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Clean pulp versus sterile plastic for mid-stream urine collection: a paired equivalence study comparing the microbiological performance of a novel low carbon collection device with the standard of care

Por: John · J. B. · Holdsworth · B. · Clarke · N. · Vere · A. · Lynda · K. · Walker · A. · Yusuf · S. · Yick · V. · Doolan · T. · Harvey · P. · Ball · C. · Butler · C. · Lowe · N. · Welsh · V. · Mayne · A. · Swann · S. · Porter · R. · Burns-Cox · N.
Objectives

To determine whether a novel urine collection device (the ‘Pee-in-Pot (PiP)’) produces the same rates of reportable urine culture results as standard of care (SOC) urine collection. To determine whether the PiP produces comparable microscopy results to SOC urine collection. To estimate the carbon footprint of the PiP compared to SOC urine collection.

Design

A prospectively designed, single-centre, paired comparison study.

Setting

A district general hospital in Southwest England, including antenatal clinical, accident and emergency, medical and surgical ward environments.

Participants

Adults aged 18 or over.

Interventions

Urine passed through the PiP device before being decanted into a 10 mL boric acid tube for microscopy and culture, compared with the same urine contained only in a sterile plastic vessel before being decanted into a boric acid tube for microscopy and culture.

Primary outcome measure

The proportion of positive urine culture results.

Secondary outcome measures

The proportion of heavy mixed growth culture results. Comparison of particle counts: all small particles, bacteria, red blood cells and white blood cells.

Results

Microscopy was performed for 1353 paired samples, of which 808 paired samples both underwent culture. Overall, urine cultures were positive in 9.3% (75/808) and 10.0% (81/808) of PiP and control cases, respectively. Overall matching between PiP and control arms for reportable positive culture results was 98.5% (796/808), with a Cohen’s Kappa test coefficient () of 0.9149 (almost perfect agreement). There was no significant difference in the rate of positive urine culture results between testing arms for any organisms (margin of non-inferiority prospectively defined as ±2.5% for Escherichia coli positive cultures). For microscopy, there was agreement in meeting culture thresholds for 1308 of 1353 paired samples with a difference in culturing rates of 0.00517 (95% CI –0.0045 to 0.015, ie, high level of agreement). The estimated base case carbon footprint of PiP testing was 95g CO2e compared to 270g CO2e for SOC testing.

Conclusions

This study found the PiP to be non-inferior for routine urine microscopy and culture testing and to have a lower carbon footprint compared with SOC urine testing.

Predictors of community pharmacists’ readiness to implement deprescribing of inappropriate medications for older adults in Qatar

by Marwa Elshazly, Sondus Jawad, Ayesha Ahmed, Hager ElGeed, Kazeem Babatunde Yusuff

There is a paucity of studies focused on the predictors of community pharmacists’ readiness to deprescribe inappropriate medications for older adults especially in developing settings. The study aimed to use the situational theory of leadership to determine community pharmacists’ readiness to implement deprescribing of inappropriate medications for older adults, and as well as its significant predictors. A theory-driven cross-sectional assessment of the readiness (knowledge and confidence) of 252 community pharmacists was conducted in Qatar with a pre-tested 40-item questionnaire. Knowledge and confidence were assessed with a 2-point and 4-point Likert-type scale respectively. The maximum obtainable score for readiness was 16. Readiness was categorized as high (≥ median) or low (

Mental health disorders among people living with HIV in sub-Saharan Africa: a scoping review protocol

Por: Adedeji · W. A. · Ishola · A. G. · Elugbadebo · O. · Oladepo · O. M. · Mudzviti · T. · Kaiyo-Utete · M. · Willis · N. · Adebayo · D. A. · Mtisi · T. J. · Chokuona · K. F. V. · Ma · Q. · Cha · R. · Hutson · A. · Charurat · M. E. · Yusuf · O. B. · Maponga · C. · Fehintola · F. A. · Gureje
Background

The mental health of people living with HIV (PLWH) is a growing concern globally, particularly in sub-Saharan Africa (SSA), where there is limited access to mental healthcare, with evidence showing high levels of depression, anxiety and neurocognitive disorders among this population. While Mental Health Disorders (MHDs) can impede HIV care and promote adverse health outcomes, there is limited literature on MHDs among PLWH. This scoping review will explore the existing literature on the burden and factors associated with MHDs among adults living with HIV in SSA.

Methods and analysis

Arksey and O’Malley’s methodological framework will guide the search of this scoping review. Relevant original research articles published in English from 1 January 2000 to 31 May 2025 on MHDs among PLWH in SSA will be identified through searches in the African Index Medicus, African Journal Online, PubMed and Embase databases. Four independent reviewers, working in pairs (one reviewer and one verifier), will screen the titles, abstracts and later the full texts, adopting the population, concept and context framework. Other coauthors will serve as tiebreakers whenever there is disagreement on the eligibility. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews flowchart will be presented. We will perform a narrative synthesis to report our findings.

Ethics and dissemination

This scoping review protocol does not require ethical approval, as it relies solely on publicly available existing data and does not involve human participants. We will disseminate the findings from this review through peer-reviewed publications and presentations at local and international conferences.

Trial registration

The protocol was registered in the Open Science Framework (https://osf.io/8ymqu).

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