Lesbian and bisexual women's human rights, sexual rights and sexual citizenship: negotiating sexual health in England.

Lesbian and bisexual women's sexual health is neglected in much Government policy and practice in England and Wales. This paper examines lesbian and bisexual women's negotiation of sexual health, drawing on findings from a small research project. Themes explored include invisibility and lack of information, influences on decision-making and sexual activities and experiences of services and barriers to sexual healthcare. Key issues of importance in this respect are homophobic and heterosexist social contexts. Drawing on understandings of lesbian, gay and bisexual human rights, sexual rights and sexual citizenship, it is argued that these are useful lenses through which to examine and address lesbian and bisexual women's sexual health and related inequalities

Erasmus Language students in a British University – a case study

Students’ assessment of their academic experience is actively sought by Higher Education institutions, as evidenced in the National Student Survey introduced in 2005. Erasmus students, despite their growing numbers, tend to be excluded from these satisfaction surveys, even though they, too, are primary customers of a University. This study aims to present results from bespoke questionnaires and semi-structured interviews with a sample of Erasmus students studying languages in a British University. These methods allow us insight into the experience of these students and their assessment as a primary customer, with a focus on language learning and teaching, university facilities and student support. It investigates to what extent these factors influence their levels of satisfaction and what costs of adaptation if any, they encounter. Although excellent levels of satisfaction were found, some costs affect their experience. They relate to difficulties in adapting to a learning methodology based on a low number of hours and independent learning and to a guidance and support system seen as too stifling. The results portray this cohort’s British University as a well-equipped and well-meaning but ultimately overbearing institution, which may indicate that minimising costs can eliminate some sources of dissatisfaction

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Comparative analysis of the Cancer Council of Victoria and the online Commonwealth Scientific and Industrial Research Organisation FFQ

FFQ are commonly used to examine the association between diet and disease. They are the most practical method for usual dietary data collection as they are relatively inexpensive and easy to administer. In Australia, the Cancer Council of Victoria FFQ (CCVFFQ) version 2 and the online Commonwealth Scientific and Industrial Research Organisation FFQ (CSIROFFQ) are used. The aim of our study was to establish the level of agreement between nutrient intakes captured using the online CSIROFFQ and the paper-based CCVFFQ. The CCVFFQ and the online CSIROFFQ were completed by 136 healthy participants. FFQ responses were analysed to give g per d intake of a range of nutrients. Agreement between twenty-six nutrient intakes common to both FFQ was measured by a variety of methods. Nutrient intake levels that were significantly correlated between the two FFQ were carbohydrates, total fat, Na and MUFA. When assessing ranking of nutrients into quintiles, on average, 56 % of the participants (for all nutrients) were classified into the same or adjacent quintiles in both FFQ, with the highest percentage agreement for sugar. On average, 21 % of participants were grossly misclassified by three or four quintiles, with the highest percentage misclassification for fibre and Fe. Quintile agreement was similar to that reported by other studies, and we concluded that both FFQ are suitable tools for dividing participants’ nutrient intake levels into high- and low-consumption groups. Use of either FFQ was not appropriate for obtaining accurate estimates of absolute nutrient intakes

Chemoprevention for breast cancer:A survey of the views of Australian women and clinicians

Background: Chemoprevention for women at elevated risk of breast cancer is endorsed by international guidelines. This study examined the uptake of chemoprevention by Australian women at increased risk and aimed to identify modifiable barriers and facilitators for both patients and clinicians. Material and Methods: 1,113 participants enrolled in the Kathleen Cuningham Foundation Consortium for Research into Familial Breast Cancer Follow-Up Study (kConFab FUS) and at ≥16% lifetime risk of BC (≥1.5 times the average population risk) were mailed a 68-item survey. 130 currently practising breast surgeons and 394 family doctors (FDs) who reportedly provided care for kConFab-FUS participants were sent a 49-item survey. Surveys were developed based on the theoretical domains framework. Results: 725 participants (65%) and 221 (42%) clinicians responded (147 (37%) FDs, 74 (57%) breast surgeons). The median age of participants was 55 years. Most (84%) were at moderately increased risk (<3 times population risk). Ten women (1.4%) had taken chemoprevention. Possible side effects, lack of information and preferring the adoption of a healthy lifestyle alone were the three strongest barriers. The 20-year reduction in BC risk with tamoxifen was the most important facilitator, followed by desire to stay healthy for their family and having an abnormal breast biopsy. Most patients preferred to get information from a cancer genetics centre (CGC) (38%) followed by their FD (33%). Most surgeons knew about chemoprevention (97%), but 35% of FDs did not; 7% and 74%, respectively, were not confident in providing chemoprevention information. The majority of FDs (75%) and breast surgeons (89%) thought discussing chemoprevention should be part of their role. For FDs the strongest barriers were insufficient knowledge and lack of confidence. For breast surgeons, the strongest barriers were medication side-effects and lack of consultation time. Clear guidelines and strong family history were facilitators for both clinician groups. FDs identified that availability of better tools to select suitable patients would be a strong facilitator. Conclusions: Chemoprevention uptake is low in Australia by international standards. This study identified barriers and facilitators not previously noted in the literature and that could suggest interventions. However, as in other studies, improving both clinician and patient knowledge may be the most important driver of interventions. Upskilling FDs is important as, in Australia, moderate risk women are not generally eligible for CGC consultation (despite their preference for one). Providing FDs and patients with tailored education resources and tools (such as iPrevent- www.petermac.org/iprevent) to improve their confidence and awareness of chemoprevention may reduce the gap between evidence and implementation. Conflict of interest: Other Substantive Relationships: KAP has a patent “System and Process of Cancer Risk Estimation” (Australian Innovation Patent) issued regarding iPrevent

Extracellular electron transfer powers Enterococcus faecalis biofilm metabolism

10.1128/mBio.00626-17mBio92e00626-1