Constellations of pain : a qualitative study of the complexity of women’s endometriosis-related pain

Introduction: Prior research into endometriosis-related pain has focused on specific aspects of the pain experience such as cyclical pain, emotional aspects of pain and certain types of pain such as dysmenorrhea and dyspareunia. However, research has paid less attention to the diversity and complexity of women’s pain experiences, which can lead to failure to recognise some symptoms as part of endometriosis and poor symptom management. Methods: We conducted qualitative semi-structured face-to-face interviews with 20 women in the United Kingdom recruited from an endometriosis self-help group with a diagnosis of endometriosis via laparoscopy. A topic guide framed questions around experiences of pain. Interviews were audio-recorded and transcribed verbatim. Transcripts were analysed using inductive thematic analysis. Results: Women experienced multiple types of pain that they felt were caused by endometriosis and affected many different parts of the body including bowel, bladder, lungs, kidneys, nerves, upper body, lower limbs and head. These pains consisted of different conceptual categories: type, pattern and intensity. These categories came together to create a complex, interrelated experience for each individual that we termed ‘constellations of pain’ because each woman had a complex set of pain categories and no two individuals appeared to have the same pain experience. Conclusion: The complexity and diversity of endometriosis-related pain found in this study has implications for improving diagnosis, medical and non-medical pain management and improving the clinical encounter between women and healthcare professionals

What works in changing energy-using behaviours in the home? A rapid evidence assessment

RAND Europe was commissioned by the Department of Energy & Climate Change (DECC) to undertake a Rapid Evidence Assessment* to understand “What works in changing energy-using behaviours in the home?”. The main objective was to answer this question by systematically reviewing the evidence around domestic behaviour change, with a particular focus on international evidence.In order to identify relevant studies, and avoid overlap with other previous evidence reviews, a set of search criteria was established. For inclusion, studies must:• Target energy-using behaviours in the home.• Consider at least one intervention.**• Go beyond the use of direct feedback on past energy use and pricing strategies to shift or reduce demand; and consider behaviour beyond one-off purchasing decisions (such as the installation of insulation or the purchase of energy-efficient appliances).• Measure a behaviour change in a real-world setting, either observed or self-reported.• Make a comparison between groups (e.g. between treatment and control groups), or across different time periods.No restrictions were applied regarding sample size; and both quantitative and qualitative studies were included.This report draws on 48 behaviour change programmes identified and selected through a systemic search process. These programmes involve a wide range of innovative approaches (such as the provision of Home Energy Reports that compare households’ consumption with their neighbours’) as well as more traditional approaches (including advertising campaigns)

V-V Bond-Length Fluctuations in Vox

We report a significantly stronger suppression of the phonon contribution to the thermal conductivity in VOx than can be accounted for by disorder of the 16 % atomic vacancies present in VO. Since the transition from localized to itinerant electronic behavior is first-order and has been shown to be characterized by bond-length fluctuations in several transition-metal oxides with the perovskite structure, we propose that cooperative V-V bond-length fluctuations play a role in VO similar to the M-O bond-length fluctuations in the perovskites. This model is able to account for the strong suppression of the thermal conductivity, the existence of a pseudogap confirmed by thermoelectric power, an anomalously large Debye-Waller factor, the temperature dependence of the magnetic susceptibility, and the inability to order atomic vacancies in VO.Comment: 5 pages, 5 figure

“Family before Anyone Else”: A Qualitative Study on Family, Marginalization, and HIV among Hispanic or Latino/a/x Mexican Sexual Minority Males

This study explored the influence family relationships have on HIV-related factors among Hispanic or Latino/a/x Mexican sexual minority cisgender males in San Antonio, TX, US. A total of 15 young adults (7 people living with HIV; PLWH) ages 21–30 completed a semi-structured interview. Data were transcribed verbatim and analyzed using thematic analysis. The following themes emerged: (1) family support; (2) mother-son relationships; (3) father-son relationships; (4) sibling support; (5) family marginalization of sexual minorities; and (6) internalized homophobia. People who reported being HIV negative were more likely to have a prominent mother-son relationship, strong sense of family, supportive siblings, and family acceptance as a sexual minority. PLWH were more likely to report a weak sense of family, being raised in a maternal-led household, and less likely to have a relationship with their father and siblings. Marginalization among participants regardless of HIV status included exposure to religious rhetoric stigmatizing sexual minorities and fathers’ reinforcing Mexican traditional gender norms. In addition to encountering homophobia, PLWH were further marginalized by family members due to their HIV status. The findings suggest a need for greater attention to examining the impact of familial support of Hispanic or Latino/a/x Mexican sexual minority cisgender males as young adults with or at risk of HIV

Managing ovarian hyperstimulation syndrome: a qualitative interview study with women and healthcare professionals

To explore the experiences of women who have had ovarian hyperstimulation syndrome, and healthcare professionals who care for them. Background Ovarian hyperstimulation syndrome is a side effect of fertility treatment. Little research exists internationally that explores the experiences of women who have had this condition, or the healthcare professionals who manage it. Design Qualitative study using semi-structured interviews. Methods Eighteen interviews with women who had experienced ovarian hyperstimulation syndrome (n = 10) and healthcare professionals (n = 8) in six UK fertility centres. Framework analysis was used. This paper is reported following COREQ guidelines. Results Women described a range of symptoms and severity, sometimes experiencing worrying physical health problems such as abdominal swelling and shortness of breath. The combination of the symptoms, and their management, on delaying future fertility treatment could cause emotional distress. Healthcare professionals at different centres described variation in practice, which generally involved ‘active monitoring’ until symptoms became severe, when women would be hospitalised. Women expressed feeling ‘left in limbo’ while waiting for symptoms to improve or worsen, and described a lack of control during this waiting period. Healthcare professionals felt they provided adequate information about ovarian hyperstimulation syndrome and its management. This, however, did not align with women's perceptions that information, including potential delays to their fertility treatment, was missing. There was similar mismatch between women's and healthcare professionals' views of decision-making about fertility treatment following ovarian hyperstimulation syndrome, including women's concerns about having to make rushed, unplanned decisions about their fertility treatment when they did not feel adequately informed to do so. Conclusion Ovarian hyperstimulation syndrome and its management can have a significant physical and emotional impact on women, and influence their fertility treatment. Improvements could be made to the information women receive about this condition, its management and its implications for wider fertility treatment. Implications for the profession and/or patient care Nurses have the skills and knowledge to support women through the physical and emotional stresses of fertility treatment. Therefore, they are well placed to provide specialist information and support for OHSS and ensure women are fully informed about all aspects of the condition, including how its management might delay fertility treatment

Perceived psychosocial impacts of legalized same-sex marriage: A scoping review of sexual minority adults’ experiences

A growing body of literature provides important insights into the meaning and impact of the right to marry a same-sex partner among sexual minority people. We conducted a scoping review to 1) identify and describe the psychosocial impacts of equal marriage rights among sexual minority adults, and 2) explore sexual minority women (SMW) perceptions of equal marriage rights and whether psychosocial impacts differ by sex. Using Arksey and O’Malley’s framework we reviewed peer-reviewed English-language publications from 2000 through 2019. We searched six databases (PubMed, PsycINFO, CINAHL, Web of Science, JSTOR, and Sociological Abstracts) to identify English language, peer-reviewed journal articles reporting findings from empirical studies with an explicit focus on the experiences and perceived impact of equal marriage rights among sexual minority adults. We found 59 studies that met our inclusion criteria. Studies identified positive psychosocial impacts of same-sex marriage (e.g., increased social acceptance, reduced stigma) across individual, interpersonal (dyad, family), community (sexual minority), and broader societal levels. Studies also found that, despite equal marriage rights, sexual minority stigma persists across these levels. Only a few studies examined differences by sex, and findings were mixed. Research to date has several limitations; for example, it disproportionately represents samples from the U.S. and White populations, and rarely examines differences by sexual or gender identity or other demographic characteristics. There is a need for additional research on the impact of equal marriage rights and same-sex marriage on the health and well-being of diverse sexual minorities across the globe

How to tie dangerous surgical knots: easily. Can we avoid this?

ObjectiveSecure knots are essential in all areas of surgical, medical and veterinary practice. Our hypothesis was that technique of formation of each layer of a surgical knot was important to its security.DesignEqual numbers of knots were tied, by each of three groups, using three techniques, for each of four suture materials; a standard flat reef knot (FRK), knots tied under tension (TK) and knots laid without appropriate hand crossing (NHCK). Each knot technique was performed reproducibly, and tested by distraction with increasing force, till each material broke or the knot separated completely.SettingTemporary knot tying laboratory.MaterialsThe suture materials were, 2/0 polyglactin 910 (Vicryl), 3/0 polydioxanone, 4/0 poliglecaprone 25 (Monocryl) and 1 nylon (Ethilon).ParticipantsThree groups comprised, a senior surgeon, a resident surgeon and three medical students.Outcome measuresProportion of each knot type that slipped, degree of slippage and length of suture held in loop secured by each knot type.Results20% of FRK tied with all suture materials slipped; all knots tied with the other two techniques, with all materials, slipped, TK (100%) and NHCK (100%). The quantitative degree of slip was significantly less for FRK (mean 6.3%–, 95% CI 2.2% to 10.4%) than for TK (mean 312%, 95% CI 280.0% to 344.0%) and NHCK (mean 113.0%, –95% CI 94.3% to 131.0%).The mean length of suture in loops held within (FRK mean 25.1 mm 95% CI 24.2 to 26.0 mm) was significantly greater than mean lengths held by the other techniques (TK mean 17.0 mm, 95% CI 16.3 to 17.7 mm), (NHCK mean 16.3 mm, 95% CI 15.9 to 16.7 mm). The latter two types of knot may have tightened more than anticipated, in comparison to FRK, with potential undue tissue tension.ConclusionMeticulous technique of knot tying is essential for secure knots, appropriate tissue tension and the security of anastomoses and haemostasis effected.</jats:sec

Spin-orbit interaction effect in the electronic structure of \BiTe \ observed by angle-resolved photoemission spectroscopy

The electronic structure of $p$-type doped \BiTe is studied by angle resolved photoemission spectroscopy (ARPES) to experimentally confirm the mechanism responsible for the high thermoelectric figure of merit. Our ARPES study shows that the band edges are located off the $\Gamma$-Z line in the Brillouin zone, which provides direct observation that the spin-orbit interaction is a key factor to understand the electronic structure and the corresponding thermoelectric properties of \BiTe. Successive time dependent ARPES measurement also reveals that the electron-like bands crossing E$_F$ near the $\underline{\Gamma}$ point are formed in an hour after cleaving the crystals. We interpret these as surface states induced by surface band bending, possibly due to quintuple inter-layer distance change of \BiTe.Comment: 3 figure

Gender and sexual orientation differences in cognition across adulthood : age is kinder to women than to men regardless of sexual orientation

Despite some evidence of greater age-related deterioration of the brain in males than in females, gender differences in rates of cognitive aging have proved inconsistent. The present study employed web-based methodology to collect data from people aged 20-65 years (109,612 men; 88,509 women). As expected, men outperformed women on tests of mental rotation and line angle judgment, whereas women outperformed men on tests of category fluency and object location memory. Performance on all tests declined with age but significantly more so for men than for women. Heterosexuals of each gender generally outperformed bisexuals and homosexuals on tests where that gender was superior; however, there were no clear interactions between age and sexual orientation for either gender. At least for these particular tests from young adulthood to retirement, age is kinder to women than to men, but treats heterosexuals, bisexuals, and homosexuals just the same