29 research outputs found
"I don't want to be seen as a screaming queen": an interpretative phenomenological analysis of gay men's masculine identities
It has been argued that gay men who live in Western societies must negotiate masculine identities against a cultural backdrop where the most desirable and locally hegemonic masculinity is heterosexual. However, contemporary masculinity theories conceptualize masculinities as increasingly inclusive of gay men. The purpose of this study was to use a discourse-dynamic approach to studying masculine subjectivity to identify how gay men in England and Wales negotiated masculinity discourses to construct their masculine identities. One-to-one, semi-structured interviews were undertaken with six younger gay men aged 20 to 24, and 11 older gay men aged 30 to 42. Participants were asked to describe their subjective experiences of masculinity. The results of an Interpretative Phenomenological Analysis indicated that discourses of hegemonic and alternative masculinities had implications for lived experiences of masculinity. Older participants in particular emphasized their attributes they associated with masculine dominance, including anti-effeminacy attitudes. The majority of younger participants did not feel masculine. Irrespective of age, many participants resisted hegemonic masculinity by highlighting the value of “gayness” at times. The findings suggested that hegemonic masculinity was the most readily available discourse for conceptualizing masculinity, but that lived experiences of masculinity were not necessarily located within this discourse
'There’s too many gay categories now': discursive constructions of gay masculinity
“Masculine capital” refers to the social power afforded by the display of traits and behaviors that are associated with orthodox, stereotypical masculinity. Men who are concerned with their masculine identity may utilize these traits and behaviors to increase their overall masculine capital, and to mitigate “failures” in other domains of masculinity. However, their success at accruing and trading masculine capital may be limited, because different traits and behaviors are not equal in the capital they convey, and their value may vary depending on the social context in which they are deployed. Research suggests that heterosexuality contributes more to masculine capital than other stereotypically masculine characteristics: The possibilities for gay men to accrue and trade masculine capital may therefore be particularly limited, especially in heteronormative contexts. Focus groups were undertaken with gay men, straight women and straight men living in a coastal city in the south of England to explore discursive constructions of gay masculinity, and to examine gay men’s possibilities for accruing and trading masculine capital. Discourse analysis identified constructions of gay masculinity in reference to hegemonic masculinity, where gay men may acquire masculine capital in similar ways to straight men. However, the meaning and value of this capital may also vary, because certain characteristics and behaviors may have different value for and between gay men than they do for straight men, and in heteronormative contexts. The analysis also identified discourses of gay masculinity where it was not constructed as a singular entity, but rather as complex, multiple and diverse
Recommended from our members
Quantitative comparative analysis of human erythrocyte surface proteins between individuals from two genetically distinct populations
Abstract: Red blood cells (RBCs) play a critical role in oxygen transport, and are the focus of important diseases including malaria and the haemoglobinopathies. Proteins at the RBC surface can determine susceptibility to disease, however previous studies classifying the RBC proteome have not used specific strategies directed at enriching cell surface proteins. Furthermore, there has been no systematic analysis of variation in abundance of RBC surface proteins between genetically disparate human populations. These questions are important to inform not only basic RBC biology but additionally to identify novel candidate receptors for malarial parasites. Here, we use ‘plasma membrane profiling’ and tandem mass tag-based mass spectrometry to enrich and quantify primary RBC cell surface proteins from two sets of nine donors from the UK or Senegal. We define a RBC surface proteome and identify potential Plasmodium receptors based on either diminished protein abundance, or increased variation in RBCs from West African individuals
Human cytomegalovirus interactome analysis identifies degradation hubs, domain associations and viral protein functions
Human cytomegalovirus (HCMV) extensively modulates host cells, downregulating >900 human proteins during viral replication and degrading ≥133 proteins shortly after infection. The mechanism of degradation of most host proteins remains unresolved, and the functions of many viral proteins are incompletely characterised. We performed a mass spectrometry-based interactome analysis of 169 tagged, stably-expressed canonical strain Merlin HCMV proteins, and two non-canonical HCMV proteins, in infected cells. This identified a network of >3,400 virus-host and >150 virus-virus protein interactions, providing insights into functions for multiple viral genes. Domain analysis predicted binding of the viral UL25 protein to SH3 domains of NCK Adaptor Protein-1. Viral interacting proteins were identified for 31/133 degraded host targets. Finally, the uncharacterised, non-canonical ORFL147C protein was found to interact with elements of the mRNA splicing machinery, and a mutational study suggested its importance in viral replication. The interactome data will be important for future studies of herpesvirus infection
Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial
Background
Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy
Prehospital transdermal glyceryl trinitrate in patients with ultra-acute presumed stroke (RIGHT-2): an ambulance-based, randomised, sham-controlled, blinded, phase 3 trial
Background
High blood pressure is common in acute stroke and is a predictor of poor outcome; however, large trials of lowering blood pressure have given variable results, and the management of high blood pressure in ultra-acute stroke remains unclear. We investigated whether transdermal glyceryl trinitrate (GTN; also known as nitroglycerin), a nitric oxide donor, might improve outcome when administered very early after stroke onset.
Methods
We did a multicentre, paramedic-delivered, ambulance-based, prospective, randomised, sham-controlled, blinded-endpoint, phase 3 trial in adults with presumed stroke within 4 h of onset, face-arm-speech-time score of 2 or 3, and systolic blood pressure 120 mm Hg or higher. Participants were randomly assigned (1:1) to receive transdermal GTN (5 mg once daily for 4 days; the GTN group) or a similar sham dressing (the sham group) in UK based ambulances by paramedics, with treatment continued in hospital. Paramedics were unmasked to treatment,
whereas participants were masked. The primary outcome was the 7-level modified Rankin Scale (mRS; a measure of functional outcome) at 90 days, assessed by central telephone follow-up with masking to treatment. Analysis was hierarchical, first in participants with a confirmed stroke or transient ischaemic attack (cohort 1), and then in all participants who were randomly assigned (intention to treat, cohort 2) according to the statistical analysis plan. This trial is registered with ISRCTN, number ISRCTN26986053.
Findings
Between Oct 22, 2015, and May 23, 2018, 516 paramedics from eight UK ambulance services recruited 1149 participants (n=568 in the GTN group, n=581 in the sham group). The median time to randomisation was 71 min (IQR 45–116). 597 (52%) patients had ischaemic stroke, 145 (13%) had intracerebral haemorrhage, 109 (9%) had transient ischaemic attack, and 297 (26%) had a non-stroke mimic at the final diagnosis of the index event. In the GTN group, participants’ systolic blood pressure was lowered by 5·8 mm Hg compared with the sham group (p<0·0001), and diastolic blood pressure was lowered by 2·6 mm Hg (p=0·0026) at hospital admission. We found no difference in mRS between the groups in participants with a final diagnosis of stroke or transient ischaemic stroke (cohort 1): 3 (IQR 2–5; n=420) in the GTN group versus 3 (2–5; n=408) in the sham group, adjusted common odds ratio for poor outcome 1·25 (95% CI 0·97–1·60; p=0·083); we also found no difference in mRS between all patients (cohort 2: 3 [2–5]; n=544, in the GTN group vs 3 [2–5]; n=558, in the sham group; 1·04 [0·84–1·29]; p=0·69). We found no difference in secondary outcomes, death (treatment-related deaths: 36 in the GTN group vs 23 in the sham group [p=0·091]), or serious adverse events (188 in the GTN group vs 170 in the sham group [p=0·16]) between treatment groups.
Interpretation
Prehospital treatment with transdermal GTN does not seem to improve functional outcome in patients with presumed stroke. It is feasible for UK paramedics to obtain consent and treat patients with stroke in the ultraacute prehospital setting.
Funding British Heart Foundation
Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial
Background
Results of small trials indicate that fluoxetine might improve functional outcomes after stroke. The FOCUS trial aimed to provide a precise estimate of these effects.
Methods
FOCUS was a pragmatic, multicentre, parallel group, double-blind, randomised, placebo-controlled trial done at 103 hospitals in the UK. Patients were eligible if they were aged 18 years or older, had a clinical stroke diagnosis, were enrolled and randomly assigned between 2 days and 15 days after onset, and had focal neurological deficits. Patients were randomly allocated fluoxetine 20 mg or matching placebo orally once daily for 6 months via a web-based system by use of a minimisation algorithm. The primary outcome was functional status, measured with the modified Rankin Scale (mRS), at 6 months. Patients, carers, health-care staff, and the trial team were masked to treatment allocation. Functional status was assessed at 6 months and 12 months after randomisation. Patients were analysed according to their treatment allocation. This trial is registered with the ISRCTN registry, number ISRCTN83290762.
Findings
Between Sept 10, 2012, and March 31, 2017, 3127 patients were recruited. 1564 patients were allocated fluoxetine and 1563 allocated placebo. mRS data at 6 months were available for 1553 (99·3%) patients in each treatment group. The distribution across mRS categories at 6 months was similar in the fluoxetine and placebo groups (common odds ratio adjusted for minimisation variables 0·951 [95% CI 0·839–1·079]; p=0·439). Patients allocated fluoxetine were less likely than those allocated placebo to develop new depression by 6 months (210 [13·43%] patients vs 269 [17·21%]; difference 3·78% [95% CI 1·26–6·30]; p=0·0033), but they had more bone fractures (45 [2·88%] vs 23 [1·47%]; difference 1·41% [95% CI 0·38–2·43]; p=0·0070). There were no significant differences in any other event at 6 or 12 months.
Interpretation
Fluoxetine 20 mg given daily for 6 months after acute stroke does not seem to improve functional outcomes. Although the treatment reduced the occurrence of depression, it increased the frequency of bone fractures. These results do not support the routine use of fluoxetine either for the prevention of post-stroke depression or to promote recovery of function.
Funding
UK Stroke Association and NIHR Health Technology Assessment Programme
Recommended from our members
“You Don’t Even Get a Hug”: Sexuality and Relational Security in Secure Mental Healthcare
Relational security in secure mental healthcare can be conceptualised as an outcome of social climate—the physical conditions of the wards and the social relationships that play out within them. Staff knowledge and understanding of patients is seen as key to maintaining relational security, by facilitating staff responsivity and personalised care. Discussions of relational security focus principally on patients’ therapeutic relationships and less so on their relationships with other patients and visitors, which are policed closely within discourses of appropriateness and vulnerability. Patients’ needs and desires for emotional and physical intimacy are typically overlooked in daily ward life, academic enquiry, and clinical praxis. This chapter describes the experiences of two patients interviewed for our research into intimate and sexual relationality in forensic mental healthcare facilities in England. A case is presented for the development of policies that honour the intimate relational and sexual needs of people in secure care. It is argued that an absence of such policies and a culture of stringent sexual regulation produce disordered sexualities, enacted by patients in subversive and secretive ways. This poses a threat to relational security and is conducive to neither the formation of effective intimate relationships nor recovery from mental distress
Recommended from our members
Quantitative comparative analysis of human erythrocyte surface proteins between individuals from two genetically distinct populations
Abstract: Red blood cells (RBCs) play a critical role in oxygen transport, and are the focus of important diseases including malaria and the haemoglobinopathies. Proteins at the RBC surface can determine susceptibility to disease, however previous studies classifying the RBC proteome have not used specific strategies directed at enriching cell surface proteins. Furthermore, there has been no systematic analysis of variation in abundance of RBC surface proteins between genetically disparate human populations. These questions are important to inform not only basic RBC biology but additionally to identify novel candidate receptors for malarial parasites. Here, we use ‘plasma membrane profiling’ and tandem mass tag-based mass spectrometry to enrich and quantify primary RBC cell surface proteins from two sets of nine donors from the UK or Senegal. We define a RBC surface proteome and identify potential Plasmodium receptors based on either diminished protein abundance, or increased variation in RBCs from West African individuals
Recommended from our members
Human cytomegalovirus interactome analysis identifies degradation hubs, domain associations and viral protein functions
Human cytomegalovirus (HCMV) extensively modulates host cells, downregulating >900 human proteins during viral replication and degrading ≥133 proteins shortly after infection. The mechanism of degradation of most host proteins remains unresolved, and the functions of many viral proteins are incompletely characterised. We performed a mass spectrometry-based interactome analysis of 169 tagged, stably-expressed canonical strain Merlin HCMV proteins, and two non-canonical HCMV proteins, in infected cells. This identified a network of >3400 virus-host and >150 virus-virus protein interactions, providing insights into functions for multiple viral genes. Domain analysis predicted binding of the viral UL25 protein to SH3 domains of NCK Adaptor Protein-1. Viral interacting proteins were identified for 31/133 degraded host targets. Finally, the uncharacterised, non-canonical ORFL147C protein was found to interact with elements of the mRNA splicing machinery, and a mutational study suggested its importance in viral replication. The interactome data will be important for future studies of herpesvirus infection