Exploring the costs and outcomes of sexually transmitted infection (STI) screening interventions targeting men in football club settings: preliminary cost-consequence analysis of the SPORTSMART pilot randomised controlled trial

Background: The objective of this study was to compare the costs and outcomes of two sexually transmitted infection (STI) screening interventions targeted at men in football club settings in England, including screening promoted by team captains. Methods: A comparison of costs and outcomes was undertaken alongside a pilot cluster randomised control trial involving three trial arms: (1) captain-led and poster STI screening promotion; (2) sexual health advisor-led and poster STI screening promotion and (3) poster-only STI screening promotion (control/comparator). For all study arms, resource use and cost data were collected prospectively. Results: There was considerable variation in uptake rates between clubs, but results were broadly comparable across study arms with 50% of men accepting the screening offer in the captain-led arm, 67% in the sexual health advisor-led arm and 61% in the poster-only control arm. The overall costs associated with the intervention arms were similar. The average cost per player tested was comparable, with the average cost per player tested for the captain-led promotion estimated to be £88.99 compared with £88.33 for the sexual health advisor-led promotion and £81.87 for the poster-only (control) arm. Conclusions: Costs and outcomes were similar across intervention arms. The target sample size was not achieved, and we found a greater than anticipated variability between clubs in the acceptability of screening, which limited our ability to estimate acceptability for intervention arms. Further evidence is needed about the public health benefits associated with screening interventions in non-clinical settings so that their cost-effectiveness can be fully evaluated

On waiting for something to happen

This paper seeks to examine two particular and peculiar practices in which the mediation of apparently direct encounters is made explicit and is systematically theorized: that of the psychoanalytic dialogue with its inward focus and private secluded setting, and that of theatre and live performance, with its public focus. Both these practices are concerned with ways in which “live encounters” impact on their participants, and hence with the conditions under which, and the processes whereby, the coming-together of human subjects results in recognizable personal or social change. Through the rudimentary analysis of two anecdotes, we aim to think these encounters together in a way that explores what each borrows from the other, the psychoanalytic in the theatrical, the theatrical in the psychoanalytic, figuring each practice as differently committed to what we call the “publication of liveness”. We argue that these “redundant” forms of human contact continue to provide respite from group acceptance of narcissistic failure in the post-democratic era through their offer of a practice of waiting

The effect of undernutrition on brain-rhythm development

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The views of general practitioners and practice nurses towards the barriers and facilitators of proactive, internet-based chlamydia screening for reaching young heterosexual men

Background: Chlamydia trachomatis is a common bacterial sexually transmitted infection (STI), which disproportionately affects young people under 25 years. Commonly, more women are offered screening than men. This study obtained the views of general practitioners and practice nurses towards Internet-based screening and assessed levels of support for the development of proactive screening targeting young heterosexual men via the Internet. Methods: Semi-structured telephone interviews with 10 general practitioners and 8 practice nurses, across Central Scotland. Topics covered: experience of screening heterosexual men for chlamydia, views on the use of the Internet as a way to reach young men for chlamydia screening, beliefs about the potential barriers and facilitators to Internet-based screening. Transcripts from audio recordings were analysed with Framework Analysis, using QSR NVivo10. Results: Experiences of chlamydia screening were almost exclusively with women, driven by the nature of consultations and ease of raising sexual health issues with female patients; few practice nurses reported seeing men during consultations. All participants spoke in favour of Internet-based screening for young men. Participants reported ease of access and convenience as potential facilitators of an Internet-based approach but anonymity and confidentiality could be potential barriers and facilitators to the success of an Internet approach to screening. Concerns over practical issues as well as those pertaining to gender and socio-cultural issues were raised. Conclusions: Awareness of key barriers and facilitators, such as confidentiality, practicality and socio-cultural influences, will inform the development of an Internet-based approach to screening. However, this approach may have its limits in terms of being able to tackle wider social and cultural barriers, along with shifts in young people's and health professionals' attitudes towards screening. Nevertheless, employing innovative efforts as part of a multi-faceted approach is required to ensure effective interventions reach the policy agenda

Homozygosity for a missense mutation in the 67 kDa isoform of glutamate decarboxylase in a family with autosomal recessive spastic cerebral palsy: parallels with Stiff-Person Syndrome and other movement disorders

Background Cerebral palsy (CP) is an heterogeneous group of neurological disorders of movement and/or posture, with an estimated incidence of 1 in 1000 live births. Non-progressive forms of symmetrical, spastic CP have been identified, which show a Mendelian autosomal recessive pattern of inheritance. We recently described the mapping of a recessive spastic CP locus to a 5 cM chromosomal region located at 2q24-31.1, in rare consanguineous families. Methods Here we present data that refine this locus to a 0.5 cM region, flanked by the microsatellite markers D2S2345 and D2S326. The minimal region contains the candidate gene GAD1, which encodes a glutamate decarboxylase isoform (GAD67), involved in conversion of the amino acid and excitatory neurotransmitter glutamate to the inhibitory neurotransmitter γ-aminobutyric acid (GABA). Results A novel amino acid mis-sense mutation in GAD67 was detected, which segregated with CP in affected individuals. Conclusions This result is interesting because auto-antibodies to GAD67 and the more widely studied GAD65 homologue encoded by the GAD2 gene, are described in patients with Stiff-Person Syndrome (SPS), epilepsy, cerebellar ataxia and Batten disease. Further investigation seems merited of the possibility that variation in the GAD1 sequence, potentially affecting glutamate/GABA ratios, may underlie this form of spastic CP, given the presence of anti-GAD antibodies in SPS and the recognised excitotoxicity of glutamate in various contexts

Temporal drag: transdisciplinarity and the 'case' of psychosocial studies

Psychosocial studies is a putatively ‘new’ or emerging field concerned with the irreducible relation between psychic and social life. Genealogically, it attempts to re-suture a tentative relation between mind and social world, individual and mass, internality and externality, norm and subject, and the human and non-human, through gathering up and re-animating largely forgotten debates that have played out across a range of other disciplinary spaces. If, as I argue, the central tenets, concepts and questions for psychosocial studies emerge out of a re-appropriation of what have become anachronistic or ‘useless’ concepts in other fields – ‘the unconscious’, for instance, in the discipline of psychology – then we need to think about transdisciplinarity not just in spatial terms (that is, in terms of the movement across disciplinary borders) but also in temporal terms. This may involve engaging with theoretical ‘embarrassments’, one of which – the notion of ‘psychic reality’ – I explore here

Microcephaly with or without chorioretinopathy, lymphoedema, or mental retardation (MCLMR): review of phenotype associated with KIF11 mutations

Microcephaly with or without chorioretinopathy, lymphoedema, or mental retardation (MCLMR) (MIM No.152950) is a rare autosomal dominant condition for which a causative gene has recently been identified. Mutations in the kinesin family member 11 (KIF11) gene have now been described in 16 families worldwide. This is a review of the condition based on the clinical features of 37 individuals from 22 families. This report includes nine previously unreported families and additional information for some of those reported previously. The condition arose de novo in 8/20 families (40%). The parental results were not available for two probands. The mutations were varied and include missense, nonsense, frameshift, and splice site and are distributed evenly throughout the KIF11 gene. In our cohort, 86% had microcephaly, 78% had an ocular abnormality consistent with the diagnosis, 46% had lymphoedema, 73% had mild-moderate learning difficulties, 8% had epilepsy, and 8% had a cardiac anomaly. We identified three individuals with KIF11 mutations but no clinical features of MCLMR demonstrating reduced penetrance. The variable expression of the phenotype and the presence of mildly affected individuals indicates that the prevalence may be higher than expected, and we would therefore recommend a low threshold for genetic testing

Ethical conference economies? Reimagining the costs of convening academic communities when moving online

Online conferences are widely thought to reduce many of the costs of convening academic communities. From lower carbon emissions, lower fees, less difficulty in attending (particularly for marginalised researchers), and greater accessibility, virtual events promise to address many of the issues that in-person events take for granted. In this article, we draw on a community economies framing from geographers J.K. Gibson-Graham to argue for centring the work of convening within efforts to explore reparative possibilities within the academy. Reflecting on the changing costs arising from moving an originally in-person conference series online, we argue for embracing the opportunities offered. We explore how organising teams might enact alternative values through allocating the material, financial and labour resources traditionally spent for these events differently. We look particularly at how our carbon and financial costs changed, and how, by retaining a fee, we were able to allocate our budgets in ways which redistributed the surplus to participants in need (rather than bolster conference centre profits). We then explore what these changing costs meant in terms of our attendance levels across career stages and geographical locations. Looking at whether our experiment resulted in increased support for online events, we examine the continued ambivalence felt for the virtual. Finally, while we largely explore the benefits of online options, our last section urges caution over assumptions that this move will result in a more sustainable academia, particularly given the intensifications surrounding high quality streaming video, and suggest that we treat current trends as ongoing experiments, rather than solutions

‘What about the coffee break?’: Designing virtual conference spaces for conviviality

Geography, like many other disciplines, is reckoning with the carbon intensity of its practices and rethinking how activities such as annual meetings are held. The Climate Action Task Force of the American Association of Geographers (AAG), for example, was set up in 2019 and seeks to transform the annual conference in light of environmental justice concerns. Mirroring shifts it geographic practice across the globe, these efforts point to a need to understand how new opportunities for knowledge production such as online events can operate effectively. In this article, we offer suggestions for best practice in virtual spaces arising from our Material Life of Time conference held in March 2021, a two day global event that ran synchronously across 15 time zones. Given concerns about lack of opportunities for informal exchanges at virtual conferences, or the “coffee break problem”, we designed the event to focus particularly on opportunities for conviviality. This was accomplished through a focus on three key design issues: the spatial, the temporal and the social. We review previous work on the benefits and drawbacks of synchronous and asynchronous online conference methods and the kinds of geographic communities they might support. We then describe our design approach and reflect on its effectiveness via a variety of feedback materials. We show that our design enabled high delegate satisfaction, a sense of conviviality, and strong connections with new colleagues. However we also discuss the problems with attendance levels and external commitments which hampered shared time together. We thus call for collective efforts to support the ‘event time’ of online meetings, rather than expectations to fit them around everyday tasks. Even so, our results suggest that synchronous online events need not result in geographical exclusions linked to time zone differences, and we outline further recommendations for reworking the spacetimes of the conference