Detection of human papillomavirus from liquid-based cytology specimens by in-house PCR: a pilot study

The Papanicolaou smear remains the most common method for the detection of precancerous changes in cervical cytology. However, the introduction of a liquidbased cytology (LBC) technique expands the possibility of cervical intraepithelial neoplasia (CIN) diagnosis, and permits detection of precancerous changes and human papillomavirus (HPV) simultaneously. In the pilot study reported here, using an in-house polymerase chain reaction (PCR) method, high-grade HPV was detected in 32% of a cohort of 38 patients. This conventional PCR method could be developed for use on a real-time PCR platform or in a microtitre-well format and subsequently automated

‘It's like the bad guy in a movie who just doesn't die’ : a qualitative exploration of young people's adaptation to eczema and implications for self‐care

Background Eczema is a common childhood inflammatory skin condition, affecting more than one in five children. A popular perception is that children ‘outgrow eczema’, although epidemiological studies have shown that, for many, eczema follows a lifelong episodic course. Objectives To explore the perceptions of young people about the nature of their eczema and how these perceptions relate to their self‐care and adapting to living with eczema. Methods This is a secondary inductive thematic analysis of interviews conducted for Healthtalk.org. In total 23 interviews with young people with eczema were included. Of the 23 participants, 17 were female and six male, ranging from 17 to 25 years old. Results Participants generally experienced eczema as an episodic long‐term condition and reported a mismatch between information received about eczema and their experiences. The experience of eczema as long term and episodic had implications for self‐care, challenging the process of identifying triggers of eczema flare‐ups and evaluating the success of treatment regimens. Participants’ experiences of eczema over time also had implications for adaptation and finding a balance between accepting eczema as long term and hoping it would go away. This linked to a gradual shift in treatment expectations from ‘cure’ to ‘control’ of eczema. Conclusions For young people who continue to experience eczema beyond childhood, a greater focus on self‐care for a long‐term condition may be helpful. Greater awareness of the impact of early messages around ‘growing out of’ eczema and provision of high‐quality information may help patients to manage expectations and support adaptation to treatment regimens

Mixed methods process evaluation of my breathing matters, a digital intervention to support self-management of asthma.

This study aimed to explore user engagement with 'My Breathing Matters', a digital self-management intervention for asthma, and identify factors that may influence engagement. In a mixed methods design, adults with asthma allocated to the intervention arm of a feasibility trial (n = 44) participated in semi-structured interviews (n = 18) and a satisfaction questionnaire (n = 36) to explore their views and experiences of the intervention. Usage data highlighted that key intervention content was delivered to most users. The majority of questionnaire respondents (78%; n = 28) reported they would recommend the intervention to friends and family. Interviewees expressed positive views of the intervention and experienced several benefits, mainly improved asthma control, medication use, and breathing technique. Factors that may influence user engagement were identified, including perceptions of asthma control, current self-management practices, and appeal of the target behaviours and behaviour change techniques. Findings suggested My Breathing Matters was acceptable and engaging to participants, and it was used as intended

Economics of Field Pea Supplementation for Cattle Grazing Crested Wheatgrass

Heifers grazing crested wheat grass were supplemented either field peas or dried distillers grains plus solubles (DDGS) at 0.4% or 0.8% of body weight. Heifers supplemented with field peas had 10% lower daily gain compared to their DDGS supplemented counterparts. The decision to supplement field peas for producers depends on the price at which field peas can be acquired, as well as the distance that DDGS has to be hauled in order to be utilized. Field peas are a viable option in western Nebraska as a supplement for grazing cattle when DDGS is unavailable or field peas are in excess and can be obtained below the human consumption and pet food market price

A systematic review of techniques and effects of self-help interventions for tinnitus: application of taxonomies from health psychology

Objective: Self-help interventions are followed by people independently with minimal or no therapist contact. This review aims to assess the effectiveness of self-help interventions for adults with chronic tinnitus and systematically identify the self-help techniques used. Design: Systematic review and application of health psychology taxonomies. Electronic database searches were conducted, supplemented by citation searching and hand-searching of key journals. Prospective controlled trials, which used measures of tinnitus distress, functional management, anxiety, depression, and quality of life, were included. Michie et al’s behaviour change techniques (BCTs) taxonomy and Taylor et al’s PRISMS taxonomy of self-management components were applied to describe interventions. Study sample: Five studies were included, providing low-to-moderate levels of evidence. Results: Randomized controlled trial studies were too few and heterogeneous for meta-analysis to be performed. Studies comparing self-help interventions to therapist-guided interventions and assessing non tinnitus-specific psychosocial outcomes and functional management were lacking. Fifteen BCTs and eight self-management components were identified across interventions. Conclusions: A lack of high-quality and homogeneous studies meant that confident conclusions could not be drawn regarding the efficacy of self-help interventions for tinnitus. Better reporting and categorization of intervention techniques is needed for replication in research and practice and to facilitate understanding of intervention mechanisms

Views and experiences of managing eczema:systematic review and thematic synthesis of qualitative studies*

Background: The number of qualitative studies on eczema has increased rapidly in recent years. Systematically reviewing these can provide greater understandings of people’s perceptions of eczema and eczema treatments. Objectives: We sought to systematically review and thematically synthesize qualitative studies exploring views and experiences of people with eczema and parents/carers of children with eczema. Methods: We searched MEDLINE, EMBASE, PsycINFO and CINAHL from the earliest date available to February 2019. We selected papers focusing on views and experiences of eczema and eczema treatments, and barriers/facilitators to eczema self-management. We excluded papers focusing on health service provision models or health professionals’ views. Results: We synthesized 39 papers (reporting 32 studies) from 13 countries. We developed four analytical themes: (1) Eczema not viewed as a long-term condition; (2) Significant psychosocial impact not acknowledged by others; (3) Hesitancy (patient/carer uncertainty) about eczema treatments; and (4) Insufficient information and advice. Our findings suggest that people with eczema and their carers experience frustration at having to manage a condition that is often seen by others as mundane but has significant psychosocial impact and is difficult to manage due to concerns about, and burden of, treatment. This frustration can be exacerbated by experiences of conflicting and/or insufficient information and advice from health professionals, family and others. Conclusions: Effective self-management of eczema could be supported by addressing beliefs and concerns about treatments; seeking positive ways to promote a ‘control not cure’ message; acknowledging psychosocial impacts of eczema and treatment burden; and providing clear consistent advice or signposting towards reliable information.</p

Provider diversity in the English NHS: a study of recent developments in four local health economies

Objectives: The overall objective of the research was to assess the impact of provider diversity on quality and innovation in the English NHS. The aims were to map the extent of diverse provider activity, identify the differences in performance between Third Sector Organisations (TSOs), for-profit private enterprises, and incumbent organisations within the NHS, and the factors that affect the entry and growth of new private and TSOs. Methods: Case studies of four Local Health Economies (LHEs). Data included: semi-structured interviews with 48 managerial and clinical staff from NHS organizations and providers from the private and Third Sector; some documentary evidence; a focus group with service users; and routine data from the Care Quality Commission and Companies House. Data collection was mainly between November 2008 and November 2009. Results: Involvement of diverse providers in the NHS is limited. Commissioners’ local strategies influence degrees of diversity. Barriers to the entry for TSOs include lack of economies of scale in the bidding process. Private providers have greater concern to improve patient pathways and patient experience, whereas TSOs deliver quality improvements by using a more holistic approach and a greater degree of community involvement. Entry of new providers drives NHS Trusts to respond by making improvements. Information sharing diminishes as competition intensifies. Conclusions: There is scope to increase the participation of diverse providers in the NHS, but care must be taken not to damage public accountability, overall productivity, equity and NHS providers (especially acute hospitals, which are likely to remain in the NHS) in the process

Taking charge of eczema self-management : a qualitative interview study with young people with eczema

Objectives: To explore young people’s experiences of eczema self-management and interacting with health professionals. Design: Secondary qualitative data analysis of data sets from two semistructured interview studies. Data were analysed using inductive thematic analysis. Setting: Participants were recruited from the UK primary care, dermatology departments and a community-based sample (eg, patient representative groups, social media). Participants: Data included 28 interviews with young people with eczema aged 13–25 years (mean age=19.5 years; 20 female). Results: Although topical treatments were generally perceived as effective, young people expressed doubts about their long-term effectiveness, and concerns around the safety and an over-reliance on topical corticosteroids. Participants welcomed the opportunity to take an active role in their eczema management, but new roles and responsibilities also came with initial apprehension and challenges, including communicating their treatment concerns and preferences with health professionals, feeling unprepared for transition to an adult clinic and obtaining treatments. Decisions regarding whether to engage in behaviours that would exacerbate their eczema (eg, irritants/triggers, scratching) were influenced by young people’s beliefs regarding negative consequences of these behaviours, and perceived control over the behaviour and its negative consequences. Conclusions: Behavioural change interventions must address the treatment concerns of young people and equip them with the knowledge, skills and confidence to take an active role in their own eczema management

Zero-Gap Bipolar Membrane Electrolyzer for Carbon DioxideReduction Using Acid-Tolerant Molecular Electrocatalysts

[Image: see text] The scaling-up of electrochemical CO(2) reduction requires circumventing the CO(2) loss as carbonates under alkaline conditions. Zero-gap cell configurations with a reverse-bias bipolar membrane (BPM) represent a possible solution, but the catalyst layer in direct contact with the acidic environment of a BPM usually leads to H(2) evolution dominating. Here we show that using acid-tolerant Ni molecular electrocatalysts selective (>60%) CO(2) reduction can be achieved in a zero-gap BPM device using a pure water and CO(2) feed. At a higher current density (100 mA cm(–2)), CO selectivity decreases, but was still >30%, due to reversible product inhibition. This study demonstrates the importance of developing acid-tolerant catalysts for use in large-scale CO(2) reduction devices

Accretion physics at high X-ray spectral resolution: New frontiers and game-changing science

Microcalorimeters have demonstrated success in delivering high spectral resolution, and have paved the path to revolutionary new science possibilities in the coming decade of X-ray astronomy. There are several research areas in compact object science that can only be addressed with energy resolution Delta(E)<~5 eV at photon energies of a few keV, corresponding to velocity resolution of <~a few hundred km/s, to be ushered in by microcalorimeters. Here, we review some of these outstanding questions, focusing on how the research landscape is set to be transformed (i) at the interface between accreting supermassive black holes and their host galaxies, (ii) in unravelling the structures of accretion environments, (iii) in resolving long-standing issues on the origins of energy and matter feedback, and (iv) to test mass-scaled unification of accretion and feedback. The need to learn lessons from Hitomi and to make improvements in laboratory atomic data precision as well as plasma modeling are highlighted.Comment: To appear in Nature Astronomy as a review. Author version, before final editorial and style revision