Barriers and Facilitators to Stool-Based Screening for Colorectal Cancer Among Black Louisville Residents.

Knowledge of colorectal cancer (CRC) screening options remains suboptimal in Black populations, contributing to screening disparities. Guided by community-based participatory research (CBPR) principles, we partnered with five Black churches in Louisville, a region of Kentucky with high Black-white CRC screening disparities, to explore screening barriers and facilitators for CRC education and outreach. Project champions (n = 5) served as primary points of contact, developed project support within their churches, and were trained to recruit church and community members (n = 39) to participate in five semi-structured focus groups. Interview questions probed actual and perceived barriers to CRC screening, focusing on knowledge and perceptions of stool-based tests. Subsequent questions explored perceptions of different screening tests, CRC knowledge and beliefs, and trusted community locations for screening outreach. Transcripts were analyzed iteratively, and codes were derived inductively and refined to develop overarching themes. Participants experienced multilevel barriers to completing CRC screening. Primary themes about CRC screening included acknowledgment of importance, positive and negative personal experiences, need for increased outreach, and desire for greater cultural representation in educational materials. Participants frequently discussed perceptions of inadequate medical care, with most having only ever been offered colonoscopy; subsequently, knowledge of stool-based tests was low. To address this knowledge gap, participants stressed interpersonal communication from trusted individuals, such as local Black medical providers and CRC survivors. Given the low knowledge of stool-based testing among participants and identified inequities in receipt of clinical care, community-based CRC screening interventions are warranted to reduce Black-white CRC screening disparities.

Effects of litter from antimicrobial-fed broiler chickens on soil bacterial community structure and diversity.

This study examined changes in soil bacterial community composition and diversity in response to fertilization with litter from chickens fed a diet without antibiotics and with bambermycin, penicillin, bacitracin, salinomycin, or mix of salinomycin and bacitracin. Litter (27.5 T/ha) was applied to 24 agricultural plots in the Fraser Valley of British Columbia. Nonfertilized plots were used as a negative control. Soil samples collected from the studied plots were used to quantify Escherichia coli by plate counts, and Clostridium perfringens by qPCR. The 16S rRNA gene sequencing was performed for microbiota analysis. Following litter application in December, the population size of E. coli was 5.4 log CFU/g; however, regardless of treatments, the results revealed 5.2 and 1.4 log CFU/g of E. coli in soil sampled in January and March, respectively. Fertilization with litter from antibiotic-treated birds increased (P < 0.05) the relative abundance of Proteobacteria, Actinobacteria, and Firmicutes in soil, but decreased Acidobacteria and Verrucomicrobia groups. The alpha diversity parameters were higher (P < 0.05) in nonfertilized soil compared to the fertilized ones, suggesting that litter application was a major factor in shaping the soil bacterial communities. These results may help develop efficient litter management strategies like composting, autoclaving, or anaerobic digestion of poultry litter before application to land for preservation of soil health and crop productivity.

Cancer diagnosis in Scottish primary care: Results from the National Cancer Diagnosis Audit.

OBJECTIVE: To characterize cancer diagnosis in Scottish primary care and draw comparisons with cancer diagnostic activity in England. METHOD: A national audit of cancer diagnosis was conducted in Scottish and English general practices. Participating GPs collected diagnostic pathway data on patients diagnosed in 2014 from medical records. Data were supplemented by linkage to national cancer registries. Analysis explored and compared patient characteristics, diagnostic intervals, and routes to diagnosis. RESULTS: 7.7% of all Scottish general practices in 2017 provided data on 2,014 cancer diagnoses. 71.5% of cases presented to GPs and 37.4% were referred using the "Urgent-Suspected Cancer" route. The median primary care interval was 5 days (IQR 0-23 days) and median diagnostic interval was 30 days (IQR 13-68). Both varied by cancer-site. Diagnostic intervals were longer in the most remote patients and those with more comorbidities. Scottish and English samples corresponded closely in key characteristics. CONCLUSIONS: Most people diagnosed with cancer in Scotland present to a GP first. Most are referred and diagnosed quickly, with variations by cancer-site. Intervals were longest for the most remote patients. GPs in Scotland and England appear to perform equally but, in view of growing differences between health systems, future comparative audits may be informative.

Promoting excellence using a novel educational tool in the North of Scotland.

The General Medical Council (GMC) sets the standards and requirements for the delivery of all stages of medical education and training in the United Kingdom (UK). Using a novel educational tool (the 'Digital Carousel'), we set out to determine to what extent current systems and process sit alongside standards as set out in GMC document 'Promoting excellence' and establish key foci of work going forward to promote excellence in the Caledonian-Rural track (CRT) General Practice Specialty Training (GPST) educational programmes by engaging key stakeholders in the process. The 'Digital Carousel' allowed a large group of participants (including the Deanery team, GPSTs and ESs) to efficiently collaborate views on how our current GP training programme reflects guidance in 'Promoting excellence' and on areas for development. There was a sense of 'working together' in identifying key priorities of work for 'our' GP training programme. The tool may have value in a variety of medical educational settings.

Modelling intertidal sediment transport for nutrient change and climate change scenarios.

A model of intertidal sediment transport, including effects of bioturbation and biostabilisation, was applied to two transects on the east coast of England: Leverton (within the Wash) and Skeffling (in the Humber Estuary). The physical and biological parameters were chosen to represent four 1-year scenarios: a baseline year (1995), the same year but with estuarine nitrate inputs reduced by 50% and by 16%, and a year with climate change effects estimated for 2050. The changes in nitrate supply can potentially change microphytobenthos numbers within the surface sediment, which will then affect erodibility. The model results show a range of behaviour determined by bathymetry, external forcing and biotic state. When intertidal sediment transport is dominated by external sediment supply, the model produces highest deposition at the most offshore point, and there is greatest deposition in the winter and spring, when offshore sediment concentrations are highest. When intertidal processes dominate intertidal sediment transport, there is a peak of deposition at the high-shore level and erosion at mid-tide levels. The greatest deposition now occurs in winter and summer, when low chlorophyll levels mean that the sediment is most erodible. The Skeffling transect was dominated by intertidal processes for the baseline scenario and with a 16% reduction in nitrate. Under the climate change (warm winter) scenario, the Skeffling transect was dominated by external sediment supply. The scenario with 50% reduction in nitrate gave intermediate behaviour at Skeffling (intertidally driven during the winter and summer, and governed by offshore sediment supply during spring and autumn). The Leverton transect was dominated by offshore sediment supply for all the scenarios.