Pharmacotherapies for Obesity: Past, Current, and Future Therapies

Past therapies for the treatment of obesity have typically involved pharmacological agents usually in combination with a calorie-controlled diet. This paper reviews the efficacy and safety of pharmacotherapies for obesity focusing on drugs approved for long-term therapy (orlistat), drugs approved for short-term use (amfepramone [diethylpropion], phentermine), recently withdrawn therapies (rimonabant, sibutamine) and drugs evaluated in Phase III studies (taranabant, pramlintide, lorcaserin and tesofensine and combination therapies of topiramate plus phentermine, bupropion plus naltrexone, and bupropion plus zonisamide). No current pharmacotherapy possesses the efficacy needed to produce substantial weight loss in morbidly obese patients. Meta-analyses support a significant though modest loss in bodyweight with a mean weight difference of 4.7 kg (95% CI 4.1 to 5.3 kg) for rimonabant, 4.2 kg (95% CI 3.6 to 4.8 kg) for sibutramine and 2.9 kg (95% CI 2.5 to 3.2 kg) for orlistat compared to placebo at ≥12 months. Of the Phase III pharmacotherapies, lorcaserin, taranabant, topiramate and bupropion with naltrexone have demonstrated significant weight loss compared to placebo at ≥12 months. Some pharmacotherapies have also demonstrated clinical benefits. Further studies are required in some populations such as younger and older people whilst the long term safety continues to be a major consideration and has led to the withdrawal of several drugs

“You’re free from just a girl or a boy”:Nonbinary children’s understanding of their gender

BackgroundIn recent years, research on gender diversity in early childhood has increased significantly. However, much of the published literature still focuses on children whose experiences align with binary gender norms, inadvertently excluding nonbinary experiences from analysis.AimsWe seek to explore how nonbinary children, aged five to eight, perceive and understand their gender modality and experiences.MethodsNine American nonbinary children were interviewed using a semi-structured approach, which included two book readings, a drawing activity, and approximately 23 pre-determined questions. Inductive reflexive thematic analysis was utilized for developing, analyzing, and interpreting patterns across a qualitative dataset. All authors engaged in various aspects of reflexivity throughout the process, including personal, functional, and disciplinary reflexivity.AnalysisWe constructed five themes, which were evident across the accounts of participating children. The first one, Being nonbinary has different meanings for different people, illustrates the diverse interpretations of nonbinary identities. Gender is hard to describe but my pronouns help me make sense of it, highlights the challenges of explaining gender, yet pronouns help participants lucidly put their and others’ gender into words. People can change their gender for good or just for a little while, reflect participants’ view of gender as dynamic and fluid. “I have the agency to decide who I am with a little help of others”: feeling, learning, choosing and telling, explores participants’ journey in adopting the label “nonbinary”. Lastly, Being nonbinary is both easy and hard: easy because I am myself, hard because of other people, depicts the multifaceted experiences of being nonbinary, from the affirmation to bullying.DiscussionIn an era marked by a contentious political climate and ongoing debates about trans/nonbinary individuals, these young children defy conventional norms and establish themselves as active architects of their identity narratives, driven by their agency and self-determination

Book Review: TJ Demos, The Migrant Image: The Art and Politics of Documentary during Global Crisis

TJ Demos makes a compelling contribution with this book to the discussion within contemporary visual studies that seeks to re-think the political significance of art for the struggles of our post-2001 present. These pages are best read as an anti-scepticism manual of contemporary art. Against swift dismissals of art practices and institutions as unavoidably complicit with the neoliberal system, Demos insists throughout his analysis on treating art as a complex site of negotiation between aesthetics and politics. Proceeding case by case, he assembles an impressive array of artistic evidence not simply to examine but rather to affirm the capacity of the arts to ‘inflect meanings’, ‘contest formulations’, ‘shift perspectives’ and ‘invite collaborative and creative interpretation’ (pp. 32, 209). The exploration of critical modes of documentary representation delineates a common field for the artworks gathered here from film, photography, video and other media. Furthermore, in this affirmative intervention that is The Migrant Image, each case operates as a critical representational player within the arena of globalisation

Rebeliões de extinção

The article analyses how different environmentalist groups confront issues regarding climate justice and racial inequalities in the wake of climate emergency and the emergence of the Anthropocene, by presenting artworks that mobilize related matters.O presente artigo analisa como diferentes grupos ambientalistas encaram questões de justiça climática e desigualdades raciais em face da emergência climática e da emergência do Antropoceno, apresentando produções artísticas que mobilizam questões afins

A vision for care fit for the twenty-first century: Commission on Residential Care

In 2013-14, Demos is hosted a Commission into the future of residential care, chaired by former MP and Care Services Minister Paul Burstow. The Commission was formed with the aim of developing a vision of residential care that is fit for the 21st century

New development: Directly elected mayors in Italy: creating a strong leader doesn’t mean creating strong leadership

More than 20 years after their introduction, directly elected mayors are key players in Italian urban governance. This article explains the main effects of this reform on local government systems and provides lessons for other countries considering directly elected mayors

Advances in Optical Spectroscopy and Imaging of Breast Lesions

A review is presented of recent advances in optical imaging and spectroscopy and the use of light for addressing breast cancer issues. Spectroscopic techniques offer the means to characterize tissue components and obtain functional information in real time. Three-dimensional optical imaging of the breast using various illumination and signal collection schemes in combination with image reconstruction algorithms may provide a new tool for cancer detection and monitoring of treatment

Comparative Population Genomics of African Montane Forest Mammals Support Population Persistence across a Climatic Gradient and Quaternary Climatic Cycles

The Eastern Afromontane biodiversity hotspot (EABH) has the highest concentration of biodiversity in tropical Africa, yet few studies have investigated recent historical diversification processes in EABH lineages. Herein, we analyze restriction-site associated DNA-sequences (RAD-Seq) to study recent historical processes in co-distributed mouse (Hylomyscus) and shrew (Sylvisorex) species complexes, with an aim to better determine how historical paleoenvironmental processes might have contributed to the EABH’s high diversity. We analyzed complete SNP matrices of \u3e 50,000 RAD loci to delineate populations, reconstruct the history of isolation and admixture, and discover geographic patterns of genetic partitioning. These analyses demonstrate that persistently unsuitable habitat may have isolated multiple populations distributed across montane habitat islands in the Itombwe Massif and Albertine Rift to the west as well as Mt Elgon and Kenyan Highlands to the east. We detected low genetic diversity in Kenyan Highland populations of both genera, consistent with smaller historical population sizes in this region. We additionally tested predictions that Albertine Rift populations are older and more persistently isolated compared to the Kenyan Highlands. Phylogenetic analyses support greater historical isolation among Albertine Rift populations of both shrews and mice compared to the Kenyan Highlands and suggest that there are genetically isolated populations from both focal genera in the Itombwe Massif, Democratic Republic of Congo. The Albertine Rift ecoregion has the highest mammalian tropical forest species richness per unit area on earth. Our results clearly support accelerating efforts to conserve this diversity