The nature of medical evidence and its inherent uncertainty for the clinical consultation : qualitative study

Objective To describe how clinicians deal with the uncertainty inherent in medical evidence in clinical consultations. Design Qualitative study. Setting Clinical consultations related to hormone replacement therapy, bone densitometry, and breast screening in seven general practices and three secondary care clinics in the UK NHS. Participants Women aged 45-64. Results 45 of the 109 relevant consultations included sufficient discussion for analysis. The consultations could be categorised into three groups: focus on certainty for now and this test, with slippage into general reassurance; a coherent account of the medical evidence for risks and benefits, but blurring of the uncertainty inherent in the evidence and giving an impression of certainty; and acknowledging the inherent uncertainty of the medical evidence and negotiating a provisional decision. Conclusion Strategies health professionals use to cope with the uncertainty inherent in medical evidence in clinical consultations include the use of provisional decisions that allow for changing priorities and circumstances over time, to avoid slippage into general reassurance from a particular test result, and to avoid the creation of a myth of certainty

Domestic violence education and risk mitigation for prelicensure nursing students

The purpose of this project is to develop a domestic violence consciousness raising-education program and a self-administered risk assessment for a population of community college nursing students. When the faculty became aware that attrition rates were rising and that a high number of requests to drop out of nursing school were disproportionately linked to recent incidences of domestic violence, a potential contributing cause of the high drop out rate was revealed

The impact of maternal obesity on vascular and metabolic function throughout pregnancy.

Maternal obesity increases the risk of numerous maternal and fetal complications of pregnancy. Women were recruited at booking for antenatal care. Each subject was examined in the first, Second and third trimester of pregnancy as well as twelve weeks post partum. Using non invasive techniques microvasular function was measured at each visit. Fasting bloods were taken. This assessment allowed us to observe microvascular function, inflammatory response, dislipidaemia and changes in fatty acid composition with advancing gestation and the degree of recovery in the post partum. By recruitment of women with varying body mass index (BMI) values we were able to examine the influence of maternal BMI on these responses to pregnancy

The forest and the trees : Industrialization, demographic change, and the ongoing gender revolution in Sweden and the United States, 1870-2010

Background: The separate spheres, in which men dominate the public sphere of politics, arts, media, and wage work and women dominate the private sphere of unpaid production and caring, is a powerful configuration in much social theory (including Parsons, Becker, and Goode), which posited that with industrialization, family structures and activities would converge towards the nuclear family with strict gender roles.Objective: This paper examines the major trends unraveling the gender division of family support and care that reached its peak in the mid-20th century, often called the ‘worker-carer’ or the ‘separate spheres’ model, by comparing the experiences of Sweden and the United States.Methods: We use data that includes time series of macro-level demographic and economic indicators, together with cross-sectional data from censuses and time use surveys.Results: The unraveling of the separate spheres began with the increase in the labor force participation of married women and continues with the increase in men’s involvement with their homes and children, but its foundations were laid in the 19th century, with industrialization. We show that despite short-term stalls, slowdowns, and even reverses, as well as huge differences in policy contexts, the overall picture of increasing gender sharing in family support and care is strongly taking shape in both countries.Contribution: By doing a comparative, in-depth analysis, it becomes clear that the extreme role specialization within the couple that divided caring from ‘work,’ though theoretically important, applied only for a limited period in Northern Europe and the United States, however important it might be in other regions

Family health narratives : midlife women’s concepts of vulnerability to illness

Perceptions of vulnerability to illness are strongly influenced by the salience given to personal experience of illness in the family. This article proposes that this salience is created through autobiographical narrative, both as individual life story and collectively shaped family history. The paper focuses on responses related to health in the family drawn from semi-structured interviews with women in a qualitative study exploring midlife women’s health. Uncertainty about the future was a major emergent theme. Most respondents were worried about a specified condition such as heart disease or breast cancer. Many women were uncertain about whether illness in the family was inherited. Some felt certain that illness in the family meant that they were more vulnerable to illness or that their relatives’ ageing would be mirrored in their own inevitable decline, while a few expressed cautious optimism about the future. In order to elucidate these responses, we focused on narratives in which family members’ appearance was discussed and compared to that of others in the family. The visualisation of both kinship and the effects of illness, led to strong similarities being seen as grounds for worry. This led to some women distancing themselves from the legacies of illness in their families. Women tended to look at the whole family as the context for their perceptions of vulnerability, developing complex patterns of resemblance or difference within their families

Gatekeeping the interactional order:Field access and linguistic ideologies in CLIL-type bilingual education programs in Spanish secondary schools

This article reflexively discusses field access as a continuous process in linguistic ethnographic fieldwork and illustrates how interactions generated during negotiations to establish a research collaboration, initial contacts with participants or data gathered to complement audio-visual recordings of naturally occurring interaction can, in fact, become rich sources to answer research questions. The discussion is based on a critical sociolinguistic ethnography on the implementation of English-Spanish ‘bilingual programs’ in a mid-sized city in central Spain. To build this discussion we propose a framework in which particular research stances held by participants become closely intertwined with particular research processes, spaces and techniquesResearch reported in this article was supported by the project "The appropriation of English as a global language in Castilla-La Mancha secondary schools: A multilingual, situated and comparative approach", funded by the Spanish Ministry of Science and Innovation (Plan Nacional I+D+I 2014 / Reference: FFI2014-54179-C2-2-P). It has also been possible thanks to the funds granted to the Research Consolidated Group LADIC - UCLM, co-financed by the European Union and the European Regional Development Fund (Ref: 2019-GRIN-26973

Embodied cartographies of Mexican-Canadian transnationalism

Given that processes of globalization now significantly trouble the \u27natural\u27 boundaries of geographic territories, questions of spatiality--space and place, boundaries and mobility, flows and interconnections--have become foundational to contemporary migration research. In this context, scholars now generally acknowledge that many migrants organize their daily lives across the borders of nation states. This dissertation explores the under researched transnational lives of Mexican migrants in Canada--lives lived here and there. The study corroborates the widely perceived need to \u27ground\u27 the study of transnationalism, by advancing embodied transnationalism which explores the intimate, material and corporeal social-spatial relations from which the practices of transnational engagement are produced. The research highlights the importance of attending to affective transnationalism by demonstrating the emotive, intimate and subjective geographies of Mexican transnationalism in Canada, as well as their importance in shaping transnational practices. Findings document the existence of rich transnational social spaces, as well as the ways in which migrants are embedded in localities which are powerfully mediated by gender and class. Research participants\u27 stories of migration reflect the struggle of leading lives \u27in-between\u27 and a strong sense of belonging to place, or emotional embeddedness in Mexico. In this way, the research speaks to both: the fluid reconfigurative potential of transnationalism and the solid \u27multiple hegemonies\u27 that underpin Mexican migrants\u27 struggles to produce locality in an increasingly globalized world

Autophagy and polyglutamine diseases

AbstractIn polyglutamine diseases, an abnormally elongated polyglutamine tract results in protein misfolding and accumulation of intracellular aggregates. The length of the polyglutamine expansion correlates with the tendency of the mutant protein to aggregate, as well as with neuronal toxicity and earlier disease onset. Although currently there is no effective cure to prevent or slow down the progression of these neurodegenerative disorders, increasing the clearance of mutant proteins has been proposed as a potential therapeutic approach. The ubiquitin–proteasome system and autophagy are the two main degradative pathways responsible for eliminating misfolded and unnecessary proteins in the cell. We will review some of the studies that have proposed autophagy as a strategy to reduce the accumulation of polyglutamine-expanded protein aggregates and protect against mutant protein neurotoxicity. We will also discuss some of the currently known mechanisms that induce autophagy, which may be beneficial for the treatment of these and other neurodegenerative disorders

The Influence of Emotional and Foreign Language Context in Content Learning

Published online by Cambridge University Press: 09 January 2020Prior research has found reduced emotionality with foreign language use, especially with single words, but what happens if emotionality is conveyed throughout a longer text? Does emotionality affect how well we remember and associate information, that is, content learning? We played participants descriptions of two invented countries and tested how well they remembered facts about these countries. Each participant listened to one positive and one neutral description, which was read either in their native language (Spanish) or in their foreign language (English). Participants remembered facts they heard in positive semantic contexts better than those learned in neutral semantic contexts and did better in their native than their foreign language. Importantly, there was no interaction between language and emotionality, suggesting that the previously reported decrease in emotionality in a foreign language might not extend to all areas of foreign language useThis research has been partially funded by grants PGC2018-097145-B-I00, PSI2015-65689-P, the Basque Government through the BERC 2018-2021 program, SEV-2015-0490 from the Spanish Government, and AThEME-613465 from the European Union. CF is supported by a MINECO predoctoral grant from the Spanish government (BES-2016-077169). AdB is supported by a Marie Skłodowska-Curie fellowship from the European Research Council (grant agreement number 743691). JAD is supported by the Spanish Government grant RED2018-102615-T