STI testing, diagnoses and online chlamydia self-sampling among young people during the first year of the COVID-19 pandemic in England

PURPOSE: COVID-19 control measures reduced face-to-face appointments at sexual health services (SHSs). Remote access to SHSs through online self-sampling was increased. This analysis assesses how these changes affected service use and STI testing among 15-24 year olds ('young people') in England. METHODS: Data on all chlamydia, gonorrhoea and syphilis tests from 2019-2020, among English-resident young people were obtained from national STI surveillance datasets. We calculated proportional differences in tests and diagnoses for each STI, by demographic characteristics, including socioeconomic deprivation, between 2019-2020. Binary logistic regression was used to determine crude and adjusted odds ratios (OR) between demographic characteristics and being tested for chlamydia by an online service. RESULTS: Compared to 2019, there were declines in testing (chlamydia-30%; gonorrhoea-26%; syphilis-36%) and diagnoses (chlamydia-31%; gonorrhoea-25%; syphilis-23%) among young people in 2020. Reductions were greater amongst 15-19 year-olds vs. 20-24 year-olds. Amongst people tested for chlamydia, those living in the least deprived areas were more likely to be tested using an online self-sampling kit (males; OR = 1.24 [1.22-1.26], females; OR = 1.28 [1.27-1.30]). CONCLUSION: The first year of the COVID-19 pandemic in England saw declines in STI testing and diagnoses in young people and disparities in the use of online chlamydia self-sampling which risk widening existing health inequalities

Priorities and interactions of Sustainable Development Goals (SDGs) with focus on wetlands

Wetlands are often vital physical and social components of a country's natural capital, as well as providers of ecosystem services to local and national communities. We performed a network analysis to prioritize Sustainable Development Goal (SDG) targets for sustainable development in iconic wetlands and wetlandscapes around the world. The analysis was based on the information and perceptions on 45 wetlandscapes worldwide by 49 wetland researchers of the GlobalWetland Ecohydrological Network (GWEN). We identified three 2030 Agenda targets of high priority across the wetlandscapes needed to achieve sustainable development: Target 6.3-'Improve water quality'; 2.4-'Sustainable food production'; and 12.2-'Sustainable management of resources'. Moreover, we found specific feedback mechanisms and synergies between SDG targets in the context of wetlands. The most consistent reinforcing interactions were the influence of Target 12.2 on 8.4-'Efficient resource consumption'; and that of Target 6.3 on 12.2. The wetlandscapes could be differentiated in four bundles of distinctive priority SDG-targets: 'Basic human needs', 'Sustainable tourism', 'Environmental impact in urban wetlands', and 'Improving and conserving environment'. In general, we find that the SDG groups, targets, and interactions stress that maintaining good water quality and a 'wise use' of wetlandscapes are vital to attaining sustainable development within these sensitive ecosystems. © 2019 by the authors

Pharmacy student decision making in over-the-counter medicine supply: a critical incident study.

Background: Various factors influence decision making in over-the-counter (OTC) medicine consultations, yet limited studies have focused, in-depth, on the thought process of pharmacy staff. This includes pharmacy students as pharmacists-in-training. Aim: To explore the factors that influence pharmacy students’ decisions in relation to OTC consultations and choice of OTC medicine/s. Methods: Semi-structured interviews using the critical incident technique were undertaken with ten pharmacy students in Australia, who also worked as part-time pharmacy staff. Results: Nine key themes were identified to influence pharmacy student decision making in OTC consultations, including customer response, confidence and scope of practice. Product requests were reported as more challenging due to customer expectations and experiences in other pharmacies, states or countries. Although negative customer response influenced some students to supply medicines in contradiction of evidence, an overarching concern for safety meant that a medicine was only supplied if unlikely to cause harm. Students reported developing confidence in OTC decision making more from real-life practice than university training; greater confidence was identified for inquiries more frequently experienced in the pharmacy. Students perceived that customers had assumptions around support staff, and were happier to talk to students than assistants. Conclusion: This study further identified that OTC decision making is a complex process for pharmacy students. Additional opportunities for experiential learning within this area are suggested, such as work-based placements or in-class activities such as role-plays with simulated patients

The Global Alliance for Infections in Surgery : defining a model for antimicrobial stewardship-results from an international cross-sectional survey

Background: Antimicrobial Stewardship Programs (ASPs) have been promoted to optimize antimicrobial usage and patient outcomes, and to reduce the emergence of antimicrobial-resistant organisms. However, the best strategies for an ASP are not definitively established and are likely to vary based on local culture, policy, and routine clinical practice, and probably limited resources in middle-income countries. The aim of this study is to evaluate structures and resources of antimicrobial stewardship teams (ASTs) in surgical departments from different regions of the world. Methods: A cross-sectional web-based survey was conducted in 2016 on 173 physicians who participated in the AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections) project and on 658 international experts in the fields of ASPs, infection control, and infections in surgery. Results: The response rate was 19.4%. One hundred fifty-six (98.7%) participants stated their hospital had a multidisciplinary AST. The median number of physicians working inside the team was five [interquartile range 4-6]. An infectious disease specialist, a microbiologist and an infection control specialist were, respectively, present in 80.1, 76.3, and 67.9% of the ASTs. A surgeon was a component in 59.0% of cases and was significantly more likely to be present in university hospitals (89.5%, p <0.05) compared to community teaching (83.3%) and community hospitals (66.7%). Protocols for pre-operative prophylaxis and for antimicrobial treatment of surgical infections were respectively implemented in 96.2 and 82.3% of the hospitals. The majority of the surgical departments implemented both persuasive and restrictive interventions (72.8%). The most common types of interventions in surgical departments were dissemination of educational materials (62.5%), expert approval (61.0%), audit and feedback (55.1%), educational outreach (53.7%), and compulsory order forms (51.5%). Conclusion: The survey showed a heterogeneous organization of ASPs worldwide, demonstrating the necessity of a multidisciplinary and collaborative approach in the battle against antimicrobial resistance in surgical infections, and the importance of educational efforts towards this goal.Peer reviewe

Correction: Priorities and interactions of sustainable development goals (SDGs) with focus on wetlands. Water 2019, 11, 619 doi: 10.3390/w11030619

10.3390/w12010088Water (Switzerland)1218

Advancement, Testing and Validation of an Innovative SmallSat Solar Panel Fabrication Process

For universities, solar panels can be some of the highest expenditures of CubeSat development. In response, groups often opt to purchase solar panels from commercial providers to avoid in-house production complications; unfortunately, this option greatly restricts subsystem customizability and design flexibility. For those groups that choose to build, test and integrate solar panels internally, the process can turn into a monumental effort due to the lack of readily-available validated procedures outside of industry. In addition to being labor and cost intensive, traditional methods of solar panel fabrication contain intrinsic inefficiencies that compromise the subsystem’s overall reliability and reproducibility. Using techniques developed by University of Colorado Boulder and previously validated by University of Michigan, that paradigm is being shifted. The procedure uses a double-sided adhesive tape along with surface mounted tabs as a simplified method for mounting; it can be adapted to purely use silver epoxy if additional tabs cannot be procured. The solar panel fabrication techniques and testing results from the MinXSS and QB50-Challenger satellite will be presented, demonstrating substantial improvements to subsystem reliability, performance, and manufacturability. These results will be affirmed by the highly promising on-orbit results from MinXSS. Two procedures will be outlined, both of which can be readily adapted for a variety of solar cells and panel configurations. Overall, these procedures empower cost and time-constrained groups to fabricate solar panels to their unique system specifications, providing the option of high-performance panel production in a single day

A molecular diagnostic approach able to detect the recurrent genetic prognostic factors typical of presenting myeloma

Risk stratification in myeloma requires an accurate assessment of the presence of a range of molecular abnormalities including the differing IGH translocations and the recurrent copy number abnormalities that can impact clinical behavior. Currently, interphase fluorescence in situ hybridization is used to detect these abnormalities. High failure rates, slow turnaround, cost, and labor intensiveness make it difficult and expensive to use in routine clinical practice. Multiplex ligation-dependent probe amplification (MLPA), a molecular approach based on a multiplex polymerase chain reaction method, offers an alternative for the assessment of copy number changes present in the myeloma genome. Here, we provide evidence showing that MLPA is a powerful tool for the efficient detection of copy number abnormalities and when combined with expression assays, MLPA can detect all of the prognostically relevant molecular events which characterize presenting myeloma. This approach opens the way for a molecular diagnostic strategy that is efficient, high throughput, and cost effectiv