Some Musings About the Limits of an Ethics That Can Be Applied – A Response to a Question About Courage and Convictions That Confronted the Author When She Woke Up on November 9, 2016

I experienced the 2016 Presidential election as a loss of innocence. For the first time in my life, the prospect of losing my most basic rights and freedoms did not feel so remote. Confronting this possibility prompted the musings in this article. I call them ‘musings’ because the article is not a systematic defense of a clearly demarcated position. It is, rather, a somewhat circuitous exploration of the many questions that pressed themselves upon me as I struggled to understand what distinguishes (a) reasonable accommodations to injustice from (b) morally unacceptable accommodations. When is a commitment not really a commitment? When does reasonable fear become shameful cowardice? When does my knowledge that I can do something to resist injustice give me good enough reason to resist? Under what conditions is my reason an enemy of my ideals? What is the proper balance between valuing myself beyond price and appreciating that many, many things matter far more than my own life and security? In grappling with these questions, I have been reminded of the extent to which moral discernment does not involve applying a ‘philosophy’ and the extent to which it cannot be secured by prior training.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154334/1/japp12408.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154334/2/japp12408_am.pd

"Remember the women of Osiri":Women and gender in artisanal and small-scale mining in Migori County, Kenya

In this paper, we explore women’s livelihoods and the operation of gender norms and structures in the Osiri artisanal gold mining area in western Kenya. While “women” and “gender” are seen as increasingly important to policy frameworks for developing mineral resources on the African continent, understandings of women’s roles in artisanal and small-scale mining, and of the importance of gender in structuring those livelihoods, remain limited. Drawing on field research conducted from 2014 to 2018, we demonstrate that while gender norms and structures operate to delimit women’s mining roles, in daily encounters women and men navigate, resist and sometimes reframe those norms. Further, we explore how gender norms may not impact all women the same and how other social variables, such as age, may also influence how women navigate their mining livelihoods

Trends in daily cigarette consumption among smokers: a population study in England, 2008-2023

Introduction: This study aimed to estimate time trends in cigarette consumption among smokers in England between 2008 and 2023 and to explore differences by key potential moderators. Aims and Methods: We used data from 57 778 adult cigarette smokers participating in a nationally representative monthly cross-sectional survey between January 2008 and September 2023. We estimated monthly time trends in mean daily consumption of (1) any, (2) manufactured, and (3) hand-rolled cigarettes among all smokers and by main type of cigarettes smoked, smoking frequency, age, gender, occupational social grade, region, nicotine replacement therapy use, and vaping status. Results: Overall cigarette consumption fell from 13.6 [95% CI = 13.3 to 13.9] to 10.6 [10.5 to 10.8] per day between January 2008 and October 2019 (a 22% decrease), then remained stable up to September 2023. Over this period, the proportion mainly or exclusively smoking hand-rolled cigarettes increased (from 30.6% [29.1%–32.1%] in 2008 to 52.1% [49.7%–54.5%] in 2023). As a result, manufactured cigarette consumption fell by 47%, from 9.5 [9.2–9.8] per day in January 2008 to 5.0 [4.7–5.3] in September 2023, while hand-rolled cigarette consumption increased by 35%, from 4.2 [3.9–4.4] to 5.6 [5.3–5.9], respectively. The decline in overall cigarette consumption was observed across all subgroups, but was greater among non-daily smokers, younger smokers, and those who vaped. Conclusions: Over the last 15 years, the average number of cigarettes consumed each day by smokers in England has fallen by almost a quarter, but has plateaued since October 2019. There has been a sharp decline in the number of manufactured cigarettes consumed and an increase in the number of hand-rolled cigarettes consumed, as smokers have increasingly shifted towards using hand-rolled tobacco. Implications: While average cigarette consumption in England has fallen over the past 15 years, this declining trend has stalled (and reversed in some population groups) since 2019. The availability of cheap, hand-rolled tobacco appears to be undermining policies that aim to reduce smoking by raising the price of tobacco (eg, through taxation) and could be targeted to reignite the decline in cigarette consumption

Are men intimidated by highly educated women? Undercover on Tinder

In this study, we examine the impact of an individual's education level on her/his mating success on the mobile dating app Tinder. To do so, we conducted a field experiment on Tinder in which we collected data on 3,600 profile evaluations. In line with previous research on mating preferences from multiple fields, our results indicate a heterogeneous effect of education level by gender: while women strongly prefer a highly educated potential partner, this hypothesis is rejected for men. In contrast with recent influential studies from the field of economics, we do not find any evidence that men would have an aversion to a highly educated potential partner. Additionally, in contrast with most previous research - again from multiple fields we do not find any evidence for preferences for educational assortative mating, i.e. preferring a partner with a similar education level

Correspondence between hair cortisol concentrations and 30-day integrated daily salivary and weekly urinary cortisol measures

Characterization of cortisol production, regulation and function is of considerable interest and relevance given its ubiquitous role in virtually all aspects of physiology, health and disease risk. The quantification of cortisol concentration in hair has been proposed as a promising approach for the retrospective assessment of integrated, long-term cortisol production. However, human research is still needed to directly test and validate current assumptions about which aspects of cortisol production and regulation are reflected in hair cortisol concentrations (HCC). Here, we report findings from a validation study in a sample of 17 healthy adults (mean ± SD age: 34 ± 8.6 yrs). To determine the extent to which HCC captures cumulative cortisol production, we examined the correspondence of HCC, obtained from the first 1cm scalp-near hair segment, assumed to retrospectively reflect 1-month integrated cortisol secretion, with 30-day average salivary cortisol area-under-the curve (AUC) based on 3 samples collected per day (on awakening, +30 min, at bedtime) and the average of 4 weekly 24-hr urinary free cortisol (UFC) assessments. To further address which aspects of cortisol production and regulation are best reflected in the HCC measure, we also examined components of the salivary measures that represent: 1) production in response to the challenge of awakening (using the cortisol awakening response [CAR]), and 2) chronobiological regulation of cortisol production (using diurnal slope). Finally, we evaluated the test-retest stability of each cortisol measure. Results indicate that HCC was most strongly associated with the prior 30-day integrated cortisol production measure (average salivary cortisol AUC) (r = 0.61, p = 0.01). There were no significant associations between HCC and the 30-day summary measures using CAR or diurnal slope. The relationship between 1-month integrated 24-hr UFC and HCC did not reach statistical significance (r = 0.30, p = 0.28). Lastly, of all cortisol measures, test-retest correlations of serial measures were highest for HCC (month-to-month: r = 0.84, p < 0.001), followed by 24-hr UFC (week-to-week: r’s between 0.59 and 0.68, ps < 0.05) and then integrated salivary cortisol concentrations (week-to-week: r’s between 0.38 and 0.61, p’s between 0.13 and 0.01). These findings support the contention that HCC provides a reliable estimate of long-term integrated free cortisol production that is aligned with integrated salivary cortisol production measured over a corresponding one-month period

Using a novel ambulatory monitoring system to support patient safety on an acute infectious disease ward during an unfolding pandemic

Aim: To gain staff feedback on the implementation and impact of a novel ambulatory monitoring system to support coronavirus patient management on an isolation ward. Design: Qualitative service evaluation. Methods: Semi-structured interviews were conducted with 15 multidisciplinary isolation ward staff in the United Kingdom between July 2020 and May 2021. Interviews were audio-recorded, transcribed and analysed using thematic analysis. Findings: Adopting Innovation to Assist Patient Safety was identified as the overriding theme. Three interlinked sub-themes represent facets of how the system supported patient safety. Patient Selection was developed throughout the pandemic, as clinical staff became more confident in choosing which patients would benefit most. Trust In the System described how nurses coped with discrepancies between the ambulatory system and ward observation machines. Finally, Resource Management examined how, once trust was built, staff perceived the ambulatory system assisted with caseload management. This supported efficient personal protective equipment resource use by reducing the number of isolation room entries. Despite these reported benefits, face-to-face contact was still highly valued, despite the risk of coronavirus exposure. Conclusion: Hospital wards should consider using ambulatory monitoring systems to support caseload management and patient safety. Patients in isolation rooms or at high risk of deterioration may particularly benefit from this additional monitoring. However, these systems should be seen as an adjunct to nursing care, not a replacement. Implications for the Profession and/or Patient Care: Nurses valued ambulatory monitoring as a means of ensuring the safety of patients at risk of deterioration and prioritizing their workload. Impact: The findings of this research will be useful to all those developing or considering implementation of ambulatory monitoring systems in hospital wards. Reporting Method: This manuscript follows the Consolidated criteria for Reporting Qualitative Research (COREQ) guidelines with inclusion of relevant SQUIRE guidelines for reporting quality improvement. Patient or Public Contribution: No Patient or Public Contribution

Metodologia ativa de ensino na formação do enfermeiro: inovação na atenção básica

Aim: to report the experience of applying an active methodology of teaching and learning with nursing students in primary health care. Method: experience report. Eight students and one teacher participated, in a morning of practical activity of a health unity in Florianopolis, Santa Catarina, Brazil. The methodology was applied in eight distinct, sequential and complementary phases. Results: the students were initially stimulated to represent a situation of health/disease and seek support at the Health Centre as users, posteriorly they observed the facility structure and socialized the individual experiences. During the whole process, the students were stimulated to reflect and share their experiences, to discuss the functioning of the service and the professionals’ roles. Final Considerations: it was an important experience in different ways of teaching and learning that involved both teachers and studentsObjetivo: presentar la experiencia de la aplicación de una metodología activa de enseñanza y aprendizaje con estudiantes de enfermería de la atención primaria. Método: relato de experiencia. Participaron ocho estudiantes y un profesor en una mañana con actividad práctica en una unidad de salud en Florianópolis, Santa Catarina, Brasil. La metodología se aplicó en ocho fases distintas, secuenciales y complementarias. Resultados: inicialmente los estudiantes representaron una condición de salud/enfermedad y buscaron apoyo en la unidad de salud como usuarios, más tarde observaron la estructura física de la unidad y socializaron las experiencias individuales. Durante el proceso, se recomendó al estudiante reflejar y compartir sus experiencias, discutiendo la prestación del servicio y los roles profesionales. Consideraciones Finales: fue una experiencia importante por la diferenciada forma de enseñanza y aprendizaje, tanto para los profesionales cuanto para los estudiantes.http://dx.doi.org/10.5902/2179769216920Objetivo: relatar a experiência na aplicação de uma metodologia ativa de ensino e aprendizagem na atenção básica com discentes de enfermagem. Método: relato de experiência. Participaram oito discentes e um docente, em uma manhã de atividade prática num Centro de Saúde de Florianópolis, Santa Catarina, Brasil. A metodologia foi aplicada em oito fases distintas, sequenciais e complementares. Resultados: inicialmente, os discentes foram estimulados a representar uma situação de saúde/doença e buscar apoio no Centro de Saúde como usuários, posteriormente observaram a estrutura física da Unidade e socializaram as vivências individuais. Durante todo processo, estimulou-se o discente a refletir e compartilhar suas experiências, discutir o funcionamento do serviço e papéis dos profissionais. Considerações Finais: foi uma importante experiência pela forma diferenciada de ensinar e aprender, que envolveu tanto o docente quanto os discentes.

Entamoeba histolytica Phagocytosis of Human Erythrocytes Involves PATMK, a Member of the Transmembrane Kinase Family

Entamoeba histolytica is the cause of amebic colitis and liver abscess. This parasite induces apoptosis in host cells and utilizes exposed ligands such as phosphatidylserine to ingest the apoptotic corpses and invade deeper into host tissue. The purpose of this work was to identify amebic proteins involved in the recognition and ingestion of dead cells. A member of the transmembrane kinase family, phagosome-associated TMK96 (PATMK), was identified in a proteomic screen for early phagosomal proteins. Anti-peptide affinity-purified antibody produced against PATMK demonstrated that it was a type I integral membrane protein that was expressed on the trophozoite surface, and that co-localized with human erythrocytes at the site of contact. The role of PATMK in erythrophagocytosis in vitro was demonstrated by: (i) incubation of ameba with anti-PATMK antibodies; (ii) PATMK mRNA knock-down using a novel shRNA expression system; and (iii) expression of a carboxy-truncation of PATMK (PATMKΔ932). Expression of the carboxy-truncation of PATMKΔ932 also caused a specific reduction in the ability of E. histolytica to establish infection in the intestinal model of amebiasis, however these amebae retained the ability to cause hepatic abscesses when directly injected in the liver. In conclusion, PATMK was identified as a member of the TMK family that participates in erythrophagocytosis and is uniquely required for intestinal infection

Hazenella coriacea gen. nov., sp nov., isolated from clinical specimens

A Gram-staining-positive, endospore-forming rod was isolated independently from clinical specimens in New York State, USA, once in 2009 and twice in 2011. The three isolates had identical 16S rRNA gene sequences and, based on their 16S rRNA gene sequence, are most closely related to the type strains of Laceyella sediminis and L. sacchari (94.6% similarity). The partial 23S rRNA gene sequences of the three strains were also 100% identical. Maximumlikelihood phylogenetic analysis suggests that the new isolates belong to the family Thermoactinomycetaceae. Additional biochemical and phenotypic characteristics of the strains support the family designation and suggest that the three isolates represent a single species. In each of the strains, the predominant menaquinone is MK-7, the diagnostic diamino acid is mesodiaminopimelic acid and the major cellular fatty acids are iso-C15 : 0, anteiso-C15 : 0 and iso-C13 : 0. The polar lipids are phosphatidylglycerol, diphosphatidylglycerol, phosphatidylethanolamine, four unknown phospholipids, four unknown aminophospholipids and an unknown lipid. It is proposed that the novel isolates represent a single novel species within a new genus, for which the name Hazenella coriacea gen. nov., sp. nov. is proposed. The type strain of Hazenella coriacea is strain 23436T (5DSM 45707T5LMG 27204T)