Cancer diagnosis as discursive capture: Phenomenological repercussions of being positioned within dominant constructions of cancer

This paper is concerned with the phenomenological repercussions of being positioned within widely available discursive constructions of cancer. One of the many challenges of being diagnosed with cancer is that it requires the person to make sense of the diagnosis and to find meaning in their changed circumstances. From a social constructionist point of view, such meaning is made out of discursive resources which are available within one’s culture. This paper critically reviews some of the dominant discourses surrounding cancer which are available within English-speaking Western industrialized cultures. It maps out the discursive positions available to those diagnosed with cancer and it traces some of their implications for how cancer may be experienced and how it may be lived with. As such, this paper is concerned with the social and psychological consequences of being positioned within dominant cancer discourses

Ultrafast heterogeneous electron transfer reactions Comparative theoretical studies on time and frequency domain data

Recent theoretical studies on linear absorption spectra of dye semiconductor systems perylene attached to nanostructured TiO2, L. Wang et al., J. Phys. Chem. B 109, 9589 2005 are extended here in different respects. Since the systems show ultrafast photoinduced heterogeneous electron transfer the time dependent formulation used to compute the absorbance is also applied to calculate the temporal evolution of the sub 100 fs charge injection dynamics after a 10 fs laser pulse excitation. These studies complement our recent absorption spectra fit for two perylene bridge anchor group TiO2 systems. Moreover, the time dependent formulation of the absorbance is confronted with a frequency domain description. The latter underlines the central importance of the self energy caused by the coupling of the dye levels to the semiconductor band continuum. The used model is further applied to study the effect of different parameters such as 1 the dependence on the reorganization energies of the involved intramolecular transitions, 2 the effect of changing the transfer integral which couples the excited dye state with the band continuum, and 3 the effect of the concrete form of the semiconductor band density of states. Emphasis is also put on the case where the charge injection level of the dye is near or somewhat below the band edge. This nicely demonstrates the change from a structureless absorption to a well resolved vibrational progression including characteristic shifts of the absorption lines which are a direct measure for the dye semiconductor couplin

Weight gain among treatment-naïve persons with HIV starting integrase inhibitors compared to non-nucleoside reverse transcriptase inhibitors or protease inhibitors in a large observational cohort in the United States and Canada.

IntroductionWeight gain following antiretroviral therapy (ART) initiation is common, potentially predisposing some persons with HIV (PWH) to cardio-metabolic disease. We assessed relationships between ART drug class and weight change among treatment-naïve PWH initiating ART in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD).MethodsAdult, treatment-naïve PWH in NA-ACCORD initiating integrase strand transfer inhibitor (INSTI), protease inhibitor (PI) or non-nucleoside reverse-transcriptase inhibitor (NNRTI)-based ART on/after 1 January 2007 were followed through 31 December 2016. Multivariate linear mixed effects models estimated weight up to five years after ART initiation, adjusting for age, sex, race, cohort site, HIV acquisition mode, treatment year, and baseline weight, plasma HIV-1 RNA level and CD4+ cell count. Due to shorter follow-up for PWH receiving newer INSTI drugs, weights for specific INSTIs were estimated at two years. Secondary analyses using logistic regression and all covariates from primary analyses assessed factors associated with >10% weight gain at two and five years.ResultsAmong 22,972 participants, 87% were male, and 41% were white. 49% started NNRTI-, 31% started PI- and 20% started INSTI-based regimens (1624 raltegravir (RAL), 2085 elvitegravir (EVG) and 929 dolutegravir (DTG)). PWH starting INSTI-based regimens had mean estimated five-year weight change of +5.9kg, compared to +3.7kg for NNRTI and +5.5kg for PI. Among PWH starting INSTI drugs, mean estimated two-year weight change was +7.2kg for DTG, +5.8kg for RAL and +4.1kg for EVG. Women, persons with lower baseline CD4+ cell counts, and those initiating INSTI-based regimens had higher odds of >10% body weight increase at two years (adjusted odds ratio = 1.37, 95% confidence interval: 1.20 to 1.56 vs. NNRTI).ConclusionsPWH initiating INSTI-based regimens gained, on average, more weight compared to NNRTI-based regimens. This phenomenon may reflect heterogeneous effects of ART agents on body weight regulation that require further exploration

In vivo STED microscopy visualizes morphological changes of large PSD95 assemblies over several hours in the mouse visual cortex

Abstract The post-synaptic density (PSD) is an electron dense region consisting of ~1000 proteins, found at the postsynaptic membrane of excitatory synapses, which varies in size depending upon synaptic strength. PSD95 is an abundant scaffolding protein in the PSD and assembles a family of supercomplexes comprised of neurotransmitter receptors, ion channels, as well as signalling and structural proteins. We use superresolution STED (STimulated Emission Depletion) nanoscopy to determine the size and shape of PSD95 in the anaesthetised mouse visual cortex. Adult knock-in mice expressing eGFP fused to the endogenous PSD95 protein were imaged at time points from 1 min to 6 h. Superresolved large assemblies of PSD95 show different sub-structures; most large assemblies were ring-like, some horse-shoe or figure-8 shaped, and shapes were continuous or made up of nanoclusters. The sub-structure appeared stable during the shorter (minute) time points, but after 1 h, more than 50% of the large assemblies showed a change in sub-structure. Overall, these data showed a sub-morphology of large PSD95 assemblies which undergo changes within the 6 hours of observation in the anaesthetised mouse

Reconciling biodiversity and carbon stock conservation in an Afrotropical forest landscape

Protecting aboveground carbon stocks in tropical forests is essential for mitigating global climate change and is assumed to simultaneously conserve biodiversity. Although the relationship between tree diversity and carbon stocks is generally positive, the relationship remains unclear for consumers or decomposers. We assessed this relationship for multiple trophic levels across the tree of life (10 organismal groups, 3 kingdoms) in lowland rainforests of the Congo Basin. Comparisons across regrowth and old-growth forests evinced the expected positive relationship for trees, but not for other organismal groups. Moreover, differences in species composition between forests increased with difference in carbon stock. These variable associations across the tree of life contradict the implicit assumption that maximum co-benefits to biodiversity are associated with conservation of forests with the highest carbon storage. Initiatives targeting climate change mitigation and biodiversity conservation should include both old-growth and regenerating forests to optimally benefit biodiversity and carbon storage

Geographic Variations in Retention in Care among HIV-Infected Adults in the United States

ObjectiveTo understand geographic variations in clinical retention, a central component of the HIV care continuum and key to improving individual- and population-level HIV outcomes.DesignWe evaluated retention by US region in a retrospective observational study.MethodsAdults receiving care from 2000–2010 in 12 clinical cohorts of the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) contributed data. Individuals were assigned to Centers for Disease Control and Prevention (CDC)-defined regions by residential data (10 cohorts) and clinic location as proxy (2 cohorts). Retention was ≥2 primary HIV outpatient visits within a calendar year, >90 days apart. Trends and regional differences were analyzed using modified Poisson regression with clustering, adjusting for time in care, age, sex, race/ethnicity, and HIV risk, and stratified by baseline CD4+ count.ResultsAmong 78,993 adults with 444,212 person-years of follow-up, median time in care was 7 years (Interquartile Range: 4–9). Retention increased from 2000 to 2010: from 73% (5,000/6,875) to 85% (7,189/8,462) in the Northeast, 75% (1,778/2,356) to 87% (1,630/1,880) in the Midwest, 68% (8,451/12,417) to 80% (9,892/12,304) in the South, and 68% (5,147/7,520) to 72% (6,401/8,895) in the West. In adjusted analyses, retention improved over time in all regions (p<0.01, trend), although the average percent retained lagged in the West and South vs. the Northeast (p<0.01).ConclusionsIn our population, retention improved, though regional differences persisted even after adjusting for demographic and HIV risk factors. These data demonstrate regional differences in the US which may affect patient care, despite national care recommendations

"So I Feel Like I’m Getting It and Then Sometimes I Think OK, No I’m Not": couple and family therapists learning an evidence-based practice

This research concerns itself with the experiences of couple and family therapists (CFT) learning about and using an evidence-based practice. The engagement with evidence-based practice is growing across many aspects of the mental health and health care systems. The evidence-based practice model is now being applied in a broad range of health and human service systems, including mental and behavioral health care, social work, education, and criminal justice (Hunsley, 2007). The dialogue about the role of evidence-based approaches in the practice of couple and family therapy and research literature about same is also evolving (Sexton et al., 2011; Sprenkle 2012). Interestingly, while the research delves into what are the best approaches with different populations and presenting issues, little research has explored the experience of CFTs themselves, particularly while learning and adopting an evidence-based practice. Using a phenomenological approach called interpretive phenomenological analysis (Smith, Flowers, & Larking, 2009), this research explored the experiences of CFTs learning and using an evidence-based practice. The paper reports key issues, challenges, and areas for CFTs, educators, and supervisors. As researchers, educators, administrators, policy makers, and CFTs struggle with what works best with which populations and when, how best to allocate resources, how best to educate and support CFTs, and the complexity of doing research in real-life settings, this research has the potential to contribute to those varied dialogues

Qualitatively exploring the effect of change in the residential environment on travel behaviour

Qualitative research with residents relocating from London was undertaken to develop an understanding of how and to what extent a change in the residential environment affected people’s travel behaviour and attitudes. Data was collected through semi-structured interviews and was thematically analysed. The findings reveal that when in a new location, residents observe the features of their built environment, identify the cause of their stress, and make efforts to address it with a change in travel behaviour. The key contribution of this study is the realisation of different levels of travel behaviour in response to a change in residential location – some residents maintained their travel behaviour, some complemented it, while some changed their behaviour to adapt to their new built environment. Theoretically, this research contributes to the extension of knowledge on travel behaviour as it focuses on suburbanising Londoners; the qualitative method adopted for this research also contributes to current knowledge. Practically, there is the potential of developing a travel behaviour change initiative around ridesharing and policy changes and initiatives to improve physical planning and sustainable travel

End-Stage Renal Disease Among HIV-Infected Adults in North America

Background. Human immunodeficiency virus (HIV)-infected adults, particularly those of black race, are at high-risk for end-stage renal disease (ESRD), but contributing factors are evolving. We hypothesized that improvements in HIV treatment have led to declines in risk of ESRD, particularly among HIV-infected blacks

The sociology of cancer: a decade of research

Biomedicine is often presented as the driving force behind improvements in cancer care, with genomics the latest innovation poised to change the meaning, diagnosis, treatment, prevention and lived experience of cancer. Reviewing sociological analyses of a diversity of patient and practitioner experiences and accounts of cancer during the last decade (2007–17), we explore the experiences of, approaches to and understandings of cancer in this period. We identify three key areas of focus: (i) cancer patient experiences and identities; (ii) cancer risk and responsibilities and (iii) bioclinical collectives. We explore these sociological studies of societal and biomedical developments and how sociologists have sought to influence developments in cancer identities, care and research. We end by suggesting that we extend our understanding of innovations in the fields of cancer research to take better account of these wider social and cultural innovations, together with patients, activists' and sociologists' contributions therein