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Discourses of HIV status neutrality have emerged in the wake of advances in biomedical technologies for HIV prevention and treatment of HIV. The combined effects of Treatment as Prevention (TasP) a...

Despite widespread use of Electronic Health Records (EHR), the promise of benefits has not been clearly realised due, in part, to inadequate physician training. Training for EHR use is a highly complex intervention that occurs in a dynamic socio-technical health system. The purpose of this study was to describe and critically assess the interplay between educational activities and organisational factors that influenced EHR training and implementation across two different hospitals.Based in a socio-technical framework, a comparative qualitative case study was undertaken as well suited to real-world processes. Semi-structured interviews were completed (n = 43), representing administrative leaders, staff physicians, residents and EHR trainers from two Canadian academic hospitals. Thematic analysis was employed for analysis.Similar findings were noted at both hospitals despite different implementation strategies. Despite mandatory training, physicians described limited transferability of training to the workplace. Factors contributing to this included standardised vendor modules (lacking specificity for their clinical context); variable EHR trainer expertise; limited post-launch training; and insufficient preparation for changes to workflow. They described learning while caring for patients and using workarounds. Strong emotional responses were described, including anger, frustration, anxiety and fear of harming patients.Training physicians for effective EHR utilisation requires organisational culture transformation as EHRs impacts all aspects of clinical workflows. Analytic thinking to consider workflows, ongoing post-launch training and the recognition of the interdependency of multiple factors are critical to preparing physicians to provide effective clinical care, and potentially reducing burnout. A list of key considerations is provided for educational leaders.

Click Cu(I)-catalyzed polymerization of diynes and diazides was performed to obtain a novel type of linear copolymer, which were prepared from monomers derived from poly (ethylene glycol), 5, 5′-azodisalicylic acid [olsalazine] and 1,4-butanediol diglycidyl ether. The resulting copolymers will carry ester and azo functions along the polymer backbone, so they will be sensitive to pH as well as be degraded by azoreductase enzymes present in the colonic microbiota. Most of the copoly (azoester triazole)s obtained were water soluble, and all of them were characterized by Fourier transform infrared, nuclear magnetic resonance (NMR), and gel permeation chromatography (GPC). Differential scanning calorimetry (DSC) revealed them to be amorphous, and in general, the polymers were stable up to 250 °C under nitrogen as demonstrated by thermogravimetric analysis (TGA). The degradation behavior of the polymers was evaluated in vitro. Degradation studies were carried out at 37 °C in buffered salt solution at pH 7.4, and were monitored by GPC and NMR spectroscopies. A biodegradation experiment of a water-soluble prototype polymer showed that they are biodegradable via a strain of Enterococcus faecalis. The experiment was monitored using ultraviolet–visible spectroscopy.

A school of critical sexual health scholars argues that biomedical and digital technologies need to be understood not as mere objects of use, but as having the agentic capacity to effect new senses of the self and transform social/sexual health relations and outcomes. Such a call to grapple with the multidimensionality of technologies, their affects and effects poses a challenge to current methodological frameworks. To address this challenge, we introduce a novel visual methodology called "embodied mapping" that builds on the arts-based method of body mapping. Drawing from new materialism scholarship, embodied mapping extends the scope of inquiry of sexual-health research and conventional qualitative methods. It does so by interrogating the capacities and properties of sexual agents, technologies and readily available discourses on sexual health and HIV prevention as co-constitutive within the sexual-health-technologies nexus itself. Embodied mapping's research process is collaborative and emergent; researchers, together with an artist and research participants co-create a visual collage tracing the thick moments of sexual/health encounters. Embodied mapping's methodological and analytical capacity to approach sexual health phenomena as performative and immanent to the research process could open new sight lines for comprehending and intervening in this globalised era marked by an increasing technologising of sexual health care.

Novel linear cationic poly(amide aminotriazole)s (PATnD) with secondary amine groups in the backbone were obtained by using azide-alkyne 1,3-dipolar cycloaddition reactions: metal- and solvent-free (thermal conditions, PATTnD) or copper(I)-catalyzed (Sharpless conditions, PATCnD). PATnD were investigated in vitro against strains of E. coli, P. aeruginosa, S. aureus, and S. epidermidis. Hemolytic activity was tested using human red blood cells (hRBC), and very low or no hemolytic activity was observed. The cytotoxicity of PATnD polymers against Human Gingival Fibroblasts (HGnF) cells was concentration-dependent, and significant differences between PATT1D and PATC1D were observed. The ability of these polymers to induce resistance against both Gram-positive and Gram-negative bacteria was also assessed. Studied bacterial strains acquired resistance to catalytic polymers (PATCnD) in initial passages meanwhile resistance to thermal polymers (PATTnD) appears in later passages, being the increase of the minimum inhibitory concentration lower than in catalytic polymers. This result, together with the higher biocidal capacity of thermal polymers compared to catalytic ones, seems to suggest an influence of the regiospecificity of the polymers on their antibacterial characteristics. This study also demonstrates that PAT1D polymers, which do not appear to have strong hydrophobic residues, can exert significant antimicrobial activity against Gram-positive bacteria such as S. epidermidis. This pair of polymers, PATC1D and PATT1D, displays the greatest antimicrobial activity while not causing significant hemolysis along with the lowest susceptibility for resistance development of the polymers evaluated.

Background Conventional models of cultural humility - even those extending analysis beyond the dyad of healthcare provider-patient to include concentric social influences such as families, communities and institutions that make clinical relationships possible - aren't conceptually or methodologically calibrated to accommodate shifts occurring in contemporary biomedical cultures. More complex methodological frameworks are required that are attuned to how advances in biomedical, communications and information technologies are increasingly transforming the very cultural and material conditions of health care and its delivery structures, and thus how power manifests in clinical encounters. Methods In this paper, we offer a two-pronged intervention in the cultural humility literature. At a first level of analysis, we suggest the need to broaden understandings of culture and associated workings of power to accommodate the effects of biomedicine's technologising turn. A second level of intervention invites experimentation to broaden the availability of methodological tools to analyse and assess the multidimensionality of technologies and their agentic effects in healthcare encounters. Results Drawing from new materialism theories, practices of care are approached "diffractively" as contingent and dynamic material-discursive events. Our neo-materialist framework for cultural humility expands analytical sight-lines beyond hierarchical relationships and dichotomies privileging humans (practitioner and/or patient) as sole actants in the clinical exchange. Attended to are the ongoing dynamics of practices entangling big-data driven knowledges and interventions, pharmacological technologies and material instruments and devices, diseases, and the bodies/subjectivities of health care providers and patients. We investigate the implications for clinical assessment if a cultural humility framework is methodologically attuned to the clinical encounter as a discontinuous, discursive-material process producing multiple, contextually emergent data moments and objects for analysis. Conclusion Engaging evaluative inquiry diffractively allows for a different ethical practice of care, one that attends to the forms of patient and health provider accountability and responsibility emerging in the clinical encounter.

This article builds upon Paul Preciado’s conceptualisation of pharmaco-pornographic power to understand the ongoing affects and effects of Pre-Exposure Prophylaxis (PrEP) on queer men’s sexual socialities and subjectivities. Drawing from a new-materialist epistemology, we analyze data from a sexual health pilot study in NYC to trace the techno-sexual health assemblages forming in queer life worlds. Our analysis suggests that these assemblages, entangling PrEP and other pharmacological substances, pornographic imaginaries together with mediatic technologies and public health rationalties, are creating paradoxical desires and practices of intimacy that are both normative and exceed rational health-actor logics and normative understandings of risk. These effects have population-level biopolitical implications.

We describe the synthesis and characterization of four new light and reduction sensitives poly(azoamide triazole)s, in which the azobenzene units are found along the main chain of the macromolecule. These polymers were prepared by the azide-alkyne cycloaddition reaction catalyzed with copper (I) (CuAAC). They were obtained in high yield and with apparent molecular weights in the range from 95 to 148 kDa. All poly(azoamide triazole)s are soluble in polar aprotic solvents, and two of them are also soluble in chloroform showing good coating and film-forming properties. They were characterized by Fourier transform infrared, nuclear magnetic resonance (NMR), ultraviolet-visible spectroscopy and gel permeation chromatography (GPC). The photoisomerization study of the synthesized polymers has been carried out by UV–Vis spectroscopy, as well as their trans-cis-trans reversibility behavior. Differential scanning calorimetry (DSC) and themogravimetric analysis (TGA) were used to investigate their thermal properties. Results show that the polymers were amorphous and stable up to 300 °C under nitrogen. The hydrolytic degradation of films of these polymers has been studied in vitro under various conditions of pH and temperature and was monitored by GPC. Furthermore, the presence of azo units along the polymer backbone as cleavable groups provides access to their degradation by reduction. In this sense, the degradation of polymers has also been studied using sodium dithionite as a mimic of the enzyme azoreductase. The results of these studies show that the polymers are stable enough under hydrolytic physiological conditions, but they degrade rapidly when sodium dithionite is used. A preliminary study of biocompatibility of polymers PAAT1 and PAAT4 has been carried out. A hemolysis study with human red blood cells (hRBC) and a cytotoxicity study with human gingival fibroblasts (HGnF) have been carried out. The results obtained suggest that these polymers could be good candidates to be used as drug coating materials. Ministerio de Economía y Competitividad MAT2016-77345-C3-2-P Universidad de Sevilla VI Plan Propio, PP2021/00000658

This paper enquires into the nexus of migration with sexual health among gay Latino migrants in Canada. Interviews with 25 Spanish-speaking interviewees are examined in light of models developed from studies of Latinos in the United States. Canadian immigration policy appears to result in a somewhat different selection of immigrants compared to the United States. Migrants come from a wide range of national and regional backgrounds intersected by race, generation, and social class that influence their perceptions of and adjustment to Canadian society. Pre-migration HIV knowledge varied strongly by generation with older men recalling public panic concerning HIV and younger men receiving formal education about it. Migration enters into the mix of conditions as kin ties can be less confidently relied on among gay men compared to their heterosexual counterparts and by exacerbating vulnerability among those seeking to develop new social and sexual networks.

Context Academic journals represent shared spaces wherein the significance of thematic areas, methodologies and paradigms are debated and shaped through collective engagement. By studying journals in their historical and cultural contexts, the academic community can gain insight into the ways in which authors and audiences propose, develop, harness, revise and discard research subjects, methodologies and practices. Methods Thirty top-cited articles published in Medical Education between 1986 and 2014 were analysed in a two-step process. First, a descriptive classification of articles allowed us to quantify the frequency of content areas over the time span studied. Secondly, a discourse analysis was conducted to identify the continuities, disruptions and tensions within the three most prominent content areas. Results The top-cited articles in Medical Education focused on three major areas of interest: problem-based learning, simulation and assessment. In each of these areas of interest, we noted a tension between the desire to produce and apply standardised tools, and the recognition that the contexts of medical education are highly variable and influenced by political and financial considerations. The general preoccupation with achieving efficiency may paradoxically jeopardise the ability of medical schools to address the contextual needs of students, teachers and patients. Conclusions Understanding the topics of interest for a journal's scholarly audience and how these topics are discursively positioned, provides important information for researchers in deciding how they wish to engage with the field, as well as for educators as they assess the relevance of educational products for their local contexts.

Context Health care delivery and the education of clinicians have changed immensely since the creation of the journal Medical Education. In this project, we seek to answer the following three questions: How has the concept of collaboration changed over the past 50 years in Medical Education? Have the participants involved in collaboration shifted over time? Has the idea of collaboration itself been transformed over the past 50 years? Methods Starting from a constructionist view of scientific discourse, we used directed content analysis to sample, code and analyse 144 collaboration-related articles over the 50-year life span of Medical Education. We developed an analytical framework to identify the key components of varying articulations of ‘collaboration’, with a focus on shifts in language and terminology over time. Our sample was drawn from an archive of 1221 articles developed to celebrate the 50th anniversary of Medical Education. Results Interprofessional collaboration is conceptualised in three primary ways throughout our sample: as a psychometric property; as tasks or activities, and, more recently, as ‘togetherness’. The first conceptualisation articulates collaboration as involving knowledge or skills that are teachable to individuals, the second as involving the education of teams to engage in structured meetings or task distribution, and the third as the building of networks of individuals who learn to form team identities. The ‘leader’ of collaboration is typically conceptualised as the doctor, who is consistently articulated by authors as the active agent of collaborative care. Other clinicians and students of other professions are, as the wording in this sentence suggests, usually positioned as ‘others’, and thus as more passive participants in, or even observers of, ‘collaboration’. Conclusions In order to meet goals of meaningful collaboration leading to higher-quality care, it behoves us as a community of educators and researchers to heed the ways in which we teach, think and write about interprofessional collaboration, interrogating our own language and assumptions that may be betraying and reproducing harmful care hierarchies.

Canadian media discourses on gay men's sexuality and political inclusion serve as a rich site for understanding current tensions in debates on sexual citizenship under biopolitical regimes. This paper addresses how public health reporting in one health news media source, Canada's leading newspaper The Globe and Mail, discursively produced contiguous understandings of the moral, social and biological dimensions of gay male subjectivity and sexuality within the context of HIV risk discourses. Specifically, we critically examine the newspaper's coverage of what constitutes the public good when national blood supplies are at stake. Our analysis reveals a profound dichotomy in which gay men - as sexual subjects and subjects of rights - are recalibrated following the political and economic investments of bourgeoisie communities of interest. However encompassing the securing of legal social rights might be, gay men's sexuality is resistant to a reformatting under a heteronormative regulatory regime, as the social traumas caused by HIV continue to cast a shadow on sexual behaviours that purportedly risk leakage of contamination into the body politic.

The Cuéntame! Study interviewed 25 Spanish-speaking gay and bisexual men in Toronto. Their migration experiences are traversed by economic rationales, security concerns, and the embodied experiences of race, gender, culture, and sexuality. Most express narratives of empowered opportunity in distancing themselves from restrictive sexual regimes of their place of origin, but at the same time, many migrants trade a new sense of social acceptance as gay for marginalized statuses defined by diminished social and economic capital. The social participatory rights of citizenship are particularly affected by sexuality and social class. The need and desire to establish social and sexual connections in a new environment often characterized by economic vulnerability shape experiences of social capital and citizenship rights.

Drawing on the sociology of morality, this article analyses the social contexts, discourses and ethno-methods of everyday life that shape real-world decisions of gay men around HIV prevention. Through an analysis of the predominant narratives in an online public forum created for an HIV prevention campaign, this article explores the ways in which homosexually active men engage in everyday moral reasoning and challenge a neoliberal moral order of risk and responsibility. The article concludes that gay and bisexual men engage in forms of practical morality with their sexual partners and imagine larger communities of interest, love, companionship and pleasure. At the same time, they draw heavily from discourses on individual and rational responsibility, as well as narratives of romance and community, that shape forms of moral selfhood. Risk management techniques that are grounded in notions of rational choice and that are insensitive to the emotional worlds that these men inhabit create situations of risk avoidance but also inadvertently open them to new forms of vulnerability.

The modern food system has radically modified the social-anthropological framework that informs food choices. To explore factors that influence food choices within this modified framework, eight focus groups consisting of women 15–45 years old were conducted in Nova Scotia (Canada). Using a grounded theory approach, two main themes emerged centered around (1) perceptions of a changing culinary order that emphasizes individual dietary responsibility and decision making and (2) the confusion/anxiety experienced as participants try to assimilate the information generated by today’s modern food system. Participants inextricably linked food and health to the point where it was the central organizing determinant guiding their food selection. They also felt the need to make informed dietary choices, but perceived their search for a healthy diet to be thwarted by the amount, type, and accuracy of information concerning the elements in today’s food products. A constant search for accurate information and the instability of what participants consider expert advice contribute to feelings of anxiety around food choices and a sense of futility in their efforts to navigate through the information available. The focus group discussions reflected the emergence of an Orthorexic Society, whereby individuals are socialized to take charge of their own dietary health. They do so constrained by a food system that is increasingly complex, contradictory, and opaque and where commercial dietary regimes offer quick yet incomplete solutions.