1,620 research outputs found
Ethnic diversity in academic dentistry in the United Kingdom
Careers in academic dentistry are failing to attract a new generation of academics to
steer dental education and research. Dental academia is further limited by inadequacies in levels of ethnic diversity. There is a stark contrast between the diversity of
graduates entering the dental profession and those in academic positions, especially
in senior ranks. Dentistry is not the only field in academia, which lacks representation
and lessons may be drawn from other faculties. This paper focuses on what is known
about dental academia in the United Kingdom, where there are formal research training pathways. There is an emerging recognition of the requirement for action, and it is
hoped this will stimulate debate and impetus for research across Europe. The terminology used throughout this piece follows the United Kingdom Cabinet Office recommendations for writing about ethnicity (Writing about ethnicity, 2021; https://www.
ethnicity-facts-figures.service.gov.uk/style-guide/writing-about-ethnicity). Where
cited sources have employed less acceptable terms (Please don't call me BAME or
BME!: Civil service, 2019; https://civilservice.blog.gov.uk/2019/07/08/please-dontcall-me-bame-or-bme/), these have been changed
Retrospective observational study to assess the clinical management and outcomes of hospitalised patients with complicated urinary tract infection in countries with high prevalence of multidrug resistant Gram-negative bacteria (RESCUING)
INTRODUCTION: The emergence of multidrug resistant (MDR) Gram-negative bacteria (GNB), including carbapenemase-producing strains, has become a major therapeutic challenge. These MDR isolates are often involved in complicated urinary tract infection (cUTI), and are associated with poor clinical outcomes. The study has been designed to gain insight into the epidemiology, clinical management, outcome and healthcare cost of patients with cUTI, especially in countries with high prevalence of MDR GNB.
METHODS AND ANALYSIS: This multinational and multicentre observational, retrospective study will identify cases from 1 January 2013 to 31 December 2014 in order to collect data on patients with cUTI as a cause of hospital admission, and patients who develop cUTI during their hospital stay. The primary end point will be treatment failure defined as the presence of any of the following criteria: (1) signs or symptoms of cUTI present at diagnosis that have not improved by days 5–7 with appropriate antibiotic therapy, (2) new cUTI-related symptoms that have developed within 30 days of diagnosis, (3) urine culture taken within 30 days of diagnosis, either during or after completion of therapy, that grows ≥104 colony-forming unit/mL of the original pathogen and (4) death irrespective of cause within 30 days of the cUTI diagnosis.
SAMPLE SIZE: 1000 patients afford a power of 0.83 (α=0.05) to detect an absolute difference of 10% in the treatment failure rate between MDR bacteria and other pathogens. This should allow for the introduction of about 20 independent risk factors (or their interaction) in a logistic regression model looking at risk factors for failure.
ETHICS AND DISSEMINATION: Approval will be sought from all relevant Research Ethics Committees. Publication of this study will be considered as a joint publication by the participating investigator leads, and will follow the recommendations of the International Committee of Medical Journal Editors (ICMJE)
Native IYG: Improving Psychosocial Protective Factors for HIV/STI and Teen Pregnancy Prevention among Youth in American Indian/Alaska Native Communities
Background: Few HIV/STI and pregnancy prevention programs for youth in American Indian and Alaska Native (AI/AN) communities have been rigorously evaluated despite sexual health disparities in this population. This study reports the evaluation of a culturally adapted Internet-based HIV/STI and pregnancy prevention program for AI/AN youth, Native It’s Your Game (Native IYG).
Methods: A randomized study was conducted with 523 youth (12 to 14 years old), recruited from 25 tribal sites in Alaska, Arizona, and the Pacific Northwest. Participants were surveyed at baseline and upon completion of treatment or comparison interventions. Multivariable linear regression models were used to assess impact on short term psychosocial determinants of sexual initiation.
Results: A sample of 402 intervention (n=290) and comparison (n=112) youth completed the post-intervention survey (76.9% retention) from 1 to 462 days post-baseline (mean = 114, SD = ±96.67). Participants were 55.5% female, mean age of 13.0 (± 0.97) years with 86.1% self-reporting as AI/AN. Reasons not to have sex, STI knowledge, condom knowledge, condom availability self-efficacy, and condom use self-efficacy were significantly impacted (all P ≤ .01). Limitations included variability in intervention exposure and time between data collection time points.
Conclusions: Native IYG demonstrated efficacy to impact short-term psychosocial determinants of sexual behavior in a sample of predominantly AI/AN middle school youth
Of cattle, sand flies and men : a systematic review of risk factor analyses for South Asian visceral leishmaniasis and implications for elimination
Background: Studies performed over the past decade have identified fairly consistent epidemiological patterns of risk
factors for visceral leishmaniasis (VL) in the Indian subcontinent.
Methods and Principal Findings: To inform the current regional VL elimination effort and identify key gaps in knowledge,
we performed a systematic review of the literature, with a special emphasis on data regarding the role of cattle because
primary risk factor studies have yielded apparently contradictory results. Because humans form the sole infection reservoir,
clustering of kala-azar cases is a prominent epidemiological feature, both at the household level and on a larger scale.
Subclinical infection also tends to show clustering around kala-azar cases. Within villages, areas become saturated over a
period of several years; kala-azar incidence then decreases while neighboring areas see increases. More recently, post kalaazar
dermal leishmaniasis (PKDL) cases have followed kala-azar peaks. Mud walls, palpable dampness in houses, and peridomestic
vegetation may increase infection risk through enhanced density and prolonged survival of the sand fly vector.
Bed net use, sleeping on a cot and indoor residual spraying are generally associated with decreased risk. Poor micronutrient
status increases the risk of progression to kala-azar. The presence of cattle is associated with increased risk in some studies
and decreased risk in others, reflecting the complexity of the effect of bovines on sand fly abundance, aggregation, feeding
behavior and leishmanial infection rates. Poverty is an overarching theme, interacting with individual risk factors on multiple
levels.
Conclusions: Carefully designed demonstration projects, taking into account the complex web of interconnected risk
factors, are needed to provide direct proof of principle for elimination and to identify the most effective maintenance
activities to prevent a rapid resurgence when interventions are scaled back. More effective, short-course treatment
regimens for PKDL are urgently needed to enable the elimination initiative to succeed
Cost of hospitalised patients due to complicated urinary tract infections: a retrospective observational study in countries with high prevalence of multidrug-resistant Gram-negative bacteria: the COMBACTE-MAGNET, RESCUING study
OBJECTIVE: Complicated urinary tract infections (cUTIs) impose a high burden on healthcare systems and are a frequent cause of hospitalisation. The aims of this paper are to estimate the cost per episode of patients hospitalised due to cUTI and to explore the factors associated with cUTI-related healthcare costs in eight countries with high prevalence of multidrug resistance (MDR). DESIGN: This is a multinational observational, retrospective study. The mean cost per episode was computed by multiplying the volume of healthcare use for each patient by the unit cost of each item of care and summing across all components. Costs were measured from the hospital perspective. Patient-level regression analyses were used to identify the factors explaining variation in cUTI-related costs. SETTING: The study was conducted in 20 hospitals in eight countries with high prevalence of multidrug resistant Gram-negative bacteria (Bulgaria, Greece, Hungary, Israel, Italy, Romania, Spain and Turkey). PARTICIPANTS: Data were obtained from 644 episodes of patients hospitalised due to cUTI. RESULTS: The mean cost per case was €5700, with considerable variation between countries (largest value €7740 in Turkey; lowest value €4028 in Israel), mainly due to differences in length of hospital stay. Factors associated with higher costs per patient were: type of admission, infection source, infection severity, the Charlson comorbidity index and presence of MDR. CONCLUSIONS: The mean cost per hospitalised case of cUTI was substantial and varied significantly between countries. A better knowledge of the reasons for variations in length of stays could facilitate a better standardised quality of care for patients with cUTI and allow a more efficient allocation of healthcare resources. Urgent admissions, infections due to an indwelling urinary catheterisation, resulting in septic shock or severe sepsis, in patients with comorbidities and presenting MDR were related to a higher cost
Imputation of Missing Data When Measuring Physical Activity by Accelerometry
We consider the issue of summarizing accelerometer activity count data accumulated over multiple days when the time interval in which the monitor is worn is not uniform for every subject on every day. The fact that counts are not being recorded during periods in which the monitor is not worn means that many common estimators of daily physical activity are biased downward
Staining and calculus formation after 0.12% chlorhexidine rinses in plaque-free and plaque covered surfaces: a randomized trial
OBJECTIVES: Studies concerning side effects of chlorhexidine as related to the presence of plaque are scarce. The purpose of this study was to compare the side effects of 0.12% chlorhexidine gluconate (CHX) on previously plaque-free (control group) and plaque-covered surfaces (test group). METHODS: This study had a single-blind, randomized, split-mouth, 21 days-experimental gingivitis design, including 20 individuals who abandoned all mechanical plaque control methods during 25 days. After 4 days of plaque accumulation, the individuals had 2 randomized quadrants cleaned, remaining 2 quadrants with plaque-covered dental surfaces. On the fourth day, the individuals started with 0.12% CHX rinsing lasting for 21 days. Stain index intensity and extent as well as calculus formation were evaluated during the experimental period. RESULTS: Intergroup comparisons showed statistically higher (p<0.05) stain intensity and extent index as well as calculus formation over the study in test surfaces as compared to control surfaces. Thus, 26.19% of test surfaces presented calculus, whereas calculus was observed in 4.52% in control surfaces. CONCLUSIONS: The presence of plaque increased 0.12% CHX side effects. These results strengthen the necessity of biofilm disruption prior to the start of CHX mouthrinses in order to reduce side effects
Circular economy in biocomposite development: State-of-the-art, challenges and emerging trends
Biocomposites being environmentally-friendly alternative to synthetic composites are gaining increasing demand for various applications. Hence, biocomposite development should be integrated within a circular economy (CE) model to ensure a sustainable production that is simultaneously innocuous towards the environment. This review presents an overview of the state-of-the-art technologies for the adoption of the CE concept in biocomposite development. The study outlined the properties, environmental and economic impacts of biocomposites. A critical review of the life-cycle assessment of biocomposite for evaluating greenhouse gas emissions and carbon footprints was conducted. In addition, the opportunities and challenges pertaining to the implementation of CE have been discussed in detail. Recycling and utilisation of bio-based constituents were identified as the critical factors in embracing CE. Therefore, the development of innovative recycling technologies and an enhanced use of novel biocomposite constituents could lead to a reduction in material waste and environmental footprints. This article is one of the first studies to review the circularity of biocomposites in detail that will stimulate further research in enhancing the sustainability of these polymeric materials. © 202
Susceptibility sets and the final outcome of collective Reed–Frost epidemics
This paper is concerned with exact results for the final outcome of stochastic SIR (susceptible → infective → recovered) epidemics among a closed, finite and homogeneously mixing population. The factorial moments of the number of initial susceptibles who ultimately avoid infection by such an epidemic are shown to be intimately related to the concept of a susceptibility set. This connection leads to simple, probabilistically illuminating proofs of exact results concerning the total size and severity of collective Reed–Frost epidemic processes, in terms of Gontcharoff polynomials, first obtained in a series of papers by Claude Lef`evre and Philippe Picard. The proofs extend easily to include general final state random variables defined on SIR epidemics, and also to multitype epidemics
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