Risk of root intrusion by tree and shrub species into sewer pipes in Swedish urban areas

Blockages in sewer pipes caused by roots are very common and several tree and shrub species are reported to be particularly likely to cause root intrusion. This study examined the relative ability of roots of different species to intrude into urban sewer pipes. Data on root-intruded pipes and the woody plants surrounding these pipes were collected from two Swedish cities, Malmö and Skövde. Plant material, location data and closed-circuit television (CCTV) inspections on root-intruded pipes with a total length of 33.7 km, containing 2180 different points of root intrusion, were examined. An inventory of 4107 woody plants was compiled. The results showed that broad-leaved trees dominated as a cause of root intrusion, but that conifers and a number of shrubs, e.g. the genera Ligustrum, Spiraea and Syringa, were also likely to have caused root intrusion. Malus floribunda Van Houtte was found to have the highest mean share of root intrusions per estimated number of pipe joints when all joints and all root intrusions within a 10 m radius from trees were calculated (0.694, maximum number of intrusions per joint 1.0), while Populus canadensis ‘Robusta’ Moench had the second highest, with 0.456 intrusions per estimated joint. However, other Malus and Populus species and cultivars had a much lower mean share of root intrusions. Most species seemed capable of causing root intrusion, and not only species of the genera Populus and Salix that were previously seen as the species most likely to cause damage to stormwater and sewer systems. There were differences in the frequency of joint intrusion by roots of different species, but the reasons for these differences were not identified and further research in the area is needed

Haematological nurses' experiences about palliative care trajectories of patients with life-threatening haematological malignancies: A qualitative study

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Aims: To explore haematological nurses' experiences about the palliative care trajectories of patients with life-threatening haematological malignancies. Design: A qualitative study with a descriptive and explorative design. Methods: Data were collected through 12 individual semi-structured interviews of nurses who work with patients with haematological malignancies from four hospitals in Norway. The data were analysed using systematic text condensation. The study was reported according to the Consolidated Criteria for Reporting Qualitative Research checklist. Results: Three categories emerged from the data analysis: focus on a cure delays integration of palliative care, dialogue with patients facilitates palliative care and the need for enhanced interdisciplinary understanding. Patient or public contribution: No patient or public contribution since nurses' experiences were explored.publishedVersio

Health communication and adolescents: What do their emails tell us?

This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Family Practice following peer review. The definitive publisher-authenticated version Brown, B.J. et al (2008) Health communication and adolescents: What do their emails tell us? Family Practice, 25, pp.304-311. is available online at: http://dx.doi.org/10.1093/fampra/cmn029Background. It is widely known that barriers exist in communication between adolescents and health professionals. However, little is known about the actual language used by young people articulating such difficulties and whether email might allow them to overcome these problems. Objectives. The aims of this study were to investigate concerns and difficulties relating to communication among adolescents seeking online health advice. Methods. The study design was a corpus linguistic analysis of a million-word adolescent health email database based on 62 794 emails from young people requesting health advice from a prominent UK-hosted and doctor-led website. Results. Young people reported various concerns about their health. They described numerous difficulties in disclosing such concerns to other people, in particular to parents and doctors. However, they readily expressed their concerns by email, displaying elevated levels of directness, particularly in relation to potentially sensitive or embarrassing topics. Conclusion. Email has the potential to facilitate and supplement face-to-face consultations with health professionals. Increased adoption of email by health providers may be an efficient means of engaging with a generation often reluctant to access more traditional health care services and thus encourage them to enter the primary care setting more readily

Methodological reflections on the use of asynchronous online focus groups in health research

The internet is increasingly used as a tool in qualitative research. In particular, asynchronous online focus groups are used when factors such as cost, time or access to participants can make conducting face-to-face research difficult. In this article we consider key methodological issues involved in using asynchronous online focus groups to explore experiences of health and illness. The written nature of internet communication, the lack of physical presence and the asynchronous, longitudinal aspects enable participants who might not normally contribute to research studies to reflect on their personal stories before disclosing them to the researcher. Implications for study design, recruitment strategies and ethics should be considered when deciding whether to use this method.sch_occ11pub2646pub

Influence of COVID-19 on contraception: a cross-sectional analysis of disrupted clinical trials

Background: The COVID-19 pandemic exacerbated barriers to contraceptive services and disrupted the progression of ongoing clinical trials (CTs) in several fields of medicine1–4, including contraceptive care. Further, sponsors have restricted CTs due to funding uncertainty. The impact of the pandemic has not yet been quantified in research related to contraception-related trials, thus our aim was to identify trials that were prematurely discontinued.Methods: We searched ClinicalTrials.gov to identify contraception-related trials, and where applicable, reasons for discontinuation. We extracted the number of participants per trial, funding source, and trial location. We assessed associations between reasons for discontinuation (COVID-19 vs. other reasons) and 1) trial size via Mann-Whitney U test, funding source, and location via Fishers exact.Results: Of the 107 contraceptive-related studies, 12 (11.21%) were discontinued between January 1, 2020, and June 30, 2021. There were a total of 4,614 individuals enrolled in discontinued trials, with a median enrollment of 18 (IQR: 5 - 276). Two trials explicitly stated COVID-19 as a reason for termination, four reported sponsor-requested termination, two reported recruitment issues, one reported funding issues, two studies did not report a reason and one principal investigator left.Conclusions: For the 415 women enrolled in contraception-related CTs that were discontinued explicitly due to COVID-19, access to contraception may have been impaired or discontinued. Given that COVID-19 could be an underlying reason or contributing factor to why the remaining studies were terminated, it is also possible that more women’s contraceptive care was disrupted due to the effects of the pandemic. This is worrisome because discontinuation of contraception can have many negative effects, the most significant of which is unintended pregnancy and its resulting possible ramifications

'Am I normal?' Teenagers, sexual health and the internet.

The development of new communication technologies has created a wide variety of new fields in which human beings can construct identities. The past decade has seen a proliferation of opportunities to use the internet for health related advice and information and many new sites have been created where participants can construct identities, formulate problems and seek solutions concerning health related issues. This paper will report on a study of emails written in to a UK-based website concerned with health issues for young people. Our analysis was driven by corpus linguistics, a computational methodology for interrogating extensive datasets, and we have combined both quantitative and qualitative approaches to the study of language. We interrogated a 400,000 word dataset of messages and were able to identify terms whose usage was elevated compared to the English language as a whole. As well as personal pronouns, these included many terms related to sexual ! health and bodily development, as well as terms such as "normal" and "worried" which were identified for further exploration. Whereas previous research on sexual health has discovered the use of vague terms and euphemisms, here, young people described themselves, their anatomy and their identities in meticulous detail. This study enables us to define the role of health topics raised, the presentation of health concerns, and contributes towards the discovery of a distinctive ˜genre" of health messages concerning sexual health which differs from that found by other researchers concentrating on face to face encounters. In conclusion we suggest that for researchers and practitioners working in health with young people in the medium of English there could be valuable lessons in communication to be learned from examination of corpora of the health care language concerned

Development of a toolkit to enhance care processes for people with a long-term neurological condition:A qualitative descriptive study

Objective To (A) explore perspectives of people with a long-term neurological condition, and of their family, clinicians and other stakeholders on three key processes: Two-way communication, self-management and coordination of long-term care; and (B) use these data to develop a Living Well Toolkit', a structural support aiming to enhance the quality of these care processes. Design This qualitative descriptive study drew on the principles of participatory research. Data from interviews and focus groups with participants (n=25) recruited from five hospital, rehabilitation and community settings in New Zealand were analysed using conventional content analysis. Consultation with a knowledge-user group (n=4) and an implementation champion group (n=4) provided additional operational knowledge important to toolkit development and its integration into clinical practice. Results Four main, and one overarching, themes were constructed: (1) tailoring care:referring to getting to know the person and their individual circumstances; (2) involving others: Representing the importance of negotiating the involvement of others in the person's long-term management process; (3) exchanging knowledge: Referring to acknowledging patient expertise; and (4) enabling: Highlighting the importance of empowering relationships and processes. The overarching theme was: Assume nothing. These themes informed the development of a toolkit comprising of two parts: One to support the person with the long-term neurological condition, and one targeted at clinicians to guide interaction and support their engagement with patients. Conclusion Perspectives of healthcare users, clinicians and other stakeholders were fundamental to the development of the Living Well Toolkit. The findings were used to frame toolkit specifications and highlighted potential operational issues that could prove key to its success. Further research to evaluate its use is now underway

Apathy is associated with executive functioning in first episode psychosis

<p>Abstract</p> <p>Background</p> <p>The underlying nature of negative symptoms in psychosis is poorly understood. Investigation of the relationship between the different negative subsymptoms and neurocognition is one approach to understand more of the underlying nature. Apathy, one of the subsymptoms, is also a common symptom in other brain disorders. Its association with neurocognition, in particular executive functioning, is well documented in other brain disorders, but only studied in one former study of chronic patients with schizophrenia. This study investigates the association between apathy and neurocognitive functioning in patients with first episode psychosis (FEP), with the hypothesis that apathy is more associated with tests representing executive function than tests representing other neurocognitive domains.</p> <p>Methods</p> <p>Seventy-one FEP patients were assessed with an extensive neuropsychological test battery. Level of apathy was assessed with the abridged Apathy Evaluation Scale (AES-C-Apathy).</p> <p>Results</p> <p>AES-C-Apathy was only significantly associated with tests from the executive domain [Semantic fluency (r = .37, p < .01), Phonetic fluency (r = .25, p < .05)] and working memory [Letter Number Span (r = .26; p =< .05)]; the first two representing the initiation part of executive function. Confounding variables such as co-occuring depression, positive symptoms or use of antipsychotic medication did not significantly influence the results.</p> <p>Conclusion</p> <p>We replicated in FEP patients the relationship between apathy and executive functioning reported in another study for chronic patients with schizophrenia. We also found apathy in FEP to have the same relationship to executive functioning, as assessed with the Verbal fluency tests, as that reported in patients with other brain disorders, pointing to a common underlying nature of this symptom across disorders.</p