STD syndrome packets: Improving syndromic management of sexually transmitted diseases in developing countries

Objective: To design, introduce, and evaluate STD syndrome packets containing recommended drugs for each syndrome, four condoms, a partner treatment card, and a patient information leaflet, with the goal of improving sexually transmitted disease (STD) case management. Methods: Packet design evolved around available packaging technology, informed by pilot testing with nurses working in primary care clinics, doctors in private medical practices, and patients with an STD, in Hlabisa, South Africa. Evaluation 1 year later included analysis of distribution records and interviews with 16 nurses and 61 patients. Results: A cheap packet (2 U, S, cents each, excluding contents) compatible with current legislation was designed and introduced to six public sector clinics and as a short pilot to five private medical practices, Four thousand eighty-five packets were distributed to the clinics, equivalent to approximately 115% of the STDs reported over that period. All 16 nurses reported using the packets, but only 63% did so all the time because of occasional supply problems, All believed the packets improved treatment by saving time (75%), improving supply of condoms and partner cards (44%), and making treatment easier (56%), Patients also responded positively, and most said they would buy a packet (up to $5) at a pharmacy (84%) or store (63%) if available. Conclusions: The STD syndrome packets have the potential to improve STD syndromic management by standardizing therapy and improving the supply of condoms, partner cards, and information leaflets. Packets are popular with practitioners and patients, but consistent supply is essential for maximal impact, There may be scope for social marketing of the packets, which could further increase use.

Turn up the HEAT

The recently determined crystal structure of the PR65/A subunit of protein phosphatase 2A reveals the architecture of proteins containing HEAT repeats, The structural properties of this solenoid protein explain many functional characteristics and account for the involvement of solenoids as scaffold, anchoring and adaptor proteins.

Further validation of "timed up and go" in stroke patients

Objective: To compare the Barthel Index (BI), a well-known and accepted measure of functional disability, with Timed Up and Go (TUG). Method: Thirty-three stroke patients had their BI and TUG assessed by independent blinded observers. Results: There was good agreement between BI and TUG, with good repeatability. Conclusion: Thus TUG is a good measure of function pre-discharge but needs to be further validated on more disabled patients.

Formal derivation of finite state machines for class testing

Previous work on generating state machines for the purpose of class testing has not been formally based. There has also been work on deriving state machines from formal specifications for testing non-object-oriented software. We build on this work by presenting a method for deriving a state machine for testing purposes from a formal specification of the class under test. We also show how the resulting state machine can be used as the basis for a test suite developed and executed using an existing framework for class testing. To derive the state machine, we identify the states and possible interactions of the operations of the class under test. The Test Template Framework is used to formally derive the states from the Object-Z specification of the class under test. The transitions of the finite state machine are calculated from the derived states and the class's operations. The formally derived finite state machine is transformed to a ClassBench testgraph, which is used as input to the ClassBench framework to test a C++ implementation of the class. The method is illustrated using a simple bounded queue example.

Weathering of hydrocarbons in mangrove sediments: testing the effects of using dispersants to treat oil spills

This field study was a combined chemical and biological investigation of the relative effects of using dispersants to treat oil spills impacting mangrove habitats. The aim of the chemistry was to determine whether dispersant affected the short- or long-term composition of a medium range crude oil (Gippsland) stranded in a tropical mangrove environment in Queensland, Australia. Sediment cores from three replicate plots of each treatment (oil only and oil plus dispersant) were analyzed for total hydrocarbons and for individual molecular markers (alkanes, aromatics, triterpanes, and steranes). Sediments were collected at 2 days, then 1, 7, 13 and 22 months post-spill. Over this time, oil in the six treated plots decreased exponentially from 36.6 +/- 16.5 to 1.2 +/- 0.8 mg/g dry wt. There was no statistical difference in initial oil concentrations, penetration of oil to depth, or in the rates of oil dissipation between oiled or dispersed oil plots. At 13 months, alkanes were >50% degraded, aromatics were similar to 30% degraded based upon ratios of labile to resistant markers. However, there was no change in the triterpane or sterane biomarker signatures of the retained oil. This is of general forensic interest for pollution events. The predominant removal processes were evaporation (less than or equal to 27%) and dissolution (greater than or equal to 56%), with a lag-phase of 1 month before the start of significant microbial degradation (less than or equal to 7%). The most resistant fraction of the oil that remained after 7 months (the higher molecular weight hydrocarbons) correlated with the initial total organic carbon content of the soil. Removal rate in the Queensland mangroves was significantly faster than that observed in the Caribbean and was related to tidal flushing. (C) 1999 Elsevier Science Ltd. All rights reserved.

One year follow-up of cannabis dependence among long-term users in Sydney, Australia

Eighty one percent of a sample of long-term cannabis users was followed up at 1 year (162/200). Half (51%) were daily smokers, while 20% had substantially decreased or ceased use. More than half received a dependence diagnosis on each of three measures in the last year, with 44% dependent on all three. Remission was much more common than incidence of dependence. Nevertheless, use and dependence patterns were strongly related over time. Longitudinal analyses revealed that quantity of use and severity of dependence at baseline were the primary predictors of those same variables at follow-up. These data suggest that cannabis use and dependence are fairly stable among long-term users. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.

Longitudinal research: methods for maximizing subject follow-up

Early intervention for hazardous alcohol use has been shown repeatedly to be effective in reducing alcohol consumption, limiting alcohol-related problems and improving biochemical parameters. However, in most studies the follow-up period has been 2 years or less. The current paper presents progress on a 10-year follow-up of a randomized controlled trial of early intervention. Methods used for tracing subjects and ensuring minimal refusals are detailed. The intensity of effort required to locate subjects is documented and recommendations for ensuring good follow-up rates are made. At completion of follow-up, 72.5% of the sample reviewed here and 78.2% of the total cohort had been traced. Our experiences demonstrate that long-term follow-up is feasible, given sufficient planning and persistence.

A model of specification-based testing of interactive systems

In this paper we present a model of specification-based testing of interactive systems. This model provides the basis for a framework to guide such testing. Interactive systems are traditionally decomposed into a functionality component and a user interface component; this distinction is termed dialogue separation and is the underlying basis for conceptual and architectural models of such systems. Correctness involves both proper behaviour of the user interface and proper computation by the underlying functionality. Specification-based testing is one method used to increase confidence in correctness, but it has had limited application to interactive system development to date.