Long term effect of primary health care training on HIV testing: A quasi-experimental evaluation of the Sexual Health in Practice (SHIP) intervention

BACKGROUND: To examine the effect of Sexual Health in Practice (SHIP) training for general practitioners (GPs) on HIV testing rates in Haringey, a deprived area of London, UK, with a population of over 250,000 and HIV prevalence of 0.7% (in 2014). SHIP is an educational intervention delivering peer-developed and peer-led face-to-face training to improve quality of sexual and reproductive health (SRH) care. METHODS: We carried out a quasi-experimental study of intervention effects across 52 GP practices (2008–2016). We used time variation in SHIP intervention exposure for effect estimation, controlling for practice and calendar month fixed effects in panel analysis. From 2008–2010, baseline data were collected, and in the subsequent six-year period, 78 GPs in Haringey (approximately 40% of all GPs) were SHIP trained. 46 Haringey practices (of 52) had at least one trained doctor. Outcome measures were monthly HIV tests and results by practice (obtained from the hospital laboratories). RESULTS: SHIP significantly increased HIV testing; for every GP trained, practice HIV testing rates increased by 16% (testing rate ratio (TRR) 1.16, 95% confidence interval (CI) 1.05–1.28, p value 0.004). This significant effect was demonstrated using an 8-year observation period, and was sustained over the post-intervention period. An average of 1.42% of HIV tests were positive. CONCLUSION: SHIP training produces a significant and sustained increase in HIV testing for each GP trained. Compared with general population screening, HIV tests used in routine clinical care have a high probability of detecting a positive person. Unlike an RCT, this evaluation is a ‘real life’ measure of the effect that commissioners of SHIP could expect in comparable areas of the UK. The effectiveness of the SHIP training may be related to the programme components not included in interventions that did not demonstrate an effect, such as peer-led teaching, and use of approaches to communication and rapid risk assessment tailored to the setting

Complete mitochondrial genomes and nuclear ribosomal RNA operons of two species of Diplostomum (Platyhelminthes: Trematoda): a molecular resource for taxonomy and molecular epidemiology of important fish pathogens

© 2015 Brabec et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. The attached file is the published version of the article

Final Pre-40S Maturation Depends on the Functional Integrity of the 60S Subunit Ribosomal Protein L3

Ribosomal protein L3 is an evolutionarily conserved protein that participates in the assembly of early pre-60S particles. We report that the rpl3[W255C] allele, which affects the affinity and function of translation elongation factors, impairs cytoplasmic maturation of 20S pre-rRNA. This was not seen for other mutations in or depletion of L3 or other 60S ribosomal proteins. Surprisingly, pre-40S particles containing 20S pre-rRNA form translation-competent 80S ribosomes, and translation inhibition partially suppresses 20S pre-rRNA accumulation. The GTP-dependent translation initiation factor Fun12 (yeast eIF5B) shows similar in vivo binding to ribosomal particles from wild-type and rpl3[W255C] cells. However, the GTPase activity of eIF5B failed to stimulate processing of 20S pre-rRNA when assayed with ribosomal particles purified from rpl3[W255C] cells. We conclude that L3 plays an important role in the function of eIF5B in stimulating 3′ end processing of 18S rRNA in the context of 80S ribosomes that have not yet engaged in translation. These findings indicate that the correct conformation of the GTPase activation region is assessed in a quality control step during maturation of cytoplasmic pre-ribosomal particles

Learning to live together: mutualism between self-splicing introns and their hosts

Group I and II introns can be considered as molecular parasites that interrupt protein-coding and structural RNA genes in all domains of life. They function as self-splicing ribozymes and thereby limit the phenotypic costs associated with disruption of a host gene while they act as mobile DNA elements to promote their spread within and between genomes. Once considered purely selfish DNA elements, they now seem, in the light of recent work on the molecular mechanisms regulating bacterial and phage group I and II intron dynamics, to show evidence of co-evolution with their hosts. These previously underappreciated relationships serve the co-evolving entities particularly well in times of environmental stress

Financing Patterns of European SMEs: An Empirical Taxonomy

This EIF Working Paper takes a holistic approach to investigate SME financing patterns in Europe by performing a cluster analysis including 12,726 SMEs in 28 European countries. The results reveal that SME financing in Europe is not homogenous but that different financing patterns exist. The cluster analysis identifies six distinct SME financing types: mixed-financed SMEs, state-subsidised SMEs, debt-financed SMEs, flexible-debt-financed SMEs, trade-financed SMEs and internally-financed SMEs. These SME financingtypes differ according to the number of financing instruments used and the combinations thereof. Furthermore, the SME financing types can be profiled according to their firm-, product-, industry- and country- specific characteristics. Our findings can support policy makers in assessing the impact of policy changes on SME financing and in designing financing programs tailored to the specific needs of SMEs