"It's a can of worms": understanding primary care practitioners' behaviours in relation to HPV using the Theoretical Domains Framework

Background: The relationship between infection with high-risk human papillomavirus (HPV) and cervical cancer is transforming cervical cancer prevention. HPV tests and vaccinations have recently become available. In Ireland, as elsewhere, primary care practitioners play a key role in prevention. ATHENS (A Trial of HPV Education and Support) aims to develop a theorybased intervention to support primary care practitioners in their HPV-related practice. This study, the first step in the intervention development process, aimed to: identify HPV-related clinical behaviours that the intervention will target; clarify general practitioners’ (GPs’) and practice nurses’ roles and responsibilities; and determine factors that potentially influence clinical behaviour. A secondary objective was to informally assess the utility of the Theoretical Domains Framework (TDF) in understanding clinical behaviours in an area with an evolving evidence-base. Methods: In-depth semi-structured telephone interviews were conducted with GPs and practice nurses. The topic guide, which contained open questions and HPV-related clinical scenarios, was developed through literature review and clinical experience. Interview transcripts were content-analysed using the TDF as the coding framework. Results: 19 GPs and 14 practice nurses were interviewed. The major HPV-related clinical behaviours were: initiating a discussion about HPV infection with female patients; offering/recommending HPV vaccination to appropriate patients; and answering patients’ questions about HPV testing. While the responsibility for taking smears was considered a female role, both male and female practitioners dealt with HPV-related issues. All 12 theoretical domains arose in relation to HPV infection; the domains judged to be most important were: knowledge, emotion, social influences, beliefs about capabilities and beliefs about consequences. Eleven domains emerged in relation to HPV vaccination, with beliefs about consequences, social influences, knowledge and environmental context and resources judged to be the most important. Nine domains were relevant to HPV testing, with knowledge and beliefs about capabilities judged to be the most important. Conclusions: The findings confirm the need for an intervention to support primary care practitioners around HPV and suggest it should target a range of theoretical domains. The TDF proved valuable in analysing qualitative data collected using a topic guide not specifically designed to capture TDF domains and understanding clinical behaviours in an area with an evolving evidence-base

Be prepared: communism and the politics of scouting in 1950s Britain

This article examines the exposure, and in some cases dismissal, of Boy Scouts who belonged or sympathised with the Young Communist League in Britain during the early 1950s. A focus on the rationale and repercussions of the organisation's approach and attitudes towards ‘Red Scouts’ found within their ‘ranks’ extends our understanding of youth movements and their often complex and conflicting ideological foundations. In particular, the post-World War Two period presented significant challenges to these spaces of youth work in terms of broader social and political change in Britain. An analysis of the politics of scouting in relation to Red Scouts questions not only the assertion that British McCarthyism was ‘silent’, but also brings young people firmly into focus as part of a more everyday politics of communism in British society

The Soft Power of Anglia: British Cold War Cultural Diplomacy in the USSR

This article contributes to the growing literature on the cultural Cold War through an exploration of the British national projection magazine Anglia, produced by the Foreign Office for distribution in the USSR from 1962 to 1992. As well as drawing attention to the significance of national magazines in general, the article sheds light on Britain's distinctive approach to propaganda and cultural diplomacy during the Cold War. It considers why the magazine was set up and endured for so long, despite considerable reservations about its value. It examines how Britain was projected in a manner that accorded with British understandings about the need for ‘subtle’ propaganda. Finally, it addresses the question of the magazine's impact in the USSR

At the coalface and the cutting edge: general practitioners’ accounts of the rewards of engaging with HIV medicine

The interviews we conducted with GPs suggest that an engagement with HIV medicine enables clinicians to develop strong and long-term relationships with and expertise about the care needs of people living with HIV ‘at the coalface’, while also feeling connected with a broader network of medical practitioners and other professionals concerned with and contributing to the ever-changing world of science: ‘the cutting edge’. The general practice HIV prescriber is being modelled here as the interface between these two worlds, offering a rewarding opportunity for general practitioners to feel intimately connected to both community needs and scientific change

Symbiotic Futures: Health, Well-being and Care in the Post-Covid World

The "Symbiotic Futures: Health, Well-being and Care in the Post-Covid World" project was jointly conceived by the Innovation School at Glasgow School of Art and the Institute of Cancer Sciences at the University of Glasgow. The project partnership involved a community of experts working across both organisations including the University of Glasgow’s new Mazumdar-Shaw Advanced Research Centre (ARC). Future experiences is a collaborative, futures-focused design project where students benefit from the input of a community of experts to design speculative future worlds and experiences based on research within key societal contexts. This iteration of the project asked the students to consider what happens in the Post-Covid landscape ten years from now, where symbiotic experiences of health, well-being and care have evolved to the extent that new forms of medical practice, health communities and cultures of care transform how we interact with each other, with professionals and the world around us. The GSA Innovation School’s final year BDes Product Design students and faculty formed a dynamic community of practice with health, wellbeing and care practitioners and researchers from The University of Glasgow and beyond. This gave the students the opportunity to reflect on the underlying complexities of the future of health, well-being and care, technological acceleration, human agency and quality of life, to envision a 2031 blueprint as a series of six future world exhibits, and design the products, services and system experiences for the people and environments within it. In the first part of the project (Stage 1), Future worlds are groups of students working together on specific topics, to establish the context for their project and collaborate on research and development. In this iteration of Future Experiences, the "Health, Well-being and Care" worlds were clustered together around ‘People focused’ and ‘Environment focused’, but also joined up across these groups to create pairs of worlds, and in the process generate symbiosis between the groups. These worlds were then the starting points which the students explored in their individual projects. The second part of the project (Stage 2) saw individual students select an aspect of their Future World research to develop as a design direction, which they then prototyped and produced as products, services, and/or systems. These are designed for specific communities, contexts or scenarios of use defined by the students to communicate a future experience. These Future experiences reflect the societal contexts explored during the research phase, projected 10 years into the future, and communicated in a manner that makes the themes engaging and accessible. The deposited materials are arranged as follows: 1. Project Landscape Map - A report and blueprint for the project that gives a visual overview of the structure and timeline of the project. 2. Stage one data folders - the data folders for stage one of the project are named after the themes the groups explored to create their Future Worlds. 3. Stage two data folders - the data folders for stage two of the project are named after the individual students who created the project

Understanding the urgent and emergency care navigation work undertaken by people with cancer and their informal caregivers: a conceptually framed scoping review

Background: people with cancer frequently use urgent and emergency care. Reviews of research have focussed on the incidence and predictors of service use in this population, rather than how people make decisions about which service to access. Understanding what factors influence these choices will inform ways in which we might enable people with cancer to effectively access services.Aims: (1) Describe research undertaken about choices made by people with cancer about routes to access urgent and emergency care; (2) characterise decisions made by patients and informal caregivers to use certain services, with specific reference to work involved in navigating access; and (3) identify research priorities.Methods: scoping review of qualitative and mixed methods studies. Electronic database searches (AMED, CINAHL, Embase, MEDLINE, PsycInfo) and ‘berrypicking’ identified 18 papers. Study, participant, and service characteristics were mapped, and Turnbull et al.’s Model of Urgent Care Help-seeking informed a directed qualitative content analysis.Results: studies have involved people with advanced cancer to the relative exclusion of people with curable disease, receiving anticancer treatment, and who are multi-morbid. Six subcategories of navigation work were identified: (1) making decisions with, and seeking help from, specialists, (2) seeking safety, (3) positioning to access desired treatment, (4) negotiating tortuous pathways to help, (5) making decisions in collaboration with caregivers, and (6) managing isolation from services and social networks.Conclusion: there are significant knowledge gaps and a need for more research, particularly studies of how different patient groups prepare for potential deterioration and make sense of systems of urgent and emergency care

Co-ordinating Cold War propaganda British and American liaison in anti-communist propaganda, 1950-1951

Includes bibliographical references. Title from coverAvailable from British Library Document Supply Centre- DSC:6227. 76125(no 5) / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

Routine, molecular point-of-care testing for SARS-CoV-2 and other respiratory viruses within an acute oncology service improves patient care

Objectives: COVID-19 has caused significant challenges for infection prevention measures and patient flow in hospital admission pathways. We aimed to assess the impact of replacing laboratory PCR with molecular point-of-care testing (mPOCT) for respiratory viruses including SARS-CoV2, within an Acute Oncology Service (AOS).  Methods: this pre- and post-implementation study took place in the AOS of a large teaching hospital, in Southampton, UK. We collected data from two periods: November 25th 2019 to November 24th 2020, when respiratory virus testing utilised laboratory PCR and December 1st 2020 to May 31st 2021 following the introduction of mPOCT. The primary outcome was the time to results.  Results: 2189 patients were tested in the pre-implementation period and 1540 in the post-implementation period. Median (IQR) time to results was 5.8 hours (4.2-10.6) pre-implementation and 1.9 hours (1.5-3.0) post-implementation (difference -3.6h [95%CI to -3.8 to -3.5]; p<0.0001). Median time spent in assessment areas was 6.0 hours (4.1-7.9) pre-implementation and 5.5 hours (3.8-7.4) post-implementation (p<0.0001). 20 (0.9%) patients admitted via AOS assessment unit developed hospital-acquired respiratory virus infection pre-implementation versus 0 (0%) post-implementation (p=0.031).  Conclusions: routine mPOCT for respiratory viruses, including SARS-CoV-2, was associated with a reduced time to results, reduced time in assessment areas, and a reduction in the rates of hospital-acquired respiratory virus infection in an acute oncology assessment uni