bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative assessment of CDS, CLSI disc diffusion and Etest techniques for antimicrobial susceptibility testing ofNeisseria gonorrhoeae: a 6-year study
Authors: Singh Vikram , Bala Manju , Kakran Monika , Ramesh V 
Published: July 2012

BackgroundA variety of techniques are available for antimicrobial susceptibility testing ofNeisseria gonorrhoeae.ObjectiveThe aim of this study was to find a cost-effective, reliable and easily applicable microbiological method to detect antimicrobial susceptibilities ofN. gonorrhoeaein resource-poor countries.DesignProspective study.SettingMale and female STD clinic of Regional STD Teaching, Training and Research Centre, New Delhi, India.ParticipantsN. gonorrhoeaeisolates from all male and female patients presenting with acute gonococcal urethritis and cervical discharge.Material and methodsA total of 295 consecutiveN. gonorrhoeaeisolates during 2005–2010 was used to compare the Clinical and Laboratory Standards Institute (CLSI) and CDS disc diffusion technique with Etest by performing antimicrobial susceptibility testing in parallel for penicillin, tetracycline, ceftriaxone, ciprofloxacin and spectinomycin. WHO reference strains were used as controls.ResultsCDS disc diffusion zones of inhibition showed that complete percentage agreement for penicillin, ciprofloxacin and tetracycline was high with their analogous Etest minimal inhibitory concentrations in comparison to CLSI disc diffusion technique, that is, 91.5%, 92.9% and 99.3% versus 87.5%, 88.5% and 74.9%, respectively. CDS results had less number of major and minor category discrepancies in comparison to CLSI and CDS method showed excellent correlation coefficient (r=1) with Etest for all five antimicrobial agents tested in comparison to CLSI (r=0.92). It was very poor (r=0.61) by CLSI method for tetracycline. The correlation coefficients between the two methods and the Etest were identical if tetracycline was removed from the CLSI analysis.ConclusionsThe CDS technique is an attractive alternative forN. gonorrhoeaesusceptibility testing and is recommended for monitoring the antimicrobial susceptibility in less developed and resource-poor settings to facilitate enhanced antimicrobial resistance surveillance when the WHO Gonococcal Antimicrobial Surveillance Programme is undergoing expansion to meet the ongoing challenges of surveillance and control of gonococcal antimicrobial resistance.
Human semen quality in the new millennium: a prospective cross-sectional population-based study of 4867 men
Authors: Jørgensen Niels , Joensen Ulla Nordström , Jensen Tina Kold , Jensen Martin Blomberg , Almstrup Kristian , Olesen Inge Ahlmann , Juul Anders , Andersson Anna-Maria , Carlsen Elisabeth , Petersen Jørgen Holm , Toppari Jorma , Skakkebæk Niels E 
Published: July 2012

ObjectivesConsiderable interest and controversy over a possible decline in semen quality during the 20th century raised concern that semen quality could have reached a critically low level where it might affect human reproduction. The authors therefore initiated a study to assess reproductive health in men from the general population and to monitor changes in semen quality over time.DesignCross-sectional study of men from the general Danish population. Inclusion criteria were place of residence in the Copenhagen area, and both the man and his mother being born and raised in Denmark. Men with severe or chronic diseases were not included.SettingDanish one-centre study.Participants4867 men, median age 19 years, included from 1996 to 2010.Outcome measuresSemen volume, sperm concentration, total sperm count, sperm motility and sperm morphology.ResultsOnly 23% of participants had optimal sperm concentration and sperm morphology. Comparing with historic data of men attending a Copenhagen infertility clinic in the 1940s and men who recently became fathers, these two groups had significantly better semen quality than our study group from the general population. Over the 15 years, median sperm concentration increased from 43 to 48 million/ml (p=0.02) and total sperm count from 132 to 151 million (p=0.001). The median percentage of motile spermatozoa and abnormal spermatozoa were 68% and 93%, and did not change during the study period.ConclusionsThis large prospective study of semen quality among young men of the general population showed an increasing trend in sperm concentration and total sperm count. However, only one in four men had optimal semen quality. In addition, one in four will most likely face a prolonged waiting time to pregnancy if they in the future want to father a child and another 15% are at risk of the need of fertility treatment. Thus, reduced semen quality seems so frequent that it may impair the fertility rates and further increase the demand for assisted reproduction.
An investigation of the effects of the common cold on simulated driving performance and detection of collisions: a laboratory study
Authors: Smith Andrew Paul , Jamson Samantha 
Published: July 2012

ObjectiveThe aim of the present research was to investigate whether individuals with a common cold showed impaired ability on a simulated driving task and the ability to detect potential collisions between moving objects.DesignThe study involved comparison of a healthy group with a group with colds. These scores were adjusted for individual differences by collecting further data when both groups were healthy and using these scores as covariates. On both occasions, volunteers rated their symptoms and carried out a simulated driving session. On the first occasion, volunteers also carried out a collision detection task.SettingUniversity of Leeds Institute for Transport Studies.SampleTwenty-five students from the University of Leeds. Ten volunteers were healthy on both occasions and 15 had a cold on the first session and were healthy on the second.Main outcome measuresIn the collision detection task, the main outcomes were correct detections and response to a secondary identification task. In the simulated driving task, the outcomes were speed, lateral control, gap acceptance, overtaking behaviour, car following, vigilance and traffic light violations.ResultsThose with a cold detected fewer collisions and had a higher divided attention error than those who were healthy. Many basic driving skills were unimpaired by the illness. However, those with a cold were slower at responding to unexpected events and spent a greater percentage of time driving at a headway of <2 s.ConclusionsThe finding that having a common cold is associated with reduced ability to detect collisions and respond quickly to unexpected events is of practical importance. Further research is now required to examine the efficacy of information campaigns and countermeasures such as caffeine.
Views of policymakers, healthcare workers and NGOs on HIV pre-exposure prophylaxis (PrEP): a multinational qualitative study
Authors: Wheelock Ana , Eisingerich Andreas B , Gomez Gabriela B , Gray Emily , Dybul Mark R , Piot Peter 
Published: July 2012

ObjectivesTo examine policymakers and providers' views on pre-exposure prophylaxis (PrEP) and their willingness to support its introduction, to inform policy and practice in this emerging field.DesignSemistructured qualitative interview study.SettingPeru, Ukraine, India, Kenya, Uganda, Botswana and South Africa.Participants35 policymakers, 35 healthcare workers and 21 non-governmental organisation representatives involved in HIV prevention.ResultsSix themes emerged from the data: (1) perceived HIV prevention landscape: prevention initiatives needed to be improved and expanded; (2) PrEP awareness: 50 of 91 participants had heard of PrEP; (3) benefits of PrEP: one component of the combination prevention arsenal that could help prioritise HIV prevention, empower key populations and result in economic gains; (4) challenges of PrEP: regimen complexity, cost and cost-effectiveness, risk compensation, efficacy and effectiveness, stigmatisation and criminalisation, information and training and healthcare system capacity; (5) programmatic considerations: user eligibility, communication strategy, cost, distribution, medication and HIV testing compliance and (6) early versus late implementation: participants were divided as to whether they would support an early introduction of PrEP in their country or would prefer to wait until it has been successfully implemented in other countries, with around half of those we spoke to supporting each option. Very few said they would not support PrEP at all.ConclusionsDespite the multiple challenges identified, there was general willingness to support the introduction of PrEP. Yet, strengthening existing HIV prevention efforts was also deemed necessary. Our results suggest that an effective PrEP programme would be delivered in healthcare facilities and involve non-governmental organisations and the community and consider the needs of mobile populations. Comprehensive information packages and training for users and providers would be critical. The cost of PrEP would be affordable and possibly segmented. Extensive counselling and innovative monitoring measures ought to be considered.
Touch screen computer health assessment in Australian general practice patients: a cross-sectional study protocol
Authors: Yoong Sze Lin , Carey Mariko Leanne , Sanson-Fisher Robert William , Russell Grant , Mazza Danielle , Makeham Meredith , Paul Christine Louise , Inder Kerry Jane , D'Este Catherine 
Published: July 2012

IntroductionCardiovascular disease (CVD) and cancer are leading causes of death globally. Early detection of cancer and risk factors for CVD may improve health outcomes and reduce mortality. General practitioners (GPs) are accessed by the majority of the population and play a key role in the prevention and early detection of chronic disease risk factors. This cross-sectional study aims to assess the acceptability of an electronic method of data collection in general practice patients. The study will describe the proportion screened in line with guidelines for CVD risk factors and cancer as well as report the prevalence of depression, lifestyle risk factors, level of provision of preconception care, cervical cancer vaccination and bone density testing. Lastly, the study will assess the level of agreement between GPs and patients perception regarding presence of risk factors and screening.Methods and analysisThe study has been designed to maximise recruitment of GPs by including practitioners in the research team, minimising participation burden on GPs and offering remuneration for participation. Patient recruitment will be carried out by a research assistant located in general practice waiting rooms. Participants will be asked regarding the acceptability of the touch screen computer and to report on a range of health risk and preventive behaviours using the touch screen computer. GPs will complete a one-page survey indicating their perception of the presence of risk behaviours in their patients. Descriptive statistics will be generated to describe the acceptability of the touch screen and prevalence of health risk behaviours. Cohen's κ will be used to assess agreement between GP and patient perception of presence of health risk behaviours.Ethics and disseminationThis study has been approved by the human research committees in participating universities. Findings will be disseminated via peer-reviewed publications, conference presentations as well as practice summaries provided to participating practices.
A randomised controlled trial evaluating a rehabilitation complex intervention for patients following intensive care discharge: the RECOVER study
Authors: Walsh Timothy Simon , Salisbury Lisa G , Boyd Julia , Ramsay Pamela , Merriweather Judith , Huby Guro , Forbes John , Rattray Janice Z , Griffith David M , Mackenzie Simon J , Hull Alastair , Lewis Steff , Murray Gordon D 
Published: July 2012

IntroductionPatients who survive an intensive care unit admission frequently suffer physical and psychological morbidity for many months after discharge. Current rehabilitation pathways are often fragmented and little is known about the optimum method of promoting recovery. Many patients suffer reduced quality of life.Methods and analysisThe authors plan a multicentre randomised parallel group complex intervention trial with concealment of group allocation from outcome assessors. Patients who required more than 48 h of mechanical ventilation and are deemed fit for intensive care unit discharge will be eligible. Patients with primary neurological diagnoses will be excluded. Participants will be randomised into one of the two groups: the intervention group will receive standard ward-based care delivered by the NHS service with additional treatment by a specifically trained generic rehabilitation assistant during ward stay and via telephone contact after hospital discharge and the control group will receive standard ward-based care delivered by the current NHS service. The intervention group will also receive additional information about their critical illness and access to a critical care physician. The total duration of the intervention will be from randomisation to 3 months postrandomisation. The total duration of follow-up will be 12 months from randomisation for both groups. The primary outcome will be the Rivermead Mobility Index at 3 months. Secondary outcomes will include measures of physical and psychological morbidity and function, quality of life and survival over a 12-month period. A health economic evaluation will also be undertaken. Groups will be compared in relation to primary and secondary outcomes; quantitative analyses will be supplemented by focus groups with patients, carers and healthcare workers.Ethics and disseminationConsent will be obtained from patients and relatives according to patient capacity. Data will be analysed according to a predefined analysis plan.Trial registrationThe trial is registered asISRCTN09412438and funded by the Chief Scientist Office, Scotland.
Understanding integrated care pathways in palliative care using realist evaluation: a mixed methods study protocol
Authors: Dalkin Sonia Michelle , Jones Diana , Lhussier Monique , Cunningham Bill 
Published: July 2012

IntroductionPolicy- and evidence-based guidelines have highlighted the need for improved palliative and end-of-life care. However, there is still evidence of individuals dying undignified deaths with little pain control, therefore inflicting unnecessary suffering. New commissioning powers have enabled a 2-year pilot of an innovative integrated care pathway (ICP) designed to improve arrangements for individuals with life-limiting illnesses requiring palliative care. A novel feature of the ICP is its focus on palliative care over the last 6 months of life, aiming to intervene early to prepare for and ensure a good death. What is not known is if this pathway works, how it works and who it works for.Methods and analysisA realist evaluation and a complex analytical framework will investigate and discover context, mechanism and outcome conjectures and configurations of the ICP and thus facilitate exploration of how it works and who it works for. A mixed methods approach will be used with small sample sizes to capture the breadth of the ICP. Phase 1 will identify if the pathway works through analysis of NHS MorbidityInformation Query and Export Syntax data, locality Death Audit data and the Quality of Dying and Death Questionnaire. Phase 2 employs soft systems methodology with data from focus groups with health professionals to identify how the pathway works. Phase 3 uses the Miller Behavioural Style Scale and interviews with palliative care patients and bereaved relatives to analyse communication in palliative care.Ethics and disseminationEthical approval has been granted from the NHS local ethics committee (REC reference number:11/NE/0318). Research & Development approval has been gained from four different trusts, and relevant voluntary organisations and the local council have been informed about the research. This protocol illustrates the complexity inherent in evaluating a palliative care ICP. Identification of whether the pathway works, how it works and who it works for will be beneficial to all practices and other care providers involved as it will give objective data on the impact of the ICP. Results will be disseminated throughout the study for continuous quality improvement of the ICP. Outcomes from each data collection phase will be disseminated separately if analysis warrants it; all data collection will be utilised in the realist evaluation. The research provides a potential for the dissemination of the pathway to other localities through the transferable knowledge it will generate, from its focus on the contexts that are crucial for successful implementation, the mechanisms that facilitate implementation and the outcomes achieved.
Documentation of neurovascular status in supracondylar fractures and the development of an assessment proforma
Authors: Mayne Alistair Ivan William , Perry Daniel C , Stables Gareth , Dhotare Satish , Bruce Colin E 
Published: July 2012

BackgroundSupracondylar fractures are associated with a high incidence of neurovascular complications. Comprehensive clinical evaluation is a necessity when children with these injuries present to the emergency department. Neurovascular assessment can be difficult due to pain, anxiety and the young age of these patients; however, it is crucial findings are well documented to identify patients requiring urgent surgical intervention, in addition to allowing the neurovascular status to be monitored over time. The aim of this study was to evaluate the preoperative neurovascular documentation in children presenting with displaced supracondylar fractures and devise an emergency department assessment proforma to facilitate comprehensive evaluation.MethodsA retrospective case-note review was performed on patients with Gartland grades 2 and 3 supracondylar fractures observed in a 2-year period from July 2008 to July 2010.Results137 patients were included; only 12 patients (8.8%) and 19 patients (13.9%), respectively, had a complete preoperative neurological or vascular assessment documented. Regarding the individual nerves, 59 (43.1%) patients had median nerve integrity documented, 55 (40.1%) ulnar nerve and 49 (35.8%) radial nerve integrity documented. Only 18 patients (13.1%) had their anterior interosseous nerve (AIN) function documented.ConclusionsPreoperative documentation of neurovascular status in children with displaced supracondylar fractures was poor. Documentation of AIN examination was particularly poor. The introduction of a proforma (Liverpool upper limb fracture assessment) is proposed to increase documentation of neurovascular assessment and optimise emergency department evaluation of children presenting with upper limb injuries.
Humanisation in the emergency department of an Italian hospital: new features and patient satisfaction
Authors: Lovato Emanuela , Minniti Davide , Giacometti Marika , Sacco Roberto , Piolatto Alberto , Barberis Bruno , Papalia Riccardo , Bert Fabrizio , Siliquini Roberta 
Published: July 2012

ObjectivesThe goal of this study was to describe and analyse interventions performed in the emergency department (ED) of an Italian hospital with the aim of humanising the patient care pathway. The actions taken are described and the changes analysed to determine whether they resulted in an increased level of patient satisfaction.MethodsAn observational study was conducted between October 2010 and March 2011. The data were collected via a telephone questionnaire administered to patients who were admitted to the ED before and after humanisation interventions. The respondents were questioned about their general condition and their level of satisfaction.ResultsThe study population included 297 patients (158 before and 139 after the interventions). The highest overall patient satisfaction after the interventions was highly correlated with the humanisation interventions and not with other factors such as gender, age, educational level or the severity code triage. Specifically, in patients who went to the ED after the changes had been made, there was a greater level of satisfaction regarding comfort in the waiting room, waiting time for the first visit and the privacy experienced during the triage.ConclusionThe results demonstrate that the interventions implemented in this study, designed to humanise the ED, improved overall patient satisfaction. Interventions may be taken to reduce the depersonalisation of patients in the emergency room.
Does social capital affect the incidence of functional disability in older Japanese? A prospective population-based cohort study
Authors: Aida Jun , Kondo Katsunori , Kawachi Ichiro , Subramanian S V , Ichida Yukinobu , Hirai Hiroshi , Kondo Naoki , Osaka Ken , Sheiham Aubrey , Tsakos Georgios , Watt Richard G 
Published: July 2012

BackgroundRecent increases in numbers of older people have been accompanied by increases in those with functional disability. No study has examined the association between community social capital and the onset of functional disability.MethodsThe association between community social capital and the onset of functional disability was examined using data from the Aichi Gerontological Evaluation Study, a prospective cohort established in 2003 in Japan. Perceptions of community social capital (indicators of social cohesion such as trust of others and extent of social participation) in 6953 men and 7636 women aged 65 years or older were surveyed. Multilevel survival analysis using the discrete-time hazard model was applied.ResultsDuring 4-year follow-up, onset of functional disability occurred in 759 men and 1146 women. Women living in communities with higher mistrust had 1.68 (95% CI 1.14 to 2.49) times higher OR of onset of disability, even after adjusting for covariates. Mediators did not substantially change this association. Lack of social participation seemed to affect the health of women, though the effect was marginal (OR for covariates adjusted model =1.12 (95% CI 0.96 to 1.31)). There were no significant ORs among men.ConclusionsLower community social capital was associated with higher incidence of onset of functional disability among older women but not among men. Community-based interventions to promote social capital may be useful for preventing functional disability of older Japanese women.