"I can't be dealing with this brain fog":A workplace focus group study investigating factors underpinning the menopausal experience for NHS staff

OBJECTIVES: Multiple studies highlight that individuals undergoing menopause are not receiving sufficient support at work. An improved menopausal experience in the workplace has been found to be associated with increased job satisfaction, increased economic participation and reduced absenteeism. This work was undertaken to explore the impact of menopause on the working lives of NHS staff working in Wales, with specific emphasis on their experience of menopausal symptoms and management strategies in the workplace.STUDY DESIGN: This was a qualitative study using semi-structured focus groups and thematic analysis. 14 women working in the NHS in Wales attended four focus groups, lasting up to 1.5 h. Stem questions focused on participants' positive and negative experiences in the workplace, and their receipt of support. Transcripts were analysed using the framework approach.RESULTS: Three major themes were identified: experiences of menopausal symptoms and symptom management, the impact of menopause on work and the impact of work on the menopause. Menopause symptom experience in the workplace was multifaceted and varied, depending on factors such as ongoing or past symptom experience, expectations, social support and effectiveness of management strategies. Inconsistent information was highlighted as a reason why some participants felt confused both about the symptoms that they could attribute to the menopause and the management strategies available to them. A variety of symptom management strategies had been used by participants, including hormone replacement therapy, flexible working hours, working from home, changes to uniform, peer support and lifestyle changes, with varying levels of success. Some women were reticent to ask for support at work even though they felt the workplace response was likely to be supportive. Almost all the women felt that they had to persuade their GP to prescribe HRT and felt that their doctors were too reticent in prescribing this treatment.CONCLUSIONS: Employers have a key role in supporting their staff experiencing menopausal symptoms, and such support has the potential to reduce sickness absence and boost retention. Based on the findings we recommend creating an open culture to break down taboos; protected time for peer support around shared experiences and effective symptom management techniques; and maximising the impact of non-menopause-specific policies such as flexible working to help all staff manage fatigue and become more productive in their roles.</p

A cross-national study of evolutionary origins of gender shopping styles: she gatherer, he hunter?

The authors investigate gender shopping styles across countries and explore whether differences between male and female shopping styles are greater than differences in shopping styles between consumers across countries. The study develops a conceptual model to test Eagly and Wood's (1999) convergence hypothesis. Applied to shopping, this predicts that men and women should become more similar in shopping styles as traditional gender-based divisions in wage labor and domestic labor disappear. The results of a survey on shopping behavior across 11 countries indicate that men and women are evolutionarily predisposed to different shopping styles. Counter to the convergence hypothesis, differences in shopping styles between women and men are greater in higher-gender-equality countries than in lower-gender-equality countries. Empathizing—the ability to tune into someone's thoughts and feelings—mediates shopping style more for women, while systemizing—the degree to which an individual possesses spatial skills—mediates shopping style more for men. Results suggest that gender-based retail segmentation is more strategically relevant than country-based segmentation. The authors discuss the implications of their findings for international marketing theory and practice

Behavioral Voluntary and Social Bioassays Enabling Identification of Complex and Sex-Dependent Pain-(-Related) Phenotypes in Rats with Bone Cancer

Simple Summary Bone metastases are one of the most common complications in patients with advanced cancer that result in pain, which is usually severe, thereby significantly reducing the patient's quality of life. Although preclinical pain research in rodents is improving, the pain phenotyping methods currently used have been criticized. This study aimed to identify in detail pain phenotypes of cancer-induced bone pain (CIBP) in both sexes of rats. CIBP in the splint bone on one side results in a distinct CIBP-related phenotype characterized by mechanical hypersensitivity, resting pain, and antalgic gait in both sexes. Progression of tumor growth leads to the establishment of the CIBP phenotype that appears earlier in male than in female rats and affects rat-specific social behaviors in both sexes. We demonstrate social transfer of pain in a bone cancer model in both sexes, resulting in mechanical and, in females, also heat hypervigilance in non-tumor bearing control rats. Cancer-induced bone pain (CIBP) is a common and devastating symptom with limited treatment options in patients, significantly affecting their quality of life. The use of rodent models is the most common approach to uncovering the mechanisms underlying CIBP; however, the translation of results to the clinic may be hindered because the assessment of pain-related behavior is often based exclusively on reflexive-based methods, which are only partially indicative of relevant pain in patients. To improve the accuracy and strength of the preclinical, experimental model of CIBP in rodents, we used a battery of multimodal behavioral tests that were also aimed at identifying rodent-specific behavioral components by using a home-cage monitoring assay (HCM). Rats of all sexes received an injection with either heat-deactivated (sham-group) or potent mammary gland carcinoma Walker 256 cells into the tibia. By integrating multimodal datasets, we assessed pain-related behavioral trajectories of the CIBP-phenotype, including evoked and non-evoked based assays and HCM. Using principal component analysis (PCA), we discovered sex-specific differences in establishing the CIBP-phenotype, which occurred earlier (and differently) in males. Additionally, HCM phenotyping revealed the occurrence of sensory-affective states manifested by mechanical hypersensitivity in sham when housed with a tumor-bearing cagemate (CIBP) of the same sex. This multimodal battery allows for an in-depth characterization of the CIBP-phenotype under social aspects in rats. The detailed, sex-specific, and rat-specific social phenotyping of CIBP enabled by PCA provides the basis for mechanism-driven studies to ensure robustness and generalizability of results and provide information for targeted drug development in the future

A web-based intervention for carers of individuals with anorexia nervosa (We Can): trial protocol of a randomised controlled trial investigating the effectiveness of different levels of support

Background Anorexia nervosa (AN) is a life-threatening mental disorder that is associated with substantial caregiver burden. Carers of individuals with AN report high levels of distress and self-blame, and insufficient knowledge to help their loved ones. However, carers can have a very important role to play in aiding recovery from AN, and are often highly motivated to assist in the treatment process. This manuscript presents the protocol for a randomised controlled trial (RCT) of We Can, a web-based intervention for carers for people with AN. The study aims to investigate the effectiveness of We Can delivered with different intensities of support. Methods The study takes the form of a multi-site, two-country, three group RCT, comparing We Can (a) with clinician messaging support (We Can-Ind), (b) with moderated carer chatroom support (We Can-Chat) and (c) with online forum only (We Can-Forum). Participants will be 303 carers of individuals with AN as well as, where possible, the individuals with AN themselves. Recruitment will be via specialist eating disorder services and carer support services in the UK and Germany. Randomisation of carers to one of the three intervention conditions in a 1:1:1 ratio will be stratified by whether or not the individual with AN has (a) agreed to participate in the study and (b) is a current inpatient. The We Can intervention will be provided to carers online over a period of 12 weeks. Participants will complete self-report questionnaires at pre-intervention (T1), mid-intervention (mediators only; 4-weeks post-randomisation), post-intervention (T2; 3-months post randomisation), and 6 months (T3) and 12 months (T4) after randomisation. The primary outcome variables are carer symptoms of depression and anxiety. Secondary outcome variables will be measured in both carers and individuals with AN. Secondary carer outcome variables will include alcohol and drug use and quality of life, caregiving behaviour, and the acceptability and use of We Can and associated supports. Secondary outcomes measured in individuals with AN will include eating disorder symptoms, and symptoms of depression and anxiety. The study will also evaluate the cost-effectiveness of the three We Can conditions, and test for mediators and moderators of the effects of We Can. The trial is registered at the International Standard Randomisation Controlled Trial Number (ISRCTN) database, registration number: ISRCTN11399850. Discussion The study will provide insight into the effectiveness of We Can and its optimal method/s of delivery

Control of purely-elastic instabilities in cross-slot geometries

The cross-slot stagnation point flow is one of the benchmark problems in fluid mechanics as it allows large strains to develop and can therefore be used in extensional rheometry. In such a flow, for purely-elastic cases in creeping flow regimes, elasticity can break symmetry which is perhaps an unwanted phenomenon if used as a rheometer and will limit the maximum deformation rate in which these tests can be performed, or beneficial once used as mixing device. Here, this instability will be investigated in more detail using a combination of numerical, experimental and analytical analysis and a series of methods will be proposed that can potentially be used to delay and control the start point of the instability. The first part of this presentation focuses on the effect of elongational dominated flow on the onset criteria of symmetry-breaking purely-elastic instability in the cross-slot geometry by applying a fundamental change on the kinematics of the flowfield in this region. Here, the standard geometry is modified by adding a cylinder at the geometric centre and replacing the free stagnation point by pinned stagnation points at the cylinder walls. Next, two-phase flows of Newtonian and/or viscoelastic fluids in a “cross-slot” geometry will be investigated in the creeping-flow limit. In this part, the effect of injecting two fluids with different elastic properties from each inlet arm, and effects of interfacial tension and the viscosity ratio of these flow streams will be investigated

Association between energy balance-related factors and clinical outcomes in patients with ovarian cancer: A systematic review and meta-analysis

Background: This systematic review and meta-analysis synthesized evidence in patients with ovarian cancer at diagnosis and/or during first-line treatment on; (i) the association of body weight, body composition, diet, exercise, sedentary behavior, or physical fitness with clinical outcomes; and (ii) the effect of exercise and/or dietary interventions. Methods: Risk of bias assessments and best-evidence syntheses were completed. Meta-analyses were performed when ≥ 3 papers presented point estimates and variability measures of associations or effects. Results: Body mass index (BMI) at diagnosis was not significantly associated with survival. Although the following trends were not supported by the best-evidence syntheses, the meta-analyses revealed that a higher BMI was associated with a higher risk of post-surgical complications (n = 5, HR: 1.63, 95 % CI: 1.06 – 2.51, p = 0.030), a higher muscle mass was associated with a better progression-free survival (n = 3, HR: 1.41, 95 % CI: 1.04 – 1.91, p = 0.030) and a higher muscle density was associated with a better overall survival (n = 3, HR: 2.12, 95 % CI: 1.62 – 2.79, p \u3c 0.001). Muscle measures were not significantly associated with surgical or chemotherapy-related outcomes. Conclusions: The prognostic value of baseline BMI for clinical outcomes is limited, but muscle mass and density may have more prognostic potential. High-quality studies with comprehensive reporting of results are required to improve our understanding of the prognostic value of body composition measures for clinical outcomes. Systematic review registration number: PROSPERO identifier CRD42020163058

Age determination of the Lower Watrous red-beds of the Williston Basin, Saskatchewan, Canada

The age of the Lower Watrous red-beds, which host hydrocarbon reserves in the Williston Basin, along with equivalent formations in Manitoba (Lower Amaranth Formation) and the U.S.A. (Saude Member of the Spearfish Formation) is a controversial subject, with this succession being assigned ages from Mississippian to Middle Jurassic; a timespan of over 150 million years. Using existing published data and new geochemical analyses on the Watrous Formation, we present a Triassic age for the Lower Watrous red-beds. An established well-log correlation dates the Saude Member red-beds as post-Middle Permian. Some previously published geochemical and palynological data from equivalent formations are in agreement with this age, but several palaeomagnetic studies have provided conflicting results, with age assignments of Mississippian through to Late Triassic. Our study demonstrates the equivalency of the Saude Member and Lower Watrous red-beds by extending the well-log correlation north, from the U.S.A. into Saskatchewan. The combined new strontium, sulfur and oxygen isotopic analyses of isolated Lower Watrous anhydrite nodules are most consistent with an Early or Late Triassic age, which is in agreement with the well-log correlation and potassium-argon dating of a pre-red-beds impact structure. A Pennsylvanian age for the Lower Watrous red-beds is considered most unlikely

A biomechanical evaluation of the combined elevation test

This paper was accepted for publication in the journal Physical Therapy in Sport and the definitive published version us available at http://dx.doi.org/10.1016/j.ptsp.2016.11.001.Objectives: To biomechanically evaluate the relationships between the outcome of the Combined Elevation Test, its component joint motions, and thoracic spine angles. Design: Cross-sectional study. Setting: Laboratory. Participants: 18 elite swimmers and triathletes (11 males and 7 females). Main outcome measures: Combined Elevation Test outcome in forehead and chin positions. Individual joint contributions to test outcome. Results: No sex differences were found in test components, or between head positions. Test outcome was greater in the forehead position than the chin position (34.3 cm vs 30.2 cm; p<0.001). The variables most strongly associated with test outcome were glenohumeral joint flexion (r = 0.86 – 0.97; p<0.001), and shoulder retraction (r = 0.75 - 0.82; p<0.001). Total thoracic spine angle related strongly to test outcome in females (r = -0.77 – -0.88; p<0.05), but not in males (r = -0.17 – -0.24; p>0.05). Conclusions: The Combined Elevation Test is an effective screening tool to measure upper limb mobility into shoulder flexion and scapula retraction in both sexes, and thoracic extension in women. It is recommended that the test be performed in the forehead position. If a subject performs poorly on the test, follow up assessments are required to identify the impairment location

Ocean carbon from space: Current status and priorities for the next decade

The ocean plays a central role in modulating the Earth\u27s carbon cycle. Monitoring how the ocean carbon cycle is changing is fundamental to managing climate change. Satellite remote sensing is currently our best tool for viewing the ocean surface globally and systematically, at high spatial and temporal resolutions, and the past few decades have seen an exponential growth in studies utilising satellite data for ocean carbon research. Satellite-based observations must be combined with in-situ observations and models, to obtain a comprehensive view of ocean carbon pools and fluxes. To help prioritise future research in this area, a workshop was organised that assembled leading experts working on the topic, from around the world, including remote-sensing scientists, field scientists and modellers, with the goal to articulate a collective view of the current status of ocean carbon research, identify gaps in knowledge, and formulate a scientific roadmap for the next decade, with an emphasis on evaluating where satellite remote sensing may contribute. A total of 449 scientists and stakeholders participated (with balanced gender representation), from North and South America, Europe, Asia, Africa, and Oceania. Sessions targeted both inorganic and organic pools of carbon in the ocean, in both dissolved and particulate form, as well as major fluxes of carbon between reservoirs (e.g., primary production) and at interfaces (e.g., air-sea and land–ocean). Extreme events, blue carbon and carbon budgeting were also key topics discussed. Emerging priorities identified include: expanding the networks and quality of in-situ observations; improved satellite retrievals; improved uncertainty quantification; improved understanding of vertical distributions; integration with models; improved techniques to bridge spatial and temporal scales of the different data sources; and improved fundamental understanding of the ocean carbon cycle, and of the interactions among pools of carbon and light. We also report on priorities for the specific pools and fluxes studied, and highlight issues and concerns that arose during discussions, such as the need to consider the environmental impact of satellites or space activities; the role satellites can play in monitoring ocean carbon dioxide removal approaches; economic valuation of the satellite based information; to consider how satellites can contribute to monitoring cycles of other important climatically-relevant compounds and elements; to promote diversity and inclusivity in ocean carbon research; to bring together communities working on different aspects of planetary carbon; maximising use of international bodies; to follow an open science approach; to explore new and innovative ways to remotely monitor ocean carbon; and to harness quantum computing. Overall, this paper provides a comprehensive scientific roadmap for the next decade on how satellite remote sensing could help monitor the ocean carbon cycle, and its links to the other domains, such as terrestrial and atmosphere