1,168 research outputs found

    NEXAFS and XPS of p-Aminobenzoic Acid Polymorphs: The Influence of Local Environment

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    Nitrogen K-edge XPS and NEXAFS of the two polymorphic forms of para- aminobenzoic acid (PABA) are significantly different reflecting variation in hydrogen bonding. Alteration in hydrogen bonding at the amino group leads to a shift to high energy for both the XPS N 1s core level and the 3π* NEXAFS resonance with β-PABA. Participation of the amine group in the aromatic system causes the 1π* resonance to be sensitive to the nature of the intermolecular bonding at the para-carboxylic acid group, and a shift to low energy for α- PABA is observed due to hydrogen-bonded carboxylic acid dimer formation. FEFF calculations also successfully reproduce both the energy and intensity variations observed for the σ* shape resonance associated with the C-N bond, with the majority of the decrease in energy observed for b-PABA arising from the longer C-N bond

    Interventions for increasing chlamydia screening in primary care: a review

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    <p>Abstract</p> <p>Background</p> <p>Despite guidelines recommending opportunistic chlamydia screening of younger women, screening rates in some countries remain low. Our aim was to review the evidence for specific interventions aimed at increasing chlamydia screening rates in primary care.</p> <p>Methods</p> <p>A Medline search was conducted for controlled trials that assessed the effectiveness of interventions aimed at improving chlamydia screening rates in primary health care settings. The Medline search was done for studies in English published prior to December 2005 using the following key words: chlamydia, screening, intervention, primary care and GPs. In addition, the references cited in the articles were reviewed. Studies in English published prior to December 2005 were reviewed.</p> <p>Results</p> <p>Four controlled studies met the inclusion criteria – 3 were randomized studies and one was not. Strategies to increase screening rates included the use of educational packages targeting primary care physicians and the correction of barriers to screening within clinic systems. In 3 studies, the intervention was associated with an increase in screening rates of between 100% and 276% (p < 0.04). In the fourth study, the intervention was associated with a significant attenuation in declining screening rates over time (4% versus 34% decline, p = 0.04).</p> <p>Conclusion</p> <p>There are only a limited number of randomized or controlled studies that demonstrate improved chlamydia screening of younger women in primary care.</p

    Telling partners about chlamydia: how acceptable are the new technologies?

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    BACKGROUND Partner notification is accepted as a vital component in the control of chlamydia. However, in reality, many sexual partners of individuals diagnosed with chlamydia are never informed of their risk. The newer technologies of email and SMS have been used as a means of improving partner notification rates. This study explored the use and acceptability of different partner notification methods to help inform the development of strategies and resources to increase the number of partners notified. METHODS Semi-structured telephone interviews were conducted with 40 people who were recently diagnosed with chlamydia from three sexual health centres and two general practices across three Australian jurisdictions. RESULTS Most participants chose to contact their partners either in person (56%) or by phone (44%). Only 17% chose email or SMS. Participants viewed face-to-face as the "gold standard" in partner notification because it demonstrated caring, respect and courage. Telephone contact, while considered insensitive by some, was often valued because it was quick, convenient and less confronting. Email was often seen as less personal while SMS was generally considered the least acceptable method for telling partners. There was also concern that emails and SMS could be misunderstood, not taken seriously or shown to others. Despite these, email and SMS were seen to be appropriate and useful in some circumstances. Letters, both from the patients or from their doctor, were viewed more favourably but were seldom used. CONCLUSION These findings suggest that many people diagnosed with chlamydia are reluctant to use the new technologies for partner notification, except in specific circumstances, and our efforts in developing partner notification resources may best be focused on giving patients the skills and confidence for personal interaction.The study was funded by the Australian Federal Government Department of Health and Ageing Chlamydia Pilot Program of Targeted Grants

    HIGH-LEVEL APPLICATION FRAMEWORK FOR LCLS*

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    each other easily. Also, many components such as Help, A framework for high level accelerator application Search, Cut, Copy and Paste are seamlessly integrated software is being developed for the Linac Coherent Light through the Eclipse framework. Source (LCLS). The framework is based on plug-in technology developed by an open source project, Eclipse. Many existing functionalities provided by Eclipse are available to high-level applications written within this framework. The framework also contains static data storage configuration and dynamic data connectivity. Because the framework is Eclipse-based, it is highly compatible with any other Eclipse plug-ins. The entire infrastructure of the software framework will be presented. Planned applications and plug-ins based on the framework are also presented

    The WARPS survey: III. The discovery of an X-ray luminous galaxy cluster at z=0.833 and the impact of X-ray substructure on cluster abundance measurements

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    The WARPS team reviews the properties and history of discovery of ClJ0152.7-1357, an X-ray luminous, rich cluster of galaxies at z=0.833. At L_X = 8 x 10^44 h^(-2) erg/s (0.5-2.0 keV) ClJ0152.7-1357 is the most X-ray luminous cluster known at redshifts z>0.55. The high X-ray luminosity of the system suggests that massive clusters may begin to form at redshifts considerably greater than unity. This scenario is supported by the high degree of optical and X-ray substructure in ClJ0152.7-1357, which is similarly complex as that of other X-ray selected distant clusters and consistent with the picture of cluster formation by mass infall along large-scale filaments. X-ray emission from ClJ0152.7-1357 was detected already in 1980 with the EINSTEIN IPC. However, because the complex morphology of the emission caused its significance to be underestimated, the corresponding source was not included in the EMSS cluster sample and hence not previously identified. Simulations of the EMSS source detection and selection procedure suggest a general bias of the EMSS against X-ray luminous clusters with pronounced substructure. If highly unrelaxed, merging clusters are common at high redshift, they could create a bias in some samples as the morphological complexity of mergers may cause them to fall below the flux limit of surveys that assume a unimodal spatial source geometry. Conversely, the enhanced X-ray luminosity of mergers might cause them to, temporarily, rise above the flux limit. Either effect could lead to erroneous conclusions about the evolution of the comoving cluster space density. A high fraction of morphologically complex clusters at high redshift would also call into question the validity of cosmological studies that assume that the systems under investigation are virialized.Comment: 17 pages, 7 figures; revised to focus on possible detection biases caused by substructure in clusters; accepted for publication in ApJ; uses emulateapj.sty; eps files of figures 1 and 2 can be obtained from ftp://hubble.ifa.hawaii.edu/pub/ebeling/warp

    Better than nothing? Patient-delivered partner therapy and partner notification for chlamydia: the views of Australian general practitioners

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    BACKGROUND Genital chlamydia is the most commonly notified sexually transmissible infection (STI) in Australia and worldwide and can have serious reproductive health outcomes. Partner notification, testing and treatment are important facets of chlamydia control. Traditional methods of partner notification are not reaching enough partners to effectively control transmission of chlamydia. Patient-delivered partner therapy (PDPT) has been shown to improve the treatment of sexual partners. In Australia, General Practitioners (GPs) are responsible for the bulk of chlamydia testing, diagnosis, treatment and follow up. This study aimed to determine the views and practices of Australian general practitioners (GPs) in relation to partner notification and PDPT for chlamydia and explored GPs' perceptions of their patients' barriers to notifying partners of a chlamydia diagnosis. METHODS In-depth, semi-structured telephone interviews were conducted with 40 general practitioners (GPs) from rural, regional and urban Australia from November 2006 to March 2007. Topics covered: GPs' current practice and views about partner notification, perceived barriers and useful supports, previous use of and views regarding PDPT.Transcripts were imported into NVivo7 and subjected to thematic analysis. Data saturation was reached after 32 interviews had been completed. RESULTS Perceived barriers to patients telling partners (patient referral) included: stigma; age and cultural background; casual or long-term relationship, ongoing relationship or not. Barriers to GPs undertaking partner notification (provider referral) included: lack of time and staff; lack of contact details; uncertainty about the legality of contacting partners and whether this constitutes breach of patient confidentiality; and feeling both personally uncomfortable and inadequately trained to contact someone who is not their patient. GPs were divided on the use of PDPT--many felt concerned that it is not best clinical practice but many also felt that it is better than nothing.GPs identified the following factors which they considered would facilitate partner notification: clear clinical guidelines; a legal framework around partner notification; a formal chlamydia screening program; financial incentives; education and practical support for health professionals, and raising awareness of chlamydia in the community, in particular amongst young people. CONCLUSIONS GPs reported some partners do not seek medical treatment even after they are notified of being a sexual contact of a patient with chlamydia. More routine use of PDPT may help address this issue however GPs in this study had negative attitudes to the use of PDPT. Appropriate guidelines and legislation may make the use of PDPT more acceptable to Australian GPs.The Australian Federal Government Department of Health and Ageing Chlamydia Pilot Program of Targeted Grants funded the study

    Apparent mass of small children: Experimental measurements

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    A test facility and protocol were developed for measuring the seated, vertical, whole-body vibration response of small children of less than 18 kg in mass over the frequency range from 1 to 45 Hz. The facility and protocol adhered to the human vibration testing guidelines of BS7085 and to current codes of ethics for research involving children. Additional procedures were also developed which are not currently defined in the guidelines, including the integral involvement of the parents and steps taken to maximize child happiness. Eight children were tested at amplitudes of 0.8 and 1.2 m/s2 using band-limited, Gaussian, white noise acceleration signals defined over the frequency interval from 1 to 50 Hz. Driving point apparent mass modulus and phase curves were determined for all eight children at both test amplitudes. All results presented a single, principal, anti-resonance, and were similar to data reported for primates and for adult humans seated in an automotive posture which provided backrest support. The mean frequency of the apparent mass peak was 6.25 Hz for the small children, as compared to values between 6.5 - 8.5 Hz for small primates and values between 6.5 - 8.6 Hz for adults seated with backrest support. The peak value of the mean, normalized, apparent mass was 1.54 for the children, which compares to values from 1.19 to 1.45 reported in the literature for small primates and 1.28 for adults seated with backrest support. ISO standard 5982, which specifies a mean, normalized, apparent mass modulus peak of 1.50 at a frequency of 4.0 Hz for adults seated without backrest support, provides significant differences

    Screening pregnant women for chlamydia : what are the predictors of infection?

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    Objectives: To determine the risk factors associated with chlamydial infection in pregnancy and the sensitivity and specificity of these when used for selective screening.Methods: A prospective, cross-sectional study of pregnant women aged 16&ndash;25 years attending four major public antenatal services across Melbourne, Australia. Between October 2006 and July 2007, women were approached consecutively and asked to complete a questionnaire and to provide a first-pass urine specimen for Chlamydia trachomatis testing using PCR.Results: Of 1180 eligible women, 1087 were approached and 1044 (88%) consented to participate. Among the 987 women for whom a questionnaire and a definitive diagnostic assay were available, the prevalence of chlamydia was 3.2% (95% CI 1.8 to 5.9). In a multiple logistic regression model, more than one sexual partner in the past year (AOR 11.5; 95% CI 7.1 to 18.5) was associated with chlamydia infection. The use of any antibiotic within 3 months (AOR 0.2; 95% CI 0.1 to 0.6) was associated with a decreased risk of infection. Screening restricted to women who reported more than one sexual partner in the past year would have detected 44% of infections in women aged 16&ndash;25 years and would have required only 7% of women to be screened. The addition of those women aged 20 years and under would have required 27% of women to be screened and detection of 72% of infections.Conclusions: Selective chlamydia screening of pregnant women based on risk factors can improve the yield from screening. However, the potential harm of missed infections among excluded women would need to be considered.<br /

    Women’s Views and Experiences of the Triggers for Onset of Bacterial Vaginosis and Exacerbating Factors Associated with Recurrence

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    Background Bacterial vaginosis (BV) is the most common vaginal infection affecting women of childbearing age. While the aetiology and transmissibility of BV remain unclear, there is strong evidence to suggest an association between BV and sexual activity. This study explored women’s views and experiences of the triggers for BV onset and factors associated with recurrence. Methods A descriptive, social constructionist approach was chosen as the framework for the study. Thirty five women of varying sexual orientation who had experienced recurrent BV in the past five years took part in semi-structured interviews. Results The majority of women predominantly reported sexual contact triggered the onset of BV and sexual and non-sexual factors precipitated recurrence. Recurrence was most commonly referred to in terms of a ‘flare-up’ of symptoms. The majority of women did not think BV was a sexually transmitted infection however many reported being informed this by their clinician. Single women who attributed BV onset to sex with casual partners were most likely to display self-blame tendencies and to consider changing their future sexual behaviour. Women who have sex with women (WSW) were more inclined to believe their partner was responsible for the transmission of or reinfection with BV and seek partner treatment or change their sexual practices. Conclusion Findings from this study strongly suggest women believe that BV onset is associated with sexual activity, concurring with epidemiological data which increasingly suggest BV may be sexually transmitted. Exacerbating factors associated with recurrence were largely heterogeneous and may reflect the fact it is difficult to determine whether recurrence is due to persistent BV or a new infection in women. There was however evidence to suggest possible transmission and reinfection among WSW, reinforcing the need for new approaches to treatment and management strategies including male and female partner treatment trials.Dr. Jade Bilardi is in receipt of an NHMRC Early Career Fellowship No 1013135

    Women’s Management of Recurrent Bacterial Vaginosis and Experiences of Clinical Care: A Qualitative Study.

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    Background Few data are available on how women manage recurring bacterial vaginosis (BV) and their experiences of the clinical care of this condition. This study aimed to explore women’s recurrent BV management approaches and clinical care experiences, with a view to informing and improving the clinical management of BV. Methods A descriptive, social constructionist approach was chosen as the framework for the study. Thirty-five women of varying sexual orientation who had experienced recurrent BV in the past 5 years took part in semi-structured interviews. Results The majority of women reported frustration and dissatisfaction with current treatment regimens and low levels of satisfaction with the clinical management of BV. Overall, women disliked taking antibiotics regularly, commonly experienced adverse side effects from treatment and felt frustrated at having symptoms recur quite quickly after treatment. Issues in clinical care included inconsistency in advice, misdiagnosis and inappropriate diagnostic approaches and insensitive or dismissive attitudes. Women were more inclined to report positive clinical experiences with sexual health physicians than primary care providers. Women’s frustrations led most to try their own self-help remedies and lifestyle modifications in an attempt to treat symptoms and prevent recurrences, including well-known risk practices such as douching. Conclusion In the face of considerable uncertainty about the cause of BV, high rates of recurrence, unacceptable treatment options and often insensitive and inconsistent clinical management, women are trying their own self-help remedies and lifestyle modifications to prevent recurrences, often with little effect. Clinical management of BV could be improved through the use of standardised diagnostic approaches, increased sensitivity and understanding of the impact of BV, and the provision of evidence based advice about known BV related risk factors.Dr. Jade Bilardi is in receipt of a National Health and Medical Research Council Early Career Fellowship (No. 1013135)
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