Exploring the added value of video-stimulated recall in researching the primary care doctor-patient consultation: a process evaluation

Background Video-stimulated recall (VSR) is a method whereby researchers show research participants a video of their own behaviour to prompt and enhance their recall and interpretation after the event, e.g. in a post-consultation interview. This paper describes a process evaluation with the aim of understanding what video stimulated recall (VSR) may have added to findings, to describe participants’ responses to, and the acceptability of,VSR and to explore participants’ perceptions of behaviour change in response to being video-recorded. Methods This evaluation took place in the context of a UK study concerning the discussion of osteoarthritis in primary care consultations. Post consultation VSR interviews were conducted with 13 family physicians (general practitioners, GPs) and 17 patients. Thematic analysis of these interviews and the matched 17 consultations was undertaken, and was both inductive and deductive in approach. Results The findings demonstrate VSR appeared to add value by enabling a deeper understanding of participants’ thoughts and reactions to specific parts of consultation dialogue, by facilitating participants to express concerns and possibly speak more candidly and by eliciting a more multi-layered narrative from participants. The method was broadly acceptable to participants; however, levels of mild anxiety and/or distress were reported or observed by both doctor and patient participants and this may explain in part why some participants reported behaviour change as a result of the video. Any reported behaviour change was used to inform analysis. Conclusions This study demonstrates how VSR may enable a more critical, more specific and more in-depth response from participants to events of interest, and in doing so, generates multiple layers of narrative. This results in a method that goes beyond fact finding and description and generates more meaningful explanations of consultation events, getting straight to the core of what is salient to participants

Hidden in plain sight:migration routes of the elusive Anadyr bartailed godwit revealed by satellite tracking

Satellite and GPS tracking technology continues to reveal new migration patterns of birds which enables comparative studies of migration strategies and distributional information useful in conservation. Bar-tailed godwits in the East Asian–Australasian Flyway Limosa lapponica baueri and L. l. menzbieri are known for their long non-stop flights, however these populations are in steep decline. A third subspecies in this flyway, L. l. anadyrensis, breeds in the Anadyr River basin, Chukotka, Russia, and is morphologically distinct from menzbieri and baueri based on comparison of museum specimens collected from breeding areas. However, the non-breeding distribution, migration route and population size of anadyrensis are entirely unknown. Among 24 female bar-tailed godwits tracked in 2015–2018 from northwest Australia, the main non-breeding area for menzbieri, two birds migrated further east than the rest to breed in the Anadyr River basin, i.e. they belonged to the anadyrensis subspecies. During pre-breeding migration, all birds staged in the Yellow Sea and then flew to the breeding grounds in the eastern Russian Arctic. After breeding, these two birds migrated southwestward to stage in Russia on the Kamchatka Peninsula and on Sakhalin Island en route to the Yellow Sea. This contrasts with the other 22 tracked godwits that followed the previously described route of menzbieri, i.e. they all migrated northwards to stage in the New Siberian Islands before turning south towards the Yellow Sea, and onwards to northwest Australia. Since the Kamchatka Peninsula was not used by any of the tracked menzbieri birds, the 4500 godwits counted in the Khairusova–Belogolovaya estuary in western Kamchatka may well be anadyrensis. Comparing migration patterns across the three bar-tailed godwits subspecies, the migration strategy of anadyrensis lies between that of menzbieri and baueri. Future investigations combining migration tracks with genomic data could reveal how differences in migration routines are evolved and maintained

What influences patients with osteoarthritis to consult their GP about their symptoms? A narrative review

Osteoarthritis (OA) is a common cause of disability and consultation with a GP. However research suggests the majority of sufferers choose not to consult their GP regarding their symptoms. Understanding the reasons for consulting is central to optimising patient outcomes. This review aims to summarise existing literature to identify what influences patients with OA to consult their GP

Poincar\'e Husimi representation of eigenstates in quantum billiards

For the representation of eigenstates on a Poincar\'e section at the boundary of a billiard different variants have been proposed. We compare these Poincar\'e Husimi functions, discuss their properties and based on this select one particularly suited definition. For the mean behaviour of these Poincar\'e Husimi functions an asymptotic expression is derived, including a uniform approximation. We establish the relation between the Poincar\'e Husimi functions and the Husimi function in phase space from which a direct physical interpretation follows. Using this, a quantum ergodicity theorem for the Poincar\'e Husimi functions in the case of ergodic systems is shown.Comment: 17 pages, 5 figures. Figs. 1,2,5 are included in low resolution only. For a version with better resolution see http://www.physik.tu-dresden.de/~baecker

Estimating the burden of minor ailment consultations in general practices and emergency departments through retrospective review of routine data in North East Scotland

Minor ailment attendances in general practices and emergency departments (EDs) place significant burden on health care resources

Towards an ecosystem model of infectious disease

Increasingly intimate associations between human society and the natural environment are driving the emergence of novel pathogens, with devastating consequences for humans and animals alike. Prior to emergence, these pathogens exist within complex ecological systems that are characterized by trophic interactions between parasites, their hosts and the environment. Predicting how disturbance to these ecological systems places people and animals at risk from emerging pathogens-and the best ways to manage this-remains a significant challenge. Predictive systems ecology models are powerful tools for the reconstruction of ecosystem function but have yet to be considered for modelling infectious disease. Part of this stems from a mistaken tendency to forget about the role that pathogens play in structuring the abundance and interactions of the free-living species favoured by systems ecologists. Here, we explore how developing and applying these more complete systems ecology models at a landscape scale would greatly enhance our understanding of the reciprocal interactions between parasites, pathogens and the environment, placing zoonoses in an ecological context, while identifying key variables and simplifying assumptions that underly pathogen host switching and animal-to-human spillover risk. As well as transforming our understanding of disease ecology, this would also allow us to better direct resources in preparation for future pandemics

Publisher Correction: Towards an ecosystem model of infectious disease

Correction to: Nature Ecology & Evolution https://doi.org/10.1038/s41559-021-01454-8, published online 17 May 2021

Pea3 Transcription Factors and Wnt1-Induced Mouse Mammary Neoplasia

The role of the PEA3 subfamily of Ets transcription factors in breast neoplasia is controversial. Although overexpression of PEA3 (E1AF/ETV4), and of the related factors ERM (ETV5) and ER81 (ETV1), have been observed in human and mouse breast tumors, PEA3 factors have also been ascribed a tumor suppressor function. Here, we utilized the MMTV/Wnt1 mouse strain to further interrogate the role of PEA3 transcription factors in mammary tumorigenesis based on our previous observation that Pea3 is highly expressed in MMTV/Wnt1 mammary tumors. Pea3 expression in mouse mammary tissues was visualized using a Pea3NLSlacZ reporter strain. In normal mammary glands, Pea3 expression is predominantly confined to myoepithelial cells. Wnt1 transgene expression induced marked amplification of this cell compartment in nontumorous mammary glands, accompanied by an apparent increase in Pea3 expression. The pattern of Pea3 expression in MMTV/Wnt1 mammary glands recapitulated the cellular profile of activated β-catenin/TCF signaling, which was visualized using both β-catenin immunohistochemistry and the β-catenin/TCF-responsive reporter Axin2NLSlacZ. To test the requirement for PEA3 factors in Wnt1-induced tumorigenesis, we employed a mammary-targeted dominant negative PEA3 transgene, ΔNPEA3En. Expression of ΔNPEA3En delayed early-onset tumor formation in MMTV/Wnt1 virgin females (P = 0.03), suggesting a requirement for PEA3 factor function for Wnt1-driven tumor formation. Consistent with this observation, expression of the ΔNPEA3En transgene was profoundly reduced in mammary tumors compared to nontumorous mammary glands from bigenic MMTV/Wnt1, MMTV/ΔNPEA3En mice (P = 0.01). Our data provide the first description of Wnt1-mediated expansion of the Pea3-expressing myoepithelial compartment in nontumorous mammary glands. Consistent with this observation, mammary myoepithelium was selectively responsive to Wnt1. Together these data suggest the MMTV/Wnt1 strain as a potential model of basal breast cancer. Furthermore, this study provides evidence for a protumorigenic role of PEA3 factors in breast neoplasia, and supports targeting the PEA3 transcription factor family in breast cancer

Trends in beverage prices following the introduction of a tax on sugar-sweetened beverages in Barbados.

A 10% excise tax on sugar sweetened beverages (SSBs) was implemented in Barbados in September 2015. A national evaluation has been established to assess the impact of the tax. We present a descriptive analysis of initial price changes following implementation of the SSB tax using price data provided by a major supermarket chain in Barbados over the period 2014-2016. We summarize trends in price changes for SSBs and non-SSBs before and after the tax using year-on-year mean price per liter. We find that prior to the tax, the year-on-year growth of SSB and non-SSB prices was very similar (approximately 1%). During the quarter in which the tax was implemented, the trends diverged, with SSB price growth increasing to 3% and that of non-SSBs decreasing slightly. The growth of SSB prices outpaced non-SSBs prices in each quarter thereafter, reaching 5.9% compared to <1% for non-SSBs. Future analyses will assess the trends in prices of SSBs and non-SSBs over a longer period and will integrate price data from additional sources to assess heterogeneity of post-tax price changes. A continued examination of the impact of the SSB tax in Barbados will expand the evidence base available to policymakers worldwide in considering SSB taxes as a lever for reducing the consumption of added sugar at the population level.Financial support for the analyses presented in this paper was from the US Center for Disease Control and Prevention (TEPHINET). The full evaluation is receiving support from the Canadian International Development Research Centre (grant no. 107604-001), the Pan American Health Organization. MA is funded through a Gates Cambridge PhD Scholarship. JA is funded by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged