Modelling the healthcare costs of an opportunistic chlamydia screening programme.

OBJECTIVES: To estimate the average cost per screening offer, cost per testing episode and cost per chlamydia positive episode for an opportunistic chlamydia screening programme (including partner management), and to explore the uncertainty of parameter assumptions, based on the costs to the healthcare system. METHODS: A decision tree was constructed and parameterised using empirical data from a chlamydia screening pilot study and other sources. The model was run using baseline data from the pilot, and univariate and multivariate sensitivity analyses were conducted. RESULTS: The total estimated cost for offering screening over 12 months to 33,215 females aged 16-24 was 493,412 pounds . The average cost (with partner management) was 14.88 pounds per screening offer (90% credibility interval (CI) 10.34 to 18.56), 21.83 pounds per testing episode (90% CI 18.16 to 24.20), and 38.36 pounds per positive episode (90% CI 33.97 to 42.25). The proportion of individuals accepting screening, the clinician (general practitioner/nurse) time and their relative involvement in discussing screening, the test cost, the time to notify patients of their results, and the receptionist time recruiting patients had the greatest impact on the outcomes in both the univariate and multivariate sensitivity analyses. CONCLUSIONS: Results from this costing study may be used to inform resource allocation for current and future chlamydia screening programme implementation

Social Capital During COVID-19: Research Case Studies from U.S. and U.K. Contexts

Our research used a case study methodology to explore how engineering students at a university in the United Kingdom and in the United States experienced social supports in the spring term(s) of 2020 when universities worldwide shifted into emergency remote teaching due to the COVID-19 pandemic. To the best of our knowledge, this is the first cross-cultural study to examine engineering students' social support during the pandemic. We administered the Undergraduate Support Survey to engineering undergraduates at both institutions. The survey collected data about students' sense of belonging and social capital, including names of individuals who provided support for their engineering education and the specific expressive and instrumental resources they utilized during the pandemic. Results revealed similarities and differences between students at the two institutions. Both groups reported friends/roommates, professors, and family members as the primary providers of support, and both reported almost the same frequency in communication with these individuals. Participants at both institutions also reported high rates of instrumental and expressive support. However, the mean response for both sense of belonging and satisfaction at the university was lower in the U.K. and the types of alters identified in the two groups showed marked differences. Our work affirms the importance of social relationships to engineering students' success and persistence

The missing link in emergency management: Evaluating community engagement

Community engagement programs in Australia are widely adopted by emergency management organisations as one way to get communities to recognise hazards and risks and prepare for emergency events. However, evaluation of these programs remains a challenge. A study with 30 community engagement practitioners and managers from Australian emergency management organisations, councils and not-for-profit organisations was undertaken to examine how they use measurement and evaluation of community engagement for preparedness. The findings suggest that while community engagement teams understand the importance of measuring the effects of engagement efforts and preparedness activities, most still do not link engagement activities with higher-level engagement outcomes that influence communities

Inhibition of the glycaemic response by onion : a comparison between lactose-tolerant and lactose-intolerant adults

This document is the Accepted Manuscript of the following article: R Hoffman, G Ranjbar and A M Madden, ‘Inhibition of the glycaemic response by onion: a comparison between lactose-tolerant and lactose-intolerant adults’, European Journal of Clinical Nutritin, (2016), 70: 1089-1091. The Version of Record is available online at doi: 10.1038/ejcn.2016.44.This pilot study compared inhibition of the glycaemic response to glucose by a dietary source of quercetin glucosides (onion) in lactose-tolerant adults (n = 12) and lactose-intolerant adults (n = 12). We hypothesised that lactose-intolerant people (who do not express lactase) will retain intact quercetin glucosides that can inhibit glucose uptake via the glucose transporter SGLT1 whereas lactose-tolerant people (who do express lactase) will hydrolyse quercetin glucosides to free quercetin which does not inhibit glucose uptake. In a glucose tolerance test, reduction of peak glucose levels by an onion meal was higher in lactose-intolerant people than lactose-tolerant people (44.2% versus 19.3%, p = 0.04). Incremental area under the blood glucose curve was reduced more in lactose-intolerant people, but was not statistically significantly (54.5% versus 42.1%, p = 0.42). A diet containing quercetin glucosides may be of greater benefit for glycaemic control in lactose-intolerant people than in lactose-tolerant people.Peer reviewedFinal Accepted Versio

Walking for transportation in Hong Kong Chinese urban elders: a cross-sectional study on what destinations matter and when

published_or_final_versio

Legacy Metal Contaminants and Excess Nutrients in Low Flow Estuarine Embayments Alter Composition and Function of Benthic Bacterial Communities.

Coastal systems such as estuaries are threatened by multiple anthropogenic stressors worldwide. However, how these stressors and estuarine hydrology shape benthic bacterial communities and their functions remains poorly known. Here, we surveyed sediment bacterial communities in poorly flushed embayments and well flushed channels in Sydney Harbour, Australia, using 16S rRNA gene sequencing. Sediment samples were collected monthly during the Austral summer-autumn 2014 at increasing distance from a large storm drain in each channel and embayment. Bacterial communities differed significantly between sites that varied in proximity to storm drains, with a gradient of change apparent for sites within embayments. We explored this pattern for embayment sites with analysis of RNA-Seq gene expression patterns and found higher expression of multiple genes involved in bacterial stress response far from storm drains, suggesting that bacterial communities close to storm drains may be more tolerant of localised anthropogenic stressors. Several bacterial groups also differed close to and far from storm drains, suggesting their potential utility as bioindicators to monitor contaminants in estuarine sediments. Overall, our study provides useful insights into changes in the composition and functioning of benthic bacterial communities as a result of multiple anthropogenic stressors in differing hydrological conditions

A novel real-world ecotoxicological dataset of pelagic microbial community responses to wastewater.

Real-world observational datasets that record and quantify pressure-stressor-response linkages between effluent discharges and natural aquatic systems are rare. With global wastewater volumes increasing at unprecedented rates, it is urgent that the present dataset is available to provide the necessary information about microbial community structure and functioning. Field studies were performed at two time-points in the Austral summer. Single-species and microbial community whole effluent toxicity (WET) testing was performed at a complete range of effluent concentrations and two salinities, with accompanying environmental data to provide new insights into nutrient and organic matter cycling, and to identify ecotoxicological tipping points. The two salinity regimes were chosen to investigate future scenarios based on a predicted salinity increase at the study site, typical of coastal regions with rising sea levels globally. Flow cytometry, amplicon sequencing of 16S and 18S rRNA genes and micro-fluidic quantitative polymerase-chain reactions (MFQPCR) were used to determine chlorophyll-a and total bacterial cell numbers and size, as well as taxonomic and functional diversity of pelagic microbial communities. This strong pilot dataset could be replicated in other regions globally and would be of high value to scientists and engineers to support the next advances in microbial ecotoxicology, environmental biomonitoring and estuarine water quality modelling

Re-engage: A novel nurse-led program for survivors of childhood cancer who are disengaged from cancer-related care

Background: Survivors of childhood cancer often experience treatmentrelated chronic health conditions. Survivorship care improves survivors' physical and mental health, yet many are disengaged from care. Innovative models of care are necessary to overcome patient-reported barriers to accessing survivorship care and to maximize survivors' health. Methods:We piloted a novel survivorship program, called "Reengage,"a distance-delivered, nurse-led intervention aiming to engage, educate, and empower survivors not receiving any cancerrelated care. Re-engage involves a nurse-led consultation delivered via telephone/online to establish survivors' medical history and needs. Participants completed questionnaires at baseline, 1 month postintervention, and 6-month follow-up. Results: A total of 27 survivors who had not accessed survivorship care in the last 2 years participated (median age, 31 years; interquartile range [IQR], 27-39 years); of which, 82% were at high-risk for treatment-related complications. Participation in Re-engage was high (75%) and there was no attrition once survivors enrolled. At 1 month postintervention, 92% of survivors reported that Re-engage was "beneficial,"which all survivors reported at 6-month follow-up. Survivors' overall satisfaction with their care increased from 52% before Re-engage to 84% at 1 month postintervention. Survivors' mean self-efficacy scores remained similar from baseline to 1 month postintervention (b520.33, 95% CI, 21.31 to 0.65), but increased significantly from baseline to 6-month follow-up (b 5 1.64, 95% CI, 0.28-3.00). At 6-month follow-up, 73% of survivors showed an increase in health-related self-efficacy compared with baseline. Conclusions: Re-engage is a highly acceptable and feasible intervention and promotes health-related self-efficacy, which is integral to survivors being advocates for their own health. Further empirical work is needed to evaluate the long-term efficacy of Re-engage. Trial registration: ACTRN12618000194268