Clinically based surveillance of invasive meningococcal disease in young children admitted to selected US hospitals between January 2000 and June 2009: A retrospective cohort study

Invasive meningococcal disease (IMD) is under-reported in countries that do not employ polymerase-chain reaction for surveillance because culture-negative cases are omitted. To evaluate a clinically based, case-finding method, we developed case definitions for "probable," "compatible with," and "possible, but unlikely" IMD, respectively, based on supportive documentation (e.g., discharge diagnosis of meningococcal infection, culture-negative bacterial meningitis, petechiae/purpura, Gram-negative diplococci on Gram stain) and weight of clinical evidence, which we then applied to electronic health records for all children aged ≤5 y who were admitted to approximately 100 US hospitals between January 2000 and June 2009. Among 47,863 qualifying admissions, 16 children had culture-positive IMD, 5 had "probable" IMD, and 5 had illness "compatible with" IMD. Five additional children had disease considered "possible but unlikely" IMD. Our case-finding methods suggest that culture-based ascertainment may underestimate the number of IMD cases by 31-63%, supporting findings in other nations that culture-based reporting provides incomplete information on disease incidence and therefore underestimates the potential benefits of routine vaccination of young children against meningococcal disease.     

The role of constructive feedback in patient safety and continuous quality improvement

Constructive feedback is essential for personal and professional growth. It is an integral part of continuous quality improvement and essential in maintaining patient safety in the clinical environment. The perception of feedback can interfere with professionals giving and receiving feedback, which can have negative consequences on patient outcomes. Delivering and receiving feedback effectively are learned skills that should be introduced early in prelicensure education. Faculty have the opportunity to influence the perception of feedback to be viewed as an opportunity so that students can learn to appreciate its value in maintaining patient safety and high-quality care in clinical practice.     

Reviewing studies with diverse designs: the development and evaluation of a new tool

Rationale, aims & objective Tools for the assessment of the quality of research studies tend to be specific to a particular research design (e.g. randomized controlled trials, or qualitative interviews). This makes it difficult to assess the quality of a body of research that addresses the same or a similar research question but using different approaches. The aim of this paper is to describe the development and preliminary evaluation of a quality assessment tool that can be applied to a methodologically diverse set of research articles. Methods The 16‐item quality assessment tool (QATSDD) was assessed to determine its reliability and validity when used by health services researchers in the disciplines of psychology, sociology and nursing. Qualitative feedback was also gathered from mixed‐methods health researchers regarding the comprehension, content, perceived value and usability of the tool. Results Reference to existing widely used quality assessment tools and experts in systematic review confirmed that the components of the tool represented the construct of ‘good research technique’ being assessed. Face validity was subsequently established through feedback from a sample of nine health researchers. Inter‐rater reliability was established through substantial agreement between three reviewers when applying the tool to a set of three research papers (κ = 71.5%), and good to substantial agreement between their scores at time 1 and after a 6‐week interval at time 2 confirmed test–retest reliability. Conclusions The QATSDD shows good reliability and validity for use in the quality assessment of a diversity of studies, and may be an extremely useful tool for reviewers to standardize and increase the rigour of their assessments in reviews of the published papers which include qualitative and quantitative work.     

Advances in Hemophilia Care: Report of Two Symposia at the Hemophilia 2010 World Congress

Introduction  

Combining antihyperglycemic agents with complementary mechanisms of action is a cornerstone of type 2 diabetes mellitus (T2DM) management. Although several fixed-dose combinations (FDCs) are available, representing standard types of combination therapy in T2DM, use of these products has been limited.     

Host (avian) biting preference of southern California Culex mosquitoes (Diptera: Culicidae)

The host preference of a vector mosquito species plays a significant role in determining human and animal risk of infection with mosquito-transmitted pathogens. Host preferences of common southern California Culex species for four bird species, American crow (Corvus brachyrhynchos), house sparrow (Passer domesticus), house finch (Carpodacus mexicanus), and mourning dove (Zenaida macroura), were examined by determining the proportion of each mosquito species that successfully engorged on each of the four bird species presented equally within a net trap to wild host-seeking mosquitoes. Bloodmeals in engorged mosquitoes captured within the net trap were identified to avian species by using a multiplex polymerase chain reaction assay targeting the cytochrome b gene sequence. There were significant differences in host selection by all three Culex species captured in numbers sufficient for analysis, with Culex erythrothorax Dyar preferentially biting American crows, Culex tarsalis Coquillett preferentially biting house sparrows, and Culex quinquefasciatus Say preferentially biting house finches. All three Culex species demonstrated more frequent engorgement on passerine birds (sparrows, finches, and crows) than the nonpasserine mourning dove. A greater preference for passerine birds might be expected to increase the transmission of pathogens, such as West Nile virus, to which passerine birds are particularly competent hosts.     

Novel microsphere-based method for detection and typing of 46 mucosal human papillomavirus types

We have developed a novel microsphere-based genotyping method for 46 mucosal human papillomavirus (HPV) types. HPV DNA was amplified by PCR using general primers and typed by hybridization to HPV type-specific probes coupled to sortable microspheres based on the Luminex xMAP technology. Hybridization to each probe was specific for each HPV type without cross-hybridization and sensitive enough to allow typing of HPV contained in clinical specimens. The method was validated with direct sequencing and the Roche Linear Array genotyping method.