'Rules' for the boys, 'guidelines' for the girls: a qualitative study of the factors influencing gender differences in symptom reporting during childhood and adolescence

This study uses qualitative methods to explore how boys’ and girls’ symptom reporting may be influenced by their perceptions of societal gender- and age-related expectations, their conceptualisations of symptoms, and the social context of symptom experiences. Twenty-five focus groups were conducted with girls and boys aged 10, 13 and 15. These took place in one primary and one secondary school, both located in central Scotland, between June 2004 and January 2005. Focus groups were composed of pupils who were the same age and gender. To stimulate discussion and aid comparison across groups, focussing exercises were designed and put into practice. Symptom cards were used to investigate pupils’ conceptualisations of symptoms. Vignettes encouraged pupils to explore how same- and opposite-sex peers might react to a ‘physical’ and ‘malaise’ symptom in different social contexts. Histograms displaying gender differences in symptom reporting were used as a basis for exploring pupils’ explanations for these patterns. This study found that experiences of illness are integral to boys’ and girls’ presentations of themselves and their performances of gender and age. Their efforts to conform to gender- and age-related expectations have a significant influence on their reactions to illness, their conceptualisations and assessments of symptoms, and also their perceptions of the consequences of seeking help for illness in different social contexts. Societal expectations can be seen as representing strict ‘rules’ for boys, which substantially restrict their reactions to ‘physical’ and especially ‘malaise’ symptoms, whereas they can be viewed as more lenient ‘guidelines’ for girls which are more permissive of their help-seeking for either ‘physical’ or ‘malaise’ symptoms. The ‘rules’ and ‘guidelines’ for boys and girls are not as polarised as gender stereotypes would lead us to expect. This study suggests that seeking help for illness can pose a serious threat to boys’ constructions of themselves as ‘successfully masculine’, but is also has a negative impact upon girls’ presentations of themselves as strong and independent. Boys and girls also argued that the transition from childhood to adolescence is more stressful for girls. They portrayed the advert of puberty and menarche, as well as mounting academic pressures, as stressors likely to lead to girls’ increasing experiences of ‘physical’ symptoms and ‘psychological’ distress. In order to reduce help-seeking barriers and improve boys’ and girls’ perceptions of the consequences of reporting symptoms, there needs to be an erosion of the idea that illness signifies weakness or deficiencies of character. Campaigns to reduce the stigma of mental illness would benefit from incorporating boys’ and girls’ conceptualisations of ‘malaise’ symptoms and aiming to change misconceptions which act as barriers to help-seeking

DNA polymerase activity in plasma from leukaemic guinea-pigs.

Measurement of DNA polymerase in leukaemic guinea-pig plasms reveals the presence of low levels of sedimentable and non-sedimentable enzymic activities. Since the sedimentable DNA polymerase is ribonuclease sensitive, uses poly(C).oligo(dG) as template, and bands in a sucrose density gradient at 1-17 g/ml it is thought to be the GPLV-associated reverse transcriptase. The soluble DNA polymerase is stimulated by ribonuclease and is probably of cellular origin

Stage progression and neurological symptoms in Trypanosoma brucei rhodesiense sleeping sickness: role of the CNS inflammatory response

Background: Human African trypanosomiasis progresses from an early (hemolymphatic) stage, through CNS invasion to the late (meningoencephalitic) stage. In experimental infections disease progression is associated with neuroinflammatory responses and neurological symptoms, but this concept requires evaluation in African trypanosomiasis patients, where correct diagnosis of the disease stage is of critical therapeutic importance. Methodology/Principal Findings: This was a retrospective study on a cohort of 115 T.b.rhodesiense HAT patients recruited in Eastern Uganda. Paired plasma and CSF samples allowed the measurement of peripheral and CNS immunoglobulin and of CSF cytokine synthesis. Cytokine and immunoglobulin expression were evaluated in relation to disease duration, stage progression and neurological symptoms. Neurological symptoms were not related to stage progression (with the exception of moderate coma). Increases in CNS immunoglobulin, IL-10 and TNF-α synthesis were associated with stage progression and were mirrored by a reduction in TGF-β levels in the CSF. There were no significant associations between CNS immunoglobulin and cytokine production and neurological signs of disease with the exception of moderate coma cases. Within the study group we identified diagnostically early stage cases with no CSF pleocytosis but intrathecal immunoglobulin synthesis and diagnostically late stage cases with marginal CSF pleocytosis and no detectable trypanosomes in the CSF. Conclusions: Our results demonstrate that there is not a direct linkage between stage progression, neurological signs of infection and neuroinflammatory responses in rhodesiense HAT. Neurological signs are observed in both early and late stages, and while intrathecal immunoglobulin synthesis is associated with neurological signs, these are also observed in cases lacking a CNS inflammatory response. While there is an increase in inflammatory cytokine production with stage progression, this is paralleled by increases in CSF IL-10. As stage diagnostics, the CSF immunoglobulins and cytokines studied do not have sufficient sensitivity to be of clinical value

Positive allosteric modulators of the a-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor

L-glutamate is the major excitatory neurotransmitter in the mammalian central nervous system (CNS) and plays a fundamental role in the control of motor function, cognition and mood. The physiological effects of glutamate are mediated through two functionally distinct receptor families. While activation of metabotropic (G-protein coupled) glutamate receptors results in modulation of neuronal excitability and transmission, the ionotropic glutamate receptors (ligand-gated ion channels) are responsible for mediating the fast synaptic response to extracellular glutamate

The Advanced Photon Source Injector Test Stand Control System

The Advanced Photon Source (APS) primary and backup injectors consist of two thermionic-cathode rf guns. These guns are being upgraded to provide improved performance, to improve ease of maintenance, and to reduce downtime required for repair or replacement of a failed injector. As part of the process, an injector test stand is being prepared. This stand is effectively independent of the APS linac and will allow for complete characterization and validation of an injector prior to its installation into the APS linac. A modular control system for the test stand has been developed using standard APS control solutions with EPICS to deliver a flexible and comprehensive control system. The modularity of the system will allow both future expansion of test stand functionality and evaluation of new control techniques and solutions.Comment: Poster paper (TUAP015) at ICALEPCS 2001, 3 pages, 2 figures, pd

Simulated patients enhance discharge processes for patients with type 2 diabetes

As hospital lengths of stay are reduced and patients are organised to return home with the expectation of managing more complex issues, preparing patients and their families for discharge becomes more challenging. Patients with chronic health conditions, such as type 2 diabetes typically have poorer health outcomes post discharge and higher readmission rates (Peter et al. 2015). Preparing nurses to perform safe, complex patient discharge will likely lead to improved patient confidence in self-management, and potentially better outcomes

The Effects of Traditional Cigarette and E-Cigarette Taxes on Adult Tobacco Product Use

We study the effects of traditional cigarette tax rate changes and e-cigarette tax adoption on use of these products among US adults. Data are drawn from the Behavioral Risk Factor Surveillance System and National Health Interview Survey data over the period 2011to 2017. Using a difference-in-differences model, we find that higher traditional cigarette taxes reduce adult traditional cigarette use and increase adult e-cigarette use, suggesting that the products are economic substitutes. E-cigarette tax adoption reduces e-cigarette use, with some heterogeneity across groups, and dilutes the own-tax responsiveness of traditional cigarettes