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Ares-Blanco S, López-Rodríguez JA, Polentinos-Castro E, Del Cura-González I. Effect of GP visits in the compliance of preventive services: a cross-sectional study in Europe. BMC Prim Care 2024; 25:165. [PMID: 38750446 PMCID: PMC11094967 DOI: 10.1186/s12875-024-02400-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/23/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Performing cardiovascular and cancer screenings in target populations can reduce mortality. Visiting a General Practitioner (GP) once a year is related to an increased likelihood of preventive care. The aim of this study was to analyse the influence of visiting a GP in the last year on the delivery of preventive services based on sex and household income. METHODS Cross-sectional study using data collected from the European Health Interview Survey 2013-2015 of individuals aged 40-74 years from 29 European countries. The variables included: sociodemographic factors (age, sex, and household income (HHI) quintiles [HHI 1: lowest income, HHI 5: more affluent]), lifestyle factors, comorbidities, and preventive care services (cardiometabolic, influenza vaccination, and cancer screening). Descriptive statistics, bivariate analyses and multilevel models (level 1: citizen, level 2: country) were performed. RESULTS 242,212 subjects were included, 53.7% were female. The proportion of subjects who received any cardiometabolic screening (92.4%) was greater than cancer screening (colorectal cancer: 44.1%, gynaecologic cancer: 40.0%) and influenza vaccination. Individuals who visited a GP in the last year were more prone to receive preventive care services (cardiometabolic screening: adjusted OR (aOR): 7.78, 95% CI: 7.43-8.15; colorectal screening aOR: 1.87, 95% CI: 1.80-1.95; mammography aOR: 1.76, 95% CI: 1.69-1.83 and Pap smear test: aOR: 1.89, 95% CI:1.85-1.94). Among those who visited a GP in the last year, the highest ratios of cardiometabolic screening and cancer screening benefited those who were more affluent. Women underwent more blood pressure measurements than men regardless of the HHI. Men were more likely to undergo influenza vaccination than women regardless of the HHI. The highest differences between countries were observed for influenza vaccination, with a median odds ratio (MOR) of 6.36 (under 65 years with comorbidities) and 4.30 (over 65 years with comorbidities), followed by colorectal cancer screening with an MOR of 2.26. CONCLUSIONS Greater adherence to preventive services was linked to individuals who had visited a GP at least once in the past year. Disparities were evident among those with lower household incomes who visited a GP. The most significant variability among countries was observed in influenza vaccination and colorectal cancer screening.
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Affiliation(s)
- Sara Ares-Blanco
- Federica Montseny Health Centre, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain.
- Medical Specialties and Public Health, School of Health Sciences, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
- Chronicity, Primary Care, and Health Promotion Networks (RICAPPS), ISCIII, Madrid, Spain.
| | - Juan A López-Rodríguez
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- General Ricardos Health Centre, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
- Primary Care Research Unit, Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
- Chronicity, Primary Care, and Health Promotion Networks (RICAPPS), ISCIII, Madrid, Spain
- Medical Specialties and Public Health Department, School of Health Sciences, Rey Juan Carlos, University, Alcorcón, Madrid, Spain
| | - Elena Polentinos-Castro
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Primary Care Research Unit, Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
- Chronicity, Primary Care, and Health Promotion Networks (RICAPPS), ISCIII, Madrid, Spain
- Medical Specialties and Public Health Department, School of Health Sciences, Rey Juan Carlos, University, Alcorcón, Madrid, Spain
| | - Isabel Del Cura-González
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Primary Care Research Unit, Gerencia de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
- Chronicity, Primary Care, and Health Promotion Networks (RICAPPS), ISCIII, Madrid, Spain
- Medical Specialties and Public Health Department, School of Health Sciences, Rey Juan Carlos, University, Alcorcón, Madrid, Spain
- Aging Research Center, Karolinksa Instituted, Stockholm, Sweden
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Scimia M, Pepe F, Russo G, Palumbo L, Malapelle U, Chuang R, Scimia S, Sha M, Tanaka H, Shen S, Chen D, Troncone G, Bianco MA. The Impact of potential 'confounders' on the diagnostic sensitivity of circulating free DNA in management of FIT+ patients: a pilot study. J Clin Pathol 2024:jcp-2024-209527. [PMID: 38649261 DOI: 10.1136/jcp-2024-209527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 03/29/2024] [Indexed: 04/25/2024]
Abstract
Cell-free DNA (cfDNA) has long been established as a useful diagnostic and prognostic tool in a variety of clinical settings, ranging from infectious to cardiovascular and neoplastic diseases. However, non-neoplastic diseases can act as confounders impacting on the amount of cfDNA shed in bloodstream and on technical feasibility of tumour derived free circulating nucleic acids selecting patients with cancer. Here, we investigated the potential impact of other pathological processes in the clinical stratification of 637 FIT+ patients. A single and multiple logistic regression yielded similar results. Crude sensitivity was 75.9% versus adjusted sensitivity of 74.1%, relative risk 0.9761 (0.8516 to 1.1188), risk difference 0.0181 (-0.0835 to 0.1199) and OR 0.9079 (0.5264 to 1.5658). Potential confounding effect from other source of cfDNA plays a pivotal role in the clinical stratification of FIT+ patients.
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Affiliation(s)
| | - Francesco Pepe
- Public Health, University of Naples Federico II, Naples, Italy
| | - Gianluca Russo
- Public Health, University of Naples Federico II, Naples, Italy
| | - Lucia Palumbo
- Public Health, University of Naples Federico II, Naples, Italy
| | | | | | | | | | | | - Shuo Shen
- DiaCarta Inc, Richmond, Virginia, USA
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Nadal-Barón P, Trejo-Zahinos J, García JN, Salmerón P, Sulleiro E, Arando M, Descalzo V, Álvarez-Lopez P, El Ouazzani R, López L, Zarzuela F, Ruiz E, Llinas M, Blanco-Grau A, Curran A, Larrosa MN, Pumarola T, Hoyos-Mallecot Y. Impact of time of culture specimen collection on the recovery of Neisseria gonorrhoeae after a positive nucleic acid amplification test. Sex Transm Infect 2023; 99:520-526. [PMID: 37802652 DOI: 10.1136/sextrans-2023-055899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/19/2023] [Indexed: 10/08/2023] Open
Abstract
OBJECTIVES Culture of Neisseria gonorrhoeae remains essential for antimicrobial resistance (AMR) surveillance. We evaluated the effect of time of specimen collection on culture yield following a positive nucleic acid amplification test (NAAT). METHODS We retrospectively assessed N. gonorrhoeae culture yield among asymptomatic individuals (largely men who have sex with men) who attended for sexual health screening and had a positive NAAT. Participants underwent either same-day testing and notification (Drassanes Exprés) or standard screening with deferred testing. RESULTS Among 10 423 screened individuals, 809 (7.7%) tested positive for N. gonorrhoeae. A total of 995 different anatomical sites of infection culture was performed in 583 of 995 (58.6%) of anatomical sites (Drassanes Exprés 278 of 347, 80.1%; standard screening 305 of 648, 47.1%; p<0.001). Recovery was highest when culture specimens were collected within 3-7 days of screening with only a slight drop in recovery when the interval extended to 7 days . Recovery from pharynx was 38 of 149 (25.5%) within 3 days, 19 of 81 (23.4%) after 4-7 days (p=0.7245), 11 of 102 (10.7%) after 8-14 days (p<0.0036) and 1 of 22 (4.5%) with longer delays (p=0.00287). Recovery from rectum was 49 of 75 (65.3%) within 3 days, 28 of 45 (62.2%) after 4-7 days (p=0.7318), 41 of 69 (59.4%) after 8-14 days (p=0.4651) and 6 of 18 (33.3%) with longer delays (p=0.0131). Median culture specimen collection time was 1 day within Drassanes Exprés vs 8 days within standard screening. Consequently, the overall culture yield was slightly higher within Drassanes Exprés (102/278, 36.6% vs 99/305, 32.5%; p=0.2934). CONCLUSION Reducing the interval between screening and collection of culture specimens increased N. gonorrhoeae recovery in extragenital samples. Implementing a same-day testing and notification programme increased collection of culture samples and culture yield in our setting, which may help AMR surveillance.
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Affiliation(s)
- Patricia Nadal-Barón
- Department of Microbiology and Parasitology, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jesús Trejo-Zahinos
- Department of Microbiology and Parasitology, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jorge Nestor García
- STI Unit Vall d'Hebron Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Paula Salmerón
- Department of Microbiology and Parasitology, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elena Sulleiro
- Department of Microbiology and Parasitology, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Maider Arando
- STI Unit Vall d'Hebron Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Vicente Descalzo
- STI Unit Vall d'Hebron Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Patricia Álvarez-Lopez
- STI Unit Vall d'Hebron Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Rachid El Ouazzani
- Department of Microbiology and Parasitology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Luis López
- STI Unit Vall d'Hebron Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Francesc Zarzuela
- Department of Microbiology and Parasitology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Edurne Ruiz
- Department of Microbiology and Parasitology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Montserrat Llinas
- STI Unit Vall d'Hebron Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Albert Blanco-Grau
- Department of Clinical Biochemistry, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Adrian Curran
- STI Unit Vall d'Hebron Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, Barcelona, Spain
- Vall d'Hebron Institute for Research, Barcelona, Spain
| | - María Nieves Larrosa
- Department of Microbiology and Parasitology, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBERINFEC, ISCIII-CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | - Tomàs Pumarola
- Department of Microbiology and Parasitology, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Genetics and Microbiology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Yannick Hoyos-Mallecot
- Department of Microbiology and Parasitology, Vall d'Hebron University Hospital, Barcelona, Spain
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Witzel TC, Nicholls EJ, McCabe L, Weatherburn P, McCormack S, Bonell C, Gafos M, Lampe FC, Speakman A, Dunn D, Ward D, Phillips AN, Pebody R, Gabriel MM, Collaco-Moraes Y, Rodger AJ, Burns FM. Understanding experiences of potential harm among MSM (cis and trans) using HIV self-testing in the SELPHI randomised controlled trial in England and Wales: a mixed-methods study. Sex Transm Infect 2023; 99:534-540. [PMID: 37607814 PMCID: PMC10715485 DOI: 10.1136/sextrans-2023-055840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/15/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The potential of HIV self-testing (HIVST) to cause harm is a concern hindering widespread implementation. The aim of this paper is to understand the relationship between HIVST and harm in SELPHI (An HIV Self-testing Public Health Intervention), the largest randomised trial of HIVST in a high-income country to date. METHODS 10 111 cis and trans men who have sex with men (MSM) recruited online (geolocation social/sexual networking apps, social media), aged 16+, reporting previous anal intercourse and resident in England or Wales were first randomised 60/40 to baseline HIVST (baseline testing, BT) or not (no baseline testing, nBT) (randomisation A). BT participants reporting negative baseline test, sexual risk at 3 months and interest in further HIVST were randomised to three-monthly HIVST (repeat testing, RT) or not (no repeat testing, nRT) (randomisation B). All received an exit survey collecting data on harms (to relationships, well-being, false results or being pressured/persuaded to test). Nine participants reporting harm were interviewed in-depth about their experiences in an exploratory substudy; qualitative data were analysed narratively. RESULTS Baseline: predominantly cis MSM, 90% white, 88% gay, 47% university educated and 7% current/former pre-exposure prophylaxis (PrEP) users. Final survey response rate was: nBT=26% (1056/4062), BT=45% (1674/3741), nRT=41% (471/1147), RT=50% (581/1161).Harms were rare and reported by 4% (n=138/3691) in exit surveys, with an additional two false positive results captured in other study surveys. 1% reported harm to relationships and to well-being in BT, nRT and RT combined. In all arms combined, being pressured or persuaded to test was reported by 1% (n=54/3678) and false positive results in 0.7% (n=34/4665).Qualitative analysis revealed harms arose from the kit itself (technological harms), the intervention (intervention harms) or from the social context of the participant (socially emergent harms). Intervention and socially emergent harms did not reduce HIVST acceptability, whereas technological harms did. DISCUSSION HIVST harms were rare but strategies to link individuals experiencing harms with psychosocial support should be considered for HIVST scale-up. TRIAL REGISTRATION NUMBER ISRCTN20312003.
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Affiliation(s)
- T Charles Witzel
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
- Institute for Global Health, University College London, London, UK
| | | | - Leanne McCabe
- Medical Research Council Clinical Trials Unit, University College London, London, UK
| | - Peter Weatherburn
- Social & Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Sheena McCormack
- Medical Research Council Clinical Trials Unit, University College London, London, UK
| | - Christopher Bonell
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Mitzy Gafos
- Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Fiona C Lampe
- Institute for Global Health, University College London, London, UK
| | - Andrew Speakman
- Institute for Global Health, University College London, London, UK
| | - David Dunn
- Medical Research Council Clinical Trials Unit, University College London, London, UK
| | - Denise Ward
- Medical Research Council Clinical Trials Unit, University College London, London, UK
| | | | | | - Michelle M Gabriel
- Medical Research Council Clinical Trials Unit, University College London, London, UK
| | | | - Alison J Rodger
- Institute for Global Health, University College London, London, UK
| | - Fiona M Burns
- Institute for Global Health, University College London, London, UK
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5
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Gutheil J, Stampfer P, Kramer D, Wechselberger M, Veeranki SPK, Schrempf M, Mrak P, Aubel M, Feichtner F. Frail People in LABLand: Development of an Easy-to-Use Machine Learning Model to Identify Frail People in Hospitals Based on Laboratory Data. Stud Health Technol Inform 2023; 301:212-219. [PMID: 37172183 DOI: 10.3233/shti230042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Frail individuals are very vulnerable to stressors, which often lead to adverse outcomes. To ensure an adequate therapy, a holistic diagnostic approach is needed which is provided in geriatric wards. It is important to identify frail individuals outside the geriatric ward as well to ensure that they also benefit from the holistic approach. OBJECTIVES The goal of this study was to develop a machine learning model to identify frail individuals in hospitals. The model should be applicable without additional effort, quickly and in many different places in the healthcare system. METHODS We used Gradient Boosting Decision Trees (GBDT) to predict a frailty target derived from a gold standard assessment. The used features were laboratory values, age and sex. We also identified the most important features. RESULTS The best GBDT achieved an AUROC of 0.696. The most important laboratory values are urea, creatinine, granulocytes, chloride and calcium. CONCLUSION The model performance is acceptable, but insufficient for clinical use. Additional laboratory values or the laboratory history could improve the performance.
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Affiliation(s)
- Julian Gutheil
- Joanneum Research Forschungsgesellschaft mbH, Graz, Austria
| | | | - Diether Kramer
- PH Predicting Health GmbH, Graz, Austria
- Steiermärkische Krankenanstaltengesellschaft mbH, Graz, Austria
| | | | - Sai Pavan Kumar Veeranki
- PH Predicting Health GmbH, Graz, Austria
- Steiermärkische Krankenanstaltengesellschaft mbH, Graz, Austria
| | - Michael Schrempf
- PH Predicting Health GmbH, Graz, Austria
- Steiermärkische Krankenanstaltengesellschaft mbH, Graz, Austria
| | - Peter Mrak
- Steiermärkische Krankenanstaltengesellschaft mbH, Graz, Austria
| | - Martina Aubel
- Joanneum Research Forschungsgesellschaft mbH, Graz, Austria
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Needham N, Mathews A, Murphy K, Paterson J, McFarlane Y, Humphries K, Milne A, Lawrie S. Acceptability and feasibility of sexual health screening in psychiatry inpatients. Sex Transm Infect 2023; 99:143-144. [PMID: 36522173 DOI: 10.1136/sextrans-2022-055577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/24/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Nicole Needham
- Psychiatry, NHS Lothian, Edinburgh, UK .,Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | | | | | | | | | | | - Alison Milne
- Screening and Early Detection, NHS Lothian, Edinburgh, UK
| | - Stephen Lawrie
- Psychiatry, NHS Lothian, Edinburgh, UK.,Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
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7
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Magana K, Strand L, Love M, Moore T, Peña A, Ito Ford A, Vassar M. Health inequities in human papillomavirus prevention, diagnostics and clinical care in the USA: a scoping review. Sex Transm Infect 2023; 99:128-136. [PMID: 36396174 DOI: 10.1136/sextrans-2022-055587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) represents the most common STI in the USA. HPV inequities in prevention, diagnostics and clinical care persist. We define inequities as systematic, avoidable and unfair differences in health outcomes. OBJECTIVES The objectives of this scoping review are to chart existing data on HPV-related inequities, identify gaps in existing literature and guide future research to reduce these inequities. METHODS We completed a scoping review following guidelines from the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses scoping reviews extension. We performed a literature search on PubMed and Ovid Embase in July 2022 for articles pertaining to HPV and evaluating populations within the USA. We included English language publications from 2018 to 2022 evaluating at least one health inequity outlined by the National Institutes of Health. General publication characteristics and health inequity data were charted in a masked, duplicate fashion using a pilot-tested Google Form. We analysed frequencies of health inequities and summarised main findings from included studies. RESULTS Our final sample included 170 publications. The most common inequities examined were race/ethnicity (140 studies), sex or gender (97 studies), and income (69 studies). Many historically marginalised racial/ethnic groups had lower rates of HPV-related knowledge, vaccination and worse overall outcomes related to HPV. Compared with women, men had lower rates of HPV vaccination and provider recommendation, and higher rates of HPV-infection. Results regarding income were largely conflicting. CONCLUSION Findings from our review demonstrate clear gaps in HPV-related inequity research. Vaccine completion, provider recommendation and intersectionality should continue to be evaluated to implement targeted interventions.
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Affiliation(s)
- Kimberly Magana
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Laura Strand
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Mitchell Love
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Ty Moore
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Andriana Peña
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Alicia Ito Ford
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.,Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA.,Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
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8
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Ni Y, Lu Y, He X, Li Y, Li Y, Guo S, Ong JJ, Xu C, Wang X, Yan X, Tao Y, Liu N, Tang W. Self-sampled specimens demonstrate comparable accuracy and consistency to clinician-sampled specimens for HPV detection among men who have sex with men in China. Sex Transm Infect 2023; 99:104-109. [PMID: 35534231 DOI: 10.1136/sextrans-2022-055408] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/15/2022] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Despite a high risk of human papillomavirus (HPV) infection among men who have sex with men (MSM), few have ever tested. This study aimed to evaluate the feasibility and accuracy of HPV self-sampling among Chinese MSM, with the purpose of measuring the feasibility of self-sampling as an alternative in HPV testing scenarios. METHODS Eligible participants were those who were assigned male at birth, aged 18 or above, had sex with men in the past year and had never gotten HPV vaccine. Participants followed the instructions to self-sample and were also clinician-sampled from the same anatomical sites (oral fluid, penis and rectum) in both approaches. All specimens were processed using multiplex PCR assay. The reference standard of an individual with a true positive for HPV is determined via PCR test, regardless of sampling methods. Sensitivity and specificity were calculated for each approach independently and kappa test was used to assess the consistency between the two approaches. RESULTS Overall, 211 MSM were recruited at the local clinic from April to October 2020 in Zhuhai, China. The mean age was 31 years old. Only 3% of the participants sought help from healthcare providers during self-sampling. The prevalence of HPV was 49% (103 of 211). Clinician sampling detected 91 of 103 MSM infected with HPV, with a sensitivity of 88.3% (95% CI 80.2 to 93.6) and a specificity of 100.0% (95% CI 95.7 to 100.0). Self-sampling detected 81 of 103 MSM infected with HPV, with a sensitivity of 78.6% (95% CI 69.2 to 85.9) and a specificity of 100.0% (95% CI 95.7 to 100.0). The level of agreement was moderate between clinician sampling and self-sampling (k=0.67). CONCLUSIONS Self-sampled HPV testing demonstrated comparable accuracy and consistency to clinician sampling among MSM in China. It holds the potential to complement sexual health services especially among key populations.
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Affiliation(s)
- Yuxin Ni
- University of North Carolina Project-China, Guangzhou, Guangdong, China
| | - Ying Lu
- University of North Carolina Project-China, Guangzhou, Guangdong, China
| | - Xi He
- Zhuhai Xutong Voluntary Services Center, Zhuhai, China
| | | | - Yongqing Li
- Zhuhai Xutong Voluntary Services Center, Zhuhai, China
| | - Shiyu Guo
- BGI Clinical Laboratories (Shenzhen), Shenzhen, China
| | - Jason J Ong
- Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Hospital, Melbourne, Victoria, Australia.,Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Chen Xu
- University of North Carolina Project-China, Guangzhou, Guangdong, China
| | | | - Xumeng Yan
- University of North Carolina Project-China, Guangzhou, Guangdong, China
| | - Yusha Tao
- University of North Carolina Project-China, Guangzhou, Guangdong, China
| | - Na Liu
- BGI Genomics, Shenzhen, China
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, Guangdong, China .,Guangdong No.2 People's Hospital, Guangzhou, People's Republic of China
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9
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Dema E, Sonnenberg P, Gibbs J, Conolly A, Willis M, Riddell J, Bosó Pérez R, Copas AJ, Tanton C, Bonell C, Oeser C, Clifton S, Unemo M, Mercer CH, Mitchell KR, Field N. How did the COVID-19 pandemic affect access to condoms, chlamydia and HIV testing, and cervical cancer screening at a population level in Britain? (Natsal-COVID). Sex Transm Infect 2022; 99:261-267. [PMID: 35981863 DOI: 10.1136/sextrans-2022-055516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/16/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To investigate how differential access to key interventions to reduce STIs, HIV and their sequelae changed during the COVID-19 pandemic. METHODS British participants (18-59 years) completed a cross-sectional web survey 1 year (March-April 2021) after the initial lockdown in Britain. Quota-based sampling and weighting resulted in a quasi-representative population sample. We compared Natsal-COVID data with Natsal-3, a household-based probability sample cross-sectional survey (16-74 years) conducted in 2010-2012. Reported unmet need for condoms because of the pandemic and uptake of chlamydia testing/HIV testing/cervical cancer screening were analysed among sexually experienced participants (18-44 years) (n=3869, Natsal-COVID; n=8551, Natsal-3). ORs adjusted for age and other potential confounders describe associations with demographic and behavioural factors. RESULTS In 2021, 6.9% of women and 16.2% of men reported unmet need for condoms because of the pandemic. This was more likely among participants: aged 18-24 years, of black or black British ethnicity, and reporting same-sex sex (past 5 years) or one or more new relationships (past year). Chlamydia and HIV testing were more commonly reported by younger participants, those reporting condomless sex with new sexual partners and men reporting same-sex partners; a very similar distribution to 10 years previously (Natsal-3). However, there were differences during the pandemic, including stronger associations with chlamydia testing for men reporting same-sex partners; with HIV testing for women reporting new sexual partners and with cervical screening among smokers. CONCLUSIONS Our study suggests differential access to key primary and secondary STI/HIV prevention interventions continued during the first year of the COVID-19 pandemic. However, there was not strong evidence that differential access has changed during the pandemic when compared with 2010-2012. While the pandemic might not have exacerbated inequalities in access to primary and secondary prevention, it is clear that large inequalities persisted, typically among those at greatest STI/HIV risk.
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Affiliation(s)
- Emily Dema
- Institute for Global Health, University College London, London, UK
| | - Pam Sonnenberg
- Institute for Global Health, University College London, London, UK
| | - Jo Gibbs
- Institute for Global Health, University College London, London, UK
| | - Anne Conolly
- Institute for Global Health, University College London, London, UK.,Health and Biomedical Surveys, NatCen Social Research, London, UK
| | - Malachi Willis
- Social and Public Health Sciences Unit, University of Glasgow MRC/CSO, Glasgow, UK
| | - Julie Riddell
- Social and Public Health Sciences Unit, University of Glasgow MRC/CSO, Glasgow, UK
| | - Raquel Bosó Pérez
- Social and Public Health Sciences Unit, University of Glasgow MRC/CSO, Glasgow, UK
| | - Andrew J Copas
- Institute for Global Health, University College London, London, UK
| | - Clare Tanton
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Chris Bonell
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Clarissa Oeser
- Institute for Global Health, University College London, London, UK
| | - Soazig Clifton
- Institute for Global Health, University College London, London, UK.,Health and Biomedical Surveys, NatCen Social Research, London, UK
| | - Magnus Unemo
- Department of Laboratory Medicine, Örebro University Hospital, Orebro, Sweden
| | | | - Kirstin R Mitchell
- Social and Public Health Sciences Unit, University of Glasgow MRC/CSO, Glasgow, UK
| | - Nigel Field
- Institute for Global Health, University College London, London, UK
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10
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Geretti AM, Mardh O, de Vries HJC, Winter A, McSorley J, Seguy N, Vuylsteke B, Gokengin D. Sexual transmission of infections across Europe: appraising the present, scoping the future. Sex Transm Infect 2022; 98:sextrans-2022-055455. [PMID: 35537800 DOI: 10.1136/sextrans-2022-055455] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/24/2022] [Indexed: 01/13/2023] Open
Abstract
Objectives: Our journal partnered with the Europe section of the International Union against STI (IUSTI) at a workshop held at the 18th European AIDS Conference in London on 30 October 2021. The workshop reviewed epidemiological trends and discussed STI care provision within HIV services across Europe. Methods and Results: We started by highlighting trends in bacterial STIs reported to the European Centre for Disease Prevention and Control from countries in the European Union/European Economic Area. This showed that notifications of bacterial STIs reached an all-time high in 2019, but are expected to be impacted by the COVID-19 pandemic in 2020-2021. We then reviewed the evolving relationship between STIs and HIV and pointed out how antiretroviral treatment and pre-exposure prophylaxis remain highly effective against HIV transmission despite the rising incidence of STIs. Within emerging concepts in STIs, we appraised the benefits and risks of asymptomatic screening for chlamydia, and also considered the potential perils of routinely testing for agents that lack a defined role in disease. Finally, we discussed standards of STI care for people living with HIV, informed by a brief survey of IUSTI Europe country representatives and members of the Euroguidelines in Central and Eastern Europe network. Conclusions: The survey indicated substantial variability and identified key improvement targets: fighting barriers to effective service provision and access, increasing diagnostic capability and taking leadership in driving up the quality of care. We must not forget the STI-related needs of the many people who will be living with HIV for decades into the future.
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Affiliation(s)
- Anna Maria Geretti
- Dept. of Infectious Diseases, Fondazione PTV and University of Rome Tor Vergata, Rome, Italy
- School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Otilia Mardh
- HIV/STI & Hepatitis, European Centre for Disease Prevention & Control (ECDC), Solna, Sweden
| | - Henry J C de Vries
- Dept. of Dermatology, University of Amsterdam and Public Health Service, Amsterdam, The Netherlands
| | - Andrew Winter
- Sandyford Sexual Health, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - John McSorley
- The Patrick Clements Centre, London North West Healthcare NHS Trust, London, UK
| | - Nicole Seguy
- Regional Office for Europe, World Health Organization (WHO), Copenhagen, Denmark
| | - Bea Vuylsteke
- Dept. of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Deniz Gokengin
- Dept. of Infectious Diseases, Ege University, İzmir, Turkey
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11
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Kim HJ, Lee KM. Development of the Korea Dysarthria Test Following Stroke. Ann Rehabil Med 2022; 46:71-86. [PMID: 35508926 PMCID: PMC9081393 DOI: 10.5535/arm.21153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 02/14/2022] [Indexed: 11/10/2022] Open
Abstract
Objective To develop an objective and quantitative clinical evaluation tool that can be used for diagnosis and severity assessment of dysarthria in patients with stroke. Methods A prototype test comprising 23 items was developed to test the function of each speech organ. The scoring of the prototype test was based on the analysis of the result values obtained from 50 healthy individuals. The test was performed for 50 patients with stroke who were suspected to have dysarthria. For evaluating the correlation between each prototype test item and the Urimal Test of Articulation and Phonation (U-TAP), the odds ratio was obtained for each result, based on which the final test items for composing the Korea Dysarthria Test (KDT) were selected. The validity of the test was evaluated using the receiver operator characteristic (ROC) curve and the area under the curve. We used the intraclass correlation coefficients to quantify inter- and intra-rater reliability. The Spearman correlation coefficient was used for examining the correlation between the KDT and the Speech Mechanism Screening Test and U-TAP. Results Among the 23 prototype test items, 16 exhibiting significant results were finally selected as the KDT. The higher score of the KDT is reflected the better speaking function. The sensitivity and specificity of the KDT were shown to be high at the cutoff value of 76.50 point. Conclusion KDT is a useful evaluation tool for dysarthria, showing a significant correlation with SMST and U-TAP.
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Affiliation(s)
- Hyo Jong Kim
- Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Kyoung Moo Lee
- Department of Rehabilitation Medicine, Chungbuk National University Hospital, Cheongju, Korea
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12
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Moore M, Milosevich E, Beisteiner R, Bowen A, Checketts M, Demeyere N, Fordell H, Godefroy O, Laczó J, Rich T, Williams L, Woodward-Nutt K, Husain M. Rapid screening for neglect following stroke: A systematic search and European Academy of Neurology recommendations. Eur J Neurol 2022; 29:2596-2606. [PMID: 35510782 PMCID: PMC9544365 DOI: 10.1111/ene.15381] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/21/2022] [Indexed: 11/30/2022]
Abstract
Background and purpose Unilateral neglect is a common cognitive disorder following stroke. Neglect has a significant impact on functional outcomes, so it is important to detect. However, there is no consensus on which are the best screening tests to administer to detect neglect in time‐limited clinical environments. Methods Members of the European Academy of Neurology Scientific Panel on Higher Cortical Functions, neuropsychologists, occupational therapists, and researchers produced recommendations for primary and secondary tests for bedside neglect testing based on a rigorous literature review, data extraction, online consensus meeting, and subsequent iterations. Results A total of 512 articles were screened, and 42 were included. These reported data from 3367 stroke survivors assessed using 62 neglect screens. Tests were grouped into cancellation, line bisection, copying, reading/writing, and behavioral. Cancellation tasks were most frequently used (97.6% of studies), followed by bisection, copying, behavioral, and reading/writing assessments. The panel recommended a cancellation test as the primary screening test if there is time to administer only one test. One of several cancellation tests might be used, depending on availability. If time permits, one or more of line bisection, figure copying, and baking tray task were recommended as secondary tests. Finally, if a functional and ecological test is feasible, the Catherine Bergego Scale was recommended. Overall, the literature suggests that no single test on its own is sufficient to exclude a diagnosis of neglect. Therefore, the panel recommended that multiple neglect tests should be used whenever possible. Conclusions This study provides consensus recommendations for rapid bedside detection of neglect in real‐world, clinical environments.
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Affiliation(s)
- Margaret Moore
- Dept Experimental Psychology, University of Oxford, Oxford, UK.,Queensland Brain Institute, University of Brisbane, Brisbane, Australia
| | | | | | - Audrey Bowen
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance & University of Manchester, Manchester, UK
| | - Matthew Checketts
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, MAHSC, UK
| | - Nele Demeyere
- Dept Experimental Psychology, University of Oxford, Oxford, UK
| | | | - Olivier Godefroy
- Department of Neurology and Laboratoire de Neurosciences Fonctionnelles et Pathologies, Amiens University Medical Center, Jules Verne University of Picardy, Amiens, France
| | - Jan Laczó
- Memory Clinic, Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic.,International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Timothy Rich
- Kessler Foundation, West Orange, New Jersey, USA & Rutgers University, Physical Medicine and Rehabilitation, Newark, New Jersey, USA
| | - Lindy Williams
- Cognitive Aging and Impairment Neurosciences Lab, University of South Australia, Adelaide, Australia
| | - Kate Woodward-Nutt
- Research and Innovation, Northern Care Alliance NHS Group, Salford, United Kingdom
| | - Masud Husain
- Dept Experimental Psychology, University of Oxford, Oxford, UK.,Nuffield Dept Clinical Neurosciences, University of Oxford, Oxford, UK
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13
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Palermo BJ, D'Amico SL, Kim BY, Brady CJ. Sensitivity and Specificity of Handheld Fundus Cameras for Eye Disease: A Systematic Review and Pooled Analysis. Surv Ophthalmol 2021:S0039-6257(21)00210-1. [PMID: 34822849 DOI: 10.1016/j.survophthal.2021.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/07/2021] [Accepted: 11/15/2021] [Indexed: 11/21/2022]
Abstract
In order to evaluate the accuracy of commercially available handheld fundus cameras for a variety of ophthalmic diagnoses, we conducted a systematic review, searching PubMed and PubMed Central and performing a bivariate analysis to determine the pooled sensitivity and specificity of handheld fundus cameras. Eleven studies validating handheld fundus cameras against a gold-standard method for disease diagnosis were included. For non-mydriatic images, pooled sensitivity was 83% (95% CI: 77-88%) and specificity was 92% (95% CI: 79-97%). For mydriatic images, pooled sensitivity was 87% (95% CI: 79-92%) and specificity was 90% (95% CI: 78-96%). Overall pooled sensitivity was 85% (95% CI: 80-89%) and specificity was 91% (95% CI: 83-95%). Of the 11 studies included, 5 assessed the diagnosis of diabetic retinopathy, for which sensitivity was 87% (95% CI: 80-92%) and specificity was 95% (95% CI: 85-98%). For all other diagnoses combined, sensitivity was 81% (95% CI: 74-87%) and specificity was 83% (95% CI: 76-89%). These findings suggest that handheld fundus cameras are capable of achieving acceptable sensitivity and specificity values for eye disease, with mydriatic images being more sensitive for disease. Diabetic retinopathy was the single diagnosis with the strongest data to support the use of handheld fundus cameras for disease screening.
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