The Subjective Dimension of a Bipolar Family Education/Support Group: A Sociology of Emotions Approach

This article reports on the predominant emotions experienced by members of an education/support group for the relatives and partners of individuals with bipolar manic-depression. Identified are the specific types of emotions experienced as well as the situational, definitional, and behavioral frameworks in which particular emotions or combinations of emotions were generated, experienced, interpreted, expressed, and managed. Special attention is focused on emotional uncertainty, mixed and fluctuating emotions, the erosion of positive by negative emotions, and emotional stalemates. In addition, the personal and social consequences of members\u27 adopting particular emotion management roles are examined. Finally, the article outlines the education/ support group contexts and processes through which members were able to normalize, alter, or reduce a number of particularly distressful emotions and create or reinforce specific positive emotions

Injuries in youth football and the relationship to player maturation: an analysis of time-loss injuries during four seasons in an English elite male football academy

A better insight into injuries in elite youth football may inform prevention strategies. The purpose of this prospective cohort study was to investigate the frequency, incidence and pattern of time-loss injuries in an elite male football academy, exploring injuries in relation to age and maturation status. Across four consecutive playing seasons, playing exposure and injuries to all academy players (U’9 to U’21) were recorded by club medical staff. Maturation status at the time of injury was also calculated for players competing in U’13 to U’16 aged squads. Time-loss injury occurrence and maturation status at time of injury were the main outcome measures. A total of 603 time-loss injuries were recorded, from 190 different players. Playing exposure was 229,317 hours resulting in an overall injury rate of 2.4 p/1000h, ranging from 0.7 p/1000h (U’11) to 4.8 p/1000h (u’21). Most injuries were traumatic in mechanism (73%). The most common injury location was the thigh (23%) and the most common injury type was muscle injury (29%) combining to provide the most common injury diagnosis; thigh muscle injury (17%). In U’13-U’16 players, a higher number of injuries to early-maturing players were observed in U’13-U’14 players, whilst more injuries to U’15-U’16 players occurred when classed as ‘on-time’ in maturity status. Maturation status did not statistically relate to injury pattern, however knee bone (not-fracture) injuries peaked in U’13 players whilst hip/groin muscle injuries peaked in U’15 players

Dynamical mechanisms linking Indian monsoon precipitation and the circumglobal teleconnection

The circumglobal teleconnection (CGT) is an important mode of circulation variability, with an influence across many parts of the northern hemisphere. Here, we examine the excitation mechanisms of the CGT in the ECMWF seasonal forecast model, and the relationship between the Indian summer monsoon (ISM), the CGT and the extratropical northern hemisphere circulation. Results from relaxation experiments, in which the model is corrected to reanalysis in specific regions, suggest that errors over northwest Europe are more important in inhibiting the model skill at representing the CGT, in addition to northern hemisphere skill more widely, than west-central Asia and the ISM region, although the link between ISM precipitation and the extratropical circulation is weak in all experiments. Thermal forcing experiments in the ECMWF model, in which a heating is applied over India, suggest that the ISM does force an extratropical Rossby wave train, with upper tropospheric anticyclonic anomalies over east Asia, the North Pacific and North America associated with increased ISM heating. However, this eastward-propagating branch of the wave train does not project into Europe, and the response there occurs largely through westward-propagating Rossby waves. Results from barotropic model experiments show a response that is highly consistent with the seasonal forecast model, with similar eastward- and westward-propagating Rossby waves. This westward-propagating response is shown to be important in the downstream reinforcement of the wave train between Asia and North America

Development of a conceptual framework to guide description and evaluation of social interventions for people with serious mental health conditions

People with serious mental health conditions face social exclusion and have poorer social outcomes compared to the general population in several areas of life. Social exclusion also negatively impacts mental health. Promising models of support to improve social outcomes for people with serious mental health conditions have been described in the literature and proliferate in practice, but typologies of support are not clearly established and a robust evidence base for effective approaches is lacking in many areas. We conducted a scoping review of relevant literature and consulted with experts in the field to identify models to improve social circumstances across eight life domains, with the aim of developing a conceptual framework to distinguish the main broad approaches to improving the social circumstances of people with serious mental health conditions. We also sought to explore which approaches have been used in models within each life domain. This work was conducted in collaboration with a group of expert stakeholders, including people with lived experience of accessing mental health services. We developed a conceptual framework which distinguishes sources and types of support, allowing description of complex interventions to improve the social circumstances of people with serious mental health problems, and providing a framework to guide future service development and evaluation

Conjugative Botulinum Neurotoxin-Encoding Plasmids in Clostridium botulinum

Clostridium botulinum produces seven distinct serotypes of botulinum neurotoxins (BoNTs). The genes encoding different subtype neurotoxins of serotypes A, B, F and several dual neurotoxin-producing strains have been shown to reside on plasmids, suggesting that intra- and interspecies transfer of BoNT-encoding plasmids may occur. The objective of the present study was to determine whether these C. botulinum BoNT-encoding plasmids are conjugative.C. botulinum BoNT-encoding plasmids pBotCDC-A3 (strain CDC-A3), pCLJ (strain 657Ba) and pCLL (strain Eklund 17B) were tagged with the erythromycin resistance marker (Erm) using the ClosTron mutagenesis system by inserting a group II intron into the neurotoxin genes carried on these plasmids. Transfer of the tagged plasmids from the donor strains CDC-A3, 657Ba and Eklund 17B to tetracycline-resistant recipient C. botulinum strains was evaluated in mating experiments. Erythromycin and tetracycline resistant transconjugants were isolated from donor:recipient mating pairs tested. Transfer of the plasmids to the transconjugants was confirmed by pulsed-field gel electrophoresis (PFGE) and Southern hybridizations. Transfer required cell-to-cell contact and was DNase resistant. This indicates that transfer of these plasmids occurs via a conjugation mechanism.This is the first evidence supporting conjugal transfer of native botulinum neurotoxin-encoding plasmids in C. botulinum, and provides a probable mechanism for the lateral distribution of BoNT-encoding plasmids to other C. botulinum strains. The potential transfer of C. botulinum BoNT-encoding plasmids to other bacterial hosts in the environment or within the human intestine is of great concern for human pathogenicity and necessitates further characterization of these plasmids

Increasing Support for Contraception as HIV Prevention: Stakeholder Mapping to Identify Influential Individuals and Their Perceptions

BACKGROUND: Voluntary contraceptive use by HIV-positive women currently prevents more HIV-positive births, at a lower cost, than anti-retroviral drug (ARV) regimens. Despite this evidence, most prevention of mother-to-child transmission (PMTCT) programs focus solely on providing ARV prophylaxis to pregnant women and rarely include the prevention of unintended pregnancies among HIV-positive women. METHODOLOGY/PRINCIPAL FINDINGS: To strengthen support for family planning as HIV prevention, we systematically identified key individuals in the field of international HIV/AIDS-those who could potentially influence the issue-and sought to determine their perceptions of barriers to and facilitators for implementing this PMTCT strategy. We used a criteria-based approach to determine which HIV/AIDS stakeholders have the most significant impact on HIV/AIDS research, programs, funding and policy and stratified purposive sampling to conduct interviews with a subset of these individuals. The interview findings pointed to obstacles to strengthening linkages between family planning and HIV/AIDS, including the need for: resources to integrate family planning and HIV services, infrastructure or capacity to provide integrated services at the facility level, national leadership and coordination, and targeted advocacy to key decision-makers. CONCLUSIONS/SIGNIFICANCE: The individuals we identified as having regional or international influence in the field of HIV/AIDS have the ability to leverage an increasingly conducive funding environment and a growing evidence base to address the policy, programmatic and operational challenges to integrating family planning with HIV/AIDS. Fostering greater support for implementing contraception for HIV prevention will require the dedication, collaboration and coordination of many such actors. Our findings can inform a targeted advocacy campaign

Distribution of Country of Origin in Studies Used in Cochrane Reviews

Inclusion in systematic reviews is one important component in judging the potential impact of clinical studies upon practice and hence the 'value for money' of spending for clinical research. This study aims to quantify the distribution of countries of origin of clinical studies used in Cochrane Reviews (CRs), and to link these data to the size of a country and to its spending on research. Random sample of publications used for CRs published in Issue 1 2008 and of publications used in CRs in the field of complementary and alternative medicine (CAM). Publications without original data were excluded. Likely countries of origin determined based on abstracts/full texts. CIA World Factbook (population data) and OECD database (economic data) were used. 1,000 random entries out of 140,005 references available in all specialities. In 876 (91.4%) of 959 eligible studies, country of origin was determined. The USA was the leading contributor (36.0% of the studies), followed by UK (13.4%), Canada (5.3%), Australia and Sweden (3.7%). In the CAM sample, country of origin was determined in 458 (93.5%) of 497 assessed studies. Again, the USA was the leading contributor (24.9%), with China also emerging as a significant contributor (24.7%) in this field. For both samples, the contribution of smaller countries (especially Scandinavian countries, Greece, and Ireland) became more noteworthy when considered in relation to population size and research spending. Our results support the leading roles of both the USA and the UK in publishing clinical papers. The emerging role of China can be seen, particularly related to CAM studies. Taking into account size of population and economic power, countries like France, Germany, Italy, and Spain provide small contributions. In contrast, smaller countries like Australia, Denmark, Finland, Ireland, New Zealand, and Sweden also play major roles