The response to receiving phenotypic and genetic coronary heart disease risk scores and lifestyle advice – a qualitative study

BACKGROUND: Individuals routinely receive information about their risk of coronary heart disease (CHD) based on traditional risk factors as part of their primary care. We are also able to calculate individual's risk of CHD based on their genetic information and at present genetic testing for common diseases is available to the public. Due to the limitations in previous studies further understanding is needed about the impact of the risk information on individual's well-being and health-behaviour. We aimed to explore the short term response to receiving different forms of CHD risk information and lifestyle advice for risk reduction. METHODS: We conducted fourty-one face-to-face interviews and two focus groups across England with participants from the INFORM trial who received a combination of individualised phenotypic and genotypic CHD risk scores and web-based lifestyle advice. Risk scores were presented in different formats, e.g. absolute 10 year risk was presented as a thermometer and expressed as a percentage, natural frequency and 'heart age'. Interviews and focus groups explored participants' understanding and reaction to the risk scores and attempts to change lifestyle during the intervention. We tape-recorded and transcribed the interviews and focus groups and analysed them using thematic analysis. RESULTS: Three main themes were identified: limitations of risk scores to generate concern about CHD risk; the advantages of the 'heart age' format of risk score presentation in communicating a message of sub-optimal lifestyle; and intentions and attempts to make moderate lifestyle changes which were prompted by the web-based lifestyle advice. CONCLUSIONS: There are a number of limitations to the use of risk scores to communicate a message about the need for a lifestyle change. Of the formats used, the 'heart age', if noticed, appears to convey the most powerful message about how far from optimal risk an individual person is. An interactive, user friendly, goal setting based lifestyle website can act as a trigger to initiate moderate lifestyle changes, regardless of concerns about risk scores.INFORM is funded by European Commission Framework 7 EPIC-CVD Grant agreement no: 279233. NHS Blood and Transplant funded the INTERVAL trial. DNA extraction and genotyping in INTERVAL/INFORM was funded by the UK National Institute of Health Research. The coordinating team for INTERVAL/INFORM at the Cardiovascular Epidemiology Unit of the University of Cambridge was supported by core funding from: UK Medical Research Council (G0800270), British Heart Foundation (SP/09/002), British Heart Foundation Cambridge Cardiovascular Centre of Excellence, and UK National Institute for Health Research Cambridge Biomedical Research Centre

Student accounts of space and safety at a South African university: implications for social identities and diversity

Transformation efforts in South African higher education have been under increased scrutiny in recent years, especially following the last years of student activism and calls for decolonization of universities. This article presents data from a participatory photovoice study in which a group of students reflect on their experiences of feeling safe and unsafe at an urban-based historically disadvantaged university. Findings highlight the way in which historical inequalities on the basis of social identities of race, class, and gender, among others, continue to shape experiences, both materially and social-psychologically, in South African higher education. However, and of particular relevance in thinking about a socially just university, participants speak about the value of diversity in facilitating their sense of both material and subjective safety. Thus, a diverse classroom and one that acknowledges and recognizes students across diversities, is experienced as a space of comfort, belonging and safety. Drawing on feminist work on social justice, we argue the importance of lecturer sensitivity and reflexivity to their own practices, as well as the value of social justice pedagogies that not only focus on issues of diversity and equality but also destabilize dominant forms of didactic pedagogy, and engage students’ diverse experiences and perceptions

Who needs a father? South African men reflect on being fathered

The legacy of apartheid and continued social and economic change have meant that many South African men and women have grown up in families from which biological fathers are missing. In both popular and professional knowledge and practice this has been posed as inherently a problem particularly for boys who are assumed to lack a positive male role model. In drawing on qualitative interviews with a group of South African men in which they speak about their understandings of being fathered as boys, this paper makes two key arguments. The first is that contemporary South African discourses tend to pathologize the absence of the biological father while simultaneously undermining the role of social fathers. Yet, this study shows that in the absence of biological fathers other men such as maternal or paternal uncles, grandfathers, neighbours, and teachers often serve as social fathers. Most of the men who participated in this study are able to identify men who - as social rather than biological fathers - played significant roles in their lives. Secondly, we suggest that while dominant discourses around social fatherhood foreground authoritarian and controlling behaviours, there are moments when alternative more nurturing and consultative versions of being a father and/or being fathered are evident in the experiences of this group of men.IS

Conception of low-rise earthquake-resistant energy-efficient buildings

The article proposes a new earthquake-resistant technology of low-rise building with increased energy efficiency and long-life operation. The proposed solution allows to build low-rise buildings with increased resistance to natural and man-made disasters. The building is frame (made of tube-concrete) and also completely monolithic, where foundation, all walls, floors and roof are filled of polystirolconcrete (composed of concrete and polystyrene), which forms a monolithic construction

Masculinity, sexuality and vulnerability in 'working' with young men in South African contexts: 'you feel like a fool and an idiot...a loser'

South Africa has seen a rapid increase in scholarship and programmatic interventions focusing on gender and sexuality, and more recently on boys, men and masculinities. In this paper, we argue that a deterministic discourse on men's sexuality and masculinity in general is inherent in many current understandings of adolescent male sexuality, which tend to assume that young women are vulnerable and powerless and young men are sexually powerful and inevitably also the perpetrators of sexual violence. Framed within a feminist, social constructionist the oretical perspective, the current research looked at how the masculinity and sexuality of South African young men is constructed, challenged or maintained. Focus groups were conducted with young men between the ages of 15 and 20 years from five different schools in two regions of South Africa, the Western and Eastern Cape. Data were analysed using Gilligan's listening guide method. Findings suggest that participants in this study have internalised the notion of themselves as dangerous, but were also exploring other possible ways of being male and being sexual, demonstrating more complex experiences of manhood. We argue for the importance of documenting and highlighting the precariousness, vulnerability and uncertainty of young men in scholarly and programmatic work on masculinities.IBS

"Am iz kwiin" (I'm his queen): Combining interpretative phenomenological analysis with a feminist approach to work with gems in a resource-constrained setting

This article focuses on working with gems using a feminist approach to interpretative phenomenological analysis (IPA) in a resource-constrained setting. The research explores the experiences of maternal disclosure of HIV to children of HIV positive mothers in Kingston, Jamaica. A feminist approach helps recognise power imbalances within research relationships and the women’s lived experiences. We present three “gems” which illuminate women’s lived experiences and explore how popularised representations of women’s sexuality and mothering influence disclosure discourses. We use emotion work as a conceptual resource to structure the women’s narratives and challenge existing policy discourses, which arguably represent disclosure within a binary, rationalist, decision-making framework. This article adds to global literature on maternal HIV disclosure and problematises policy discourses by bringing into relief the emotion work women engage in when deciding if and how to communicate their HIV status to their children. It adds to the body of research using IPA, particularly in resource-constrained settings where IPA has thus far had little application

Men in the Remaking: Conversion Narratives and Born-Again Masculinity in Zambia

The born-again discourse is a central characteristic of Pentecostal Christianity in Africa. In the study of African Christianities, this discourse and the way it (re)shapes people’s moral, religious, and social identities has received much attention. However, hardly any attention has been paid to its effects on men as gendered beings. In the study of men and masculinities in Africa, on the other hand, neither religion in general nor born-again Christianity in particular are taken into account as relevant factors in the construction of masculinities. On the basis of a detailed analysis of interviews with men who are members of a Pentecostal church in Lusaka, Zambia, this article investigates how men’s gender identities are reshaped by becoming and being born-again and how born-again conversion produces new forms of masculinity. The observed Pentecostal transformation of masculinity is interpreted in relation to men’s social vulnerability, particularly in the context of the HIV epidemic in Zambia

First record of the Indo-Pacific species Iphione muricata Savigny in Lamarck, 1818 (Polychaeta: Iphionidae) from the Mediterranean Sea, Israel

The Indo-Pacific scaleworm Iphione muricata was observed and caught in the Mediterranean Sea along the coast of Israel. Morphological and molecular diagnostic characters of the species are discussed. This is the first record of this alien species in the Mediterranean Sea, and its previous reports in the Suez Canal suggest its introduction via Lessepsian migration

Talking South African fathers: a critical examination of men’s constructions and experiences of fatherhood and fatherlessness

The absence of biological fathers in South Africa has been constructed as a problem for children of both sexes but more so for boy-children. Arguably the dominant discourse in this respect has demonized non-nuclear, female-headed households. Fathers are constructed as either absent or ‘bad’. Thus it has become important to explore more closely how male care-givers have been experienced by groups of men in South Africa. This article examines discourses of fatherhood and fatherlessness by drawing on qualitative interviews with a group of 29 men who speak about their reported experiences and understandings of being fathered or growing up without biological fathers. Two major and intertwined subjugated discourses about adult men’s experiences of being fathered that counter- balance the prevailing discourses about meaning of fatherhood and fatherlessness became evident, namely, ‘being always there’ and ‘talking fatherhood’. The importance of the experience of fatherhood as ‘being there’, which relates to a quality of time and relationship between child and father rather than physical time together, is illustrated. It is not only biological fathers who can ‘be there’ for their sons but also social fathers, other significant male role models and father figures who step in at different times in participants’ lives when biological fathers are unavailable for whatever reason. Second, many positive experiences of fathers or father figures that resist a traditional role of authority and control and subscribe to more nurturant and non-violent forms of care, represented as ‘talking’ fathers, are underlined. If we are to better understand the impact of colonial and apartheid history and its legacy on family life in contemporary society, there is a need for more historically and contextually informed studies on the meaning of fatherhood and fatherlessness.Web of Scienc