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Background Australian general practitioners encounter a vast array of health issues in their clinical practice. High-quality clinical record keeping is crucial to support continuity of care for patients and decision making for clinicians. Many clinical software programs used in general practice contain shortcut features that allow insertion of pre-stored, editable text into progress notes. These can be used to support documentation of specific health issues. Objective Drawing on our experience within a research project seeking to strengthen chlamydia management in general practice, this article describes the co-design, implementation and use of documentation shortcuts for chlamydia management. Discussion Shortcuts are useful as a memory prompt and timesaver for general practice clinicians. It is important that they do not replace clinical acumen and judgement. General practices using our chlamydia management shortcuts found them easy to set up, that they acted as a prompt for best practice chlamydia management and that they integrated well with the general practice workflow. [ABSTRACT FROM AUTHOR]

Restudy and re-edition of P.Würzburg 1, containing scholia on Euripides' Phoenissae (6th cent. CE), based on autopsy and new digital imaging (and collation of medieval scholia on the same passages). Contains sections as follows: Introduction; Acquisition and Imaging, Transcription (diplomatic transcription with papyrological apparatus, and interpreted transcription with apparatus criticus and translation); Commentary; Codex or loose sheet?; The nature of the P.Würzb. 1 Scholia.

Introduction Despite the considerable and increasing proportion of women of reproductive age with a chronic non-communicable disease (NCD) and the potential adverse implications of many NCDs for childbearing, little is known about the fertility management experiences of women with an NCD, including their contraceptive use, pregnancy experiences and outcomes, and reproductive health care utilisation. The aim of this study was to investigate the fertility management experiences of women with an NCD and draw comparisons with women without an NCD. Method A sample of 18-50 year-old women (n = 1543) was randomly recruited from the Australian electoral roll in 2013. Of these women, 172 women reported a physical, chronic non-communicable disease: diabetes, arthritis, asthma, hypertension, heart disease, thyroid disorders, and cystic fibrosis. Respondents completed an anonymous, self-administered questionnaire. Factors associated with fertility management were identified in multivariable analyses. Results Women who reported having an NCD were significantly more likely than women who did not report an NCD to have ever been pregnant (75.9 vs. 67.5%, p = 0.034), have had an unintended pregnancy (33.47 vs. 25.5%, p = 0.026), and have had an abortion (20.3 vs. 14.2%, p = 0.044); they were less likely to consult a healthcare provider about fertility management (45.0 vs. 54.4%, p = 0.024). Similar proportions were using contraception (48.8 vs. 54.5%, p = 0.138). Conclusion The findings have implications for healthcare providers and women with an NCD and highlight the importance of addressing possible assumptions about the inability of women with an NCD to become pregnant, and ensuring women receive information about suitable methods of contraception and pre-pregnancy care., Author(s): Sara Holton [sup.1] , Aberaami Thananjeyan [sup.1] , Heather Rowe [sup.1] , Maggie Kirkman [sup.1] , Lynne Jordan [sup.2] , Kathleen McNamee [sup.2] , Christine Bayly [sup.3] , John [...]

Discusses a program developed to assist displaced workers in a small town in Arkansas after a uniform-manufacturing company shut down and moved to Mexico, leaving nearly 200 unskilled workers unemployed. Reports that almost 100 of the workers became community college students through a cooperative program that involved the schools, the state, the employer, and the U.S. Department of Labor. (NB)

The article discusses the estetrol/drospirenone pill as a new choice of combined hormonal contraception. Topics include the potentially low environmental impact, low metabolic profile, limited effect on haemostasis and low impact on hepatic and breast tissue; the potential benefit as a contraceptive in patients aged under 50 years who are experiencing menopausal symptoms; and the performance of the estetrol/drospirenone pill in relation to combined hormonal methods.

The striped bass (Morone saxatilis) is an economically and ecologically valuable finfish species that inhabits nearshore and estuarine waters of many states along the US Atlantic coast. Chesapeake Bay provides extensive nursery and foraging habitats for striped bass, yet fish in the bay exhibit high prevalence of disease caused by bacteria in the genus Mycobacterium. Detection of population-level impacts associated with mycobacteriosis has been difficult because the disease is chronic and synoptic biological and disease data have been limited. Here, we present modeling analyses of growth data for disease-positive and -negative striped bass in Chesapeake Bay. Three growth relationships were considered, and for each, a single model was parameterized to include several covariates, most notably disease status and severity. Our results indicate that disease-positive and -negative fish have differing growth patterns and that the estimated asymptotic sizes of disease-positive fish are considerably lower than those of disease-negative fish. Compromised growth along with documentation that striped bass in Chesapeake Bay are experiencing disease-associated mortality suggests that disease may be reducing the productivity of this species. Le bar raye (Morone saxatilis) est un poisson teleosteen de grande importance economique et ecologique qui habite les eaux cotieres et estuariennes de plusieurs etats de la cote atlantique des E.-U. La baie de Chesapeake fournit d'importants habitats de nourricerie et d'alimentation au bar raye, bien que les bars dans la baie connaissent une forte prevalence de maladie causee par des bacteries du genre Mycobacterium. La detection des impacts de la mycobacteriose au niveau de la population est difficile, car la maladie est chronique et il existe peu de donnees synoptiques sur la biologie et la maladie. Nous fournissons ici des donnees de croissance dans la baie de Chesapeake chez des bars rayes presentant une reaction positive a la maladie et d'autres une reaction negative. Nous avons tenu compte de trois relations de croissance et, pour chacune, nous avons parametre un seul modele de maniere a inclure plusieurs covariables, en particulier le statut et la severite de la maladie. Les poissons a reaction positive et negative affichent des patrons de croissance differents et les tailles estimees a l'asymptote des poissons a reaction positive sont considerablement inferieures a celles des poissons a reaction negative. La croissance restreinte, ainsi que l'evidence de mortalite associee a la maladie, laissent croire que la maladie est en train de reduire la productivite du bar raye dans la baie de Chesapeake. [Traduit par la Redaction], Introduction Fish production can be defined as the time- and area-specific elaboration of tissue balanced with losses due to natural and fishing mortality (Clarke 1946; Mertz and Myers 1998). Growth [...]

This article examines the papyrus of Plato's 'Republic' Book 8 with explanatory marginalia, which dates to the 2nd century A.D., and reveals information on ancient tachygraphy and the 'Republic' 546B-C's 'nuptial number'. The author provides explanations of some of the more elusive symbols of the text, including a complete table of the papyrus's tachygraphic symbols, how they deviate from other testimonia and why they appear at all since shorthand is out of place in literary texts.

Scholia are commentaries on Greek and Latin literary texts, compiled from earlier commentaries, and copied in the margins of the text by scribes. Although scholia are dated from the ninth century, evidence proves that the the concept of leaving wide margins in the text for commentaries possibly dates back to the fourth century AD. The change in format was probably a result of the transition from Latin to Greek as the language of instruction. Although most such commentaries served only as annotations, a few of them resembled the extensively scholastic marginalia of later days.

Abstract Background Unintended pregnancy (mistimed or unwanted) remains an important health issue for women. The purpose of this study was to determine the prevalence of and factors associated with risk of unintended pregnancy in a sample of Victorian women attending family planning clinics. Methods This cross-sectional survey of three Family Planning Victoria Clinics from April to July 2011 recruited women aged 16-50 years with a male sexual partner in the last 3 months, and not intending to conceive. The questionnaire asked about contraceptive behaviours and important factors that influence contraception use (identified from a systematic literature review). Univariate analysis was calculated for the variables of interest for associations with contraceptive use. An overall multivariate model for being at risk for unintended pregnancy (due to inconsistent or ineffective contraceptive use or non-use) was calculated through backward elimination with statistical significance set at Results 1006 surveys were analyzed with 96% of women reporting contraception use in the last 3 months. 37% of women were at risk for unintended pregnancy due to imperfect use (61% inconsistent users; 31% ineffective methods) or never using contraception (8%). On multivariate analysis, women at risk for unintended pregnancy compared with women not at risk were 1 partner in the last 3 months (OR 3.2, 95% CI 2.3-4.6). These women were dissatisfied with current contraception (OR 2.5, 95% 1.8-3.5); felt “vulnerable” to pregnancy (OR 2.1, 95% CI 1.6-3.0); were not confident in contraceptive knowledge (OR 2.6, 95% CI 1.5-4.8); were unable to stop to use contraception when aroused (OR 2.1, 95% CI 1.5-2.9) but were comfortable in speaking to a doctor about contraception (OR 2.3, 95% CI 1.1-4.1). Conclusion Despite reported high contraceptive usage, nearly 40% of women were at risk for unintended pregnancy primarily due to inconsistent contraceptive use and use of ineffective contraception. Strategies for improving consistency of effective contraception use or greater emphasis on long-acting contraception may be needed for certain subpopulations at higher risk for unintended pregnancy.

Young women in Australia disproportionately experience unintended pregnancy and sexually transmissible infections (STIs). As the promotion of highly effective pregnancy prevention methods such as long-acting reversible contraception (LARC) increases, concurrent use of condoms with LARC remains optimal for pregnancy and STI prevention. There is little data exploring condom use behaviour in young Australian women using LARC. In this qualitative study we interviewed twenty women using LARC about their experiences of making decisions regarding condom use. We used inductive thematic analysis to identify factors influencing participant decision-making. We found that while LARC had an impact on condom use and sexual practices, decisions regarding condom use were influenced by multiple factors including mood, menstrual changes related to LARC, and relationship dynamics. Participants' views of 'safe sex' extended beyond pregnancy and STI protection, to include desired outcomes such as pleasure, consent and communication. Access to STI testing and treatment was key to how participants managed STI risk. Findings highlight the need for a more comprehensive approach to safer sex health promotion, and the importance of ensuring STI testing and treatment services continue to be available and accessible to all young people. [ABSTRACT FROM AUTHOR]

Abstract Background Cohort studies are an important study design however they are difficult to implement, often suffer from poor retention, low participation and bias. The aims of this paper are to describe the methods used to recruit and retain young women in a longitudinal study and to explore factors associated with loss to follow up. Methods The Chlamydia Incidence and Re-infection Rates Study (CIRIS) was a longitudinal study of Australian women aged 16 to 25 years recruited from primary health care clinics. They were followed up via the post at three-monthly intervals and required to return questionnaires and self collected vaginal swabs for chlamydia testing. The protocol was designed to maximise retention in the study and included using recruiting staff independent of the clinic staff, recruiting in private, regular communication with study staff, making the follow up as straightforward as possible and providing incentives and small gifts to engender good will. Results The study recruited 66% of eligible women. Despite the nature of the study (sexual health) and the mobility of the women (35% moved address at least once), 79% of the women completed the final stage of the study after 12 months. Loss to follow up bias was associated with lower education level [adjusted hazard ratio (AHR): 0.7 (95% Confidence Interval (CI): 0.5, 1.0)], recruitment from a sexual health centre as opposed to a general practice clinic [AHR: 1.6 (95% CI: 1.0, 2.7)] and previously testing positive for chlamydia [AHR: 0.8 (95% CI: 0.5, 1.0)]. No other factors such as age, numbers of sexual partners were associated with loss to follow up. Conclusions The methods used were considered effective for recruiting and retaining women in the study. Further research is needed to improve participation from less well-educated women.

Abstract Background Differences in the determinants of Chlamydia trachomatis ('chlamydia') and Mycoplasma genitalium (MG) genital infection in women are not well understood. Methods A cohort study of 16 to 25 year old Australian women recruited from primary health care clinics, aimed to determine chlamydia and MG prevalence and incidence. Vaginal swabs collected at recruitment were used to measure chlamydia and MG prevalence, organism-load and chlamydia-serovar a cross-sectional analysis undertaken on the baseline results is presented here. Results Of 1116 participants, chlamydia prevalence was 4.9% (95% CI: 2.9, 7.0) (n = 55) and MG prevalence was 2.4% (95% CI: 1.5, 3.3) (n = 27). Differences in the determinants were found - chlamydia not MG, was associated with younger age [AOR:0.9 (95% CI: 0.8, 1.0)] and recent antibiotic use [AOR:0.4 (95% CI: 0.2, 1.0)], and MG not chlamydia was associated with symptoms [AOR:2.1 (95% CI: 1.1, 4.0)]. Having two or more partners in last 12 months was more strongly associated with chlamydia [AOR:6.4 (95% CI: 3.6, 11.3)] than MG [AOR:2.2 (95% CI: 1.0, 4.6)] but unprotected sex with three or more partners was less strongly associated with chlamydia [AOR:3.1 (95%CI: 1.0, 9.5)] than MG [AOR:16.6 (95%CI: 2.0, 138.0)]. Median organism load for MG was 100 times lower (5.7 × 104/swab) than chlamydia (5.6 × 106/swab) (p < 0.01) and not associated with age or symptoms for chlamydia or MG. Conclusions These results demonstrate significant chlamydia and MG prevalence in Australian women, and suggest that the differences in strengths of association between numbers of sexual partners and unprotected sex and chlamydia and MG might be due to differences in the transmission dynamics between these infections.