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Abstract
W ith the advent of the Controls Assurance Standards (NHS Executive, 1999), Clinical Governance (1999), The Management and Control of Hospital Acquired Infections in Acute NHS Trusts in England (Department of Health, 2000) and other circulars and directives, the role of the infection control nurse has never been so challenging, putting infection control firmly on the government and public agenda. In line with this and the Health Service Circular 1999/217 Nurse Midwife and Health Visitor Consultants (Department of Health, 1999), it enabled the appointment of a nurse consultant in infection control at University Hospital Aintree, Liverpool. This paper will review the background to the development of the role to date, how it applies to the discipline of infection control and suggest how to take the role forward in the future.
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Pratt R, Morgan S, Hughes J, Mulhall A, Fry C, Perry C, Tew L. Healthcare governance and the modernisation of the NHS: infection prevention and control. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/175717740200300504] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Q uality is central to the government's programme for modernising the NHS and clinical quality is at the heart of this agenda. The recent introduction of corporate governance with controls assurance and clinical governance in the NHS has established a framework for providing such excellence in clinical care. Governance applies to all healthcare activities and provides an ideal opportunity for infection prevention and control practitioners to improve the quality of their service and reduce the risk of patients acquiring preventable healthcare-associated infections (HAI). This paper will discuss the introduction of governance in the NHS, describe the key principles of clinical governance and relate these to infection prevention and control.
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Scott AA, Hughes J, Hall D. Views and understanding of senior nursing staff in relation to infection control. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/14690446050060020601] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
ittle research has been conducted into the broad themes of the factors that encourage nurses to comply with infection control procedures — experimental approaches have dominated previous research. A qualitative study into the views and understanding of senior nurses related to infection control procedures was undertaken at a large district general hospital. This paper looks at a number of themes, which emerged as important bases for compliance with infection control procedures. This included the importance of role models, leadership, efficacy of link groups and communication links.
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79
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Hughes J, Berry J, Brown L. Parental Motivations and Beliefs Regarding Purchase and Use of Toddler Specific Convenience Foods in High and Low-income Massachusetts Towns. J Acad Nutr Diet 2016. [DOI: 10.1016/j.jand.2016.06.088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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80
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Richter C, Schneider C, Quick MT, Volz P, Mahrwald R, Hughes J, Dick B, Alexiev U, Ernsting NP. Dual-fluorescence pH probe for bio-labelling. Phys Chem Chem Phys 2016; 17:30590-7. [PMID: 26524563 DOI: 10.1039/c5cp05454k] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Although seminaphtorhodafluor (SNARF) dyes are already widely used to measure pH in cells and at biofilms, their synthesis has low yield and results in an unspecific position of a carboxy-group. The separation of 5'- and 6'-carboxy-SNARF reveals a pKa difference of 0.15, calling into question pH measurements with the (commercially available) mixture. Here we replace the bulky external dicarboxyphenyl ring with a propionate group and evaluate the spectral properties of the new derivative. Proceeding to the ethyl-iodoacetamide, covalent linkage to cysteine protein sites is achieved efficiently as shown with a cyanobacterial phytochrome, extending the scarce application of SNARF in bio-labelling in the current literature. Application in fluorescence lifetime imaging is demonstrated both with the lifetime-based and ratiometric-yield method.
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81
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Orton RJ, Gu Q, Hughes J, Maabar M, Modha S, Vattipally SB, Wilkie GS, Davison AJ. Bioinformatics tools for analysing viral genomic data. REV SCI TECH OIE 2016; 35:271-85. [PMID: 27217183 DOI: 10.20506/rst.35.1.2432] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The field of viral genomics and bioinformatics is experiencing a strong resurgence due to high-throughput sequencing (HTS) technology, which enables the rapid and cost-effective sequencing and subsequent assembly of large numbers of viral genomes. In addition, the unprecedented power of HTS technologies has enabled the analysis of intra-host viral diversity and quasispecies dynamics in relation to important biological questions on viral transmission, vaccine resistance and host jumping. HTS also enables the rapid identification of both known and potentially new viruses from field and clinical samples, thus adding new tools to the fields of viral discovery and metagenomics. Bioinformatics has been central to the rise of HTS applications because new algorithms and software tools are continually needed to process and analyse the large, complex datasets generated in this rapidly evolving area. In this paper, the authors give a brief overview of the main bioinformatics tools available for viral genomic research, with a particular emphasis on HTS technologies and their main applications. They summarise the major steps in various HTS analyses, starting with quality control of raw reads and encompassing activities ranging from consensus and de novo genome assembly to variant calling and metagenomics, as well as RNA sequencing.
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82
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Hughes J, Jagoe R, Clark P, Klenerman L. Pattern Recognition of Images of the Pressure Distribution under the Foot from the Pedobarograph. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/00223638.1989.11737030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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83
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Ker J, Hughes J, Hardie L, Somerville S. Re-thinking remote and rural: the role of the mobile skills unit in showcasing resilience in Islay. Rural Remote Health 2016. [DOI: 10.22605/rrh4094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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84
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Lang N, Davie R, Whitworth C, Winney R, Hughes J. Fatal Calcific Uraemic Arteriolopathy (CUA): A Case Report and Review of the Literature. Scott Med J 2016; 49:108-11. [PMID: 15462229 DOI: 10.1177/003693300404900313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Calciphylaxis, now better known as Calcific uraemic arteriolopathy (CUA), is an uncommon condition characterised by small vessel calcification and occlusion with resultant painful violaceous skin lesions that typically ulcerate to form non-healing gangrenous ulcers. The syndrome is usually found in patients with renal failure. In this report we describe a 61 year old lady who developed lower limb ulceration secondary to calciphylaxis and discuss the current treatment options for this serious condition.
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85
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Lehnert M, De Ste Croix M, Zaatar A, Hughes J, Varekova R, Lastovicka O. Muscular and neuromuscular control following soccer-specific exercise in male youth: Changes in injury risk mechanisms. Scand J Med Sci Sports 2016; 27:975-982. [DOI: 10.1111/sms.12705] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2016] [Indexed: 01/03/2023]
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86
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Roman Isler M, Golin C, Wang J, Hughes J, Justman J, Haley D, Kuo I, Adimora A, Chege W, Hodder S. Venues for Meeting Sex Partners and Partner HIV Risk Characteristics: HIV Prevention Trials Network (HPTN064) Women's HIV Seroincidence Study (ISIS). AIDS Behav 2016; 20:1208-18. [PMID: 25863466 DOI: 10.1007/s10461-015-1057-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Identifying venues where women meet sexual partners, particular partners who increase women's risk of acquiring HIV, could inform prevention efforts. We categorized venues where women enrolled in HPTN 064 reported meeting their last three sex partners as: (1) Formal, (2) Public, (3) Private, and (4) Virtual spaces. We used multinomial logistic regression to assess the association between these venues and women's individual characteristics and reports of their partners' HIV risk characteristics. The 2099 women reported meeting 3991 partners, 51 % at Public, 30 % Private, 17 % Formal and 3 % at Virtual venues. Women meeting partners at Formal venues reported more education and condom use than women meeting partners at other venues. Fewer partners met through Formal venues had "high" risk characteristics for HIV than through other venues and hence may pose less risk of HIV transmission. HIV prevention interventions can help women choose partners with fewer risk characteristics across all venue types.
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87
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Nash R, Hughes J, Kuchai R, Sandison A, Sandhu G. Assessment and management of laryngeal mucous membrane pemphigoid: our experience in six patients and a proposed severity scale. Clin Otolaryngol 2016; 42:752-756. [DOI: 10.1111/coa.12676] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2016] [Indexed: 11/28/2022]
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88
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Origlia S, Schiller S, Pramod MS, Smith L, Singh Y, He W, Viswam S, Świerad D, Hughes J, Bongs K, Sterr U, Lisdat C, Vogt S, Bize S, Lodewyck J, Le Targat R, Holleville D, Venon B, Gill P, Barwood G, Hill IR, Ovchinnikov Y, Kulosa A, Ertmer W, Rasel EM, Stuhler J, Kaenders W. Development of a strontium optical lattice clock for the SOC mission on the ISS. ACTA ACUST UNITED AC 2016. [DOI: 10.1117/12.2229473] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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89
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Schmidt M, Panek R, Colgan R, Hughes J, Sohaib A, Saran F, Murray J, Bernard J, Ravell P, Nittka M, Leach M, Hansen V. EP-1899: Evaluation of SEMAC MRI metal artifact reduction for orthopaedic implants in radiotherapy planning. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33150-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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90
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O'Flaherty M, Bandosz P, Critchley J, Capewell S, Guzman-Castillo M, Aspelund T, Bennett K, Kabir K, Björck L, Bruthans J, Hotchkiss JW, Hughes J, Laatikainen T, Palmieri L, Zdrojewski T. Exploring potential mortality reductions in 9 European countries by improving diet and lifestyle: A modelling approach. Int J Cardiol 2016; 207:286-91. [PMID: 26812643 PMCID: PMC4766942 DOI: 10.1016/j.ijcard.2016.01.147] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 01/05/2016] [Accepted: 01/06/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Coronary heart disease (CHD) death rates have fallen across most of Europe in recent decades. However, substantial risk factor reductions have not been achieved across all Europe. Our aim was to quantify the potential impact of future policy scenarios on diet and lifestyle on CHD mortality in 9 European countries. METHODS We updated the previously validated IMPACT CHD models in 9 European countries and extended them to 2010-11 (the baseline year) to predict reductions in CHD mortality to 2020(ages 25-74years). We compared three scenarios: conservative, intermediate and optimistic on smoking prevalence (absolute decreases of 5%, 10% and 15%); saturated fat intake (1%, 2% and 3% absolute decreases in % energy intake, replaced by unsaturated fats); salt (relative decreases of 10%, 20% and 30%), and physical inactivity (absolute decreases of 5%, 10% and 15%). Probabilistic sensitivity analyses were conducted. RESULTS Under the conservative, intermediate and optimistic scenarios, we estimated 10.8% (95% CI: 7.3-14.0), 20.7% (95% CI: 15.6-25.2) and 29.1% (95% CI: 22.6-35.0) fewer CHD deaths in 2020. For the optimistic scenario, 15% absolute reductions in smoking could decrease CHD deaths by 8.9%-11.6%, Salt intake relative reductions of 30% by approximately 5.9-8.9%; 3% reductions in saturated fat intake by 6.3-7.5%, and 15% absolute increases in physical activity by 3.7-5.3%. CONCLUSIONS Modest and feasible policy-based reductions in cardiovascular risk factors (already been achieved in some other countries) could translate into substantial reductions in future CHD deaths across Europe. However, this would require the European Union to more effectively implement powerful evidence-based prevention policies.
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91
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Hughes J, Jacob J, Garrity J, Salomao D, Link M. Orbitofrontal Cholesterol Granuloma: Case Reports and A Systematic Review of the English Literature. Skull Base Surg 2016. [DOI: 10.1055/s-0036-1580015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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92
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Hughes J, Isaacson A, Stavas J. Percutaneous intraosseous doxycycline injections for aneurysmal bone cysts: a minimally invasive treatment option performed by interventional radiology. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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93
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West SD, Anderson KN, Hughes J, Atalaia A, Baudouin SV, Lochmuller H. P115 Outcomes of sleep studies and targeted therapies in patients with Myotonic Dystrophy: a cohort study. Thorax 2015. [DOI: 10.1136/thoraxjnl-2015-207770.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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94
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Tse GH, Johnston CJC, Kluth D, Gray M, Gray D, Hughes J, Marson LP. Intrarenal B Cell Cytokines Promote Transplant Fibrosis and Tubular Atrophy. Am J Transplant 2015; 15:3067-80. [PMID: 26211786 DOI: 10.1111/ajt.13393] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 04/28/2015] [Accepted: 05/23/2015] [Indexed: 01/25/2023]
Abstract
Renal transplantation is the optimum treatment for end-stage renal failure. B cells have been identified in chronic allograft damage (CAD) and associated with the development of tertiary lymphoid tissue within the human renal allograft. We performed renal transplantation in mice to model CAD and identified B cells forming tertiary lymphoid tissue with germinal centers. Intra-allograft B220(+) B cells comprised of IgM(high) CD23(-) B cells, IgM(lo) CD23(+) B cells, and IgM(lo) CD23(-) B cells with elevated expression of CD86. Depletion of B cells with anti-CD20 was associated with an improvement in CAD but only when administered after transplantation and not before. Isolated intra-allograft B cells were cultured and shown to synthesize multiple cytokines, the most abundant of these were GRO-α (CXCL1), RANTES (CCL5), IL-6 and MCP-1 (CCL2). Tubular loss was observed with T cell accumulation within the allograft and development of interstitial fibrosis, whilst type III collagen deposition was observed in areas of F4/80(+) macrophages and PDGFR-β(+) and transgelin(+) fibroblasts, all of which were reduced by B cell depletion. We have shown that intra-allograft B cells are key mediators of CAD. B cells possibly contribute to CAD by intra-allograft secretion of cytokines and chemokines.
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95
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Ghedia R, Hughes J, Clarke P. Hypoglossal nerve identification during head and neck surgery. Clin Otolaryngol 2015; 41:202-3. [PMID: 26585327 DOI: 10.1111/coa.12412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2015] [Indexed: 11/30/2022]
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96
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Burrows P, Trefan L, Houston R, Hughes J, Pearson G, Edwards RJ, Hyde P, Maconochie I, Parslow RC, Kemp AM. Head injury from falls in children younger than 6 years of age. Arch Dis Child 2015; 100:1032-7. [PMID: 26297697 PMCID: PMC4680174 DOI: 10.1136/archdischild-2014-307119] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 04/13/2015] [Indexed: 01/12/2023]
Abstract
UNLABELLED The risk of serious head injury (HI) from a fall in a young child is ill defined. The relationship between the object fallen from and prevalence of intracranial injury (ICI) or skull fracture is described. METHOD Cross-sectional study of HIs from falls in children (<6 years) admitted to UK hospitals, analysed according to the object fallen from and associated Glasgow Coma Score (GCS) or alert, voice, pain, unresponsive (AVPU) and CT scan results. RESULTS Of 1775 cases ascertained (median age 18 months, 54.7% boys), 87% (1552) had a GCS=15/AVPU=alert. 19.3% (342) had a CT scan: 32% (110/342) were abnormal; equivalent to 5.9% of the overall population, 16.9% (58) had isolated skull fractures and 13.7% (47) had ICI (49% (23/47) had an associated skull fracture). The prevalence of ICI increased with neurological compromise; however, 12% of children with a GCS=15/AVPU=alert had ICI. When compared to falls from standing, falls from a person's arms (233 children (mean age 1 year)) had a significant relative OR for a skull fracture/ICI of 6.94 (95% CI 3.54 to 13.6), falls from a building (eg, window or attic) (mean age 3 years) OR 6.84 (95% CI 2.65 to 17.6) and from an infant or child product (mean age 21 months) OR 2.75 (95% CI 1.36 to 5.65). CONCLUSIONS Most HIs from a fall in these children admitted to hospital were minor. Infants, dropped from a carer's arms, those who fell from infant products, a window, wall or from an attic had the greatest chance of ICI or skull fracture. These data inform prevention and the assessment of the likelihood of serious injury when the object fallen from is known.
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Seddon JA, Hesseling AC, Dunbar R, Cox H, Hughes J, Fielding K, Godfrey-Faussett P, Schaaf HS. Decentralised care for the management of child contacts of multidrug-resistant tuberculosis. Public Health Action 2015; 2:66-70. [PMID: 26392954 DOI: 10.5588/pha.12.0023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 08/05/2012] [Indexed: 11/10/2022] Open
Abstract
SETTING Cape Town, South Africa. OBJECTIVE To determine the number of multidrug-resistant tuberculosis (MDR-TB) child contacts routinely identified by health services, and whether a model of decentralised care improves access. METHODS All MDR-TB source cases registered in Cape Town from April 2010 to March 2011 were included. All child contacts assessed at hospital and outreach clinics were recorded from May 2010 to June 2011. Electronic probabilistic matching was used to match source cases with potential child contacts; the number of children accessing decentralised (Khayelitsha) and hospital-based care was compared. RESULTS Of 1221 MDR-TB source cases identified, 189 (15.5%) were registered in Khayelitsha; 31 (16.4%) had at least one child contact assessed. In contrast, 95 (9.2%) of the 1032 source cases diagnosed in the other Cape Town subdistricts (hospital-based care) had at least one child contact assessed (P = 0.003). Children in Khayelitsha were seen at a median of 71 days (interquartile range [IQR] 37-121 days) after source case diagnosis compared to 90 days (IQR 56-132 days) in other subdistricts (P = 0.15). CONCLUSION Although decentralised care led to an increased number of child contacts being evaluated, both models led to the assessment of a small number of potential child MDR-TB contacts, with considerable delay in assessment.
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Hughes J, Ul Qamar MF, Shah K, Salisbury A. Trainee Oncologists Experience of Flexible Nasal Endoscopy in the Head and Neck Clinic. Clin Oncol (R Coll Radiol) 2015; 27:751. [PMID: 26344357 DOI: 10.1016/j.clon.2015.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 08/13/2015] [Indexed: 11/17/2022]
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Ndjeka N, Conradie F, Schnippel K, Hughes J, Bantubani N, Ferreira H, Maartens G, Mametja D, Meintjes G, Padanilam X, Variava E, Pym A, Pillay Y. Treatment of drug-resistant tuberculosis with bedaquiline in a high HIV prevalence setting: an interim cohort analysis. Int J Tuberc Lung Dis 2015; 19:979-85. [DOI: 10.5588/ijtld.14.0944] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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100
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Kelly F, Cook T, Boniface N, Hughes J, Seller C, Simpson T. Videolaryngoscopes confer benefits in human factors in addition to technical skills. Br J Anaesth 2015; 115:132-3. [DOI: 10.1093/bja/aev188] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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