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Background: The System Usability Scale (SUS) is used to measure usability of internet-based Cognitive Behavioural Therapy (iCBT). However, whether the SUS is a valid instrument to measure usability in this context is unclear. The aim of this study is to assess the factor structure of the SUS, measuring usability of iCBT for depression in a sample of professionals. In addition, the psychometric properties (reliability, convergent validity) of the SUS were tested., Methods: A sample of 242 professionals using iCBT for depression from 6 European countries completed the SUS. Confirmatory Factor Analysis (CFA) was conducted to test whether a one-factor, two-factor, tone-model or bi-direct model would fit the data best. Reliability was assessed using complementary statistical indices (e.g. omega). To assess convergent validity, the SUS total score was correlated with an adapted Client Satisfaction Questionnaire (CSQ-3)., Results: CFA supported the one-factor, two-factor and tone-model, but the bi-factor model fitted the data best (Comparative Fit Index = 0.992, Tucker Lewis Index = 0.985, Root Mean Square Error of Approximation = 0.055, Standardized Root Mean Square Residual = 0.042 (respectively χ 2 diff (9) = 69.82, p < 0.001; χ 2 diff (8) = 33.04, p < 0.001). Reliability of the SUS was good (ω = 0.91). The total SUS score correlated moderately with the CSQ-3 (CSQ1 r s  = .49, p < 0.001; CSQ2 r s  = .46, p < 0.001; CSQ3 r s  = .38, p < 0.001), indicating convergent validity., Conclusions: Although the SUS seems to have a multidimensional structure, the best model showed that the total sumscore of the SUS appears to be a valid and interpretable measure to assess the usability of internet-based interventions when used by professionals in mental healthcare.

Introduction: This retrospective study reviews the findings from cultures positive for Bordetella spp. obtained over a 19-year period, from January 1984 to December 2002., Methods: Nasopharyngeal swabs were directly plated onto charcoal agar supplemented with 10% sheep blood and cephalexin (40 mg/L). Identification of suspected colonies was done by biochemical testing and slide agglutination with specific antisera for B. pertussis and B. parapertussis. The study includes microbiological findings and epidemiological data (age, sex, yearly distribution, seasonal period and number of inpatients and outpatients)., Results: The 2064 nasopharyngeal specimens yielded 269 positive cultures: B. pertussis was isolated from 244 patients, B. parapertussis from 23 and B. bronchiseptica from two. Among the positive patients, 36.9% were younger than 7 months, 38.8% were 7 months to 6 years old and 24.3% were older than 6 years of age., Conclusions: The constant number of cases along the 19 years of the study shows that Bordetella spp. continues to circulate in our area. A high percentage of positive cultures were obtained from the group of children theoretically immunized by vaccination. Despite the low number of cases in young people and adults, adult pertussis seems to be a greater public health threat than was previously suspected and probably deserves to be further investigated. The gold standard for the diagnosis of Bordetella spp. infection is still recovery of the organism by culture, and it is especially useful for confirming outbreaks.

Background: The aim of the study is to find a rapid and reliable method for urine screen. With this purpose two semiautomatic systems have been evaluated: UTIscreen and UROQUICK., Material and Methods: We have carried out a prospective study of a total 1,070 urine specimens from patients with suspected urinary infection. Each sample has been inoculated in the two semiautomatic systems and compared with the semiquantitative plate culture as the reference method., Results: Both semiautomatic systems showed similar specificity and sensitivity at an interpretative breakpoint of 30,000 CFU/ml, with a low number of false positives. Uninfected specimens can be reported the same day of reception., Conclusions: Both UTIscreen and UROQUICK systems seem to be adequate for urinary tract infection screening. They are reliable and easy to perform, but in our particular case we find advantage in using UTIscreen because the faster reading of this system makes posible to report the negative results in the same morning of reception of the specimen and do the culture of all the positive samples during our usual working schedule.

Background: To study the incidence of Cryptosporidium infections over an eight year period in an urban area, together with the patients background and the season of the year., Materials and Methods: From January 1989 to December 1996, all 32,733 stool samples from 13,639 patients: children and immunocompromised adults, with presumed infective diarrhoea, were investigated for Cryptosporidium oocysts by the Department of Microbiology, Miguel Servet Hospital, Zaragoza (Spain)., Results: Cryptosporidial infection was identified in a 3% of the total children, been the positivity rate highest in the 2-year old group. We visualized oocysts in the 8% of the immunocompromised patients, all of them HIV-positive. The prevalence was higher in winter (February-March)., Conclusions: According to these findings we conclude that Cryptosporidium should be systematically searched by clinical laboratories, specially in children and in immunocompromised patients suffering from infectious diarrhoea.

We have reviewed 29 episodes of pneumococcal meningitis seen in a 6-year period (1983-1988) in 11 pediatric patients and 16 adults. An underlying disease or condition was present in 81.5% of cases, in 55.5% there was an anatomical defect, either congenital, acquired or traumatic in origin. Gram stain of CSF was positive in 86% of cases, and latex test was positive in the 22 CSF samples analyzed with this technique. MIC for penicillin ranges from 1 to 2 mcg/ml in 51.7% of cases. These isolates were also resistant to tetracycline (100%), trimethoprim-sulfamethoxazole (100%) and chloramphenicol (87%). All strains isolated were sensitive to vancomycin, rifampin and cefotaxime. Of all 14 episodes due to penicillin-sensitive strains, 10 cases were treated with this drug and in 4 cases, third generation cephalosporins were prescribed. All cases showed good clinical response. Of all 15 episodes due to penicillin-resistant strains, vancomycin was used first in 10 cases, cefotaxime in three, moxalactam in one and ampicillin plus chloramphenicol in another. Treatment failures (one in cefotaxime and one in moxalactam group) were solved with vancomycin. Of all 12 patients treated with vancomycin, clinical and microbiological cure was achieved in 10 cases. Two additional patients died, one with sterile CSF after 45 days of admission and one few hours after admission. Our data give support to vancomycin as a useful therapeutic option in the treatment of pneumococcal meningitis due to penicillin-resistant strains.

One pre- and two postoperative cultures of tracheo-bronchial secretions were obtained from 28 cardiac patients, subjected to open-heart surgery. Four patients received preoperative antibiotics, and all but one received postoperative prophylactic antibiotics. Preoperatively, only one patient had potential pathogens; after surgery (mean intubation time 4.2 h), four patients (14.3%) had organisms; and after 19 h of intubation, 28% of the patients had potential pathogens in their tracheo-bronchial secretions. Only three of the seven organisms recovered from the last sample were clearly sensitive to the antibiotics given prophylactically; and two of these organisms were Group A beta-haemolytic streptococci. The early presence of organisms in the airways after intubation, the high incidence of colonization, and the ineffectiveness of prophylactic antibiotics in preventing this contamination are pointed out. The factors that may possibly influence colonization of airways among these patients are commented on.