Effectiveness of interventions to increase hepatitis C testing uptake among high-risk groups: a systematic review

Background: People who inject drugs are at the greatest risk of acquiring hepatitis C virus infection in many high-income countries, including those in Europe. Our review examined the effectiveness of interventions aimed at increasing hepatitis C virus testing uptake. Methods: We undertook a systematic review of controlled studies. Searches of 13 databases were supplemented with citation searching, and manual searches of reference lists and websites. Studies of interventions that aimed to increase testing uptake among high-risk groups were included. Testing uptake was our primary outcome measure of interest and secondary outcomes were engagement in follow-up services and treatment. A narrative synthesis was undertaken. Results: Eight controlled studies were included. Three studies examined interventions in primary care; one examined dried blood spot testing as an alternative method of testing, and two examined outreach provision. Two further studies examined interventions to improve hepatitis C management. Targeted case finding in primary care, support and training for primary care practitioners, offering alternative testing and provision of outreach testing all increased uptake of testing; however, intervention effects were variable. Conclusions: Evidence from the available studies suggests that increases in testing uptake can be achieved. Careful attention needs to be paid to the resource implications associated with implementation of interventions in primary care settings and also of the potential for interventions to improve outcomes once a positive diagnosis has been made. Further research on the cost-effectiveness of the intervention approaches examined in this review is required

Study on Doping Prevention: A map of Legal, Regulatory and Prevention Practice Provisions in EU 28

Historically, anti-doping efforts have focused on the detection and deterrence of doping in elite and competitive sport. There is, however, a growing concern that doping is occurring outside the organised sporting system; giving rise to the belief that the misuse of doping agents in recreational sport has become a societal problem and a public health issue that must be addressed. The EU Commission awarded a contract (EAC/2013/0617) to a Consortium to undertake this Study with the aim of developing the evidence-base for policies designed to combat doping in recreational sport. Fourteen internationally recognised experts shaped the Study which comprised (i) the collection of primary data through a structured survey, and (ii) secondary data through literature searches and website analysis. All 28 Member States participated in the information-gathering process. Specifically, this involved a systematic study of the ethical considerations, legal position, prevention research landscape, and current practise in relation to the prevention of doping in recreational sport. The Study provides a comprehensive overview of current practice and legislation as it applies to the prevention of doping and promotes and supports the sharing of best practices in the EU regarding the fight against doping in recreational sport. It concludes with seven recommendations for future action that focus on the need for a coordinated response in relation to the problems arising from doping in recreational sport

‘Dead people don’t claim’: A psychopolitical autopsy of UK austerity suicides

One of the symptoms of post financial crisis austerity in the UK has been an increase in the numbers of suicides, especially by people who have experienced welfare reform. This article develops and utilises an analytic framework of psychopolitical autopsy to explore media coverage of ‘austerity suicide’ and to take seriously the psychic life of austerity (internalisation, shame, anxiety), embedding it in a context of social dis-ease. Drawing on three distinct yet interrelated areas of literature (the politics of affect and psychosocial dynamics of welfare, post and anti-colonial psychopolitics, and critical suicidology), the article aims to better understand how austerity ‘kills’. Key findings include understanding austerity suicides as embedded within an affective economy of the anxiety caused by punitive welfare retrenchment, the stigmatisation of being a recipient of benefits, and the internalisation of market logic that assigns value through ‘productivity’ and conceptualises welfare entitlement as economic ‘burden’. The significance of this approach lies in its ability to widen analytic framing of suicide from an individual and psychocentric focus, to illuminate culpability of government reforms while still retaining the complexity of suicide, and thus to provide relevant policy insights about welfare reform

Crystallization and preliminary X-ray diffraction analyses of several forms of the CfaB major subunit of enterotoxigenic Escherichia coli CFA/I fimbriae

Three fusion proteins were generated in order to resolve the atomic structure of the CFA/I fimbriae of enterotoxigenic E. coli. CfaEB is a fusion of the minor and major CFA/I subunits, while CfaBB and CfaBBB are tandem fusions of two and three repeats, respectively, of the major subunit. Each protein was crystallized and the crystal structures of each of these fusions were determined successively by the molecular-replacement method using the CfaE crystal structure as an initial phasing model

Views and experiences of hepatitis C testing and diagnosis among people who inject drugs: Systematic review of qualitative research

Background: Many developed countries are facing a major challenge to improve identification of individuals acutely and chronically infected with hepatitis C virus (HCV) infection. We explored the views and experiences of people who inject drugs (PWID) in relation to HCV testing, and diagnosis through a review and synthesis of qualitative research. Methods: Based on the thematic synthesis of qualitative research. Searches were conducted in 14 databases and supplemented by reference checking, hand searching of selected journals, and searches of relevant websites. Studies of any qualitative design that examined the views and experiences of, and attitudes towards, HCV testing and diagnosis among PWID or practitioners involved in their care were included. Key themes and sub-themes were systematically coded according to the meaning and content of the findings of each study which proceeded to the preparation of a narrative account of the synthesis. Results: 28 qualitative studies were identified. We identified a number of overarching descriptive themes in the literature, finding overall that PWID hold complex and differing views and experiences of testing and diagnosis. Three major themes emerged: missed opportunities for the provision of information and knowledge; shifting priorities between HCV testing and other needs; and testing as unexpected and routine. Evidence of missed opportunities for the provision of knowledge and information about HCV were clear, contributing to delays in seeking testing and providing a context to poor experiences of diagnosis. Influenced by the nature of their personal circumstances, perceptions of the risk associated with HCV and the prioritisation of other needs acted both to encourage and discourage the uptake of HCV testing. Undergoing HCV testing as part of routine health assessment, and an unawareness of being testing was common. An unexpected positive diagnosis exacerbated anxiety and confusion. Conclusions: This review has identified that there are modifiable factors that affect the uptake of HCV testing and experiences of HCV diagnosis among PWID. Intervention development should focus on addressing these factors. There is a need for further research that engages PWID from a diverse range of populations to identify interventions, strategies and approaches that they consider valuable

Palestinian children's experiences of drug abuse in the home in the Occupied Territories of Palestine: A scoping review of extant literature

The Occupied Territories of Palestine (OtP) consists of the non-contiguous West Bank including East Jerusalem, and the Gaza Strip. Its dense population with political and economic tensions is affected by a rise in drug trafficking, abuse and addiction. A scoping review mapped what is known about Palestinian children's experiences of drug abuse in the home. Following application of exclusion measures, six records remained. Charting and analysis resulted in three themes; The consequences of being a child with a drug using parent; Causal factors of drug use in Palestinian families; and Prevalence rates of parental drug use are unknown. The review paints a concerning picture of stigma, family dysfunction, school drop-out, child and family isolation and maladaptive child development. Exposure to drugs, trauma and abuse contributes to strong potential for Palestinian child drug use, sexual exploitation, overdose, psychiatric illness, and infectious diseases acquisition. The review will inform the urgent strategic response

Effect of Trap Height and Spacing in Relation to Crop Height on Catches of the Millet Stemborer, Coniesta Ignefusalis Males

Studies were conducted in pearl millet [Pennisetum glaucum] in Niger using a water-based trap baited with the synthetic female sex pheromone to gain further understanding of the effect of trap height and spacing in relation to crop height on catches of males of the millet stemborer, Coniesta ignefusalis. Regardless of crop height, catches were greatest at trap heights of 0.10 and 0.50 m when the traps were stacked vertically. When traps were sited singly at 50 m spacing there was no significant difference in catches at the different heights. When trap spacing was varied from 50, 15, 5, 1 to 0 m, male moth catches in traps increased at lower trap heights, regardless of crop height. Comparison of catches in light traps and pheromone-baited traps showed a significant positive correlation. These findings have implications for both monitoring and development of millet stemborer control systems through mating disruption and mass trapping