“It’s Non-Existent”: Haunting in Trans Youth Narratives about Naming

Often, choosing a name is one of the first ways trans people begin to assume a different gender from the one they were assigned at birth. Stories about the process of choosing a name reveal how trans youth negotiate their relationship with their old name and their emerging sense of identity. Working with Avery Gordon’s Ghostly Matters (2008), I explore the ghostly ways birth names remain in the lives of trans youth. Gordon’s concept of ghosts presents an opportunity to think about how trans youth experience their birth name and the complex ways trans youth negotiate their identity at school

Understanding resolution of deliberate self harm: qualitative interview study of patients' experiences.

OBJECTIVE: To explore the accounts of those with a history of deliberate self harm but who no longer do so, to understand how they perceive this resolution and to identify potential implications for provision of health services. DESIGN: Qualitative in-depth interview study. SETTING: Interviews in a community setting. PARTICIPANTS: 20 participants selected from a representative cohort identified in 1997 after an episode of deliberate self poisoning that resulted in hospital treatment. Participants were included if they had no further episodes for at least two years before interview. RESULTS: We identified three recurrent themes: the resolution of adolescent distress; the recognition of the role of alcohol as a precipitating and maintaining factor in self harm; and the understanding of deliberate self harm as a symptom of untreated or unrecognised illness. CONCLUSION: Patients with a history of deliberate self harm who no longer harm themselves talk about their experiences in terms of lack of control over their lives, either through alcohol dependence, untreated depression, or, in adolescents, uncertainty within their family relationships. Hospital management of deliberate self harm has a role in the identification and treatment of depression and alcohol misuse, although in adolescents such interventions may be less appropriate

What's in a Name?: Trans Youths' Experiences of Re-Naming

Often, choosing a name is one of the first ways trans people begin to assume a different gender from the one they were assigned at birth. Because of their age, trans youths relationships to and negotiation of naming is particularly complex: these young people are often still dependent on the very families who named them. In my dissertation, I turn to trans youth and their stories of re-naming themselves to explore how these narratives about the names they receive, refuse and choose can expose challenges to narrating youths negotiation and formation of identity. Informed by narrative inquiry, post structural theory, trans studies, queer theory and feminist methodologies, this qualitative study insists that by listening to the stories trans youth tell about their naming processes we can open up space for a more complex understanding of their lives and experiences. Through two sets of interviews with ten trans youth, I explore how stories about names can expose youths negotiation of their identity. My dissertation consists of six chapters focusing on ethical concerns in research about trans youth and the role of gender, development and family in the navigation of self-making through names and the daily lives of trans youth. Theorizing names is essential to understanding how young people explore who they are, who they want to be, and how they want others to recognize them, creating space for a deep reconsideration about both identity formation for young trans people and the social and personal importance of names. I argue that by listening to the stories trans youth tell about their naming processes, educators, policy makers and researchers can better comprehend the supports trans youth may need, while opening up space for more complex understandings of trans lives

Internet support for dealing with problematic alcohol use: a survey of the Soberistas online community

Aims: advances in technology have led to an increased range of possibilities for forms of mutual aid in addictions, and patient empowerment in the management of long-term conditions. However, the effective processes involved may be different online than for those that meet in person. Soberistas is a ‘social network site for people who are trying to resolve their problematic drinking patterns’. We aim to describe the population, component parts and processes that define this online community, and consider potential mechanisms of action for future research.Methods: cross-sectional online survey through an advert embedded within the Soberistas website. Participants were asked questions about themselves, their alcohol use and use of the website.Results: four hundred and thirty-eight people completed the survey, primarily women, 50% of whom lived with their children. Over 60% described having problematic alcohol use for over 10 years and 46.5% had not tried any form of previous support. Participants accessed the site at different stages of change; over half still drinking alcohol, cutting down or recently stopped. Over 18% reported abstinence of over 1 year. Anonymity, the ability to be honest, being a source of trusted information, and ongoing support were all cited as reasons for continued membership.Conclusion: Soberistas offers a form of mutual aid primarily for women who have often not engaged with other treatment or support. This preliminary study suggests that the online, flexible, platform affords members an accessible and anonymous community to address their difficulties and encourages a positive ‘alcohol free’ identity.Short summary: Soberistas is ‘an online community of people who are trying to resolve their problematic drinking patterns’. Preliminary data suggest that it offers a flexible platform for mutual aid primarily for women who have often not engaged with other treatment or support, by encouraging a positive ‘alcohol free’ identity

Competition between Discrete Random Variables, with Applications to Occupancy Problems

Consider $n$ players whose "scores" are independent and identically distributed values $\{X_i\}_{i=1}^n$ from some discrete distribution $F$. We pay special attention to the cases where (i) $F$ is geometric with parameter $p\to0$ and (ii) $F$ is uniform on $\{1,2,...,N\}$; the latter case clearly corresponds to the classical occupancy problem. The quantities of interest to us are, first, the $U$-statistic $W$ which counts the number of "ties" between pairs $i,j$; second, the univariate statistic $Y_r$, which counts the number of strict $r$-way ties between contestants, i.e., episodes of the form ${X_i}_1={X_i}_2=...={X_i}_r$; $X_j\ne {X_i}_1;j\ne i_1,i_2,...,i_r$; and, last but not least, the multivariate vector $Z_{AB}=(Y_A,Y_{A+1},...,Y_B)$. We provide Poisson approximations for the distributions of $W$, $Y_r$ and $Z_{AB}$ under some general conditions. New results on the joint distribution of cell counts in the occupancy problem are derived as a corollary.Comment: 21 page

Clinical Competencies for the Care of Hospitalized Patients with Alcohol Use Disorders

© 2020 The Author(s) 2020. Medical Council on Alcohol and Oxford University Press. Aims: The UK government aims to develop alcohol care teams (ACTs) that provide care for alcohol dependence in general hospital settings. Service descriptors have been identified to support the development of ACTs. The aim of this study was to use Delphi panel principles to identify the clinical competencies required to provide these elements of service. Methods: We formed an expert consensus panel of 24 senior clinical alcohol practitioners, leaders and experts by experience drawn from all regions of England. The study was divided into three distinct phases: (a) a review and synthesis of current literature in this area, (b) a face-to-face meeting of the expert panel and (c) subsequent iterations to refine the competencies until consensus was reached. Results: Our initial search strategy resulted in 555 competency statements being extracted from a range of national clinical professional and occupational standards and other sources. The research team refined these statements to 98 competencies in advance of the expert meeting. The panel identified 14 additional statements and reduced the number of competencies to 78. Subsequent iterations finalized 72 competencies across the 8 service descriptors. Conclusions: Drawing on the existing published resources and clinical experience, the expert panel has provided consensus on the core clinical competencies required for alcohol care teams in caring for hospitalized patients with alcohol use disorders. Whilst it is acknowledged that the range of current provision is variable, these competencies provide a template for clinical practice and the development of multidisciplinary ACTs

Impact of personal alcohol consumption on aspects of medical student alcohol-related competencies

AimAs part of the prevention and management of alcohol-related harms, health professionals need to be competent to assess the level of alcohol use in patients. In this study, we explored how medical students’ own alcohol consumption impacts on their familiarity with alcohol brands, strengths and alcohol-related harms.MethodsAs part of a wider study investigating the concept of ‘alcohol health literacy’, this study combined an anonymous online survey, linked to an electronic alcohol ‘brand’ recognition game. Participants were medical students in their first clinical year. The survey recorded demographics, self-reported alcohol consumption (using the AUDIT-C), a visual test of relative alcohol concentrations of wine, beer and spirits, and a free-text response asking them to list alcohol-related harms. Participants then completed the brand recognition game recording accuracy and reaction time for identifying alcohol drink brands.ResultsOne hundred and fifty students participated. There was a significant effect of ethnicity on drinking status, with 48% of non-white participants scoring zero on the AUDIT-C. Students who reported any alcohol consumption were more likely to correctly assess relative alcohol concentrations and were faster and more accurate at recognizing alcohol brands, which was dose dependent. Overall, only 45% correctly recognized relative alcohol strengths of drinks presented.ConclusionsAmong third-year medical students, ability to correctly identify relative strengths of alcoholic drinks is low. As might be expected, students who drink alcohol tend to identify brands and strengths more accurately. This has implications for how best to tailor the delivery of teaching and training about alcohol to ensure similar levels of clinical confidence in dealing with future patients regardless of personal experience

Accurate crop yield predictions from modelling tree-crop interactions in gliricidia-maize agroforestry

Agroforestry systems, containing mixtures of trees and crops, are often promoted because the net effect of interactions between woody and herbaceous components is thought to be positive if evaluated over the long term. From a modelling perspective, agroforestry has received much less attention than monocultures. However, for the potential of agroforestry to impact food security in Africa to be fully evaluated, models are required that accurately predict crop yields in the presence of trees. The positive effects of the fertiliser tree gliricidia (Gliricidia sepium) on maize (Zea mays) are well documented and use of this tree-crop combination to increase crop production is expanding in several African countries. Simulation of gliricidia-maize interactions can complement field trials by predicting crop response across a broader range of contexts than can be achieved by experimentation alone. We tested a model developed within the APSIM framework. APSIM models are widely used for one dimensional (1D), process-based simulation of crops such as maize and wheat in monoculture. The Next Generation version of APSIM was used here to test a 2D agroforestry model where maize growth and yield varied spatially in response to interactions with gliricidia. The simulations were done using data for gliricidia-maize interactions over two years (short-term) in Kenya and 11 years (long-term) in Malawi, with differing proportions of trees and crops and contrasting management. Predictions were compared with observations for maize grain yield, and soil water content. Simulations in Kenya were in agreement with observed yields reflecting lower observed maize germination in rows close to gliricidia. Soil water content was also adequately simulated, except for a tendency for slower simulated drying of the soil profile each season. Simulated maize yields in Malawi were also in agreement with observations. Trends in soil carbon over a decade were similar to those measured, but could not be statistically evaluated. These results show that the agroforestry model in APSIM Next Generation adequately represented tree-crop interactions in these two contrasting agro-ecological conditions and agroforestry practices. Further testing of the model is warranted to explore tree-crop interactions under a wider range of environmental conditions