Biomedical subjects

Jonathan A Smith

Publications and source records attributed to Jonathan A Smith.

10 recordsLinked to original sources

PubMed2006

Young men's ambivalence toward alcohol.

There is widespread concern about the health and social consequences of excessive alcohol consumption among young men. Interventions to reduce alcohol-related harm will be affected by ambivalence toward alcohol, because ambivalent attitudes are worse predictors of behaviour than are homogeneous attitudes. It is therefore important to identify aspects of alcohol consumption about which young men are not ambivalent. In-depth interviews were conducted with a socioeconomically diverse sample of 31 men, aged 18-21 living in London, UK. Ambivalence toward alcohol was widespread. None of the drinkers who were interviewed had uncomplicated positive evaluations of drinking: all mentioned compelling reasons not to drink. Most motives for drinking were also identified as reasons for not drinking if consumption became excessive. However, three motives for not drinking were not also motives for drinking: violence, alcoholism, and cost. These findings should be considered during the design of interventions to reduce the health and social consequences of excessive alcohol consumption amongst young men.

Adolescent↗

PubMed2006

Living with a body separate from the self. The experience of the body in chronic benign low back pain: an interpretative phenomenological analysis.

This paper presents an in-depth, idiographic study exploring the personal experience of chronic benign low back pain in relation to the participant's body and sense of self. Semi-structured interviews were conducted with patients and the resultant transcripts subjected to interpretative phenomenological analysis. One theme is presented in detail: 'Living with a body separate from the self', whereby when out of pain the body has little salience to the self yet when in pain it is consciously excluded from the self. The complex and paradoxical relationship between the body, chronic pain and the self is explored and evidence is provided to argue that the embodied unpleasantness of chronic pain involves an assault upon and a defence of a preferred or desirable self. The results are considered in relation to relevant themes in the extant literature.

Activities of Daily Living↗

PubMed2006

Mister in-between: a case study of masculine identity and health-related behaviour.

The study of young men's health-related behaviour offers an opportunity to examine the links between masculine identity and social behaviour. This article presents a case study of a 19-year-old man living in London, who describes himself as different to his peers on several important dimensions, including his engagement in health-related behaviours. The case study demonstrates the importance of health-related social behaviours such as drinking, drug use, physical activity, sport and sexual behaviour in the construction of a masculine identity. This case study also reveals that the way in which men position themselves in relation to different discourses of masculinity can have important implications not only for their masculine identities, but also for their health-related behaviour.

Adult↗

PubMed2006

I feel like a scrambled egg in my head: an idiographic case study of meaning making and anger using interpretative phenomenological analysis.

What does it feel like when one's meaning making is impoverished and threatens to break down? The aim of this study is to show how meaning making is achieved in the context of one's life and how this achievement is often a struggle for the individual. The study reports data from semi-structured interviews with a female participant, which was analysed using interpretative phenomenological analysis (IPA). This paper examines how cultural discourses and conventions are experienced and given meaning by the individual. First, the analysis demonstrates how dominant discourses are used to explain anger and aggression. These include hormones, alcohol, and the influence of past relationships on present action. Second, it examines how the participant's meaning making is often ambiguous and confused, and how she variously accepts and challenges available meanings. Finally, the analysis demonstrates how meaning making can break down and the consequences of this for the individual's sense of self.

Adult↗

PubMed2005

Managing time: an interpretative phenomenological analysis of patients' and physiotherapists' perceptions of adherence to therapeutic exercise for low back pain.

PURPOSE: Physiotherapy for low back pain (LBP) includes exercise therapy. Unfortunately adherence is problematic. This study explores patients' and physiotherapists' perceptions of exercise adherence. METHOD: Nine LBP patients and eight physiotherapists were interviewed. Interpretative Phenomenological Analysis (IPA) was used to explore transcript data. RESULTS: The main theme 'managing time', reveals how pressure on time reflects society's view of time as a commodity. Theme components include 'the bargaining process': physiotherapists spend time listening, exploring patient beliefs, but modify patients' expectations of quick cures with the need to own their back care. 'Reviewing the future' identifies fears about long-term disability, highlighting the importance of recovery time knowledge. CONCLUSIONS: Interpreting participants' stories illustrates how investing in routine exercise could help re-interpret LBP as part of everyday life.

Adult↗

PubMed2004

The personal experience of carers of stroke survivors: an interpretative phenomenological analysis.

PURPOSE: The occurrence of a stroke can result in significant traumatic consequences for the stroke survivor and their family. Efforts have tended to concentrate on the stroke survivor, and relatives and friends have been neglected. There have been limited studies concerning the impact upon the family. The present study explores the experiences of members of families who are involved as carers of stroke survivors. In order to facilitate a detailed analysis, this study is concerned with the early caring period-before patients return home. METHOD: Four relatives were interviewed about their experiences. Interpretative Phenomenological Analysis (IPA) was employed using the data provided by the verbatim transcripts of the interviews. RESULTS: Three common themes were identified: uncertainty, personal impact, and strength of relationships. This research has discovered a number of valuable findings for this group of carers. An important aspect that has been uncovered is that families experience emotional strain while relatives are still in hospital. Relatives require time to adjust and share with the stroke survivor in their difficulties. This exploration has demonstrated that the same processes of uncertainty can occur for families as well as patients themselves. CONCLUSION: This study provides a rich account of the importance that strengths of relationships have for families at this difficult time. It helps expand the current literature on the experiences of relatives of stroke survivors.

Adaptation, Psychological↗

PubMed2004

Finding qualitative research: an evaluation of search strategies.

BACKGROUND: Qualitative research makes an important contribution to our understanding of health and healthcare. However, qualitative evidence can be difficult to search for and identify, and the effectiveness of different types of search strategies is unknown. METHODS: Three search strategies for qualitative research in the example area of support for breast-feeding were evaluated using six electronic bibliographic databases. The strategies were based on using thesaurus terms, free-text terms and broad-based terms. These strategies were combined with recognised search terms for support for breast-feeding previously used in a Cochrane review. For each strategy, we evaluated the recall (potentially relevant records found) and precision (actually relevant records found). RESULTS: A total yield of 7420 potentially relevant records was retrieved by the three strategies combined. Of these, 262 were judged relevant. Using one strategy alone would miss relevant records. The broad-based strategy had the highest recall and the thesaurus strategy the highest precision. Precision was generally poor: 96% of records initially identified as potentially relevant were deemed irrelevant. Searching for qualitative research involves trade-offs between recall and precision. CONCLUSIONS: These findings confirm that strategies that attempt to maximise the number of potentially relevant records found are likely to result in a large number of false positives. The findings also suggest that a range of search terms is required to optimise searching for qualitative evidence. This underlines the problems of current methods for indexing qualitative research in bibliographic databases and indicates where improvements need to be made.

Breast Feeding↗

PubMed2003

Understanding why negative genetic test results sometimes fail to reassure.

A proportion of those receiving negative results following predictive genetic testing desire future bowel screening. This is despite a negative result meaning a general population risk of 1:7500 and despite bowel screening being experienced as aversive and clinically unnecessary. This study aimed to investigate perceptions of risk, illness, and tests amongst those receiving negative results following predictive genetic testing. Interviews with nine people receiving negative genetic test results for familial adenomatous polyposis (FAP) were analyzed using the qualitative method, interpretative phenomenological analysis (IPA). Those not reassured by negative genetic test results perceived a continuing risk to themselves and to their children. Two sets of perceptions emerged that might explain this: (1). perceptions of the genetic basis of the condition (FAP). Although the condition was perceived to be genetic, genetic status was seen as transient, so a result today could not predict the future. The condition was also seen as caused by factors other than genes, so information about only one risk factor could not be reassuring. (2). Perceptions of the genetic test. There was a lack of conviction in the ability of the genetic test, based on a blood sample, to predict a disease located in the bowel. These results suggest that some individuals receiving negative test results are not reassured because of their representations of the cause of their condition and the nature of the tests they undergo. It may be that eliciting and, when appropriate, changing people's representations prior to testing may enable those receiving negative results to be more reassured about their residual risk.

Adenomatous Polyposis Coli↗

PubMed2003

Activation of the signal transducer and activator of transcription 1 signaling pathway in thymocytes from HIV-1-infected human thymus.

OBJECTIVE: To identify HIV-induced host factors in the severe combined immunodeficient (SCID)-hu Thy/Liv mouse that may contribute to HIV pathogenesis in the thymus. DESIGN: To identify genes specifically altered by HIV-1 infection using the cDNA microarray assay, SCID-hu Thy/Liv organs derived from the same donors were used. Therefore, no genetic variations existed between HIV and mock-infected samples. In addition, the 12-14 day post-infection timepoint was chosen because no significant thymocyte depletion was detected in HIV-infected Thy/Liv organs, so mRNA from the same cell types could be compared. METHODS: Using SCID-hu Thy/Liv mice constructed from the same donor tissues, we analysed the expression of 9183 host genes in response to HIV infection with cDNA microarrays. Expression of selected genes with more than threefold induction was confirmed by measuring RNA (reverse transcriptase-polymerase chain reaction; RT-PCR) and proteins. RESULTS: HIV-1 (JD or NL4-3) infection of the SCID-hu Thy/Liv mouse led to more than threefold induction of 19 genes, 12 of which were IFN-inducible and six were unknown EST clones. We confirmed induction by RT-PCR and protein blots. Both signal transducer and activator of transcription (STAT)1 and STAT2 proteins were induced, and STAT1 was also activated by phosphorylation at the Tyr701 and Ser727 sites in human thymus infected with HIV-JD or NL4-3. Treatment of human fetal thymus organ culture or human thymocytes with recombinant HIV-1 gp120 proteins also led to induction or activation of STAT1. CONCLUSION: HIV-1 infection of the thymus led to activation of the STAT1 signaling pathway in thymocytes, which may contribute to HIV-1 pathogenesis in the thymus.

Animals↗

PubMed2002

Living with vitiligo: dealing with difference.

OBJECTIVES: Individuals with a disfigurement are at risk of experiencing psychological distress, but the level of this distress is only marginally associated with clinical severity. This study examines the experience of living with the skin condition vitiligo with a view towards understanding its impact and the ways in which participants deal with this chronic and disfiguring disease. DESIGN: The qualitative method Interpretative Phenomenological Analysis was used. METHODS: In a semi-structured interview, seven white female vitiligo sufferers were asked to describe their experiences from the time the vitiligo first became apparent to the time of the interview. They were encouraged to elaborate on their own reactions and how they dealt with the reactions of others. RESULTS: Initially, participants felt overwhelmed by their illness but over time they developed several strategies in order to 'contain' their difference in appearance within manageable limits. The behavioural strategies of avoidance and concealment had several disadvantages, whereas cognitive strategies were less problematic but difficult to sustain consistently. Social support served to facilitate the development of coping methods associated with acceptance of difference. However, maintaining this acceptance was a struggle and the process fragile. CONCLUSIONS: Living with vitiligo was a continuous struggle. The results are consistent with Leventhal's (1970) notion that coping is a problem-solving process and with Moos and Schaefer's (1984) contention that dealing with a chronic disease involves the development of a variety of strategies in order to regain equilibrium. Further research is needed to examine whether the experiences described here are common to other disfiguring conditions.

Journal Article↗