Covert observation in practice: lessons from the evaluation of the prohibition of smoking in public places in Scotland

Background: A ban on smoking in wholly or substantially enclosed public places has been in place in Scotland since 26th March 2006. The impact of this legislation is currently being evaluated in seven studies, three of which involve direct observation of smoking in bars and other enclosed public places. While the ethical issues around covert observation have been widely discussed there is little practical guidance on the conduct of such research. A workshop was therefore convened to identify practical lessons learned so far from the Scottish evaluation. Methods: We convened a workshop involving researchers from the three studies which used direct observation. In addition, one of the fieldwork managers collected written feedback on the fieldwork, identifying problems that arose in the field and some solutions. Results: There were four main themes identified: (i) the difficulty of achieving and maintaining concealment; (ii) the experience of being an observer; (iii) the risk of bias in the observations and (iv) issues around training and recruitment. These are discussed. Conclusion: Collecting covert observational data poses unique practical challenges, in particular in relation to the health and safety of the researcher. The findings and solutions presented in this paper will be of value to researchers designing similar studies

Semen quality in spinal cord injured men: Does it progressively decline postinjury?

Objective: To determine if semen quality of men with spinal cord injury (SCI) undergoes a progressive decline as a function of years postinjury. Design: A retrospective analysis of cross-sectional data. Setting: University-based research center. Subjects: Semen quality was examined in 638 specimens from 125 men with SCI. Intervention: Penile vibratory stimulation, electroejaculation, and masturbation were used as semen retrieval methods. Routine semen analysis was performed to evaluate semen quality. Main Outcome Measures: Sperm concentration, total sperm count, and percent sperm motility were examined at 2-year intervals from men whose injuries had occurred 6 weeks to 26 years earlier. Results: No difference in any semen parameter was found as a function of time postinjury. Conclusions: Semen quality in men with SCI does not progressively decline after the SCI. Men with SCI who are considering biologic fatherhood should be advised that the number of years after injury need not be a determinant in deciding when to start a family

Brown‐Colored Semen in Men With Spinal Cord Injury

The interesting condition of brown‐colored semen has often been observed during assisted ejaculation of men with spinal cord injury (SCI). This condition has not been reported in the literature, and its cause is unknown. To investigate this condition, the present study examined the incidence and quality of brown semen and its relationship to level of SCI, time since SCI, number of successive ejaculations, ejaculation frequency, and ejaculation method in a total of 664 semen specimens from 162 SCI men. In addition, a microscopic evaluation was performed on brown semen specimens from SCI men, not‐brown specimens from SCI men, and normally colored specimens from normal men. The results showed that 27% of SCI subjects had brown semen on at least one ejaculation. There was no difference between men producing and men not producing brown semen in age, level of injury, or years postinjury. The duration of anejaculation, number of successive ejaculations, and frequency of ejaculation were not associated with occurrence of brown semen. Sperm concentration and sperm motility were not significantly different in brown and not‐brown specimens. Specimens from subjects who produced brown semen had similar pH but lower volume than specimens from subjects who did not produce brown semen. Brown semen had a thin consistency more often than not‐brown semen. Brown specimens contained intact red blood cells (RBCs) and/or heme pigment more often than not‐brown specimens; however, one half and one third of the specimens, respectively, contained neither RBCs nor heme pigment. The cause of brown semen is unknown but may relate to seminal‐vesicle dysfunction

Cytofluorographic identification of activated T-cell subpopulations in the semen of men with spinal cord injuries

The semen of most men with spinal cord injury (SCI) contains an abundance of leukocytes. It is not known if this leukocytospermia contributes to the abnormally low sperm motility observed in many of these men. Our study used flow cytometry to identify the leukocyte population in the semen of 12 men with SCI compared to 8 healthy age-matched control subjects. The results showed that, compared to control subjects, the semen of men with SCI had increased numbers of mature granulocytes and lymphocytes. The largest proportion of the leukocytes consisted of lymphocytes, and immunophenotypic analysis showed that the greater fraction were T cells, many of which coexpressed human leukocyte antigen HLA-DR and CD25, suggesting they were in an "activated" state. No significant B-cell population was evident. Our finding of immunologically active leukocytes is a significant step in understanding the relationship of leukocytospermia and decreased sperm motility in the semen of men with SCI

SERUM AND SEMEN PROSTATE SPECIFIC ANTIGEN CONCENTRATIONS ARE DIFFERENT IN YOUNG SPINAL CORD INJURED MEN COMPARED TO NORMAL CONTROLS

Recent investigations have indicated that factors within the seminal plasma may contribute to the condition of low sperm motility in men with spinal cord injury. To determine whether the prostate gland functions normally in these men we chose prostate specific antigen (PSA) as a marker of prostatic function, and compared serum and semen concentrations in spinal cord injured and healthy noninjured men. The study included 21 spinal cord injured men (mean age 33.3 +/- 1.2 years) and 22 noninjured normal men (mean age 30.3 +/- 1.5 years). Blood was obtained from subjects following at least 24 hours of abstinence from ejaculation and serum PSA was determined by modified enzyme immunoassay. Antegrade ejaculates from all subjects were frozen to -80C, exactly 15 minutes after collection. Seminal plasma PSA was determined using Hybritech Tandem [dagger] MP assay. Mean serum PSA concentration was 1.20 +/- 0.19 ng./ml. in spinal cord injured and 0.69 +/- 0.07 ng./ml. in noninjured men (p <0.02). Mean seminal plasma PSA concentration was 0.59 +/- 0.11 mg./ml. in spinal cord injured and 1.29 +/- 0.15 mg./ml. in noninjured men (p <0.001). Our findings of elevated serum and decreased seminal plasma PSA concentrations indicate that prostatic secretory dysfunction is present in men with spinal cord injury

Sensitivity of 24-h EMG duration and intensity in the human vastus lateralis muscle to threshold changes

Few studies have quantified lower limb muscle activity over 24 h using electromyographic signals (EMG). None have described the changes in EMG duration and intensity when data are analyzed with different thresholds. Continuous bilateral EMG recordings were made from vastus lateralis (VL) in 10 subjects (20–48 yr) for 24 h. Before and after this recording, voluntary quadriceps forces and VL EMG at 25%, 50%, 75%, and 100% of the maximal voluntary contraction (MVC), percentage voluntary activation (twitch interpolation), and compound action potentials (M-waves) were recorded. Offline, the 24-h EMG integrals (IEMG, 10-ms time constant) were normalized to the MVC IEMG. Total EMG duration and mean IEMG ranged from 1–3 h and 3.2–12.1% MVC, respectively, when the data were analyzed using the baseline (+3 SD) as threshold. When analysis was done with progressively higher thresholds, from baseline up to 4% MVC, the total EMG duration declined curvilinearly. In some cases the decline in duration was 50–60% for a 1% MVC threshold increment. The mean 24-h IEMG increased by 1.5–2% MVC for each 1% MVC threshold increment. Hence, a small change in the analysis threshold may result in large changes in 24-h EMG duration but moderate changes in mean IEMG. Our findings suggest that VL was active for a short amount of time and at low intensities over 24 h