Objectives: To determine the prevalence and treatment outcomes among young women screened opportunistically for genital Chlamydia trachomatis and to evaluate the impact of screening in those participating. Design: An opportunistic screening programme (1 September 1999 to 31 August 2000) using urine samples, tested by ligase chain reaction (LCR). In-depth interviews were used for programme evaluation. Setting: Screening was offered in two health authorities at general practice, family planning, genitourinary medicine (GUM), adolescent sexual health, termination of pregnancy clinics and women's services in hospitals (antenatal, colposcopy, gynaecology and infertility clinics). Main participants: Sexually active women (16-24 years) attending for any reason. Main outcome measures: Screening data: prevalence of infection by age and healthcare setting; proportion of positive patients attending for treatment. Evaluation data: participants' attitudes and views towards screening and follow up. Results: In total, 16 930 women (16-24 years) were screened. Prevalence was higher in younger women (16-20) than those aged 21-24 years and was highly variable at different healthcare settings (range 3.4%-17.6%). Prevalence was approximately 9% in general practice. The role of the project health advisers in managing results and coordinating treatment of positive individuals was essential; the vast majority of all positives were known to be treated. Women felt that screening was beneficial. Improving awareness and education about sexually transmitted infections is required to alleviate negative reactions associated with testing positive for infection. Conclusions: Prevalence of infection outside GUM clinics is substantial and opportunistic screening using urine samples is an acceptable method of reaching individuals with infection who do not normally present at specialist clinics.T his paper presents data from a large scale pilot of opportunistic screening for genital Chlamydia trachomatis infection at a range of healthcare settings including primary care. Offering opportunistic screening at healthcare settings outside genitourinary medicine (GUM) clinics is likely to detect many infected individuals who may not consider themselves at risk of infection, or who are asymptomatic and so would not normally be diagnosed. The main aim of the pilot, which was undertaken in response to the recommendations of the chief medical officer's expert advisory group on Chlamydia trachomatis, 1 was to assess the feasibility and acceptability of screening in healthcare settings outside GUM clinics. In addition, the study has generated accurate estimates of prevalence in healthcare settings outside GUM clinics, which can be used to inform decision making on the cost effectiveness of screening and which settings should be utilised in a national screening programme. In this paper, we present results on the prevalence of infection, treatment outcomes, and the impact of screening on young people taking part in the programme. METHODSA full description of th...
Chlamydia trachomatis is the most common curable bacterial sexually transmitted infection in the UK. The infection is asymptomatic in up to 70% of women, and if untreated, can lead to pelvic inflammatory disease, ectopic pregnancy and infertility. Chlamydial infection can be diagnosed using urine testing and is easily treated with antibiotics. In 1999, the UK Department of Health funded a pilot opportunistic Chlamydia screening programme in two health authorities. All sexually active women between the ages of 16 and 24 years attending general practices and other healthcare settings, such as family planning clinics, antenatal clinics and genito-urinary medicine services, were offered the opportunity to be screened for Chlamydia, regardless of the purpose of their visit. This evaluation was funded to assess the feasibility and acceptability of opportunistic screening. The evaluation was conducted using both qualitative and quantitative methods. The present paper describes findings from the qualitative evaluation study arising from the health professionals' experience of opportunistic screening in general practice. Receptionists were central to the opportunistic screening model in general practice and it was this aspect of the model that raised most concerns. Whilst general practitioners reported that the involvement of receptionists saved them time, the receptionists themselves were sometimes drawn into discussions for which they felt ill equipped and unsuitably located. This research suggests that a call-recall national screening programme would provide a better model to undertake Chlamydia screening in general practice. The advantages of this model are threefold. First, each individual within the target age range can receive information about Chlamydia through the post. Secondly, the test and more detailed information can be managed by a practice nurse in a private and confidential setting. Thirdly, individuals are not repeatedly offered the test when visiting the surgery.
Present and future challenges in our society demand a solid science, technology, engineering, and mathematics (STEM) knowledge base, innovative thinking, and the ability to ask the right questions to generate multiple solutions. To prepare innovators to meet these challenges, we must recognize and develop their talents. This advancement and growth can be encouraged through classroom activities, special schools, afterschool or summer programs, competitions, and informal learning opportunities that focus on STEM curricula and authentic experiences. Purposeful introductions, early exposure, and continuous development with science and engineering concepts can affect retention and sustain interest in STEM fields. This article describes how both in-school and informal science opportunities can provide authentic and experiential opportunities to stimulate students' interests in science and engineering and foster their curiosity through problem-based investigations. In addition, the authors recommend appropriate STEM-focused professional development for teachers to provide engaging experiences for their students.
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