Evaluation of the FilmArray Blood Culture Identification Panel: Results of a Multicenter Controlled Trial.

Sepsis is a major cause of morbidity, mortality, and increased medical expense. Rapid diagnosis improves outcomes and reduces costs. The FilmArray blood culture identification panel (BioFire Diagnostics LLC, Salt Lake City, UT), a highly multiplexed PCR assay, can identify 24 etiologic agents of sepsis (8 Gram-positive, 11 Gram-negative, and 5 yeast species) and three antimicrobial resistance genes (mecA, vanA/B, and blaKPC) from positive blood culture bottles. It provides results in about 1 h with 2 min for assay setup. We present the results of an eight-center trial comparing the sensitivity and specificity of the panel with those of the laboratories' standard phenotypic identification techniques, as well as with molecular methods used to distinguish Acinetobacter baumannii from other members of the A. calcoaceticus-A. baumannii complex and to detect antimicrobial resistance genes. Testing included 2,207 positive aerobic blood culture samples, 1,568 clinical and 639 seeded. Samples were tested fresh or were frozen for later testing within 8 h after the bottles were flagged as positive by an automated blood culture system. At least one organism was detected by the panel in 1,382 (88.1%) of the positive clinical specimens. The others contained primarily off-panel organisms. The panel reported multiple organisms in 81 (5.86%) positive clinical specimens. The unresolved blood culture identification sensitivity for all target detections exceeded 96%, except for Klebsiella oxytoca (92.2%), which achieved 98.3% sensitivity after resolution of an unavoidable phenotypic error. The sensitivity and specificity for vanA/B and blaKPC were 100%; those for mecA were 98.4 and 98.3%, respectively.

Perspectives of Indigenous University Students in Canada on Mindfulness-Based Interventions and their Adaptation to Reduce Depression and Anxiety Symptoms.

Objectives: Indigenous university students experience high rates of anxiety and depression due primarily to the pernicious and persistent effects of colonialism, racism, and discrimination. Mindfulness-based interventions (MBIs) hold promise, but likely require adaptation to make them culturally relevant for Indigenous peoples. We sought to gather Indigenous students' perspectives on the consistency and adaptability of MBIs for Indigenous students experiencing symptoms of depression and anxiety. Method: This three-part longitudinal investigation employed a qualitative design mixed with Indigenous research methods to elicit feedback from students (n = 14; M age = 28.92) on the acceptability of MBIs and ways to tailor MBIs to make them more consistent with Indigenous cultures and student lifestyles. We subsequently used this feedback to develop an outline for an adapted MBI that was then re-evaluated by the same participants for its cultural relevance and safety. Results: Indigenous students emphasized the need for the adapted MBI to incorporate (a) traditional Indigenous practices; (b) Indigenous facilitators; (c) holistic conceptualizations of mental health that include spirituality; and (d) practices and methods that could improve flexibility and accessibility of the adapted intervention. Based on this feedback, we presented students with an outline of an adapted MBI tentatively titled Miyowâyâwin Mindful Wellbeing Program, which received favorable evaluations by students for cultural consistency and safety. Conclusions: We confirmed the perceived acceptability and consistency of mindfulness and mindfulness programs with Indigenous cultures. The need for a flexible MBI that centers Indigenous elements and Indigenous facilitators was highlighted by Indigenous participants. This study paves the way for latter steps of the development and subsequent evaluation of the Miyowâyâwin Mindful Wellbeing Program. Preregistration: This study is not preregistered.