Recruitment Rates Research Articles

Chromatin endogenous cleavage provides a global view of yeast RNA polymerase II transcription kinetics.

Chromatin immunoprecipitation (ChIP-seq) is the most common approach to observe global binding of proteins to DNA in vivo. The occupancy of transcription factors (TFs) from ChIP-seq agrees well with an alternative method, chromatin endogenous cleavage (ChEC-seq2). However, ChIP-seq and ChEC-seq2 reveal strikingly different patterns of enrichment of yeast RNA polymerase II. We hypothesized that this reflects distinct populations of RNAPII, some of which are captured by ChIP-seq and some of which are captured by ChEC-seq2. RNAPII association with enhancers and promoters - predicted from biochemical studies - is detected well by ChEC-seq2 but not by ChIP-seq. Enhancer/promoter bound RNAPII correlates with transcription levels and matches predicted occupancy based on published rates of enhancer recruitment, preinitiation assembly, initiation, elongation and termination. The occupancy from ChEC-seq2 allowed us to develop a stochastic model for global kinetics of RNAPII transcription which captured both the ChEC-seq2 data and changes upon chemical-genetic perturbations to transcription. Finally, RNAPII ChEC-seq2 and kinetic modeling suggests that a mutation in the Gcn4 transcription factor that blocks interaction with the NPC destabilizes promoter-associated RNAPII without altering its recruitment to the enhancer.

Annual variation in recruitment rates for the sika deer (Cervus nippon) population in eastern Hokkaido, Japan

Annual variation in recruitment rates for the sika deer (<i>Cervus nippon</i>) population in eastern Hokkaido, Japan

Challenges in performing a structured follow-up in Swedish nursing home residents after stroke: a pilot feasibility study

Multidisciplinary team-based follow-ups are recommended for all stroke patients in Sweden including those discharged to nursing homes. We aimed to explore the feasibility of a structured follow-up with the Post Stroke Checklist (PSC) in nursing home residents, and to map stroke related problems and planned interventions. Due to a complex recruitment process and low recruitment rate, the study protocol was adapted to an explorative design. Nine health professionals and five nursing home residents participated. The health professionals were generally satisfied with the PSC. Many stroke related problems were identified, and several inexpensive ongoing or planned interventions were considered. However, several obstacles for performing a routine structured stroke follow-up were identified, such as lack of coordination between different stakeholders, fear of increased paperwork and lack of referral options for some of the suggested interventions, indicating that there is a need to build up a suitable organization able to take action for the identified problems. Various hinders performing the study itself were also identified. Difficulties in recruiting physically and mentally frail participants in studies might lead to an inadequate basis for decision-making, hindering people with extensive disabilities to receive scientifically based interventions.

Multimodal prehabilitation to enhance functional capacity of patients with esophageal cancer during concurrent neoadjuvant chemotherapies-a randomized feasibility trial.

Esophageal adenocarcinoma continues to bear high morbidity and mortality. Prehabilitation, using exercise, nutrition, and psychosocial strategies to optimize patients prior to surgical resection, is largely underexplored in this malignancy, especially in patients undergoing neoadjuvant chemotherapy. Objectives of this study were (i) to determine feasibility of prehabilitation during treatment in patients with esophageal cancer and (ii) to establish differences between hospital and home-based exercise. Patients were recruited from August 2019 - February 2023 and blindly randomized to either supervised or homebased exercise, receiving identical nutritional and psychosocial support. The main outcome measures were recruitment, retention, and dropout rates. The secondary outcomes included cardiorespiratory fitness, functional capacity, and quality of life. Forty-four subjects were blindly randomized: 23 to supervised exercise and 21 to home-based exercise (72% recruitment rate). Overall compliance for the supervised group was 72%; home-based group was 77%. Baseline to pre-operative, both groups experienced significant increases in sit-to-stand, arm curls, and amount of weekly moderate-vigorous physical activity. The home-based group experienced an additional considerable decrease in up-and-go test times. Both groups maintained cardiorespiratory fitness and saw substantial increases in some quality-of-life scores. Multimodal prehabilitation is feasible for patients with esophageal cancer undergoing neoadjuvant chemotherapy. In both groups, patient fitness, which is relevant for this patient population given the anticipated decline in functional status during this period, was maintained. This study provides a foundation for future prehabilitation interventions in this patient population.

Exercise-based telerehabilitation for the management of chronic pain in people with severe haemophilia: a mixed-methods feasibility study

BackgroundChronic pain is reported by between 30 and 71% of people with haemophilia (PWH). Exercise is shown to be effective for pain management in other arthritides, but it remains unclear if such an approach is effective or acceptable to PWH. The aim of this study was to evaluate the feasibility and acceptability of a telerehabilitation exercise intervention for PWH living with chronic pain.MethodsThis was a multisite, non-randomised, pre-post feasibility design, with a nested qualitative study. People with severe haemophilia > 18 years, living with chronic pain, were recruited. The intervention comprised 12 low-impact/moderate intensity, individualised exercise sessions and 3 knowledge-sharing and discussion sessions. Primary objectives assessed according to predefined progression criteria were as follows: (a) recruitment rate (5 participants enrolled per site over 8 weeks), (b) adherence (≥ 75% participants would adhere to ≥ 75% of sessions), (c) follow-up rate (≥ 75% completion of self-reported measures), (d) fidelity (intervention delivered as described in protocol) and (e) safety (≤ 30% participants would report adverse events). Acceptability was evaluated from thematic analysis of post-intervention participant interviews. Preliminary evaluation of self-reported pain, function and quality of life (QoL) was a secondary objective. Results were reported using descriptive statistics integrated with qualitative findings.ResultsTen PWH were recruited and completed the intervention. Nine agreed to be interviewed post intervention. Attendance at individual sessions was 84.5% compared to 52.1% for the group sessions. Outcome measures were successfully completed for 100% at baseline, 70% at intervention end and 60% at 3-month follow-up. No serious adverse events were recorded. Group median values in outcome measures (pain, function, QoL) showed minimal change post intervention. Participant interviews highlighted high levels of enjoyment, confidence in continuing exercises independently and positive views of virtual delivery and condition-specific exercise.ConclusionsRecruitment rate and safety met the predefined progression criteria. Fidelity partially met the progression criteria, but the follow-up rate for self-reported measures did not. The study was acceptable to both participants and physiotherapists. Further intervention development is needed to review approaches to outcome measure collection and refine the usefulness of the knowledge-sharing sessions.Trial registrationThe study was prospectively registered on 9 July 2021: International Standard Randomised Controlled Trial Number ISRCTN 17454597.

Feasibility of ecological momentary assessment in measuring physical activity and sedentary behaviour in shift and non-shift workers

BackgroundPrevious studies assessing shift workers’ behaviours have mainly used self-report recall questionnaires, however these measures don’t always account for variations in work schedules. Alternative methods that allow for real-time assessments tailored to capture variations in work patterns might provide more accurate measures of physical activity (PA) and sedentary behaviour (SB). Therefore, the aim of this study was to evaluate the feasibility of Ecological Momentary Assessment (EMA), which provides real-time evaluations of PA and SB in shift workers. A secondary aim was to compare shift workers and non-shift worker responses.MethodsParticipants (n = 120; 58% female, mean Mage=36.0), included 69 shift workers and 51 non-shift workers. After downloading the EMA app, shift workers received either interval-contingent tailored (SW-T) or standardized EMA prompts (SW-S) over 7–10 days, while non-shift workers received standardized prompts (NSW-S) for seven days. Prompts were scheduled five times daily, every three hours. The EMA survey asked participants to report their current activity, including type, duration, and location of physical activity and sitting. Feasibility was assessed by analysing recruitment, retention, and compliance rates (EMA surveys completed) across SW-T, SW-S, and NSW-S groups.ResultsApproximately 78% of invited workers enrolled, and all enrolled workers completed at least one prompt on 4 out 7 days in the NSW-S and 7 out of 10 days in the SW group. Workers who chose not to participate reported unwillingness to travel for meetings (n = 14), while others did not respond (n = 20). Participants completed an average of 24 surveys per day, each one taking less than 30 s to complete. Overall, 64% of EMA surveys were started and completed. SW-S completed the least prompts (57%), while SW-T and NSW-S completed 64% and 68%, respectively (p = 0.90). On average, workers missed 36% EMA surveys which was similar for SW and NSW (p = 0.05).ConclusionOur study represents one of the few studies that has used EMA in the shift work population with adaptation to shift schedules. The findings showed a modest compliance to EMA. Strategies are needed to enhance compliance rates. However, EMA shows promise for capturing real-time behaviours in shift workers’ natural work environments.

Family-Centered Treatment Program for Problematic Gaming and Excessive Screen Use in a Clinical Child and Youth Population (FAME): Protocol for a Feasibility Pilot Mixed Method Study.

Screen time among children and adolescents has increased dramatically, raising concerns about its impact on development and mental health. While research highlights both potential benefits and risks, excessive use has been linked to issues like anxiety, depression, and gaming addiction. Despite growing concern, effective interventions are scarce. Recognizing the importance of family dynamics in child development, we propose a family-centered program to address problematic gaming and excessive screen use in a clinical population. By involving both children and parents, we aim to create a more comprehensive approach to prevention and treatment. This study aims to determine the possibility of distributing and evaluating a family-centered group program for problematic gaming and excessive screen use (FAME) in a clinical child and adolescent psychiatry (CAP) population. We will monitor the recruitment rate; track the retention and attendance rates of both parents and children; and assess whether each session's objectives are met, the content is delivered within the allotted time, and the necessary resources (eg, facilitators and materials) are available. Additionally, we will gather qualitative and quantitative feedback from participants through postprogram surveys and individual interviews with both children and parents. A total of 10 families with ongoing contact with CAP in Skåne, Sweden, will be recruited and offered participation in a family-centered group program targeting children aged 10-18 years with reported difficulties regarding screen gaming or screen use. The intervention to be tested is a newly developed, family-centered, psychoeducational, cognitive behavioral therapy-based intervention addressing both positive and negative aspects of screen use; setting boundaries; the connection between thoughts, feelings, and behaviors; conflict triggers; and sleep hygiene. The primary goal of the pilot study is to test the feasibility of the program, as well as recruitment and the analysis of participants' experiences with the program. A total of 11 children and their parents were enrolled during first quarter of 2024. A 4-session pilot was delivered in first quarter of 2024, and the first results are expected in the third quarter of 2024. The overarching goal of this pilot study is to determine the possibility of distributing and evaluating a family-centered group program for problematic gaming and excessive screen use (FAME) in a clinical CAP population. The insights gained from this study will guide our future research, which will focus on conducting a larger-scale evaluation of the intervention's impact on family screen time conflicts and inform future strategies for the implementation of family-centered interventions in child and youth clinics. ClinicalTrials.gov NCT06098807; https://clinicaltrials.gov/study/NCT06098807. DERR1-10.2196/56387.

Pilot Randomized Controlled Trial of a Yoga-Based Intervention Targeting Anger Management for People Who Are Incarcerated.

Introduction: Incarceration represents an opportune moment to improve self-management of anger and aggression. A hatha yoga-based intervention (YBI) could serve as a useful adjunctive intervention for anger within prisons. Methods: We enrolled 40 people with elevated levels of anger who were incarcerated (20 in a women's facility, and 20 in a men's facility) in a 10-week pilot randomized controlled trial of a YBI versus. a health education (HE) control group. Participants attended their respective groups once per week. We examined indices of feasibility and acceptability, including intervention credibility, expectancy the intervention would be helpful, intervention satisfaction, class attendance, engagement in personal practice, instructor fidelity, intervention safety, and study recruitment and retention rates. We also examined changes in clinical outcomes including anger, depression, anxiety, and behavioral infractions over time. Results: We met targets for several outcomes: credibility of the YBI and HE interventions, expectancy that they would be helpful, and satisfaction with the programs. Instructors demonstrated fidelity to both manuals. There were no serious adverse events related to study participation. Class attendance did not meet our target outcome in either facility and rates of personal practice met our target outcome in the men's but not the women's facility. For people enrolled in the YBI, anger, depression, and anxiety tended to decrease over time. Qualitative interviews with participants pointed to overall high satisfaction with the YBI and provided information on facility-related barriers to class attendance. Conclusion: Although we did not meet all our feasibility targets in this study, we note high participant enthusiasm. Thus, we believe this line of research is worth pursuing, with further attention to ways to decrease facility-related barriers to class attendance and personal practice. Clinical trials registration: NCT05336123.

12424 A Feasibility Trial Of A Co-created Digital Self-management Programme For Adults With Polycystic Ovary Syndrome (Hope PCOS)

Abstract Disclosure: C.A. Percy: None. A. Turner: None. L. Aphramor: None. D. Broom: None. C. Clark: None. F. Martin: None. P. Wark: None. Introduction: Polycystic ovary syndrome (PCOS) has significant impact on depression, anxiety, psychological wellbeing and health-related quality of life. We co-created a theory-led, evidence-based, 6-week, digital self-management and positive wellbeing intervention (Hope PCOS), delivered to UK adults. We tested the intervention’s potential to improve mental health and wellbeing outcomes and its acceptability and usability for adults living with PCOS. Methods: This was a mixed methods feasibility randomised controlled trial conducted online, with a pre-post, waitlist-controlled design. Primary outcomes were recruitment, completion (≥ 3 intervention sessions) and follow-up rates. At baseline, participants reported demographic information, PCOS symptoms, depression (Patient Health Questionnaire (PHQ-9)), anxiety ((Generalised Anxiety Disorder Assessment (GAD-7)), polycystic ovary syndrome health-related quality of life (PCOSQ-50), psychological wellbeing (Warwick-Edinburgh Mental Wellbeing Scale, WEMWBS) and self-efficacy (Self-Efficacy to Manage Chronic Disease Scale (SEMCD6)) before randomisation to an intervention group (IG) receiving the intervention immediately or a waitlist control group (CG) receiving the intervention 12 weeks later. PHQ-9, GAD-7, PCOSQ-50, WEMWBS and SEMDC6 were reassessed at 6 and 12 weeks. IG participants reported the usability of the digital intervention (system usability scale (SUS)) and acceptability via qualitative exit interviews. Results: Of 131 eligible, consented participants, 83% (N=109, age M=37.1, SD=8.6 years) completed baseline measures and were randomised to the IG (n=54) or the CG (n=55). Baseline clinical caseness was high for depression (n=77, 70.6%) and anxiety (n=78, 71.6 %). Twenty-one participants (39%) in the IG completed ≥3 intervention sessions. At 6-week follow-up, completion of secondary outcomes was n=32 (59%) for IG and n= 38 (69%) for CG; at 12 weeks, n=31 (57%) for IG and n= 38 (69%) for CG. Twelve IG participants took part in the exit interviews. Exploratory descriptive statistics suggest there were greater improvements in depression, anxiety, psychological wellbeing, self-efficacy and quality of life for the intervention group completers compared to the waitlist control group. SUS data and thematic analysis suggest the intervention was usable, acceptable, relevant and interesting. Participants reported experiences including feeling seen and valued, having the difficulties of lifestyle change acknowledged, and learning valuable lessons, particularly how to monitor and manage emotions, prioritise self-care and complete personal goals. Conclusions: This novel intervention was rated as usable and acceptable, with potential for improving mental health and wellbeing outcomes. More research is needed to identify for whom the intervention is beneficial and on implementation in practice. Presentation: 6/1/2024

Advance Consent for participation in Acute Stroke Trials (ACTION): protocol for a feasibility study

IntroductionObtaining informed consent for research from patients in medical emergencies remains a challenge, particularly in acute stroke care as treatment must be administered quickly and patients often arrive in the...

Increasing physical activity among adults affected by COVID-19 social distancing restrictions: A feasibility trial of an online intervention.

In response to COVID-19 social distancing restrictions, digitally delivered health interventions present as a potential solution for maintaining or improving individuals' physical activity. This study explored the feasibility of a web-based intervention, informed by the multi-process action control (M-PAC) framework to promote PA among individuals affected by social distancing. Fifty adults self-reporting as insufficiently active were randomized to a 6-week web-intervention (n = 27) or wait-list control (n = 23). Primary feasibility outcomes included recruitment and retention rates and usability and satisfaction scores; secondary outcomes of MVPA and M-PAC constructs and tertiary outcomes of mental health and wellbeing were also assessed. Overall, feasibility of the intervention was high, with a 96% recruitment rate, 84% retention rate, high satisfaction and usability scores, and comparable website usage to similar eHealth interventions. Intervention participants trended towards improved MVPA and M-PAC constructs and outcomes of mental health and wellbeing. Findings suggest study extension to a full-scale RCT.

Recurrent marine heatwaves compromise the reproduction success and long-term viability of shallow populations of the Mediterranean gorgonian Eunicella singularis

Mediterranean gorgonians are being threatened by the impact of recurrent extreme climatic events, such as marine heatwaves (MHWs). The white gorgonian Eunicella singularis was suggested to be the most resistant gorgonian species in the NW Mediterranean, mainly due to the presence of symbiotic algae. However, a substantial shift in the conservation condition of the species has been observed in the recent years. The aim of this study is to evaluate the lethal and sublethal effects of recent MHWs on the populations of E. singularis. Our results show that recurrent MHWs have impacted both the demography and reproduction of the species between 2002 and 2020, driving mortalities up to 36%, an increase in the percentages of non-reproducing adult colonies (11-58%), and a significant decrease in the recruitment rates. Although E. singularis is a highly dynamic species in comparison with other temperate gorgonians, the present study suggests that the persistence of this species may be severely compromised under recurrent MHWs, at least at shallowest depths.

Development, feasibility, and preliminary effects of a culturally adapted, evidence-based, and theory-driven diabetes self-management programme for Chinese adults with type 2 diabetes receiving insulin injection therapy

AimsTo describe the development of a culturally adapted, evidence-based, and theory-driven diabetes self-management programme for Chinese adults with type 2 diabetes receiving insulin injection therapy and to assess the feasibility, acceptability, and preliminary effects of the newly developed intervention. MethodsThe Medical Research Council framework was adopted to guide the intervention development and a feasibility study. A prospective, two-arm, parallel-group, assessor-blinded randomised controlled trial was conducted. Participants were randomly allocated to receive either the newly developed intervention or parallel attention control contact from community nurses. Between-group differences in changes in outcome variables were analysed using the Mann-Whitney U test. ResultsThe newly developed intervention consists of one individual interview session, three group-based education sessions, and two telephone-based maintenance sessions. A total of 24 participants were recruited with the recruitment rate and overall retention rate of 77.4 % and 95.8 %, respectively. The results indicated that the intervention participants reported significantly greater improvements in self-efficacy (Hedge’s g = 1.69) and self-management behaviours (Hedge’s g = 3.24), and reductions in diabetes-related distress (Hedge’s g = 1.49) compared with those in the control group (all p< 0.05). ConclusionThe diabetes self-management programme was feasible and acceptable. The intervention showed promising patient-centred benefits. A future large-scale randomised controlled trial is warranted.

Anticoagulation Therapy Timing in patients with Atrial Fibrillation after Acute and Chronic Subdural Haematoma (ATTAACH): a pilot randomised controlled trial

IntroductionSubdural haematomas (SDHs), acute or chronic, are common neurosurgical diagnoses. These problems can occur among patients requiring direct oral anticoagulation (DOAC) for atrial fibrillation. There are currently no guidelines regarding...

What influences people’s decision to participate in clinical trials? A qualitative interview study with patients and parents of patients diagnosed with primary membranoproliferative glomerulonephritis (MPGN)

Primary membranoproliferative glomerulonephritis (MPGN) is a group of ultra rare kidney disorders associated with complement activation. MPGN often appears in young age and is uncurable. Current treatments have varying efficiency and new clinical trials are underway to identify better and more tailored treatment pathways. We conducted semi-structured digital interviews with an international sample of MPGN patients and parents of MPGN patients to understand how they would make any potential future decision to participate in future clinical trials. Six main factors influenced the decision-making process: the trial design and practical aspects, personal motivation, concerns about participation, expert advice, current state of illness, and family situation. More specifically, patients and parents considered important that participation in clinical trials is compatible with work and family life and that the expected side effects are limited. They would be motivated by the prospect of maintaining or improving their kidney function or if their current condition was poor. Providing comprehensive information about the risks and benefits of participation, co-designing trials in partnership with patients and limiting the burdens associated with participation may positively impact recruitment and adherence rates.

Effectiveness and acceptability of different lifestyle interventions for women with polycystic ovary syndrome: protocol for a systematic review and network meta-analysis.

Women with polycystic ovary syndrome (PCOS) experience various metabolic, endocrine, reproductive and psychosocial manifestations. Lifestyle modification is crucial for the management of PCOS to reduce long-term complications. Nonetheless, the efficacy and acceptability of lifestyle interventions differs, and there are no uniform methods of clinical application. Hence, a systematic review and network meta-analysis (NMA) are needed to explore the efficacy and acceptability of lifestyle interventions to inform clinical practice. Ten databases (Cochrane Gynaecology and Fertility Specialised Register, Cochrane Register of Studies Online, PubMed, EMBASE (Excerpta Medica Database), PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Chinese National Knowledge Infrastructure, WanFang, VIP, and Sinomed) and four clinical trial registry platforms will be searched to identify literature published in English or Chinese reporting results of randomised clinical trials conducted to evaluate the effects of lifestyle interventions for women with PCOS. The reference lists of the included studies will be manually searched. Primary outcomes will include biochemical and clinical hyperandrogenism, recruitment and retention rates. Secondary outcomes will encompass menstrual regularity, ovulation, anthropometry and quality of life. Literature selection and extraction of data will be performed independently by at least two researchers. An NMA random-effects model will be implemented for amalgamating evidence. All treatments will be ranked based on the value of p. OpenBUGS will be used for Bayesian modelling, with output verifications generated in Stata and R. The quality of evidence supporting network estimates of major outcomes will also be appraised using the Grading of Recommendations Assessment, Development, and Evaluation framework. Ethical approval is not required for this review as no data will be collected from human participants. Results will be presented in a peer-reviewed publication. CRD42024499819.

A feasibility study of a couple-based illness perception intervention for couples coping with colorectal cancer

PurposeAs a special psychological variable, illness perception significantly affects the cancer adaptions of colorectal cancer couples. No studies focus on facilitating cancer adaption by targeting the illness perception in colorectal cancer couples. This research attempted to explore the feasibility, acceptability, and potential effectiveness of an illness perception intervention program designed for couples with colorectal cancer, guided by a self-regulation common sense model. MethodsA single-group pilot study including pre- and post-testing was carried out with Chinese couples having colorectal cancer. Six sessions were delivered consecutively by researchers via in-person or telephone for couples. By calculating the rates of recruitment and retention, the feasibility of the intervention was analyzed. Intervention acceptability was evaluated by analysis of the post-intervention quantitative and qualitative data. Outcomes were described as illness perception, cancer-related communication problems, dyadic coping, quality of life, anxiety and depression, and benefit finding. Effect sizes were computed to assess the preliminary program effects. ResultsThe feasibility was confirmed by the recruitment (67.6%) and retention (82.6%) rates. The acceptability was endorsed by the reported participant satisfaction. Validating the program’s preliminary effectiveness, the intervention program has moderate effect sizes (Cohen’s d: 0.33-0.79) that boost illness perception and major cancer adjustment results for patients and their spousal caregivers. ConclusionsThe research proved that the couple-based illness perception intervention among colorectal couples was feasible, acceptable, and initially effective. To investigate this intervention program more thoroughly and apply it to a wider range of disease backgrounds, an extensive randomized controlled experiment is necessary.

Feasibility of a theory-based intervention towards benzodiazepine deprescribing in Belgian nursing homes: protocol of the END-IT NH cluster-randomised controlled trial

IntroductionDespite several calls to deprescribe benzodiazepine receptor agonists (BZRA) in older adults, their use among nursing home residents (NHRs) remains high. Therefore, we developed an intervention targeting general practitioners’ and...

Variation in Successional Dynamics Shape Biodiversity Patterns over a Tropical-Temperate Latitudinal Gradient.

AbstractSuccessional dynamics can vary because of a range of ecological and environmental factors, but our understanding of biogeographic variation in succession, and the processes contributing to community development across ecosystems, is limited. The pattern and rate of recruitment of dispersive propagules likely differs over large spatial scales and can be an important predictor of successional trajectory. Over a 20° tropical-temperate latitudinal gradient, we measured sessile invertebrates over 12 months of community development and successive 3-month recruitment windows to understand succession and how it is influenced by recruitment. Succession and recruitment patterns varied over latitude. In the tropics, fast temporal turnover, fluctuating abundances, and lack of successional progression suggest that the contribution of stochastic processes was high. As latitude increased, successional progression became more apparent, characterized by increasing species richness and community cover and a shift to more competitive taxa over time. At temperate locations, species identities were similar between older communities and recruiting assemblages; however, community composition became more variable across space over time. Such divergence suggests an important role of early colonizers and species interactions on community structure. These findings demonstrate differences in the processes contributing to community development and biodiversity patterns over latitude. Understanding such biogeographic variation in community dynamics and identifying the prevalence of different processes can provide insights into how communities assemble and persist in response to environmental variability.

Contraception Used by People Assigned Female at Birth With Spinal Cord Injury

ObjectivesThere is limited data on contraception used by people assigned female at birth with spinal cord injury (SCI). Pregnancy in people with SCI can be medically complex, therefore access to contraception to prevent unplanned pregnancies is imperative. This study aimed to assess the availability of contraception from health care providers (HCPs) to people with SCI and the contraception methods used. MethodsAn online international questionnaire was distributed. Demographic data and reproductive histories were recorded. Overall, 780 responses were received from participants in 33 different countries. Most participants lived in North America and self-identified as White. In total, 75% had a traumatic SCI. Most SCIs were at cervical and thoracic levels and American Spinal Injury Association-A and American Spinal Injury Association-B. Descriptive and χ2 statistics were used. ResultsThe recruitment rate was 85.4% and the completion rate was 73.8%. Overall, 93.6% of participants reported ever having been sexually active, while 60.7% reported sexual activity over the past year. Of people who were injured under the age of 50 years and who have been sexually active, 63.6% were offered birth control by an HCP. Condoms were used by 44.5% of participants, withdrawal by 20.1%, the combined oral contraceptive pill by 28.4% and intrauterine device by 20.1% of respondents. ConclusionsThis is the largest known study on SCI and contraception. Most people with SCI are sexually active. The withdrawal method and no contraception are used by many individuals, which may increase the risk of unplanned pregnancy. Increased use of highly effective contraception in this population may be achieved through HCP-initiated conversations about sexual health.