The association between hysterectomy and ovarian cancer risk: A population-based record-linkage study

Background: Recent studies have called into question the long-held belief that hysterectomy without oophorectomy protects against ovarian cancer. This population-based longitudinal record-linkage study aimed to explore this relationship, overall and by age at hysterectomy, time period, surgery type, and indication for hysterectomy. Methods: We followed the female adult Western Australian population (837 942 women) across a 27-year period using linked electoral, hospital, births, deaths, and cancer records. Surgery dates were determined from hospital records, and ovarian cancer diagnoses (n¼1640) were ascertained from cancer registry records.We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between hysterectomy and ovarian cancer incidence. Results: Hysterectomy without oophorectomy (n¼78 594) was not associated with risk of invasive ovarian cancer overall (HR ¼ 0.98, 95% CI ¼ 0.85 to 1.11) or with the most common serous subtype (HR ¼ 1.05, 95% CI ¼ 0.89 to 1.23). Estimates did not vary statistically significantly by age at procedure, time period, or surgical approach. However, among women with endometriosis (5.8%) or with fibroids (5.7%), hysterectomy was associated with substantially decreased ovarian cancer risk overall (HR ¼ 0.17, 95% CI ¼ 0.12 to 0.24, and HR ¼ 0.27, 95% CI ¼ 0.20 to 0.36, respectively) and across all subtypes. Conclusions: Our results suggest that for most women, having a hysterectomy with ovarian conservation is not likely to substantially alter their risk of developing ovarian cancer. However, our results, if confirmed, suggest that ovarian cancer risk reduction could be considered as a possible benefit of hysterectomy when making decisions about surgical management of endometriosis or fibroids

Comparing non-invasive surveying techniques for elusive, nocturnal mammals: a case study of the West European hedgehog (Erinaceus europaeus)

Monitoring changes in populations is fundamental for effective management. The West European hedgehog (Erinaceus europeaus) is of conservation concern in the UK because of recent substantial declines. Surveying hedgehogs is, however, problematic because of their nocturnal, cryptic behaviour. We compared the effectiveness of three methods (infra-red thermal camera, specialist search dog, spotlight) for detecting hedgehogs in three different habitats. Significantly more hedgehogs were detected, and at greater distance, using the camera and dog than the spotlight in amenity grassland and pasture; no hedgehogs were detected in woodland. Increasing ground cover reduced detection distances, with most detections (59.6%) associated with bare soil or mown grass; the dog was the only method that detected hedgehogs in vegetation taller than the target species’ height. The additional value of surveying with a detection dog is most likely to be realised in areas where badgers (Meles meles), an intra-guild predator, are and/or where sufficient ground cover is present; both would allow hedgehogs to forage further from refuge habitats such as hedgerows. Further consideration of the effectiveness of detection dogs for finding hedgehogs in nests, as well as developing techniques for monitoring this species in woodland, is warranted

Avenues of Opportunity: Journeys of Activities through Third Sector Organisations

This chapter discusses a social anthropological research study that considers the place of third sector organisations (TSOs) in society, particularly for those who have been in contact with the criminal justice services. The work is based on insights from journeys through Norway, and to a lesser extent the UK, captured as narratives by a TSO case worker in partnership with other research team members. The insights were drawn from interactions with those along the journey such as ex-prisoners, volunteers, charity worker, members of religious communities and so forth. What these revealed were the many and sometimes hidden universes that exist in and outside TSOs. This chapter offers deep and sometimes different perspectives, asking the reader to consider the range of opportunities TSOs can offer and sets these against concepts of self and other, place, boundary crossing and organisational learning. The work speaks to those seeking to reintegrate into society after prison, their families, significant others, professional practitioners, students, and academics, and although primarily based around Norway, the content resonates internationally

Introducing equating methodologies to compare test scores from two different self-regulation scales

Abstract Standardizing the measurement tools that researchers use to assess the effectiveness of interventions would strengthen our ability to compare results across studies. In practice, however, standardization is difficult to implement, in part, because researchers prefer to use measurement tools that focus specifically on the components of their interventions. This paper demonstrates the usefulness of item response modeling linking methodology in comparing groups of participants who were administered different scales intended to measure the same underlying constructs. The Treatment Self-Regulation Questionnaire (TSRQ) as it relates to diet improvement provided the empirical application to demonstrate how two different scales that measure the same construct can be compared. The results showed that two eight-item TSRQ scales can be linked if they have at least four items in common. As expected, varying the number of linking items did not affect the reliability of the results; however, it significantly affected the relative rating with respect to the 15-item scale. In health behavior and health education research, linking methodologies can be used to compare results across studies that use slightly different versions of a scale to measure the same construct

Inclusion of people with multiple long-term conditions in pregnancy research:patient, public and stakeholder involvement and engagement in a randomised controlled trial

Background: Both pregnant women and those with multiple long-term conditions are under-served groups in clinical research. Informing and improving research through patient and public involvement, including pregnant women with two or more long-term health conditions, is critical to increasing their inclusion in maternity research. Giant PANDA is a randomised controlled trial, evaluating the effect of a treatment initiation strategy with nifedipine versus labetalol on severe maternal hypertension and a composite outcome of fetal/neonatal death, or neonatal unit admission. We aimed to undertake a mixed methods study-within-a-project within the Giant PANDA trial to understand barriers and facilitators to participation, understand and optimise current representativeness of clinical trial delivery of those with multiple long-term conditions and co-create a checklist to support their inclusion in pregnancy research. Methods: We undertook online workshops with women with lived experience and hybrid workshops with healthcare professionals who look after women with multiple long-term conditions. A site audit of Giant PANDA sites provided insights into research delivery capacity and health system set-up, and how this influences inclusion. An extension to the Giant PANDA screening log captured data on multiple long-term conditions enabling analysis of the impact of these health conditions on women’s inclusion in the trial. We co-created a checklist of recommendations for those designing and recruiting to similar clinical trials. Results: Five key recommendations were identified including a need to (1) involve women with multiple long-term conditions as partners in maternity research and (2) minimise barriers that stop them from taking part through (3) designing and delivering research that is flexible in time and place (4) consider research as part of care for everyone, including those with multiple long-term conditions and (5) measure and report inclusion of those with two or more health conditions in maternity research. Multiple long-term conditions were not a barrier to recruitment or randomisation in the Giant PANDA trial. Conclusion: Women with multiple long-term conditions would like opportunities to find out about and participate in research which accounts for their needs. Our checklist aims to support those designing and delivering maternity research to optimise inclusion of individuals with multiple-long term conditions. Trial registration: Giant PANDA: EudraCT number: 2020-003410-12, ISRCTN: 12,792,616

Coagulation and fragmentation processes with evolving size and shape profiles : a semigroup approach

We investigate a class of bivariate coagulation-fragmentation equations. These equations describe the evolution of a system of particles that are characterised not only by a discrete size variable but also by a shape variable which can be either discrete or continuous. Existence and uniqueness of strong solutions to the associated abstract Cauchy problems are established by using the theory of substochastic semigroups of operators

Nurses\u27 Alumnae Association Bulletin, June 1964

President\u27s Message Officers and Committee Chairmen Financial Report Hospital and School of Nursing Report Student Activities Jefferson Expansion Program Resume of Alumnae Meetings Staff Nurses Private Duty Social Committee Reports Program Scholarship Bulletin Committee Report Annual Luncheon Notes Membership and Dues Units in Jefferson Expansion Program Center Annual Giving Drive 1963 Report of Ways and Means Committee Jefferson Building Fund Contributions Annual Giving Contributions 1964 Jefferson Building Fund Report Help the Building Fund Committee! Vital Statistics Class News Notice

A randomised controlled trial of blood pressure self-monitoring in the management of hypertensive pregnancy. OPTIMUM-BP:A feasibility trial

Objective: To assess the feasibility of a blood pressure self-monitoring intervention for managing pregnancy hypertension. Study design: OPTIMUM-BP was an unmasked randomised controlled trial comparing a self-monitoring of blood pressure (SMBP) intervention versus usual care for the management of pregnancy hypertension. Women with chronic (CH) or gestational hypertension (GH) from 4 UK centres were randomised (2:1) intervention to control. Self-monitoring involved daily home blood pressure (BP) measurements, with recording via study diary or telemonitoring. Clinicians were invited to use the home readings in clinical and antihypertensive titration decisions. Main outcomes: The primary outcomes were recruitment, retention, adherence and persistence with the intervention. Results: Women from four UK centres were randomised: 158/222 (71%) of those approached agreed, comprising: 86 women with chronic hypertension (55 SMBP, 31 control) and 72 with gestational hypertension (49 SMBP, 23 control) of whom outcome data were available from 154 (97%) and were included in the analysis. The median (IQR) number of days with home BP readings per week were 5.5 (3.1–6.5) for those with chronic hypertension and 6.1 (4.5–6.7) with gestational hypertension. Participants persisted with the intervention for 80% or more of their time from enrolment until delivery in 86% (43/50) and 76% (38/49) of those with chronic and gestational hypertension respectively. Recorded clinic and study BPs were similar for both groups. Conclusions: This is the first randomised investigation of BP self-monitoring for the management of pregnancy hypertension and indicates that a large RCT would be feasible.</p

Nurses\u27 Alumnae Association Bulletin, June 1965

President\u27s Page Officers and Committee Chairmen Financial Report Hospital and School of Nursing Report Student Activities Annual Report Students Activities Annual Report Student Activities Annual Report Jefferson Expansion Program Psychiatric Unit Progress of the Alumnae Association Nightingale Pledge Resume of Alumnae Meetings Nursing Service Staff Association Scholarship Program Sick and Welfare Social Committee Report Bulletin Membership- WHY JOIN? Private Duty Report Annual Giving Report - 1964 PIT Alumnae Day Notes Building Fund Report - 1965 Vital Statistics IN MEMORIAM Class News Affiliated Institutions Notice

Clinical components and associated behavioural aspects of a complex healthcare intervention : Multi-methods study of selective decontamination of the digestive tract in critical care

Copyright © 2013 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.Peer reviewedPostprin