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Contrary to prevailing assumptions, both women and men described negative (and often similar) feelings about hair loss. Understanding these experiences can help professionals better equip their patients to deal with this aspect of their treatment.

Poor control of chronic illness is often attributed to patients’ non‐adherence to medical advice and treatment. Policy and practice has traditionally focused on improving adherence, assuming that the more patients comply, the better their control and outcomes will be. Drawing on complexity theory, we question this logic in a secondary analysis of qualitative data from studies of young adults’ experiences of growing up with a chronic illness. Examining their sense of mastery of their condition, we found they valued both being in medical control of their condition and having autonomy but had different ideas about how to achieve these goals. While some young adults mostly shared the traditional medical view that achieving good control was the key to retaining their autonomy, others saw control and autonomy as independent, non‐linear and potentially conflicting goals. The latter endeavoured to achieve both goals by striking a balance, variously adopting strategies of engagement with and resistance to their regime in the changing social contexts of their lives. We suggest that policy and practice needs to do more to promote autonomy and adaptive capacity, rather than simply maximising adherence and control, recognising the mundane complexity of living with and managing a chronic illness.

Objective To identify outcomes relevant to women with lived experience of pre-eclampsia.Design Qualitative interview study.Setting A national study conducted in the United Kingdom.Sample Purposive sample of women with lived experience of preeclampsia.Methods Thematic analysis of qualitative interview transcripts.Results Thirty women with lived experience of pre-eclampsia were interviewed. Thematic analysis identified 71 different treatment outcomes. Fifty-nine of these had been previously reported by pre-eclampsia trials. Outcomes related to maternal and neonatal morbidity, commonly reported by pre-eclampsia trials, were frequently discussed by women with lived experience of pre-eclampsia. Twelve outcomes had not been previously reported by pre-eclampsia trials. When compared with published research, it was evident that the outlook of women with lived experience of pre-eclampsia was broader. They considered pre-eclampsia in relation to the 'whole' person and attached special significance to outcomes relating to emotional wellbeing and the future health, development and wellbeing of their offspring.Conclusions Selecting, collecting and reporting outcomes relevant to women with pre-eclampsia should ensure that future preeclampsia research has the necessary reach and relevance to inform clinical practice. Future core outcome set development studies should use qualitative research methods to ensure that the long list of potential core outcomes holds relevance to patients.

Objective-To determine the precision and agreement of synovial fluid (SF) cell counts done manually and with automated counters, and to determine the degree of variability of the counts in SF samples, kept in the tubes used for routine white blood cell (WBC) counts-which use liquid EDTA as anticoagulant-at 24 and 48 hours at 4°C, and at room temperature. Methods-To determine precision, cell counts were repeated 10 times-both manually and by an automated counter-in a SF sample of low, medium, and high cellularity. The variances were calculated to determine the interobserver variation in two manual (M1,M2) and two automated cell counts (C1,C2). The agreement between a manual (M1) and automated counter (C1) results, was analysed by the Bland and Altman method and the diVerence against the mean of the two methods was plotted. Then, the mean diVerence between the two methods was estimated and the standard deviation of the diVerence. To determine the eVects of storage, SF samples were kept in a refrigerator at 4°C, and at room temperature; cell counts were done manually (M1) and automatically (C1) at 24 and 48 hours and the changes analysed by the Bland and Altman method. The variances were compared using an F test. Results-(1) Precision. With the manual technique, the coeYcients of variation were 27.9%, 14%, and 10.7% when used for counting the SF with low (270), medium (6200), and high cellularities (25 000). With the automated technique the coeYcients of variation were 20%, 3.4%, and 2.9% in the same SF samples. In the fluids of medium and high cellularity, the variances of the automated cell counts were significatively lower (F test, p<0.002) than those of the manual counts. (Ann Rheum Dis 1997;56:622-626) The white blood cell (WBC) count in synovial fluid provides information about the amount of inflammation present in the joints, and is the basis for the classification of synovial fluids (SF) into the categories of non-inflammatory, inflammatory, and septic.1-3 The WBC count is generally performed manually, using saline as a diluent to avoid the formation of a mucin clot, which would result from the use of haematological diluents containing acetic acid. 4 DiVerent problems have been found in relation to the performance of the WBC counts in the SF; a poor reproducibility of manual WBC counts, 5 as well as contradictory results in relation to the stability of the SF have been reported, emphasising the need of performing the procedure without delay. 6 Counting by means of automatic counters has occasionally been done, but problems such as the error produced by fat globules have been found when the counts are performed by such a method. 7Our aim is to determine the precision and reproducibility of WBC counts of SF

Football, gambling and gambling-harms v3; 1 st July 2016 2 Media reports suggest high rates of gambling amongst professional footballers but little is known about how footballers develop and then seek help for gambling problems. Here, we report the findings of in-depth, qualitative interviews with 11 British professional footballers who had, or who were, being treated for gambling problems at a residential clinic. These individuals experienced gambling as a highly salient feature of life as a professional football player in UK professional leagues. Often gambling began as part of social networks of young players, but then progressed to gambling problematically in isolation. Factors that facilitated this transition included structural aspects of professional football as an occupation (e.g. high salaries, spare time, gambling as a shared leisure pursuit) as well as the competitive and emotional challenges of the game (e.g. loss of form, injury or contract release and their effects upon mood). Seeking help was delayed by a reluctance to disclose problems to peers and club managers, but facilitated by recommendations from other players with similar experiences. Football, gambling and gambling-harms v3; 1 st

Chronic pain (CP) and rheumatoid arthritis (RA) pose particular challenges for the individual. Although biomedicine inevitably plays a role in the reduction or control of some symptoms for people living with chronic pain, directed self-management is also increasingly recognized as an important tool. Self-management can address pain-associated symptoms of CP and RA, and often has broader aims, such as promoting positive well-being. Forty-six interviews with people experiencing CP and 46 interviews with those living with RA-associated pain were analyzed. Our analysis uncovered three broad strategies adopted by participants: body management, mind-management and mind-body management. The analysis demonstrated that for those living with pain, a sense of well-being is achieved not through pain control alone, but also through various mind/body techniques for managing pain, accepting new limits, and adjusting the way people relate to themselves. These self-management strategies are an important adjunct to biomedical care for those experiencing chronic pain.

The strategies designed between the laboratory and the requesting clinicians and automatically established by using our laboratory information system were successful.