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For many heart failure patients, a heart transplant is required. Few hospitals in Canada perform heart transplants; thus, patients and caregivers must relocate to access transplant care.This study explores Canadian patients' and caregivers' experiences of to access transplant care and how patients and caregivers define home. The study's goal is to gain insights from the patient and caregiver experience and identify opportunities to improve the experience for those who relocate to access heart transplants. The research question was: How is the concept of home connected to the heart transplant journey?We conducted 18 interviews with advanced heart failure patients and caregivers, to explore patient and caregiver experiences of relocating to access transplant care. Patients and caregivers ranged in ages from 20's to 60's and had left their home of origin to move to a new location where medical care was available. 7 patients were male, 3 were female. All caregivers were female.Patients and caregivers identified three supports during relocation: other patients and caregivers, medical team and family. Patients and caregivers defined home as friends, family, community, warmth, safety, belonging and comfort.During relocation, patients and caregivers were supported by: other patients and caregivers, their medical team and family, and how these people made them feel: safe, warm, comfortable and that they belonged is how they defined home. The supports and definitions of home are connected; thus, a sense of home is inextricably linked to the transplant journey for patients and caregivers.

Sanism is an oppression. It makes normal the practice of discrimination, rejection, silencing, exclusion, low expectations, incarceration, and other forms of violence against people who are othered through mental ‘illness’ diagnosis, history, or even suspicion. Of particular concern for us are the sanist experiences of racialized people who identify as Black, African, or of African descent, for we and others have long noted and experienced an anti-Black crisis in mental health diagnosis and “care.” For instance, young Black men are diagnosed with schizophrenia more than any other group, Black children are being psychiatrized at higher rates, and in our experience on the front lines here in Toronto, more Black-identified patients are being held against their will in hospitals. Is what we are seeing here a kind of sanism, a particular form of racism, or something combined that has not yet been named? In 2013, we three authors began to call this place of intersection anti-Black Sanism, starting a historical, theoretical, methodological, personal, and practice conversations in our community work, in our research, and in our classrooms. In this article, we outline our analyses thus far. We also chart the responses we have had to date, responses of the community, research, and pedagogical kinds. We detail how the anti-Black Sanist experience makes itself present in multiple places and spaces complicating “care,” critique, and madness.

Sanism is a devastating form of oppression, often leading to negative stereotyping or arguments that individuals with ‘mental health’ histories are not fit to study social work. However, the term sanism is rarely used, understood, or interrogated in the social work academy, even in anti-oppressive spaces. Indeed, social work has been so loyal to the medical model that sanist aggressions, such as pathologizing, labelling, exclusion, and dismissal have become a ‘normal’ part of professional practice and education. We query the moral integrity of a profession that at its foundational core could play a role in such a discriminatory tactic as sanism. We wonder what the effect of this has been on social work and its education. We ask, who has been excluded, what has been silenced or denied because of the privileging of medical conceptualizations of madness, and how can we work toward anti-sanist social work today? In this paper we provide an overview of sanism. We offer a more critical review of the literature on ‘mental health’ and social work. We report on our anti-sanist participatory pilot research, and aligned with current Canadian rights work, we call for action with respect to how social workers theorize, research, and respond to madness now.

COVID-19 has saturated many spaces in loss and grief. Higher education has been saturated too, despite ongoing institutional demands that educators mitigate and manage the grief away. Such demands expose the colonial and carceral logics that operate in much of so-called higher education, logics that may often create what we call ‘transcarceral grief’. Inspired by abolitionist activist scholarship, we understand transcarceral grief as an involuntary response to the surveillance, compliance, discipline, and punishment practices (or carceral logics) that have made education a site of restriction and confinement. Such a lens demonstrates how dangerous many of the ‘must-do’s’ of grief and pedagogy can be and changes how we understand our own pandemic pedagogy. Thus, in this piece, we draw on scholarship, activism, theory, and narrated experiences to identify and work against transcarcerality while teaching/learning with grief in our Canadian and American institutions. Rather than mitigating, managing or recovering from grief, we offer a grief-facing praxis that has the potential to disrupt and re-form how we metabolize grief in higher education. Further, we posit that our anti-transcarceral grief pedagogy has the potential to move us closer to the life-affirming space that we crave more than ever both in and out of the classroom.

How do we limit our focus to mental health when Indigenous teaching demands a much wider lens? How do we respond to mental health recovery when Indigenous experience speaks to a very different approach to healing, and how can we take up the health of Indigenous people in Canada without a discussion of identity and colonization? We cannot, for the mental health and recovery of Indigenous people in Canada have always been tied to history, identity, politics, language and dislocation. Thus, in this paper, our aim is to make clear that history, highlight the impacts of colonization and expound on Indigenous healing practices taking place in Toronto. Based on findings from a local research project, we argue these healing practices go beyond limited notions of recovery and practice, offering profound and practical ways to address the physical, emotional, spiritual and mental health of Indigenous peoples.

Of heart transplant recipients, 30 per cent report ongoing or episodic emotional issues post-transplant, which are not attributable to medications or pathophysiological changes. To this end, our team theorized that cardiac transplantation introduces pressing new questions about how patients incorporate a transplanted heart into their sense of self and how this impacts their identity. The work of Merleau-Ponty provided the theoretical underpinning for this project as it rationalizes how corporeal changes affect one’s self and offer an innovative framework to access these complex aspects of living with a transplanted heart. We used visual methodology and recorded 25 semi-structured interviews videographically. Both visual and verbal data were analyzed at the same time in an iterative process. The most common theme was that participants expressed a disruption to their own identity and bodily integrity. Additionally, participants reported interconnectedness with the donor, even when the transplanted heart was perceived as an intruder or stranger. Finally, transplant recipients were very vivid in their descriptions and speculation of how they imagined the donor. Receiving an anonymous donor organ from a stranger often leaves the recipient with questions about who they themselves are now. Our study provides a nuanced understanding of heart transplant recipients’ embodied experiences of self and identity. Insights gained are valuable to educate transplant professionals to develop new supportive interventions both pre- and post-transplant, and to improve the process of informed consent. Ultimately, such insights could be used to enable heart transplant recipients to incorporate the graft optimally over time, easing distress and improving recovery.

Critical qualitative health researchers typically occupy and navigate liminal academic spaces and statuses, with one foot planted in the arts and social sciences and the other in biomedical science. We are at once marginalized and empowered, and this liminality presents both challenges and opportunities. In this article, we draw on our experiences of being (often the lone) critical qualitative health scholars on thesis advisory committees and dissertation examinations, as well as our experiences of publishing and securing funding, to illuminate how power and knowledge relations create conditions that shape the nature of our roles. We share strategies we have developed for standing our theoretical and methodological ground. We discuss how we use the power of our liminality to hold firm, push back, and push forward, to ensure that critical qualitative research is not further relegated to the margins and its quality and integrity sustained.

This study examines Generation Z’s buying habits and whether a company’s social responsibility (CSR) impacts purchasing decisions. A content analysis was conducted using nine factors (sustainability prominence on website, human rights prominence on website, mission statement, source of manufacturing, percentage of line dedicated to recycled product, independent/accredited agencies involving recycling and sustainability, independent/ accredited agencies involving animal welfare, independent/ accredited agencies involving worker welfare, and the “Good on You” rating) in order to evaluate nine different apparel companies impact on environmental, social, and overall company production aspects. The companies used were Nike, Adidas, Vans, Ugg, Patagonia, New Balance, North Face, Levi’s, and Under Armour. This content analysis was paired with a survey to determine which factors were relevant to consumers and if CSR influenced purchasing habits.

Human Trafficking is the emerging social-safety issue surrounding most communities across the globe. Unfortunately, due to it’s untraceable nature, and free victims fearing to go public with information, human trafficking is not often discussed or warned against. The purpose of this study is to target local students from Central Florida through analyzing their preferred approaches of education regarding the basis of human trafficking. The method involved a completely anonymous online survey with ten specific questions distributed to high school and college students from across six schools in addition to interviews with two adults actively engaged in the cause of human trafficking and three chosen student participants. The questionnaire sought to collect students’ passionate opinions on handling the teaching of difficult social troubles such as human trafficking. A total of 123 respondents completed the survey; 44.7% particularly desired annual presentations, 37.4% chose the inclusion of content in classes already required, and 9.8% selected mandated online courses. Interviews revealed that educational methods should not be prioritized, but instead the initiative or beginning force in means to widely spread accurate truths about human trafficking. Overall, these students from Central Florida demonstrated that in order to promote human trafficking awareness, productive conversations throughout schools as well as small incentives such as visual posters, pamphlets or resourceful packets are enough to secure an increase in knowledge of the dangers and commonality of human trafficking.

Politics are a fundamental part of human society, and as such, studies have been done to attempt to find ways to predict one’s political views, particularly for advertising purposes. In recent years, politicians and political movements have begun to employ the use of popular music or musicians to accompany their causes and advertisements. Studies have been done in the past to determine whether or not a correlation exists between politics and music, yet most have fallen short in data collection or simply did not achieve any results with correlation. This study attempts to go beyond previous studies by using more accurate data reporting with Spotify’s API, which allows for data collection from a participant’s entire listening history on the platform. All of the programming, survey questions, excel formulas and instructions can be found at https://github.com/ajlacognata/researchspotifyapp if you wish to attempt to replicate this study.

Integrating computing into other subjects promises to address many challenges to offering standalone CS courses in K-12 contexts. Integrated curricula must be designed carefully, however, to both meet learning objectives of the host discipline and to gain traction with teachers. We describe the multi-year evolution of Bootstrap, a curriculum for integrating computing into middle- and high-school mathematics. We discuss the initial design and the various modifications we have made over the years to better support math instruction, leading to our goal of using integrated curricula to cover standards in both math and CS. We provide advice for others aiming for integration and raise questions for CS educators about how we might better support learning in other disciplines.

The FFA, an American agricultural educational organization, was studied to determine its influence on the meat paradox, an ambivalent response towards eating meat while being troubled about its moral consequences. The study was completed using survey research, which involved asking FFA and non-FFA members about their feelings towards eating different types of meat, such as cows and rabbits. Participants were asked whether they would eat a particular animal and then their reasoning when choosing not to. The results were collected and compared between the FFA and non-FFA members’ responses. Overall, FFA members were more likely to eat abnormal animals. However, whenever participants decided that they were unwilling to eat an animal, FFA members reasoned that they wouldn’t like its taste while non-FFA members chose that it was against their morals. This may reveal a lower moral connection to animals when FFA members, or other individuals who work with animals regularly, spend more time with specific species. This study has implications in the field of psychology, but more specifically paradox, cognitive dissonance, and dehumanization studies. These results suggest for further research into the influence of other variables on ambivalence as well as additional maintenance strategies involved in paradoxes.

The paper engages with a variety of data around a supposedly single biomedical event, that of heart transplantation. In conventional discourse, organ transplantation constitutes an unproblematised form of spare part surgery in which failing biological components are replaced by more efficient and enduring ones, but once that simple picture is complicated by employing a radically interdisciplinary approach, any biomedical certainty is profoundly disrupted. Our aim, as a cross-sectorial partnership, has been to explore the complexities of heart transplantation by explicitly entangling research from the arts, biosciences and humanities without privileging any one discourse. It has been no easy enterprise yet it has been highly productive of new insights. We draw on our own ongoing funded research with both heart donor families and recipients to explore our different perceptions of what constitutes data and to demonstrate how the dynamic entangling of multiple data produces a constitutive assemblage of elements in which no one can claim priority. Our claim is that the use of such research assemblages and the collaborations that we bring to our project breaks through disciplinary silos to enable a fuller comprehension of the significance and experience of heart transplantation in both theory and practice.

Former BSW student: I’m really worried about this job interview. I know they are going to think I am too critical, too passionate, too much. How can I dumb myself down Jennifer? How do I get in the door so I can do the work I want to do? Maybe staying quiet will get me the job I need…maybe I should shut up about AOP? This was part of a conversation I had last week, with a passionate, anti-oppressive and critical former undergraduate student who had been told, on more than one occasion, that she was just “too much” for the ‘mainstream’ social work organizations to which she had been applying for employment. It was not the first time one of my graduates had shared such worries, for many had reported negative workplace reactions to their critical and anti-oppressive stance, nor would it be the last. As the literature reminds us, social workers are now labouring in a post-welfare context where critiques of power, racism, ageism, sexism, heterosexism and ableism will not make ‘best practice’ lists unless they also save money and increase productivity (Baines, 2007; Hugman, 2001). As Donna Baines writes

Objectives The purpose of the study was to examine the loss and grief experiences of patients waiting for and living with new hearts. Background There is much scholarship on loss and grief. Less attention has been paid to these issues in clinical transplantation, and even less on the patient experience. Methods Part of a qualitative inquiry oriented to the work of Merleau-Ponty, a secondary analysis was carried out on audiovisual data from interviews with thirty participants. Results Patients experience loss and three forms of grief. Pre-transplant patients waiting for transplant experience loss and anticipatory grief related to their own death and the future death of their donor. Transplanted patients experience long-lasting complicated grief with respect to the donor and disenfranchised grief which may not be sanctioned. Conclusions Loss as well as anticipatory, complicated and disenfranchised grief may have been inadvertently disregarded or downplayed. More research and attention is needed.

Introduction The medical model of mental illness/health is based on a system that often locates the “problem” within an individual, takes that individual out of their context and community, and seeks to treat and change. In the name of “best practice,” those treatments may be iatrogenic, involve multiple rights violations, as well as perpetuation of a kind of discrimination known as sanism. The “insane,” once labeled, or suspected of being thus are often incarcerated, and if released, surveilled in multiple ways.

Purpose Policies and procedures exist in many jurisdictions regarding ‘anonymity’. These prohibit communication between transplant recipients and donor families. Social media may enable identification of donor families/recipients resulting in unsupervised communication and exchange of information. We have previously reported that heart transplant recipients want to connect with their donor families. The purpose of this study was to ask heart donor families what they thought about current practices around anonymity. Methods This was a phenomenologically informed audiovisual qualitative study. Inclusion criteria: ability to provide informed consent, having consented to heart donation, between 1 and 10 years after consent to donation, ability to communicate their experiences with clarity. Semi-structured open ended interviews were conducted in their homes, by an experienced qualitative interviewer. Interviews were audio/video-taped to capture voice and body language and were transcribed verbatim. Data collected also included personal artifacts (e.g. photos, letters) and field notes. Analysis involved coding language, bodily gestures, volume and tone in keeping with our phenomenologically informed visual method. Results Mean time since donation was 61.7 months (± 31.01; range 15-115 months). 22 donor families (40 participants) were interviewed from across Canada (27% Alberta, 32% Ontario & 41% B.C). Mean interview duration was 72 minutes (range 19-149). Four key themes emerged relating to anonymity: 21/22 families wanted to know the recipient(s), 19/22 wanted to meet the recipient(s). 17 had received letters from the recipient(s) and 12 had sent letters. Those who didn't write a letter frequently cited concerns around 3rd party vetting and redaction as a barrier. 21 of 22 donor families wanted to meet their recipients, and wanted to see policy change to enable this. Conclusion Donor families want to know and meet the recipients. This is in keeping with the views of heart transplant recipients who wish to know their donor families. We believe it is time to re-assess current policies on anonymity in transplantation. Donor families raised many possible solutions to how this may be accomplished.

In this article, we introduce a pilot project at a Canadian school of social work, a project that asked whether this expressly anti-oppressive school was really open to Mad students (or those with mental health issues). Using principles of community-based participatory research, we interviewed eight students who identified as having had experiences with mental health issues and asked them to speak about their experiences in the classroom. Working with the data, we co-voiced next steps for pedagogy, research, and action around madness and social work.

The recent reports of methane in the atmosphere of Mars, as well as the findings of hypersaline paleoenvironments on that planet, have underscored the need to evaluate the importance of biological (as opposed to geological) trace gas production and consumption, particularly in hypersaline environments. Methane in the atmosphere of Mars may be an indication of extant life, but it may also be a consequence of geologic activity and/or the thermal alteration of ancient organic matter. On Earth these methane sources can be distinguished using stable isotopic analyses and the ratio of methane (C1) to C2 and C3 alkanes present in the gas source (C1/(C2 + C3)). We report here that methane produced in hypersaline environments on Earth has an isotopic composition and alkane content outside the values presently considered to indicate a biogenic origin. Methane-rich bubbles released from sub-aqueous substrates contained δ13CCH4 and δ2HCH4 values ranging from −65‰ to −35‰ and −350‰ to −140‰ respectively. Higher salinity endoevaporites yielded what would be considered non-biogenic methane based upon stable isotopic and alkane content, however incubation of crustal and algal mat samples resulted in methane production with similar isotopic values. Radiocarbon analysis indicated that the production of the methane was from recently fixed carbon. An extension of the isotopic boundaries of biogenic methane is necessary in order to avoid the possibility of false negatives returned from measurements of methane on Mars and other planetary bodies.

A critique of regulation in the helping professions, this chapter is a riveting investigation into the everyday practices by which able nurses are declared “unfit to practice.” The researchers trace the construction of two nurses as “unfit,” showing the conflation of “mental illness” with incompetence. In one of the cases, they additionally show how anti-Black racist prejudices became de-raced and reinscribed as “incompetence” because of “mental illness.”

Motivated by the increasingly abundant evidence for hypersaline environments on Mars and reports of methane in its atmosphere, we examined methanogenesis in hypersaline ponds in Baja California Sur, Mexico, and in northern California, USA. Methane-rich bubbles trapped within or below gypsum/halite crusts have δ¹³C values near -40‰. Methane with these relatively high isotopic values would typically be considered thermogenic; however, incubations of crust samples resulted in the biological production of methane with similar isotopic composition. A series of measurements aimed at understanding the isotopic composition of methane in hypersaline systems was therefore undertaken. Methane production rates, as well as the concentrations and isotopic composition of the particulate organic carbon (POC), were measured. Methane production was highest from microbial communities living within gypsum crusts, whereas POC content at gypsum/halite sites was low, generally less than 1% of the total mass. The isotopic composition of the POC ranged from -26‰ to -10‰. To determine the substrates used by the methanogens, ¹³C-labeled methylamines, methanol, acetate, and bicarbonate were added to individual incubation vials, and the methane produced was monitored for ¹³C content. The main substrates used by the methanogens were the noncompetitive substrates, the methylamines, and methanol. When unlabeled trimethylamine (TMA) was added to incubating gypsum/halite crusts in increasing concentrations, the isotopic composition of the methane produced became progressively lower; the lowest methane δ¹³C values occurred when the most TMA was added (1000 μM final concentration). This decrease in the isotopic composition of the methane produced with increasing TMA concentrations, along with the high in situ methane δ¹³C values, suggests that the methanogens within the crusts are operating at low substrate concentrations. It appears that substrate limitation is decreasing isotopic fractionation during methanogenesis, which results in these abnormally high biogenic methane δ¹³C values.

Transplant recipients are encouraged to write anonymous thank-you letters to the donor family. We prospectively explored heart transplant recipients' embodied responses to the 'obligation' to write a thank-you letter using audio/video-taped open-ended interviews (N = 27). Fifteen of the 19 participants, who wrote letters to the donor family, expressed or visually revealed significant distress about issues such as the obligation to write anonymously and the inadequacy of the 'thank-you'. Writing the thank-you letter is not a neutral experience for heart transplant recipients. Rethinking the obligatory practice regarding the thank-you letter and developing the necessary support for the recipient through this process is necessary.

In earlier work the concept of Orientation (O) was proposed as the key factor in successful literacy acquisition. This article develops that idea further to discuss the potential of Orientation The...

In this article, the authors report on a qualitative study that explored the use of narrative therapy with a diverse group of older adults dealing with mental health and substance misuse issues. Narrative therapy supports individuals to critically assess their lives and develop alternative and empowering life stories that aim to keep the problem in its place. Although the literature suggests this is a promising intervention for individuals, there is a lack of research on narrative therapy and group work. Aiming to address this gap, the authors developed and researched a narrative therapy group for older adults coping with mental health and substance misuse issues in Toronto, Canada. Taking an ethnographic approach, field notes and interviews provided rich data on how, when, and for whom, such a group could be beneficial. Findings contribute to the literature on group work, older adults, and narrative therapy.

How do we limit our focus to mental health when Indigenous teaching demands a much wider lens? How do we respond to mental health recovery when Indigenous experience speaks to a very different approach to healing, and how can we take up the health of Indigenous people in Canada without a discussion of identity and colonization? We cannot, for the mental health and recovery of Indigenous people in Canada have always been tied to history, identity, politics, language and dislocation. Thus, in this paper, our aim is to make clear that history, highlight the impacts of colonization and expound on Indigenous healing practices taking place in Toronto. Based on findings from a local research project, we argue these healing practices go beyond limited notions of recovery and practice, offering profound and practical ways to address the physical, emotional, spiritual and mental health of Indigenous peoples.

Various factors including social isolation and financial worries put older adults at risk for addictions. Indeed, older adults are the largest consumers of medication, and alcohol consumption is rising. Yet interventions are limited and problems often go unreported. Unearthing “problem” stories in people’s lives (i.e., “the addiction story”) and retelling them in more empowering ways, narrative therapy offers a viable therapeutic alternative, and research on narrative therapy has proven encouraging. However, little is known about narrative therapy with older adults and with addictions. Seeking to address these gaps, an ethnographic study was conducted in Toronto, Canada, with a group of older adults receiving narrative therapy for addictions. Findings suggest that the therapy was “helpful” and participants were able to reduce or halt their substance misuse. Most important, aspects of narrative therapy such as storytelling may be particularly well suited to older adults, offering powerful possibilities for applied gerontology.

Background Anonymity has been central to medical, psychosocial, and societal practices in organ donation and transplantation. The purpose of this investigation was to explore transplant professionals' views on anonymity in the context of organ transplantation. Methods The study consisted of an electronic 18-item survey distributed to the Canadian Society of Transplantation membership, asking about anonymity vs open communication/contact between organ recipients and donor families. Results Of the 541 members surveyed, 106 replied. Among respondents, 71% felt that organ recipients and donor families should only communicate anonymously, yet 47% felt that identifying information could be included in correspondence between consenting recipients and donor families. When asked whether organ recipients and donor families should be allowed to meet, 53% of respondents agreed, 27% disagreed, and 20% neither agreed nor disagreed. With social media facilitating communication and eliminating the ability to maintain donor/recipient anonymity, 38% of respondents felt that a reexamination of current policies and practices pertaining to anonymity was necessary. Conclusion In conclusion, there was no dominant position on the issue of anonymity/communication between donor families and transplant recipients. Further research and discussion concerning the views of healthcare professionals, organ recipients, and donor families on the mandate of anonymity is needed and may influence future policy.

Increasingly, patients are surviving cancer and presenting with new health challenges, and there is greater demand for self-help and complementary and alternative medicine (CAM).To explore the benefits of a three-month course of individualised homeopathy (IH) for survivors of cancer.Small, community-based study.Hampshire, UK.Fifteen survivors of any type of cancer were recruited by a walk-in cancer support centre. Conventional treatment had to have taken place within the last three years. Patients scored their total, physical and emotional wellbeing using the Functional Assessment of Chronic Illness Therapy for Cancer (FACIT-G) before and after receiving four IH sessions.Eleven women had statistically positive results for emotional, physical and total wellbeing based on FACIT-G scores.Findings support previous research, suggesting CAM or IH could be beneficial for survivors of cancer.

Mentalism or sanism is a devastating form of oppression, often leading to negative stereotyping and arguments that individuals with mental health histories are not fit to study, work, or enjoy basic human rights. Despite 50 years of scholarship and recent developments in policy and research, the terms are still rarely used, understood, or interrogated in the social sciences. Indeed, social work in particular has been so loyal to the medical model that mentalist/sanist aggressions, such as pathologizing, labeling, exclusion, and dismissal have become a typical part of best professional practice and education. In this article, we provide an overview, history, analysis of, and response to mentalism and sanism.

A series of [1-aryl-1H-pyrazolo[3,4-d]pyrimidin-4-yl]arylhydrazones were discovered as novel inhibitors glycogen synthase kinase-3 (GSK-3). Based on initial modeling a detailed SAR was constructed. Modification of the interior binding aryl ring (Ar1) determined this to be a tight binding region with little room for modification. As predicted from the model, a large variety of modifications could be incorporated into the hydrazone aryl ring. This work led to GSK-3 inhibitors in the low nano-molar range.

This paper explores several debated issues of 'dyslexia', while suggesting that they are largely constructed within the historically dominant scientific paradigm. By shifting to an ecological perspective, individual assessment becomes the key factor in progressing towards solutions which focus not solely on the child, but on whole-school approaches, teaching to individual differences, and social and cultural factors. This shift also enables the removal of 'dyslexia' as a purely educational problem by incorporating currently under-applied predictive research from within the scientific paradigm. By widening our perspective in this way, children may be liberated from constructed 'failure' and schools become free to value individuality and creativity, while meeting the needs of all learners.

Heart transplantation is now the accepted therapy for end-stage heart failure that is resistant to medical treatment. Families of deceased donors routinely are urged to view the heart as a “gift of life” that will enable the donor to live on by extending and sustaining the life of a stranger. In contrast, heart recipients are encouraged to view the organ mechanistically—as a new pump that was rendered a spare, reusable part when a generous stranger died. Psychosocial and psychoanalytic research, anecdotal evidence and first-person accounts indicate that after transplant, many recipients experience unexpected changes or distress that cannot be understood adequately using biomedical explanatory models alone. In this paper it is argued that phenomenological philosophy offers a promising way to frame an ongoing empirical study that asks recipients to reflect on what it is like to incorporate the heart of another person. Merleau-Ponty and others have posited that any change to the body inevitably transforms the self. Hence, it is argued in this paper that replacing failing hearts with functioning hearts from deceased persons must be considered much more than a complex technical procedure. Acknowledging the disturbances to embodiment and personal identity associated with transplantation may explain adverse outcomes that heretofore have been inexplicable. Ultimately, a phenomenological understanding could lead to improvements in the consent process, preoperative teaching and follow-up care.

A novel series of pyridyl carboxamide-based CCR5 inhibitors was designed, synthesized, and demonstrated to be highly potent against HIV-1 infection in both HOS and PBL assays. Attempts to evaluate this series of compounds in a rat PK model revealed its instability in rat plasma. A hypothesis for this liability was proposed, and strategies to overcome this issue were pursued, leading to discovery of highly potent 40 and 41, which featured dramatically improved rat PK profiles.

We recently described ( J. Med. Chem. 2008 , 51 , 6538 - 6546 ) a novel class of CCR5 antagonists with strong anti-HIV potency. Herein, we detail SAR converting leads 1 and 2 to druglike molecules. The pivotal structural motif enabling this transition was the secondary sulfonamide substituent. Further fine-tuning of the substituent pattern in the sulfonamide paved the way to enhancing potency and bioavailability and minimizing hERG inhibition, resulting in discovery of clinical compound 122 (GSK163929).

Quality of life (QoL) studies in heart transplant recipients (HTRs) using validated, quantitative, self-report questionnaires have reported poor QoL in approximately 20% of patients. This consecutive mixed methods study compared self-report questionnaires, the Medical Outcomes Study 36-item Short Form Health Survey (MOS SF-36) and the Atkinson Life Satisfaction Scale, with phenomenologically informed audiovisual (AV) qualitative interview data in 27 medically stable HTRs (70% male; age 53 ± 13.77 years; time since transplant 4.06 ± 2.42 years). Self-report questionnaire data reported poor QoL and more distress compared with previous studies and normative population samples; in contrast, 52% of HTRs displayed pervasive distress according to visual methodology. Using qualitative methods to assess QoL yields information that would otherwise remain unobserved by the exclusive use of quantitative QOL questionnaires.

Background Quality of life (QoL) studies in heart transplant recipients generally rely on quantifiable self-report questionnaires and have shown that approximately 20% of patients undergo distress and poor QoL not clearly related to medical variables. Methods Building on existing qualitative research, we used a phenomenologically informed audiovisual method to explore the nature of "distress" in heart transplant recipients. Focused open-ended interviews were conducted in non-clinical settings with 27 medically stable heart transplant recipients (70% male, mean age 53 ± 13 years, range 18 to 72 years; mean time since transplant 4.1 ± 2.4 years). Interviews were audio/videotaped and transcribed verbatim. A qualitative software program (NVIVO8) was used to code interview transcripts and videotaped bodily gestures and "expressive artifacts" as well as vocal tone and volume. Results Distress was displayed by 88% of patients during the interview, and 52% displayed a profound disjunct between the words they used to describe their quality of life (e.g., "wonderful") and their embodied expressions of the same (e.g., protective body posturing, distressed facial expression). Most also expressed significant distress when discussing issues such as the donor and their "gift of life," as well as a disrupted sense of bodily integrity and identity that they felt could only be appreciated by fellow heart recipients. Conclusions Increased awareness of this distress and disruption related to bodily integrity and identity after heart transplant may allow transplant professionals and researchers to see beyond "words" to more effectively reduce distress and improve quality of life.

Background Severe chronic neutropenia (SCN) places the sufferer at increased risk of bacterial infection, often requiring emergency hospital admission and long-term antibiotic treatment. Method A single clinical case study of idiopathic SCN in a boy of 3 years and 8 months at the start of treatment individualized, classical homeopathic treatment was given. Neutrophil count was measured at: 5, 17, 21, 29 and 41 months after commencing treatment. Results Low neutrophil count (0.6 and 0.3 × 10 9 /L) was documented for 17 months prior to commencing treatment. After 17 months of individualized homeopathy, neutrophil count was 1.74, rising to 2.22 at 21 and 3.4 at 29 months treatment. Forty-one months after commencing treatment neutrophil count was 3.8 with an intermediate peak of 9 recorded during the year. As the child found the procedure distressing, blood testing was then discontinued by the parents. Conclusions The child received no other treatment, including complementary medicine or antibiotics, while receiving homeopathic treatment. Individualized homeopathic intervention may be the catalyst for the resolution of idiopathic SCN in this case. However, as this was a single case, a controlled study is recommended as a next step.