Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK: a prospective study

<p>Abstract</p> <p>Background</p> <p>More women are requesting Emergency Hormonal Contraception (EHC) at pharmacies where screening for <it>Chlamydia trachomatis </it>is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK.</p> <p>Methods</p> <p>Six Primary Care Trusts (PCTs) that had contracted with pharmacies to provide free EHC, requested the largest EHC providers (≥ 40 doses annually) to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate.</p> <p>Results</p> <p>33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718) of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348/2904 EHC clients (46.4%) who had been offered screening accepted a screening kit. 264 (17.6%) of those who accepted a kit returned a sample, of whom 24 (9.1%) were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015).</p> <p>Conclusion</p> <p>Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group.</p

Livelihood and vulnerability in the wake of Typhoon Yolanda: lessons of community and resilience

Livelihood strategies that are crafted in ‘extra-ordinary’ post-disaster conditions should also be able to function once some semblance of normalcy has resumed. This article aims to show that the vulnerability experienced in relation to Typhoon Yolanda was, and continues to be, directly linked to inadequate livelihood assets and opportunities. We examine the extent to which various livelihood strategies lessened vulnerability post-Typhoon Yolanda and argue that creating conditions under which disaster survivors have the freedom to pursue sustainable livelihood is essential in order to foster resilience and reduce vulnerability against future disasters. We offer suggestions to improve future relief efforts, including suggestions made by the survivors themselves. We caution against rehabilitation strategies that knowingly or unknowingly, resurrect pre-disaster vulnerability. Strategies that foster dependency, fail to appreciate local political or ecological conditions or undermine cooperation and cohesion in already vulnerable communities will be bound to fail. Some of the livelihood strategies that we observed post-Typhoon Yolanda failed on some or all of these points. It is important for future policy that these failings are addressed

Chlamydia trachomatis Incidence and Re-Infection among Young Women – Behavioural and Microbiological Characteristics

This study aimed to estimate rates of chlamydia incidence and re-infection and to investigate the dynamics of chlamydia organism load in prevalent, incident and re-infections among young Australian women.1,116 women aged 16 to 25 years were recruited from primary care clinics in Australia. Vaginal swabs were collected at 3 to 6 month intervals for chlamydia testing. Chlamydia organism load was measured by quantitative PCR.There were 47 incident cases of chlamydia diagnosed and 1,056.34 person years of follow up with a rate of 4.4 per 100 person years (95% CI: 3.3, 5.9). Incident infection was associated with being aged 16 to 20 years [RR = 3.7 (95%CI: 1.9, 7.1)], being employed [RR = 2.4 (95%CI: 1.1, 4.9)] and having two or more new sex partners [RR = 5.5 (95%CI: 2.6, 11.7)]. Recent antibiotic use was associated with a reduced incidence [RR:0.1 (95%CI: 0.0, 0.5)]. There were 14 re-infections with a rate of 22.3 per 100 person years (95%CI: 13.2, 37.6). The median time to re-infection was 4.6 months. Organism load was higher for prevalent than incident infections (p<0.01) and for prevalent than re-infections (p<0.01).Chlamydia is common among young women and a high proportion of women are re-infected within a short period of time, highlighting the need for effective partner treatment and repeat testing. The difference in organism load between prevalent and incident infections suggests prevalent infection may be more important for ongoing transmission of chlamydia

Microbial community structure elucidates performance of Glyceria maxima plant microbial fuel cell

The plant microbial fuel cell (PMFC) is a technology in which living plant roots provide electron donor, via rhizodeposition, to a mixed microbial community to generate electricity in a microbial fuel cell. Analysis and localisation of the microbial community is necessary for gaining insight into the competition for electron donor in a PMFC. This paper characterises the anode–rhizosphere bacterial community of a Glyceria maxima (reed mannagrass) PMFC. Electrochemically active bacteria (EAB) were located on the root surfaces, but they were more abundant colonising the graphite granular electrode. Anaerobic cellulolytic bacteria dominated the area where most of the EAB were found, indicating that the current was probably generated via the hydrolysis of cellulose. Due to the presence of oxygen and nitrate, short-chain fatty acid-utilising denitrifiers were the major competitors for the electron donor. Acetate-utilising methanogens played a minor role in the competition for electron donor, probably due to the availability of graphite granules as electron acceptors

User Centered Scenario Based Approach for Developing Mobile Interfaces for Social Life Networks

In recent years the explosive growth of smartphones and the evolution of mobile communication networks have certainly revolutionized the way how people communicate and access information. This revolution is even more tangible in developing countries where mobile devices are becoming the preferred way to access services for their daily activities. In this context, the development of mobile applications in the areas of health, education, agriculture, and mobile banking become a crucial factor. Unfortunately, the development process presents non-trivial human and technological challenges. The goal of our research is to support people living in developing countries to improve their lives. In particular we focused our attention on assisting farmers from rural zones of Sri Lanka in optimizing their crops

Spatial data and mobile applications - general solutions for interface design

Nowadays, spatial data are totally widespread in mobile applications. They are present in games, map applications, web community applications and office automations. However this kind of spatial information potentially needs a large display area and the hardware constraint related to the limited screen dimensions creates many usability challenges. Our investigation in the last few years to find solutions to these challenges has led us to the discovery of general usability principles that a well-designed interface should adopt. In this paper we describe the mental path we have followed to derive those principles from the experience gained in developing mobile interfaces for different application domains. The principles are formalized in terms of two interaction design patterns, specific for mobile interfaces managing spatial data. They extend existing HCI patterns and are completed, as usual, with concrete examples of their applications

Design science research based blended approach for usability driven requirements gathering and application development

Extracting user requirements in designing innovative ICT based solutions for emerging vague problems is a challenge. We successfully addressed this challenge by blending several techniques in Software Engineering (SE) and Human Computer Interaction (HCI) within a Design Science Research (DSR) framework. These techniques were traditional surveys and interviews, causal analysis, scenario creation and transformation, use of paper-based and functional prototypes for communicating with users and capturing their feedback, user centered design, and incremental development. This approach enabled us to better capture requirements based on usability aspects and guided us to design a successful solution. We present a framework derived from this research for wider applicability

Interplay of Requirements Engineering and Human Computer Interaction Approaches in the Evolution of a Mobile Agriculture Information System

Very high adoption of mobile phones in developing countries can be used to empower people engaged in various sectors such as agriculture, fisheries and healthcare by providing timely information in right context, thus facilitating them to make informed decisions. Having identified lack of such information is badly affecting farmers in Sri Lanka we embarked on a project to develop a mobile based agriculture information system. We had to combine different theories and methods both from Requirements engineering (RE) and Human Computer Interaction (HCI) on a need basis to successfully gather the requirements. When we retraced the process we saw a definitive systematic pattern as to how RE and HCI can be used to enrich such an artefact; highlighting the strong interplay between RE and HCI. Discovery of this pattern enabled us to generalise the process