The impact of consent on observational research: a comparison of outcomes from consenters and non consenters to an observational study

Background Public health benefits from research often rely on the use of data from personal medical records. When neither patient consent nor anonymisation is possible, the case for accessing such records for research purposes depends on an assessment of the probabilities of public benefit and individual harm. Methods In the late 1990s, we carried out an observational study which compared the care given to affluent and deprived women with breast cancer. Patient consent was not required at that time for review of medical records, but was obtained later in the process prior to participation in the questionnaire study. We have re-analysed our original results to compare the whole sample with those who later provided consent. Results Two important findings emerged from the re-analysis of our data which if presented initially would have resulted in insufficient and inaccurate reporting. Firstly, the reduced dataset contains no information about women presenting with locally advanced or metastatic cancer and we would have been unable to demonstrate one of our initial key findings: namely a larger number of such women in the deprived group. Secondly, our re-analysis of the consented women shows that significantly more women from deprived areas (51 v 31%, p = 0.018) received radiotherapy compared to women from more affluent areas. Previously published data from the entire sample demonstrated no difference in radiotherapy treatment between the affluent and deprived groups. Conclusion The risk benefit assessment made regarding the use of medical records without consent should include the benefits of obtaining research evidence based on 100% of the population and the possibility of inappropriate or insufficient findings if research is confined to consented populations

'Failed' mothers,‘failed’ womxn: Demarcating normative mothering

"This is an Accepted Manuscript of a book chapter published by Routledge in Intersections of Mothering: Feminist Accounts, 2019, available online: http://www.routledge.com/9781138366268This book presents new interdisciplinary and intersectional research about women as mothers, highlighting that alternative accounts of mothering can challenge normative societal assumptions and broaden understandings of women as mothers, ...falseLondo

Effects of cyclic nucleotides on midgut infections and maturation of T. b. brucei in G. m. morsitans

Cyclic nucleotide signalling through cyclic adenosine monophosphate (cAMP) is thought to play an important role in the transformation of the long slender (dividing) form to the short-stumpy (arrested) form in the mammalian bloodstream but the role of cyclic nucleotides in the tsetse-based part of the trypanosome life cycle is unknown. In a series of in vivo experiments, it was found that cyclic guanosine monophosphate (cGMP) but not cAMP could induce significantly higher rates of midgut infection in tsetse. Continuous feeding of either cGMP or cAMP to tsetse had no effect on rates of maturation of established midgut infections suggesting that these two parts of the life cycle in tsetse are not linked

Geodynamic setting and origin of the Oman/UAE ophiolite

The ~500km-long mid-Cretaceous Semail nappe of the Sultanate of Oman and UAE (henceforth referred to as the Oman ophiolite) is the largest and best-preserved ophiolite complex known. It is of particular importance because it is generally believed to have an internal structure and composition closely comparable to that of crust formed at the present-day East Pacific Rise (EPR), making it our only known on-land analogue for ocean lithosphere formed at a fast spreading rate. On the basis of this assumption Oman has long played a pivotal role in guiding our conceptual understanding of fast-spreading ridge processes, as modern fast-spread ocean crust is largely inaccessible

Nesting by Canada Geese on Baffin Island, Nunavut

Outside of northern Quebec, there is little evidence to confirm reports of nesting by Canada Geese in Arctic habitats of North America, but they nest regularly in the Arctic tundra of West Greenland, from about 62˚ N to as far north as 76.96˚ N, 71.11˚ W. In 2013, we documented successful nesting by a pair of Canada Geese on northern Baffin Island (71.36˚ N, 79.59˚ W), approximately 1200 km north of the nearest known site of regular nesting by this species in northern Quebec. Photographs, egg measurements, and mitochondrial DNA evidence confirmed that these were Canada Geese. Egg laying began around 17 June, the nest of five eggs hatched on 18 July, and we determined that fledging should have occurred around 20 September. Daily mean temperatures on northern Baffin Island fell below freezing after 5 September 2013, and we suspect that the probability of recruitment for this brood was very low. Climate warming in the Arctic is likely to favor northward range expansion by Canada Geese.En dehors du nord du Québec, il existe peu de preuves permettant de confirmer des rapports selon lesquels la bernache du Canada nidifierait dans les habitats arctiques de l’Amérique du Nord. Cela dit, la bernache du Canada nidifie régulièrement dans la toundra arctique de l’ouest du Groenland, à partir d’environ 62˚ N et aussi loin qu’à 76,96˚ N, 71,11˚ O. En 2013, nous avons documenté la nidification réussie d’une paire de bernaches du Canada dans le nord de l’île de Baffin (71,36˚ N, 79,59˚ O), à environ 1 200 km au nord du site le plus près de nidification habituel connu de cette espèce dans le nord du Québec. Des photographies, la mesure des oeufs et des échantillons d’ADN mitochondrial ont permis de confirmer qu’il s’agissait effectivement de bernaches du Canada. La ponte a commencé vers le 17 juin, puis la couvée de cinq oeufs a éclos le 18 juillet. Nous avons ensuite déterminé que la prise des ailes aurait eu lieu vers le 20 septembre. Dans le nord de l’île de Baffin, les températures moyennes quotidiennes sont tombées sous le point de congélation après le 5 septembre 2013, si bien que nous estimons que pour cette nichée, la probabilité de recrutement était très faible. Le réchauffement climatique dans l’Arctique favorisera vraisemblablement l’expansion du parcours naturel de la bernache du Canada vers le nord.

Do colorectal cancer patients diagnosed as an emergency differ from non-emergency patients in their consultation patterns and symptoms? A longitudinal data-linkage study in England

Background: More than 20% of colorectal cancers are diagnosed following an emergency presentation. We aimed to examine pre-diagnostic primary-care consultations and related symptoms comparing patients diagnosed as emergencies with those diagnosed through non-emergency routes. Methods: Cohort study of colorectal cancers diagnosed in England 2005 and 2006 using cancer registration data individually linked to primary-care data (CPRD/GPRD), allowing a detailed analysis of clinical information referring to the 5-year pre-diagnostic period. Results: Emergency diagnosis occurred in 35% and 15% of the 1029 colon and 577 rectal cancers. ‘Background’ primary-care consultations (2–5 years before diagnosis) were similar for either group. In the year before diagnosis, >95% of emergency and non-emergency presenters had consulted their doctor, but emergency presenters had less frequently relevant symptoms (colon cancer: 48% vs 71% (P<0.001); rectal cancer: 49% vs 61% (P=0.043)). ‘Alarm’ symptoms were recorded less frequently in emergency presenters (e.g., rectal bleeding: 9 vs 24% (P=0.002)). However, about 1/5 of emergency presenters (18 and 23% for colon and rectal cancers) had ‘alarm’ symptoms the year before diagnosis. Conclusions: Emergency presenters have similar ‘background’ consultation history as non-emergency presenters. Their tumours seem associated with less typical symptoms, however opportunities for earlier diagnosis might be present in a fifth of them

Adaptive light-sheet fluorescence microscopy with a deformable mirror for video-rate volumetric imaging

Light-sheet fluorescence microscopy (LSFM) achieves optically sectioned imaging with the relatively low photobleaching and phototoxic effect. To achieve high-speed volumetric LSFM imaging without perturbing the sample, it is necessary to use some form of remote refocusing in the detection beam path. Previous work used electrically tunable lenses, tunable acoustic gradient index of refraction lenses, or the remote-refocusing approach of Botcherby et al. [Opt. Lett. 32(14), 2007 (2007)] to achieve remote refocusing. However, these approaches generally only provide low-order defocus correction, which is not compatible with higher-NA objectives that require higher order defocus corrections or reduce the optical throughput. In order to simultaneously achieve high-speed remote refocusing and correct system aberrations, we employ a deformable mirror in the detection path that is capable of providing higher orders of defocus and aberration correction in an optical system with an NA of 0.72–0.75. We demonstrate high-speed volumetric imaging at 26.3 volumes per second and 35 frames per volume for a defocus range of −50 to 50 μm

Men and talk about legal abortion in South Africa: equality, support and rights discourses undermining reproductive ‘choice’

Discursive constructions of abortion are embedded in the social and gendered power relations of a particular socio-historical space. As part of research on public discourses concerning abortion in South Africa where there has been a radical liberalisation of abortion legislation, we collected data from male group discussions about a vignette concerning abortion, and newspaper articles written by men about abortion. Our analysis revealed how discourses of equality, support and rights may be used by men to subtly undermine women’s reproductive right to ‘choose’ an abortion. Within an Equal Partnership discourse, abortion, paired with the assumption of foetal personhood, was equated with violating an equal heterosexual partnership and a man’s patriarchal duty to protect a child. A New Man discourse, which positions men as supportive of women, was paired with the assumption of men as rational and women as irrational in decision-making, to allow for the possibility of men dissuading women from terminating a pregnancy. A Rights discourse was invoked to suggest that abortion violates men’s paternal rights