Microbiological quality and proximate analysis of locally produced soymilk drinks sold in Calabar Metropolis; a public health assessment.

Background: This study was aimed at evaluating the microbial quality and proximate analysis of soymilk produced and sold within Calabar Metropolis. Methodology: Soymilk samples were purchased in pairs from five locations in Calabar Metropolis. The samples collected were subjected to microbiological and proximate analysis to ascertain the hygienic standards of the products and nutrient contents. Results: The result showed that the highest heterotrophic bacterial count of 5.3 × 105 cfu/ml was recorded in soymilk sample sold in Goldie market while the least (2.7 × 104 cfu/ml) was recorded at Watt market. The mean fungal count was highest in Akim market samples (5.8 x 104 cfu/ml) and lowest in Atimbo market samples (2.4 x 103 cfu/ml). The probable bacterial and fungal isolates were identified as: Pseudomonas aeruginosa, Bacillus sp, Escherichia coli, Klebsiella sp, Salmonella sp, Streptococcus sp, Staphylococcus aureus, Aspergillus sp, Rhizopus sp, Penicillium sp and Mucor sp. All the isolated bacteria species were found to be resistant to more than 50% of the antibiotics used. Proximate composition analysis of the soymilk samples revealed high moisture, carbohydrate and protein contents. Conclusion: The microbial population detected in terms of number and types reflected poor hygienic standard of production.

Exploring psychosocial predictors of STI testing in University students.

BACKGROUND: To explore university students' Sexually Transmitted Infection (STI) testing knowledge, psychosocial and demographic predictors of past STI testing behaviour, intentions to have an STI test, and high risk sexual behaviour, to inform interventions promoting STI testing in this population. METHODS: A cross-sectional, quantitative online survey was conducted in March 2016, recruiting university students from North East Scotland via an all-student email. The anonymous questionnaire assessed student demographics (e.g. sex, ethnicity, age), STI testing behaviours, sexual risk behaviours, knowledge and five psychological constructs thought to be predictive of STI testing from theory and past research: attitudes, perceived susceptibility to STIs, social norms, social fear and self-efficacy. RESULTS: The sample contained 1294 sexually active students (response rate 10%) aged 18-63, mean age = 23.61 (SD 6.39), 888 (69%) were female. Amongst participants, knowledge of STIs and testing was relatively high, and students held generally favourable attitudes. 52% reported ever having an STI test, 13% intended to have one in the next month; 16% reported unprotected sex with more than one 'casual' partner in the last six months. Being female, older, a postgraduate, longer UK residence, STI knowledge, perceived susceptibility, subjective norms, attitudes and self-efficacy all positively predicted past STI testing behaviour (p < 0.01). Perceived susceptibility to STIs and social norms positively predicted intentions to have an STI test in the next month (p < 0.05); perceived susceptibility also predicted past high-risk sexual behaviour (p < 0.01). CONCLUSIONS: Several psychosocial predictors of past STI testing, of high-risk sexual behaviour and future STI intentions were identified. Health promotion STI testing interventions could focus on male students and target knowledge, attitude change, and increasing perceived susceptibility to STIs, social norms and self-efficacy towards STI-testing.

Factors associated with late HIV diagnosis in North-East Scotland: a six-year retrospective study.

OBJECTIVES: Late HIV diagnosis is associated with increased morbidity and mortality, increased risk of transmission, impaired response to antiretroviral therapy and increased health care costs. The aim of this study was to determine the factors associated with late HIV diagnosis in Grampian, North-East Scotland. STUDY DESIGN: A population based retrospective database analysis. METHODS: All newly diagnosed HIV positive individuals in Grampian, North-East Scotland between 2009 and 2014 were included in the study. Participants were classified as having a late diagnosis if the CD4 cell count at presentation was less than 350 cells/mm3. Socio-economic and demographic factors were investigated in relation to outcome (late diagnosis) using Chi-squared and Mann-Whitney tests. RESULTS: CD4 cell count results were available for 111 (89.5%) of the 124 newly diagnosed individuals during the study period. The prevalence of late diagnosis was 53.2% (n = 59). Those infected via heterosexual mode of transmission had a 2.83 times higher odds of late diagnosis (OR 2.83 [95% CI: 1.10-7.32]) than men who have sex with men (MSM) and those with no previous HIV testing had a 5.46 increased odds of late diagnosis (OR 5.46 [95% CI: 1.89-15.81]) compared to those who had previously been tested. Missed opportunities for HIV diagnosis were identified in 16.3% (n = 15) of participants. CONCLUSION: Heterosexual individuals and those with no previous HIV testing were more likely to be diagnosed late. Targeted initiatives to increase perception of HIV risk and uptake of testing in these risk groups are recommended.

'But you can't reverse a hysterectomy!' Perceptions of long acting reversible contraception (LARC) among young women aged 16-24 years: a qualitative study.

OBJECTIVES: Long Acting Reversible Contraception (LARC) methods are highly effective in reducing the incidence of unwanted pregnancy. Recent data indicates that the rate of abortion in Grampian, North East of Scotland is above the Scottish average and LARC uptake among young women low. This study sought to explore young women's perceptions of LARC, with the aim of developing a strategy to increase LARC uptake. STUDY DESIGN: Qualitative study. METHODS: Sixty five women aged 16-24 were randomly recruited to this qualitative study from community centres and shopping areas. Recruitment and interviews were conducted in friendship pairs, triads or one-to-one basis. Participants were asked about current and past contraception use, views of contraception methods including LARC; and sources of information about contraception. Data were analysed using thematic content analysis. RESULTS: Women interviewed were aware of some of the delivery systems used for long acting contraception (intrauterine devices, implants and injections) but did not recognise them as 'LARC'. 'Long acting' was equated with permanency and the term 'reversible' appeared to have the opposite effect to its intention. Intrauterine devices were commonly referred to as 'coil'. The women often relied on verbal testimonies from those who had experienced using LARC, many of which were negative and inaccurate. A lack of in-depth knowledge about LARC and the opinion that LARC methods were for older women were also cited as barriers to use. CONCLUSIONS: This study shows that negative testimonies and the belief that LARC are not appropriate for young women may discourage LARC uptake.

Home versus in-patient treatment for deep vein thrombosis.

BACKGROUND: Deep vein thrombosis (DVT) occurs when a blood clot blocks blood flow through a vein. This can happen after surgery, trauma, or when a person has been immobile. Clots can dislodge and block blood flow to the lungs, causing death. Heparin is a blood-thinning drug used in the first 3-5 days of DVT treatment. Low molecular weight heparins (LMWH) allow people with DVT to receive their initial treatment at home instead of in hospital. OBJECTIVES: To collate randomised controlled trials (RCTs) comparing home (LMWH) versus hospital (LMWH or UH) treatment for DVT, and to compare the safety, efficacy, acceptability and cost implications of home versus hospital treatment. SEARCH STRATEGY: We searched the Cochrane Peripheral Vascular Diseases Group trials register (inception to May 2007) and the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (last searched Issue 2, 2007) which includes searches of MEDLINE (January 1966 onwards) and EMBASE (January 1980 onwards). We also handsearched non-listed journals and contacted researchers in the field. SELECTION CRITERIA: RCTs of home versus hospital treatment for DVT in which DVT was clinically confirmed and treated with either LMWH or UH. DATA COLLECTION AND ANALYSIS: One reviewer selected the material for inclusion and another reviewed the literature and selection of trials. Two reviewers independently extracted data. Outcomes included PE, recurrent DVT, gangrene, heparin complications, and death. MAIN RESULTS: Six RCTs involving 1708 participants with comparable treatment arms were included. All six had fundamental problems including high exclusion rates, partial hospital treatment of many in the LMWH arms, and comparison of UH in hospital with LMWH at home. The trials showed that patients treated at home with LMWH are less likely to have recurrence of venous thromboembolism (VTE) compared to hospital treatment with UH or LMWH (fixed effect relative risk (FE RR) 0.61; 95% confidence interval (CI) 0.42 to 0.90). Home treated patients also had lower mortality (FE RR 0.72; 95% CI 0.45 to 1.15) and fewer major bleeding (FE RR 0.67; 95% CI 0.33 to 1.36), but were more likely to have minor bleeding than those in hospital (FE RR 1.29; 95% CI 0.94 to 1.78) though these were not statistically significant. AUTHORS' CONCLUSIONS: The limited evidence suggests that home management is cost effective and preferred by patients. Further large trials comparing these treatments are unlikely to occur. Therefore, home treatment is likely to become the norm; further research will be directed to resolving practical issues.