Psychology of Sexualities: Past, present and future directions

Psychology of sexualities: Past, present and future directions

Civil partnership & marriage: what they mean to same-sex couples

An online qualitative survey was used to explore the perspectives of those who have had a civil partnership, a same-sex marriage or have converted a civil partnership to a marriage. The survey asked for views about the legal recognition of relationships and the impact (or not) the introduction of same-sex marriage in England, Wales and Scotland is having. A total of 82 responses were received between Oct 2015 – Apr 2016. This report provides an overview of the findings

Exhaled biomarkers in acute asthma.

Objectives – The research aimed to a) determine the feasibility of conducting a study of exhaled breath biomarkers in the acute asthma setting; and b) determine whether a positive bronchial challenge test results in detectable changes in exhaled volatile organic compounds (VOC). Methods – The Exhaled Breath Biomarkers in Acute Asthma feasibility study was undertaken to compare two different approaches to capturing acute asthma data. In the first, participants attending secondary care for treatment of an acute asthma attack were recruited; in the second participants who were at high risk of experiencing an attack were recruited and asked to contact the researcher should such an event occur. The Bronchial Challenge Testing in Asthma study was undertaken to determine the effect of mannitol dry powder inhalation on VOC in exhaled breath. In addition to the above studies, systematic reviews of the literature on 8-isoprostane in exhaled breath condensate and exhaled breath VOC in adult asthma were conducted. Findings – The literature reviews found insufficient evidence to confirm that EBC 8-isoprostane levels were raised in the presence of asthma or acute asthma attack; a number of exhaled VOC were found to be associated with asthma but with a high level of inter-study variation. Breath capture studies in acute asthma proved feasible - both approaches were successful in recruiting participants and capturing breath samples, and the acceptability of breath sampling devices was similar to that of existing clinical devices. Obtaining breath samples before systemic corticosteroids were administered and identifying infectious triggers of exacerbation proved difficult. The effect of bronchial challenge on exhaled VOC was detectable but further development of methods is required to produce reliable results. Conclusion – Designing a phase II biomarker study with the aim of validating previous studies and estimating the accuracy of predictive models appears feasible but further methodological refinement is required

“Seismic cultural change?”: British media representations of same-sex ‘marriage’

The legal recognition of same-sex relationships is a contested terrain that has been hotly debated by feminists. This article provides a social constructionist analysis of the UK newspaper media coverage around the time of the introduction of the Civil Partnership Act (2004). In examining the 348 national newspaper coverage over a three month period (November 2005–January 2006) we highlight three prevalent, and conflicting, themes: ‘same-sex marriage becomes legal under the Civil Partnership Act’; ‘couples will not get full legal status’ and ‘marriage is a heterosexual business’. We discuss these media representations and argue that the heteronormativity of the coverage provided little space for more radical constructions of same-sex relationship recognition

Safety of 80% vs 30–35% fraction of inspired oxygen in patients undergoing surgery: a systematic review and meta-analysis

Background: Evidence-based guidelines from the World Health Organization (WHO) have recommended a high (80%) fraction of inspired oxygen (FiO2) to reduce surgical site infection in adult surgical patients undergoing general anaesthesia with tracheal intubation. However, there is ongoing debate over the safety of high FiO2. We performed a systematic review to define the relative risk of clinically relevant adverse events (AE) associated with high FiO2. Methods: We reviewed potentially relevant articles from the WHO review supporting the recommendation, including an updated (July 2018) search of EMBASE and PubMed for randomised and non-randomised controlled studies reporting AE in surgical patients receiving 80% FiO2 compared with 30–35% FiO2. We assessed study quality and performed meta-analyses of risk ratios (RR) comparing 80% FiO2 against 30–35% for major complications, mortality, and intensive care admission. Results: We included 17 moderate–good quality trials and two non-randomised studies with serious-critical risk of bias. No evidence of harm with high FiO2 was found for major AE in the meta-analysis of randomised trials: atelectasis RR 0.91 [95% confidence interval (CI) 0.59–1.42); cardiovascular events RR 0.90 (95% CI 0.32–2.54); intensive care admission RR 0.93 (95% CI 0.7–1.12); and death during the trial RR 0.49 (95% CI 0.17–1.37). One non-randomised study reported that high FiO2 was associated with major respiratory AE [RR 1.99 (95% CI 1.72–2.31)]. Conclusions: No definite signal of harm with 80% FiO2 in adult surgical patients undergoing general anaesthesia was demonstrated and there is little evidence on safety-related issues to discourage its use in this population

Volatile organic compounds associated with diagnosis and disease characteristics in asthma – A systematic review

Background: Metabolomics refers to study of the metabolome, the entire set of metabolites produced by a biological system. The application of metabolomics to exhaled breath samples - breathomics - is a rapidly growing field with potential application to asthma diagnosis and management. Objectives: We aimed to review the adult asthma breathomic literature and present a comprehensive list of volatile organic compounds identified by asthma breathomic models. Methods: We undertook a systematic search for literature on exhaled volatile organic compounds in adult asthma. We assessed the quality of studies and performed a qualitative synthesis. Results: We identified twenty studies; these were methodologically heterogenous with a variable risk of bias. Studies almost universally reported breathomics to be capable of differentiating - with moderate or greater accuracy - between samples from healthy controls and those with asthma; and to be capable of phenotyping disease. However, there was little concordance in the compounds upon which discriminatory models were based. Conclusion: Results to-date are promising but validation in independent prospective cohorts is needed. This may be challenging given the high levels of inter-individual variation. However, large-scale, multi-centre studies are underway and validation efforts have been aided by the publication of technical standards likely to increase inter-study comparability. Successful validation of breathomic models for diagnosis and phenotyping would constitute an important step towards personalised medicine in asthma

The role of measuring exhaled breath biomarkers in sarcoidosis: A systematic review

Introduction: Sarcoidosis is a chronic granulomatous disease of unknown aetiology with a variable clinical course and prognosis. There is a growing need to identify non-invasive biomarkers to differentiate between clinical phenotypes, identify those at risk of disease progression and monitor response to treatment. Objectives: We undertook a systematic review and meta-analysis, to evaluate the utility of breath-based biomarkers in discriminating sarcoidosis from healthy controls, alongside correlation with existing non-breath based biomarkers used in clinical practice, radiological stage, markers of disease activity and response to treatment. Methods: Electronic searches were undertaken during November 2017 using PubMed, Ebsco, Embase and Web of Science to capture relevant studies evaluating breath-based biomarkers in adult patients with sarcoidosis. Results: 353 papers were screened; 21 met the inclusion criteria and assessed 25 different biomarkers alongside VOCs in exhaled breath gas or condensate. Considerable heterogeneity existed amongst the studies in terms of participant characteristics, sampling and analytical methods. Elevated biomarkers in sarcoidosis included 8-isoprostane, carbon monoxide, neopterin, TGF-β1, TNFα, CysLT and several metallic elements including chromium, silicon and nickel. Three studies exploring VOCs were able to distinguish sarcoidosis from controls. Meta-analysis of four studies assessing alveolar nitric oxide showed no significant difference between sarcoidosis and healthy controls (2.22ppb; 95% CI -0.83, 5.27) however, a high degree of heterogeneity was observed with an I2 of 93.4% (p<0.001). Inconsistent or statistically insignificant results were observed for correlations between several biomarkers and radiological stage, markers of disease activity or treatment. Conclusions: The evidence for using breath biomarkers to diagnose and monitor sarcoidosis remains inconclusive with many studies limited by small sample sizes and lack of standardisation. VOCs have shown promising potential but further research is required to evaluate their prognostic role