Evaluation of Parasite Control Programmes in Beef Cattle

End of Project ReportThe objective of this project was to examine the effect of methods of animal management in a dairy calf to beef (Study 1) and a suckler beef (Study 2) production system on parasitic burdens of calves and accompanying animals. Parasitic burdens were defined by quantifying faecal egg counts and plasma pepsinogen levels (concentrations greater than 1U/l are an indicator of a possible heavy parasitic burden). In the first study three different grazing systems for dairy calves and steers, were investigated. The leader follower system (L-F1) was described by calves grazing ahead of steers; the separate (S) system was described by calves and steers grazing separate areas and thirdly the combined (T) system where both calves and steers grazed together. In the second study, two different grazing systems for suckler cows and calves, and yearling animals were examined. The leader follower (L-F2) system was described by yearlings grazing ahead of suckler cows with calves at foot or a conventional (C) system where the cows and calves grazed areas separate to the yearlings

Presentation for care and antenatal management of HIV in the United Kingdom:temporal trends and demographic variations, 2009-2014

OBJECTIVES: Despite very low rates of vertical transmission of HIV in the UK overall, rates are higher among women starting antenatal antiretroviral therapy (ART) late. We investigated the timing of key elements of the care of HIV‐positive pregnant women [antenatal care booking, HIV laboratory assessment (CD4 count and HIV viral load) and antenatal ART initiation], to assess whether clinical practice is changing in line with recommendations, and to investigate factors associated with delayed care. METHODS: We used the UK's National Study of HIV in Pregnancy and Childhood for 2009−2014. Data were analysed by fitting logistic regression and Cox proportional hazards models. RESULTS: A total of 5693 births were reported; 79.5% were in women diagnosed with HIV prior to that pregnancy. Median gestation at antenatal booking was 12.1 weeks [interquartile range (IQR) 10.0–15.6 weeks] and booking was significantly earlier during 2012–2014 vs. 2009–2011 (P < 0.001), although only in previously diagnosed women. Overall, 42.2% of pregnancies were booked late (≥ 13 gestational weeks). Among women not already on treatment, antenatal ART commenced at a median of 21.4 (IQR18.1–24.5) weeks and started significantly earlier in the most recent time period (P < 0.001). Compared with previously diagnosed women, those newly diagnosed during the current pregnancy booked later for antenatal care and started antenatal ART later (both P < 0.001). Multivariable analyses revealed demographic variations in access to or uptake of care, with groups including migrants and parous women initiating care later. CONCLUSIONS: Although women are accessing antenatal and HIV care earlier in pregnancy, some continue to face barriers to timely initiation of antenatal care and ART

Measuring patient satisfaction with exercise therapy for knee osteoarthritis: evaluating the utility of the physiotherapy outpatient survey.

OBJECTIVES: To assess patient satisfaction with exercise for knee osteoarthritis (OA). METHODS: A convenience sample of 27 patients recruited to a randomized controlled trial (RCT) comparing open kinetic chain and closed kinetic chain exercises for knee OA were reassessed at nine months post-randomization. Clinical outcomes included self-report and physical performance measures of function and pain severity. Patients also completed the Physiotherapy Outpatient Survey (POPS), which is a multi-dimensional measure of patient satisfaction with physiotherapy. RESULTS: There was no significant difference in satisfaction between the two intervention groups. Overall mean satisfaction for the entire cohort was 4.07 of a maximum score of 5 (standard deviation (SD) = 0.52). Lower levels of satisfaction with outcome (mean = 3.56, SD = 0.8) were reported compared with other domains of expectations, communication, organization and the therapist (mean = 3.79-4.49; SDs = 0.42-0.92). Both intervention groups improved from baseline on clinical outcomes of pain, self-report function and walking distance, with no significant differences between the two groups. CONCLUSIONS: High levels of satisfaction were reported in this subsample of knee OA patients participating in an RCT evaluating the effects of different exercise approaches for knee OA. Satisfaction varied depending on the satisfaction domain, with lower satisfaction with outcome compared with other aspects of care. The POPS questionnaire can be used to measure the multi-dimensional aspects of satisfaction with physiotherapy

Who is being tested by the English National Chlamydia Screening Programme? A comparison with national probability survey data

Objectives We compare data collected by England's National Chlamydia Screening Programme (NCSP) with national probability survey data to examine demographic and behavioural differences that may be important in understanding who the NCSP is reaching and interpreting chlamydia positivity.Methods Data for 538 119 men and women aged 16-24 years who were screened in 2008 and data collected from 2180 interviewees in Britain's second National Survey of Sexual Attitudes and Lifestyles 1999-2001 (Natsal-2), of whom 644 were tested for chlamydia, were compared using the chi(2) statistic and logistic regression.Results Compared with Natsal-2, the NCSP tested more women (67% vs 49%). NCSP participants were more likely to be younger: 29% were 16-17 years versus 16% of men and 15% of women in Natsal-2; from ethnic minority groups: 17% of men and 14% of women versus 8% and 6%, respectively, in Natsal-2; not to have used condoms at last sex: 66% of men and 68% of women versus 48% and 63%, respectively, in Natsal-2: and more likely to report two or more partners in the last year: 62% of men and 47% of women versus 47% and 30%, respectively, in Natsal-2. In multivariate analyses, higher AOR of chlamydia positivity were found for those reporting non-use of condoms and for those reporting multiple partners in both the NCSP and Natsal-2.Conclusions The NCSP is testing young people at increased risk of chlamydia. The impact of this testing bias on the effectiveness of the programme should be evaluated

Professional learning and/or development (PL): principles and practices. A review of the literature.

B5.

Loss to follow-up after pregnancy among Sub-Saharan Africa-born women living with HIV in England, Wales and Northern Ireland:results from a large national cohort

BACKGROUND: Little is known about retention in human immunodeficiency virus (HIV) care in HIV-positive women after pregnancy in the United Kingdom. We explored the association between loss to follow-up (LTFU) in the year after pregnancy, maternal place of birth and duration of UK residence, in HIV-positive women in England, Wales, and Northern Ireland. METHODS: We analyzed combined data from 2 national data sets: the National Study of HIV in Pregnancy and Childhood; and the Survey of Prevalent HIV Infections Diagnosed, including pregnancies in 2000 to 2009 in women with diagnosed HIV. Logistic regression models were fitted with robust standard errors to estimate adjusted odds ratios (AOR). RESULTS: Overall, 902 of 7211 (12.5%) women did not access HIV care in the year after pregnancy. Factors associated with LTFU included younger age, last CD4 in pregnancy of 350 cells/μL or greater and detectable HIV viral load at the end of pregnancy (all P < 0.001). On multivariable analysis, LTFU was more likely in sub-Saharan Africa-born (SSA-born) women than white UK-born women (AOR, 2.17; 95% confidence interval, 1.50–3.14; P < 0.001). The SSA-born women who had migrated to the UK during pregnancy were 3 times more likely than white UK-born women to be lost to follow-up (AOR, 3.19; 95% confidence interval, 1.94–3.23; P < 0.001). CONCLUSIONS: One in 8 HIV-positive women in England, Wales, and Northern Ireland did not return for HIV care in the year after pregnancy, with SSA-born women, especially those who migrated to the United Kingdom during pregnancy, at increased risk. Although emigration is a possible explanatory factor, disengagement from care may also play a role

Actually existing racial capitalism: Financialisation and bordering in UK housing associations

Abstract: This paper provides a critical intervention into recent geographical debates on racial capitalism, interrogating the role that Housing Associations (HAs), the main form of UK social housing, play in its (re)production. Housing Associations are institutional, third‐sector spaces within which novel forms of financialisation and bordering take place. Race is central to these processes, but insufficient critical attention has been afforded to the intersections of class, race, and migratory status in extant research on UK HAs. Moreover, existing research into housing and racial capitalism is provincial in its North American focus, typically examining home ownership and private renting. We argue this is a significant lacuna given that new and multiple forms of racialised exclusion, inequality, and extraction cohere in social housing. There is accordingly a pressing need for a robust interrogation of racial capitalisms through UK HAs, and of the role of HAs via the conceptual lens of racial capitalism. In concluding, the paper argues for a new focus on ‘actually existing’ racial capitalisms, and the need for detailed analyses of the logics and practices of racial capitalisms across a variety of sites and scales, helping debates move beyond their conceptual heartland in North America

Actually existing racial capitalism: financialisation and bordering in UK housing associations

This paper provides a critical intervention into recent geographical debates on racial capitalism, interrogating the role that Housing Associations (HAs), the main form of UK social housing, play in its (re)production. Housing Associations are institutional, third-sector spaces within which novel forms of financialisation and bordering take place. Race is central to these processes, but insufficient critical attention has been afforded to the intersections of class, race, and migratory status in extant research on UK HAs. Moreover, existing research into housing and racial capitalism is provincial in its North American focus, typically examining home ownership and private renting. We argue this is a significant lacuna given that new and multiple forms of racialised exclusion, inequality, and extraction cohere in social housing. There is accordingly a pressing need for a robust interrogation of racial capitalisms through UK HAs, and of the role of HAs via the conceptual lens of racial capitalism. In concluding, the paper argues for a new focus on ‘actually existing’ racial capitalisms, and the need for detailed analyses of the logics and practices of racial capitalisms across a variety of sites and scales, helping debates move beyond their conceptual heartland in North America