AIDS Coalition to Unleash Power: Changing through movement, leadership, and Internet capabilities

The examination of AIDS Coalition to Unleash Power (ACT UP) past and present shows a vivid and often extreme organization, branching from Gay Men\u27s Health Crisis (GMHC). Both groups were formed by Larry Kramer, who has played a large role in the gay liberation movement in the United States. This study provides a map of the decline of ACT UP with regards to the decline in public fear of AIDS, the resulting decline in public interest, and the ineffective leadership strategies of Larry Kramer. In addition, this study offers a hypothesis for better exposure; a possible symbiotic effect between the Internet (passive) and humanistic (active) devices. In mapping ACT UP\u27s use and misuse of leadership and communication, this study will provide a clear view of the path ACT UP has taken, in addition to posing a better way of promoting information to current audiences

Memorandum on Motion for New Trial, 1/3/55

Judge Blythin overruled Sam Sheppard\u27s motion for a new trial filed 12/23/54 and supplemental motion filed 12/24/54. The defendant\u27s motion for a new trial based on newly discovered evidence is not addressed in this opinion; this opinion addresses 40 grounds for a new trial including: pretrial publicity, denial of a change of venue, presence of the press in the courtroom, substitution of a juror, errors in jury instructions, and denial of a motion for continuance. The transcript of the hearing on these motions can be found at Volume 12 of the 1954 Trial Transcript, beginning at page 7033

Scenic views and paternalistic obligations : depictions of landscape in the Victorian realist novel

With the many details that fill Victorian realist novels, the frequent descriptions of scenic country views that interrupt and halt the action of the narrative could be dismissed as part of realism\u2019s illusion of comprehensive and objective reporting. However, I suggest that the realist novel uses landscape depictions as a vehicle for exploring the tensions between its wish to relieve the suffering of the rural poor and its desire to preserve the countryside as a site to be enjoyed by the privileged. By representing the countryside in terms of landscape, the novels showcase what is pleasing about land that has not been developed for purposes of industry, yet landscape, as a representative and interpretative mode, is grounded in ideologies that validate and reinforce the oppressive power structures that are largely responsible for the hardships that the novels wish to alleviate. I argue that the realist novel attempts to solve this paradox by shifting the way landscape is represented and interpreted, thus changing the way the countryside itself is perceived, in order to posit a new understanding of the relationship between social leadership and control over the land. This project examines how mid-century realist novels employ landscape as a means of linking the pleasures of land ownership with a paternalistic obligation to care for the local poor in an attempt to solve the problems of rural poverty and social instability. These novels are sympathetic to the plight of the poor, yet they are also invested in the preservation of the country estate, not only in terms of maintaining the existing physical structures that make up an estate and its grounds, but also with regard to its roles as an institution of land ownership and as a seat of political power. I suggest that this problem drives how land is represented in many realist novels: by depicting the enjoyment of landscape as being linked with a paternalistic responsibility to provide for the poor, the novels attempt to mitigate the social problems of the countryside, which are rooted in the landholding institution, while still preserving the relative sociopolitical stability provided by the landholding model and the accompanying aesthetic properties of landed estates and undeveloped countryside. Chapter one examines Jane Austen\u2019s Mansfield Park as an example of how the landed gentry\u2019s desire to manipulate the structure of private land through \u201cimprovements\u201d resulted in their virtual appropriation of all open lands in the countryside. In chapter two, I claim that Dinah Craik\u2019s John Halifax, Gentleman and Charles Dickens\u2019s Bleak House depict the estate as a reward for good behavior as opposed to an indicator of lineage, and the novels work to change the meaning of landscape by infusing the enjoyment of scenic views with a sense of paternalistic duty; however, they are unsure of how to handle the large manor house, both as a physical entity in which the characters live and as a symbol of the estate in general. The third chapter argues that Charlotte Yonge\u2019s The Clever Woman of the Family presents the preservation and appreciation of landscape as being a crucial means of battling the ills of capitalism, particularly the gentry\u2019s increasing loss of control over the land and the exploitation of the poor that stems from the free market, yet the novel ends up mobilizing the picturesque as a conscious fantasy in order to avoid rather than solve the problems it identifies. In the last chapter, I claim that Charlotte Bront\ueb\u2019s Shirley exposes how the layout and design of private estate grounds serve to restrict genteel women\u2019s bodies and minds, whereas uncultivated areas are both visually and materially unstructured and thus do not restrict the women\u2019s movements and thinking; but when the needs of the rural poor require that the open land be developed, women must sacrifice their freedom outdoors in the interest of the greater social good.Thesis (Ph. D.)--Michigan State University. English, 2015Includes bibliographical references (pages 228-233

Evidence generation for the clinical impact of myCOPD in patients with mild, moderate and newly diagnosed COPD: a randomised controlled trial

Self-management interventions in COPD aim to improve patients’ knowledge, skills and confidence to make correct decisions, thus improving health status and outcomes. myCOPD is a web-based self-management app known to improve inhaler use and exercise capacity in individuals with more severe COPD. We explored its impact in patients with mild-moderate or recently diagnosed COPD through a 12-week, 34open-label, parallel-group, randomised-controlled trial of myCOPD compared with usual care. The co-primary outcomes were between group differences in mean COPD assessment test (CAT) score at 90 days and critical inhaler errors. Key secondary outcomes were app usage and patient activation measurement (PAM) score. 3860 patients were randomised (29 myCOPD, 31 usual care). Groups were balanced for FEV1% predicted but baseline imbalance between groups for exacerbation frequency and CAT score. There was no significant adjusted mean difference in CAT score at study completion, -1.27 (95% CI -4.47 to 1.92, p=0.44) lower in COPD. However increasing app use associated with greater CAT score improvement. The odds of ≥1 critical inhaler error was lower in the myCOPD arm (adjusted odds ratio of 0.30 (0.09; 431.06, p=0.061)). The adjusted odds ratio for being in a higher PAM level at 90 days was 1.65 (0.46; 5.85) in favour of myCOPD. The small sample size and phenotypic difference between groups limited our ability to demonstrate statistically significant evidence of benefit beyond inhaler technique. However, our findings provide important insights into associations between increased app use and clinically meaningful benefit 48warranting further study in real world settings

Ethyl 1-sec-butyl-2-(2-hydroxy­phen­yl)-1H-benzimidazole-5-carboxyl­ate 0.25-hydrate

In the title compound, C20H22N2O3·0.25H2O, the water mol­ecule (occupancy 0.25) is disordered across a crystallographic inversion center. The dihedral angle between the hydroxy­phenyl ring and the benzimidazole ring system is 59.31 (9)°. In the crystal structure, mol­ecules are connected by inter­molecular O—H⋯N and C—H⋯O hydrogen bonds. The crystal structure is further stabilized by a weak C—H⋯π inter­action involving the imidazole ring

Can digital health apps provide patients with support to promote structured diabetes education and ongoing self-management? A real-world evaluation of myDiabetes usage

Objective Structured diabetes education has evidenced benefits yet reported uptake rates for those referred to traditional in-person programmes within 12 months of diagnosis were suboptimal. Digital health interventions provide a potential solution to improve diabetes education delivery at population scale, overcoming barriers identified with traditional approaches. myDiabetes is a cloud-based interactive digital health self-management app. This evaluation analysed usage data for people with type 2 diabetes focusing on digital structured diabetes education. Methods Descriptive quantitative analyses were conducted on existing anonymised user data over 12 months (November 2019–2020) to evaluate whether digital health can provide additional support to deliver diabetes education. Data was divided into two equal 6-month periods. As this overlapped the onset of COVID-19, analyses of its effect on usage were included as a secondary outcome. All data was reported via myDiabetes. Users were prescribed myDiabetes by National Health Service healthcare primary care teams. Those who registered for app use within the study period (n = 2783) were assessed for eligibility (n = 2512) and included if activated. Results Within the study period, n = 1245/2512 (49.6%) registered users activated myDiabetes. No statistically significant differences were observed between gender (p = 0.721), or age (p = 0.072) for those who activated (59.2 years, SD 12.93) and those who did not activate myDiabetes (57.6 years, SD 13.77). Activated users (n = 1119/1245 (89.8%)) viewed 11,572 education videos. No statistically significant differences were observed in education video views across age groups (p = 0.384), gender (p = 0.400), diabetes treatment type (p = 0.839) or smoking status (p = 0.655). Comparison of usage pre-COVID-19 and post-COVID-19 showed statistically significant increases in app activity (p ≤0.001). Conclusion Digital health is rapidly evolving in its role of supporting patients to self-manage. Since COVID-19 the benefits of digital technology have become increasingly recognised. There is potential for increasing diabetes education rates by offering patients a digital option in combination with traditional service delivery which should be substantiated through future research

Evidence generation for the clinical impact of mycopd in patients with mild, moderate and newly diagnosed copd: A randomised controlled trial

Self-management interventions in COPD aim to improve patients’ knowledge, skills and confidence to make correct decisions, thus improving health status and outcomes. myCOPD is a web-based self-management app known to improve inhaler use and exercise capacity in individuals with more severe COPD. We explored the impact of myCOPD in patients with mild–moderate or recently diagnosed COPD through a 12-week, open-label, parallel-group, randomised controlled trial of myCOPD compared with usual care. The co-primary outcomes were between-group differences in mean COPD assessment test (CAT) score at 90 days and critical inhaler errors. Key secondary outcomes were app usage and patient activation measurement (PAM) score. Sixty patients were randomised (29 myCOPD, 31 usual care). Groups were balanced for forced expiratory volume in 1 s (FEV1 % pred) but there was baseline imbalance between groups for exacerbation frequency and CAT score. There was no significant adjusted mean difference in CAT score at study completion, −1.27 (95% CI −4.47–1.92, p=0.44) lower in myCOPD. However, an increase in app use was associated with greater CAT score improvement. The odds of ⩾1 critical inhaler error was lower in the myCOPD arm (adjusted OR 0.30 (95% CI 0.09–1.06, p=0.061)). The adjusted odds ratio for being in a higher PAM level at 90 days was 1.65 (95% CI 0.46–5.85) in favour of myCOPD. The small sample size and phenotypic difference between groups limited our ability to demonstrate statistically significant evidence of benefit beyond inhaler technique. However, our findings provide important insights into associations between increased app use and clinically meaningful benefit warranting further study in real world settings

An examination of the relationship between shame, guilt and self-harm: A systematic review and meta-analysis

Self-harm is a major public health concern associated with suicide risk and significant psychological distress. Theories suggest that aversive emotional states are an important process that drives self-harm. Shame and guilt may , in particular, be important emotions in self-harm. This review therefore sought to provide a systematic review and meta-analysis of the relationship between shame, guilt, and self-harm. A systematic search of electronic databases (PsycINFO; Medline; CINAHL Plus; Web of Science and ProQuest) was undertaken to identify studies measuring shame, guilt and self-harm (including suicidal and non-suicidal behaviour). Meta-analysis was undertaken where papers focused on the same subtype of shame or guilt and shared a common outcome. Thirty studies were identified for inclusion. Most forms of shame were associated with non-suicidal self-injury (NSSI), but research was sparse concerning suicidal behaviour. Fewer studies examined guilt and findings were more varied. Methodological issues included a paucity of longitudinal designs and lack of justification for sample sizes. Results of this review support the link between shame and self-harm, particularly NSSI. The direction of this relationship is yet to be established. Clinically, consideration should be given to the role of shame amongst individuals who present with NSSI. This review was pre-registered on PROSPERO (CRD42017056165)