Employability and the UseMyAbility Online Tool: Raising Sports Students’ Awareness to Inform the Development of Their Skills and Attributes

The collaborative project UseMyAbility (UMA) sought to reduce discrimination and enhance disabled graduates’ employability through equipping them with the skills to match employability skills and attributes. An outcome from the project, completed in 2011, was a web-based tool which gave students advice on how to improve their employability. Subsequently, an online self-audit questionnaire was developed, which allowed students to record and map their employability skills and attributes. This paper reports on two projects that used this UMA online questionnaire with undergraduate sports students at a UK University. The first group were students undertaking a second-year Physical Education (PE) module and the second were students undertaking internships in a variety of sporting contexts. Drawing on data gained from questionnaires and student and mentor interviews, the two projects sought to evaluate the effectiveness of the UMA questionnaire for the students in these two contexts. It aimed to enhance students’ employability profiles, enable them to benchmark and track their development, provide practical help in preparing job applications, tackle interview questions and develop evidence-based curricula vitae. It is hoped that through identifying ways of adapting the use of the questionnaire to these contexts, learning from participant data from the completion of the questionnaires, and gaining a better understanding of students’ and mentors’ perceptions of its use, that insights may be gained that will aid the wider adoption of the online tool

Acute presentations of HIV are still missed in low prevalence areas

Objectives To evaluate missed opportunities and delays in the diagnosis of HIV in a low prevalence setting over a 24 year period. Methods Patients with acute presentations of HIV were included in a retrospective note based review. Data were compared from acute presentations in 1985e2001 (88/241 new patients) with 2005e2007 (99/136 new patients). The number of recorded clinical and laboratory clues to infection and subsequent time delays to diagnosis of HIV were evaluated. Results The findings reflect the shifting demographics of HIV in the UK over the past two decades, exemplified by an eightfold increase in tuberculosis at presentation. Despite recording clinical stigmata of HIV (clues) in the notes, the number of missed clues increased, and many clinicians failed to request HIV testing. The median delay between presentation and diagnosis reduced from 5 to 1 day (p<0.001), and mortality dropped from 14% to 4% among patients presenting with acute symptoms. However, there was still a delay of more than 30 days before diagnosis for almost one in five patients. Conclusions Despite some improvement and better awareness, there are still significant delays before hospital doctors consider the diagnosis of HIV for patients in low prevalence areas, even among some patient groups with high risk. Hospitals should consider moving to opt-out routine HIV testing of all medical admission

Clostridium difficile: a healthcare associated infection of unknown significance in adults in sub-Saharan Africa

Background: Clostridium difficile infection (CDI) causes a high burden of disease in high-resource healthcare systems, with significant morbidity, mortality and financial implications. CDI is a healthcare-associated infection for which the primary risk factor is antibiotic usage and it is the leading cause of bacterial diarrhoea in HIV infected patients in USA. Little is known about the disease burden of CDI in sub-Saharan Africa, where HIV and healthcare associated infection have a higher prevalence and antibiotic usage is less restricted. Aim: To review published literature on CDI in sub-Saharan Africa, highlighting areas for future research. Methods: English language publications since 1995 were identified from online databases (PubMed, Medline, Google Scholar, SCOPUS) and personal collections of articles, using combinations of keywords to include C. difficile, Africa and HIV. Results: Ten relevant studies were identified. There is considerable variation in methodology to assess for carriage of toxigenic C. difficile and its associations. Eight studies report carriage of toxigenic C. difficile. Three (of four) studies found an association with antibiotic usage. One (of four) studies showed an association with HIV infection. One study showed no association with degree of immunosuppression in HIV. Two (of three) studies showed an association between carriage of toxigenic C. difficile and diarrhoeal illness. Conclusion: Whilst the carriage of toxigenic C. difficile is well described in sub-Saharan Africa, the impact of CDI in the Region remains poorly l understood and warrants high quality research

An integrated model of care for neurological infections: the first six years of referrals to a specialist service at a university teaching hospital in Northwest England

Background A specialist neurological infectious disease service has been run jointly by the departments of infectious disease and neurology at the Royal Liverpool University Hospital since 2005. We sought to describe the referral case mix and outcomes of the first six years of referrals to the service. Methods Retrospective service review. Results Of 242 adults referred to the service, 231 (95 %) were inpatients. Neurological infections were confirmed in 155 (64 %), indicating a high degree of selection before referral. Viral meningitis (35 cases), bacterial meningitis (33) and encephalitis (22) accounted for 38 % of referrals and 61 % of confirmed neurological infections. Although an infrequent diagnosis (n = 19), neurological TB caused the longest admission (median 23, range 5 – 119 days). A proven or probable microbiological diagnosis was found in 100/155 cases (64.5 %). For the whole cohort, altered sensorium, older age and longer hospital stay were associated with poor outcome (death or neurological disability); viral meningitis was associated with good outcome. In multivariate analysis altered sensorium remained significantly associated with poor outcome, adjusted odds ratio 3.04 (95 % confidence interval 1.28 – 7.22, p = 0.01). Conclusions A service of this type provides important specialist care and a focus for training and clinical research on complex neurological infections