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The Water Quality Analysis Simulation Program (WASP) helps users interpret and predict water quality responses to natural phenomena and manmade pollution for various pollution management decisions. WASP is a dynamic compartment-modeling program for aquatic systems, including both the water column and the underlying benthos. WASP allows the user to investigate 1, 2 and 3 dimensional systems and a variety of pollutant types—including both conventional pollutants (e.g., dissolved oxygen, nutrients, phytoplankton, etc.) and toxic materials. WASP has capabilities of linking with hydrodynamic and watershed models which allows for multi-year analyses under varying meteorological and environmental conditions. WASP was originally developed by HydroScience, Inc. in 1970 and was later adapted by the US Environmental Protection Agency’s Large Lakes Research Station (LLRS) for applications to the Great Lakes. The LLRS first publicly released the model in 1981. WASP has undergone continuous development since that time and this year will mark its 50th anniversary. This paper follows the development of WASP from its origin to the latest release of the model in 2020, documenting its evolution and present structure and capabilities.

BackgroundSTI/HIV self-sampling has the potential to improve sexual health by increasing access to testing, yet uptake and sample return rates are currently sub-optimal. Our inter-disciplinary research team explored home-based self-sampling from the user perspective, to inform its optimisation (within the context of LUSTRUM, a UK based trial of Accelerated Partner Therapy (APT)). We describe how implementation science approaches were used to reconcile user, professional and practical requirements for APT and to suggest a series of simple improvements.Methods11 focus groups with the public (n=36), and those recently diagnosed with an STI (n =20), explored perceived barriers and facilitators to using prototype self-sampling packs and returning samples. Using the behaviour change wheel approach to direct intervention development, we engineered an optimised self-sampling and treatment pack and instructions, supported by audio-visual online materials. In this way we translated lay perspectives into evidence-based and theoretically informed, pragmatic recommendations.ResultsUsing rich participant extracts we illustrate how our analysis suggests: the design of the package should physically separate and order components to be used at each stage in the self-sampling/treatment process; simple written and online audio-visual instructions, suitable for those with low literacy levels should be provided; the rationale for and health consequences of not testing for STIs, including HIV, should be clearly articulated, enabling users to opt-out of HIV testing without inadvertently opting-out of STI testing; specific information concerning the viability of both self-taken samples and postal delivery to laboratories is neededConclusionThis study represents the first evidence-based approach to improving the design of self-sampling packs and sample return. Using qualitative approaches and implementation science it is possible to systematically suggest refinements to product design and the need for additional sources of psychological and behavioural support to improve user experience, increase acceptability of self-sampling, broaden uptake and boost sample returnDisclosureNo significant relationships.

BackgroundAccelerated Partner Therapy (APT) is a method of partner notification (PN) which includes remote assessment, self-sampling and treatment of the sex partner(s) of a person diagnosed with STIs. Using the Behaviour Change Wheel approach, we sought to understand, and then systematically moderate, the psychological and behavioural challenges involved in delivering and receiving APT as part of LUSTRUM, a UK-based chlamydia PN trial.MethodsWe conducted 11 focus groups with patients (n=30) and the public (n=26), and five focus groups with healthcare professionals (n=30) involved in PN. Initial thematic analysis explored the barriers and facilitators to each essential and sequential step in APT, from the perspective of each role in this interpersonal, relay intervention. Further analysis specified a series of theoretically based, and evidence-informed approaches that can be used to methodically reduce the various barriers to uptake and implementation of APTResultsActive, intervention components that can enhance staff delivery, index patient and sex partner uptake of APT included providing: clearer information for all about the overall sequential steps involved in APT (highlighting shared roles and responsibilities); a stronger focus upon what healthcare professionals, index patients and their sex partners should do in relation to each step of APT, including written checklists for staff and index patients; essential messages supporting PN and self-management of sex partners engaging in APT; pertinent information about why to engage in APT (in relation to considering key consequences).ConclusionThis is the first study to provide evidence-based and theoretically informed approaches to enhance contemporary PN. These findings informed the development of an intervention manual, training resources for staff and online video materials. Together, these materials detail, in highly specific and replicable ways, the optimal methods to reduce barriers to implementation of APT and utilise factors that facilitate implementation thereby potentially improving PN outcomes for chlamydia.DisclosureNo significant relationships.

IntroductionPartner notification (PN) is a process aiming to identify, test and treat the sex partners of people (index patients) with sexually transmitted infections (STIs). Accelerated partner therapy (APT) is a PN method whereby healthcare professionals assess sex partners, by telephone consultation, before giving the index patient antibiotics and STI self-sampling kits to deliver to their sex partner(s). The Limiting Undetected Sexually Transmitted infections to RedUce Morbidity programme aims to determine the effectiveness of APT in heterosexual women and men with chlamydia and determine whether APT could affect Chlamydia trachomatis transmission at population level.Methods and analysisThis protocol describes a cross-over cluster randomised controlled trial of APT, offered as an additional PN method, compared with standard PN. The trial is accompanied by an economic evaluation, transmission dynamic modelling and a qualitative process evaluation involving patients, partners and healthcare professionals. Clusters are 17 sexual health clinics in areas of England and Scotland with contrasting patient demographics. We will recruit 5440 heterosexual women and men with chlamydia, aged ≥16 years.The primary outcome is the proportion of index patients testing positive for C. trachomatis 12-16 weeks after the PN consultation. Secondary outcomes include: proportion of sex partners treated; cost effectiveness; model-predicted chlamydia prevalence; experiences of APT.The primary outcome analysis will be by intention-to-treat, fitting random effects logistic regression models that account for clustering of index patients within clinics and trial periods. The transmission dynamic model will be used to predict change in chlamydia prevalence following APT. The economic evaluation will use mathematical modelling outputs, taking a health service perspective. Qualitative data will be analysed using interpretative phenomenological analysis and framework analysis.Ethics and disseminationThis protocol received ethical approval from London—Chelsea Research Ethics Committee (18/LO/0773). Findings will be published with open access licences.Trial registration numberISRCTN15996256.

ObjectivesTo develop a classification of sexual partner types for use in partner notification (PN) for STIs.MethodsA four-step process: (1) an iterative synthesis of five sources of evidence: scoping review of social and health sciences literature on partner types; analysis of relationship types in dating apps; systematic review of PN intervention content; and review of PN guidelines; qualitative interviews with public, patients and health professionals to generate an initial comprehensive classification; (2) multidisciplinary clinical expert consultation to revise the classification; (3) piloting of the revised classification in sexual health clinics during a randomised controlled trial of PN; (4) application of the Theoretical Domains Framework (TDF) to identify index patients’ willingness to engage in PN for each partner type.ResultsFive main partner types emerged from the evidence synthesis and consultation: ‘established partner’, ‘new partner’, ‘occasional partner’, ‘one-off partner’ and ‘sex worker’. The types differed across several dimensions, including likely perceptions of sexual exclusivity, likelihood of sex reoccurring between index patient and sex partner. Sexual health professionals found the classification easy to operationalise. During the trial, they assigned all 3288 partners described by 2223 index patients to a category. The TDF analysis suggested that the partner types might be associated with different risks of STI reinfection, onward transmission and index patients’ engagement with PN.ConclusionsWe developed an evidence-informed, useable classification of five sexual partner types to underpin PN practice and other STI prevention interventions. Analysis of biomedical, psychological and social factors that distinguish different partner types shows how each could warrant a tailored PN approach. This classification could facilitate the use of partner-centred outcomes. Additional studies are needed to determine the utility of the classification to improve measurement of the impact of PN strategies and help focus resources.

Unlike the oil industry, where price is \"regulated\" by Opec at levels that demand wouldn't justify, or the pharmaceutical industry, where \"regulations\" (patents and approvals) can act as a licence to make money, the chemical industry is, for the most part, exposed to the harsh wind of undistorted competition. Nor is agrochemicals the only example of the deliberate expansion of the industry into regulated areas. The heavy investment both organically and via M&A in pharmaceutical manufacturing assets by many (Lonza, DSM, Clariant, Rhodia and Degussa) in the chemical industry in the late 1990s was driven, in part, by the security that FDA plant approval and cGMP status afforded the assets. Environmental regulations introduced in the early 1990s demanded significant reductions in the use of solvents and volatile organic components. Although resisted at the time, these regulations had a number of positive effects. Ciba Speciality Chemicals attributes some of its reduced capital requirements to reduced need for expensive effluent plant.

Background The Cass Review aimed to provide recommendations for the delivery of services for gender diverse children and young people in England. The final product of this project, the Cass report, relied on commissioned research output, including quantitative and qualitative primary research as well as seven systematic reviews, to inform its recommendations and conclusions. Methods We critically evaluated the Cass report and the research that was commissioned to inform it. To evaluate the Risk of Bias within the seven systematic reviews commissioned by the Cass Review, we applied the ROBIS tool – a domain-based assessment of risk of bias within systematic reviews. It focuses on four domains (i) study eligibility criteria, (ii) identification and selection of studies, (iii) data collection and study appraisal, and (iv) synthesis and findings. To maintain rigour, the ROBIS tool was applied to each systematic review by two independent assessors, within Covidence, with conflicts resolved by an additional two independent assessors. We also conducted a detailed critical evaluation of the methods used in the survey of gender services for young people in Europe, the two quantitative studies of health records, and the qualitative study on the experience of gender dysphoria among young people and the claims made in the Cass report based on these studies. Results Using the ROBIS tool, we identified a high risk of bias in each of the systematic reviews driven by unexplained protocol deviations, ambiguous eligibility criteria, inadequate study identification, and the failure to integrate consideration of these limitations into the conclusions derived from the evidence syntheses. We also identified methodological flaws and unsubstantiated claims in the primary research that suggest a double standard in the quality of evidence produced for the Cass report compared to quality appraisal in the systematic reviews. Conclusions We discuss these issues in relation to how evidence regarding gender affirming care is framed, the wider political context, and the future for gender affirming care. The Cass report’s recommendations, given its methodological flaws and misrepresentation of evidence, warrant critical scrutiny to ensure ethical and effective support for gender-diverse youth.

Favipiravir is a ribonucleoside analogue that has been explored as a therapeutic for the treatment of Ebola Virus Disease (EVD). Promising data from rodent models has informed nonhuman primate trials, as well as evaluation in patients during the 2013–2016 West African EVD outbreak of favipiravir treatment. However, mixed results from these studies hindered regulatory approval of favipiravir for the indication of EVD. This study examined the influence of route of administration, duration of treatment, and treatment schedule of favipiravir in immune competent mouse and guinea pig models using rodent-adapted Zaire ebolavirus (EBOV). A dose of 300 mg/kg/day of favipiravir with an 8-day treatment was found to be fully effective at preventing lethal EVD-like disease in BALB/c mice regardless of route of administration (oral, intraperitoneal, or subcutaneous) or whether it was provided as a once-daily dose or a twice-daily split dose. Preclinical data generated in guinea pigs demonstrates that an 8-day treatment of 300 mg/kg/day of favipiravir reduces mortality following EBOV challenge regardless of route of treatment or duration of treatments for 8, 11, or 15 days. This work supports the future translational development of favipiravir as an EVD therapeutic.

Distress Intolerance (DI), defined as the perceived inability to tolerate negative mood states and experiential discomfort, has been posited as a vulnerability factor for several anxiety and emotional disorders. There is a relative paucity of research on DI in youth samples, in large part due to the absence of a psychometrically sound measure of DI in youth. The current study evaluated the psychometric properties of the Distress Intolerance Index for Youth (DII-Y) and the Distress Intolerance Index for Youth–Parent Report (DII-Y-P), which are downward extension adaptations of the adult-oriented Distress Intolerance Index (McHugh and Otto Behavior Therapy 43(3), 641–651, 2012). Participants were 176 youth (ages 9–17) and their parents who were seeking treatment for child anxiety problems. The DII-Y and DII-Y-P demonstrated good-to-excellent internal consistency. Convergent validity of the DII-Y and the DII-Y-P was supported by large, significant associations with measures of intolerance of uncertainty, as well as with anxiety sensitivity in the case of the DII-Y. Discriminant validity of the DII-Y and the DII-Y-P was supported by the absence of significant direct relationships with a measure of defiant behavior. Results support the use of DII-Y and DII-Y-P as reliable and valid instruments for the assessment of youth DI, providing a practical and efficient tool to study DI as a potential factor in the etiology and maintenance of youth anxiety and emotional disorders.