Chlamydia control activities in Europe: cross-sectional survey

Background: Chlamydia is the most commonly reported bacterial sexually transmitted infection in Europe. The objective of the Screening for Chlamydia in Europe (SCREen) project was to describe current and planned chlamydia control activities in Europe. Methods: The authors sent a questionnaire asking about different aspects of chlamydia epidemiology and control to public health and clinical experts in each country in 2007. The principles of sexually transmitted infection control were used to develop a typology comprising five categories of chlamydia control activities. Each country was assigned to a category, based on responses to the questionnaire. Results: Experts in 29 of 33 (88%) invited countries responded. Thirteen of 29 countries (45%) had no current chlamydia control activities. Six countries in this group stated that there were plans to introduce chlamydia screening programmes. There were five countries (17%) with case management guidelines only. Three countries (10%) also recommended case finding amongst partners of diagnosed chlamydia cases or people with another sexually transmitted infection. Six countries (21%) further specified groups of asymptomatic people eligible for opportunistic chlamydia testing. Two countries (7%) reported a chlamydia screening programme. There was no consistent association between the per capita gross domestic product of a country and the intensity of chlamydia control activities (P = 0.816). Conclusion: A newly developed classification system allowed the breadth of ongoing national chlamydia control activities to be described and categorized. Chlamydia control strategies should ensure that clinical guidelines to optimize chlamydia diagnosis and case management have been implemented before considering the appropriateness of screening programmes

Chemically defined culture media: rational recipes or witches' brew?

A rational approach to study cells, tissues or even organs is to isolate them from the body and bring them into a controlled, and therefore reproducible, environment. In vivo, cells are surrounded by the extracellular matrix, and the body fluids nourish them. In vitro, these fluids are replaced by culture media. In the early days of tissue culture, tissue was cultured in a drop of clotted lymph. The early-day natural nutrient media have gradually become replaced by media of a more defined composition, culminating in the advent of completely defined culture media.Biomedical Reviews 1996; 6: 111-119

Global gene expression profiling of ischemic preconditioning in the rat retina

PURPOSE: To obtain and analyze the gene expression changes after ischemic preconditioning (IPC) in the rat retina. METHODS: Ischemic damage to the inner retina can be prevented by a short, non-deleterious, ischemic insult of 5 min applied 24 h preceding a full ischemic insult of 60 min; a phenomenon termed tolerance or IPC. The time course of changes in gene expression after induction of IPC was assessed by 22K oligonucleotide microarrays, followed by real-time quantitative polymerase chain reaction (qPCR) validation. Functional pathways of interest were identified by Gene Ontology-term analysis. RESULTS: Histology confirmed that IPC induction by 5 min of retinal ischemia results in a complete protection against the neurodegenerative effects of a 60 min ischemic period applied 24 or 48 h later. The microarray analysis revealed differential expression of 104 known genes at one or more time points between 1 h and 7 days after IPC. The group of altered genes contained a significant overrepresentation of genes involved in aminoacyl-tRNA synthetase activity (Iars, Lars, Cars, Yars, Gars, Tars), amino acid transport (Slc3a2, Slc6a6, Slc7a1, Slc38a2), regulation of transcription (including Egr1, Egr4, Nr4a1, Nr4a3, c-fos), and cell death (including Anxa1, Trib3). qPCR assays on cDNA of individual animals confirmed the microarray results. CONCLUSIONS: Endogenous neuroprotection, provoked by ischemic preconditioning is associated with changes in transcript levels of several functionally-related groups of genes. During the time window of effective protection, transcript levels of genes encoding for aminoacyl-tRNA synthetases and for amino acid transport are reduced. These changes suggest that a reduction of translational activity may play a significant role in preconditioning-mediated neuroprotectio

Prevention of reading difficulties in children with and without familial risk:Short- and long-term effects of an early intervention

In a randomized-controlled trial we tested a computer-assisted intervention for the prevention of reading difficulties, delivered by nonprofessional tutors, running from kindergarten to halfway Grade 2. The full sample included 123 prereaders (M = 5; 6 years; 56 intervention; 67 controls) with low preliteracy skills. Parents were sent a questionnaire to assess family risk (FR) for reading difficulties. There was no intervention effect in the full sample, but, unexpectedly, the effect differed between subsamples that did and did not return the questionnaire. The intervention did not affect reading acquisition in the subsample (N = 49) without FR-data, mostly children from immigrant, non-Dutch speaking, low-socioeconomic status (SES) families, but had large effects in the subsample of Dutch-speaking, middle and high SES-parents with FR-data (N = 74). The latter subsample was followed until Grade 6, 4 years after the intervention, and included 36 intervention children and 38 controls. Long-lasting improvements were found in word-reading fluency, which transferred to reading fluency for pseudowords, English words: and texts, and to spelling. The intervention substantially reduced the need for remedial teaching and grade retention. On all measures, children with FR performed worse than children without FR. The intervention had similar effects on the progress of both groups, but the FR children needed more sessions. This study shows that a 2-year cost-effective early intervention can reduce the incidence of reading difficulties. However, it remains a challenge to make the intervention suited for children in which a lack of preliteracy skills merely seems to reflect a lack of learning opportunities

Long-term oral anticoagulant treatment after myocardial infarction : results of the 'Anticoagulants in the Secondary Prevention of Events in Coronary Thrombosis' (ASPECT) trial

Despite the fact that mortality from cardiovascular diseases has declined considerably over the last decades, it still represents the leading cause of mortality and morbidity in industrialized countries. Most clinical manifestations of cardiovascular disease share the underlying pathophysiological process of atherosclerosis. Atherosclerosis is a diseased state of the intima and media of medium to large sized arteries characterized by focal plaques preferentially located in areas of low shear. It is assumed that plaques origin from fatty streaks that are initiated by oxidation of low density lipoprotein. Formation of fatty streaks may also follow initial injury from a wide range of agents including toxins, viral infections and intraluminal devices such as catheters. The subsequent inflammatory reactions induce smooth muscle proliferation by growth factor production from a wide range of cells including platelets, endothelial cells, macrophages, and other smooth muscle cells. The development of fatty streaks may already commence early in childhood and progress over a period of decades to become atherosclerotic plaques which contain lipid-filled foam cells, extracellular lipid and a layer of smooth muscle cells just beneath the endothelium.' Plaque growth is mediated by the proliferation of smooth muscle cells and extracellular connective tissue elements such as collagen, elastin, and proteoglycans. Growth factors derived from the interaction between platelets and the underlying artery wall further stimulates this process. This process will lead to the formation of a fibrolipid plaque that constitutes a core of extracellular lipid separated from the media by smooth muscle cells and covered and separated from the lumen by a thick cap of collagen-rich fibrous tissue containing smooth muscle cells. Surrounding the lipid core are lipid-filled foam cells. Elevated coronary plaques may cause clinical symptoms when the plaque size is sufficient to obstruct the normal bloodflow, usually when it occupies more than 40 percent of the original cross-sectional area of the lumen. As the result of a dynamic interplay between plaque vulnerability, possibly mediated through a process of inflammation, and external stresses the atherosclerotic plaque surface may eventually rupture

Hanging Out in the Past: Looking for Trouble or Romance? An Exploration of the Practice and Meaning of Hanging Out for Young Dutch People in 1930–60

Young people’s ‘hanging out’ has had different meanings in the recent and distant past in various countries and cultures, including delinquency or a common social phenomenon. Although there is evidence for hanging out as social behaviour in various countries, Dutch research on hanging out as a common social phenomenon is scarce. This article retrospectively explores the practice and meaning of hanging out for young people in the Netherlands between 1930 and 1960. Semi-structured qualitative interviews (n = 60) were analysed using the Constant Comparative Method, resulting in three key themes: familiarity, features and the meanings assigned to hanging out. Results indicate that hanging out was practised and known by most respondents, and included particular features (time, location, gender and routines). Meet, flirt with and date other young people was the most frequently mentioned meaning associated with hanging out. Accordingly, hanging out can indeed be considered to have been a common social phenomenon

Проектирование оборудования автоцистерны для применения в подразделениях добровольной пожарной охраны на базе специального автомобиля АРС-14

Актуальность данной работы заключается в том, что пожары с течением времени охватывают большую территорию и наносит значительный экономический ущерб сельским поселениям, удаленным на значительное расстояние от подразделений ФПС МЧС России. В связи с этим укомплектование добровольно пожарных команд ВДПО является решением данной проблемы. Целью данной работы является повышение эффективности ведения пожаротушения подразделениями ВДПО.The relevance of this work is that fires over time cover a large area and cause significant economic damage to rural settlements remote from a significant distance from the units of the Federal Emergency Service of Russia. In this regard, the manning of volunteer firefighters VDPO is the solution to this problem. The purpose of this work is to increase the efficiency of firefighting by VDPO units

Purchase order finance: A conceptual model with economic insights

Purchase Order (PO) finance is a form of financial intermediation which can alleviate capital constraints in certain supply chains. PO finance is typically utilized by small and medium-sized enterprises (SMEs) that operate as importers, exporters, wholesalers, or distributors and have high sales growth. When applicable, PO finance creates value for the supply chain by providing capital that is not available through regular lending channels, due to informational problems. We provide a conceptual model that clarifies the value proposition of PO finance and describe how the transactions are carried out in practice. The conceptual model allows us to highlight the settings where economic conditions will favor the application of PO finance

Quality of patient- and proxy-reported outcomes for children with impairment of the lower extremity:A systematic review using the COnsensus-based Standards for selection of health Measurement INstruments methodology

Background: Patient-reported outcome measures have become crucial in the clinical evaluation of patients. Appropriate selection, in a young population, of the instrument is vital to providing evidence-based patient-centered healthcare. This systematic review applies the COnsensus-based Standards for selection of health Measurement INstruments methodology to provide a critically appraised overview of patient-reported outcome measures targeted at pediatric orthopedic patients with lower limb impairment.Method: A systematic search of electronic databases was performed to identify original studies reporting the development and/or validation of patient-reported outcome measures evaluating children with impairment of the lower extremity. Data extraction, quality assessment, and risk of bias evaluation were performed following the COnsensus-based Standards for selection of health Measurement INstruments guidelines and Preferred Reporting Items for Systematic reviews and Meta-Analyses statement.Results: A total of 6919 articles were screened. Thirty-three studies were included, reporting evidence on the measurement properties of 13 different patient-reported outcome measures and 20 translations. Four studies reported on content validity and patient-reported outcome measure development. The methodological quality of studies on structural validity, content validity, or patient-reported outcome measure development was mostly rated as "doubtful" or "very good." The quality of evidence on measurement properties varied noticeably, with most studies needing to perform improve their methodological quality to justify their results.Conclusion: This review provides an extensive overview of all available patient-reported outcome measures for patients with lower extremity impairment within pediatric orthopedics. We cautiously advise the use of four patient-reported outcome measures. However, the scarce availability of research on content validity and patient-reported outcome measure development highlights an area for future research endeavors to improve our knowledge on the currently available patient-reported outcome measures.Level of evidence: Diagnostic level

Trends in sexually transmitted infections in the Netherlands, combining surveillance data from general practices and sexually transmitted infection centers

<p>Abstract</p> <p>Background</p> <p>Sexually transmitted infections (STI) care in the Netherlands is primarily provided by general practitioners (GPs) and specialized STI centers. STI surveillance is based on data from STI centers, which show increasing numbers of clients. Data from a GP morbidity surveillance network were used to investigate the distribution in the provision of STI care and the usefulness of GP data in surveillance.</p> <p>Methods</p> <p>Data on STI-related episodes and STI diagnoses based on ICPC codes and, for chlamydia, prescriptions, were obtained from GP electronic medical records (EMRs) of the GP network and compared to data from STI centers from 2002 to 2007. Incidence rates were estimated for the total population in the Netherlands.</p> <p>Results</p> <p>The incidence of STI-consultations and -diagnoses increased substantially in recent years, both at GPs and STI centers. The increase in consultations was larger than the increase in diagnoses; Chlamydia incidence rose especially at STI centers. GPs were responsible for 70% of STI-related episodes and 80-85% of STI diagnoses. STI centers attract relatively younger and more often male STI-patients than GPs. Symptomatic STIs like <it>Herpes genitalis </it>and genital warts were more frequently diagnosed at GPs and chlamydia, gonorrhea and syphilis at STI centers.</p> <p>Conclusions</p> <p>GPs fulfill an important role in STI care, complementary to STI centers. Case definitions of STI could be improved, particularly by including laboratory results in EMRs. The contribution of primary care is often overlooked in STI health care. Including estimates from GP EMRs can improve the surveillance of STIs.</p