#all naats

[hillbillyoracle]

Now is the Time to Start Masking Again

If you stopped paying attention to COVID with the release of vaccines, you've missed a lot.

COVID is airborne.

Long COVID impacts 10% of people infected by COVID (though this is beginning to look like a low estimate). Risk of Long COVID goes up with each reinfection. Long COVID is worse than initially reported.

Bisexual and trans people are more likely to develop Long COVID.

Black and Hispanic folks are more likely than White folks experience more symptoms and health problems from Long COVID.

***COVID and Long COVID has much more in common with HIV and AIDS than the flu (28:19 - 38:30 of linked video)***

The Basics

[WEBSITE] You Have to Live Your Life

[ZINE] What's Up With COVID and How to Protect Yourself - 2024 Edition

[FAQ] r/ZeroCOVIDCommunity's FAQ and Resource List

"This is great and all but it's overwhelming. TL;DR?"

COVID is airborne. Long COVID is much more common (and serious/debilitating) than previously thought.

Mask with an N95 or better in all indoor spaces and outside when close to others. Improve your indoor air quality by opening windows and using fans/air filters.

Rapid tests are prone to false negatives so make sure to retest in 48 hours after exposure and/or when you develop symptoms. Isolate in the meantime. Consider upgrading to a NAAT (PlusLife, Metrix) or PCR (Lucira) if you have the money.

Things for you to do today:

buy some N95s or request some from a local mask bloc

open a window more often and/or buy an air purifier

buy the best COVID tests you can afford

Basics in Video Form

If you have limited time, watch the videos with * first. They will cover the basics in about 20 minutes.

*VIDEO: COVID is Airborne [2:53]

*VIDEO: What the latest research tells us about long COVID's most common symptoms [5:58]

*VIDEO: FDA warns of false negatives with at home COVID Tests [2:19]

*VIDEO: How to Stay Safe(r) at Home [10:35]

--

VIDEO: The Astounding Physics of N95 Mask [6:08]

VIDEO: Mask Fit 101: Seal [4:07]

VIDEO: Mask Fit 101: Qualitative [3:49]

VIDEO: Mask Fit 102: Quantitative [5:04]

VIDEO: How to get [and give] FREE Masks [6:07]

VIDEO: Try this DIY indoor air purifier for cleaner air [4:22]

VIDEO: Why is EVERYONE more SICK [54:55]

Want to Get Involved?

Join your local Mask Bloc

No local Mask Bloc? Consider starting one

Talk to the people in your life about COVID

Print quality zines and spread them in your communities

Push for COVID Conscious changes in your spaces.

[cin-cant-donate-blood]

Ever wanted to know how to pronounce the name of our favorite Ur copper merchant, Ea-nāṣir? If you haven't looked it up, I can almost guarantee that you are saying it wrong, but fret not. I will share the secret with you (or at least the buest guess modern experts have).

The reconstruction of how to pronounce his name currently looks like this in the IPA:

[e.a.ˈnaː.t͡sʼiʁ]

If that looks daunting, keep reading.

While Ea-nāṣir may be remembered to us as a Sumerian, he did not speak Sumerian. The Sumerian language was all but extinct in his day, and Sumerians now spoke an unrelated language called Akkadian.

The infamous complaint tablets are written in Akkadian Cuneiform, which is a complicated writing system that it is difficult to figure out the pronunciation of after the fact. Pronunciations have shifted considerably during the time that modern people have studied it. All the same, we have a "buest guess" at pronunciation.

The first thing to note is that Akkadian has phonemic vowel quantity, which is a fancy way if saying that the length of a vowel is really important. Ea-nāṣir's name has four vowels, and three are short and one is long. The long one is the A with a bar on top (called a macron, pronounced MACK-ron or MAKE-ron). If you see that symbol in other languages it is probably also a long vowel (you'll see this in Arabic, Latin, and many other languages).

This also tells us where to stress the word. While Akkadian has somewhat complicated rules for stress, Ea-nāṣir's case is simple: stress the syllable with the long vowel.

The vowels themselves are the vowels you would find in Spanish, Japanese or Swahili: the E is closest to the English vowel in dress, the As are between trap and palm, just like Spanish gato, and the I is somewhere around sheep or fear.

So far, intuitively, you're probably pronouncing it something like "e-a-NAW-sir", which is getting closer to the accurate idea, but we haven't looked at the consonants yet, and unfortunately they are the hardest parts (for an English speaker).

The N is just a regular N. This isn't too surprising since N is one of the single most common sounds across all spoken languages (perhaps only beaten by M).

The R, while contested among scholars, seems to be leaning towards a "back R" or "guttural R", the way French people and some Germans do it.

That leaves the ṣ. Oh boy. It is, first of all, an affricate, like the Z in pizza. "e-a-NAAT-sir" would as such be a good try. It is, however, also something called an ejective, which is a notoriously tricky type of consonant where you block the airflow while saying it, only to release it immediately after.

You know the T-dropping that some brits do, or the way you rapidly close off air flow at the back of your throat when saying ah-ah-ah (and perhaps wagging your finger)? Try putting an air release like that right after the ts sound. If the closest you get is "e-a-NAT-suh-ir" then you are already doing a good job.

If you are a perfectionist, here is an old youtube video of a person making the noise, with decent audio.

And that's it, really. That is a complete breakdown of the best guess we have at how Ea-nāṣir's name would have been pronounced.

[creatingblackcharacters]

I honestly think there is something in specifically white english teachers that make them foam at the mouth when it comes to having students read aloud books that contain the n word. In high school grade 10 we read to kill a mocking bird and my teacher was delighted to tell everyone that when reading it in class each student would read a chapter and that the book contained the racial slur and that it had to be said out loud. No one wanted to do that and when a few of the Black students in my class, along with some other Native and white students, were like do we have to its pretty insensitive the teacher then made it a rule where we had to say it or a mark would be deducted from the class participation for that unit since we were refusing to participate.

And yes there was some students who were delighted to say the word didn't matter the context as long as they weren't getting in trouble for saying it because racists will be racist. There was this one girl super shy and sheltered most of her life never even heard her say the word crap when it was her turn to read she literally broke down crying not wanting to say it and how uncomfortable it made her. The teacher just rolled her eyes and got one of the eager racist people in the class to say it.

When this was brought to our principal and school board they dismissed it since they didn't want to censor a book if it said that word it said it for a reason and by that we had to say it. I would also like to add this was a very white school with all-white teachers and a school board in a smallish town and also a catholic school. A few years later when a Native student and a Black student did projects on residential schools and the catholic church involvement, and Canada's emancipation day both students got in trouble for topics that weren't allowed. So much for not wanting to censor things huh.

"Canada's safer than the US" oh ho HO naat really!

Sidebar; It's time to let a book other than To Kill a Mockingbird be read in schools about racism. Is it a good book? Sure, and I'm not saying don't read it. But I shouldn't have to read from the perspective of a "good white" to get my only acceptable reference to dealing with racism in this world (and then told I HAVE to say the slur from the otherwise sanitized perspective, which apparently is still considered ban-able). But your English teacher wouldn't wanna hear that 😭 I'm sorry that someone like that was even allowed to be around kids, let alone teach.

[covid-safer-hotties]

Reference saved on our archive

By Amanda Blum

PCR tests are far superior to rapid antigen tests—and now you can get them for home use.

Last week, I was about to go on a date, and because I'm severely immunocompromised, we agreed he would take a COVID test using one of my rapid home PCR tests. It was a courtesy—he felt perfectly fine— but he tested positive. By the next day, he was sick as a dog. And, by the way, the rapid antigen test he took when he got home that night was negative.

Regardless of how you much of a health risk you see in COVID, it is still, at best, an inconvenience that costs you days off work. A simple home PCR test saved me from that inconvenience (and worse), and if I'd relied on the common rapid antigen test or done nothing at all, I would probably be sick right now.

While the world has desperately attempted to move on from COVID, this summer saw the highest case loads since 2022, with a winter surge just around the corner. Almost 300,000 people died from COVID in the US over the last three months alone, so while the pandemic has transitioned into endemic, according to the CDC, there are still risks to be aware of. Around 400 million people worldwide have long COVID, where symptoms can range from annoying to absolutely debilitating, regardless of your age, pre-COVID health, or fitness levels. Cases of long COVID are crushing our medical system, too. The two best tools to avoid getting COVID continue to be masking and testing. Unfortunately, the PCR testing centers that used to be available in each city have long closed, and obtaining a PCR has become expensive and hard to locate. This is why home testing kits are so important.

While you may be used to thinking of COVID tests as interchangeable, there’s a big difference between the standard at-home antigen test and a PCR (molecular) test. Almost five years in, it’s important to understand why PCR tests are the ones you want when accurate testing is important.

The difference between a PCR and a Rapid Antigen Test What you normally think of as a home COVID test—like the kind you can order for free from the government—is a rapid antigen test. When these at-home COVID tests became available, they were a powerful tool to help people know they were positive so they could isolate themselves from others. Almost all at-home tests were lateral flow tests, also known as rapid antigen tests (RATs). They measure for proteins on the outside of SARS-C0V-2, but they have a major flaw: They can only detect active virus. If you’re asymptomatic or don’t have a high viral load yet, the RAT may show negative results while you have an active and contagious infection.

This is why, if you already have symptoms, a negative antigen test isn't conclusive. You may need to test a number of times to confirm you have COVID. When you first get sick, you may go a number of days (as many as five) without enough virus to set off a positive RAT test. RATs were designed to be taken multiple times in sequence.

A PCR, also known as a NAAT or molecular test, measures RNA and can detect even small amounts of the virus. This is why it has always been considered the “gold standard” of COVID testing. These tests are generally considered accurate starting one to three days before you experience symptoms. Until last year, you needed to get a PCR from a testing center, but home tests have evolved and there are now four rapid, at-home molecular COVID tests, meaning you test and get a result within 30 minutes.

Why we still need COVID testing The world is now divided into people who view COVID as part of regular life and those who, due to chronic illness, immune issues, previous infections, or age, cannot afford to get infected. For a long time, we viewed COVID testing as something you do for your own health, but home PCR testing represents a way you can easily protect those vulnerable people in your life without cutting them off from society.

But even if you're not concerned about others, you should still care about protecting yourself from multiple infections. While the likelihood you will die of COVID has gone down dramatically due to vaccines, medical interventions, and natural immunity from infection, the news has not done a great job talking about long COVID. As people get infected two, three, four, and more times, they are playing against the odds. It’s estimated that one in 10—or even as many as one in five—infections leads to long COVID, and to explain how much it’s not “just the flu,” COVID is now considered to be a vascular illness. That means it affects the blood vessels in your body, which go everywhere. Thinking of COVID as a vascular illness helps explain why long COVID is everything from extreme fatigue to migraines to numbness in your extremities, loss of smell and taste, extreme fatigue, and neurological and cardiovascular conditions.

While lots of people no longer even test to see if they have COVID, there are a few reasons to get a definitive answer. First, you can only get the intervention Paxlovid within the first five days of symptoms. Anti-virals like Paxlovid knock down your viral load, one of the things we think helps prevent long COVID. Second, no one knows who will get long COVID, and you might need proof of that positive test in the future for insurance or benefits or even to justify sick days.

Lastly, you need to get tested because it is hard to know when you have COVID. Symptoms of COVID include headache, body ache, fever, sniffles, congestion, fatigue, sore throat, vomiting, diarrhea, and loss of smell or taste. In other words, absolutely anything out of the ordinary. While a RAT is unreliable for safe socializing with people for the reasons explained above, a molecular test can pretty reliably clear someone to come in your house that day, or be in close proximity. In that way, these molecular tests can be a tool to help immunocompromised people back into the world and make multigenerational celebrations safer.

How to get a molecular/PCR test Outside of your home, your main options now are urgent care clinics and places that do testing for travel. In both cases, they’ll be expensive. In the case of urgent care, they’ll put you in the same space as all the sick people, who are now no longer required to mask in healthcare settings, so if you don't already have COVID, you might pick it up there. Fortunately, there are molecular (PCR quality) tests you can take at home.

Rapid molecular tests require a similar effort on your part as a RAT test. You’ll swab yourself and then insert that swab into a machine that gives you a result. There are currently just four brands of these tests available: Lucira, Metrix, 3EO, and PlusLife. Unlike RAT tests, you have to order them, although Metrix and Lucira tests are available on Amazon, and Walgreens stocks Lucira tests in select stores. For a long time, they were just too expensive for most people, so they were relegated to the likes of movie sets, law firms, and Google employees. Prices have gone down, so now they’re more accessible—as low as $10 a test. Here are your options.

Follow the link to see the full review with relevant links!

[visualtaehyun]

I know Love Storm's script like the back of my hand so I noticed some textual parallels with CirPhu~

Disclaimer: not a native speaker but a learner of Thai 🙏

ลูกหมาตกน้ำ /luuk maa dtohk naam/ (= lit. puppy that fell into the water)

Phu: เกิดเป็นลูกหมาตกน้ำอีกแน่เลยอ่า /geert bpen luuk maa dtohk naam eek naae loei aa/ = I'm so gonna end up [soaked like] a drowning puppy again.

Payu: สภาพนี้เหมือนลูกหมาตกน้ำเลยน่ะ /sa-phaap nee meuuan luuk maa dtohk naam loei na/ = You're [drenched] like a drowning puppy.

ขี้โกง /khee gohng/ (= tricksy, cheating, deceitful)

- Phu: พี่เซอร์ค้าบ /phi Cir khaap/ = P'Cir khaap~ - Cir: เด็กขี้โกง /dek khee gohng/ = Sneaky boy.

Rain: เรนขอเวลานอก พี่พายุขี้โกง /Rain khaaw weh-laa naawk. phi Payu khee gohng/ = Time out, please! You're cheating, P'Payu!

ผม /pom/ (=I) -> name

- Cir: พู่ /"Phu"/ = "Phu". - Phu: ครับ /khrap?/ = Yes? - Cir: ไม่ใช่ ผม สิ แทนตัวเองว่า พู่ ได้ไหม /mai chai "pom" si. thaaen dtuaa eng waa "Phu" dai mai?/ = Not "I". Can you refer to yourself as "Phu"? - Phu: ไม่เอาอ่ะ /mai ao a/ = No~

- Payu: พี่พายุ ปล่อยเรนนะครับ พูด /"phi Payu, bplaawy Rain na khrap." puut/ = "P'Payu, let me go, please." Say it. - Rain: ไม่ /mai/ = No!

Phu: แล้วทีนี้พี่เซอร์จะบอก พู่ ได้หรือยังครับ ว่าในโลกนั้นอ่ะ พี่เซอร์ถือของให้พู่แบบนี้ตลอดเลยหรอ /laaeo thee nee phi Cir ja baawk- Phu dai reuu yang khrap? waa nai lohk nan a, phi Cir theuu khaawng hai Phu baaep nee dta-laawt loei raaw/ = So now, will you tell- ...me already? In that world, do you hold stuff for me like this all the time? Phu: แต่ถึงพู่ไม่ใช่แฟนพี่อ่ะ พู่ก็เป็นห่วงพี่ได้น่ะ /dtaae theung Phu mai chai faen phi a, Phu gaaw bpen huuang phi dai na/ = Even though I'm not your boyfriend, I can still worry about you.

Rain: พี่พายุฟังเรนนะ /phi Payu fang Rain na/ = Hear me out, P'Payu. -> this marks the moment Rain officially starts calling himself เรน /Rain/ with Payu

หล่อ /laaw/ (= handsome, good-looking)

Phu: คนอะไร หล่อบ้าหล่อบออะไรขนาดนั้นอะ /khohn a rai, laaw baa laaw baaw a rai kha-naat nan a/ = What kinda person is this crazily handsome! Phu: หล่อเป็นบ้าเลยอ่า /laaw bpen baa loei aa/ = He is so crazily handsome!

Rain: เชี้ย ฉิบหายแล้วไง ทำไมมันหล่อจังวะ /chiia! chip-haai laaeo ngai! tham mai man laaw jang wa/ = Shit! This is fucking bad! Why's he so damn handsome?

หนีหนี้ /nee nee/ (= evade/flee from debt)

Achi: แล้วมึงเป็นไรเนี่ย ยังกะหนีหนี้เลย /laaeo meung bpen rai niia? yang ga nee nee loei/ = And what's up with you? [Acting] like you're hiding from debtors.

Sky: นี่หนีหนี้อยู่มึงอะ /nee, nee nee yuu meung a/ = [Trying to] avoid a debt here, dude?

[unscharf-an-den-raendern]

Leider sind wir schon lange an dem Punkt, an dem es mehr Reinfektionen als Erstinfektionen gibt. Fast niemand hatte noch nie Covid. Es ist davon auszugehen (weil, es gab ja Welle um Welle um Welle, auch wenn es leider nicht von Seiten der Politik so kommuniziert wurde und die meisten Menschen es nicht geglaubt oder ignoriert haben) dass sich der average Mensch in den letzten Jahren wieder und wieder angesteckt hat. Viele Ansteckungen verlaufen asymptomatisch, und wenn Symptome auftreten, werden diese oft nicht als Covid wahrgenommen. Covid-Symptome sind vielfältig (da das Virus mehr oder weniger Gewebe im ganzen Körper angreifen kann) und werden nicht alle als solche erkannt. Und wenn jemand vermutet, Covid zu haben, und einen negativen Schnelltest macht, ist das leider auch nicht sehr aussagekräftig, weil die nur bei sehr hohen Virenlasten eine gute Präzision haben. Es müssten 3-4 Tests im Abstand von 2 Tagen durchgeführt werden, und selbst dann ist es eher meh zuverlässig. Nur molekulare Tests (also PCR oder NAAT) können Covid relativ gut ausschließen. Das ist halt das, was passiert, wenn es ein extrem ansteckendes und schnell mutierendes Virus gibt, und wir als Gesellschaft so tun, als wäre es plötzlich gar nicht mehr da. Es wird nach wie vor da sein, und nach wie vor extrem ansteckend sein, und Leute werden sich immer wieder anstecken, aber wir hören nichts mehr davon. Ist leider scheiße.

Und dabei sind gerade diese Reinfektionen das perfide an Corona: Sie erhöhen das Sterberisiko und das Risiko für Long Covid und können bei bereits an Long Covid erkrankten die Krankheit verschlimmern.

Und deswegen dürfen wir "endemisch" auch nicht als Synonym für "ist harmlos und wir müssen nichts mehr machen" verstehen. Erkältungen sind endemisch, Malaria, Cholera und die Pocken (vor ihrer weltweiten Ausrottung) aber auch. Und Malaria bleibt uns literally (bis auf ein paar eingeschleppte Fälle) nur erspart, weil wir das Glück haben, dass es hier zu kalt ist.

[thepoopdokyeomtouched]

HI!!!!

dude sajda karaan>>>

ik this is random but there's only so many desi blogs on tumblr and you seem like a really cool person idk

BRO WHAT OTHER BOLLYWOOD SONGS DO YOU LIKE BECAUSE YK THE 2000S SONGS LIKE DESI GIRL, BREAK UP SONG, MAKE SOME NOISE FOR THE DESI BOYZ ALL HIT SO HARD

(this is my somewhat subtle way of asking if you wanna be moots?)

OH DAMN WE ARE GOING THERE!?! Ok lets get in it

Starting of from old bollywood

Maine poocha chand se

Bahon mai chale aao

Chura liya hai

Aaj mausam

Lag ja gale

Pehla nasha

These are my favorite 90's songs 😭

Then 2000's

Piyu bole

Tu hi re

My dil goes hmm

👏🏻RHTDM👏🏻 THE WHOLE ALBUM IS MY SOUL EVEN THE RAIN SCENE FLUTE TUNES 😭😭😩😩😩💗💗💗💗

Suno na suno na

Main yahi hoon

Hosh walon ko khabar kya 😩🤌🏻

Kabhi khushi kabhi gam, the whole album 🤭💗

Falak tak

Lazy lamhe, ab to forever, hey shona, ladki kyu, chhalka, saathiyaan, chupke se 😭🤭💗

----NOW THE GOLDEN ERA OF BOLLYWOOD---

Starting with kk's songs : Tu hi meri shab hai, soniye, abhi abhi, beetain lamhe, dil ibaadat, kya mujhe pyaar hai, labon ko, tujhe sochta hoon, zara sa, haan tu hai, oh meri jaan, mat aazma , humko pyaar hua and more ☝🤓

Then Mohit chauhan : the whole ROCKSTAR album like hello?!?! Tujhe bhula diya , masakali, kuch khaas hai, khoya khoya, rabba, IS THIS LOVE, DOORIYAAN, bheegi si bhaagi si, abhi kuch dino se, TUMSE HI, tune jo na kaha and my ultimate fav PEE LOON

My fav artist kk, mohit chauhan, javed ali, sonu nigam, shreya ghoshal, monali thankur, nikita gandhi, sunidhi chauhan , MITRAZ, Vilen, darshan raval, arijit singh, jubin nautyal, asees kaur, shaan, neeti mohan, armaan malik, pritam, vishal shakher, ar rehman, ayushmaan khurana and so many more

Then all emraan haashmi songs 😭 pee loon, tuhi mera, hosaana, tum mile(the whole album 🔥) saibo, I hate love stories (whole album), ek break ke baad, uff teri aadat, hey yeah, tum tak, ranjhaana, rishte naate, paani da rang , soniyo(raaz), AASHIQI 2 WHOLE ALBUM 😩, tera hone laga tu, aajao tamanna, ek din teri raahon mai, hum tum, tere liye(prince), o bekhabar,, sawar loon, JAB TAK HAI JAAN 👺, allah maaf kare, rabba mai to marr gaya oye, mera mann, mann mera, baatein kuch ankahi si, tera chehra(adnan sami), MAULA MERE MAULA, deewana kar raha hai, oh my love, khyaalon mai, guzarish, tose naina, raabta, chori kya re, dagabaaz re, sanam re, gazab ka hai ye din, moh moh ke dhaage, ishq risk, ANJANA ANJAANI(THE WHOLE ALBUM ⚰️, ye tune kya kiya, halka halka, tere naina, ishq bulawa, THE BEST IKTARA, KYA KAROON, WAKE UP SID.

I have a whole sensual playlist romantic, sad, dance, I'M CRAZY ABOUT IT 😩😩😩😩

Even pops like "blam the nights, oh gujariyan, subha hone na de, lat lag gai, lucky boy(bachna ae haseeno is also a DOPE ALBUM🔥😩) , ladies vs ricky bahl, baand baja barat's ayyvien ayyvein, dum dum, aadha ishq, aa zara and so many 😭😭😭😭😭😭😭😭

And OF COURSE WE ARE FRIENDS NOW (moot is so weird for a hindi speaker me yk🤓)

[bunbunsheart]

got them applebelle jeans……boots with the….gay….whole club……asleep on a cake…..

hiii max. can we get a belle q&a. can i ask what an average day in the neighborhood looks like for belle…like does he go to the store often…does he visit any ppl…does he stay in his home all day in his studio watching paint dry (doing art)…. oh so importante…whats a day in the life of this silly sad artist…!

HAI NAAT and of courseeee smiles... i was actually thinking abt that the other day so i had to doodle the whole sequence i had imagined in my gay little braaaain

sooooo for starters belle loves to paint in the morning, it's his favorite time of the day to do so, since he and wally live together he also likes to join ^^ belle and wally love to paint together after all, it's like a sweet way to enjoy each other's company, although belle is a little insecure and shy of his artistic process so he makes sure that wally isn't looking at his canvas while he's painting (wally respects this of course... he is a polite fella)

in the afternoon he normally likes to nap... belle sleeps and naps a whole lot, like for almost half the day...! he has both chronic insomnia and chronic fatigue so he needs this to charge his battery pretty much, he sometimes even falls asleep in the middle of painting but it's okay wally is there to watch over him ^^ he likes to watch him sleep and belle likes that he's there whenever he wakes up, always at cuddle distance... so silley!

in the evening when he wakes up a little earlier than usual, julie likes to drag him to play with her and the rest of the neighbors :] sometimes he hangs out with both julie and frank :b he has a hard time keeping up with julie's energy but it's okaay he appreciates her efforts to keep him active regardless, also not pictured cause i was too lazy to draw it but he also likes to go to the store constantly to buy art supplies of course... he is very awful at puns and jokes but howdy appreciates his efforts to be funny so he gives him the paint supplies regardless...

at night finally when he and wally are alone together they like to do all sort of sweet little activities to past the time! since belle has insomnia it takes a whole lot for him to finally get tired and fall asleep but wally doesn't mind ^^ they sometimes bake, dance (belle taught him some moves...! wally is still a bit stiff with his dance moves but belle thinks is endearing) and sometimes they even paint some more... although belle's favorite activity is cuddling together, he could do that the whole day :] (likewise with wally, he never wants to let go... they're both awfully clingy)

[thehorrortree]

Deadline: January 30th, 2024 Payment: 8 cents per word for fiction, $50 per poem Theme: Character-focused, weird sword-and-sorcery: stories of a dark and transgressive nature, set in a secondary or historical-paranormal (“our” reality, but with a twist, if you will) world, What  We  Want Old Moon publishes character-focused, weird sword-and-sorcery: stories of a dark and transgressive nature, set in a secondary or historical-paranormal (“our” reality, but with a twist, if you will) world, with a focus on rounded characters undergoing some sort of conflict, resolved (though not always successfully!) by the might of their main or mind. ​ We love stories that combine that sense of action and adventure with well-rounded characters who make us question our own realities and perceptions. We love to see the gothic, the baroque, the eldritch, and we love to see it hit with an axe. Weird fiction and sword-and-sorcery can both be slippery terms. That is part of the fun! But, for our purposes we know it may help prospective writers if we list a series of authors and their stories we feel encompass (at least in part) what we love about the borderland of sword/sorcery and weird fiction: ​ Joe Abercrombie ("Three's a Crowd," "Yesterday, Near a Village Called Barden...") Laird Barron ("Oblivion Mode," "Ode to Jode the Toad") Leigh Brackett ("The Sea-Kings of Mars")  E.R. Eddison (The Worm Ouroboros) John R. Fultz ("Chivaine") Robert E. Howard ("The Shadow Kingdom," "Worms of the Earth") John Langan ("The Savage Angela in: The Beast in the Tunnels") Tanith Lee (Birthgrave, "Southern Lights") C.L. Moore ("The Black God's Kiss") Silvia Moreno-Garcia (The Return of the Sorcereress) Michael Shea (Nifft the Lean) Clark Ashton Smith ("The Charnel God," "Necromancy in Naat") E. Catherine Tobler ("The Living, Vengeant Stars, "And After the Fire, A Still Small Voice") Gene Wolfe ("Bloodsport") ​ The list could go on and on, of course, but we feel those provide a representative sample of the work we enjoy. We do not ask for pastiches of their work, but simply as examples of the diverse tones and forms weird fiction and sword/sorcery may take when at their best. Characters: We want defined, rounded characters who encounter and interact with conflict of some kind (preferably weird!) over the course of your story. ​ Narrative style: We’ve a broad taste in styles, from the poetic to the plain. Our preferred prose is vibrant yet readable. Particularly poetic prose can win us over, but it must always support the story itself. ​ Point-of-View: We prefer limited POVs: first-person and third-person limited, for example, but will accept any if done well. ​ Grammar: We tend to prefer works that stick to established rules of written English, though we understand the need to deviate for artistic purposes. ​ Originality: We want original works that speak with your authorial voice and flair. Though we love Lovecraftian works, for example, we are not necessarily all that enthused by straight pastiche.  ​ Setting: We prefer medieval and antique-adjacent settings, though we're not strict on that point. But in general, we prefer something either pre-gunpowder or early-gunpowder. It can either be a version of our own real world, or a constructed secondary world (or a combination thereof). ​ Extreme Content: We do not mind violence or sexual content, but we prefer it not be the sole or defining feature of a work. Gore for gore’s sake, extended torture scenes, depictions of extreme violence/conduct done to children, drawn-out erotic scenes and so forth are not right for our venue. ​ Fiction Submissions Guidelines ​ Length: 1000-6000 words. This is a hard limit, unfortunately. ​ Simultaneous Submissions: We do not accept them.  ​ Multiple Submissions: We do not accept them. Send only one story at a time, please, and only one story per submission window. ​ Reprints: We do not accept them at this time, unfortunately. ​ Language: English. ​ Rights: We purchase first world electronic rights and first-world print rights.

This means you cannot publish a story we buy as a first-run or “new” story anywhere else in the world; this means it can only be published elsewhere as a reprint, typically at a much lower rate.  ​ Payment: We pay 8c (0.08 USD) per word per short story. Payment occurs within 30 days of online publication, via PayPal. Poetry Submissions Guidelines ​ Subject Matter: We prefer our poems deal with the same subjects as our fiction: tales of eldritch war, images of strange melancholy, and moments of bloody reflection, among other things. ​ Exemplar poems: Our tastes run towards the antique. Some of our current favorites include John Milton's Paradise Lost, Algernon Swinburne's Tristram of Lyonesse, Robert Browning's "Childe Roland to the Dark Tower Came," and Charles Young's "Night-Thoughts." That being said, we are willing to be convinced by just about anything in verse, so long as it conforms to the aesthetic of our magazine. ​ Length: You may submit up to five poems, each of fifty lines or less. This is a hard limit, unfortunately. ​ Simultaneous Submissions: We do not accept them.  ​ Reprints: We do not accept them at this time, unfortunately. ​ Language: English. ​ Rights: We purchase first world electronic rights and first-world print rights. This means you cannot publish a poem we buy as a first-run or “new” poem anywhere else in the world; this means it can only be published elsewhere as a reprint, typically at a much lower rate.  ​ Payment: We pay $50 per poem. Payment occurs within 30 days of online publication, via PayPal. HOW TO SUBMIT Please send submissions as a .doc or .docx file to Old Moon's email: oldmoonpub@gmail.com Title your email "Submission: [title]." Provide a short, 1-2 line cover letter with the story's name and word count. Please do not provide an intro or synopsis of the story (we like to be surprised). ​ We'd appreciate if your manuscript was in something approaching "Standard Manuscript Format," as well. Via: Old Moon Publishing.

[ge]

🐌: huh... off topic but the part where you were talking about how cm was born (in your legend of hei au) reminds me of my rotbb (not self insert, not ship) oc's lore which i had based off on burmese buddhist folktales. ig the difference is that i had her be found in a hole of a plum blossom tree and she's considered that tree's daughter because in the burmese buddhist tradition, trees are considered to be another life form the way animals are to humans. more specifically, the older or bigger the tree is, the more likely there is a နတ် (naat) residing in that tree. technically you can consider a နတ် to be a guardian spirit because they do protect and purify the land they are on, plus they have very long lives (not immortal, they can die) since 100 human years is 1 day as a နတ်. and there's also a ranking system for them as well, the closer you are to the human realm the lower your rank and power as a နတ် is. so if someone were to chop down that plum blossom tree it's good-bye to my oc's mother lol. and like she's supposed to be a side character in my xreader fic, the bridge for the reader character and mt hua and im going to kill her off by burning her alive not from saving reader... oh no, that's too boring. she's burned alive on a mission and reader has to watch it all happen etc etc and since she was raised on mt hua values she's surprisingly calm in death and when reader themselves passes their spirit wanders into mt hua but not in the same timeline as my oc.

im sorry i went on a tangent lol i got excited to share the stuff i was cooking... i say that it's an xreader but i dont want to add romance... its icky to me for now... idk i just want to expand on the genres in xreaders in general (rotbb isnt the first fandom ive tried this on) because as much as i love xreader romance its becoming too saturated...? and if i want to read some world building fanfics all of them are related to a ship some way or another and uhhhh i have to make my own fics to scratch my own itch...

sorry for another tangent into ranting ahahah it's 9.30am and i just woke up 😭😭😭😭😭

oooh thats an interesting oc concept..i enjoy reading self inserts sometimes so if u ever wrote this id def be intrigued in reading it..

[thesufidotcom]

Nusrat Fateh Ali Khan's Legacy: Nusrat Fateh Ali Khan is widely regarded as one of the greatest qawwali singers of all time. He not only preserved the rich traditions of qawwali but also pushed the boundaries of the genre, experimenting with new styles and collaborating with artists from various musical backgrounds. His work continues to inspire and influence musicians even after his passing. Nusrat Fateh Ali Khan's music has had a profound impact on both Pakistani and international music scenes. His powerful vocals, improvisational skills, and ability to connect with listeners on a deep emotional level have left an indelible mark on the world of music. For Golden Voice of Nusrat Fateh Ali Khan (NFAK): Download Qawwali, Sufiana Kalaam, Hamd, Naat and Ghazal MP3 Songs click link: https://ift.tt/H0Y6RKE https://ift.tt/vR4Y7BM

[hadeschan]

item # K20F09

RARE Tagrut Tone, Nua Tagua, Ut Pong Buddha-khun, Luang Phu Paew, Wat Rang Man. A roll of lead alloy sheet engraved with cabalistic writings inside, stuffed with Buddhakhun (Power of Buddha) holy powder at both ends, wrapped with blue nylon string crochet case, and patch with a gold foil. Made by Luang Phu Paew of Wat Rang Man (Wat Pracha Rat Bamrung), Nakhon Pathom Province in BE 2550 (CE 2007).

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BEST FOR: Nang Nieow, a rock-hard skin that is completely impervious to damage with bludgeoning or piercing weapons. Kongkraphan Chatrie (it makes you invulnerable to all weapon attack), Klawklad Plodpai (it pushes you away from all danger), Maha-ut (it helps stop gun from shooting at you). Wealth Fetching, Maha Larp (it brings lucky wealth), Maha-ut (it stops gun from shooting at you), Metta Maha Niyom (it helps bring loving, caring, and kindness, and compassion from people all around you to you), Mahasanay (Magic Charm) it helps turn you to prince charming in the eyes of girls, Maha Larp (it brings Lucky Wealth / wealth fetching), and Kaa Kaai Dee (it helps tempt your customers to buy whatever you are selling, and it helps attract new customers and then keep them coming back. Ponggan Poot-pee pee-saat Kunsai Mondam Sa-niat jan-rai Sat Meepit (it helps ward off evil spirit, demon, bad ghost, bad omen, bad spell, curse, accursedness, black magic, misfortune, doom, and poisonous animals). It helps protect you from manipulators, backstabbers, and toxic people. This amulet would grant your wish to have glorious future in your career, business, with success plus wealth and prosperity. And this amulet has a tendency to draw positive energy.

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Tagrut

Tagrut is an early amulet worn by Thai men as necklace and as cord belt dated back over 800 years ago. Tagrut is usually made from sheet of metal or animal skin or bamboo or palm leaf inscribed with cabalistic writings, and then rolled as a tube.

Tagrut Tone (big Tagrut)

The Tagrut Tone refers to a big roll of metal sheet or other materials engraved with cabalistic writings inside. The Tagrut Tone is with the power of Nang Nieow, a rock-hard skin that is completely impervious to damage with bludgeoning or piercing weapons. Kongkraphan Chatrie (it makes you invulnerable to all weapon attack), Klawklad Plodpai (it pushes you away from all danger), Maha-ut (it helps stop gun from shooting at you). And Maha Am-naat (it provides Power of Authority to you). It helps make people who work under you follow your lead and encourage them to work hard for you, and it helps you have victory over your troubles.

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Pong Viset Ha Pragaan (5 kinds of Holy Powder)

A Pra Somdej amulet MUST contain Pong Viset Ha Pragaan (5 kinds of Holy Powder), and the Pong Viset Ha Pragaan is the COMPONENTS of the following 18 sacred materials:-

1)Din Sor Pong, marly limestone powder.

2)Poon Pleuak hoi, tabby is a type of concrete made by burning oyster shells to create lime, then mixing it with water, sand, ash and broken oyster shells.

3)Din Jet Phong, earth taken from 7 forests where deposit of salts and other minerals are. A mineral lick (also known as a salt lick) is a place where animals can go to lick essential mineral nutrients from a deposit of salts and other minerals. Din Jet Phong is believed to have the force of temptation and distraction.

4)Din Jet Ta, earth taken from 7 bus/boat/railways destination terminals. Thais believe that these areas filled with lovers’ mind power while waiting for one their love one to come homes.

5)Din Lak Muang Jet Lak, earth taken from 7 Holy City Pillars at Holy Pillar Shrines in Thailand that guarded by angels and devas. City Pillars are believed to accumulate the power/energy of protection, prosperity and abundance.

6)Kee Thoop Sai Tain Bucha Pra, joss stick ashes, and candle wicks after offering to Holy Buddha Statues.

7)Dok Galong, powder crushed from sundried snowy orchid tree flowers. The snowy orchid tree flower is believed to have the force of passion.

8)Yod Sawas, powder crushed from sundried young leaves of Guilandina bonduc, commonly known as grey nicker, nicker bean, fever nut or knicker nut. Yod Sawas is believed to have the force of passion and temptation.

9)Yod Ruck Son, powder crushed from sundried double crown flowers. Yod Ruck Son is believed to have the force of love and care.

10)Kee Klai Say-ma, powder crushed from stains, sundried mosses and lichens taken from important temple boundary marking stones. Kee Klai Say-ma is believed to accumulate energy of guarding angles.

11)Kee Klai Pratuu Wang, powder crushed from stains, sundried mosses and lichens taken from gates of the ancient Royal Palaces. Kee Klai Pratuu Wang is believed to accumulate energy of guarding angles.

12)Kee Klai Sao Ta-lung Chang-peuuak, powder crushed from stains, sundried mosses and lichens taken from Royal white elephant hitching Posts. Kee Klai Sao Ta-lung Chang-peuuak is believed to accumulate energy of Devas.

13)Ton Rat-cha-preuk, saw dust of Golden Shower Tree is believed to have force of auspicious omens.

14)Ton Chaiya Preuk, saw dust of Cassia javanica Tree, also known as Java cassia, pink shower, apple blossom tree and rainbow shower tree,  is believed to have force of auspicious omens.

15)Phu Ruam Jai, powder crushed from sundried Betel Vine leaves, those leaves were taken from engagement tray presented during a wedding ceremony to the bride’s parents. Phu Ruam Jai is believed to have power of family unity, support, relationship and happiness.

16)Phu Song Hang, powder crushed from sundried Wild Betel leaves that have double tips. Phu Song Hang is believed to have power of Metta Maha Niyom (gaining loving, caring, kindness and compassion from people all around).

17)Bor Nam Jet Ros, water taken from 7 wells, and water in each well has a taste and not all 7 wells taste the same. Taste is subjective and influenced by the water source, and minerals in them. Bor Nam Jet Ros is believed to have power of Pra Mae Kongka, the mythical Goddess of Water and Rivers.

18)Din Sor Viset or Sila Thikhun, powder of calcite stone, calcite is believed having the ability to amplify and cleanse energy, as well as clear and balance the chakras. It can also absorb and transform negative energy. Calcite is a crystal that calms the mind and enhances mental clarity, and it also connects the emotions with the intellect.

THE FIRST PROCESS (Sang Pong / the preparation of holy materials)

After 18 materials are crushed in fine powder, and then added holy powder, water from 7 wells, and plaster cement as binder. The resultant putty was then rolled into cylinders or slender sticks and dried. During the mixing process of these holy materials, the rituals were performed, the offerings were presented to Buddha, Holy Guru Monks, Devas, Masters (teachers), and holy spirits. The ceremonies were held in the temple buildings in front of the Principle Buddha Statue, and monks were saying sermons to invite Buddha, Holy Guru Monks, Devas, Masters (teachers), and holy spirits to bless on the holy powders. And the ritual of spirit possession is performed, a monk who roll the putty into cylinders or slender sticks his body will be controlled by holy spirits, ghosts of departed master or guru monk or devas.

THE SECOND PROCESS (Kiang Pong Lop Pong / drawing formulas of holy cabalistic writings, and then erase them).

After the sticks of powder are dried, then process of making Pong Viset Ha Pragaan begins. The monk will draw formulas of holy cabalistic writings on a chalkboard made of a sheet of mudstone. The formulas are written accordingly to the ancient scriptures, and while drawing them, the monk must say sermons and prayers to invite the power of Buddha, Devas, and holy ghosts of departed master or guru monk to accumulate their power in the molecule of the powder. At the end of each writing, monk will then erase the formulas of cabalistic writings, and keep the chalk dust in a container for further making Buddha amulets.

The Pong Viset Ha Pragaan must be made orderly, beginning with 1)Pong Pattamang, 2)Pong Itthijay, 3)Pong Maharaj, 4)Pong Buddhakhun, and 5)Pong Tri Nisinghe.

The first holy powder or the precursor to make Pong Viset Ha Pragaan is Pong Pattamang Holy Powder by drawing the formulas of Pattamang cabalistic writings with sermons and prayers. After the completion of Pong Pattamang Holy Powder, it will be divided into 2 parts, one as “Pong Pattamang”, and another one is for making of the next Pong Itthijay Holy Powder. Then returning to the first process of making the chalk sticks and then follow the second process to drawn Itthijay cabalistic writings with sermons and prayers, and keep repeating the processes for the next 3 holy powders.

THE POWER OF PONG VISET HA PRAGAAN (5 kinds of Holy Powders)

1)Pong Pattamang Holy Powder is believed to have magic power of Kongkraphan Chatrie (it makes you invulnerable to all weapon attack), Maha-ut (it stops gun from shooting at you), Kambang Longhon Hai-tua (it makes you invisible in the eyes of the enemies), and Ponggan Poot-pee pee-saat Kunsai Mondam Sat Meepit (it helps ward off evil spirit, demon, bad ghost, bad omen, bad spell, curse and black magic, and poisonous animals).

2)Pong Itthijay Holy Powder, it was made from Pong Pattamang believed to have magic power of Metta Maha Niyom (it helps bring loving, caring, and kindness, and compassion from people all around you to you), and curing and preventing all diseases.

3)Pong Maharaj Holy Powder, it was made from Pong Itthijay believed to have magic power of Klawklad Plodpai (it brings safety, and pushes you away from all danger), Metta Maha Niyom (it helps bring loving, caring, and kindness, and compassion from people all around you to you), and Ponggan Kunsai Mondam (it keeps you away from bad spell, curse and black magic).

4)Pong Buddhakhun Holy Powder, it was made from Pong Maharaj believed to have magic power of Metta Maha Niyom (it helps bring loving, caring, and kindness, and compassion from people all around you to you), Kambang Longhon Hai-tua (it makes you invisible in the eyes of the enemies), and Sador (it helps unlock all bad spells, and lift the curses).

5)Pong Tri Nisinghe Holy Powder, it was made from Pong Buddhakhun believed to have magic power of Metta Maha Niyom (it helps bring loving, caring, and kindness, and compassion from people all around you to you), Ponggan Poot-pee pee-saat Kunsai Mondam Sat Meepit (it helps ward off evil spirit, demon, bad ghost, bad omen, bad spell, curse and black magic, and poisonous animals). Klawklad Plodpai (it brings safety, and pushes you away from all danger), and curing and preventing all diseases.

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Luang Phu Paew of Wat Rang Man (Wat Pracha Rat Bamrung), Nakhon Prathom Province

Luang Phu Paew, born Paew Boonrat on October 7, BE 2466 (CE 1923) at Mooban Lak Met, Kamphaeng Saen, Nakhon Pathom Province, a rice farmer family. Paew had his primary education at Wat Nong Muang, at the age of 20, Paew ordained as Buddhist monk at Wat Nong Pla Lai, Nakhon Pathom Province. In BE 2497, Luang Phu Paew moved to Wat Sawang Chat Pracha Bamrung. And in the year BE 2502, Luang Phu Paew was promoted to the abbot of Wat Rang Man. Luang Phu Paew is a disciple of Luang Phor Wang of Wat Kamphaeng Saen, and the holy Luang Phor Ta of Wat Phaniang Taek. Luang Phu Paew is a today holy monk of Kamphaeng Saen District, Nakhon Pathom Province. Many of amulets made or blessed by Luang Phu Paew are the most wanted among youngsters of Kamphaeng Saen District, the amulets of Luang Phu Paew perform countless of miracles to save their lives. And the policemen stationed at Nakhon Pathom Province must wear one amulet of Luang Phu Paew for their own safety and protection. ………………………………………………..

DIMENSION: 7.50 cm long (3 inches) / 1.00 cm in diameter

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item # K20F09

Price: price upon request, pls PM and/or email us hadesamulet@protonmail.com

100% GENUINE WITH 365 DAYS FULL REFUND WARRANTY

Item location: Hong Kong, SAR

Ships to: Worldwide

Delivery: Estimated 7 days handling time after receipt of cleared payment. Please allow additional time if international delivery is subject to customs processing.

Shipping: FREE Thailandpost International registered mail. International items may be subject to customs processing and additional charges.

Payments: PayPal / Western Union / MoneyGram /maybank2u.com / DBS iBanking / Wechat Pay / Alipay / INSTAREM / PromptPay International / Remitly

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[strawberry-gigglepup]

I dunno why but half way through typing this i started reading in that supportive jersey mom voice and couldnt stop myself from typing like how she would talk so im going back and rewriting it all to be in that kind of voice.

Is anyone else gunna mention th'way he pops his hips t'the back n to the side ta make his butt look bigga? Oh and lets naat fuhgget that head tilt with the side eye, i see yoo benny, tryna act sly about bein so sassy. Oh the sun wuzzin yer eyes? Mhm suuure what's yer jawb again? Dontchu work fer sum fancy talk show? Ya know how to light yer shots hon, that was an intentional choice so ya could have an excuse. You can try to hide it all you want but we ALL know thatcha gay sweetiee. B'sides its ok ta admit yer a bawttum

this picture is so funny to me like the faggot radiating off this image is so warm i could heat my home… he literally went to home depot and bought the finest grade finnish wood 1x12 that cost at least $15 and then put it in a tiny plastic bag…. camp

[smqazi]

SHAMSHAD BEGUM-(Naat Recorded in 1935)-Muhammad Mustafaa Ke Naam Ko-[ My Fav ]

[blackbiobiotech]

The Role of PML RARA PCR Kits and Malaria Detection Kits in Advanced Molecular Diagnostics

Advancements in molecular interrogation have revolutionized the detection of hematologic malignancies and vector-borne diseases. Among the pivotal innovations are the PML RARA PCR Kit, PML RARA Quantitative Kit, and PML RARA RT PCR Kit, instrumental in identifying acute promyelocytic leukemia (APL) through precise gene fusion analysis. Similarly, the Malaria PCR Kit and Malaria Detection Kit provide unparalleled sensitivity in isolating Plasmodium species, ensuring targeted therapeutic interventions.

PML RARA Fusion: A Hallmark of APL

Acute promyelocytic leukemia, a distinct subset of acute myeloid leukemia, is characterized by the PML-RARA fusion gene, a consequence of chromosomal translocation t(15;17). This aberration disrupts normal hematopoiesis, leading to unchecked proliferation of promyelocytes. Early identification of this genetic anomaly is crucial, as targeted therapies such as all-trans retinoic acid (ATRA) and arsenic trioxide have transformed prognosis when implemented promptly.

The PML RARA PCR Kit enables precise detection of this fusion at the molecular level, offering clinicians definitive insights into disease status. By employing reverse transcription polymerase chain reaction (RT-PCR), the PML RARA RT PCR Kit amplifies specific transcripts, allowing differentiation between variant fusion isoforms—bcr1, bcr2, and bcr3. This stratification is indispensable for monitoring minimal residual disease (MRD) and guiding treatment adaptations.

Quantitative assessments further refine therapeutic decision-making. The PML RARA Quantitative Kit integrates real-time fluorescence-based amplification to track disease kinetics, ensuring dynamic response evaluation. Such refined molecular tools mitigate relapse risks by detecting subclinical disease burdens with remarkable precision.

Molecular Dissection of Malaria: A Paradigm Shift in Pathogen Detection

Malaria remains a formidable global health challenge, necessitating high-fidelity diagnostic modalities for effective case management. Traditional microscopy and rapid diagnostic tests (RDTs) often lack the necessary sensitivity, particularly in low-parasitemia conditions. Molecular assays, such as the Malaria PCR Kit, have emerged as gold-standard methodologies for definitive parasite detection.

The kit employs nucleic acid amplification techniques (NAATs) to identify Plasmodium DNA with unmatched specificity. Differentiation between Plasmodium falciparum, P. vivax, P. ovale, and P. malariae is pivotal in tailoring therapeutic regimens, as drug resistance profiles vary across species.

Moreover, the Malaria Detection Kit offers a streamlined workflow, enhancing rapid throughput in clinical and epidemiological applications. Multiplex real-time PCR formats enable simultaneous detection of multiple Plasmodium species, reducing diagnostic ambiguity. The unparalleled sensitivity of these molecular assays ensures accurate case identification, particularly in asymptomatic carriers contributing to silent transmission.

The Interplay of Molecular Diagnostics and Clinical Outcomes

Both PML RARA PCR-based assays and malaria molecular diagnostics exemplify the transformative impact of genetic and pathogen-specific detection. While hematologic malignancies demand rigorous genetic profiling, vector-borne infections necessitate rapid and definitive species differentiation to circumvent treatment failures.

By leveraging cutting-edge amplification platforms, these diagnostic kits refine disease surveillance, enable precision medicine, and mitigate morbidity. As molecular diagnostics continue to evolve, their integration into routine clinical workflows will redefine disease management, fostering a paradigm of targeted therapeutic interventions.

[nursingwriter]

Chlamydia Screening Focus Groups of Healthcare Providers My research focus is the study of Chlamydia trachomatis. I am interested in Chlamydia because it is the most prevalent bacterial sexually transmitted disease in the United States. Young adults have the highest rates of chlamydial infection and are at the highest risk for infection among all age groups. Yet, as a group, they do not use Chlamydia screening services. Why? Early diagnosis of Chlamydia is important, not only to minimize disease spread but also to prevent sequelae, including epididymitis, pelvic inflammatory, disease, ectopic pregnancy, infertility and chronic pelvic pain. Traditional Chlamydia testing procedures have served as another obstacle to early detection because collection of endocervical and urethral specimens is uncomfortable at best. Fortunately, the introduction of several nucleic acid amplification tests (NAATs) now makes it possible to detect Chlamydia noninvasively from male and female using a simple urine sample. My interest in increasing the participation of the gatekeepers, the medical profession in offering these screening programs to this age group by having focus groups address concerns and dispel misconceptions, and provide more information about Chlamydia to this population that is the highest risk. REVIEW OF THE LITERATURE Chlamydia is one of the most common sexually transmitted diseases in modern Western society. In the United States alone, there are about four million chlamydia infections annually. However, a disturbing amount of those infected with Chlamydia -- as many as fifty percent of the men infected, and three-quarters of the women infected -- are asymptomatic and do not know that they have this disease. (Dedius et al., 2005) Lack of symptoms, however, does not imply harmlessness. Complications range from infertility to blindness, and it is therefore vital that steps be taken to reduce the number of Chlamydia infections that remain undetected. Among women infected with Chlamydia, about fifty percent of them will develop pelvic inflammatory disease; Chlamydia causes between 250,000 to 500,000 cases of pelvic inflammatory disease every year in the United States alone. (Dedius et al., 2005) Pelvic inflammatory disease, or PID, is something of a catch-all phrase referring to an infection of the uterus, fallopian tubes, or ovaries. Up to ten percent of the total cases of PID are complications of Chlamydia, and PID itself is identifies as the leading cause of infertility. Thirteen percent of women that experience pelvic inflammatory disease will become infertile, and multiple infections increase this percentage. (Icarus et al., 2005) Sometimes, PID does not show any symptoms, however some of the common symptoms are fever, tenderness of the cervix, abdominal pain, abnormal vaginal discharge, pain during intercourse, and irregular menstrual bleeding. Even without the presence of these symptoms, PID may still cause permanent damage, including scarring of the reproductive tissues, which may cause problems such as chronic pelvic pain, ectopic pregnancy, or other reproductive problems. Women face a particular danger if they are infected with Chlamydia during pregnancy, or if they become pregnant while infected. It is estimated that half of all infants born to mothers with this disease will be affected by it. Chlamydia can cause spontaneous abortion (or miscarriage), premature birth, blindness, and pneumonia in the child. Avoiding vaginal birth can significantly reduce the risk of transmission during birth, however the child may still be affected. While men do not (and cannot) suffer from PID, other diseases may be caused by Chlamydia that can also cause sterility and other long-term problems. One such disease is epididymitis, which is an inflammation of the epididymis, which is likely to occur if Chlamydia spreads to the testicles. Another condition which is particularly problematic for young men infected with Chlamydia is Reiter's Syndrome. Reiter's syndrome is identified by three symptoms: inflammatory arthritis of large joints, inflammation of the eyes, and arthritis. Chlamydia is among the most common bacterial infections that will cause Reiter's syndrome. (YurikBot et al., 2005) Fifty percent or more of men with Reiter's syndrome will develop eye problems and/or blindness, and up to forty percent of men will develop penile lesions. Additionally, the Chlamydia bacteria will cause Trachoma, an eye disease which causes ulceration and scarring of the cornea. This is the leading cause of blindness worldwide and afflicts as many as 400 million people, although it is rare in the United States. (Arcadian et al., 2005) With or without the presence of pelvic inflammatory disease or other secondary diseases, Chlamydia may be with or without noticeable symptoms. If symptoms do occur, they may include, in women, vaginal discharge of an abnormal color or with an unusual smell, pain in the abdomen and reproductive regions, painful urination, and/or the urge to urinate more often than usual. In men, if symptoms do occur, chlamydia may cause painful or burning urination, unusual discharge from the penis, swollen or tender testicles, and/or fever. (Dedius et al., 2005) The Chlamydia infection is caused by bacteria. The Chlamydia trachomatis is a species of the chlamydiae, a group of obligately intracellular bacteria. This bacteria replicates within cells, then bursts out of the cell membrane to spread the infection to other cells. This is one of the smallest bacteria, as tiny as 500nm wide. (Grosse et al., 2005) Additionally, they cannot be cultured outside of host cells because of the intracellular nature. Due to these factors regarding the Chlamydia trachomatis bacteria, research has faced many challenges. Fortunately, this very common sexually transmitted disease can be effectively treated and cured with simple antibiotics, which is not the case with some common STDs. Unfortunately, large numbers of infected patients do not realize they have Chlamydia, and screening for this disease is lacking in many ways. People do not realize how important it is to get tested for Chlamydia, and there are a vast array of misconceptions and misunderstandings about this infection. Doctors are limited by patient concerns, financial issues, lack of education, and many other unfortunate factors. Education, screening, and proper treatment are vital in curbing the occurrences of Chlamydia. According to the U.S. Preventitive Services Task Force (USPSTF), sexually active women up to twenty-five years of age should be routinely screened for Chlamydia trachomatis. The American Family Physician article "Recommendations on screening for Chlamydia" (Morantz, 2003), rates of infection vary greatly among different communities and populations. Infection is the most common among females under twenty-one years of age, however it is also extremely prevalent among women up to twenty-five years of age. Women over the age of twenty-five are also at risk, however some sources such as this one recommend screening only if particular risk factors occur, such as not using condoms all of the time, having new or many sexual partners, or a history of sexually transmitted diseases. Screening pregnant women is also necessary, because of the danger posed to the unborn child. This article reveals that the optimal timing for screening pregnant women is not known, and that early screening may help improve outcomes such as low birth weight and premature delivery, while screening in the third trimester may be more effective in preventing the transmission of the infection to the child during childbirth. Additionally, this article reveals that the ideal time between screenings (which have negative results) is not known, and that risk factors such as age and sexual behavior should be taken into consideration. This article is clear that screening is recommended and that Chlamydia is a threat, however in this source several of the problematic attitudes which may be interfering with proper screening practices. Automatic screening for Chlamydia is not recommended by the USPSTF, but rather many risk factors are recommended for consideration before deciding to screen for the infection. Additionally, if there are benefits to both early and late screening during pregnancy, it would be logical to recommend screening twice during pregnancy as an automatic part of prenatal care. According to the British Medical Journal article "Screening for genital chlamydial infection - Evidence-Based Health Policy Report" (Pimenta, 2000), there are serious consequences for an inadequate sexual and reproductive health care system. The United Kingdom developed an integrated strategy on sexual health in response to these concerns. This report found that in the 1990's, there was a significant rise in the occurrence of Chlamydia infections among females between sixteen and nineteen years of age, and among males between twenty and twenty-four years of age. Women attending clinics to have an abortion were also found to have higher rates of infection than samples from the general public. Professional awareness of the disease is rising, however it is not sufficient to curb the danger, and vast quantities of infected individuals remain untreated. This article additionally addresses the questions of whether screening itself is effective, and how to determine the costs and benefits of different screening procedures. A study conducted in Wisconsin from 1986 to 1990 confirmed that screening for Chlamydia lowered the incidents of pelvic inflammatory disease. (Pimenta, 2000) The proposal discussed in this article suggested a focus on opportunistic screening, such as screening females only when they are attending certain types of clinics. Again, the concern of keeping cost low is suggesting severe limitations on screening of women, and even stricter limitations on screening men. This proposed program does suggest the use of less invasive tests, as well as providing continued education and support for patients. Some doctors involved in this pilot study expressed concerns that STD testing may affect insurance premiums, and while most health insurance companies will omit specific questions about STDs, this concern is relevant; various insurance-related complications are a significant obstacle to screening and treating Chlamydia. (Pimenta, 2000) According to the Morbidity and Mortality Weekly Report article "Chlamydia screening among sexually active young female enrollees of health plans -- United States, 1999-2001" (Shih, 2004), there is further evidence that screening is beneficial, but that screening methods currently in use are not effective enough. Up to fourteen percent of young women who are routinely screened for Chlamydia are found to be infected, which proves the need for further screening to be done. Many groups, including the CDC and the U.S. Preventive Services Task Force, as well as many clinical organizations, have recommended routine screening for Chlamydia for young sexually active women, as well as all pregnant women. Studies found that despite these recommendations, as well as an increase in coverage by commercial and Medicaid health insurance plans, data from this two-year period found Chlamydia screening rates remained very low. "Increased screening by healthcare providers and coverage of screening by health plans will be necessary to reduce substantially the burden of chlamydial infection in the United States." (Shih, 2004) Health care alone is not enough to prevent Chlamydia infection if screening specifically for the disease is not done. According to the Perspectives on Sexual and Reproductive Health article "Gonorrhea and chlamydia infection among women visiting family planning clinics: racial variation in prevalence and predictors" (Einwalter, 2005), the prevalence of Chlamydia infection in different populations must be taken into consideration in order to ensure that the most at-risk patients consistently receive screening. Considering patient populations that attend STD clinics alone is not sufficient; at-risk populations in all clinical settings must be screened. Previous studies did not provide information regarding ethnicity as a determining factor of risk, however this study revealed that rates of Chlamydia infection are higher among African-American populations and other minorities. This study, however, did not provide evidence from a broad enough sampling, and the reasons for higher rates among the Black population were not clear. White women seemed most at-risk when having contact with a new sexual partner, while among Black women, being under twenty-one years of age appeared to be the cause of the most risk. (Einwalter, 2005) This data is not conclusive, and race certainly should not be used to exclude patients from screening because of an assumption that they are not "at-risk." However, using this preliminary data to ensure that groups which may be at the most risk are screened thoroughly and provided with information. Screening is not a simple subject to broach with at-risk groups. "Improving Chlamydia Screening Programs" from the American Family Physician (Miller, 2004) identifies some of the obstacles that prevent the most at-risk group -- teenagers and young adults -- from getting screened. "These obstacles include lack of health insurance and a regular health care source, fear of the traditional chlamydia testing methods and results of tests for sexually transmitted diseases (STDs), and concern that others might discover that they were tested." (Miller, 2004) This study interviewed people from fifteen to twenty-four years of age, which revealed a lot of misinformation. Participants recommended that educational material be more easily accessible, make testing simple and less invasive, and to make the entire process more confidential. "Limitations of screening tests for asymptomatic Chlamydia" (Miller, 2005) identifies the importance of finding the least invasive testing methods. Nucleic acid amplification tests can detect the bacteria on secretions and urine samples, however there were different levels of effectiveness found among nine different tests available for screening. Combining testing methods improved accuracy, and the accuracy levels of different tests must be taken into consideration. There are many psychosocial implications to keep in mind when implementing screening for Chlamydia. In the British Medical Journal article "Qualitative analysis of psychosocial impact of diagnosis of Chlamydia trachomatis: implications for screening" (Duncan, 2001) Interviews with women recently diagnosed with chlamydia revealed many of the same concerns that others have expressed regarding screening. "Three themes were identified: perceptions of stigma associated with sexually transmitted infection, uncertainty about reproductive health after diagnosis, and anxieties regarding partner's reaction to diagnosis." (Duncan, 2001) These women revealed that stereotypes about who is "at-risk" for Chlamydia prevented them from finding information about STDs to be personally relevant. This is one reason that only screening women who appear to be at-risk is a dangerous way to approach screening methods. Because these women believed that only "other" sorts of women got STDs, they feared a negative reaction from others. Education should focus on the prevalence of this disease among people of all classes, races, and groups of people, and help "normalize" getting STDs so that there will be less anxiety. Additionally, screening for Chlamydia in men must be combined with education that normalizes STDs for men. There is a tendency to associate certain STDs, such as Chlamydia, with women only. "Sexuality and health: the hidden costs of screening for Chlamydia trachomatis" from the British Medical Journal (Duncan, 1999) identifies that screening women for chlamydia, but not men, minimizes men's responsibility for sexual and reproductive health. "Women have feelings of "contamination" reduced attractiveness, and sexual dysfunction and that a positive test result is associated with promiscuity." (Duncan, 1999) Furthering gender inequalities, social divisions, and misconceptions about sexually transmitted diseases is an unfortunate consequence of the way in which most screening programs are approached. In fact, many physicians simply do not screen for Chlamydia because they are "worried about backlash in the community." (Many HMO Docs, 2000) Self-reporting screening criteria is simply not effective. In order to reduce many of the stressing factors of Chlamydia screening, anonymous home-testing was done with a sample of teenagers in a report found in the British Medical Journal. (Ostergaard, 1998) Responses to this way of testing were very positive, because the home tests were far less invasive than a vaginal swab or other testing method done in the office. While many health care workers are failing at providing adequate education, screening, and treatment for Chlamydia, some are already putting forth excellent effort. For example, the Kaiser Permanente medical group has worked closely with the CDC to improve screening and treatment. (PRNewswire, 2005) "When we thought about changes in how we do this screening at Kaiser Permanente, we decided to keep it straightforward. For instance, the clinical assistants in our OB/GYN department now set out a chlamydia test along with any Pap test, so it's effortless for our physicians." (PRNewswire, 2005) Kaiser Permanente also provides training for health care workers. Due to their increased standards, there was a very significant increase in the number of screenings -- forty-two percent in the OB/GYN departments -- , and there has been a ten percent increase in the number of diagnoses. Health care costs attributed to chlamydia exceeds $3.5 billion per year in the United States, however proper screening and treatment will actually reduce these costs, not increase them, because it is easy and inexpensive to treat the disease with antibiotics if it is caught early. However, many health care workers are not aware of current screening methods, treatment methods, or the benefits of proper care. RESEARCH QUESTIONS It is apparent that screening for Chlamydia is the key to preventing high rates of morbidity from this infection. However, screening is not widespread or common enough, and health care workers seem to not have access to the latest information on screening methods. The proposed study will attempt to answer the following questions: 1. Can we increase the diagnosis and treatment of chlamydia with the new urine-based tests? 2. Why don't healthcare providers use these tests or offer these tests more often? RESEARCH DESIGN AND RATIONALE This research will be conducted with a wide focus group, so as to achieve the most accurate results. Use focus groups of high medium and low testers. Include high, middle and lower income clinic healthcare professionals. WORKS CITED Arcadian, et al. (2005, September 4) Trachoma. Wikipedia. http://en.wikipedia.org/wiki/Trachoma Decius, et al. (2005, October 2) Chlamydia. Wikipedia. http://en.wikipedia.org/wiki/Chlamydia Duncan, B. (2001, January 27) Qualitative analysis of psychosocial impact of diagnosis of Chlamydia trachomatis: implications for screening. British Medical Journal. http://findarticles.com/p/articles/mi_m0999/is_7280_322/ai_70634425/print Duncan, B. (1999, April 3) Sexuality and health: the hidden costs of screening for Chlamydia trachomatis. British Medical Journal. http://findarticles.com/p/articles/mi_m0999/is_7188_318/ai_54514754/print Einwalter, L.A. (2005, September) Gonorrhea and chlamydia infection among women visiting family planning clinics: racial variation in prevalence and predictors. Perspectives on Sexual and Reproductive Health. Read the full article