Experiences of treatment and sexuality for women with cervical cancer

What is the experience of cancer treatment and sexuality after treatment for women with cervical cancer? Although the number of women with cervical cancer is low in North America, the potential for sexually devastating treatment side effects is high. Eleven women, aged 33 to 71, were interviewed from April to August 2008 using a qualitative research design intended to capture their subjective experience. All women had received treatment from 2003 to 2008 at a small cancer centre in Ontario. Most women felt an ongoing loss of sexual pleasure and desire, and several experienced continuing pain and discomfort during intercourse. Although individual experiences varied, all women found brachytherapy treatment, which was administered without sedation at this centre, difficult and some women implicated the trauma of this treatment in later sexual problems. Women felt that more comprehensive information and support may improve women\u27s treatment and sexual experience

Refugees International: A Case Study on NGO Advocacy to Venerate Nationality Rights

Resolution of one of the world’s most persistent human rights problems is finally within reach. In the campaign to fulfill the right to nationality and end statelessness, non-governmental organizations (NGOs) and civil society are at the forefront of ensuring change. We have come to understand that effective strategies to end this injustice require not only changes in laws and norms, but such action must be partnered with focused, ceaseless and well-timed research and advocacy. As a result of multifarious efforts, countries such as Bangladesh, Mauritania, Nepal and Sri Lanka have made significant strides in ensuring nationality rights. The response of UN agencies has improved. And media attention has increased. Governments, international agencies, NGOs, legal experts, scientists and the stateless themselves are joining forces as never before. Yet, at the same time, challenges to uphold nationality rights for all may never have been greater than they are today. This article reflects on the re-emergence of statelessness as a global concern, the role of one NGO in a multifaceted movement, and the exigent path that lies ahead

The Library Ireland Week (LIW) job swop initiative Experiences from Maynooth University Library

Each year, as part of Library Ireland Week (LIW), Irish libraries are encouraged to engage in job swops. This initiative, championed by the Library Association of Ireland (LAI) (https://libraryassociation.ie/) is straightforward, with individual libraries organising swops and absorbing any costs involved. This article describes the experiences of six library assistants from Maynooth University (MU) (https://www.maynoothuniversity.ie/library) Ireland, who participated in job swop

Remifentanil patient controlled analgesia versus epidural analgesia in labour. A multicentre randomized controlled trial

Contains fulltext : 109349.pdf (publisher's version ) (Open Access)ABSTRACT: BACKGROUND: Pain relief during labour is a topic of major interest in the Netherlands. Epidural analgesia is considered to be the most effective method of pain relief and recommended as first choice. However its uptake by pregnant women is limited compared to other western countries, partly as a result of non-availability due to logistic problems. Remifentanil, a synthetic opioid, is very suitable for patient controlled analgesia. Recent studies show that epidural analgesia is superior to remifentanil patient controlled analgesia in terms of pain intensity score; however there was no difference in satisfaction with pain relief between both treatments. METHODS/DESIGN: The proposed study is a multicentre randomized controlled study that assesses the cost-effectiveness of remifentanil patient controlled analgesia compared to epidural analgesia. We hypothesize that remifentanil patient controlled analgesia is as effective in improving pain appreciation scores as epidural analgesia, with lower costs and easier achievement of 24 hours availability of pain relief for women in labour and efficient pain relief for those with a contraindication for epidural analgesia.Eligible women will be informed about the study and randomized before active labour has started. Women will be randomly allocated to a strategy based on epidural analgesia or on remifentanil patient controlled analgesia when they request pain relief during labour. Primary outcome is the pain appreciation score, i.e. satisfaction with pain relief.Secondary outcome parameters are costs, patient satisfaction, pain scores (pain-intensity), mode of delivery and maternal and neonatal side effects.The economic analysis will be performed from a short-term healthcare perspective. For both strategies the cost of perinatal care for mother and child, starting at the onset of labour and ending ten days after delivery, will be registered and compared. DISCUSSION: This study, considering cost effectiveness of remifentanil as first choice analgesia versus epidural analgesia, could strongly improve the care for 180.000 women, giving birth in the Netherlands yearly by giving them access to pain relief during labour, 24 hours a day. TRIAL REGISTRATION NUMBER: Dutch Trial Register NTR2551, http://www.trialregister.nl

"A Sort of Rathmines Version of a Dior Design": Maeve Brennan, Self-Fashioning, and the Uses of Style

This article explores the politics of style in the writing of Maeve Brennan. Brennan's concern with style, subjectivity and power is strikingly visible in her short stories and ‘Talk of the Town’ essays for the New Yorker. While in some of her short stories published in the New Yorker in the 1950s, Brennan seems to offer an extended critique of dandyism, elsewhere in her writing self-fashioning takes on an altogether more positive value and is steeped in the political as well as literary commitments of her work. The article argues that Brennan's interest in the politics of style, both personally and in her writing, is informed by the different strategies she deployed as an Irish woman writer establishing her place amongst a New York literary elite in the mid twentieth century.This work began as a conversation with Neil Sammells about Irish women's writing and self-fashioning, and his encouragement and insightful responses to ideas in development were invaluable to the progress of the research. I am also very grateful to Maureen O'Connor and Caitríona Clear, whose work on the Irish woman writer and dandyism, and women and magazine culture, lays an all-important foundation for the arguments developed here. Archival research for the article was made possible by a Fulbright Scholarship in the Humanities (September 2012—January 2013), and I am most grateful to my host institution, Fordham University in New York. I would like to thank the literary estate of Maeve Brennan for kind permission to cite from Maeve Brennan's letters and unpublished material held in the Special Collections at the University of Delaware and the Manuscripts and Archives Division of the New York Public Library. The work was completed with the assistance of a Moore Institute Visiting Fellowship to the National University of Ireland, Galway in 2015, which provided a valuable opportunity to present work in progress as part of the seminar series hosted by the Centre for Irish Studies. Finally, I am grateful to the anonymous peer reviewers and editors at Women: A Cultural Review for their thorough and expert responses to the article

A large-scale genome-wide association study meta-analysis of cannabis use disorder

Summary Background Variation in liability to cannabis use disorder has a strong genetic component (estimated twin and family heritability about 50–70%) and is associated with negative outcomes, including increased risk of psychopathology. The aim of the study was to conduct a large genome-wide association study (GWAS) to identify novel genetic variants associated with cannabis use disorder. Methods To conduct this GWAS meta-analysis of cannabis use disorder and identify associations with genetic loci, we used samples from the Psychiatric Genomics Consortium Substance Use Disorders working group, iPSYCH, and deCODE (20 916 case samples, 363 116 control samples in total), contrasting cannabis use disorder cases with controls. To examine the genetic overlap between cannabis use disorder and 22 traits of interest (chosen because of previously published phenotypic correlations [eg, psychiatric disorders] or hypothesised associations [eg, chronotype] with cannabis use disorder), we used linkage disequilibrium score regression to calculate genetic correlations. Findings We identified two genome-wide significant loci: a novel chromosome 7 locus (FOXP2, lead single-nucleotide polymorphism [SNP] rs7783012; odds ratio [OR] 1·11, 95% CI 1·07–1·15, p=1·84 × 10−9) and the previously identified chromosome 8 locus (near CHRNA2 and EPHX2, lead SNP rs4732724; OR 0·89, 95% CI 0·86–0·93, p=6·46 × 10−9). Cannabis use disorder and cannabis use were genetically correlated (rg 0·50, p=1·50 × 10−21), but they showed significantly different genetic correlations with 12 of the 22 traits we tested, suggesting at least partially different genetic underpinnings of cannabis use and cannabis use disorder. Cannabis use disorder was positively genetically correlated with other psychopathology, including ADHD, major depression, and schizophrenia. Interpretation These findings support the theory that cannabis use disorder has shared genetic liability with other psychopathology, and there is a distinction between genetic liability to cannabis use and cannabis use disorder. Funding National Institute of Mental Health; National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse; Center for Genomics and Personalized Medicine and the Centre for Integrative Sequencing; The European Commission, Horizon 2020; National Institute of Child Health and Human Development; Health Research Council of New Zealand; National Institute on Aging; Wellcome Trust Case Control Consortium; UK Research and Innovation Medical Research Council (UKRI MRC); The Brain & Behavior Research Foundation; National Institute on Deafness and Other Communication Disorders; Substance Abuse and Mental Health Services Administration (SAMHSA); National Institute of Biomedical Imaging and Bioengineering; National Health and Medical Research Council (NHMRC) Australia; Tobacco-Related Disease Research Program of the University of California; Families for Borderline Personality Disorder Research (Beth and Rob Elliott) 2018 NARSAD Young Investigator Grant; The National Child Health Research Foundation (Cure Kids); The Canterbury Medical Research Foundation; The New Zealand Lottery Grants Board; The University of Otago; The Carney Centre for Pharmacogenomics; The James Hume Bequest Fund; National Institutes of Health: Genes, Environment and Health Initiative; National Institutes of Health; National Cancer Institute; The William T Grant Foundation; Australian Research Council; The Virginia Tobacco Settlement Foundation; The VISN 1 and VISN 4 Mental Illness Research, Education, and Clinical Centers of the US Department of Veterans Affairs; The 5th Framework Programme (FP-5) GenomEUtwin Project; The Lundbeck Foundation; NIH-funded Shared Instrumentation Grant S10RR025141; Clinical Translational Sciences Award grants; National Institute of Neurological Disorders and Stroke; National Heart, Lung, and Blood Institute; National Institute of General Medical Sciences.Peer reviewe

Association of the OPRM1 Variant rs1799971 (A118G) with Non-Specific Liability to Substance Dependence in a Collaborative de novo Meta-Analysis of European-Ancestry Cohorts

Peer reviewe

Case Reports1. A Late Presentation of Loeys-Dietz Syndrome: Beware of TGFβ Receptor Mutations in Benign Joint Hypermobility

Background: Thoracic aortic aneurysms (TAA) and dissections are not uncommon causes of sudden death in young adults. Loeys-Dietz syndrome (LDS) is a rare, recently described, autosomal dominant, connective tissue disease characterized by aggressive arterial aneurysms, resulting from mutations in the transforming growth factor beta (TGFβ) receptor genes TGFBR1 and TGFBR2. Mean age at death is 26.1 years, most often due to aortic dissection. We report an unusually late presentation of LDS, diagnosed following elective surgery in a female with a long history of joint hypermobility. Methods: A 51-year-old Caucasian lady complained of chest pain and headache following a dural leak from spinal anaesthesia for an elective ankle arthroscopy. CT scan and echocardiography demonstrated a dilated aortic root and significant aortic regurgitation. MRA demonstrated aortic tortuosity, an infrarenal aortic aneurysm and aneurysms in the left renal and right internal mammary arteries. She underwent aortic root repair and aortic valve replacement. She had a background of long-standing joint pains secondary to hypermobility, easy bruising, unusual fracture susceptibility and mild bronchiectasis. She had one healthy child age 32, after which she suffered a uterine prolapse. Examination revealed mild Marfanoid features. Uvula, skin and ophthalmological examination was normal. Results: Fibrillin-1 testing for Marfan syndrome (MFS) was negative. Detection of a c.1270G > C (p.Gly424Arg) TGFBR2 mutation confirmed the diagnosis of LDS. Losartan was started for vascular protection. Conclusions: LDS is a severe inherited vasculopathy that usually presents in childhood. It is characterized by aortic root dilatation and ascending aneurysms. There is a higher risk of aortic dissection compared with MFS. Clinical features overlap with MFS and Ehlers Danlos syndrome Type IV, but differentiating dysmorphogenic features include ocular hypertelorism, bifid uvula and cleft palate. Echocardiography and MRA or CT scanning from head to pelvis is recommended to establish the extent of vascular involvement. Management involves early surgical intervention, including early valve-sparing aortic root replacement, genetic counselling and close monitoring in pregnancy. Despite being caused by loss of function mutations in either TGFβ receptor, paradoxical activation of TGFβ signalling is seen, suggesting that TGFβ antagonism may confer disease modifying effects similar to those observed in MFS. TGFβ antagonism can be achieved with angiotensin antagonists, such as Losartan, which is able to delay aortic aneurysm development in preclinical models and in patients with MFS. Our case emphasizes the importance of timely recognition of vasculopathy syndromes in patients with hypermobility and the need for early surgical intervention. It also highlights their heterogeneity and the potential for late presentation. Disclosures: The authors have declared no conflicts of interes

Shared genetic risk between eating disorder- and substance-use-related phenotypes:Evidence from genome-wide association studies

First published: 16 February 202