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Background: The use of the PCR to aid in the diagnosis of Pneumocystis pneumonia (PcP) has demonstrated excellent clinical performance, as evidenced through various systematic reviews and meta-analyses, yet there are concerns over the interpretation of positive results due to the potential presence of Pneumocystis colonization of the airways. While this can be overcome by applying designated positivity thresholds to PCR testing, the shear number of assays described limits the development of a universal threshold. Commercial assays provide the opportunity to overcome this problem, provided satisfactory performance is determined through large-scale, multi-centre evaluations. Methods: Retrospective case/control and consecutive cohort performance evaluations of the OLM PneumID real-time PCR assay were performed on DNA eluates from a range of samples sent from patients where "in-house" PCR had been performed as part of routine diagnostic testing. The clinical performance of the PneumID assay was determined before including it in a diagnostic algorithm to provide the probability of PcP (dependent on diagnostic evidence). Results: After being used to test 317 patients (32 with PcP), the overall performance of the PneumID assay was found to be excellent (Sensitivity/Specificity: 96.9%/95.1%). False positivity could be removed by applying a threshold specific to sample type (<33.1 cycles for BAL fluid; <37.0 cycles for throat swabs), whereas considering any positive respiratory samples as significant generated 100% sensitivity, making absolute negativity sufficient to exclude PcP. Incorporating the PneumID assay into diagnostic algorithms alongside (1-3)-β-D-Glucan testing provided high probabilities of PcP (up to 85.2%) when both were positive and very low probabilities (<1%) when both were negative. Conclusions: The OLM PneumID qPCR provides a commercial option for the accurate diagnosis of PcP, generating excellent sensitivity and specificity, particularly when testing respiratory specimens. The combination of PcP PCR with serum (1-3)-β-D-Glucan provides excellent clinical utility for diagnosing PcP. [ABSTRACT FROM AUTHOR]

Person-Environment (P-E) fit models provide a conceptually powerful way to think about career development, vocational choice, and occupational success. The work reported here focuses on yet another pair of P-E criteria: self-reported individual capacity for information processing (the ability to tolerate information overload from a variety of stimulus sources), and the corresponding demand characteristics for information processing of the occupational environment. To achieve the aims of this project, the authors have borrowed from the literature on information processing, anthropology, and human factors to define the information load context of the occupational environment. The authors have constructed a P-E congruence scheme for five domains of information processing: information load, interpersonal load, change load, activity structure, and time structure, and employed the methods of psychophysics to quantify occupational environments across these domains. The results of this preliminary work, replicated across two cultures, are presented here. (Contains 1 table, 2 figures, and 5 notes.)

Gender-role conflict theory has suggested that women athletes will experience role conflict because they are attempting to enact both feminine and masculine gender roles, yet research findings have shown mixed support for this notion. The purpose of this study was to explore how women rugby players negotiate gender-role expectations and conflict as women participating in a traditionally masculine sport. Eleven Caucasian women, noncollege rugby players between the ages of 25 and 38 were interviewed. The results indicated that women rugby players perceived numerous discrepant gender-role expectations. In addition, three different types of gender-role conflict emerged; however, similar to previous findings, participants perceived conflicting expectations for their gender-role behavior more than they seemed to experience conflict about those expectations. Participants actively employed various strategies to resolve or avoid experiencing gender-role conflict. The resiliency displayed by the women athletes in coping with discrepant gender-role messages provides new considerations for gender-role conflict theory.

Background: Treatment for invasive candidiasis (IC) is time-critical, and culture-based tests can limit clinical utility. Nonculture-based methods such as Candida PCR represent a promising approach to improving patient management but require further evaluation to understand their optimal role and incorporation into clinical algorithms. This study determined the performance of the commercially available OLM CandID real-time PCR when testing serum and developed a diagnostic algorithm for IC. Methods: The study comprised a retrospective performance evaluation of the CandID real-time PCR assay when testing surplus serum (n = 83 patients, 38 with IC), followed by a prospective consecutive cohort evaluation (n = 103 patients, 24 with IC) post incorporation into routine service. A combined diagnostic algorithm, also including (1-3)-β-D-Glucan testing, was generated. Results: Prospective CandID testing generated a sensitivity/specificity of 88%/82%, respectively. Specificity was improved (>95%) when both PCR replicates were positive and/or the patient had multiple positive samples. When combining CandID with (1-3)-β-D-Glucan testing, the probability of IC when both were positive or negative was >69% or <1%, respectively. Conclusions: The CandID provides excellent performance and a rapid time-to-result using methods widely available in generic molecular diagnostic laboratories. By combining nonculture diagnostics, it may be possible to accurately confirm or exclude IC. [ABSTRACT FROM AUTHOR]