), basic and instrumental activities of daily living, haemoglobin, blood pressure, weight, body mass index and waist circumference. Patients are monitored for specific adverse events of interest including incident atrial fibrillation, heart failure and bone fracture. Discussion: This large multicentre RCT of levothyroxine treatment of subclinical hypothyroidism is powered to detect clinically relevant change in symptoms / quality of life and is likely to be highly influential in guiding treatment of this common condition. Trial registration: Clinicaltrials.gov NCT01660126; registered 8th June 2012

Framing the relationship between people and nature in the context of European conservation

A key controversy in conservation is the framing of the relationship between people and nature. The extent to which the realms of nature and human culture are viewed as separate (dualistic view) or integrated is often discussed in the social sciences. To explore how this relationship is represented in the practice of conservation in Europe, we considered examples of cultural landscapes, wildlife (red deer, reindeer, horses), and protected area management. We found little support, for a dualistic worldview, where people and nature are regarded as separate in the traditional practice of conservation in Europe. The borders between nature and culture, wild and domestic, public land and private land, and between protected areas and the wider landscape were blurred and dynamic. The institutionalized (in practice and legislation) view is of an interactive mutualistic system in which humans and nature share the whole landscape. However, more dualistic ideals, such as wilderness and rewilding that are challenging established practices are expanding. In the context of modern day Europe, wilderness conservation and rewilding are not valid for the whole landscape, although it is possible to integrate some areas of low-intervention management into a wider matrix. A precondition for success is to recognize and plan for a plurality of values concerning the most valid approaches to conservation and to plan for this plurality at the landscape scale

Thermoelectric spin voltage in graphene

In recent years, new spin-dependent thermal effects have been discovered in ferromagnets, stimulating a growing interest in spin caloritronics, a field that exploits the interaction between spin and heat currents. Amongst the most intriguing phenomena is the spin Seebeck effect, in which a thermal gradient gives rise to spin currents that are detected through the inverse spin Hall effect. Non-magnetic materials such as graphene are also relevant for spin caloritronics, thanks to efficient spin transport, energy-dependent carrier mobility and unique density of states. Here, we propose and demonstrate that a carrier thermal gradient in a graphene lateral spin valve can lead to a large increase of the spin voltage near to the graphene charge neutrality point. Such an increase results from a thermoelectric spin voltage, which is analogous to the voltage in a thermocouple and that can be enhanced by the presence of hot carriers generated by an applied current. These results could prove crucial to drive graphene spintronic devices and, in particular, to sustain pure spin signals with thermal gradients and to tune the remote spin accumulation by varying the spin-injection bias

Moderators of pre-post changes in school-based mental health promotion: Psychological stress symptom decrease for adolescents with mental health problems, knowledge increase for all.

Background School-based mental health promotion aims to strengthen mental health and reduce stress. Results on the effectiveness of such programs are heterogeneous. This study realized a school-based mental health promotion program (StresSOS) for all students and aimed to identify moderators (mental health status, gender, grade level) of pre- to post-changes in stress symptoms and knowledge. Methods Participants were N = 510 adolescents (from 29 classes; 46.7% female) aged 12-18 years (M = 13.88, SD = 1.00; grade levels 7-10). They were without mental health problems (65.9%), at risk for mental health problems (21.6%), or with mental health problems (12.5%) and participated in a 90 min per week face-to-face training with 8 sessions in class at school. Demographic variables, mental health status, stress symptoms, and knowledge about stress and mental health were collected at baseline. Program acceptance, stress symptoms, and knowledge were collected post-intervention. Multilevel mixed effects models were conducted with the fixed effects time (within factor), mental health status, gender, and grade level (between factors). Random effects for students within classes were included. Results In the pre-post comparison, mental health status moderated the changes on psychological stress symptoms (p < 0.05). In adolescents with mental health problems the largest reduction in stress symptoms was observed between pre- and post-assessment. Gender and grade level were less relevant. For all adolescents knowledge gains were revealed (p < 0.001). Program acceptance was moderated by mental health status and grade level (p < 0.01). Mentally healthy adolescents and within the group of adolescents at-risk or with mental health problems, especially younger students (7th/8th grade), rated program acceptance higher. Conclusion Psychological stress symptoms decreased among adolescents with mental health problems and not among adolescents at risk for or without mental health problems. Mental health-related knowledge increased for all adolescents. The results add to knowledge on school-based mental health intervention research and practice. Its implications for different prevention strategies (universal, selective or a combination of both) are discussed

Avaliação da idade gestacional do recém-nascido (RN), pelo método de Capurro, por enfermeiros e médicos que atuam na Unidade de Neonatologia do Hospital de Clínicas de Porto Alegre, UIN-HCPA

O estudo compara a avaliação da idade gestacional do RN, pelo método de Capurro, por médicos e enfermeiros da UIN-HCPA. Não houve diferença significativa entre as médias dos dias avaliados por estes profissionais. Recomenda-se o procedimento, uma vez que favorece a identificação precoce do RN com risco provável

Bacterial porin disrupts mitochondrial membrane potential and sensitizes host cells to apoptosis

The bacterial PorB porin, an ATP-binding beta-barrel protein of pathogenic Neisseria gonorrhoeae, triggers host cell apoptosis by an unknown mechanism. PorB is targeted to and imported by host cell mitochondria, causing the breakdown of the mitochondrial membrane potential (delta psi m). Here, we show that PorB induces the condensation of the mitochondrial matrix and the loss of cristae structures, sensitizing cells to the induction of apoptosis via signaling pathways activated by BH3-only proteins. PorB is imported into mitochondria through the general translocase TOM but, unexpectedly, is not recognized by the SAM sorting machinery, usually required for the assembly of beta-barrel proteins in the mitochondrial outer membrane. PorB integrates into the mitochondrial inner membrane, leading to the breakdown of delta psi m. The PorB channel is regulated by nucleotides and an isogenic PorB mutant defective in ATP-binding failed to induce delta psi m loss and apoptosis, demonstrating that dissipation of delta psi m is a requirement for cell death caused by neisserial infection

Individual and group-level job resources and their relationships with individual work engagement

OBJECTIVES: This study adds a multilevel perspective to the well-researched individual-level relationship between job resources and work engagement. In addition, we explored whether individual job resources cluster within work groups because of a shared psychosocial environment and investigated whether a resource-rich psychosocial work group environment is beneficial for employee engagement over and above the beneficial effect of individual job resources and independent of their variability within groups. METHODS: Data of 1,219 employees nested in 103 work groups were obtained from a baseline employee survey of a large stress management intervention project implemented in six medium and large-sized organizations in diverse sectors. A variety of important job resources were assessed and grouped to an overall job resource factor with three subfactors (manager behavior, peer behavior, and task-related resources). Data were analyzed using multilevel random coefficient modeling. RESULTS: The results indicated that job resources cluster within work groups and can be aggregated to a group-level job resources construct. However, a resource-rich environment, indicated by high group-level job resources, did not additionally benefit employee work engagement but on the contrary, was negatively related to it. CONCLUSIONS: On the basis of this unexpected result, replication studies are encouraged and suggestions for future studies on possible underlying within-group processes are discussed. The study supports the presumed value of integrating work group as a relevant psychosocial environment into the motivational process and indicates a need to further investigate emergent processes involved in aggregation procedures across levels