Couple-level minority stress and mental health among people in same-sex relationships: Extending minority stress theory

We simultaneously examined the effects of individual- and couple-level minority stressors on mental health among people in same-sex relationships. Individual-level minority stressors emerge from the stigmatization of sexual minority individuals; couple-level minority stressors emerge from the stigmatization of same-sex relationships. Dyadic data from 100 same-sex couples from across the United States were analyzed with actor–partner interdependence models. Couple-level stigma was uniquely associated with nonspecific psychological distress, depressive symptomatology, and problematic drinking, net the effects of individual-level stigma and relevant sociodemographic controls. Analyses also show that couple-level minority stress played unique roles in critical stress processes of minority stress proliferation: minority stress expansion and minority stress contagion. The inclusion of couple-level stress constructs represents a useful extension of minority stress theory, enriching our capacity to deepen understandings of minority stress experience and its application in the study of well-being and health inequalities faced by vulnerable populations

The Complicated Connection Between Closeness and the Quality of Romantic Relationships

Closeness is often considered synonymous with better quality romantic relationships. However, individual differences exist in the degree of closeness people desire in their relationships. This study examined the implications that discrepancies between actual and ideal closeness have for relationship quality in romantic couples. A questionnaire was administered to a sample of 103 cohabiting couples (N = 206) in the United States, who were randomly selected from a nationally representative survey panel. Dyadic analysis using Actor-Partner Interdependence Models with latent outcomes revealed that internal discrepancies between actual and idealized closeness were associated with poorer relationship quality for both individuals and their partners. These associations persisted above and beyond the effects of actual closeness and dyad-level differences in actual and ideal closeness. The association between closeness and relationship quality may be more individual than dyadic in nature, warranting renewed attention to the idiographic experience of closeness and its association with relational well-being

Viral dynamics during structured treatment interruptions of chronic human immunodeficiency virus type 1 infection

Although antiviral agents which block human immunodeficiency virus (HIV) replication can result in long-term suppression of viral loads to undetectable levels in plasma, long-term therapy fails to eradicate virus, which generally rebounds after a single treatment interruption. Multiple structured treatment interruptions (STIs) have been suggested as a possible strategy that may boost HIV-specific immune responses and control viral replication. We analyze viral dynamics during four consecutive STI cycles in 12 chronically infected patients with a history (>2 years) of viral suppression under highly active antiretroviral therapy. We fitted a simple model of viral rebound to the viral load data from each patient by using a novel statistical approach that allows us to overcome problems of estimating viral dynamics parameters when there are many viral load measurements below the limit of detection. There is an approximate halving of the average viral growth rate between the first and fourth STI cycles, yet the average time between treatment interruption and detection of viral loads in the plasma is approximately the same in the first and fourth interruptions. We hypothesize that reseeding of viral reservoirs during treatment interruptions can account for this discrepancy, although factors such as stochastic effects and the strength of HIV-specific immune responses may also affect the time to viral rebound. We also demonstrate spontaneous drops in viral load in later STIs, which reflect fluctuations in the rates of viral production and/or clearance that may be caused by a complex interaction between virus and target cells and/or immune responses

Phenotypic hypersusceptibility to multiple protease inhibitors and low replicative capacity in patients who are chronically infected with human immunodeficiency virus type 1

Increased susceptibility to the protease inhibitors saquinavir and amprenavir has been observed in human immunodeficiency virus type 1 (HIV-1) with specific mutations in protease (V82T and N88S). Increased susceptibility to ritonavir has also been described in some viruses from antiretroviral agent-naïve patients with primary HIV-1 infection in association with combinations of amino acid changes at polymorphic sites in the protease. Many of the viruses displaying increased susceptibility to protease inhibitors also had low replication capacity. In this retrospective study, we analyze the drug susceptibility phenotype and the replication capacity of virus isolates obtained at the peaks of viremia during five consecutive structured treatment interruptions in 12 chronically HIV-1-infected patients. Ten out of 12 patients had at least one sample with protease inhibitor hypersusceptibility (change ≤0.4-fold) to one or more protease inhibitor. Hypersusceptibility to different protease inhibitors was observed at variable frequency, ranging from 38% to amprenavir to 11% to nelfinavir. Pairwise comparisons between susceptibilities for the protease inhibitors showed a consistent correlation among all pairs. There was also a significant relationship between susceptibility to protease inhibitors and replication capacity in all patients. Replication capacity remained stable over the course of repetitive cycles of structured treatment interruptions. We could find no association between in vitro replication capacity and in vivo plasma viral load doubling time and CD4(+) and CD8(+) T-cell counts at each treatment interruption. Several mutations were associated with hypersusceptibility to each protease inhibitor in a univariate analysis. This study extends the association between hypersusceptibility to protease inhibitors and low replication capacity to virus isolated from chronically infected patients and highlights the complexity of determining the genetic basis of this phenomenon. The potential clinical relevance of protease inhibitor hypersusceptibility and low replication capacity to virologic response to protease inhibitor-based therapies deserves to be investigated further

The relationship timeline: A method for the study of shared lived experiences in relational contexts

Lifeline methods—graphic illustrations of the pathways of lived experience traveled by individuals from birth to anticipated death—have been useful in the study of lived experience. Existing lifeline methods and research focus on the individual experience; absent from this literature are the collective experiences of those in intimate relationships. In this paper, based on our research with 120 same-sex couples, we present a method to allow for the joint creation of relationship timelines, which serve as the basis for eliciting dyadic data in multiple forms: graphic representations of relationship development through couples’ creation of a timeline of key events and periods; qualitative narratives of couples’ shared experiences; and quantitative ratings of significant events and periods in their lives together. Lessons learned from the application of this Relationship Timeline Method are discussed, as are implications for future study of shared lived experiences in relational contexts

Measuring a New Stress Domain: Validation of the Couple-Level Minority Stress Scale

Existing social stress frameworks largely conceive of stress as emanating from individual experience. Recent theory and research concerning minority stress have focused on same-sex couples' experiences of both eventful and chronic stressors associated with being in a stigmatized relationship, including having ongoing or episodic fears of discrimination, and experiencing actual acts of discrimination. Such couple-level minority stressors represent a novel domain of social stress affecting minority populations that is only beginning to become a focus in empirical investigations testing minority stress theory. This article presents the results of psychometric analyses of dyadic data from 106 same-sex couples from across the U.S., introducing the Couple-Level Minority Stress (CLMS) scale featuring eight new couple-level minority stress factors: (1) Couple-Level Stigma; (2) Couple-Level Discrimination; (3) Seeking Safety as a Couple; (4) Perceived Unequal Relationship Recognition; (5) Couple-Level Visibility; (6) Managing Stereotypes about Same-Sex Couples; (7) Lack of Integration with Families of Origin; and (8) Lack of Social Support for Couples. The CLMS demonstrated a clear factor structure with satisfactory model-data fit and subscale reliabilities. The CLMS also exhibited validity as a correlate of one indicator of relationship quality (relationship satisfaction) and three indicators of mental health (nonspecific psychological distress, depressive symptomatology, and problematic drinking) when controlling for individual-level minority stressors and has great potential to extend and enrich minority stress research, particularly studies that deepen understandings of longstanding health inequities based on sexual orientation

Understanding How Emerging Same-Sex Couples Make Meaning of Minority Stress: A Narrative Approach

Minority stress—in the form of experiences of prejudice and discrimination—can have negative consequences on individuals in same-sex relationships. However, little is known about the ways in which members of same-sex couples make meaning of minority stress, especially in the context of newly formed relationships that may be most vulnerable to minority stressors. The present study draws upon emerging understandings of couple-level minority stress to investigate the ways in which newly formed same-sex couples make meaning of their minority stress experiences jointly as a couple. A narrative analysis was conducted using data from dyadic interviews with 40 same-sex couples who had been together for at least 6 months but less than 3 years. Analyses highlighted six distinct narrative strategies used by couples when making-meaning of their minority stress experiences: “minority stress made couples stronger,” “minority stress contaminates positive experiences,” “minority stress is not a big deal,” “couples resign in the face of minority stress,” “minority stress is worse than expected,” and “couples hope minority stress experiences will get better.” These findings not only provide valuable evidence for couple-level minority stress constructs, but crucially give a nuanced insight into how same-sex couples that are in the early stages of relationship development, make meaning of their minority stress experiences. Findings have important implications for the design and implementation of effective clinical and counseling interventions aimed at reducing negative outcomes among individuals in same-sex relationships, and the potential for relationship dissolution resulting from minority stress experiences

A multi-scale exploration of a massive young stellar object: A transition disk around G305.20+0.21?

Context. The rarity of young massive stars combined with the fact that they are often deeply embedded has limited the understanding of the formation of stars larger than 8 M⊙. Ground based mid-infrared (IR) interferometry is one way of securing the spatial resolution required to probe the circumstellar environments of massive young stellar objects (MYSOs). Given that the spatial-frequency coverage of such observations is often incomplete, direct-imaging can be supplementary to such a dataset. By consolidating these observations with modelling, the features of a massive protostellar environment can be constrained. Aims. This paper aims to detail the physical characteristics of the protostellar environment of the MYSO G305.20+0.21 at three size-scales by fitting one 2.5D radiative transfer model to three different types of observations simultaneously, providing an extensive view of the accreting regions of the MYSO. Methods. Interferometry, imaging and a multi-wavelength spectral energy distribution (SED) are combined to study G305.20+0.21. The high-resolution observations were obtained using the Very Large Telescope’s MIDI and VISIR instruments, producing visibilities in the N-band and near-diffraction-limited imaging in the Q-band respectively. By fitting simulated observables, derived from the radiative transfer model, to our observations the properties of the MYSO are constrained. Results. The VISIR image shows elongation at 100 mas scales and also displays a degree of asymmetry. From the simulated observables derived from the radiative transfer model output we find that a central protostar with a luminosity of ~5 × 104 L⊙ surrounded by a low-density bipolar cavity, a flared 1 M⊙ disk and an envelope is sufficient to fit all three types of observational data for G305.20+0.21. The weak silicate absorption feature within the SED requires low-density envelope cavities to be successfully fit and is an atypical characteristic in comparison to previously studied MYSOs. Conclusions. The fact that the presence of a dusty disk provides the best fit to the MIDI visibilities implies that this MYSO is following a scaled-up version of the low-mass star formation process. The low density, low extinction environment implies the object is a more evolved MYSO and this combined with large inner radius of the disk suggests that it could be an example of a transitional disk around an MYSO

Unveiling the traits of massive young stellar objects through a multi-scale survey

Context: The rarity and deeply embedded nature of young massive stars has limited the understanding of the formation of stars with masses larger than 8 M⊙. Previous work has shown that complementing spectral energy distributions with interferometric and imaging data can probe the circumstellar environments of massive young stellar objects (MYSOs) well. However, complex studies of single objects often use different approaches in their analysis. Therefore the results of these studies cannot be directly compared. Aims: This work aims to obtain the physical characteristics of a sample of MYSOs at ~0.01″ scales, at ~0.1″ scales, and as a whole, which enables us to compare the characteristics of the sources. Methods: We apply the same multi-scale method and analysis to a sample of MYSOs. High-resolution interferometric data (MIDI/VLTI), near-diffraction-limited imaging data (VISIR/VLT, COMICS/Subaru), and a multi-wavelength spectral energy distribution are combined. By fitting simulated observables derived from 2.5D radiative transfer models of disk-outflow-envelope systems to our observations, the properties of the MYSOs are constrained. Results: We find that the observables of all the MYSOs can be reproduced by models with disk-outflow-envelope geometries, analogous to the Class I geometry associated with low-mass protostars. The characteristics of the envelopes and the cavities within them are very similar across our sample. On the other hand, the disks seem to differ between the objects, in particular with regards to what we interpret as evidence of complex structures and inner holes. Conclusions: The MYSOs of this sample have similar large-scale geometries, but variance is observed among their disk properties. This is comparable to the morphologies observed for low-mass young stellar objects. A strong correlation is found between the luminosity of the central MYSO and the size of the transition disk-like inner hole for the MYSOs, implying that photoevaporation or the presence of binary companions may be the cause

The double burden of malnutrition in individuals: Identifying key challenges and re-thinking research focus

\ua9 2024 The Authors. Nutrition Bulletin published by John Wiley & Sons Ltd on behalf of British Nutrition Foundation.The ‘double burden of malnutrition’ is a global health challenge that increasingly affects populations in both low- and middle-income countries (LMICs). This phenomenon refers to the coexistence of undernutrition and overweight or obesity, as well as other diet-related non-communicable diseases, in the same population, household or even individual. While noteworthy progress has been made in reducing undernutrition in some parts of the world, in many of these areas, the prevalence of overweight and obesity is increasing, particularly in urban areas, resulting in greater numbers of people who were undernourished in childhood and have overweight or obesity in adulthood. This creates a complex and challenging situation for research experts and policymakers who must simultaneously address the public health burdens of undernutrition and overweight/obesity. This review identifies key challenges and limitations in the current research on the double burden of malnutrition in individuals, including the need for a more comprehensive and nuanced understanding of the drivers of malnutrition, the importance of context-specific interventions and the need for greater attention to the food environment and food systems. We advocate for the re-evaluation of research strategies and focus, with a greater emphasis on multidisciplinary and systems approaches and greater attention to the synergistic relationship between the biological, environmental, commercial and socio-economic determinants of malnutrition. Addressing these key challenges can enable us to better comprehend and tackle the multifaceted and dynamic issues of the double burden of malnutrition, particularly in individuals and work towards more effective and sustainable solutions