A Study to Explore the Impact of Endometriosis in the United Kingdom: A Qualitative Content Analysis

Objective To gain insight into the areas that impact women with endometriosis. Design A qualitative content analysis of an online survey. Setting Online questionnaire via Endometriosis UK. Population Women diagnosed with endometriosis of any age range. Methods Free-text online questionnaire through Endometriosis UK completed by women. Results were analysed using NVivo version 9, qualitative analysis software. The software creates links between common words (codes), and these links allow data to be placed in nodes (called themes) which are then developed into categories. Content analysis was used to understand this data.  Main outcome measures  Impact of endometriosis on women’s lives. Results In total, 1872 questionnaires were returned but not everyone was able to identify ten separate features that affected them. As such, 1872 women provided at least one area that affected them, 1800 provided two areas, 1770 provided three areas and 1600 provided four areas. The results show that the main areas of concern for these women were pain (53%), heavy menstrual bleeding (11%), low mood (8%) and the perceived lack of understanding displayed by other people (7%). Other important factors were fertility concerns, impact on employment, problems with the medical team and uncertainty. These then impacted on their daily life whereby some women felt “guilty” for not ‘being a normal mother’. A key term that resonated was that endometriosis is an “invisible disease”. Conclusion This analysis provides us with insight into the complex psycho-social factors that interact with bio-physical symptoms. Further research is required in sub-population groups such as teenagers and ethnic minority women to explore any differences in impact and how care can be guided accordingly

Women’s perceptions of COVID-19 and their healthcare experiences: a qualitative thematic analysis of a national survey of pregnant women in the United Kingdom

Background The aim of this national survey was to explore pregnant women’s perceptions of COVID-19 and their healthcare experiences. Methods Through patient and public involvement, a questionnaire was developed and advertised via the BBC website, Twitter and other online media during May 2020. The findings were analysed by qualitative thematic analysis. Women who are currently pregnant, or who have delivered during the COVID-19 pandemic were invited to partake in a national online survey. Results One thousand four hundred fifty-one participants replied to the online questionnaire. Participants provided significant insight into the perceived barriers to seeking healthcare during this pandemic. These include ‘not wanting to bother anyone’, ‘lack of wider support from allied healthcare workers’ and the influence of the media. Other concerns included the use of virtual clinics antenatally and their acceptability to patients, the presence of birthing partners, and the way in which information is communicated about rapidly changing and evolving services. The influence of the media has also had a significant impact on the way women perceive hospital care in light of COVID-19 and for some, this has shaped whether they would seek help. Conclusions This is the first ever reported study in the United Kingdom to explore pregnant women’s perceptions of COVID-19 and their subsequent healthcare experiences. It has also provided insight into perceived barriers into seeking care as well as maternal concerns antenatally, intrapartum and postpartum

Integrating the role of sports associations in the promotion of sports and recreation tourism at the destination level: creating a partnering framework for Kenya

International Journal of Tourism Sciences, Volume 11, Number 3, pp. 21-35, 2011 Tourism Sciences Society of KoreaIn Kenya, tourism is the second most important earner of foreign exchange after agriculture. It has had a great impact in the direct employment of local population as well as in generating opportunities for other business activities such as accommodation, food service, transport, retail, and other auxiliary services. In the recent past, Kenya’s tourism has faced numerous challenges which may have slowed tourist arrivals and growth considerably. The challenges have been driven by climatic and environmental changes that maybe interfering with the ecosystem. Kenyan tourism faces significant challenges also from intense regional competition, political instability, poor governance, corruption, negative travel advisory by the governments of source markets, poor security at the destination, dilapidated infrastructure within the destination, poor product/ service innovation, and inadequate market and customer value perception of the destination. In this regard, a need to examine possible ways of reinvigorating and diversifying Kenya’s tourism offerings has emerged and one area that holds a great potential is Sports and Recreation tourism. This paper therefore carries out an exploratory assessment of the awareness of the members of the various sports associations regarding the significance of sports tourism to Kenya’s economy. Club representatives duly registered within ten selected sports associations that represent popular sports in Kenya were surveyed to achieve this objective. This research proposes an integrated approach to the creation of a partnering role amongst sports associations to help promote sports and recreation tourism in Kenya.In Kenya, tourism is the second most important earner of foreign exchange after agriculture. It has had a great impact in the direct employment of local population as well as in generating opportunities for other business activities such as accommodation, food service, transport, retail, and other auxiliary services. In the recent past, Kenya’s tourism has faced numerous challenges which may have slowed tourist arrivals and growth considerably. The challenges have been driven by climatic and environmental changes that maybe interfering with the ecosystem. Kenyan tourism faces significant challenges also from intense regional competition, political instability, poor governance, corruption, negative travel advisory by the governments of source markets, poor security at the destination, dilapidated infrastructure within the destination, poor product/ service innovation, and inadequate market and customer value perception of the destination. In this regard, a need to examine possible ways of reinvigorating and diversifying Kenya’s tourism offerings has emerged and one area that holds a great potential is Sports and Recreation tourism. This paper therefore carries out an exploratory assessment of the awareness of the members of the various sports associations regarding the significance of sports tourism to Kenya’s economy. Club representatives duly registered within ten selected sports associations that represent popular sports in Kenya were surveyed to achieve this objective. This research proposes an integrated approach to the creation of a partnering role amongst sports associations to help promote sports and recreation tourism in Kenya

Proton Decay in Intersecting D-brane Models

We analyze proton decay via dimension six operators in certain GUT-like models derived from Type IIA orientifolds with $D6$-branes. The amplitude is parametrically enhanced by a factor of $\alpha_{GUT}^{-1/3}$ relative to the coresponding result in four-dimensional GUT's. Nonetheless, even assuming a plausible enhancement from the threshold corrections, we find little overall enhancement of the proton decay rate from dimension six operators, so that the predicted lifetime from this mechanism remains close to $10^{36}$ years.Comment: 21 pages, LaTeX; v2: references added; v3: minor clarifications, version to appear in NP

Antimalarials and Phytotoxins from Botryosphaeria dothidea Identified from a Seed of Diseased Torreya taxifolia

The metabolic pathways in the apicoplast organelle of Plasmodium parasites are similar to those in plastids in plant cells and are suitable targets for malaria drug discovery. Some phytotoxins released by plant pathogenic fungi have been known to target metabolic pathways of the plastid; thus, they may also serve as potential antimalarial drug leads. An EtOAc extract of the broth of the endophyte Botryosphaeria dothidea isolated from a seed collected from a Torreya taxifolia plant with disease symptoms, showed in vitro antimalarial and phytotoxic activities. Bioactivity-guided fractionation of the extract afforded a mixture of two known isomeric phytotoxins, FRT-A and flavipucine (or their enantiomers, sapinopyridione and (-)-flavipucine), and two new unstable γ-lactam alkaloids dothilactaenes A and B. The isomeric mixture of phytotoxins displayed strong phytotoxicity against both a dicot and a monocot and moderate cytotoxicity against a panel of cell lines. Dothilactaene A showed no activity. Dothilactaene B was isolated from the active fraction, which showed moderate in vitro antiplasmodial activity with high selectivity index. In spite of this activity, its instability and various other biological activities shown by related compounds would preclude it from being a viable antimalarial lead

Macrophage-derived human resistin is induced in multiple helminth infections and promotes inflammatory monocytes and increased parasite burden.

Parasitic helminth infections can be associated with lifelong morbidity such as immune-mediated organ failure. A better understanding of the host immune response to helminths could provide new avenues to promote parasite clearance and/or alleviate infection-associated morbidity. Murine resistin-like molecules (RELM) exhibit pleiotropic functions following helminth infection including modulating the host immune response; however, the relevance of human RELM proteins in helminth infection is unknown. To examine the function of human resistin (hResistin), we utilized transgenic mice expressing the human resistin gene (hRetnTg+). Following infection with the helminth Nippostrongylus brasiliensis (Nb), hResistin expression was significantly upregulated in infected tissue. Compared to control hRetnTg- mice, hRetnTg+ mice suffered from exacerbated Nb-induced inflammation characterized by weight loss and increased infiltration of inflammatory monocytes in the lung, along with elevated Nb egg burdens and delayed parasite expulsion. Genome-wide transcriptional profiling of the infected tissue revealed that hResistin promoted expression of proinflammatory cytokines and genes downstream of toll-like receptor signaling. Moreover, hResistin preferentially bound lung monocytes, and exogenous treatment of mice with recombinant hResistin promoted monocyte recruitment and proinflammatory cytokine expression. In human studies, increased serum resistin was associated with higher parasite load in individuals infected with soil-transmitted helminths or filarial nematode Wuchereria bancrofti, and was positively correlated with proinflammatory cytokines. Together, these studies identify human resistin as a detrimental factor induced by multiple helminth infections, where it promotes proinflammatory cytokines and impedes parasite clearance. Targeting the resistin/proinflammatory cytokine immune axis may provide new diagnostic or treatment strategies for helminth infection and associated immune-mediated pathology

Threatening of olive ridley sea turtle Lepidochelys olivacea (eschscholtz, 1829) nesting ground and its populations in Kolavipalam beach, North Kerala, India

A study was carried out to explore the status of threatening olive ridley turtle nesting ground and turtle populations in the Kolavipalam area which covers Tikkoti (110 29’38.634’’ N and 750 36’54.316’’ E) to Kottapuzha estuary (110 34’12.151’’ N and 750 35’26.754’’ E) of about 8 km, Kozhikode, Kerala, India during the year 1998-99 to 2015-16. Despite the sporadic nature of sea turtles, every individual of olive ridley sea turtle nests were monitored by Theeram volunteers in Kolavipalam region, North Kerala, India from the the last two decades. From that a total of 410 olive ridley sea turtle nests have been recorded. The maximum number of sea turtles nests of 65 nos. has been recorded during the year 1999-2000 and 2000-2001 continuously. The maximum and minimum percentage of hatchlings of 89.29%, 33% observed from the year 2002-03 and 2014-15 respectively. This study will provide the baseline data on medium term status of olive ridley turtles and their nesting populations in Kolavipalam beach, Kozhikode, India

Role of vitamin D supplementation in modifying outcomes after surgery:a systematic review of randomised controlled trials

Background: There is increasing evidence to suggest vitamin D plays a role in immune and vascular function; hence, it may be of biological and clinical relevance for patients undergoing major surgery. With a greater number of randomised studies being conducted evaluating the impact of vitamin D supplementation on surgical patients, it is an opportune time to conduct further analysis of the impact of vitamin D on surgical outcomes. Methods: MEDLINE, EMBASE and the Cochrane Trials Register were interrogated up to December 2023 to identify randomised controlled trials of vitamin D supplementation in surgery. The risk of bias in the included studies was assessed using the Cochrane Risk of Bias tool. A narrative synthesis was conducted for all studies. The primary outcome assessed was overall postoperative survival. Results: We screened 4883 unique studies, assessed 236 full-text articles and included 14 articles in the qualitative synthesis, comprising 1982 patients. The included studies were highly heterogeneous with respect to patient conditions, ranging from open heart surgery to cancer operations to orthopaedic conditions, and also with respect to the timing and equivalent daily dose of vitamin D supplementation (range: 0.5–7500 mcg; 20–300 000 IU). No studies reported significant differences in overall survival or postoperative mortality with vitamin D supplementation. There was also no clear evidence of benefit with respect to overall or intensive care unit length of stay. Discussion: Numerous studies have reported the benefits of vitamin D supplementation in different surgical settings without any consistency. However, this systematic review found no clear evidence of benefit, which warrants the supposition that a single biological effect of vitamin D supplementation does not exist. The observed improvement in outcomes in low vitamin D groups has not been convincingly proven beyond chance findings. Trial registration number: CRD42021232067

Circulating Microbial Products and Acute Phase Proteins as Markers of Pathogenesis in Lymphatic Filarial Disease

Lymphatic filariasis can be associated with development of serious pathology in the form of lymphedema, hydrocele, and elephantiasis in a subset of infected patients. Dysregulated host inflammatory responses leading to systemic immune activation are thought to play a central role in filarial disease pathogenesis. We measured the plasma levels of microbial translocation markers, acute phase proteins, and inflammatory cytokines in individuals with chronic filarial pathology with (CP Ag+) or without (CP Ag−) active infection; with clinically asymptomatic infections (INF); and in those without infection (endemic normal [EN]). Comparisons between the two actively infected groups (CP Ag+ compared to INF) and those without active infection (CP Ag− compared to EN) were used preliminarily to identify markers of pathogenesis. Thereafter, we tested for group effects among all the four groups using linear models on the log transformed responses of the markers. Our data suggest that circulating levels of microbial translocation products (lipopolysaccharide and LPS-binding protein), acute phase proteins (haptoglobin and serum amyloid protein-A), and inflammatory cytokines (IL-1β, IL-12, and TNF-α) are associated with pathogenesis of disease in lymphatic filarial infection and implicate an important role for circulating microbial products and acute phase proteins

The secreted triose phosphate isomerase of Brugia malayi is required to sustain microfilaria production in vivo

Human lymphatic filariasis is a major tropical disease transmitted through mosquito vectors which take up microfilarial larvae from the blood of infected subjects. Microfilariae are produced by long-lived adult parasites, which also release a suite of excretory-secretory products that have recently been subject to in-depth proteomic analysis. Surprisingly, the most abundant secreted protein of adult Brugia malayi is triose phosphate isomerase (TPI), a glycolytic enzyme usually associated with the cytosol. We now show that while TPI is a prominent target of the antibody response to infection, there is little antibody-mediated inhibition of catalytic activity by polyclonal sera. We generated a panel of twenty-three anti-TPI monoclonal antibodies and found only two were able to block TPI enzymatic activity. Immunisation of jirds with B. malayi TPI, or mice with the homologous protein from the rodent filaria Litomosoides sigmodontis, failed to induce neutralising antibodies or protective immunity. In contrast, passive transfer of neutralising monoclonal antibody to mice prior to implantation with adult B. malayi resulted in 60–70% reductions in microfilarial levels in vivo and both oocyte and microfilarial production by individual adult females. The loss of fecundity was accompanied by reduced IFNγ expression by CD4+ T cells and a higher proportion of macrophages at the site of infection. Thus, enzymatically active TPI plays an important role in the transmission cycle of B. malayi filarial parasites and is identified as a potential target for immunological and pharmacological intervention against filarial infections