Responsibility for managing musculoskeletal disorders – A cross-sectional postal survey of attitudes

Background: Musculoskeletal disorders are a major burden on individuals, health systems and social care systems and rehabilitation efforts in these disorders are considerable. Self-care is often considered a cost effective treatment alternative owing to limited health care resources. But what are the expectations and attitudes in this question in the general population? The purpose of this study was to describe general attitudes to responsibility for the management of musculoskeletal disorders and to explore associations between attitudes and background variables. Methods: A cross-sectional, postal questionnaire survey was carried out with a random sample of a general adult Swedish population of 1770 persons. Sixty-one percent (n = 1082) responded to the questionnaire and was included for the description of general attitudes towards responsibility for the management of musculoskeletal disorders. For the further analyses of associations to background variables 683–693 individuals could be included. Attitudes were measured by the "Attitudes regarding Responsibility for Musculoskeletal disorders" (ARM) instrument, where responsibility is attributed on four dimensions; to myself, as being out of my hands, to employers or to (medical) professionals. Multiple logistic regression was used to explore associations between attitudes to musculoskeletal disorders and the background variables age, sex, education, physical activity, presence of musculoskeletal disorders, sick leave and whether the person had visited a care provider. Results: A majority of participants had internal views, i.e. showed an attitude of taking personal responsibility for musculoskeletal disorders, and did not place responsibility for the management out of their own hands or to employers. However, attributing shared responsibility between self and medical professionals was also found.The main associations found between attitude towards responsibility for musculoskeletal disorders and investigated background variables were that physical inactivity (OR 2.92–9.20), musculoskeletal disorder related sick leave (OR 2.31–3.07) and no education beyond the compulsory level (OR 3.12–4.76) increased the odds of attributing responsibility externally, i.e placing responsibility on someone or something else.Conclusion: Respondents in this study mainly saw themselves as responsible for managing musculoskeletal disorders. The associated background variables refined this finding and one conclusion is that, to optimise outcome when planning the prevention, treatment and management of these disorders, people's attitudes should be taken into account

The Antimicrobial Peptide Histatin-5 Causes a Spatially Restricted Disruption on the Candida albicans Surface, Allowing Rapid Entry of the Peptide into the Cytoplasm

Antimicrobial peptides play an important role in host defense against microbial pathogens. Their high cationic charge and strong amphipathic structure allow them to bind to the anionic microbial cell membrane and disrupt the membrane bilayer by forming pores or channels. In contrast to the classical pore-forming peptides, studies on histatin-5 (Hst-5) have suggested that the peptide is transported into the cytoplasm of Candida albicans in a non-lytic manner, and cytoplasmic Hst-5 exerts its candicidal activities on various intracellular targets, consistent with its weak amphipathic structure. To understand how Hst-5 is internalized, we investigated the localization of FITC-conjugated Hst-5. We find that Hst-5 is internalized into the vacuole through receptor-mediated endocytosis at low extracellular Hst-5 concentrations, whereas under higher physiological concentrations, Hst-5 is translocated into the cytoplasm through a mechanism that requires a high cationic charge on Hst-5. At intermediate concentrations, two cell populations with distinct Hst-5 localizations were observed. By cell sorting, we show that cells with vacuolar localization of Hst-5 survived, while none of the cells with cytoplasmic Hst-5 formed colonies. Surprisingly, extracellular Hst-5, upon cell surface binding, induces a perturbation on the cell surface, as visualized by an immediate and rapid internalization of Hst-5 and propidium iodide or rhodamine B into the cytoplasm from the site using time-lapse microscopy, and a concurrent rapid expansion of the vacuole. Thus, the formation of a spatially restricted site in the plasma membrane causes the initial injury to C. albicans and offers a mechanism for its internalization into the cytoplasm. Our study suggests that, unlike classical channel-forming antimicrobial peptides, action of Hst-5 requires an energized membrane and causes localized disruptions on the plasma membrane of the yeast. This mechanism of cell membrane disruption may provide species-specific killing with minimal damage to microflora and the host and may be used by many other antimicrobial peptides

An overview of periodontal regenerative procedures for the general dental practitioner.

The complete regeneration of the periodontal tissues following periodontal disease remains an unmet challenge, and has presented clinicians with a remarkably difficult clinical challenge to solve given the extensive research in this area and our current understanding of the biology of the periodontal tissues. In particular as clinicians we look for treatments that will improve the predictability of the procedure, improve the magnitude of the effect of treatment, and perhaps most importantly in the long term would extend the indications for treatment beyond the need for single enclosed bony defects to allow for suprabony regeneration, preferably with beneficial effects on the gingival soft tissues. A rapid development in both innovative methods and products for the correction of periodontal deficiencies have been reported during the last three decades. For example, guided tissue regeneration with or without the use of bone supplements has been a well-proven treatment modality for the reconstruction of bony defects prior to the tissue engineering era. Active biomaterials have been subsequently introduced to the periodontal community with supporting dental literature suggesting that certain factors should be taken into consideration when undertaking periodontal regenerative procedures. These factors as well as a number of other translational research issues will need to be addressed, and ultimately it is vital that we do not extrapolate results from pre-clinical and animal studies without conducting extensive randomized clinical trials to substantiate outcomes from these procedures. Whatever the outcomes, the pursuit of regeneration of the periodontal tissues remains a goal worth pursuing for our patients. The aim of the review, therefore is to update clinicians on the recent advances in both materials and techniques in periodontal regenerative procedures and to highlight the importance of both patient factors and the technical aspects of regenerative procedures

Hyper-compressions: The rise of flash fiction in “post-transitional” South Africa

Blair, P. (2020). Hyper-compressions: The rise of flash fiction in “post-transitional” South Africa', The Journal of Commonwealth Literature, 55(1), 38-60. Copyright © 2018. Reprinted by permission of SAGE Publications.This article begins with a survey of flash fiction in “post-transitional” South Africa, which it relates to the nation’s post-apartheid canon of short stories and short-short stories, to the international rise of flash fiction and “sudden fiction”, and to the historical particularities of South Africa’s “post-transition”. It then undertakes close readings of three flash fictions republished in the article, each less than 450 words: Tony Eprile’s “The interpreter for the tribunal” (2007), which evokes the psychological and ethical complexities, and long-term ramifications, of the Truth and Reconciliation Commission; Michael Cawood Green’s “Music for a new society” (2008), a carjacking story that invokes discourses about violent crime and the “‘new’ South Africa”; and Stacy Hardy’s “Kisula” (2015), which maps the psychogeography of cross-racial sex and transnational identity-formation in an evolving urban environment. The article argues that these exemplary flashes are “hyper-compressions”, in that they compress and develop complex themes with a long literary history and a wide contemporary currency. It therefore contends that flash fiction of South Africa’s post-transition should be recognized as having literary-historical significance, not just as an inherently metonymic form that reflects, and alludes to, a broader literary culture, but as a genre in its own right

Counselling formerly heterosexually partnered gay fathers raised with religion

Formerly heterosexually partnered gay fathers raised with religion are an under-researched group of LGBTQ parents. This group have potentially complex coming out journeys, which can result in them seeking counselling. This research explores the counselling experiences of such men and offers suggestions for working therapeutically with them. Twelve self-identified gay fathers participated in qualitative interviews. These men all had children in the context of a heterosexual marriage or committed partnership, and a religious upbringing of some kind in the US, Canada, the UK or Ireland. The key finding of the qualitative analysis was that participants wanted therapists to not assume a ‘best’ outcome for them as either gay or ‘straight’. Instead, they wanted therapists to respect and assist them to explore their own individual sense-making around their identities and to reject fixed notions from both ex-gay and (some versions of) gay affirmative therapy of what it means to be a ‘well-adjusted’ (gay) father

Reflections on the challenges of understanding racial, cultural and sexual differences in couple relationship research

In the field of systemic psychotherapy there has been much recent interest in the areas of culture and reflexivity, and in working with couples. In this article we reflect on the process of conducting research in these areas. Drawing on findings from a large, national, empirical mixed-methods study on long-term relationships, we use two examples from the data to illustrate the complexity of researching across racial, cultural and sexual differences, in terms of research design and sampling, fieldwork and research practice, and making sense of multidimensional data. We point to findings that suggest that notions of coupledom are culturally constructed and thus challenge straightforward ideas of the procreative, sexually active couple dyad, separate from intergenerational extended families. The clinical significance of the findings for both lesbian, gay, bisexual or queer and culturally diverse couples and families are discussed