Biliary complications during a decade of increased cholecystectomy rate

Background

Bile duct injury is a rare complication of cholecystectomy. The aims of this study were to analyse the mechanism and outcome of biliary complications and determine the Northern Ireland incidence of bile duct injury over the last decade.

Methods

Annual numbers of cholecystectomies were obtained from the Northern Ireland Hospital Inpatient System database. Bile duct injury referrals to a hepatobililary unit over an 11-year period from 2000 were reviewed. Mechanism and recognition of injury, referral interval, management and outcome were analysed.

Results

The annual incidence of laparoscopic cholecystectomy in Northern Ireland increased from 0.038% in 1995 to 0.101% in 2009. Thirty-five patients with biliary complications from cholecystectomy were referred from 2000. The incidence of bile duct injury associated with laparoscopic cholecystectomy during this period was 0.2%. Only 26% of injuries were recognised intra-operatively, only 40% were referred immediately and 91% required operative intervention.

Conclusion

The incidence of laparoscopic cholecystectomy has increased in Northern Ireland. The incidence of bile duct injuries over the last 11 years was 0.2%. Recognition and referral were delayed in most cases. The majority of injuries required operative management and long-term follow-up.     

Socio-demographic characteristics associated with HIV and syphilis seroreactivity among pregnant women in Blantyre,Malawi, 2000–2004

Objectives

We aimed to evaluate socio-demographic factors associated with HIV and syphilis seroreactivity in pregnant Malawians presenting for antenatal care in late third trimester of pregnancy.

Methods

Between December 2000 and March 2004 at Queen Elizabeth Central Hospital Blantyre, Malawi, we collected cross-sectional clinical and socioeconomic data from consenting women. HIV-1 status was determined using rapid HIV antibody tests and syphilis seroreactivity was determined using Rapid Plasma Reagin (RPR) and confirmed with Treponema pallidum hemagglutination assay (TPHA).

Results

Of 3,824 women screened for HIV, 1156 (30%) were HIV seropositive and 198 (5%) were RPR and TPHA seroreactive. In the multivariate analysis, HIV infection was positively associated with elevated socio-economic status, being formerly married, and age, but not with education level. HIV prevalence was lower in women of Yao ethnicity than in other women (OR: 0.78, 95%CI: 0.64 – 0.95). Increased maternal education was negatively associated with syphilis seroreactivity.

Conclusions

The seroprevalence of HIV and syphilis among women attending the antenatal ward in Blantyre remains unacceptably high. Demographic correlates of HIV and syphilis infections were different. Our results demonstrate the need for better strategies to prevent HIV and syphilis in women and calls for optimizing antenatal syphilis screening and treatment in Malawi.     

Childhood circumcision in Northern Ireland: a barometer of the current practice of general paediatric surgery

Purpose:

Studies undertaken in England and Scotland have identified a decrease in the number of circumcision operations being performed during childhood. The aims of this study were two-fold. Firstly, to determine the trend in circumcision operations performed in boys in Northern Ireland over a ten year period. Secondly, to compare the number of operations performed by paediatric surgeons with the number performed by general surgeons over the same period.

Method:

Data were collected from the Northern Ireland Department of Health and Social Services and Public Safety. A retrospective analysis was conducted of the number of circumcisions performed in boys aged between 0 and 13 years for the year beginning 1^st September 1991 to the 1^st of September 1992 and for the year beginning 1^st September 2001 until the 1^st of September 2002.

Results:

769 circumcisions were performed in the year 1991 to 1992 compared with 264 in the year 2001 to 2002, representing a 66% decrease. In the ten year study period, the number of circumcisions performed by general surgeons fell by 71% whilst specialist paediatric surgeons performed 56% less.

Conclusions:

The decrease in rates of circumcision in boys aged 0 to 13 years in Northern Ireland is consistent with trends in the remainder of the United Kingdom. The results also suggest a greater decrease in the proportion of circumcisions being performed by general surgeons in district general hospitals compared to those performed by paediatric surgeons.     

The patient-provider relationship and antenatal care uptake at two referral hospitals in Malawi: A qualitative study

Background

Approximately 90% of Malawian women attend antenatal care at least once during their pregnancies; however, most mothers first present during months five and six and do not adhere to the World Health Organization''s recommended four visits. The objective of this study was to explore the role the patient-provider relationship has on antenatal care uptake.

Methods

A qualitative study, consisting of interviews with 20 urban pregnant mothers and eight health workers, was conducted from September to December 2014. Two large tertiary care hospitals in the Central and Southern regions of Malawi were selected as study sites.

Results

Several factors influenced antenatal care attendance. Significant barriers reported included the patient-provider relationship, clinic wait times, family and friend support, distance from home to the clinic, transportation, cost, and number of visits. The patient-provider relationship appears to have a large impact on antenatal clinic participation. Mothers indicated that health workers often mistreat or demean them during visits. Additionally, health workers revealed that, due to staff shortages, patients often do not receive the care they deserve.

Conclusions

The results of this study suggest that, in addition to other factors, healthcare provider attitudes influence antenatal clinic attendance. Improving the patient-provider relationship may increase antenatal clinic attendance and decrease pregnancy complications during pregnancy. Professional development opportunities and quality improvement programmes are would help improve patient care and health outcomes while the continued staff shortages in the country are addressed.     

Assessing the need for low secure care in Northern Ireland

Aims and method

To assess the need for the provision of low secure care in Northern Ireland. A survey of the providers of healthcare in Northern Ireland was conducted using a study tool based on Royal College of Psychiatrists Low Secure Network Standards admission criteria.

Results

A total of 105 patients were assessed as needing low secure care including 93 patients currently admitted to hospital in the region and 12 patients admitted to hospital outside of the region.

Clinical Implications

The results of this study are similar to previous estimates of need for the provision of low secure care in the UK. The results provide information likely to be of assistance in the commissioning of low secure services.

Declaration of Interest

NoneIt is self evident that what is needed in one part of a service will depend on the provision in other parts of the service. Mental Health Services in Northern Ireland have undergone substantial change in the past ten years through the implementation of the Bamford Review and Transforming Your Care.^{1, 2, 3} A significant consequence has been a change in the provision of inpatient care. A reduction in average available mental health beds by 35% over the past 5 years combined with high occupancy rates (90%) and a 19% reduced length of stay reflect a reduction in inpatient bed availability.⁴A regional network of forensic mental health services has been developing including the opening of the first medium secure unit, Shannon Clinic, in 2005, the development of community forensic mental health teams, and mental health services in prison.There are plans for the closure of long stay wards over the next few years.⁴ The Bamford Adult Implementation Group is chaired by commissioners and is tasked with planning the provision of low secure care. Low secure units provide rehabilitation for patients who need to be detained to hospital under mental health legislation. The criteria for detention to hospital are that the person suffers from a mental illness and failure to detain them would create a substantial risk of serious physical harm to self or others.The secure component of care consists of physical security, such as locked doors and fences, procedural security, such as control of various items coming into the ward, and relational security, which involves fostering therapeutic relationships through an in depth knowledge of the patient''s illness and behaviour. Low secure rehabilitation aims to reintegrate the patient back into society through multidisciplinary treatment of their illness and a reduction in the risk of harm that led to their detention.This survey aimed to assess the current need for the provision low secure services in the region. Unlike other parts of the UK, there is no private sector provision of secure mental healthcare in Northern Ireland.     

Multidisciplinary assessment of vision in children with neurological disability

Introduction

There is no consensus as to the best method of assessing vision in children with neurological disability. There are a variety of tests and approaches that can be used. It is important to look at models of assessment that identify the visual diagnosis and provide appropriate feedback and explanation to parents, carers and educational professionals.

Methods

This study reports on the results of comprehensive visual assessments of fifty children with neurological disability over a three year period. It focuses on the feedback from families and professionals after the assessment report was disseminated.

Results

The majority of families and professionals strongly agreed that a specialist assessment was needed in this population. Parents and professionals particularly valued the written report which provided guidance on appropriate visual material including advice relevant to education.

Conclusion

This study highlights the importance of specialist teams engaging with local child development services and indicates how partnership working can potentially be emotionally supportive as well as developmentally beneficial.     

Health Professionals Expose TB Patients to Stigmatization in Society: Insights from Communities in an Urban District in Ghana

Objectives

To determine how the activities and attitudes of health professionals expose TB patients to stigmatization in the community.

Design

Qualitative research approach using individual interviews and focus groups

Setting

Shama Ahanta East Metropolitan district in the western region of Ghana

Participants

Members in nine communities in the district

Outcome measures

Words and statements that depict how activities and attitudes of health professionals may expose TB patients to stigmatization

Results

Five interrelated ways by which activities and attitudes of health professionals may expose TB patients to stigmatization in the community were identified in data: TB control practices; fear-based responses to TB; inappropriate health education messages; medical licensing for sellers; and prohibition of burial rites.

Conclusions

The findings may explain the diagnostic delay and low TB case detection rate in Ghana. This calls for intensification of education on TB and regular organization of refresher courses and possibly retraining of health professionals in TB control and management. When health professionals are seen to be treating TB patients as ‘normal’ individuals, it has the potential of changing the society''s perception about the disease.     

Perinatal mortality audit at Tikure Anbessa Teaching Hospital,Addis Ababa,Ethiopia: 1995 to 1996

Objectives

To determine the prevalence and causes of perinatal mortality rates at Tikure Anbessa hospital, Ethiopia, 1995–96

Design

A cross-sectional review of hospital records of all women who delivered at Tikure Anbessa Hospital. Data were collected prospectively.

Setting

Teaching Hospital of Tikure Anbessa, Addis Ababa, Ethiopia

Subjects

Women and neonates from 8986 deliveries. Deliveries exceeding 28 weeks of gestation or birth weight of 1000 grams were considered.

Materials and Methods

All deliveries were included for infants whose gestational age exceeded 28 completed weeks. When the gestational age was unknown, the birth weight of 1000 grams or more was considered. All perinatal deaths and obstetric complications were identified. Labour chart, mode of delivery and summary of delivery had been recorded by the responsible resident at a monthly combined obstetric and paediatric perinatal mortality meeting. Age of the mother, parity, booking status for antenatal care, obstetric complications, labour, mode of delivery, birth weight, gestational age, one and five minutes Apgar scores were collected.

Results

A total of 8986 deliveries were conducted during the study period. Of these 6933 (77.2%) were booked for antenatal care while the remaining 2053 (22.8%) were not booked in any health institution. The perinatal mortality rate of the hospital was 71.6 per 1000 live births. The risk of perinatal mortality was more than doubled among mothers who failed to book for antenatal care follow-up and no laboratory investigations was done were birth asphyxia followed by premature birth 15.4% and 12% respectively.

Conclusions

Perinatal mortality rates are high at Tikure Anbessa Hospital, Ethiopia. There is need to ensure that pregnant women are booked for antenatal care so as to provide adequate antenatal and perinatal health care.     

The design and evaluation of a graphical display for laboratory data

Objective

Advances in healthcare information technology have provided opportunities to present data in new, more effective ways. In this study, we designed a laboratory display that features small, data-dense graphics called sparklines, which have recently been promoted as effective representations of medical data but have not been well studied. The effect of this novel display on physicians'' interpretation of data was investigated.

Design

Twelve physicians talked aloud as they assessed laboratory data from four patients in a pediatric intensive care unit with the graph display and with a conventional table display.

Measurements

Verbalizations were coded based on the abnormal values and trends identified for each lab variable. The correspondence of interpretations of variables in each display was evaluated, and patterns were investigated across participants. Assessment time was also analyzed.

Results

Physicians completed assessments significantly faster with the graphical display (3.6 min vs 4.4 min, p=0.042). When compared across displays, 37% of interpretations did not match. Graphs were more useful when the visual cues in tables did not provide trend information, while slightly abnormal values were easier to identify with tables.

Conclusions

Data presentation format can affect how physicians interpret laboratory data. Graphic displays have several advantages over numeric displays but are not always optimal. User, task and data characteristics should be considered when designing information displays.     

Clinical decision support with automated text processing for cervical cancer screening

Objective

To develop a computerized clinical decision support system (CDSS) for cervical cancer screening that can interpret free-text Papanicolaou (Pap) reports.

Materials and Methods

The CDSS was constituted by two rulebases: the free-text rulebase for interpreting Pap reports and a guideline rulebase. The free-text rulebase was developed by analyzing a corpus of 49 293 Pap reports. The guideline rulebase was constructed using national cervical cancer screening guidelines. The CDSS accesses the electronic medical record (EMR) system to generate patient-specific recommendations. For evaluation, the screening recommendations made by the CDSS for 74 patients were reviewed by a physician.

Results and Discussion

Evaluation revealed that the CDSS outputs the optimal screening recommendations for 73 out of 74 test patients and it identified two cases for gynecology referral that were missed by the physician. The CDSS aided the physician to amend recommendations in six cases. The failure case was because human papillomavirus (HPV) testing was sometimes performed separately from the Pap test and these results were reported by a laboratory system that was not queried by the CDSS. Subsequently, the CDSS was upgraded to look up the HPV results missed earlier and it generated the optimal recommendations for all 74 test cases.

Limitations

Single institution and single expert study.

Conclusion

An accurate CDSS system could be constructed for cervical cancer screening given the standardized reporting of Pap tests and the availability of explicit guidelines. Overall, the study demonstrates that free text in the EMR can be effectively utilized through natural language processing to develop clinical decision support tools.     

Delivery room management of very low birth weight infants in Germany,Austria and Switzerland - a comparison of protocols

Background

Surveys from the USA, Australia and Spain have shown significant inter-institutional variation in delivery room (DR) management of very low birth weight infants (VLBWI, < 1500 g) at birth, despite regularly updated international guidelines.

Objective

To investigate protocols for DR management of VLBWI in Germany, Austria and Switzerland and to compare these with the 2005 ILCOR guidelines.

Methods

DR management protocols were surveyed in a prospective, questionnaire-based survey in 2008. Results were compared between countries and between academic and non-academic units. Protocols were compared to the 2005 ILCOR guidelines.

Results

In total, 190/249 units (76%) replied. Protocols for DR management existed in 94% of units. Statistically significant differences between countries were found regarding provision of 24 hr in house neonatal service; presence of a designated resuscitation area; devices for respiratory support; use of pressure-controlled manual ventilation devices; volume control by respirator; and dosage of Surfactant. There were no statistically significant differences regarding application and monitoring of supplementary oxygen, or targeted saturation levels, or for the use of sustained inflations. Comparison of academic and non-academic hospitals showed no significant differences, apart from the targeted saturation levels (SpO₂) at 10 min. of life. Comparison with ILCOR guidelines showed good adherence to the 2005 recommendations.

Summary

Delivery room management in German, Austrian and Swiss neonatal units was commonly based on written protocols. Only minor differences were found regarding the DR setup, devices used and the targeted ranges for SpO₂ and FiO₂. DR management was in good accordance with 2005 ILCOR guidelines, some units already incorporated evidence beyond the ILCOR statement into their routine practice.     

Enrollment into a time sensitive clinical study in the critical care setting: results from computerized septic shock sniffer implementation

Objective

Recruitment of patients into time sensitive clinical trials in intensive care units (ICU) poses a significant challenge. Enrollment is limited by delayed recognition and late notification of research personnel. The objective of the present study was to evaluate the effectiveness of the implementation of electronic screening (septic shock sniffer) regarding enrollment into a time sensitive (24 h after onset) clinical study of echocardiography in severe sepsis and septic shock.

Design

We developed and tested a near-real time computerized alert system, the septic shock sniffer, based on established severe sepsis/septic shock diagnostic criteria. A sniffer scanned patients'' data in the electronic medical records and notified the research coordinator on call through an institutional paging system of potentially eligible patients.

Measurement

The performance of the septic shock sniffer was assessed.

Results

The septic shock sniffer performed well with a positive predictive value of 34%. Electronic screening doubled enrollment, with 68 of 4460 ICU admissions enrolled during the 9 months after implementation versus 37 of 4149 ICU admissions before sniffer implementation (p<0.05). Efficiency was limited by study coordinator availability (not available at nights or weekends).

Conclusions

Automated electronic medical records screening improves the efficiency of enrollment and should be a routine tool for the recruitment of patients into time sensitive clinical trials in the ICU setting.     

Analysis of phytochemical profile of Terminalia arjuna bark extract with antioxidative and antimicrobial properties

Objective

To investigate phytochemical screening, antimicrobial activity and qualitative thin layer chromatographic separation of flavonoid components, antioxidant activity and total flavonoid compound of Terminalia arjuna.

Methods

For phytochemical screening, some common and available standard tests were done. Antimicrobial bioassay was done through agar well diffusion method. Detection of antioxidant activity and flavonoid compounds were done through thin layer chromatography. Total antioxidant activity was measured by 2, 2-diphenyl-1-picrylhydrazyl (DPPH) in colorimetric method. Aluminum chloride colorimetric method was used for total flavonoid determination.

Results

Phytochemical screening showed the active compounds presence in high concentration, such as phytosterol, lactones, flavonoids, phenolic compounds and tannins and glycosides. The antimicrobial activity of extract showed that greater inhibition zone against Gram negative bacteria than Gram positive bacteria. This methanolic extract showed a promising antioxidant activity, as absorption of DPPH redicles decreased in DPPH free radical scavenging assay. Flavonoids components having antioxidant property present in the methanol extract at a level of 199.00 mg quercetin equivalent/g of dried methanol extract in colorimetric method.

Conclusions

The Terminalia arjuna bark extract revealed the presence of bio-active constituents which are known to exhibit medicinal as well as physiological activities.     

Research and applications: The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals

Background

Effective clinical communication is critical to providing high-quality patient care. Hospitals have used different types of interventions to improve communication between care teams, but there have been few studies of their effectiveness.

Objectives

To describe the effects of different communication interventions and their problems.

Design

Prospective observational case study using a mixed methods approach of quantitative and qualitative methods.

Setting

General internal medicine (GIM) inpatient wards at five tertiary care academic teaching hospitals.

Participants

Clinicians consisting of residents, attending physicians, nurses, and allied health (AH) staff working on the GIM wards.

Methods

Ethnographic methods and interviews with clinical staff (doctors, nurses, medical students, and AH professionals) were conducted over a 16-month period from 2009 to 2010.

Results

We identified four categories that described the intended and unintended consequences of communication interventions: impacts on senders, receivers, interprofessional collaboration, and the use of informal communication processes. The use of alphanumeric pagers, smartphones, and web-based communication systems had positive effects for senders and receivers, but unintended consequences were seen with all interventions in all four categories.

Conclusions

Interventions that aimed to improve clinical communications solved some but not all problems, and unintended effects were seen with all systems.     

Study of Clinicobiochemical Spectrum of Hypothyroidism

Background

The aim of this study was to assess the clinico biochemical spectrum of hypothyroidism and the relative importance of thyroid function tests, clinical symptoms and signs in thyroid dysfunction.

Methods

A retrospective study was done and 1702 requisitions for screening of hypothyroidism were analysed. The clinical presentation of cases was correlated with the results of thyroid profile tests.

Results

31.5% of the 1702 cases referred had thyroid dysfunction in the form of subclinical or overt hypothyroidism. In the hypothyroid group generalized weakness, weight gain and myxoedema was common. In cases of primary infertility and depression, subclinical and overt hypothyroidism was high (40% and 45.8% respectively). The average age of females with subclinical hypothyroidism was 30.8 years, 5.4 years less than females with overt hypothyroidism.

Conclusion

We conclude that hypothyroidism is common and often under-diagnosed. Therefore routine evaluation of female patients with weight gain, generalized weakness, infertility, depression and mood changes should include thyroid profile.Key Words: Hypothyroidism, Thyroid profile, Screening, Infertility, Depression     

Routine prenatal ultrasound anomaly screening program in a Nigerian university hospital: Redefining obstetrics practice in a developing African country

Background:

Congenital anomalies are among the leading causes of fetal and infant morbidity and mortality worldwide. Prenatal ultrasound (US) screening has become an essential part of antenatal care in the developed world. Such practice is just evolving in the developing countries such as Nigeria. The aim of this article is to present our initial experience and demonstrate the effectiveness of a prenatal US screening program in detecting congenital malformation in a developing country.

Materials and Methods:

This was a prospective evaluation of the prenatal US screenings conducted at a major referral hospital in Southwestern Nigeria. All pregnant women referred to the antenatal clinic for mid-trimester screening during the period of study were assessed.

Results:

Two hundred and eighty-seven pregnant women (5 with twin gestations) were presented for fetal anomaly scan during the study period. Twenty-nine anomalies (9.9%) were detected among the scanned population. Sixteen of the anomalies were followed to delivery/termination with a specificity of 93.5%. The commonest malformations were demonstrated in the genitourinary tract (34.5%) followed by malformations within the central nervous system (27.6%). Six (20.6%) of the anomalies were lethal. Five of the anomalies were surgically correctable.

Conclusion:

Institutions and hospitals across Nigeria and other low- and middle-income countries need to develop policies and programs that would incorporate a standardized routine screening prenatal US in order to improve feto-maternal well-being and reduce the high perinatal mortality and morbidity in developing nations.     

Recombinant PTH: A Study of the Outcome of Teriparatide Therapy for 138 Patients with Osteoporosis

Introduction

Osteoporosis results in significant morbidity and mortality for a large number of patients within Northern Ireland. Recombinant PTH (Teriparatide) is one of a growing number of treatment options for the disease.

Methods

A retrospective analysis was carried out for all patients who had been commenced on Teriparatide since it was first used in the Belfast Health and Social Care Trust (BHSCT) in 2007. Patient demographics, clinical history and prior treatment were recorded prior to an eighteen month treatment protocol. Outcome measures including bone densitometry, bone turnover markers and health status were assessed on commencement and completion.

Results

138 patients have commenced teriparatide therapy since 2007 (9 male, 129 female). At the time of analysis 60 patients had completed treatment, 53 patients were receiving ongoing treatment and 25 patients did not complete the 18 month course. On completion vertebral bone mineral density (BMD) had increased by 8.3% while femoral neck BMD had increased by 3.5%. Bone turnover markers demonstrated a significant increase of bone formation and resorption at 4 months, with a smaller increase at 18 months. Health outcome measures (EuroQoL-5 and patient visual analogue scale) indicated improvement in the quality of life of patients of those who completed the treatment course.

Conclusions

Experience in the BHSCT with teriparatide since 2007 demonstrates improvement in BMD comparable to published data, changes in bone turnover markers consistent with increased bone remodeling and better health outcomes for patients.     

Post-operative telephone review is cost-effective and acceptable to patients

Introduction

Patients undergoing selective minor emergency and elective procedures are followed up by a nurse-led structured telephone review six weeks post-operatively in our hospital. Our study objectives were to review patients'' satisfaction, assess cost-effectiveness and compare our practice with other surgical units in Northern Ireland (NI).

Patients and Methods

Completed telephone follow-up forms were reviewed retrospectively for a three-year period and cost savings calculated. Fifty patients were contacted prospectively by telephone using a questionnaire to assess satisfaction of this follow-up. A postal questionnaire was sent to 68 general and vascular surgeons in NI, assessing individual preferences for patient follow-up.

Results

A total of 1378 patients received a telephone review from September 2005 to September 2008. One thousand one hundred and seventy-seven (85.4%) were successfully contacted, while 201 (14.6%) did not respond despite multiple attempts. One hundred and forty-seven respondents (10.7%) required further outpatient follow-up, thereby saving 1231 outpatient reviews, equivalent to £41,509 per annum. Thirty-nine (78%) patients expected post-operative follow-up, with 29 (58%) expecting this in the outpatient department. However, all patients were satisfied with the nurse-led telephone review. Fifty-three (78%) consultants responded. Those who always, or occasionally, review patients post-operatively varies according to the operation performed, ranging from 2.2% appendicectomy patients to 40.0% for varicose vein surgery.

Conclusion

Current practice in NI varies, but a significant proportion of patients are not routinely reviewed. This study confirmed that patients expect post-operative follow-up. A nurse-led telephone review service is acceptable to patients, cost-effective and reduces the number of unnecessary outpatient reviews.     

US and Scottish Health Professionals' Attitudes toward DNA Biobanking

Background

The authors define a DNA biobank as a repository of genetic information correlated with patient medical records. DNA biobanks may assist in the research and identification of genetic factors influencing disease and drug interactions, but may raise ethical issues. How healthcare providers perceive DNA biobanks is unknown.

Objectives

To determine how useful healthcare professionals believe DNA biobanks will be and whether these attitudes differ between private and socialized healthcare systems.

Design

The authors surveyed 200 healthcare professionals, including research and non-research focused doctors, nurses and other staff from medical centers and independent practice in both the United States and Scotland. The survey included fifteen items evaluated for general receptiveness toward biobanks, presumed usefulness of biobanks and perceived attitudes in recruiting patients for a biobank.

Measurements

A total of 81 (45%) of 179 eligible participants responded: 41 from the U.S. and 40 from Scotland. Of these respondents, most (70%) were from academic centers.

Results

Results indicate that there is a broadly favorable attitude in both locations toward the creation of a DNA biobank (83%) and its perceived benefit (75%). This enthusiasm is tempered in Scotland when respondents evaluated their comfort in consenting patients for entry into a biobank; 16 of 40 respondents (40%) were uncomfortable doing so, representing a significant difference from those in the U.S. (p=0.001).

Conclusions

Despite systematic differences in healthcare practice between the U.S. and Scotland, health care professionals in both nations believe DNA biobanks will be useful in curing disease. This finding appears to support further development of such a research tool.