Given the budgetary restrictions on scientific research and the increasing need to better inform conservation actions, it is important to identify the patterns and causes of biases in research effort. We combine bibliometric information from a literature review of almost 16,500 peer-reviewed publications on a well-known group of 286 species, the Order Carnivora, with global datasets on species' life history and ecological traits to explore patterns in research effort. Our study explores how species' characteristics influenced the degree to which they were studied (measured as the number of publications). We identified a wide variation in intensity of research effort at both Family and Species levels, with some of the least studied being those which may need protection in future. Our findings hint at the complex role of human perspectives in setting research agendas. We found that better-studied species tended to be large-bodied and have a large geographic range whilst omnivory had a negative relationship with research effort. IUCN threat status did not exhibit a strong relationship with research effort which suggests that the conservation needs of individual species are not major drivers of research interest. This work is the first to use a combination of bibliometric analysis and biological data to quantify and interpret gaps in research knowledge across an entire Order. Our results could be combined with other resources, such as Biodiversity Action Plans, to prioritise and co-ordinate future research effort, whilst our methods can be applied across many scientific disciplines to describe knowledge gaps.

Background Lesbian, gay, bisexual and transgender (LGBT) patients have an increased incidence of a range of health problems, and face many barriers to accessing healthcare. Our research aimed to explore the awareness of health issues and attitudes of medical students towards LGBT patients’ health including barriers to health services, their attitudes towards inclusion of LGBT content in the curriculum and their confidence with providing care for their LGBT patients in the future. Methods Medical students were recruited to take part in a cross-sectional survey. We used a 28-item survey to explore views about the undergraduate medical curriculum. Results 252 surveys were analysed from 776 eligible participants. Attitudes towards LGBT patients were positive but awareness and confidence with respect to LGBT patients were variable. Confidence discussing sexual orientation with a patient significantly increased with year of study but confidence discussing patient gender identity did not. The majority of participants (n = 160; 69%) had not received specific training on LGBT health needs, and 85% (n = 197) wanted to receive more training. Conclusions Increasing the amount of LGBT teaching in undergraduate medical curricula could help to increase the quality of doctor-patient interactions, to facilitate patients’ disclosure of sexual orientation and gender identity in healthcare and increase the quality of healthcare.

Background: Transgender men and non-binary people assigned female at birth (TMNB) who have not had surgery to remove the cervix are recommended to undertake cervical screening with the same frequency as cisgender women but evidence suggests that TMNB have lower odds of lifetime and up-to-date cervical screening uptake. Aim: To understand the attitudes towards and preferences for cervical screening among UK-based TMNB. Design & Setting: Cross-sectional survey of TMNB at an NHS gender identity clinic (GIC) and an NHS sexual health service specialising in care of transgender people. Method: Recruitment was via email invitations to patients of the GIC and sexual health service. Inclusion criteria were: female sex assigned at birth, trans man, masculine, or non-binary gender identity, age ≥18 and UK resident. Quantitative results were analysed using descriptive statistics and free text comments were analysed thematically. Results: There were 137 participants, 79% identifying as transmasculine and 18% as non-binary. Sixty-five participants (46%) were eligible for cervical screening and 56.9% of those had ever been screened. Only 53.1% of those eligible felt they had sufficient information about cervical screening . Just over half (53%) stated they would like the option to self-swab for high-risk HPV. Only half of the participants were in favour of an automatic invitation for cervical screening . Thematic analysis identified a number of additional barriers and facilitators of screening. Conclusions: TMNB have identified numerous potential areas for change that may improve cervical screening uptake and patient experience.

We observed significant differences in adjusted mortality between hospitals, suggesting differences in quality of care. However, mortality is strongly influenced by patient mix and thus, crude mortality is not a suitable quality indicator.