Telling partners about chlamydia: how acceptable are the new technologies?

BACKGROUND Partner notification is accepted as a vital component in the control of chlamydia. However, in reality, many sexual partners of individuals diagnosed with chlamydia are never informed of their risk. The newer technologies of email and SMS have been used as a means of improving partner notification rates. This study explored the use and acceptability of different partner notification methods to help inform the development of strategies and resources to increase the number of partners notified. METHODS Semi-structured telephone interviews were conducted with 40 people who were recently diagnosed with chlamydia from three sexual health centres and two general practices across three Australian jurisdictions. RESULTS Most participants chose to contact their partners either in person (56%) or by phone (44%). Only 17% chose email or SMS. Participants viewed face-to-face as the "gold standard" in partner notification because it demonstrated caring, respect and courage. Telephone contact, while considered insensitive by some, was often valued because it was quick, convenient and less confronting. Email was often seen as less personal while SMS was generally considered the least acceptable method for telling partners. There was also concern that emails and SMS could be misunderstood, not taken seriously or shown to others. Despite these, email and SMS were seen to be appropriate and useful in some circumstances. Letters, both from the patients or from their doctor, were viewed more favourably but were seldom used. CONCLUSION These findings suggest that many people diagnosed with chlamydia are reluctant to use the new technologies for partner notification, except in specific circumstances, and our efforts in developing partner notification resources may best be focused on giving patients the skills and confidence for personal interaction.The study was funded by the Australian Federal Government Department of Health and Ageing Chlamydia Pilot Program of Targeted Grants

Better than nothing? Patient-delivered partner therapy and partner notification for chlamydia: the views of Australian general practitioners

BACKGROUND Genital chlamydia is the most commonly notified sexually transmissible infection (STI) in Australia and worldwide and can have serious reproductive health outcomes. Partner notification, testing and treatment are important facets of chlamydia control. Traditional methods of partner notification are not reaching enough partners to effectively control transmission of chlamydia. Patient-delivered partner therapy (PDPT) has been shown to improve the treatment of sexual partners. In Australia, General Practitioners (GPs) are responsible for the bulk of chlamydia testing, diagnosis, treatment and follow up. This study aimed to determine the views and practices of Australian general practitioners (GPs) in relation to partner notification and PDPT for chlamydia and explored GPs' perceptions of their patients' barriers to notifying partners of a chlamydia diagnosis. METHODS In-depth, semi-structured telephone interviews were conducted with 40 general practitioners (GPs) from rural, regional and urban Australia from November 2006 to March 2007. Topics covered: GPs' current practice and views about partner notification, perceived barriers and useful supports, previous use of and views regarding PDPT.Transcripts were imported into NVivo7 and subjected to thematic analysis. Data saturation was reached after 32 interviews had been completed. RESULTS Perceived barriers to patients telling partners (patient referral) included: stigma; age and cultural background; casual or long-term relationship, ongoing relationship or not. Barriers to GPs undertaking partner notification (provider referral) included: lack of time and staff; lack of contact details; uncertainty about the legality of contacting partners and whether this constitutes breach of patient confidentiality; and feeling both personally uncomfortable and inadequately trained to contact someone who is not their patient. GPs were divided on the use of PDPT--many felt concerned that it is not best clinical practice but many also felt that it is better than nothing.GPs identified the following factors which they considered would facilitate partner notification: clear clinical guidelines; a legal framework around partner notification; a formal chlamydia screening program; financial incentives; education and practical support for health professionals, and raising awareness of chlamydia in the community, in particular amongst young people. CONCLUSIONS GPs reported some partners do not seek medical treatment even after they are notified of being a sexual contact of a patient with chlamydia. More routine use of PDPT may help address this issue however GPs in this study had negative attitudes to the use of PDPT. Appropriate guidelines and legislation may make the use of PDPT more acceptable to Australian GPs.The Australian Federal Government Department of Health and Ageing Chlamydia Pilot Program of Targeted Grants funded the study

AAPM medical physics practice guideline 10.a.: Scope of practice for clinical medical physics.

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education, and professional practice of medical physics. The AAPM has more than 8000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline (MPPG) represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiation requires specific training, skills, and techniques as described in each document. As the review of the previous version of AAPM Professional Policy (PP)-17 (Scope of Practice) progressed, the writing group focused on one of the main goals: to have this document accepted by regulatory and accrediting bodies. After much discussion, it was decided that this goal would be better served through a MPPG. To further advance this goal, the text was updated to reflect the rationale and processes by which the activities in the scope of practice were identified and categorized. Lastly, the AAPM Professional Council believes that this document has benefitted from public comment which is part of the MPPG process but not the AAPM Professional Policy approval process. The following terms are used in the AAPM's MPPGs: Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline. Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances

Exercise and glycemic control: focus on redox homeostasis and redox-sensitive protein signaling

Physical inactivity, excess energy consumption, and obesity are associated with elevated systemic oxidative stress and the sustained activation of redox-sensitive stress-activated protein kinase (SAPK) and mitogen-activated protein kinase signaling pathways. Sustained SAPK activation leads to aberrant insulin signaling, impaired glycemic control, and the development and progression of cardiometabolic disease. Paradoxically, acute exercise transiently increases oxidative stress and SAPK signaling, yet postexercise glycemic control and skeletal muscle function are enhanced. Furthermore, regular exercise leads to the upregulation of antioxidant defense, which likely assists in the mitigation of chronic oxidative stress-associated disease. In this review, we explore the complex spatiotemporal interplay between exercise, oxidative stress, and glycemic control, and highlight exercise-induced reactive oxygen species and redox-sensitive protein signaling as important regulators of glucose homeostasis.<br /

Generalised hierarchical bayesian microstructure modelling for diffusion MRI

Microstructure imaging combines tailored diffusion MRI acquisition protocols with a mathematical model to give insights into subvoxel tissue features. The model is typically fit voxel-by-voxel to the MRI image with least squares minimisation to give voxelwise maps of parameters relating to microstructural features, such as diffusivities and tissue compartment fractions. However, this fitting approach is susceptible to voxelwise noise, which can lead to erroneous values in parameter maps. Data-driven Bayesian hierarchical modelling defines prior distributions on parameters and learns them from the data, and can hence reduce such noise effects. Bayesian hierarchical modelling has been demonstrated for microstructure imaging with diffusion MRI, but only for a few, relatively simple, models. In this paper, we generalise hierarchical Bayesian modelling to a wide range of multi-compartment microstructural models, and fit the models with a Markov chain Monte Carlo (MCMC) algorithm. We implement our method by utilising Dmipy, a microstructure modelling software package for diffusion MRI data. Our code is available at github.com/PaddySlator/dmipy-bayesian

BlackOPs: Increasing confidence in variant detection through mappability filtering

Identifying variants using high-throughput sequen-cing data is currently a challenge because true biological variants can be indistinguishable from technical artifacts. One source of technical arti-fact results from incorrectly aligning experimen-tally observed sequences to their true genomic origin (‘mismapping’) and inferring differences in mismapped sequences to be true variants. We de-veloped BlackOPs, an open-source tool that simu-lates experimental RNA-seq and DNA whole exome sequences derived from the reference genome, aligns these sequences by custom parameters, detects variants and outputs a blacklist of positions and alleles caused by mismapping. Blacklist

Anti-motility and reductions in the concentrations of gut electrolytes: Mechanisms for the anti-spasmodic use of the seeds of avocado (Persea americana Mill) in folk medicine

The seeds of avocado (Persea americana Mill) are used in traditional medicine to treat, allay or prevent some spasm-related disorders, for instance, diarrhoea. The chloroform and methanol fractions of the chloroform-methanol extract of the seeds of P. americana were investigated for their qualitative and quantitative phytochemical constituents as well as effects on gastro-intestinal motility (transit) and castor oil-induced intestinal fluid sodium ion (Na+) and potassium ion (K+) concentrations in Wistar rats. The qualitative and quantitative phytochemical studies of the chloroform and methanol fractions showed the presence and amounts of alkaloids (2.92 ± 0.14 g/100 g and 2.81 ± 0.08 g/100 g respectively), flavonoids (3.43 ± 0.19 g/100 g and 3.11 ± 0.16 g/100 g, respectively), tannins (2.64 ± 0.13 g/100 g and 2.85 ± 0.14 g/100 g, respectively), steroids (1.51 ± 0.07 g/100 g and 1.27 ± 0.04 g/100 g, respectively), saponins (2.35 ± 0.08 % and 2.47 ± 0.09%, respectively), terpenoids, proteins and carbohydrates in both fractions. Fats and oil were present only in the chloroform fraction. At the two doses (100 and 200 mg/kg body weight), the chloroform and methanol fractions produced significant (p&lt;0.05) and dose-related decreases in the gastro-intestinal motility and concentration of the intestinal fluid potassium ions but only the chloroform fraction at the dose of 200 mg/kg body weight significantly (p&lt;0.05) decreased the concentration of the intestinal fluid sodium ions. Results of the fractions were comparable with those of the standard anti-diarrhoeal drug, hyoscine butylbromide (3 mg/kg body weight). The results indicate that the chloroform-methanol extract of the seeds of P. americana contains compounds with anti-spasmodic effect.Keywords: Persea americana, spasm-related, castor oil, gastro-intestinal motility and electrolytesAfrican Journal of Biotechnology Vol. 12(37), pp. 5610-561