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ABSTRACTThe opportunities and challenges that younger, female, civilian researchers can encounter when undertaking ethnographic research with predominantly male military veterans are relatively underexplored sociologically. This is despite a growing literature on reflexivity in military studies over the past decade. To address this gap, we draw on symbolic interactionist insights to examine the reflective account of a British, female researcher in her mid-20s, who conducted qualitative research with 20 ‘older’ (aged 60+) retired servicemen from the Royal British Legion, a United Kingdom charity providing support for military veterans and their families. The study explored ex-servicemen’s embodied experiences of physical activity. The findings presented here cohere around four salient themes identified in the ethnographic reflections: (1) researcher positionality as a young, female, civilian researcher in a traditionally masculine militarised world; (2) managing distressing topics and interactional discomfort; (3) maintaining an ‘ethic of care’; and (4) dilemmas regarding representational issues and ex-servicemen’s embodied experiences.

I really enjoyed Meaghan Winter's "The New Supervision" (November/ December). Minneapolis, MN A Magic Touch Jay Lappin's "Through the One-Way Mirror" (November/December) captures more than his education as a family therapist. Although I can appreciate Lappin's early imposter syndrome when he first joined the clinic, considering the brilliance of the characters in this story, he beautifully captured the humanity of those ground-breaking therapists after he realized his place among them. [Extracted from the article]

Using an online tool, we report the association between tasks and ‘affect’ (underlying experience of feeling, emotion or mood) among 565 doctors in training, how positive and negative emotional intensity are associated with time of day, the extent to which positive affect is associated with breaks, and consideration about leaving the profession. Respondents spent approximately 25% of their day on paperwork or clinical work that did not involve patients, resulting in more negative emotions. Positive emotions were expressed for breaks, staff meetings, research, learning and clinical tasks that involved patients. Those having considered leaving the profession report more negative feelings. Systematic workplace changes (regular breaks, reducing paperwork and improved IT systems) could contribute to positive workday experiences and reduce intention to quit. Educators and employers have important roles in recognising, advocating for and implementing improvements at work to enhance wellbeing with potential to improve retention of doctors in training.

Awareness of drug‐drug interactions is critical in organ transplant recipient management. However, biologic agents interfering with monoclonal antibodies is not widely considered. We report the effect of high‐dose intravenous immunoglobulin (IVIg) on safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of the human anti‐C5 monoclonal antibody tesidolumab (LFG316) in end‐stage renal disease patients awaiting kidney transplant. In this single‐center, phase 1, open‐label, parallel‐group study, 8 patients were assigned to receive either single‐dose tesidolumab + IVIg or tesidolumab alone, with 56‐day follow‐up. Within‐group PK parameters were consistent. Mean tesidolumab exposure decreased 34%, clearance increased 63%, and half‐life decreased 41% comparing tesidolumab + IVIg to tesidolumab alone. IVIg influence on tesidolumab elimination was most evident in the first 3 weeks. Complete suppression of both total and alternative complement activities was maintained for 4 weeks in the tesidolumab alone group and for 2 weeks in the tesidolumab + IVIg group. Tesidolumab was well tolerated. IVIg infused before tesidolumab affected tesidolumab PK and PD, resulting in a shortened period of full complement activity inhibition. These findings suggest a clinically relevant impact of IVIg on monoclonal antibody clearance and indirectly hint at an IVIg mechanism of action in treating autoimmune diseases and allosensitization by accelerating pathogenic IgG antibody degradation. Trial registration number: NCT02878616. This article shows that concurrent administration of high dose intravenous immunoglobulin causes a therapeutically relevant reduction in the complement inhibition efficacy of anti‐C5 monoclonal antibody tesidolumab.

The ZnO/Cu2O heterojunction promises high efficiency in photocurrent conversion and other light-driven processes, but the lattice mismatch between ZnO and Cu2O leads to slow electron transfer and low conversion efficiency. In addition, the stability of Cu2O is still the main challenging and limiting factor for device applications in real environments. CuxO is a mixed semiconductor of CuO and Cu2O, which is a promising alternative to Cu2O in device fabrication due to its better stability and photocatalytic efficiency. In this work, CuxO nanorods were attached to vertically aligned gold-decorated ZnO nanorods, creating a hierarchical ZnO/Au/CuxO nanoforest. In addition, the hierarchical surface shows superhydrophobicity, which can prevent Cu2O degradation by water and oxygen. Femtosecond time-resolved transient absorption spectroscopy was employed to investigate the electron transfer dynamics in the ZnO/Au/CuxO heterojunction. The nanoforest demonstrates enhanced electron mobility, increased lattice match, and higher photocurrent conversion efficiency compared with bare ZnO, CuxO, or ZnO/CuxO.

In clinical practice, the co-existence of endometriosis and gastrointestinal symptoms is often observed. Using large-scale datasets, we report a genetic correlation between endometriosis and irritable bowel syndrome (IBS), peptic ulcer disease (PUD), gastro-esophageal reflux disease (GORD), and a combined GORD/PUD medicated (GPM) phenotype. Mendelian randomization analyses support a causal relationship between genetic predisposition to endometriosis and IBS and GPM. Identification of shared risk loci highlights biological pathways that may contribute to the pathogenesis of both diseases, including estrogen regulation and inflammation, and potential therapeutic drug targets (CCKBR; PDE4B). Higher use of IBS, GORD, and PUD medications in women with endometriosis and higher use of hormone therapies in women with IBS, GORD, and PUD, support the co-occurrence of these conditions and highlight the potential for drug repositioning and drug contraindications. Our results provide evidence of shared disease etiology and have important clinical implications for diagnostic and treatment decisions for both diseases.

The delivery of healthcare is a major contributor to the climate crisis, with the NHS being the largest public sector contributor of carbon emissions in the UK. Physicians have an important role to play in the fight against climate change through the practice of sustainable healthcare. This involves maintaining the current and future quality of healthcare through balancing environmental, social and financial constraints. To this end, integrating these skills into medical education is crucial. A large number of medical schools have already embedded planetary health and sustainability theory into their curriculum, however, there is no formal sustainability curriculum in postgraduate education and training. This is vital for enabling clinicians to translate sustainability theory taught at undergraduate level into clinical practice. This article proposes which topics should be included in a postgraduate sustainability curriculum and explores various methods that could be used to incorporate these into the current educational framework.