Palaeoclimate Change

Level 3 (BSc) module with lectures and practical

Maintaining access to HIV pre-exposure prophylaxis in a pandemic: a service evaluation of telephone-based pre-exposure prophylaxis provision

Objectives: The objective was to perform a survey-based service evaluation of our telephone PrEP clinic (Tele-PrEP), which was instituted during the COVID-19 pandemic, to inform future service delivery. // Methods: We administered parallel, web-based, anonymous surveys to PrEP-users who had a Tele-PrEP appointment between 13.11.2020 and 17.12.2020 and all healthcare professionals (HCPs) conducting Tele-PrEP clinics. We used descriptive statistics to summarise demographic and qualitative data, and thematically categorised free text responses using the Framework for a Systems Approach to Healthcare Delivery. // Results: 62/117 (53%) PrEP-users and 8/9 (89%) HCPs completed the surveys. Tele-PrEP was rated ‘excellent’ or ‘good’ by 61/62 (98%) PrEP-users. All HCPs felt that Tele-PrEP allowed them to assess patients safely and confidently. 10/62 (16%) PrEP-users and 1 (11%) HCP expressed a preference for face-to-face care. Using the Framework for a Systems Approach to Healthcare Delivery we identified key areas important to respondents who highlighted the rapid changes as a result of COVID-19, which required an increase in dedicated resources. HCPs valued teamwork, support/supervision and convenience in achieving quality care for the patient, who in turn, valued convenient, holistic and individualised management to meet their sexual healthcare needs. // Conclusion: Tele-PrEP is feasible and acceptable. While most respondents rated the service highly, others identified a need/preference for face-to-face appointments

Parental abduction from the perspective of the victims: Implications for counselors

This is a descriptive study that examined parental abductions from the perspective of the abductee. The results will help counseling professionals better to understand the psychological consequences of parental abduction, coping mechanisms that were used by the abducted children and counseling techniques and strategies that helped the children through this difficult time and after being returned to the left-behind parent. A 32 multiple choice and short answer questionnaire was developed for this study. The survey consists of 12 closed answer (Yes or No) questions, three open ended questions, and seventeen demographic questions. The questionnaire was given through a phone interview which took approximately 20-60 minutes depending on the participants\u27 responses. The instrument began with closed answer personal questions about the participants\u27 parental abduction, then it asked three open ended personal questions about the parental abduction and ended with demographics of the participant and the parent who abducted the child. The participants were contacted through a social services professional in the field who worked with abducted children. The researcher then called the potential participant and began with the informed consent, if the individual still wished to participate in the study the researcher continued with the survey. When the surveys were completed, the researcher first transcribed the interviews for the most accurate recording of the data. The researcher then tallied the results for each item and some items were compared to gain knowledge in parental abductions regarding possible consequences of the abduction. A total of thirteen people participated in the study. Some of the side effects of parental abduction include loss of trust in the opposite sex, trouble making and keeping good friends, things around them feeling dreamlike, trouble recalling important aspects of the abduction, and trouble sleeping and concentrating since the abduction. Coping mechanisms were also looked at in the study. They include: using arts and reading to escape, talking to people about the abduction and process the event. The most helpful part of counseling for the participants was to talk, process the situation and their feelings about the abduction

Delivering HIV prevention medication online: findings from a qualitative study exploring the acceptability of an online HIV pre-exposure prophylaxis (PrEP) care pathway among service users and healthcare professionals

Objective: Eliminating HIV transmission worldwide could become a reality with the advent of HIV pre-exposure prophylaxis (PrEP) where people take HIV medication to prevent HIV acquisition. Incorporating digital health into PrEP provision could help services scale up and meet increasing demand. We aimed to explore the prospective acceptability of a novel online PrEP care pathway (the ePrEP clinic) among PrEP users and healthcare professionals. The ePrEP clinic is composed of online postal self-sampling for HIV and other sexually transmitted infections, an online consultation, and remote medication provision.Methods: We conducted semi-structured interviews with 15 PrEP users recruited from a large sexual health service and online cohort, and focus groups with nine healthcare professionals from the same sexual health service (May to December 2021). We analysed data using framework analysis.Results: Participants found the ePrEP clinic highly acceptable, anticipating that it would provide convenience, empower PrEP users, and increase capacity within sexual health services. The need for blood self-sampling was a considerable barrier for some. Participants anticipated that the ePrEP clinic would be appropriate for established PrEP users with adequate digital health literacy and no medically significant conditions requiring in-clinic monitoring. Participants highlighted the need for support, including access to in-clinic care, and the integration of the ePrEP clinic within existing services.Conclusions: Our findings provide clear justification for the development of the ePrEP clinic as an addition to in-clinic PrEP care pathways and provide useful insights for those developing digital services for other conditions incorporating testing, consultations, and prescribing

Is There a Causal Association between Genotoxicity and the Imposex Effect?

There is a growing body of evidence that indicates common environmental pollutants are capable of disrupting reproductive and developmental processes by interfering with the actions of endogenous hormones. Many reports of endocrine disruption describe changes in the normal development of organs and tissues that are consistent with genetic damage, and recent studies confirm that many chemicals classified to have hormone-modulating effects also possess carcinogenic and mutagenic potential. To date, however, there have been no conclusive examples linking genetic damage with perturbation of endocrine function and adverse effects in vivo. Here, we provide the first evidence of DNA damage associated with the development of imposex (the masculinization of female gastropods considered to be the result of alterations to endocrine-mediated pathways) in the dog-whelk Nucella lapillus. Animals (n = 257) that displayed various stages of tributyltin (TBT)-induced imposex were collected from sites in southwest England, and their imposex status was determined by physical examination. Linear regression analysis revealed a very strong relationship (correlation coefficient of 0.935, p < 0.0001) between the degree of imposex and the extent of DNA damage (micronucleus formation) in hemocytes. Moreover, histological examination of a larger number of dog-whelks collected from sites throughout Europe confirmed the presence of hyperplastic growths, primarily on the vas deferens and penis in both TBT-exposed male snails and in females that exhibited imposex. A strong association was found between TBT body burden and the prevalence of abnormal growths, thereby providing compelling evidence to support the hypothesis that environmental chemicals that affect reproductive processes do so partly through DNA damage pathways

Understanding the attitudes and experiences of people living with potentially stigmatised long-term health conditions with respect to collecting and sharing health and lifestyle data

Background: The emerging landscape of patient-generated data (PGData) provides an opportunity to collect large quantities of information that can be used to develop our understanding of different health conditions and potentially improve the quality of life for those living with long-term health condition (LTHCs). If the potential benefits of PGData are to be realised, we need a better understanding of the psychological barriers and facilitators to the collection and beneficial sharing of health and lifestyle data. Due to the understudied role that stigma plays in sharing PGData, we explore the attitudes and experiences of those living with potentially stigmatised LTHCs with respect to collecting and sharing health and lifestyle data. Methods: This study used semi-structured interviews and a card sorting task to explore the attitudes and experiences of people living with potentially stigmatised LTHCs. Fourteen adult participants who reported having a range of conditions were recruited in England. Template analysis was used to analyse interview transcripts and descriptive statistics were used for the card sorting task. Results: The findings present four overarching themes: Preferences for collecting health and lifestyle data, Importance of anonymity, Expected use of data, and Sources of emotional support. Participants illustrated a general willingness to share health and lifestyle data; however, there were some notable differences in sharing experiences, varying both by information type and recipient group. Overall, participants did not identify health-related stigma as a barrier to collecting or sharing their personal health and lifestyle data. Conclusions: We outline a number of preferences that participants feel would encourage them to collect and share data more readily, which may be considered when developing data sharing tools for the future

HCI and Health: Learning from Interdisciplinary Interactions

HCI has multidisciplinary roots and has drawn from and contributed to different disciplines, including computer science, psychology, sociology, and medicine. There is a natural overlap between health and HCI researchers, given their joint focus on utilising technologies to better support people’s health and wellbeing. However, the best digital health interventions are not simply the result of the ‘application’ of HCI to the domain of healthcare, but emerge when researchers from both camps seek to overcome differences in disciplinary practices, traditions, and values in order to collaborate more effectively and productively. We propose a special interest group (SIG) to include interdisciplinary researchers (i.e., participants active in both communities) as well as researchers from either discipline, but with interests in the other field