Sexual intercourse, age of initiation and contraception among adolescents in Ireland: findings from the Health Behaviour in School-aged Children (HBSC) Ireland study

Background: The need to tackle sexual health problems and promote positive sexual health has been acknowledged in Irish health policy. Young people’s sexual behaviour however remains under-researched with limited national data available. Methods: This study presents the first nationally representative and internationally comparable data on young people’s sexual health behaviours in Ireland. Self-complete questionnaire data were collected from 4494 schoolchildren aged 15-18 as part of a broader examination of health behaviour and their context. The prevalence of sexual initiation, very early sexual initiation (<14 years) and non-condom use at last intercourse are reported and used as outcomes in separate multilevel logistic regression models examining associations between sociodemographic characteristics, lifestyle characteristics and young people’s sexual behaviours. Results: Overall, 25.7% of boys and 21.2% of girls were sexually initiated. Older age was consistently predictive of initiation for both boys and girls, as were alcohol, tobacco and cannabis involvement, living in poorer neighbourhoods and having good communication with friends. Involvement in music and drama was protective. Very early sexual initiation (<14 years) was reported by 22.8% of sexually initiated boys and 13.4% of the sexually initiated girls, and was consistently associated with rural living, cannabis involvement, bullying others and attending fewer health check-ups for both. Boys’ very early initiation was predicted by alcohol involvement, receiving unhealthy food from parents and taking medication for psychological symptoms, whereas better communication with friends and more experience of health symptoms were protective. Girls’ very early initiation was predicted by belonging to a non-Traveller community, whereas taking medication for physical symptoms was protective. Condom use was reported by 80% of sexually initiated students at last intercourse. Boys’ condom use was associated with older age, higher social class, bullying others and self-care behaviours. For girls, condom use was predicted by belonging to a non-Traveller community, healthy food consumption, higher quality of life and being bullied, whereas taking medication for physical and psychological symptoms was associated with non-condom use. Conclusions: These nationally representative research findings highlight the importance of focusing on young people as a distinct population subgroup with unique influences on their sexual health requiring targeted interventions and policy

Surveys of experiences of sexual violence and harassment in higher education: reports and findings

In April 2021, the Minister for Further and Higher Education, Research, Innovation and Science, Simon Harris, asked the Higher Education Authority (HEA) to conduct national surveys to track students\u27 and staff\u27s experiences of sexual violence and harassment. Working with an expert advisory group, the HEA Centre of Excellence for Equality Diversity and Inclusion ran surveys of staff and students in April 2021. 7,901 students and 3,516 staff answered the surveys (11,417 responses in total). The department will use the results of these surveys to make policy and funding decisions to tackle sexual violence and harassment in higher education institutions (HEIs)

Navigation-by-preference: A new conversational recommender with preference-based feedback

We present Navigation-by-Preference, n-by-p, a new conversational recommender that uses what the literature calls preference-based feedback. Given a seed item, the recommender helps the user navigate through item space to find an item that aligns with her long-term preferences (revealed by her user profile) but also satisfies her ephemeral, short-term preferences (revealed by the feedback she gives during the dialog). Different from previous work on preference-based feedback, n-by-p does not assume structured item descriptions (such as sets of attribute-value pairs) but works instead in the case of unstructured item descriptions (such as sets of keywords or tags), thus extending preference-based feedback to new domains where structured item descriptions are not available. Different too is that it can be configured to ignore long-term preferences or to take them into account, to work only on positive feedback or to also use negative feedback, and to take previous rounds of feedback into account or to use just the most recent feedback. We use an offline experiment with simulated users to compare 60 configurations of n-by-p. We find that a configuration that includes long-term preferences, that uses both positive and negative feedback, and that uses previous rounds of feedback is the one with highest hit-rate. It also obtains the best survey responses and lowest measures of effort in a trial with real users that we conducted with a web-based system. Notable too is that the user trial has a novel protocol for experimenting with short-term preferences

Expanding the role of young people in research: Towards a better understanding of their lives

The participation of young people in the research process can be empowering for the participants and valuable for the research outcomes. This paper presents the methods used and outcomes of involving youth in the development of priorities for the Health Behaviour in School-aged Children study in Ireland.Two participative workshops were conducted with young people: the first focused on identifiying what is important for people to understand about young people’s lives; the second served to expand and prioritise the themes identified, for the purpose of developing questionnaire items. Following idea generation, discussion and voting four themes emerged as priorities. These were; ‘Diversity and Individuality’, ‘Independence’, ‘Mental Health’ and ‘Bullying’.The process enabled young people to prioritise dimensions of their lives that deserved further quantitative research attention. The findings of the study identify the potential of such a methodology to transform the path of any research project concerning young people

Planning for tranquil spaces in rural destinations through mixed methods research

There is a view that applied researchers produce more relevant findings for practitioners in the tourism industry if they use quantitative methods. This paper claims that findings relevant to industry can be produced through the use of qualitative methods of data collection, and indeed a unique perspective is offered by qualitative research that a quantitative approach may not produce. Furthermore, a mixed methods approach to research combines the advantages offered by both qualitative and quantitative research, and is advocated as an appropriate way forward when both types of data are needed. Using a unique mixed-methods study of the meaning of tranquillity to visitors to and authorities and residents in Dorset, Southern England, this paper illustrates the value of both qualitative and quantitative data to tourism planners. The study reveals that tranquillity was most commonly aligned to the natural environment whereas non-tranquillity concerned both sounds and sights of manmade origin

Participatory arts and affective engagement with climate change: the missing link in achieving climate compatible behaviour change?

Despite a growing number of arts based climate change interventions and the importance emphasised in the social psychology literature of achieving affective (emotional) engagement with climate change before climate compatible behaviour change is likely (exactly the kind of engagement the arts and humanities are arguably best at), to date there has been no systematic application of interpretive social science techniques to understand the ways in which these arts based interventions do, or do not, achieve affective public engagement with climate change and hence might hold the key to unlocking broader climate compatible behaviour change. This article makes three key contributions. First, it analyses the literature across social psychology and participatory arts to demonstrate why participatory, climate change based arts interventions could hold the key to more effective approaches to engaging multiple publics in climate compatible behaviour change. Second, using a small sample of participants in an arts based climate change intervention in the Inner Hebrides, Scotland, it demonstrates the potential value of combining social science techniques (in this case Q Methodology) with participatory arts interventions to better understand and learn from the ways in which climate based arts interventions achieve affective public engagement with climate change. Thirdly, it extends its analysis to engage explicitly with the under-researched issue of the role of place attachment and local, situated knowledge in mediating the influence of climate change communication. These contributions provide the basis for a significant new research and policy agenda looking forward

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p&lt;0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p&lt;0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p&lt;0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP &gt;5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts