Symptom Burden, Treatment Goals, and Information Needs of Younger Women with Pelvic Organ Prolapse: A Content Analysis of ePAQ-Pelvic Floor Free-Text Responses

Background/Objectives: Pelvic organ prolapse (POP) is a common condition that significantly impacts quality of life. Research has focused largely on older women, while experiences of younger women remain relatively underexplored despite challenges unique to this population. Informed by the biopsychosocial model of illness, this study aims to assess the symptom burden, treatment goals, and information needs of younger women complaining of prolapse by analyzing questionnaire responses from an existing electronic Personal Assessment Questionnaire—Pelvic Floor (ePAQ-PF) dataset. Methods: Mixed-methods content analysis was conducted using free-text data from an anonymized multi-site ePAQ-PF dataset of 5717 responses collected across eight UK NHS trusts (2018–2022). A quantitative, deductive approach was first used to identify younger women (≤50 years old) with self-reported prolapse. ePAQ-PF scores for younger women with prolapse were compared with those aged >50 years, using Mann–Whitney tests. Free-text response data were analyzed inductively to qualitatively explore younger women’s symptom burden, treatment goals, and information needs. Results: Of the 1473 women with prolapse identified, 399 were aged ≤50 years. ePAQ-PF scores of the younger cohort demonstrated significantly greater symptom severity and bother than those aged >50, particularly in bowel, prolapse, vaginal, body image, and sexual health domains (p < adjusted threshold). Qualitative analysis undertaken to understand women’s concerns and priorities produced five health-related themes (physical health; functionality; psychosocial and emotional wellbeing; reproductive and sexual health; and healthcare journeys) and a sixth intersecting theme representing information needs. Conclusions: The findings highlight the substantial symptom burden of younger women with prolapse, as well as treatment goals and information needs specific to this population. The development of age-specific resources is identified as a requirement to support this group

Disparity in Anterior Cruciate Ligament injury management: A case series review across six National Health Service Trusts

Background Effective management of anterior cruciate ligament (ACL) injuries requires a comprehensive approach, from initial assessment, through treatment, rehabilitation, and discharge, however no gold standard care pathway exists to help guide clinicians. This case series provides an overview of current ACL injury management processes in six National Health Service (NHS) Trusts. Methods This study utilised a retrospective case series design within six NHS Trusts in the Yorkshire region of the United Kingdom. Using a standard operating procedure, each Trust selected ten consecutive ACL injured patients (≥ 16 years), managed either surgically or non-surgically. Data relating to the patient injury journey, patient and injury characteristics, key pathway events, rehabilitation management, outcome measures, and discharge, were collected. Data was anonymised and analysed using descriptive statistics. Results Reviews covered 55 patients, median age 25.5 years, (41 males, 14 females). Median time to specialist assessment from injury was 12 days (Interquartile Range [IQR] 6 to 20 days), with 43 patients managed operatively, and 12 non operatively. The median number of physiotherapy sessions was 21 (IQR 9 to 29.5), with outcome measures being variably used across Trusts. Trusts using patient reported outcome measures (PROMS) consistently with their patients provided more physiotherapy appointments (34.5 and 27) and achieved higher return to sport (RTS) rates. Time from injury to discharge varied with a median of 421 (IQR 249 to 546) days. Discharge criteria were applied inconsistently across Trusts, with 31% of cases not using specific criteria. However, Trusts using standardised discharge criteria showed better RTS outcomes, with 27 (61%) patients successfully returning to sport. Conclusions This case series review highlighted some good practice in initial ACL management across six NHS Trusts in the Yorkshire region. However, from time to MRI diagnosis to discharge, substantial variation in care is observed. Whether treated operatively or non-operatively, for patients aiming to RTS, this was achieved with greater consistency when more physiotherapy appointments were undertaken, outcome measures and PROMs were used, and specific discharge criteria was utilised. Future larger pathway investigation studies incorporating causative and predictive analysis studies on a national scale are required to determine whether similar trends are observed in a wider ACL injured population, which could help to improve national pathways for patients and clinicians working towards ensuring more positive and standardised patient-related ACL injury outcomes

‘We need to give it more attention’. Educators’, students’, and social work apprentices’ experiences of teaching and learning child-centred recordkeeping

Maintaining records about children and families who are the subject of social work intervention is a routinized aspect of everyday practice and has been recognized as vital in protecting children from harm and promoting their wellbeing. There is evidence that the fast-paced nature of statutory social work, as well as bureau cratic demands and difficulties with writing, can inhibit workers’ capacity to keep child-centered records, with inadequate record keeping having serious implications for protecting children from harm in the present and meeting their potential memory and identity needs in the future. This paper presents evidence from social work educators, as well as undergraduate, postgraduate, and apprentice social work students about their experiences of teaching and learning skills for child-centered case recording while at university and on placement. We highlight the interaction of university and practice learning, identifying key barriers to the complex task of maintaining child-centered records and outlining evidence from learners that there is a case for the prioritization of teaching skills for writing for practice within the university environment. We conclude by making recommendations as to how skills for child-centered recordkeeping could be more effectively taught, assessed, and embedded in pre-qualifying social work education

A secure medical image encryption technique based on DNA cryptography with elliptic curves

Health services and telemedicine have proven to be an important area for information protection in research, especially with medical services and smart health care applications. In these systems, medical imaging protection are important not only for clinical diagnosis, but also to protect the very sensitive and confidential patient data. With progress in imaging technologies and biomedical processing algorithms, the amount of image data increases rapidly. However, securing this information while transferring through insecure channel is still a constant challenge. Existing encryption techniques often face limitations such as high computational complexity, insufficient security against advanced cryptographic attacks, poor reversal and pixel correlation. To overcome these challenges, the proposed approach provides an innovative hybrid encryption technique that integrates DNA cryptography with Elliptical Curve Cryptography (ECC). The DNA-based coding shows high randomness and equality while the ECC provides strong security and confidentiality. The DNA encoding and secure key generation are employed in the proposed technique to obtain the encrypted medical image. The combination of these techniques addresses the main boundaries of existing disadvantage by increasing both security and calculation efficiency, making it well suited for real time medical applications. The experimental analysis was carried out with various parameters like histogram analysis, correlation coefficient, Chi square, MSE, PSNR, entropy etc. The result analysis states that the proposed methodology outperforms the state-of-the-art existing methods with enhanced performance such as entropy of 7.9981, Correlation coefficient of 0.0019 and PSNR of 53.97. Also, the proposed methodology is tested for runtime analysis, memory analysis and security analysis

Circular Pedagogy, Assessment and Cultural Capital: What a student journal can do for graduates, current students and tutors

This paper explores a third-year Sociology module assessment where students critically analyze contemporary social phenomena using theoretical frameworks from the course. By incorporating their generational perspectives and zeitgeist, students produce insightful commentaries that contribute to a shared learning experience among peers and tutors. This exercise fosters a community of practice, emphasizing mutual learning and engagement. Furthermore, the assessment follows a circular pedagogy, as the most outstanding student work is published annually in an open-access online journal by a student-staff editorial board. This initiative not only enhances academic discourse but also provides students with their first publication, strengthening their CVs and employability. The paper reflects on the impact of this pedagogical approach, highlighting its role in promoting research skills, critical thinking, and collaborative knowledge production

Tackle Height and Tackle Success—An Analysis of 52,204 Tackle Events

To compare the probability of tackle success (the tackler preventing the ball‐carrier and ball from progressing towards the tackler try‐line) when contacting the ball‐carrier at different heights (shoulder, mid‐torso and legs) for different types of tackles (active, passive, smother and arm) while accounting for other tackler situational factors within seven playing levels. Video footage of 271 male rugby union matches were analysed across seven playing groups (Under [U] 12, n = 25 matches; U14, n = 35; U16, n = 39; U18 Amateur n = 39; U18 Elite n = 38; Senior Amateur, n = 40 and Senior Elite, n = 50) across England, New Zealand, South Africa, Portugal and USA (a total of 51,106 tackles). A multi‐level logistic regression model with tackle success as the outcome variable and first point of contact and type of tackle as the explanatory variables were computed. Included in the model as cofounders were the situational variables tackle direction, tackle sequence, number of players in the tackle and attacker intention. Post‐estimation marginal effects were used to calculate the probabilities (expressed as a percentage %) of tackle success for each interaction between tackle type (active shoulder, smother, passive shoulder and arm) and the first point of contact (shoulder, mid‐torso and legs). The probability of tackle success in relation to where the ball‐carrier is contacted varied by tackle type and within each age group. The probabilities (Pr) for contacting the shoulder versus mid‐torso at the senior levels (elite and amateur) did not differ in relation to tackle success (for instance, for active shoulder tackles within senior elite; shoulder Pr 86% 95% CI 82–89 and mid‐torso Pr 82% 95% CI 77–86), whereas at the junior levels, contacting the shoulder had a higher probability than other points of contact. Active shoulder tackles had the highest probability of tackle success across the different playing levels across the different contact heights, whereas arm tackles had the lowest probability (for instance, for mid‐torso tackles within senior elite, active Pr 82% 95% CI 77–86 vs. arm Pr 69% 95% CI 64–75). Coaches and practitioners can use this information to improve tackle training design and planning within the different age groups and facilitate player development

Correlation Between a 3-Step MRI Assessment and Surgical Findings in Classifying Pyramidalis–Anterior Pubic Ligament–Adductor Longus Complex (PLAC) Injuries in 161 Athletes: Validation of Application of the PLAC Classification System

Background: Adductor avulsions are complex injuries often involving multiple structures, as indicated by several magnetic resonance imaging (MRI) studies. However, no studies have compared MRI assessments using a dedicated groin protocol with surgical findings. Hypothesis: It was hypothesized that MRI assessments using a dedicated groin protocol would correlate closely with surgical findings, applicable to both experienced and novice users of the pyramidalis–anterior pubic ligament–adductor longus complex (PLAC) classification. Study Design: Case series; Level of evidence, 4. Methods: This retrospective study analyzed 161 athletes who underwent MRI using a dedicated groin protocol, followed by surgical repair of the PLAC. Two musculoskeletal radiologists—1 experienced (rater A) and 1 inexperienced (rater B) in the use of the PLAC classification—independently assessed the MRI scans twice, 6 weeks apart, using a structured 3-step protocol to evaluate (1) adductor longus fibrocartilage (intact, partially avulsed, or completely avulsed), (2) pyramidalis separation from adductor longus (intact, partially separated, or completely separated), and (3) pectineus status (intact or partially avulsed). Agreement between MRI and surgical findings was evaluated using a PLAC injury classification (types 1-5), with intra- and interobserver reliability measured by Cohen kappa. Results: Among the 161 athletes, 93 played soccer, of whom 69 were professional. All athletes exhibited complete fibrocartilage avulsion, with 83 athletes (52%) showing adductor longus separation from the pyramidalis. Isolated adductor longus avulsions (PLAC type 1) were observed in only 36 athletes (22%). The interobserver kappa score between MRI assessments and surgical findings was 0.942 for rater A and 0.858 for rater B. Intraobserver ratings were 0.967 for rater A and 0.875 for rater B. Both inter- and intraobserver scores indicated almost perfect agreement. In combination, these statistical findings support the validity, reliability, and applicability of the MRI protocol using the PLAC classification system for 2 users with varying levels of experience. Conclusion: Adductor avulsions were rarely isolated, typically involving multiple muscles. The PLAC classification effectively captured the complexity of these injuries. When used in conjunction with a dedicated MRI protocol, the PLAC classification demonstrated almost perfect agreement and concordance with surgical findings. Together, the PLAC classification and MRI protocol offered a more comprehensive and accurate representation of patients’ clinical and radiological features and provided valuable guidance for surgical planning

Editorial: Preventing Sarcopenia and Promoting Musculoskeletal Health in Middle-Aged Adults: The Role of Exercise and Nutrition

Sarcopenia, once considered an inevitable consequence of ageing, is now recognised as a complex syndrome influenced by lifestyle, disease, and acute physiological stress. As global life expectancy rises, its prevalence is increasing, straining healthcare systems [1, 2] due to its association with disability, frailty, and comorbidities [3]. Prevalence estimates range from 0.2% to 86.5% depending on diagnostic criteria [4]. While typically studied in older adults, evidence suggests earlier onset, with rates between 8%-36% in those under 60 and 10%-27% in those aged 60 and older [4]. This variability partly reflects classification differences, with the European Working Group on Sarcopenia in Older People (EWGSOP2) [5] defining primary sarcopenia (ageing-related) and secondary sarcopenia (driven by disease, inactivity, or malnutrition), each posing distinct diagnostic challenges

Elective peri‐operative management of adults taking glucagon‐like peptide‐1 receptor agonists, glucose‐dependent insulinotropic peptide agonists and sodium‐glucose cotransporter‐2 inhibitors: a multidisciplinary consensus statement

Summary Introduction Glucagon‐like peptide‐1 receptor agonists, dual glucose‐dependent insulinotropic peptide receptor agonists and sodium‐glucose cotransporter‐2 inhibitors are used increasingly in patients receiving peri‐operative care. These drugs may be associated with risks of peri‐operative pulmonary aspiration or euglycaemic ketoacidosis. We produced a consensus statement for the peri‐operative management of adults taking these drugs. Methods This multidisciplinary consensus statement included surgeons, anaesthetists, physicians, pharmacists and people with lived experience relevant to these guidelines. Following the directed literature review, a three‐round modified Delphi process was conducted to generate and ratify recommendations. Results Patients taking glucagon‐like peptide‐1 receptor agonists and dual glucose‐dependent insulinotropic peptide receptor agonists should: continue these drugs before surgery; have full risk assessment and stratification; and receive peri‐operative techniques that may mitigate risk of pulmonary aspiration before, during and after sedation or general anaesthesia. Patients taking sodium‐glucose cotransporter‐2 inhibitors should omit them the day before and the day of a procedure. All patients should have risks and mitigation strategies discussed with a shared decision‐making approach. Discussion Until more evidence becomes available, this pragmatic, multidisciplinary consensus statement aims to support shared decision‐making and improve safety for patients taking glucagon‐like peptide‐1 receptor agonists, dual glucose‐dependent insulinotropic peptide receptor agonists and sodium‐glucose cotransporter‐2 inhibitors during the peri‐operative period

‘Why don’t you…’: R.J. Morris and the European Association for Urban History

Bob Morris was elected as president of the European Association for Urban History (EAUH) ahead of its 2002 conference in Edinburgh. Bob’s presidency, and the Edinburgh conference specifically, took place at an important point in the development of urban history within Europe and further afield. First, the programme reveals several emerging themes and topics of interest that have since shaped the sub-field in new and innovative ways. Second, Bob’s informal and collegial approach towards networking is reflected in the decision to place the EAUH on a quasi-formal constitutional basis. Both of these developments reflect, in part, Bob’s own research interests, as well as the sub-field’s welcoming approach to younger researchers, including taught and research postgraduate students, interested in networking with more established scholars