GPs understanding of how depression affects gay and HIV positive men

In contrast to the broad literature on depression in the general population, little is known about the management of depression affecting gay men and HIV-positive men attending general practice clinics. GPs identified a range of features in their experience of managing depression in gay men and in HIV-positive men. Some were common to the care of other groups with depression, but this paper reports on features unique to this patient group. These include capitalizing on the high frequency of contact with this patient group, taking advantage of the specialist multidisciplinary teams who provide support, building upon the unusual willingness of this patient group to take medication, appreciating the central importance to many gay men of sexual functioning, and recreational drug use, responding to social isolation in this patient group and coping with increasing challenges for the HIV general practice workforce

Sustaining sexual and reproductive health through COVID-19 pandemic restrictions: qualitative interviews with Australian clinicians

Background. The sexual and reproductive health care of people with HIV and those at risk of HIV has largely been delivered face-to-face in Australia. These services adapted to the coronavirus disease 2019 (COVID-19) pandemic with a commitment to continued care despite major impacts on existing models and processes. Limited attention has been paid to understanding the perspectives of the sexual and reproductive health care workforce in the research on COVID-19 adaptations. Methods. Semi-structured interviews were conducted between June and September 2021 with 15 key informants representing a diverse range of service settings and professional roles in the Australian sexual and reproductive health sector. Inductive themes were generated through a process of reflexive thematic analysis, informed by our deductive interest in clinical adaptations. Results. The major adaptations were: triage (rapidly adapting service models to protect the most essential forms of care); teamwork (working together to overcome ongoing threats to service quality and staff wellbeing), and the intwined themes of telehealth and trust (remaining connected to marginalised communities through remote care). Despite impacts on care models and client relationships, there were sustained benefits from the scaleup of remote care, and attention to service safety, teamwork and communication. Conclusions. Attending to the experiences of those who worked at the frontline of the COVID-19 response provides essential insights to inform sustained, meaningful system reform over time. The coming years will provide important evidence of longer-term impacts of COVID-19 interruptions on both the users and providers of sexual and reproductive health services

Families Living with Blood-Borne Viruses: The Case for Extending the Concept of “Serodiscordance”

The concept of “serodiscordance” (mixed infection status) is primarily associated with epidemiological concerns about HIV transmission risk in couples. We make the case for extending this concept to include families with mixed HIV and viral hepatitis status. Social research on couples with mixed HIV and hepatitis C status has laid an important foundation for illuminating how experiences of serodiscordance within intimate partnerships are much broader than concerns about risk. This body of work attests to serodiscordance holding promise as a valuable concept for understanding viral infections as socially situated and intensely relational phenomena. However, serodiscordance is still limited as a concept because of its near universal focus on couples. It is rarely applied to wider relationships, including family networks beyond the couple. Despite evidence in the literature that families are affected by blood-borne viruses in multiple social, emotional, financial, and generational ways, the concept of serodiscordance does not capture these broader dynamics. Making serodiscordance more inclusive is an important step in recognising the diverse ways families’ everyday lives, relationships, and futures can be entangled with HIV, hepatitis C, and hepatitis B, and for understanding how today’s era of effective treatment options might shape the “family life” of viral infections

Hdelta-Selected Galaxies in the Sloan Digital Sky Survey I: The Catalog

[Abridged] We present here a new and homogeneous sample of 3340 galaxies selected from the Sloan Digital Sky Survey (SDSS) based solely on the observed strength of their Hdelta absorption line. These galaxies are commonly known as ``post-starburst'' or ``E+A'' galaxies, and the study of these galaxies has been severely hampered by the lack of a large, statistical sample of such galaxies. In this paper, we rectify this problem by selecting a sample of galaxies which possess an absorption Hdelta equivalent width of EW(Hdelta_max) - Delta EW(Hdelta_max) > 4A from 106682 galaxies in the SDSS. We have performed extensive tests on our catalog including comparing different methodologies of measuring the Hdelta absorption and studying the effects of stellar absorption, dust extinction, emission-filling and measurement error. The measured abundance of our Hdelta-selected (HDS) galaxies is 2.6 +/- 0.1% of all galaxies within a volume-limited sample of 0.05<z<0.1 and M(r*)<-20.5, which is consistent with previous studies of such galaxies in the literature. We find that only 25 of our HDS galaxies in this volume-limited sample (3.5+/-0.7%) show no evidence for OII and Halpha emission, thus indicating that true E+A (or k+a) galaxies are extremely rare objects at low redshift, i.e., only 0.09+/-0.02% of all galaxies in this volume-limited sample are true E+A galaxies. In contrast, 89+/-5% of our HDS galaxies in the volume-limited sample have significant detections of the OII and Halpha emission lines. We find 27 galaxies in our volume-limited HDS sample that possess no detectable OII emission, but do however possess detectable Halpha emission. These galaxies may be dusty star-forming galaxies. We provide the community with this new catalog of Hdelta-selected galaxies to aid in the understanding of these galaxies.Comment: Submitted to PASJ. Catalog of galaxies available at http://astrophysics.phys.cmu.edu/~tomo/ea

AEGIS: New Evidence Linking Active Galactic Nuclei to the Quenching of Star Formation

Utilizing Chandra X-ray observations in the All-wavelength Extended Groth Strip International Survey (AEGIS) we identify 241 X-ray selected Active Galactic Nuclei (AGNs, L > 10^{42} ergs/s) and study the properties of their host galaxies in the range 0.4 < z < 1.4. By making use of infrared photometry from Palomar Observatory and BRI imaging from the Canada-France-Hawaii Telescope, we estimate AGN host galaxy stellar masses and show that both stellar mass and photometric redshift estimates (where necessary) are robust to the possible contamination from AGNs in our X-ray selected sample. Accounting for the photometric and X-ray sensitivity limits of the survey, we construct the stellar mass function of X-ray selected AGN host galaxies and find that their abundance decreases by a factor of ~2 since z~1, but remains roughly flat as a function of stellar mass. We compare the abundance of AGN hosts to the rate of star formation quenching observed in the total galaxy population. If the timescale for X-ray detectable AGN activity is roughly 0.5-1 Gyr--as suggested by black hole demographics and recent simulations--then we deduce that the inferred AGN "trigger" rate matches the star formation quenching rate, suggesting a link between these phenomena. However, given the large range of nuclear accretion rates we infer for the most massive and red hosts, X-ray selected AGNs may not be directly responsible for quenching star formation.Comment: 12 pages. Submitted to ApJ. Comments welcom

How do self‐advocates use community development to change attitudes to disability?

Background Negative attitudes remain a major barrier to the equality of people with disability, especially when coupled with the lack of autonomy imposed on many people. This paper analyses how disability self‐advocacy groups seek to change community attitudes and work towards systemic change by mobilising knowledge from their lived experience. Methods The paper applies a cycle of praxis community development approach (a cycle of experience, learning and reflection, synthesis and planning, and implementation and review) to conceptualise and analyse their activities. The methods were a desktop document search, focus groups and reflective analysis with members of two self‐advocacy groups. Findings A synthesised data analysis found that applying the four‐part community development framework was useful to understand the practice and the purpose of work by self‐advocacy groups to change attitudes. The analysis also demonstrates the benefits for advocates and codesigned activities to intentionally apply the cycle of praxis model to guide their future efforts to change attitudes. Conclusions The research provides evidence that self‐advocacy groups achieve sustained impacts on attitudes in the community, beyond the direct benefit to their members. Government investment in self‐advocacy has potential to leverage wider system change in attitudes to achieve policy goals for the rights of people with disability. Methodologically, the research also has implications for the benefit of inclusive roles in reflective analysis to understand the lived experience of how practices contribute to system change. The design is an opportunity for inclusive researchers to intentionally incorporate reflective analysis into research processes

Experiences in managing problematic crystal methamphetamine use and associated depression in gay men and HIV positive men: in-depth interviews with general practitioners in Sydney, Australia

© 2008 Saltman et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background This paper describes the experiences of Australian general practitioners (GPs) in managing problematic crystal methamphetamine (crystal meth) use among two groups of male patients: gay men and HIV positive men. Methods Semi-structured qualitative interviews with GPs with HIV medication prescribing rights were conducted in Sydney, Adelaide and a rural-coastal town in New South Wales between August and October 2006. Participants were recruited from practices with high caseloads of gay and HIV positive men. Results Sixteen GPs were recruited from seven practices to take part in interviews. Participants included 14 male GPs and two female GPs, and the number of years each had been working in HIV medicine ranged from two to 24. Eleven of the GPs who were based in Sydney raised the issue of problematic crystal meth use in these two patient populations. Five key themes were identified: an increasing problem; associations with depression; treatment challenges; health services and health care; workforce issues. Conclusion Despite study limitations, key implications can be identified. Health practitioners may benefit from broadening their understandings of how to anticipate and respond to problematic levels of crystal meth use in their patients. Early intervention can mitigate the impact of crystal meth use on co-morbid mental illness and other health issues. Management of the complex relationships between drug use, depression, sexuality and HIV can be addressed following a 'stepped care' approach. General practice guidelines for the management of crystal meth use problems should address specific issues associated with gay men and HIV positive men. GPs and other health practitioners must appreciate drug use as a social practice in order to build trust with gay men to encourage full disclosure of drug use. Education programs should train health practitioners in these issues, and increased resourcing provided to support the often difficult task of caring for people who use crystal meth. Greater resourcing of acute care and referral services can shift the burden away from primary care and community services. Further investigation should consider whether these findings are reproducible in other general practice settings, the relationship between depression, drug use and HIV medication, and challenges facing the HIV general practice workforce in Australia

Investigating the lived experience of LGBT+ people with dementia and their care partners: a scoping review

Dementia, a global health priority, poses a disproportionately high risk to lesbian, gay, bisexual and trans plus (LGBT+)/gender and sexuality diverse people. Despite this, little research has explored the lived experience of LGBT+ people with dementia or their care partners. This scoping review aims to understand what the literature reveals about their experiences, the ways in which their lives have been investigated, to inform future research, policy and practice. Using an established scoping review methodology, we identified seven papers that reported empirical research on the lived experience of LGBT+ people with dementia and their care partners. Only a single study reported on in two of the papers included people who were trans. This in itself reveals how rarely LGBT+ people are asked to speak about how dementia has shaped their lives in academic research. Our reflexive thematic analysis indicates that LGBT+ people with dementia and their care partners endure overlapping forms of disadvantage. This results in heightened experiences of fear and discrimination, lack of services and compounded social isolation. Importantly, while dementia was embodied as interference and loss by LGBT+ people, it was their gender and sexuality differences that provided solace, even in the face of disadvantage. Importantly, people's relationships with LGBT+ identities were framed as fundamental for safety, resilience and wellbeing, rather than a complicating or confounding factor in living with dementia

A Lyman-alpha-only AGN from the Sloan Digital Sky Survey

The Sloan Digital Sky Survey has discovered a z=2.4917 radio-loud active galactic nucleus (AGN) with a luminous, variable, low-polarization UV continuum, H I two-photon emission, and a moderately broad Lyman-alpha line (FWHM = 1430 km/s) but without obvious metal-line emission. SDSS J113658.36+024220.1 does have associated metal-line absorption in three distinct, narrow systems spanning a velocity range of 2710 km/s. Despite certain spectral similarities, SDSS J1136+0242 is not a Lyman-break galaxy. Instead, the Ly-alpha and two-photon emission can be attributed to an extended, low-metallicity narrow-line region. The unpolarized continuum argues that we see SDSS J1136+0242 very close to the axis of any ionization cone present. We can conceive of two plausible explanations for why we see a strong UV continuum but no broad-line emission in this `face-on radio galaxy' model for SDSS J1136+0242: the continuum could be relativistically beamed synchrotron emission which swamps the broad-line emission; or, more likely, SDSS J1136+0242 could be similar to PG 1407+265, a quasar in which for some unknown reason the high-ionization emission lines are very broad, very weak, and highly blueshifted.Comment: AJ, in press, 10 pages emulateapj forma