Psychobiological, Clinical, and Sociocultural Factors That Influence Black Women Seeking Treatment for Infertility: A Mixed-methods Study

OBJECTIVE: To provide a comprehensive and multidimensional description and conceptualization of the experiences of Black women seeking treatment for infertility. DESIGN: Convergent parallel mixed-methods study combining retrospective chart review data and semistructured interview data. SETTING: Private infertility clinic. PATIENT(S): African American/Black women between 18 and 44 years of age who presented for an initial infertility evaluation with a male partner between January 2015 and September 2019 at an infertility clinic in the metropolitan Washington D.C. area. INTERVENTION(S): None MAIN OUTCOME(S): Treatment seeking. MEASURE(S): Psychobiological, clinical, and sociocultural factors. RESULT(S): Along with the psychobiological, clinical, and sociocultural domains, we understood that Black women who sought treatment for infertility were older and overweight, had complex gynecological diagnoses, and experienced infertility for long periods of time. The delay in seeking treatment was possibly because of a low perceived risk of infertility, poor understanding of treatment options, inadequate referral patterns of primary care providers, and limited social support. Further, Black women experienced delays in seeking treatment because they attempted lifestyle-based self-interventions before considering medical interventions. Facilitators to care included psychological distress, complex gynecological medical history, and finding culturally competent providers. CONCLUSION(S): The study findings show that Black women in the United States are vulnerable to disparities in healthcare delivery, especially within reproductive endocrinology. Our findings highlight areas where Black women are experiencing missed opportunities for teaching, early identification, and early referrals for infertility-related concerns. Future studies should seek to reduce barriers to infertility treatment at the clinical and policy levels

Football: a counterpoint to the procession of pain on the Western Front, 1914-1918?

In this article, three artworks of the First World War containing images of recreational football are analysed. These three images, In the Wings of the Theatre of War, Artillery Men at Football and Gassed, span the war from its beginning to its conclusion and are discussed in relationship to the development of recreational football in the front-line area, the evolving policies of censorship and propaganda and in consideration of the national mood in Britain. The paper shows how football went from being a spontaneous and improvised pastime in the early stages of the war to a well organized entertainment by war’s end. The images demonstrate how the war was portrayed as a temporary affair by a confident nation in 1914 to a more resigned acceptance of a semi-permanent event to be endured by 1918; however, all three artworks show that the sporting spirit, and hence the fighting spirit, of the British soldier was intact

Effect of near‐bed turbulence on chronic detachment of epilithic biofilm: Experimental and modeling approaches.

The biomass dynamics of epilithic biofilm, a collective term for a complex microorganism community that grows on gravel bed rivers, was investigated by coupling experimental and numerical approaches focusing on epilithic biofilm‐flow interactions. The experiment was conducted during 65 days in an artificial rough open‐channel flow, where filtered river water circulated at a constant discharge. To characterize the effect of near‐bed turbulence on the chronic detachment process in the dynamics of epilithic biofilm, local hydrodynamic conditions were measured by laser Doppler anemometry and turbulent boundary layer parameters inferred from double‐averaged quantities. Numerical simulations of the EB biomass dynamics were performed using three different models of chronic detachment based upon three different descriptors for the flow conditions: Discharge Q, friction velocity u*, and roughness Reynolds number k+. Comparisons of numerical simulation results with experimental data revealed chronic detachment to be better simulated by taking the roughness Reynolds number as the external physical variable forcing chronic detachment. Indeed, the loss of epilithic matter through the chronic detachment process is related not only to hydrodynamic conditions, but also to change in bottom roughness. This suggests that changes in the behavior and dimensions of river bed roughness must be considered when checking the dynamics of epilithic biofilm in running waters

Waking up to sleepiness: Modafinil, the media and the pharmaceuticalisation of everyday/night life

This paper examines the social construction of the new wakefulness-promoting drug Modafinil (brand name Provigil) in the British press. Key themes in this newspaper coverage include the potential 'uses' and 'abuses' of this drug in relation to: (i) medical conditions; (ii) lifestyle choices; (iii) military operations; and (iv) sporting competition. The British press, we show, play a dual role in reporting on these trends and developments: on the one hand constructing this as something of a 'wonder drug' in relation to the treatment of a number of medical complaints or conditions, on the other hand articulating and amplifying a range of cultural concerns and anxieties about the non-medical 'uses' and 'abuses' of this drug, both now and in the future. These issues, it is argued, are best interpreted in terms of media concerns over the pharmaceuticalisation rather than the medicalisation of everyday/night life. The paper concludes with some further thoughts and reflections on these issues, including the potential reworking of notions of 'pharmaceutical Calvinism' and the 'elective affinity' between this 'smart' new drug and the spirit of (bio)capitalism

Explicit filtering to obtain grid-spacing-independent and discretization-order-independent large-eddy simulation of compressible single-phase flow

In large-eddy simulation (LES), it is often assumed that the filter width is equal to the grid spacing. Predictions from such LES are grid-spacing dependent since any subgrid-scale (SGS) model used in the LES equations is dependent on the resolved flow field which itself varies with grid spacing. Moreover, numerical errors affect the flow field, especially the smallest resolved scales. Thus, predictions using this approach are affected by both modelling and numerical choices. However, grid-spacing-independent LES predictions unaffected by numerical choices are necessary to validate LES models through comparison with a trusted template. First, such a template is created here through direct numerical simulation (DNS). Then, simulations are conducted using the conventional LES equations and also LES equations which are here reformulated so that the small-scale-producing nonlinear terms in these equations are explicitly filtered (EF) to remove scales smaller than a fixed filter width; this formulation is called EFLES. First, LES is conducted with four SGS models, then EFLES is performed with two of the SGS models used in LES; the results from all these simulations are compared to those from DNS and from the filtered DNS (FDNS). The conventional LES solution is both grid-spacing and spatial discretization-order dependent, thus showing that both of these numerical aspects affect the flow prediction. The solution from the EFLES equations is grid independent for a high-order spatial discretization on all meshes tested. However, low-order discretizations require a finer mesh to reach grid independence. With an eighth-order discretization, a filter-width to grid-spacing ratio of two is sufficient to reach grid independence, while a filter-width to grid-spacing ratio of four is needed to reach grid independence when a fourth- or a sixth-order discretization is employed. On a grid fine enough to be utilized in a DNS, the EFLES solution exhibits grid independence and does not converge to the DNS solution. The velocity-fluctuation spectra of EFLES follow those of FDNS independent of the grid spacing used, in concert with the original concept of LES. The reasons for the different predictions of conventional LES or EFLES according to the SGS model used, and the different characteristics of the EFLES predictions compared to those from conventional LES are analysed

The Effect of Weak Interactions on the Ultra-Relativistic Bose-Einstein Condensation Temperature

We calculate the ultra-relativistic Bose-Einstein condensation temperature of a complex scalar field with weak lambda Phi^4 interaction. We show that at high temperature and finite density we can use dimensional reduction to produce an effective three-dimensional theory which then requires non-perturbative analysis. For simplicity and ease of implementation we illustrate this process with the linear delta expansion.Comment: Latex2e, 12 pages, three eps figures, replacement with additional discussion and extra figur

Disgust sensitivity is not associated with health in a rural Bangladeshi sample.

Disgust can be considered a psychological arm of the immune system that acts to prevent exposure to infectious agents. High disgust sensitivity is associated with greater behavioral avoidance of disease vectors and thus may reduce infection risk. A cross-sectional survey in rural Bangladesh provided no strong support for this hypothesis. In many species, the expression of pathogen- and predator-avoidance mechanisms is contingent on early life exposure to predators and pathogens. Using childhood health data collected in the 1990s, we examined if adults with more infectious diseases in childhood showed greater adult disgust sensitivity: no support for this association was found. Explanations for these null finding and possible directions for future research are discussed

Who Owns the Data? Open Data for Healthcare.

Research on large shared medical datasets and data-driven research are gaining fast momentum and provide major opportunities for improving health systems as well as individual care. Such open data can shed light on the causes of disease and effects of treatment, including adverse reactions side-effects of treatments, while also facilitating analyses tailored to an individual's characteristics, known as personalized or "stratified medicine." Developments, such as crowdsourcing, participatory surveillance, and individuals pledging to become "data donors" and the "quantified self" movement (where citizens share data through mobile device-connected technologies), have great potential to contribute to our knowledge of disease, improving diagnostics, and delivery of -healthcare and treatment. There is not only a great potential but also major concerns over privacy, confidentiality, and control of data about individuals once it is shared. Issues, such as user trust, data privacy, transparency over the control of data ownership, and the implications of data analytics for personal privacy with potentially intrusive inferences, are becoming increasingly scrutinized at national and international levels. This can be seen in the recent backlash over the proposed implementation of care.data, which enables individuals' NHS data to be linked, retained, and shared for other uses, such as research and, more controversially, with businesses for commercial exploitation. By way of contrast, through increasing popularity of social media, GPS-enabled mobile apps and tracking/wearable devices, the IT industry and MedTech giants are pursuing new projects without clear public and policy discussion about ownership and responsibility for user-generated data. In the absence of transparent regulation, this paper addresses the opportunities of Big Data in healthcare together with issues of responsibility and accountability. It also aims to pave the way for public policy to support a balanced agenda that safeguards personal information while enabling the use of data to improve public health