Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

'At the hospital I learnt the truth': diagnosing male infertility in rural Malawi

This paper examines how men's reproductive bodies are problematised in rural northern Malawi as access to biomedically defined diagnoses of the health of men's sperm contribute to the visibility of male infertility. Ethnographic research with infertile and fertile men explored pathways into the sexual health and fertility services offered in district hospitals, men's clinical engagements and masculine imaginaries. The research suggested that men's willingness to be referred for semen analysis is an extension of intensive and persistent help-seeking for childlessness instigated by couples and encouraged by families. Within the laboratory, acceptable social arrangements for semen sample collection are negotiated between male clients and laboratory staff, which emphasise heterosexual and marital virility. Following diagnosis, counselling by clinical officers, without any significant therapeutic interventions, focuses on compassion in marriage. This paper considers: what is the role of semen analysis within public health facilities and why do men participate? How do men experience an infertility diagnosis and what do they and their partners do with this knowledge? In addition, how do these practices shape gendered relationships in families and communities? The analysis builds on Inhorn's (2012) concept of ‘emergent masculinities’ to better understand the connections between male subjectivities, medical technologies and the globalisation of male reproductive health, as they relate to men's lives in rural Malawi

The transformation of photography, memory and the domestic interior: an ethnographic study of the representational, memorial and ancestral practices of South London householders

This thesis describes the interdependence of visual and material cultures in the home and seeks to understand of the place of structures of mass consumption and mass visual communication in the making of personhood. It brings together the study of the photograph with that of the memento and the collection. Through an eighteen-month ethnography of eighty households in South London, material culture categories and consumer genres are dissolved in favour of exploring the precise relationships between images and objects in the representational, memorial and ancestral practices that establish kinship and friendship, and shape experiences of migration and belonging, death and memory. Cross-cultural comparison sheds light on the themes of inalienability, memory, materiality, reproduction and ancestralisation. In particular, works on photography in non-Western settings have established its ‘other histories’, embedding photography in everyday social and ritual lives. Turning to the Euro-American cultural region, this thesis abandons the search to define the essence of ‘the photograph’, offering instead a guide to the range of practices in which specific types of photographic images and mementos establish the sociality, time and memory of households in Britain. The thesis transforms the photograph as an object of analysis, shifting the gaze from the image-in-itself to its place among the sensuous materials and values of the interior. Secondly, it explores the consequences of the labour that householders invest in the material transformation of memory and experience. This is summarised in the three parts of the thesis as the work of display, collection and dispersal. This perspective develops the theorisation of the mutual implication of images, objects and persons in establishing different forms of knowledge and community, illuminates relations between domestic, museum and consumer landscapes, and allows for the productive convergence of new and established anthropological literatures