Tuesday, June 07, 2022

Brain scans remarkably good at predicting political ideology

Study provides evidence of biological roots of partisan views

Peer-Reviewed Publication

OHIO STATE UNIVERSITY


Brain scans of people taken while they performed various tasks – and even did nothing – accurately predicted whether they were politically conservative or liberal, according to the largest study of its kind.

Researchers found that the “signatures” in the brain revealed by the scans were as accurate at predicting political ideology as the strongest predictor generally used in political science research, which is the ideology of a person’s parents.

“Can we understand political behavior by looking solely at the brain? The answer is a fairly resounding ‘yes,’” said study co-author Skyler Cranmer, the Phillips and Henry Professor of Political Science at The Ohio State University.

“The results suggest that the biological and neurological roots of political behavior run much deeper than we previously thought.”

The study, published recently in the journal PNAS Nexus, is the largest to date to use functional magnetic resonance imaging (fMRI) scans of the brain to study political ideology.

It is also one of the few to examine functional connectivity in connection to ideology – a whole-brain approach that examined which parts of the brain showed similar patterns of activity at the same time when performing specific tasks, indicating that they are communicating with each other.

The researchers used state-of-the-art artificial intelligence techniques and the resources of the Ohio Supercomputer Center to analyze the scans. They found correlations between the scan results and the participants’ reports of their ideology on a six-point scale from “very liberal” to “very conservative.”

Data came from the Ohio State University Wellbeing project, which involved 174 healthy adults who performed standard tasks often used in scientific experiments while in an fMRI scanner.

“None of the eight tasks was designed to elicit partisan responses,” said study co-author Seo Eun Yang, now an assistant professor of political science at Northeastern University, who did the work as a doctoral student at Ohio State.

“But we found the scans from all eight tasks were related to whether they identified as liberals or conservatives.”

In fact, even when participants were asked to sit quietly and think of nothing in particular, the resulting scans showed a relationship to political ideology, said co-author James Wilson, assistant professor of psychiatry and biostatistics at the University of Pittsburgh School of Medicine.

“Even without any stimulus at all, functional connectivity in the brain can help us predict a person’s political orientation,” Wilson said.

While the scans from all eight tasks were predictive of the participants’ ideology, three tasks had particularly strong links.

One was an empathy task, where participants are shown photos of emotional people with neutral, happy, sad and fearful faces. The second task examined episodic memory, and the third was a reward task where participants could win or lose money based on how quickly they pushed a button.

Only the scans of the reward task could predict political extremism – those who said they were very conservative or very liberal.  And only the empathy (emotional faces) task was significantly associated with moderate ideology.

“More work needs to be done to understand the relationship of reward decision-making with extreme political views,” Wilson said.

“The results with the empathy task suggest that political thought may be closely tied to emotion and emotional response.”

While this study did find a link between the brain signatures and political ideology, it can’t explain what causes what, Cranmer said.

“What we don’t know is whether that brain signature is there because of the ideology that people choose or whether people’s ideology is caused by the signatures we found,” he said.

“It also could be a combination of both, but our study does not have the data to address this question.”

The fact that the brain scans did as well at predicting ideology as the standard of parental ideology was impressive in itself, the researchers said.  But when the brain results were combined with demographic and socioeconomic indicators, such as age, gender, income and education, the resulting model did even better at predicting ideology than parental ideology.

“Functional connectivity and all survey-based responses provided the strongest predictive capabilities of any model we considered,” Yang said.

Cranmer noted how this study was different from others that have also used brain scans to examine ideology.

“We looked at the brain as a complex system of regions interacting with each other to produce these behaviors. Most other studies have looked at one region of the brain in isolation to see how it was activated or not activated when they were subjected to political stimuli,” he said.

This study showed that activations of specific regions of the brain – the amygdala, inferior frontal gyrus and the hippocampus – were most strongly associated with political affiliation.

Study co-author Zhong-Lin Lu, now at New York University, ran the Ohio State Wellbeing project while director of the university’s Center for Cognitive and Behavioral Brain Imaging.

The research was funded by the National Science Foundation and the National Institutes of Health.

A new framework for web scraping data to ensure its validity for use in marketing studies

News from the Journal of Marketing

Peer-Reviewed Publication

AMERICAN MARKETING ASSOCIATION

Researchers from Erasmus University Rotterdam, Tilburg University, INSEAD, and Oxford University published a new paper in the Journal of Marketing that proposes a methodological framework focused on enhancing the validity of web data.

The study, forthcoming in the Journal of Marketing, is titled “Fields of Gold: Scraping Web Data for Marketing Insights” and is authored by Johannes Boegershausen, Hannes Datta, Abhishek Borah, and Andrew T. Stephen.

The recent ruling of the Ninth Circuit in HiQ Labs v. LinkedIn underscores the importance of navigating the legal challenges when using web scraping to collect data for academic research. While it may be permissible to collect information from publicly available sites, researchers still need to be cautious about how they design their extraction software. For example, collecting information from publicly available user profiles in some jurisdictions may trigger privacy concerns—and prompts researchers to anonymize their data already during the collection.

While marketing researchers increasingly employ web data, the idiosyncratic and sometimes insidious challenges in its collection have received limited attention. How can researchers ensure that the datasets generated via web scraping and APIs are valid? This research team developed a novel framework that highlights how addressing validity concerns requires the joint consideration of idiosyncratic technical and legal/ethical questions.

The authors say that “Our framework covers the broad spectrum of validity concerns that arise along the three stages of the automatic collection of web data for academic use: selecting data sources, designing the data collection, and extracting the data. In discussing the methodological framework, we offer a stylized marketing example for illustration. We also provide recommendations for addressing challenges researchers encounter during the collection of web data via web scraping and APIs.”

The article further provides a systematic review of more than 300 articles using web data published in the top five marketing journals. Using this review, the researchers explain how web data has advanced marketing thought. Understanding the richness and versatility of web data is invaluable for scholars curious about integrating it into their research programs.

Interested researchers can access the database developed for this review on the companion website at https://web-scraping.org/. This website also features additional useful resources and tutorials for collecting web data via web scraping and APIs.

The researchers add, “We use our methodological framework and typology to unearth new and underexploited ‘fields of gold’ associated with web data. We seek to demystify the use of web scraping and APIs and thereby facilitate broader adoption of web data across the marketing discipline. Our Future Research section highlights novel and creative avenues of using web data that include exploring underutilized sources, creating rich multi-source datasets, and fully exploiting the potential of APIs beyond data extraction.”

Full article and author contact information available at: https://doi.org/10.1177/00222429221100750 

About the Journal of Marketing 

The Journal of Marketing develops and disseminates knowledge about real-world marketing questions useful to scholars, educators, managers, policy makers, consumers, and other societal stakeholders around the world. Published by the American Marketing Association since its founding in 1936, JM has played a significant role in shaping the content and boundaries of the marketing discipline. Christine Moorman (T. Austin Finch, Sr. Professor of Business Administration at the Fuqua School of Business, Duke University) serves as the current Editor in Chief.
https://www.ama.org/jm

About the American Marketing Association (AMA) 

As the largest chapter-based marketing association in the world, the AMA is trusted by marketing and sales professionals to help them discover what is coming next in the industry. The AMA has a community of local chapters in more than 70 cities and 350 college campuses throughout North America. The AMA is home to award-winning content, PCM® professional certification, premiere academic journals, and industry-leading training events and conferences.
https://www.ama.org

A ‘Goldilocks amount’ of time spent online could be good for teenagers’ wellbeing

Poor mental wellbeing in adolescents associated with low as well as high levels of digital engagement in study of 6,000 young people

Peer-Reviewed Publication

TRINITY COLLEGE DUBLIN

New research from the Department of Sociology in Trinity College Dublin has found further evidence of a relationship between online engagement and mental wellbeing in teenagers. The study, published recently in the journal ‘Computers in Human Behaviour’, contributes to mounting international evidence on the dangers of high levels of digital media use. 

Additionally, the researchers found that in today’s connected world low engagement with digital media is also associated with poor mental health outcomes for adolescents who spend less time online than their peers. This finding supports the ‘goldilocks’ hypothesis – that digital media use at moderate levels is not intrinsically harmful and there is a point between low and high use that is ‘just right’ for young people.  

This is the first time the ‘goldilocks’ theory has been examined in Irish teenagers/young adults. It is also the first study to attempt the integration of both time and online behaviours when examining associations between digital media and mental wellbeing.

Professor Richard Layte, Professor of Sociology and co-author on the paper, said:

“Evidence is mounting internationally that online engagement among adolescents may be damaging for mental well-being but the evidence is mixed. Our work provides fresh insights on the impact of digital engagement at the age of 17/18 and the results provide worrying evidence of real harms that require urgent action.”

“There is a simple narrative out there that more is worse. It is important to emphasise that online engagement is now a normal channel of social participation and non-use has consequences.  Our findings also raise the possibility that moderate use is important in today’s digital world and that low levels of online engagement carries its own risks. Now the questions for researchers are how much is too much and how little is too little?”

The research, drawing on longitudinal data from the Growing Up in Ireland study, looked at the association between adolescent use of online engagement and mental wellbeing in over 6,000 young people between the age of 13 and again at the age of 17/18. 

The researchers asked participants to report the time they spent on line as well as the activities they engaged in: online messaging, sharing of videos and pictures, school or college work, watching movies and listening to music. Mental wellbeing was assessed by questions investigating emotional, behavioural and peer issues.  

The study characterised young person’s online behaviour based on length of time spent online as well as the types of online behaviours engaged in. Adjusting for prior psychiatric disorders and symptoms at the age of 9 and 13, the study found that high engagement in digital media strongly predicted worse mental health outcomes for both boys and girls. Furthermore, low use of digital media was associated with worse mental health for both boys and girls and was also predictive of peer problems for girls.  

Dr Ross Brannigan, lead author of the study and a former postdoctoral researcher in Trinity’s Department of Sociology, said:

“This study is novel in that it considers the importance of both time and online behaviours when examining associations between digital media and mental wellbeing. We found clear distinctions between groups spending similar time online, but differing in their behaviours online. This indicates the importance of considering both time and behaviours online as well as the quality of these behaviours, for example passive compared to active behaviours, or the types of behaviours such as social, educational, entertainment.”

“Digital media and online usage is a controversial topic when it comes to its effect on mental health, with no real consistency of results overall. While these results are not causal or deterministic, our findings are an important first step on the path to revealing why these relationships exist. It will now be importance to build on these findings and further investigate WHY digital media engagement may be related to mental wellbeing.”

This study is part of the TeenPath Project, a collaborative project between the Department of Sociology in Trinity College Dublin and the Department of Public Health and Epidemiology in The School of Population Health, Royal College of Surgeons in Ireland. 

The paper “Digital engagement and its association with adverse psychiatric symptoms: A longitudinal cohort study utilizing latent class analysis” is available to read here.  

The space between us

Peer-Reviewed Publication

WASHINGTON UNIVERSITY IN ST. LOUIS

Student researcher 

IMAGE: A STUDY FROM THE MISSOURI OZARKS HIGHLIGHTS THE IMPORTANCE OF SPATIAL ASPECTS OF BIODIVERSITY FOR HEALTHY FUNCTIONING OF NATURALLY OCCURRING FORESTS. JACQUELINE REU, FIRST AUTHOR OF THE STUDY IN THE JOURNAL ECOLOGY, GRADUATED FROM WASHINGTON UNIVERSITY IN 2019 WITH A DOUBLE MAJOR IN ENVIRONMENTAL BIOLOGY AND IN PHYSICS IN ARTS & SCIENCES. view more 

CREDIT: JONATHAN MYERS, WASHINGTON UNIVERSITY IN ST. LOUIS

A study from the Missouri Ozarks highlights the importance of spatial aspects of biodiversity for healthy functioning of naturally occurring forests.

Biologists from Washington University in St. Louis determined that tree beta diversity — a measure of site-to-site variation in the composition of species present within a given area — matters more for ecosystem functioning than other components of biodiversity at larger scales. The research also shows that the relationship between beta diversity and tree biomass strengthens with increasing spatial scale (the size of an area), a finding that has implications for conservation planning. The study was published in the journal Ecology.

The study was led by Jacqueline Reu, who graduated from Washington University in 2019 with a double major in environmental biology and in physics in Arts & Sciences, as part of her honors thesis in biology. Reu was mentored by Christopher P. Catano, a PhD graduate of Washington University who is now a postdoctoral research associate at Michigan State University, and Jonathan A. Myers, associate professor of biology in Arts & Sciences at Washington University.

The data for Reu’s thesis was collected as part of a large-scale forest ecology project led by Myers’ research team at Tyson Research Center, Washington University’s environmental field station. More than 60 undergraduate students, high school students and research technicians have surveyed more than 30,000 trees for the project.

“A lot of studies have focused only on small scales when they look at biodiversity and ecosystem functioning,” said Reu, first author of the study. “Our study is one of the first that looks at multiple different measures of biodiversity, as well as direct and indirect effects of the environment, on ecosystem functioning as you increase scale in a natural system.”

“Our results back the theory that beta diversity, or the variation in species composition across space, is the best biodiversity measure at larger scales,” she said. “It’s stronger than the other diversity measures that we considered, like local and regional diversity. And its importance increases as you increase spatial scale.”

Studying landscapes in the Ozarks

For this study, researchers identified 14 landscapes of oak-hickory forest, each of which contained at least three major habitat types that are often found in Ozarks forests, including west- or south-facing slopes that tend to be sunnier, drier and nutrient poor; valleys and bottom lands, which are often shady, nutrient-rich and have small streams running through them; and east- and north-facing slopes, which tend to be the most productive in terms of tree cover.

Each landscape included an environmental gradient of nutrient and moisture availability, light availability and a variety of topographic conditions.

Washington University’s Tyson Research Center, located 20 miles southwest of the Danforth Campus, provides rich, collaborative field opportunities for both scientists and students. (Photo: Thomas Malkowicz/Washington University)

The scientists quantified the direct effects of three different diversity components — beta diversity, local diversity (the average number of species present in a small area) and regional diversity (the total number of species in the larger landscape) — and then calculated the strength of the relationship between each diversity component and the aboveground tree biomass, a property of forests related to ecosystem functioning.

Finally, they considered the strength of these relationships across 11 spatial scales within each of the landscapes, ranging from 20×20m to 120×120m. (For comparison, that’s a difference in size ranging from about the size of an end zone in American football to about 2.6 football fields.)

“It’s been a thorny thing in ecology — and most sciences, really — to try to identify the scale that we should use to study a system,” said Catano, who co-led the new study. “It leads to a lot of controversy and a lot of confusion.”

Other studies have drawn similar connections between beta diversity and ecosystem functioning, but those previous studies tended to rely on comparisons drawn on small plots of land.

Understanding how and why the relationship between beta diversity and ecosystem functioning scales up is a high-stakes analysis, in part because scientists are struggling to map out the myriad consequences of biodiversity loss in recent decades.

“It’s not just the gain or the loss and the number of species that matters, it’s also changes in the distribution of these species and where you might find them in an ecosystem,” Catano said. “This study and a few others recently have been pretty consistent, in the sense that they’re showing it’s (species) turnover, or variation across space, that seems to be really critical.

“(Beta diversity) is driving a variety of different functions, as well as the stability of these functions over time, as you scale up from small, local plot-based ecosystems to large, heterogeneous landscapes,” he said.

“This project highlights the utility of large-scale, long-term field research projects,” Myers said. “The study was largely fortuitous, because we had set up the 14 large forest plots across the Tyson landscape for a different project. But the way that we set them up was perfect for addressing questions about how environmental variation and species composition across space contribute to ecosystem functioning.

“One implication is that if you homogenize the environmental conditions, that might also negatively impact ecosystem functioning,” Myers said. “Habitat loss or homogenizing the amount of nutrients and other limiting resources for organisms in an ecosystem could have cascading effects on ecosystem functioning and services. These are indirect effects that are challenging to predict if you don’t consider both environment and diversity together.”

Montioring ecosystem functioning

Since graduating from Washington University, the study’s first author, Reu, has worked as an intern at the Smithsonian Marine Station at Fort Pierce, Fla., and at the Smithsonian Environmental Research Center’s Marine Invasions Lab in Tiburon, Calif. But she continues to be motivated by her work at Tyson Research Center.

“Forests are my favorite ecosystem to be in,” Reu said. “Without plants, nothing else in the food chain would work at all: it wouldn’t exist. And that’s why I find studying them especially fascinating.”

During the hot, humid days of her undergraduate summers, Reu tramped through the forest with a small squad of other Tyson research fellows — identifying trees, measuring their diameters and tagging and mapping them as part of a long-term forest monitoring program. Reu identified seeds collected from seed traps and cleaned, weighed and cataloged seedlings. At night, she taught herself a statistical programming language to help sort through the data she was recording.

“I’ve always liked the math side of things,” Reu said. “For this project, I mostly taught myself to program in R, using YouTube videos.

“It wasn’t the first computer language I’ve learned, but I think it’s the most thorough one I’ve learned so far,” she said. “Then I made some graphics using GIS as well.”

This coming summer, Reu will be doing a project with rare butterflies in New Hampshire while she prepares to apply for graduate school.

“I’ve always had a passion for ecology,” Reu said. “So when I was just looking at different options, Jonathan’s lab really stood out to me. He’s so inventive and they do really thorough work.

“And I love trees, so that definitely helped,” she said. “The work at Tyson was very interesting, partly because it’s part of the Smithsonian Forest Global Earth Observatory (ForestGEO) network. That just opens a lot of doors.”


Funding: This work was supported by a grant from the National Science Foundation (DEB 1557094).

Hormone therapy remains most effective treatment for menopause symptoms of hot flashes and night sweats

NAMS video on the 20th anniversary of The Women's Health Initiative helps dispel misconceptions regarding risks of hormones

Business Announcement

THE NORTH AMERICAN MENOPAUSE SOCIETY (NAMS)

CLEVELAND, Ohio (June 1, 2022)—It has been 20 years since The Women’s Health Initiative suggested a link between hormone therapy (HT) and increased risks for breast cancer, heart disease, and stroke. Although much has been learned since 2002, many women still suffer needlessly with menopause symptoms from fear of using HT. A new video from The North American Menopause Society (NAMS) summarizes why HT remains the most effective, safest treatment for menopause symptoms.

The video, Hormone Therapy: Understanding the Risks and Benefits, is hosted by NAMS past-president Dr. Marla Shapiro and features expert insights from Dr. Juliana Kling, chair of Women’s Health, Internal Medicine at the Mayo Clinic in Scottsdale, Arizona.

“Twenty years later, women are still asking about the risks of HT,” says Dr. Kling. “Although they also remain concerned about heart disease and stroke, their top concern is breast cancer, even though more recent studies have demonstrated that the risks of hormones are low and are far outweighed by the benefits.”

According to Dr. Kling, there is overwhelming evidence that HT remains the most effective treatment for an array of menopause symptoms, especially hot flashes and night sweats, two of the most common and burdensome symptoms. Moreover, the associated risk is very low for most women without contraindications for hormones and is primarily associated with the timing of initiation of HT.

“For most women who are aged younger than 60 years or within 10 years of their last menstrual cycle when they initiate HT, the health risks are very low,” says Dr. Kling, who likened the level of risk to that of obesity or a sedentary lifestyle. “Duration of therapy influences that risk, but that doesn’t mean there is a definitive cutoff of 5 years or so for all women. In addition, any potential increased risk related to a longer duration of HT can often be offset by a healthy lifestyle that includes a balanced diet and exercise.”

The video details how the various formulations of HT affect a woman’s risk levels. Women with a uterus who need progesterone to protect against endometrial cancer, for example, may face a slightly increased risk of breast cancer, whereas women on estrogen alone have actually been found to have a lower risk of breast cancer and a lower mortality rate from breast cancer than women on placebo.

“Unfortunately, a lot of women going through the menopause transition are suffering unnecessarily because of misrepresentation of the data from 20 years ago,” says Dr. Stephanie Faubion, NAMS medical director. “It’s important that women be presented with the benefits and risks on the basis of accurate data and then make the decision that is best for their specific situation in collaboration with their healthcare professionals. For most healthy women, HT is the best option for management of disruptive menopause symptoms.”

The video is part of NAMS’ comprehensive video series for women and professionals on important midlife health topics. For more information about menopause and healthy aging, visit www.menopause.org.

Founded in 1989, The North American Menopause Society (NAMS) is North America’s leading nonprofit organization dedicated to promoting the health and quality of life of all women during midlife and beyond through an understanding of menopause and healthy aging. Its multidisciplinary membership of 2,000 leaders in the field—including clinical and basic science experts from medicine, nursing, sociology, psychology, nutrition, anthropology, epidemiology, pharmacy, and education—makes NAMS uniquely qualified to serve as the definitive resource for health professionals and the public for accurate, unbiased information about menopause and healthy aging. To learn more about NAMS, visit www.menopause.org.

Screening every five years safe for women who test negative for HPV, study confirms

Peer-Reviewed Publication

KING'S COLLEGE LONDON

A study of 1.3 million women in England has provided evidence to support the extension of cervical cancer screening intervals from three years to five years for those that have a negative screen result.

The study, published today in the British Medical Journal by researchers from King’s College London and funded by Cancer Research UK, provides reassurance to women and people with a cervix aged 24-49 years who test negative for the human papillomavirus (HPV), that screening at five-year intervals prevents as many cancers as screening at three-year intervals, even if they are not vaccinated against HPV.

The study confirms that women in this age group are much less likely to develop clinically relevant cervical lesions (high-grade cervical intraepithelial neoplasia, which are abnormal changes of the cells that line the cervix and are otherwise known as CIN3+) and cervical cancer, three years after a negative HPV screen compared to a negative smear test. This risk is more than halved.

Lead author Dr Matejka Rebolj, Senior Epidemiologist at King’s College London said: “These results are very reassuring. They build on previous research that shows that following the introduction of HPV testing for cervical screening, a 5-year interval is at least as safe as the previous 3-year interval. Changing to 5-yearly screening will mean we can prevent just as many cancers as before, while allowing for fewer screens.”

Almost all cervical cancers are caused by HPV infection. Usually, the immune system gets rid of the virus on its own, but if it doesn’t HPV can cause abnormal cells to develop in the cervix. If these abnormal cells are not treated, they can turn into cancer. This is a process that often takes 10-15 years, and sometimes even longer.

Before 2019, cytology tests, otherwise known as smear tests, checked cervical cells for abnormalities first. If found, some of the samples would then be tested for HPV. These tests were recommended every three years. In 2019, following expert scientific evidence, the NHS Cervical Screening Programme in England fully implemented primary high-risk HPV testing using cytology as a triage test, whilst keeping the same screening intervals (3 years for those aged 24-49 years). Now samples taken during cervical screening are tested for HPV first. As having HPV infection comes before having abnormal cells, HPV testing detects more women at risk of cervical cancer.

The study shows that the HPV test is more accurate than a cytology test. Researchers from King’s College London, the University of Manchester, and the NHS have analysed data the from the NHS Cervical Screening Programme in England. They followed those attending screening for two rounds, the first from 2013-2016 with a follow up by end of 2019.

Researchers found that people eligible for screening under fifty who had a negative HPV screen in the first round had a lower risk of detection of CIN3+ in the second round compared to cytology. 1.21 in 1000 people had a detection of CIN3+ after a negative HPV screen compared to 4.52 in 1000 people after a negative cytology.

Currently in the UK, where the HPV screen is negative, the NHS Cervical Screening Programme in England invites women and people with a cervix aged 25-49 years to test every three years and people aged 50-64 years to test every five years or three years if they test positive.  Scotland and Wales are the first to implement the new intervals. England has introduced HPV testing but continue to invite those eligible under fifty every three years and over fifty to test every five years. Northern Ireland currently use cytology tests but will switch to HPV primary screening in the future.

Dr Rebolj added: “This monumental study relied on a multidisciplinary team including those in the NHS Cervical Screening Programme in England, working with women undergoing screening and their samples, and our academic partners. This partnership provides evidence that will best serve the millions of women invited for screening throughout most of their adult lives. These promising results show most women and people with a cervix do not need to be screened as frequently as they are now.”

Michelle Mitchell, Cancer Research UK’s chief executive, said: “This large study shows that offering cervical screening using HPV testing effectively prevents cervical cancer, without having to be screened as often. This builds on findings from years of research showing HPV testing is more accurate at predicting who is at risk of developing cervical cancer compared to the previous way of testing. As with any change to a screening programme, this will be monitored to ensure that cervical screening is as effective as possible for all who take part.

“It’s important to remember, screening is for people without symptoms. So, if you notice any unusual changes for you, do not wait for a screening invitation - speak to your doctor.”

ENDS

NOTES TO EDITORS:

About Cervical Screening & HPV

 

High-risk Human Papillomavirus (HPV) DNA is found in over 99% of all cervical cancers. Cervical screening now primarily tests for the presence of this high-risk HPV infection, which is a common virus that most people will get at some point. HPV primary screening is a more sensitive and accurate test than the previous method (cytology alone) and is the best way to find out who is at higher risk of developing the cervical cell changes that over time could potentially lead to cervical cancer.

 

While the risk for people with high-risk HPV of getting cervical cancer is low, any abnormal changes can be identified early. If HPV is detected, the sample is then checked for any changes in the cells of the cervix. Cell changes are easily treated if caught early, so they don’t get a chance to turn into cervical cancer. 

 

For further information about cervical screening, please visit www.nhs.uk/cervicalscreening.   

About extended screening intervals

  • The National Screening Committee recommended that, following the introduction of primary HPV screening in the cervical screening programme screening invites should be changed from 3 to 5 years for 24.5 to 49 year olds for anyone that is found not to have high-risk HPV at their routine screening test.
  • The NHS in England has not changed cervical screening invites to every five years for eligible people aged 24.5 to 49 years old if their screen shows they don’t have high-risk HPV.
  • The NHS Cervical Screening Programme in England invites over 4.5m people each year. NHS Digital is working with NHS England and NHS Improvement at pace to prepare for the safe and smooth transition to a new IT system for cervical screening which would safely and effectively support any changes to the programme. This is a major piece of work which the programme is working closely with NHS Digital, to implement.

King’s College London

 

King's College London is one of the top 35 UK universities in the world and one of the top 10 in Europe (QS World University Rankings, 2020/21) and among the oldest in England. King's has more than 31,000 students (including more than 12,800 postgraduates) from some 150 countries worldwide, and some 8,500 staff.

 

King's has an outstanding reputation for world-class teaching and cutting-edge research. In the 2014 Research Excellence Framework (REF), eighty-four per cent of research at King’s was deemed ‘world-leading’ or ‘internationally excellent’ (3* and 4*).

 

Since our foundation, King’s students and staff have dedicated themselves in the service of society. King’s will continue to focus on world-leading education, research and service, and will have an increasingly proactive role to play in a more interconnected, complex world. Visit our website to find out more about Vision 2029, King's strategic vision to take the university to the 200th anniversary of its founding.

 

World-changing ideas. Life-changing impact: https://www.kcl.ac.uk/news/headlines.aspx

 

About Cancer Research UK

  • Cancer Research UK is the world’s leading cancer charity dedicated to saving lives through research, influence and information.
  • Cancer Research UK’s pioneering work into the prevention, diagnosis and treatment of cancer has helped save millions of lives.
  • Cancer Research UK has been at the heart of the progress that has already seen survival in the UK double in the last 40 years.
  • Today, 2 in 4 people survive their cancer for at least 10 years. Cancer Research UK wants to accelerate progress and see 3 in 4 people surviving their cancer by 2034.
  • Cancer Research UK supports research into the prevention and treatment of cancer through the work of over 4,000 scientists, doctors and nurses.
  • Together with its partners and supporters, Cancer Research UK is working towards a world where people can live longer, better lives, free from the fear of cancer.

For further information about Cancer Research UK's work or to find out how to support the charity, please call 0300 123 1022 or visit www.cancerresearchuk.org. Follow us on Twitter and Facebook. 

Mandating flu jab, but not COVID-19 jab, ethically justified for healthcare staff

Peer-Reviewed Publication

BMJ

Few side effects; cuts infection risks; minimises staff shortages and presenteeism

And professional obligations to patients trump curbs on personal freedom, argue ethicists

Mandating the flu jab for healthcare staff is ethically justified, but the same can’t be said of the COVID-19 jab, argue leading ethicists in an extended essay published online in the Journal of Medical Ethics.

Unlike the COVID-19 jab, the pros outweigh the cons for all age groups: the flu jab is safe and has few side effects; it cuts the risk of infection; and it minimises staff shortages and ‘presenteeism’, they suggest. 

And healthcare workers have professional obligations to protect patients from a virus that is particularly deadly for older people who are overrepresented among hospital patients. Such obligations trump curbs on personal freedom, the authors contend.

In light of the infection control issues raised by the pandemic, and the steps taken by various countries to overcome vaccine hesitancy, the authors compare the ethical criteria for mandating vaccination of healthcare staff against COVID-19 and seasonal flu.

A vaccine mandate for healthcare workers would align with existing professional requirements, based on preventing harm to patients. But not every professional obligation is also a legal requirement. 

Further ethical criteria are therefore required to justify such a policy, the authors explain. These include the pros and cons of the vaccines and the availability of less restrictive alternatives to achieve comparable health benefits.

During the pandemic, several countries mandated COVID-19 vaccination for healthcare workers: France; Italy; many US states; several Canadian provinces; and Australia.

The UK government also planned to do the same, but stopped short amid fears of staff losses and perceived heavy-handedness in light of the emergence of the milder Omicron variant.

However, it did consult on mandating the seasonal flu jab for healthcare workers, around 1 in 4 of whom don’t get vaccinated against the virus. 

Flu kills more than 11,000 people every year in England alone, a toll that rose to more than 22,000 in 2017-18.

Data from London University College hospitals during the 2018–2019 flu season suggest that 15% of inpatients with flu caught the infection while in hospital (nosocomial infection).

In some flu seasons large numbers of unvaccinated staff fall ill, prompting shortages or ‘presenteeism’---where staff with the infection keep on working—so heightening the risk of spreading it to patients and colleagues.

“Vaccine mandates are typically controversial as they entail limitations of individual liberties for the sake of the collective good,” acknowledge the authors. 

“However, when it comes to [healthcare workers], liberty-based counter-arguments are more difficult to apply. Quite simply, [healthcare workers] have an ethical and professional obligation not to harm patients, or to minimise the risk of harm to patients, which other people do not have,” they point out.

“It is already commonly accepted that [healthcare workers] should take on at least some additional health risk for the sake of their patients…The issue at stake is not if this is justified, but how much extra risk is justifiable by contractual and professional obligations,” they add.

COVID-19 vaccines are associated with a small risk of blood clots and myocarditis (inflammation of the heart muscle), and given the relatively low risk of serious illness from COVID-19 among younger staff, the cons may very well outweigh the pros, they suggest.

Nor do the current crop of COVID-19 vaccines seem very effective at preventing spread, while the protection they afford against symptoms tails off within months.

What’s more, COVID-19 illness severity has reduced, due to changes in the circulating form of the virus, high vaccine uptake in those at highest risk, high rates of natural immunity and increasingly more treatments becoming available, point out the authors.

These issues don’t apply to the seasonal flu vaccine, which has been used for decades, has a well established safety profile, and few and mostly minor side effects, they highlight.

Higher flu jab uptake minimises risk of harm to patients, not just by reducing the risk of infection, but also by reducing the risk of staff shortages due to illness. And the evidence suggests that compulsory flu jabs increase uptake more than less severe measures, say the authors.

But the question remains as to what level of coercion is ethically acceptable. “One way to strike a balance between individual freedom and patients’ interests is to make vaccination a condition of entry into the profession rather than mandating those already employed, and adopt a conditional mandate if at all possible for those already in the profession,” they write. 

“Ultimately, there is an ethical balance to be drawn between protecting patients (including their own right to not acquire serious but preventable nosocomial infections) and coercing some healthcare professionals into having a vaccine that they would prefer not to receive.”

They conclude: “For reasons that we have given above, the balance of risks and benefits suggests that an influenza vaccine mandate, but not a COVID-19 mandate, would currently be ethically proportionate.”

But they caution: “Mandates should be introduced on a disease-specific and vaccine-specific basis. The problem must be a significant one; the vaccines must be safe and effective at preventing illness and/or transmission; mandatory measures must be superior to less coercive alternatives; and the costs in loss of liberty and risk to health professionals must be proportionate in professional terms to the benefits to patients.”

 

Violent incidents at GP practices double in five years, BMJ investigation finds

Peer-Reviewed Publication

BMJ

The number of violent incidents recorded by police forces at UK general practices has almost doubled in the past five years, finds an investigation published by The BMJ today.

Worryingly these figures also show a near doubling of assaults that cause physical harm, causing some GPs and their staff to leave their jobs, reports Gareth Iacobucci.

GP leaders said the “appalling” figures highlighted how assaults, harassment, and other forms of abuse aimed at doctors and their staff had worsened during the pandemic, as services have been under increased pressure and some sections of the media have perpetuated the notion that GP services were “closed.” 

The BMJ sent freedom of information requests to the 45 police forces in the UK asking for the number of recorded crimes committed at general practices and how each crime was categorised. A total of 42 forces (93%) had sent responses by the time of publication, 32 of which (71%) were able to provide complete and comparable data for the past five years. 

In total, the 32 police forces recorded 1068 incidents of violence at health centres and GP surgeries in 2021-22, compared to 791 in 2020-21 and 586 in 2017-18. These figures include all incidents defined in the category of “violence against the person”, which include all forms of assault and harassment.

Within this number there were 182 assaults resulting in injury last year, the highest for five years and almost double the 98 recorded in 2017-18. 

And also within this number, recorded incidents of stalking and harassment at GP surgeries have almost tripled over the past five years, with 223 instances last year compared to 85 in 2017-18. This is to a large extent driven by a surge in malicious communications - which can include sending letters or emails - which increased from 25 in 2017-18 to 92 last year. 

As well as a rise in incidents of violence, public order offences such as threatening behaviour rose by 24% last year from 438 to 541 and are up 40% on five years ago (387).

Richard Van Mellaerts, a GP in Kingston Upon Thames and an executive officer for the BMA’s GP Committee, said the figures obtained by The BMJ matched the experiences of doctors on the frontline, including his own. “I regularly hear abuse directed at reception staff in my practice, we've had to call the police several times over the last year,” he said. 

Meanwhile, Richard Vautrey, a GP in Leeds and former chair of the BMA’s GP committee, said the police crime figures are only “the tip of a much, much bigger iceberg” of the incidents occurring in general practice, citing “often daily abuse that staff are having to deal with.”

Van Mellaerts noted that as well as the police and courts taking action against perpetrators of violent crimes, it was crucial to understand why the increase in abuse and violence was happening to try to tackle the problem. 

He points to possible drivers for some of the aggression, including a dramatic increase in remote consultations, and fewer GPs doing more and more, but says the rise in violent incidents and abuse aimed at GPs and staff will only exacerbate the staff shortages which are contributing to difficulties in accessing care. 

“We appreciate patients’ frustrations and upset with delays in their care, but those frustrations need to be channelled into holding governments to account in order that they invest appropriately in general practice and solve these systemic issues, not taken out on their GPs and practice staff.”

In response to The BMJ’s findings, a Department of Health and Care spokesperson said, “Deliberate violence or abuse directed at NHS staff, who continue to work tirelessly to provide care, is unacceptable – all staff, including GPs and their teams, deserve to work in a safe and secure environment.
 
“The NHS violence reduction programme aims to protect the workforce and ensure offenders are punished quickly and effectively, and the government has taken action to support this – including by passing legislation to double the maximum sentence for assaults on emergency workers, including those in the NHS.
 
“Security measures including CCTV, panic buttons and screens at reception have also been rolled out across GP surgeries.”

NHS England also recently updated its Primary Medical Care Policy and Guidance Manual for service commissioners to add a new chapter on managing inappropriate and unacceptable patient behaviours.

An NHS spokesperson said: “The NHS will not tolerate abuse or violence towards its staff and, despite the despicable actions of a minority, is grateful for the overwhelming sense of national support NHS workers have received from the wider public over the last two years as it stepped up to fight covid.