A systematic review of lesbian, gay, bisexual and transgender health in the West Midlands region of the UK compared to published UK research

It is estimated that approximately 3-8% of the UK population identify as lesbian, gay, bisexual or trans (LGBT). Until now, most health research on gay and bisexual men has been around HIV, AIDS and sexually transmitted diseases and for trans people has been on the transitioning process only. However, it has been apparent to the LGBT community that that there are a wide variety of other physical and mental health issues that are also important and that the proportion of gay and bisexual men who have HIV/AIDS is relatively small. Very little general LGBT health research has been published so far and there are very few health services that specifically address the general health concerns of the LGBT community. This systematic review presents all available research conducted in the West Midlands on LGBT health since 2000. Local health research is compared to UK national, peer reviewed and published LGBT health research in order to determine whether the local results are unusual compared to national LGBT data, and to routinely collected data on the UK population, where appropriate, in order to determine whether and where the LGBT population differ from the general population. Only UK research has been included because there was no previous UK specific systematic review so it was unclear how generalisable foreign research would be to the UK

A model balancing cooperation and competition explains our right-handed world and the dominance of left-handed athletes

An overwhelming majority of humans are right-handed. Numerous explanations for individual handedness have been proposed, but this population-level handedness remains puzzling. Here we use a minimal mathematical model to explain this population-level hand preference as an evolved balance between cooperative and competitive pressures in human evolutionary history. We use selection of elite athletes as a test-bed for our evolutionary model and account for the surprising distribution of handedness in many professional sports. Our model predicts strong lateralization in social species with limited combative interaction, and elucidates the rarity of compelling evidence for "pawedness" in the animal world.Comment: 5 pages of text and 3 figures in manuscript, 8 pages of text and two figures in supplementary materia

Environmental auditing of a packaging system for redesign: A case study exploration

Within the United Kingdom a significant portion of the energy consumed each year is done so through industry. It is therefore desirable to take measures that reduce this consumption. A process common to all manufacturing sectors is that of packaging, and this research focused on identifying, quantifying and reducing the environmental impact of one such system. It finally took the form of an abridged life cycle assessment focusing on the manufacturing and assembly stage of a packaging systems life. Two separate studies were conducted to evaluate the performance of specific tools for such environmental studies. Where, the total embodied energy and carbon of each sub-assembly of the systems was calculated and their contribution to the whole machine established. These were further broken down into material production and machine processes in order to establish where the major impacts were and potential areas for redesign. Both approaches were found to be resource hungry in their application, an output that may restrict their application in the type of company that operate in this domain. A surprising finding was that producing a design with lower environmental impact could be less expensive

Shear-free, Irrotational, Geodesic, Anisotropic Fluid Cosmologies

General relativistic anisotropic fluid models whose fluid flow lines form a shear-free, irrotational, geodesic timelike congruence are examined. These models are of Petrov type D, and are assumed to have zero heat flux and an anisotropic stress tensor that possesses two distinct non-zero eigenvalues. Some general results concerning the form of the metric and the stress-tensor for these models are established. Furthermore, if the energy density and the isotropic pressure, as measured by a comoving observer, satisfy an equation of state of the form $p = p(\mu)$, with $\frac{dp}{d\mu} \neq -\frac{1}{3}$, then these spacetimes admit a foliation by spacelike hypersurfaces of constant Ricci scalar. In addition, models for which both the energy density and the anisotropic pressures only depend on time are investigated; both spatially homogeneous and spatially inhomogeneous models are found. A classification of these models is undertaken. Also, a particular class of anisotropic fluid models which are simple generalizations of the homogeneous isotropic cosmological models is studied.Comment: 13 pages LaTe

The specialty choices of graduates from Brighton and Sussex Medical School: a longitudinal cohort study

BACKGROUND Since 2007 junior doctors in the UK have had to make major career decisions at a point when previously many had not yet chosen a specialty. This study examined when doctors in this new system make specialty choices, which factors influence choices, and whether doctors who choose a specialty they were interested in at medical school are more confident in their choice than those doctors whose interests change post-graduation. METHODS Two cohorts of students in their penultimate year at one medical school (n = 227/239) were asked which specialty interested them as a career. Two years later, 210/227 were sent a questionnaire measuring actual specialty chosen, confidence, influence of perceptions of the specialty and experiences on choice, satisfaction with medicine, personality, self-efficacy, and demographics. Medical school and post-graduation choices in the same category were deemed 'stable'. Predictors of stability, and of not having chosen a specialty, were calculated using bootstrapped logistic regression. Differences between specialties on questionnaire factors were analysed. RESULTS 50% responded (n = 105/277; 44% of the 239 Year 4 students). 65% specialty choices were 'stable'. Factors univariately associated with stability were specialty chosen, having enjoyed the specialty at medical school or since starting work, having first considered the specialty earlier. A regression found doctors who chose psychiatry were more likely to have changed choice than those who chose general practice. Confidence in the choice was not associated with stability. Those who chose general practice valued lifestyle factors. A psychiatry choice was associated with needing a job and using one's intellect to help others. The decision to choose surgical training tended to be made early. Not having applied for specialty training was associated with being lower on agreeableness and conscientiousness. CONCLUSION Medical school experiences are important in specialty choice but experiences post-graduation remain significant, particularly in some specialties (psychiatry in our sample). Career guidance is important at medical school and should be continued post-graduation, with senior clinicians supported in advising juniors. Careers advice in the first year post-graduation may be particularly important, especially for specialties which have difficulty recruiting or are poorly represented at medical school

Rapid creation and quantitative monitoring of high coverage shRNA libraries.

Short hairpin RNA libraries are limited by low efficacy of many shRNAs and by off-target effects, which give rise to false negatives and false positives, respectively. Here we present a strategy for rapidly creating expanded shRNA pools (approximately 30 shRNAs per gene) that are analyzed by deep sequencing (EXPAND). This approach enables identification of multiple effective target-specific shRNAs from a complex pool, allowing a rigorous statistical evaluation of true hits

Which doctors and with what problems contact a specialist service for doctors? A cross sectional investigation

Background: In the United Kingdom, specialist treatment and intervention services for doctors are underdeveloped. The MedNet programme, created in 1997 and funded by the London Deanery, aims to fill this gap by providing a self-referral, face-to-face, psychotherapeutic assessment service for doctors in London and South-East England. MedNet was designed to be a low-threshold service, targeting doctors without formal psychiatric problems. The aim of this study was to delineate the characteristics of doctors utilising the service, to describe their psychological morbidity, and to determine if early intervention is achieved. Methods: A cross-sectional study including all consecutive self-referred doctors (n = 121, 50% male) presenting in 2002–2004 was conducted. Measures included standardised and bespoke questionnaires both self-report and clinician completed. The multi-dimensional evaluation included: demographics, CORE (CORE-OM, CORE-Workplace and CORE-A) an instrument designed to evaluate the psychological difficulties of patients referred to outpatient services, Brief Symptom Inventory to quantify caseness and formal psychiatric illness, and Maslach Burnout Inventory. Results: The most prevalent presenting problems included depression, anxiety, interpersonal, self-esteem and work-related issues. However, only 9% of the cohort were identified as severely distressed psychiatrically using this measure. In approximately 50% of the sample, problems first presented in the preceding year. About 25% were on sick leave at the time of consultation, while 50% took little or no leave in the prior 12 months. A total of 42% were considered to be at some risk of suicide, with more than 25% considered to have a moderate to severe risk. There were no significant gender differences in type of morbidity, severity or days off sick. Conclusion: Doctors displayed high levels of distress as reflected in the significant proportion of those who were at some risk of suicide; however, low rates of severe psychiatric illness were detected. These findings suggest that MedNet clients represent both ends of the spectrum of severity, enabling early clinical engagement for a significant proportion of cases that is of importance both in terms of personal health and protecting patient care, and providing a timely intervention for those who are at risk, a group for whom rapid intervention services are in need and an area that requires further investigation in the UK