Testing for sexually transmitted infections among students: a discrete choice experiment of service preferences

Objectives To assess preferences among students for sexually transmitted infection (STI) testing services, with a view to establishing strength of preference for different service attributes. Design Online discrete choice experiment (DCE) questionnaire. Setting South East of England. Participants A convenience sample of 233 students from two universities. Outcomes Adjusted ORs in relation to service characteristics. Results The study yielded 233 responses. Respondents’ ages ranged from 16 to 34 years with a mean age of 22 years. Among this sample, the respondents demonstrated strong preferences for a testing service which provided tests for all STIs including syphilis, herpes and HIV (OR 4.1; 95% CI 3.36 to 4.90) and centres staffed by a doctor or nurse with specialist knowledge of STIs (OR 2.1; 95% CI 1.78 to 2.37). Receiving all test results, whether positive or negative, was also significantly preferable to not being notified when tests were all negative (‘no news is good news’; OR 1.3; 95% CI 1.16 to 1.5). The length of time waiting for an appointment and the method by which results are received were not significant service characteristics in terms of preferences. Patient level characteristics such as age, sex and previous testing experience did not predict the likelihood of testing. Conclusions This study demonstrates that of the examined attributes, university students expressed the strongest preference for a comprehensive testing service. The next strongest preferences were for being tested by specialist STI staff and receiving negative as well as positive test results. However, it remains unclear how strong these preferences are in relation to characteristics which were not part of the study design and whether or not they are cost-effective

Reactions of clover plants to soil contamination with zinc salts

Вивчено вплив іонів цинку на ріст, масу та стан пігментної системи листків Trifolium prаtense L. Розвиток кореневої системи проростків більше пригнічується, ніж надземної частини. За перевищення МДК у 10 разів площа листків зменшувалася порівняно з контролем на 65–70 %. З’ясовано закономірності акумуляції та розподілу цинку в органах конюшини. При збільшенні концентрації елемента у ґрунті його концентрація в рослині зростає до певної межі, а при низьких концентраціях зростає лінійно. При концентрації цинку у ґрунті (1, 5, 10 МДК) вміст полютанта в коренях зростає в 2, 3, у надземній частині – в 1,5–2,0 раза. Изучено влияние ионов цинка на рост, массу и состояние пигментной системы листьев Trifolium prаtense L. Развитие корневой системы проростков больше подавляется, чем надземной части. При превышении МДК в 10 раз площадь листьев уменьшалась по сравнению с контролем на 65–70 %. Выяснены закономерности аккумуляции и распределения цинка в органах клевера. При увеличении концентрации элемента в почве концентрация в растении вырастает до определенного предела, а при низких концентрациях растет линейно. При концентрации цинка в почве (1, 5, 10 МДК) содержание поллютанта в корнях увеличивается в 2, 3, в надземной части – в 1,5–2 раза. It is studied the influence of zinc ions on growth, weight, and pigment system state of leaves of Trifolium pratense L. It is revealed that the root development of seedlings is suppressed more than above-ground parts. It is shown that under tenfold excess of MAC the leaves area decreased by 65–70 %in comparison with the control. It is ascertained the regularities of accumulation and distribution of zinc in the clover organs. It was found that with increasing concentration of the element in soil, its concentration in the plant grows to a certain extent, but under low concentrations it increases linearly. Thus, under the concentrations of zinc in soil (1, 5 and 10 MAC) its content in the roots increases 2–3 times  and in the above-ground parts – by 1.5–2 times.

Protective effect of sodium chloride for cultivated oat’s adaptation to the surplus of cooper sulphate

Досліджено механізм підвищення толерантності до впливу сульфату купруму шляхом попередньої адаптації до надлишкового засолення. Показано, що короткочасна (протягом доби) попередня адаптація рослин вівса до NaCl (400 мМ) знижує наступну токсичну дію CuSO4 (25 і 50 мкМ)Исследован механизм повышения толерантности к воздействию сульфата меди путем предварительной адаптации к избыточному засолению. Показано, что кратковременная (в течение суток) предварительная адаптация растений овса к NaCl (400 мМ) снижает следующее токсическое воздействие CuSO4 (25 и 50 мкМ). Mechanism of increasing tolerance to copper sulfate by way of preliminary adaptation to excessive saltiness was investigated. It is detected that short-term (twenty-four hours) influence of NaCl (400 mM) on the oat plants reduces the further toxic effects of CuSO4 (25 and 50 µM)

A Multicriteria Decision Analysis Comparing Pharmacotherapy for Chronic Neuropathic Pain, Including Cannabinoids and Cannabis-Based Medical Products

BACKGROUND: Pharmacological management of chronic neuropathic pain (CNP) still represents a major clinical challenge. Collective harnessing of both the scientific evidence base and clinical experience (of clinicians and patients) can play a key role in informing treatment pathways and contribute to the debate on specific treatments (e.g., cannabinoids). A group of expert clinicians (pain specialists and psychiatrists), scientists, and patient representatives convened to assess the relative benefit–safety balance of 12 pharmacological treatments, including orally administered cannabinoids/cannabis-based medicinal products, for the treatment of CNP in adults. METHODS: A decision conference provided the process of creating a multicriteria decision analysis (MCDA) model, in which the group collectively scored the drugs on 17 effect criteria relevant to benefits and safety and then weighted the criteria for their clinical relevance. FINDINGS: Cannabis-based medicinal products consisting of tetrahydrocannabinol/cannabidiol (THC/CBD), in a 1:1 ratio, achieved the highest overall score, 79 (out of 100), followed by CBD dominant at 75, then THC dominant at 72. Duloxetine and the gabapentinoids scored in the 60s, amitriptyline, tramadol, and ibuprofen in the 50s, methadone and oxycodone in the 40s, and morphine and fentanyl in the 30s. Sensitivity analyses showed that even if the pain reduction and quality-of-life scores for THC/CBD and THC are halved, their benefit–safety balances remain better than those of the noncannabinoid drugs. INTERPRETATION: The benefit–safety profiles for cannabinoids were higher than for other commonly used medications for CNP largely because they contribute more to quality of life and have a more favorable side effect profile. The results also reflect the shortcomings of alternative pharmacological treatments with respect to safety and mitigation of neuropathic pain symptoms. Further high-quality clinical trials and systematic comprehensive capture of clinical experience with cannabinoids is warranted. These results demonstrate once again the complexity and multimodal mechanisms underlying the clinical experience and impact of chronic pain

A multicriteria decision analysis comparing pharmacotherapy for chronic neuropathic pain, including cannabinoids and cannabis-based medical products

Background: Pharmacological management of chronic neuropathic pain (CNP) still represents a major clinical challenge. Collective harnessing of both the scientific evidence base and clinical experience (of clinicians and patients) can play a key role in informing treatment pathways and contribute to the debate on specific treatments (e.g., cannabinoids). A group of expert clinicians (pain specialists and psychiatrists), scientists, and patient representatives convened to assess the relative benefit–safety balance of 12 pharmacological treatments, including orally administered cannabinoids/cannabis-based medicinal products, for the treatment of CNP in adults. Methods: A decision conference provided the process of creating a multicriteria decision analysis (MCDA) model, in which the group collectively scored the drugs on 17 effect criteria relevant to benefits and safety and then weighted the criteria for their clinical relevance. Findings: Cannabis-based medicinal products consisting of tetrahydrocannabinol/cannabidiol (THC/CBD), in a 1:1 ratio, achieved the highest overall score, 79 (out of 100), followed by CBD dominant at 75, then THC dominant at 72. Duloxetine and the gabapentinoids scored in the 60s, amitriptyline, tramadol, and ibuprofen in the 50s, methadone and oxycodone in the 40s, and morphine and fentanyl in the 30s. Sensitivity analyses showed that even if the pain reduction and quality-of-life scores for THC/CBD and THC are halved, their benefit–safety balances remain better than those of the noncannabinoid drugs. Interpretation: The benefit–safety profiles for cannabinoids were higher than for other commonly used medications for CNP largely because they contribute more to quality of life and have a more favorable side effect profile. The results also reflect the shortcomings of alternative pharmacological treatments with respect to safety and mitigation of neuropathic pain symptoms. Further high-quality clinical trials and systematic comprehensive capture of clinical experience with cannabinoids is warranted. These results demonstrate once again the complexity and multimodal mechanisms underlying the clinical experience and impact of chronic pain

Once the shovel hits the ground : Evaluating the management of complex implementation processes of public-private partnership infrastructure projects with qualitative comparative analysis

Much attention is being paid to the planning of public-private partnership (PPP) infrastructure projects. The subsequent implementation phase – when the contract has been signed and the project ‘starts rolling’ – has received less attention. However, sound agreements and good intentions in project planning can easily fail in project implementation. Implementing PPP infrastructure projects is complex, but what does this complexity entail? How are projects managed, and how do public and private partners cooperate in implementation? What are effective management strategies to achieve satisfactory outcomes? This is the fi rst set of questions addressed in this thesis. Importantly, the complexity of PPP infrastructure development imposes requirements on the evaluation methods that can be applied for studying these questions. Evaluation methods that ignore complexity do not create a realistic understanding of PPP implementation processes, with the consequence that evaluations tell us little about what works and what does not, in which contexts, and why. This hampers learning from evaluations. What are the requirements for a complexity-informed evaluation method? And how does qualitative comparative analysis (QCA) meet these requirements? This is the second set of questions addressed in this thesis

Протекторний ефект хлориду натрію при адаптації рослин вівса посівного до надлишку cульфату купруму

Mechanism of increasing tolerance to copper sulfate by way of preliminary adaptation to excessive saltiness was investigated. It is detected that short-term (twenty-four hours) influence of NaCl (400 mM) on the oat plants reduces the further toxic effects of CuSO4 (25 and 50 µM)