Enhanced cognitive behaviour therapy (CBT-E) for severe and extreme anorexia nervosa in an outpatient eating disorder unit at a public hospital: a quality-assessment study

Background The aim of this quality-assessment study was to determine the outcome of patients with severe and extreme anorexia nervosa (AN) in a real-world outpatient setting. Methods Twenty-one adults with AN and a body mass index (BMI) of < 16 were recruited from consecutive referrals to an outpatient clinic at a public hospital in Western Norway. All enrolled patients were provided with enhanced cognitive behaviour therapy (CBT-E) to treat their AN, commencing between January 2013 and December 2016. Their BMI was recorded at baseline, at the end of CBT-E and 1 year after the end of treatment. Results Ten patients completed the CBT-E treatment and achieved a large weight gain with the change remaining stable at follow-up. Eleven patients did not complete the treatment but had a significant increase in BMI at the premature end of treatment. One year after end of therapy 14/21 (66.7%) of the patients had BMI above 18.5 kg/m2. No severe complications were observed during therapy. Conclusions Although 52.4% of the patients did not complete outpatient CBT-E, the findings of this quality-assessment study support previous findings indicating that CBT-E may represent a valid alternative to inpatient treatment in patients with severe and extreme AN.

A64 REVIEW OF PATIENTS REFERRED TO THE DIVISION OF DIGESTIVE CARE AND ENDOSCOPY AT DALHOUSIE UNIVERSITY FOR COLORECTAL CANCER SCREENING BASED ON A FAMILY HISTORY OF COLORECTAL CANCER: HOW MANY UNDERWENT COLONOSCOPY?

Background Nova Scotia has provincial colorectal cancer (CRC) screening for asymptomatic, average risk individuals age 50–74 using fecal immunochemical testing (FIT) every 2 years. However, individuals with 1 or more first degree relatives (FDR) diagnosed with CRC by age 60 have a 2–4 fold increased risk for developing CRC. For these high risk individuals, current guidelines recommend CRC screening with colonoscopy rather than FIT testing. Annually, the Division of Digestive Care & Endoscopy (DCE) at Dalhousie University receives many referrals for patients with a family history of CRC but the percentage of patients who require this procedure is unclear. Aims The objectives of this quality assessment study were to review patients referred to DCE for a family history of CRC to (1) better understand the indication for referral; and (2) determine the percentage of patients undergoing colonoscopy Methods This was a retrospective cross sectional review of a prospectively updated database. The study population was patients referred to DCE from 2012–2019 based on a family history of CRC, as indicated on the referral. Family history of CRC was defined as 1 or more FDRs diagnosed with CRC. High risk patients were those with 2 or more FDRs with CRC or 1 FDR diagnosed by age 60. All patients were reviewed by a single gastroenterologist in clinic. Results A total of 107 referrals from 2012–2019 were reviewed. Of patients age 50 or older, 51/78 (65.4%) had performed at least 1 FIT. The indications for referral were 2 or more FDR diagnosed with CRC for 6/107 (5.6%) patients, 1 FDR diagnosed with CRC by age 60 for 37/107 patients (34.6%) and 1 FDR diagnosed with CRC over age 60 for 33/107 patients (30.8%). The remaining 31/107 patients (29.0%) had no FDR with CRC. Of the 43/107 patients (40.2%) considered high risk based on family history alone, 34/43 (79.1%) underwent colonoscopy and 8/43 (18.6%) opted for FIT testing. Of the 64/107 patients (59.8%) considered average risk based on family history alone, 26/64 (40.6%) had another indication for colonoscopy and 35/64 (54.7%) resumed FIT testing. Conclusions The majority of patients (71.0%) referred to the DCE for a family history of CRC had at least 1 FDR with CRC. Just over half of patients (55.1%) referred to the DCE for a family history of CRC underwent colonoscopy. Strategies to improve the referral process by better capturing high risk individuals are needed. Funding Agencies None

Systematic Longitudinal Evaluating on boosting preschool children’s food literacy

To evaluate different methods in lifting food literacy which are applied to preschool children. Most articles are based on cross-sectional studies, an observational longitudinal design is seldom used, making it difficult to identify the true effectiveness of the methods. Thus, this article use a longitudinal method, including several online database. A systematic article based on longitudinal researches, by searching data in four electronic databases, Web of Science, PubMed, Elsevier (Science Direct) and Google Scholar, setting eligibility criteria, data selection, extracting data, data synthesis and quality assessment. Study identifies 771 original data, and after the de-duplication and eligibility selection, 9 studies are included in the article. Despite the small amount of literature applied, evidences are quiet useful. In comparison of caregiver-based intervention and classroom-based intervention, the later shows more effectiveness in short-term awareness training. Also, great potential has been found in technology-based intervention. The authors recommend future studies to focus on longitudinal research, so as to assess the potential of early childhood food literacy intervention, the mechanism and methods of these studies, the duration and effectiveness in different followup time etc.

How Frequently Is Asthma Objectively Demonstrated before Starting a Biologic? Quality Assessment of a Group Practice of Allergists and Immunologists

Worldwide, asthma-related healthcare cost remains a major burden. Individuals with severe asthma account for 50% of that cost. Although they are expensive, biologics such as anti-IL5 and anti-IgE agents promise cost-effectiveness when judiciously used to decrease asthma-related hospitalization and the debilitating side effects of systemic corticosteroids. Before considering biologics to treat patients with asthma, current guidelines recommend confirmation of asthma and control of comorbid diseases. Diagnostic confirmation of asthma can be challenging among individuals with severe asthma. In this quality assessment study, we determined the frequency of objective asthma confirmation and addressing of comorbidities prior to starting biologics at a group practice of allergists and immunologists. We surveyed our specialty providers to understand habit(s) leading to the observed results. We identified 40 adult patients who started on biologic modifiers for asthma over the past 5 years. Only 58% of these patients had a proper diagnosis of asthma. Providers underutilized several diagnostic methods that may prove useful in confirming asthma diagnosis in this patient population. The factors contributing to poor asthma control were rarely addressed. A sense of urgency to initiate biologics was the primary reason for the observed results. Further interventions are needed to improve asthma diagnosis and management prior to the initiation of biologic therapeutics.

International external quality assessment for SARS-CoV-2 molecular detection and survey on clinical laboratory preparedness during the COVID-19 pandemic, April/May 2020

Laboratory preparedness with quality-assured diagnostic assays is essential for controlling the current coronavirus disease (COVID-19) outbreak. We conducted an external quality assessment study with inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) samples to support clinical laboratories with a proficiency testing option for molecular assays. To analyse SARS-CoV-2 testing performance, we used an online questionnaire developed for the European Union project RECOVER to assess molecular testing capacities in clinical diagnostic laboratories.

Users' perceived level of service at the African Union Court on Human and Peoples' Rights library in Arusha, Tanzania

PurposeThe study examined users' perceived level of service at the African Union Court on Human and Peoples' Rights (AUCHPR) library in Arusha, Tanzania.Design/methodology/approachThe study adopted a quantitative approach in line with the tenets of the LibQUAL and SERVQUAL protocols, which were used as theoretical lenses and informed the development of questionnaires which were used to collect data. The target population consisted of 94 library users.FindingsThe study found that the library's best services, in terms of their quality and as perceived by users, lie in its human resources (i.e. affect of service, assurance and responsiveness). On the other hand, the lowest perceived level of services was recorded in the aspects related to information collection and physical facilities (i.e. library as a place and tangibles).Research limitations/implicationsThis study was based on the African Court on Human and Peoples' Rights library in Arusha, Tanzania. The study covered both internal and external users of the library.Practical implicationsThe study identified strengths and weaknesses of the African Court library as far as the perceived level of service is concerned, and the findings can therefore be used to inform decisions on the improvement of quality of the library services. In so doing, the library will be in a stronger position to offer quality services and assist the court in attaining its objectives of promoting and protecting human rights in Africa. With improved library service quality, the non-judicial staff, external users and society in general will stand to benefit from the library.Originality/valueWhile drawing lessons from previous service quality studies, this study is the first quality assessment study to be done in the African Court library. It is also the first to use a combination of LibQUAL and SERVQUAL models in the context of the African Court library services.

Quality assessment of brands of erythromycin stearate tablets marketed in Abuja, Nigeria

Erythromycin is one of the most frequently prescribed antibiotics. With the increasing number of pharmaceutical industries, the possibility of purchasing a substandard product is on the high side. This makes it necessary to subject various commercially produced brands of erythromycin to quality evaluation in order to ascertain the quality. In this quality assessment study, six (6) brands of erythromycin tablets were subjected to physicochemical assay using standard physical methods and UV/VIS spectrophotometric analysis at 480 nm. The calibration curve for reference erythromycin was linear over a concentration range of 10-100 μg/ml with a correlation coefficient (R2) of 0.999. All the brands had standard deviation of weight greater than ±5 for the weight uniformity test. 66.67% of the brands passed the test for content of active ingredient. 83.33% of the brands examined passed the hardness test. All the brands failed the friability test because the percentage weight loss are greater than 1% as specified in the official book. Keywords: Erythromycin stearate; Tablets; Brands; Pharmaceutical Industries