1,143 research outputs found

    The SPORTSMART study: a pilot randomised controlled trial of sexually transmitted infection screening interventions targeting men in football club settings

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    Background: Uptake of chlamydia screening by men in England has been substantially lower than by women. Non-traditional settings such as sports clubs offer opportunities to widen access. Involving people who are not medically trained to promote screening could optimise acceptability. Methods: We developed two interventions to explore the acceptability and feasibility of urine-based sexually transmitted infection (STI) screening interventions targeting men in football clubs. We tested these interventions in a pilot cluster randomised control trial. Six clubs were randomly allocated, two to each of three trial arms: team captain-led and poster STI screening promotion; sexual health adviser-led and poster STI screening promotion; and poster-only STI screening promotion (control/comparator). Primary outcome was test uptake. Results: Across the three arms, 153 men participated in the trial and 90 accepted the offer of screening (59%, 95% CI 35% to 79%). Acceptance rates were broadly comparable across the arms: captain-led: 28/56 (50%); health professional-led: 31/46 (67%); and control: 31/51 (61%). However, rates varied appreciably by club, precluding formal comparison of arms. No infections were identified. Process evaluation confirmed that interventions were delivered in a standardised way but the control arm was unintentionally ‘enhanced’ by some team captains actively publicising screening events. Conclusions: Compared with other UK-based community screening models, uptake was high but gaining access to clubs was not always easy. Use of sexual health advisers and team captains to promote screening did not appear to confer additional benefit over a poster-promoted approach. Although the interventions show potential, the broader implications of this strategy for UK male STI screening policy require further investigation

    Análisis de los servicios de test del VIH de cinco centros comunitarios españoles para la mejora de nuevas estrategias de promoción del diagnóstico precoz

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    Background: In recent years, the number of people tested for HIV has experienced a significant increase. The purpose of this study is to analyze data obtained in Spain in the HIV testing services of five Community Centres members of Agrupación Prueba de VIHda throughout 2014 and 2015,to determine its effectiveness and to characterize the subpopulation with a HIV reactive result. Study design and methods: agrupación Prueba de VIHda performed free, anonymous and confidential HIV tests according to the Consolidated guidelines on HIV testing services of WHO (2015). Data were collected using the questionnaire of the COBATEST network, developed by the COBATEST Project, and its significance was determined statistically. Results: 3061 HIV tests were performed during 2014 and 2015, with a prevalence of reactive results of 2.5%. Heterosexual and bisexual men got tested at older ages than homosexual men and women. Non-Spanish origin seems to be a risk factor for HIV infection within the sample. Bisexual men showed as high prevalence of reactive test as homosexual men, as well as they reported less previous HIV tests. Finally, index testing performed by HIV positive peer educators to the sexual partners of newly diagnosed patients showed higher prevalence than that of the classical Voluntary Counselling and Testing approach outreach most at risk populations. Conclusion:The analysis of the data shows higher prevalence of reactive results in people of non-Spanish origin compared to that of the Spanish subgroup, the former still facing barriers to access the public health system in Spain. It also demonstrates the need of new and adapted approaches for promoting early diagnosis specifically in bisexual men. Index testing by peer HIV positive educators is a highly effective method for testing people at high risk of acquiring HIV infection.Antecedentes: En los últimos años, el número de personas sometidas a pruebas frente al VIH ha experimentado un aumento significativo. El propósito de este estudio es analizar los datos de prevalencia de la infección por VIH obtenidos por cinco centros comunitarios en España pertenecientes a la Agrupación Prueba de VIHda entre 2014 y 2015, determinar su efectividad y caracterizar la subpoblación con un resultado preliminar reactivo. Diseño experimental y métodos: La Agrupación Prueba de VIHda realizó pruebas de VIH gratuitas, anónimas y confidenciales de acuerdo con las directrices consolidadas por la OMS (2015). Los datos fueron recogidos mediante el cuestionario desarrollado por el Proyecto COBATEST y su significación se determinó estadísticamente. Resultados: Durante 2014 y 2015 se realizaron un total de 3061 pruebas frente al VIH, obteniendo una prevalencia de resultados preliminares positivos del 2,5%. Los hombres heterosexuales y bisexuales se realizaron la prueba a edades más avanzadas que los hombres homosexuales y las mujeres. Las personas de origen no español parecieron mostrar un mayor riesgo de infección frente al VIH. Hombres bisexuales mostraron una prevalencia elevada similar a la de hombres homosexuales, así como declararon menos pruebas anteriores frente al VIH. Finalmente, las pruebas realizadas a través de indextesting por los educadores pares de VIH a parejas sexuales de pacientes recién diagnosticados mostraron una prevalencia superior a la obtenida por el modelo tradicional de counselling y testado voluntario ofrecido desde los centros comunitarios a poblaciones de mayor riesgo. Conclusión: El análisis de los datos muestra mayores prevalencias de resultados preliminares reactivos en personas de origen no español comparadas con aquellas del subgrupo de personas españolas, el primero de ellos todavía enfrentando barreras de acceso al sistema sanitario público en España, El análisis también demuestra la necesidad de nuevos enfoques adaptados para promover el diagnóstico precoz especialmente entre hombres bisexuales. Las pruebas realizadas a través de indextesting por educadores pares VIH positivos es un método muy eficaz para el testado de las personas con alto riesgo de contraer la infección por VIH

    BRCA2 polymorphic stop codon K3326X and the risk of breast, prostate, and ovarian cancers

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    Background: The K3326X variant in BRCA2 (BRCA2*c.9976A>T; p.Lys3326*; rs11571833) has been found to be associated with small increased risks of breast cancer. However, it is not clear to what extent linkage disequilibrium with fully pathogenic mutations might account for this association. There is scant information about the effect of K3326X in other hormone-related cancers. Methods: Using weighted logistic regression, we analyzed data from the large iCOGS study including 76 637 cancer case patients and 83 796 control patients to estimate odds ratios (ORw) and 95% confidence intervals (CIs) for K3326X variant carriers in relation to breast, ovarian, and prostate cancer risks, with weights defined as probability of not having a pathogenic BRCA2 variant. Using Cox proportional hazards modeling, we also examined the associations of K3326X with breast and ovarian cancer risks among 7183 BRCA1 variant carriers. All statistical tests were two-sided. Results: The K3326X variant was associated with breast (ORw = 1.28, 95% CI = 1.17 to 1.40, P = 5.9x10- 6) and invasive ovarian cancer (ORw = 1.26, 95% CI = 1.10 to 1.43, P = 3.8x10-3). These associations were stronger for serous ovarian cancer and for estrogen receptor–negative breast cancer (ORw = 1.46, 95% CI = 1.2 to 1.70, P = 3.4x10-5 and ORw = 1.50, 95% CI = 1.28 to 1.76, P = 4.1x10-5, respectively). For BRCA1 mutation carriers, there was a statistically significant inverse association of the K3326X variant with risk of ovarian cancer (HR = 0.43, 95% CI = 0.22 to 0.84, P = .013) but no association with breast cancer. No association with prostate cancer was observed. Conclusions: Our study provides evidence that the K3326X variant is associated with risk of developing breast and ovarian cancers independent of other pathogenic variants in BRCA2. Further studies are needed to determine the biological mechanism of action responsible for these associations

    New science, synthesis, scholarship, and strategic vision for society

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    Harvard Forest LTER (HFR) is a two decade-strong, integrated research and educational program investigating responses of forest dynamics to natural and human disturbances and environmental changes over broad spatial and temporal scales. HFR engages \u3e30 researchers, \u3e200 graduate and undergraduate students, and dozens of institutions in research into fundamental and applied ecological questions of national and international relevance. Through LTER I–IV, HFR has added historical perspectives, expanded its scope to the New England region, integrated social, biological, and physical sciences, and developed education and outreach programs for K-12, undergraduate, and graduate students, along with managers, decision-makers, and media professionals

    Testing metabolic ecology theory for allometric scaling of tree size, growth and mortality in tropical forests

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    The theory of metabolic ecology predicts specific relationships among tree stem diameter, biomass, height, growth and mortality. As demographic rates are important to estimates of carbon fluxes in forests, this theory might offer important insights into the global carbon budget, and deserves careful assessment. We assembled data from 10 old-growth tropical forests encompassing censuses of 367 ha and > 1.7 million trees to test the theory's predictions. We also developed a set of alternative predictions that retained some assumptions of metabolic ecology while also considering how availability of a key limiting resource, light, changes with tree size. Our results show that there are no universal scaling relationships of growth or mortality with size among trees in tropical forests. Observed patterns were consistent with our alternative model in the one site where we had the data necessary to evaluate it, and were inconsistent with the predictions of metabolic ecology in all forests

    Assessing Evidence for a Pervasive Alteration in Tropical Tree Communities

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    In Amazonian tropical forests, recent studies have reported increases in aboveground biomass and in primary productivity, as well as shifts in plant species composition favouring fast-growing species over slow-growing ones. This pervasive alteration of mature tropical forests was attributed to global environmental change, such as an increase in atmospheric CO2 concentration, nutrient deposition, temperature, drought frequency, and/or irradiance. We used standardized, repeated measurements of over 2 million trees in ten large (16–52 ha each) forest plots on three continents to evaluate the generality of these findings across tropical forests. Aboveground biomass increased at seven of our ten plots, significantly so at four plots, and showed a large decrease at a single plot. Carbon accumulation pooled across sites was significant (+0.24 MgC ha−1 y−1, 95% confidence intervals [0.07, 0.39] MgC ha−1 y−1), but lower than reported previously for Amazonia. At three sites for which we had data for multiple census intervals, we found no concerted increase in biomass gain, in conflict with the increased productivity hypothesis. Over all ten plots, the fastest-growing quartile of species gained biomass (+0.33 [0.09, 0.55] % y−1) compared with the tree community as a whole (+0.15 % y−1); however, this significant trend was due to a single plot. Biomass of slow-growing species increased significantly when calculated over all plots (+0.21 [0.02, 0.37] % y−1), and in half of our plots when calculated individually. Our results do not support the hypothesis that fast-growing species are consistently increasing in dominance in tropical tree communities. Instead, they suggest that our plots may be simultaneously recovering from past disturbances and affected by changes in resource availability. More long-term studies are necessary to clarify the contribution of global change to the functioning of tropical forests

    Meta-analysis of Genome-Wide Association Studies for Extraversion: Findings from the Genetics of Personality Consortium

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    Extraversion is a relatively stable and heritable personality trait associated with numerous psychosocial, lifestyle and health outcomes. Despite its substantial heritability, no genetic variants have been detected in previous genome-wide association (GWA) studies, which may be due to relatively small sample sizes of those studies. Here, we report on a large meta-analysis of GWA studies for extraversion in 63,030 subjects in 29 cohorts. Extraversion item data from multiple personality inventories were harmonized across inventories and cohorts. No genome-wide significant associations were found at the single nucleotide polymorphism (SNP) level but there was one significant hit at the gene level for a long non-coding RNA site (LOC101928162). Genome-wide complex trait analysis in two large cohorts showed that the additive variance explained by common SNPs was not significantly different from zero, but polygenic risk scores, weighted using linkage information, significantly predicted extraversion scores in an independent cohort. These results show that extraversion is a highly polygenic personality trait, with an architecture possibly different from other complex human traits, including other personality traits. Future studies are required to further determine which genetic variants, by what modes of gene action, constitute the heritable nature of extraversion
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