.... A record review of 28 active duty women who received pelvic exams at a military health clinic for chlamydia screening and chlamydia prevalence was performed to enrich the interpretation of the data...
van Liere, Geneviève; Dukers-Muijrers, Nicole; van Bergen, Jan; Götz, Hannelore M.; Stals, Frans; Hoebe, Christian
Background: Internet-based Chlamydia Screening Implementation (chlamydia screening programme) was introduced in the Netherlands in 2008-2010 to detect and treat asymptomatic infections and to limit ongoing transmission through annual testing and treatment of Chlamydia trachomatis in young people
Wilbur, David C; Crothers, Barbara A; Eichhorn, John H; Ro, Min S; Gelfand, Jeffrey A
This project explores the combination of computerized automated primary screening of cervical cytology specimens in remote sites with interpretation of device-selected images transmitted via the Internet...
Wilbur, David C; Crothers, Barbara A; Eichhorn, John H; Ro, Min S; Gelfand, Jeffrey A
This project explores the combination of computerized automated primary screening of cervical cytology specimens in remote sites with interpretation of device-selected images transmitted via the Internet...
Wilbur, David C; Crothers, Barbara A; Eichhorn, John H; Ro, Min S; Gelfand, Jeffrey A
This project explores the combination of computerized automated primary screening of cervical cytology specimens in remote sites with interpretation of device-selected images transmitted via the Internet...
Full Text Available Introduction: Around 92 million urogenital infections are caused yearly by Chlamydia trachomatis worldwide . The overall incidence of sexually transmitted diseases is increasing, as shown by the increases in the number of reported cases of syphilis and gonorrhea . Chlamydia trachomatis infections are associated with various serious diseases in women, men and newborns, which could be, at least partially, avoided by means of early diagnosis and therapy. The Federal Joint Committee - responsible for decision-making concerning the benefit package of the German Social Health Insurance - has publicly announced the starting of deliberations on the issue of screening for Chlamydia trachomatis. Research Questions: The leading question to be answered is whether screening for Chlamydia trachomatis should be included in the German benefit basket. The aim of this report is to provide a summary of the available evidence concerning the issue of screening for Chlamydia trachomatis. Methods: The summary of published scientific evidence, including HTA reports, systematic reviews, guidelines and primary research is represented. The synthesis follows the structure given by the criteria of Wilson and Jungner  for the introduction of screening in a population: relevance of the condition, availability of an adequate test, effectiveness of screening, acceptance of the programme, and economical issues. A literature search was conducted for each aspect of the synthesis and the evidence has been summarised in evidence tables. Results: We identified five HTA reports from three European agencies , , ,  and one from the USA . In addition, we identified four guidelines from Northamerica , , ,  and one from Europe . A total of 56 primary research publications were included: relevance of the disease (n=26, availability of test (n=1, effectiveness of screening (n=11, acceptance of the programme (n=11, economical issues (n=7. Discussion
Full Text Available The Dementia Risk Assessment (DRA is an online tool consisting of questions about known risk factors for dementia, a novel verbal memory test, and an informant report of cognitive decline. Its primary goal is to educate the public about dementia risk factors and encourage clinical evaluation where appropriate. In Study 1, more than 3,000 anonymous persons over age 50 completed the DRA about themselves; 1,000 people also completed proxy reports about another person. Advanced age, lower education, male sex, complaints of severe memory impairment, and histories of cerebrovascular disease, Parkinson's disease, and brain tumor all contributed significantly to poor memory performance. A high correlation was obtained between proxy-reported decline and actual memory test performance. In Study 2, 52 persons seeking first-time evaluation at dementia clinics completed the DRA prior to their visits. Their responses (and those of their proxy informants were compared to the results of independent evaluation by geriatric neuropsychiatrists. The 30 patients found to meet criteria for probable Alzheimer's disease, vascular dementia, or frontotemporal dementia differed on the DRA from the 22 patients without dementia (most other neuropsychiatric conditions. Scoring below criterion on the DRA's memory test had moderately high predictive validity for clinically diagnosed dementia. Although additional studies of larger clinical samples are needed, the DRA holds promise for wide-scale screening for dementia risk.
Brandt, Jason; Sullivan, Campbell; Burrell, Larry E; Rogerson, Mark; Anderson, Allan
The Dementia Risk Assessment (DRA) is an online tool consisting of questions about known risk factors for dementia, a novel verbal memory test, and an informant report of cognitive decline. Its primary goal is to educate the public about dementia risk factors and encourage clinical evaluation where appropriate. In Study 1, more than 3,000 anonymous persons over age 50 completed the DRA about themselves; 1,000 people also completed proxy reports about another person. Advanced age, lower education, male sex, complaints of severe memory impairment, and histories of cerebrovascular disease, Parkinson's disease, and brain tumor all contributed significantly to poor memory performance. A high correlation was obtained between proxy-reported decline and actual memory test performance. In Study 2, 52 persons seeking first-time evaluation at dementia clinics completed the DRA prior to their visits. Their responses (and those of their proxy informants) were compared to the results of independent evaluation by geriatric neuropsychiatrists. The 30 patients found to meet criteria for probable Alzheimer's disease, vascular dementia, or frontotemporal dementia differed on the DRA from the 22 patients without dementia (most other neuropsychiatric conditions). Scoring below criterion on the DRA's memory test had moderately high predictive validity for clinically diagnosed dementia. Although additional studies of larger clinical samples are needed, the DRA holds promise for wide-scale screening for dementia risk.
Ladd, Jessica; Hsieh, Yu-Hsiang; Barnes, Mathilda; Quinn, Nicole; Jett-Goheen, Mary; Gaydos, Charlotte A
Internet-based screening for vaginal sexually transmitted infections (STI) has been shown to reach high-risk populations. Published studies of internet-based screening for rectal STIs in women are needed. Our objectives were to describe the female users of a rectal internet-based screening intervention and assess what factors correlated with rectal positivity for STIs. The website http://www.iwantthekit.org offers free STI testing via home self-sampling kits. Women could order vaginal and rectal kits, both containing questionnaires. Rectal and vaginal swabs were tested for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis using nucleic acid amplification tests. Data were analysed from 205 rectal kits from January 2009 through February 2011. Self-reported characteristics of participants were examined, and correlates of rectal STI positivity were analysed. Of the 205 rectal samples returned and eligible for testing, 38 (18.5%) were positive for at least one STI. The women were young (mean age 25.8 years), mostly African-American (50.0%), and only 14.0% always used condoms. After adjusting for age and race, Black race (AOR=3.06) and vaginal STI positivity (AOR=40.6) were significantly correlated with rectal STI positivity. Of women testing positive for rectal STIs who also submitted vaginal swabs, 29.4% were negative in the vaginal sample. Internet-based rectal screening can reach populations that appear to be at high risk for rectal STIs (18.5% prevalence) and led to the diagnosis of STIs in women who would not have been diagnosed vaginally. Black race and vaginal STI positivity were highly correlated with rectal STI positivity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Novak, Masuma; Novak, Daniel
This study aims to assess potential risk factors for Chlamydia trachomatis infection among users of an Internet-based testing service in Sweden. Users of an Internet-based C. trachomatis testing service sent in home urine samples by post which were analysed for C. trachomatis and answered a questionnaire regarding their socio-demographic background, sexual risk behaviour, and sexual health. Potential risk factors for C. trachomatis were determined by logistic regression models. The questionnaire response rate was 86% (6025/6978) with a male and female response rate of 77% and 93%, respectively. 5763 subjects both answered questionnaire and supplied urine sample. Mean age was 24.4 years (range 15-67 years) and 62% were women. The participants'C. trachomatis prevalence in men was 8.0% (73/2163) and 5.6% in women (201/3600). Compared to non-infected individuals, the C. trachomatis infected men and women were younger, had a higher number of sexual partners, more intercourse without condom (only men). After adjusting for age, civil status, and geographical region, the risk factors significantly associated with C. trachomatis infection were multiple partners during the previous year, non-condom usage, and having symptoms (only men). A novel finding was that, in women, believing to be infected and having been requested to be tested by a sexual partner, was associated with an increased risk of having a C. trachomatis infection. The Internet-based C. trachomatis testing service reaches a risk group of men and women. The results emphasise the value of self-risk assessment for C. trachomatis infection and the importance of easy accessible and simple sexual transmitted infection testing services. Copyright © 2012 Elsevier B.V. All rights reserved.
O’Dell KJ, Volk RJ, Cass AR, Spann AL. (1999). Screening for prostate cancer with the prostate-specific antigen test: are patients making informed...Jibaja-Weiss, M. L., Hawley, S. T., Kneuper, S., Spann , S. J., Miles, B. J., et al. (2008). Entertainment education for prostate cancer screening...Weiss ML, Hawley ST, Kneuper S, Spann SJ, Miles BJ, et al: Entertainment education for prostate cancer screening: a randomized trial among primary care
Taylor, Kathryn L
.... We will compare the efficacy of a new web-based, interactive decision support approach to our existing print-based PCa screening decision tool, among a diverse sample of male primary care patients...
Taylor, Kathryn L
.... We will compare the efficacy of a new web-based, interactive decision support approach to our existing print-based PCa screening decision tool, among a diverse sample of male primary care patients...
Taylor, Kathryn L
.... We will compare the efficacy of a new web-based, interactive decision support approach to our existing print-based PCa screening decision tool, among a diverse sample of male primary care patients...
Ruutel, K; Lohmus, L; Janes, J
The aim of the current project was to develop an Internet-based recruitment system for HIV and sexually transmitted infection (STI) screening for men who have sex with men (MSM) in Estonia in order to collect biological samples during behavioural studies. In 2013, an Internet-based HIV risk-behaviour survey was conducted among MSM living in Estonia. After completing the questionnaire, all participants were offered anonymous and free-of-charge STI testing. They could either order a urine sample kit by post to screen for chlamydia infections (including lymphogranuloma venereum (LGV)), trichomoniasis, gonorrhoea and Mycoplasma genitalium infections, or visit a laboratory for HIV, hepatitis A virus, hepatitis B virus,hepatitis C virus and syphilis screening. Of 301 participants who completed the questionnaire, 265 (88%),reported that they were MSM. Of these 265 MSM,68 (26%) underwent various types of testing. In the multiple regression analysis, Russian as the first language,previous HIV testing and living in a city or town increased the odds of testing during the study. Linking Internet-based behavioural data collection with biological sample collection is a promising approach. As there are no specific STI services for MSM in Estonia,this system could also be used as an additional option for anonymous and free-of-charge STI screening.
Full Text Available Abstract Background As most genital chlamydia infections are asymptomatic, screening is the main way to detect and cases for treatment. We undertook a systematic review of studies assessing the efficacy of interventions for increasing the uptake of chlamydia screening in primary care. Methods We reviewed studies which compared chlamydia screening in the presence and the absence of an intervention. The primary endpoints were screening rate or total tests. Results We identified 16 intervention strategies; 11 were randomised controlled trials and five observational studies, 10 targeted females only, five both males and females, and one males only. Of the 15 interventions among females, six were associated with significant increases in screening rates at the 0.05 level including a multifaceted quality improvement program that involved provision of a urine jar to patients at registration (44% in intervention clinics vs. 16% in the control clinic; linking screening to routine Pap smears (6.9% vs. 4.5%, computer alerts for doctors (12.2% vs. 10.6%; education workshops for clinic staff; internet-based continuing medical education (15.5% vs. 12.4%; and free sexual health consultations (16.8% vs. 13.2%. Of the six interventions targeting males, two found significant increases including the multifaceted quality improvement program in which urine jars were provided to patients at registration (45% vs. 15%; and the offering by doctors of a test to all presenting young male clients, prior to consultation (29 vs. 4%. Conclusions Interventions that promoted the universal offer of a chlamydia test in young people had the greatest impact on increasing screening in primary care.
Full Text Available Abstract Background The advent of urine testing for Chlamydia trachomatis has raised the possibility of large-scale screening for this sexually transmitted infection, which is now the most common in the United Kingdom. The purpose of this study was to investigate the effect of an invitation to be screened for chlamydia and of receiving a negative result on levels of anxiety, depression and self-esteem. Methods 19,773 men and women aged 16 to 39 years, selected at random from 27 general practices in two large city areas (Bristol and Birmingham were invited by post to send home-collected urine samples or vulvo-vaginal swabs for chlamydia testing. Questionnaires enquiring about anxiety, depression and self-esteem were sent to random samples of those offered screening: one month before the dispatch of invitations; when participants returned samples; and after receiving a negative result. Results Home screening was associated with an overall reduction in anxiety scores. An invitation to participate did not increase anxiety levels. Anxiety scores in men were lower after receiving the invitation than at baseline. Amongst women anxiety was reduced after receipt of negative test results. Neither depression nor self-esteem scores were affected by screening. Conclusion Postal screening for chlamydia does not appear to have a negative impact on overall psychological well-being and can lead to a decrease in anxiety levels among respondents. There is, however, a clear difference between men and women in when this reduction occurs.
Campbell, Rona; Mills, Nicola; Sanford, Emma; Graham, Anna; Low, Nicola; Peters, Tim J
The advent of urine testing for Chlamydia trachomatis has raised the possibility of large-scale screening for this sexually transmitted infection, which is now the most common in the United Kingdom. The purpose of this study was to investigate the effect of an invitation to be screened for chlamydia and of receiving a negative result on levels of anxiety, depression and self-esteem. 19,773 men and women aged 16 to 39 years, selected at random from 27 general practices in two large city areas (Bristol and Birmingham) were invited by post to send home-collected urine samples or vulvo-vaginal swabs for chlamydia testing. Questionnaires enquiring about anxiety, depression and self-esteem were sent to random samples of those offered screening: one month before the dispatch of invitations; when participants returned samples; and after receiving a negative result. Home screening was associated with an overall reduction in anxiety scores. An invitation to participate did not increase anxiety levels. Anxiety scores in men were lower after receiving the invitation than at baseline. Amongst women anxiety was reduced after receipt of negative test results. Neither depression nor self-esteem scores were affected by screening. Postal screening for chlamydia does not appear to have a negative impact on overall psychological well-being and can lead to a decrease in anxiety levels among respondents. There is, however, a clear difference between men and women in when this reduction occurs.
Chen Marcus Y
Full Text Available Abstract Background Chlamydia trachomatis is the most common notifiable disease in Australia, mainly affecting those aged 15 to 29 years. Testing rates are low in Australia and considerably lower in rural areas, with access and confidentiality of sexual health services being problematic in rural and regional areas. This study aimed to determine the feasibility of establishing a pilot chlamydia testing outreach program among 16–25 year old males and females in rural Victoria (Australia undertaken at local sporting clubs and to determine the prevalence of chlamydia and acceptability of the program in this population. Methods We aimed to recruit young people from the Loddon Mallee region of Victoria, Australia between May and September 2007. After a night of sporting practice, participants provided a first pass urine sample, completed a brief questionnaire regarding risk taking behaviour and were then provided with condoms and health promotion materials about sexually transmitted infections (STIs. Those positive for chlamydia were managed by telephone consultation with a practitioner from Melbourne Sexual Health Centre. Results A total of 709 young people participated (77% male, 23% female, 77% being sexually active. All provided a urine sample and completed the questionnaire. Participation rate on recruitment nights was over 95%. Overall chlamydia prevalence in those sexually active was 5.1% (95%CI: 3.4–7.3, 7.4% in females (95%CI: 3.5–13.6 and 4.5% in males (95%CI: 2.7–6.9. Conclusion Sporting clubs represent a feasible, acceptable and innovative community based setting to screen, treat and educate young people in a rural and regional setting, especially for males.
Chout, R T; Vaton, S; Duval-Violton, D; Leguyader-Despres, P; Orfila, J
To determine the prevalence of Chlamydia trachomatis urogenital infection and to identify behavioral, demographic, and clinical factors associated with the infection in pregnant women in Martinique. One-thousand-four-hundred-eleven patients 15-39 years old, at 10-16 weeks of gestation and attending the prenatal clinic at Lamentin Hospital, were tested for Chlamydia trachomatis infection of the cervix and urethra using tissue culture. Chlamydia trachomatis was isolated from 375 (26.7%) women; 34% of them were positive in the cervix and urethra, 58% in the cervix only, and 8% in the urethra only. Factors found by multivariate analysis to be significantly associated with chlamydial infection were age less than 25 years, first intercourse at less than 18 years old, previous induced abortions, mucopurulent cervicitis, and repeated candidiasis. None of the factors associated with chlamydial infection was sensitive enough to permit efficient selective screening. It is cost effective to recommend a routine screening for chlamydial infection together with an educational program.
AlKhalili, Rend; Shukla, Pratik A; Patel, Ronak H; Sanghvi, Saurin; Hubbi, Basil
The US Department of Health and Human Services (USDHHS) recommends that Internet-based patient education materials (IPEMs) be written below the sixth-grade reading level to target the average American adult. This study was designed to determine the readability of IPEMs regarding mammography for breast cancer screening. Three-hundred mammography-related Web sites were reviewed for IPEMs. Forty-two IPEMs that met the Health on the Net Foundation Code of Conduct were assessed for readability level with four readability indices that use existing algorithms based on word and sentence length to quantitatively analyze Internet sources for language intricacy including the following: Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease Score (FRES), Simple Measure of Gobbledygook (SMOG), and Gunning Frequency of Gobbledygook (Gunning FOG; GFOG). Results were compared to national recommendations, and intergroup analysis was performed. No IPEMs (0%) regarding mammography were written at or below the sixth-grade reading level, based on FKGL. The mean readability scores were as follows: FRES, 49.04 ± 10.62; FKGL, 10.71 ± 2.01; SMOG, 13.33 ± 1.67; and Gunning FOG, 14.32 ± 2.18. These scores indicate that the readability of mammography IPEMs is written at a "difficult" level, significantly above the recommended sixth-grade reading level (P related to mammography are written well above the recommended sixth-grade level and likely reflect other IPEMs in diagnostic radiology. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.
Hambidge, Simon J; Phibbs, Stephanie; Beck, Arne; Bergman, David Aaron
Internet-based developmental screening is being implemented in pediatric practices across the United States. Little is known about the application of this technology in poor urban populations. We describe here the results of focus groups, surveys, and in-depth interviews during home visits with families served by an urban safety-net organization to address the question of whether it is possible to use Internet or e-mail communication for medical previsit engagement in a population that is majority Hispanic, of low socioeconomic status, and has many non-English-speaking families. This study included families in 4 clinics within a safety-net health care system. The study design included the use of (1) parental surveys (n = 200) of a convenience sample of parents whose children received primary care in the clinics, (2) focus groups (n = 7 groups) with parents, and (3) in-depth interviews during home visits with 4 families. We used χ(2) and multivariate analyses to compare Internet access in English- and Spanish-speaking families. Standard qualitative methods were used to code focus-group texts and identify convergent themes. In multivariate analysis, independent factors associated with computer use were English versus Spanish language (odds ratio: 3.2 [95% confidence interval: 1.4-6.9]) and education through at least high school (odds ratio: 4.7 [95% confidence interval: 2.3-9.7]). In focus groups, the concept of parental previsit work, such as developmental screening tests, was viewed favorably by all groups. However, many parents expressed reservations about doing this work by using the Internet or e-mail and stated a preference for either paper or telephone options. Many Spanish-speaking families discussed lack of access to computers and printers. In this economically disadvantaged population, language and maternal education were associated with access to the Internet. Given the potential power of previsit work to tailor well-child visits to the needs of
Pereboom, M.T.R.; Spelten, E.R.; Manniën, J.; Rours, G.I.J.G.; Morré, S.A.; Schellevis, F.G.; Hutton, E.K.
Background: Chlamydia trachomatis infections in pregnancy can cause maternal disease, adverse pregnancy outcomes and neonatal disease, which is why chlamydia screening during pregnancy has been advocated. The effectiveness of a screening program depends on the knowledge of health care professionals,
Pereboom, M.T.R.; Spelten, E.R.; Manniën, J.; Rours, G.I.J.G.; Morré, S.A.; Schellevis, F.G.; Hutton, E.K.
Background: Chlamydia trachomatis infections in pregnancy can cause maternal disease, adverse pregnancy outcomes and neonatal disease, which is why chlamydia screening during pregnancy has been advocated. The effectiveness of a screening program depends on the knowledge of health care professionals,
Blake, Diane R; Quinn, Thomas C; Gaydos, Charlotte A
To compare the cost-effectiveness of various chlamydia screening strategies within a population of male and female youth entering a national job training program. Cost-effectiveness analysis of various chlamydia screening strategies among a cohort of 4000 female and male New England job training students. Strategies for women include (a) no screening, (b) universal endocervical DNA probe screening, (c) universal urine based NAAT screening, and (d) universal endocervical NAAT screening. Strategies for men include (a) no screening, (b) selective urine NAAT screening of leukocyte esterase (LE)-positive urines, and (c) universal urine-based NAAT screening. Universal endocervical NAAT screening of women and universal urine NAAT screening of men were the most effective and cost-effective strategies individually and in combination. Endocervical NAAT screening of women prevented 23 more cases of PID and saved $27,000 more than endocervical DNA probe screening. Likewise, universal urine NAAT screening of men prevented 21 more cases of PID in their female partners and saved $16,000 more than selective urine NAAT screening of LE positive men. Use of a sensitive NAAT to screen both men and women for chlamydia upon entry to a National Job Training Program is cost-effective, cost-saving, and provides a public health opportunity to substantially reduce chlamydia infections among youth at risk for sexually transmitted diseases.
Wesolowski, Jordan; Weber, Mary M; Nawrotek, Agata; Dooley, Cheryl A; Calderon, Mike; St Croix, Claudette M; Hackstadt, Ted; Cherfils, Jacqueline; Paumet, Fabienne
The intracellular bacterium Chlamydia trachomatis develops in a parasitic compartment called the inclusion. Posttranslationally modified microtubules encase the inclusion, controlling the positioning of Golgi complex fragments around the inclusion. The molecular mechanisms by which Chlamydia coopts the host cytoskeleton and the Golgi complex to sustain its infectious compartment are unknown. Here, using a genetically modified Chlamydia strain, we discovered that both posttranslationally modified microtubules and Golgi complex positioning around the inclusion are controlled by the chlamydial inclusion protein CT813/CTL0184/InaC and host ARF GTPases. CT813 recruits ARF1 and ARF4 to the inclusion membrane, where they induce posttranslationally modified microtubules. Similarly, both ARF isoforms are required for the repositioning of Golgi complex fragments around the inclusion. We demonstrate that CT813 directly recruits ARF GTPases on the inclusion membrane and plays a pivotal role in their activation. Together, these results reveal that Chlamydia uses CT813 to hijack ARF GTPases to couple posttranslationally modified microtubules and Golgi complex repositioning at the inclusion. IMPORTANCE Chlamydia trachomatis is an important cause of morbidity and a significant economic burden in the world. However, how Chlamydia develops its intracellular compartment, the so-called inclusion, is poorly understood. Using genetically engineered Chlamydia mutants, we discovered that the effector protein CT813 recruits and activates host ADP-ribosylation factor 1 (ARF1) and ARF4 to regulate microtubules. In this context, CT813 acts as a molecular platform that induces the posttranslational modification of microtubules around the inclusion. These cages are then used to reposition the Golgi complex during infection and promote the development of the inclusion. This study provides the first evidence that ARF1 and ARF4 play critical roles in controlling posttranslationally modified
Ahmed, Navera; Jayasinghe, Yasmin; Wark, John D; Fenner, Yeshe; Moore, Elya E; Tabrizi, Sepehr N; Fletcher, Ashley; Garland, Suzanne M
Chlamydia (Chlamydia trachomatis) is the commonest bacterial sexually transmissible infection worldwide and contributes to significant morbidity in females. We examined potential barriers and facilitating factors for screening in young Victorian women, using the social networking site, Facebook to recruit participants. This was part of a larger study on young women's health that assessed the feasibility of using social networking sites for recruitment. An advertisement was placed on Facebook between May and September 2010, and was visible to eligible women. Women who clicked on the advertisement and expressed their interest in participating were invited to complete a questionnaire either at a study site or online. In total, 278 participants completed the survey, with 76% reporting willingness to participate in chlamydia screening by recruitment via an online system. Overall, 73% of participants indicated they were comfortable providing a urine sample collected at home for chlamydia screening, with older participants less comfortable with this method (P=0.02, odds ratio (OR)=0.09, 95% confidence interval (CI)=0.01-0.7). Participants expressed comfort with their Pap smear and chlamydia screening being performed together (92.7%), especially those who were aware of human papillomavirus (PFacebook to participate in screening for chlamydia. There was strong acceptance of self-collected sampling, and of combined chlamydia and cervical cytology screening. Facebook may therefore be a feasible way for improving screening coverage at a population level.
Brandie D Taylor
Full Text Available Brandie D Taylor, Catherine L HaggertyUniversity of Pittsburgh, Department of Epidemiology, Pittsburgh, PA, USAAbstract: Chlamydia trachomatis is a prevalent sexually transmitted infection that can lead to serious reproductive morbidity. Management and control of C. trachomatis is a challenge, largely due to its asymptomatic nature and our incomplete understanding of its natural history. Although chlamydia screening programs have been implemented worldwide, several countries have observed increasing rates of reported chlamydia cases. We reviewed the literature relating to the long-term complications of C. trachomatis, as well as screening strategies, treatment, and prevention strategies for reducing chlamydia in the population. Articles from 1950–2010 were identified through a Medline search using the keyword “Chlamydia trachomatis” combined with “screening”, “pelvic inflammatory disease”, “endometritis”, “salpingitis”, “infertility”, "ectopic pregnancy”, “urethritis”, “epididymitis”, “proctitis”, “prostatitis”, “reinfection”, “cost-effectiveness”, “treatment”, “vaccines”, or “prevention”. Progression of C. trachomatis varies, and recurrent infections are common. Currently, there is limited evidence on the effectiveness of chlamydia screening. Higher quality studies are needed to determine the efficacy of more frequent screening, on a broader range of sequelae, including infertility and ectopic pregnancy, in addition to pelvic inflammatory disease. Studies should focus on delineating the natural history of recurrent infections, paying particular attention to treatment failures. Furthermore, alternatives to screening, such as vaccines, should continue to be explored.Keywords: Chlamydia trachomatis, sexually transmitted disease, chlamydia screening, chlamydia treatment
Full Text Available Remah M Kamel Department of Obstetrics and Gynecology, Faculty of Medicine, University of Jazan, Saudi Arabia Background: Chlamydia trachomatis infection is a worldwide-distributed sexually transmitted infection that may lead to infertility. Objectives: This study aims to report the prevalence of Chlamydia trachomatis infection among infertile women in Saudi Arabia. Patients and methods: A community-based study carried out at the obstetrics and gynecology clinic at Jazan General Hospital, Saudi Arabia. The study group included 640 Saudi infertile women who were aged between 18 and 40 years and who attended the gynecology clinic for infertility examination throughout 1 year of study (from July 1, 2011 to June 30, 2012. The randomized control group included 100 Saudi fertile women who attended the obstetrics clinic for routine antenatal care. All recruited women were screened for chlamydia infection by enzyme-linked immunosorbent assay (ELISA for detection of serum-specific antibodies and then retested by the McCoy cell culture technique. Results: The prevalence of Chlamydia trachomatis infection among infertile women was high, at 15.0%. The rate of chlamydia infection detected by ELISA was 9.84%, and it was 12.03% by the culture method (P = 0.2443. Conclusion: The high prevalence of Chlamydia trachomatis infection among Saudi infertile women demands a national screening program for early detection among infertile couples. ELISA is available as a simple screening test alternative to the culture method. Keywords: Chlamydia trachomatis, ELISA, McCoy cell culture, infertility, sexually transmitted infection
Full Text Available Abstract Background General practice staff are reluctant to discuss sexual health opportunistically in all consultations. Health promotion materials may help alleviate this barrier. Chlamydia screening promotion posters and leaflets, produced by the English National Chlamydia Screening Programme (NCSP, have been available to general practices, through local chlamydia screening offices, since its launch. In this study we explored the attitudes of general practice staff to these screening promotional materials, how they used them, and explored other promotional strategies to encourage chlamydia screening. Methods Twenty-five general practices with a range of screening rates, were purposively selected from six NCSP areas in England. In focus groups doctors, nurses, administrative staff and receptionists were encouraged to discuss candidly their experiences about their use and opinions of posters, leaflets and advertising to promote chlamydia screening. Researchers observed whether posters and leaflets were on display in reception and/or waiting areas. Data were collected and analysed concurrently using a stepwise framework analytical approach. Results Although two-thirds of screening practices reported that they displayed posters and leaflets, they were not prominently displayed in most practices. Only a minority of practices reported actively using screening promotional materials on an ongoing basis. Most staff in all practices were not following up the advertising in posters and leaflets by routinely offering opportunistic screening to their target population. Some staff in many practices thought posters and leaflets would cause offence or embarrassment to their patients. Distribution of chlamydia leaflets by receptionists was thought to be inappropriate by some practices, as they thought patients would be offended when being offered a leaflet in a public area. Practice staff suggested the development of pocket-sized leaflets. Conclusion The NCSP
Bilardi Jade E
Full Text Available Abstract Background In pregnancy, untreated chlamydia infection has been associated with adverse outcomes for both mother and infant. Like most women, pregnant women infected with chlamydia do not report genital symptoms, and are therefore unlikely to be aware of their infection. The aim of this study was to determine the acceptability of screening pregnant women aged 16-25 years for chlamydia as part of routine antenatal care. Methods As part of a larger prospective, cross-sectional study of pregnant women aged 16-25 years attending antenatal services across Melbourne, Australia, 100 women were invited to participate in a face-to-face, semi structured interview on the acceptability of screening for chlamydia during pregnancy. Women infected with chlamydia were oversampled (n = 31. Results Women had low levels of awareness of chlamydia before the test, retained relatively little knowledge after the test and commonly had misconceptions around chlamydia transmission, testing and sequelae. Women indicated a high level of acceptance and support for chlamydia screening, expressing their willingness to undertake whatever care was necessary to ensure the health of their baby. There was a strong preference for urine testing over other methods of specimen collection. Women questioned why testing was not already conducted alongside other antenatal STI screening tests, particularly in view of the risks chlamydia poses to the baby. Women who tested positive for chlamydia had mixed reactions, however, most felt relief and gratitude at having had chlamydia detected and reported high levels of partner support. Conclusions Chlamydia screening as part of routine antenatal care was considered highly acceptable among young pregnant women who recognized the benefits of screening and strongly supported its implementation as part of routine antenatal care. The acceptability of screening is important to the uptake of chlamydia screening in future antenatal screening
Boris V Schmid
Full Text Available BACKGROUND: A large trial to investigate the effectiveness of population based screening for chlamydia infections was conducted in the Netherlands in 2008-2012. The trial was register based and consisted of four rounds of screening of women and men in the age groups 16-29 years in three regions in the Netherlands. Data were collected on participation rates and positivity rates per round. A modeling study was conducted to project screening effects for various screening strategies into the future. METHODS AND FINDINGS: We used a stochastic network simulation model incorporating partnership formation and dissolution, aging and a sexual life course perspective. Trends in baseline rates of chlamydia testing and treatment were used to describe the epidemiological situation before the start of the screening program. Data on participation rates was used to describe screening uptake in rural and urban areas. Simulations were used to project the effectiveness of screening on chlamydia prevalence for a time period of 10 years. In addition, we tested alternative screening strategies, such as including only women, targeting different age groups, and biennial screening. Screening reduced prevalence by about 1% in the first two screening rounds and leveled off after that. Extrapolating observed participation rates into the future indicated very low participation in the long run. Alternative strategies only marginally changed the effectiveness of screening. Higher participation rates as originally foreseen in the program would have succeeded in reducing chlamydia prevalence to very low levels in the long run. CONCLUSIONS: Decreasing participation rates over time profoundly impact the effectiveness of population based screening for chlamydia infections. Using data from several consecutive rounds of screening in a simulation model enabled us to assess the future effectiveness of screening on prevalence. If participation rates cannot be kept at a sufficient level
Hansberry, David Richard; White, Michael D; D'Angelo, Michael; Prabhu, Arpan V; Kamel, Sarah; Lakhani, Paras; Sundaram, Baskaran
Following the findings of the National Lung Screening Trial, several national societies from multiple disciplines have endorsed the use of low-dose chest CT to screen for lung cancer. Online patient education materials are an important tool to disseminate information to the general public regarding the proven health benefits of lung cancer screening. This study aims to evaluate the reading level at which these materials related to lung cancer screening are written. The four terms "pulmonary nodule," "radiation," "low-dose CT," and "lung cancer screening" were searched on Google, and the first 20 online resources for each term were downloaded, converted into plain text, and analyzed using 10 well-established readability scales. If the websites were not written specifically for patients, they were excluded. The 80 articles were written at a 12.6 ± 2.7 (mean ± SD) grade level, with grade levels ranging from 4.0 to 19.0. Of the 80 articles, 62.5% required a high school education to comprehend, and 22.6% required a college degree or higher (≥ 16th grade) to comprehend. Only 2.5% of the analyzed articles adhered to the recommendations of the National Institutes of Health and American Medical Association that patient education materials be written at a 3rd- to 7th-grade reading level. Commonly visited online lung cancer screening-related patient education materials are written at a level beyond the general patient population's ability to comprehend and may be contributing to a knowledge gap that is inhibiting patients from improving their health literacy.
Hook, E W; Spitters, C; Reichart, C A; Neumann, T M; Quinn, T C
To compare a rapid, office-based test with standard cell culture for screening of women for Chlamydia trachomatis infections. An 8-month prospective crossover trial used alternating screening protocols in two Baltimore (Md) sexually transmitted disease clinics from January 2 through August 14, 1991. Consecutive women attending the two clinics who had no indication for administration of antichlamydial antibiotic therapy (eg, history of recent sexual contact with a partner with a sexually transmitted disease, mucopurulent cervicitis, pelvic inflammatory disease, known gonorrhea, or previously diagnosed Chlamydia infections). Chlamydia screening was offered according to one of two protocols. Use of the two screening protocols was alternated between clinics each month. In the "rapid test clinic," eligible women were screened with both a 30-minute enzyme immunoassay test and tissue culture. Patients screened with the rapid test were asked to remain in the clinic until their rapid assay results were available so that, if positive, the patients could be treated. In the "routine screening clinic," eligible women were screened for Chlamydia by cell culture. Women identified as being infected with Chlamydia by screening culture were later confidentially notified of their test results by health department disease intervention specialists and referred for therapy. Performance of screening tests for bringing infected patients to therapy; time intervals between initial clinic visits and therapy; and pelvic inflammatory disease occurring between initial visits and therapy. Chlamydia cultures were positive in 100 (6.6%) of 1526 women screened with the solid-phase immunoassay, 47 of which were detected and treated on the basis of rapid test results. In contrast, 93 (74%) of 126 women with positive screening cultures returned to the clinic and received therapy. The median interval between testing and therapy for women with positive screening cultures was 14 days, and three (3
Sheikh Rashid, Marya; Leensen, Monique Cj; de Laat, Jan Apm; Dreschler, Wouter A.
Objectives The Occupational Earcheck (OEC) is an online internet test to detect high-frequency hearing loss for the purposes of occupational hearing screening. In this study, we evaluated the OEC in an occupational setting in order to assess test sensitivity, specificity, and validity. Methods A
Tapia, Olga; Slepenkin, Anatoly; Sevrioukov, Evgueni; Hamor, Kathi; de la Maza, Luis M.; Peterson, Ellena M.
A study was conducted to determine the ability of the inclusion immunofluorescence assay (inclusion IFA) to act as a screening test to detect samples with antibodies to Chlamydia pneumoniae; microimmunofluorescence (MIF) was used as the “gold standard.” In addition, the inclusion IFA was compared using HEp-2 cells infected with either C. pneumoniae CM-1 or Chlamydia trachomatis serovar E. A total of 331 serum samples representing a range of MIF titers were evaluated. The sensitivities of the ...
Kamel, Remah M
Chlamydia trachomatis infection is a worldwide-distributed sexually transmitted infection that may lead to infertility. This study aims to report the prevalence of Chlamydia trachomatis infection among infertile women in Saudi Arabia. A community-based study carried out at the obstetrics and gynecology clinic at Jazan General Hospital, Saudi Arabia. The study group included 640 Saudi infertile women who were aged between 18 and 40 years and who attended the gynecology clinic for infertility examination throughout 1 year of study (from July 1, 2011 to June 30, 2012). The randomized control group included 100 Saudi fertile women who attended the obstetrics clinic for routine antenatal care. All recruited women were screened for chlamydia infection by enzyme-linked immunosorbent assay (ELISA) for detection of serum-specific antibodies and then retested by the McCoy cell culture technique. The prevalence of Chlamydia trachomatis infection among infertile women was high, at 15.0%. The rate of chlamydia infection detected by ELISA was 9.84%, and it was 12.03% by the culture method (P = 0.2443). The high prevalence of Chlamydia trachomatis infection among Saudi infertile women demands a national screening program for early detection among infertile couples. ELISA is available as a simple screening test alternative to the culture method.
Lunny, Carole; Taylor, Darlene; Hoang, Linda; Wong, Tom; Gilbert, Mark; Lester, Richard; Krajden, Mel; Ogilvie, Gina
Background The increases in STI rates since the late 1990s in Canada have occurred despite widespread primary care and targeted public health programs and in the setting of universal health care. More innovative interventions are required that would eliminate barriers to STI testing such as internet-based or mail-in home and community service testing for patients that are hard to reach, who refuse to go for clinician-based testing, or who decline an examination. Jurisdictions such as New Zealand and some American states currently use self-collected sampling, but without the required evidence to determine whether self-collected specimens are as accurate as clinician-collected specimens in terms of chlamydia and gonorrhea diagnostic accuracy. The objective of the review is to compare self-collected vaginal, urine, pharyngeal and rectal samples to our reference standard - clinician-collected cervical, urethral, pharyngeal and rectal sampling techniques to identify a positive specimen using nucleic acid amplification test assays. Methods The hierarchical summary receiver operating characteristic and the fixed effect models were used to assess the accuracy of comparable specimens that were collected by patients compared to clinicians. Sensitivity and specificity estimates with 95% confidence intervals (CI) were reported as our main outcome measures. Findings We included 21 studies based on over 6100 paired samples. Fourteen included studies examined chlamydia only, 6 compared both gonorrhea and chlamydia separately in the same study, and one examined gonorrhea. The six chlamydia studies comparing self-collection by vaginal swab to a clinician-collected cervical swab had the highest sensitivity (92%, 95% CI 87-95) and specificity (98%, 95% CI 97-99), compared to other specimen-types (urine/urethra or urine/cervix). Six studies compared urine self-samples to urethra clinician-collected samples in males and produced a sensitivity of 88% (95% CI 83-93) and a specificity of
Ciemins, E L; Kent, C K; Flood, J; Klausner, J D
The advent of more sensitive diagnostic testing technologies and competition in public healthcare spending have resulted in a reevaluation of sexually transmitted disease (STD) screening practices in an attempt to target populations at greatest risk. Screening among populations with a < 2% prevalence of chlamydia and a < 1% prevalence of gonorrhea may not be cost-effective. To identify subpopulations with a low prevalence of chlamydia or gonorrhea. The prevalence of genital chlamydia and gonorrhea among asymptomatic STD patients screened from 1997 to 1998 at San Francisco City Clinic was stratified by demographic and behavioral risk factors. The prevalence of chlamydia and gonorrhea was 3.4% and 1.1% among asymptomatic women and 4.0% and 1.0% among asymptomatic men, respectively. Two low-prevalence subpopulations identified among asymptomatic patients were women older than 29 years (chlamydia, 1.2%) and men who have sex with women (gonorrhea, 0.8%). These data identified low-prevalence subpopulations among asymptomatic STD patients. As a result, the STD screening criteria at San Francisco City Clinic were changed accordingly.
Wilson Carlene J
Full Text Available Abstract Background Australia has a comparatively high incidence of colorectal (bowel cancer; however, population screening uptake using faecal occult blood test (FOBT remains low. This study will determine the impact on screening participation of a novel, Internet-based Personalised Decision Support (PDS package. The PDS is designed to measure attitudes and cognitive concerns and provide people with individually tailored information, in real time, that will assist them with making a decision to screen. The hypothesis is that exposure to (tailored PDS will result in greater participation in screening than participation following exposure to non-tailored PDS or resulting from the current non-tailored, paper-based approach. Methods/design A randomised parallel trial comprising three arms will be conducted. Men and women aged 50-74 years (N = 3240 will be recruited. They must have access to the Internet; have not had an FOBT within the previous 12 months, or sigmoidoscopy or colonoscopy within the previous 5 years; have had no clinical diagnosis of bowel cancer. Groups 1 and 2 (PDS arms will access a website and complete a baseline survey measuring decision-to-screen stage, attitudes and cognitive concerns and will receive immediate feedback; Group 1 will receive information 'tailored' to their responses in the baseline survey and group 2 will received 'non-tailored' bowel cancer information. Respondents in both groups will subsequently receive an FOBT kit. Group 3 (usual practice arm will complete a paper-based version of the baseline survey and respondents will subsequently receive 'non-tailored' paper-based bowel cancer information with accompanying FOBT kit. Following despatch of FOBTs, all respondents will be requested to complete an endpoint survey. Main outcome measures are (1 completion of FOBT and (2 change in decision-to-screen stage. Secondary outcomes include satisfaction with decision and change in attitudinal scores from baseline to
Currie, Marian J; Schmidt, Matthias; Davis, Belinda K; Baynes, Anne M; O'Keefe, Elissa J; Bavinton, Tim P; McNiven, Michelle; Martin, Sarah J; Bowden, Francis J
We hypothesise that text-messaging and financial incentives would increase tertiary student participation in chlamydia screening. A cross-sectional study was conducted over two phases on eight tertiary campuses during 2007. During Phase 1 (6 months) study activities were advertised through student organisations and media. Education and screening were offered during a range of student activities. During Phase 2 (4 days) education and screening were offered via text messages. Non-financial incentives were offered during Phase 1 and a $10 cash incentive was offered during Phase 2. Rates of specimens provided by students and the direct costs incurred during each phase were compared. 2786 students attended the 31 activities conducted in Phase 1. Of these, 627 students (22.5%) provided urine specimens for chlamydia testing. During Phase 2, the dissemination of 866 text messages resulted in urine specimens from 392 students (45.3%). Costs per test were AUD $175.11 in Phase 1 and AUD $27.13 in Phase 2. Compared with more labour intensive (and therefore more expensive) screening activities conducted over a 6-month period, offering a small financial incentive to tertiary students through text messaging over a 4-day period significantly increased participation in on-campus chlamydia screening. This model could readily be applied to other populations to increase participation in chlamydia screening.
Davies, Stephen C; Shepherd, Brooke; Wiig, Rebecca; Kaan, Iain
Young international backpackers frequently have new sexual partners. We conducted a pilot project of unsupervised screening for chlamydia (Chlamydia trachomatis) and gonorrhoea (Neisseria gonorrhoeae) by self-collected specimens at two backpacker hostels in Manly, Sydney. The median age was 24 years for men and 23 years for women. A new sexual partner during travel was reported by 94%, of whom only 20% always using condoms. The prevalence of chlamydia was 11.9% (14.3% of 35 men and 10.2% of 49 women). No cases of gonorrhoea were detected. Half of the dispensed testing kits went missing or were tampered with, and there was spoilage of the receptacle bins, which persisted despite a redesign to a more secure and locked box. While populations such as young backpackers may be a priority group for sexually transmissible infection screening, we advise caution for projects contemplating an unsupervised model.
Salerno, Jennifer; Darling-Fisher, Cindy; Hawkins, Nicole M.; Fraker, Elizabeth
Background: This article describes a school-wide sexually transmitted infection (STI) screening to identify adolescent high-risk sexual behaviors, STI history/incidence, and presence of chlamydia and gonorrhea, and examines relationships between high-risk behaviors and screening positive for chlamydia and gonorrhea in an alternative high school…
Kretzschmar, Mirjam; Satterwhite, Catherine; Leichliter, Jami; Berman, Stuart
Model impact of increasing screening and partner notification (PN) on chlamydia positivity. We used a stochastic simulation model describing pair formation and dissolution in an age-structured heterosexual population. The model accounts for steady, casual, and concurrent partnerships and a highly sexually active core group. The model used existing sexual behavior data from the United States and was validated using chlamydia positivity data from Region X (Alaska, Idaho, Oregon, Washington). A screening program with a coverage rate of 20% was implemented among women aged 15 to 24 years. After 10 years, we increased screening coverage to 35%, 50%, and 65% and partner treatment rates from 20% to 40% and 55%. Finally, we included male screening (aged 15-24, screening coverage: 20% and 35%, partner treatment: 25% and 40%). We analyzed the effects on chlamydia positivity in women and the frequency of reinfection 6 months after treatment. The model described the decline in positivity observed from 1988 to 1997 in Region X, given screening coverage of 20% and a 25% partner treatment rate. Increasing screening coverage from 35% to 65% resulted in incremental decreases in positivity as did increasing the PN rate; a 23% reduction in positivity was achieved by either increasing screening by 3-fold or PN by 2-fold. Adding male screening to the program had less impact than increasing screening coverage or PN among women. Increased PN and treatment reduced reinfection rates considerably. Increasing efforts in PN may contribute at least as much to control of chlamydia infection as increasing screening coverage rates.
Kuder, Margaret; Goheen, Mary Jett; Dize, Laura; Barnes, Mathilda; Gaydos, Charlotte A
The www.iwantthekit.org provides Internet-based, at-home sexually transmitted infection screening. The Web site implemented an automated test result access system. To evaluate potential deleterious effects of the new system, we analyzed demographics, Web site usage, and treatment. The post-Web site design captured more participant information and no decrease in requests, kit return, or treatment adherence.
de Vries, R.; Van Bergen, J.E.A.M.; de Jong-van den Berg, Lolkje; Postma, Maarten
To estimate the cost-effectiveness of a systematic one-off Chlamydia trachomatis (CT) screening program including partner treatment for Dutch young adults. Data on infection prevalence, participation rates, and sexual behavior were obtained from a large pilot study conducted in The Netherlands.
de Vries, Robin; van Bergen, Jan E. A. M.; de Jong-van den Berg, Lolkje T. W.; Postma, Maarten J.
To estimate the cost-effectiveness of a systematic one-off Chlamydia trachomatis (CT) screening program including partner treatment for Dutch young adults. Data on infection prevalence, participation rates, and sexual behavior were obtained from a large pilot study conducted in The Netherlands.
Land, Jolande; Van Bergen, J E A M; Morré, S A; Postma, Maarten
BACKGROUND: The majority of Chlamydia trachomatis infections in women are asymptomatic, but may give rise to pelvic inflammatory disease (PID) and tubal infertility. Screening programmes aim at reducing morbidity in individuals by early detection and treatment, and at decreasing the overall
van Valkengoed, I. G.; Morré, S. A.; van den Brule, A. J.; Meijer, C. J.; Devillé, W.; Bouter, L. M.; Boeke, A. J.
OBJECTIVES: To develop and validate selective screening criteria for asymptomatic Chlamydia trachomatis infections in the general population. METHODS: 11,505 people, aged 15-40 years, registered in 16 general practices in Amsterdam were invited to return by mail a home obtained first void urine
Full Text Available Abstract Background More women are requesting Emergency Hormonal Contraception (EHC at pharmacies where screening for Chlamydia trachomatis is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK. Methods Six Primary Care Trusts (PCTs that had contracted with pharmacies to provide free EHC, requested the largest EHC providers (≥ 40 doses annually to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate. Results 33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718 of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348/2904 EHC clients (46.4% who had been offered screening accepted a screening kit. 264 (17.6% of those who accepted a kit returned a sample, of whom 24 (9.1% were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015. Conclusion Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group.
Wang, Ze-yu; Fu, Guang-yu; Wang, Shan-mei; Qin, Dong-chun; Wang, Zhong-quan; Cui, Jing
Abstract Background Chlamydia trachomatis may cause multiple different urogenital tract disorders, but current non-culture assays for rapid screening of C. trachomatis typically use immunochromatography-based methods. We established another new rapid non-culture method for detection of C. trachomatis based on the measurement of α-mannosidase enzymatic activity in urogenital tract specimens. Method To evaluate the performance of this method, α-mannosidase activities of C. trachomatis serotype ...
Hengel, Belinda; Jamil, Muhammad S; Mein, Jacqueline K; Maher, Lisa; Kaldor, John M; Guy, Rebecca J
Background High Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) prevalence have been reported in populations that do not regularly access health centres for sexually transmissible infections (STI) testing. We reviewed current outreach strategies used to increase access to STI testing and their outcomes. Methods We systematically reviewed the literature for English language studies published between 1 January 2005 and 28 January 2011 describing CT and/or NG screening programs in non-...
Wallace Louise M
Full Text Available Abstract Background Despite the known health and healthcare costs of untreated chlamydia infection and the efforts of the National Chlamydia Screening Programme (NCSP to control chlamydia through early detection and treatment of asymptomatic infection, the rates of screening are well below the 2010-2011 target rate of 35%. General Practitioner (GP surgeries are a key venue within the NCSP however; previous studies indicate that GP surgery staff are concerned that they may offend their patients by offering a screen. This study aimed to identify the attitudes to, and preferences for, chlamydia screening in 15-24 year old men and women attending GP surgeries (the target group. Methods We undertook 36 interviews in six surgeries of differing screening rates. Our participants were 15-24 year olds attending a consultation with a staff member. Data were analysed thematically. Results GP surgeries are acceptable to young people as a venue for opportunistic chlamydia screening and furthermore they think it is the duty of GP surgery staff to offer it. They felt strongly that it is important for surgery staff to have a non-judgemental attitude and they did not want to be singled out as 'needing' a chlamydia screen. Furthermore, our sample reported a strong preference for being offered a screen by staff and providing the sample immediately at the surgery rather than taking home a testing kit. The positive attitude and subjective norms demonstrated by interviewees suggest that young peoples' behaviour would be to accept a screen if it was offered to them. Conclusion Young people attending GP surgeries have a positive attitude towards chlamydia screening and given the right environment are likely to take up the offer in this setting. The right environment involves normalising screening by offering a chlamydia screen to all 15-24 year olds at every interaction with staff, offering screening with a non-judgemental attitude and minimising barriers to screening
Hogan, Angela H; Howell-Jones, Rebecca S; Pottinger, Elizabeth; Wallace, Louise M; McNulty, Cliodna Am
Despite the known health and healthcare costs of untreated chlamydia infection and the efforts of the National Chlamydia Screening Programme (NCSP) to control chlamydia through early detection and treatment of asymptomatic infection, the rates of screening are well below the 2010-2011 target rate of 35%. General Practitioner (GP) surgeries are a key venue within the NCSP however; previous studies indicate that GP surgery staff are concerned that they may offend their patients by offering a screen. This study aimed to identify the attitudes to, and preferences for, chlamydia screening in 15-24 year old men and women attending GP surgeries (the target group). We undertook 36 interviews in six surgeries of differing screening rates. Our participants were 15-24 year olds attending a consultation with a staff member. Data were analysed thematically. GP surgeries are acceptable to young people as a venue for opportunistic chlamydia screening and furthermore they think it is the duty of GP surgery staff to offer it. They felt strongly that it is important for surgery staff to have a non-judgmental attitude and they did not want to be singled out as 'needing' a chlamydia screen. Furthermore, our sample reported a strong preference for being offered a screen by staff and providing the sample immediately at the surgery rather than taking home a testing kit. The positive attitude and subjective norms demonstrated by interviewees suggest that young peoples' behaviour would be to accept a screen if it was offered to them. Young people attending GP surgeries have a positive attitude towards chlamydia screening and given the right environment are likely to take up the offer in this setting. The right environment involves normalising screening by offering a chlamydia screen to all 15-24 year olds at every interaction with staff, offering screening with a non-judgmental attitude and minimising barriers to screening such as embarrassment. The GP surgery is the ideal place to screen
Sinadinovic, Kristina; Wennberg, Peter; Berman, Anne H
This trial investigated the effects of access to an Internet-based screening and brief intervention site for illicit drug users. This article adds to previously published results from the 3- and 6-month follow-ups by extending the follow-up period to 12 months and reporting changes in substance use between the 6- and 12-month follow-ups. In total, 202 Internet help-seekers with illicit drug use, 15-70 years old, were randomly assigned to either an intervention group that received Internet-based screening and brief intervention via eScreen.se or to an assessment-only control group. The primary outcome measure was the Drug Use Disorders Identification Test consumption questions (DUDIT-C) score, and secondary outcome measures were the DUDIT, Alcohol Use Disorders Identification Test consumption questions (AUDIT-C), and AUDIT scores, as well as the proportion of drug abstainers and participants making a clinically significant change in their alcohol and other drug use. DUDIT-C, DUDIT, AUDIT-C, and AUDIT scores remained stable between the 6- and 12-month follow-ups. However, 12 months after recruitment, 34.3% of those who used eScreen.se had changed their alcohol use to a clinically lower level compared with the 21.8% of the controls. Also, none of the eScreen.se users increased their level of alcohol use during this 12-month period, whereas 5.0% in the control group did so. Despite no changes in illicit drug use from the 6- to 12-month follow-up for both the intervention and control group, eScreen.se seems to be more effective than assessment only for reducing alcohol use among illicit drug users over a 12-month period.
Grentzer, Jaclyn M; Peipert, Jeffrey F; Zhao, Qiuhong; McNicholas, Colleen; Secura, Gina M; Madden, Tessa
The objective was to compare three strategies for Chlamydia trachomatis and Neisseria gonorrhoeae screening prior to intrauterine device (IUD) insertion. This was a secondary analysis of the Contraceptive CHOICE Project. We measured the prevalence of C. trachomatis and/or N. gonorrhoeae at the time of IUD insertion. We then compared sensitivity, specificity, negative and positive predictive values, and likelihood ratios for three screening strategies for C. trachomatis and N. gonorrhoeae prior to IUD insertion: (a) "age-based" — age ≤25 years alone; (b) "age/partner-based" — age ≤25 and/or multiple sexual partners; and (c) "risk-based" — age ≤25, multiple sexual partners, inconsistent condom use and/or history of prior sexually transmitted infection (STI). Among 5087 IUD users, 140 (2.8%) tested positive for C. trachomatis, 16 (0.3%) tested positive for N. gonorrhoeae, and 6 (0.1%) were positive for both at the time of IUD insertion. The "risk-based" screening strategy had the highest sensitivity (99.3%) compared to "age-based" and "age/partner-based" screening (80.7% and 84.7%, respectively.) Only one (0.7%) woman with a chlamydia or gonorrhea infection would not have been screened using "risk-based" screening. A risk-based strategy to screen for C. trachomatis and N. gonorrhoeae prior to IUD insertion has higher sensitivity than screening based on age alone or age and multiple sexual partners. Using a risk-based screening strategy (age≤25, multiple sexual partners, inconsistent condom use and/or history of an STI) to determine who should be screened for C. trachomatis and N. gonorrhoeae prior to IUD insertion will miss very few cases of infection and obviates the need for universal screening. Copyright © 2015 Elsevier Inc. All rights reserved.
Oh, M Kim; Grimley, Diane M; Merchant, Jeanne S; Brown, Pernell R; Cecil, Heather; Hook, Edward W
To determine the feasibility and affect of mass media use in a population-level intervention for chlamydia screening promotion. A population-level chlamydia intervention protocol was field tested. The intervention, targeting 15-25-year-old individuals, was designed to: (a) increase awareness of personal risk for chlamydial infection; (b) facilitate dissemination of chlamydia knowledge by use of a telephone hot line; and (c) promote care-seeking behavior (report for a chlamydia screening program). The intervention activities included: (a) mail outreach, (b) a television and radio campaign, (c) a prerecorded Check-It-Out chlamydia hot line, (d) a staffed chlamydia Options information line, and (e) a free confidential urine ligase chain reaction (LCR) test for chlamydia. Mass mailings were scheduled at intervals, starting two-weeks before the beginning of the television advertisement. The 30-second television advertisement was aired on local television stations 130 times in a 6-week period. The outcome measures were quantity and characteristics of incoming calls to the automated hot line and staffed chlamydia information phone line in response to the chlamydia campaign, and response to the urine screening program. Descriptive and bivariate analyses were used to evaluate the outcomes. The hot line was called 642 times during the monitoring period (November 1, 1999 to March 8, 2000), the majority (92%) during the 6 weeks of television advertisement, with an average of 99 calls per week, compared with an average of 9 calls per week after the commercial ended. Each bulk mailing was accompanied by a boost in the incoming hot line calls. The research staff triaged 133 calls to the "Options" phone line, 81% in the 6 weeks of the TV ad. The mean age of the 133 callers was 23.9 +/- 7.7 years (range 14-49 years). A majority called for screening information; 67% of callers were females and 84% of female callers were under age 26 years. Five percent of callers identified
Hart Graham J
Full Text Available Abstract Background Poor awareness and knowledge of Chlamydia trachomatis could be a barrier to uptake of screening. This study aimed to determine the level of awareness and knowledge of chlamydia among young people who were being approached in a variety of community settings and offered opportunistic screening. Methods Men and women aged 16-24 years were approached in education, health and fitness, and workplace settings and invited to complete a self-administered questionnaire then provide a urine sample for chlamydia testing. Follow-up semi-structured interviews with 24 respondents were carried out after test results were received. Results 363 questionnaires were completed (43.5% from men. Whilst awareness of chlamydia was high, knowledge decreased as questions became increasingly focussed so that around half of respondents were unaware of the asymptomatic nature of chlamydia infections. Men's knowledge of symptoms was consistently lower than women's, with most men failing to identify unusual discharge as a symptom in men (men 58.3%, female 45.8%, p = 0.019; fewer men knew unusual discharge was a symptom among women (men 65.3% female 21.4%, p Conclusions Despite scientific gains in understanding chlamydia infection, public understanding remains limited. Greater efforts are required to translate scientific evidence to the public. An improvement in knowledge may maximise gains from interventions to improve detection.
San-Cristobal, Rodrigo; Navas-Carretero, Santiago; Celis-Morales, Carlos; Livingstone, Katherine M; Stewart-Knox, Barbara; Rankin, Audrey; Macready, Anna L; Fallaize, Rosalind; O'Donovan, Clare B; Forster, Hannah; Woolhead, Clara; Walsh, Marianne C; Lambrinou, Christina P; Moschonis, George; Manios, Yannis; Jarosz, Miroslaw; Daniel, Hannelore; Gibney, Eileen R; Brennan, Lorraine; Gundersen, Thomas E; Drevon, Christian A; Gibney, Mike; Marsaux, Cyril F M; Saris, Wim H M; Lovegrove, Julie A; Frewer, Lynn J; Mathers, John C; Martinez, J Alfredo
National guidelines emphasize healthy eating to promote wellbeing and prevention of non-communicable diseases. The perceived healthiness of food is determined by many factors affecting food intake. A positive perception of healthy eating has been shown to be associated with greater diet quality. Internet-based methodologies allow contact with large populations. Our present study aims to design and evaluate a short nutritional perception questionnaire, to be used as a screening tool for assessing nutritional status, and to predict an optimal level of personalisation in nutritional advice delivered via the Internet. Data from all participants who were screened and then enrolled into the Food4Me proof-of-principle study (n = 2369) were used to determine the optimal items for inclusion in a novel screening tool, the Nutritional Perception Screening Questionnaire-9 (NPSQ9). Exploratory and confirmatory factor analyses were performed on anthropometric and biochemical data and on dietary indices acquired from participants who had completed the Food4Me dietary intervention (n = 1153). Baseline and intervention data were analysed using linear regression and linear mixed regression, respectively. A final model with 9 NPSQ items was validated against the dietary intervention data. NPSQ9 scores were inversely associated with BMI (β = -0.181, p nutritional status and to tailor nutritional advice. NCT01530139 .
Andersen, Berit; van Valkengoed, Irene; Olesen, Frede; Møller, Jens K.; Østergaard, Lars
Submission of samples from the home allows screening for Chlamydia trachomatis without preceding professional assessment of clinical risk factors. Therefore, a validation of self-reportable information for use as selective screening criteria is needed. We asked a total of 1175 women and 1033 men who
Turner, Katy; Adams, Elisabeth; Grant, Arabella; Macleod, John; Bell, Gill; Clarke, Jan; Horner, Paddy
To compare the cost, cost effectiveness, and sex equity of different intervention strategies within the English National Chlamydia Screening Programme. To develop a tool for calculating cost effectiveness of chlamydia control programmes at a local, national, or international level. An economic and mathematical modelling study with cost effectiveness analysis. Costs were restricted to those of screening and partner notification from the perspective of the NHS and excluded patient costs, the costs of reinfection, and costs of complications arising from initial infection. England. Population Individuals eligible for the National Chlamydia Screening Programme. Cost effectiveness of National Chlamydia Screening Programme in 2008-9 (as cost per individual tested, cost per positive diagnosis, total cost of screening, number screened, number infected, sex ratio of those tested and treated). Comparison of baseline programme with two different interventions-(i) increased coverage of primary screening in men and (ii) increased efficacy of partner notification. In 2008-9 screening was estimated to cost about £46.3m in total and £506 per infection treated. Provision for partner notification within the screening programme cost between £9 and £27 per index case, excluding treatment and testing. The model results suggest that increasing male screening coverage from 8% (baseline value) to 24% (to match female coverage) would cost an extra £22.9m and increase the cost per infection treated to £528. In contrast, increasing partner notification efficacy from 0.4 (baseline value) to 0.8 partners per index case would cost an extra £3.3m and would reduce the cost per infection diagnosed to £449. Increasing screening coverage to 24% in men would cost over six times as much as increasing partner notification to 0.8 but only treat twice as many additional infections. In the English National Chlamydia Screening Programme increasing the effectiveness of partner notification is likely
Oakeshott, Pippa; Kerry, Sally; Aghaizu, Adamma; Atherton, Helen; Hay, Sima; Taylor-Robinson, David; Simms, Ian; Hay, Phillip
To determine whether screening and treating women for chlamydial infection reduces the incidence of pelvic inflammatory disease over the subsequent 12 months. Randomised controlled trial. Common rooms, lecture theatres, and student bars at universities and further education colleges in London. 2529 sexually active female students, mean age 21 years (range 16-27). Participants completed a questionnaire and provided self taken vaginal swabs, with follow-up after one year. Samples were randomly allocated to immediate testing and treatment for chlamydial infection, or storage and analysis after a year (deferred screening controls). Incidence of clinical pelvic inflammatory disease over 12 months. Baseline prevalence of chlamydia was 5.4% (68/1254) in screened women and 5.9% (75/1265) in controls. 94% (2377/2529) of women were followed up after 12 months. The incidence of pelvic inflammatory disease was 1.3% (15/1191) in screened women compared with 1.9% (23/1186) in controls (relative risk 0.65, 95% confidence interval 0.34 to 1.22). Seven of 74 control women (9.5%, 95% confidence interval 4.7% to 18.3%) who tested positive for chlamydial infection at baseline developed pelvic inflammatory disease over 12 months compared with one of 63 (1.6%) screened women (relative risk 0.17, 0.03 to 1.01). However, most episodes of pelvic inflammatory disease occurred in women who tested negative for chlamydia at baseline (79%, 30/38). 22% (527/2377) of women reported being tested independently for chlamydia during the trial. Although some evidence suggests that screening for chlamydia reduces rates of pelvic inflammatory disease, especially in women with chlamydial infection at baseline, the effectiveness of a single chlamydia test in preventing pelvic inflammatory disease over 12 months may have been overestimated. Trial registration ClinicalTrials.gov NCT00115388.
Conclusions: Prevalence of extragenital Chlamydia is increasing in men as well as women. What needs to be stressed on is the sexual behaviour of an individual and not the sexual identity. Further studies are needed to help formulate guidelines and recommendations for extragenital screening in a population.
de Vrieze, Nynke H. N.; van Rooijen, Martijn S.; van de Loeff, Maarten Schim; de Vries, Henry J. C.
Sexually transmitted infection was found in 16.5% of the men who have sex with men with a postexposure prophylaxis indication. Chlamydia and gonorrhea screening was repeated after 14 days. Among those who were initially sexually transmitted infection negative, 4.1% had chlamydia or gonorrhea. In
The purpose of the current study is (1) to apply Internet-based N-Screen (this is used like the term "emultiscreen"; as the technology that provides services of shared content or application via N devices, it includes all screens such as personal computers [PCs], TV, and mobile devices) services to healthcare services by developing games for improving one's health and (2) to present ways to activate the use of health promotion contents in the future by investigating user satisfaction and whether there is any intention to accept the contents and/or use the services continuously. In order to evaluate the customized health maintenance content provided by the healthcare walking system developed in the current study, 98 adult men and women residing in Seoul, Korea, were instructed to use 10 minutes' worth of the walking content. Perceived quality, level of trust in the results, effectiveness of the exercise, and overall satisfaction were measured in regard to the N-Screen-based walking content, including those for the cell phone, PC, and Internet protocol TV (IPTV). Walking contents using N-Screen services were perceived with high levels of trust in the results of the exercise, the effectiveness of the exercise, and overall satisfaction. In terms of the usability of N-Screen services, the younger the participants, the more usable they found the mobile or PC programs. The older the participants, the more usable they found the IPTV screens, although they still struggled with using the content given; operating IPTVs proved to be difficult for them. Furthermore, participants who were engaged in exercise on a regular basis were less satisfied with the program, in general. The present study has developed a walking system using N-Screen programs to make the most common and effective forms of exercise-walking and running-accessible indoors. This may increase motivation to exercise by offering services that boost one's interest in exercising, such as personal monitoring and real
Postma, M.J.; Welte, R.; Van Den Hoek, J.A.R.; Van Doornum, G.J.J.; Coutinho, R.A.; Jager, J.C.
Objective. To estimate the cost effectiveness of Chlamydia trachomatis (CT) screening of young women visiting general practitioners. Design. Economic model analysis. Methods. Data on the health care needs for CT complications were derived from various sources; costing was done using estimated cost
Downing, Jennifer; Cook, Penny A; Madden, Hannah C E; Phillips-Howard, Penelope A; Higgins, Stephen P; Bellis, Mark A
The National Chlamydia Screening Programme in Greater Manchester (NCSP-GM) commissioned an evaluation of the management of gonorrhoea cases identified using the Gen-Probe APTIMA Combo 2 assay (AC2). NCSP-GM provided data on gonorrhoea cases from a 6-month period (September 2007-February 2008). Data were collected from patient referral pathways to genitourinary medicine (GUM) clinics, including confirmatory testing, antibiotic resistance patterns and contact tracing. The AC2 positive predictive value (PPV) was calculated. 111 individuals tested positive for gonococcal infection using AC2 (0.7% of 16,028 individuals tested). Of these, 96 (0.6% of all tested) known index cases were seen at Greater Manchester GUM clinics. 78/96 (14 men, 64 women) underwent confirmatory microscopy and gonococcal culture. Confirmatory tests were positive in 14 men (100%) but only 40 women (63%). Thus the PPV of AC2 was 69% (54/78). Sensitivity in women may have been reduced by limited partner information and sample-taking (only 28% had a full gonorrhoea screen). Gonorrhoea screening in an NCSP-targeted population identified gonorrhoea in a low-risk population. Subsequent management in GUM clinics was variable and limited sample-taking may have decreased the sensitivity of confirmatory testing in women. Appropriate antibiotic sensitivity tests or, in their absence, a test of cure may be needed to ensure effective treatment.
Full Text Available Abstract Background Recruiting to trials is complex and difficult. The Prevention of Pelvic Infection (POPI trial aims to see if screening women for chlamydia and treating those found to be infected reduces the incidence of pelvic inflammatory disease in the following twelve months. It focuses on young, sexually active, multiethnic, mainly inner city, female students. The main aim of this paper is to describe our recruitment methods. Secondary aims in two small subgroups, are to compare characteristics of women recruited with those not recruited, and to explore participants' understanding of when their samples would be tested for chlamydia. Methods Women students attending lectures or in common rooms at 22 universities and further education colleges were recruited by female research assistants working in pairs. Participants were asked to complete a questionnaire on sexual health and to provide self-taken vaginal swabs. In addition, during 3 recruitment sessions, a female medical student asked non-participants to complete a brief anonymous questionnaire on reasons for not taking part. Finally another female medical student contacted 40 consecutive participants within a month of recruitment and asked if they understood that their samples might not be tested for a year. Results With enormous effort over 2 years we recruited 2526 women. A survey of 61 non-responders showed only 18 (30% were eligible to take part (age Conclusion As in other studies, a key to attaining recruitment targets was the enthusiasm of the research team. Minority ethnic groups were probably under-represented, but understanding of participants was good. Trial registration Clinical Trials NCT 00115388
Tsoumanis, Achilleas; Hens, Niel; Kenyon, Chris Richard
Neisseria gonorrhoeae (gonorrhea) could become untreatable in the near future. Indeed, while the treatment of symptomatic gonorrhea in core groups, such men who have sex with men (MSM), is crucial for gonorrhea control programs, screening for and treating asymptomatic gonorrhea/Chlamydia trachomatis(chlamydia) in MSM may contribute to antibiotic resistance in gonorrhea. In this systematic review we aim to assess if there is evidence that screening MSM for gonorrhea/chlamydia is associated with a decline in the prevalence of these infections. We conducted a systematic review in PubMed and Web of Science for relevant studies including uncontrolled observational studies and reported the results following the PRISMA guidelines. The change in estimated prevalences for chlamydia and gonorrhea across the different time points for three anatomical sites (oral, urethral and anal) were collected and examined. Twelve studies met our entry criteria. We were able to statistically assess the change in prevalence in 10 out of 12 studies. In three studies, there was a significant increase in chlamydia prevalence, while for gonorrhea two studies reported a significant increase and two others a decrease. Our review provides little evidence that screening for gonorrhea and chlamydia in MSM has an effect on the prevalence of these infections. No evidence was found that more frequent screening reduces prevalence more effectively than annual screening. Our study was not able to provide evidence that screening for chlamydia and gonorrhea lowers the prevalence of these infections in MSM. Randomized controlled trials are required to assess the risks and benefits of gonorrhea/chlamydia screening in high and low risk MSM.
Wang, Ze-yu; Fu, Guang-yu; Wang, Shan-mei; Qin, Dong-chun; Wang, Zhong-quan; Cui, Jing
Chlamydia trachomatis may cause multiple different urogenital tract disorders, but current non-culture assays for rapid screening of C. trachomatis typically use immunochromatography-based methods. We established another new rapid non-culture method for detection of C. trachomatis based on the measurement of α-mannosidase enzymatic activity in urogenital tract specimens. To evaluate the performance of this method, α-mannosidase activities of C. trachomatis serotype D strain 、 and 29 standard strains related to clinical urogenital pathogens were investigated. Furthermore, 553 urogenital tract specimens were used for clinical assays via cell culture method and ligase chain reaction method (LCR), adopting an expanded gold standard. Only C. trachomatis was positive for α-mannosidase activity among different types of microbes tested in the research. When prostate fluid specimens, which have some interfering activity, were excluded, the sensitivity and specificity of the enzymatic method were 91.8% (78/85) and 98.3% (409/416), respectively. There were no significant differences (P > 0.05). These results showed that α-mannosidase activity could be utilised as a screening marker of C. trachomatis infection.
Full Text Available Abstract Background Chlamydia trachomatis may cause multiple different urogenital tract disorders, but current non-culture assays for rapid screening of C. trachomatis typically use immunochromatography-based methods. We established another new rapid non-culture method for detection of C. trachomatis based on the measurement of α-mannosidase enzymatic activity in urogenital tract specimens. Method To evaluate the performance of this method, α-mannosidase activities of C. trachomatis serotype D strain 、 and 29 standard strains related to clinical urogenital pathogens were investigated. Furthermore, 553 urogenital tract specimens were used for clinical assays via cell culture method and ligase chain reaction method (LCR, adopting an expanded gold standard. Results Only C. trachomatis was positive for α-mannosidase activity among different types of microbes tested in the research. When prostate fluid specimens, which have some interfering activity, were excluded, the sensitivity and specificity of the enzymatic method were 91.8% (78/85 and 98.3% (409/416, respectively. There were no significant differences (P > 0.05. Conclusions These results showed that α-mannosidase activity could be utilised as a screening marker of C. trachomatis infection.
Bogetoft, Peter; Nielsen, Kurt
We discuss the design of interactive, internet based benchmarking using parametric (statistical) as well as nonparametric (DEA) models. The user receives benchmarks and improvement potentials. The user is also given the possibility to search different efficiency frontiers and hereby to explore...
Bogetoft, Peter; Nielsen, Kurt
We discuss the design of interactive, internet based benchmarking using parametric (statistical) as well as non-parametric (DEA) models. The user receives benchmarks and improvement potentials. The user is also given the possibility to search different efficiency frontiers and hereby to explore alternative improvement strategies. An implementation of both a parametric and a non parametric model are presented.
Reed, Jennifer L; Punches, Brittany E; Taylor, Regina G; Macaluso, Maurizio; Alessandrini, Evaline A; Kahn, Jessica A
We qualitatively explore adolescent and parent or guardian attitudes about benefits and barriers to universally offered gonorrhea and chlamydia screening and modalities for assessing interest in screening in the pediatric emergency department (ED). A convenience sample of forty 14- to 21-year-olds and parents or guardians of adolescents presenting to an urban and community pediatric ED with any chief complaint participated in individual, semistructured, confidential interviews. Topics included support of universally offered gonorrhea and chlamydia screening, barriers and benefits to screening, and modalities for assessing interest in screening. Data were analyzed with framework analysis. Almost all adolescents (37/40; 93%) and parents (39/40; 98%) support offering ED gonorrhea or chlamydia screening. Benefits included earlier diagnosis and treatment, convenience and transmission prevention (cited by both groups), and improved education and long-term health (cited by parents/guardians). Barriers included concerns about confidentiality and cost (cited by both groups), embarrassment (cited by adolescents), and nondisclosure to parents or guardians (cited by parents/guardians). Adolescents preferred that the request for gonorrhea or chlamydia screening be presented in a private room, using tablet technology. Both groups noted that the advantages to tablets included confidentiality and adolescents' familiarity with technology. Adolescents noted that tablet use would address concerns about bringing up gonorrhea or chlamydia screening with clinicians, whereas parents or guardians noted that tablets might increase screening incidence but expressed concern about the lack of personal interaction. Universally offered gonorrhea and chlamydia screening in a pediatric ED was acceptable to the adolescents and parents or guardians in this study. Offering a tablet-based method to assess interest in screening may increase participation. Copyright © 2017 American College of
Thanh, Nguyen X; Akpinar, Ilke; Gratrix, Jennifer; Plitt, Sabrina; Smyczek, Petra; Read, Ron; Jacobs, Philip; Wong, Tom; Singh, Ameeta E
Adding universal rectal screening to urogenital screening should positively impact rectal Chlamydia trachomatis (CT) incidence in affected populations. A dynamic Markov model was used to evaluate costs and outcomes of three rectal CT screening strategies among women attending sexually transmitted infection clinics in Alberta, Canada: universal urogenital-only screening (UG-only), additional selected (exposure-based) rectal screening (UG+SR), and additional universal rectal screening (UG+UR). The model included two mutually exclusive health states: infected and susceptible. Additionally, the model included two rounds of transmission: male sex partners of women infected with rectal-only CT and female sex partners of those men. CT complications impacting patients' quality of life (QALY) were considered. Alberta and Canadian data were used to estimate model inputs. We used a health care perspective, a time period of 10 years, and a discount rate of 3% for analyses. Compared to UG-only screening, the incremental cost effectiveness ratios (ICERs) were CA$34,000 and CA$49,000 per QALY gained for UG+SR and UG+UR screening strategies, respectively. Compared to UG+SR, the ICER was CA$62,000 per QALY gained for the UG+UR strategy. Both adjunct selected and universal rectal screening strategies are cost effective compared to UG-only screening, and UG+UR screening is cost effective when compared to UG+SR screening.
Guy, Rebecca; Wand, Handan; Knight, Vickie; Kenigsberg, Aurelie; Read, Phillip; McNulty, Anna M
In 2009, Sydney Sexual Health Centre implemented a short message service (SMS) reminder system to improve re-screening after chlamydia infection. SMS reminders were sent at 3 months recommending the patient make an appointment for a re-screen. Using a before-and-after study, the authors compared the proportion re-screened within 1-4 months of chlamydia infection in women and heterosexual men who were sent an SMS in January to December 2009 (intervention period) with a 18-month period before the SMS was introduced (before period). The authors used a χ(2) test and multivariate regression. Visitors and sex workers were excluded. In the intervention period, 141 of 343 (41%) patients were diagnosed with chlamydia and sent the SMS reminder. In the before period, 338 patients were diagnosed as having chlamydia and none received a reminder. The following baseline characteristics were significantly different between those sent the SMS in the intervention period and the before period: new patients (82% vs 72%, p=0.02), aged SMS (30%) than the before period (21%), p=0.04, and after adjusting for baseline differences, the OR was 1.57 (95% CI 1.01 to 2.46). SMS reminders increased re-screening in patients diagnosed as having chlamydia at a sexual health clinic. The clinic now plans to introduce electronic prompts to maximise the uptake of the initiative and consider strategies to further increase re-screening.
Phillipson, Lyn; Gordon, Ross; Telenta, Joanne; Magee, Chris; Janssen, Marty
Chlamydia trachomatis is one of the most frequently reported sexually transmitted infections (STI) in Australia, the UK and Europe. Yet, rates of screening for STIs remain low, especially in younger adults. To assess effectiveness of Chlamydia screening interventions targeting young adults in community-based settings, describe strategies utilized and assess them according to social marketing benchmark criteria. A systematic review of relevant literature between 2002 and 2012 in Medline, Web of Knowledge, PubMed, Scopus and the Cumulative Index to Nursing and Allied Health was undertaken. Of 18 interventions identified, quality of evidence was low. Proportional screening rates varied, ranging from: 30.9 to 62.5% in educational settings (n = 4), 4.8 to 63% in media settings (n = 6) and from 5.7 to 44.5% in other settings (n = 7). Assessment against benchmark criteria found that interventions incorporating social marketing principles were more likely to achieve positive results, yet few did this comprehensively. Most demonstrated customer orientation and addressed barriers to presenting to a clinic for screening. Only one addressed barriers to presenting for treatment after a positive result. Promotional messages typically focused on providing facts and accessing a testing kit. Risk assessment tools appeared to promote screening among higher risk groups. Few evaluated treatment rates following positive results; therefore, impact of screening on treatment rates remains unknown. Future interventions should consider utilizing a comprehensive social marketing approach, using formative research to increase insight and segmentation and tailoring of screening interventions. Easy community access to both screening and treatment should be prioritized. © 2015 John Wiley & Sons Ltd.
Hengel, Belinda; Jamil, Muhammad S; Mein, Jacqueline K; Maher, Lisa; Kaldor, John M; Guy, Rebecca J
High Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) prevalence have been reported in populations that do not regularly access health centres for sexually transmissible infections (STI) testing. We reviewed current outreach strategies used to increase access to STI testing and their outcomes. We systematically reviewed the literature for English language studies published between 1 January 2005 and 28 January 2011 describing CT and/or NG screening programs in non-clinical outreach settings. We identified 25 programs, with the majority occurring in either Australia (32%) or the United States (32%). The most common target groups were young people aged 15-29 years (52%), men who have sex with men (24%) and sex workers (8%). The median CT positivity was 7.7% (Inter Quartile Range [IQR]: 3.0%-11.1%, n=19 programs), and median NG positivity was 2.6% (IQR: 0.0%-8.0%, n=10). The median participation rate was 53% (IQR: 23.9%-81.3%), and a median of 79.6% (IQR: 55.1%-89.4%) of participants were tested, with a median of 100 tests conducted per program (IQR: 65-331, range: 11-1808). Across all settings the participation rate was highest among target groups gathering in community service venues (community centres, parenting centres, homeless shelters) (median=81.4%, n=4), and social venues (sporting venues or bars) (80.4%, n=1). Lower participation rates were found in street/public community areas (median=23.9%, n=3) and sex on premises venues (10.4% and 24.3%, n=2). The review indicated that although CT and NG outreach programs reached a relatively small number of people the yield of infections is high. Settings which appear to be more effective at encouraging participation appear to be those within an existing venue, rather than in public areas.
Teng, Yu; Kong, Nan; Tu, Wanzhu
Chlamydia infection (CT) is one of the most commonly reported sexually transmitted diseases. It is often referred to as a "silent" disease with the majority of infected people having no symptoms. Without early detection, it can progress to serious reproductive and other health problems. Economical identification of asymptomatically infected is a key public health challenge. Increasing evidence suggests that CT infection risk varies over the range of adolescence. Hence, age-dependent screening strategies with more frequent testing for certain age groups of higher risk may be cost-saving in controlling the disease. We study the optimization of age-dependent screening strategies for population-based chlamydia infection screening among young women. We develop an age-structured compartment model for CT natural progress, screening, and treatment. We apply parameter optimization on the resultant PDE-based system dynamical models with the objective of minimizing the total care spending, including screening and treatment costs during the program period and anticipated costs of treating the sequelae afterwards). For ease of practical implementation, we also search for the best screening initiation age for strategies with a constant screening frequency. The optimal age-dependent strategies identified outperform the current CDC recommendations both in terms of total care spending and disease prevalence at the termination of the program. For example, the age-dependent strategy that allows monthly screening rate changes can save about 5% of the total spending. Our results suggest early initiation of CT screening is likely beneficial to the cost saving and prevalence reduction. Finally, our results imply that the strategy design may not be sensitive to accurate quantification of the age-specific CT infection risk if screening initiation age and screening rate are the only decisions to make. Our research demonstrates the potential economic benefit of age-dependent screening
Eade, Donna M; Henning, Dorothy
To identify the percentage of young people presenting to a primary healthcare service targeting homeless youth, in Melbourne, Australia, who, based on youth-specific Home, Education, Activities, Drug and alcohol use, Sexuality and Suicide (HEADSS) psychosocial assessment tool, were screened for the sexually transmitted infection Chlamydia and tested positive. Homeless young people are at high risk of poor health outcomes including sexual health. Chlamydia prevalence is highest in 16-24 years. Youth psychosocial assessment tools such as the HEADSS can engage young people and provide comprehensive health assessment that identifies health risks. A retrospective audit. One hundred consecutive client files of youth who presented to a primary healthcare service for the first time were selected. Client data were collected at the health services' inner city drop-in clinic and clinical refuge outreach (CRO). HEADSS assessments were made on new presentations to identify those at risk of Chlamydia. These young people were then offered screening for Chlamydia using a first-pass urine sample. One hundred HEADSS assessments were audited, of which 15 were incomplete. Of the 85 completed HEADSS assessments, 43 were tested and 11 had Chlamydia-positive results. Comprehensive youth assessment tools, such as the HEADSS, can provide a valuable resource in identifying sexual health risks such as Chlamydia. In turn, skilled nursing staff can provide opportunistic screening. Early identification and treatment for Chlamydia can reduce the spread and sequela of this highly infectious STI. Youth health nurses can enhance their nursing practice in working with young people at risk of homelessness and improve their health outcomes by employing youth-specific assessments. © 2013 John Wiley & Sons Ltd.
van Valkengoed, I.G.M.; Postma, M.J.; Morre, S.A.; van den Brule, A.J.C.; Meijer, C.J.L.M.; Bouter, L.M.; Boeke, A.J.P.
Objectives: To evaluate the cost effectiveness of a systematic screening programme for asymptomatic Chlamydia trachomatis infections in a female inner city population. To determine the sensitivity of the cost effectiveness analysis to variation in the probability of developing sequelae. Methods: A
van Valkengoed, IGM; Postma, MJ; Morre, SA; van den Brule, AJC; Meijer, CJLM; Bouter, LM; Boeke, AJP
Objectives: To evaluate the cost effectiveness of a systematic screening programme for asymptomatic Chlamydia, trachomatis infections in a female inner city population. To determine the sensitivity of the cost effectiveness analysis to variation in the probability of developing sequelae. Methods: A
van Valkengoed, I. G.; Postma, M. J.; Morré, S. A.; van den Brule, A. J.; Meijer, C. J.; Bouter, L. M.; Boeke, A. J.
OBJECTIVES: To evaluate the cost effectiveness of a systematic screening programme for asymptomatic Chlamydia trachomatis infections in a female inner city population. To determine the sensitivity of the cost effectiveness analysis to variation in the probability of developing sequelae. METHODS: A
M. Xiridou (Maria); H.J. Vriend (Henrike); A.K. Lugnér (Anna); J. Wallinga (Jacco); J.S.A. Fennema (Johan); J.M. Prins (Jan); S.E. Geerlings (Suzanne); B.J.A. Rijnders (Bart); M. Prins (Mariia); H.J.C. de Vries (Henry); M.J. Postma (Maarten); M.G. van Veen (Maaike); M. Schim van der Loeff (Maarten); M.A.B. van der Sande (Marianne)
textabstractBackground: Recent studies have found high prevalences of asymptomatic rectal chlamydia among HIV-infected men who have sex with men (MSM). Chlamydia could increase the infectivity of HIV and the susceptibility to HIV infection. We investigate the role of chlamydia in the spread of HIV
Neves, Dária; Sabidó, Meritxell; Bôtto-Menezes, Camila; Benzaken, Nina Schwartz; Jardim, Lucília; Ferreira, Cynthia; Leturiondo, André; Santos, Camila Gurgel Dos; Benzaken, Adele Schwartz
Screening for Chlamydia trachomatis is not routinely offered to young asymptomatic women in Brazil. This study evaluated the performance, usefulness, and operational suitability of the Digene Hybrid Capture II (HCII) CT-ID DNA-test as an opportunistic screening tool to detect C. trachomatis in the public health system in Manaus, Amazonas State. Women aged 14-25 years who attended primary health care services were interviewed and one cervical specimen was collected during cytological screening. The HCII CT test was evaluated for its ability to detect the presence of C. trachomatis and against real-time PCR (q-PCR) in a subset of samples. Operational performance was assessed through interviews with providers and patients. Overall, 1,187 women were screened, and 1,169 had a HCII CT-ID test result (292 of these were also tested by q-PCR). Of those, 13.1% (n = 153) were positive. The sensitivity, specificity, positive and negative predictive values of HCII CT were 72.3% (95%CI: 65.4-78.6), 91.3% (95%CI: 84.1-95.9), 93.8% (95%CI: 88.5-97.1), and 64.4% (95%CI: 56.0-72.1), respectively. Sample collection caused discomfort in 19.7% of women. Among health professionals (n = 52), the main barriers reported included positive cases who did not return for results (56.4%), unwillingness to screen without an appointment (45.1%), and increase in their workload (38.8%). HCII CT-ID identified a high proportion of C. trachomatis cases among young women in Manaus. However, its moderate sensitivity limits its use as an opportunistic screening tool in primary health care settings in Manaus. Screening was well accepted although the barriers we identified, especially among health professionals, challenge screening detection and treatment efforts.
Bristow, Claire C; Mathelier, Patricia; Ocheretina, Oksana; Benoit, Daphne; Pape, Jean W; Wynn, Adriane; Klausner, Jeffrey D
In Haiti, routine screening for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) among pregnant women is not conducted; yet these sexually transmitted infections (STIs) are associated with adverse birth and newborn health outcomes. We aimed to assess the acceptability and feasibility of screening and the prevalence of STIs among pregnant women in Port-au-Prince, Haiti. Pregnant women of at least 18 years of age who attend Haitian Study Group for Kaposi's sarcoma and Opportunistic Infections (GHESKIO) clinics in Port-au-Prince, Haiti provided self-collected vaginal swab specimens. Laboratory testing was done with Xpert® CT/NG and Xpert® TV. The results of this study showed that of the 322 pregnant women who visited GHESKIO for their regular scheduled appointments, 300 (93.2%) consented for CT, NG, and TV testing. Of those, 107 women (35.7%) tested positive for at least one STI. There were 42 (14.7%) cases of CT, 8 (2.8%) NG, and 83 (29.0%) TV infections. Most infections were treated - 122 of 133 (91.7%). In summary, we found that it was highly acceptable and feasible to implement CT, NG, and TV screening among pregnant women in Port-au-Prince, Haiti. We found high prevalence of STIs among pregnant women, which suggest that STI screening in this population may be warranted.
This women's health podcast focuses on chlamydia, its severe health consequences for women if left untreated, and the importance of annual chlamydia screening. Created: 4/2/2009 by Office of Womenâs Health (OWH) and National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). Date Released: 4/2/2009.
Jansen Casper L
Full Text Available Abstract Background Sexually transmitted infection (STI screening programmes are implemented in many countries to decrease burden of STI and to improve sexual health. Screening for Chlamydia trachomatis and Neisseria gonorrhoeae has a prominent role in these protocols. Most of the screening programmes concerning men having sex with men (MSM are based on opportunistic urethral testing. In The Netherlands, a history-based approach is used. The aim of this study is to evaluate the protocol of screening anatomic sites for C. trachomatis and N. gonorrhoeae infection based on sexual history in MSM in routine practice in The Netherlands. Methods All MSM visiting the clinic for STI in The Hague are routinely asked about their sexual practice during consulting. As per protocol, tests for urogenital, oropharyngeal and anorectal infection are obtained based on reported site(s of sexual contact. All consultations are entered into a database as part of the national STI monitoring system. Data of an 18 months period were retrieved from this database and analysed. Results A total of 1455 consultations in MSM were registered during the study period. The prevalence of C. trachomatis and N. gonorrhoeae per anatomic site was: urethral infection 4.0% respectively and 2.8%, oropharynx 1.5% and 4.2%, and anorectum 8.2% and 6.0%. The majority of chlamydia cases (72% involved a single anatomic site, which was especially manifest for anorectal infections (79%, while 42% of gonorrhoea cases were single site. Twenty-six percent of MSM with anorectal chlamydia and 17% with anorectal gonorrhoea reported symptoms of proctitis; none of the oropharyngeal infections were symptomatic. Most cases of anorectal infection (83% and oropharyngeal infection (100% would have remained undiagnosed with a symptom-based protocol. Conclusions The current strategy of sexual-history based screening of multiple anatomic sites for chlamydia and gonorrhoea in MSM is a useful and valid guideline
Sheikh Rashid, Marya; Leensen, Monique C. J.; de Laat, Jan A. P. M.; Dreschler, Wouter A.
Objective: The "Occupational Earcheck'' (OEC) is a Dutch onlineself-screening speech-in-noise test developed for the detection of occupational high-frequency hearing loss (HFHL). This study evaluates an optimised version of the test and determines the most appropriate masking noise. Design: The
Morton Ann Gernsbacher
Full Text Available This essay illustrates five ways that Internet-based higher education can capitalize on fundamental principles of learning. Internet-based education can enable better mastery through distributed (shorter, more frequent practice rather than massed (longer, less frequent practice; it can optimize performance because it allows students to learn at their peak time of their day; it can deepen memory because it requires cheat-proof assignments and tests; it can promote critical thinking because it necessitates intellectual winnowing and sifting; and it can enhance writing skills by requiring students to write frequently and for a broad audience.
Abstract Background The aim of the study was to explore the acceptability and uptake of on-campus screening using a youth friendly approach in two Third Level higher education institutions (HEIs). This study is part of wider research exploring the optimal setting for chlamydia screening in Ireland. Methods Male and female students were given the opportunity to take a free anonymous test for chlamydia during a one week programme of "pee-in-a-pot" days at two HEI campuses in the West of Ireland. The study was set up after extensive consultation with the two HEIs and advertised on the two campuses using a variety of media in the two weeks preceding the screening days. Screening involved the provision and distribution of testing packs at communal areas and in toilet facilities. In Ireland, chlamydia notifications are highest amongst 20-29 year olds and hence the screening criterion was aimed at 18-29 year olds. Urine samples were tested using a nucleic acid amplification test (NAAT). Following the screening days, qualitative in-depth interviews were conducted with participants about their experiences of the event. Results Out of 1,249 test kits distributed in two HEIs, 592 specimens were collected giving a return rate of 47.5%. Tests excluded (54) were due to labelling errors or ineligibility of participants\\' age. Two thirds of those tested were females and the mean age was 21 years. Overall,3.9% (21\\/538) of participants tested positive, 5% (17\\/336) among females and 2% (4\\/191) among males. Participant interviews identified factors which enhanced student participation such as anonymity, convenience, accessibility of testing, and the informal and non-medical approach to testing. Conclusions Screening for chlamydia using on-campus "pee-in-a-pot" days is an acceptable strategy in this population. This model can detect and treat asymptomatic cases of chlamydia and avoid many of the barriers associated with testing for sexually transmitted infections (STIs) in
McNulty, Cliodna A M; Hogan, Angela H; Ricketts, Ellie J; Wallace, Louise; Oliver, Isabel; Campbell, Rona; Kalwij, Sebastian; O'Connell, Elaine; Charlett, Andre
To determine if a structured complex intervention increases opportunistic chlamydia screening testing of patients aged 15-24 years attending English general practitioner (GP) practices. A prospective, Cluster Randomised Controlled Trial with a modified Zelen design involving 160 practices in South West England in 2010. The intervention was based on the Theory of Planned Behaviour (TPB). It comprised of practice-based education with up to two additional contacts to increase the importance of screening to GP staff and their confidence to offer tests through skill development (including videos). Practical resources (targets, posters, invitation cards, computer reminders, newsletters including feedback) aimed to actively influence social cognitions of staff, increasing their testing intention. Data from 76 intervention and 81 control practices were analysed. In intervention practices, chlamydia screening test rates were 2.43/100 15-24-year-olds registered preintervention, 4.34 during intervention and 3.46 postintervention; controls testing rates were 2.61/100 registered patients prior intervention, 3.0 during intervention and 2.82 postintervention. During the intervention period, testing in intervention practices was 1.76 times as great (CI 1.24 to 2.48) as controls; this persisted for 9 months postintervention (1.57 times as great, CI 1.27 to 2.30). Chlamydia infections detected increased in intervention practices from 2.1/1000 registered 15-24-year-olds prior intervention to 2.5 during the intervention compared with 2.0 and 2.3/1000 in controls (Estimated Rate Ratio intervention versus controls 1.4 (CI 1.01 to 1.93). This complex intervention doubled chlamydia screening tests in fully engaged practices. The modified Zelen design gave realistic measures of practice full engagement (63%) and efficacy of this educational intervention in general practice; it should be used more often. The trial was registered on the UK Clinical Research Network Study Portfolio database
Abstract Background Randomised controlled trials often rely on questionnaires for follow up. Objective To compare response rates to an online and postal 12 month follow up questionnaire on sexual health in female students who took part in a chlamydia screening trial. Methods 1329 sexually active female students aged 16-27 were recruited from 12 universities and further education (FE) colleges. The 299 participants recruited between September 2004 and February 2005 ...
Sheikh Rashid, Marya; Leensen, Monique C J; de Laat, Jan A P M; Dreschler, Wouter A
The "Occupational Earcheck" (OEC) is a Dutch online self-screening speech-in-noise test developed for the detection of occupational high-frequency hearing loss (HFHL). This study evaluates an optimised version of the test and determines the most appropriate masking noise. The original OEC was improved by homogenisation of the speech material, and shortening the test. A laboratory-based cross-sectional study was performed in which the optimised OEC in five alternative masking noise conditions was evaluated. The study was conducted on 18 normal-hearing (NH) adults, and 15 middle-aged listeners with HFHL. The OEC in a low-pass (LP) filtered stationary background noise (test version LP 3: with a cut-off frequency of 1.6 kHz, and a noise floor of -12 dB) was the most accurate version tested. The test showed a reasonable sensitivity (93%), and specificity (94%) and test reliability (intra-class correlation coefficient: 0.84, mean within-subject standard deviation: 1.5 dB SNR, slope of psychometric function: 13.1%/dB SNR). The improved OEC, with homogenous word material in a LP filtered noise, appears to be suitable for the discrimination between younger NH listeners and older listeners with HFHL. The appropriateness of the OEC for screening purposes in an occupational setting will be studied further.
Chlamydia trachomatis infections are the most prevalent bacterial sexually transmitted infections (STT) worldwide. A better understand of the transmission of C. trachomatis may contribute to improved screening and prevention programs in the future and ultimately alleviate this burden. Through the
Oswalt, Sara B.; Eastman-Mueller, Heather P.
Objective: To examine college student health centers' (SHCs) practices related to sexually transmitted disease (STD) screening and treatment over a 5-year period. Participants: College SHCs that completed the ACHA Pap and STI Survey between 2010 and 2014. Methods: Chi-square tests were conducted with Cramer's V providing a measure of association.…
Welte, R; Kretzschmar, M; Leidl, R; Van den Hoek, A; Jager, JC; Postma, MJ
Background: Models commonly used for the economic assessment of chamydial screening programs do not consider population effects. Goal: To develop a novel dynamic approach for the economic evaluation of chlamydial prevention measures and to determine the cost-effectiveness of a general
... FAQs Chlamydia, Gonorrhea, and Syphilis Page Navigation ▼ ACOG Pregnancy Book Chlamydia, Gonorrhea, and Syphilis Patient Education FAQs Chlamydia, Gonorrhea, and Syphilis Patient Education Pamphlets - ...
McNulty, Cliodna A M; Hogan, Angela H; Ricketts, Ellie J; Wallace, Louise; Oliver, Isabel; Campbell, Rona; Kalwij, Sebastian; O'Connell, Elaine; Charlett, Andre
Objective To determine if a structured complex intervention increases opportunistic chlamydia screening testing of patients aged 15–24 years attending English general practitioner (GP) practices. Methods A prospective, Cluster Randomised Controlled Trial with a modified Zelen design involving 160 practices in South West England in 2010. The intervention was based on the Theory of Planned Behaviour (TPB). It comprised of practice-based education with up to two additional contacts to increase the importance of screening to GP staff and their confidence to offer tests through skill development (including videos). Practical resources (targets, posters, invitation cards, computer reminders, newsletters including feedback) aimed to actively influence social cognitions of staff, increasing their testing intention. Results Data from 76 intervention and 81 control practices were analysed. In intervention practices, chlamydia screening test rates were 2.43/100 15–24-year-olds registered preintervention, 4.34 during intervention and 3.46 postintervention; controls testing rates were 2.61/100 registered patients prior intervention, 3.0 during intervention and 2.82 postintervention. During the intervention period, testing in intervention practices was 1.76 times as great (CI 1.24 to 2.48) as controls; this persisted for 9 months postintervention (1.57 times as great, CI 1.27 to 2.30). Chlamydia infections detected increased in intervention practices from 2.1/1000 registered 15–24-year-olds prior intervention to 2.5 during the intervention compared with 2.0 and 2.3/1000 in controls (Estimated Rate Ratio intervention versus controls 1.4 (CI 1.01 to 1.93). Conclusions This complex intervention doubled chlamydia screening tests in fully engaged practices. The modified Zelen design gave realistic measures of practice full engagement (63%) and efficacy of this educational intervention in general practice; it should be used more often. Trial registration The trial was
Del Piano, M; Nicosia, R; Pustorino, R; Santino, I; Sessa, R
Throughout the animal kingdom the Chlamydiae are among the most common and ancient pathogens, but only in the 1966 they were classified by Page in the same genus because of different nosological pictures that they cause, while more recently were identified as bacteria. Chlamydiae have been divided into two species: C. trachomatis and C. psittaci. In 1986 Grayston et al. proved the etiological role of a "new chlamydial strain", named TWAR (Taiwan-Acute Respiratory), in human pneumonia and bronchitis; TWAR is distinguishable from other Chlamydiae and possibly represents a new entity. The Chlamydiae are non-motile, metabolically poor bacteria, completely lacking of any enzimatic system for energy production (ATP) and for this reason are obligate intracellular parasites; they poses group-specific, species-specific and type-specific antigens. Four series of surface proteins were identified as responsible for their pathogenic properties, while many Authors consider a particular lipopolysaccharidical acid, group antigen, as a real LPS. These bacteria poses an unique developmental cycle with production of two type of particles different for metabolic and infecting characters: elementary body and reticulate body. The Chlamydiae have a broad spectrum of host. They cause persistent or chronic infections and their survival is insured by the elementary body. The Chlamydiae stimulate the humoral and the cellular-mediate immunity system and are capable of survival in the monocytes and macrophages.
Full Text Available Abstract Background Pelvic inflammatory disease (PID is common and can lead to tubal factor infertility, ectopic pregnancy or chronic pelvic pain. Despite major UK government investment in the National Chlamydia Screening Programme, evidence of benefit remains controversial. The main aim of this trial was to investigate whether screening and treatment of chlamydial infection reduced the incidence of PID over 12 months. Secondary aims were to conduct exploratory studies of the role of bacterial vaginosis (BV in the development of PID and of the natural history of chlamydial infection. Design Randomised controlled trial with follow up after 12 months. Setting non-healthcare Common rooms and lecture theatres at 20 universities and further education colleges in Greater London. Participants 2500 sexually active female students were asked to complete a questionnaire on sexual health and provide self-administered vaginal swabs and smears. Intervention Vaginal swabs from intervention women were tested for chlamydia by polymerase chain reaction (PCR and those infected referred for treatment. Vaginal swabs from control women were stored and analysed after a year. Vaginal smears were Gram stained and analysed for BV. Main outcome measure Incidence of clinical PID over 12 months in intervention and control groups. Possible cases of PID will be identified from questionnaires and record searches. Confirmation of the diagnosis will be done by detailed review of medical records by three independent researchers blind to whether the woman is in intervention or control group. Trial registration Clinical Trials NCT 00115388
Chow, Joan M; de Bocanegra, Heike Thiel; Hulett, Denis; Park, Hye-Youn; Darney, Philip
Annual chlamydia screening is recommended for adolescent and young adult females and targeted screening is recommended for women ≥26 years based on risk. Although screening levels have increased over time, adherence to these guidelines varies, with high levels of adherence among Title X family planning providers. However, previous studies of provider variation in screening rates have not adjusted for differences in clinic and client population characteristics. Administrative claims from the California Family Planning, Access, Care, and Treatment (Family PACT) program were used to (1) examine clinic and client sociodemographic characteristics by provider group-Title X-funded public sector, non-Title X public sector, and private sector providers, and (2) estimate age-specific screening and differences in rates by provider group during 2009. Among 833 providers, Title X providers were more likely than non-Title X public sector providers and private sector providers to serve a higher client volume, a higher proportion of clients aged ≤25 years, and a higher proportion of African American clients. Non-Title X public providers were more likely to be located in rural areas, compared with Title X grantees and private sector providers. Title X providers had the largest absolute difference in screening rates for young females vs. older females (10.9%). Unadjusted screening rates for young clients were lower among non-Title X public sector providers (54%) compared with private sector and Title X providers (64% each). After controlling for provider group, urban location, client volume, and percent African American, private sector providers had higher screening rates than Title X and non-Title X public providers. Screening rates for females were higher among private providers compared with Title X and non-Title X public providers. However, only Title X providers were more likely to adhere to screening guidelines through high screening rates for young females and low
Low, N; S, Redmond; Alexander, K
Executive summary The literature reviews in this report bring together published evidence about the prevalence and reproductive tract complications of chlamydia infection, and about the effectiveness and cost-effectiveness of chlamydia screening interventions. Population prevalence of chlamydia...... prevalence. Estimates of chlamydia positivity in surveys with low response rates should not be interpreted as estimates of population prevalence. Only two population-based surveys in EU/EEA Member States in this review had a response rate of >70%. The highest response rates were seen when specimens...
Geelen, Tanja H.; Hoebe, Christian J. P. A.; Dirks, Anne; Dukers-Muijrers, Nicole H. T. M.; van Bergen, Jan E. A. M.; Wolffs, Petra F. G.
The goal of this multi-cohort study is to investigate the positivity rate of Trichomonas vaginalis (TV) among three distinct Dutch patient populations and its relation with Chlamydia trachomatis (CT) positivity. Few studies have been performed in Europe where TV positivity rate seems to be low.
Tamarelle, Jeanne; Thiébaut, Anne C M; Sabin, Bénédicte; Bébéar, Cécile; Judlin, Philippe; Fauconnier, Arnaud; Rahib, Delphine; Méaude-Roufai, Layidé; Ravel, Jacques; Morré, Servaas A; de Barbeyrac, Bertille; Delarocque-Astagneau, Elisabeth
Genital infection with Chlamydia trachomatis (Ct) is the most common bacterial sexually transmitted infection, especially among young women. Mostly asymptomatic, it can lead, if untreated, to pelvic inflammatory disease (PID), tubal factor infertility and ectopic pregnancy. Recent data suggest that Ct infections are not controlled in France and in Europe. The effectiveness of a systematic strategy for Ct screening in under-25 women remains controversial. The main objective of the i-Predict trial (Prevention of Diseases Induced by Chlamydia trachomatis) is to determine whether early screening and treatment of 18- to-24-year-old women for genital Ct infection reduces the incidence of PID over 24 months. This is a randomised prevention trial including 4000 eighteen- to twenty-four-year-old sexually active female students enrolled at five universities. The participants will provide a self-collected vaginal swab sample and fill in an electronic questionnaire at baseline and at 6, 12 and 18 months after recruitment. Vaginal swabs in the intervention arm will be analysed immediately for Ct positivity, and participants will be referred for treatment if they have a positive test result. Vaginal swabs from the control arm will be analysed at the end of the study. All visits to general practitioners, gynaecologists or gynaecology emergency departments for pelvic pain or other gynaecological symptoms will be recorded to evaluate the incidence of PID, and all participants will attend a final visit in a hospital gynaecology department. The primary endpoint measure will be the incidence of PID over 24 months. The outcome status (confirmed, probable or no PID) will be assessed by two independent experts blinded to group assignment and Ct status. This trial is expected to largely contribute to the development of recommendations for Ct screening in young women in France to prevent PID and related complications. It is part of a comprehensive approach to gathering data to
Davies, Bethan; Turner, Katy M.E.; Leung, Stella
Background: The impact of Chlamydia trachomatis (chlamydia) control on the incidence of pelvic inflammatory disease (PID) is theoretically limited by the proportion of PID caused by chlamydia. We estimate the population excess fraction (PEF) of treated chlamydia infection on PID at 12-months...... chlamydia on PID at 12-months. We undertook a systematic review to identify further studies that reported the risk of PID in women who were tested for chlamydia (infected and uninfected). We used the same method to calculate the PEF in eligible studies then compared all estimates of PEF. Results......: The systematic review identified a single study, a randomised controlled trial of chlamydia screening (POPI-RCT). In the presence of testing and treatment PID at 12-months was attributable to treated (baseline) chlamydia infections (Manitoba: 8.86%(95%CI 7.15-10.75); Denmark: 3.84%(3.26-4.45); screened...
Kent, G P; Harrison, H R; Berman, S M; Keenlyside, R A
Of 212 consecutive male patients and 212 consecutive female patients attending a sexually transmitted disease (STD) clinic, 36 (17%) men and 28 (13%) women had urethral or cervical cultures positive for Chlamydia trachomatis. When compared with culture, the direct fluorescent antibody test (MicroTrak, Syva Co., Palo Alto, CA) had a sensitivity of 75% and a specificity of 97% in men; for women the sensitivity and specificity were 68% and 82%, respectively. One percent of test slides from men and 11% of slides from women were uninterpretable. Designation of high-risk patients for presumptive treatment, i.e., those with suggestive clinical syndromes, gonococcal infection, or exposure to others considered at high risk for chlamydial infection, as recommended by the Centers for Disease Control, proved to be 94% sensitive, 22% specific in men, and 82% sensitive, 35% specific in women when compared with results of culture. Three different screening methods using mucopurulent cervicitis, a cervicitis score, and a series of key risk factors were less sensitive than presumptive treatment and performed worse in our study than in those published previously. Our findings suggest that use of presumptive treatment guidelines appears to be effective in directing treatment to STD clinic patients with chlamydial infection.
Maria Agnese Latino
Full Text Available Chlamydia trachomatis (C.t. infection is one of the most prevalent sexually transmitted disease in Europe and in developed countries. The main biological features and pathogenic mechanisms of C.t. infection are summarized in this review. It usually occurs without symptoms and often goes undiagnosed. If untreated, it can cause severe consequences for women, including pelvic inflammatory disease (PID, ectopic pregnancy and tubal infertility. Several studies have found that Chlamydia is more common among young women <25 years old, with multiple sexual partners within six months and non protected intercourses. Because re-infection rates are high, complications may be reduced if partners are treated and women re-tested. This paper emphasizes the importance of counselling and prevention programs and underlines that selective screening of high-risk population remains an essential component of C.t. control. In the last years, the detection of C.t. infection has been improved in sensitivity and specificity.We describe the main diagnostic techniques, from culture, enzyme immunoassay (EIA, direct fluorescent-antibody assay (DFA to the new DNA-based test systems. Actually, NAATs (nucleic acid amplification tests are regarded as the gold standard diagnostic techniques for chlamydial infections.
...-Based Telecommunications Relay Service Numbering AGENCY: Federal Communications Commission. ACTION... toll-free numbers by users of Internet- based Telecommunications Relay Services (iTRS). DATES... any rules of particular applicability. Subject: Internet-Based Telecommunications Relay Service...
Flickinger, Kathleen Anne
Distance education and Internet instruction are increasingly being used in college science teaching. In an effort to reach more students, Iowa State University's Human Anatomy and Physiology course was offered via Internet as well as via traditional lecture format. To assess the educational ramifications of this offering, three studies were conducted. In the first study, a collective case study approach was utilized to describe the learning environment created by an Internet-based college science course. In this study, three students were followed as they worked their way through the course. Collective case study methodologies were used to provide a rich description of the learning environment experienced by these students. Motivation, computer savvy, and academic and personal self-confidence appeared to impact the satisfaction level of the students enrolled in the class. To evaluate the effectiveness of the learning environment offered through the Internet-based science course, a quantitative comparison study was undertaken. In this study a comparison of achievement scores and study habits between students enrolled in the Internet-based class and those enrolled in the traditional section was made. Results from this study indicated that content understanding and retention did not appear to be effected by the type of instruction. Desirable study habits were reportedly used more frequently in the Internet section of the class than in the traditional class. To complete the description of the Internet course experience, a qualitative examination of Internet instructors' time commitment and level of teaching satisfaction was conducted. Data for this study consisted of interviews and researcher observations. Instructor time-on-task was initially quite high, and remained above the average spent on average face-to-face instruction in subsequent semesters. Additionally the role of the faculty member changed dramatically, causing some lessening of job satisfaction. Taken as
Study objective: To determine the prevalence of Chlamydia trachomatis infection in patients presenting for termination of pregnancy. Chlamydia trachomatis is associated with severe morbidity and determining the prevalence would be a big step forward towards possible instituting a screening process or a universal ...
From the cultured samples 230 were positive for Chlamydia trachomatis and 99 positive to Chlamydia pneumoniae. Statistical analysis using the student\\'s t test at 95% confidence interval shows that there was no significant difference between the number of females and males that presented themselves for screening.
Abstract. Background and Objectives: Tubal disease is often associated with persistent chlamydia trachomatis infection. The objective detection of this infection depends on tissue culture which is time consuming and expensive. Serologic techniques for chlamydia detection have been documented. While this may be rapid, ...
Jo, Jung Hwan; Kim, Eui Joo; Kim, Ji Rak; Kim, Moon Jong; Chung, Jin Woo; Park, Ji Woon
To evaluate quality and readability of Internet-based information on halitosis. An Internet search through 3 engines (Google, Yahoo, and Bing) was done with the terms ("bad breath," "halitosis," "oral malodor," "foul breath," "mouth malodor," "breath malodor," "fetor ex ore," "fetor oris," "ozostomia," and "stomatodysodia"). The first 50 websites from each engine resulting from each search term were screened. Included websites were evaluated using Health on the Net (HON) criteria, Journal of American Medical Association (JAMA) benchmarks, DISCERN, Ensuring Quality Information for Patients (EQIP), Flesch Reading Ease (FRE) score, and Flesch-Kincaid Grade level. A total of 101 websites were included. HON, DISCERN, EQIP, and FRE score were 42.9%, 37.6%, 37.4%, and 51.9% of the maximum score, respectively. Fewer than 50% of sites displayed attribution, disclosure, and currency according to JAMA benchmarks. HON score, DISCERN score, and EQIP score had significant correlation with each other and were significantly higher in sites displaying the HON seal. The current quality and readability of informative websites on halitosis are generally low and poorly organized. Clinicians should be able to assess the Internet-based information on halitosis, as well as give accurate advice and guide patients concerning this issue. Copyright © 2017 Elsevier Inc. All rights reserved.
Davies, Bethan; Turner, Katy M. E.; Leung, Stella
BACKGROUND: The impact of Chlamydia trachomatis (chlamydia) control on the incidence of pelvic inflammatory disease (PID) is theoretically limited by the proportion of PID caused by chlamydia. We estimate the population excess fraction (PEF) of treated chlamydia infection on PID at 12-months......: The systematic review identified a single study, a randomised controlled trial of chlamydia screening (POPI-RCT). In the presence of testing and treatment PID at 12-months was attributable to treated (baseline) chlamydia infections (Manitoba: 8.86%(95%CI 7.15-10.75); Denmark: 3.84%(3.26-4.45); screened...... in settings with widespread chlamydia control (testing and treatment) and compare this to the estimated PEF of untreated chlamydia. METHODS: We used two large retrospective population-based cohorts of women of reproductive age from settings with widespread chlamydia control to calculate the PEF of treated...
Civljak, Marta; Sheikh, Aziz; Stead, Lindsay F; Car, Josip
The Internet has become a regular part of daily life for the majority of people in many parts of the world. It now offers an additional means of effecting changes to behaviour such as smoking. To determine the effectiveness of Internet-based interventions for smoking cessation. We searched the Cochrane Tobacco Addiction Group Specialized Register, with additional searches of MEDLINE, EMBASE, CINAHL, PsycINFO, and Google Scholar. There were no restrictions placed on language of publication or publication date. The most recent search was in June 2010. We included randomized and quasi-randomized trials. Participants were people who smoked, with no exclusions based on age, gender, ethnicity, language or health status. Any type of Internet-based intervention was eligible. The comparison condition could be a no-intervention control or a different Internet site or programme. Methodological and study quality details were extracted using a standardised form. We selected smoking cessation outcomes at short term (one to three months) and long term (6 months or more) follow up, and reported study effects as a risk ratio with 95% confidence intervals. Only limited meta-analysis was performed, as the heterogeneity of the data for populations, interventions and outcomes allowed for very little pooling. Twenty trials met the inclusion criteria. There were more female than male participants. Some Internet programmes were intensive and included multiple outreach contacts with participants, whilst others relied on participants to initiate and maintain use.Ten trials compared an Internet intervention to a non-Internet based smoking cessation intervention or to a no intervention control. Six of these recruited adults, one recruited young adult university students and three recruited adolescents. Two trials of the same intensive automated intervention in populations of adult who smoked showed significantly increased cessation compared to printed self-help materials at 12 months. In one
can also cause post gonococcal urethritis. Chlamydia trachomatis can cause pelvic inflammatory diseases resulting in infertility and ectopic pregnancy9. Hence the screening of women with infertility cases, though they were asymptomatic. It has been found from studies reported in Italy, Sweden and USA that about 60% of.
... behaviors and biological factors common among young people. Gay, bisexual, and other men who have sex with men are also at risk since chlamydia ... should get a test for chlamydia every year. Gay, bisexual, and other men who have sex with men; as well as pregnant women should ...
Warmerdam, E.H.; van Straten, A.; Twisk, J.; Cuijpers, P.
In this study we explored predictors and moderators of response to Internet-based cognitive behavioral therapy (CBT) and Internet-based problem-solving therapy (PST) for depressive symptoms. The sample consisted of 263 participants with moderate to severe depressive symptoms. Of those, 88 were
Convery, Ian; Cox, Diane
Internet-based research methods can include: online surveys, web page content analysis, videoconferencing for online focus groups and/or interviews, analysis of "e-conversations" through social networking sites, email, chat rooms, discussion boards and/or blogs. Over the last ten years, an upsurge in internet-based research (IBR) has led…
... Docket No. 10-191; FCC 11-123] Internet-Based Telecommunications Relay Service Numbering AGENCY: Federal..., the information collection associated with the Commission's Internet- Based Telecommunications Relay... Telecommunications Relay Service Numbering, CG Docket No. 03-123; WC Docket No. 05-196; WC Docket No. 10-191; FCC 11...
Lee, Silvia Wen-Yu; Tsai, Chin-Chung; Wu, Ying-Tien; Tsai, Meng-Jung; Liu, Tzu-Chien; Hwang, Fu-Kwun; Lai, Chih-Hung; Liang, Jyh-Chong; Wu, Huang-Ching; Chang, Chun-Yen
Internet-based science learning has been advocated by many science educators for more than a decade. This review examines relevant research on this topic. Sixty-five papers are included in the review. The review consists of the following two major categories: (1) the role of demographics and learners' characteristics in Internet-based science…
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Wolfe, Christopher R
This discussion of the symposium 20 Years of Internet-Based Research at SCiP: Surviving Concepts, New Methodologies compares the issues faced by the pioneering Internet-based psychology researchers who presented at the first symposia on the topic, at the 1996 annual meeting of the Society for Computers in Psychology, to the issues facing researchers today. New methodologies unavailable in the early days of Web-based psychological research are discussed, with an emphasis on mobile computing with smartphones that is capitalizing on capabilities such as touch screens and gyro sensors. A persistent issue spanning the decades has been the challenge of conducting scientific research with consumer-grade electronics. In the 1996 symposia on Internet-based research, four advantages were identified: easy access to a geographically unlimited subject population, including subjects from very specific and previously inaccessible target populations; bringing the experiment to the subject; high statistical power through large sample size; and reduced cost. In retrospect, it appears that Internet-based research has largely lived up to this early promise-with the possible exception of sample size, since the public demand for controlled psychology experiments has not always been greater than the supply offered by researchers. There are many reasons for optimism about the future of Internet-based research. However, unless courses and textbooks on psychological research methods begin to give Web-based research the attention it deserves, the future of Internet-based psychological research will remain in doubt.
Gottlieb, Sami L; Stoner, Bradley P; Zaidi, Akbar A; Buckel, Christina; Tran, Molly; Leichliter, Jami S; Berman, Stuart M; Markowitz, Lauri E
Few data exist on potential harms of chlamydia screening. We assessed the psychosocial impact of receiving a positive Chlamydia trachomatis test result. We prospectively studied women ≥16 years of age undergoing chlamydia testing in 2 Midwestern family planning clinics. We surveyed women at baseline and about 1 month after receiving test results, using 9 validated psychosocial scales/subscales and chlamydia-specific questions. Changes in scale scores were calculated for each woman. Mean percent changes in scores for chlamydia-positive and -negative women were compared using a t test. We enrolled 1807 women (response rate, 84%). Of the 1688 women with test results, 149 (8.8%) tested positive. At follow-up, chlamydia-positive women (n = 71) had a 75% increase in anxiety about sexual aspects of their life on the Multidimensional Sexual Self-Concept Questionnaire (P < 0.001), significantly greater than the 26% increase among 280 randomly selected chlamydia-negative women (P = 0.02). There were no differences for the other 8 scales/subscales, including general measures of anxiety, depression, and self-esteem. Chlamydia-positive women were more likely than chlamydia-negative women to be "concerned about chlamydia" (80% vs. 40%, P < 0.001) and to report breaking up with a main partner (33% vs. 11%, P < 0.001) at follow-up. Women testing positive reported a range of chlamydia-specific concerns. Chlamydia-positive women had significant increases in anxiety about sex and concern about chlamydia, but did not have marked changes in more general measures of psychosocial well-being about 1 month after diagnosis. Chlamydia diagnoses were associated with some disruption of relationships with main partners. Chlamydia-specific concerns may guide counseling messages to minimize psychosocial impact.
Civljak, Marta; Stead, Lindsay F; Hartmann-Boyce, Jamie; Sheikh, Aziz; Car, Josip
The Internet is now an indispensable part of daily life for the majority of people in many parts of the world. It offers an additional means of effecting changes to behaviour such as smoking. To determine the effectiveness of Internet-based interventions for smoking cessation. We searched the Cochrane Tobacco Addiction Group Specialized Register. There were no restrictions placed on language of publication or publication date. The most recent search was conducted in April 2013. We included randomized and quasi-randomized trials. Participants were people who smoked, with no exclusions based on age, gender, ethnicity, language or health status. Any type of Internet intervention was eligible. The comparison condition could be a no-intervention control, a different Internet intervention, or a non-Internet intervention. Two authors independently assessed and extracted data. Methodological and study quality details were extracted using a standardized form. We extracted smoking cessation outcomes of six months follow-up or more, reporting short-term outcomes where longer-term outcomes were not available. We reported study effects as a risk ratio (RR) with a 95% confidence interval (CI). Clinical and statistical heterogeneity limited our ability to pool studies. This updated review includes a total of 28 studies with over 45,000 participants. Some Internet programmes were intensive and included multiple outreach contacts with participants, whilst others relied on participants to initiate and maintain use.Fifteen trials compared an Internet intervention to a non-Internet-based smoking cessation intervention or to a no-intervention control. Ten of these recruited adults, one recruited young adult university students and two recruited adolescents. Seven of the trials in adults had follow-up at six months or longer and compared an Internet intervention to usual care or printed self help. In a post hoc subgroup analysis, pooled results from three trials that compared
Taylor, Gemma M J; Dalili, Michael N; Semwal, Monika; Civljak, Marta; Sheikh, Aziz; Car, Josip
Tobacco use is estimated to kill 7 million people a year. Nicotine is highly addictive, but surveys indicate that almost 70% of US and UK smokers would like to stop smoking. Although many smokers attempt to give up on their own, advice from a health professional increases the chances of quitting. As of 2016 there were 3.5 billion Internet users worldwide, making the Internet a potential platform to help people quit smoking. To determine the effectiveness of Internet-based interventions for smoking cessation, whether intervention effectiveness is altered by tailoring or interactive features, and if there is a difference in effectiveness between adolescents, young adults, and adults. We searched the Cochrane Tobacco Addiction Group Specialised Register, which included searches of MEDLINE, Embase and PsycINFO (through OVID). There were no restrictions placed on language, publication status or publication date. The most recent search was conducted in August 2016. We included randomised controlled trials (RCTs). Participants were people who smoked, with no exclusions based on age, gender, ethnicity, language or health status. Any type of Internet intervention was eligible. The comparison condition could be a no-intervention control, a different Internet intervention, or a non-Internet intervention. To be included, studies must have measured smoking cessation at four weeks or longer. Two review authors independently assessed and extracted data. We extracted and, where appropriate, pooled smoking cessation outcomes of six-month follow-up or more, reporting short-term outcomes narratively where longer-term outcomes were not available. We reported study effects as a risk ratio (RR) with a 95% confidence interval (CI).We grouped studies according to whether they (1) compared an Internet intervention with a non-active control arm (e.g. printed self-help guides), (2) compared an Internet intervention with an active control arm (e.g. face-to-face counselling), (3) evaluated the
... Throat Emotional Problems Eyes Fever From Insects or Animals Genitals and Urinary ... Pneumoniae Infections Page Content Article Body When you hear the word chlamydia, you might think of the sexually transmitted disease (STD) by that ...
... other types of STIs. Most common STIs are: Gonorrhea HIV/AIDS Syphilis Hepatitis Herpes Even if you ... you from passing the STIs back and forth. Gonorrhea often occurs with chlamydia. Therefore, treatment for gonorrhea ...
Sethson, Magnus R.
This paper describes an Internet based remote experimental setup of a double lined pendulum mechanism for students experiments at the M. Sc. Level. Some of the first year experience using this web-based setup in classes is referred. In most of the courses given at the division of mechanical engineering systems at Linkoeping Institute of Technology we provide experimental setups to enhance the teaching Of M.Sc. students. Many of these experimental setups involve mechatronical systems. Disciplines like fluid power, electronics, and mechanics and also software technologies are used in each experiment. As our campus has recently been split into two different cities some new concepts for distance learning have been studied. The one described here tries to implement remotely controlled mechatronic setups for teaching basic programming of real-time operating systems and analysis of the dynamics of mechanical systems. The students control the regulators for the pendulum through a web interface and get measurement results and a movie back through their email. The present setup uses a double linked pendulum that is controlled by a DC-motor and monitored through both camera and angular position sensors. All software needed is hosted on a double-processor PC running the RedHat 7.1. distribution complemented with real-time scheduling using DIAPM-RTAI 1.7. The Internet site is presented to the students using PHP, Apache and MySQL. All of the used software originates from the open source domain. The experience from integrating these technologies and security issues is discussed together with the web-camera interface. One of the important experiences from this project so far is the need for a good visual feedback. This is both in terms of video speed but also in resolution. It has been noticed that when the students makes misstates and wants to search the failure they want clear, large images with high resolution to support their personal believes in the cause of the failure. Even
Marziali, Elsa; Garcia, Linda J
The aim of this study was to examine the impact on dementia caregivers' experienced stress and health status of 2 Internet-based intervention programs. Ninety-one dementia caregivers were given the choice of being involved in either an Internet-based chat support group or an Internet-based video conferencing support group. Pre-post outcome measures focused on distress, health status, social support, and service utilization. In contrast to the Chat Group, the Video Group showed significantly greater improvement in mental health status. Also, for the Video Group, improvements in self-efficacy, neuroticism, and social support were associated with lower stress response to coping with the care recipient's cognitive impairment and decline in function. The results show that, of 2 Internet-based intervention programs for dementia caregivers, the video conferencing intervention program was more effective in improving mental health status and improvement in personal characteristics were associated with lower caregiver stress response.
Zhang, Wenqiu; Yang, Xubo; Liao, Meng; Zhang, Ning; Liu, Longqian
Amblyopia is a common childhood condition, which affects 2%-3% of the population. The efficacy of conventional treatment in amblyopia seems not to be high and recently perceptual learning has been used for treating amblyopia. The aim of this study was to address the efficacy of Internet-based perceptual learning in treating amblyopia. A total of 530 eyes of 341 patients with amblyopia presenting to the outpatient department of West China Hospital of Sichuan University between February 2011 and December 2011 were reviewed. A retrospective cohort study was conducted to compare the efficacy of Internet-based perceptual learning and conventional treatment in amblyopia. The efficacy was evaluated by the change in visual acuity between pretreatment and posttreatment. The change in visual acuity between pretreatment and posttreatment by Internet-based perceptual learning was larger than that by conventional treatment in ametropic and strabismic amblyopia (pInternet-based perceptual learning was larger for patients with amblyopia not younger than 7 years (pInternet-based perceptual learning was 3.06 ± 1.42 months, while conventional treatment required 3.52 ± 1.67 months to reach the same improvement (pInternet-based perceptual learning can be considered as an alternative to conventional treatment. It is especially suitable for ametropic and strabismic patients with amblyopia who are older than 7 years and can shorten the cure time of amblyopia.
Suijkerbuijk, A.W.M.; Broek, I.V.F. van den; Brouwer, H.J.; Vanrolleghem, A.M.; Joosten, J.H.K.; Verheij, R.A.; Sande, M.A.B. van der; Kretzschmar, M.E.E.
BACKGROUND: Chlamydia is the most common curable sexually transmitted infection (STI) in the Netherlands. The majority of chlamydia diagnoses are made by general practitioners (GPs). Baseline data from primary care will facilitate the future evaluation of the ongoing large population-based screening
Suijkerbuijk, A.W.M.; van den Broek, I.V.F.; Brouwer, H.J.; Vanrolleghem, A.M.; Joosten, J.H.K.; Verheij, R.A.; van der Sande, M.A.B.; Kretzschmar, M.E.E.
Background: Chlamydia is the most common curable sexually transmitted infection (STI) in the Netherlands. The majority of chlamydia diagnoses are made by general practitioners (GPs). Baseline data from primary care will facilitate the future evaluation of the ongoing large population-based screening
Wolbrink, Traci A; Burns, Jeffrey P
Recent changes in duty hour allowances and economic constraints are forcing a paradigm shift in graduate medical education in the United States. Internet-based learning is a rapidly growing component of postgraduate medical education, including the field of critical care medicine. Here, we define the key concepts of Internet-based learning, summarize the current literature, and describe how Internet-based learning may be uniquely suited for the critical care provider. A MEDLINE/PubMed search from January 2000 to July 2011 using the search terms: "e-learning," "Web-based learning," "computer-aided instruction," "adult learning," "knowledge retention," "intensive care," and "critical care." The growth of the Internet is marked by the development of new technologies, including more user-derived tools. Nonmedical fields have embraced Internet-based learning as a valuable teaching tool. A recent meta-analysis described Internet-based learning in the medical field as being more effective than no intervention and likely as efficacious as traditional teaching methods. Web sites containing interactive features are aptly suited for the adult learner, complementing the paradigm shift to more learner-centered education. Interactive cases, simulators, and games may allow for improvement in clinical care. The total time spent utilizing Internet-based resources, as well as the frequency of returning to those sites, may influence educational gains. Internet-based learning may provide an opportunity for assistance in the transformation of medical education. Many features of Web-based learning, including interactivity, make it advantageous for the adult medical learner, especially in the field of critical care medicine, and further work is necessary to develop a robust learning platform incorporating a variety of learning modalities for critical care providers.
Chebli, Jaymee-Lee; Blaszczynski, Alexander; Gainsbury, Sally M
Internet-based interventions have emerged as a new treatment and intervention modality for psychological disorders. Given their features of treatment flexibility, anonymity and confidentiality, this modality may be well suited in the management of addictive behaviours. A systematic literature review of the effectiveness and treatment outcomes of Internet-based interventions for smoking cessation, problematic alcohol use, substance abuse and gambling was performed. Studies were included if they met the following criteria: clients received a structured therapeutic Internet-based intervention for a problematic and addictive behaviour; included more than five clients; effectiveness was based on at least one outcome; outcome variables were measured before and immediately following the interventions; had a follow-up period; and involved at least minimal therapist contact over the course of the program. Sixteen relevant studies were found; nine addressed the effects of Internet-based interventions on smoking cessation, four on gambling, two on alcohol and one on opioid dependence. All studies demonstrated positive treatment outcomes for their respective addictive behaviours. The current review concluded that Internet-based interventions are effective in achieving positive behavioural change through reducing problematic behaviours. This mode of therapy has been found to have the capacity to provide effective and practical services for those who might have remained untreated, subsequently reducing the barriers for help-seekers. This in turn provides imperative information to treatment providers, policy makers, and academic researchers.
Jorm, Anthony Francis; Mackinnon, Andrew James
Background Recruiting participants to randomized controlled trials of health interventions can be very difficult. Internet-based recruitment is becoming an increasingly important mode of recruitment, yet there are few detailed accounts of experiences recruiting participants to mental health interventions. Objective To report on our experience with Internet-based recruitment to an online depression prevention intervention and pass on lessons we learned. Methods Participants were recruited to the Mood Memos study, an online preventive depression intervention, purely through Internet-based sources. The study was targeted to adults with subthreshold depression symptoms from several English-speaking countries. A variety of online recruitment sources were trialed, including search engine advertising (Google, Yahoo!, Bing), Facebook advertising, posts in forums and online noticeboards, and promotion through relevant websites and email newsletters of mental health organizations. Results The study website received visits from 94,808 individuals over the 14-month recruitment period. The recruitment target was reached with 1699 individuals signing up to the randomized controlled trial and 1326 fully enrolling. Most visitors arrived via Google advertising, which promoted a depression-screening questionnaire. Google advertising accounted for nearly half of the total participants who signed up to the study, at an average cost of AUD $12 per participant. Promoting the study through trustworthy organizations and websites known to participants was also effective. Recruitment techniques that were less effective were contacting forums, email groups, and community noticeboards. Conclusions Several techniques, including Google advertising, were successful in recruiting participants to a trial evaluating an online depression intervention. Results suggest that Internet-based recruitment to mental health interventions is feasible and can be relatively affordable. Trial Registration ACTRN
Morgan, Amy Joanna; Jorm, Anthony Francis; Mackinnon, Andrew James
Recruiting participants to randomized controlled trials of health interventions can be very difficult. Internet-based recruitment is becoming an increasingly important mode of recruitment, yet there are few detailed accounts of experiences recruiting participants to mental health interventions. To report on our experience with Internet-based recruitment to an online depression prevention intervention and pass on lessons we learned. Participants were recruited to the Mood Memos study, an online preventive depression intervention, purely through Internet-based sources. The study was targeted to adults with subthreshold depression symptoms from several English-speaking countries. A variety of online recruitment sources were trialed, including search engine advertising (Google, Yahoo!, Bing), Facebook advertising, posts in forums and online noticeboards, and promotion through relevant websites and email newsletters of mental health organizations. The study website received visits from 94,808 individuals over the 14-month recruitment period. The recruitment target was reached with 1699 individuals signing up to the randomized controlled trial and 1326 fully enrolling. Most visitors arrived via Google advertising, which promoted a depression-screening questionnaire. Google advertising accounted for nearly half of the total participants who signed up to the study, at an average cost of AUD $12 per participant. Promoting the study through trustworthy organizations and websites known to participants was also effective. Recruitment techniques that were less effective were contacting forums, email groups, and community noticeboards. Several techniques, including Google advertising, were successful in recruiting participants to a trial evaluating an online depression intervention. Results suggest that Internet-based recruitment to mental health interventions is feasible and can be relatively affordable. ACTRN12609000925246.
Kang, Melissa; Rochford, Arlie; Skinner, Rachel; Mindel, Adrian; Webb, Marianne; Peat, Jenny; Usherwood, Tim
Chlamydia notifications have been rising in Australia for over a decade and are highest in young people. This study aimed to evaluate the impact of an internet-based intervention on chlamydia testing among young people 16-25 years. In this randomised controlled trial, recruitment, data collection, study interventions and follow-up occurred entirely in cyberspace, facilitated by a website. Eligible participants were aged 16-25 years and resided in Australia. The intervention group received personalised emails inviting interaction about chlamydia testing, while the control group received regular impersonal emails. Primary outcome was self-reported chlamydia testing at 6-month follow-up; secondary outcomes were condom use and changes in knowledge and attitudes. 704 young people completed baseline information, 40 were excluded and five withdrew prior to follow-up. The follow-up rate was 47.3% overall. In the intervention group, 40.6% (95% CI 30.7% to 51.1%) reported having had a chlamydia test at follow-up compared with 31.0% (95% CI 24.8% to 37.2%) in the control group (p=0.07). A per-protocol analysis found that those who engaged in email interaction were more likely to report chlamydia test uptake compared with those in the control group (52.5%, 95% CI 39.3 to 65.4% cf 31.0%, 95% CI 24.8% to 37.2%, p=0.002). There were no differences in secondary outcomes between groups. This is the first randomised controlled trial undertaken in cyberspace to promote chlamydia testing. E-technology may be useful in promoting chlamydia testing and healthcare seeking behaviour in young people.
Blomqvist, Maria; Christerson, Linus; Waldenström, Jonas; Lindberg, Peter; Helander, Björn; Gunnarsson, Gunnar; Herrmann, Björn; Olsen, Björn
Chlamydia psittaci is an intracellular bacterium primarily causing respiratory diseases in birds but may also be transmitted to other animals, including humans. The prevalence of the pathogen in wild birds in Sweden is largely unknown. DNA was extracted from cloacae swabs and screened for C. psittaci by using a 23S rRNA gene PCR assay. Partial 16S rRNA and ompA gene fragments were sequence determined and phylogenies were analysed by the neighbour-joining method. The C. psittaci prevalence was 1.3% in 319 Peregrine Falcons and White-tailed Sea Eagles, vulnerable top-predators in Sweden. 16S rRNA and ompA gene analysis showed that novel Chlamydia species, as well as novel C. psittaci strains, are to be found among wild birds.
Full Text Available Background: Chlamydia psittaci is an intracellular bacterium primarily causing respiratory diseases in birds but may also be transmitted to other animals, including humans. The prevalence of the pathogen in wild birds in Sweden is largely unknown. Methods: DNA was extracted from cloacae swabs and screened for C. psittaci by using a 23S rRNA gene PCR assay. Partial 16S rRNA and ompA gene fragments were sequence determined and phylogenies were analysed by the neighbour-joining method. Results and conclusion: The C. psittaci prevalence was 1.3% in 319 Peregrine Falcons and White-tailed Sea Eagles, vulnerable top-predators in Sweden. 16S rRNA and ompA gene analysis showed that novel Chlamydia species, as well as novel C. psittaci strains, are to be found among wild birds.
Meer, Victor van der
This thesis describes the role of internet-based support in the delivery of an asthma self management program. First, the compliance and reliability of home lung function monitoring, one of the key features of asthma self-management, was studied and appeared to be high over a 4-week period. Second,
Kristo, G.; Janssen, S.M.J.; Murre, J.M.J.
In this online study we examined the retention of recent personal events using an Internet-based diary technique. Each participant (N=878) recorded on a website one recent personal event and was contacted after a retention interval that ranged between 2 and 46 days. We investigated how well the
Yadav, Rajan; Tiruwa, Anurag; Suri, Pradeep Kumar
Purpose: The growing use of internet-based learning (IBL) platforms in institutions of higher education is producing profound changes in the traditional teaching learning process worldwide. This paper aims to identify and understand the ways in which higher education institutions draw benefits by the use of such means, synthesizing the literature…
It is against this background that the status, presentation and representation of African languages are being investigated. This article reports on the contribution of the website Sesotho Online to the establishment of an internet-based language knowledge community for the Sesotho language. In its literature review the article ...
... Docket No. 10-191; FCC 11-123] Internet-Based Telecommunications Relay Service Numbering AGENCY: Federal... Telecommunications Relay Service (iTRS). These rules specifically address Video Relay Service (VRS), which allows... SBA has developed a small business size standard for Wired Telecommunications Carriers, which consists...
Milinovich, Gabriel J; Williams, Gail M; Clements, Archie C A; Hu, Wenbiao
Emerging infectious diseases present a complex challenge to public health officials and governments; these challenges have been compounded by rapidly shifting patterns of human behaviour and globalisation. The increase in emerging infectious diseases has led to calls for new technologies and approaches for detection, tracking, reporting, and response. Internet-based surveillance systems offer a novel and developing means of monitoring conditions of public health concern, including emerging infectious diseases. We review studies that have exploited internet use and search trends to monitor two such diseases: influenza and dengue. Internet-based surveillance systems have good congruence with traditional surveillance approaches. Additionally, internet-based approaches are logistically and economically appealing. However, they do not have the capacity to replace traditional surveillance systems; they should not be viewed as an alternative, but rather an extension. Future research should focus on using data generated through internet-based surveillance and response systems to bolster the capacity of traditional surveillance systems for emerging infectious diseases. Copyright © 2014 Elsevier Ltd. All rights reserved.
... 47 Telecommunication 3 2010-10-01 2010-10-01 false Internet-based TRS registration. 64.611 Section 64.611 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Telecommunications Relay Services and Related...
Guay, Cassioppée; Auger, Claudine; Demers, Louise; Mortenson, W Ben; Miller, William C; Gélinas-Bronsard, Dominique; Ahmed, Sara
When trying to access interventions to improve their well-being and quality of life, family caregivers face many challenges. Internet-based interventions provide new and accessible opportunities to remotely support them and can contribute to reducing their burden. However, little is known about the link existing between the components, the use of behavior change techniques, and the outcomes of these Internet-based interventions. This study aimed to provide an update on the best available evidence about the efficacy of Internet-based interventions for caregivers of older adults. Specifically, the components and the use of behavior change techniques and how they impact on the efficacy of the intervention were sought. A systematic review searched primary source studies published between 2000 and 2015. Included studies were scored with a high level of evidence by independent raters using the GRADE criteria and reported caregiver-specific outcomes about interventions delivered through the Internet for caregivers of people aged 50 years and older. A narrative synthesis identified intervention components (eg, content, multimedia use, interactive online activities, and provision of support), behavior change techniques, and caregiver outcomes (eg, effects on stressors, mediators, and psychological health). The risk of bias within the included studies was assessed. A total of 2338 articles were screened and 12 studies describing 10 Internet-based interventions were identified. Seven of these interventions led to statistically significant improvements in caregiver outcomes (eg, reducing depression or anxiety, n=4). These efficacious interventions used interactive components, such as online exercises and homework (n=4) or questionnaires on health status (n=2) and five of them incorporated remote human support, either by professionals or peers. The most frequently used behavior change techniques included in efficacious interventions were provision of social support (n=6) and
Enns, Eva Andrea; Kao, Szu-Yu; Kozhimannil, Katy Backes; Kahn, Judith; Farris, Jill; Kulasingam, Shalini L
Mathematical models are important tools for assessing prevention and management strategies for sexually transmitted infections. These models are usually developed for a single infection and require calibration to observed epidemiological trends in the infection of interest. Incorporating other outcomes of sexual behavior into the model, such as pregnancy, may better inform the calibration process. We developed a mathematical model of chlamydia transmission and pregnancy in Minnesota adolescents aged 15 to 19 years. We calibrated the model to statewide rates of reported chlamydia cases alone (chlamydia calibration) and in combination with pregnancy rates (dual calibration). We evaluated the impact of calibrating to different outcomes of sexual behavior on estimated input parameter values, predicted epidemiological outcomes, and predicted impact of chlamydia prevention interventions. The two calibration scenarios produced different estimates of the probability of condom use, the probability of chlamydia transmission per sex act, the proportion of asymptomatic infections, and the screening rate among men. These differences resulted in the dual calibration scenario predicting lower prevalence and incidence of chlamydia compared with calibrating to chlamydia cases alone. When evaluating the impact of a 10% increase in condom use, the dual calibration scenario predicted fewer infections averted over 5 years compared with chlamydia calibration alone [111 (6.8%) vs 158 (8.5%)]. While pregnancy and chlamydia in adolescents are often considered separately, both are outcomes of unprotected sexual activity. Incorporating both as calibration targets in a model of chlamydia transmission resulted in different parameter estimates, potentially impacting the intervention effectiveness predicted by the model.
Woodhall Sarah C
Full Text Available Abstract Background In recent years there has been interest in websites as a means of increasing access to free chlamydia tests through the National Chlamydia Screening Programme (NCSP in England. We aimed to describe and evaluate online access to chlamydia testing within the NCSP. Methods We analysed NCSP chlamydia testing data (2006–2010 for 15–24 year olds from the 71/95 programme areas in England where site codes were available to identify tests ordered through the internet. The characteristics of people using online testing services in 2010 were compared with those testing in general practice (GP or community sexual and reproductive health (SRH services. We evaluated 58 websites offering free chlamydia tests through the NCSP, and 32 offering kits on a commercial basis for signposting to clinical service and health promotion advice offered. Results Between 2006 and 2010, 5% of all tests in the included programme areas were accessed through the internet. The number of internet tests increased from 18 (1 sexual partner in the past year. Provision of sexual health information and appropriate signposting for those in need of clinical services varied between websites. Service provision within the NCSP was fragmented with multiple providers serving specific geographical catchment areas. Conclusion Internet testing reaches a population with a relatively high risk of chlamydia infection and appears acceptable to young men, a group that has been difficult to engage with chlamydia testing. In order to maximise the potential benefit of these services, websites should be consistent with national guidelines and adhere to minimum standards for signposting to clinical care and health promotion information. The current system with multiple providers servicing geographically specific catchment areas is contrary to the geographically unrestricted nature of the internet and potentially confusing for clients.
Zarski, A C; Lehr, D.; Berking, M.
of this study was to investigate the influence of different guidance formats (content-focused guidance, adherence-focused guidance, and administrative guidance) on adherence and to identify predictors of nonadherence in an Internet-based mobile-supported stress management intervention (ie, GET.ON Stress......) for employees. Methods: The data from the groups who received the intervention were pooled from three randomized controlled trials (RCTs) that evaluated the efficacy of the same Internet-based mobile-supported stress management intervention (N=395). The RCTs only differed in terms of the guidance format...... (content-focused guidance vs waitlist control, adherence-focused guidance vs waitlist control, administrative guidance vs waitlist control). Adherence was defined by the number of completed treatment modules (0-7). An ANOVA was performed to compare the adherence rates from the different guidance formats...
Pauline Ratnasingam; Paul A. Pavlou
Trust in Internet-based Business-to-Business (B2B) e-commerce is an important issue for both practicioners and academicians. Whereas the traditional notion of dyadic interfirm trust primarily focuses on trust in a trading partner firm, trust in e-commerce also implicitly incorporates the notion of trust in the transaction infrastructure and underlying control mechanisms (technology trust), which deals with transaction integrity, authentication, confidentliality, non-repudiation, and best busi...
van der Sande Marianne AB
Full Text Available Abstract Background Chlamydia is the most common curable sexually transmitted infection (STI in the Netherlands. The majority of chlamydia diagnoses are made by general practitioners (GPs. Baseline data from primary care will facilitate the future evaluation of the ongoing large population-based screening in the Netherlands. The aim of this study was to assess the usefulness of electronic medical records for monitoring the incidence of chlamydia cases diagnosed in primary care in the Netherlands. Methods In the electronic records of two regional and two national networks, we identified chlamydia diagnoses by means of ICPC codes (International Classification of Primary Care, laboratory results in free text and the prescription of antibiotics. The year of study was 2007 for the two regional networks and one national network, for the other national network the year of study was 2005. We calculated the incidence of diagnosed chlamydia cases per sex, age group and degree of urbanization. Results A large diversity was observed in the way chlamydia episodes were coded in the four different GP networks and how easily information concerning chlamydia diagnoses could be extracted. The overall incidence ranged from 103.2/100,000 to 590.2/100,000. Differences were partly related to differences between patient populations. Nevertheless, we observed similar trends in the incidence of chlamydia diagnoses in all networks and findings were in line with earlier reports. Conclusions Electronic patient records, originally intended for individual patient care in general practice, can be an additional source of data for monitoring chlamydia incidence in primary care and can be of use in assessing the future impact of population-based chlamydia screening programs. To increase the usefulness of data we recommend more efforts to standardize registration by (specific ICPC code and laboratory results across the existing GP networks.
Heikkinen, Katja; Leino-Kilpi, H; Salanterä, S
There is a growing need for patient education and an evaluation of its outcomes. The aim of this study was to compare ambulatory orthopaedic surgery patients' knowledge with Internet-based education and face-to-face education with a nurse. The following hypothesis was proposed: Internet-based patient education (experiment) is as effective as face-to-face education with a nurse (control) in increasing patients' level of knowledge and sufficiency of knowledge. In addition, the correlations of demographic variables were tested. The patients were randomized to either an experiment group (n = 72) or a control group (n = 75). Empirical data were collected with two instruments. Patients in both groups showed improvement in their knowledge during their care. Patients in the experiment group improved their knowledge level significantly more in total than those patients in the control group. There were no differences in patients' sufficiency of knowledge between the groups. Knowledge was correlated especially with patients' age, gender and earlier ambulatory surgeries. As a conclusion, positive results concerning patients' knowledge could be achieved with the Internet-based education. The Internet is a viable method in ambulatory care.
Jiang Zhong; Wu Jinchang
Comparison of the population excess fraction of Chlamydia trachomatis infection on pelvic inflammatory disease at 12-months in the presence and absence of chlamydia testing and treatment: Systematic review and retrospective cohort analysis.
Davies, Bethan; Turner, Katy M E; Leung, Stella; Yu, B Nancy; Frølund, Maria; Benfield, Thomas; Blanchard, James; Westh, Henrik; Ward, Helen
The impact of Chlamydia trachomatis (chlamydia) control on the incidence of pelvic inflammatory disease (PID) is theoretically limited by the proportion of PID caused by chlamydia. We estimate the population excess fraction (PEF) of treated chlamydia infection on PID at 12-months in settings with widespread chlamydia control (testing and treatment) and compare this to the estimated PEF of untreated chlamydia. We used two large retrospective population-based cohorts of women of reproductive age from settings with widespread chlamydia control to calculate the PEF of treated chlamydia on PID at 12-months. We undertook a systematic review to identify further studies that reported the risk of PID in women who were tested for chlamydia (infected and uninfected). We used the same method to calculate the PEF in eligible studies then compared all estimates of PEF. The systematic review identified a single study, a randomised controlled trial of chlamydia screening (POPI-RCT). In the presence of testing and treatment <10% of PID at 12-months was attributable to treated (baseline) chlamydia infections (Manitoba: 8.86%(95%CI 7.15-10.75); Denmark: 3.84%(3.26-4.45); screened-arm POPI-RCT: 0.99%(0.00-29.06)). In the absence of active chlamydia treatment 26.44%(11.57-46.32) of PID at 12-months was attributable to untreated (baseline) chlamydia infections (deferred-arm POPI-RCT). The PEFs suggest that eradicating baseline chlamydia infections could prevent 484 cases of PID at 12-months per 100,000 women in the untreated setting and 13-184 cases of PID per 100,000 tested women in the presence of testing and treatment. Testing and treating chlamydia reduced the PEF of chlamydia on PID by 65% compared to the untreated setting. But in the presence of testing and treatment over 90% of PID could not be attributed to a baseline chlamydia infection. More information is needed about the aetiology of PID to develop effective strategies for improving the reproductive health of women.
O'Connor, Catherine C; Ali, Hammad; Guy, Rebecca J; Templeton, David J; Fairley, Christopher K; Chen, Marcus Y; Dickson, Bridget M; Marshall, Lewis J; Grulich, Andrew E; Hellard, Margaret E; Kaldor, John M; Donovan, Basil; Ward, James S
To assess the clinical epidemiology of chlamydia among Aboriginal and Torres Strait Islander (Indigenous) people attending sexual health services around Australia. Retrospective analysis of routine demographic, behavioural and clinical data, between 1 January 2006 and 31 December 2011. 18 sexual health services in major cities and regional centres in five jurisdictions. Attendance, chlamydia testing and positivity rates in patients visiting for the first time, and factors associated with chlamydia positivity. Of 168 729 new patients, 7103 (4.2%) identified as Indigenous, of whom 74.3% were tested for chlamydia. Chlamydia positivity was 17.0% in Indigenous women (23.3% in 15-19-year-olds and 18.9% in 20-24-year-olds) and 17.3% in Indigenous men (20.2% in 15-19-year-olds and 24.2% in 20-24-year-olds). There was an increasing trend in chlamydia positivity in Indigenous women from 2006 to 2011 (P for trend = 0.001), but not in Indigenous men. In Indigenous women, factors independently associated with positivity were: younger age, being heterosexual, living in Queensland and attending the service in 2010. In Indigenous men, independent factors associated with chlamydia positivity were younger age, being heterosexual, having sex only in Australia and living in a regional area. The high and increasing chlamydia positivity rates highlight the need for enhanced prevention and screening programs for Indigenous people.
Postma, M.J.; Welte, R.; Van Den Hoek, J.A.R.; Van Doornum, G.J.J.; Coutinho, R.A.; Jager, J.C.
Objective. To estimate the cost effectiveness of Chlamydia trachomatis (CT) screening of young women visiting general practitioners. Design. Economic model analysis. Methods. Data on the health care needs for CT complications were derived from various sources; costing was done using estimated cost
Morgan D. Wilbanks
Full Text Available Introduction: The clinical presentation of genital Chlamydia trachomatis infection (chlamydia in women is often indistinguishable from a urinary tract infection. While merited in the setting of dysuria, emergency department (ED clinicians do not routinely test for chlamydia in women. The primary aim of our study was to evaluate the frequency of chlamydia testing among women presenting to the ED with dysuria. Methods: We conducted a retrospective chart review of women 19-25 years of age presenting with dysuria to an urban ED and who had been coded with urinary tract infection (UTI as their primary diagnosis (ICD-9 599.0 from October 2005 to March 2011. We excluded women who were pregnant, had underlying anatomical or neurological urinary system pathology, had continuation of symptoms from UTI or a sexually transmitted infection (STI diagnosed elsewhere, or were already on antibiotics for a UTI or STI. We identified the rates of sexual history screening, pelvic examination and chlamydia assay testing and evaluated predictors using univariate and multivariate analyses. Results: Of 280 women with dysuria and a UTI diagnosis, 17% were asked about their sexual history, with 94% reporting recent sexual activity. Pelvic examination was performed in 23%. We were unable to determine the overall chlamydia prevalence as only 20% of women in the cohort were tested. Among the 20% of women tested for chlamydia infection, 21% tested positive. Only 42% of chlamydia-positive women were prescribed treatment effective for chlamydia (azithromycin or doxycycline at their visit; the remaining were prescribed UTI treatment not effective against chlamydia. Predictors of sexual history screening included vaginal bleeding (OR 5.4, 95% CI=1.5 to 19.6 and discharge (OR 2.8, 95% CI=1.1 to 6.9. Predictors of a pelvic examination being performed included having a complaint of vaginal discharge (OR 11.8, 95% CI=4.2 to 32.9, a sexual history performed (OR 2.5, 95% CI=1.1 to 5
Herzog Sereina A
Full Text Available Abstract Background Pelvic inflammatory disease (PID results from the ascending spread of microorganisms from the vagina and endocervix to the upper genital tract. PID can lead to infertility, ectopic pregnancy and chronic pelvic pain. The timing of development of PID after the sexually transmitted bacterial infection Chlamydia trachomatis (chlamydia might affect the impact of screening interventions, but is currently unknown. This study investigates three hypothetical processes for the timing of progression: at the start, at the end, or throughout the duration of chlamydia infection. Methods We develop a compartmental model that describes the trial structure of a published randomised controlled trial (RCT and allows each of the three processes to be examined using the same model structure. The RCT estimated the effect of a single chlamydia screening test on the cumulative incidence of PID up to one year later. The fraction of chlamydia infected women who progress to PID is obtained for each hypothetical process by the maximum likelihood method using the results of the RCT. Results The predicted cumulative incidence of PID cases from all causes after one year depends on the fraction of chlamydia infected women that progresses to PID and on the type of progression. Progression at a constant rate from a chlamydia infection to PID or at the end of the infection was compatible with the findings of the RCT. The corresponding estimated fraction of chlamydia infected women that develops PID is 10% (95% confidence interval 7-13% in both processes. Conclusions The findings of this study suggest that clinical PID can occur throughout the course of a chlamydia infection, which will leave a window of opportunity for screening to prevent PID.
Beach, Pamela; Willows, Dale
This qualitative study examined an innovative methodology, combining screen capture technology and a retrospective think aloud, for exploring the use of Internet-based resources by elementary teachers. Pre-service and in-service teachers explored "The Balanced Literacy Diet," a free, interactive, and evidenced-informed professional…
Jones, Krista; Baldwin, Kathleen A; Lewis, Patricia Ryan
The purpose of this descriptive pilot study was to evaluate an evidence-based social-networking intervention aimed at reducing the incidence of Chlamydia among 15- to 24-year-olds. The intervention consists of a Facebook site that addresses signs, symptoms, treatment, screening, and prevention of Chlamydia infection. Findings included a 23% self-reported increase in condom utilization, and a 54% reduction in positive Chlamydia cases among 15- to 17-year-olds. Study results support that social media may be an effective mechanism for information dissemination and the promotion of positive behavioral changes among this population. Copyright © Taylor & Francis Group, LLC
Learner, Emily R; Torrone, Elizabeth A; Fine, Jason P; Pence, Brian W; Powers, Kimberly A; Miller, William C
Evaluating chlamydia prevalence trends from sentinel surveillance is important for understanding population disease burden over time. However, prevalence trend estimates from surveillance data may be misleading if they do not account for changes in risk profiles of individuals who are screened (case mix) and changing performance of the screening tests used. We analyzed chlamydia screening data from a sentinel surveillance population of 389,555 young women (1990-2012) and 303,699 young men (2003-2012) entering the US National Job Training Program. This period follows the introduction of national chlamydia screening programs designed to prevent transmission and reduce population disease burden. After ruling out bias due to case mix, we used an expectation-maximization based maximum likelihood approach to account for measurement error from changing screening tests, and generated minimally-biased long-term chlamydia prevalence trend estimates among youth and young adults in this sentinel surveillance population. Adjusted chlamydia prevalence among women was high throughout the study period, but fell from 20% in 1990 to 12% in 2003, and remained between 12% and 14% through 2012. Adjusted prevalence among men was steady throughout the study period at approximately 7%. For both women and men, adjusted prevalence was highest among Black and American Indian youth and young adults, and in the Southern and Midwestern regions of the US throughout the study period. Our minimally-biased trend estimates provide support for an initial decrease in chlamydia prevalence among women soon after the introduction of national chlamydia screening programs. Constant chlamydia prevalence in more recent years suggests that screening may not be sufficient to further reduce chlamydia prevalence among high-risk youth and young adults.
Full Text Available It is widely established debriefing in business games is important and influences the students' learning performance. Most games only support game statistics instead of explaining solution paths. We suggest the automatic generation of explanations for internet-mediated business games to improve the debriefing quality. As a proof of concept we developed a prototype of an internet-based auction game embedding an open simulation model and an automatic explanation component helping students and teachers to analyse the decision making process. This paper describes the usefulness of automated explanations and the underlying generic software architecture.
In recent years, the proliferation of available video content and the popularity of the Internet have encouraged service providers to develop new ways of distributing content to clients. Increasing video scaling ratios and advanced digital signal processing techniques have led to Internet Video-on-Demand applications, but these currently lack efficiency and quality. Scalable Video on Demand: Adaptive Internet-based Distribution examines how current video compression and streaming can be used to deliver high-quality applications over the Internet. In addition to analysing the problems
Steele, Robert; Kiss, Attilla
Emergency Department (ED) overcrowding is a national crisis with few prospective data to document its occurrence. The objective of this study was to prospectively collect data on variables involved in Emergency Department overcrowding (EMDOC) using an Internet-based data entry model. A prospective observational Internet-based study involving 18 hospitals over a 13-month period was designed. Investigators input data into the EmDOC Internet site at 10:00 p.m. on 7 random days each month. The study found that the primary reason for ED overcrowding was lack of inpatient beds. Important means were: patient-to-nurse ratio = 2.85, diversion was 7.4 h/24 h, and hospital census was 83%. From ED waiting room to an ED bed took a mean time of 209 min. The mean number of makeshift beds was 3.1. There was no single variable that was noted to define or predict overcrowding. Documentation of factors involved in ED overcrowding found that overcrowding was not just an ED problem, but a problem that occurs due to overcrowding in the entire institution.
Full Text Available Health education, which also includes medicine education, promotes social sustainability in society. Through the context of Internet-based intervention, this study reports on fourth graders’ (N = 51, aged 10–11 years perspectives on medicines, their use with common diseases and medicine-related information sources. The study was qualitative by nature. Data was collected in spring 2010, by audio recording students’ group discussions during the study process and group interviews. After intervention, students were well aware of the proper use of medicines and how to find information both on medicines and health issues. The main challenge was finding websites that provide reliable and confidential information. The results of this study raise awareness of a concrete pedagogical approach to health education. The pedagogical approach conducted in the intervention could, to some extent, be transferred to any school setting. This study underlies the promotion of Internet-based health literacy and criteria, for evaluating online health information in the primary school context.
Catherine M. O’Connell
Full Text Available Etiology, transmission and protection: Chlamydia trachomatis is the leading cause of bacterial sexually transmitted infection (STI globally. However, C. trachomatis also causes trachoma in endemic areas, mostly Africa and the Middle East, and is a leading cause of preventable blindness worldwide. Epidemiology, incidence and prevalence: The World Health Organization estimates 131 million new cases of C. trachomatis genital infection occur annually. Globally, infection is most prevalent in young women and men (14-25 years, likely driven by asymptomatic infection, inadequate partner treatment and delayed development of protective immunity. Pathology/Symptomatology: C. trachomatis infects susceptible squamocolumnar or transitional epithelial cells, leading to cervicitis in women and urethritis in men. Symptoms are often mild or absent but ascending infection in some women may lead to Pelvic Inflammatory Disease (PID, resulting in reproductive sequelae such as ectopic pregnancy, infertility and chronic pelvic pain. Complications of infection in men include epididymitis and reactive arthritis. Molecular mechanisms of infection: Chlamydiae manipulate an array of host processes to support their obligate intracellular developmental cycle. This leads to activation of signaling pathways resulting in disproportionate influx of innate cells and the release of tissue damaging proteins and pro-inflammatory cytokines. Treatment and curability: Uncomplicated urogenital infection is treated with azithromycin (1 g, single dose or doxycycline (100 mg twice daily x 7 days. However, antimicrobial treatment does not ameliorate established disease. Drug resistance is rare but treatment failures have been described. Development of an effective vaccine that protects against upper tract disease or that limits transmission remains an important goal.
Gupta, Krishan M.
Within the last few years, a host of value-based metrics like EVA, MVA, TBR, CFORI, and TSR have evolved. This paper attempts to analyze the validity and applicability of EVA and Balanced Scorecard for Internet based organizations. Despite the collapse of the dot-com model, the firms engaged in e- commerce continue to struggle to find new ways to account for customer-base, technology, employees, knowledge, etc, as part of the value of the firm. While some metrics, like the Balance Scorecard are geared towards internal use, others like EVA are for external use. Value-based metrics are used for performing internal audits as well as comparing firms against one another; and can also be effectively utilized by individuals outside the firm looking to determine if the firm is creating value for its stakeholders.
Sun, Gordon H
The ubiquity of the Internet has led to the widespread availability of health-related information to the public, and the subsequent empowerment of patients has fundamentally altered the patient-physician relationship. Among several concerns of physicians is the possibility that patients may be misinformed by information obtained from the Internet. One opportunity for health care providers to address this problem exists within Internet-based patient education materials (IPEMs). According to recent research in Otolaryngology-Head and Neck Surgery, IPEMs found within professional otolaryngology websites are written at the 8th- to 18th-grade reading comprehension level, essentially unchanged over the past 3 years. This greatly exceeds the fourth- to sixth-grade reading level recommended by the National Institutes of Health. Benefits, strategies, and challenges to improving the readability of IPEMs are discussed.
Bryant, Jessica; Mohan, Rohith; Koottappillil, Brian; Wong, Kevin; Yi, Paul H
This is a cross-sectional study. The purpose of this study is to evaluate the content of information available on the Internet regarding minimally invasive spine surgery (MISS). Patients look to the Internet for quick and accessible information on orthopedic procedures to help guide their personal decision making process regarding the care they receive. However, the quality of internet-based orthopedic education material varies significantly with respect to accuracy and readability. The top 50 results were generated from each of 3 search engines (Google, Yahoo!, and Bing) using the search term "minimally invasive spine surgery." Results were categorized by authorship type and evaluated for their description of key factors such as procedural benefits, risks, and techniques. Comparisons between search engines and between authorship types were done using the Freeman-Halton extension for the Fisher exact test. The content of websites certified by Health on the Net Foundation (HONcode) was compared with those not HONcode certified. Of the 150 websites and videos, only 26% were authored by a hospital or university, whereas 50% were by a private physician or clinic. Most resources presented some benefits of MISS (84%, 126/150), but only 17% presented risks of the procedure (26/150). Almost half of all resources described the technique of MISS, but only 27% had thorough descriptions that included visual representations while 26% failed to describe the procedure. Only 12 results were HONcode certified, and 10 (83%) of these were authored by a medical industry company. Internet-based resources on MISS provide inconsistent content and tend to emphasize benefits of MISS over risks.
Garland, S M; Tabrizi, S; Hallo, J; Chen, S
To determine the prevalence of Chlamydia trachomatis in a patient population presenting for legal termination of pregnancy by polymerase chain reaction (PCR) and ligase chain reaction (LCR), from first catch urine and self administered tampons, and comparing with the traditionally collected endocervical swab tested by both PCR and culture. Consecutive women attending for legal termination of pregnancy were screened for chlamydia by patient collected first catch urine and tampon, and physician collected endocervical swab. Of 1175 patients with complete samples, there were 33 (2.8%) in whom chlamydia was detected by two or more assays from one or more sample site. Chlamydia was detected equally well by both PCR and LCR in first catch urine (p = 0.25), tampon (p = 0.5), and endocervical swab (p = 0.5). However, both PCR and LCR were significantly better than culture of an endocervical swab (p = 0.0005) for detection of C trachomatis. The prevalence of chlamydia in patients presenting for termination of pregnancy was 2.8%. A simple efficient way of performing screening for chlamydia for women presenting for termination of pregnancy is by first catch urine or tampon, which can be tested by the highly sensitive amplification assays, PCR or LCR.
Bexelius, Christin; Honeth, Louise; Ekman, Alexandra; Eriksson, Mikael; Sandin, Sven; Bagger-Sjöbäck, Dan; Litton, Jan-Eric
program (P = .007) than those who only answered the questionnaire. Though an Internet-based hearing test cannot replace a clinical pure-tone audiogram conducted by a trained audiologist, it is a valid and useful screening tool for hearing ability in a large population carried out at a low cost.
Ong, Koh Jun; Soldan, Kate; Jit, Mark; Dunbar, J Kevin; Woodhall, Sarah C
Current evidence suggests that chlamydia screening programmes can be cost-effective, conditional on assumptions within mathematical models. We explored differences in cost estimates used in published economic evaluations of chlamydia screening from seven countries (four papers each from UK and the Netherlands, two each from Sweden and Australia, and one each from Ireland, Canada and Denmark). From these studies, we extracted management cost estimates for seven major chlamydia sequelae. In order to compare the influence of different sequelae considered in each paper and their corresponding management costs on the total cost per case of untreated chlamydia, we applied reported unit sequelae management costs considered in each paper to a set of untreated infection to sequela progression probabilities. All costs were adjusted to 2013/2014 Great British Pound (GBP) values. Sequelae management costs ranged from £171 to £3635 (pelvic inflammatory disease); £953 to £3615 (ectopic pregnancy); £546 to £6752 (tubal factor infertility); £159 to £3341 (chronic pelvic pain); £22 to £1008 (epididymitis); £11 to £1459 (neonatal conjunctivitis) and £433 to £3992 (neonatal pneumonia). Total cost of sequelae per case of untreated chlamydia ranged from £37 to £412. There was substantial variation in cost per case of chlamydia sequelae used in published chlamydia screening economic evaluations, which likely arose from different assumptions about disease management pathways and the country perspectives taken. In light of this, when interpreting these studies, the reader should be satisfied that the cost estimates used sufficiently reflect the perspective taken and current disease management for their respective context. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Corbett, G. [Natural Resources Canada, Explosives Regulatory Division, Ottawa, ON (Canada); Brown, J. [Health Canada, Laboratory Center for Disease Control, Ottawa, ON (Canada)
In an effort to reduce preventable injuries resulting from family fireworks displays, the Explosives Regulatory Division of Natural Resources Canada is developing a client service regulatory package - EXPLONET - which will be made available on the Internet. EXPLONET includes several components which address industry and public concerns. The initial component described here is the family educational safety module, designed to deal with the safe use of family fireworks. The objective is to reduce injuries to elementary school-age children through the delivery of an Internet-based lesson plan. The lesson plan is expected to be implemented on a pilot program basis to reach the target audience during the 1998 Halloween season when the use of fireworks is high. The lesson plan consists of four units and will be delivered over a period of four weeks prior to Hallo wen. Students will be active participants in the web-based sessions. The sessions will cover off-aspects of mathematics, history and science clustered around the central theme of fireworks safety, presented in a way to keep the children interested. The lesson will also include follow-up queries after Hallo wen, providing the children (and teachers) the opportunity to comment on what they have learned, and to identify product or safety improvements. Provision is also made for parent involvement. The module will be implemented on a pilot project basis in two schools, one in Nova Scotia and one in British Columbia. 6 refs., 1 tab., 10 figs.
Social networking sites such as MySpace and virtual communities such as on-line support groups can be a rich source of data for researchers. These sites can be an effective way of reaching and researching young people in order to address their particular health needs. Internet-based research is also potentially risky and exploitative. There is some guidance for conducting research online, but there are no detailed or universally accepted ethics guidelines for research of webspaces such as MySpace or virtual communities in which young people participate. One question that arises is--If MySpace is a public webspace, can research be done without consent? In this paper I investigate ethical issues surrounding young people's consent in cyber research. I identify issues that help determine whether consent is needed, offer suggestions for dealing with consent in cyberspace and add my voice to the call for a resource of case studies--indispensible in the development of guidelines and the education of researchers and research ethics committees.
Kim, Y. S.; Lee, S. L.
Implementation of information technology system through the nuclear power plant life cycle which covers site selection, design, construction, operation and decommission has been suggested continually by the reports or guidelines from NIRMA, INPO, NUMARC, USNRC and EPRI since late 1980's, and some of it has been actually implemented and applied partially to the practical design process. However, for the NSSS system design, a high level activity of nuclear power plant design phase, none of the effects has been reported with regard to implementing the information system. In Korea, KAERI studied NuIDEAS(Nuclear Integrated Database and Design Advancement System) in 1995, and KAERI (Korea Electric Power Research Institute) worked with CENP (Combustion Engineering Nuclear Power) for KNGR IMS(Information Management System) in 1997 as trials to adopt information system for NSSS system design. In this paper, after reviewing the pre-studied two information system, we introduce implementation of the information system for NSSS system design which is compatible with the on-going design works and can be used as means of concurrent engineering through internet. With this electronic design system, we expect increase of the design efficiency and productivity by switching from hard copy based design flow to internet based system. In addition, reliability and traceability of the design data is highly elevated by containing the native document file together with all the review, comment and resolution history in one database
Ho, Jessica; Boughton, Nick; Kehoe, Dennis; Michaelides, Zenon
The Internet is playing an increasingly important role in enhancing the operations of supply networks as many organizations begin to recognize the benefits of Internet- enabled supply arrangements. However, the developments and applications to-date do not extend significantly beyond the dyadic model, whereas the real advantages are to be made with the external and network models to support a coordinated and collaborative based approach. The DOMAIN research group at the University of Liverpool is currently defining new Internet- enabled approaches to enable greater collaboration across supply chains. Different e-business models and tools are focusing on different applications. Using inappropriate e- business models, tools or techniques will bring negative results instead of benefits to all the tiers in the supply network. Thus there are a number of issues to be considered before addressing Internet based supply network integration, in particular an understanding of supply chain management, the emergent business models and evaluating the effects of deploying e-business to the supply network or a particular tier. It is important to utilize a contingent approach to selecting the right e-business model to meet the specific supply chain requirements. This paper addresses the issues and provides a case study on the indirect materials supply networks.
Woo, C.K.; Lloyd, D.; Borden, M.; Warrington, R.; Baskette, C.
Securing forward contracts to manage procurement-cost risk is an intuitively appealing and economically reasonable strategy for a load-serving local distribution company (LDC) in today's volatile electricity marketplace. However, knowing what to buy does not guarantee least-cost implementation. The forward-contract price quoted by a prospective seller may not be the 'best deal' that an LDC could have obtained, especially when the forward contract desired by the LDC is not actively traded. This paper reports the results from five internet-based auctions for electricity forward contracts with non-firm delivery and varying hourly quantities held monthly by a Florida municipal utility (MU) from September 2002 to January 2003. The results confirm that a multi-round auction design is robust in realizing competitive price offers made by credit-worthy sellers, time-efficient contracting, and consistent cost savings to the MU. Thus, the Anglo-Dutch auction described herein is a reasonable substitute for generation ownership by an LDC. (author)
Wan, Chunyang; Jiang, Yanqing
Internet based education media are developing at an amazing rate and being seen as an upstart that will likely take the place of traditional education means worldwide in the future. This paper presents the results of a comparative analysis on user preferences for four major categories of internet-based media used in China. In this paper, we first…
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This article presents an overview of internet-based research, highlighting the absence of a standard terminology to define and classify such research. The label internet-based research or online research can cover a diverse range of research designs and methods, involving different degrees of ethical concern regarding privacy, transparency,…
Tsai, Chin-Chung; Chuang, Shih-Chyueh; Liang, Jyh-Chong; Tsai, Meng-Jung
This paper reviews 46 papers from 1999 to 2009 regarding self-efficacy in Internet-based learning environments, and discusses three major categories of research: (1) learners' Internet self-efficacy, assessing learners' confidence in their skills or knowledge of operating general Internet functions or applications in Internet-based learning; (2)…
Limayem, Moez; Cheung, Christy M. K.
The proliferation and advance of Internet-based technologies create expanded opportunities for educators to provide students with better learning experiences. Although current studies focus mostly on the learning processes and learning outcomes, this article examines the students' usage behaviour with Internet-based learning technologies across…
Peng, Ying; Yan, Weirong
Internet-based learning is increasingly applied in medical education, but its effect in the field of public health training is still unclear. This meta-analysis was undertaken to explore the impact of Internet-based learning on students'/professionals' knowledge of public health compared with no intervention and with traditional face-to-face (FTF)…
Cook, David A.; Levinson, Anthony J.; Garside, Sarah
Authors have claimed that Internet-based instruction promotes greater learning efficiency than non-computer methods. Objectives Determine, through a systematic synthesis of evidence in health professions education, how Internet-based instruction compares with non-computer instruction in time spent learning, and what features of Internet-based…
Weidt, Steffi; Bruehl, Annette Beatrix; Delsignore, Aba; Zai, Gwyneth; Kuenburg, Alexa; Klaghofer, Richard; Rufer, Michael
Many patients suffering from trichotillomania (TTM) have never undergone treatment. Without treatment, TTM often presents with a chronic course. Characteristics of TTM individuals who have never been treated (untreated) remain largely unknown. Whether treatment history impacts Internet-based interventions has not yet been investigated. We aimed to answer whether Internet-based interventions can reach untreated individuals and whether treatment history is associated with certain characteristics and impacts on the outcome of an Internet-based intervention. We provided Internet-based interventions. Subjects were characterized at three time points using the Massachusetts General Hospital Hairpulling Scale, Hamilton Depression Rating Scale, and the World Health Organization Quality of Life questionnaire. Of 105 individuals, 34 were untreated. Health-related quality of life (HRQoL) was markedly impaired in untreated and treated individuals. Symptom severity did not differ between untreated and treated individuals. Nontreatment was associated with fewer depressive symptoms ( P =0.002). Treatment history demonstrated no impact on the outcome of Internet-based interventions. Results demonstrate that Internet-based interventions can reach untreated TTM individuals. They show that untreated individuals benefit as much as treated individuals from such interventions. Future Internet-based interventions should focus on how to best reach/support untreated individuals with TTM. Additionally, future studies may examine whether Internet-based interventions can reach and help untreated individuals suffering from other psychiatric disorders.
Full Text Available Abstract Background A national chlamydia screening programme is currently being rolled out in the UK and other countries. However, much of the epidemiology remains poorly understood. In this paper we present a stochastic, individual based, dynamic sexual network model of chlamydia transmission and its parameterisation. Mathematical models provide a theoretical framework for understanding the key epidemiological features of chlamydia: sexual behaviour, health care seeking and transmission dynamics. Results The model parameters were estimated either directly or by systematic fitting to a variety of appropriate data sources. The fitted model was representative of sexual behaviour, chlamydia epidemiology and health care use in England. We were able to recapture the observed age distribution of chlamydia prevalence. Conclusion Estimating parameters for models of sexual behaviour and transmission of chlamydia is complex. Most of the parameter values are highly correlated, highly variable and there is little empirical evidence to inform estimates. We used a novel approach to estimate the rate of active treatment seeking, by combining data sources, which improved the credibility of the model results. The model structure is flexible and is broadly applicable to other developed world settings and provides a practical tool for public health decision makers.
Full Text Available Infections caused by genus Chlamydia are challenging for phisicians, as a results of a complicated pathogenesis and a variable clinical picture. Furthermore, potential sequelae following Chlamydia trachomatis, Chlamydia pneumoniae, Chlamydia psittaci infections are of clinical relevant interest. Serodiagnosis is a clue tool when the direct antigen research or the bacteria fragments detection is impaired. Some serological tests such as the ELISA or the indirect micro-immunofluorescence methods are routinely performed. To improve the diagnostic efficiency of these tests, a selective coating of specie-specific reactive antigens on microwells or on microscopic slides is proposed.A highly selective coating is essential to generate a specific immune response for each Chlamydia species and high levels of distinct IgA, IgG, IgM antibody classes.The goal of serology is the diagnostic value of results, therefore the correct choice of the best screening and confirmation test is of extreme relevance due to the clinical impact of results for the therapeutical approach and management of acute and chronic infections. In conclusion, a quantitative specific anti-Chlamydia IgG and IgA antibody detection is a useful method to improve the follow up of complicated chronic clinical sequelae.
Kadi, Z; Bouguermouh, A; Ait-Mokhtar, N; Allouache, A; Ziat, A; Orfilla, J
The prevalence of anti-Chlamydia antibodies was studied among 329 patients divided into 5 groups, 34 (36%) of the women with a low genital infection have antibodies at a titre greater than 16 versus 12 (17%) of the patients attending the women's clinic for routine pelvic examination. 44 (100%) of 44 prostitutes had antibodies greater than 16 meanwhile only 2 (7%) of 30 women attending an obstetric clinic had antibodies greater than 16. Titres suggesting active chlamydial infection were found in prostitutes (95%), women with low genital infection (17%) and patients attending a cancer screening clinic (11%). In other hand, using immunofluorescence test with monoclonal anti Chlamydia trachomatis antibodies, 20 (45.5%) of the prostitutes were found antigen positive.
Westh, H.; Kolmos, H J
OBJECTIVE: To examine the impact of a stable, large-scale enzyme immunoassay (EIA) Chlamydia trachomatis testing situation in Copenhagen, and to estimate the impact of introducing a genomic-based assay with higher sensitivity and specificity. METHODS: Over a five-year study period, 25 305-28 505...... and negative predictive values of the Chlamydia test result, new screening strategies for both men and women in younger age groups will be necessary if chlamydial infections are to be curtailed....
Pannekoek, Y.; Dickx, V.; Beeckman, D.S.A.; Jolley, K.A.; Keijzers, W.C.; Vretou, E.; Maiden, M.C.J.; Vanrompay, D.; van den Ende, A.
Chlamydia comprises a group of obligate intracellular bacterial parasites responsible for a variety of diseases in humans and animals, including several zoonoses. Chlamydia trachomatis causes diseases such as trachoma, urogenital infection and lymphogranuloma venereum with severe morbidity.
Brandt, Jason; Rogerson, Mark
The identification of individuals who are at high risk of dementia may lead to earlier detection and diagnosis. In this study, we describe the development and preliminary validation of a very brief, Internet-based risk assessment tool. The Dementia Risk Assessment collected information on demographic, neurologic, and medical risk factors; perceived cognitive functioning; and emotional symptoms. Participants answered questions pertaining to themselves ("patient page") or to a relative or friend ("proxy page"). Patients also completed a novel short-delayed recognition memory test. Subjects received personalized feedback about their risk factors and were advised to seek clinical evaluation for concerning symptoms. By November 2009, 500 respondents completed the patient page. The 352 respondents aged 50 years or older (M = 62 years) included a high percentage of women (72%) and college graduates (67%). Among the respondents, only 10% complained of having severe memory problems, whereas 38% reported having a first-degree relative who experienced severe memory loss. The prevalence of major neurologic risk factors was low. Although the delay interval for the recognition memory test averaged around 2 minutes, there was sufficient variability in performance. Individuals with scores ≤10th percentile were significantly older and more likely to be men, have hypertension, and report having severe memory problems. History of major dementia risk factors can be ascertained through the Internet, and several of these factors are shown to be moderately predictive of performance on a brief test of episodic memory. These data provide preliminary validation of the Dementia Risk Assessment for identifying current cognitive impairment, and suggest its potential for assessing future dementia risk. Ongoing studies will further establish the validity of these findings against proxy reports of cognitive and functional decline, the results of more detailed cognitive assessments, and formal
Maio Maurício de
Full Text Available PURPOSE: The Internet expands the range and flexibility of teaching options and enhances the ability to process the ever-increasing volume of medical knowledge. The aim of this study is to describe and discuss our experience with transforming a traditional medical training course into an Internet-based course. METHOD: Sixty-nine students were enrolled for a one-month course. They answered pre- and post-course questionnaires and took a multiple-choice test to evaluate the acquired knowledge. RESULTS: Students reported that the primary value for them of this Internet-based course was that they could choose the time of their class attendance (67%. The vast majority (94% had a private computer and were used to visiting the Internet (75% before the course. During the course, visits were mainly during the weekends (35% and on the last week before the test (29%. Thirty-one percent reported that they could learn by reading only from the computer screen, without the necessity of printed material. Students were satisfied with this teaching method as evidenced by the 89% who reported enjoying the experience and the 88% who said they would enroll for another course via the Internet. The most positive aspect was freedom of scheduling, and the most negative was the lack of personal contact with the teacher. From the 80 multiple-choice questions, the mean of correct answers was 45.5, and of incorrect, 34.5. CONCLUSIONS: This study demonstrates that students can successfully learn with distance learning. It provides useful information for developing other Internet-based courses. The importance of this new tool for education in a large country like Brazil seems clear.
Shaw, A.C.; Vandahl, B.B.; Larsen, M.R.
Chlamydiae are obligate intracellular bacteria that are important human pathogens. The Chlamydia genomes contain orthologues to secretion apparatus proteins from other intracellular bacteria, but only a few secreted proteins have been identified. Most likely, effector proteins are secreted in order...... to promote infection. Effector proteins cannot be identified by motif or similarity searches. As a new strategy for identification of secreted proteins we have compared 2D-PAGE profiles of [35S]-labelled Chlamydia proteins from whole lysates of infected cells to 2D-PAGE profiles of proteins from purified...... Chlamydia. Several secretion candidates from Chlamydia trachomatis D and Chlamydia pneumoniae were detected by this method. Two protein spots were identified among the candidates. These represent fragments of the 'chlamydial protease- or proteasome-like activity factor' (CPAF) and were clearly present in 2D...
Van Voorhees, Benjamin W; Fogel, Joshua; Pomper, Benjamin E; Marko, Monika; Reid, Nicholas; Watson, Natalie; Larson, John; Bradford, Nathan; Fagan, Blake; Zuckerman, Steve; Wiedmann, Peggy; Domanico, Rocco
BACKGROUND: Internet-based interventions for education and behavior change have proliferated, but most adolescents may not be sufficiently motivated to engage in Internet-based behavior change interventions. We sought to determine how two different forms of primary care physician engagement, brief advice (BA) versus motivational interview (MI), could enhance participation outcomes in an Internet-based depression prevention intervention. METHODS: Eighty-three adolescents at risk for developing major depression were recruited by screening in primary care and randomized to two groups: BA (1-2 minutes) + Internet program versus MI (10-15 minutes) + Internet program. We compared measures of participation and satisfaction for the two groups for a minimum of 12 months after enrollment. RESULTS: Both groups engaged the site actively (MI: 90% versus BA: 78%, p=0.12). MI had significantly higher levels of engagement than BA for measures including total time on site (143.7 minutes versus 100.2 minutes, p=0.03), number of sessions (8.16 versus 6.00, p=0.04), longer duration of session activity on Internet site (46.2 days versus 29.34 days, p=0.04), and with more characters typed into exercises (3532 versus 2004, p=0.01). Adolescents in the MI group reported higher trust in their physician (4.18 versus 3.74, p=0.05) and greater satisfaction with the Internet-based component (7.92 versus 6.66, p=0.01). CONCLUSIONS: Primary care engagement, particularly using motivational interviewing, may increase Internet use dose, and some elements enhance and intensify adolescent use of an Internet-based intervention over a one to two month period. Primary care engagement may be a useful method to facilitate adolescent involvement in preventive mental health interventions.
Al-Durra, Mustafa; Torio, Monika-Bianca; Cafazzo, Joseph A
The high prevalence rate of asthma represents a major societal burden. Advancements in information technology continue to affect the delivery of patient care in all areas of medicine. Internet-based solutions, social media, and mobile technology could address some of the problems associated with increasing asthma prevalence. This review evaluates Internet-based asthma interventions that were published between 2004 and October 2014 with respect to the use of behavioral change theoretical frameworks, applied clinical guidelines, and assessment tools. The search term (Asthma AND [Online or Internet or Mobile or Application or eHealth or App]) was applied to six bibliographic databases (Ovid MEDLINE, PubMed, BioMed Central, ProQuest Computing, Web of Knowledge, and ACM Digital Library) including only English-language articles published between 2004 and October 2014. In total, 3932 articles matched the priori search terms and were reviewed by the primary reviewer based on their titles, index terms, and abstracts. The matching articles were then screened by the primary reviewer for inclusion or exclusion based on their abstract, study type, and intervention objectives with respect to the full set of priori inclusion and exclusion criteria; 331 duplicates were identified and removed. A total of 85 articles were included for in-depth review and the remaining 3516 articles were excluded. The primary and secondary reviewer independently reviewed the complete content of the 85 included articles to identify the applied behavioral change theories, clinical guidelines, and assessment tools. Findings and any disagreement between reviewers were resolved by in-depth discussion and through a consolidation process for each of the included articles. The reviewers identified 17 out of 85 interventions (20%) where at least one model, framework, and/or construct of a behavioral change theory were applied. The review identified six clinical guidelines that were applied across 30 of the 85
Full Text Available The mental health of young people is decreasing. It is therefore important to develop early interventions for young people with mental health problems. One previous randomized controlled trial on tailored Internet-based treatment for young adults with minimal therapist guidance has shown promising results for anxiety symptoms. The purpose of this study was to investigate the effects of tailored internet-administered CBT for young adults (16–25 years old with anxiety, depression and possible comorbidity in regular care. Participants were recruited from a youth health care centre (n = 15. Screening consisted of online questionnaires followed by a semi-structured interview. A total of 10 participants completed pre and post measurement. The treatment consisted of individually prescribed CBT text modules with online therapist guidance. All dependent measures improved significantly immediately following treatment and the within-group effect based on pre- to post measurement on the primary outcome measure, the Beck Anxiety Inventory, was d = 1.50, the within-group effect on the secondary outcome measures, Montgomery Åsberg Depression Rating Scale-Self-Rated, Clinical Outcomes in Routine Evaluation and Quality of Life Inventory showed large improvement. Tailored internet-based treatment can be an approach in the treatment of anxiety symptoms and comorbid depressive symptoms in youth care.
ten Hoor, Gill; Hoebe, Christian Jpa; van Bergen, Jan Eam; Brouwers, Elfi Ehg; Ruiter, Robert Ac; Kok, Gerjo
In The Netherlands, screening for chlamydia (the most prevalent sexually transmitted infection worldwide) is a relatively simple and free procedure. Via an invitation letter sent by the public health services (PHS), people are asked to visit a website to request a test kit. They can then do a
G.I.J.G. Rours (Ingrid); M.R. Hammerschlag; A. Ott (Alewijn); J.T.H.N. de Faber; H.A. Verbrugh (Henri); R. de Groot (Ronald); R.P.A.J. Verkooyen (Roel)
textabstractBACKGROUND. Chlamydia trachomatis is the most common sexually transmitted pathogen in adults, which at delivery may be transmitted from mother to child and cause conjunctivitis and pneumonia. In the Netherlands, prenatal chlamydial screening and treatment of pregnant women is not routine
Rours, I.G.; Hammerschlag, M.R.; Ott, A.; Faber, T.J. de; Verbrugh, H.A.; Groot, R. de; Verkooyen, R.P.
BACKGROUND: Chlamydia trachomatis is the most common sexually transmitted pathogen in adults, which at delivery may be transmitted from mother to child and cause conjunctivitis and pneumonia. In The Netherlands, prenatal chlamydial screening and treatment of pregnant women is not routine practice.
Lindholt, J.S; Juul, Svend; Vammen, S
BACKGROUND: The aim of this study was to examine the possible association between the progression of small abdominal aortic aneurysm (AAA) and chronic infection with Chlamydia pneumoniae. METHODS: Patients from a hospital-based mass screening programme for AAA with annual follow-up (mean 2.7 years...
Satpathy, G; Mohanty, S; Pani, S P; Panda, S K
OBJECTIVE: To determine the presence of Chlamydia trachomatis in hydrocele fluid. METHODS: 90 male patients with hydrocele of tunica vaginalis from an endemic area for bancroftian filariasis were investigated for the presence of Chlamydia trachomatis in their hydrocele fluids. C trachomatis antigen detection tests-a direct immunofluorescence assay and an enzyme immunoassay along with polymerase chain reaction assay for amplification of a 517 bp fragment of C trachomatis endogenous plasmid-were used in this study. The patients were also tested for the presence of microfilaria in their hydrocele fluids and night blood. Histopathological examination was carried out to detect adult filarial worm in tunica vaginalis testes. RESULTS: Eight (8.88%) patients had chlamydia antigen in the hydrocele fluids; C trachomatis plasmid sequences could be amplified from five of these. Seven (7.77%) patients had microfilaria in the hydrocele fluids, three of them having adult worm in tunica vaginalis. CONCLUSION: C trachomatis infection might be associated with hydrocele in some of these patients. PMID:9582470
Blanken, I.; Leusink, P.; van Diest, S.; Gijs, L.; van Lankveld, J.J.D.M.
The authors investigated whether baseline and therapy process characteristics of 82 heterosexual men participating in an Internet-based sex therapy study predict posttreatment sexual functioning. Problem severity, baseline sexual desire and baseline sexual satisfaction, but also partner problems and
Pequegnat, Willo; Rosser, B R Simon; Bowen, Anne M; Bull, Sheana S; DiClemente, Ralph J; Bockting, Walter O; Elford, Jonathan; Fishbein, Martin; Gurak, Laura; Horvath, Keith; Konstan, Joseph; Noar, Seth M; Ross, Michael W; Sherr, Lorraine; Spiegel, David; Zimmerman, Rick
The aim of this paper is to advance rigorous Internet-based HIV/STD Prevention quantitative research by providing guidance to fellow researchers, faculty supervising graduates, human subjects' committees, and review groups about some of the most common and challenging questions about Internet-based HIV prevention quantitative research. The authors represent several research groups who have gained experience conducting some of the first Internet-based HIV/STD prevention quantitative surveys in the US and elsewhere. Sixteen questions specific to Internet-based HIV prevention survey research are identified. To aid rigorous development and review of applications, these questions are organized around six common criteria used in federal review groups in the US: significance, innovation, approach (broken down further by research design, formative development, procedures, sampling considerations, and data collection); investigator, environment and human subjects' issues. Strategies promoting minority participant recruitment, minimizing attrition, validating participants, and compensating participants are discussed. Throughout, the implications on budget and realistic timetabling are identified.
Guay, Cassioppée; Auger, Claudine; Demers, Louise; Mortenson, W Ben; Miller, William C; Gélinas-Bronsard, Dominique; Ahmed, Sara
Background When trying to access interventions to improve their well-being and quality of life, family caregivers face many challenges. Internet-based interventions provide new and accessible opportunities to remotely support them and can contribute to reducing their burden. However, little is known about the link existing between the components, the use of behavior change techniques, and the outcomes of these Internet-based interventions. Objective This study aimed to provide an update on th...
Yuon, Egor; Soukhanov, Mikhail; Markov, Kirill
is the web-service, which realizes the interaction of all parts of the system and controls whole the way of the request from the user to the database and back, adopted to the GeoSciML and EarthResourceML view. The experience of creation the Internet-based information system of digital geological data providing, and also previous works, including the developing of web-service of NGKIS-system, allows to tell, that technological realization of presenting Russian geological-cartographical data with using of international standards is possible. While realizing, it could be some difficulties, associated with geological material depth. Russian informational geological model is more deep and wide, than foreign. This means the main problem of using international standards and formats: Russian geological data presentation is possible only with decreasing the data detalisation. But, such a problem becomes not very important, if the service publishes also Russian vocabularies, not associated with international vocabularies. In this case, the international format could be the interchange format to change data between Russian users. The integration into the international projects reaches developing of the correlation schemes between Russian and foreign classificators and vocabularies.
Park, Eunhee; Drake, Emily
To review the characteristics and effects Internet-based youth smoking prevention and cessation programs. Systematic review of published articles in peer-reviewed journals in the past 10 years, focused on Internet-based youth smoking prevention and cessation programs. Twelve articles were selected based on the following criteria: studies reporting the outcomes of Internet-based smoking cessation or prevention intervention programs for adolescents who are younger than 24 years. The components of youth Internet-based smoking intervention programs are analyzed based on study features (i.e., sample, design, theoretical basis, analysis, outcome measures) and program characteristics (i.e., focus, setting, frequency, duration, intensity, and different components) that make the programs effective. The most common components of effective Internet-based programs are identified as the following: the use of multimedia, tailored approaches, personalized feedback, and interactive features. The characteristics and effects of the programs vary, but most programs show positive results in youth smoking prevention and cessation in spite of the studies' limitations. The evidence from this review provides useful information of recent efforts related to Internet-based youth smoking prevention and cessation programs, which can have significant clinical implications in developing future innovative youth smoking prevention and intervention programs. © 2014 Sigma Theta Tau International.
Philip A. Chan
Full Text Available In the United States, sexually transmitted diseases due to Chlamydia trachomatis and Neisseria gonorrhoeae continue to be a major public health burden. Screening of extragenital sites including the oropharynx and rectum is an emerging practice based on recent studies highlighting the prevalence of infection at these sites. We reviewed studies reporting the prevalence of extragenital infections in women, men who have sex with men (MSM, and men who have sex only with women (MSW, including distribution by anatomical site. Among women, prevalence was found to be 0.6–35.8% for rectal gonorrhea (median reported prevalence 1.9%, 0–29.6% for pharyngeal gonorrhea (median 2.1%, 2.0–77.3% for rectal chlamydia (median 8.7%, and 0.2–3.2% for pharyngeal chlamydia (median 1.7%. Among MSM, prevalence was found to be 0.2–24.0% for rectal gonorrhea (median 5.9%, 0.5–16.5% for pharyngeal gonorrhea (median 4.6%, 2.1–23.0% for rectal chlamydia (median 8.9%, and 0–3.6% for pharyngeal chlamydia (median 1.7%. Among MSW, the prevalence was found to be 0–5.7% for rectal gonorrhea (median 3.4%, 0.4–15.5% for pharyngeal gonorrhea (median 2.2%, 0–11.8% for rectal chlamydia (median 7.7%, and 0–22.0% for pharyngeal chlamydia (median 1.6%. Extragenital infections are often asymptomatic and found in the absence of reported risk behaviors, such as receptive anal and oral intercourse. We discuss current clinical recommendations and future directions for research.
Chlamydia trachomatis was isolated from 58.5% of 159 patients with non-specific urethritis (NSU) using irradiated McCoy cell cultures. Patients with persistent Chlamydia-positive NSU remained Chlamydia-positive each time they were examined before treatment and patients with Chlamydia-negative NSU remained Chlamydia-negative during the course of the illness. Neither the duration of symptoms of urethritis nor a history of previous urethritis affected the chlamydial isolation rate significantly. Of 40 patients with severe discharge 30 (75%) harboured C. trachomatis. One-third of the Chlamydia-positive patients had a severe urethral discharge, while this was present in only 15% of Chlamydia-negative patients. Complications--such as conjunctivitis, arthritis, and epididymitis--were more severe in men with Chlamdia-positive NSU than in those with Chlamydia-negative NSU. Of 64 men matched for sexual promiscuity but without urethritis, none harboured C. trachomatis in his urethra. This differs significantly (P less than 0.001) when compared with patients with NSU. C. trachomatis was isolated from the urogenital tract in 24 (42%) out of 57 female sexual contacts of patients with NSU. The presence of C. trachomatis in the women correlated significantly (P less than 0.001) with the isolation of the agent from their male contacts. These findings give further evidence for the aetiological role of C. trachomatis in non-specific urethritis and its sexual transmission. PMID:678958
Keywords: Chlamydia trachomatis, Neisseria gonor- rhoeae, at-risk women, Kumasi metropolis. INTRODUCTION. Chlamydia trachomatis is a small obligate intracellular bacterium transmitted by sexual intercourse. It is a cause of endocervicitis and also pelvic inflammatory disease (PID) in women.1,2,3 Chlamydial infection ...
The prevalence of Chlamydia trachomatis infection was investigated among 100 women attending infertility clinics and compared with another subset of 100 pregnant women who served as control. Chlamydia trachomatis antigen detection cassette supplied by Biomil Diagnostics was used to detect the presence of ...
Background: Genital Chlamydia trachomatis infection is a common bacterial sexually transmitted infection worldwide. There is little information about this infection in Nigeria. This study determined the prevalence of genital Chlamydia trachomatis infection among female undergraduates of University of Port Harcourt and ...
Jul 11, 2011 ... application of direct immunofluorescence in the diagnostics of. Chlamydia trachomatis in the East Bohemian Region of Czech. Republic during 1997-2003. Ceska Gynekol. 70:128-33. Gerris H (2005). Molecular diagnostic methods for the Detection of. Neisseria gonorrheae and Chlamydia trachomatis. Rev ...
Lundemose, A G; Banner, Jytte; Birkelund, Svend
A procedure to detect Chlamydia in postmortal formalin-fixed tissue is described. Monoclonal antibodies against a genus specific chlamydia epitope were used in immunofluorescence to detect chlamydia inclusions in formalin-fixed tissue sections. Lung sections from chlamydia-infected mice were exam...
Clarke, James; White, K A Jane; Turner, Katy
Chlamydia has a significant impact on public health provision in the developed world. Using pair approximation equations we investigate the efficacy of control programmes for chlamydia on short time scales that are relevant to policy makers. We use output from the model to estimate critical measures, namely, prevalence, incidence, and positivity in those screened and their partners. We combine these measures with a costing tool to estimate the economic impact of different public health strategies. Increasing screening coverage significantly increases the annual programme costs whereas an increase in tracing efficiency initially increases annual costs but over time reduces costs below baseline, with tracing accounting for around 10% of intervention costs. We found that partner positivity is insensitive to changes in prevalence due to screening, remaining at around 33%. Whether increases occur in screening or tracing levels, the cost per treated infection increases from the baseline because of reduced prevalence.
Davies, Bethan; Turner, Katy M E; Frølund, Maria
BACKGROUND: Uncertainty in the risk of reproductive complications (pelvic inflammatory disease, ectopic pregnancy, and tubal factor infertility) following chlamydia infection and repeat infection hampers the design of evidence-based chlamydia control programmes. We estimate the association between...... diagnosed chlamydia and episodes of hospital health care (inpatient, outpatient, and emergency department) for a reproductive complication. METHODS: We constructed and analysed a retrospective population-based cohort of women aged 15-44 years from administrative records in Denmark (1995-2012). We used...... a subset of the national Danish Chlamydia Study. The master dataset contains all residents of Denmark (including Greenland) who had a positive chlamydia test recorded by a public health microbiology laboratory from Jan 1, 1992, to Nov 2, 2011. Individuals were randomly matched (by age and sex) to four...
Satterwhite, Catherine Lindsey; Grier, LaZetta; Patzer, Rachel; Weinstock, Hillard; Howards, Penelope P; Kleinbaum, David
Annual chlamydia screening is recommended for all sexually active women aged clinics reporting data to IPP. Using the clinic as the unit of analysis, a correlated, longitudinal data analysis with a random intercept was conducted among clinics reporting ≥3 years of data during the analysis timeframe. Sensitivity analyses were performed to address the impact of various clinic participation levels in addition to the assessment of various correlation structures. Over 5 million chlamydia tests were reported to IPP family planning clinics from 2004 to 2008. A majority of tests were conducted among white women (clinic-specific mean: 63.2%, interquartile range: 37.6%-91.5%); the clinic-specific mean percent of tests conducted among black women was 17.9% (interquartile range: 0.8%-25.7%). Overall chlamydia positivity from 2004 to 2008 was 7.0%. The odds ratio associated with a single year change (1.00; 95% confidence interval: 0.99, 1.00) suggested that chlamydia positivity did not change from 2004 to 2008, after controlling for clinic-specific population factors (age, race, test usage, and geography). Findings support previous analyses suggesting that chlamydia prevalence is not increasing despite apparent increasing rates based on case reports.
Kantar, Rami S; Plana, Natalie M; Cutting, Court B; Diaz-Siso, Jesus Rodrigo; Flores, Roberto L
In October 2012, a freely available, internet-based cleft simulator was created in partnership between academic, nonprofit, and industry sectors. The purpose of this educational resource was to address global disparities in cleft surgery education. This report assesses demographics, usage, and global effect of our simulator, in its fifth year since inception. Evaluate the global effect, usage, and demographics of an internet-based educational digital simulation cleft surgery software. Simulator modules, available in five languages demonstrate surgical anatomy, markings, detailed procedures, and intraoperative footage to supplement digital animation. Available data regarding number of users, sessions, countries reached, and content access were recorded. Surveys evaluating the demographic characteristics of registered users and simulator use were collected by direct e-mail. The total number of simulator new and active users reached 2865 and 4086 in June 2017, respectively. By June 2017, users from 136 countries had accessed the simulator. From 2015 to 2017, the number of sessions was 11,176 with a monthly average of 399.0 ± 190.0. Developing countries accounted for 35% of sessions and the average session duration was 9.0 ± 7.3 minutes. This yields a total simulator screen time of 100,584 minutes (1676 hours). Most survey respondents were surgeons or trainees (87%) specializing in plastic, maxillofacial, or general surgery (89%). Most users found the simulator to be useful (88%), at least equivalent or more useful than other resources (83%), and used it for teaching (58%). Our internet-based interactive cleft surgery platform reaches its intended target audience, is not restricted by socioeconomic barriers to access, and is judged to be useful by surgeons. More than 4000 active users have been reached since inception. The total screen time over approximately 2 years exceeded 1600 hours. This suggests that future surgical simulators of this kind may be sustainable by
Sundström, Christopher; Kraepelien, Martin; Eék, Niels; Fahlke, Claudia; Kaldo, Viktor; Berman, Anne H
A large proportion of individuals with alcohol problems do not seek psychological treatment, but access to such treatment could potentially be increased by delivering it over the Internet. Cognitive behavior therapy (CBT) is widely recognized as one of the psychological treatments for alcohol problems for which evidence is most robust. This study evaluated a new, therapist-guided internet-based CBT program (entitled ePlus) for individuals with alcohol use disorders. Participants in the study (n = 13) were recruited through an alcohol self-help web site ( www.alkoholhjalpen.se ) and, after initial internet screening, were diagnostically assessed by telephone. Eligible participants were offered access to the therapist-guided 12-week program. The main outcomes were treatment usage data (module completion, treatment satisfaction) as well as glasses of alcohol consumed the preceding week, measured with the self-rated Timeline Followback (TLFB). Participant data were collected at screening (T0), immediately pre-treatment (T1), post-treatment (T2) and 3 months post-treatment (T3). Most participants were active throughout the treatment and found it highly acceptable. Significant reductions in alcohol consumption with a large within-group effect size were found at the three-month follow-up. Secondary outcome measures of craving and self-efficacy, as well as depression and quality of life, also showed significant improvements with moderate to large within-group effect sizes. Therapist-guided internet-based CBT may be a feasible and effective alternative for people with alcohol use disorders. In view of the high acceptability and the large within-group effect sizes found in this small pilot, a randomized controlled trial investigating treatment efficacy is warranted. ClinicalTrials.gov ( NCT02384278 , February 26, 2015).
Seo, Dong-Chul; Niu, Jingjing
Internet-based interventions are more cost-effective than conventional interventions and can provide immediate, easy-to-access, and individually tailored support for behavior change. Waist circumference is a strong predictor of an increased risk for a host of diseases, such as hypertension, diabetes, and dyslipidemia, independent of body mass index. To date, no study has examined the effect of Internet-based lifestyle interventions on waist circumference change. This study aimed to systematically review the effect of Internet-based interventions on waist circumference change among adults. This meta-analysis reviewed randomized controlled trials (N=31 trials and 8442 participants) that used the Internet as a main intervention approach and reported changes in waist circumference. Internet-based interventions showed a significant reduction in waist circumference (mean change -2.99 cm, 95% CI -3.68 to -2.30, I(2)=93.3%) and significantly better effects on waist circumference loss (mean loss 2.38 cm, 95% CI 1.61-3.25, I(2)=97.2%) than minimal interventions such as information-only groups. Meta-regression results showed that baseline waist circumference, gender, and the presence of social support in the intervention were significantly associated with waist circumference reduction. Internet-based interventions have a significant and promising effect on waist circumference change. Incorporating social support into an Internet-based intervention appears to be useful in reducing waist circumference. Considerable heterogeneity exists among the effects of Internet-based interventions. The design of an intervention may have a significant impact on the effectiveness of the intervention.
Green, Michael L; Reddy, Siddharta G; Holmboe, Eric
Diplomates in the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) program satisfy the self-evaluation of medical knowledge requirement by completing open-book multiple-choice exams. However, this method remains unlikely to affect practice change and often covers content areas not relevant to diplomates' practices. We developed and evaluated an Internet-based point of care (POC) learning portfolio to serve as an alternative. Participants enter information about their clinical questions, including characteristics, information pursuit, application, and practice change. After documenting 20 questions, they reflect upon a summary report and write commitment-to-change statements about their learning strategies. They can link to help screens and medical information resources. We report on the beta test evaluation of the module, completed by 23 internists and 4 internal medicine residents. Participants found the instructions clear and navigated the module without difficulty. The majority preferred the POC portfolio to multiple-choice examinations, citing greater relevance to their practice, guidance in expanding their palette of information resources, opportunity to reflect on their learning needs, and "credit" for self-directed learning related to their patients. Participants entered a total of 543 clinical questions, of which 250 (46%) resulted in a planned practice change. After completing the module, 14 of 27 (52%) participants committed to at least 1 change in their POC learning strategies. Internists found the portfolio valuable, preferred it to multiple-choice examinations, often changed their practice after pursuing clinical questions, and productively reflected on their learning strategies. The ABIM will offer this portfolio as an elective option in MOC.
Full Text Available Background: The prevalence of anxiety disorders among children and adolescents are found to be approximately between 8–12 and 5–10, respectively, and the long-lasting effects of such disorders can expose the sufferers to impairment and dysfunction in several areas of life the examples of which are poor educational performance, low self-esteem, and depression. The present study aims to evaluate the efficacy of internet-based, cognitive-behavioral therapy (ICBT in treating the anxiety disorders among adolescent females. Materials and Methods: The sample included thirty girls aged between 10 and 18 years suffering from a variety of anxiety disorders, under pharmaceutical therapy and referred to clinics of child and adolescent psychiatry specialists in Isfahan. The sample was selected through diagnostic interviews by psychiatrists based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision; afterward, they were randomly assigned to either the experimental or the control groups. To evaluate the efficacy of an ICBT in reducing anxiety disorder symptoms, Screen for Child Anxiety Related Emotional Disorders questionnaire was administered among the patients both before and 4 weeks after the treatment. Results: The covariance analysis results aimed to compare the anxiety disorder score variations between the two groups which demonstrate the fact that anxiety disorder scores in these two groups differ from one another (P < 0.001. Conclusions: This study is comprised of two Conclusions.the significant reduction in the mean of anxiety disorders scores in the experimental group compared to those in control group can be indicative of the efficacy of ICBT. In addition the significant reduction in the average of anxiety disorders symptoms' scores according to the type of anxiety disorders in the experimental group, compared to those in control group, can be indicative of the efficacy of ICBT.
Cetinceviz, Yucel; Bayindir, Ramazan
The network requirements of control systems in industrial applications increase day by day. The Internet based control system and various fieldbus systems have been designed in order to meet these requirements. This paper describes an Internet based control system with wireless fieldbus communication designed for distributed processes. The system was implemented as an experimental setup in a laboratory. In industrial facilities, the process control layer and the distance connection of the distributed control devices in the lowest levels of the industrial production environment are provided with fieldbus networks. In this paper, the Internet based control system that will be able to meet the system requirements with a new-generation communication structure, which is called wired/wireless hybrid system, has been designed on field level and carried out to cover all sectors of distributed automation, from process control, to distributed input/output (I/O). The system has been accomplished by hardware structure with a programmable logic controller (PLC), a communication processor (CP) module, two industrial wireless modules and a distributed I/O module, Motor Protection Package (MPP) and software structure with WinCC flexible program used for the screen of Scada (Supervisory Control And Data Acquisition), SIMATIC MANAGER package program ("STEP7") used for the hardware and network configuration and also for downloading control program to PLC. Copyright © 2012 ISA. Published by Elsevier Ltd. All rights reserved.
Hemelrijk, E.; van Ballegooijen, W.; Donker, T.; van Straten, A.; Kerkhof, A.J.F.M.
Background: Common mental disorders have been found to be related to suicidal ideation and behavior. Research in the field of web-based interventions for common mental disorders, however, usually excludes participants with a suicidal risk, although a large proportion of participants might suffer
Full Text Available Internet-based systems for epidemiological studies have advantages over traditional approaches as they can potentially recruit and monitor a wider range of individuals in a relatively inexpensive fashion. We studied the association between communication strategies used for recruitment (offline, online, face-to-face and follow-up participation in nine Internet-based cohorts: the Influenzanet network of platforms for influenza surveillance which includes seven cohorts in seven different European countries, the Italian birth cohort Ninfea and the New Zealand birth cohort ELF. Follow-up participation varied from 43% to 89% depending on the cohort. Although there were heterogeneities among studies, participants who became aware of the study through an online communication campaign compared with those through traditional offline media seemed to have a lower follow-up participation in 8 out of 9 cohorts. There were no clear differences in participation between participants enrolled face-to-face and those enrolled through other offline strategies. An Internet-based campaign for Internet-based epidemiological studies seems to be less effective than an offline one in enrolling volunteers who keep participating in follow-up questionnaires. This suggests that even for Internet-based epidemiological studies an offline enrollment campaign would be helpful in order to achieve a higher participation proportion and limit the cohort attrition.
Cicila, Larisa N; Georgia, Emily J; Doss, Brian D
Although there are a number of highly efficacious in-person treatments designed to ameliorate relationship distress, only a small proportion of distressed couples seek out in-person treatment. Recently developed internet-based interventions based on these in-person treatments are a promising way to circumvent common barriers to in-person treatment and give more distressed couples access to these efficacious interventions. The overarching aims of this review are to provide couple and family therapists with a broad overview of the available internet-based interventions and provide suggestions about how these interventions might be utilized before, during, or after in-person treatment. First, we review internet-based interventions targeting individual psychopathology (e.g. anxiety and depression). These interventions would be particularly useful as an adjunctive resource for in-person couple or family therapy when referrals for a concurrent in-person individual therapist are not feasible (because of time, financial, or geographic constraints). The majority of the review centers on internet-based interventions for distressed couples and covers four distinct types of resources: relationship advice websites, assessment/feedback interventions, enrichment interventions for satisfied couples, and interventions targeting at-risk or distressed couples. We close with a case study of one couple's journey through a newly developed intervention targeting at-risk couples, OurRelationship.com, and provide two appendices with information on currently available internet-based interventions.
Brandt, Jason; Blehar, Justin; Anderson, Allan; Gross, Alden L
Most approaches to the detection of presymptomatic or prodromal Alzheimer's disease require the costly collection and analysis of biological samples or neuroimaging measurements. The Dementia Risk Assessment (DRA) was developed to facilitate this detection by collecting self-report and proxy-report of dementia risk variables and episodic memory performance on a free Internet website. We now report two validation studies. In Study 1, 130 community-residing older adults seeking memory screening at senior health fairs were tested using the Mini-Cog, and were then observed while taking the DRA. They were compared to a demographically-matched subsample from our anonymous Internet sample. Participants seeking memory screening had more dementia risk factors and obtained lower scores on the DRA's recognition memory test (RMT) than their Internet controls. In addition, those who failed the Mini-Cog obtained much lower scores on the RMT than those who passed the Mini-Cog. In Study 2, 160 older adults seeking evaluation of cognitive difficulties took the DRA prior to diagnostic evaluations at outpatient dementia clinics. Patients who ultimately received the diagnosis of a dementia syndrome scored significantly lower on the RMT than those diagnosed with other conditions or deemed normal. Lower education, family history of dementia, presence of hypercholesterolemia and diabetes, and memory test score distinguished the dementia and no-dementia groups with around 82% accuracy. In addition, score on the RMT correlated highly with scores on other instruments widely used to detect cognitive decline. These findings support the concurrent validity of the DRA for detecting prevalent cognitive impairment. Prospective studies of cognitively normal persons who subsequently develop dementia will be necessary to establish its predictive validity.
Full Text Available Chlamydia trachomatis is the most common cause of curable bacterial sexually transmitted infection (STI worldwide. It manifests primarily as urethritis in males and endocervicitis in females. Untreated chlamydial infection in man can cause epididymitis and proctitis. Though most women with Chlamydia infection are asymptomatic or have minimal symptoms, some develop salpingitis, endometritis, pelvic inflammatory disease (PID, ectopic pregnancy and tubal factor infertility. It is associated with an increased risk for the transmission or acquisition of HIV and is also attributed to be a risk factor for the development of cervical carcinoma. Early diagnosis and treatment of infected individuals is required to prevent the spread of the disease and severe sequelae. Traditionally, tissue culture was considered the gold standard for the diagnosis. However, with the availability of newer diagnostic techniques particularly molecular methods which are not only highly sensitive and specific but are cost-effective also, the diagnosis has became fast and easy. The purpose of this review is to study the various aspects of genital C. trachomatis infection. Also the advances related to the clinical picture, various diagnostic modalities, prevention, treatment, drug resistance and control measures will be dealt with.
Full Text Available Introduction: Chlamydia trachomatis infection is a common pathogen in sexual transmitted disease, but most of female patients with this infection are asymptomatic. Sequealae include pelvic inflammatory disease, infertility and ectopic pregnancy. The aim of the study was to determine the association between Chlamydia trachomatis and tubal factor infertility, if significant. Methods: This prospective, case -control study was done in April 2005-April2006. The study group consisted of 125 patients with tubal factor infertility and the control group included 125 fertile women. The level of antibodies to Chlamydia trachomatis was determined in both groups by ELIZA method. Results: Antibody to Chlamydia trachomatis was present in 29 women in the study group (23.2% and in15 women in the control group ( 12%, respectively, (P< 0.005. The mean level of antibody in both groups was 0.76 and 0.49, respectively (P<0.0005. Conclusion: The study showed that the level of antibody against Chlamydia is significantly more in tubal factor infertile women. We therefore suggest the screening of Chlamydia antibody testing is necessary for tubal factor infertility workup.
Beukes, Eldré W; Allen, Peter M; Manchaiah, Vinaya; Baguley, David M; Andersson, Gerhard
, insomnia, cognitive functioning, hyperacusis, anxiety, depression, and life satisfaction were used to investigate the effects of iCBT with audiological support. In addition, a weekly questionnaire was incorporated to monitor change in tinnitus distress while undertaking the intervention. Feasibility was established using an audiologist to support this guided iCBT intervention, as a significant change postintervention was found for tinnitus severity, as measured by the TFI and the Tinnitus Handicap Inventory, Screening version. The attrition rate was 22% and compliance was variable. Although these results were based on a small sample, they provide encouraging evidence for the feasibility of delivering iCBT treatment for tinnitus symptoms with audiology support in the United Kingdom. An Internet-based intervention of tinnitus appears to be feasible in the United Kingdom when using audiological support. Randomized controlled trials to further investigate the effectiveness of iCBT for tinnitus in the United Kingdom are required. American Academy of Audiology
Yan, S J; Chughtai, A A; Macintyre, C R
Rapid epidemic detection is an important objective of surveillance to enable timely intervention, but traditional validated surveillance data may not be available in the required timeframe for acute epidemic control. Increasing volumes of data on the Internet have prompted interest in methods that could use unstructured sources to enhance traditional disease surveillance and gain rapid epidemic intelligence. We aimed to summarise Internet-based methods that use freely-accessible, unstructured data for epidemic surveillance and explore their timeliness and accuracy outcomes. Steps outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist were used to guide a systematic review of research related to the use of informal or unstructured data by Internet-based intelligence methods for surveillance. We identified 84 articles published between 2006-2016 relating to Internet-based public health surveillance methods. Studies used search queries, social media posts and approaches derived from existing Internet-based systems for early epidemic alerts and real-time monitoring. Most studies noted improved timeliness compared to official reporting, such as in the 2014 Ebola epidemic where epidemic alerts were generated first from ProMED-mail. Internet-based methods showed variable correlation strength with official datasets, with some methods showing reasonable accuracy. The proliferation of publicly available information on the Internet provided a new avenue for epidemic intelligence. Methodologies have been developed to collect Internet data and some systems are already used to enhance the timeliness of traditional surveillance systems. To improve the utility of Internet-based systems, the key attributes of timeliness and data accuracy should be included in future evaluations of surveillance systems. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Full Text Available The author developed a freely available open source internet-based testing program for medical examination. PHP and Java script were used as the programming language and postgreSQL as the database management system on an Apache web server and Linux operating system. The system approach was that a super user inputs the items, each school administrator inputs the examinees’ information, and examinees access the system. The examinee’s score is displayed immediately after examination with item analysis. The set-up of the system beginning with installation is described. This may help medical professors to easily adopt an internet-based testing system for medical education.
The author developed a freely available open source internet-based testing program for medical examination. PHP and Java script were used as the programming language and postgreSQL as the database management system on an Apache web server and Linux operating system. The system approach was that a super user inputs the items, each school administrator inputs the examinees' information, and examinees access the system. The examinee's score is displayed immediately after examination with item analysis. The set-up of the system beginning with installation is described. This may help medical professors to easily adopt an internet-based testing system for medical education.
Ebert, D. D.; Heber, E.; Berking, M.
Objective This randomised controlled trial (RCT) aimed to evaluate the efficacy of a self-guided internet-based stress management intervention (iSMI) for employees compared to a 6-month wait-list control group (WLC) with full access for both groups to treatment as usual. M e t h o d A sample of 264...... of stressed employees. Internet-based self-guided interventions could be an acceptable, effective and potentially costeffective approach to reduce the negative consequences associated with work-related stress....
Full Text Available Steffi Weidt,1 Annette Beatrix Bruehl,2,3 Aba Delsignore,1 Gwyneth Zai,2,4–6 Alexa Kuenburg,1 Richard Klaghofer,1 Michael Rufer1 1Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Zurich, Switzerland; 2Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK; 3Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, Zurich, Switzerland; 4Department of Psychiatry, Institute of Medical Science, University of Toronto, 5Neurogenetics Section, Centre for Addiction and Mental Health, 6Department of Psychiatry, Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada Background: Many patients suffering from trichotillomania (TTM have never undergone treatment. Without treatment, TTM often presents with a chronic course. Characteristics of TTM individuals who have never been treated (untreated remain largely unknown. Whether treatment history impacts Internet-based interventions has not yet been investigated. We aimed to answer whether Internet-based interventions can reach untreated individuals and whether treatment history is associated with certain characteristics and impacts on the outcome of an Internet-based intervention.Methods: We provided Internet-based interventions. Subjects were characterized at three time points using the Massachusetts General Hospital Hairpulling Scale, Hamilton Depression Rating Scale, and the World Health Organization Quality of Life questionnaire.Results: Of 105 individuals, 34 were untreated. Health-related quality of life (HRQoL was markedly impaired in untreated and treated individuals. Symptom severity did not differ between untreated and treated individuals. Nontreatment was associated with fewer depressive symptoms (P=0.002. Treatment history demonstrated no impact on the outcome of Internet-based interventions.Conclusion: Results
Full Text Available Interventions delivered via the Internet have the potential to address the problem of hazardous alcohol consumption at minimal incremental cost, with potentially major public health implications. It was hypothesised that providing access to a psychologically enhanced website would result in greater reductions in drinking and related problems than giving access to a typical alcohol website simply providing information on potential harms of alcohol. DYD-RCT Trial registration: ISRCTN 31070347.A two-arm randomised controlled trial was conducted entirely on-line through the Down Your Drink (DYD website. A total of 7935 individuals who screened positive for hazardous alcohol consumption were recruited and randomized. At entry to the trial, the geometric mean reported past week alcohol consumption was 46.0 (SD 31.2 units. Consumption levels reduced substantially in both groups at the principal 3 month assessment point to an average of 26.0 (SD 22.3 units. Similar changes were reported at 1 month and 12 months. There were no significant differences between the groups for either alcohol consumption at 3 months (intervention: control ratio of geometric means 1.03, 95% CI 0.97 to 1.10 or for this outcome and the main secondary outcomes at any of the assessments. The results were not materially changed following imputation of missing values, nor was there any evidence that the impact of the intervention varied with baseline measures or level of exposure to the intervention.Findings did not provide support for the hypothesis that access to a psychologically enhanced website confers additional benefit over standard practice and indicate the need for further research to optimise the effectiveness of Internet-based behavioural interventions. The trial demonstrates a widespread and potentially sustainable demand for Internet based interventions for people with hazardous alcohol consumption, which could be delivered internationally.Controlled-Trials.com ISRCTN
Wallace, Paul; Murray, Elizabeth; McCambridge, Jim; Khadjesari, Zarnie; White, Ian R; Thompson, Simon G; Kalaitzaki, Eleftheria; Godfrey, Christine; Linke, Stuart
Interventions delivered via the Internet have the potential to address the problem of hazardous alcohol consumption at minimal incremental cost, with potentially major public health implications. It was hypothesised that providing access to a psychologically enhanced website would result in greater reductions in drinking and related problems than giving access to a typical alcohol website simply providing information on potential harms of alcohol. DYD-RCT Trial registration: ISRCTN 31070347. A two-arm randomised controlled trial was conducted entirely on-line through the Down Your Drink (DYD) website. A total of 7935 individuals who screened positive for hazardous alcohol consumption were recruited and randomized. At entry to the trial, the geometric mean reported past week alcohol consumption was 46.0 (SD 31.2) units. Consumption levels reduced substantially in both groups at the principal 3 month assessment point to an average of 26.0 (SD 22.3) units. Similar changes were reported at 1 month and 12 months. There were no significant differences between the groups for either alcohol consumption at 3 months (intervention: control ratio of geometric means 1.03, 95% CI 0.97 to 1.10) or for this outcome and the main secondary outcomes at any of the assessments. The results were not materially changed following imputation of missing values, nor was there any evidence that the impact of the intervention varied with baseline measures or level of exposure to the intervention. Findings did not provide support for the hypothesis that access to a psychologically enhanced website confers additional benefit over standard practice and indicate the need for further research to optimise the effectiveness of Internet-based behavioural interventions. The trial demonstrates a widespread and potentially sustainable demand for Internet based interventions for people with hazardous alcohol consumption, which could be delivered internationally. Controlled-Trials.com ISRCTN31070347.
U.S. Department of Health & Human Services — NNDSS - Table II. Chlamydia to Coccidioidomycosis - 2017. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during the...
Lindholt, Jes Sanddal; Fasting, H; Henneberg, E W
Chlamydia pneumoniae is a Gram-negative obligate intracellular bacterium that causes acute upper and lower respiratory infections. Its distribution is worldwide. Seroepidemiological studies have shown an association between C. pneumoniae and atherosclerosis, and the risk of acute myocardial...
. Nigeria. The aim of this research is to determine the prevalence of and predictive risk factors for Chlamydia trachomatis infection among female undergraduate students of the University of Port Harcourt. Methods: Four hundred undergraduate ...
U.S. Department of Health & Human Services — NNDSS - Table II. Chlamydia to Coccidioidomycosis - 2017. In this Table, provisional cases of selected notifiable diseases (â¥1,000 cases reported during the...
U.S. Department of Health & Human Services — NNDSS - Table II. Chlamydia to Coccidioidomycosis - 2016. In this Table, provisional* cases of selected† notifiable diseases (≥1,000 cases reported during the...
U.S. Department of Health & Human Services — NNDSS - Table II. Chlamydia to Coccidioidomycosis - 2015.In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during the preceding...
Cong, W; Huang, S Y; Zhang, X X; Zhou, D H; Xu, M J; Zhao, Q; Qian, A D; Zhu, X Q
Chlamydia psittaci is a zoonotic pathogen with a wide range of avian hosts and may be transmitted to humans and cause severe disease. To assess the risk of psittacosis posed by pet birds, the seroprevalence of Chlamydia psittaci antibodies in 360 Eurasian siskins (Carduelis spinus), 289 oriental skylarks (Alauda arvensis) and 36 black-tailed grosbeaks (Coccothraustes migratorius) in Gansu province, north-western China was detected by an indirect haemagglutination assay. Twenty-seven out of 289 (9.34 %) Alauda arvensis, 45 out of 360 (12.50 %) Carduelis spinus and 2 out of 36 (5.56 %) Coccothraustes migratorius were positive for Chlamydia psittaci infection at a cut-off dilution of 1 : 16. The prevalence of Chlamydia psittaci was higher in Carduelis spinus (12.5 %) than in Alauda arvensis (9.34 %) and Coccothraustes migratorius (5.56 %); however, the differences were not statistically significant (P>0.05). Statistical analysis indicated that Chlamydia psittaci seroprevalence in adult pet birds (12.4 %, 67/540) was significantly higher than that in juvenile pet birds (4.83 %, 7/145) (P<0.01). There was no statistical difference in Chlamydia psittaci seroprevalence between male (12.4 %) and female (8.27 %) birds. To our knowledge, this is the first report indicating the seroprevalence of Chlamydia psittaci exposure in pet birds in China. Our results indicate that close contact with pet birds poses the risk of zoonotic transmission of Chlamydia psittaci.
Krawiec, Marta; Piasecki, Tomasz; Wieliczko, Alina
Avian chlamydiosis is a zoonotic disease occurring in humans, poultry, and exotic birds. It has been suggested that some wild bird species play an important role as reservoirs for Chlamydia, especially Chlamydia psittaci. Whereas C. psittaci is the predominant chlamydial agent in birds, in the present study we have determined the prevalence of different species of Chlamydia among selected wild bird species in Poland using a rapid and sensitive real-time PCR method. In total, 369 free-living birds from 35 bird species and 15 orders were examined. Samples from 27 birds (7.3%) were positive for chlamydial DNA in the PCR; 22 positive samples (81.5%) belonged to C. psittaci, three to Chlamydia trachomatis (11.1%), and two (7.4%) classified only to the genus Chlamydia. Most of C. psittaci-positive samples belonged to five orders: Anseriformes, Columbiformes, Gruiformes, Phasianiformes, and Passeriformes. All C. trachomatis samples were obtained from Eurasian coots (Gruiformes). Two Chlamydia-positive samples not classified to any Chlamydia species were obtained from a common wood pigeon (Columbiformes) and a common buzzard (Accipitriformes). Detection of C. psittaci and C. trachomatis in free-living bird populations force to think on significance of birds as reservoir of varied Chlamydia species and their epidemiological importance.
Nijhof, S.L.; Priesterbach, L.P.; Uiterwaal, C.S.; Bleijenberg, G.; Kimpen, J.L.L.; Putte, E.M. van de
OBJECTIVE: Cognitive behavioral therapy (CBT) is known to be an effective treatment of adolescents with chronic fatigue syndrome (CFS), but its availability is limited. Fatigue in Teenagers on the Internet (FITNET), an Internet-based CBT program for adolescents with CFS, has been developed as an
Hedman, Erik; Lindefors, Nils; Andersson, Gerhard; Andersson, Erik; Lekander, Mats; Rück, Christian; Ljótsson, Brjánn
Internet-based cognitive behavior therapy (CBT) for severe health anxiety can be effective, but not all patients achieve full remission. Under these circumstances, knowledge about predictors is essential for the clinician in order to make reliable treatment recommendations. The primary aim of this study was to investigate clinical, demographic, and therapy process-related predictors of Internet-based CBT for severe health anxiety. We performed three types of analyses on data from a sample comprising participants (N = 81) who had received Internet-based CBT in a randomized controlled trial. Outcomes were a) end state health anxiety, b) improvement in health anxiety (continuous change scores), and c) clinically significant improvement. Outcomes were assessed at six-month follow-up. The results showed that the most stable predictors of both end state health anxiety and improvement were baseline health anxiety and depressive symptoms. Treatment adherence, i.e. the number of completed treatment modules, also significantly predicted outcome. Notably, health anxiety at baseline was positively associated with symptom improvement while depressive symptoms was negatively related to improvement. Demographic factors were largely without significant impact on end state symptoms or improvement. We conclude that baseline symptom burden and adherence to treatment have strong predictive effects in Internet-based CBT for severe health anxiety. Copyright © 2013 Elsevier Ltd. All rights reserved.
Spek, V.; Nyklicek, I.; Cuijpers, P.; Pop, V.
Background: Little is known about which participant characteristics determine the effectiveness of various types of cognitive behavior therapy for sub-threshold depression. The aim of this study was to investigate which characteristics predict treatment outcome of group and internet-based
Spek, V.; Nyklicek, I.; Cuijpers, P.; Pop, V.
Background: Little is known about which participant characteristics determine the effectiveness of various types of cognitive behavior therapy for sub-threshold depression. The aim of this study was to investigate which characteristics predict treatment outcome of group and internet-based
Stromso, Helge I.; Braten, Ivar
The predictability of Internet-specific epistemic beliefs for self-regulated learning within Internet technologies was examined in a sample of 84 physics undergraduates. Dimensions of Internet-specific epistemic beliefs were found to explain unique variance in Internet-based search, help-seeking, and self-regulatory strategies, respectively.…
Bacon, Melanie; Blood, Leslie; Ault, Marilyn; Adams, Doug
4Kids.org is an online resource with an accompanying syndicated print publication created to promote safe access to websites and technology literacy. 4Kids.org, created by ALTEC at the University of Kansas in 1995, provides a variety of Internet-based activities as well as access to a database of websites reviewed for educational content,…
Gungordu, Nahide; Yalcin-Celik, Ayse; Kilic, Ziya
In this study, students' misconceptions about the ozone layer were investigated, looking specifically at the effect internet-based media has on the formation of these misconceptions. Quantitative and qualitative research approaches were used to perform the research. As part of the quantitative portion of the research, the descriptive survey…
Colvin, Jan; Chenoweth, Lillian; Bold, Mary; Harding, Cheryl
We explored the perceptions of caregivers of older adults using Internet-based social support networks regarding the unique advantages and disadvantages of online social support. Participants were recruited with permission of Web owners through 15 Web sites that offered social networks, and responses from 63 electronically submitted surveys were…
Jordan, C.W.; Cavitt, R.E.; Niven, W.A.; Warren, F.E.; Taylor, S.S.; Sharick, T.M.; Vickers, D.L.; Mitschkowetz, N.; Weaver, R.L.
Lawrence Livermore National Laboratory (LLNL) is piloting an Internet- based paperless process called `Zephyr` to streamline engineering procurements. Major benefits have accrued by using Zephyr in reducing procurement time, speeding the engineering development cycle, facilitating industrial collaboration, and reducing overall costs. Programs at LLNL are benefiting by the efficiencies introduced since implementing Zephyr`s engineering and commerce on the Internet.
Meer, V. van der; Stel, H.F. van; Detmar, S.B.; Otten, W.; Sterk, P.J.; Sont, J.K.
Background: Internet and short message service are emerging tools for chronic disease management in adolescents, but few data exist on the barriers to and benefits of internet-based asthma self-management. Our objective was to reveal the barriers and benefits perceived by adolescents with
van der Meer, Victor; van Stel, Henk F.; Detmar, Symone B.; Otten, Wilma; Sterk, Peter J.; Sont, Jacob K.
BACKGROUND: Internet and short message service are emerging tools for chronic disease management in adolescents, but few data exist on the barriers to and benefits of internet-based asthma self-management. Our objective was to reveal the barriers and benefits perceived by adolescents with
In this research, the articles concerning interaction in the Internet-based distance learning, which were published in three most outstanding journals in 2003, 2004 and until March of 2005, have been examined and classified. The research provides opportunities for discussing topics, methods and some other variables. It is thought that, the…
Wireless mesh networks (WMNs) have recently emerged to be a cost-effective solution to support large-scale wireless Internet access. They have numerous applications, such as broadband Internet access, building automation, and intelligent transportation systems. One research challenge for Internet-based WMNs is to design efficient mobility…
The Internet has made it possible for teachers to administer online assessments with affordability and ease. However, little is known about Japanese English as a Foreign Language (EFL) students' attitudes of internet-based tests (IBTs). Therefore, this study aimed to measure the perceptions of IBTs among Japanese English language learners with the…
Gutierrez, Melida; Coulter, Bob; Goodwin, David R.
Describes a week-long "Mapping Natural Disasters" workshop offered to K-12 teachers to promote inquiry-based teaching approaches. The workshop modeled the integration of hands-on activities, internet-based data, and the use of geographic information systems (GIS) software. (Author/MM)
Rand, Debbie; Lee Ben-Haim, Keren; Malka, Rachel; Portnoy, Sigal
The Executive Function Performance Test (EFPT) is a reliable and valid performance-based tool to assess executive functions (EFs). This study's objective was to develop and verify two Internet-based tasks for the EFPT. A cross-sectional study assessed the alternate-form reliability of the Internet-based bill-paying and telephone-use tasks in healthy adults and people with subacute stroke (Study 1). It also sought to establish the tasks' criterion reliability for assessing EF deficits by correlating performance with that on the Trail Making Test in five groups: healthy young adults, healthy older adults, people with subacute stroke, people with chronic stroke, and young adults with attention deficit hyperactivity disorder (Study 2). The alternative-form reliability and initial construct validity for the Internet-based bill-paying task were verified. Criterion validity was established for both tasks. The Internet-based tasks are comparable to the original EFPT tasks and can be used for assessment of EF deficits. Copyright © 2018 by the American Occupational Therapy Association, Inc.
Mouthaan, Joanne; Sijbrandij, Marit; de Vries, Giel-Jan; Reitsma, Johannes B.; van de Schoot, Rens; Goslings, J. Carel; Luitse, Jan S. K.; Bakker, Fred C.; Gersons, Berthold P. R.; Olff, Miranda
Background: Posttraumatic stress disorder (PTSD) develops in 10-20% of injury patients. We developed a novel, self-guided Internet-based intervention (called Trauma TIPS) based on techniques from cognitive behavioral therapy (CBT) to prevent the onset of PTSD symptoms. Objective: To determine
Mouthaan, J.; Sijbrandij, M.; de Vries, G.J.; Reitsma, J.B.; van de Schoot, R.; Goslings, J.C.; Luitse, J.S.K.; Bakker, F.C.; Gersons, B.P.R.; Olff, M.
Background: Posttraumatic stress disorder (PTSD) develops in 10-20% of injury patients. We developed a novel, self-guided Internet-based intervention (called Trauma TIPS) based on techniques from cognitive behavioral therapy (CBT) to prevent the onset of PTSD symptoms. Objective: To determine
Benabdelkader, A.; Afsarmanesh, H.; Hertzberger, L.O.; Ibrahim, M.; Küng, J.; Revell, N.
To support necessary requirements and flexibility to the buyers of different goods; advanced and efficient internet-based Electronic Commerce services must be designed and developed. In addition to the traditional user requirements, the developed system must properly address efficiency issues, among
Chen, Su-Yen; Fang, Sheng-Ping
This study expanded the definition of reading practices to include both print- and Internet-based reading, and examined the relationship of reading profiles to Taiwanese college students' performance on various practices. The results showed that more time was spent on Internet-than print-based extracurricular reading, and that the three…
Caffray, Christine M.; Chatterji, Pinka
This manuscript describes the development and testing of an Internet-based cost survey that was designed by the authors for the National Assembly on School-Based Health Care (NASBHC) to capture the costs of school-based health programs. The intent of the survey was twofold. First, the survey was designed to collect comprehensive data on costs in a…
Hill, Anne J.; Theodoros, Deborah G.; Russell, Trevor G.; Cahill, Louise M.; Ward, Elizabeth C.; Clark, Kathy M.
Purpose: This pilot study explored the feasibility and effectiveness of an Internet-based telerehabilitation application for the assessment of motor speech disorders in adults with acquired neurological impairment. Method: Using a counterbalanced, repeated measures research design, 2 speech-language pathologists assessed 19 speakers with…
Hans Christian B. Vangberg
Full Text Available Background. Focus upon depression and prevention of its occurrence among adolescents is increasing. Novel ways of dealing with this serious problem have become available especially by means of internet-based prevention and treatment programs of depression and anxiety. The use of Internet-based intervention programs among adolescents has revealed some difficulties in implementation that need to be further elucidated. The aim of this study is to investigate the association between personality and adolescent depression and the characteristics of users of an Internet-based intervention program. Method. The Junior Temperament and Character Inventory (JTCI, the General Self-Efficacy scale (GSE and the Centre for Epidemiological Studies-Depression scale (CES-D have been administered to a sample (=1234 of Norwegian senior high-school students. Results. Multiple regression analysis revealed associations between depression and gender, and several JTCI domains and facets. In line with previous findings in adults, high Harm Avoidance and low Self-Directedness emerged as the strongest predictors of adolescent depressive symptoms. Further, in logistic regression analysis with the covariates JTCI, GSE and CES-D, the only significant variables predicting use/non-use were the CES-D and the temperament domain Reward Dependence. Conclusion. The results in this study revealed level of depressive symptoms as the strongest predictor of the use of the Internet based intervention and that personality might provide useful information about the users.
... can cause serious health problems in women, including: Pelvic inflammatory disease (PID), an infection of a woman's reproductive organs. ... HIV and AIDS Human papillomavirus (HPV) Pap test Pelvic inflammatory disease Pregnancy Sexually transmitted infections (STI) Sexually transmitted infections, ...
Pugh, Carys A; Summers, Kim M; Bronsvoort, B Mark C; Handel, Ian G; Clements, Dylan N
Internet-based data collection relies on well-designed and validated questionnaires. The theory behind designing and validating questionnaires is well described, but few practical examples of how to approach validation are available in the literature. We aimed to validate data collected in an ongoing Internet-based longitudinal health study through direct visits to participants and recall of their health records. We demonstrate that despite extensive pre-planning, social desirability can still affect data in unexpected ways and that anticipation of poor quality data may be confounded by positive validation. Dogslife is a large-scale, Web-based longitudinal study of canine health, in which owners of Labrador Retrievers were recruited and questioned at regular intervals about the lifestyle and health of their dogs using an Internet-based questionnaire. The Dogslife questionnaire predominantly consists of closed-answer questions. In our work, two separate validation methodologies were used: (1) direct interviews with 43 participants during visits to their households and (2) comparison of owner-entered health reports with 139 historical health records. Our results indicate that user-derived measures should not be regarded as a single category; instead, each measurement should be considered separately as each presents its own challenge to participants. We recommend trying to ascertain the extent of recall decay within a study and, if necessary, using this to guide data collection timepoints and analyses. Finally, we recommend that multiple methods of communication facilitate validation studies and aid cohort engagement. Our study highlighted how the theory underpinning online questionnaire design and validation translates into practical data issues when applied to Internet-based studies. Validation should be regarded as an extension of questionnaire design, and that validation work should commence as soon as sufficient data are available. We believe that validation is a
Peng, Ying; Wu, Xi; Atkins, Salla; Zwarentein, Merrick; Zhu, Ming; Zhan, Xing Xin; Zhang, Fan; Ran, Peng; Yan, Wei Rong
The Internet is increasingly being applied in health education worldwide; however there is little knowledge of its use in Chinese higher education institutions. The present study provides the first review and highlights the deficiencies and required future advances in Chinese Internet-based health education. Two authors independently conducted a duplicate Internet search in order to identify information regarding Internet-based health education in China. The findings showed that Internet-based education began in China in September 1998. Currently, only 16 of 150 (10.7%) health education institutions in China offer fee-based online undergraduate degree courses, awarding associates and/or bachelors degrees. Fifteen of the 16 institutions were located in the middle or on the eastern coast of China, where were more developed than other regions. Nursing was the most popular discipline in Internet-based health education, while some other disciplines, such as preventive medicine, were only offered at one university. Besides degree education, Chinese institutions also offered non-degree online training and free resources. The content was mainly presented in the form of PowerPoint slides or videos for self-learning. Very little online interactive mentoring was offered with any of the courses. There is considerable potential for the further development of Internet-based health education in China. These developments should include a focus on strengthening cooperation among higher education institutions in order to develop balanced online health curricula, and on enhancing distance education in low- and middle-income regions to meet extensive learning demands.
OBJECTIVE: The aim of this study was to determine the prevalence of cervical Chlamydia trachomatis infection by polymerase chain reaction (PCR) in urban women undergoing routine cervical cytological screening and to investigate the relationship with age, cytology, smoking status and concurrent human papillomavirus (HPV) infection. METHODS: A total of 996 women (age range 16-69 years) attending general practitioners for routine liquid-based cervical smear screening in the Dublin area were recruited in the study of prevalence of C. trachomatis. Informed consent was obtained and liquid-based cytology (LBC) specimens were sent for cytological screening. DNA was extracted from residual LBC and tested for C. trachomatis by PCR using the highly sensitive C. trachomatis plasmid (CTP) primers and for HPV infection using the MY09\\/11 primers directed to the HPV L1 gene in a multiplex format. RESULTS: The overall prevalence of C. trachomatis was 5.4%. Prevalence was highest in the <25 years age group (10%). Coinfection with HPV and C. trachomatis occurred in 1% of the screening population. A higher rate of smoking was observed in women positive for C. trachomatis, HPV infections or those with abnormal cervical cytology. Chlamydia trachomatis infection was not associated with abnormal cytology. CONCLUSIONS: Women (5.4%) presenting for routine cervical screening are infected with C. trachomatis. Opportunistic screening for C. trachomatis from PreservCyt sample taken at the time of cervical cytological screening may be a possible strategy to screen for C. trachomatis in the Irish female population.
Chu, Regina Juchun; Chu, Anita Zichun; Weng, Cathy; Tsai, Chin-Chung; Lin, Chia-chun
This research explores the relationships between self-directed learning readiness and transformative learning theory (TLT) reflected by the Constructivist Internet-based Learning Environment Scale (CILES). A questionnaire survey about adult learner's perceptions of Internet-based learning was administered to adults enrolled in classes in community…
Celis-Morales, C.; Livingstone, K.M.; Woolhead, C.; Forster, H.; O’Donovan, C.B.; Macready, A.L.; Fallaize, R.; Marsaux, C.F.M.; Tsirigoti, L.; Efstathopoulou, E.; Moschonis, G.; Navas-Carretero, S.; San-Cristobal, R.; Kolossa, S.; Klein, U.L.; Hallmann, J.; Godlewska, M.; Surwiłło, A.; Drevon, C.A.; Bouwman, J.; Grimaldi, K.; Parnell, L.D.; Manios, Y.; Traczyk, I.; Gibney, E.R.; Brennan, L.; Walsh, M.C.; Lovegrove, J.A.; Martinez, J.A.; Daniel, H.; Saris, W.H.M.; Gibney, M.; Mathers, J.C.
In e-health intervention studies, there are concerns about the reliability of internet-based, self-reported (SR) data and about the potential for identity fraud. This study introduced and tested a novel procedure for assessing the validity of internet-based, SR identity and validated anthropometric
BACKGROUND In e-health intervention studies, there are concerns about the reliability of internet-based, self-reported (SR) data and about the potential for identity fraud. This study introduced and tested a novel procedure for assessing the validity of internet-based, SR identity and validated anth...
Full Text Available Background: Self-testing technology allows people to test themselves for chlamydia without professional support. This may result in reassurance and wider access to chlamydia testing, but anxiety could occur on receipt of positive results. This study aimed to identify factors important in understanding self-testing for chlamydia outside formal screening contexts, to explore the potential impacts of self-testing on individuals, and to identify theoretical constructs to form a Framework for future research and intervention development. Methods: Eighteen university students participated in semi-structured interviews; eleven had self-tested for chlamydia. Data were analysed thematically usingaFrameworkapproach. Results: Perceivedbeneﬁtsofself-testingincludeditsbeingconvenient, anonymousandnotrequiringphysicalexamination. Therewasconcernabouttestaccuracyandsome participants lacked conﬁdence in using vulvo-vaginal swabs. While some participants expressed concern about the absence of professional support, all said they would seek help on receiving a positive result. Factors identiﬁed in Protection Motivation Theory and the Theory of Planned Behaviour, such as response efﬁcacy and self-efﬁcacy, were found to be highly salient to participants in thinking about self-testing. Conclusions: These exploratory ﬁndings suggest that self-testing independentlyofformalhealthcaresystemsmaynomorenegativelyimpactpeoplethanbeingtested by health care professionals. Participants’ perceptions about self-testing behaviour were consistent with psychological theories. Findings suggest that interventions which increase conﬁdence in using self-tests and that provide reassurance of test accuracy may increase self-test intentions.
Catherine D G Hines
Full Text Available Chlamydia trachomatis is among the most prevalent of sexually transmitted diseases. While Chlamydia infection is a reportable event and screening has increased over time, enhanced surveillance has not resulted in a reduction in the rate of infections, and Chlamydia infections frequently recur. The development of a preventative vaccine for Chlamydia may be the only effective approach for reducing infection and the frequency of pathological outcomes. Current vaccine research efforts involve time consuming and/or invasive approaches for assessment of disease state, and MRI presents a clinically translatable method for assessing infection and related pathology both quickly and non-invasively. Longitudinal T2-weighted MRI was performed over 63 days on both control or Chlamydia muridarum challenged mice, either with or without elementary body (EB immunization, and gross necropsy was performed on day 65. A scoring system was developed to assess the number of regions affected by Chlamydia pathology and was used to document pathology over time and at necropsy. The scoring system documented increasing incidence of pathology in the unimmunized and challenged mice (significantly greater compared to the control and EB immunized-challenged groups by 21 days post-challenge. No differences between the unchallenged and EB immunized-challenged mice were observed. MRI scores at Day 63 were consistently higher than gross necropsy scores at Day 65, although two of the three groups of mice showed no significant differences between the two techniques. In this work we describe the application of MRI in mice for the potential evaluation of disease pathology and sequelae caused by C. muridarum infection and this technique's potential for evaluation of vaccines for Chlamydia.
Cook, David A; Levinson, Anthony J; Garside, Sarah; Dupras, Denise M; Erwin, Patricia J; Montori, Victor M
The increasing use of Internet-based learning in health professions education may be informed by a timely, comprehensive synthesis of evidence of effectiveness. To summarize the effect of Internet-based instruction for health professions learners compared with no intervention and with non-Internet interventions. Systematic search of MEDLINE, Scopus, CINAHL, EMBASE, ERIC, TimeLit, Web of Science, Dissertation Abstracts, and the University of Toronto Research and Development Resource Base from 1990 through 2007. Studies in any language quantifying the association of Internet-based instruction and educational outcomes for practicing and student physicians, nurses, pharmacists, dentists, and other health care professionals compared with a no-intervention or non-Internet control group or a preintervention assessment. Two reviewers independently evaluated study quality and abstracted information including characteristics of learners, learning setting, and intervention (including level of interactivity, practice exercises, online discussion, and duration). There were 201 eligible studies. Heterogeneity in results across studies was large (I(2) > or = 79%) in all analyses. Effect sizes were pooled using a random effects model. The pooled effect size in comparison to no intervention favored Internet-based interventions and was 1.00 (95% confidence interval [CI], 0.90-1.10; P Internet formats, the pooled effect sizes (positive numbers favoring Internet) were 0.10 (95% CI, -0.12 to 0.32; P = .37; n = 43) for satisfaction, 0.12 (95% CI, 0.003 to 0.24; P = .045; n = 63) for knowledge, 0.09 (95% CI, -0.26 to 0.44; P = .61; n = 12) for skills, and 0.51 (95% CI, -0.24 to 1.25; P = .18; n = 6) for behaviors or patient effects. No important treatment-subgroup interactions were identified. Internet-based learning is associated with large positive effects compared with no intervention. In contrast, effects compared with non-Internet instructional methods are heterogeneous and
Full Text Available Planning for appropriate preventive measures against Chlamydia trachomatis, a common cause of sexually transmitted disease, requires knowledge of prevalence of infection so that interventions can be targeted in a cost-effective manner. This study was performed on 178 male patients presenting with urethritis in the Mashhad province to determine the prevalence of chlamydial infection in Northeast Iran. A cotton swab and first voided urine specimen were collected according to standard procedures. Polymerase chain reaction (PCR tests were used for the detection of C. trachomatis in the specimens collected and the results were analyzed using SPSS program. Results showed that 10.6% of male patients in this group were infected with C. trachomatis. This study provides strong evidence that prevalence of Chlamydia in the Northeast Iran is high and suggests that Chlamydia screening as a routine part of STD investigations is highly necessary in this area.
Lundemose, A G; Banner, Jytte; Birkelund, Svend
A procedure to detect Chlamydia in postmortal formalin-fixed tissue is described. Monoclonal antibodies against a genus specific chlamydia epitope were used in immunofluorescence to detect chlamydia inclusions in formalin-fixed tissue sections. Lung sections from chlamydia-infected mice were....... Background and non-specific fluorescence were reduced by treating the tissue sections with trypsin, rabbit serum and Evans blue counterstain. Besides giving an exact diagnosis at autopsy, the method provides the possibility of determining the occurrence of chlamydia infections in various tissues, based...
Full Text Available Background. Pelvic inflammatory disease (PID rarely results in diffuse ascites. Severe adhesive disease secondary to PID may lead to the formation of inclusion cysts and even pelvic peritoneal nodularity due to postinflammatory scarring and cause an elevation of serum CA-125 levels. The constellation of these findings may mimic an ovarian neoplasm. Case. We report a case of a 22-year-old female who presented with multiple pelvic cysts and diffuse ascites due to Chlamydia trachomatis infection. The initial gynecologic exam did not reveal obvious evidence of PID; however, a positive Chlamydia trachomatis test, pathologic findings, and the exclusion of other etiologies facilitated the diagnosis. Conclusion. Chlamydia trachomatis and other infectious agents should be considered in the differential diagnosis of a young sexually active female with abdominal pain, ascites, and pelvic cystic masses. Thorough workup in such a population may reduce the number of more invasive procedures as well as unnecessary repeat surgical procedures.
Nielsen, Jørn Flohr; Mols, Niels Peter; Høst, Viggo
, specialised investments, and management support. This is mainly the case in small firms, as the importance of the various drivers and the adoption pattern vary between size categories. Market-pull factors have relatively more explanatory power in medium-sized and large companies.......This chapter analyses factors influencing manufacturers= adoption and implementation of Internet-based marketing channels, using models based on marketing channel and organisational innovation theory. Survey data from 1163 Danish, Finnish, and Swedish manufacturers form the empirical basis...... for testing the models using LISREL analysis. The results stress that adoption of Internet-based marketing is influenced by willingness to cannibalize, management support, market pressure, and a firm=s knowledge of IT. Willingness to cannibalize mediates the effects of future market orientation, ownership...
Full Text Available Epidemics of a biological and technological nature pervade modern life. For centuries, scientific research focused on biological epidemics, with simple compartmental epidemiological models emerging as the dominant explanatory paradigm. Yet there has been limited translation of this effort to explain internet-based spreading phenomena. Indeed, single-epidemic models are inadequate to explain the multimodal nature of complex phenomena. In this paper we propose a novel paradigm for modelling internet-based spreading phenomena based on the composition of multiple compartmental epidemiological models. Our approach is inspired by Fourier analysis, but rather than trigonometric wave forms, our components are compartmental epidemiological models. We show results on simulated multiple epidemic data, swine flu data and BitTorrent downloads of a popular music artist. Our technique can characterise these multimodal data sets utilising a parsimonous number of subepidemic models.
Park, Sung Taek; Lee, Suk Woo; Kim, Min Jeong; Kang, Young Mo; Moon, Hye Min; Rhim, Chae Chun
Chlamydia infection in acute pelvic inflammatory disease (PID) is associated with serious complications including ectopic pregnancy, tubal infertility, Fitz-Hugh-Curtis syndrome and tubo-ovarian abscess (TOA). This study compared clinical and laboratory data between PID with and without chlamydia infection. The medical records of 497 women who were admitted with PID between 2002 and 2011 were reviewed. The patients were divided into two groups (PID with and without chlamydia infection), which were compared in terms of the patients' characteristics, clinical presentation, and laboratory findings, including inflammatory markers. The chlamydia and non-chlamydia groups comprised 175 and 322 women, respectively. The patients in the chlamydia group were younger and had a higher rate of TOA, a longer mean hospital stay, and had undergone more surgeries than the patients in the non- chlamydia group. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and CA-125 level were higher in the chlamydia group than in the non-chlamydia group, but there was no significant difference in the white blood cell count between the two groups. The CA-125 level was the strongest predictor of chlamydia infection, followed by the ESR and CRP level. The area under the receiving operating curve for CA-125, ESR, and CRP was 0.804, 0.755, and 0.663, respectively. Chlamydia infection in acute PID is associated with increased level of inflammatory markers, such as CA-125, ESR and CRP, incidence of TOA, operation risk, and longer hospitalization.
Hong, OiSaeng; Eakin, Brenda L; Chin, Dal Lae; Feld, Jamie; Vogel, Stephen
Noise-induced hearing loss is a significant occupational injury for firefighters exposed to intermittent noise on the job. It is important to educate firefighters about using hearing protection devices whenever they are exposed to loud noise. Computer technology is a relatively new health education approach and can be useful for tailoring specific aspects of behavioral change training. The purpose of this study is to present the development process of an Internet-based tailored intervention program and to assess its efficacy. The intervention programs were implemented for 372 firefighters (mean age = 44 years, Caucasian = 82%, male = 95%) in three states (California, Illinois, and Indiana). The efficacy was assessed from firefighters' feedback through an Internet-based survey. A multimedia Internet-based training program was developed through (a) determining program content and writing scripts, (b) developing decision-making algorithms for tailoring, (c) graphic design and audio and video productions, (d) creating computer software and a database, and (e) postproduction quality control and pilot testing. Participant feedback regarding the training has been very positive. Participants reported that they liked completing the training via computer (83%) and also that the Internet-based training program was well organized (97%), easy to use (97%), and effective (98%) and held their interest (79%). Almost all (95%) would recommend this Internet training program to other firefighters. Interactive multimedia computer technology using the Internet was a feasible mode of delivery for a hearing protection intervention among firefighters. Participants' favorable feedback strongly supports the continued utilization of this approach for designing and developing interventions to promote healthy behaviors.
Lopez-Gonzalez, H; Estévez, A; Griffiths, MD
With the adoption and popularization of internet-based platforms, sports betting has introduced new functionalities that transform the design of its products and therefore the way bettors interact with them. This study aims to explore the association between the use of new structural characteristics of online betting and gambling severity. Five characteristics are examined here: (i) live in-play betting; (ii) cash out feature use (as example of in-play betting in-built features); (iii) fantas...
Villegas, Natalia; Santisteban, Daniel; Cianelli, Rosina; Ferrer, Lilian; Ambrosia, Todd; Peragallo, Nilda; Lara, Loreto
The incidence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is high among young Chilean women, and there are no STI or HIV prevention interventions available to them that incorporate technology. The purpose of this study was to investigate the preliminary efficacy of an Internet-based STI and HIV prevention intervention (I-STIPI) for Chilean young women on measures of STI- and HIV-related information, motivation, behavioral skills, and preventive behaviors. This is a pretest-posttest study. Forty young Chilean women between 18 and 24 years of age participated in an investigation of the I-STIPI's preliminary efficacy on STI and HIV prevention-related outcomes between baseline and a postintervention assessment. The intervention consisted of four online modules. Data collection was conducted in Santiago, Chile. Paired-samples t test analysis was used to determine whether there were significant differences in each of the outcome variables. After receiving I-STIPI, women reported a significant increase in levels of STI- and HIV-related knowledge, attitudes toward the use of condoms and perceived self-efficacy, and a reduction of risky sexual behaviors with uncommitted partners. The I-STIPI showed promise as an Internet-based intervention that can reduce barriers to accessing preventive interventions and increase STI and HIV preventive behaviors in young Chilean women. The study provided important information about the ability of an Internet-based intervention to reduce young women's risk factors and to provide positive preliminary efficacy on STI- and HIV-related outcomes. Internet-based interventions can eliminate many barriers to receiving prevention interventions and may prove to be cost effective. © 2014 Sigma Theta Tau International.
Jane Tiller; Paul Lacaze
The Internet currently enables unprecedented ease of access for direct-to-consumer (DTC) genetic testing, with saliva collection kits posted directly to consumer homes from anywhere in the world. This poses new challenges for local jurisdictions in regulating genetic testing, traditionally a tightly-regulated industry. Some Internet-based genetic tests have the capacity to cause significant confusion or harm to consumers who are unaware of the risks or potential variability in quality. The em...
Villegas, Natalia; Santisteban, Daniel; Cianelli, Rosina; Ferrer, Lilian; Ambrosia, Todd; Peragallo, Nilda; Lara, Loreto
Purpose The incidence of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is high among young Chilean women, and there are no STI or HIV prevention interventions available to them that incorporate technology. The purpose of this study was to investigate the preliminary efficacy of an Internet-based STI and HIV prevention intervention (I-STIPI) for Chilean young women on measures of STI- and HIV-related information, motivation, behavioral skills, and preventive behaviors. Design This is a pretest-posttest study. Forty young Chilean women between 18 and 24 years of age participated in an investigation of the I-STIPI’s preliminary efficacy on STI and HIV prevention-related outcomes between baseline and a postintervention assessment. The intervention consisted of four online modules. Data collection was conducted in Santiago, Chile. Paired-samples t test analysis was used to determine whether there were significant differences in each of the outcome variables. Findings After receiving I-STIPI, women reported a significant increase in levels of STI- and HIV-related knowledge, attitudes toward the use of condoms and perceived self-efficacy, and a reduction of risky sexual behaviors with uncommitted partners. Conclusions The I-STIPI showed promise as an Internet-based intervention that can reduce barriers to accessing preventive interventions and increase STI and HIV preventive behaviors in young Chilean women. Clinical Relevance The study provided important information about the ability of an Internet-based intervention to reduce young women’s risk factors and to provide positive preliminary efficacy on STI- and HIV-related outcomes. Internet-based interventions can eliminate many barriers to receiving prevention interventions and may prove to be cost effective. PMID:25410132
Isenmann, Ralf; Warkotsch, Nicolas
Corporate environmental reporting makes good business and environmental sense. A big challenge for companies is to utilize the technical benefit of state of the art IT, especially of Internet-technologies and Internet-services. In this paper an approach of internet-based environmental reports by companies is presented. Three different levels are discussed: The first level deals with the basics of corporate environmental reports (CER) by companies. Illustrating the order within the emerging fi...
De Vera, Mary A.; Ratzlaff, Charles; Doerfling, Paul; Kopec, Jacek
Lifetime exposure to physical activity is an important construct for evaluating associations between physical activity and disease outcomes, given the long induction periods in many chronic diseases. The authors' objective in this study was to evaluate the measurement properties of the Lifetime Physical Activity Questionnaire (L-PAQ), a novel Internet-based, self-administered instrument measuring lifetime physical activity, among Canadian men and women in 2005–2006. Reliability was examined u...
Boettcher, Johanna; Åström, Viktor; Påhlsson, Daniel; Schenström, Ola; Andersson, Gerhard; Carlbring, Per
Mindfulness-based interventions have proven effective for the transdiagnostic treatment of heterogeneous anxiety disorders. So far, no study has investigated the potential of mindfulness-based treatments when delivered remotely via the Internet. The current trial aims at evaluating the efficacy of a stand-alone, unguided, Internet-based mindfulness treatment program for anxiety. Ninety-one participants diagnosed with social anxiety disorder, generalized anxiety disorder, panic disorder, or an...
Heilig, Gerhard K.
The paper reviews seven types of Internet-based technologies and services that may be especially suitable for rural areas. Its main focus is to analyze, which of these applications could promote rural development and prevent further economic and socio-demographic decline in peripheral rural areas. In particular, we will analyze whether these technologies have the potential to create income alternatives for the rural population. The paper also criticizes the current rural development policy of...
have recently become emplaced in and ac- cessible through the Internet . Worldwide, internet usage is increasing at an astounding rate, particularly...Distribution Unlimited Final Report on "Survey of Quantification and Distance Functions Used for Internet -based Weak-link Sociological Phenomena...comments regarding this burden estimate or any other aspect of this collection of information, including suggesstions for reducing this burden, to
Conclusions: Guidance is a beneficial feature of Internet-based interventions, although its effect is smaller than reported before when compared to unguided interventions. The qualification of the e-coaches seems of minor importance. However, methodological limitations need to be considered when interpreting these findings. Overall, the number of studies was small and mainly limited to depression and social phobia restricting the generalizability of the findings.
Jensen, Klaus Thorleif; Petersen, Lise; Falk, Søren
Chlamydia trachomatis is the aetiological agent of trachoma and sexually transmitted infections. The C. trachomatis genome sequence revealed an organism adapted to the intracellular habitat with a high coding ratio and a small genome consisting of 1.042-kilobase (kb) with 895 annotated protein...... of the novel genes in C. trachomatis Serovar A and Chlamydia muridarum. Several of the genes have typical gene-like and protein-like features. Furthermore, we confirm transcriptional activity from 10 of the putative genes. The combined evidence suggests that at least seven of the 15 are protein coding genes...
Birkelund, Svend; Lundemose, AG; Christiansen, Gunna
Monoclonal antibodies (MAb) specific for Chlamydia trachomatis lipopolysaccharide (LPS) and major outer membrane protein (MOMP) were used for immunoelectron microscopy analysis. MAb specific for MOMP showed strong reaction with the chlamydial surface, whereas MAb specific for LPS showed strong...... association of gold particles with the periphery of the chlamydial body. After fixation of the chlamydia cells, the reactivity was, however, similar to the anti-MOMP reactivity. Enzyme-linked immunosorbent assay showed that MAb specific for LPS could remove LPS from the chlamydial membrane....
Kreakie, B. J.; Hychka, K. C.; Belaire, J. A.; Minor, E.; Walker, H. A.
Social network analysis (SNA) is based on a conceptual network representation of social interactions and is an invaluable tool for conservation professionals to increase collaboration, improve information flow, and increase efficiency. We present two approaches to constructing internet-based social networks, and use an existing traditional (survey-based) case study to illustrate in a familiar context the deviations in methods and results. Internet-based approaches to SNA offer a means to overcome institutional hurdles to conducting survey-based SNA, provide unique insight into an institution's web presences, allow for easy snowballing (iterative process that incorporates new nodes in the network), and afford monitoring of social networks through time. The internet-based approaches differ in link definition: hyperlink is based on links on a website that redirect to a different website and relatedness links are based on a Google's "relatedness" operator that identifies pages "similar" to a URL. All networks were initiated with the same start nodes [members of a conservation alliance for the Calumet region around Chicago ( n = 130)], but the resulting networks vary drastically from one another. Interpretation of the resulting networks is highly contingent upon how the links were defined.
Gulec, Hayriye; Moessner, Markus; Túry, Ferenc; Fiedler, Peter; Mezei, Agnes; Bauer, Stephanie
Despite effective treatment approaches, relapses are frequent in eating disorders. Posttreatment care is essential to enhance continuous recovery and prevent deterioration. This study evaluated the effects of an Internet-based intervention following routine care. One hundred five women who received treatment for bulimia nervosa and related eating disorders not otherwise specified were randomly assigned either to an immediate Internet-based support program (EDINA) over 4 months or to a 4-month waiting-list treatment as usual (TAU) control condition. The primary outcome was eating disorder-related attitudes at baseline and after 4 months assessed by the Eating Disorder Examination Questionnaire (EDE-Q). The program proved feasible and was well accepted. A significant reduction in eating disorder-related attitudes could be shown for both groups at the end of the 4 months. There was a tendency for participants of the aftercare intervention to show better results on all outcome measures. In total, 40.6% (13/32) of the EDINA participants and 24.4% (10/41) of the TAU participants showed statistically reliable improvement on the EDE-Q total score by the end of the intervention period [χ(2)(1)=2.195, p=0.138]. The Internet-based support program was feasible and well accepted but did not prove efficacious in a heterogeneous sample of patients following routine care.
The aim of this study was to evaluate the quality and value of web-based information on advance directives. Internet-based information on advance directives was selected because, if it is inaccurate or difficult to understand, patients risk making decisions about their care that may not be followed in practice. Two validated health information evaluation tools, the Suitability Assessment of Materials and DISCERN, and a focus group were used to assess credibility, user orientation and effectiveness. Only one of the 34 internet-based information items on advance directives reviewed fulfilled the study criteria and 30% of the sites were classed as unreadable. In terms of learning and informing, 79% of the sites were considered unsuitable. Using health literacy tools to evaluate internet-based health information highlights that often it is not at a functional literacy level and neither informs nor empowers users to make independent and valid healthcare decisions. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.
Tiller, Jane; Lacaze, Paul
The Internet currently enables unprecedented ease of access for direct-to-consumer (DTC) genetic testing, with saliva collection kits posted directly to consumer homes from anywhere in the world. This poses new challenges for local jurisdictions in regulating genetic testing, traditionally a tightly-regulated industry. Some Internet-based genetic tests have the capacity to cause significant confusion or harm to consumers who are unaware of the risks or potential variability in quality. The emergence of some online products of questionable content, unsupported by adequate scientific evidence, is a cause for concern. Proliferation of such products in the absence of regulation has the potential to damage public trust in accredited and established clinical genetic testing during a critical period of evidence generation for genomics. Here, we explore the challenges arising from the emergence of Internet-based DTC genetic testing. In particular, there are challenges in regulating unaccredited or potentially harmful Internet-based DTC genetic testing products. In Australia, challenges exist for the Therapeutic Goods Administration, which oversees regulation of the genetic testing sector. Concerns and challenges faced in Australia are likely to reflect those of other comparable non-US jurisdictions. Here, we summarize current Australian regulation, highlight concerns, and offer recommendations on how Australia and other comparable jurisdictions might be more proactive in addressing this emerging public health issue.
Fichter, Manfred M; Quadflieg, Norbert; Nisslmüller, Kerstin; Lindner, Susanne; Osen, Bernhard; Huber, Thomas; Wünsch-Leiteritz, Wally
Technological advancements allow new approaches to psychotherapy via electronic media. The eating disorder literature currently contains no studies on internet intervention in anorexia nervosa (AN). This study presents a RCT on an internet-based relapse prevention program (RP) over nine months after inpatient treatment for AN. The sample comprised 258 women, randomized to the RP or treatment as usual (TAU). Expert- and self-ratings were evaluated by intent-to-treat analyses. Concerning age, age at onset and comorbidity, both groups were comparable at randomization. During the RP, the intervention group gained weight while the TAU group had minimal weight loss. RP completers gained significantly more body weight than patients in the TAU condition. Group-by-time comparisons for eating-related cognitions and behaviors and general psychopathology showed a significantly more favorable course in the RP program for "sexual anxieties" and "bulimic symptoms" (interview), and "maturity fears" and "social insecurity" (EDI-2). General psychopathology showed no significant group-by-time interaction. Important factors for successful relapse prevention were adherence to the intervention protocol and increased spontaneity. Considering the unfavorable course and chronicity of anorexia nervosa (AN), internet-based relapse prevention in AN following inpatient treatment appears a promising approach. Future internet-based programs may be further improved and enhanced. Copyright Â© 2012 Elsevier Ltd. All rights reserved.
Ray, James V; Kimonis, Eva R; Donoghue, Christine
With its ever-growing penetration of remote regions of the world, the Internet provides great opportunity for conducting research. Beyond clear advantages such as increased cost-effectiveness and efficiency in collecting large samples, Internet-based research has proven particularly useful in reaching hidden or marginalized populations who engage in illegal or deviant behaviors. However, this new medium for research raises important and complex legal, ethical, and methodological/technological issues that researchers must address, particularly when studying undetected criminal behaviors. The current paper chronicles various issues that were encountered in the implementation of an active Internet-based pilot research study of child pornography (CP) users. Moreover, this study was undertaken to address a critical gap in the existing research on CP offending, which has to date primarily focused on incarcerated or convicted samples. The Internet provides the optimal medium for studying community populations of CP users, given that it has become the primary market for CP distribution. This paper is designed to serve as a guide for researchers interested in conducting Internet-based research studies on criminal and sexually deviant populations, particularly CP offenders. Several recommendations are offered based on our own experiences in the implementation of this study. Copyright 2009 John Wiley & Sons, Ltd.
Eimontas, Jonas; Rimsaite, Zivile; Gegieckaite, Goda; Zelviene, Paulina; Kazlauskas, Evaldas
Adjustment disorder is one of the most diagnosed mental disorders. However, there is a lack of studies of specialized internet-based psychosocial interventions for adjustment disorder. We aimed to analyze the outcomes of an internet-based unguided self-help psychosocial intervention BADI for adjustment disorder in a two armed randomized controlled trial with a waiting list control group. In total 284 adult participants were randomized in this study. We measured adjustment disorder as a primary outcome, and psychological well-being as a secondary outcome at pre-intervention (T1) and one month after the intervention (T2). We found medium effect size of the intervention for the completer sample on adjustment disorder symptoms. Intervention was effective for those participants who used it at least one time in 30-day period. Our results revealed the potential of unguided internet-based self-help intervention for adjustment disorder. However, high dropout rates in the study limits the generalization of the outcomes of the intervention only to completers.
Rakovshik, Sarah G; McManus, Freda; Vazquez-Montes, Maria; Muse, Kate; Ougrin, Dennis
To investigate the effect of Internet-based training (IBT), with and without supervision, on therapists' (N = 61) cognitive-behavioral therapy (CBT) skills in routine clinical practice. Participants were randomized into 3 conditions: (1) Internet-based training with use of a consultation worksheet (IBT-CW); (2) Internet-based training with CBT supervision via Skype (IBT-S); and (3) "delayed-training" controls (DTs), who did not receive the training until all data collection was completed. The IBT participants received access to training over a period of 3 months. CBT skills were evaluated at pre-, mid- and posttraining/wait using assessor competence ratings of recorded therapy sessions. Hierarchical linear analysis revealed that the IBT-S participants had significantly greater CBT competence at posttraining than did IBT-CW and DT participants at both the mid- and posttraining/wait assessment points. There were no significant differences between IBT-CW and the delayed (no)-training DTs. IBT programs that include supervision may be a scalable and effective method of disseminating CBT into routine clinical practice, particularly for populations without ready access to more-traditional "live" methods of training. There was no evidence for a significant effect of IBT without supervision over a nontraining control, suggesting that merely providing access to IBT programs may not be an effective method of disseminating CBT to routine clinical practice. (c) 2016 APA, all rights reserved).
Hartman, Sheri J; Dunsiger, Shira I; Marinac, Catherine R; Marcus, Bess H; Rosen, Rochelle K; Gans, Kim M
Physical inactivity is a modifiable risk factor for breast cancer. Physical activity interventions that can be delivered through the Internet have the potential to increase participant reach. The efficacy of an Internet-based physical activity intervention was tested in a sample of women at an elevated risk for breast cancer. A total of 55 women with at least 1 first-degree relative with breast cancer (but no personal history of breast cancer) were randomized to a 3-month theoretically grounded Internet-based physical activity intervention or an active control arm. Minutes of moderate to vigorous physical activity, psychosocial mediators of physical activity adoption and maintenance, as well as worry and perceived risk of developing breast cancer were assessed at baseline, 3-month, and 5-month follow up. Participants were on average 46.2 (SD = 11.4) years old with a body mass index of 27.3 (SD = 4.8) kg/m2. The intervention arm significantly increased minutes of moderate to vigorous physical activity compared to the active control arm at 3 months (213 vs. 129 min/week) and 5 months (208 vs. 119 min/week; both ps Internet-based physical activity intervention may substantially increase physical activity in women with a family history of breast cancer. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
Rozental, Alexander; Shafran, Roz; Wade, Tracey; Egan, Sarah; Nordgren, Lise Bergman; Carlbring, Per; Landström, Andreas; Roos, Stina; Skoglund, Malin; Thelander, Elisabet; Trosell, Linnéa; Örtenholm, Alexander; Andersson, Gerhard
Being highly attentive to details can be a positive feature. However, for some individuals, perfectionism can lead to distress and is associated with many psychiatric disorders. Cognitive behavior therapy has been shown to yield many benefits for those experiencing problems with perfectionism, but the access to evidence-based care is limited. The current study investigated the efficacy of guided Internet-based Cognitive Behavior Therapy (ICBT) and predictors of treatment outcome. In total, 156 individuals were included and randomized to an eight-week treatment or wait-list control. Self-report measures of perfectionism, depression, anxiety, self-criticism, self-compassion, and quality of life were distributed during screening and at post-treatment. Intention-to-treat were used for all statistical analyses. Moderate to large between-group effect sizes were obtained for the primary outcome measures, Frost Multidimensional Perfectionism Scale, subscales Concerns over Mistakes and Personal Standards, Cohen's d = 0.68-1.00, 95% Confidence Interval (CI) [0.36-1.33], with 35 (44.9%) of the patients in treatment being improved. Predictors were also explored, but none were related to treatment outcome. In sum, guided ICBT can be helpful for addressing problems with clinical perfectionism, but research of its long-term benefits is warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available Abstract Background Depression is a highly prevalent condition, affecting more than 15% of the adult population at least once in their lives. Guided self-help is effective in the treatment of depression. The purpose of this study is to investigate the effectiveness of two Internet-based guided self-help treatments with adults reporting elevated depressive symptoms. Other research questions concern the identification of potential mediators and the search for subgroups who respond differently to the interventions. Methods This study is a randomized controlled trial with three conditions: two treatment conditions and one waiting list control group. The two treatment conditions are Internet-based cognitive behavior therapy and Internet-based problem-solving therapy. They consist of 8 and 5 weekly lessons respectively. Both interventions are combined with support by e-mail. Participants in the waiting list control group receive the intervention three months later. The study population consists of adults from the general population. They are recruited through advertisements in local and national newspapers and through banners on the Internet. Subjects with symptoms of depression (≥ 16 on the Center for Epidemiological Studies Depression scale are included. Other inclusion criteria are having sufficient knowledge of the Dutch language, access to the Internet and an e-mail address. Primary outcome is depressive symptoms. Secondary outcomes are anxiety, quality of life, dysfunctional cognitions, worrying, problem solving skills, mastery, absence at work and use of healthcare. We will examine the following variables as potential mediators: dysfunctional cognitions, problem solving skills, worrying, anxiety and mastery. Potential moderating variables are: socio-demographic characteristics and symptom severity. Data are collected at baseline and at 5 weeks, 8 weeks, 12 weeks and 9 months after baseline. Analyses will be conducted on the intention
Baud, David; Regan, Lesley; Greub, Gilbert
This review considers the roles of Chlamydia spp. and newly identified Chlamydia-like organisms in miscarriage, stillbirths and preterm labour in both animals and humans. The cause of miscarriage, stillbirth and preterm labour often remains unexplained. Intracellular bacteria that grow either poorly or not at all on media used routinely to detect human pathogens could be the aetiological agents of these obstetrical conditions. There is growing evidence that Chlamydia trachomatis, Chlamydophila abortus, Chlamydophila psittaci and Chlamydophila pneumoniae infections may result in adverse pregnancy outcomes in humans and/or animals. Waddlia, a Chlamydia-like organism first isolated from an aborted bovine, has emerged as an agent of abortion in cattle. Recently, Waddlia was also implicated in human foetal death. Moreover, Parachlamydia acanthamoebae is also abortigenic in ruminants. Whether additional novel Chlamydia-like organisms, such as Protochlamydia amoebophila, Neochlamydia hartmanellae, Criblamydia sequanensis, Rhabdochlamydia crassificans and Simkania negevensis, are involved in foetal loss or premature delivery remains to be determined. This review provides an update on the consequences of chlamydial infection during pregnancy and summarizes current evidence suggesting that some Chlamydia-related organisms are probably emerging obstetrical pathogens.
Cuijpers, P.; Boluijt, P.R.; van Straten, A.
The Internet may offer new opportunities for treating depressed adolescents. However, before such treatments are possible, well-validated screening instruments are needed. In the current study, we validate two Internet-based screening instruments for depression among adolescents, the major
Bowden Francis J
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.
Luquiens, Amandine; Tanguy, Marie-Laure; Lagadec, Marthylle; Benyamina, Amine; Aubin, Henri-Jean; Reynaud, Michel
Internet-based interventions targeted at the most at-risk gamblers could reduce the treatment gap for addictive disorders. Currently, no clinical trial has included non-treatment-seeking patients who have been recruited directly in their gambling environment. This study was the first exclusively Internet-based randomized controlled trial among non-help-seeking problem gamblers with naturalistic recruitment in their gambling environment. The aim of this study was to assess the efficacy of three modalities of Internet-based psychotherapies with or without guidance, compared to a control condition, among problem gamblers who play online poker. All active poker gamblers on the Winamax website were systematically offered screening. All problem poker gamblers identified with a Problem Gambling Severity Index (PGSI) score of ≥ 5 were eligible to be included in the trial. Problem gamblers were randomized into four groups: (1) waiting list (control group), (2) personalized normalized feedback on their gambling status by email, (3) an email containing a self-help book to be downloaded with a Cognitive Behavioral Therapy (CBT) program without guidance, and (4) the same CBT program emailed weekly by a trained psychologist with personalized guidance. Efficacy was assessed based on the change in PGSI between baseline and 6 weeks (end of treatment) or 12 weeks (maintenance) and supported by player account-based gambling data automatically collected at the three time points. All groups met high attrition rates (83%), but the group with guidance had a significantly higher dropout rate than the other three groups, including the control group. Although all groups showed some improvement, with a mean decrease of 1.35 on the PGSI, no significant difference in efficacy between the groups was observed. One-third of the problem gamblers fell below the problem gambling threshold at 6 weeks. Guidance could have aversively affected problem gamblers who had not sought help. Despite the lack
Wilson, Emma; Free, Caroline; Morris, Tim P; Kenward, Michael G; Syred, Jonathan; Baraitser, Paula
Ensuring rapid access to high quality sexual health services is a key public health objective, both in the United Kingdom and internationally. Internet-based testing services for sexually transmitted infections (STIs) are considered to be a promising way to achieve this goal. This study will evaluate a nascent online STI testing and results service in South East London, delivered alongside standard face-to-face STI testing services. The aim of this study is to establish whether an online testing and results services can (1) increase diagnoses of STIs and (2) increase uptake of STI testing, when delivered alongside standard face-to-face STI testing services. This is a single-blind randomized controlled trial. We will recruit 3000 participants who meet the following eligibility criteria: 16-30 years of age, resident in the London boroughs of Lambeth and Southwark, having at least one sexual partner in the last 12 months, having access to the Internet and willing to take an STI test. People unable to provide informed consent and unable to read and understand English (the websites will be in English) will be excluded. Baseline data will be collected at enrolment. This includes participant contact details, demographic data (date of birth, gender, ethnicity, and sexual orientation), and sexual health behaviors (last STI test, service used at last STI test and number of sexual partners in the last 12 months). Once enrolled, participants will be randomly allocated either (1) to an online STI testing and results service (Sexual Health 24) offering postal self-administered STI kits for chlamydia, gonorrhoea, syphilis, and HIV; results via text message (short message service, SMS), except positive results for HIV, which will be delivered by phone; and direct referrals to local clinics for treatment or (2) to a conventional sexual health information website with signposting to local clinic-based sexual health services. Participants will be free to use any other interventions
Birkelund, Svend; Lundemose, AG; Christiansen, Gunna
Purified elementary bodies (EBs) of Chlamydia trachomatis serovar L2 were analyzed by chemical cross-linking with disuccinimidyl selenodipropionate. The effect of the cross-linking was analyzed by immunoblotting sodium dodecyl sulfate-polyacrylamide gel electrophoresis-separated components which...
Christiansen, Gunna; Østergaard, Lars; Birkelund, Svend
Chlamydia pneumoniaeis a fastidious microorganism with a characteristic biphasic lifecycle causing a variety of human respiratory tract infections. There is limited knowledge about the molecular biology of C. pneumoniae, and only a few genes have been sequenced. The structure of the chlamydial...
Full Text Available Bacterial cell division predominantly occurs by a highly conserved process, termed binary fission, that requires the bacterial homologue of tubulin, FtsZ. Other mechanisms of bacterial cell division that are independent of FtsZ are rare. Although the obligate intracellular human pathogen Chlamydia trachomatis, the leading bacterial cause of sexually transmitted infections and trachoma, lacks FtsZ, it has been assumed to divide by binary fission. We show here that Chlamydia divides by a polarized cell division process similar to the budding process of a subset of the Planctomycetes that also lack FtsZ. Prior to cell division, the major outer-membrane protein of Chlamydia is restricted to one pole of the cell, and the nascent daughter cell emerges from this pole by an asymmetric expansion of the membrane. Components of the chlamydial cell division machinery accumulate at the site of polar growth prior to the initiation of asymmetric membrane expansion and inhibitors that disrupt the polarity of C. trachomatis prevent cell division. The polarized cell division of C. trachomatis is the result of the unipolar growth and FtsZ-independent fission of this coccoid organism. This mechanism of cell division has not been documented in other human bacterial pathogens suggesting the potential for developing Chlamydia-specific therapeutic treatments.
R.P.A.J. Verkooyen (Roel)
textabstractThe Chlamydiae are characterized as bacteria because of the composition of their cell wall and their growth by binary division. However, they are obligate intracellular bacterial parasites of eukaryotic cells that have a unique replication cycle similar to Rickettsia. Chlamydial
Jul 11, 2011 ... Chlamydia trachomatis is a ubiquitous human pathogen that is responsible for the most prevalent bacterial sexually transmitted disease worldwide. Studies show that polymerase chain reaction (PCR) is more sensitive than cellular culture for detection of C. trachomatis infections. The aim of this study is to.
acquiring sexually transmitted infections in the Kumasi metropolis, Ghana. Design: Structured interviews and clinical examination of participants and obtaining vaginal swabs to test for gonorrhoea and chlamydia infections. ... subjects detects the outer membrane protein of C. tra- chomatis14. The endocervical swab was ...
Chlamydia trachomatis is a ubiquitous human pathogen that is responsible for the most prevalent bacterial sexually transmitted disease worldwide. Studies show that polymerase chain reaction (PCR) is more sensitive than cellular culture for detection of C. trachomatis infections. The aim of this study is to compare different ...
Background: Chlamydia trachomatis is the most common bacterial sexually transmitted disease in the world with severe complications. The aim of this study was to determine the prevalence and possible risk factors of C. trachomatis in Kano. There is dearth of information on this subject in this locality. Method: Urine samples ...
Background: Chlamydia trachomatis is the most common bacterial sexually transmitted disease in the world with severe complications. ... Conclusion: C. trachomatis infection if unchecked will continue to pose a threat to reproductive life with its established ... lead to chronic pelvic pain, ectopic pregnancy, and infertility3.
Ten Hoor, Gill; Hoebe, Christian Jpa; van Bergen, Jan Eam; Brouwers, Elfi Ehg; Ruiter, Robert Ac; Kok, Gerjo
In The Netherlands, screening for chlamydia (the most prevalent sexually transmitted infection worldwide) is a relatively simple and free procedure. Via an invitation letter sent by the public health services (PHS), people are asked to visit a website to request a test kit. They can then do a chlamydia test at home, send it anonymously to a laboratory, and, within two weeks, they can review their test results online and be treated by their general practitioner or the PHS. Unfortunately, the participation rates are low and the process is believed to be not (cost-) effective. The objective of this study was to assess whether the low participation rate of screening for chlamydia at home, via an invitation letter asking to visit a website and request a test kit, could be improved by optimizing the invitation letter through systematically applied behavior change theories and evidence. The original letter and a revised letter were randomly sent out to 13,551 citizens, 16 to 29 years old, in a Dutch municipality. Using behavior change theories, the revised letter sought to increase motivation to conduct chlamydia screening tests. The revised letter was tailored to beliefs that were found in earlier studies: risk perception, advantages and disadvantages (attitude), moral norm, social influence, and response- and self-efficacy. Revisions to the new letter also sought to avoid possible unwanted resistance caused when people feel pressured, and included prompts to trigger the desired behavior. No significant differences in test package requests were found between the two letters. There were also no differences between the original and revised letters in the rates of returned tests (11.80%, 581/4922 vs. 11.07%, 549/4961) or positive test results (4.8%, 23/484 vs. 4.1%, 19/460). It is evident that the new letter did not improve participation compared to the original letter. It is clear that the approach of inviting the target population through a letter does not lead to higher
K. Jonas Brännström
Conclusions: An Internet-based support system can be used in audiologic rehabilitation. Both audiologists and clients recognized the system's potential value to offer an online support to the provision of audiologic services.
Beintner, Ina; Jacobi, Corinna; Taylor, C. Barr
Study and treatment dropout and adherence represent particular challenges in studies on Internet-based interventions. However, systematic investigations of the relationship between study, intervention and patient characteristics, participation, and intervention outcomes in online-prevention are scarce. A review of participation in trials investigating a cognitive-behavioral, Internet-based, 8-week prevention program (StudentBodies™) for eating disorders, moderators of participation, and the i...
Chiu, T.; Lottridge, D.
This poster reports on the developmental phase of a new internet-based support services (ICSS) for Chinese caregivers of people with Alzheimer Disease (AD): a specialized email application and an informational website. Bilingual Chinese caregivers wanted internet-based information in both Chinese and English. Usability testing and heuristic evaluation results revealed that the interface successfully supported the core functionality, but can be refined to improve usability.
Chiu, T; Lottridge, D
This poster reports on the developmental phase of a new internet-based support services (ICSS) for Chinese caregivers of people with Alzheimer Disease (AD): a specialized email application and an informational website. Bilingual Chinese caregivers wanted internet-based information in both Chinese and English. Usability testing and heuristic evaluation results revealed that the interface successfully supported the core functionality, but can be refined to improve usability.
Moessner, Markus; Minarik, Carla; Ozer, Fikret; Bauer, Stephanie
Only little is known about costs and effects (i.e., success) of dissemination strategies, although cost-effective dissemination strategies are crucial for the transfer of interventions into routine care. This study investigates the effects and cost-effectiveness of five school-based dissemination strategies for an Internet-based intervention for the prevention and early intervention of eating disorders. Three-hundred ninety-five schools were randomly assigned to one of five dissemination strategies. Strategies varied with respect to intensity from only sending advertisement materials and asking the school to distribute them among students to organizing presentations and workshops at schools. Effects were defined as the number of page visits, the number of screenings conducted, and the number of registrations to the Internet-based intervention. More expensive strategies proved to be more cost-effective. Cost per page visit ranged from 2.83€ (introductory presentation plus workshop) to 20.37€ (dissemination by student representatives/peers). Costs per screening ranged from 3.30€ (introductory presentation plus workshop) to 75.66€ (dissemination by student representatives/peers), and costs per registration ranged from 6.86€ (introductory presentation plus workshop) to 431.10€ (advertisement materials only). Dissemination of an Internet-based intervention for prevention and early intervention is challenging and expensive. More intense, expensive strategies with personal contact proved to be more cost-effective. The combination of an introductory presentation on eating disorders and a workshop in the high school was most effective and had the best cost-effectiveness ratio. The sole distribution of advertisement materials attracted hardly any participants to the Internet-based program.
Pannekoek, Yvonne; Dickx, Veerle; Beeckman, Delphine S A; Jolley, Keith A; Keijzers, Wendy C; Vretou, Evangelia; Maiden, Martin C J; Vanrompay, Daisy; van der Ende, Arie
Chlamydia comprises a group of obligate intracellular bacterial parasites responsible for a variety of diseases in humans and animals, including several zoonoses. Chlamydia trachomatis causes diseases such as trachoma, urogenital infection and lymphogranuloma venereum with severe morbidity. Chlamydia pneumoniae is a common cause of community-acquired respiratory tract infections. Chlamydia psittaci, causing zoonotic pneumonia in humans, is usually hosted by birds, while Chlamydia abortus, causing abortion and fetal death in mammals, including humans, is mainly hosted by goats and sheep. We used multi-locus sequence typing to asses the population structure of Chlamydia. In total, 132 Chlamydia isolates were analyzed, including 60 C. trachomatis, 18 C. pneumoniae, 16 C. abortus, 34 C. psittaci and one of each of C. pecorum, C. caviae, C. muridarum and C. felis. Cluster analyses utilizing the Neighbour-Joining algorithm with the maximum composite likelihood model of concatenated sequences of 7 housekeeping fragments showed that C. psittaci 84/2334 isolated from a parrot grouped together with the C. abortus isolates from goats and sheep. Cluster analyses of the individual alleles showed that in all instances C. psittaci 84/2334 formed one group with C. abortus. Moving 84/2334 from the C. psittaci group to the C. abortus group resulted in a significant increase in the number of fixed differences and elimination of the number of shared mutations between C. psittaci and C. abortus. C. psittaci M56 from a muskrat branched separately from the main group of C. psittaci isolates. C. psittaci genotypes appeared to be associated with host species. The phylogenetic tree of C. psittaci did not follow that of its host bird species, suggesting host species jumps. In conclusion, we report for the first time an association between C. psittaci genotypes with host species.
Full Text Available Chlamydia comprises a group of obligate intracellular bacterial parasites responsible for a variety of diseases in humans and animals, including several zoonoses. Chlamydia trachomatis causes diseases such as trachoma, urogenital infection and lymphogranuloma venereum with severe morbidity. Chlamydia pneumoniae is a common cause of community-acquired respiratory tract infections. Chlamydia psittaci, causing zoonotic pneumonia in humans, is usually hosted by birds, while Chlamydia abortus, causing abortion and fetal death in mammals, including humans, is mainly hosted by goats and sheep. We used multi-locus sequence typing to asses the population structure of Chlamydia. In total, 132 Chlamydia isolates were analyzed, including 60 C. trachomatis, 18 C. pneumoniae, 16 C. abortus, 34 C. psittaci and one of each of C. pecorum, C. caviae, C. muridarum and C. felis. Cluster analyses utilizing the Neighbour-Joining algorithm with the maximum composite likelihood model of concatenated sequences of 7 housekeeping fragments showed that C. psittaci 84/2334 isolated from a parrot grouped together with the C. abortus isolates from goats and sheep. Cluster analyses of the individual alleles showed that in all instances C. psittaci 84/2334 formed one group with C. abortus. Moving 84/2334 from the C. psittaci group to the C. abortus group resulted in a significant increase in the number of fixed differences and elimination of the number of shared mutations between C. psittaci and C. abortus. C. psittaci M56 from a muskrat branched separately from the main group of C. psittaci isolates. C. psittaci genotypes appeared to be associated with host species. The phylogenetic tree of C. psittaci did not follow that of its host bird species, suggesting host species jumps. In conclusion, we report for the first time an association between C. psittaci genotypes with host species.
Newton, Nicola C; Teesson, Maree; Vogl, Laura E; Andrews, Gavin
To establish the long-term efficacy of a universal internet-based alcohol and cannabis prevention programme in schools. A cluster-randomized controlled trial was conducted to assess the effectiveness of the Climate Schools: Alcohol and Cannabis Course. The evidence-based course, aimed at reducing alcohol and cannabis use, is facilitated by the internet and consists of 12 novel and curriculum consistent lessons delivered over 6 months. A total of 764 year 8 students (13 years) from 10 Australian secondary schools were allocated randomly to the internet-based prevention programme (n = 397, five schools), or to their usual health classes (n = 367, five schools). Participants were assessed at baseline, immediately post, and 6 and 12 months following completion of the intervention, on measures of alcohol and cannabis knowledge, attitudes, use and related harms. This paper reports the final results of the intervention trial, 12 months following the completion of the Climate Schools: Alcohol and Cannabis Course. The effectiveness of the course 6 months following the intervention has been reported previously. At the 12-month follow-up, compared to the control group, students in the intervention group showed significant improvements in alcohol and cannabis knowledge, a reduction in average weekly alcohol consumption and a reduction in frequency of drinking to excess. No differences between groups were found on alcohol expectancies, cannabis attitudes or alcohol- and cannabis-related harms. The course was found to be acceptable by teachers and students as a means of delivering drug education in schools. Internet-based prevention programs for school-age children can improve student's knowledge about alcohol and cannabis, and may also reduce alcohol use twelve months after completion.
Papadaki, Angeliki; Thanasoulias, Andreas; Pound, Rachael; Sebire, Simon J; Jago, Russell
Explore employees' perceptions of ability to follow the Mediterranean diet (MedDiet), preferences for setting goals if asked to follow the MedDiet, and expectations of an Internet-based, workplace MedDiet intervention. Seven focus groups to guide intervention development. Four workplaces (business/professional services, government branches) in Southwest England. Employees (n = 29, 51.7% women), ages 24-58 years. Ability to follow the MedDiet; preferences for goal-setting if asked to follow the MedDiet; intervention content. Data were analyzed with the use of thematic analysis. Participants perceived that adhering to some MedDiet recommendations would be challenging and highlighted cost, taste, and cooking skills as adherence barriers. Behavior change preferences included a tailored approach to goal-setting, reviewing goal progress via a website/smartphone app, and receiving expert feedback via an app/website/text/face-to-face session. Desirable features of an Internet-based MedDiet application included recipes, interactivity, nutritional information, shopping tips, cost-saving information, and a companion smartphone app. Engaging in social support was deemed important to facilitate adherence. An Internet-based, workplace MedDiet intervention should address adherence barriers, utilize a tailored approach to setting and reviewing goals, and activate social support to facilitate adherence. These findings provide insights to planning to promote the MedDiet in non-Mediterranean regions. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Tsugihashi, Yukio; Kakudate, Naoki; Yokoyama, Yoko; Yamamoto, Yosuke; Mishina, Hiroki; Fukumori, Norio; Nakamura, Fumiaki; Takegami, Misa; Ohno, Shinya; Wakita, Takafumi; Watanabe, Kazuhiro; Yamaguchi, Takuhiro; Fukuhara, Shunichi
We developed a novel Internet-based blended learning programme that allows busy health care professionals to attain core competency in clinical research. This study details the educational strategies and learning outcomes of the programme. This study was conducted at Kyoto University and seven satellite campuses from September 2009 to March 2010. A total of 176 health care professionals who had never attempted to attain core competency in clinical research were enrolled. The participants were supplied with a novel programme comprising the following four strategies: online live lectures at seven satellite campuses, short examinations after each lecture, an Internet-based feedback system and an end-of-course examination. We assessed the proportion of attendance at the lectures as the main outcome. In addition, we evaluated interaction via the feedback system and scores for end-of-course examination. Of the 176 participants, 134 (76%) reported working more than 40 hours per week. The mean proportion of attendance over all 23 lectures was 82%. A total of 156 (89%) participants attended more than 60% of all lectures and were eligible for the end-of-course examination. A total of the participants accessed the feedback system 3564 times and asked 284 questions. No statistically significant differences were noted in the end-of-course scores among medical doctors, pharmacists, registered nurses and other occupations. We developed an Internet-based blended learning programme providing core competency in clinical research. Most busy health care professionals completed the programme successfully. In addition, the participants could attain the core competency effectively, regardless of their occupation. © 2011 Blackwell Publishing Ltd.
Wolbrink, Traci A; Kissoon, Niranjan; Burns, Jeffrey P
Advances in Internet technology now enable unprecedented global collaboration and collective knowledge exchange. Up to this time, there have been limited efforts to use these technologies to actively promote knowledge exchange across the global pediatric critical care community. To develop an open-access, peer-reviewed, not-for-profit Internet-based learning application, OPENPediatrics, a collaborative effort with the World Federation of Pediatric Intensive and Critical Care Societies, was designed to promote postgraduate educational knowledge exchange for physicians, nurses, and others caring for critically ill children worldwide. Description of program development. International multicenter tertiary pediatric critical care units across six continents. Multidisciplinary pediatric critical care providers. A software application, providing information on demand, curricular pathways, and videoconferencing, downloaded to a local computer. In 2010, a survey assessing postgraduate educational needs was distributed through World Federation of Pediatric Intensive and Critical Care Societies to constituent societies. Four hundred and twenty-nine critical care providers from 49 countries responded to the single e-mail survey request. Respondents included 68% physicians and 28% nurses who care for critically ill children. Fifty-two percent of respondents reported accessing the Internet at least weekly to obtain professional educational information. The five highest requests were for educational content on respiratory care [mechanical ventilation] (48% [38%]), sepsis (28%), neurology (25%), cardiology (14%), extracorporeal membrane oxygenation (10%), and ethics (8%). Based on these findings, and in collaboration with researchers in adult learning and online courseware, an application was developed and is currently being used by 770 registered users in 60 countries. We describe here the development and implementation of an Internet-based application which is among the first
Schmidt, A; Greuter, T; Möller, A; Steiß, J O
The effectiveness and practicality of the "Luftikids" (www.luftikids.de) structured, internet-based asthma refresher course was evaluated in a pilot study with 53 patients (ages 8 - 14 years). All patients had previously participated in either an inpatient or outpatient asthma education program. This prospective study examined the effect of a 4-week refresher course on parameters such as asthma symptoms (coughing, dyspnea), the number of unscheduled doctor's visits, use of on-demand medications, number of days absent from school, and asthma monitoring using the Asthma Control Questionnaire (ACQ) and lung function tests. The duration of program use and the number of logins was used to investigate acceptance of the game format. Data were collected at the beginning of the study and at 4 - 6 months after the end of the online refresher course. Significant changes were shown with regard to the decrease in intensity of asthma symptoms such as coughing (p = 0.001) and dyspnea (p = 0.007), reduction in the number of unscheduled doctor's visits (p = 0.005), the use of on-demand medications (4.0 ± 6.5 vs. 1.5 ± 4.9, p = children and adolescents derived "much" to "very much" benefit. Only 7.5% reported no effect. Participation in the "Luftikids" internet-based asthma refresher course resulted in fewer asthma symptoms, a decrease in unscheduled doctor's visits, reduction in the use of on-demand medications, decrease in the number of days absent from school, and improved asthma knowledge. No effect in lung function could be demonstrated. The results support the effectiveness and good acceptance of an outpatient, internet-based asthma refresher course. Young asthma patients in particular can succeed with and be motivated by this form of refresher course. © Georg Thieme Verlag KG Stuttgart · New York.
Miller, R; Schmidt, K; Kirschbaum, C; Enge, S
The internet-based assessment of response time (RT) and error rate (ERR) has recently become a well-validated alternative to traditional laboratory-based assessment, because methodological research has provided evidence for negligible setting- and setup-related differences in RT and ERR measures of central tendency. However, corresponding data on potential differences in the variability of such performance measures are still lacking, to date. Hence, the aim of this study was to conduct internet-based mental chronometry in both poorly standardized domestic and highly standardized laboratory environments and to compare the variabilities of the corresponding performance measures. Using the Millisecond Inquisit4Web software, 127 men and women completed three different RT-based cognitive paradigms (i.e., go/no-go, two-back, and number-letter). Each participant completed all paradigms in two environments (i.e., at home and in the laboratory), with a time lag of seven days and in a counterbalanced order. Mixed-effects modeling was employed to estimate the between-setting variability across a comprehensive set of performance measures, including conventional measures of central tendency (i.e., mean RT and ERR) and further measures characterizing the joint distribution of RT/ERR. The latter measures were estimated using the diffusion model. The results suggested negligible differences between the domestic and laboratory settings. Thus, this study provides novel evidence suggesting that the statistical power of internet-based mental chronometry is commonly not compromised by increased environmental variance. The within- and between-session reliabilities were in a satisfactory range-that is, comparable to performance measures collected offline in laboratory settings. In consequence, our results support the broad applicability, robustness, and cost efficiency of mental chronometry assessment using the internet.
Quan, Stuart F.; Anderson, Janis L.; Hodge, Gordon K.
Introduction: Knowledge regarding the importance of sleep in health and performance and good sleep hygiene practices is low, especially among adolescents and young adults. It is important to improve sleep literacy. Introductory psychology is one of the most highly enrolled courses at colleges and universities. This study tested the impact of an Internet-based learning module on improving sleep literacy in this venue. Methods: An Internet-based supplementary learning module containing sleep physiology and hygiene information was developed using content from the Harvard Medical School sleep educational website http://www.understandingsleep.org. Access to the module was provided as an extra credit activity for 2 of 4 sections (Supplemental Sleep, SS, N = 889) of an introductory college psychology course during their standard instruction on sleep and dreaming. The remaining 2 sections (Standard Instruction, SI, N = 878) only were encouraged to visit the website without further direction. Level of knowledge was assessed before and after availability to the module/website and at the end of the semester. Students were asked to complete a survey at the end of the semester inquiring whether they made any changes in their sleep behaviors. Results: Two hundred fifty students participated in the extra credit activity and had data available at all testing points. Students in the SS Group had a significant improvement in sleep knowledge test scores after interacting with the website in comparison to the SI group (19.41 ± 3.15 vs. 17.94 ± 3.08, p psychology course. Citation: Quan SF; Anderson JL; Hodge GK. Use of a supplementary internet based education program improves sleep literacy in college psychology students. J Clin Sleep Med 2013;9(2):155-160. PMID:23372469
Collinson, A; Lindley, R; Campbell, A; Waters, I; Lindley, T; Wallace, A
The prevalence of overweight and obesity is increasing worldwide at an alarming rate. An Internet-based weight-loss programme has the potential to reach larger numbers of people than traditional face-to-face programmes. A growing body of evidence supports the use of low glycaemic load (GL) diets for weight loss. The present study aimed to investigate the efficacy of an Internet-based weight-loss programme that included foods with a low GL. One hundred and three volunteers, with a body mass index (BMI) ≥28 kg m(-2) , enrolled into an Internet weight-loss programme. A dietitian counselled participants over the Internet via weekly interactive chat rooms and monthly e-mails. Participants self-recorded body weight and food intake directly on to the Internet site. Weight, BMI and waist circumference were measured, and dietary data collected, at baseline and 6 months. Seventy participants completed the 6-month weight-loss programme. Among these, mean weight, BMI and waist circumference significantly decreased by 3.5 kg (95% CI = 2.3-4.7), 1.2 kg m(-2) (95% CI = 0.8-1.7) and 4.8 cm (95% CI = 2.8-6.8), of baseline values respectively (P 5% of initial body weight). This descriptive study has shown that an Internet-based weight-loss programme with low GL principles can promote weight loss. This type of intervention and approach could be used to enhance other weight-loss strategies. © 2010 The Authors. Journal compilation © 2010 The British Dietetic Association Ltd.
Magdalena N. Junge
Full Text Available Internet-based problem-solving training (IPST effectively reduces depressive symptoms in employees. Yet, it is unknown which employees benefit most from this particular treatment. The study aimed to identify predictors and moderators of treatment outcome in IPST offered to employees with depressive symptoms. Within a randomized controlled trial (N = 150, designed to test the effectiveness of IPST, variables that predict and moderate the effects of IPST when compared with a waitlist control group (WLC were explored. The outcome was change in depression severity, assessed using the Center for Epidemiological Studies Depression Scale (CES-D. Both depression severity and other psychopathological symptoms and potential predictors/moderators were assessed as self-reports at baseline (t1 and in follow-up assessments after seven weeks (t2, three months (t3 and six months (t4. Higher depression severity at baseline predicted improvement in depressive symptomology in follow-up assessments after seven weeks, and three- and six months. Depression severity moderated the effectiveness of IPST assessed at six-month follow-up. Simple slope analyses revealed that the long-term effectiveness of the intervention was more pronounced among participants with high (CES-D range: 33–44, M = 37.0, SD = 3.2 and moderate (CES-D range: 14–32, M = 23.1, SD = 5.6 depression baseline scores, compared to participants displaying low depression baseline scores (CES-D range: 5–13, M = 9.0, SD = 2.2. No indication was found that participants presenting low depression severity at baseline significantly benefitted from IPST in the long-term. IPST might be appropriate for employees with a wide range of different characteristics. While there appears to be no reason to exclude employees with severe depression from Internet-based occupational mental health interventions, for employees low in depression severity, watchful waiting or potentially no intervention should
Roberts, C M; Milon, S; Kurosinski, P
We studied the learning preferences of 160 respiratory specialists from four European countries who participated in ten internet-based learning modules and answered linked survey questions. Specialists were enthusiastic for internet learning amongst all national groups and particularly wanted to access material for teaching others. The value of social interactive learning was acknowledged but British and German subjects appeared more reluctant to participate. Internet delivered distance learning is well perceived amongst respiratory specialists. There is potential for both individual and group learning that could be realized by developing Europe-wide continuing professional development communities.
Troullos, Emanuel; Baird, Lisa; Jayawardena, Shyamalie
Conducting and analyzing clinical studies of cough and cold medications is challenging due to the rapid onset and short duration of the symptoms. The use of Internet-based surveillance tools is a new approach in clinical studies that is gradually becoming popular and may become a useful method of recruitment. As part of an initiative to assess the safety and efficacy of cough and cold ingredients in children 6-11 years of age, a surveillance program was proposed as a means to identify and recruit pediatric subjects for clinical studies. The objective of the study was to develop an Internet-based surveillance system and to assess the feasibility of using such a system to recruit children for common cold clinical studies, record the natural history of their cold symptoms, and determine the willingness of parents to have their children participate in clinical studies. Healthy potential subjects were recruited via parental contact online. During the 6-week surveillance period, parents completed daily surveys to record details of any cold symptoms in their children. If a child developed a cold, symptoms were followed via survey for 10 days. Additional questions evaluated the willingness of parents to have their children participate in a clinical study shortly after onset of symptoms. The enrollment target of 248 children was reached in approximately 1 week. Children from 4 distinct geographic regions of the United States were recruited. Parents reported cold symptoms in 163 children, and 134 went on to develop colds. The most prevalent symptoms were runny nose, stuffed-up nose, and sneezing. The most severe symptoms were runny nose, stuffed-up nose, and sore/scratchy throat. The severity of most symptoms peaked 1-2 days after onset. Up to 54% of parents expressed willingness to bring a sick child to a clinical center shortly after the onset of symptoms. Parents found the Internet-based surveys easy to complete. Internet-based surveillance and recruitment can be useful
The rapid development of biotechnological methods provides the potential of dissecting the molecular structure of microorganisms. In this review the molecular biology of chlamydia is described. The genus Chlamydia contains three species C. trachomatis, C. psittaci, and C. pneumonia which all...... are important human pathogens. Chlamydia is obligate intracellular bacteria with a unique biphasic life cycle. The extracellularly chlamydial elementary bodies (EB) are small, metabolic inactive, infectious particles with a tight outer cell membrane. After internalization into host cells the chlamydial...
Hatch, T.P.; Miceli, M.; Silverman, J.A.
Synthesis of protein by the obligate intracellular parasitic bacteria Chlamydia psittaci (6BC) and Chlamydia trachomatis (serovar L2) isolated from host cells (host-free chlamydiae) was demonstrated for the first time. Incorporation of [ 35 S]methionine and [ 35 S]cysteine into trichloroacetic acid-precipitable material by reticulate bodies of chlamydiae persisted for 2 h and was dependent upon a exogenous source of ATP, an ATP-regenerating system, and potassium or sodium ions. Magnesium ions and amino acids stimulated synthesis; chloramphenicol, rifampin, oligomycin, and carbonyl cyanide p-trifluoromethoxyphenylhydrazone (a proton ionophore) inhibited incorporation. Ribonucleoside triphosphates (other than ATP) had little stimulatory effect. The optimum pH for host-free synthesis was between 7.0 and 7.5. The molecular weights of proteins synthesized by host-free reticulate bodies closely resembled the molecular weights of proteins synthesized by reticulate bodies in an intracellular environment, and included outer membrane proteins. Elementary bodies of chlamydiae were unable to synthesize protein even when incubated in the presence of 10 mM dithiothreitol, a reducing agent which converted the highly disulfide bond cross-linked major outer membrane protein to monomeric form
Internet-based reservation system (Internet-based control of timers for building technical services) - Final report; Internetbasiertes Reservationssystem (Internetbasierte Einstellung von Zeitsteuerungen haustechnischer Anlagen) - Schlussbericht
Huber, A.; Woodtli, M.
A common measure to save energy in buildings is the adjustment of the operating time of the building service facilities to the busy time of the building (i.e. lowering period). For lack of better resources, the general lowering periods in irregularly occupied buildings often are reduced to a minimum or the adjustment of the operating time is completely missing. In order to adjust the operating time optimally to the actual busy time, an internet-based booking system has been developed, which allows users to register a room assignment online. This booking system is linked with the building service facilities. This ensure the optimal setting of the lowering periods and therefore allows saving energy. The technical implementation resulted from a programmable logic controller (PLC) that can be accessed via a web browser. Temperature offset boxes have been added as interface between the PLC and the existing facilities in order that the system is applicable in existing buildings too. The booking system has been installed in two test objects and has also been successfully tested with the responsible staff (caretaker, real estate management). The booking system may be contemplated online: http://www.hetag.ch. (author)
Carter, JD; Espinoza, LR; Inman, RD; Sneed, KB; Ricca, LR; Vasey, FB; Valeriano, J; Stanich, JA; Oszust, C; Gerard, HC; Hudson, AP
Background Chlamydia trachomatis (Ct) and Chlamydophila (Chlamydia) pneumoniae (Cpn) are known triggers of reactive arthritis (ReA). These chlamydial species exist in a persistent metabolically active infection state in the synovium suggesting that persistent chlamydiae may be susceptible to antimicrobial agents. The goal of this study was to investigate whether a six-month course of combination antibiotics is an effective therapy for patients with chronic Chlamydia-induced ReA. Methods This study was a 9-month, double-blind, triple-dummy prospective trial assessing a 6-month course of combination antibiotics as a treatment for Chlamydia-induced ReA. Eligible patients were age 18 to 70 years, fulfilled the European Spondyloarthropathy Study Group (ESSG) Criteria, and had disease duration equal to or longer than 6 months. Subjects had to be polymerase chain reaction (PCR)-positive for Ct or Cpn in order to be randomized to therapy; randomization was performed in a 1:1:1 fashion. Treatment was for 6 months; the 3 groups included doxycycline 100mg twice daily and rifampin 300mg daily, azithromycin 500mg daily × 5 days then twice weekly and rifampin 300mg daily, or matching placebos. The primary efficacy endpoint was to assess the number of responders in the combination antibiotic group vs. placebo at month 6 compared to baseline. Responders were defined as those subjects who improved 20% or more in at least 4 of 6 variables without worsening in any one variable. Results 80 subjects were screened and 42 were randomized to treatment (27 to combination antibiotics and 15 to placebo). Subjects in each group had similar demographics and baseline characteristics. At month 6, 17/27 subjects (63%) randomized to combination antibiotics were responders compared to 3/15 (20%) on placebo (P-value = 0.01). Secondary efficacy endpoints showed similar results with significant improvement in the modified swollen joint count, tender joint count, physician global assessment (P
Guan, Li; Hao, Bibo; Cheng, Qijin; Yip, Paul Sf; Zhu, Tingshao
Traditional offline assessment of suicide probability is time consuming and difficult in convincing at-risk individuals to participate. Identifying individuals with high suicide probability through online social media has an advantage in its efficiency and potential to reach out to hidden individuals, yet little research has been focused on this specific field. The objective of this study was to apply two classification models, Simple Logistic Regression (SLR) and Random Forest (RF), to examine the feasibility and effectiveness of identifying high suicide possibility microblog users in China through profile and linguistic features extracted from Internet-based data. There were nine hundred and nine Chinese microblog users that completed an Internet survey, and those scoring one SD above the mean of the total Suicide Probability Scale (SPS) score, as well as one SD above the mean in each of the four subscale scores in the participant sample were labeled as high-risk individuals, respectively. Profile and linguistic features were fed into two machine learning algorithms (SLR and RF) to train the model that aims to identify high-risk individuals in general suicide probability and in its four dimensions. Models were trained and then tested by 5-fold cross validation; in which both training set and test set were generated under the stratified random sampling rule from the whole sample. There were three classic performance metrics (Precision, Recall, F1 measure) and a specifically defined metric "Screening Efficiency" that were adopted to evaluate model effectiveness. Classification performance was generally matched between SLR and RF. Given the best performance of the classification models, we were able to retrieve over 70% of the labeled high-risk individuals in overall suicide probability as well as in the four dimensions. Screening Efficiency of most models varied from 1/4 to 1/2. Precision of the models was generally below 30%. Individuals in China with high suicide
Botella, C; Gallego, M J; Garcia-Palacios, A; Guillen, V; Baños, R M; Quero, S; Alcañiz, M
This study offers data about the efficacy of "Talk to Me," an Internet-based telepsychology program for the treatment of fear of public speaking that includes the most active components in cognitive-behavior therapy (CBT) for social phobia (exposure and cognitive therapies). One hundred twenty-seven participants with social phobia were randomly assigned to three experimental conditions: (a) an Internet-based self-administered program; (b) the same program applied by a therapist; (c) a waiting-list control group. Results showed that both treatment conditions were equally efficacious. In addition, Talk to Me and the same treatment applied by a therapist were more efficacious than the waiting-list condition. Treatment gains were maintained at 1-year follow-up. The results from this study support the utility of Internet-delivered CBT programs in order to reach a higher number of people who could benefit from CBT. Internet-delivered CBT programs could also play a valuable role in the dissemination of CBT.
Wilder-Smith, Annelies; Cohn, Emily; Lloyd, David C; Tozan, Yesim; Brownstein, John S
Internet-based media coverage to explore the extent of awareness of a disease and perceived severity of an outbreak at a national level can be used for early outbreak detection. Dengue has emerged as a major public health problem in Sri Lanka since 2009. To compare Internet references to dengue in Sri Lana with references to other diseases (malaria and influenza) in Sri Lanka and to compare Internet references to dengue in Sri Lanka with notified cases of dengue in Sri Lanka. We examined Internet-based news media articles on dengue queried from HealthMap for Sri Lanka, for the period January 2007 to November 2015. For comparative purposes, we compared hits on dengue with hits on influenza and malaria. There were 565 hits on dengue between 2007 and 2015, with a rapid rise in 2009 and followed by a rising trend ever since. These hits were highly correlated with the national epidemiological trend of dengue. The volume of digital media coverage of dengue was much higher than of influenza and malaria. Dengue in Sri Lanka is receiving increasing media attention. Our findings underpin previous claims that digital media reports reflect national epidemiological trends, both in annual trends and inter-annual seasonal variation, thus acting as proxy biosurveillance to provide early warning and situation awareness of emerging infectious diseases.
Full Text Available Background: Internet-based media coverage to explore the extent of awareness of a disease and perceived severity of an outbreak at a national level can be used for early outbreak detection. Dengue has emerged as a major public health problem in Sri Lanka since 2009. Objective: To compare Internet references to dengue in Sri Lana with references to other diseases (malaria and influenza in Sri Lanka and to compare Internet references to dengue in Sri Lanka with notified cases of dengue in Sri Lanka. Design: We examined Internet-based news media articles on dengue queried from HealthMap for Sri Lanka, for the period January 2007 to November 2015. For comparative purposes, we compared hits on dengue with hits on influenza and malaria. Results: There were 565 hits on dengue between 2007 and 2015, with a rapid rise in 2009 and followed by a rising trend ever since. These hits were highly correlated with the national epidemiological trend of dengue. The volume of digital media coverage of dengue was much higher than of influenza and malaria. Conclusions: Dengue in Sri Lanka is receiving increasing media attention. Our findings underpin previous claims that digital media reports reflect national epidemiological trends, both in annual trends and inter-annual seasonal variation, thus acting as proxy biosurveillance to provide early warning and situation awareness of emerging infectious diseases.
Okazaki, Kanzo; Okano, Shinji; Haga, Shinichiro; Seki, Akiho; Suzuki, Hisao; Takahashi, Kayo
The purpose of the present study was to evaluate whether improvement in physical activity of students following a 4-month intervention of a university course was maintained 8 months later. Data on 77 students who responded to our scheduled inquiries completely through 1 year were analyzed. Participants of the intervention group (n=49) using the internet-based physical activity program exhibited significant increases in energy expenditures measured by IPAQ compared with the no-treatment control group (n=28) through 1 year. Participants who did not engage in regular university sports activities (baseline: 450±351kcalday(-1); post: 587±320kcalday(-1); 8-month follow-up: 580±394kcalday(-1)) only exhibited significant increases in energy expenditures compared with those of the control group (baseline: 498±341kcalday(-1); post: 414±242kcalday(-1); 8-month follow-up: 347±275kcalday(-1)). These results suggested that an internet-based interactive intervention could become a helpful tool in promoting and maintaining physical activity in the long term. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Routh, Jonathan C; Gong, Edward M; Cannon, Glenn M; Yu, Richard N; Gargollo, Patricio C; Nelson, Caleb P
An increasing number of parents and practitioners use the Internet for health related purposes, and an increasing number of models are available on the Internet for predicting spontaneous resolution rates for children with vesicoureteral reflux. We sought to determine whether currently available Internet based calculators for vesicoureteral reflux resolution produce systematically different results. Following a systematic Internet search we identified 3 Internet based calculators of spontaneous resolution rates for children with vesicoureteral reflux, of which 2 were academic affiliated and 1 was industry affiliated. We generated a random cohort of 100 hypothetical patients with a wide range of clinical characteristics and entered the data on each patient into each calculator. We then compared the results from the calculators in terms of mean predicted resolution probability and number of cases deemed likely to resolve at various cutoff probabilities. Mean predicted resolution probabilities were 41% and 36% (range 31% to 41%) for the 2 academic affiliated calculators and 33% for the industry affiliated calculator (p = 0.02). For some patients the calculators produced markedly different probabilities of spontaneous resolution, in some instances ranging from 24% to 89% for the same patient. At thresholds greater than 5%, 10% and 25% probability of spontaneous resolution the calculators differed significantly regarding whether cases would resolve (all p calculators. For certain patients, particularly those with a lower probability of spontaneous resolution, these differences can significantly influence clinical decision making. Copyright (c) 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Van Voorhees, Benjamin W; Gollan, Jackie; Fogel, Joshua
This article evaluates an Internet-based early intervention combining online cognitive-behavioral therapy (CBT) with electronic peer-to-peer support intended to promote mental health and well-being among combat veterans. We conducted a phase 1 clinical trial of 50 Iraq and Afghanistan veterans using a pre and post single-arm design. We evaluated feasibility and changes in mental health symptoms (depression and posttraumatic stress disorder [PTSD]), functional status, and attitudes toward treatment seeking at baseline and weeks 4, 8, and 12. A diverse group of veterans was enrolled (26% ethnic minority, 90% male, 66% with income <$30,000/year, 88% with no prior treatment for depression). Participants completed a mean of 4 of 6 lessons (standard deviation = 2.54). From baseline to week 12, there were significant declines in the Center for Epidemiologic Studies-Depression scale score (effect size [ES] = 0.41) and PTSD Checklist-Military version score (ES = 0.53). There were significant improvements in willingness to accept diagnosis (ES = 1.08) and perceived social norms and stigma regarding friends (ES = 1.51). Although lack of a control group is a limitation, the Internet-based program combining CBT-based coping skills training and peer-to-peer support demonstrated potential feasibility and evidenced benefit in symptom remediation for depression and PTSD.
Donati, Manuela; Cenacchi, Giovanna; Biondi, Roberta; Papa, Valentina; Borel, Nicole; Vecchio Nepita, Edoardo; Magnino, Simone; Pasquinelli, Gianandrea; Levi, Aurora; Franco, Octavio L
The in vitro activity of six synthetic peptides against 36 strains of Chlamydia from different origins was investigated. Clavanin MO (CMO) proved to be the most active peptide, reducing the inclusion number of all Chlamydia strains from eight different species tested by ≥50% at 10 µg mL -1 . Mastoparan L showed an equal activity against C. trachomatis, C. pneumoniae, C. suis, and C. muridarum, but did not exert any inhibitory effect against C. psittaci, C. pecorum, C. abortus, and C. avium even at 80 µg mL -1 . These data suggest that CMO could be a promising compound in the prevention and treatment of chlamydial infections. © 2017 Wiley Periodicals, Inc.
Lundemose, AG; Rousch, DA; Birkelund, Svend
A 27 kDa Chlamydia trachomatis Mip-like protein with homology of a 175-amino-acid C-terminal fragment to the surface-exposed Legionella pneumophila mip-gene product has previously been described. In this paper the entire chlamydia Mip-like sequence of C. trachomatis serovar L2 (lymphogranuloma...... venereum (LGV) biovar) is presented. The sequence shows high similarity to the legionella Mip protein and its C-terminal region, like that of the legionella Mip, has high amino acid similarity to eukaryotic and prokaryotic FK506-binding proteins. The chlamydial mip-like gene was detected by polymerase...... chain reaction (PCR) in other C. trachomatis serovars and by sequencing of the mip-like genes of serovars B and E (trachoma biovar) was shown to be highly conserved within the two major biovars of C. trachomatis. Monoclonal and polyclonal antibodies raised against the recombinant Mip-like protein failed...
Satterwhite, Catherine Lindsey; Tian, Lin H; Braxton, Jimmy; Weinstock, Hillard
To analyze 5-year prevalence trends in Chlamydia trachomatis infections among high-risk young men and women aged 16 to 24 years entering the National Job Training Program, where universal screening is required. Entrance exams conducted in over 100 National Job Training Program centers from 2003 to 2007 were considered. Women provided cervical specimens tested using either a DNA hybridization probe (PACE 2, Gen-Probe, San Diego, CA) or a strand displacement amplification test (SDA, BD ProbeTec ET, Becton-Dickinson, Sparks, MD). In the absence of a pelvic exam, urine specimens were tested using SDA. PACE 2 testing was performed predominately from 2002 to 2005; from 2005 to 2007, SDA was used. All male testing was conducted using SDA on urine specimens. Chlamydia prevalence trends were assessed for women and men, using logistic regression models. Adjusted odds ratios (AOR), 95% confidence intervals (CI), and P-values were calculated. Approximately 15,000 women and 30,000 men were screened annually for chlamydia. Among both sexes, adjusted prevalence declined significantly from 2003 to 2007. In 2003, crude prevalence among women was 9.9%; in 2007, prevalence was 13.7%. However, after controlling for covariates, including increasingly sensitive tests, the model indicated a significant declining prevalence trend (AOR: 0.95, CI: 0.93-0.97, 4.6% decrease in odds per year). Among men, crude prevalence in 2003 was 8.4%; in 2007, prevalence was 8.3%; after controlling for possible confounding, a significant decline in prevalence was also detected (AOR: 0.98, CI: 0.96-0.99, 1.9% decrease in odds per year). In a relatively stable, high-risk population of young women and men, adjusted chlamydia prevalence declined from 2003 to 2007. Test technology plays a critical role in interpreting rates and should be considered whenever chlamydia rates are examined.
Rours, G.I.J.G.; Verkooyen, R.P.; Willemse, H.F.M.; Zwaan, E.A. van der; Belkum, A. van; Groot, R. de; Verbrugh, H.A.; Ossewaarde, J.M.
The success of large-scale screening for Chlamydia trachomatis depends on the availability of noninvasive samples, low costs, and high-quality testing. To evaluate C. trachomatis testing with pregnant women, first-void urine specimens from 750 consecutive asymptomatic pregnant women from the
Theunissen, Kevin; Hoebe, Christian; Kok, Gerjo; Crutzen, Rik; Kara-Zaïtri, Chakib; de Vries, Nanne; van Bergen, Jan; Hamilton, Robert; van der Sande, Marianne; Dukers-Muijrers, Nicole
With the aim of targeting high-risk hidden heterosexual young people for Chlamydia trachomatis (CT) testing, an innovative web-based screening strategy using Respondent Driven Sampling (RDS) and home-based CT testing, was developed, piloted and evaluated. Two STI clinic nurses encouraged 37 CT
Lee, Young-Suk; Lee, Kyu-Sung
Of the chlamydia species that can cause infections in humans, C. trachomatis is responsible for lower urinary tract diseases in men and women. C. trachomatis infections are prevalent worldwide, but current research is focused on females, with the burden of disease and infertility sequelae considered to be a predominantly female problem. However, a role for this pathogen in the development of male urethritis, epididymitis, and orchitis is widely accepted. Also, it can cause complications such ...
Yang, Rongchang; Jacobson, Caroline; Gardner, Graham; Carmichael, Ian; Campbell, Angus J D; Ryan, Una
The prevalence and faecal shedding of Chlamydia spp. in sheep in Australia has not been well described. Two species-specific quantitative PCRs (qPCRs) targeting the chlamydial outer membrane protein cell surface antigen gene (ompA) were validated and used to determine the prevalence and faecal shedding of C. abortus and C. pecorum from faecal samples of lambs at three sampling times (weaning, post-weaning and pre-slaughter) from eight farms in South Australia, New South Wales, Victoria and Western Australia. A total of 3412 faecal samples were collected and screened from approximately 1189 lambs across the four states. C. abortus was not detected in any of the samples screened. The overall prevalence of C. pecorum was 1027/3412 (30.1%) and median bacterial concentrations at weaning, post-weaning and pre-slaughter were 1.8 × 10(7), 1.2 × 10(7) and 9.6 × 10(5)/g faeces, respectively. A subset of C. pecorum positive samples from each farm, (n = 48) was sequenced to confirm their identity. The present study demonstrates that C. pecorum is prevalent in Australian sheep, highlighting a need for further research on the impact of this bacterium on production. Copyright © 2014 Elsevier Ltd. All rights reserved.
Essig, A; Heinemann, M; Simnacher, U; Marre, R
Chlamydia pneumoniae is an intracellular respiratory pathogen, which, similar to Legionella, might have developed mechanisms to escape the intracellular bactericidal activity of both human host cells and amoeba. We therefore investigated the intracellular growth and survival of C. pneumoniae in Acanthamoeba castellanii by using cell culture, immunofluorescence microscopy, and electron microscopy. A castellanii was incubated with purified elementary bodies of C. pneumoniae TW 183 at a concentration of 10(6) inclusion-forming units (IFU)/ml to give a ratio of approximately 1 IFU of C. pneumoniae per amoeba. Quantitative determination of chlamydial growth within A. castellanii revealed viable and infective C. pneumoniae in the range of 10(4) to 10(5) IFU/ml between days 7 and 14 postinfection. Immunofluorescence analysis and transmission electron microscopy with subsequent immunogold staining confirmed evidence of infection of the amoebae by C. Pneumoniae and additionally revealed that C. pneumoniae entered the typical growth cycle. Our results show that amoebae allow the survival of C. pneumoniae, suggesting that amoebae may serve as an additional reservoir for Chlamydia or Chlamydia-related organisms.
Bourgeois-Nicolaos, Nadège; Jaureguy, Françoise; Pozzi-Gaudin, Stéphanie; Masson, Claire; Guillet-Caruba, Christelle; Lavisse, Frédérique; Larmignat, Philippe; Benachi, Alexandra; Picard, Bertrand; Doucet-Populaire, Florence
We evaluated the benefits of on-demand systematic screening for Chlamydia trachomatis and Neisseria gonorrhoeae using the Xpert CT/NG assay in 589 women attending family planning clinics. The sexually transmitted infection prevalence was 16.5% with 15.1% C. trachomatis and 3.1% N. gonorrhoeae infections. The on-demand test allowed for a quicker management of patients at high risk for sexually transmitted infections.
Full Text Available Monitoring adherence to national recommendations for annual chlamydia screening of female adolescents and young adult women is important for targeting quality improvement interventions to improve low screening rates. However, accurate measurement of rates may vary depending on the data source used to determine eligible sexually-active women.The 2001-2004 NHANES data linked with Medicaid administrative data by respondent's unique identifier, the 2011-2012 NHANES data, and the 2004 and 2010 Medicaid data were used in this cross-sectional analysis. We defined self-reported sexual activity by self-reported sexual behaviors, claim-identified sexual activity by reproductive-related claims among women who had ≥ one healthcare claim, HEDIS-defined sexual activity by reproductive-related claims among women who were enrolled in Medicaid for ≥330 days and had ≥ one healthcare claim, and chlamydia tests by claims submitted in the 12 months prior to the survey interview.Of Medicaid women aged 18-25 years, 91.5% self-reported to be sexually-active. Of self-reported sexually-active women aged 18-25 years, 92.0% had ≥ one healthcare claim in the 12 months prior to the survey interview; of this subpopulation, only 58.8% were enrolled in Medicaid for ≥ 330 days in the 12 months prior to the survey interview; of this further subpopulation, 74.1% had healthcare claims identifying them as sexually-active in the 12 months prior to the survey interview. Of HEDIS-defined sexually-active women, 42.4% had chlamydia testing.Our study suggests that the number of sexually-active women aged 18-25 years used as the denominator in the chlamydia testing measure could be significantly different, depending upon the definition applied and the data used. Our data highlight the limited representativeness of Medicaid population in the current HEDIS measure on chlamydia testing when a high proportion of women who were enrolled in Medicaid for <330 days had been excluded from
Svetlana V. Doubova
Full Text Available Abstract Background Risky sexual behaviors of adolescents in Mexico are a public health problem; 33.4 % of adolescent girls and 14.7 % of boys report not having used any protection at their first intercourse. The fertility rate is 77 births/1000 girls aged 15–19 years. The infrequent contact of adolescents with health services and the limited extent of school sex and reproductive health education require the support of innovative strategies. The objective of this paper is to present the design of an internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents. Methods A field trial with intervention and comparison group and with ex-ante and ex-post measurements will be conducted in two public secondary schools. Adolescents between 14 and 15 years of age will participate. The intervention will be conducted in one school and the second school will serve as a comparison group where the investigators will observe the usual sex education provided by the school. The intervention will be delivered using an internet web page that includes four educational sessions provided during a 4 week period. Follow-up will last 3 months. Information on the study variables will be obtained through an Internet-based self-applied questionnaire and collected on three occasions: 1 when the adolescents enter the study (baseline, 2 once the intervention is completed (at 1 month and 3 after 3 months of follow-up (at the fourth month. There will be three outcome variables: 1 knowledge in regard to sexually transmitted infections, 2 attitudes regarding condom use, and 3 self-efficacy toward consistent condom use. The generalized linear model will be used to assess changes in each outcome variable controlling for baseline measures and for study covariates. Discussion The design and evaluation of an Internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents is important in order to provide a new, large
Doubova, Svetlana V; Infante-Castañeda, Claudia; Pérez-Cuevas, Ricardo
Risky sexual behaviors of adolescents in Mexico are a public health problem; 33.4 % of adolescent girls and 14.7 % of boys report not having used any protection at their first intercourse. The fertility rate is 77 births/1000 girls aged 15-19 years. The infrequent contact of adolescents with health services and the limited extent of school sex and reproductive health education require the support of innovative strategies. The objective of this paper is to present the design of an internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents. A field trial with intervention and comparison group and with ex-ante and ex-post measurements will be conducted in two public secondary schools. Adolescents between 14 and 15 years of age will participate. The intervention will be conducted in one school and the second school will serve as a comparison group where the investigators will observe the usual sex education provided by the school. The intervention will be delivered using an internet web page that includes four educational sessions provided during a 4 week period. Follow-up will last 3 months. Information on the study variables will be obtained through an Internet-based self-applied questionnaire and collected on three occasions: 1) when the adolescents enter the study (baseline), 2) once the intervention is completed (at 1 month) and 3) after 3 months of follow-up (at the fourth month). There will be three outcome variables: 1) knowledge in regard to sexually transmitted infections, 2) attitudes regarding condom use, and 3) self-efficacy toward consistent condom use. The generalized linear model will be used to assess changes in each outcome variable controlling for baseline measures and for study covariates. The design and evaluation of an Internet-based educational strategy to prevent risky sexual behaviors in Mexican adolescents is important in order to provide a new, large-scale, easily implemented preventive tool. The
Opota, Onya; Brouillet, René; Greub, Gilbert; Jaton, Katia
The advances in molecular biology of the last decades have dramatically improved the field of diagnostic bacteriology. In particular, PCR-based technologies have impacted the diagnosis of infections caused by obligate intracellular bacteria such as pathogens from the Chlamydiacae family. Here, we describe a real-time PCR-based method using the Taqman technology for the diagnosis of Chlamydia pneumoniae, Chlamydia psittaci, and Chlamydia abortus infection. The method presented here can be applied to various clinical samples and can be adapted on opened molecular diagnostic platforms.
L. B. Kulyashova
Full Text Available Abstract. Chlamydia trachomatis causes various diseases of reproductive organs. Only limited data on the incidence of urogenital chlamydia infection in the Russian Federation are available. The main goal of this study was to detect the prevalence of infection associated with Chlamydia trachomatis in citizens of St.Petersburg. Overall 3833 individuals including 2190 children and adolescents aged from 0 to 18 years old and 1643 adults aged 19–70 years old were tested in 2008–2010. This group included patients with acute and chronic pelvic inflammatory disease, infertility as well as patients without clinical symptoms of Chlamydia infection. The high level of Chlamydia trachomatis infection among newborns and dramatic increase of the infection among adolescents were determined. These results support urgent needs to develop adequate preventive measures to control Chlamydia trachomatis infection in the population. The effectiveness of different laboratory tests to detect Chlamydia trachomatis infection depends on the causative agent localization in the macroorganism, on acuity of infection process and on immune response. The combined using of different laboratory tests give the possibility to obtain objective results about Chlamydia etiology role in inflammatory disease of urogenital tract as well as about prevalence of infection in regions of the country.
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Chlamydia serological reagents. 866.3120 Section 866.3120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... identification aids in the diagnosis of disease caused by bacteria belonging to the genus Chlamydia and provides...
Popov, G.; Dimitrova, Zl. (Akademiya na Selskostopanskite Nauki, Sofia (Bulgaria). Veterinaren Inst. za Infektsiozni i Parazitni Bolesti); Martinov, Sv.
It was concluded that the main condition for the production of high titer labelled gammaglobulins was to obtain purified and concentrated Chlamydial antigens and use these with an adjuvant. To indicate Chlamydia in testing the conjugates it is essential to prepare standard test lamellas infected at high multiplicity of purified and concentrated Chlamydia.
Chlamydiae are prokaryotic, gram negative, intracellular parasites, causing a number of human diseases with serious sequelae. The exact mechanism of chlamydial attachment and entry into the host cell is still unclear. Chlamydia trachomatis, SA2F (L2) was tested for the activity of glycosidases. Glycosidases are involved ...
Objective: To study the prevalence of genital chlamydia and gonococcal infections in women at risk of acquiring sexually transmitted infections in the Kumasi metropolis, Ghana. Design: Structured interviews and clinical examination of participants and obtaining vaginal swabs to test for gonorrhoea and chlamydia infections.
Chlamydia infection is a common sexually transmitted infection (STI) in humans caused by the bacterium Chlamydia trachomatis. This study ... Hence, there is need to institute appropriate prevention and control measures against the transmission of the disease especially among those at risk of contracting the disease.
G.I.J.G. Rours (Ingrid); R.R. de Krijger (Ronald); A. Ott (Alewijn); H.F. Willemse; R. de Groot (Ronald); L.J.I. Zimmermann (Luc); R.F. Kornelisse (René); H.A. Verbrugh (Henri); R.P.A.J. Verkooijen (Roel)
textabstractChlamydia trachomatis may infect the placenta and subsequently lead to preterm delivery. Our aim was to evaluate the relationship between the presence of Chlamydia trachomatis and signs of placental inflammation in women who delivered at 32 weeks gestation or less. Setting: placental
Rours, G.I.J.G.; Krijger, R.R. de; Ott, A.; Willemse, H.F.; Groot, R. de; Zimmermann, L.J.; Kornelisse, R.F.; Verbrugh, H.A.; Verkooijen, R.P.
Chlamydia trachomatis may infect the placenta and subsequently lead to preterm delivery. Our aim was to evaluate the relationship between the presence of Chlamydia trachomatis and signs of placental inflammation in women who delivered at 32 weeks gestation or less. Setting: placental histology and
Mar 15, 2010 ... Our previous studies have shown that Baicalin could effectively inhibit Chlamydia trachomatis in vitro. In this study, Baicalin was tested for potential antichlamydial activity using a murine genital Chlamydia trachomatis infection model. It was demonstrated that Baicalin significantly reduced C. trachomatis.
Given the lack of information concerning the role of Chlamydia trachomatis in male infertility, it has become imperative to analyse the quality of semen of male with seroevidence of antibody to Chlamydia trachomatis infection. A total of 156 male patients attending the Human Reproduction Research Programme/Invitro ...
Warren N. Ponder
Full Text Available The purpose of this study was to explore the question: Is a service member’s post-deployment marital satisfaction correlated with frequency and mode of communication during deployment? This study used an anonymous exploratory design with a sample of 119 Operation Iraqi Freedom (OIF or Operation Enduring Freedom (OEF married veterans. Service members who communicated daily during deployment with their spouses had higher marital satisfaction scores than those who communicated less than once per week. Additionally, participants who used US mail had the highest marital satisfaction scores compared to telephone and internet-based communication. This study expands the overwhelmingly qualitative current literature to include quantitative analysis of this topic. This study also depicts the veterans’ experiences since many of the previous studies of this topic used samples of spouses.
Xu, Xiaonong; Song, Aiguo; Zhang, Huatao; Ji, Peng
Random time delay may cause instability in the internet based teleoperation system. Transparency and intuitiveness are also very important for operator to control the system to accurately perform the desired action, especially for the gripper teleoperation system. This paper presents a new grip force control method of gripper teleoperation system with haptic feedback. The system employs the SEMG signal as the control parameter in order to enhance the intuitive control experience for operator. In order to eliminate the impacts on the system stability caused by random time delay, a non-time based teleoperation method is applied to the control process. Besides, neural network and designed fuzzy logic controller is also utilized to improve this control method. The effectiveness of the proposed method is demonstrated by experiment results.
Nielsen, Amalie; Gaardsvig, Majken Maria; Stjerneklar, Silke
-17 years. Inclusion criteria were an anxiety disorder as primary diagnosis, access to a computer and the Internet at home, and ability to read and write in Danish. Exclusion criteria were comorbid depression (CSR ≥ 6), school absenteeism above 50%, self-harm, suicidal ideation, substance dependence......Aim Only a small proportion of children and adolescents with anxiety disorders receive treatment, despite evidence of the efficacy of CBT (cognitive behavioral therapy) (Reynolds, Wilson, Austin & Hooper, 2012). Lately there has been an increase in the development of ICBT (internet-based CBT......) programs to reduce costs and enhance accessibility of psychological interventions. ICBT has proven efficacious towards adults with anxiety disorders (Haug, Nordgreen, Ost & Havik, 2012; Reger & Gahm, 2009). Research in ICBT with children and adolescents is still in its infancy and no program targeting...
Hu, Chaolang; Wu, Rongjun; Liu, Jiayong
This paper constructs a model of the consensus formation in Internet based on the directed graph after analyzing the classical models of the social consensus formation, sets up the rules for the evolvement of opinions of agents and induces the evolving algorithm of consensus in Internet. The paper presents some key parameters such as the influence area of the mainstream media, the average influence of the mainstream media, the average self-persisting ability of agents and etc. Simulation results on a small-world networks show that the less the average self-persisting capability of the agents is, the easier the guidance of the media will be. The stronger the average influence of the main stream media is, the easier the mainstream media guides the consensus. These results reflect the formation law of the network consensus and are consistent approximately with the real circumstance.
Stjerneklar, Silke; Hougaard, Esben; Nielsen, Amalie D.
Background: Cognitive behavioral therapy (CBT) is a well-documented effective method for the treatment of anxiety disorders in children and adolescents. While internet based CBT (ICBT) programs for adults have been widely investigated, research on ICBT programs for anxiety disorders in youth...... disorders, developed at Macquarie University, Australia. Methods: At the University Clinic in Aarhus, Denmark, we conducted a feasibility study with six adolescents with a primary anxiety disorder. The 12-week ICBT intervention consisted of eight online modules. Participants received weekly phone calls from...... a clinical psychologist. Semi-structured interviews on participant's experiences of the program were administered post-treatment and at three-month follow-up. Outcome was evaluated post-treatment and at follow-up using diagnostic interview and questionnaires. Results: Five of the six participants completed...
Müller, Andre Matthias; Khoo, Selina
Physical activity promotes health in children and adolescents, but activity levels are low. The Internet offers opportunities for physical activity interventions because children and adolescents are widely exposed to the web and enjoy being online. This review investigated the success of Internet-based interventions designed to increase physical activity in children and adolescents. Of the 13 studies we included, five reported that Internet-based interventions had significant effects on most physical activities. Internet-based physical activity interventions in children and adolescents are potentially successful, but interdisciplinary, child-centred collaboration is needed to design interventions that align with their Internet experiences and preferences. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Pollett, Simon; Althouse, Benjamin M; Forshey, Brett; Rutherford, George W; Jarman, Richard G
Internet-based surveillance methods for vector-borne diseases (VBDs) using "big data" sources such as Google, Twitter, and internet newswire scraping have recently been developed, yet reviews on such "digital disease detection" methods have focused on respiratory pathogens, particularly in high-income regions. Here, we present a narrative review of the literature that has examined the performance of internet-based biosurveillance for diseases caused by vector-borne viruses, parasites, and other pathogens, including Zika, dengue, other arthropod-borne viruses, malaria, leishmaniasis, and Lyme disease across a range of settings, including low- and middle-income countries. The fundamental features, advantages, and drawbacks of each internet big data source are presented for those with varying familiarity of "digital epidemiology." We conclude with some of the challenges and future directions in using internet-based biosurveillance for the surveillance and control of VBD.
Full Text Available Internet-based surveillance methods for vector-borne diseases (VBDs using "big data" sources such as Google, Twitter, and internet newswire scraping have recently been developed, yet reviews on such "digital disease detection" methods have focused on respiratory pathogens, particularly in high-income regions. Here, we present a narrative review of the literature that has examined the performance of internet-based biosurveillance for diseases caused by vector-borne viruses, parasites, and other pathogens, including Zika, dengue, other arthropod-borne viruses, malaria, leishmaniasis, and Lyme disease across a range of settings, including low- and middle-income countries. The fundamental features, advantages, and drawbacks of each internet big data source are presented for those with varying familiarity of "digital epidemiology." We conclude with some of the challenges and future directions in using internet-based biosurveillance for the surveillance and control of VBD.
Toumas, Mariam; Basheti, Iman A; Bosnic-Anticevich, Sinthia Z
To compare the effectiveness of small-group training in correct inhaler technique with self-directed Internet-based training. Pharmacy students were randomly allocated to 1 of 2 groups: small-group training (n = 123) or self-directed Internet-based training (n = 113). Prior to intervention delivery, all participants were given a placebo Turbuhaler and product information leaflet and received inhaler technique training based on their group. Technique was assessed following training and predictors of correct inhaler technique were examined. There was a significant improvement in the number of participants demonstrating correct technique in both groups (small group training, 12% to 63%; p training, 9% to 59%; p groups in the percent change (n = 234, p > 0.05). Increased student confidence following the intervention was a predictor for correct inhaler technique. Self-directed Internet-based training is as effective as small-group training in improving students' inhaler technique.
Fung, M F; Walker, M; Fung, K F; Temple, L; Lajoie, F; Bellemare, G; Bryson, S C
To describe the Computerized Obstetrics and Gynecology Automated Learning Anaalysis (KOALAtrade mark), a multicentre, Internet-based learning portfolio and to determine its effects on residents' perception of their self-directed learning abilities. The KOALA programme allows residents to record their obstetrical, surgical, ultrasound, and ambulatory patient encounters and to document critical incidents of learning or elements of surprise that arose during these encounters. By prompting the student to reflect on these learning experiences, KOALA encourages residents to articulate questions which can be directly pursued through hypertext links to evidence-based literature. Four Canadian residency training programmes participated in the pilot project, from February to May 1997, using a dynamic relational database with a central server. All participants completed the Self-directed Learning Readiness Scale and a learning habits questionnaire. The impact of the KOALA programme on residents' perception of their self-directed learning abilities was measured by comparing KOALA-naive schools (schools 2, 3, and 4) with school 1 (exposed to the KOALA prototype for 1 year). Ordered variables were compared using the Mann-Whitney U test and continuous variables with the Student t test (statistical significance P learning were recorded by 41 residents in the four participating universities. Residents at the exposed school (school 1) had a significantly higher perception of their self-directed learning (P learning was less likely to be from continuing medical education (P learning portfolio with online resources. This Internet-based, multi-user, multicentre learning portfolio has a significant effect on residents' perception of their self-directed learning abilities.
Rozental, Alexander; Forsell, Erik; Svensson, Andreas; Andersson, Gerhard; Carlbring, Per
Procrastination can be a persistent behavior pattern associated with personal distress. However, research investigating different treatment interventions is scarce, and no randomized controlled trial has examined the efficacy of cognitive-behavior therapy (CBT). Meanwhile, Internet-based CBT has been found promising for several conditions, but has not yet been used for procrastination. Participants (N = 150) were randomized to guided self-help, unguided self-help, and wait-list control. Outcome measures were administered before and after treatment, or weekly throughout the treatment period. They included the Pure Procrastination Scale, the Irrational Procrastination Scale, the Susceptibility to Temptation Scale, the Montgomery Åsberg Depression Rating Scale-Self-report version, the Generalized Anxiety Disorder Assessment, and the Quality of Life Inventory. The intention-to-treat principle was used for all statistical analyses. Mixed-effects models revealed moderate between-groups effect sizes comparing guided and unguided self-help with wait-list control; the Pure Procrastination Scale, Cohen's d = 0.70, 95% confidence interval (CI) [0.29, 1.10], and d = 0.50, 95% CI [0.10, 0.90], and the Irrational Procrastination Scale, d = 0.81 95% CI [0.40, 1.22], and d = 0.69 95% CI [0.29, 1.09]. Clinically significant change was achieved among 31.3-40.0% for guided self-help, compared with 24.0-36.0% for unguided self-help. Neither of the treatment conditions was found to be superior on any of the outcome measures, Fs(98, 65.17-72.55) .19. Internet-based CBT could be useful for managing self-reported difficulties due to procrastination, both with and without the guidance of a therapist. (c) 2015 APA, all rights reserved).
Quan, Stuart F; Anderson, Janis L; Hodge, Gordon K
Knowledge regarding the importance of sleep in health and performance and good sleep hygiene practices is low, especially among adolescents and young adults. It is important to improve sleep literacy. Introductory psychology is one of the most highly enrolled courses at colleges and universities. This study tested the impact of an Internet-based learning module on improving sleep literacy in this venue. An Internet-based supplementary learning module containing sleep physiology and hygiene information was developed using content from the Harvard Medical School sleep educational website http://www.understandingsleep.org. Access to the module was provided as an extra credit activity for 2 of 4 sections (Supplemental Sleep, SS, N = 889) of an introductory college psychology course during their standard instruction on sleep and dreaming. The remaining 2 sections (Standard Instruction, SI, N = 878) only were encouraged to visit the website without further direction. Level of knowledge was assessed before and after availability to the module/website and at the end of the semester. Students were asked to complete a survey at the end of the semester inquiring whether they made any changes in their sleep behaviors. Two hundred fifty students participated in the extra credit activity and had data available at all testing points. Students in the SS Group had a significant improvement in sleep knowledge test scores after interacting with the website in comparison to the SI group (19.41 ± 3.15 vs. 17.94 ± 3.08, p sleep habits after participation in the extra credit sleep activity (p sleep learning module has the potential to enhance sleep literacy and change behavior among students enrolled in an introductory college psychology course.
Lippi, Giuseppe; Sanchis-Gomar, Fabian
The cardiovascular disease (CVD) is the leading cause of disability and premature death around the world. The ongoing publication of systematic and critical literature reviews has contributed to generate a kaleidoscope of guidelines by different scientific organizations. We investigated the accordance among the most popular web-based CVD risk calculators on the Internet. We carried out a simple study, by estimating the risk of CVD using the most popular Internet-based calculators available on the Internet. A Google search was performed, using the keyword "cardiovascular risk calculator", to identify the first 10 websites providing free on-line CVD risk calculators. We arbitrarily selected the cardiovascular profile of two subjects of a typical Western family: a 55-year man at a likely intermediate cardiovascular risk and a 45-year woman at a probable low risk. The score calculated according to the two arbitrary CVD risk profiles, one of whom was supposed to be at intermediate risk and the other at lower risk, was extremely variable. More specifically, the 10-year CVD risk of the 55-year old man varied from 3% to over 25% (median value, 12.9%, interquartile range [IQR], 10.7-19.0%), whereas that of the 45-year women varied between 0% and 4% (median value, 1.2%; IQR, 0.4-2.2%), thus displaying a nearly 10-fold variation in both cases. We concluded from our analysis of 11 different Internet-based CVD risk calculators that the final 10-year risk score can be extremely different, especially for the 55-year old man at predictably intermediate risk.
Girault, Anne; Ferrua, Marie; Lalloué, Benoît; Sicotte, Claude; Fourcade, Aude; Yatim, Fatima; Hébert, Guillaume; Di Palma, Mario; Minvielle, Etienne
The uses of internet-based technologies (e.g. patient portals, websites and applications) by cancer patients could be strong drive for change in cancer care coordination practices. The goal of this study was to assess the current utilisation of internet-based technologies (IBT) among cancer patients, and their willingness to use them for their health, as well as analyse the influence of socio-demographics on both aspects. A questionnaire-based survey was conducted in June 2013, over seven non-consecutive days within seven outpatient departments of Gustave Roussy, a comprehensive cancer centre (≈160,000 consultations yearly), located just outside Paris. We computed descriptive statistics and performed correlation analysis to investigate patients' usage and attitudes in correspondence with age, gender, socioeconomic status, social isolation, and place of living. We then conducted multinomial logistic regressions using R. The participation level was 85% (n=1371). The median age was 53.4. 71% used a mobile phone everyday and 93% had access to Internet from home. Age and socioeconomic status were negatively associated with the use of IBT (puse in health care, and especially, the possibility to enhance communication with providers. 84% of patients reported feeling comfortable with the use of such technologies but age and socioeconomic status had a significant influence. Most patients used IBTs every day. Overall, patients advocated for an extended use of IBT in oncology. Differences in perceived ease of use corresponding to age and socioeconomic status have to be addressed. Copyright © 2014 Elsevier Ltd. All rights reserved.
Smartt, Heidi Anne
Full text: The costs associated with secure data transmission can be an obstacle to International Safeguards. Typical communication methods are priced by distance and may include telephone lines, frame relay, and ISDN. It is therefore costly to communicate globally. The growth of the Internet has provided an extensive backbone for global communications; however, the Internet does not provide intrinsic security measures. Combining the Internet with Virtual Private Network technology, which encrypts and authenticates data, creates a secure and potentially cost-effective data transmission path, as well as achieving other benefits such as reliability and scalability. Access to the Internet can be achieved by connecting to a local Internet Service Provider, which can be preferable to installing a static link between two distant points. The cost-effectiveness of the Internet-based Virtual Private Network is dependent on such factors as data amount, current operational costs, and the specifics of the Internet connection, such as user proximity to an Internet Service Provider or existing access to the Internet. This paper will introduce Virtual Private Network technology, the benefits of Internet communication, and the emergence of Internet-based Virtual Private Networks throughout the International Safeguards community. Specific projects to be discussed include: The completed demonstration of secure remote monitoring data transfer via the Internet between STUK in Helsinki, Finland, and the IAEA in Vienna, Austria; The demonstration of secure remote access to IAEA resources by traveling inspectors with Virtual Private Network software loaded on laptops; The proposed Action Sheets between ABACC/DOE and ARN/DOE, which will provide a link between Rio de Janeiro and Buenos Aires; The proposed use at the HIFAR research reactor, located in Australia, to provide remote monitoring data to the IAEA; The use of Virtual Private Networks by JRC, Ispra, Italy. (author)
Sara A. Freedman
Full Text Available Background: Posttraumatic stress disorder (PTSD develops in approximately 20% of people exposed to a traumatic event, and studies have shown that cognitive-behavioral therapy (CBT is effective as a treatment for chronic PTSD. It has also been shown to prevent PTSD when delivered early after a traumatic event. However, studies have shown that uptake of early treatment is generally low, and therefore, the need to provide interventions through other mediums has been identified. The use of technology may overcome barriers to treatment. Objective: This paper describes a randomized controlled trial that will examine an early CBT intervention for PTSD. The treatment incorporates virtual reality (VR as a method for delivering exposure-based elements of the treatment. The intervention is Internet based, such that the therapist and patient will “meet” in a secure online site. This site will also include multi-media components of the treatment (such as videos, audios, VR that can be accessed by the patient between sessions. Method: Two hundred patients arriving to a Level 1 emergency department following a motor vehicle accident will be randomly assigned to either treatment or control groups. Inclusion criteria are age 18–65, PTSD symptoms 2 weeks posttrauma related to current trauma, no suicidality, no psychosis. Patients will be assessed by telephone by a team blind to the study group, on four occasions: before and after treatment, and 6 and 12 months posttreatment. The primary outcome is PTSD symptoms at follow up. Secondary outcomes include depression and cost effectiveness. Analyses will be on an intention-to-treat basis. Discussion: The results will provide more insight into the effects of preventive interventions, in general, and Internet-based early interventions, in particular, on PTSD, in an injured population, during the acute phase after trauma. We will discuss possible strengths and limitations.
Boettcher, Johanna; Aström, Viktor; Påhlsson, Daniel; Schenström, Ola; Andersson, Gerhard; Carlbring, Per
Mindfulness-based interventions have proven effective for the transdiagnostic treatment of heterogeneous anxiety disorders. So far, no study has investigated the potential of mindfulness-based treatments when delivered remotely via the Internet. The current trial aims at evaluating the efficacy of a stand-alone, unguided, Internet-based mindfulness treatment program for anxiety. Ninety-one participants diagnosed with social anxiety disorder, generalized anxiety disorder, panic disorder, or anxiety disorder not otherwise specified were randomly assigned to a mindfulness treatment group (MTG) or to an online discussion forum control group (CG). Mindfulness treatment consisted of 96 audio files with instructions for various mindfulness meditation exercises. Primary and secondary outcome measures were assessed at pre-, posttreatment, and at 6-months follow-up. Participants of the MTG showed a larger decrease of symptoms of anxiety, depression, and insomnia from pre- to postassessment than participants of the CG (Cohen's d(between)=0.36-0.99). Within effect sizes were large in the MTG (d=0.82-1.58) and small to moderate in the CG (d=0.45-0.76). In contrast to participants of the CG, participants of the MTG also achieved a moderate improvement in their quality of life. The study provided encouraging results for an Internet-based mindfulness protocol in the treatment of primary anxiety disorders. Future replications of these results will show whether Web-based mindfulness meditation can constitute a valid alternative to existing, evidence-based cognitive-behavioural Internet treatments. The trial was registered at ClinicalTrials.gov (NCT01577290). Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.
Full Text Available Personality traits have traditionally been viewed as stable, but recent studies suggest that they could be affected through psychological treatment. Internet-based cognitive behavior therapy (ICBT for severe health anxiety (DSM-IV hypochondriasis has been shown to be effective in reducing health anxiety, but its effect on measures of personality traits has not been investigated. The main aim of this study was to investigate the impact of ICBT on personality traits in the three broad dimensions--neuroticism, extraversion and aggression. We hypothesized that participants in ICBT would reduce their level of neuroticism compared to controls that did not receive the active treatment. No specific predictions were made regarding extraversion and aggression. Data from a randomized controlled trial were used in which participants were allocated to 12 weeks of ICBT (n = 40 or to a basic attention control condition (n = 41. Personality traits were assessed with the Swedish Universities Scales of Personality and the primary outcome of health anxiety was the Health Anxiety Inventory. There was a significant interaction effect of group and time on neuroticism-related scales, indicating larger pre- to post-treatment reductions in the Internet-based CBT group compared to the control condition. Analyses at 6-month follow-up showed that changes were stable. Traits relating to extraversion and aggression were largely unchanged. This study is the first to demonstrate that a brief ICBT intervention for severe health anxiety causes long-term changes in measures of personality traits related to neuroticism. The treatment thus has a broader impact than just reducing health anxiety.Clinicaltrials.gov (ID NCT00828152.
De Oliveira, Gildasio S; Jung, Michael; Mccaffery, Kirsten J; McCarthy, Robert J; Wolf, Michael S
The main objective of the current investigation was to assess the readability of Internet-based patient education materials related to the field of anesthesiology. We hypothesized that the majority of patient education materials would not be written according to current recommended readability grade level. Online patient education materials describing procedures, risks, and management of anesthesia-related topics were identified using the search engine Google (available at www.google.com) using the terms anesthesia, anesthesiology, anesthesia risks, and anesthesia care. Cross-sectional evaluation. None. Assessments of content readability were performed using validated instruments (Flesch-Kincaid Grade Formulae, the Gunning Frequency of Gobbledygook, the New Dale-Chall Test, the Fry graph, and the Flesch Reading Ease score). Ninety-six Web sites containing Internet patient education materials (IPEMs) were evaluated. The median (interquartile range) readability grade level for all evaluated IPEMs was 13.5 (12.0-14.6). All the evaluated documents were classified at a greater readability level than the current recommended readability grade, P < .001. Readability grades were not significantly different among different IPEM sources. Assessment by the Flesch Reading Ease test classified all but 4 IPEMs as at least fairly difficult to read. Internet-based patient education materials related to the field of anesthesiology are currently written far above the recommended readability grade level. High complexity of written education materials likely limits access of information to millions of American patients. Redesign of online content of Web sites that provide patient education material regarding anesthesia could be an important step in improving access to information for patients with poor health literacy. Copyright © 2015 Elsevier Inc. All rights reserved.
Wootton, Bethany M; Titov, Nickolai; Dear, Blake F; Spence, Jay; Kemp, Alice
Obsessive-compulsive disorder (OCD) is a disabling anxiety disorder, but most individuals delay seeking treatment. Internet-based cognitive behavioural therapy (iCBT) is an innovative service delivery method that may help to improve access to care, but the acceptability to consumers of such programs has not yet been established. People with symptoms of OCD were invited to complete an online survey enquiring about demographic characteristics, symptom severity, and acceptability of Internet-based treatment. Demographic and symptom severity data were compared with people with OCD identified in a national epidemiological survey and with a sample of patients with OCD from a specialist outpatient anxiety clinic. 129 volunteers to an online Internet survey, 135 patients at a specialist anxiety disorders outpatient clinic, and 297 cases identified in a national epidemiological survey. Demographic characteristics, and severity of symptoms as measured by the Kessler 10-Item scale, the 12-item World Health Organisation Disability Assessment Schedule-Second Edition and the Yale Brown Obsessive Compulsive Scale-Self Report Version. The Internet sample was similar demographically but reported more severe symptoms than the comparison groups, although had similar severity of symptoms of OCD compared with other clinical samples reported in the literature. Participants reported Internet-based treatment for OCD would be highly acceptable. Internet-based treatment may reduce barriers to accessing treatment to people with OCD. Individuals in this study were similar demographically to other samples and had similar severity of symptoms as those identified in other clinical samples, suggesting that Internet-based treatment using techniques employed in face-to-face treatment may be effective in this group. Internet-based treatments for OCD need to be developed and evaluated.
Baumeister, Harald; Seifferth, Holger; Lin, Jiaxi; Nowoczin, Lisa; Lüking, Marianne; Ebert, David
Results from clinical trials indicate that Internet-based psychological pain interventions are effective in treating chronic pain. However, little is known about patients' acceptance of these programs and how to positively influence patients' intention to engage in them. Therefore, the present study aimed (1) to assess patients' acceptance of Internet-based interventions, and (2) to examine whether patients' acceptance can be increased by an acceptance facilitating intervention. A total of 104 patients with chronic pain from 2 pain units were randomly allocated to an intervention group (IG) and a no-intervention control group (CG). The IG was shown a short informational video about Internet-based psychological pain interventions before receiving a questionnaire on patients' acceptance of Internet-based psychological pain interventions and predictors of acceptance (performance expectancy, effort expectancy, social influence, facilitating conditions, Internet usage, and Internet anxiety). The CG filled out the questionnaire immediately. Patients' acceptance was measured with a 4-item scale (sum score ranging from 4 to 20). Baseline acceptance of Internet-based interventions was reported as low (sum-score:4-9) by 53.8%, moderate (10 to 15) by 42.3%, and high (16 to 20) by 3.9% of the patients with chronic pain in the CG. The IG showed a significantly higher acceptance (M = 12.17, SD = 4.22) than the CG (M = 8.94, SD = 3.71) with a standardized mean difference of d = 0.81 (95% CI, 0.41, 1.21). All predictor variables were significantly improved in the IG compared with the CG, except for Internet usage. Patients with chronic pain display a relatively low acceptance of Internet-based psychological pain interventions, which can be substantially increased by a short informational video.
Conclusões: a infecção por Chlamydia pneumoniae pode constituir achado de importância etiopatogênica na ateromatose. Entretanto, a relevância clínica dessa associação, como mostram os estudos epidemiológicos e ensaios clínicos aqui revisados, ainda é incerta
Balla, Eszter; Donders, Gilbert G G; Petrovay, Fruzsina; Urbán, Edit
To determine the seroprevalence of specific IgM indicative of respiratory tract infection (RTI) due to Chlamydia trachomatis (CT) among symptomatic infants. A descriptive study was conducted on young infants up to 5 months old at the Bacterial Sexually Transmitted Infections Reference Laboratory, National Centre for Epidemiology, Budapest, covering the period 2008-2016. Serum samples from infants suffering from RTIs were screened with a micro-immunofluorescence test (Focus, Cypress, USA) for the presence of anti-Chlamydia trachomatis-specific IgM. A parallel Bordetella pertussis screening was performed by an indirect immunofluorescence test (Euroimmun, Lübeck, Germany) that detected specific IgM. The CT-specific serum IgM was highly reactive in 50 (19.1 %) of the 262 neonates with RTIs, while all proved negative for Bordetella pertussis-specific IgM. Vertically transmitted C. trachomatis must be regarded as a common pathogen among symptomatic neonates with RTIs in Hungary. Routine screening and treatment of pregnant women could be one option to help prevent these conditions. Focused laboratory testing based on raised clinical awareness should enable early diagnosis and appropriate therapy for symptomatic infants.
Al Ateeq, Asma; Al Moamary, Eman; Daghestani, Tahani; Al Muallem, Yahya; Al Dogether, Majed; Alsughayr, Abdulrahman; Altuwaijri, Majid; Househ, Mowafa
The objective of this paper is to investigate the experiences of using a digital marketing platform to promote the use of an internet based health encyclopedia in Saudi Arabia. Key informant interviews, meeting documentation, and Google Analytics were the data collection sources used in the study. Findings show that using a digital marketing platform led to a significant increase in the number of visitors to the health encyclopedia. The results demonstrate that digital marketing platforms are effective tools to be used for promoting internet based health education interventions. Future work will examine long-term educational impacts and costs in using digital marketing platforms to promote online healthcare sites in Saudi Arabia.
A total of 162 participants were included in the study and 94 and 84 participants completed the post and follow-up measurements respectively. Participants in all conditions improved significantly on the main outcome measures, and the different levels of Presentation or therapist Support did not significantly affect treatment outcome. Registered number of completed exercises was a predictor of better treatment outcome, but this effect was independent of treatment condition. Enhancing internet based interventions by improving presentations and the quality of support may thus not be the best way to further improve the effect of internet based interventions. More specific knowledge of the mechanisms that affect outcomes in online psychotherapy is needed.
Lintvedt, Ove K; Griffiths, Kathleen M; Sørensen, Kristian; Østvik, Andreas R; Wang, Catharina E A; Eisemann, Martin; Waterloo, Knut
The Internet has the potential to increase the capacity and accessibility of mental health services. This study aimed to investigate whether an unguided Internet-based self-help intervention delivered without human support or guidance can reduce symptoms of depression in young people at risk of depression. The study also aimed to explore the usage of such sites in a real-life setting, to estimate the effects of the intervention for those who received a meaningful intervention dose and to evaluate user satisfaction. Young adults were recruited by means of a screening survey sent to all students at the University of Tromsø. Of those responding to the survey, 163 students (mean age 28.2 years) with elevated psychological distress were recruited to the trial and randomized to an Internet intervention condition or the waiting list control group. The Internet condition comprised a depression information website and a self-help Web application delivering automated cognitive behavioural therapy. The participants in the waiting list condition were free to access formal or informal help as usual. Two-thirds of the users who completed the trial initially reported an unmet need for help. The findings demonstrated that an unguided intervention was effective in reducing symptoms of depression and negative thoughts and in increasing depression literacy in young adults. Significant improvements were found at 2-month follow up. Internet-based interventions can be effective without tracking and thus constitute a minimal cost intervention for reaching a large number of people. User satisfaction among participants was high. Copyright © 2011 John Wiley & Sons, Ltd.
Mol, Mayke; Dozeman, Els; van Schaik, Digna J. F.; Vis, Christiaan P. C. D.; Riper, Heleen; Smit, Jan H
Background Internet-based Cognitive Behavioural Therapy (iCBT) for the treatment of depressive disorders is innovative and promising. Various studies have demonstrated large effect sizes up to 2.27, but implementation in routine practice lags behind. Mental health therapists play a significant role in the uptake of internet-based interventions. Therefore, it is interesting to study factors that influence the therapists in whether they apply internet-based therapy or not. This study, as part o...
Henning, K; Sachse, K; Sting, R
The isolation and identification of a chlamydial agent from an equine fetus is reported. The fetus was aborted by a mare with respiratory disease and fever in the 9th month of pregnancy. The serum of the mare was investigated by the compliment fixation test. Specific antibodies were detected for chlamydial antigen in a titer of > 1:40 and for equine herpes virus 1 antigen in a titer of 1:32. Pathological lesions were not found in the organs of the fetus. Chlamydiae were detected in the placenta by ELISA and subsequently isolated by cell culture. Using PCR technique the agent was identified as Chlamydophila psittaci.
Hilger, T M; Smith, E M; Ault, K
To determine predictors of Chlamydia trachomatis infection among women 14-24 years of age attending family planning clinics throughout a rural Midwestern state. The study population included 16,756 women between the ages of 14 and 24 years attending family planning clinics for annual examinations throughout the state of Iowa in 1997. All women under 25 years of age having annual exams were tested for C. trachomatis during the visit. At the time of exam, both behavioral and demographic data were collected on all women participating in the study. The majority of women in the study (96%) reported no symptoms of chlamydia. Only 2.5% of all women had a positive test result. In the multivariate model, the odds ratios were significantly increased among the youngest age (14-17 years; OR = 2.2), those with mucopurulent cervicitis (OR = 3.4), cervical friability (OR = 2.2), symptomatic for infection (OR = 1.8), risk history (OR = 1.6), and black race (OR = 1.2) and predictive of a C. trachomatis infection. Risk factors predictive of C. trachomatis infection among younger aged women attending family planning clinics in a Midwest rural population are consistent with predictors of infection among women attending family planning clinics across the United States. The overall findings suggest the importance of developing screening guidelines as a means of lowering chlamydia rates. This may be a particularly difficult task in light of the low rate of symptoms that would lead a woman to seek medical care, even in younger age women who are at higher risk. In addition, screening guidelines would be more difficult to implement in a rural setting.
Balla, Eszter; Petrovay, Fruzsina; Erdősi, Tímea; Balázs, Andrea; Henczkó, Judit; Urbán, Edit; Donders, Gilbert G G
The objective of the present study was to determine the frequency and age distribution of different Chlamydia trachomatis (CT) genotypes causing ophthalmia neonatorum (ON) in Hungary. Using CT specific PCR, we tested 76 conjunctival samples from symptomatic infants up to 3 months old in the National Centre for Epidemiology, Budapest between 2008 and 2016. CT tested positive in 30 of 76 conjunctival samples (39.5 %). The sequencing of the positive samples was successful in every case but one, and resulted in 48 % dominance for genotype E (14/29), followed by 24 % for genotype G (7/29), 10 % for J (3/29), 6.9 % for K and F (2/29), and 3.4 % for H (1/29). CT must still be regarded as a common pathogen causing ON in Hungary. Routine screening and treatment of pregnant women can be recommended to prevent these conditions. Chronic ON cases can be reduced by early diagnosis. Further research is needed to explain the dominance of genotypes E and G.
Rawre, Jyoti; Juyal, Deepak; Dhawan, Benu
Urogenital infection due to Chlamydia trachomatis (CT) is one of the most common bacterial sexually transmitted infections (STIs) and is a major public health problem worldwide. Molecular characterisation of CT is important for understanding the pathophysiological mechanisms of chlamydial disease and its transmission dynamics in sexual networks. Traditionally, strain typing of CT was based on serotyping methods characterising the major outer membrane protein (MOMP). With the advent of polymerase chain reaction and sequencing the era of molecular typing began. Molecular characterization of CT strains is based on sequence analysis of ompA gene encoding MOMP. However, in due course of time, improvements were made to enhance the discriminatory power of sequencing and quality of epidemiological information. New high-resolution genotyping methods using multiple loci such as multilocus sequence typing (MLST) and multiple loci variable number of tandem repeats (MLVA) were developed but were unable to differentiate mixed infections (MIs). The development of DNA-hybridisation methods emerged as a major breakthrough in detecting MIs. Although MLST and MLVA are more discriminative than other genotyping methods, they are laborious and expensive. DNA microarray technique is an affordable alternative for genotyping. Since recombination is widespread in the CT genome, ompA is not a reliable marker for phylogenetic studies; hence, whole genome sequencing may provide maximum phylogenetic resolution of CT strains. A descriptive review is provided of the various molecular CT typing methods. The vital information gained can be used for formulating screening programmes, targeted prevention and optimising therapeutic measures aiming to reduce disease transmission.
Hanski, Leena; Vuorela, Pia
Throughout its known history, the gram-negative bacterium Chlamydia pneumoniae has remained a challenging target for antibacterial chemotherapy and drug discovery. Owing to its well-known propensity for persistence and recent reports on antimicrobial resistence within closely related species, new approaches for targeting this ubiquitous human pathogen are urgently needed. In this review, we describe the strategies that have been successfully applied for the identification of nonconventional antichlamydial agents, including target-based and ligand-based virtual screening, ethnopharmacological approach and pharmacophore-based design of antimicrobial peptide-mimicking compounds. Among the antichlamydial agents identified via these strategies, most translational work has been carried out with plant phenolics. Thus, currently available data on their properties as antichlamydial agents are described, highlighting their potential mechanisms of action. In this context, the role of mitogen-activated protein kinase activation in the intracellular growth and survival of C . pneumoniae is discussed. Owing to the complex and often complementary pathways applied by C. pneumoniae in the different stages of its life cycle, multitargeted therapy approaches are expected to provide better tools for antichlamydial therapy than agents with a single molecular target.
Full Text Available Throughout its known history, the gram-negative bacterium Chlamydia pneumoniae has remained a challenging target for antibacterial chemotherapy and drug discovery. Owing to its well-known propensity for persistence and recent reports on antimicrobial resistence within closely related species, new approaches for targeting this ubiquitous human pathogen are urgently needed. In this review, we describe the strategies that have been successfully applied for the identification of nonconventional antichlamydial agents, including target-based and ligand-based virtual screening, ethnopharmacological approach and pharmacophore-based design of antimicrobial peptide-mimicking compounds. Among the antichlamydial agents identified via these strategies, most translational work has been carried out with plant phenolics. Thus, currently available data on their properties as antichlamydial agents are described, highlighting their potential mechanisms of action. In this context, the role of mitogen-activated protein kinase activation in the intracellular growth and survival of C. pneumoniae is discussed. Owing to the complex and often complementary pathways applied by C. pneumoniae in the different stages of its life cycle, multitargeted therapy approaches are expected to provide better tools for antichlamydial therapy than agents with a single molecular target.
Full Text Available Abstract Background There are numerous reports linking Chlamydia infection to human coronary atherosclerosis. However, there is a lack of data regarding this correlation in dogs and cats, and there are no reports investigating coronary arteriosclerosis and Chlamydia in these species. The aim of the present study was to examine whether there is a correlation between canine and feline spontaneous atherosclerosis or arteriosclerosis and the presence of Chlamydia. Archived histopathological samples of dogs (n = 16 and cats (n = 13 with findings of atherosclerosis or arteriosclerosis in heart tissue were examined for the presence of Chlamydiaceae using real-time PCR, ArrayTube Microarray and immunohistochemistry. Additionally, arteriosclerotic lesions of all cases were histologically classified and graded. Results Both canine atherosclerotic cases, and all 14 canine arteriosclerotic cases were negative for Chlamydia. Only one of the 13 arteriosclerotic feline cases was positive for Chlamydia by real-time PCR, revealing C. abortus by ArrayTube Microarray. To our knowledge, this is the first description of C. abortus in a cat. Overall, the type and grade of canine and feline arteriosclerotic lesions revealed similarities, and were predominantly moderate and hyperplastic. Conclusions These findings suggest that there is no obvious correlation between canine and feline coronary arteriosclerosis and the presence of Chlamydia. In order to draw final conclusions about the correlation between Chlamydia and canine atherosclerosis, examination of more samples is required.
Sostaric-Zuckermann, Ivan C; Borel, Nicole; Kaiser, Carmen; Grabarevic, Zeljko; Pospischil, Andreas
There are numerous reports linking Chlamydia infection to human coronary atherosclerosis. However, there is a lack of data regarding this correlation in dogs and cats, and there are no reports investigating coronary arteriosclerosis and Chlamydia in these species. The aim of the present study was to examine whether there is a correlation between canine and feline spontaneous atherosclerosis or arteriosclerosis and the presence of Chlamydia. Archived histopathological samples of dogs (n = 16) and cats (n = 13) with findings of atherosclerosis or arteriosclerosis in heart tissue were examined for the presence of Chlamydiaceae using real-time PCR, ArrayTube Microarray and immunohistochemistry. Additionally, arteriosclerotic lesions of all cases were histologically classified and graded. Both canine atherosclerotic cases, and all 14 canine arteriosclerotic cases were negative for Chlamydia. Only one of the 13 arteriosclerotic feline cases was positive for Chlamydia by real-time PCR, revealing C. abortus by ArrayTube Microarray. To our knowledge, this is the first description of C. abortus in a cat. Overall, the type and grade of canine and feline arteriosclerotic lesions revealed similarities, and were predominantly moderate and hyperplastic. These findings suggest that there is no obvious correlation between canine and feline coronary arteriosclerosis and the presence of Chlamydia. In order to draw final conclusions about the correlation between Chlamydia and canine atherosclerosis, examination of more samples is required.
Sawyer, Michael G; Reece, Christy E; Bowering, Kerrie; Jeffs, Debra; Sawyer, Alyssa C P; Mittinty, Murthy; Lynch, John W
Internet-based interventions moderated by community nurses have the potential to improve support offered to new mothers, many of whom now make extensive use of the Internet to obtain information about infant care. However, evidence from population-based randomized controlled trials is lacking. The aim of this study was to test the non-inferiority of outcomes for mothers and infants who received a clinic-based postnatal health check plus nurse-moderated, Internet-based group support when infants were aged 1-7 months as compared with outcomes for those who received standard care consisting of postnatal home-based support provided by a community nurse. The design of the study was a pragmatic, preference, non-inferiority randomized control trial. Participants were recruited from mothers contacted for their postnatal health check, which is offered to all mothers in South Australia. Mothers were assigned either (1) on the basis of their preference to clinic+Internet or home-based support groups (n=328), or (2) randomly assigned to clinic+Internet or home-based groups if they declared no strong preference (n=491). The overall response rate was 44.8% (819/1827). The primary outcome was parenting self-competence, as measured by the Parenting Stress Index (PSI) Competence subscale, and the Karitane Parenting Confidence Scale scores. Secondary outcome measures included PSI Isolation, Interpersonal Support Evaluation List-Short Form, Maternal Support Scale, Ages and Stages Questionnaire-Social-Emotional and MacArthur Communicative Development Inventory (MCDI) scores. Assessments were completed offline via self-assessment questionnaires at enrolment (mean child age=4.1 weeks, SD 1.3) and again when infants were aged 9, 15, and 21 months. Generalized estimating equations adjusting for post-randomization baseline imbalances showed that differences in outcomes between mothers in the clinic+Internet and home-based support groups did not exceed the pre-specified margin of
Harden, Samantha M.; You, Wen; Almeida, Fabio A.; Hill, Jennie L.; Linnan, Laura A.; Allen, Kacie C.; Estabrooks, Paul A.
Certain risk factors associated with overweight and obesity may lead to reduced productivity in the workforce (i.e., increased absenteeism and presenteeism). Participants in a large, Internet-based worksite weight loss intervention, who were present at follow-up (N = 1,030), completed a self-reported productivity measure (World Health…
Ebert, D.D.; Lehr, D.; BoB, L.; Riper, H.; Cuijpers, P.; Andersson, G.; Thiart, H.; Heber, E.; Berking, M.
Objective The primary purpose of this randomized controlled trial (RCT) was to evaluate the efficacy of internet-based problem-solving training (iPST) for employees in the educational sector (teachers) with depressive symptoms. The results of training were compared to those of a waitlist control
Bingham, Teri; Ray, Jan
In an effort to keep up with the new generation of digital learners, educators are integrating multiple forms of technology into their teaching, including online learning game applications. The purpose of this study was to determine the degree to which internet-based learning game applications selected by preservice teachers were aligned with the…
Hemmati, Nima; Omrani, Soghra; Hemmati, Naser
The purpose of this study was to compare the satisfaction and effectiveness of Internet-based learning (IBL) and traditional classroom lecture (TCL) for continuing medical education (CME) programs by comparing final resuscitation exam results of physicians who received the newest cardiopulmonary resuscitation (CPR) curriculum guidelines training…
Jiang, Jiahong; Yu, Yibing
English writing, an indispensable skill in English learning, plays an important role in improving learners' language proficiency. With the wide spread and use of wired or wireless internet, EFL students can easily help and be helped with English writing. Therefore, the application of internet-based peer feedback training on writing to foreign or…
Kleiboer, A; Donker, T; Seekles, W.; van Straten, A.; Riper, H.; Cuijpers, P.
Internet-based interventions can be effective treatments for anxiety and depression. Meta-analytic evidence suggests that they should be delivered with human support to reach optimal effects. These findings have not consistently been replicated in direct comparisons of supported and unsupported
Kuntsche, E.N.; Labhart, F.
Rapid advances in mobile data-transfer technologies offer new possibilities in the use of cell phones to conduct assessments of a person’s natural environment in real time. This paper describes features of a new Internet-based, cell phone-optimized assessment technique (ICAT), which consists of a
This study assesses the effectiveness of internet-based distance learning (IBDL) through the VClass live e-education platform. The research examines (1) the effectiveness of IBDL for regular and distance students and (2) the distance students' experience of VClass in the IBDL course entitled Computer Programming 1. The study employed the common…
LaChausse, Robert G.
Objective: To determine the impact of My Student Body (MSB)-Nutrition, an Internet-based obesity prevention program for college students. Participants: Three hundred and twenty ethnically diverse undergraduate students were randomly assigned to 1 of 3 conditions: MSB-Nutrition program, an on-campus weight management course, and a comparison group.…
Ellis, Louise A.; McCabe, Kathryn; Davenport, Tracey; Burns, Jane M.; Rahilly, Kitty; Nicholas, Mariesa; Hickie, Ian B
Purpose: This paper aims to describe the development of WorkOut, an Internet-based program designed to help young men overcome the barriers towards help-seeking and to build the skills they need to understand and manage their own mental health. Information and communication technologies (ICT) hold great potential to significantly improve mental…
Raiff, Bethany R.; Dallery, Jesse
The current study used Internet-based contingency management (CM) to increase adherence with blood glucose testing to at least 4 times daily. Four teens diagnosed with Type 1 diabetes earned vouchers for submitting blood glucose testing videos over a Web site. Participants submitted a mean of 1.7 and 3.1 blood glucose tests per day during the 2…
....540 Exportation of certain services and software incident to Internet-based communications. (a) To the....S. persons, wherever located, to persons in Iran of software necessary to enable the services... indirect exportation of services or software with knowledge or reason to know that such services or...
....533 Exportation of certain services and software incident to Internet-based communications. (a) To the....S. persons, wherever located, to persons in Sudan of software necessary to enable the services... indirect exportation of services or software with knowledge or reason to know that such services or...
Jang, Yuri; Yoon, Hyunwoo; Marti, C. Nathan; Kim, Miyong T.
Using the translated contents of the National Institute on Aging (NIA)'s Aging IQ, an educational intervention was delivered to older Korean Americans. The educational program was delivered via two different modalities, Internet-based education (n = 12) and in-class education (n = 11), and the overall feasibility and efficacy were evaluated by the…
van Rooijen, Martijn S.; van der Loeff, Maarten F. Schim; Morré, Servaas A.; van Dam, Alje P.; Speksnijder, Arjen G. C. L.; de Vries, Henry J. C.
Objectives Pharyngeal Chlamydia trachomatis (chlamydia) might contribute to ongoing chlamydia transmission, yet data on spontaneous clearance duration are rare. We examined the prevalence, spontaneous clearance, chlamydial DNA concentration and genotypes of pharyngeal chlamydia among clinic patients
Leszczyńska-Gorzelak, Bozena; Darmochwal-Kolarz, Dorota; Borowiec-Blinowska, Agnieszka; Oleszczuk, Jan
The aim of our study was to estimate the prevalence of Chlamydia trachomatis infection, the risk factors, the impact of the infection on the course of pregnancy and the condition of neonates born from pregnancies complicated by Chlamydia trachomatis infection. 558 pregnant women aged 18-42 yrs, between the 4th and 40th week of pregnancy recruited from the Department of Obstetrics and Gynaecology, Medical Academy Lublin, and 10 men, partners of Chlamydia trachomatis infected patients were included in the study. All patients were examined using an immunoenzymatic method (MEIA). The ligase chain reaction (LCR) method was used only in cases of Chlamydia trachomatis detection with the use of MEIA method, in male partners of infected women and in patients with a cervical erosion and with a mucopurulent cervicitis. There were 64 women and 10 men who were examined using the LCR method. Positive results of MEIA test were found in 10 women (1.8% of studied population). Among men, the infection by Chlamydia trachomatis was present in 9 cases (90%). There were no infections with Chlamydia trachomatis in the group of neonates born from infected mothers. The prevalence of Chlamydia trachomatis infection was 1.8% in the studied group. The factors favourable for an infection are: young, unmarried patients, residents of towns or cities and changes in the cervix such as cervicitis or ectopy. In the cases of pathological pregnancy we should take into account Chlamydia trachomatis infections as a cause of abdominal pain or premature uterine contractions. The test towards Chlamydia trachomatis infection should be performed in pregnant patients to decrease the rate of pregnancy complications.
Brunault, P; Bray, A; Rerolle, C; Cognet, S; Gaillard, P; El-Hage, W
Internet has become a major tool for patients to search for health-related information and to communicate on health. We currently lack data on how patients with psychiatric disorders access and use Internet to search for information on their mental health. This study aimed to assess, in patients followed for a psychiatric disorder (schizophrenia, bipolar disorder, mood and anxiety disorder, substance-related and addictive disorders and eating disorders), prevalence of Internet access and use, and patient expectations and needs regarding the use of Internet to search for mental-health information depending on the psychiatric disorder. We conducted this cross-sectional study between May 2013 and July 2013 in 648 patients receiving psychiatric care in 8 hospitals from the Region Centre, France. We used multivariate logistic regression adjusted for age, gender, socio-educational level and professional status to compare use, expectations and needs regarding Internet-based information about the patient's psychiatric disorder (65-items self-administered questionnaires) as a function of the psychiatric disorders. We identified patients clusters with multiple correspondence analysis and ascending hierarchical classification. Although 65.6% of our population accessed Internet at home, prevalence for Internet access varied depending on the type of psychiatric disorder and was much more related to limited access to a computer and low income than to a lack of interest in the Internet. Most of the patients who used Internet were interested in having access to reliable Internet-based information on their health (76.8%), and most used Internet to search for Internet based health-information about their psychiatric disorder (58.8%). We found important differences in terms of expectations and needs depending on the patient's psychiatric disorder (e.g., higher interest in Internet-based information among patients with bipolar disorder, substance-related and addictive disorders
Berryhill, K. J.; Coble, K.; Slater, T. F.; McLin, K. M.; Cominsky, L. R.
Responding to national science education reform documents calling for students to have more opportunities for authentic research experiences, several national projects have developed online telescope networks to provide students with Internet-access to research grade telescopes. The nature of astronomical observation (e.g., remote sites, expensive equipment, and odd hours) has been a barrier in the past. Internet-based robotic telescopes allow scientists to conduct observing sessions on research-grade telescopes half a world away. The same technology can now be harnessed by STEM educators to engage students and reinforce what is being taught in the classroom, as seen in some early research in elementary schools (McKinnon and Mainwaring 2000 and McKinnon and Geissinger 2002), middle/high schools (Sadler et al. 2001, 2007 and Gehret et al. 2005) and undergraduate programs (e.g., McLin et al. 2009). This project looks at the educational value of using Internet-based robotic telescopes in a general education introductory astronomy course at the undergraduate level. Students at a minority-serving institution in the midwestern United States conducted observational programs using the Global Telescope Network (GTN). The project consisted of the use of planetarium software to determine object visibility, observing proposals (with abstract, background, goals, and dissemination sections), peer review (including written reviews and panel discussion according to NSF intellectual merit and broader impacts criteria), and classroom presentations showing the results of the observation. The GTN is a network of small telescopes funded by the Fermi mission to support the science of high energy astrophysics. It is managed by the NASA E/PO Group at Sonoma State University and is controlled using SkyNet. Data includes course artifacts (proposals, reviews, panel summaries, presentations, and student reflections) for six semesters plus student interviews. Using a grounded theory approach
Full Text Available Screening and treatment of sexually transmitted infections (STIs in pregnancy represents an overlooked opportunity to improve the health outcomes of women and infants worldwide. Although Chlamydia trachomatis is the most common treatable bacterial STI, few countries have routine pregnancy screening and treatment programs. We reviewed the current literature surrounding Chlamydia trachomatis in pregnancy, particularly focusing on countries in sub-Saharan Africa and Asia. We discuss possible chlamydial adverse pregnancy and infant health outcomes (miscarriage, stillbirth, ectopic pregnancy, preterm birth, neonatal conjunctivitis, neonatal pneumonia, and other potential effects including HIV perinatal transmission and review studies of chlamydial screening and treatment in pregnancy, while simultaneously highlighting research from resource-limited countries in sub-Saharan Africa and Asia.
Prasko, Jan; Kamaradova, Dana; Jelenova, Daniela; Ociskova, Marie; Sedlackova, Zuzana
Despite pharmacological treatment of bipolar affective disorder has many advantages; only drug treatment remains insufficiently beneficial to many patients. The combination of pharmacotherapy and internet psychoeducation seems to be the effective way how to improve remission. Internet-based therapy programs offer an exclusive chance for large underserved parts of the population to make evidence-based treatment without the need of full-time therapist. Our goal was to create a psychoeducational program for patients suffering from bipolar disorder that can be used in Czech Republic. There were identified studies through Web of Science, PUBMED, and Scopus databases as well as existing reviews were used in development of comprehensive internet psychoeducational program for patients with bipolar disorder. The search terms included "bipolar disorder", "psychoeducation", and "internet psychoeducation". The search was performed with no language or time restrictions. The internet psychoeducational program was developed in accordance to the data from the literature review. The aim of the Internet psychoeducational program of the Department of Psychiatry University Hospital in Olomouc is to familiarize patients with the fundamental nature of bipolar affective disorder, the character and principles of pharmacotherapy, the recognition of the warning signs of relapse, inappropriate and stressful stereotypes in communication within families, and finally the practice of social skills. Information from studies can help to prepare comprehensive psychoeducational program for bipolar patients.
Pron, G; Ieraci, L; Kaulback, K
Executive Summary Objective The objective of this Medical Advisory Secretariat (MAS) report was to conduct a systematic review of the available published evidence on the safety, effectiveness, and cost-effectiveness of Internet-based device-assisted remote monitoring systems (RMSs) for therapeutic cardiac implantable electronic devices (CIEDs) such as pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. The MAS evidence-based review was performed to support public financing decisions. Clinical Need: Condition and Target Population Sudden cardiac death (SCD) is a major cause of fatalities in developed countries. In the United States almost half a million people die of SCD annually, resulting in more deaths than stroke, lung cancer, breast cancer, and AIDS combined. In Canada each year more than 40,000 people die from a cardiovascular related cause; approximately half of these deaths are attributable to SCD. Most cases of SCD occur in the general population typically in those without a known history of heart disease. Most SCDs are caused by cardiac arrhythmia, an abnormal heart rhythm caused by malfunctions of the heart’s electrical system. Up to half of patients with significant heart failure (HF) also have advanced conduction abnormalities. Cardiac arrhythmias are managed by a variety of drugs, ablative procedures, and therapeutic CIEDs. The range of CIEDs includes pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices. Bradycardia is the main indication for PMs and individuals at high risk for SCD are often treated by ICDs. Heart failure (HF) is also a significant health problem and is the most frequent cause of hospitalization in those over 65 years of age. Patients with moderate to severe HF may also have cardiac arrhythmias, although the cause may be related more to heart pump or haemodynamic failure. The presence of HF, however
Wang, Weiwen; Sun, Ran; Mulvehill, Alice M; Gilson, Courtney C; Huang, Linda L
Patient care problems arise when health care consumers and professionals find health information on the Internet because that information is often inaccurate. To mitigate this problem, nurses can develop Web literacy and share that skill with health care consumers. This study evaluated a Web-literacy intervention for undergraduate nursing students to find reliable Web-based health information. A pre- and postsurvey queried undergraduate nursing students in an informatics course; the intervention comprised lecture, in-class practice, and assignments about health Web site evaluation tools. Data were analyzed using Wilcoxon and ANOVA signed-rank tests. Pre-intervention, 75.9% of participants reported using Web sites to obtain health information. Postintervention, 87.9% displayed confidence in using an evaluation tool. Both the ability to critique health Web sites (p = .005) and confidence in finding reliable Internet-based health information (p = .058) increased. Web-literacy education guides nursing students to find, evaluate, and use reliable Web sites, which improves their ability to deliver safer patient care. [J Nurs Educ. 2017;56(2):110-114.]. Copyright 2017, SLACK Incorporated.
Guo, Z; Moulder, C; Zou, Y; Loew, M; Durand, L G
The objective of this study is to develop a phonocardiogram (PCG) acquisition and analysis instrument using virtual instrumentation technology and investigate its Internet-based application. The PCG instrument was developed using a Pentium 200 computer, a data acquisition board, and a two-channel custom designed bio-signal preamplifier. LabVIEW was used to create the instrument's front panels. Spectral and joint time-frequency analyses were implemented into the instrument. This instrument can be used to display the PCG and to analyze the individual heart sound and murmur for the detection of heart valve diseases. Using a test-bed, the PCG data acquisition and analysis were performed remotely over the Internet. Through the main PCG panel, an operator can control the acquisition and analysis of PCG signals. In the remote test, real-time transmission of the PCG signal over the Internet was possible. Remote operators were able to view smoothly scrolling PCG waveforms and could control all the acquisition parameters and perform spectral and time-frequency analyses on the acquired heart sound. This study demonstrated that a LabVIEW-based medical virtual instrument provides a low-cost and flexible solution for data acquisition and analysis of PCG. It also showed that the current Internet supports the transmission of real-time PCG signals. Compared with other telemedicine systems, this application transfers not only the medical data, but also the virtual instrument and its signal processing capability through the Internet.
Essery, Rosie; Kirby, Sarah; Geraghty, Adam W A; Yardley, Lucy
Factors influencing engagement with self-managed rehabilitation are not well understood, but evidence suggests they may change over time. Despite increasing digitalisation of self-managed interventions, little is known about the role of internet-based interventions in patients' experiences of self-directed rehabilitation. This longitudinal qualitative study investigated individuals' ongoing experiences of internet-guided, self-managed rehabilitation within the context of rehabilitation for dizziness. Eighteen adults aged fifty and over who experienced dizziness used the 'Balance Retraining' internet intervention for six weeks. Participants took part in semi-structured telephone interviews at two-week intervals to explore their experiences. Data were inductively thematically analysed. The internet intervention was reported to facilitate engagement with rehabilitation exercises, providing motivation to continue through symptom reduction and simple but helpful strategies. It was perceived as informative, reassuring, visually pleasing and easy to use. Barriers to engagement included practicalities, symptoms and doubts about exercise efficacy. Participants' perceptions did not always remain consistent over time. The internet intervention may be a feasible method of supporting self-managed vestibular rehabilitation. More generally, longitudinal findings suggest that appearance-related perceptions of online interventions may be especially important for initial engagement. Furthermore, intervention features targeting self-efficacy seem important in overcoming barriers to engagement.
Herrera-Usagre, Manuel; Reyes-Alcázar, Víctor; Valverde, José A
Analyze factors affecting the predisposition of Spanish citizens to use Internet-based communication channels (E-mail, blogs, social networks, and online recommendations). Secondary data were analyzed by applying a boosted regression tree (BRT) to the results obtained from the survey "Use and Applications of Information and Communications Technology in Health," administered to a representative sample of the Spanish population between 16 and 85 years of age who use the Internet. Model forecasts achieved different degrees of precision for each of the communication channels: for E-mail, AUC (area under the curve) = 0.79; for the physician's blog or personal website, AUC = 0.736; for social networks, AUC = 0.73; for recommendations of websites related to health problems, AUC = 0.768. Being young was the most important parameter in citizen predisposition to communicate through social networks (relative influence; RI = 21.05%), while population density was the most important parameter in likelihood that the physician would have a blog or personal health-related website (RI = 19.48%). Having a positive perception of the technology when facilitating health-related transactions was the most important characteristic in wanting to receive recommendations on health-related Internet resources (RI = 18.66%), while having a higher level of education was the best predictor of wanting to establish E-mail communication (RI = 18.98%). Many of Spanish people are open to using physician-patient interaction channels on the Internet.
Medek, Danielle Eve; Kljakovic, Marjan; Fox, Ian; Pretty, David George; Prebble, Matthew
Investigating the impact of climate change on human health requires the development of efficient tools that link patient symptoms with changing environmental variables. We developed an internet-based hay fever diary linked to simultaneously recorded pollen load and weather variables in Canberra, Australia over spring 2010. We recruited 42 hay fever sufferers to complete a simple online pollen diary daily over a period of 60 days. In conjunction, daily airborne pollen load was counted and meteorological data collected simultaneously. We focused on the relationships between temperature, rainfall, pollen count and rhinoconjunctivitis symptoms. Pollen load increased after a peak rainfall event until the end of the study. Compliance was high, averaging 79% of days per person. Nasal rhinoconjunctivitis symptoms increased in concert with increasing pollen load, and then remained high. Mucosal itching increased more gradually and strongly coincided with increased daily maximum temperature. Our study successfully demonstrated the feasibility of linking pollen load and climate variables to symptoms of rhinoconjunctivitis in the Australian community. However, a larger study would better explore the nature of associations between these variables. Similar online methods could be used to monitor a range of health responses to our changing environment.
Andy T. Woods
Full Text Available According to a popular family of hypotheses, crossmodal matches between distinct features hold because they correspond to the same polarity on several conceptual dimensions (such as active–passive, good–bad, etc. that can be identified using the semantic differential technique. The main problem here resides in turning this hypothesis into testable empirical predictions. In the present study, we outline a series of plausible consequences of the hypothesis and test a variety of well-established and previously untested crossmodal correspondences by means of a novel internet-based testing methodology. The results highlight that the semantic hypothesis cannot easily explain differences in the prevalence of crossmodal associations built on the same semantic pattern (fast lemons, slow prunes, sour boulders, heavy red; furthermore, the semantic hypothesis only minimally predicts what happens when the semantic dimensions and polarities that are supposed to drive such crossmodal associations are made more salient (e.g., by adding emotional cues that ought to make the good/bad dimension more salient; finally, the semantic hypothesis does not explain why reliable matches are no longer observed once intramodal dimensions with congruent connotations are presented (e.g., visually presented shapes and colour do not appear to correspond.
Feng, Ren-Nan; Du, Shan-Shan; Chen, Yang; Li, Zhen; Zhang, Ying-Feng; Sun, Chang-Hao; Jiang, Yong-Shuai
National dietary surveys are needed and difficult to conduct in China. The current study aims to develop and validate an internet-based diet questionnaire for Chinese (IDQC) to assess intakes in Northern China. We recruited 292 city residents by email and telephone in Harbin to obtain the IDQC and 3-day diet diaries. The food group and nutrient intakes from the IDQC were validated against those from the 3-day diet diaries. Paired sample t-tests were used to compare the methodological differences, and repeatability was estimated using Pearson's correlations. Cross-classification was used to calculate the percentage agreement in quartiles for all food groups and nutrients. Positive correlations were found between the IDQC and 3-day diet diaries for all food groups after energy adjustment (from 0.28 for seeds and nuts to 0.63 for dairy products). Positive correlations were observed for all nutrients between the IDQC and 3-day diet diaries, with correlations ranging from 0.37 for folic acid to 0.98 for iodine. The overall agreements for food groups and nutrients were above 69.2%, indicating satisfactory consistency between the IDQC and 3-day diet diaries. The IDQC can be used to estimate the food and nutrient intakes in a Northern China population for both clinical nutrition epidemiological and public health nutritional purposes. The questionnaire system IDQC (v1.0) is freely available at http://www.yyjy365.org/diet/.
Kim, Jong Choon; Choi, Jae Boong; Kim, Young Jin; Choi, Young Hwan
Since early 1950s fracture mechanics has brought significant impact on structural integrity assessment in a wide range of industries such as power, transportation, civil and petrochemical industries, especially in nuclear power plant industries. For the last two decades, significant efforts have been devoted in developing defect assessment procedures, from which various fitness-for-purpose or fitness-for-service codes have been developed. From another aspect, recent advances in IT (Information Technologies) bring rapid changes in various engineering fields. IT enables people to share information through network and thus provides concurrent working environment without limitations of working places. For this reason, a network system based on internet or intranet bas been appeared in various fields of business. Evaluating the integrity of structures is one of the most critical issues in nuclear industry. In order to evaluate the integrity of structures, a complicated and collaborative procedure is required including regular in-service inspection, fracture mechanics analysis, etc. And thus, experts in different fields have to cooperate to resolve the integrity problem. In this paper, an internet-based cooperative system for integrity evaluation system which adapts IT into a structural integrity evaluation procedure for reactor pressure vessel is introduced. The proposed system uses Virtual Reality (VR) technique, Virtual Network Computing (VNC) and agent programs. This system is able to support 3-dimensional virtual reality environment and to provide experts to cooperate by accessing related data through internet
Adams Clive E
Full Text Available Abstract Background The internet is becoming a widely used source of accessing medical research through various on-line databases. This instant access to information is of benefit to busy clinicians and service users around the world. The population of the Arab World is comparable to that of the United States, yet it is widely believed to have a greatly contrasting output of randomised controlled trials related to mental health. This study was designed to investigate the existence of such research in the Arab World and also to investigate the availability of this research on-line. Methods Survey of findings from three internet-based potential sources of randomised trials originating from the Arab world and relevant to mental health care. Results A manual search of an Arabic online current contents service identified 3 studies, MEDLINE, EMBASE, and PsycINFO searches identified only 1 study, and a manual search of a specifically indexed, study-based mental health database, PsiTri, revealed 27 trials. Conclusion There genuinely seem to be few trials from the Arab world and accessing these on-line was problematic. Replication of some studies that guide psychiatric/psychological practice in the Arab world would seem prudent.
Full Text Available Objective To evaluate the effectiveness of internet-based cognitive behavioral therapy (ICBT for the treatment of insomnia by comparison of sleep parameters, degrees of anxiety and depression of the ICBT, with traditional face-to-face cognitive behavioral therapy (CBT and pharmacotherapy for insomnia. Methods Seventy-nine cases meeting proposed DSM-5 criteria for insomnia disorder were randomly assigned to ICBT (n=27, CBT (n=26, and pharmacotherapy (n=26 group, and treated accordingly for 8 consecutive weeks. The sleep parameters, the levels of anxiety and depression in the 3 groups were compared and analyzed before, 4 weeks after and the termination of treatment. Results Comparing to that of pre-treatment, the sleep parameters were significantly improved, anxiety and depression levels obviously decreased after treatment for 4 and 8 consecutive weeks, the differences were statistically significant (P0.05 was found in sleep parameters and anxiety level between ICBT group and CBT group. Conclusion ICBT may display a slower effect on improving speed in falling asleep than the pharmacotherapy does, but the efficacy of ICBT is better than that of pharmacotherapy after treatment, and there is no significant difference compared to traditional face-to-face CBT. DOI: 10.11855/j.issn.0577-7402.2016.04.09
Full Text Available Major depression is among the most common and debilitating disorders worldwide, associated with large societal and individual costs. Effective treatments exist, but accessibility is scarce. Guided Internet-Based Cognitive Behavioral Therapy (guided iCBT is a promising approach to reach more people in need of help. In the present pilot study, we investigated the outcome of a guided iCBT program for mild and moderate depression when disseminated from Sweden to Norway. The guided iCBT intervention was implemented within a university-based outpatient clinic by six student therapists under supervision. Twenty-two participants with mild and moderate depression were included in the study. Large treatment effects were found for depressive symptoms, whereas small to medium effects were observed for anxiety symptoms. More than half (55% of the participants were classified as recovered at post-treatment and more than a third (41% at follow-up. No participants had a significant deterioration from pre- to post-treatment, but two reported a significant deterioration from post-treatment to 6-month follow-up. Benchmarking the present results against those reported in the four original Swedish studies, we found that the treatment effect in the Norwegian study was slightly higher at post-treatment and slightly lower at 6-month follow-up compared to the outcome in the Swedish studies. The results should be interpreted with caution, as our sample was small and had no control group.
Matthew Phillip Simon
Full Text Available Communication technologies are commonplace in modern society. For many years there were only a handful of communication technologies provided by large companies, namely the Public Switched Telephone Network (PSTN and mobile telephony; these can be referred to as traditional communication technologies. Over the lifetime of traditional communication technologies has been little technological evolution and as such, law enforcement developed sound methods for investigating targets using them. With the advent of communication technologies that use the Internet – Internet-based or contemporary communication technologies – law enforcement are faced with many challenges. This paper discusses these challenges and their potential impact. It first looks at what defines the two technologies then explores the laws and methods used for their investigation. It then looks at the issues of applying the current methodologies to the newer and fundamentally different technology. The paper concludes that law enforcement will be required to update their methods in order to remain effective against the current technology trends.
Kwasny, R.; Max, A.
Information has become a commodity particularly important to industry, science, and politics. Information becomes critical because of its rapid change. The basis and the catalyst of this change in information are the information technologies now available, and the Internet with its varied contents. This makes the Internet a new market place which, although it is open, can quickly turn into an information maze because of its sheer volume. Also the nuclear industry must find its way through this maze. eNICE was created in order to build a bridge between the flood of information in the Internet and the information really needed in a specific case. eNICE (e stands for electronic, and NICE stands for Nuclear Information Compendium Europe), a living Internet-based nuclear compendium in the English language, is a unique combination of a broad spectrum of information and data about the use of nuclear power in Europe. The information and data contained in eNICE are interconnected with the World Wide Web in such a way that structured searching for nuclear information is possible quickly and efficiently. This avoids the difficulties sometimes encountered in searches in the Internet as a consequence of the unstructured volume of information. A monthly update of eNICE ensures that the data available are up to date and reliable. eNICE also offers direct access to the library used by RWE NUKEM for internal purposes. (orig.) [de
Full Text Available Abstract Background In a recent exploratory randomised trial we found that a novel, internet-based psychoeducation programme for bipolar disorder (Beating Bipolar was relatively easy to deliver and had a modest effect on psychological quality of life. We sought to explore the experiences of participants with respect to feasibility, acceptability and impact of Beating Bipolar. Methods Participants were invited to take part in a semi-structured interview. Thematic analysis techniques were employed; to explore and describe participants’ experiences, the data were analysed for emerging themes which were identified and coded. Results The programme was feasible to deliver and acceptable to participants where they felt comfortable using a computer. It was found to impact upon insight into illness, health behaviour, personal routines and positive attitudes towards medication. Many participants regarded the programme as likely to be most beneficial for those recently diagnosed. Conclusions An online psychoeducation package for bipolar disorder, such as Beating Bipolar, is feasible and acceptable to patients, has a positive impact on self-management behaviours and may be particularly suited to early intervention. Alternative (non-internet formats should also be made available to patients.
Kumar, Vikram; Sattar, Yasar; Bseiso, Anan; Khan, Sara; Rutkofsky, Ian H
This review article is an overview of the effectiveness of internet-based cognitive behavioral therapy (ICBT) in the treatment of psychiatric disorders. ICBT's effectiveness has been investigated in treating and managing conditions like depression, generalized anxiety disorder (GAD), panic disorder, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD), adjustment disorder, bipolar disorder, chronic pain, and phobias. ICBT's role in the treatment of medical conditions such as diabetes mellitus with comorbid psychiatric illnesses was also explored. Furthermore, this study elaborates on its cost-effectiveness and its impact in rural areas. We conducted a thorough literature search using PubMed and Google Scholar with no restrictions on the date. ICBT's role in treating and controlling psychiatric illnesses has been established in the literature. From the data compiled, we conclude that ICBT is useful in treating mental health and medical illnesses with psychiatric comorbidities. It has also been found to be cost-effective for patients and society. ICBT is a potential tool emerging with modern day technological advancements and is useful in rural and urban settings, across various languages and cultures, and on a global scale. Larger randomized control trials on its use in clinical practice and in reaching rural populations are bound to shed more light on the effectiveness of this tool along with spreading awareness among physician and patient communities.
Wilson, David P
Beliefs regarding the origins of the universe and life differ substantially between groups of people and are often particularly associated with religious worldviews. It is important to understand factors associated with evolution and creationism beliefs and unacceptance of scientific evidence for evolution. An internet-based survey was conducted to elicit information from people who self-identify as Christians, atheists, agnostics and other belief systems, as well as by geographical location and other demographic variables, on acceptance of evolution or creationism, certainty with which each position is believed, and reasons for rejecting the alternative. It was found that almost 60% of Christians believe in creationism and less than 10% believe in natural evolution. Worldwide, these proportions were relatively consistent across all locations except for in Europe. Among European Christians the majority of Christians believe in a form of evolution. It was found that the vast majority (87%) of Christians are 'absolutely certain' about their beliefs, compared with the minority of atheists and agnostics claiming 'absolute certainty'. Generally, reasons Christians did not accept evolution were based not on evidence but on religious doctrine. In contrast, the most common reason for not accepting the existence of a god by atheists who supported evolution was the lack of evidence. Innovative strategies may be required to communicate evolutionary science effectively to non-European Christians. © 2010 Wiley Periodicals, Inc.
Full Text Available Abstract Background Cognitive behavior therapy (CBT is widely regarded as an effective treatment for obsessive compulsive disorder (OCD, but access to CBT therapists is limited. Internet-based CBT (ICBT with therapist support is a way to increase access to CBT but has not been developed or tested for OCD. The aim of this study was to evaluate ICBT for OCD. Method An open trial where patients (N = 23 received a 15-week ICBT program with therapist support consisting of psychoeducation, cognitive restructuring and exposure with response prevention. The primary outcome was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS, which was assessed by a psychiatrist before and immediately after treatment. Secondary outcomes were self-rated measures of OCD symptoms, depressive symptoms, general functioning, anxiety and quality of life. All assessments were made at baseline and post-treatment. Results All participants completed the primary outcome measure at all assessment points. There were reductions in OCD symptoms with a large within-group effect size (Cohen's d = 1.56. At post-treatment, 61% of participants had a clinically significant improvement and 43% no longer fulfilled the diagnostic criteria of OCD. The treatment also resulted in statistically significant improvements in self-rated OCD symptoms, general functioning and depression. Conclusions ICBT with therapist support reduces OCD symptoms, depressive symptoms and improves general functioning. Randomized trials are needed to confirm the effectiveness of this new treatment format. Trial Registration ClinicalTrials.gov: NCT01348529
Levy, Sharon; Van Hook, Shari; Knight, John
To review home drug-testing products and the Internet-based recommendations intended for parents. A qualitative review of drug-testing products and structured analysis of information presented on company Internet sites were conducted. Eight Internet sites that sold home drug-testing products and contained a "parent's section" were identified by Ixquick using the search term "home drug testing." Description and prices of products sold by each Internet site and recommended indications for testing, consent, collection procedures, and follow-up of positive and negative test results were researched. A variety of drug-testing products were available, including breath and saliva tests for alcohol, a multidrug panel hair test, and a variety of laboratory and instant urine tests. Prices ranged from 2.75 dollars for a single alcohol test to 89.00 dollars for a multidrug combination urine/hair package. A total of 14 indications for home drug-testing were cited; all sites claimed that drug testing was a way to know with certainty whether a child has used drugs. Only 1 web site made a clear statement against testing an adolescent against his or her will. Little information was presented on valid specimen collection procedures and the risks of false-positive and false-negative tests. Only half of the sites recommended that parents consult a professional if a test is positive. Pediatricians should advise parents of the limitations and potential risks associated with home drug-testing products.
Wei, Xuejuan; Wu, Hao; Cui, Shuqi; Ge, Caiying; Wang, Li; Jia, Hongyan; Liang, Wannian
To evaluate the effect of an intelligent Internet-based information system upon optimising the management of patients diagnosed with type 2 diabetes mellitus (T2DM). In 2015, a T2DM information system was introduced to optimise the management of T2DM patients for 1 year in Fangzhuang community of Beijing, China. A total of 602 T2DM patients who were registered in the health service centre of Fangzhuang community were enrolled based on an isometric sampling technique. The data from 587 patients were used in the final analysis. The intervention effect was subsequently assessed by statistically comparing multiple parameters, such as the prevalence of glycaemic control, standard health management and annual outpatient consultation visits per person, before and after the implementation of the T2DM information system. In 2015, a total of 1668 T2DM patients were newly registered in Fangzhuang community. The glycaemic control rate was calculated as 37.65% in 2014 and significantly elevated up to 62.35% in 2015 ( p information system, the rate of standard health management was increased from 48.04% to 85.01% ( p information system optimised the management of T2DM patients in Fangzhuang community and decreased the outpatient numbers in both community and general hospitals, which played a positive role in assisting T2DM patients and their healthcare providers to better manage this chronic illness.
Vera, Chido; Herr, Allen; Mandato, Kenneth; Englander, Meridith; Ginsburg, Lauren; Siskin, Gary P
The Internet is being seen as a growing resource for health-related information for a large number of patients. It is undeniable that its widespread presence has led to the growth of awareness that chronic cerebrospinal venous insufficiency (CCSVI) as an entity that may contribute to the symptoms experienced by patients with multiple sclerosis (MS). Social networking and file-sharing Web sites have brought patients with MS together from all over the world and have facilitated the distribution of personal experiences and information derived from medical research as it relates to CCSVI. As a result, there has been an accelerated growth in the number of patients seeking treatment for this syndrome in light of the possibility that it may improve their present condition. This article will review this phenomenon, the Internet-based resources available to MS patients seeking information about CCSVI, and the responsibilities of physicians as they participate in these online discussions. Copyright © 2012 Elsevier Inc. All rights reserved.
Peterson-Clark, Geraldine; Aslani, Parisa; Williams, Kylie Anne
Pharmacists need effective skills in accessing and using Internet-based medicines information (IBMI) for themselves and their consumers. However, there is limited information regarding how pharmacists use the Internet. To develop and use a research instrument to measure pharmacists' Internet knowledge, search skills, evaluation of and opinions about using IBMI. A structured questionnaire examining general Internet knowledge, ability to search for and select pertinent IBMI, evaluation of IBMI, opinions about using IBMI and current Internet use was developed. Exploratory factor analysis was performed to analyse IBMI evaluation. 208 pharmacists responded (response rate 20.6%). There was a large variation in pharmacists' scores. Mean scores were low for General Internet Knowledge (mean 7.91 +/- 3.62; scale 0-16), Search and Selection of IBMI (4.98 +/- 2.91; 0-10) and Opinions on IBMI (44.51 +/- 9.61; 0-80). Four factors [Professionalism of website (4 items; factor loading 0.62-0.87; Cronbach's alpha 0.84), Disclosure (5; 0.37-0.79; 0.73), Appropriateness of content (5; 0.32-0.50; 0.65), Standard of information (6; 0.31-0.48; 0.58)] were extracted from the evaluation scale, explaining 36.89% of the total variance. A tool was developed to evaluate pharmacists' skills and opinions in using IBMI. A wide range of skills and opinions highlighted the need for training in online information literacy.
Sum, Raymond Kim Wai; Leung, Elean Fung Lin
The purpose of this study was to examine the effectiveness of an Internet-based behavioral intervention for physical activity (PA) promotion among secondary school students. It was hypothesized that the Internet-based PA promotion program could increase the PA levels of secondary school students. The action research approach together with…
Karatas, Sercin; Simsek, Nurettin
The purpose of this study is to determine whether "equivalent learning experiences" ensure equivalency, in the Internet-based and face-to-face interaction methods on learning results and student satisfaction. In the experimental process of this study, the effect of the Internet-based and face-to-face learning on the equivalency in…
Ferwerda, M.; Beugen, S. van; Burik, A. van; Middendorp, H. van; Jong, E.M.G.J. de; Kerkhof, P.C.M. van de; Riel, P.L.C.M. van; Evers, A.W.M.
In the past decade, the use of internet-based cognitive behavioral treatments (internet-based CBT) for a wide range of patients has grown intensively. Incorporating the patients' opinions and perspective into new health care innovations might improve the quality and applicability of these
Spek, V.; Cuijpers, P.; Nyklicek, I.; Smits, N; Riper, H.; Keyzer, J.; Pop, V.
Background. Internet-based cognitive behaviour therapy (CBT) is a promising new approach for the treatment of depressive symptoms. The current study had two aims: (1) to determine whether, after 1 year, an internet-based CBT intervention was more effective than a waiting-list control group; and (2)
U.S. Department of Health & Human Services — NNDSS - Table II. Chlamydia trachomatis infection to Coccidioidomycosis - 2018. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases...
U.S. Department of Health & Human Services — NNDSS - Table II. Chlamydia trachomatis infection to Coccidioidomycosis - 2018. In this Table, provisional cases of selected notifiable diseases (â¥1,000 cases...
Dr. Kwame Owusu-Edusei discusses the importance of chlamydia vaccine development. Created: 6/19/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID). Date Released: 6/22/2015.
Full Text Available Relevance. Peripheral neuropathy (PNP in urogenital chlamydia reactive arthritis (CRA is described as single observations, and many clinical and pathogenetic aspects of this lesion of the nervous system remain unclear. Objective of the study: to evaluate the incidence and nature of the clinical course of PNP in CRA, the connection of the nerve and joint injuries, to explore the questions of pathogenetic constructions of this neuropathy, to identify risk factors. Material and methods. We observed 101 patients with CRA, mean age of them was 32 years, disease duration — 4 years, and the male to female ratio — 1 : 1. In 90 % of CRA cases, Chlamydia trochamatis was found in prostatic secretions, in scraps from the urethra, the cervix, the vaginal wall, in 83 % — positive serologic tests for chlamydia infection. Results. Signs of PNP in CRA were in 19 % of patients in the ratio of mononeuropathy to polyneuropathy as 1 : 1, with motor, sensory and mixed disorders in a ratio of 1 : 3 : 6, the presence of autonomic changes in every second patient and more frequent distal localization of the process in the hands, which is influenced by the severity of the articular syndrome, high levels of antichlamydia antibodies in the blood, and the axonal and demyelinating indicators of electroneuromyography — by the severity of urogenital lesions and the presence of Guillain-Barre syndrome. A high rate of arthritis progression is a prognosis-negative sign of PNP course in patients with CRA. The pathogenic constructions of PNP involve the inflammatory immune proteins, disturbances of vascular endothelial function and physicochemical surface rheological properties of the serum. Conclusion. PNP takes place in every fifth patient with CRA, correlates with clinical and laboratory signs of joint disease, and in the future will be useful to identify actively this pathology of the nervous system for the subsequent timely rehabilitation, and CRA
Doull, Laura Elizabeth
Chlamydia abortus is the most common known infectious cause of ovine abortion worldwide but is rarely linked with bovine abortion. The reasons for this differential pathogenesis are unknown but may involve differences in innate immune recognition and immune responsiveness. This is supported by the observation that chlamydial abortion in sheep is associated with an inflammatory cytokine/chemokine cascade that is not commonly observed in cattle. Studies with other Chlamydia speci...
Bisson Jonathan I
Full Text Available Abstract Background After the tsunami disaster in the Indian Ocean basin an Internet based self-screening test was made available in order to facilitate contact with mental health services. Although primarily designed for surviving Swiss tourists as well as relatives and acquaintances of the victims, the screening instrument was open to anyone who felt psychologically affected by this disaster. The aim of this study was to evaluate the influences between self-declared increased substance use in the aftermath of the tsunami disaster, trauma exposure and current PTSD symptoms. Methods One section of the screening covered addiction related behavior. We analyzed the relationship between increased substance use, the level of PTSD symptoms and trauma exposure using multivariable logistic regression with substance use as the dependent variable. Included in the study were only subjects who reported being residents of Switzerland and the analyses were stratified by gender in order to control for possible socio-cultural or gender differences in the use of psychotropic substances. Results In women PTSD symptoms and degree of exposure enlarged the odds of increased alcohol, pharmaceuticals and cannabis use significantly. In men the relationship was more specific: PTSD symptoms and degree of exposure only enlarged the odds of increased pharmaceutical consumption significantly. Increases in alcohol, cannabis and tobacco use were only significantly associated with the degree of PTSD symptoms. Conclusion The tsunami was associated with increased substance use. This study not only replicates earlier findings but also suggests for a gender specificity of post-traumatic substance use increase.
Rozental, Alexander; Carlbring, Per
therapist contact. The current study is believed to result in three important findings. First, a CBT intervention is assumed to be beneficial for people suffering from problems caused by procrastination. Second, the degree of therapist contact will have a positive effect on treatment outcome as procrastination can be partially explained as a self-regulatory failure. Third, an Internet based CBT intervention is presumed to be an effective way to administer treatment for procrastination, which is considered highly important, as the availability of adequate care is limited. The current study is therefore believed to render significant knowledge on the treatment of procrastination, as well as providing support for the use of Internet based CBT for difficulties due to delayed tasks and commitments. To our knowledge, the current study is the first clinical trial to examine the effects of CBT for procrastination, and is assumed to render significant knowledge on the treatment of procrastination, as well as investigating whether it can be delivered via the Internet. ClinicalTrials.gov: NCT01842945; http://clinicaltrials.gov/show/NCT01842945 (Archived by WebCite at http://www.webcitation.org/6KSmaXewC).
period, albeit without therapist contact. Results The current study is believed to result in three important findings. First, a CBT intervention is assumed to be beneficial for people suffering from problems caused by procrastination. Second, the degree of therapist contact will have a positive effect on treatment outcome as procrastination can be partially explained as a self-regulatory failure. Third, an Internet based CBT intervention is presumed to be an effective way to administer treatment for procrastination, which is considered highly important, as the availability of adequate care is limited. The current study is therefore believed to render significant knowledge on the treatment of procrastination, as well as providing support for the use of Internet based CBT for difficulties due to delayed tasks and commitments. Conclusions To our knowledge, the current study is the first clinical trial to examine the effects of CBT for procrastination, and is assumed to render significant knowledge on the treatment of procrastination, as well as investigating whether it can be delivered via the Internet. Trial Registration ClinicalTrials.gov: NCT01842945; http://clinicaltrials.gov/show/NCT01842945 (Archived by WebCite at http://www.webcitation.org/6KSmaXewC). PMID:24220277
Full Text Available In this issue of the Journal, Patrick et al (pages 298-300 report on the results of a pilot study testing the hypothesis that seropositivity to Chlamydia pneumoniae together with a specific bacteriophage protein is associated with first-episode myocardial infarction or unstable angina. The study evolved from an earlier report suggesting that C pneumoniae with phage seropositivity was strongly associated with the presence of abdominal aortic aneurysm. The phage association suggested a potential explanation for some of the variability in previous studies exploring C pneumoniae as a cause for atherosclerosis (ie, only selected strains of C pneumoniae were pathogenic. Patrick et al found no significant association or trend, and the authors concluded that the negative findings in their pilot study did not support further studies to address this potential association.
Rebecca Tave Gluskin
Full Text Available Dengue is a common and growing problem worldwide, with an estimated 70-140 million cases per year. Traditional, healthcare-based, government-implemented dengue surveillance is resource intensive and slow. As global Internet use has increased, novel, Internet-based disease monitoring tools have emerged. Google Dengue Trends (GDT uses near real-time search query data to create an index of dengue incidence that is a linear proxy for traditional surveillance. Studies have shown that GDT correlates highly with dengue incidence in multiple countries on a large spatial scale. This study addresses the heterogeneity of GDT at smaller spatial scales, assessing its accuracy at the state-level in Mexico and identifying factors that are associated with its accuracy. We used Pearson correlation to estimate the association between GDT and traditional dengue surveillance data for Mexico at the national level and for 17 Mexican states. Nationally, GDT captured approximately 83% of the variability in reported cases over the 9 study years. The correlation between GDT and reported cases varied from state to state, capturing anywhere from 1% of the variability in Baja California to 88% in Chiapas, with higher accuracy in states with higher dengue average annual incidence. A model including annual average maximum temperature, precipitation, and their interaction accounted for 81% of the variability in GDT accuracy between states. This climate model was the best indicator of GDT accuracy, suggesting that GDT works best in areas with intense transmission, particularly where local climate is well suited for transmission. Internet accessibility (average ∼ 36% did not appear to affect GDT accuracy. While GDT seems to be a less robust indicator of local transmission in areas of low incidence and unfavorable climate, it may indicate cases among travelers in those areas. Identifying the strengths and limitations of novel surveillance is critical for these types of data to
Gluskin, Rebecca Tave; Johansson, Michael A; Santillana, Mauricio; Brownstein, John S
Dengue is a common and growing problem worldwide, with an estimated 70-140 million cases per year. Traditional, healthcare-based, government-implemented dengue surveillance is resource intensive and slow. As global Internet use has increased, novel, Internet-based disease monitoring tools have emerged. Google Dengue Trends (GDT) uses near real-time search query data to create an index of dengue incidence that is a linear proxy for traditional surveillance. Studies have shown that GDT correlates highly with dengue incidence in multiple countries on a large spatial scale. This study addresses the heterogeneity of GDT at smaller spatial scales, assessing its accuracy at the state-level in Mexico and identifying factors that are associated with its accuracy. We used Pearson correlation to estimate the association between GDT and traditional dengue surveillance data for Mexico at the national level and for 17 Mexican states. Nationally, GDT captured approximately 83% of the variability in reported cases over the 9 study years. The correlation between GDT and reported cases varied from state to state, capturing anywhere from 1% of the variability in Baja California to 88% in Chiapas, with higher accuracy in states with higher dengue average annual incidence. A model including annual average maximum temperature, precipitation, and their interaction accounted for 81% of the variability in GDT accuracy between states. This climate model was the best indicator of GDT accuracy, suggesting that GDT works best in areas with intense transmission, particularly where local climate is well suited for transmission. Internet accessibility (average ∼ 36%) did not appear to affect GDT accuracy. While GDT seems to be a less robust indicator of local transmission in areas of low incidence and unfavorable climate, it may indicate cases among travelers in those areas. Identifying the strengths and limitations of novel surveillance is critical for these types of data to be used to make
Joscelyne, Amy; Knuckey, Sarah; Satterthwaite, Margaret L; Bryant, Richard A; Li, Meng; Qian, Meng; Brown, Adam D
Human rights advocates play a critical role in promoting respect for human rights world-wide, and engage in a broad range of strategies, including documentation of rights violations, monitoring, press work and report-writing, advocacy, and litigation. However, little is known about the impact of human rights work on the mental health of human rights advocates. This study examined the mental health profile of human rights advocates and risk factors associated with their psychological functioning. 346 individuals currently or previously working in the field of human rights completed an internet-based survey regarding trauma exposure, depression, posttraumatic stress disorder (PTSD), resilience and occupational burnout. PTSD was measured with the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) and depression was measured with the Patient History Questionnaire-9 (PHQ-9). These findings revealed that among human rights advocates that completed the survey, 19.4% met criteria for PTSD, 18.8% met criteria for subthreshold PTSD, and 14.7% met criteria for depression. Multiple linear regressions revealed that after controlling for symptoms of depression, PTSD symptom severity was predicted by human rights-related trauma exposure, perfectionism and negative self-appraisals about human rights work. In addition, after controlling for symptoms of PTSD, depressive symptoms were predicted by perfectionism and lower levels of self-efficacy. Survey responses also suggested high levels of resilience: 43% of responders reported minimal symptoms of PTSD. Although survey responses suggest that many human rights workers are resilient, they also suggest that human rights work is associated with elevated rates of PTSD and depression. The field of human rights would benefit from further empirical research, as well as additional education and training programs in the workplace about enhancing resilience in the context of human rights work.
Simmons, Rex D; Ponsonby, Anne-Louise; van der Mei, Ingrid A F; Sheridan, Peter
Evolving information technology has raised the possibility of new methods of data collection in multiple sclerosis (MS) research. An anonymous, self-report, Internet-based survey was developed, which asked people with MS their opinion on how various extrinsic factors affected their condition. From September 2001 to July 2002, a total of 2529 people completed the questionnaire. The demographic and clinical profiles of the anonymous respondents indicated that most were likely to have MS. Common factors reported as beneficial were cannabis, cold baths, meditation and dietary factors. Common adverse factors reported were high stress, exposure to high temperatures and viral infections. There was an increasing report of high temperatures as being adverse with increasing respondent age (test for trend, P < 0.001). The adverse report of high temperatures correlated significantly with the report of strong sunlight apparently making MS worse (r = 0.35, P < 0.0001). In Australia, high temperatures were more likely to be reported as adverse in warmer, lower latitude regions. The association between strong sunlight as adverse and age or region did not persist after adjustment for high temperatures. Thus, this apparent adverse factor appeared to relate to solar heat, not solar light. People with MS may risk vitamin D deficiency because of sun avoidance due to heat-related fatigue or intolerance. This is of clinical significance not only for bone health but because vitamin D may have beneficial immunomodulatory properties. The present study provides new information from people with MS on factors that may influence symptoms or clinical course. This information will now be used in the design of formal epidemiological cohort studies.
Titov, Nickolai; Andrews, Gavin; Choi, Isabella; Schwencke, Genevieve; Mahoney, Alison
In two previous randomized controlled trials Titov et al. demonstrated significant benefit from an Internet- and email-based treatment programme for social phobia. The present study (Shyness 3) explores whether participants are able to complete this programme independently. A total of 98 individuals with social phobia were randomly assigned to a clinician-assisted computerized cognitive behavioural treatment (CaCCBT) group, a self-guided computerized CBT (CCBT) group, or to a waitlist control group. CaCCBT group participants completed the usual Shyness programme consisting of six online lessons, cognitive behavioural homework assignments, email contact with a therapist, and participation in an online discussion forum. CCBT group participants accessed the same resources except for therapist emails. An intention-to-treat model was used for data analyses. A total of 77% of CaCCBT and 33% of CCBT group participants completed all lessons. Significant differences were found after treatment between CaCCBT and control groups (mean between-groups effect size (ES) for the social phobia measures=1.04), and between the CaCCBT and CCBT groups (mean between-groups ES for the social phobia measures=0.66). No significant differences were found after treatment between the CCBT and control groups (mean between-groups ES for the social phobia measures=0.38). CCBT participants, however, who completed the six lessons made good progress (mean within-group ES for the social phobia measures=0.62). Quantitative and qualitative data indicate that both the CaCCBT and CCBT procedures were acceptable to participants. The reliability of this Internet-based treatment programme for social phobia has been confirmed. The therapist-guided condition was superior to the self-guided condition, but a subgroup of participants still benefited considerably from the latter. These data confirm that self-guided education or treatment programmes for common anxiety disorders can result in significant
Joscelyne, Amy; Knuckey, Sarah; Satterthwaite, Margaret L.; Bryant, Richard A.; Li, Meng; Qian, Meng; Brown, Adam D.
Human rights advocates play a critical role in promoting respect for human rights world-wide, and engage in a broad range of strategies, including documentation of rights violations, monitoring, press work and report-writing, advocacy, and litigation. However, little is known about the impact of human rights work on the mental health of human rights advocates. This study examined the mental health profile of human rights advocates and risk factors associated with their psychological functioning. 346 individuals currently or previously working in the field of human rights completed an internet-based survey regarding trauma exposure, depression, posttraumatic stress disorder (PTSD), resilience and occupational burnout. PTSD was measured with the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) and depression was measured with the Patient History Questionnaire-9 (PHQ-9). These findings revealed that among human rights advocates that completed the survey, 19.4% met criteria for PTSD, 18.8% met criteria for subthreshold PTSD, and 14.7% met criteria for depression. Multiple linear regressions revealed that after controlling for symptoms of depression, PTSD symptom severity was predicted by human rights-related trauma exposure, perfectionism and negative self-appraisals about human rights work. In addition, after controlling for symptoms of PTSD, depressive symptoms were predicted by perfectionism and lower levels of self-efficacy. Survey responses also suggested high levels of resilience: 43% of responders reported minimal symptoms of PTSD. Although survey responses suggest that many human rights workers are resilient, they also suggest that human rights work is associated with elevated rates of PTSD and depression. The field of human rights would benefit from further empirical research, as well as additional education and training programs in the workplace about enhancing resilience in the context of human rights work. PMID:26700305
Persson Asplund, Robert; Dagöö, Jesper; Fjellström, Ida; Niemi, Linnea; Hansson, Katja; Zeraati, Forough; Ziuzina, Masha; Geraedts, Anna; Ljótsson, Brjánn; Carlbring, Per; Andersson, Gerhard
The aim of this randomised controlled trial (RCT) was to evaluate the efficacy of a guided internet-based stress management intervention (iSMI) among distressed managers compared with a attention control group (AC) with full access to treatment-as-usual. A total sample of 117 distressed managers, mainly employed in the healthcare, IT, communication and educational sector, were randomised to either iSMI (n=59) or an AC group (n=58). The iSMI consisted of eight modules including cognitive behavioural stress management and positive management techniques. Participants received a minimal and weekly guidance from a psychologist or master-level psychology student focusing on support, feedback and adherence to the intervention. Self-report data were assessed at pre, post and 6 months after the intervention. The primary outcome was perceived stress (Perceived Stress Scale-14). The secondary outcomes included mental and work-related health outcomes. Participants in the iSMI intervention reported significantly less symptoms of perceived stress (d=0.74, 95% CI 0.30 to 1.19) and burnout (d=0.95, 95% CI 0.53 to 1.37) compared with controls, at postassessment. Significant medium-to-large effect sizes were also found for depression, insomnia and job satisfaction. Long-term effects (6 months) were seen on the mental health outcomes. This is one of the first studies showing that iSMIs can be an effective, accessible and potentially time-effective approach of reducing stress and other mental-related and work-related health symptoms among distressed managers. Future studies are needed addressing distressed managers and the potential of indirect effects on employee stress and satisfaction at work. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Machiko R Tomita
Full Text Available Machiko R Tomita1, Bin-Min Tsai2, Nadine M Fisher1, Neeraj A Kumar1, Greg Wilding3, Kathy Stanton1, Bruce J Naughton41Department of Rehabilitation Science, University at Buffalo, Buffalo, New York, USA; 2Department of Occupational Therapy, I-Shou University, Taiwan; 3Department of Biostatistics, University at Buffalo, Buffalo, New York, USA; 4Department of Medicine, University at Buffalo, Buffalo, New York, USAObjectives: To develop and test the effectiveness of an Internet-based self management program by multidisciplinary health care professionals for patients with heart failure (HF.Methods: The comprehensive educational material for HF was created and posted on a website. A computer with Internet connection and computer training were provided first. A secure and simple web-based recording system of vital signs and health behaviors and a mechanism for feedback regarding each participant’s record were developed. A randomized controlled trial with a one-year intervention was conducted using a total of 40 patients who were assessed three times in their homes. An intention-to-treat analysis used multivariate statistics.Results: The treatment group had a high (85% adherence to the intervention. Only the treatment group showed a significant improvement in the knowledge level (p < 0.001, amount of exercise (p = 0.001, and quality of life (p = 0.001, and reduction in HF related symptoms (dyspnea, p = 0.001; fatigue, p = 0.003; functional emotion, p < 0.001, blood pressure (systolic, p = 0.002; diastolic, p < 0.001, frequency of emergency room visit, and length of hospital stay (both p = 0.001.Conclusions: An effective program to change one’s behaviors in managing HF takes a multidisciplinary approach to create and provide feedback regarding a patient’s daily record, which can be accomplished through Internet use.Keywords: e-health, self-management, Internet, heart failure, older adults, exercise
Full Text Available Internet interventions constitute a promising and cost-effective treatment alternative for a wide range of psychiatric disorders and somatic conditions. Several clinical trials have provided evidence for its efficacy and effectiveness, and recent research also indicate that it can be helpful in the treatment of conditions that are debilitating, but do not necessarily warrant more immediate care, for instance, procrastination, a self-regulatory failure that is associated with decreased well-being and mental health. However, providing treatment interventions for procrastination via the Internet is a novel approach, making it unclear how the participants themselves perceive their experiences. The current study thus investigated participants' own apprehension of undergoing Internet-based cognitive behavior therapy for procrastination by distributing open-ended questions at the post-treatment assessment, for instance, “What did you think about the readability of the texts”, “How valuable do you believe that this treatment has been for you?”, and “The thing that I am most displeased with (and how it could be improved is …”. In total, 75 participants (50% responded, and the material was examined using thematic analysis. The results indicate that there exist both positive and negative aspects of the treatment program. Many participants increased their self-efficacy and were able to gain momentum on many tasks and assignments that had been deferred in their everyday life. Meanwhile, several participants lacked motivation to complete the exercises, had too many conflicting commitments, and were unable to keep up with the tight treatment schedule. Hence, the results suggest that Internet interventions for procrastination could profit from individual tailoring, shorter and more manageable modules, and that the content need to be adapted to the reading comprehension and motivational level of the participant.
Zagorscak, Pavle; Heinrich, Manuel; Sommer, Daniel; Wagner, Birgit; Knaevelsrud, Christine
Even though there is an increasing number of studies on the efficacy of Internet-based interventions (IBI) for depression, experimental trials on the benefits of added guidance by clinicians are scarce and inconsistent. This study compared the efficacy of semistandardized feedback provided by psychologists with fully standardized feedback in IBI. Participants with mild-to-moderate depression (n = 1,089, 66% female) from the client pool of a health insurance company participated in a cognitive-behavioral IBI targeting depression over 6 weeks. Individuals were randomized to weekly semistandardized e-mail feedback from psychologists (individual counseling; IC) or to automated, standardized feedback where a psychologist could be contacted on demand (CoD). The contents and tasks were identical across conditions. The primary outcome was depression; secondary outcomes included anxiety, rumination, and well-being. Outcomes were assessed before and after the intervention and 3, 6, and 12 months later. Changes in outcomes were evaluated using latent change score modeling. Both interventions yielded large pre-post effects on depression (Beck Depression Inventory-II: dIC = 1.53, dCoD = 1.37; Patient Health Questionnaire-9: dIC = 1.20, dCoD = 1.04), as well as significant improvements of all other outcome measures. The effects remained significant after 3, 6, and 12 months. The groups differed with regard to attrition (IC: 17.3%, CoD: 25.8%, p = 0.001). Between-group effects were statistically nonsignificant across outcomes and measurement occasions. Adding semistandardized guidance in IBI for depression did not prove to be more effective than fully standardized feedback on primary and secondary outcomes, but it had positive effects on attrition. © 2018 S. Karger AG, Basel.
De Vera, Mary A; Ratzlaff, Charles; Doerfling, Paul; Kopec, Jacek
Lifetime exposure to physical activity is an important construct for evaluating associations between physical activity and disease outcomes, given the long induction periods in many chronic diseases. The authors' objective in this study was to evaluate the measurement properties of the Lifetime Physical Activity Questionnaire (L-PAQ), a novel Internet-based, self-administered instrument measuring lifetime physical activity, among Canadian men and women in 2005-2006. Reliability was examined using a test-retest study. Validity was examined in a 2-part study consisting of 1) comparisons with previously validated instruments measuring similar constructs, the Lifetime Total Physical Activity Questionnaire (LT-PAQ) and the Chasan-Taber Physical Activity Questionnaire (CT-PAQ), and 2) a priori hypothesis tests of constructs measured by the L-PAQ. The L-PAQ demonstrated good reliability, with intraclass correlation coefficients ranging from 0.67 (household activity) to 0.89 (sports/recreation). Comparison between the L-PAQ and the LT-PAQ resulted in Spearman correlation coefficients ranging from 0.41 (total activity) to 0.71 (household activity); comparison between the L-PAQ and the CT-PAQ yielded coefficients of 0.58 (sports/recreation), 0.56 (household activity), and 0.50 (total activity). L-PAQ validity was further supported by observed relations between the L-PAQ and sociodemographic variables, consistent with a priori hypotheses. Overall, the L-PAQ is a useful instrument for assessing multiple domains of lifetime physical activity with acceptable reliability and validity.
Morch, Andrei Z.
The increase within the energy and effect consumption in Norway, parallel with a small development of new power production has resulted in an increased focus on the end user flexibility. An efficient utilisation of the end user flexibility assumes that the market mechanisms are adapted/developed so that the user has economical incentives for reducing the consumption in periods with energy and effect shortage. Furthermore the technological solutions within the information and communication technology (ICT) open new possibilities for acquiring energy and effect reducing potentials at the end users. The Internet is an universal communication channel which opens new possibilities for communication between the power market and the end users. The unique properties of the internet particularly the easy access and low costs for upgrading and maintenance, makes a considerable potential for the use of new products and services which will increase the flexibility in the use of energy and effect. The report presents a survey of existing products and services which are offered on the Internet in the power sector. The report emphasises particularly on a comparison of these solutions regarding purpose, functionality, user friendliness and limitations of these products. The appendix includes a glossary of works and expressions which is related to the ICT. This report is published as a part of a sub project ''Internet based services for customers with current communication'' in a research project. ''Consumer flexibility and efficient use of ICT''. The project is financed by the Norges Forskningsraad, EBL Kompetanse AS and others and is carried out at the SINTEF Energiforskning AS. This project has been started from results and experiences from earlier projects as ''End user market'' and ''Information and communication systems for the energy sector''
Full Text Available Most neuroimaging studies of human social cognition have focused on brain activity of single subjects. More recently, "two-person neuroimaging" has been introduced, with simultaneous recordings of brain signals from two subjects involved in social interaction. These simultaneous "hyperscanning" recordings have already been carried out with a spectrum of neuroimaging modalities, such as functional magnetic resonance imaging (fMRI, electroencephalography (EEG, and functional near-infrared spectroscopy (fNIRS.We have recently developed a setup for simultaneous magnetoencephalographic (MEG recordings of two subjects that communicate in real time over an audio link between two geographically separated MEG laboratories. Here we present an extended version of the setup, where we have added a video connection and replaced the telephone-landline-based link with an Internet connection. Our setup enabled transmission of video and audio streams between the sites with a one-way communication latency of about 130 ms. Our software that allows reproducing the setup is publicly available.We demonstrate that the audiovisual Internet-based link can mediate real-time interaction between two subjects who try to mirror each others' hand movements that they can see via the video link. All the nine pairs were able to synchronize their behavior. In addition to the video, we captured the subjects' movements with accelerometers attached to their index fingers; we determined from these signals that the average synchronization accuracy was 215 ms. In one subject pair we demonstrate inter-subject coherence patterns of the MEG signals that peak over the sensorimotor areas contralateral to the hand used in the task.
We have developed and tested an internet based application that facilitates the creation of animations for use in lectures and permits movie production by students in laboratory classes. Animation have been found to be extremely useful educational aids in the geosciences, particularly relating to topics requiring comprehension of geospatial relationships. With this program, instructors are able to assemble and caption animations using an online video clip catalogue and present these movies through a standard internet browser. Captioning increases student comprehension by increasing the multimodality of information delivery. For student use, we developed an exercise for introductory, undergraduate, laboratory class sections that was informed by learning pedagogy, particularly as related to game-based learning. Students were asked to assemble video clips and captions into a coherent movie to explain geospatial concepts, with questions such as "Explain why we have seasons?" The affinity of students to digital technology, particularly computer games and digital media, makes this type of exercise particularly captivating to the typical undergraduate. The opportunity to select and arrange video clips (and add background music) into a unique production offers students a greater degree of ownership of the learning process and allows unique non-linear pathways for accomplishing learning objectives. Use in a laboratory section permitted rapid feedback from the instructor. The application was created using open-sourced software and the database populated with video clips and music contributed by faculty and students under a non-commercial-use license. This tool has the potential to permit the wider dissemination of scientific research results given the increasing use animations for scientific visualization, because it eases the creation of multiple presentations targeted to various audiences and allows user participation in the creation of multimedia.
Full Text Available Human rights advocates play a critical role in promoting respect for human rights world-wide, and engage in a broad range of strategies, including documentation of rights violations, monitoring, press work and report-writing, advocacy, and litigation. However, little is known about the impact of human rights work on the mental health of human rights advocates. This study examined the mental health profile of human rights advocates and risk factors associated with their psychological functioning. 346 individuals currently or previously working in the field of human rights completed an internet-based survey regarding trauma exposure, depression, posttraumatic stress disorder (PTSD, resilience and occupational burnout. PTSD was measured with the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C and depression was measured with the Patient History Questionnaire-9 (PHQ-9. These findings revealed that among human rights advocates that completed the survey, 19.4% met criteria for PTSD, 18.8% met criteria for subthreshold PTSD, and 14.7% met criteria for depression. Multiple linear regressions revealed that after controlling for symptoms of depression, PTSD symptom severity was predicted by human rights-related trauma exposure, perfectionism and negative self-appraisals about human rights work. In addition, after controlling for symptoms of PTSD, depressive symptoms were predicted by perfectionism and lower levels of self-efficacy. Survey responses also suggested high levels of resilience: 43% of responders reported minimal symptoms of PTSD. Although survey responses suggest that many human rights workers are resilient, they also suggest that human rights work is associated with elevated rates of PTSD and depression. The field of human rights would benefit from further empirical research, as well as additional education and training programs in the workplace about enhancing resilience in the context of human rights work.
Sanghvi, Saurin; Cherla, Deepa V; Shukla, Pratik A; Eloy, Jean Anderson
Various professional societies, clinical practices, hospitals, and health care-related Web sites provide Internet-based patient education material (IPEMs) to the general public. However, this information may be written above the 6th-grade reading level recommended by the US Department of Health and Human Services. The purpose of this study is to assess the readability of facial fracture (FF)-related IPEMs and compare readability levels of IPEMs provided by four sources: professional societies, clinical practices, hospitals, and miscellaneous sources. Analysis of IPEMs on FFs available on Google.com. The readability of 41 FF-related IPEMs was assessed with four readability indices: Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease Score (FRES), Simple Measure of Gobbledygook (SMOG), and Gunning Frequency of Gobbledygook (Gunning FOG). Averages were evaluated against national recommendations and between each source using analysis of variance and t tests. Only 4.9% of IPEMs were written at or below the 6th-grade reading level, based on FKGL. The mean readability scores were: FRES 54.10, FKGL 9.89, SMOG 12.73, and Gunning FOG 12.98, translating into FF-related IPEMs being written at a "difficult" writing level, which is above the level of reading understanding of the average American adult. IPEMs related to FFs are written above the recommended 6th-grade reading level. Consequently, this information would be difficult to understand by the average US patient. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Fenger, Morten; Lindschou, Jane; Gluud, Christian
BACKGROUND: Internet-based self-help psychotherapy (IBT) could be an important alternative or supplement to ordinary face-to-face therapy. The findings of randomised controlled trials indicate that the effects of various IBT programmes for anxiety disorders seem better than no intervention...... and in some instances are equivalent to usual therapy. In Denmark, IBT is part of future treatment plans in mental health care services, but the verification level of the current clinical scientific knowledge is insufficient. The objective of this trial is feasibility assessment of benefits and harms...... of the Internet-based cognitive behavioural therapy (ICBT) programme FearFighter™ versus no intervention for anxiety disorders in adults. METHODS AND DESIGN: We will conduct an investigator-initiated, feasibility randomised controlled trial. Sixty-four participants are expected to be recruited via...
Lachausse, Robert G
To determine the impact of My Student Body (MSB)-Nutrition, an Internet-based obesity prevention program for college students. Three hundred and twenty ethnically diverse undergraduate students were randomly assigned to 1 of 3 conditions: MSB-Nutrition program, an on-campus weight management course, and a comparison group. Students completed baseline and follow-up surveys regarding their nutrition and physical activity behaviors, self-efficacy, stress, attitudes, and body weight. Compared with the on-campus course and a comparison group, the MSB-Nutrition program increased fruit and vegetable consumption, reduced stress, and increased fruit and vegetable self-efficacy but had no significant effect on students' exercise self-efficacy, exercise behavior, or weight loss. The MSB-Nutrition program was effective in changing students' nutrition behaviors but had no effect on physical activity behaviors or weight loss. Suggestions for improving Internet-based interventions aimed at decreasing obesity rates among college students are offered.
Palmer, Liisa; Johnston, Stephen S; Rousculp, Matthew D; Chu, Bong-Chul; Nichol, Kristin L; Mahadevia, Parthiv J
Although Internet-based surveys are becoming more common, little is known about agreement between administrative claims data and Internet-based survey self- and proxy-reported health care resource utilization (HCRU) data. This analysis evaluated the level of agreement between self- and proxy-reported HCRU data, as recorded through an Internet-based survey, and administrative claims-based HCRU data. The Child and Household Influenza-Illness and Employee Function study collected self- and proxy-reported HCRU data monthly between November 2007 and May 2008. Data included the occurrence and number of visits to hospitals, emergency departments, urgent care centers, and outpatient offices for a respondent's and his or her household members' care. Administrative claims data from the MarketScan® Databases were assessed during the same time and evaluated relative to survey-based metrics. Only data for individuals with employer-sponsored health care coverage linkable to claims were included. The Kappa (κ) statistic was used to evaluate visit concordance, and the intraclass correlation coefficient was used to describe frequency consistency. Agreement for presence of a health care visit and the number of visits were similar for self- and proxy-reported HCRU data. There was moderate to substantial agreement related to health care visit occurrence between survey-based and claims-based HCRU data for inpatient, emergency department, and office visits (κ: 0.47-0.77). There was less agreement on health care visit frequencies, with intraclass correlation coefficient values ranging from 0.14 to 0.71. This study's agreement values suggest that Internet-based surveys are an effective method to collect self- and proxy-reported HCRU data. These results should increase confidence in the use of the Internet for evaluating disease burden. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
To meet the demands of today's students, teaching in veterinary medicine evolved away from sheer, classical frontal teaching. In addition to seminars and practical exercises, the students are provided with new teaching tools such as e-learning. However, problem-based learning is still offered rarely. To fill this gap, several German-speaking veterinary universities established the use of the internet-based interactive multimedia online learning- and authoring-system CASUS. The first aim of...
Aneni, Ehimen C.; Roberson, Lara L.; Maziak, Wasim; Agatston, Arthur S.; Feldman, Theodore; Rouseff, Maribeth; Tran, Thinh H.; Blumenthal, Roger S.; Blaha, Michael J.; Blankstein, Ron; Al-Mallah, Mouaz H.; Budoff, Matthew J.; Nasir, Khurram
Context The internet is gaining popularity as a means of delivering employee-based cardiovascular (CV) wellness interventions though little is known about the cardiovascular health outcomes of these programs. In this review, we examined the effectiveness of internet-based employee cardiovascular wellness and prevention programs. Evidence Acquisition We conducted a systematic review by searching PubMed, Web of Science and Cochrane library for all published studies on internet-based programs aimed at improving CV health among employees up to November 2012. We grouped the outcomes according to the American Heart Association (AHA) indicators of cardiovascular wellbeing – weight, BP, lipids, smoking, physical activity, diet, and blood glucose. Evidence Synthesis A total of 18 randomized trials and 11 follow-up studies met our inclusion/exclusion criteria. Follow-up duration ranged from 6 – 24 months. There were significant differences in intervention types and number of components in each intervention. Modest improvements were observed in more than half of the studies with weight related outcomes while no improvement was seen in virtually all the studies with physical activity outcome. In general, internet-based programs were more successful if the interventions also included some physical contact and environmental modification, and if they were targeted at specific disease entities such as hypertension. Only a few of the studies were conducted in persons at-risk for CVD, none in blue-collar workers or low-income earners. Conclusion Internet based programs hold promise for improving the cardiovascular wellness among employees however much work is required to fully understand its utility and long term impact especially in special/at-risk populations. PMID:24421894
Schwebel, David C; McClure, Leslie A; Severson, Joan
Child pedestrian injury is a preventable global health challenge. Successful training efforts focused on child behavior, including individualized streetside training and training in large virtual pedestrian environments, are laborious and expensive. This study considers the usability and feasibility of a virtual pedestrian environment "game" application to teach children safe street-crossing behavior via the internet, a medium that could be broadly disseminated at low cost. Ten 7- and 8-year-old children participated. They engaged in an internet-based virtual pedestrian environment and completed a brief assessment survey. Researchers rated children's behavior while engaged in the game. Both self-report and researcher observations indicated the internet-based system was readily used by the children without adult support. The youth understood how to engage in the system and used it independently and attentively. The program also was feasible. It provided multiple measures of pedestrian safety that could be used for research or training purposes. Finally, the program was rated by children as engaging and educational. Researcher ratings suggested children used the program with minimal fidgeting or boredom. The pilot test suggests an internet-based virtual pedestrian environment offers a usable, feasible, engaging, and educational environment for child pedestrian safety training. If future research finds children learn the cognitive and perceptual skills needed to cross streets safely within it, internet-based training may provide a low-cost medium to broadly disseminate child pedestrian safety training. The concept may be generalized to other domains of health-related functioning such as teen driving safety, adolescent sexual risk-taking, and adolescent substance use.
van der Mark, Marianne; Jonasson, Josefine; Svensson, Madeleine; Linné, Yvonne; Rossner, Stephan; Lagerros, Ylva Trolle
New technology offers increased opportunities for weight control. However, it is not clear whether older people with less computer training can make use of this tool. Our objective was to examine how members above the age of 65 years performed in an internet-based behavioral weight loss program, compared to younger members. Data from members (n = 23,233) of an internet-based behavioral weight loss program were analyzed. We restricted our study to active participants accessing the weight club, during a 6-month period (n = 4,440). The number of logins, food intake, and weight records were examined. Participants were divided into age tertiles separately for men and women. The oldest tertile was further subdivided into two groups: above and below the age of 65 years. Participants aged 65 or older were more likely to remain active in the weight club for at least 6 months compared to younger age groups. They had the highest frequency of recordings of food intake and current weight. Among women, those older than 65 years had on average the highest percentage of weight loss (5.6 kg, 6.8%). Men above 65 years of age had the highest number of logins, on average 161 times during the 6-month period. Older participants are performing equally well or even better in an internet-based behavioral weight loss program than younger participants. Internet-based programs could be a promising and attractive option for older adults requiring assistance in losing weight. 2009 S. Karger AG, Basel.
Meadan, Hedda; Meyer, Lori E.; Snodgrass, Melinda R.; Halle, James W.
The purpose of this paper is to describe a pilot program (i.e., Internet-Based Parent-Implemented Communication Strategies [i-PiCS] program) that provides long-distance training and coaching via the Internet to parents of young children with autism spectrum disorders (ASD). The i-PiCS program is designed to teach parents how to use evidence-based…
Cernvall, Martin; Carlbring, Per; Ljungman, Lisa; Ljungman, Gustaf; von Essen, Louise
The aim of the study was to investigate the feasibility and preliminary efficacy of an Internet-based guided self-help intervention for posttraumatic stress symptoms (PTSS) and related symptoms in parents of children on cancer treatment. Parents of children on cancer treatment, who fulfilled the modified symptom criteria on the PTSD Checklist, were randomly allocated to the intervention or to a wait-list control condition. The intervention group accessed a 10-week guided self-help program via the Internet based on principles from cognitve behavior therapy. The primary outcome PTSS and the secondary outcomes depression and anxiety were assessed by self-report preintervention and postintervention. Seven hundred forty-seven parents were approached and informed about the study, 92 were assessed for eligibility, and 58 were included and randomized to the intervention (n = 31) or wait list (n = 27). Eightteen participants completed the intervention. Intention-to-treat analyses indicated a significant effect of the intervention on PTSS with a large between-group effect size at postassessment (Cohen's d = 0.88). The intervention group reported reductions in PTSS with a large within-group effect size (d = 1.62) compared with a minimal reduction in the wait-list group (d = 0.09). There was a significant intervention effect on depression and anxiety and reductions in the intervention group with large within-group effect sizes (d = 0.85-1.09). Findings indicate a low enrollment rate and considerable attrition but also that Internet-based guided self-help shows promise for parents of children on cancer treatment who report a high level of PTSS and would like to take part in an Internet-based intervention. © 2015 The Authors. Psycho-Oncology published by John Wiley & Sons, Ltd.
Dunlop, Sally; Freeman, Becky; Perez, Donna
Background Since legislation prohibiting tobacco advertising in traditional media, online communication platforms and social media have become one of the few avenues for the tobacco industry to promote its products to Australians. Little is currently known about the exposure of young people to these new media promotions. Objective To measure exposure to Internet-based tobacco advertising and branding among Australian youth, identify common formats of branding encountered, and examine the asso...
Alderson, J. Charles
In this article, the author reviews the TOEFL iBT which is the latest version of the TOEFL, whose history stretches back to 1961. The TOEFL iBT was introduced in the USA, Canada, France, Germany and Italy in late 2005. Currently the TOEFL test is offered in two testing formats: (1) Internet-based testing (iBT); and (2) paper-based testing (PBT).…
Frevel, D; Mäurer, M
Balance disorders are common in multiple sclerosis. Aim of the study is to investigate the effectiveness of an Internet-based home training program (e-Training) to improve balance in patients with multiple sclerosis. A randomized, controlled study. Academic teaching hospital in cooperation with the therapeutic riding center Gut Üttingshof, Bad Mergentheim. Eighteen multiple sclerosis patients (mean EDSS 3,5) took part in the trial. Outcome of patients using e-Training (N.=9) was compared to the outcome of patients receiving hippotherapy (N.=9), which can be considered as an advanced concept for the improvement of balance and postural control in multiple sclerosis. After simple random allocation patients received hippotherapy or Internet-based home training (balance, postural control and strength training) twice a week for 12 weeks. Assessments were done before and after the intervention and included static and dynamic balance (primary outcome). Isometric muscle strength of the knee and trunk extension/flexion (dynamometer), walking capacity, fatigue and quality of life served as secondary outcome parameters. Both intervention groups showed comparable and highly significant improvement in static and dynamic balance capacity, no difference was seen between the both intervention groups. However looking at fatigue and quality of life only the group receiving hippotherapy improved significantly. Since e-Training shows even comparable effects to hippotherapy to improve balance, we believe that the established Internet-based home training program, specialized on balance and postural control training, is feasible for a balance and strength training in persons with multiple sclerosis. We demonstrated that Internet-based home training is possible in patients with multiple sclerosis.
Ehimen C Aneni
Full Text Available CONTEXT: The internet is gaining popularity as a means of delivering employee-based cardiovascular (CV wellness interventions though little is known about the cardiovascular health outcomes of these programs. In this review, we examined the effectiveness of internet-based employee cardiovascular wellness and prevention programs. EVIDENCE ACQUISITION: We conducted a systematic review by searching PubMed, Web of Science and Cochrane library for all published studies on internet-based programs aimed at improving CV health among employees up to November 2012. We grouped the outcomes according to the American Heart Association (AHA indicators of cardiovascular wellbeing--weight, BP, lipids, smoking, physical activity, diet, and blood glucose. EVIDENCE SYNTHESIS: A total of 18 randomized trials and 11 follow-up studies met our inclusion/exclusion criteria. Follow-up duration ranged from 6-24 months. There were significant differences in intervention types and number of components in each intervention. Modest improvements were observed in more than half of the studies with weight related outcomes while no improvement was seen in virtually all the studies with physical activity outcome. In general, internet-based programs were more successful if the interventions also included some physical contact and environmental modification, and if they were targeted at specific disease entities such as hypertension. Only a few of the studies were conducted in persons at-risk for CVD, none in blue-collar workers or low-income earners. CONCLUSION: Internet based programs hold promise for improving the cardiovascular wellness among employees however much work is required to fully understand its utility and long term impact especially in special/at-risk populations.
Boeschoten, Rosa E; Dekker, Joost; Uitdehaag, Bernard M J; Polman, Chris H; Collette, Emma H; Cuijpers, Pim; Beekman, Aartjan T F; van Oppen, Patricia
Depression in MS patients is frequent but often not treated adequately. An important underlying factor may be physical limitations that preclude face-to-face contact. Internet-based treatment showed to be effective for depressive symptoms in general and could thus be a promising tool for treatment in MS. Here, we present a study protocol to investigate the effectiveness of a 5 week Internet-based self-help problem solving treatment (PST) for depressive symptoms in MS patients in a randomized controlled trial. We aim to include 166 MS patients with moderate to severe depressive symptoms who will be randomly assigned to an Internet-based intervention (with or without supportive text-messages) or waiting list control group. The primary outcome is the change in depressive symptoms defined by a change in the sum score on the Beck Depression Inventory (BDI-II). Secondary outcomes will include measures of anxiety, fatigue, cognitive functioning, physical and psychological impact of MS, quality of life, problem solving skills, social support, mastery, satisfaction and compliance rate. Assessments will take place at baseline (T0), within a week after the intervention (T1), at four months (T2) and at ten months follow-up (T3: only the intervention group). The control group will be measured at the same moments in time. Analysis will be based on the intention-to-treat principle. If shown to be effective, Internet-based PST will offer new possibilities to reach and treat MS patients with depressive symptoms and to improve the quality of care. The Dutch Cochrane Center, NTR2772.