There is heterogeneity in intrapartum antibiotic use and implementation of policy varies widely. Global strategies to enhance the prevention of group B streptococcal disease that may include maternal vaccination are needed.
The findings demonstrated the relevance of emotional factors in the development and maintenance of urge incontinence. Currently, assessment and treatment protocols for urge incontinence concentrate on physical symptoms and toilet behaviours. A more integrated psychological model of urge incontinence is proposed.
Background
In response to reported COVID-19 outbreaks among people experiencing homelessness (PEH) in other U.S. cities, we conducted multiple, proactive, facility-wide testing events for PEH living sheltered and unsheltered and homelessness service staff in Atlanta, Georgia. We describe SARS-CoV-2 prevalence and associated symptoms and review shelter infection prevention and control (IPC) policies
Methods
PEH and staff were tested for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR) during April 7–May 6, 2020. A subset of PEH and staff was screened for symptoms. Shelter assessments were conducted concurrently at a convenience sample of shelters using a standardized questionnaire
Results
Overall, 2,875 individuals at 24 shelters and nine unsheltered outreach events underwent SARS-CoV-2 testing and 2,860 (99.5%) had conclusive test results. SARS-CoV-2 prevalence was 2.1% (36/1,684) among PEH living sheltered, 0.5% (3/628) among PEH living unsheltered, and 1.3% (7/548) among staff. Reporting fever, cough, or shortness of breath in the last week during symptom screening was 14% sensitive and 89% specific for identifying COVID-19 cases compared with RT-PCR. Prevalence by shelter ranged 0%–27.6%. Repeat testing 3–4 weeks later at four shelters documented decreased SARS-CoV-2 prevalence (0%–3.9%). Nine of 24 shelters completed shelter assessments and implemented IPC measures as part of the COVID-19 response
Conclusions
PEH living in shelters experienced higher SARS-CoV-2 prevalence compared with PEH living unsheltered. Facility-wide testing in congregate settings allowed for identification and isolation of COVID-19 cases and is an important strategy to interrupt SARS-CoV-2 transmission
Objective To assess the acquisition of skills in digital rectal examination (DRE) and urethral catheterization by medical students and house of®cers associated with a UK medical school, and to determine their con®dence in these techniques. Subjects and methods Questionnaires were sent to all ®nal-year medical students at Oxford Medical School immediately before their ®nal examinations. Similar questionnaires were sent to all pre-registration house of®cers who had graduated from Oxford in the previous year. Results Responses were received from 71% of the students and 84% of the graduates; 88% of the students and 94% of the graduates had been taught how to perform a DRE as a medical student, but 42% of medical students had performed fewer than ®ve DREs before quali®cation. Their ®ndings were rarely checked by a doctor. Of the students, 44% had never felt a clinically malignant prostate gland and 41% were`not at all con®dent' in their ability to give an opinion based on their ®ndings on a DRE. House of®cers performed DRE regularly (53% o 50 DREs) but rarely received additional instruction, and exposure to pathology remained limited. House of®cers' ®ndings on DRE were rarely con®rmed by a more senior doctor. Most respondents had been taught how to perform male urethral catheterization as a medical student (92% of students, 89% of house of®cers) but 48% of students had performed fewer than two catheterizations on quali®cation and 68% of house of®cers had received no additional instruction; however, 69% of house of®cers werè very con®dent' in their ability to perform male urethral catheterization. Conclusions The DRE is a critical skill in assessing the prostate; students conduct few DREs, lack con®dence and are exposed to minimal pathology. Legitimate concerns over students carrying out intimate examinations may be mitigating against the acquisition of skills. Possible solutions are explored. House of®cers perform DREs regularly, but with no additional instruction they may continue to lack con®dence. Students lack experience in male urethral catheterization and rarely receive postgraduate instruction. House of®cers' con®dence in their ability to perform male urethral catheterization may be misplaced.
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