Societal beliefs about pain may be more balanced than previously thought. Results of the Guernsey pain survey.

BACKGROUND: Musculoskeletal pain is multidimensional and associated with significant societal impact. Persistent or chronic pain is a public health priority. A step towards high-value care is a contemporary understanding of pain. While pain-related knowledge has been examined in specific conditions (e.g. neck pain) knowledge of the public's broader understanding regarding musculoskeletal pain per se, warrants investigation. This study examined the public's knowledge and beliefs regarding musculoskeletal pain and pain management. METHODS: This observational cohort study was conducted in Guernsey (January 2019-February 2020). Participants (n = 1656; 76.0% female) completed an online questionnaire capturing: demographics, pain experience, work absenteeism, understanding of pain and pain management, multidimensional influences, physical activity, pain catastrophising and healthcare decision-making. Statements were deemed true/false/equivocal and mapped to biopsychosocial/biomedical/neutral perspectives based upon contemporary literature. Descriptive statistics were analysed for each statement. Participants' responses were examined for alignment to a contemporary viewpoint and themes within responses derived using a semi-quantitative approach modelled on direct content analysis. Comparisons between participants with/without pain were examined (χ2-squared/Wilcoxon Rank Sum test). RESULTS: Within the cohort 83.6% reported currently experiencing pain. The overarching theme was perspectives that reflected both biomedical and contemporary, multidimensional understandings of pain. Sub-themes included uncertainty about pain persistence and evidence-based means to reduce recurrence, and reliance upon healthcare professionals for guiding decision-making. Compared to those with pain, those without had a greater belief that psychological interventions may help and lower pain catastrophising. CONCLUSIONS: Participants' understanding of pain demonstrated both biomedical and multidimensional pain understanding consistent with elements of a contemporary understanding of pain.

Marker selection and genomic prediction of economically important traits using imputed high-density genotypes for 5 breeds of dairy cattle.

Marker sets used in US dairy genomic predictions were previously expanded by including high-density (HD) or sequence markers with the largest effects for Holstein breed only. Other non-Holstein breeds lacked enough HD genotyped animals to be used as a reference population at that time, and thus were not included in the genomic prediction. Recently, numbers of non-Holstein breeds genotyped using HD panels reached an acceptable level for imputation and marker selection, allowing HD genomic prediction and HD marker selection for Holstein plus 4 other breeds. Genotypes for 351,461 Holsteins, 347,570 Jerseys, 42,346 Brown Swiss, 9,364 Ayrshires (including Red dairy cattle), and 4,599 Guernseys were imputed to the HD marker list that included 643,059 SNP. The separate HD reference populations included Illumina BovineHD (San Diego, CA) genotypes for 4,012 Holsteins, 407 Jerseys, 181 Brown Swiss, 527 Ayrshires, and 147 Guernseys. The 643,059 variants included the HD SNP and all 79,254 (80K) genetic markers and QTL used in routine national genomic evaluations. Before imputation, approximately 91 to 97% of genotypes were unknown for each breed; after imputation, 1.1% of Holstein, 3.2% of Jersey, 6.7% of Brown Swiss, 4.8% of Ayrshire, and 4.2% of Guernsey alleles remained unknown due to lower density haplotypes that had no matching HD haplotype. The higher remaining missing rates in non-Holstein breeds are mainly due to fewer HD genotyped animals in the imputation reference populations. Allele effects for up to 39 traits were estimated separately within each breed using phenotypic reference populations that included up to 6,157 Jersey males and 110,130 Jersey females. Correlations of HD with 80K genomic predictions for young animals averaged 0.986, 0.989, 0.985, 0.992, and 0.978 for Jersey, Ayrshire, Brown Swiss, Guernsey, and Holstein breeds, respectively. Correlations were highest for yield traits (about 0.991) and lowest for foot angle and rear legs-side view (0.981and 0.982, respectively). Some HD effects were more than twice as large as the largest 80K SNP effect, and HD markers had larger effects than nearby 80K markers for many breed-trait combinations. Previous studies selected and included markers with large effects for Holstein traits; the newly selected HD markers should also improve non-Holstein and crossbred genomic predictions and were added to official US genomic predictions in April 2020.

Development of the Guernsey community participation and leisure assessment-Revised (GCPLA-R).

A sufficiently psychometrically robust measure of community and leisure participation of adults with intellectual disabilities was not in existence, despite research identifying this as an important outcome and a key contributor to quality of life. The current study aimed to update the Guernsey Community Participation and Leisure Assessment (GCPLA). Adults with intellectual disabilities, carers and experts were consulted in creating a revised pool of 46 items. These were then tested and data from 326 adults with intellectual disabilities were analysed for their component structure and psychometric properties. Principal component analysis discovered a stable set of components describing seven different clusters. This revised measure (the GCPLA-R) was demonstrated to have satisfactory reliability, and scores were related to challenging behaviour and adaptive behaviour in theoretically consistent ways and were correlated with scores on comparable measures.

Genomic Selection in Dairy Cattle: The USDA Experience.

Genomic selection has revolutionized dairy cattle breeding. Since 2000, assays have been developed to genotype large numbers of single-nucleotide polymorphisms (SNPs) at relatively low cost. The first commercial SNP genotyping chip was released with a set of 54,001 SNPs in December 2007. Over 15,000 genotypes were used to determine which SNPs should be used in genomic evaluation of US dairy cattle. Official USDA genomic evaluations were first released in January 2009 for Holsteins and Jerseys, in August 2009 for Brown Swiss, in April 2013 for Ayrshires, and in April 2016 for Guernseys. Producers have accepted genomic evaluations as accurate indications of a bull's eventual daughter-based evaluation. The integration of DNA marker technology and genomics into the traditional evaluation system has doubled the rate of genetic progress for traits of economic importance, decreased generation interval, increased selection accuracy, reduced previous costs of progeny testing, and allowed identification of recessive lethals.

Island life is calling: make the move to Guernsey.

The island of Guernsey has plenty to offer: beautiful countryside, miles of beaches and mild winters. But, like mainland UK, it finds recruiting nurses a challenge.

Genomic evaluation, breed identification, and population structure of Guernsey cattle in North America, Great Britain, and the Isle of Guernsey.

As of December 2015, 2,376 Guernsey bulls and cows had genotypes from collaboration between the United States, Canada, the United Kingdom, and the Isle of Guernsey. Of those, 439 bulls and 504 cows had traditional US evaluations, which provided sufficient data to justify investigation of the possible benefits of genomic evaluation for the Guernsey breed. Evaluation accuracy was assessed using a traditional 4-yr cutoff study. Twenty-two traits were analyzed (5 yield traits, 3 functional traits, and 14 conformation traits). Mean reliability gain over that for parent average was 16.8 percentage points across traits, which compares with 8.2, 18.5, 20.0, and 32.6 percentage points reported for Ayrshires, Brown Swiss, Jerseys, and Holsteins, respectively. Highest Guernsey reliability gains were for rump width (44.5 percentage points) and dairy form (40.5 percentage points); lowest gains were for teat length (1.9 percentage points) and rear legs (side view) (2.3 percentage points). Slight reliability losses (1.5 to 4.5 percentage points) were found for udder cleft, final score, and udder depth as well as a larger loss (13.6 percentage points) for fore udder attachment. Twenty-one single nucleotide polymorphisms were identified for Guernsey breed determination and can be used in routine genotype quality control to confirm breed and identify crossbreds. No haplotypes that affect fertility were identified from the current data set. Principal component analysis showed some divergence of US and Isle of Guernsey subpopulations. However, the overlap of US, Canadian, UK, and Isle of Guernsey subpopulations indicated the presence of gene flow, and the similarities in the subpopulations supports a common genomic evaluation system across the regions.

A total health economy approach to revalidation.

Revalidation has been a source of anxiety and uncertainty for some nurses and midwives. With a mixed health economy including private and public sector organisations, the Bailiwick of Guernsey wanted to ensure the system was implemented consistently. A programme of training was developed to help staff through the revalidation process and link the Nursing and Midwifery Council's Code of Conduct to practice. Training and support was also provided for confirmers.

Climate sensitivity and variation in first flowering of 26 Narcissus cultivars.

The first flowering dates of 26 Narcissus cultivars were recorded over a 27-year period on the island of Guernsey, within the English Channel. We analysed flowering trends over time and relationships with climate variables. The study revealed that earlier flowering cultivars advanced most and were more variable than later flowering Narcissus. We furthermore discovered a strong relationship between flowering and climate variables, with temperature appearing to be the main driver. Whilst the first flowering date averaged over all cultivars did show a significant advance, this was significant for only one of the individual cultivars. This is likely because temperatures from December to March had not significantly increased in Guernsey during the study period (1985 to 2011).

Changes in first flowering dates and flowering duration of 232 plant species on the island of Guernsey.

Climate change has affected plant phenology; increasing temperatures are associated with advancing first flowering dates. The impact on flowering duration, however, has rarely been studied. In this study, we analysed first flowering dates and flowering durations from a 27 year dataset of weekly flower observations on 232 plant species from the island of Guernsey in the English Channel. The aim of this study was to explore variation in trends and relationships between first flowering dates, flowering duration and temperature. We specifically looked for evidence that traits, such as life forms and phylogenetic groups, explained variation in sensitivity of first flowering and flowering duration among species. Overall trends revealed significantly earlier flowering over time, by an average of 5.2 days decade(-1) since 1985. A highly significant shortening of flowering duration was observed by an average of 10 days decade(-1) . Correlations between first flowering, flowering duration and year varied between different species, traits and flowering periods. Significant differences among traits were observed for first flowering and to a lesser degree for flowering duration. Overall, in comparison to first flowering, more species had significant trends in flowering duration. Temperature relationships revealed large differences in strength and direction of response. 55% of the species revealed a significant negative relationship of first flowering dates and temperature. In contrast, only 19% of flowering durations had a significant negative temperature relationship. The advance in first flowering date together with a shortening of flowering duration suggests potentially serious impacts on pollinators, which might pose a major threat to biodiversity, agriculture and horticulture. Human health, in terms of pollen allergies, however, might benefit from a shortening of specific plant pollen seasons.

First-morning urinary melatonin and breast cancer risk in the Guernsey Study.

It has been hypothesized that suppressed nocturnal melatonin production is associated with an increased risk of breast cancer, but results from several small prospective studies of the association have been inconclusive. We examined the association between nocturnal melatonin and breast cancer risk in a case-control study nested within the Guernsey III Study, a British prospective cohort study (1977-2009). Concentrations of 6-sulfatoxymelatonin were measured in prediagnostic first-morning urine samples from 251 breast cancer cases and 727 matched controls. Conditional logistic regression models were used to calculate odds ratios for breast cancer in relation to 6-sulfatoxymelatonin level. No significant association was found between 6-sulfatoxymelatonin level and breast cancer risk, either overall (for highest third vs. lowest, multivariable-adjusted odds ratio = 0.90, 95% confidence interval: 0.61, 1.33) or by menopausal status. However, in a meta-analysis of all published prospective data, including 1,113 cases from 5 studies, higher 6-sulfatoxymelatonin levels were associated with lower breast cancer risk (for highest fourth vs. lowest, odds ratio = 0.81, 95% confidence interval: 0.66, 0.99). In summary, we found no evidence that 6-sulfatoxymelatonin level in a first-morning urine sample was associated with breast cancer risk among British women. However, overall the published data suggest a modest inverse association between melatonin levels and breast cancer risk. Further data are needed to confirm this association.

A qualitative exploration of the production of Hospital Episode Statistics in a Guernsey hospital: implications for regional comparisons of UK health data.

Hospital Episode Statistics (HES) are widely used in the UK for audit and research. This often includes comparisons between different geographical regions, but there is some doubt as to the reliability of comparisons made using these data. Previous studies have focused on the quantitative accuracy of the coding, but not the full data chain. This study is a qualitative examination of the production of HES in a small hospital in Guernsey, which is not part of the NHS. Interviews were conducted with key participants in the production of HES to determine how the data were created, and the strengths and weaknesses of this system. We found that face-to-face communication between administrative and clinical staff was felt to contribute to the accuracy of the HES codes, and that a lack of detail in the case-notes was felt to be more problematic than the accuracy of the coders themselves. These findings have implications for the comparison of HES between NHS Trusts, since the processes involved in producing the data will be different in larger hospitals with less contact between coders and clinicians. It is therefore important to bear this in mind when making comparisons between such diverse sources of HES.

Bottom up and top down: analysis of participatory processes for sustainability indicator identification as a pathway to community empowerment and sustainable environmental management.

The modern environmental management literature stresses the need for community involvement to identify indicators to monitor progress towards sustainable development and environmental management goals. The purpose of this paper is to assess the impact of participatory processes on sustainability indicator identification and environmental management in three disparate case studies. The first is a process of developing partnerships between First Nations communities, environmental groups, and forestry companies to resolve conflicts over forest management in Western Canada. The second describes a situation in Botswana where local pastoral communities worked with development researchers to reduce desertification. The third case study details an on-going government led process of developing sustainability indicators in Guernsey, UK, that was designed to monitor the environmental, social, and economic impacts of changes in the economy. The comparative assessment between case studies allows us to draw three primary conclusions. (1) The identification and collection of sustainability indicators not only provide valuable databases for making management decisions, but the process of engaging people to select indicators also provides an opportunity for community empowerment that conventional development approaches have failed to provide. (2) Multi-stakeholder processes must formally feed into decision-making forums or they risk being viewed as irrelevant by policy-makers and stakeholders. (3) Since ecological boundaries rarely meet up with political jurisdictions, it is necessary to be flexible when choosing the scale at which monitoring and decision-making occurs. This requires an awareness of major environmental pathways that run through landscapes to understand how seemingly remote areas may be connected in ways that are not immediately apparent.

A prospective study of endogenous serum hormone concentrations and breast cancer risk in premenopausal women on the island of Guernsey.

The associations between serum concentrations of oestradiol, progesterone, testosterone and sex hormone-binding globulin (SHBG) and risk of breast cancer in premenopausal women were investigated in a prospective study of breast cancer on the island of Guernsey. Sixty-two women diagnosed with breast cancer an average of 8 years subsequent to blood collection were matched for day of menstrual cycle, age and year of blood collection with 182 control subjects. Cases had a 12% higher mean oestradiol concentration over the whole menstrual cycle (P = 0.17) with a large difference at mid-cycle (75% higher, P = 0.04). Differences between cases and control subjects in progesterone (luteal phase), testosterone and SHBG were small and not statistically significant: luteal phase progesterone 9% lower in cases, P = 0.64; testosterone 4% higher, P = 0.57; SHBG 8% higher, P = 0.24. The small difference in oestradiol concentration could be aetiologically important, but larger prospective studies are needed.