Development and validation of a stages of change algorithm for calcium intake for college female students.

OBJECTIVES: The purpose of this study was to develop and validate a staging algorithm for calcium intake. METHODS: Three hundred seventy-six college-aged females at a private university were randomly selected to participate. After 8.5% of the data were omitted due to incomplete surveys, the sample consisted of 344 female participants. Calcium intake was measured as self-reported consumption with a 26-item food frequency questionnaire. Stages of change classifications were based on a four-item algorithm for calcium intake, and self-efficacy was measured with three items. RESULTS: Significant differences were found between calcium intake levels between precontemplation, contemplation/preparation and action/maintenance. Results also showed that 40% of the participants were in action/maintenance and were consuming the Dietary Reference Intake level of 1,000 mg of daily calcium. Participants in the action and maintenance stages had significantly higher self-efficacy than the preaction group. CONCLUSION: The study suggests that the stages of change algorithm may be used as an effective tool in assessing daily calcium intake among a college female population.

Triage clinics: a way forward in genitourinary medicine.

Our objective was to evaluate the effectiveness of a nurse-led triage clinic in genitourinary medicine (GUM). A prospective study was made of 200 consecutive patients attending the triage clinic in the GUM Department, Portsmouth. These patients were seen by the triage nurse and treated according to clinic guidelines. The consultants reviewed the case notes to assess the appropriateness of management. During the 6-week study period, 3009 patients were seen in the department. Of the 200 patients seen in the triage clinic, 38 were referred to a doctor during the initial visit. One or more sexually transmitted or associated infections were found in 61 female and 58 male patients. Six female and 4 male patients were not treated according to the clinic guidelines. Given appropriate education and training and working within a supportive framework the nurse undertaking a triage role in GUM can provide a highly effective and high-quality service to patients.

Optimizing detection of microbial sepsis: a comparison of culture systems using packaged sets with directions for blood collection.

Detection of microbial sepsis is an important aspect of medical practice. To facilitate the recovery of bacteria and fungi we evaluated 10,933 complete blood culture sets integrating the automated ESP system (Difco) with a manual system using the Isolator (Wampole) and Thiol broth bottle (Difco). To improve compliance with the recommended procedure for submitting specimens, we packaged the three components as a unit that included brief instructional material. A three-component (one ESP bottle, one Thiol bottle, and one Isolator tube) package containing specific instructions was used. The aerobic ESP performance was compared with the Isolator, and the anaerobic ESP with the Thiol bottle. A hypothetical assessment involving all three components was also made. The cultures were processed under routine laboratory conditions. Charts were reviewed from specimens with discrepant results to ascertain true positives versus contaminant cultures in the discordant culture sets. There were 896 organisms recovered from 393 patients. Of these, 421 were in the aerobic compared with 475 in the anaerobic portion of the study. ESP enhanced the recovery of Streptococcus pneumoniae (P < .05). The Isolator was superior for the recovery of yeasts (.05 < P < .1). Using the packaged system, the compliance rate for complete three-component culture sets was 95.2%, with a 34.4% resultant increase in positive blood cultures from only a 5.7% increase in sets. Packaged culture media including instructions enhance appropriate collection of complete sets, increase the number of recovered organisms, and improve medical practice.