This finding can probably explain why patients in the EASIER tria

This finding can probably explain why patients in the EASIER trial had controlled viraemia under an enfuvirtide-containing regimen for a median of 2.2 years. The presence of archived resistance mutations may particularly jeopardize treatment this website outcome when the drugs concerned are included in the regimen. Further prospective studies evaluating the efficacy of the antiretroviral regimen according to DNA genotype results are needed. In conclusion, in patients with past episodes of antiretroviral failure who have suppressed plasma HIV levels under their current regimen, resistance testing performed on HIV DNA lacks sensitivity compared

with cumulated drug resistances from previous plasma genotypes and therefore cannot be used on its own to select an active antiretroviral regimen. Of note, for more recent antiretrovirals, interpretation of past RNA genotypes may be less informative, suggesting the need to reinterpret RT and PR sequences with more recent algorithms. Our study was performed in heavily pretreated patients and the conclusions may not directly apply to patients with less extensive exposure to antiretrovirals. In contrast, analysis of resistance in DNA in naïve patients find more has been shown to be useful and more informative than standard RNA genotyping [31, 32], probably because resistance acquired at the time of primary infection massively fuels the cellular reservoir and persists for long periods of time [33-36]. Our results

have Fossariinae implications for the clinical management of patients, and the design of switch studies. In the absence of available therapeutic history and/or previous plasma genotypes, the use of resistance genotyping of proviral DNA is possible but its limitations must be taken into account when interpreting the results. The detection of even low numbers of resistance mutations reflects the accumulation

of resistance during past therapy. Drug resistance in proviral DNA can be used to inform therapy decisions, such as the choice of drugs with a higher genetic barrier and no cross-resistance. Conflict of interest: CD and JMM: National Board membership. MSD, JB, IC, SD, MLN, NDC, TM, BM, FS and JPA have no conflict of interest to declare. “
“The aim of the study was to assess pregnancy complications in HIV-positive women and changes in the rates of such complications over 11 years in the Frankfurt HIV Cohort. There were 330 pregnancies in HIV-positive women between 1 January 2002 and 31 December 2012. The rate of pregnancy-related complications, such as gestational diabetes mellitus (GDM), pre-eclampsia and preterm delivery, the mode of delivery and obstetric history were analysed. Maternal and neonatal morbidity/mortality as well as HIV mother-to-child transmission (MTCT) were evaluated. In our cohort, GDM was diagnosed in 38 of 330 women (11.4%). Five women (1.5%) developed pre-eclamspia or hypertension. In 16 women (4.8%), premature rupture of membranes (PROM) occurred and 46 women (13.

This investigation therefore results in recommendations on the be

This investigation therefore results in recommendations on the best biofilm substrate for long-term water quality monitoring studies in coral reefs. Four different substrates (glass slides, coral skeletons, reef sediments and ceramic tiles) were deployed for biofilm development. Glass microscope slides (Sail Brand) were pre-cleaned with 70% ethanol and

fixed in polyvinyl chloride frames. Reef sediment (approximately 50 : 50 carbonate, silicate mixture) was collected at 8 m depth from near-shore islands (Long, Lindeman, Repulse) in the Whitsunday Islands and sieved to a grain size of <100 and >63 μm. The sediment was autoclaved and dried at 60 °C over night. Sediment was glued onto microscope glass slides with aquarium grade silicone (Selleys), dried for 24 h and fixed onto PVC frames. Coral cores from Porites sp. Dapagliflozin price (cylinders of 2 × 2 cm) were autoclaved, and unglazed ceramic tiles were sterilized by a 30 min UV treatment on each side. This study followed a hierarchical sampling design. Each substrate was deployed in duplicates at two replicate sites (25 m

apart) at both Daydream Island (inshore, S 20°15.345′ E 148°48.729) and Deloraine Island (offshore, S 20°09.457′ E 149°04.183) (Fig. S1), and therefore making four samples per substrate for each island. These two islands were positioned at each end of a previously described water quality gradient in the Whitsunday Islands of the central GBR (van Woesik et al., 1999; Cooper et al., 2007; Uthicke & Nobes, 2008; Uthicke & Altenrath, 2010; Kriwy & Uthicke, 2011). Daydream selleck products Island Thalidomide (a permanent site of the long-term Reef Plan Marine Monitoring Program) was positioned inshore in

‘low’ water quality and Deloraine Island was positioned offshore in ‘high’ water quality (Table 1). All parameters measured were generally lower during the winter dry season than the summer wet season and higher inshore at Daydream Island compared with offshore at Deloraine Island, except light and salinity, which showed the inverse trend. The water quality measurements are consistent with data obtained from the same monitoring sites along the water quality gradient from previous years (Cooper et al., 2007; Schaffelke et al., 2010). Substrates were deployed on two separate times (48 days during austral winter of August–October 2008, average temperature 21 °C and austral summer of January–February 2009, average temperature 29 °C) to represent annual water temperature extremes. In summary, there were two islands with two sites each where duplicate substrates were deployed. These were sampled at two different times giving a total of 16 samples per substrate. Substrates were deployed at 6 m water depth (below the lowest astronomical tide level) for c. 48 days, and were vertically mounted approximately 40 cm from the underlying sediment on steel pickets (covered by ziplock bags to avoid effects from leached iron) and secured by cable ties.

Direct and inverted repeat regions were identified with the Repse

Direct and inverted repeat regions were identified with the Repseek software integrated in the MaGe platform (Achaz

et al., 2007). To insertionally inactivate xbpS1, a 736 base pair internal fragment located near the 5′ end of the gene was amplified and subsequently ligated into the EcoRV site of pSTBlue-1 (Novagen). The xbpS1 fragment from the recombinant plasmid was ligated into the PstI-XbaI sites of the conjugal suicide vector pKnock-Cm. The resultant plasmid was transformed into E. coli S17-λpir and subsequently transferred into X. bovienii-SF43. The xbpS1 mutant strain (SF70) was selected on LB supplemented with ampicillin (50 μg mL−1) and chloramphenicol (25 μg mL−1), and gene disruption was confirmed by PCR. The xenorhabdicin activity assay was performed as described previously (Morales-Soto & Forst, 2011). SF31 and TT01 strains (Table 1) were separately subcultured in 5 mL of NU7441 supplier LB and grown at 30 °C to an OD600 nm of 0.5–0.6. Cultures were diluted 1200-fold, and 100 μL mixed with 50 μL of each

polyethylene glycol (PEG)-precipitated xenorhabdicin preparations in a 96-well microplate. Experiments were performed in triplicate. Microplate cultures were incubated at 30 °C with shaking. The OD600 nm was measured at 0 and 24 h of incubation. R-type phage tail structures derived from different strains of X. bovienii induced with mitomycin C were analyzed by transmission electron microscopy (Fig. 1). X. bovienii strains, Selleckchem Ceritinib SF43, SF44,

and SF32 isolated from the Steinernema nematodes S. jollieti, S. feltiae, and PTK6 S. kraussei, respectively, produced higher levels of phage tail structures (Fig. 1). The xenorhabdicin preparations contained extended tails (Ext), empty sheaths (Emt), and contracted sheaths (CS). Other structures such as uncharacterized filamentous strands were also visualized. SF31 (S. oregonense) and SF35 (S. puntauvense) produced lower levels of phage tail structures, and SF36 (S. intermedium) produced hardly any tail structures. These findings suggest that the contribution of R-type bacteriocin to intraspecies and interspecies competition may vary depending on the level of xenorhabdicin production by the individual strains. As X. bovienii-SF43 produced phage tail structures, its genome was analyzed for P2-like phage clusters. Xenorhabdus bovienii-SF43 contained two P2-type prophage and six other clusters of mostly hybrid lambdoid-like phage genes (Table S1). One P2-type phage locus was a remnant cluster (Fig. 2) consisting of mostly tail synthesis genes (xbp1), while the second cluster (xbp2) also contained capsid, lysis, and replication genes (data not shown). A 400 kb inversion in X. bovienii on the right side of the chromosome (Ogier et al., 2010) places the xbp1 cluster in the opposite orientation in the chromosome relative to X. nematophila.

0% (n = 13) would use antivirals as influenza prophylaxis Regard

0% (n = 13) would use antivirals as influenza prophylaxis. Regarding prevention, the majority (78.9%; n = 498) of the travelers did not seek advice on influenza before going on their last business trip, 58.0% (n = 381) did not take any preventive measures against influenza, 27.2% (n = 179) had their annual vaccination, and 15.7% (n = 103) observed hand hygiene. Of the travelers, 9.7% (n = 64) carried

antiviral medication on their last business trip and 7.0% (n = 46) actually used this medication. Conclusions. Business travelers have a good kowledge about the transmission and the symptoms of influenza but guidelines are needed that concisely address the indications for influenza vaccination in travelers and the carriage and use of antiviral medication. The recent influenza A (H1N1) pandemic has brought influenza into the infectious disease limelight. In Europe, more than 29% of all confirmed influenza Selleck Apoptosis Compound Library Protease Inhibitor Library price A (H1N1) pandemic cases were travel related and were registered after importation into European Union/European Economic Area countries.1 Seasonal influenza

affects 5% to 15% of the world’s population annually and is considered to be among the most frequent vaccine-preventable infections in travelers.2,3 The attack rate of influenza in intercontinental travelers is estimated at 1%.4 A study which analyzed travel-associated pandemic (H1N1) infection in Singapore showed that one fourth of the case-patients traveled after illness onset, and 15% became ill while traveling.5 Wagner and colleagues showed that air travel

by one infectious individual, rather than causing a single outbreak of H1N1, could cause several simultaneous outbreaks, especially in Economy Class O-methylated flavonoid on long-haul flights.6 Fever in ill-returned travelers is a common presenting symptom and about 14% of presenting fevers can be attributed to a respiratory illness.7 In patients with severe acute respiratory syndromes, influenza viruses are prevalent 14.2%.8 Furthermore, the recent pandemic influenza showed an increased risk of infection and death among young adults who constitute a mobile population.9 In the temperate regions of the northern hemisphere, most influenza activity occurs from November through April, in the temperate regions of the southern hemisphere it is from April through October, whereas in the tropics the influenza virus circulates at low levels year-round.10 Thus, influenza is particularly associated with travel in the northern hemisphere during wintertime or travel in the southern hemisphere during their influenza season.11 Due to close contact of large numbers of individuals who may harbor influenza, travelers are at a higher risk for influenza.10,12,13 Air travel, in particular, facilitates the spread of influenza around the globe and as soon as influenza is spread to the top 50 global airports, the transmission is greatly accelerated.

4% of the flights to Australia from Thailand during this period

4% of the flights to Australia from Thailand during this period. Eligible respondents were persons 18 years or older, departing on the day of interview. Transit passengers were excluded. The self-administered questionnaires were developed using simplified English and piloted at Sydney airport. The revised Nintedanib order questionnaire was translated into Thai, Chinese, and Vietnamese

and back-translated to ensure accuracy, and required 5 minutes to complete. Variables assessed included socio-demographic characteristics, travel characteristics, self-reported symptoms of infection, and social contacts on the day prior to departure. Contact with a febrile person and a range of activities suggestive of increased social contacts in the 2 weeks prior to departure were also collected. Symptoms assessed included fever, sore throat, diarrhea, myalgia, and rash. A definition of fever as a temperature >37.7°C

was given but no definition of other symptoms were provided. The Sydney sample was weighted to reflect the proportion of passenger departures to each destination using aviation statistics,17 Obeticholic Acid providing a representative sample of travelers departing Australia for destinations in Asia. No weighting was applied to the Bangkok sample. Data were analyzed using spss version 17.0 (SPSS Inc., Chicago, IL, USA) and missing data were excluded from the analyses. The chi-squared test was used to assess statistical significance in bivariate analyses, and we considered a p value of <0.05 to be significant. Variables with a significance of <0.25 were considered for inclusion in logistic regression analyses and adequacy of sample sizes for logistic regression modeling were assessed using a method

described by Peduzzi and colleagues.19,20 The research was approved by the Human Research Ethics Committees of the University of New South Wales, Australia (08254), and the Ministry of Public Health, Thailand (3-2399-00051-49-4), as well as the relevant airport authorities. A total of 878 surveys was collected at Sydney airport with a response rate of 56%. Of those, 149 (17.0%) were excluded from the weighted analysis as the reported flight destinations were outside Asia or unknown. The 729 weighted Sydney surveys represent 0.08% of Unoprostone the total travelers departing Australia for a destination in Asia during the study period.17 The number of weighted respondents by flight destination is shown in Table 1. The majority of respondents were remaining in Asia (511/729, 70.1%), while 218 (29.9%) were also traveling to other regions, mainly in Europe. A total of 114 surveys were collected at Bangkok airport, with a response rate of 60%. The 114 surveys collected at Bangkok airport represent 0.8% of the total travelers departing from Thailand on flights to Australia during the study period.

Compared with individuals with a CD4 count ≥350 cells/μL at the t

Compared with individuals with a CD4 count ≥350 cells/μL at the time of SAB diagnosis, the adjusted IRR was 10.2 (95% CI 6.0–17.3) for individuals in the lowest CD4 cell count stratum (<100 cells/μL). IDU as HIV transmission group, nonsuppressed HIV RNA and lack of HAART remained significantly associated with

SAB. Compared with MSM, IDUs were at a 5-fold increased risk of SAB. Table 5 OSI-744 order shows the multivariate analysis repeated after stratification on HIV transmission group. Latest CD4 count <100 cells/μL remained the strongest predictor for SAB in all the groups, although the association was much more pronounced in the MSM group, with an IRR of 31.1 compared with 3.8 for IDUs. In this study, we found that the incidence of SAB among HIV-infected individuals declined between 1995 and 2007, but remained higher than that among HIV-uninfected individuals. The burden of SAB was unevenly distributed among groups of HIV-infected individuals, with IDUs having a higher IR than other transmission groups. Among HIV-infected individuals, immunodeficiency was the strongest predictor

of SAB, although this association was much more pronounced in the MSM group compared with the IDUs. IDU, nonsuppressed HIV RNA and lack of HAART were also predictors of SAB. However, the origin of SAB is likely to differ fundamentally by HIV transmission group. Few population-based studies of SAB in HIV-infected and uninfected

learn more individuals have been carried out and to our knowledge this is the largest study yet. Senthilkumar et al. [4] investigated 84 cases of SAB, of which seven were recurrent episodes. The study, which included men diagnosed with SAB from 1994 to 1997, reported an IRR of 16.5 for HIV-associated SAB. The majority of cases were related to intravascular devices delivering intravenous treatments required for manifestations of severe immunodeficiency. Our study supports the findings that SAB in the MSM group is largely HA and associated with low CD4 cell counts, suggesting that MSM mafosfamide acquired SAB while being treated for AIDS-associated diseases. By including men and women from all HIV transmission groups over a longer, contemporary time period, we have added further knowledge to this field. We found that IDUs predominantly had CA SAB acquired at higher CD4 cell counts. These cases are presumably related to active drug injection. However, the IDUs’ risk of SAB increased at lower CD4 cell counts, indicating that immunodeficiency per se increased the risk of SAB. We further found that IRs and IRRs varied considerably over time and by HIV transmission group. Our IRR of 42 in the early time period is 2.5-fold higher than that reported by Senthilkumar et al. and probably reflects the higher proportion of IDUs in our study population. A population-based study by Laupland et al.

HIV-seropositive individuals should receive IAV vaccination each

HIV-seropositive individuals should receive IAV vaccination each year (category Ib recommendation) HIV-seronegative, immunocompromised individuals have prolonged shedding of IAV but there are limited data on the duration of shedding in HIV-seropositive individuals [147]. However, this possibility should be considered and appropriate droplet infection control policies implemented for both outpatients and in-patients with advanced immunosuppression. Recent data for pandemic H1N1 IAV have shown no evidence for prolonged

viral shedding in a group of HIV-seropositive children, with CD4 T-cell counts >350 cells/μL receiving HAART but not neuraminidase inhibitors, when compared to historical controls [148]. Moreover when oseltamivir was prescribed it significantly Dabrafenib mw shortened the duration of shedding, therefore IAV treatment

may reduce secondary transmission in HIV-seropositive individuals, regardless of symptoms and treatment of index cases may be considered as a preventative measure (category IV recommendation). In line with recommendations for the general population the use of antiviral prophylaxis is not routinely required in HIV-seropositive individuals exposed to IAV [137]. For individuals who are (1) significantly immunosuppressed (CD4 T-cell count <200 cells/μL), (2) have not received vaccination or are believed to be at significant risk of vaccine non-response due to either immunosuppression buy GSK2126458 or recent administration and (3) have been exposed within the last 48 h, antiviral prophylaxis may be considered although there are no HIV-specific data currently on which

to base this recommendation (category IV recommendation). Oseltamivir is most often prescribed for prophylactic use in the general population using 75 mg od for 10 days although in more significantly immunosuppressed individuals or in the presence of oseltamivir-resistance, inhaled zanamivir 10 mg od for 10 days may be considered [137]. Some authorities recommend doubling the dose of these agents to levels equivalent to treatment doses (oseltamivir 75 mg bd orally AZD9291 or zanamivir 10 mg bd by inhalation) for 10 days in more severely immunocompromised individuals. This area, like treatment recommendations discussed above, changes from year to year therefore practitioners are referred to national guidance on IAV management, which varies from year to year. In the UK these guidelines are provided by the Health Protection Agency [137]. “
“The success of antiretroviral therapy (ART) for treating HIV infection is now being turned towards HIV prevention. The Swiss Federal Commission for HIV/AIDS has declared that HIV-positive persons who are treated with ART, have an undetectable viral load, and are free of co-occurring sexually transmitted infections (STIs) should be considered noninfectious for sexual transmission of HIV.

Selenomonas ruminantium, F succinogenes, and total bacteria were

Selenomonas ruminantium, F. succinogenes, and total bacteria were quantified using a LightCycler system (Roche, Mannheim, Germany) as described by Koike et al. (2007). Optimal PCR conditions for clade II of S. ruminantium were experimentally defined (annealing temperature for 62 °C and extension time for 15 s). Total DNA from ruminally incubated hay stems and whole rumen content obtained in a previous experiment (Koike et al., 2003a) were used as templates to monitor the changes in the abundance of S. ruminantium, F. succinogenes, and total bacteria over time. The details of these samples are as described by Koike et al. (2003a). In brief, orchardgrass hay stems in a

nylon bag were suspended in sheep rumen, and samples were periodically withdrawn (at 10, 60, and 120 min, and Selleck ERK inhibitor 6, 14, 24, 48 and 96 h) and rinsed. Whole rumen content was also periodically taken (at 0, 2, 6, 14, and 24 h after feeding). Both in sacco and in vivo samples (n = 3) were stored at −80 °C until DNA extraction. The abundance of clade I was estimated by subtracting the assay value of clade II from the species (S. ruminantium)-specific assay value, for which primers for the species-specific

assay had been confirmed to amplify clade II bacteria. All assay values were expressed as copy numbers of bacterial 16S rRNA gene g−1 sample. Data of bacterial adhesion, acid production, and fiber digestion were subjected LGK 974 to anova followed by the Tukey–Kramer test using the GLM procedure of SAS (1989). Comparison of mean value between two clades was made by Student’s t-test. Statistical significance was defined as P < 0.05.

Of 154 Gram-negative curved rods recovered from roll tubes, 19 isolates were identified as S. ruminantium and its relatives based on their 16S rRNA sequences. These isolates were classified into two clades (I and II) (Fig. 1). Clade I comprised 13 novel isolates obtained in the present study, together with the S. ruminantium type strain GA192 and other 21 known isolates of S. ruminantium. The sequence similarity Methane monooxygenase within this clade I ranged from 93.8% to 99.7%. Although branching of clade II from clade I was not supported by a bootstrap value (< 80%), clade II comprised six novel isolates found in the present study, a previously cultured rumen bacterium (RC-11) and three uncultured bacteria, and the sequence similarity within the clade II ranged from 95.6% to 98.4%. Clade I isolates obtained in the present study showed high sequence similarity (97.5–99.2%) with known isolates of S. ruminantium, while clade II isolates shared a low sequence similarity (93.6–94.9%) with those isolates (Table 1). All isolates produced propionate and acetate as the main metabolites, while the presence and activity of fibrolytic enzymes (CMCase and xylanase) differed among isolates and even within clades (Table 1). Ten of 14 isolates of clade I displayed CMCase activity, while all six isolates of clade II lacked this enzyme or exhibited low activity.

Until 2002, this occurred almost annually after the Hajj However

Until 2002, this occurred almost annually after the Hajj. However,

potentially risks may still occur, as illustrated by a 2009 case of an individual aged 43 years who contracted a fluoroquinolone-resistant strain of Neisseria meningitidis serogroup A.12 The patient developed symptoms within 24 hours of returning to Italy after traveling to Delhi and Chennai in India, with a stopover of a few hours in Frankfurt, Germany. Although the patient had no known contact with anyone in India Bcl-2 inhibitor with previous or current meningococcal disease, testing revealed the strain was the same that had caused epidemics in the area in 2005 to 2006. Fortunately, no known secondary cases have been reported in Italy.12 During epidemics of meningococcal disease in sub-Saharan Africa, the so-called African meningitis belt that stretches from Senegal to Ethiopia, as many as 1,000 per 100,000 population may be affected.25 Recently, the epidemic-susceptible

area has been expanded to Guinea-Bissau, Guinea, the Galunisertib mouse Ivory Coast, Togo, the Central African Republic, and Eritrea.8 Countries around the Rift Valley and Great Lakes regions are also now considered to be at risk (Figure 3).26,27 The risk of meningococcal disease in the population in this area is particularly elevated during the dry season between December and June because of dust winds and background upper respiratory tract infections. However, due to the dynamics of climate variability, risk exists somewhat all year. Population displacements, such as when nomads and farmers congregate in traditional market areas, and overcrowded living conditions can increase the risk of transmission and contribute to epidemics of disease.28 According to the World Health Organization (WHO), in the 2009 epidemic season, 78,416 suspected cases of meningococcal disease, including 4,053 deaths, were reported in 14 African countries implementing enhanced surveillance techniques.28 This represents Fossariinae the largest number of cases and

deaths since the previous large meningococcal disease epidemic in this region in 1996 to 1997, during which >25,000 people died.25 However, to our knowledge, there has not been a single case published about a traveler having been affected in the African meningitis belt. At the least, to some extent, this may be due to the fact that, following essentially congruent vaccination recommendations, a fair proportion of high-risk travelers may have been protected appropriately. This may also be, in part, because active surveillance is limited in Africa, Latin America, and Asia,25 which may result in an underestimation of burden. Finally, an important proportion of travelers has a different behavior and far more social distancing as compared to the local population. During the annual Hajj pilgrimage, >2 million Muslims from across the globe travel to Mecca and Medina.

Participants were asked to estimate their current pain prevalence

Participants were asked to estimate their current pain prevalence and severity (an 11-point numerical scale) and also to estimate what these would be in the absence of any treatment. The questionnaire was piloted before being distributed. Non-respondents were sent a reminder

and replacement questionnaire. Acceptability and validity of the pain management questions were assessed by interviewing a random sample of 20 participants who had provided contact details. The interview included a check on current medications (based on a brown bag review). The item agreement between answers to the questionnaire, and the answers to the selleckchem same questions at the interview, was assessed using a sensitivity analysis, and the Prevalence And Bias Adjusted Kappa (PABAK). Differences in perceived pain prevalence and severity in the presence and absence of pain management were assessed for significance (95% confidence interval; Wilcoxon signed rank test) The study was approved by the North of Scotland Research Ethics Committee. One thousand six hundred four (36.3%)

patients returned a completed questionnaire. The agreement between responses to questions in the questionnaire was ‘almost perfect’ as demonstrated by MAPK inhibitor a PABAK of 0.95. Taking the interview data as the gold standard, the questionnaire had a sensitivity of 91.9% and a specificity of 97.9%. Participants reported that there were no difficulties in completing the pain management questions. Current pain was reported by 50.5% (95%CI = 48.0, 52.9) PTK6 of respondents; when the effect of current pain management was taken into account, this increased to 56.2% (95%CI = 53.7, 58.7). This difference was statistically significant (difference = 5.7%; 95%CI = 2.2, 9.2). Likewise, when pain management was taken into account, perceived pain severity was significantly increased (p < 0.001) from a median of 3 (IQR = 2, 6) to a median of 6 (IQR = 4, 8). Incorporating pain management

questions into pain surveys is feasible. It results in increased estimates of pain prevalence and severity, because respondents report their pain without the benefit of treatment . This is the first study that has quantified the under-reporting of pain when pain management is not taken into account. Future studies of pain should collect and consider pain management information when assessing the burden of pain. 1. Bruhn H et al., 2013. Pharmacist-led management of chronic pain in primary care: results from a randomised controlled exploratory trial. BMJ Open, vol. 3, no. 4. A. N. Rasheda,b, C. Whittleseac, B. Forbesa, S. Tomlina,b aKing’s College London, King’s Health Partners, London, UK, bEvelina London Children’s Hospital, Guy’s & St. Thomas’ NHS Foundation Trust, London, UK, cDurham University, London, UK No standard guidance for intravenous nurse/patient-controlled analgesia preparation in current practice.