‘I don’t talk about my distress to others; I feel that I have to suffer my problems..’ Voices of Indian women with breast cancer: a qualitative interview study

Background: Breast cancer is the commonest form of cancer among women globally, including in India. The rising incidence in the developing world is thought to be due to increased life expectancy, urbanization and adoption of western lifestyles. A recent systematic review found that Indian women living in India or as immigrants in Canada experienced a range of psychological distresses both ameliorated and exacerbated by cultural issues personally, within the family, their community and in the context of faith and only two of the five qualitative studies explored the experience of women with breast cancer living in India. Distress may also affect treatment compliance. Aim: The aim of the study was to explore the psychological distresses experienced by Indian women with breast cancer living in Kerala, South India during and after treatment and to understand better what helped to relieve or increase these distresses.Methods: In-depth interviews were conducted with 20 consenting women undergoing treatment for breast cancer. Purposive sampling was used to obtain maximum variation in socio-demographic and clinical characteristics. Interviews were verbatim transcribed, translated into English and back translated to Malayalam to ensure that the meaning had not been lost. English data were analyzed using thematic frame work analysis and synthesized to provide a deeper understanding of the individuals’ experience.Results: Three major themes emerged from the data. The first major theme was “far-reaching psychological distress”. This included anxiety, guilt, anger and depression in response to the disease and physical side effects of treatment and issues relating to body image, especially hair loss and sexuality. The second major theme was “getting on with life”. Women tried to make sense of the disease, by actively seeking information, the role of medical professionals, and their practical adaptations. Many found a new future and a new way to live normal. The third major theme was the “support system” strongly based on family, friends, faith and the community which affect them positively as well as negatively.Conclusion: Psychological concerns related to disease and treatment is common in Indian women with particular emphasis on body image issues associated with hair loss. Family and faith were key support systems for almost all the women although could also be causes of distress

Constitutional Convention

Billings Gazette special issue about the Montana Constitutional Convention and government information articles pertaining to the subject. Included is a list of 1972 delegates.https://digitalcommons.mtech.edu/crucible_materials/1007/thumbnail.jp

“So, when a woman becomes ill, the total structure of the family is affected, they can’t do anything…” Voices from the community on women with breast cancer in India: a qualitative focus group study

Background: Psychological symptoms are common in women with breast cancer and profoundly affect their role in the family and wider community, varying across cultural backgrounds. Breast cancer is becoming the most common cancer among women in India. We aimed to understand the cultural context within which Indian women with breast cancer living in India, experience psychological concerns from the perspectives of healthcare professionals, volunteers and church members. Methods: Five focus groups were conducted in South India (clinicians (2 groups)) lay public (3 groups). A topic guide was explored: understanding of breast cancer, experiences of patients with regard to diagnosis and treatment and psychological impact. Groups were audio-recorded and verbatim transcribed. Lay groups were conducted in Malayalam with translation and back-translation. Transcripts were subjected to thematic analysis using “cultural task analysis” as a lens for analysis. Results: Forty-five (oncologists (5), nurses (10), church members (16) and community volunteers working in a palliative care unit (14)participated. Three major themes psychosocial issues related to diagnosis, psychosocial impact of cancer treatment and coping with diagnosis and treatment and nine subthemes emerged from the two groups. All described psychological impact on women with breast cancer including body image, change of family role and their need for support. Family and faith were recognised as the major framework providing key support but also significant stress. Clinicians were also concerned about financial implications and issues around early cancer detection. Laypeople and nurses also commented that poor communication and lack of empathy from doctors aggravated distress. Conclusion: Clinical and lay communities were aware of the widespread psychological impact affecting women with breast cancer which are amplified by the patriarchal context within which they live, which extends into clinical practice. Family and faith provide a strong support structure and are a cause of distress, as core roles and expectations are challenged by this disease of womanhood

Existence of immersed spheres minimizing curvature functionals in compact 3-manifolds

We study curvature functionals for immersed 2-spheres in a compact, three-dimensional Riemannian manifold M. Under the assumption that the sectional curvature of M is strictly positive, we prove the existence of a smoothly immersed sphere minimizing the L^{2} integral of the second fundamental form. Assuming instead that the sectional curvature is less than or equal to 2, and that there exists a point in M with scalar curvature bigger than 6, we obtain a smooth 2-sphere minimizing the integral of 1/4|H|^{2} +1, where H is the mean curvature vector

A new lizard species (Scincidae: Ctenotus) highlights persistent knowledge gaps on the biodiversity of Australia’s central deserts

Australia harbors the most diverse lizard assemblages on Earth, yet the biodiversity of its vast arid zone remains incompletely characterized. Recent sampling of remote regions has revealed new species with unique phenotypes and unclear evolutionary affinities. Here, we describe a new species of scincid lizard that appears to be widely distributed across the Great Victoria Desert and adjacent regions. The new species was previously overlooked among specimens of the wide-ranging desert taxon Ctenotus schomburgkii but is distinguished from it by coloration and scalation characters. Phylogenetic analyses based on mitochondrial and genome-wide nuclear loci confirmed that the new species is highly divergent from C. schomburgkii, with which it appears to be sympatric across much of its range. In addition to the new species, our survey of genetic variation within C. schomburgkii as currently recognized revealed three additional lineages that approach one another in southern and northwestern Australia, and which may also represent distinct species. These results suggest that our knowledge of the extraordinary biodiversity of arid Australia remains incomplete, with implications for the conservation and management of this unique fauna. The targeted collection of voucher specimens in undersampled regions, coupled with population genetic screening of lineage diversity, will be crucial for characterizing species boundaries and understanding the composition of Australia’s vertebrate communities

2-Methyl-4,6-bis­(1-methyl­hydrazino)pyrimidine

In the title compound, C7H14N6, the amine groups of the two methyl­hydrazino substituents are orientated in the opposite direction to the methyl substituent at the 2-position of the pyrimidine ring. The mol­ecule is almost planar with only the two amine N atoms lying substanti­ally out of the mean plane of the pyrimidine ring [by 0.1430 (2) and 0.3092 (2) Å]. The H atoms on these amine groups point inwards towards the aromatic ring, such that the lone pair of electrons points outwards from the mol­ecule. Each mol­ecule is linked to two others through N—H⋯N hydrogen bonds between the two amino groups, forming a one-dimensional chain in the [010] direction. Offset face-to-face π–π stacking inter­actions between the pyrimidine rings organize these chains into a two-dimensional array [centroid–centroid distance = 3.789 (2) Å]

Real-time energy storage simulators for the electricity grid

In this paper, a novel Distributed Real-Time Simulation Environment (DRTSE) which enables the coordinated control of multiple Real-Time Simulators (RTSs) positioned across the UK is introduced and demonstrated for an energy storage application. Using RTSs instead of physical energy storage assets enables the testing of different communication and control strategies, thereby reducing the risk of failure when the physical storage assets are deployed. In addition, the testing of different storage types (e.g. batteries, compressed air, flywheels, etc.) and storage locations can be conducted without expensive hardware modifications. In this paper, technical details of the RTSs are given, including the hardware and electrical storage models. The Central Controller (CC) and communication are also described, and results from the DRTSE presented

Identification of factors associated with morbidity and postoperative length of stay in surgically managed chronic subdural haematoma using electronic health records: a retrospective cohort study.

INTRODUCTION: Chronic subdural haematoma (cSDH) tends to occur in older patients, often with significant comorbidity. The incidence and effect of medical complications as well as the impact of intraoperative management strategies are now attracting increasing interest. OBJECTIVES: We used electronic health record data to study the profile of in-hospital morbidity and examine associations between various intraoperative events and postoperative stay. DESIGN, SETTING AND PARTICIPANTS: Single-centre, retrospective cohort of 530 cases of cSDH (2014-2019) surgically evacuated under general anaesthesia at a neurosciences centre in Cambridge, UK. METHODS AND OUTCOME DEFINITION: Complications were defined using a modified Electronic Postoperative Morbidity Score. Association between complications and intraoperative care (time with mean arterial pressure <80 mm Hg, time outside of end-tidal carbon dioxide (ETCO2) range of 3-5 kPa, maintenance anaesthetic, operative time and opioid dose) on postoperative stay was assessed using Cox regression. RESULTS: 53 (10%) patients suffered myocardial injury, while 24 (4.5%) suffered acute renal injury. On postoperative day 3 (D3), 280 (58% of remaining) inpatients suffered at least 1 complication. D7 rate was comparable (57%). Operative time was the only intraoperative event associated with postoperative stay (HR for discharge: 0.97 (95% CI: 0.95 to 0.99)). On multivariable analysis, postoperative complications (0.61 (0.55 to 0.68)), anticoagulation (0.45 (0.37 to 0.54)) and cognitive impairment (0.71 (0.58 to 0.87)) were associated with time to discharge. CONCLUSIONS: There is a high postoperative morbidity burden in this cohort, which was associated with postoperative stay. We found no evidence of an association between intraoperative events and postoperative stay.Wellcome Trust Studentshi

A hepatitis C avidity test for determining recent and past infections in both plasma and dried blood spots

DBS testing has been used successfully to detect HCV antibody positive individuals. Determining how long someone has been infected is important for surveillance initiatives. Antibody avidity is a method that can be used to calculate recency of infection. A HCV avidity assay was evaluated for both plasma and DBS. Study design: To measure antibody avidity a commercial HCV ELISA was modified using 7 M urea. The plasma samples were split into: group 1 (recently infected N = 19), group 2 (chronic carrier N = 300) and group 3 (resolved infection N = 82). Mock DBS made from group 1 (N = 12), group 2 (N = 50), group 3 (N = 25) and two seroconverter panels were evaluated. 133 DBS taken from patients known to have a resolved infection or be a chronic carrier were also tested. The avidity assay cut-off was set at AI ≤ 30 for a recent infection. Using sequential samples the assay could detect a recent infection in the first 4–5 months from the point of infection. Most of the false positive results (AI < 30 among cases known not to have had recent infection) were detected among known resolved infections, in both the plasma and DBS; as a result, a testing algorithm has been designed incorporating both PCR and two dilution factors. The sensitivity and specificity of the assay on plasma was 100% and 99.3%, respectively, while DBS had 100% sensitivity and 98.3% specificity. The HCV avidity assay can be used to distinguish between chronic and recent infection using either plasma or DBS as the sample type