‘It's just a peripheral issue’: A qualitative analysis of mental health clinicians’ accounts of (not) addressing sexuality in their work

Sexuality, relationships, and intimacy are integral parts of many peoples’ lives, not negated by mental distress and illness. Yet typically, these needs are not addressed adequately in mental health settings. In‐depth interviews were conducted with mental health clinicians with an aim of exploring their perceptions and understandings of sexuality and sexual concerns within mental health settings. Participants were 22 mental health nurses, psychologists, and psychiatrists working with people across a range of settings in four Australian cities. Sexuality or aspects of this were often not addressed in clinical practice, and this was common across participants’ accounts. A critical thematic analysis was conducted to explore how participants made sense of or explained this silence in relation to sexuality. Two key themes were ‘Sexuality is hard to talk about’ and ‘Sexuality is a “peripheral issue”’. In positioning sexuality as a peripheral issue, participants drew on three key explanations (sub‐themes): that sexuality rarely ‘comes up’, that it is not pragmatic to address sexuality, and that addressing sexuality is not part of participants’ roles or skill sets. A third theme captured the contrasting perception that ‘Sexuality could be better addressed’ in mental health settings. This analysis indicates that, beyond anticipated embarrassment, mental health clinicians from three disciplines account for omissions of sexuality from clinical practice in similar ways. Moreover, these accounts serve to peripheralize sexuality in mental health settings. We consider these results within the context of espoused holistic and recovery‐oriented principles in mental health settings.     

Linking genome and proteome by mass spectrometry: Large-scale identification of yeast proteins from two dimensional gels

The function of many of the uncharacterized open reading frames discovered by genomic sequencing can be determined at the level of expressed gene products, the proteome. However, identifying the cognate gene from minute amounts of protein has been one of the major problems in molecular biology. Using yeast as an example, we demonstrate here that mass spectrometric protein identification is a general solution to this problem given a completely sequenced genome. As a first screen, our strategy uses automated laser desorption ionization mass spectrometry of the peptide mixtures produced by in-gel tryptic digestion of a protein. Up to 90% of proteins are identified by searching sequence data bases by lists of peptide masses obtained with high accuracy. The remaining proteins are identified by partially sequencing several peptides of the unseparated mixture by nanoelectrospray tandem mass spectrometry followed by data base searching with multiple peptide sequence tags. In blind trials, the method led to unambiguous identification in all cases. In the largest individual protein identification project to date, a total of 150 gel spots—many of them at subpicomole amounts—were successfully analyzed, greatly enlarging a yeast two-dimensional gel data base. More than 32 proteins were novel and matched to previously uncharacterized open reading frames in the yeast genome. This study establishes that mass spectrometry provides the required throughput, the certainty of identification, and the general applicability to serve as the method of choice to connect genome and proteome.     

Interaction between human polymorphonuclear leukocytes and Streptococcus milleri group bacteria.

Because Streptococcus milleri group (SMG) bacteria--Streptococcus constellatus, Streptococcus intermedius, and Streptococcus anginosus--exhibit a striking propensity to cause abscesses, the interaction of these organisms with human polymorphonuclear leukocytes (PMNL) was examined. After incubation in pooled normal human serum, SMG stimulated less chemotaxis than did Staphylococcus aureus, in contrast to viridans streptococci, which caused greater chemotaxis than did S. aureus. PMNL ingested greater numbers of SMG and viridans streptococci than S. aureus but killed these organisms more slowly and less completely. Relative resistance to killing by PMNL is expected in organisms that cause abscesses, and inhibition of chemotaxis may contribute to pathogenicity, because delayed arrival of PMNL gives a head start to proliferating bacteria. This study helps explain the capacity of SMG to cause abscesses. It is unclear, however, why viridans streptococci, bacteria that rarely produce abscesses, share some of these same properties.     

Prevalence of and risk factors for anal human papillomavirus infection in heterosexual men

In US men, the incidence of anal cancer, the primary cause of which is human papillomavirus (HPV) infection, has increased almost 3-fold in 3 decades; however, little is known about the epidemiology of anal HPV infection, especially in heterosexual men. In 2 US cities, behavioral data and anal biological specimens were collected from 253 men who acknowledged having engaged in sexual intercourse with a woman during the preceding year. On the basis of DNA analysis, overall prevalence of anal HPV infection was found to be 24.8% in 222 men who acknowledged having had no prior sexual intercourse with men. Of the men with anal HPV infection, 33.3% had an oncogenic HPV type. Risk factors independently associated with anal HPV were lifetime number of female sex partners and frequency of sex with females during the preceding month. These results suggest that anal HPV infection may be common in heterosexual men.     

Years of good life is a well-being indicator designed to serve research on sustainability

Sustainable development (SD) as popularized by the Brundtland Commission and politically enshrined in the Sustainable Development Goals has been the explicit focus of sustainability science. While there is broad agreement that the trend of human well-being (W) over time should serve as a sustainability criterion, the literature so far has mostly addressed this in terms of its determinants rather than focusing on W itself. There is broad agreement that an indicator for W should have multiple constituents, clearly going beyond gross domestic product. Here, we propose a tailor-made indicator to serve precisely this purpose following a set of specified desiderata, including its applicability to flexibly defined subnational populations by gender, place of residence, ethnicity, and other relevant characteristics. The indicator, years of good life (YoGL), reflects the evident fact that in order to be able to enjoy any quality of life, one has to be alive and thus is primarily based on life expectancy. However, since mere survival is not considered good enough, life years are counted conditional on meeting minimum standards in two dimensions: the objective dimension of capable longevity (consisting of being out of absolute poverty and enjoying minimal levels of physical and cognitive health) and the subjective dimension of overall life satisfaction. We illustrate the calculation of this indicator for countries and subpopulations at different stages of development and with different degrees of data availability.

Sustainability science refers to the most comprehensive scholarly effort to understand the interactions between natural and social systems in order to assess whether certain developmental pathways can be considered sustainable. This should also include the possible negative effects of environmental changes, such as climate change and biodiversity loss, on future human well-being. In this paper, we propose a tailor-made indicator to assess long-term human well-being as the ultimate end of sustainable development. This indicator, called “years of good life” (YoGL), is designed in such a way that it can be both empirically measured—which is the focus of this paper—and modeled in its long-term future trends—which will be the focus of future work.When assessing changes over time in the well-being of certain human populations (or subpopulations, as defined, e.g., by gender, ethnicity, urban/rural place of residence, or other social groupings), one can focus on the determinants or the constituents of well-being. In sustainability science, thus far, empirical and theoretical research has placed more emphasis on studying the determinants, including environmental services (1), whereas specifying its constituents has received less systematic attention, often leaving us with nothing but the unspecific notion of “utility.” The focus on determinants has led to the concept of “inclusive wealth” (IW) which can be used to assess whether a society is on a sustainable development trajectory in terms of the productive base necessary to maintain a high standard of living in the future (2). However, empirically measuring the values and relative effects of the different capitals determining human well-being remains extremely challenging and “no current attempt to date can be said to be fully inclusive” (3).The idea behind YoGL, on the other hand, is to study sustainability by focusing explicitly on the constituents of well-being and its change over time. In doing so, YoGL avoids several of the pitfalls by which the IW approach is plagued (3, 4). For example, rather than making contestable quantitative assessments of the relative contributions of the different determinants of well-being, the demographic approach underlying YoGL provides numerical values of human well-being directly, expressed as the average number of years of good life a person can expect to live as part of a given subpopulation under the conditions of a specified point in time. Based on the assumed universal nature of its unit of measurement—YoGL lived today in one specific population has the same meaning as YoGL lived in the future or in another population—the indicator has a time-independent meaning. This also avoids the pitfalls of specifying a rate at which to discount future well-being, which have become apparent at least since the debates around the Stern report (5). YoGL allows us to directly compare human well-being across different subpopulations and generations. Moreover, while all estimates of the different determinants of future human well-being are highly sensitive to population growth, as a measure referring to per-person well-being the derivation of YoGL is not directly affected by assumptions about the future trajectory of population size. Finally, as stressed by Dasgupta (6), the nature of determinants can change over time and across places depending on different commodities and technological regimes, whereas the constituents of well-being—as used in YoGL—are arguably shared across space and time.In the following, we will first present the proposed design of the indicator. We will then provide a step-by-step user’s guide for empirically deriving YoGL based on the most appropriate available data source, before offering examples of how it can be calculated based on auxiliary information on populations for which the necessary data are not yet fully available. We will close with a discussion and brief outlook as to what is still needed to use this indicator for the assessment of sustainability.     

alphaB-crystallin promotes tumor angiogenesis by increasing vascular survival during tube morphogenesis

Selective targeting of endothelial cells in tumor vessels requires delineation of key molecular events in formation and survival of blood vessels within the tumor microenvironment. To this end, proteins transiently up-regulated during vessel morphogenesis were screened for their potential as targets in antiangiogenic tumor therapy. The molecular chaperone alphaB-crystallin was identified as specifically induced with regard to expression level, modification by serine phosphorylation, and subcellular localization during tubular morphogenesis of endothelial cells. Small interfering RNA-mediated knockdown of alphaB-crystallin expression did not affect endothelial proliferation but led to attenuated tubular morphogenesis, early activation of proapoptotic caspase-3, and increased apoptosis. alphaB-crystallin was expressed in a subset of human tumor vessels but not in normal capillaries. Tumors grown in alphaB-crystallin(-/-) mice were significantly less vascularized than wild-type tumors and displayed increased areas of apoptosis/necrosis. Importantly, tumor vessels in alphaB-crystallin(-/-) mice were leaky and showed signs of caspase-3 activation and extensive apoptosis. Ultrastructural analyses showed defective vessels partially devoid of endothelial lining. These data strongly implicate alphaB-crystallin as an important regulator of tubular morphogenesis and survival of endothelial cell during tumor angiogenesis. Hereby we identify the small heat shock protein family as a novel class of angiogenic modulators.