Injecting Drug Users' Understanding of Hepatitis C

Most Australians who have hepatitis C contracted the virus through the shared use of drug injecting equipment. Further, the prevalence and incidence of hepatitis C virus (HCV) are high among Australian injecting drug users (IDUs), around 50 to 60 percent and 15 percent respectively. The task, therefore, of controlling the spread of hepatitis C depends largely on controlling transmission among IDUs. Although there is a considerable body of research describing hepatitis C epidemiology and infection risk factors, very little research has examined IDUs’ understanding of hepatitis C. The aim of the current study, therefore, was to examine IDUs’ knowledge of hepatitis C, their understanding of virus transmission, the clinical markers and symptoms of the virus, and treatment in particular. How IDUs prioritise hepatitis C relative to other life areas was also examined. A cross-sectional survey, using an interviewer administered, structured questionnaire, was conducted across inner-city, suburban and regional sites of New South Wales. Participants were recruited through advertisements at needle and syringe programs (NSPs), methadone clinics, and snowballing (word-of-mouth) techniques. Participation was not determined by hepatitis C status. One hundred and forty nine IDUs were interviewed. The median age of the sample was 34 years and approximately two-thirds were male. The median age of first drug injection was 17 years, with the most commonly reported illicit drugs injected in the last month being amphetamine (62%) and heroin (61%). Over half of the sample (62%) was in treatment for drug use at the time of interview, with the majority in a methadone or buprenorphine program. Over half the sample rated their knowledge and understanding of hepatitis C as either ‘good’ (30%) or ‘very good’ (23%). Testing for hepatitis C was common among the sample, with all but one participant tested for hepatitis C in their lifetime, and the majority (74%) tested one or more times in the past 12 months. ‘Routine screening’ was the main reason selected for their last test (39%), followed by ‘mandatory testing’ (13%) and then ‘risky behaviour’ (12%). Seventy six percent of the sample believed they had hepatitis C at the time of interview. Despite most participants reporting recent and often multiple testing, a number of IDUs were clearly confused about the results of the various tests. Only about 40 percent of those tested during or after 2000 reported receiving pre- and post-test counselling. Significant gaps in IDUs’ knowledge of hepatitis C were uncovered in the study, with respect to transmission risks, symptoms, clinical markers and treatment. For instance, substantial proportions of participants believed it was possible to contract hepatitis C by re-using their own needle (48%), or from dirt (17%). Forty-two percent of participants believed antibodies to hepatitis C gave protection against acquiring the virus (42%), and over one-third (35%) believed that some people are immune to hepatitis C. IDUs’ understanding of their own hepatitis C infection was similarly confused, with one in five participants who reported having hepatitis C believing they could not infect others (19%), and that they were immune to hepatitis C (19%). One in three participants stated they did not have antibodies for hepatitis C, and an even greater number were unsure, despite reporting themselves to have hepatitis C. Very few IDUs were found to prioritise hepatitis C highly relative to other life areas. For many IDUs, hepatitis C appears to be a relatively low priority compared with the numerous health, welfare and social concerns that exist among this often economically and socially marginalised group. However, health was frequently selected as one of the most important life areas determining quality of life, which may incorporate symptoms and sequelae resulting from hepatitis C impacting on day-to-day life. Given the high prevalence and incidence of hepatitis C among Australian IDUs, and that many continue to share injecting equipment, the findings of this study are of great concern. The fundamental misconceptions held about hepatitis C, particularly regarding ‘antibodies’ and their perceived role in providing immunity, place IDUs at serious risk of transmitting and contracting hepatitis C. These findings warrant further development of, and research into, strategies to improve IDUs’ understanding of hepatitis C

The role of ultrasound simulators in education: An investigation into sonography student experiences and clinical mentor perceptions

Introduction: Simulation as an effective pedagogy is gaining momentum at all levels of healthcare education. Limited research has been undertaken on the role of simulated learning in healthcare, and further evaluation is needed to explore the quality of learning opportunities offered, and their effectiveness in the preparation of students for clinical practice. This study was undertaken to explore ways of integrating simulation into sonography training to enhance clinical preparation.Research method: A qualitative study was undertaken, using interviews to investigate the experiences of a group of sonography students after interacting with an ultrasound simulator. The perceptions of their clinical mentors on the effectiveness of this equipment to support the education and development of sonographers, were also explored.Findings: The findings confirm that ultrasound simulators provide learning opportunities in an unpressurised environment, which reduces stress for the student and potential harm to patients. Busy clinical departments acknowledge the advantages of opportunities for students to acquire basic psychomotor skills in a classroom setting, thereby avoiding the inevitable reduction in patient throughput which results from clinical training. The limitations of simulation equipment to support the development of the full range of clinical skills required by sonographers, were highlighted, and suggestions made for more effective integration of simulation into the teaching and learning process. Conclusion: Ultrasound simulators have a role in sonography education, but continued research needs to be undertaken in order to develop appropriate strategies to support students, educators, and mentors to effectively integrate this methodology

Detection of Vacuum Birefringence with Intense Laser Pulses

We propose a novel technique that promises hope of being the first to directly detect a polarization in the quantum electrodynamic (QED) vacuum. The technique is based upon the use of ultra-short pulses of light circulating in low dispersion optical resonators. We show that the technique circumvents the need for large scale liquid helium cooled magnets, and more importantly avoids the experimental pitfalls that plague existing experiments that make use of these magnets. Likely improvements in the performance of optics and lasers would result in the ability to observe vacuum polarization in an experiment of only a few hours duration.Comment: 4 pages, 1 figur

The OMERACT emerging leaders program: The good, the bad, and the future

The Journal of Rheumatology Copyright © 2019. All rights reserved. Objective. To describe the experience of the first OMERACT Emerging Leaders Program (ELP). Methods. A Delphi process identified positive aspects, areas for improvement, and future directions. Core items were defined as essential if they received ≥ 70% ratings. Results. Participants valued relatable/accessible mentors (100%), including an OMERACT Executive mentor (100%), and a support network of peers (90%). Key items for future development were funding support (100%) and developing knowledge about OMERACT processes (90%) and politics (80%). Conclusion. The ELP has the potential to provide targeted training for early career researchers to develop relevant skills for future leadership roles within OMERACT

Development of predictive equations for thermal conductivity of compost bedding

Among animal facilities, compost-bedded pack (CBP) barns have attracted a lot of attention from milk producers and the scientific community. Systematic investigation of the main thermal properties utilizing sawdust in CBP barns is of environmental and economic relevance. In this paper, the aim was to (a) develop predictive equations for the thermal conductivity (k) of compost bedding as a function of moisture content (MC), the degree of compaction (DCo), and particle size (PS); and (b) investigate the links between k and depth within bedding material. Samples of compost bedding materials were collected from 42 commercial CBP barns distributed throughout Kentucky (USA). From these predictive equations, it was possible to understand how the MC, DCo, and PS of the bedding materials may influence the behavior of k. These results are very useful for solving obstacles to simulate and predict the variable outcomes of the compost bedding materials process in CBP barns, allowing for its optimization, consequently reducing the time and energy spent on their optimization and allowing for simulation and assessment of compost bedding process modifications. The results of the current study may have important implications in the design and management of bedded pack barns

VALIDATION OF WEIGHED RECORDS AND OTHER METHODS OF DIETARY ASSESSMENT USING THE 24-H URINE NITROGEN TECHNIQUE AND OTHER BIOLOGICAL MARKERS

Results from analysis of 24 h urine collections, verified for completeness with para-amino benzoic acid, and blood samples collected over 1 year were compared with 16 d weighed records of all food consumed collected over the year, and with results from 24 h recalls, food-frequency questionnaires and estimated food records in 160 women. Using the weighed records, individuals were sorted into quintiles of the distribution of the urine N excretion: dietary N intake ratio (UN:DN). UN exceeded DN in the top quintile of this ratio; mean ratio UN:DN = 1·13 Individuals in this top quintile were heavier, had significantly greater body mass indices, were reportedly more restrained eaters, had significantly lower energy intake:basal metabolic rate ratios (EI:BMR), and had correlated ratios of UN:DN and EI:BMR (r - 0·62). Those in the top quintile reported lower intakes of energy and energy-yielding nutrients, Ca, fats, cakes, breakfast cereals, milk and sugars than individuals in the other quintiles but not lower intakes of non-starch polysaccharides, vitamin C, vegetables, potatoes or meat. Correlations between dietary intake from weighed records and 24 h urine K were 0·74 and 0·82, and between dietary vitamin C and β-carotene and plasma vitamin C and β-carotene 0·86 and 0·48. Correlations between dietary N intake from weighed records and 24 h urine excretion were high (0·78–0·87). Those between N from estimated food records and urine N were r 0·60–0·70. Correlations between urine N and 24 h recalls and food-frequency questionnaires were in the order of 0·01 to 0·5. Despite problems of underreporting in overweight individuals in 20% of this sample, weighed records remained the most accurate method of dietary assessment, and only an estimated 7 d diary was able to approach this accuracy

Classification of a supersolid: Trial wavefunctions, Symmetry breakings and Excitation spectra

A state of matter is characterized by its symmetry breaking and elementary excitations. A supersolid is a state which breaks both translational symmetry and internal $U(1)$ symmetry. Here, we review some past and recent works in phenomenological Ginsburg-Landau theories, ground state trial wavefunctions and microscopic numerical calculations. We also write down a new effective supersolid Hamiltonian on a lattice. The eigenstates of the Hamiltonian contains both the ground state wavefunction and all the excited states (supersolidon) wavefunctions. We contrast various kinds of supersolids in both continuous systems and on lattices, both condensed matter and cold atom systems. We provide additional new insights in studying their order parameters, symmetry breaking patterns, the excitation spectra and detection methods.Comment: REVTEX4, 19 pages, 3 figure

People of the British Isles: preliminary analysis of genotypes and surnames in a UK control population

There is a great deal of interest in fine scale population structure in the UK, both as a signature of historical immigration events and because of the effect population structure may have on disease association studies. Although population structure appears to have a minor impact on the current generation of genome-wide association studies, it is likely to play a significant part in the next generation of studies designed to search for rare variants. A powerful way of detecting such structure is to control and document carefully the provenance of the samples involved. Here we describe the collection of a cohort of rural UK samples (The People of the British Isles), aimed at providing a well-characterised UK control population that can be used as a resource by the research community as well as providing fine scale genetic information on the British population. So far, some 4,000 samples have been collected, the majority of which fit the criteria of coming from a rural area and having all four grandparents from approximately the same area. Analysis of the first 3,865 samples that have been geocoded indicates that 75% have a mean distance between grandparental places of birth of 37.3km, and that about 70% of grandparental places of birth can be classed as rural. Preliminary genotyping of 1,057 samples demonstrates the value of these samples for investigating fine scale population structure within the UK, and shows how this can be enhanced by the use of surnames

Population genomics reveals that an anthropophilic population of Aedes aegypti mosquitoes in West Africa recently gave rise to American and Asian populations of this major disease vector

Abstract Background The mosquito Aedes aegypti is the main vector of dengue, Zika, chikungunya and yellow fever viruses. This major disease vector is thought to have arisen when the African subspecies Ae. aegypti formosus evolved from being zoophilic and living in forest habitats into a form that specialises on humans and resides near human population centres. The resulting domestic subspecies, Ae. aegypti aegypti, is found throughout the tropics and largely blood-feeds on humans. Results To understand this transition, we have sequenced the exomes of mosquitoes collected from five populations from around the world. We found that Ae. aegypti specimens from an urban population in Senegal in West Africa were more closely related to populations in Mexico and Sri Lanka than they were to a nearby forest population. We estimate that the populations in Senegal and Mexico split just a few hundred years ago, and we found no evidence of Ae. aegypti aegypti mosquitoes migrating back to Africa from elsewhere in the tropics. The out-of-Africa migration was accompanied by a dramatic reduction in effective population size, resulting in a loss of genetic diversity and rare genetic variants. Conclusions We conclude that a domestic population of Ae. aegypti in Senegal and domestic populations on other continents are more closely related to each other than to other African populations. This suggests that an ancestral population of Ae. aegypti evolved to become a human specialist in Africa, giving rise to the subspecies Ae. aegypti aegypti. The descendants of this population are still found in West Africa today, and the rest of the world was colonised when mosquitoes from this population migrated out of Africa. This is the first report of an African population of Ae. aegypti aegypti mosquitoes that is closely related to Asian and American populations. As the two subspecies differ in their ability to vector disease, their existence side by side in West Africa may have important implications for disease transmission