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This article provides guidelines for assessing and managing bleeding risk before invasive procedures. It recommends individualized assessment and decision-making based on the specific procedure and patient characteristics. The article discusses the management of anticoagulant and antiplatelet therapy, the limitations of routine coagulation testing, and the potential use of global haemostatic and platelet function testing to predict bleeding risk. It also addresses the use of plasma products and platelet transfusions in the ICU, emphasizing the lack of evidence supporting their prophylactic use. The article highlights the importance of operator and procedural factors in reducing the risk of complications during procedures. [Extracted from the article]

In the mid‐southern United States, rice (Oryza sativa L.) is flooded primarily to suppress weed germination and growth. Two experiments were conducted to determine whether herbicide performance in conventional or Clearfield rice weed control programs was affected by intermittent flooding. The effects of flooding and herbicide program on barnyardgrass [Echinochloa crus‐galli (L.) P. Beauv] control, rice grain yield, and water applied were investigated at the Delta Research and Extension Center in Stoneville, MS, on Sharkey clay (very fine, smectitic, thermic Chromic Epiaquert). For herbicides commonly applied in conventional (clomazone, quinclorac, pendimethalin, thiobencarb, fenoxaprop‐ethyl, cyhalofop‐butyl, and bisypriboac sodium) or Clearfield rice weed control programs (imazethapyr plus bispyribac‐sodium followed by imazethapyr, imazamox or bispyribac‐sodium), intermittent flooding had no adverse effect on barnyardgrass control relative to a continuous flood. Moreover, initiating irrigation when the perched water table drops to 8 inches below the soil surface had no effect on rice grain yield and reduced water applied by 51%. Mid‐southern US rice producers can capture the water‐saving benefits of intermittent flooding while having no adverse effects on herbicide activity or crop productivity in conventional and Clearfield systems. Core Ideas: Barnyardgrass control did not differ between intermittently and continuously flooded systems.Initiating irrigation when perched water table drops 8 inches below soil surface had no effect on rice grain yield.Intermittent flooding reduced water applied 51% compared to continuous flooding. [ABSTRACT FROM AUTHOR]

Background: Little is known about whether digital competence is related to psychological wellbeing, with most previous research focusing on students and elderly people. There is also limited evidence on seasonal changes in psychological wellbeing, particularly in specific groups. Social housing residents are an underserved and under-researched population. The objectives of this study were to explore associations between digital competence (assessed by general technology self-efficacy) and psychological wellbeing (assessed by mental wellbeing and life satisfaction), and to explore seasonal effects, in social housing residents. Methods: A repeated survey design was used. The Happiness Pulse questionnaire with a bespoke digital module was sent via post or e-mail at four timepoints between July 2021 and July 2022 to 167 social housing residents in West Cornwall, England. There were 110 respondents in total; thirty completed all four questionnaires and 59 completed an autumn/winter and summer questionnaire. Data were analysed using descriptive and inferential methods including regression, repeated measures analysis of variance and panel analysis. Results: Significant positive associations were found between digital self-efficacy and mental wellbeing, and between digital self-efficacy and life satisfaction. However, there were no significant seasonal changes in psychological wellbeing. Conclusions: The findings extend the existing literature beyond student and elderly populations and suggest that improving digital competence is a potential pathway to improving psychological wellbeing. Surveys with larger samples and qualitative studies are needed to elucidate the mechanisms involved. [ABSTRACT FROM AUTHOR]

Copyright of Social & Cultural Geography is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In general, research demonstrates that deprivation, education, health, and well-being are determinants of volunteering, and that volunteering can play an important role in building stronger communities and provides many benefits for individual health and well-being. This study concentrates on the effects of physical and mental health and well-being as predictors when the aspect of socio-economic impact has been minimised. It utilises a unique data set from a UK Housing Association community with generally high levels of deprivation. Data were analysed using bivariate probit regression. In contrast to previous findings, physical health and mental health were not significantly related to volunteering. The key finding was that mental well-being was significantly related to informal volunteering. [ABSTRACT FROM AUTHOR]

As with many OECD countries, graduating medical students have been choosing specialist careers at a greater rate than ever before. Generalism in the form of family (general practice) and more generalist medical specialties have been trending down resulting in distributional geographic challenges. With the advent of COVID-19 in March 2020, medical schools and in particular the Joint Medical Program situated in a regional and rural area in NSW Australia had the unique opportunity to rethink the penultimate year curriculum when the previous rapid rotation model through numerous medical specialities became untenable. The need to vision a new practical pragmatic curriculum spurred a rapid revaluation of assessment, placement length and model with a pivot to an “embedded senior student placement” agnostic of discipline and supported by a competency-based learning portfolio. This article explores the barriers and enablers and identifies the potential elements of this type of placement which can be adapted to community and smaller rural sites. The positive student and supervisor experience also enabled an employment model to be woven into the students learning and ensured on hand medical student workforce for hospitals throughout the rural footprint. The capacity of these placements to celebrate variation in experience and support students to learn on the job have now caused a revision of the penultimate year with expectation of gains in students’ satisfaction and in employability. It has also opened up options to deliver and increase the inherent value of generalist placements with likely long term workforce benefit. [ABSTRACT FROM AUTHOR]

Background: Ebola Virus Disease (EVD) is a deadly and feared infectious disease, which can be responsible of debilitating physical and psychological sequelae in survivors including depression and anxiety disorders. Unfortunately, there are scarce data on survivor sequelae in Democratic Republic of the Congo. So this study assessed PTSD, depression and anxiety symptoms among EVD survivors enrolled in the follow-up program of the psychosocial care team of Beni town's general hospital. Methods: A cross-sectional study used consecutive sampling to recruit 144 Ebola virus disease survivors who came for follow up from October 23 to November 13; 2019. Basic socio-demographic data, presence of headache and short-term memory function were assessed. The Post-traumatic Checklist Scale and Hospital Anxiety and Depression Scale were used to assess psychological burden among participants. Descriptive statistics were used to summarized data and Pearson's or likelihood chi-square were used to test association between psychiatric disorders and associated factors. Results: The prevalence of PTSD, depression and anxiety was 24.3, 24.3 and 33.3% respectively. Being male (OR = 0.42, 95% CI: 0.16, 0.95, p = 0.049), suffering from persistent headache (OR = 2.62, 95% CI: 1.12, 6.14, p = 0.014), losing a loved one because of EVD (OR: 2.60, 95% CI: 1.11, 6.15, p = 0. 015) and being young − 18-24 years - (OR: 0. 261, 95% CI: 0. 08, 0.82, p = 0,026) were statistically associated with PTSD diagnosis. Having short-term memory impairment and suffering from persistent headache were statistically associated with depression and anxiety diagnoses (OR = 2.44, 95% CI: 1.03, 5.82, p = 0.026); (OR = 2.24, 95% CI: 1.04, 4.85, p = 0.025); (OR = 2.62, 95% CI: 1.12, 6.14, p = 0.014); (OR = 2.31, 95% CI: 1.06, 5.01, p = 0.020). Conclusion: The prevalence of PTSD, depression and anxiety is high among EVD survivors. Development of specialized psychiatric services to sustain psychiatric and psychological health amongst survivors in the cultural context of the Eastern part of the DRC should be considered by the teams fighting against EVD in the DRC. [ABSTRACT FROM AUTHOR]

Continuous cultivation of dry seeded rice in addition to adverse environmental factors make the rice soils deficient of nitrogen more than any other essential nutrient. The study was conducted under greenhouse conditions in pots by varying soil N during seedling growth. Six cultivars with diverse genetic background, CL152, R4100412, Antonio, Bowman, Nipponbare, and Rex, were seeded in 6 × 12 inch PVC pots filled with 3:1 (sand: soil) as the rooting medium. All plants were irrigated with full-strength Hoagland nutrient solution, delivered three times for 28 days after sowing. Then, half the plants in each cultivar were supplied with 100% of control nutrient solution minus N for another 4 weeks. Agronomic, physiological and root parameters measurements recorded at optimum interval. Cumulative indices were calculated by summing each response index value as a ratio of treatment by control values. Cultivars were classified based on total cumulative N stress response index (TCNSRI), the sum of all the traits measured, into different groups based on mean and standard error. The reductions in most of the measured traits were less in CL152 and R4100412 than other rice cultivars to soil N stress. Based on total cumulative N stress response indices, the cultivars were classified. The cultivar R41004122 was identified as tolerant, CL152 as intermediate, and Antonio, Bowman, Nipponbare and Rex were sensitive to soil N stress. The identified soil N stress tolerant and intermediately tolerant cultivars will be useful to breeders to develop new genotypes and farmers to select cultivars best suited for dry seeded rice. [ABSTRACT FROM AUTHOR]

This paper describes a novel approach to explore how regulators, working with patients and practitioners, may contribute to supporting person‐centred care and processes of shared decision making in implementing professional standards and reducing harms. Osteopathic patients report high levels of patient care. However, areas of consultations less likely to be rated as high included "fully understanding your concerns," "helping you to take control," and "making a plan of action with you," suggestive of a paternalistic approach to care and a barrier to the effective implementation of standards. This programme explored how to support patients and practitioners to make more explicit what is important to support consultations with better communication in accordance with standards. A series of workshops took place involving approximately 80 participants, which explored and identified practitioner and patient values; these were themed to develop a common framework and tested using case studies. Aspects of what enables or presents a barrier to a positive consultation were further explored with real patient narratives, and a range of resources were subsequently developed, which may support patients and practitioners to make explicit what is important to them in a consultation. A series of approaches and tools were then developed for piloting including patient curriculum vitae; patient goal planner; patient animation to support preparation for an appointment; infographic: a patient poster or leaflet; practitioner reflective tool; and an audio recording to increase awareness and understanding of values‐based practice. In conclusion, a range of approaches may help to support patients and practitioners to make explicit what is important to them in a consultation. The next phase of our programme will use a range of methods including cluster sampling, pre‐testing and post‐testing with the Consultation and Relational Empathy (CARE) measure tool, and interviews and focus groups with users and practitioners to demonstrate impact. [ABSTRACT FROM AUTHOR]

Background: Laparoscopy has proven to be feasible and effective at reducing surgical morbidity and mortality in low resource settings. In Rwanda, the demand for and perceived challenges to laparoscopy use remain unclear.Methods: A mixed-methods study was performed at the four Rwandan national referral teaching hospitals. Retrospective logbook reviews (July 2014-June 2015) assessed procedure volume and staff involvement. Web-based surveys and semi-structured interviews investigated barriers to laparoscopy expansion.Results: During the study period, 209 laparoscopic procedures were completed: 57 (27.3%) general surgery cases; 152 (72.7%) ob/gyn cases. The majority (58.9%, 125/209) occurred at the private hospital, which performed 82.6% of cholecystectomies laparoscopically (38/46). The three public hospitals, respectively, performed 25% (7/28), 15% (12/80), and 0% (denominator indeterminate) of cholecystectomies laparoscopically. Notably, the two hospitals with the highest laparoscopy volume relied on a single surgeon for more than 85% of cases. The four ob/gyn departments performed between 4 and 87 laparoscopic cases (mostly diagnostic). Survey respondents at all sites listed a dearth of trainers as the most significant barrier to performing laparoscopy (65.7%; 23/35). Other obstacles included limited access to training equipment and courses. Equipment and material costs, equipment functionality, and material supply were perceived as lesser barriers. Twenty-two interviews revealed widespread interest in laparoscopy, insufficient laparoscopy exposure, and a need for trainers.Conclusion: While many studies identify cost as the most prohibitive barrier to laparoscopy utilization in low resource settings, logbook review and workforce perception indicate that a paucity of trainers is currently the greatest obstacle in Rwanda. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to develop and validate Kinyarwanda versions of Short-Form Leeds Dyspepsia Questionnaire (SF-LDQ) and Short-Form Nepean Dyspepsia Index (SF-NDI) to measure the frequency and severity of dyspepsia and associated quality-of-life impact in Rwanda. Setting: A single, tertiary care centre in Rwanda. Participants: 200 consecutive Kinyarwanda-speaking patients referred to endoscopy (100 patients) or medical outpatients (100 patients). Interventions: Kinyarwanda versions of the SF-LDQ and SF-NDI were developed from English versions by translation, with back translation, crosschecking and pilot testing. Study participants completed these questionnaires at enrolment (time 1), and then completed the surveys again with blinded phone interviewers 3 days later (time 2). 20 randomly selected participants, diagnosed with a peptic ulcer on index endoscopy, completed a third survey by phone at day 30 (time 3), after therapy. Primary outcome measures: Internal consistency at time 1 (by Cronbach's α) and test-retest reliability between time 1 and time 2 (Spearman's correlation coefficient) for translated SF-LDQ and SF-NDI; validity versus clinical diagnosis (by receiver operating characteristic (ROC) curve) and responsiveness to treatment for SF-LDQ (by change in mean score). All outcomes were measured as per protocol. Results: Cronbach's a of the translated SF-LDQ was 0.93, showing high internal consistency. Spearman's correlation coefficient comparing time 1 and time 2 was 0.978 (p<0.001), demonstrating high reliability. Cronbach's a for the translated SF-NDI was 0.92. A cut-off score of 16 on the SF-LDQ showed a sensitivity of 97% and a specificity of 71% for the diagnosis of dyspepsia, correctly classifying 89% of patients. In the responsiveness analysis, the mean SF-LDQ score was reduced from 20.1 prior to treatment to 13.9 after 30 days of treatment (p=0.003). Conclusions: The Kinyarwanda versions of the SFLDQ and SF-NDI were valid, reliable and responsive to treatment. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to develop and validate Kinyarwanda versions of Short-Form Leeds Dyspepsia Questionnaire (SF-LDQ) and Short-Form Nepean Dyspepsia Index (SF-NDI) to measure the frequency and severity of dyspepsia and associated quality-of-life impact in Rwanda. Setting: A single, tertiary care centre in Rwanda. Participants: 200 consecutive Kinyarwanda-speaking patients referred to endoscopy (100 patients) or medical outpatients (100 patients). Interventions: Kinyarwanda versions of the SF-LDQ and SF-NDI were developed from English versions by translation, with back translation, crosschecking and pilot testing. Study participants completed these questionnaires at enrolment (time 1), and then completed the surveys again with blinded phone interviewers 3 days later (time 2). 20 randomly selected participants, diagnosed with a peptic ulcer on index endoscopy, completed a third survey by phone at day 30 (time 3), after therapy. Primary outcome measures: Internal consistency at time 1 (by Cronbach's a) and test-retest reliability between time 1 and time 2 (Spearman's correlation coefficient) for translated SF-LDQ and SF-NDI; validity versus clinical diagnosis (by receiver operating characteristic (ROC) curve) and responsiveness to treatment for SF-LDQ (by change in mean score). All outcomes were measured as per protocol. Results: Cronbach's a of the translated SF-LDQ was 0.93, showing high internal consistency. Spearman's correlation coefficient comparing time 1 and time 2 was 0.978 (p<0.001), demonstrating high reliability. Cronbach's a for the translated SF-NDI was 0.92. A cut-off score of 16 on the SF-LDQ showed a sensitivity of 97% and a specificity of 71% for the diagnosis of dyspepsia, correctly classifying 89% of patients. In the responsiveness analysis, the mean SF-LDQ score was reduced from 20.1 prior to treatment to 13.9 after 30 days of treatment (p=0.003). Conclusions: The Kinyarwanda versions of the SFLDQ and SF-NDI were valid, reliable and responsive to treatment. [ABSTRACT FROM AUTHOR]

Ecosystem services are the multitude of resources and processes that are supplied by natural ecosystems. This includes a wide range of natural processes that help sustain and fulfill human life, such as: purifying air and water, detoxifying and decomposing wastes in water, pollinating natural vegetation, cycling and moving nutrients, protecting coastal shores from erosion by waves, moderating weather extremes and their impacts, and providing aesthetic beauty and intellectual stimulation that lift the human spirit. A total ecosystem services quantification using the ECOSERVE mapping methodology was developed by the Southwest Florida Regional Planning Council in partnership with the Charlotte Flarbor National Estuary Program (CFINEP) and the Sanibel-Captiva Conservation Foundation in the project "Estimating and Forecasting Ecosystem Services within Pine Island Sound, Sanibel Island, Captiva Island, North Captiva Island, Cayo Costa Island, Useppa Island, Other Islands of the Sound, and the Nearshore Gulf of Mexico" (Beever and Walker 2013), linking the derived ecosystem function measurements with a geo-spatially positioned ecosystem services database, derived from wetland functional analyses that are utilized to forecast, evaluate and report trends in wetlands ecosystem services. [ABSTRACT FROM AUTHOR]

Administrators of sport organizations have increasingly become aware of the importance of management not only for the operation of their day to day affairs, but alsofor the successfully operation of their respective sport organizations. In the case of national sport federations, management techniques that implement good governance can ultimately lead to success not only in the boardroom but also on the playing field as well. The purpose of this paper is to examine the perception of good governance and management by National Sport Federations administrators in Cyprus. Specifically, the objective of this paper is to examine: 1) the perception of good governance and management in National Sports Federations, and 2) the challenges in introducing good governance and better management practices in the sport system of Cyprus. The results revealed a positive perception orientation towards the inclusion of good governance as a management practice by National Sport Federation administrators. The results also revealed a limited understanding as well as a skill set for the application of good governance and management practice. [ABSTRACT FROM AUTHOR]

This article details how a council service established an integrated management system ( IMS) within a wider corporate framework. In this context, an IMS was used as a tool to improve (i) Performance, (ii) Quality, (iii) Environment, and (iv) Health and Safety Management. A key factor was that the IMS had to be appropriate for accreditation and integratible with an emerging corporate management framework. In this case study, the authors provided a literature review before considering the issues facing the management team in implementing the IMS. Next, the discussion reflected on how the IMS has delivered improvements before concluding with recommendations on how to implement an IMS within similar services. These points of learning may be relevant beyond local government. This article therefore provides a summary of action research and the steps taken to deliver an IMS within a broader context. [ABSTRACT FROM AUTHOR]

In responding to the demand for change and improvement, local government has applied a plethora of operations management-based methods, tools and techniques. This article explores how these methods, specifically in the form of performance management models, are used to improve alignment between central government policy and local government practice, an area which has thus far been neglected in the literature. Using multiple case studies from Environmental Waste Management Services, this research reports that models derived in the private sector are often directly ‘implanted’ into the public sector. This has challenged the efficacy of all performance management models. However, those organisations which used models most effectively did so by embedding (contextualisation) and extending (reconceptualisation) them beyond their original scope. Moreover, success with these models created a cumulative effect whereby other operations management approaches were probed, adapted and used. [ABSTRACT FROM PUBLISHER]

From 2004 to 2008, 1,834 Environmental Resource Permits were issued for development projects in coastal wetlands within the Charlotte Harbor National Estuary Program. We evaluated 118 sites utilizing three wetland functional assessment methods (WFAMs): Hydrogeomorphic Method (HGM), Wetland Rapid Assessment Procedure (WRAP), and Uniform Mitigation Assessment Method (UMAM). All functioned as designed and produced similar assessments of wetlands but yielded different mitigation results. The study results showed that HGM was most effective in identifying and quantifying wetland functions of coastal wetlands. UMAM and WRAP are useful but delivered mitigation ratios less than one in both function and area, resulting in net wetland losses. The wetland area lost over the study period was small relative to total wetland area, but the permitted wetland elimination is gradually reducing the extent of wetlands. The process relocates wetland functions out of impacted watersheds toward off-site mitigation areas. The WFAM site evaluations indicated an equal or greater balance of ecosystem functions within the total service area when utilizing off-site mitigation. However, there is loss of wetland area and function in the donor watershed and an increase in function, but not area, of wetlands in the receiving watershed. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study measured: 1) levels of awareness and understanding among practicing obstetricians regarding umbilical cord blood (UCB) donation and the use of UCB in transplant therapy, 2) motivations for obstetricians to support donation and collection for donation to a public cord blood bank (CBB), and 3) current practices for discussing this option with their patients. STUDY DESIGN AND METHODS: Obstetricians practicing in major metropolitan areas in the United States were randomly surveyed in 2009. Of 2041 surveys mailed, 295 were returned, 139 from obstetricians with privileges at hospitals affiliated with a public CBB (affiliated) and 156 from obstetricians without such privileges (nonaffiliated). Cross-tabulation analyses were conducted to compare responses between these two groups. RESULTS: Both affiliated and nonaffiliated obstetricians report being somewhat or very familiar with the use of cord blood in transplant therapy (88% vs. 82%, respectively; p = NS), but some misperceptions concerning clinical application exist. Eighty percent of affiliated obstetricians feel confident discussing cord blood options with their patients; however, 49% indicated that they have insufficient knowledge of cord blood donation to effectively answer patients' questions about donation. CONCLUSION: Obstetricians are generally familiar with the utility of donated cord blood in transplantation, but could benefit from additional information regarding how cord blood is used in transplantation. Further, obstetricians play an important role in encouraging women to donate their baby's cord blood to a public CBB, are willing to do so, and indicate a desire for more information so they can effectively educate their patients. [ABSTRACT FROM AUTHOR]

Purpose – The aim of this paper is to investigate the links and relationships between strategy and operations in local government improvement efforts under the umbrella of the Local Government Modernisation Agenda (LGMA) in England. More specifically, it explores the implementation of structured change methods and performance measurement and management initiatives that claim to have a linked strategic and operational focus through to stakeholder impact. Design/methodology/approach – This research adopts an interpretive multiple case approach (n=5), using in-depth semi-structured interviews and focus groups, as well as substantive archive information. Findings – The structured integration of strategic level policy-setting and its associated operational level activity in local authorities is often obscure and lacking in cohesiveness. Performance measurement and management at the strategic level is, for the most part, driven by emerging legislation and the need for compliance rather than improving service effectiveness. This has led to discontinuity, delays in implementing policy, and criticism of performance measures from service delivery staff. Practical implications – There is a need for improved integration across the strategic-operational divide, which requires improved understanding and translation approaches. Methods adopted from other sectors should be assessed critically and tailored to suit this need rather than adopting an off-the-shelf provision. Originality/value – There is a paucity of in-depth studies relating to performance measurement and management across the strategic-operational span in the public sector in general, and local government in particular. Increased understanding in this area is of critical importance in relation to implementing effectively the current and future modernisation and reform initiatives. [ABSTRACT FROM AUTHOR]

The article describes the case of a late steroid-refractory immunotherapy-induced colitis relapse in a 65-year-old man without the precipitant of further immunotherapy. Highlights include severe colitis of the entire colon with oedema according to colonoscopy, the challenge of gaining hospital formulary or Pharmaceutical Benefits Scheme (PBS) approval, and PBS approval of combination immunotherapy for melanoma and renal cell carcinoma.

SD/01, a sustained-duration molecule, has been developed by adding a poly [ethylene glycol] molecule to the filgrastim molecule. The pegylation does not change the properties of filgrastim, except that the plasma clearance is decreased and plasma half-life is increased. Increasing the duration of the biological effects of filgrastim may offer certain groups of patients better benefits. Early clinical studies have been encouraging with no serious toxicities noted.Copyright © 2001 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The article discusses the "What Is Crime?" photography competition held by the Centre for Crime and Justice, an educational charity at Kings College London in England. It explains the three categories considered for the said competition, such as environment, finance and violence. It describes the context and theme of some photograph entries for the 2009 competition, as interpreted by the artist who took the picture. The winners of the photography awards are mentioned.

Background: Successful H. pylori treatment requires the knowledge of local antimicrobial resistance. Data on the efficacy of H. pylori eradication regimens available in sub-Saharan Africa are scant, hence the optimal treatment is unknown. Our goals were to determine the efficacy of available regimens in Rwanda as well as evaluate the effect of treatment on health-related quality of life (HRQoL) in patients undergoing esophagogastroduodenoscopy.Methods: This is a randomized controlled trial conducted from November 2015 to October 2016 at a tertiary hospital in Rwanda. Enrollees were 299 patients (35% male, age 42 ± 16 years (mean ± SD)) who had a positive modified rapid urease test on endoscopic biopsies. After a fecal antigen test (FAT) and HRQoL assessment by the Short Form Nepean Dyspepsia Index (SF-NDI) questionnaire, patients were randomized 1:1:1:1 to either a triple therapy combining omeprazole, amoxicillin and one of clarithromycin/ciprofloxacin/metronidazole or a quadruple therapy combining omeprazole, amoxicillin, ciprofloxacin and doxycycline. All therapies were given for a duration of 10 days. The outcome measures were the persistence of positive FAT (treatment failure) 4 to 6 weeks after treatment and change in HRQoL scores.Results: The treatment success rate was 80% in the total population and 78% in patients with a history of prior triple therapy. Significant improvement in HRQoL in the total group (HRQoL mean scores before and after treatment respectively: 76 ± 11 and 32 ± 11, p < 0.001) and the group with functional dyspepsia (HRQoL mean scores before and after treatment respectively: 73 ± 11 and 30 ± 9, P < 0.001) was observed across all treatment groups. Using clarithromycin based triple therapy (standard of care) as a reference, the group treated with metronidazole had worse HRQoL (p = 0.012) and had a trend towards worse treatment outcome (p = 0.086) compared to the ciprofloxacin based combination therapies.Conclusion: Clarithromycin and ciprofloxacin based combination therapies are effective and safe to use alternatively for H. pylori eradication and improve HRQoL. Among the regimens studied, metronidazole based triple therapy is likely to be clinically inferior.Trial Registration: The clinical trial was retrospectively registered ( PACTR201804003257400 ) with the Pan African Clinical Trial Registry database, on April 6th, 2018 in South Africa. [ABSTRACT FROM AUTHOR]