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

Familia en lo bueno y lo malo ("Family in the good and the bad"): the experience of emerging adults: a counselling psychology perspective

According to recent figures from the Office of National Statistics (ONS) and Eurostat in England and Wales (2016), 42% of marriages are expected to end in divorce. Existing literature is varied and often contradictory about the implications of this phenomenon for the offspring of divorced parents, proposing evidence for both positive and negative outcomes. The majority of studies have used a quantitative approach to focus on the effects of parental divorce on children and adolescents. This qualitative study used Interpretative Phenomenological Analysis (IPA) to explore how emerging adults describe their experiences of parental divorce. Semi-structured interviews produced in-depth insights into how respondents made sense of their experiences. The following three key themes emerge: loss, highlighting feelings of grief and disbelief related to the end of the 'family' as respondents had known it; altered reality, in which respondents describe issues related to altered parental relationships and mediating interparental conflict post-divorce; and finally hope and continuity, highlighted the way that emerging adults adapt, adjust and develop coping mechanisms following the divorce of their parents. The findings expand academic knowledge of the ways in which emerging adults experience parental divorce, and will encourage counselling psychologists working with divorcing couples or with their offspring to remain curious and mindful of the significance of these themes

Prucalopride for the treatment of women with chronic constipation in whom standard laxative regimens have failed to provide adequate relief

© Queen’s Printer and Controller of HMSO 2011This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of prucalopride for the treatment of women with chronic constipation in whom standard laxative regimens have failed to provide adequate relief. The ERG report is based on the manufacturer's submission (MS) to the National Institute for Health and Clinical Excellence as part of the single technology appraisal process. In the submission, quality-of-life data [Patient Assessment of Constipation Quality of Life (PAC-QOL) and Patient Assessment of Constipation Symptoms (PAC-SYM) questionnaires] from trials of prucalopride were extrapolated to EQ-5D (European Quality of Life-5 Dimensions) data and used to inform effectiveness in an economic model. Response rates to prucalopride were derived from observed response rates in trials, defined as the proportion of patients achieving an average of three or more spontaneous complete bowel movements over the 4- or 12-week trial periods. Adult (18-64 years) and elderly (≥ 65 years) patients were considered separately in the model. Cost-effectiveness was determined from estimated improvements in EQ-5D and anticipated response rates, adjusted for baseline severity of chronic constipation. The ERG considered that the patients participating in these trials were not representative of those in the licensed indication. They were not all refractory to laxatives, and baseline EQ-5D scores showed a large spread in quality of life, with many patients experiencing little baseline dissatisfaction. The mapping of quality-of-life data from trials (PAC-QOL and PAC-SYM data) to EQ-5D was unclear and invalidated. The assumption of the long-term effectiveness and safety of prucalopride to 1 year was considered unjustified. There was no justification or sources given for coefficients used to predict effectiveness in the economic model, and no costs other than the cost of prucalopride were incorporated into the model. Owing to the many areas of uncertainty, particularly the effectiveness of prucalopride in the licensed patient group and its long-term effectiveness and safety, it was considered that the MS provided no evidence for whether prucalopride is effective or not in women with laxative-refractory chronic constipation. Further subgroup analysis of the actual patient group of interest may have better guided decision-making. However, long-term efficacy data, with validated estimates of quality of life incorporated in a well-founded model, would be important for an evidence-based judgement to be made

A systematic review of positron emission tomography (PET) and positron emission tomography/computed tomography (PET/CT) for the diagnosis of breast cancer recurrence.

addresses: West Midlands Health Technology Assessment Collaboration, Unit of Public Health, Epidemiology & Biostatistics, University of Birmingham, Birmingham, UK.types: Journal Article; Research Support, N.I.H., Extramural; ReviewPublished version. Copyright © 2010 NIHR Health Technology Assessment ProgrammeBreast cancer (BC) accounts for one-third of all cases of cancer in women in the UK. Current strategies for the detection of BC recurrence include computed tomography (CT), magnetic resonance imaging (MRI) and bone scintigraphy. Positron emission tomography (PET) and, more recently, positron emission tomography/computed tomography (PET/CT) are technologies that have been shown to have increasing relevance in the detection and management of BC recurrence

The effects of laryngeal mask airway passage simulation training on the acquisition of undergraduate clinical skills: a randomised controlled trial

Background\ud Effective use of the laryngeal mask airway (LMA) requires learning proper insertion technique in normal patients undergoing routine surgical procedures. However, there is a move towards simulation training for learning practical clinical skills, such as LMA placement. The evidence linking different amounts of mannequin simulation training to the undergraduate clinical skill of LMA placement in real patients is limited. The purpose of this study was to compare the effectiveness in vivo of two LMA placement simulation courses of different durations. \ud \ud Methods\ud Medical students (n = 126) enrolled in a randomised controlled trial. Seventy-eight of these students completed the trial. The control group (n = 38) received brief mannequin training while the intervention group (n = 40) received additional more intensive mannequin training as part of which they repeated LMA insertion until they were proficient. The anaesthetists supervising LMA placements in real patients rated the participants' performance on assessment forms. Participants completed a self-assessment questionnaire. \ud \ud Results\ud Additional mannequin training was not associated with improved performance (37% of intervention participants received an overall placement rating of > 3/5 on their first patient compared to 48% of the control group, $X^2$ = 0.81, p = 0.37). The agreement between the participants and their instructors in terms of LMA placement success rates was poor to fair. Participants reported that mannequins were poor at mimicking reality. \ud \ud Conclusions\ud The results suggest that the value of extended mannequin simulation training in the case of LMA placement is limited. Educators considering simulation for the training of practical skills should reflect on the extent to which the in vitro simulation mimics the skill required and the degree of difficulty of the procedure. \ud \u

Leisure, refuge and solidarity:messages in visitors’ books as microforms of travel writing

Visitors’ books not only trace developments in modern tourism, but they also reveal changes in the socio-cultural and language attitudes of travellers from all walks of life over prolonged periods of time. This article investigates messages in visitors’ books from Wales from the mid-nineteenth century up to the present and argues for their recognition as microforms of travel writing. Despite their brevity, entries in visitors’ books are a highly complex form of travel writing particularly in the inscribers’ self-fashioning of identity for future readers. The article examines how writerly choices are not only directly rooted in the discourse of travel, but also in socio-political circumstances in the individual travellers’ countries of origin and their travel destinations

Small Change: Economics and the British coin-tree

This is the accepted manuscript for the following article: Ceri Houlbrook, “Small Change: Economics and the British coin-tree”, Post Medieval Archaeology, Vol. 49(1), June 2015. The final published version can be found at: http://www.tandfonline.com/doi/full/10.1179/0079423615Z.00000000074 © Society for Post-Medieval Archaeology 2015Throughout the c.2000 year period coins have been circulated in Britain, they have also been ritually employed, most notably as votive deposits. Focusing specifically on the understudied custom of the British coin-tree, whereby coins are ritually embedded into the barks of trees, this paper considers the coin’s role and applicability as a deposit. It aims to demonstrate that our understanding of the coin’s past, present, and future ritual employment is not only aided by a consideration of economics and the coin’s secular function; it would be utterly incomplete without it.Peer reviewedFinal Accepted Versio

Cultural geographies of extinction: animal culture amongst Scottish ospreys

This paper explores cultural geographies of extinction. I trace the decline of the Scottish osprey during the nineteenth century, and its enduring, haunting presence in the landscape today. Taking inspiration from the environmental humanities, extinction is framed as an event affecting losses that exceed comprehension in terms merely of biological species numbers and survival rates. Disavowing the ‘species thinking’ of contemporary conservation biopolitics, the osprey’s extinction story pays attention to the worth of ‘animal cultures’. Drawing a hybrid conceptual framework from research in the environmental humanities, ‘speculative’ ethology and more-than-human geographies, I champion an experimental attention to the cultural geographies of animals in terms of historically contingent, communally shared, spatial practices and attachments. In doing so, I propose nonhuman cultural geographies as assemblages that matter, and which are fundamentally at stake in the face of extinction