Fishing in your backyard: otters that prey on urban resources

We monitored the incidence of predation behavior in Eurasian otters (Lutra lutra) from urban ponds in southern Spain, following reports of the mustelids’ presence in various urban locations. In one of the case studies, 30 small common carp and 35 Koi fish were released in May 2017 and April 2018, respectively, into two different ponds. Otters extensively predated on these fish over a period of 75–80 days. Only two small carp (6.6%) survived in one of the ponds and 10 Koi fish (28.5%) in the other. The surviving Koi were relocated. We determined that fish survival functions and mortality rates between these two years were not significantly different. At the second urban location, otters extensively predated on Iberian frogs over a period of 5–6 days in May 2018, left the area, and repeated this pattern in May 2019. Finally, at the third urban location, otters consumed 20 goldfish in 16 days in August 2018. Our results indicate that available food resources in urban settings can become a viable option for certain bold individuals of wildlife species and that otters appear to explore urban habitats when it suits them. Appropriate management and damage control strategies are therefore needed to ensure the survival of this protected species in case food resources in the wild become limited and urban raids become habitual.

Study on awareness, perceptions, experiences in decision process of hysterectomy in women presenting to Goa Medical College

Background: Hysterectomy (removal of uterus) has many indications like fibroids, dysfunctional uterine bleeding, uterine prolapse and chronic pelvic pain. The purpose of this study is to know the level of awareness of women about hysterectomy, to study their experiences, to assess their involvement in decision making process and to develop a suitable protocol, counselling and education material to ensure women’s involvement.Methods: This is a cross sectional study using validated semi-structured interview questionnaire over 6 months (1st December, 2018 to 31st May, 2019) in Goa Medical College. Data was entered in epidata manager and analysed using SPSS 22 version. Categorical variables were expressed in percentages and proportions and quantitative variables in mean±SD. Significance was checked using Chi square test and association between dependent and independent variables was assessed by using bivariate analysis. P value <0.05 was taken as significant.Results: A total of 149 women were recruited into the study who were admitted for hysterectomy. The mean age of women was 49.3 years. The awareness with respect to various aspects of hysterectomy was good in 23.4% subjects and poor in 76.6% subjects. The awareness was significantly related to level of education (p=0.002), urban location (p=0.016) and socioeconomic status (p=0.028). Education was significant factor in decision-making process (p< 0.05). It was observed that good experience had positive correlation to their perception about hysterectomy.Conclusions: It was concluded that awareness about hysterectomy was significantly related to education, urban location and socio-economic status of women. Pre-operative education would help to reduce the post-operative symptoms for a women undergoing hysterectomy.

Is continuity of primary care declining in England? Practice-level longitudinal study, 2012-2017

Background: Continuity of care is a core principle of primary care and related to improved patient outcomes and reduced healthcare costs. Evidence suggests continuity of care is declining. Aim: (i) to confirm reports of declining continuity of care, (ii) to explore differences in decline according to practice characteristics, (iii) to examine associations between practice populations or appointment provision and changes in continuity of care. Design and Setting: Longitudinal study of aggregated practice-level data from repeated questions in GP-Patient surveys between 2012-2017 on having a preferred GP, seeing this GP always/often (usually), appointment system and practice population characteristics, linked to rural/urban location and deprivation. Method: Multilevel modelling; time (level-1) and practices (level-2). Results: 56.7% of patients had a preferred GP in 2012, declining by 9.4%-points (95%CI -9.6 to -9.2) by 2017. 66.4% of patients with a preferred GP saw this GP usually in 2012, which declined by 9.7%-points (95%CI -10.0 to -9.4) by 2017. This decline was visible in all types of practices, irrespective of baseline continuity, rural/urban location, or deprivation. At practice-level, an increase over time in the percentage of patients reporting good overall experience of making appointments was associated with an increase in both the percentage of patients having a preferred GP, and the percentage of patients being able to see that GP usually. Conclusion: Patients reported a steady decline in continuity of care over time, which should concern clinicians and policymakers. The ability of practices to offer patients a satisfactorily working appointment system could partly counteract this decline.