The natural history of <i>Chlamydia trachomatis </i>infection in women:a multi-parameter evidence synthesis

Background and objectives: The evidence base supporting the National Chlamydia Screening Programme, initiated in 2003, has been questioned repeatedly, with little consensus on modelling assumptions, parameter values or evidence sources to be used in cost-effectiveness analyses. The purpose of this project was to assemble all available evidence on the prevalence and incidence of Chlamydia trachomatis (CT) in the UK and its sequelae, pelvic inflammatory disease (PID), ectopic pregnancy (EP) and tubal factor infertility (TFI) to review the evidence base in its entirety, assess its consistency and, if possible, arrive at a coherent set of estimates consistent with all the evidence. Methods: Evidence was identified using ‘high-yield’ strategies. Bayesian Multi-Parameter Evidence Synthesis models were constructed for separate subparts of the clinical and population epidemiology of CT. Where possible, different types of data sources were statistically combined to derive coherent estimates. Where evidence was inconsistent, evidence sources were re-interpreted and new estimates derived on a post-hoc basis. Results: An internally coherent set of estimates was generated, consistent with a multifaceted evidence base, fertility surveys and routine UK statistics on PID and EP. Among the key findings were that the risk of PID (symptomatic or asymptomatic) following an untreated CT infection is 17.1% [95% credible interval (CrI) 6% to 29%] and the risk of salpingitis is 7.3% (95% CrI 2.2% to 14.0%). In women aged 16–24 years, screened at annual intervals, at best, 61% (95% CrI 55% to 67%) of CT-related PID and 22% (95% CrI 7% to 43%) of all PID could be directly prevented. For women aged 16–44 years, the proportions of PID, EP and TFI that are attributable to CT are estimated to be 20% (95% CrI 6% to 38%), 4.9% (95% CrI 1.2% to 12%) and 29% (95% CrI 9% to 56%), respectively. The prevalence of TFI in the UK in women at the end of their reproductive lives is 1.1%: this is consistent with all PID carrying a relatively high risk of reproductive damage, whether diagnosed or not. Every 1000 CT infections in women aged 16–44 years, on average, gives rise to approximately 171 episodes of PID and 73 of salpingitis, 2.0 EPs and 5.1 women with TFI at age 44 years. Conclusions and research recommendations: The study establishes a set of interpretations of the major studies and study designs, under which a coherent set of estimates can be generated. CT is a significant cause of PID and TFI. CT screening is of benefit to the individual, but detection and treatment of incident infection may be more beneficial. Women with lower abdominal pain need better advice on when to seek early medical attention to avoid risk of reproductive damage. The study provides new insights into the reproductive risks of PID and the role of CT. Further research is required on the proportions of PID, EP and TFI attributable to CT to confirm predictions made in this report, and to improve the precision of key estimates. The cost-effectiveness of screening should be re-evaluated using the findings of this report. Funding: The Medical Research Council grant G0801947

Mycoplasma pneumoniae infections, 11 countries in Europe and Israel, 2011 to 2016

Background: Mycoplasma pneumoniae is a leading cause of community-acquired pneumonia, with large epidemics previously described to occur every 4 to 7 years. Aim: To better understand the diagnostic methods used to detect M. pneumoniae; to better understand M. pneumoniae testing and surveillance in use; to identify epidemics; to determine detection number per age group, age demographics for positive detections, concurrence of epidemics and annual peaks across geographical areas; and to determine the effect of geographical location on the timing of epidemics. Methods: A questionnaire was sent in May 2016 to Mycoplasma experts with national or regional responsibility within the ESCMID Study Group for Mycoplasma and Chlamydia Infections in 17 countries across Europe and Israel, retrospectively requesting details on M. pneumoniae-positive samples from January 2011 to April 2016. The Moving Epidemic Method was used to determine epidemic periods and effect of country latitude across the countries for the five periods under investigation. Results: Representatives from 12 countries provided data on M. pneumoniae infections, accounting for 95,666 positive samples. Two laboratories initiated routine macrolide resistance testing since 2013. Between 2011 and 2016, three epidemics were identified: 2011/12, 2014/15 and 2015/16. The distribution of patient ages for M. pneumoniae-positive samples showed three patterns. During epidemic years, an association between country latitude and calendar week when epidemic periods began was noted. Conclusions: An association between epidemics and latitude was observed. Differences were noted in the age distribution of positive cases and detection methods used and practice. A lack of macrolide resistance monitoring was noted

A comparison of the diagnostic protocols used in screening for contagious equine metritis (CEM) in the United Kingdom and the United States

The aim of this literature review was to provide a synopsis of the current diagnostic protocols that are used to detect carriers of contagious equine metritis (CEM) in the United States and in the United Kingdom, establish the differences, and discuss ways to improve them. CEM is a venereal disease of horses caused by the fastidious, slow-growing bacterium T. eguigenitalis. The disease has been recorded in many countries across the world, some in which it is eradicated, and the source of the disease is often non-Thoroughbred horses in mainland Europe. CEM causes temporary infertility in the mare, which subsequently leads to a significant financial loss to horse owners and breeders. Stallions exist only as carriers. Detecting the carrier stallion and mare is the key solution to preventing a CEM outbreak

Softening Stereotypes : A Multimodal Critical Discourse Analysis of TikTok and the Swedish newspaper Aftonbladet in Framing the 'Soft Girl' Trend

This study centers on the trending phenomenon 'soft girl', which gained traction on TikTok's platform in 2024. The study delves into how this trend is depicted across two specific TikTok accounts and within articles published by Aftonbladet. Recognizing the multimodal nature of TikTok videos, the study employs a Multimodal Critical Discourse Analysis (MCDA). The analysis utilizes tools such as connotation, attributes, and lexical choices to explore the representations in both media forms. An important result of the study was that the TikTok videos frame the “soft girl” trend in a romanticized, controlled depiction of women’s life choices, with control over their life situations and futures. Aftonbladet articles depict “soft girls” as active in demanding rights but passive in handling workloads, indicating limited control. The ‘soft girl’ trend is critically framed, highlighting impacts on gender norms and using provocative language that shapes audience perceptions. The study depicted two common themes: romanticizing the soft life and framing financial dependence and control. Future research could focus on analyzing a larger sample of TikTok content to better understand trends such as the "soft girl" trend and its impact on societal norms and gender roles, especially among younger women

“If you don’t grow you die” : En retorisk analys på ett miljardföretags personaltidning, från ledning till golv

The following essay is based on an anonymous organization. We are calling the organization Company X. Our main goal is to emphasize Company X internal communication with a focus on the company's values. We have chosen to start from the company's values and brand, as this should set the tone for their internal communication and brand strategy. The analyzes are based on Company X's employee magazine which consists of informational texts. The method is based on the rhetorical situation and social identity theory. We have chosen to analyze from a top-down perspective within the company. The analysis is divided in two parts, 7.1 is written by Sanna and 7.2 is written by Michaela. The result shows that Company X has varied success in communicating their values. Our result shows that Company X personal magazine as an internal communication channel could be more effective if they did a rhetorical situation analysis. The discussion includes a result from interviews we conducted to investigate whether our analysis is consistent or not and how our study is complemented by previous research

“If you don’t grow you die” : En retorisk analys på ett miljardföretags personaltidning, från ledning till golv

The following essay is based on an anonymous organization. We are calling the organization Company X. Our main goal is to emphasize Company X internal communication with a focus on the company's values. We have chosen to start from the company's values and brand, as this should set the tone for their internal communication and brand strategy. The analyzes are based on Company X's employee magazine which consists of informational texts. The method is based on the rhetorical situation and social identity theory. We have chosen to analyze from a top-down perspective within the company. The analysis is divided in two parts, 7.1 is written by Sanna and 7.2 is written by Michaela. The result shows that Company X has varied success in communicating their values. Our result shows that Company X personal magazine as an internal communication channel could be more effective if they did a rhetorical situation analysis. The discussion includes a result from interviews we conducted to investigate whether our analysis is consistent or not and how our study is complemented by previous research