“Someone’s got to do it” – Primary care providers (PCPs) describe caring for rural women with mental health problems

Objective: Little is known about how primary care providers (PCPs) approach mental health care for low-income rural women. We developed a qualitative research study to explore the attitudes and practices of PCPs regarding the care of mood and anxiety disorders in rural women. Method: We conducted semi-structured interviews with 19 family physicians, internists, and obstetrician-gynecologists (OBGYNs) in office-based practices in rural central Pennsylvania. Using thematic analysis, investigators developed a coding scheme. Questions focused on 1) screening and diagnosis of mental health conditions, 2) barriers to treatment among rural women, 3) management of mental illnesses in rural women, and 4) ideas to improve care for this population. Results: PCP responses reflected these themes: 1) PCPs identify mental illnesses through several mechanisms including routine screening, indicator-based assessment, and self-identification by the patient; 2) Rural culture and social ecology are significant barriers to women in need of mental healthcare; 3) Mental healthcare resource limitations in rural communities lead PCPs to seek creative solutions to care for rural women with mental illnesses; 4) To improve mental healthcare in rural communities, both social norms and resource limitations must be addressed. Conclusion: Our findings can inform future interventions to improve women\u27s mental healthcare in rural communities. Ideas include promoting generalist education in mental healthcare, and expanding access to consultative networks. In addition, community programs to reduce the stigma of mental illnesses in rural communities may promote healthcare seeking and receptiveness to treatment

Roles for a Lipid Phosphatase in the Activation of its Opposing Lipid Kinase

Fig4 is a phosphoinositide phosphatase that converts PI3,5P2 to PI3P. Paradoxically, mutation of Fig4 results in lower PI3,5P2, indicating that Fig4 is also required for PI3,5P2 production. Fig4 promotes elevation of PI3,5P2, in part, through stabilization of a protein complex that includes its opposing lipid kinase, Fab1, and the scaffold protein Vac14. Here we show that multiple regions of Fig4 contribute to its roles in the elevation of PI3,5P2: Its catalytic site, an N-terminal disease-related surface, and a C-terminal region. We show that mutation of the Fig4 catalytic site enhances the formation of the Fab1-Vac14-Fig4 complex, and reduces the ability to elevate PI3,5P2. This suggests that independent of its lipid phosphatase function, the active site plays a role in the Fab1-Vac14-Fig4 complex. We also show that the N-terminal disease-related surface contributes to the elevation of PI3,5P2 and promotes Fig4 association with Vac14 in a manner that requires the Fig4 C-terminus. We find that the Fig4 C-terminus alone interacts with Vac14 in vivo and retains some functions of full-length Fig4. Thus, a subset of Fig4 functions are independent of its phosphatase domain and at least three regions of Fig4 play roles in the function of the Fab1-Vac14-Fig4 complex

Double differentiation in a cross-national comparison of populist political movements and online media uses in the United States and the Netherlands

In a context of highly visible and politically influential populist movements, this study considers the online self-representation of the Tea Party Patriots (TPP) in the United States and the Party for Freedom (PVV) in the Netherlands. A multi-methodological approach was adopted to compare the discursive manifestation of key populism concepts: leadership characteristics, adversary definition and mobilizing information. Analyses reconstruct and account for similarities and differences in discursive framing strategies of 'double differentiation' through which both movements attempt inclusion in and exclusion from the political establishment, and, in doing so, mobilize communities of support. Altogether, this study advances the understanding of what constitutes 'unmediated' content that is presented through user-generated media production, and how self-determined media spaces have facilitated shifts in populist media legitimation and political representation in two politically unique countries

Door locks, wall stickers, fireplaces: Assemblage Theory and home (un)making in Lewisham’s temporary accommodation

This paper explores resident experiences of life in PLACE/Ladywell, a “pop‐up” social housing scheme in London providing temporary accommodation for homeless families. Specifically, we consider barriers to, and assertions of, homemaking in this temporary setting through fixtures and fittings—a door lock, wall stickers, and a fireplace. The paper utilises assemblage thinking to understand homemaking within these time‐limited and constrained circumstances. Despite their seeming banality, fixtures and fittings offer a material, politicised, and lively means of studying the attempted and thwarted production of home by residents living in PLACE/Ladywell. The absence of door locks reduces parents’ ability to maintain privacy and intimate relations; restrictions on hanging pictures and other decorative measures are circumvented by the use of wall stickers; and a defiant decorative fireplace establishes a sense of home in a temporary setting. Together, these objects constitute vital elements in negotiations between fixity and impermanence in temporary accommodation

Recognition of Face Identity and Emotion in Expressive Specific Language Impairment

Objective: To study face and emotion recognition in children with mostly expressive specific language impairment (SLI-E). Subjects and Methods: A test movie to study perception and recognition of faces and mimic-gestural expression was applied to 24 children diagnosed as suffering from SLI-E and an age-matched control group of normally developing children. Results: Compared to a normal control group, the SLI-E children scored significantly worse in both the face and expression recognition tasks with a preponderant effect on emotion recognition. The performance of the SLI-E group could not be explained by reduced attention during the test session. Conclusion: We conclude that SLI-E is associated with a deficiency in decoding non-verbal emotional facial and gestural information, which might lead to profound and persistent problems in social interaction and development. Copyright (C) 2012 S. Karger AG, Base

Estimation of interdomain flexibility of N-terminus of factor H using residual dipolar couplings

Characterization of segmental flexibility is needed to understand the biological mechanisms of the very large category of functionally diverse proteins, exemplified by the regulators of complement activation, that consist of numerous compact modules or domains linked by short, potentially flexible, sequences of amino acid residues. The use of NMR-derived residual dipolar couplings (RDCs), in magnetically aligned media, to evaluate interdomain motion is established but only for two-domain proteins. We focused on the three N-terminal domains (called CCPs or SCRs) of the important complement regulator, human factor H (i.e. FH1-3). These domains cooperate to facilitate cleavage of the key complement activation-specific protein fragment, C3b, forming iC3b that no longer participates in the complement cascade. We refined a three-dimensional solution structure of recombinant FH1-3 based on nuclear Overhauser effects and RDCs. We then employed a rudimentary series of RDC datasets, collected in media containing magnetically aligned bicelles (disk-like particles formed from phospholipids) under three different conditions, to estimate interdomain motions. This circumvents a requirement of previous approaches for technically difficult collection of five independent RDC datasets. More than 80% of conformers of this predominantly extended three-domain molecule exhibit flexions of < 40 °. Such segmental flexibility (together with the local dynamics of the hypervariable loop within domain 3), could facilitate recognition of C3b via initial anchoring and eventual reorganization of modules to the conformation captured in the previously solved crystal structure of a C3b:FH1-4 complex

Confidentiality, anonymity and amnesty for midwives in distress seeking online support – Ethical?

BACKGROUND: Midwife health is intrinsically linked to the quality of safe patient care. To ensure safe patient care, there is a need to deliver emotional support to midwives. One option that midwives may turn to may be a confidential online intervention, instead of localised, face-to-face support. RESEARCH DESIGN: Following the Realist And MEta-narrative Evidence Syntheses: Evolving Standards publication standards, this realist synthesis approach explores the ethical considerations in permitting confidentiality, anonymity and amnesty in online interventions to support midwives in work-related psychological distress. An iterative search methodology was used to select nine papers for review. To assimilate information, papers were examined for ideas relating to ethical dimensions of online interventions to support midwives in work-related psychological distress. This review takes a narrative approach. FINDINGS: Online interventions can support the development of insight, help seeking and open discussion. Additionally, Internet support groups can become morally persuasive in nature. Anonymity and confidentiality are both effective and therapeutic features of online interventions when used in collaboration with effective online moderation. Yet, ethical dilemmas remain where users cannot be identified. DISCUSSION: Confidentiality and anonymity remain key components of successful online interventions. However, sanctioning the corollary component of amnesty may provoke moral discomfort for those seeking immediate accountability. For others, amnesty is seen as essential for open disclosure and help seeking. Ultimately, the needs of midwives must be balanced with the requirement to protect the public and the professional reputation of midwifery. CONCLUSION: In supporting midwives online, the principles of anonymity, confidentiality and amnesty may evoke some resistance on ethical grounds. However, without offering identity protection, it may not be possible to create effective online support services for midwives. The authors of this article argue that the principles of confidentiality, anonymity and amnesty should be upheld in the pursuit of the greatest benefit for the greatest number of people

Rethinking the Ambiguities of Abstraction in the Anthropocene

The ambiguities of abstraction were at the heart of critical approaches to the problems of modernity. Abstraction, so fundamental to the modernist episteme, was seen to have alienated humanity from itself and from its entangled relations with its environment, constituting a fundamental rift between the subject and the world. This article analyses how the critique of the modernist episteme has increasingly shifted under the auspices of the Anthropocene. Rather than seeking to overcome the ambiguities of abstraction and return the human to the world, approaches that seek to affirm the Anthropocene have emphasised that modernist thought did not take abstraction far enough. Rather than abstraction being problematic for contemporary thought, abstraction is seen to be a facet of the world in its lively, partial and contingent interaction. This article is organised in three sections. The first section introduces the problematic of abstraction in the Anthropocene, highlighting that critical theory approaches tend to see the Anthropocene within a discourse of modernist critique. The second section draws out the importance of understanding the distinct mode of contemporary affirmation, which rather than seeking to return man to the world, emphasises the impossibility of finding meaning in the world. It is this inverting of critical understandings that enables abstraction to be seen positively rather than problematically. The final section expands on this point to consider how contemporary theoretical approaches articulate the transvaluation of abstraction as the guide to contemporary modes of life