Job dissatisfaction and early retirement: a qualitative study of general practitioners in the Northern Deanery

Early retirement has become an important labour market trend for workers in professional occupations. General practitioners (GPs), however, are in short supply, and are being encouraged by the government to stay at work beyond the age of 60. In this study, which followed up a questionnaire survey of all general practitioners over 44 working in the Northern Deanery, 21 GPs took part in semi-structured interviews looking at their plans, reasons for, and feelings about, retirement. Interviews were taped, transcribed, and the text coded using themes from the interview schedule and those derived from the data. Findings are reported using a qualitative distinction between ‘happy’ and ‘unhappy’ doctors and on this basis just over two-fifths of those interviewed were ‘unhappy’, all of whom wanted to take early retirement. The major factor influencing these plans to retire was dissatisfaction with their role and none of this group would be persuaded to change their minds by various incentives such as ‘golden handcuffs’. ‘Happy’ doctors who wanted to stay in practice had found ways of accommodating themselves to change and factors outside of work provided no incentive or ‘pull’. This was not the case for ‘happy’ doctors who wanted to leave: they wanted to pursue hobbies and other interests whilst they were young enough to do so. The paper concludes that change is a major factor producing job dissatisfaction among GPs and that future generations of doctors need to be equipped with the means to cope with it, while governments need to consider the merits of stability and continuity

The microbiome of urban waters

More than 50% of the world’s population lives in urban centers. As collection basins for landscape activity, urban waters are an interface between human activity and the natural environment. The microbiome of urban waters could provide insight into the impacts of pollution, the presence of human health risks, or the potential for long-term consequences for these ecosystems and the people who depend upon them. An integral part of the urban water cycle is sewer infrastructure. Thousands of miles of pipes line cities as part of wastewater and stormwater systems. As stormwater and sewage are released into natural waterways, traces of human and animal microbiomes reflect the sources and magnitude of fecal pollution and indicate the presence of pollutants, such as nutrients, pathogens, and chemicals. Non-fecal organisms are also released as part of these systems. Runoff from impervious surfaces delivers microbes from soils, plants and the built environment to stormwater systems. Further, urban sewer infrastructure contains its own unique microbial community seemingly adapted to this relatively new artificial habitat. High microbial densities are conveyed via pipes to waterways, and these organisms can be found as an urban microbial signature imprinted on the natural community of rivers and urban coastal waters. The potential consequences of mass releases of non-indigenous microorganisms into natural waters include creation of reservoirs for emerging human pathogens, altered nutrient flows into aquatic food webs, and increased genetic exchange between two distinct gene pools. This review highlights the recent characterization of the microbiome of urban sewer and stormwater infrastructure and its connection to and potential impact upon freshwater systems. [Int Microbiol 18(3):141-149 (2015)]Keywords: urban freshwaters · infrastructure and sanitation · next generation sequencing · human health · aquatic food web

Epidemiologija virusa influence konja: patogenost i prenosivost

A large-scale outbreak caused by equine influenza virus of the H3N8 subtype has occurred in each decade since an H3N8 virus was first isolated from horses in 1963. Each epidemic, and some minor outbreaks, has influenced equine influenza surveillance and vaccination policies in the UK and elsewhere. The latest widespread outbreak of equine influenza occurred in 2003. The possible reasons for infection of horses despite intensive vaccination are currently being investigated and may shed new light on the epidemiology of equine influenza.Podtip H3N8 virusa influence konja uzrokovao je velik broj epizootija svakog desetljeća otkako je 1963. godine prvi put bio izdvojen iz konja. Svaka epizootija, a i neke manje pojave, utjecale su na mjere nadzora i cijepljenja u Velikoj Britaniji i drugdje. Posljednja velika epizootija influence konja zabilježena je 2003. Mogući razlozi prijemljivosti konja usprkos stalnog cijepljenja još se istražuju i mogli bi dati novo svjetlo na epidemiologiju influence konja

‘I no longer know that person’: Experiences of families living with someone using crystal methamphetamine

BackgroundCrystal methamphetamine (‘ice’) use is a large and growing worldwide problem, yet few research studies have explored the impact of crystal methamphetamine use on affected friends and family members. We explored the experiences and narratives of family members and friends of people who use methamphetamine to inform the development of a Family and Friend Support Program.MethodsThis paper reports on a subset of findings from a mixed method study, which sought to better understand the experiences of family members and friends of people who use methamphetamine. Participants were recruited via Facebook advertising and asked to complete a survey outlining their experiences. At the end of the survey, participants were invited to be interviewed by a clinical psychologist on the research team, to discuss their experiences in greater depth; seventeen people agreed to be interviewed. This paper is based on a qualitative thematic analysis of these interviews using Braun and Clarke’s 6-stage approach to identify key areas of concern for friends and family members of people who use methamphetamine.ResultsThrough thematic analysis, five key themes were developed, namely: (1) loss, (2) stigma, (3) support (or lack thereof), (4) ways of coping, and (5) the value in sharing personal experiences. The results of this study revealed the profound sadness, frustration and loss friends and family members experienced when caring for a loved one who uses methamphetamine. This loss was further complicated by societal stigma surrounding the use of methamphetamine, which often extended to friends and family members themselves. Since experiences of grief and loss were interwoven across the three themes, concepts of ambiguous loss, disenfranchised grief, and narrative constructivist approaches to understanding loss, were applied to the discussion of results.ConclusionThis study provides a more complete picture of family and caregiver experiences when caring for a loved one using methamphetamine, which may further help inform the design of intervention programs. Implications for future research and practice with this population are considered

Paramedics' perceptions and experiences of pelvic injuries in prehospital situations

Mortality rates remain high in patients with pelvic injuries despite improvements in trauma care in recent years. Pelvic injuries are associated with patients with a high Injury Severity Score (ISS); it can therefore be difficult to distinguish whether the pelvic injury was a primary causative factor of mortality. ‘Open book’ fractures carry a mortality rate as high as 50% and clinicians should therefore have a low threshold for suspecting a pelvic injury. Paramedics should follow the latest guidance found in the UK Ambulance Service Clinical Practice Guidelines (Joint Royal Colleges Ambulance Liaison Committee (JRCALC), 2016; 2017). Additionally, log rolling and/or ‘springing’ the pelvis of a patient with a pelvic injury will cause pain, disrupt clots and distort a potential fracture. Furthermore, pelvic binders/splints can reduce the area into which a patient can haemorrhage, if they are placed correctly. Lastly, triage of these patients can be difficult and major trauma centres should be considered for definitive care

A single genus in the gut microbiome reflects host preference and specificity

© The Author(s), 2014. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in ISME Journal 9 (2015): 90–100, doi:10.1038/ismej.2014.97.Delineating differences in gut microbiomes of human and animal hosts contributes towards understanding human health and enables new strategies for detecting reservoirs of waterborne human pathogens. We focused upon Blautia, a single microbial genus that is important for nutrient assimilation as preliminary work suggested host-related patterns within members of this genus. In our dataset of 57 M sequence reads of the V6 region of the 16S ribosomal RNA gene in samples collected from seven host species, we identified 200 high-resolution taxonomic units within Blautia using oligotyping. Our analysis revealed 13 host-specific oligotypes that occurred exclusively in fecal samples of humans (three oligotypes), swine (six oligotypes), cows (one oligotype), deer (one oligotype), or chickens (two oligotypes). We identified an additional 171 oligotypes that exhibited differential abundance patterns among all the host species. Blautia oligotypes in the human population obtained from sewage and fecal samples displayed remarkable continuity. Oligotypes from only 10 Brazilian human fecal samples collected from individuals in a rural village encompassed 97% of all Blautia oligotypes found in a Brazilian sewage sample from a city of three million people. Further, 75% of the oligotypes in Brazilian human fecal samples matched those in US sewage samples, implying that a universal set of Blautia strains may be shared among culturally and geographically distinct human populations. Such strains can serve as universal markers to assess human fecal contamination in environmental samples. Our results indicate that host-specificity and host-preference patterns of organisms within this genus are driven by host physiology more than dietary habits.This study was funded by the NIH grant R01AI091829-01A1 to SLM

The undiscovered ultra-diffuse galaxies of the Local Group

Ultra-diffuse galaxies (UDGs) are attractive candidates to probe cosmological models and test theories of galaxy formation at low masses; however, they are difficult to detect because of their low surface brightness. In the Local Group (LG) a handful of UDGs have been found to date, most of which are satellites of the Milky Way and M31, and only two are isolated galaxies. It is unclear whether so few UDGs are expected. We address this by studying the population of UDGs formed in hydrodynamic constrained simulations of the LG from the HESTIA suite. For a LG with mass $M_{\rm LG}\!\left(<2.5\, {\rm Mpc}\right)=8\times10^{12}{\rm M_\odot}$, we predict that there are $12\pm3$ UDGs (68 per cent confidence) with stellar masses $10^6 \leq M_\ast\, /\, {\rm M_\odot} < 10^9$, and effective radii $R_{\rm e} \geq 1.5\, {\rm kpc}$, in the field of the LG, of which $2^{+2}_{-1}$ (68 per cent confidence) are detectable in the footprint of the Sloan Digital Sky Survey (SDSS). Accounting for survey incompleteness, we find that up to 82, 90, and 100 per cent of all UDGs in the LG field would be observable in a future all-sky survey with a depth similar to the SDSS, the Dark Energy Survey, or the Legacy Survey of Space and Time, respectively. Our results suggest that there is a population of UDGs in the LG awaiting discovery.Comment: 5 pages + acknowledgements and references. Submitted to MNRA