Factors Affecting Women's Knowledge of Antenatal Serum Screening

1997 ◽  
Vol 42 (4) ◽  
pp. 111-113 ◽  
Author(s):  
G.K. Grewal ◽  
H.J. Moss ◽  
D.A. Aitken ◽  
S. Bjornsson ◽  
A.D. Cameron ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Fetal Anomaly ◽  
Antenatal Screening ◽  
Fetal Abnormality ◽  
Factors Affecting ◽  
Negative Results ◽  
Written Information ◽  
Superior Knowledge ◽  
Increased Risk ◽  
Positive Results

Antenatal screening for fetal anomaly is offered routinely in Glasgow. This study assessed pregnant women S knowledge of the test and implications of results. Questionnaires were completed by 574 women. Knowledge of the nature and uses of the test was superior to earlier studies Two-thirds knew that screening was undertaken for Down's syndrome, and 81% for spina bifida. The majority were aware of the sample used, ages invited and gestation at which it was undertaken. Knowledge of the likely results and implications was poorer. Three-quarters were unaware that 10% of results would suggest an increased risk. Half did not realise that positive results could occur without fetal abnormality, or negative results could be falsely reassuring. Socioeconomic deprivation was associated with poorer knowledge but not lower uptake. Written information was associated with superior knowledge and higher uptake. Leaflets should be provided prior to booking, at which time resultant queries can be answered.

scholarly journals Audit of antenatal screening for syphilis and HIV in migrant and refugee women on the Thai-Myanmar border: a descriptive study

F1000Research ◽  
2015 ◽  
Vol 3 ◽  
pp. 123 ◽  
Author(s):  
Rose McGready ◽  
Joy Kang ◽  
Isabella Watts ◽  
Mary Ellen G Tyrosvoutis ◽  
Miriam B. Torchinsky ◽  
...  
Keyword(s):  
Descriptive Study ◽  
First Year ◽  
Antenatal Screening ◽  
Testing Strategies ◽  
Syphilis Testing ◽  
Increased Risk ◽  
Syphilis Screening ◽  
Potential Impact ◽  
Low Prevalence ◽  
Positive Results

Objective: The antenatal prevalence of syphilis and HIV/AIDS in migrants and refugees is poorly documented. The aim of this study was to audit the first year of routine syphilis screening in the same population and reassess the trends in HIV rates.Methods: From August 2012 to July 2013, 3600 pregnant women were screened for HIV (ELISA) and syphilis (VDRL with TPHA confirmation) at clinics along the Thai-Myanmar border.Results: Seroprevalence for HIV 0.47% (95% CI 0.30-0.76) (17/3,599), and syphilis 0.39% (95% CI 0.23-0.65) (14/3,592), were low. Syphilis was significantly lower in refugees (0.07% 95% CI 0.01-0.38) (1/1,469), than in migrants (0.61% 95% CI 0.36-1.04) (13/2,123). The three active (VDRL≥1:8 and TPHA reactive) syphilis cases with VDRL titres of 1:32 were easy to counsel and treat. Women with low VDRL titres (>75% were < 1:8) and TPHA reactive results, in the absence of symptoms and both the woman and her husband having only one sexual partner in their lifetime, and the inability to determine the true cause of the positive results presented ethical difficulties for counsellors.Conclusion: As HIV and syphilis testing becomes available in more and more settings, the potential impact of false positive results should be considered, especially in populations with low prevalence for these diseases. This uncertainty must be considered in order to counsel patients and partners accurately and safely about the results of these tests, without exposing women to increased risk for abuse or abandonment. Our findings highlight the complexities of counselling patients about these tests and the global need for more conclusive syphilis testing strategies.

Reproduction, fetal medicine and genomics

2020 ◽  
pp. 175573802097470
Author(s):  
Tessa Homfray ◽  
Judith Hayward ◽  
Imran Rafi
Keyword(s):  
Primary Care ◽  
Recurrent Miscarriage ◽  
Genetic Disorder ◽  
Prenatal Testing ◽  
Antenatal Screening ◽  
Fetal Abnormality ◽  
Fetal Medicine ◽  
Non Invasive ◽  
Genomic Technologies ◽  
Increased Risk

Identification of a genetic disorder within a family raises the question of risk of the genetic disorder to other family members and future pregnancies. This question is particularly pertinent when considering reproductive risks and choices. Primary care is crucial in identifying and managing couples at increased risk of having an affected pregnancy, both pre-conceptually and in early pregnancy, before the first midwife appointment. Genomic technologies have an increasing role in antenatal screening programmes and antenatal testing; specifically non-invasive prenatal testing considered in this article. Infertility, recurrent miscarriage and fetal abnormality may all have an underlying genetic cause.

scholarly journals Discordant QuantiFERON-TB Gold Test Results Among US Healthcare Workers With Increased Risk of Latent Tuberculosis Infection: A Problem or Solution?

2008 ◽  
Vol 29 (9) ◽  
pp. 878-886 ◽  
Author(s):  
Nira R. Pollock ◽  
Antonio Campos-Neto ◽  
Suely Kashino ◽  
Danielle Napolitano ◽  
Samuel M. Behar ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Interferon Γ ◽  
Tuberculosis Infection ◽  
Test Results ◽  
Negative Results ◽  
Increased Risk ◽  
Release Assay ◽  
Positive Results

Objective.In late 2006, our hospital implemented use of the QuantiFERON-TB Gold (QFT-G) assay, a whole-blood interferon-γ release assay, for detection of tuberculosis infection. All newly hired healthcare workers (HCWs) with positive Mantoux tuberculin skin test (TST) results were routinely tested with the QFT-G assay, to take advantage of its higher specificity. We then undertook a quality assurance review to evaluate the QFT-G test results in HCWs with multiple risk factors for latent tuberculosis infection (LTBI).Methods.The clinical records for TST-positive HCWs tested with the QFT-G assay were reviewed. HCWs with 2 or more risk factors commonly associated with LTBI were classified as “increased risk” (IR). IR HCWs who had negative QFT-G test results underwent repeat QFT-G testing and were offered testing with a different interferon-γ release assay (T-SPOT.TB) and with extended T cell stimulation assays.Results.Ofl43 TST-positive HCWs tested with the QFT-G assay, 26 (18%) had positive results, 115 (81%) had negative results, and 2 (1 %) had indeterminate results. Of 82 IR HCWs, 23 (28%) had positive QFT-G test results, and 57 (70%) had negative results. Of the 57 IR HCWs with negative results, 43 underwent repeat QFT-G testing: 41 had negative results again, and 2 had positive results. These 43 HCWs were also offered additional testing with the T-SPOT.TB diagnostic, and 36 consented: 31/36 tested negative, and 5/36 tested positive. Extended assays using the antigens ESAT-6 and CFP-10 confirmed the positive results detected by the overnight assays and yielded positive results for an additional 7/36 (19%) of individuals; strikingly, all 36 HCWs had strongly positive test results with assays using purified protein derivative.Conclusions.The extreme discordance between the results of our clinical diagnostic algorithm and the results of QFT-G testing raises concern about the sensitivity of the QFT-G assay for detection of LTBI in our HCWs. Results of extended stimulation assays suggest that many of our IR HCWs have indeed been sensitized to Mycobacterium tuberculosis. It is possible that the QFT-G assay identifies those at higher reactivation risk rather than all previously infected, but, in the absence of long-term follow-up data, we should interpret negative QFT-G results with some caution.

Critical Evaluation of Impedance Phlebography for the Diagnosis of Deep Vein Thrombosis

1974 ◽  
Vol 31 (02) ◽  
pp. 273-278
Author(s):  
Kenneth K Wu ◽  
John C Hoak ◽  
Robert W Barnes ◽  
Stuart L Frankel
Keyword(s):  
Deep Vein Thrombosis ◽  
False Positive ◽  
False Negative ◽  
Critical Evaluation ◽  
Original Method ◽  
Vein Thrombosis ◽  
Negative Results ◽  
False Negative Results ◽  
Deep Vein ◽  
Positive Results

SummaryIn order to evaluate its daily variability and reliability, impedance phlebography was performed daily or on alternate days on 61 patients with deep vein thrombosis, of whom 47 also had 125I-fibrinogen uptake tests and 22 had radiographic venography. The results showed that impedance phlebography was highly variable and poorly reliable. False positive results were noted in 8 limbs (18%) and false negative results in 3 limbs (7%). Despite its being simple, rapid and noninvasive, its clinical usefulness is doubtful when performed according to the original method.

PET/CT WITH 68GA-PSMA-11 IN DETECTION OF PRIMARY TUMOR AND RECURRENCE OF PROSTATE CANCER

2018 ◽  
Vol 64 (6) ◽  
pp. 799-804
Author(s):  
Darya Ryzhkova ◽  
M. Poyda
Keyword(s):  
Prostate Cancer ◽  
Primary Tumor ◽  
Biochemical Recurrence ◽  
Whole Body ◽  
Negative Results ◽  
Primary Prostate Cancer ◽  
Pet Ct ◽  
The Relationship ◽  
Positive Results ◽  
T Category

Purpose: To study the diagnostic value of PET-CT with 68Ga-PSMA-11 in the diagnosis of a primary prostate cancer, preoperative staging, and the detection of recurrence of prostate cancer (PCa). Methods: 28 patients aged 64.7 ± 8.74 years were included. 10 patients primary prostate cancer, and 18 patients with biochemical recurrence of the disease after radical treatment were examined. All patients underwent PET-CT with 68Ga-PSMA-11 according the whole body protocol. Interpretation of images was performed visually and quantitatively by calculation of SUL max. Results: High focal or diffuse 68Ga-PSMA-11 uptake was found in prostate parenchyma in patients with primary prostate cancer. Additionally metastases in regional lymph nodes were diagnosed in 4 patients and bone metastases were found in one patient. The correlation between 68Ga-PSMA-11 uptake level and Gleason index in the primary tumor (R Spearmen = 0.25, p = 0.57) was not observed. PET-positive results were obtained in 14 patients and PET-negative results in 4 patients with biochemical recurrence of PCa. The relationship between the frequency of PET-positive results and Gleason index was not revealed (R Spearmen = 0.2, p = 0.39). We found a weak but significant correlation between the frequency of PET-positive results and the prostate tumor stage according to the T category (R Spearmen = 0.49, p = 0.049). In patients with low values of PSA (less than 1.0 ng/ml) in 4 out of 9 cases, PET-negative results were obtained. In patients with PSA level more than 1.0 ng/ml PET-positive results were obtained in all cases. Conclusions: PET/CT with 68Ga-PSMA-11 allows to diagnose the primary prostate cancer, to establish the stage of the disease in categories N and M, and also to determine the localization and dissemination of the tumor in patients with biochemical recurrence of prostate cancer. The relationship between 68Ga-PSMA-11 uptake in primary tumor and Gleason index was not found. The probability of obtaining PET-positive results in cases of biochemical recurrence is affected by a PSA level above 1 ng/ml and a high stage of the disease according to the T category (T3-T4).

Using Self-report to Study How Application affect Motivation of Behavior Change (Preprint)

2020 ◽  
Author(s):  
Yuan Yin ◽  
Yurong Yu
Keyword(s):  
Behavior Change ◽  
Self Report ◽  
Group Method ◽  
Behavior Changes ◽  
Technology Design ◽  
Factors Affecting ◽  
Negative Results ◽  
Long Time ◽  
Ecological Momentary ◽  
Positive Effect

BACKGROUND Currently, changing behaviors with the assistance of mobile applications has been popularized. However, most of the participants are unable to persist in participating in behavior-changing activities for a long time. Some researchers have studied what factors motivate people to maintain behaviors-changing actions. There has been controversy about whether the commonly used triggers, negative results or competitions, could motivate behavior changes. In the meantime, the main methodology these researchers have been using is to conduct experiments, from which data was collected from subjects’ recalling previous behavior changing. The experiments are time-consuming, and the results can be unreliable. To resolve this problem, the Ecological Momentary Assessment (EMA) was developed to record real-time feedback. However, the EMA unavoidably increases the workload of the subjects. OBJECTIVE This study investigated the factors affecting behavior change, especially from the motivation aspect. Additionally, this paper attempted to identify a way to record human behavior changes without increasing the subjects’ workload. METHODS The methodology of “self-report” was adopted to report how people’s views regarding the behavior-changing intervention. To achieve a balance between workload and being timely, the self-reporting data was recorded once a day. After the 28-day “self-report” experiment, the “focus group” method was used to gather people’s feedback on behavior changing process. RESULTS This paper identified 9 factors: cooperation, competition, award, understandable graphic, reminder and alarm, trust and willing, gender, relation with disease and environmental factors). These factors could affect motivation of behavior changing. Besides, we found that negative results could be a motivation for behavior changing. In the experiment, we also found that a small number of subjects tended to cheat for a more “beautiful” result. The last part of the paper has presented possible implications for technology design to facilitate behavior-changing. CONCLUSIONS In particular, (i) the research promoted the possibility of cheating when recording data which is ignored by existing research and will make the digital applications less useful; (ii) the results show that not all cooperation is needed to lead to a positive effect; (iii) the research identified the negative results caused by over-competition in behavior change. Finally, the paper proposes technology design directions should focus on giving motivation through keeping dairy, negative results feedback and avoid cheating.

scholarly journals Diagnostic Performance of Ankle-Brachial Pressure Index in Lower Extremity Arterial Disease

2021 ◽  
Vol 07 (03) ◽  
pp. e132-e137
Author(s):  
Mohammed Alagha ◽  
Thomas M. Aherne ◽  
Ahmed Hassanin ◽  
Adeel S. Zafar ◽  
Doireann P. Joyce ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Sensitivity And Specificity ◽  
False Negative ◽  
Arterial Disease ◽  
Initial Assessment ◽  
Reference Standard ◽  
Lower Extremity Arterial Disease ◽  
Negative Results ◽  
Positive Results ◽  
Arterial Imaging

Abstract Introduction Ankle-brachial pressure indices (ABIs) continue to form the basis of diagnostics for lower extremity arterial disease (LEAD). However, there remains a paucity of data to support its accuracy. This study aims to evaluate its diagnostic sensitivity and specificity using established arterial-imaging modalities as a benchmark. Methods In this retrospective study, a regional, prospectively maintained, vascular laboratory database was interrogated to identify referred patients with arterial disease who underwent concomitant assessment with ABI and lower limb arterial duplex ultrasound (DUS). Duplex acted as the reference standard. Those who had peripheral computed tomography angiogram (CTA) within 3 months of initial assessment were included in a subgroup analysis to correlate ABI with CTA. The primary end point was the sensitivity and specificity of ABI compared with DUS as the reference standard. Results Concomitant assessment was performed in 438 limbs (250 patients) over a 27-month period. The ABI was normal (0.9 to 1.4) in 196 limbs (44.9%) and abnormal in the remaining 241 limbs (55.1%). False-positive results occurred in 83 out of 241 limbs (34.4%), and false-negative results occurred in 54 limbs out of 196 (27.5%). True-positive results were 158 out of 241 limbs (65.6%), whereas true-negative results were 142 out of 196 limbs (72.4%). ABI using DUS as a benchmark identified a sensitivity for peripheral artery disease of 72.3% and a specificity of 69.3%. Concomitant CTA imaging was available in 200 limbs. The sensitivity and specificity of ABI correlated with CTA were 65.5 and 68.8%, respectively. Conclusion ABIs have a moderate predictive value in the diagnosis of LEAD. Normal range outcomes cannot be taken to infer the absence of LEAD and, as such, further arterial imaging in the form of DUS or angiography should be strongly considered in those with suspected underlying disease requiring intervention. Further noninvasive tests such as exercise studies or pulse volume waveforms should be considered, if diagnostic uncertainty exists, in those requiring nonoperative intervention and risk factor control.

Factors affecting coagulation: fibrinolysis in chronic subdural fluid collections

1983 ◽  
Vol 58 (2) ◽  
pp. 242-245 ◽  
Author(s):  
Bryce Weir ◽  
Philip Gordon
Keyword(s):  
Degradation Products ◽  
Hemoglobin Content ◽  
Fibrin Degradation Product ◽  
Content Type ◽  
Factors Affecting ◽  
Fibrin Degradation Products ◽  
Subdural Hematomas ◽  
Increased Risk ◽  
Fluid Collections ◽  
Fine Print

✓ Plasminogen, alpha2-antiplasmin, fibrinogen, fibrin degradation products (FDP's), and hemoglobin were measured in the supernatant fluid of 25 chronic subdural hematomas and five chronic subdural hygromas. The 30 patients underwent pre- and postoperative computerized tomography. The hematomas were characterized by low fibrinogen and high fibrin degradation product concentrations. The hemoglobin content varied directly with the alpha2-antiplasmin, and inversely with the plasminogen. Four patients underwent reoperation for recurrences. The initial fluid from these cases was characterized by relatively high plasminogen and low alpha2-antiplasmin. The hygromas had no hemoglobin, and low fibrinogen, high FDP's, low alpha2-antiplasmin, and variable plasminogen levels. It is possible that those cases having the greatest capacity to produce plasmin (high plasminogen and low alpha2-antiplasmin) can produce more FDP's which in turn causes more rebleeding and an increased risk of reaccumulation of chronic subdural hematomas.

scholarly journals New technical advances in swivel walkers

2003 ◽  
Vol 27 (2) ◽  
pp. 132-138 ◽  
Author(s):  
J. Stallard ◽  
B. Lomas ◽  
P. Woollam ◽  
I. R. Farmer ◽  
N. Jones ◽  
...  
Keyword(s):  
Spina Bifida ◽  
Muscular Atrophy ◽  
Young Patients ◽  
Suitable Alternative ◽  
Detail Design ◽  
Increased Risk ◽  
Technical Advances ◽  
Disabled Patients ◽  
Manual Handling ◽  
The Uk

Swivel walkers were commonly prescribed for children with complete thoracic lesion myelomeningocele in the 1970s and 80s, when the incidence of spina bifida in the UK was of the order of 3 per 100,000 live births. The advent of reciprocal walking orthoses provided a more suitable alternative for those with good upper limb and trunk function, and swivel walkers were then used primarily for very young or more severely disabled patients. Prenatal screening has dramatically reduced the incidence of spina bifida in the UK and subsequently swivel walkers have been used in a wider range of pathology, including spinal muscular atrophy, multiple sclerosis, muscular dystrophy and other neurological conditions that lead to lower limb dysfunction. The detail design of these devices has been adapted to accommodate the specific problems encountered in these conditions. In particular the designs have been updated to: enable very young patients to be more readily fitted at the age of 1 year; allow the walking mechanisms to be conveniently adjusted for easier ambulation when weakness or lack of confidence inhibits performance; permit simple adjustment to a standing frame mode to enhance stability in situations of increased risk; promote manual handling practice that is compatible with the National Health Service (NHS) policy of compliance with relevant regulations. To underpin appropriate prescription and safe supply the NHS Procurement Agency have encouraged the development of a common course for all types of swivel walker.

scholarly journals The Interpretation of Studies Using the Reading Level Design

1989 ◽  
Vol 21 (4) ◽  
pp. 413-424 ◽  
Author(s):  
Usha Goswami ◽  
Peter Bryant
Keyword(s):  
Reading Disability ◽  
Reading Level ◽  
Chronological Age ◽  
Control Group ◽  
Causal Factors ◽  
Negative Results ◽  
Level Design ◽  
Positive Results

Recent research in reading disability has been strengthened by the addition of a reading level (RL) control group to the more traditional chronological age (CA) control group. However, caution is required in interpreting results from these two kinds of control. Only positive results in a RL match and negative results in a CA match are interpretable; negative results in a CA match and positive results in a RL match are not. Furthermore, the RL control group cannot be used to unambiguously determine between specific deficit and developmental lag interpretations of reading disability. It is argued that the use of the RL control can only ever be a first step in research aimed at delineating the causal factors in reading backwardness.

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