Does welfare reform affect fertility? Evidence from the UK

In 1999 the UK government made major reforms to the system of child-contingent benefits, including the introduction of Working Families’ Tax Credit and an increase in means-tested Income Support for families with children. Between 1999-2003 government spending per-child on these benefits rose by 50 per cent in real terms, a change that was unprecedented over a thirty year period. This paper examines whether there was a response in childbearing. To identify the effect of the reforms, we exploit the fact that the spending increases were targeted at low-income households and we use the (exogenously determined) education of the woman and her partner to define treatment and control groups. We argue that the reforms are most likely to have a positive fertility effect for women in couples and show that this is the case. We find that there was an increase in births (by around 15 per cent) among the group affected by the reforms

The personal experience of parenting a child with Juvenile Huntington’s Disease: perceptions across Europe

The study reported here presents a detailed description of what it is like to parent a child with juvenile Huntington’s disease in families across four European countries. Its primary aim was to develop and extend findings from a previous UK study. The study recruited parents from four European countries: Holland, Italy, Poland and Sweden,. A secondary aim was to see the extent to which the findings from the UK study were repeated across Europe and the degree of commonality or divergence across the different countries. Fourteen parents who were the primary caregiver took part in a semistructured interview. These were analyzed using an established qualitative methodology, interpretative phenomenological analysis. Five analytic themes were derived from the analysis: the early signs of something wrong; parental understanding of juvenile Huntington’s disease; living with the disease; other people’s knowledge and understanding; and need for support. These are discussed in light of the considerable convergence between the experiences of families in the United Kingdom and elsewhere in Europe

Human papillomavirus vaccine and behavioural disinhibition

Objectives—We sought to identify characteristics of parents who believe in sexual disinhibition and that Pap smears can safely be stopped after females receive HPV vaccine. Methods—We surveyed 647 parents of adolescent girls living in areas of North Carolina with elevated rates of cervical cancer. We report data primarily from a survey conducted in Fall 2008. Results—Only 16% (101/647) of parents agreed that teenage girls who receive HPV vaccine may be more likely to have sex. Parents who believed in vaccine-induced sexual disinhibition were more likely to be older (OR 1.89; 95% CI 1.09, 3.26) or report conservative political views (OR 2.26; 95% CI 1.37, 3.73). Parents were less likely to believe in sexual disinhibition if they had greater knowledge about HPV vaccine (OR 0.52; 95% CI 0.32 0.85) or if their daughters had received HPV vaccine (OR 0.31; 95% CI 0.17, 0.57). While few parents (5%, 30/647) believed that women could safely stop getting regular Pap smears after receiving HPV vaccine, this belief was somewhat more common among racial and ethnic minority parents (16%) and among fathers (13%). Conclusions—Few parents believed that HPV vaccine is likely to lead to increased sexual activity among females or reduce the need for vaccinated women to have regular Pap smears in the future. Characterizing parents who hold beliefs in behavioral disinhibition is important as clinicians encountering parents in practice may desire information about this population

Reducing Delirium in Patients with COVID-19

The purpose of our critically appraised topic is to synthesize the best current evidence regarding interventions that would be effective in reducing delirium in patients with COVID-19 in the acute care setting. The final portfolio contains a total of five research articles. Study designs include three randomized controlled trials, one non randomized controlled trial, and one quasi-experimental quantitative design. All studies relate directly to interventions within the OT scope of practice and were implemented in the acute care setting. Due to limited research on the novel coronavirus, these findings apply to critically ill patients but are not specific to patients with COVID-19. Early and intensive OT intervention in combination with multicomponent intervention strategies were found to significantly decrease delirium. Promising evidence can be used to draft new practice guidelines for decreasing delirium in critically ill patients within the acute care setting. In addition, modified implementation of slow tempo music and family participation/visitation interventions are recommended for patients with COVID-19. Due to the minimal time for therapy interventions within the acute care setting, implementation of these interventions as frequently as possible is recommended

Territorial Tactics: The Socio-spatial Significance of Private Policing Strategies in Cape Town

This paper analyses the policing strategies of private security companies operating in urban space. An existing literature has considered the variety of ways that territory becomes of fundamental importance in the work of public police forces. However, this paper examines territory in the context of private security companies. Drawing on empirical research in Cape Town, it examines how demarcated territories become key subjects in private policing. Private security companies are responsible for a relatively small section of the city, while in contrast the public police ultimately have to see city space as a whole. Hence, private policing strategy becomes one of displacement, especially of so-called undesirables yielding a patchworked public space associated with private enclaves of consumption. The conclusions signal the historical resonances and comparative implications of these political-legal-security dynamics. © 2013 Urban Studies Journal Limited

Human papillomavirus knowledge and vaccine acceptability among a national sample of heterosexual men

If approved for use in young males in the United States, prophylactic human papillomavirus (HPV) vaccine may reduce the incidence of HPV-related disease in vaccinated males and their sexual partners. We aimed to characterise heterosexual men’s willingness to get HPV vaccine and identify correlates of vaccine acceptability

Patient perspectives on cervical cancer screening interventions among underscreened women

Background Cervical cancer is highly preventable with regular screening, yet over 4,000 women die from it annually in the United States. Over half of new cervical cancer cases in the U.S. are attributable to insufficient screening. Methods Participants were 23 low-income, uninsured or Medicaid-insured women in North Carolina who were overdue for cervical cancer screening according to national guidelines. Semi-structured interviews examined perspectives on barriers to cervical cancer screening and on interventions to reduce these barriers. We also elicited feedback on three proposed evidence-based interventions: one-on-one education, coupons to reduce out-of-pocket costs, and self-collection of samples for detection of high-risk human papillomavirus (HPV) infection, the primary cause of cervical cancer. Results Reported barriers included high cost, inconvenient clinic hours, lack of provider recommendation, poor transportation, difficulty finding a provider, fear of pain, and low perceived need. Participants suggested interventions including reducing cost, improving convenience through community-based screening or extended clinic hours, strengthening provider recommendations, and providing one-on-one counseling and education outreach. HPV self-collection was most frequently selected as the “most helpful” of 3 proposed interventions (n = 11), followed by reducing out-of-pocket costs (n = 7) and one-on-one education (n = 5). Conclusion Cost was the most reported barrier to cervical cancer screening, although women experience multiple simultaneous barriers. Novel interventions such as HPV self-collection promise to reduce some, but not all, barriers to primary screening. Interventions that work on reducing multiple barriers, including obstacles to receiving follow-up care, may be most effective to prevent cervical cancer among these high-risk women

Data sharing: not as simple as it seems

In recent years there has been a major change on the part of funders, particularly in North America, so that data sharing is now considered to be the norm rather than the exception. We believe that data sharing is a good idea. However, we also believe that it is inappropriate to prescribe exactly when or how researchers should preserve and share data, since these issues are highly specific to each study, the nature of the data collected, who is requesting it, and what they intend to do with it. The level of ethical concern will vary according to the nature of the information, and the way in which it is collected - analyses of anonymised hospital admission records may carry a quite different ethical burden than analyses of potentially identifiable health information collected directly from the study participants. It is striking that most discussions about data sharing focus almost exclusively on issues of ownership (by the researchers or the funders) and efficiency (on the part of the funders). There is usually little discussion of the ethical issues involved in data sharing, and its implications for the study participants. Obtaining prior informed consent from the participants does not solve this problem, unless the informed consent process makes it completely clear what is being proposed, in which case most study participants would not agree. Thus, the undoubted benefits of data sharing does not remove the obligations and responsibilities that the original investigators hold for the people they invited to participate in the study

Applications of urinary extracellular vesicles in the diagnosis and active surveillance of prostate cancer

Prostate cancer is the most common non-cutaneous cancer among men in the UK, causing significant health and economic burdens. Diagnosis and risk prognostication can be challenging due to the genetic and clinical heterogeneity of prostate cancer as well as uncertainties in our knowledge of the underlying biology and natural history of disease development. Urinary extracellular vesicles (EVs) are microscopic, lipid bilayer defined particles released by cells that carry a variety of molecular cargoes including nucleic acids, proteins and other molecules. Urine is a plentiful source of prostate-derived EVs. In this narrative review, we summarise the evidence on the function of urinary EVs and their applications in the evolving field of prostate cancer diagnostics and active surveillance. EVs are implicated in the development of all hallmarks of prostate cancer, and this knowledge has been applied to the development of multiple diagnostic tests, which are largely based on RNA and miRNA. Common gene probes included in multi-probe tests include PCA3 and ERG, and the miRNAs miR-21 and miR-141. The next decade will likely bring further improvements in the diagnostic accuracy of biomarkers as well as insights into molecular biological mechanisms of action that can be translated into opportunities in precision uro-oncology

Afoxolaner as a Treatment for a Novel Sarcoptes scabiei Infestation in a Juvenile Potbelly Pig

A 2 months old female Vietnamese potbellied pig presented to a veterinary teaching hospital with a referring complaint of pruritus. A human caretaker of the pig had recently been diagnosed with a Sarcoptes spp. dermatitis. Microscopic examination of the skin scrape samples and BLAST analysis confirmed the species of the mite as most closely related to Sarcoptes scabiei var. canis (AY493391). The pig was treated with afoxolaner as previous treatment with ivermectin was not efficacious. Recheck examinations and follow up revealed the pig to be non-pruritic and resolving. Afoxolaner may be a therapeutic option when treating Sarcoptes spp. infections in companion pigs