Health service implications of the introduction of STI point-of-care testing in Australia

Chlamydia trachomatis (CT) and Neisseria gonorrhoea (NG) are curable sexually transmissible infections (STIs) which represent a significant public health burden, particularly in young Australia Aboriginal people in remote communities. Prompt testing and treatment is fundamental to STI control yet distance to urban laboratories is a significant barrier. CT/NG point-of-care (POC) testing offers an ideal solution, but until recently had been unavailable. This thesis aims to identify settings where POC testing could be beneficial, benefits and barriers to implementation and health service staff acceptability. The thesis was based on two sets of qualitative interviews. The first occurred with 18 Australian key informants with remote, sexual health and laboratory expertise, and generated three discrete studies. The second occurred with 16 trained nurses and Aboriginal health workers (AHWs) from the first 12 remote primary care services internationally to use GeneXpert CT/NG POC testing and resulted in study four. Study one focused on settings where the technology would have greatest benefit, with remote Aboriginal communities most commonly identified, as well as juvenile justice and outreach services to highly mobile or marginalised populations. In study two, informants identified the benefits of POC use for clinical practice including improved management of STIs- more timely and targeted treatment, earlier commencement of partner notification, and reduced effort associated with client recall, but noted it will result in changes to the STI management pathway, and policy and clinical guidelines may need to be altered. Study three focused on the public health implications; with the key perceived benefit being STI control, and barriers including the potential to negatively impact on disease notification and NG antibiotic sensitivity surveillance. In study four, most nurses and AHWs found the test easy to use and useful, and reported improved management of STIs consistent with the key informant’s perceived benefits. In conclusion, this thesis has provided information to inform implementation of CT/NG POC testing, including selection of appropriate settings, and the need to review clinical guidelines and establish systems to avoid adverse impact on public health surveillance. Importantly the research demonstrated the new technology was highly acceptable to staff working in remote primary care

Menstrual hygiene management in disasters: the concerns, needs, and preferences of women and girls in Vanuatu

In disaster settings, women and girls face additional challenges in safely managing menstruation with confidence and dignity. Assessing women’s and girls’ needs and preferences at country level prior to a disaster assists Red Cross National Societies with preparedness planning and development of local menstrual hygiene management (MHM) kits for pre-positioning. This study, conducted in Vanuatu, examined the experiences, concerns, needs, and preferences of women and girls in managing menstruation in disasters. Participants trialled one of four different sanitary products included in a MHM kit. Absorbency, security of fit, and odour were the main determinants of product acceptability. Water supply and safe disposal options influenced the preference for either reusable or disposable products. Access to sanitary products, distribution processes, water supply, and privacy were key concerns. Detailed recommendations within this paper will support the Vanuatu Red Cross in decision making and programming for MHM in disaster preparedness and response

Efficient low-loaded ternary Pd-In2O3-Al2O3 catalysts for methanol production

Pd-In2O3 catalysts are among the most promising alternatives to Cu-ZnO-Al2O3 for synthesis of CH3OH from CO2. However, the intrinsic activity and stability of In2O3 per unit mass should be increased to reduce the content of this scarcely available element and to enhance the catalyst lifetime. Herein, we propose and demonstrate a strategy for obtaining highly dispersed Pd and In2O3 nanoparticles onto an Al2O3 matrix by a one-step coprecipitation followed by calcination and activation. The activity of this catalyst is comparable with that of a Pd-In2O3 catalyst (0.52 vs 0.55 gMeOH h−1 gcat-1 at 300 \ub0C, 30 bar, 40,800 mL h−1 gcat-1) but the In2O3 loading decreases from 98 to 12 wt% while improving the long-term stability by threefold at 30 bar. In the new Pd-In2O3-Al2O3 system, the intrinsic activity of In2O3 is highly increased both in terms of STY normalized to In specific surface area and In2O3 mass (4.32 vs 0.56 g gMeOH h−1 gIn2O3-1 of a Pd- In2O3 catalyst operating at 300 \ub0C, 30 bar, 40,800 mL h−1 gcat-1).The combination of ex situ and in situ catalyst characterizations during reduction provides insights into the interaction between Pd and In and with the support. The enhanced activity is likely related to the close proximity of Pd and In2O3, wherein the H2 splitting activity of Pd promotes, in combination with CO2 activation over highly dispersed In2O3 particles, facile formation of CH3OH

Quantum Optics and Photonics

Contains reports on nine research projects.U.S. Air Force - Office of Scientific Research (Contract F49620-82-C-0091)Joint Services Electronics Program (Contract DAAG29-83-K-0003)National Science Foundation (Grant PHY82-10369)Litton Guidance and Control Syste

A New Dolphin Species, the Burrunan Dolphin Tursiops australis sp. nov., Endemic to Southern Australian Coastal Waters

Small coastal dolphins endemic to south-eastern Australia have variously been assigned to described species Tursiops truncatus, T. aduncus or T. maugeanus; however the specific affinities of these animals is controversial and have recently been questioned. Historically ‘the southern Australian Tursiops’ was identified as unique and was formally named Tursiops maugeanus but was later synonymised with T. truncatus. Morphologically, these coastal dolphins share some characters with both aforementioned recognised Tursiops species, but they also possess unique characters not found in either. Recent mtDNA and microsatellite genetic evidence indicates deep evolutionary divergence between this dolphin and the two currently recognised Tursiops species. However, in accordance with the recommendations of the Workshop on Cetacean Systematics, and the Unified Species Concept the use of molecular evidence alone is inadequate for describing new species. Here we describe the macro-morphological, colouration and cranial characters of these animals, assess the available and new genetic data, and conclude that multiple lines of evidence clearly indicate a new species of dolphin. We demonstrate that the syntype material of T. maugeanus comprises two different species, one of which is the historical ‘southern form of Tursiops’ most similar to T. truncatus, and the other is representative of the new species and requires formal classification. These dolphins are here described as Tursiops australis sp. nov., with the common name of ‘Burrunan Dolphin’ following Australian aboriginal narrative. The recognition of T. australis sp. nov. is particularly significant given the endemism of this new species to a small geographic region of southern and south-eastern Australia, where only two small resident populations in close proximity to a major urban and agricultural centre are known, giving them a high conservation value and making them susceptible to numerous anthropogenic threats

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Research on responding to menstrual hygiene needs of women and girls in disaster settings, in Vanuatu

[Extract] Managing their own menstruation in a safe and dignified manner can be especially challenging for girls and women in low and middle-income countries. Disaster and displacement contexts exacerbate these challenges, which are compounded by discriminatory gender norms, societal taboos, secrecy and embarrassment around menstruation. There is increasing global recognition of the importance of addressing women’s menstrual hygiene needs in these context

Responding to menstrual hygiene management needs in disaster settings, in Vanuatu

Managing menstruation in a safe and dignified manner can be challenging for girls and women in resource poor settings. These challenges can be compounded by societal taboos, secrecy and embarrassment around menstruation. Displacement and living in emergency contexts can further increase the challenges experienced by girls and women due to a lack of access to sanitary materials, private/safe water and sanitation facilities, places to dry reusable sanitary materials or dispose of used pads and reduced privacy and dignity especially in overcrowded, temporary and transit settings. The increasing global focus on improving Menstrual Hygiene Management (MHM) interventions in emergency contexts is recognized in the recent (2018) revision of the Sphere Guidelines, which highlight the importance of understanding MHM related practices, social norms and myths to inform this aspect of the humanitarian response. Increasingly, the Vanuatu Red Cross Society (VRCS) have been working to integrate MHM considerations in disaster preparedness and response programming. In 2019, James Cook University and Australian Red Cross partnered with VRCS in a study to explore the sanitary protection needs and preferences of girls/women in Vanuatu and the socio-cultural aspects of menstruation likely to impact MHM in disaster settings. Four communities, one rural and one urban on both Efate and Espiritu Santo islands, that had previously experienced disasters were selected for the study. Participating women and girls each received a MHM kit which included one of four sanitary products, two disposable and two reusable. Qualitative data was collected through eleven focus group discussions involving 125 participants and two interviews of women with disabilities. Quantitative data focusing on sanitary product acceptability was obtained via a simple paper-based survey which was completed by 136 participants. This paper will present the key findings and discuss the implications in disaster preparedness and response for the VRCS

Reducing harmful traditional practices in Adjibar, Ethiopia : lessons learned from the Adjibar safe motherhood project

This paper assesses the impact of the Adjibar Safe Motherhood Project and derives lessons of value to future interventions. Amongst the participatory qualitative methods used were 15 group discussions, eight semi-structured interviews, a number of opportunistic informal discussions and observation. The information gathering was complemented by a detailed review of project documents. Field visits for data collection took place over a six day period in March 2005. The project was effective in raising awareness about maternal health, and the social, economic and health consequences of various harmful traditional practices (HTPs). It has also mobilised the community to monitor and report HTPs and has strengthened referral systems for counselling, support and treatment. A number of effective strategies were identified as having contributed to project success. These are presented using the framework offered by the Ottawa Charter for Health Promotion which presents five areas of public health action: developing personal skills; strengthening community action; building healthy public policy; re-orienting health services; and, creating supportive environments. This evaluation contributes to and strengthens the expanding body of literature about effective development practices to reduce HTPs. It demonstrates that addressing HTPs takes time and long term investment; both are necessary to enable better understanding of the social and cultural reasons for HTPs before attempting to address them, and to build the community trust necessary to overcome the natural resistance to challenging such deeply entrenched practices. The project also highlighted the importance of developing a multi pronged strategy based on engagement with a broad range of stakeholders and supportive legislation.<br /