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Within marketing, postmodern perspectives relate conspicuous consumption and status to the realisation of self-identity. The consumption of goods and their symbolic meaning allow an individual to reinforce, create and maintain his or her identity. Notions of conformity and consumption of visible goods could be attributed to social identity theory, where identity shifts from context to context. The consumption or rejection of certain goods thus reinforces an individual’s shifting identity among various contexts, such as home, school or work. It is the view of evolutionary psychology that theories such as social identity theory and consumer culture theory provide a proximal explanation of consumer behaviour, yet beyond these explanations are thought to be universal and ultimate drivers of behaviour. Evolutionary psychology presents cost signalling theory to help explain why individuals compete for status. However, existing evolutionary theories are still incomplete, particularly in explaining the paths in which individuals take to achieve status within a peer group. This research explores how and why people engage in pro-environmental behaviour. A review of the literature indicates that a desire for status is the main underlying driver motivating this type of behaviour, however the literature further indicates that theory on status is still incomplete in terms of understanding the path a person takes to achieve higher status. Therefore the gap this thesis aims to fill is to clarify the path an individual takes to achieve higher status within the context of pro-environmental behaviour. In order to identify how and why people engage in pro-environmental behaviour and strategies for status this research uses netnography to explore hierarchy negotiation within an online community of pro-environmental behaviourists called the Litterati. The Litterati is an Instagram community consisting of over 15,000 members worldwide, whom pick up and photograph litter. The main Litterati site and associated social media pages provide the visible conditions necessary for people to compete for higher status through cost signalling. The research findings are presented as three levels. The first level addressed observed empirical events, consisting of the observed tactics used within the Litterati for gaining status. The observed tactics among the Litterati are the use of visual appeal, time, humour and reciprocity. The next level addresses events, which are not wholly observable. This consists of the themes or patterns arising from the retroductive analysis of the interviews and participant observation and how they relate to status strategies. The main themes that help explain the paths to status are self-efficacy; community; and reciprocity or validation. The third level applies evolutionary theories of status and cost signalling to explain the underlying causes of the observed behaviours. The two strategies for status, Dominance and Prestige are presented as manifestations of the dynamic relationships between each level of the findings. This research contributes to exiting theory by clarifying the path an individual takes to achieve higher status, with the analysis demonstrating that Dominance and Prestige are not as distinct as the extant literature would suggest. Additionally, this research indicates that behaviour online influences behaviour offline provided there is a strong sense of community and feelings of self-efficacy are promoted through social modelling and social persuasion. The sense of validation participants reported through the community membership led to an increase in their uptake of pro-environmental behaviours offline, including changes in their consumption decisions. The wider implications of these findings indicate online communities of ethical consumption, such as the Litterati, promote a feeling of passive activism, where discussion of social change and interaction result in behaviour change.

To characterize patients with coronavirus disease 2019 (covid-19) in a large New York City medical center and describe their clinical course across the emergency department, hospital wards, and intensive care units. Retrospective manual medical record review. NewYork-Presbyterian/Columbia University Irving Medical Center, a quaternary care academic medical center in New York City. The first 1000 consecutive patients with a positive result on the reverse transcriptase polymerase chain reaction assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who presented to the emergency department or were admitted to hospital between 1 March and 5 April 2020. Patient data were manually abstracted from electronic medical records. Characterization of patients, including demographics, presenting symptoms, comorbidities on presentation, hospital course, time to intubation, complications, mortality, and disposition. Of the first 1000 patients, 150 presented to the emergency department, 614 were admitted to hospital (not intensive care units), and 236 were admitted or transferred to intensive care units. The most common presenting symptoms were cough (732/1000), fever (728/1000), and dyspnea (631/1000). Patients in hospital, particularly those treated in intensive care units, often had baseline comorbidities including hypertension, diabetes, and obesity. Patients admitted to intensive care units were older, predominantly male (158/236, 66.9%), and had long lengths of stay (median 23 days, interquartile range 12-32 days); 78.0% (184/236) developed acute kidney injury and 35.2% (83/236) needed dialysis. Only 4.4% (6/136) of patients who required mechanical ventilation were first intubated more than 14 days after symptom onset. Time to intubation from symptom onset had a bimodal distribution, with modes at three to four days, and at nine days. As of 30 April, 90 patients remained in hospital and 211 had died in hospital. Patients admitted to hospital with covid-19 at this medical center faced major morbidity and mortality, with high rates of acute kidney injury and inpatient dialysis, prolonged intubations, and a bimodal distribution of time to intubation from symptom onset.

Hedgehog signaling is essential for bone formation, including functioning as a means for the growth plate to drive skeletal mineralization. However, the mechanisms regulating hedgehog signaling specifically in bone-forming osteoblasts are largely unknown. Here, we identified SLIT and NTRK-like protein-5( Slitrk5 ), a transmembrane protein with few identified functions, as a negative regulator of hedgehog signaling in osteoblasts. Slitrk5 is selectively expressed in osteoblasts and loss of Slitrk5 enhanced osteoblast differentiation in vitro and in vivo. Loss of SLITRK5 in vitro leads to increased hedgehog signaling and overexpression of SLITRK5 in osteoblasts inhibits the induction of targets downstream of hedgehog signaling. Mechanistically, SLITRK5 binds to hedgehog ligands via its extracellular domain and interacts with PTCH1 via its intracellular domain. SLITRK5 is present in the primary cilium, and loss of SLITRK5 enhances SMO ciliary enrichment upon SHH stimulation. Thus, SLITRK5 is a negative regulator of hedgehog signaling in osteoblasts that may be attractive as a therapeutic target to enhance bone formation. Hedgehog signaling is essential for bone formation. Here, the authors show that the transmembrane protein SLITRK5 is a negative regulator of hedgehog signaling in osteoblasts, suggesting it may be a potential therapeutic target to enhance bone formation.