Views and experiences of men who have sex with men on the ban on blood donation: a cross sectional survey with qualitative interviews.

OBJECTIVE: To explore compliance with the UK blood services' criterion that excludes men who have had penetrative sex with a man from donating blood, and to assess the possible effects of revising this policy. DESIGN: A random location, cross sectional survey followed by qualitative interviews. SETTING: Britain. PARTICIPANTS: 1028 of 32,373 men in the general population reporting any male sexual contact completed the survey. Additional questions were asked of a general population sample (n=3914). Thirty men who had had penetrative sex with a man participated in the qualitative interviews (19 who had complied with the blood services' exclusion criterion and 11 who had not complied). Main outcome measure Compliance with the blood services' lifetime exclusion criterion for men who have had penetrative sex with a man. RESULTS: 10.6% of men with experience of penetrative sex with a man reported having donated blood in Britain while ineligible under the exclusion criterion, and 2.5% had donated in the previous 12 months. Ineligible donation was less common among men who had had penetrative sex with a man recently (in previous 12 months) than among men for whom this last occurred longer ago. Reasons for non-compliance with the exclusion included self categorisation as low risk, discounting the sexual experience that barred donation, belief in the infallibility of blood screening, concerns about confidentiality, and misunderstanding or perceived inequity of the rule. Although blood donation was rarely viewed as a "right," potential donors were seen as entitled to a considered assessment of risk. A one year deferral since last male penetrative sex was considered by study participants to be generally feasible, equitable, and acceptable. CONCLUSIONS: A minority of men who have sex with men who are ineligible to donate blood under the current donor exclusion in Britain have nevertheless done so in the past 12 months. Many of the reasons identified for non-compliance seem amenable to intervention. A clearly rationalised and communicated one year donor deferral is likely to be welcomed by most men who have sex with men

Women's health care: The potential of long-chain Omega-3 polyunsaturated fatty acids

Health care requirements are challenged by longer life expectancies with the fastest growing age group being women aged 85 years and older. The health care requirements for older women require further investigation with clinical trials seeking to represent this growing proportion of our population. Gender specific and general health care requirements for women over their lifespan need to be aimed at prolonging health adjusted life expectancy. Health care utilization has been linked to exposure to printed and online health information although which is the causal factor is unknown. Health literacy remains a concern in the transmission of health information especially with regard to complex messages such as the many health benefits associated with marine sourced long-chain omega-3 polyunsaturated fatty acids. These health benefits include: all-cause morbidity, coronary heart disease, cardiovascular disease, mental health including depression, dementia and Alzheimer’s disease, polycystic ovarian syndrome, dysmenorrhea and infant cognitive development. In many cases prevention is possible or at the very least a delay in onset of disease. Depression remains the single greatest contributor to the burden of disease in women in low-, medium- and high-income countries. Quality of womens’ health care throughout the lifespan and targeted health communications including those around diet has the ability to greatly influence health adjusted life expectancy

A hazard model of the probability of medical school dropout in the United Kingdom

From individual level longitudinal data for two entire cohorts of medical students in UK universities, we use multilevel models to analyse the probability that an individual student will drop out of medical school. We find that academic preparedness—both in terms of previous subjects studied and levels of attainment therein—is the major influence on withdrawal by medical students. Additionally, males and more mature students are more likely to withdraw than females or younger students respectively. We find evidence that the factors influencing the decision to transfer course differ from those affecting the decision to drop out for other reasons

Relationships between scores on the Jefferson Scale of physician empathy, patient perceptions of physician empathy, and humanistic approaches to patient care: a validity study.

BACKGROUND: Empathy is the backbone of a positive physician-patient relationship. Physician empathy and the patient\u27s awareness of the physician\u27s empathic concern can lead to a more positive clinical outcome. MATERIAL/METHODS: The Jefferson Scale of Physician Empathy (JSPE) was completed by 36 physicians in the Family Medicine residency program at Thomas Jefferson University Hospital, and 90 patients evaluated these physicians by completing the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and a survey about physicians\u27 humanistic approaches to patient care. RESULTS: A statistically significant correlation was found between scores of the JSPE and JSPPPE (r=0.48, p CONCLUSIONS: These findings provide further support for the validity of the JSPE. Implications for the assessments of empathy in the physician-patient relationship as related to clinical outcomes are discussed

Resource ecology of the Bolinao coral reef system

Resource /Energy Economics and Policy,

Ethnicity and academic performance in UK trained doctors and medical students: systematic review and meta-analysis

Objective To determine whether the ethnicity of UK trained doctors and medical students is related to their academic performance

Oceanographic dynamics and the end of the last interglacial in the subpolar North Atlantic

The last interglacial interval was terminated by the inception of a long, progressive glaciation that is attributed to astronomically influenced changes in the seasonal distribution of sunlight over the earth. However, the feedbacks, internal dynamics, and global teleconnections associated with declining northern summer insolation remain incompletely understood. Here we show that a crucial early step in glacial inception involves the weakening of the subpolar gyre (SPG) circulation of the North Atlantic Ocean. Detailed new records of microfossil foraminifera abundance and stable isotope ratios in deep sea sediments from Ocean Drilling Program site 984 south of Iceland reveal repeated, progressive cold water-mass expansions into subpolar latitudes during the last peak interglacial interval, marine isotope substage 5e. These movements are expressed as a sequence of progressively extensive southward advances and subsequent retreats of a hydrographic boundary that may have been analogous to the modern Arctic front, and associated with rapid changes in the strength of the SPG. This persistent millennial-scale oceanographic oscillation accompanied a long-term cooling trend at a time of slowly declining northern summer insolation, providing an early link in the propagation of those insolation changes globally, and resulting in a rapid transition from extensive regional warmth to the dramatic instability of the subsequent ∼100 ka

What do benthic δ13C and δ18O data tell us about Atlantic circulation during Heinrich Stadial 1?

Approximately synchronous with the onset of Heinrich Stadial 1 (HS1), δ13C decreased throughout most of the upper (~1000–2500 m) Atlantic, and at some deeper North Atlantic sites. This early deglacial δ13C decrease has been alternatively attributed to a reduced fraction of high-δ13C North Atlantic Deep Water (NADW) or to a decrease in the NADW δ13C source value. Here we present new benthic δ18O and δ13C records from three relatively shallow (~1450–1650 m) subpolar Northeast Atlantic cores. With published data from other cores, these data form a depth transect (~1200–3900 m) in the subpolar Northeast Atlantic. We compare Last Glacial Maximum (LGM) and HS1 data from this transect with data from a depth transect of cores from the Brazil Margin. The largest LGM-to-HS1 decreases in both benthic δ13C and δ18O occurred in upper waters containing the highest NADW fraction during the LGM. We show that the δ13C decrease can be explained entirely by a lower NADW δ13C source value, entirely by a decrease in the proportion of NADW relative to Southern Ocean Water, or by a combination of these mechanisms. However, building on insights from model simulations, we hypothesize that reduced ventilation due to a weakened but still active Atlantic Meridional Overturning Circulation also contributed to the low δ13C values in the upper North Atlantic. We suggest that the benthic δ18O gradients above ~2300 m at both core transects indicate the depth to which heat and North Atlantic deglacial freshwater had mixed into the subsurface ocean by early HS1