University of the Sunshine Coast
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Staff perceptions of the emergency department working environment: An international cross-sectional survey
No full textOBJECTIVES: The aims of this study were to describe clinical staff perceptions of their ED working environment and to explore associations between staff demographics, coping styles and the work environment.
METHODS: A cross-sectional study was conducted in one Swedish ED and two Australian EDs in 2015-2016. Descriptive statistics were used to explore stressors, coping styles and aspects of the working environment for the combined cohort and the cohort split by age, sex, professional role, years of employment in the ED and country. Regression analyses examined the impact of coping style and demographic characteristics on staff perceptions of the working environment.
RESULTS: Two hundred and six ED staff completed the survey (response rate: 64%). Factors most stressful for ED staff included death or sexual abuse of a child, heavy workload and poor skill mix. Staff perceptions of the working environment differed based on age, sex, country, tenure and job role. Regression analysis of perceptions of the work environment on demographics and coping strategies revealed that negative coping strategies were associated with low self-realisation, high workload, high conflict and high nervousness. Active coping and positive thinking were associated with increased self-realisation. Positive thinking was associated with lower levels of conflict.
CONCLUSIONS: Employees engaging in positive coping strategies had more positive perceptions of the work environment, while those engaging in maladaptive coping strategies reported negative perceptions of the work environment. These data suggest that strategies that promote the use of active coping and positive thinking should be encouraged and warrant further research in the ED
Changes in endogenous and exogenous Koala Retrovirus (KoRV) subtype expression over time reflects koala health outcomes
No full textKoala retrovirus (KoRV) is unique in that it exists as both an exogenous and actively endogenizing gamma-retrovirus of koalas. While nine subtypes of KoRV have been recognized, focused study of these subtypes in koalas over time and with different health outcomes has been lacking. Therefore, in this study, three wild koala cohorts were established and monitored to examine KoRV proviral and expression data from koalas that either remained healthy over time, began healthy before developing chlamydial cystitis or presented with chlamydial cystitis and were treated with antibiotics. Deep sequencing of the proviral KoRV envelope gene revealed KoRV-A, -B, -D and -F to be the major subtypes in this population and allowed for subtype-specific assays to be created. Quantification of KoRV transcripts revealed that KoRV-D expression mirrored the total KoRV expression levels (106 copies/ml of plasma), with KoRV-A and KoRV-F expression being ∼10-fold less and KoRV-B expression being ∼100-fold less, when detected. Strikingly, there was significantly higher expression of KoRV-D in healthy koalas compared to koalas that developed chlamydial cystitis, with healthy koalas expressing a major KoRV-D/minor KoRV-A profile, whereas koalas that developed cystitis had variable KoRV expression profiles. Total anti-KoRV IgG antibody levels were found not to correlate with the expression of total KoRV or any individual KoRV subtype. Finally, KoRV expression was consistent between systemic and mucosal body sites and during antibiotic treatment. Collectively, this gives a comprehensive picture of KoRV dynamics during several important koala health states
ARDaP: Antimicrobial Resistance Detection and Prediction from whole-genome sequence data
No full textAntibiotic resistance (ABR) is a major threat to human health worldwide, with increasing instances of multi-drug resistant pathogens emerging to diminish the effectiveness of antibiotics(1). Whole-genome sequencing (WGS) is rapidly changing the clinical microbiology landscape, with exciting potential for rapidly and accurately detecting ABR in diagnostic laboratories, a crucial factor in infection control and treatment. Most work to date has focussed on the development of software capable of detecting the presence of mobile genetic elements conferring ABR from WGS data(2). However, less consideration has been given to the identification of chromosomally-encoded ABR mechanisms, such as single-nucleotide polymorphisms (SNPs), insertion-deletions (indels), copy number variants (CNV), and functional gene loss. We present an improved software for Antibiotic Resistance Detection and Prediction (ARDaP) from WGS data. ARDaP was designed with two main aims: 1) to accurately identify all characterised ABR genetic mechanisms and present the predicted ABR profile in an easy-to-interpret report; and 2) to predict enigmatic ABR mechanisms based on i) novel mutants in known ABR-conferring genes, or ii) a microbial genome-wide association approach that correlates ABR phenotypes with genetic variants to identify putative causative mutant/s. We demonstrate the applicability of ARDaP using the Tier 1 select agent and melioidosis pathogen, Burkholderia pseudomallei, as a model organism due to its exclusively chromosomally-encoded ABR mechanisms and high mortality rate (3). Using an extensive, well-characterised collection of 991 B. pseudomallei clinical strains, we demonstrate that ARDaP can accurately detect all known ABR mechanisms in B. pseudomallei (>40 mutations) with high rates of precision and recall. Furthermore, ARDaP predicted four novel loss-of-function mutations that decreased meropenem susceptibility in B. pseudomallei; this phenotype is associated with increased treatment failure and fatality rates(3). ARDaP is a comprehensive and accurate tool for identifying and predicting ABR mechanisms from WGS data. Its clinician-friendly report(4), which summarises a given strain’s AbR profile, holds great promise for informing personalised treatment regimens and treatment shifts in response to the detection of precursor or ABR-conferring mutations
Selection for improved white spot syndrome virus resistance increased larval survival and growth rate of Pacific Whiteleg shrimp, Liptopenaeus vannamei
No full textOutbreaks of contagious diseases, including White spot syndrome virus (WSSV), occur more frequently due to environment changes and as commercial shrimp production becomes intensified. The over-arching aim of this study was to examine new traits to improve disease resistance of Whiteleg shrimp, Liptopenaeus vannamei, to WSSV. Specifically, we made a compressive evaluation of the breeding population to determine a suitable selection criterion for improved WSSV resistance. To achieve this objective, we analysed five traits (viral titre, WSSV resistance, larval survival, body weight and standard length) recorded for 120,000 individual shrimps that were offspring of 228 sires and 300 dams produced over two generations of selection in 2017 and 2018. Our restricted maximum likelihood mixed model analysis showed that there is additive genetic variation in viral copy number (or viral titre, viral load) with the heritability that equals 0.18 ± 0.02. Viral titre displayed a moderate and negative genetic correlation with WSSV resistance (rg = −0.55). These results suggest that viral titre can be used as a selection criterion to improve WSSV resistance, but selection for decreased viral titre (i.e., increased resistance) may not capture all genetic expression in WSSV resistance. In addition to the estimation of population genetic parameters, we evaluated direct response to selection for increased WSSV resistance, which was measured as differences in estimated breeding values between the high and low resistant lines. The direct genetic gain achieved for WSSV resistance averaged 12.9% after one generation of selection in this Whiteleg shrimp population. The selection program also resulted in positive impacts on growth and larval survival by 7% and 17%, respectively. There is abundant genetic variation in WSSV resistance (h2 = 0.19–0.27), suggesting that the tested Whiteleg shrimp population will continue to respond to future selection. Collectively, the results obtained in our study provide important information to assist the design and implementation of genetic improvement programs for disease traits in aquaculture species, including L. vannamei
Factors influencing self-management priority setting and decision-making among Chinese patients with acute coronary syndrome and type 2 diabetes mellitus
No full textBackground:
Priority setting and decision-making in relation to self-management of multiple conditions is particularly challenging for both patients and health professionals. The aim of this study was to validate a conceptual model of self-management priority setting and decision-making in multimorbidity and confirm factors that influence self-management prioritizing and decision-making in a sample of patients with acute coronary syndrome and type 2 diabetes mellitus.
Methods:
This was a qualitative study using deductive directed content analysis. A purposive sample of 21 participants with acute coronary syndrome and type 2 diabetes mellitus that were admitted to a Shanghai hospital were interviewed.
Results:
Participants provided evidence to confirm all but one of the factors from the conceptual model. Internal factors influencing self-management predominated. Agreement with recommended treatment, functional capacity and perceived synergies, antagonistic effects, or interactions among the conditions and prescribed treatments, was emphasized. The facilitators and barriers to priority setting and decision-making were related to available resources, provider communication and, to a lesser extent, confusion about recommendations, and treatment complexity. Some participants were also concerned about treatment side effects.
Conclusions:
Internal factors (personal beliefs, preferences, and attitudes) and facilitators and barriers (knowledge, finances, social support, and transportation) were related to changes in priority setting and decision-making and self-management behavior in this sample. Health education, which includes case studies with shifting self-management priorities is recommended, rather than a unique disease-specific focus. Further research, exploring the relationship between these factors and changes in the dominant condition and related management, using valid and reliable instruments that capture these key factors, is recommended
Using an alternate reality game to facilitate student engagement during orientation
No full textAn alternate reality game was designed to facilitate transition and engagement amongst students commencing a tertiary preparation program at a regional university in Australia. The design of the game was informed by a student engagement framework which proposes four psychosocial constructs which mediate engagement at the intersection between student and institutional influences: self-efficacy, belonging, well-being, and emotion. The 108 participants completed a survey which measured these constructs prior to the commencement of the game. Game players (n = 13) were surveyed again immediately after the game. The results of statistical analysis indicated that game players reported agreater sense of well-being and more positive emotions than the group surveyed before the game
Gender-specific perspectives of mangrove ecosystem services: case study from Bua Province, Fiji Islands
No full textIn many Pacific Island Countries, mangroves deliver ecosystem goods and services that are essential to the livelihoods of local people. For coastal and rural communities throughout Fiji, it is common for women to be the main caretakers of mangroves, and to access and utilise their resources on a regular basis. This paper explores local perspectives of Fijian men and women on the use, benefit and value of mangrove ecosystems. Across six rural villages within the Bua Province, Fiji, a series of semi-structured household interviews (n=41) were undertaken, coupled with participant observation. These findings provide insights into how gender roles influence the ways people value and interact with local ecosystems. This paper concludes with a call to incorporate gender into ecosystem-service valuation and management interventions so that they can produce sustainable and equitable livelihood outcomes
Quantitative real-time PCR assay for the rapid identification of the multidrug-resistant bacterial pathogen Stenotrophomonas maltophilia
No full textStenotrophomonas maltophilia is emerging as an important cause of disease in nosocomial and community-acquired settings, including bloodstream, wound and catheter-associated infections. Cystic fibrosis airways also provide optimal growth conditions for various opportunistic pathogens with high antibiotic tolerance, including S. maltophilia. Currently, there is no rapid, cost-effective, and accurate molecular method for detecting this potentially life-threatening pathogen, particularly in polymicrobial specimens, suggesting that its true prevalence may be underestimated. Here, we used large-scale comparative genomics to identify a specific genetic target for S. maltophilia, with subsequent development and validation of a real-time PCR assay for its detection. Analysis of 165 Stenotrophomonas spp. genomes identified a 4kb region specific to S. maltophilia, which was targeted for Black Hole Quencher assay design. Our assay yielded the positive detection of 89 of 89 (100%) clinical S. maltophilia strains, and no amplification of 23 non-S. maltophilia clinical isolates. S. maltophilia was detected in 10/16 CF sputa, demonstrating the utility for direct detection in respiratory specimens. The assay demonstrated good sensitivity, with limits of detection and quantitation on pure culture of ~10 and ~100 genome equivalents, respectively. Our assay provides a highly specific, sensitive, and cost-effective method for the accurate identification of S. maltophilia, and will improve the diagnosis and treatment of this under-recognized pathogen by enabling its accurate and rapid detection from polymicrobial clinical and environmental samples
Effects of shading on periphyton characteristics and performance of sandfish, Holothuria scabra Jaeger 1833, juveniles
No full textMass production of sea cucumber (sandfish; Holothuria scabra) juveniles is carried out in periphyton-based ocean nursery systems. However, detailed studies on the importance of periphyton as a food source for post-settled juveniles, and on factors influencing biofilm development and composition are scarce. Such information is critical in the optimization of both culture systems and husbandry procedures, and to improve production of juveniles. In this study, the effects of relative food abundance and shading on the feeding activity of the juveniles (~5 mm) under laboratory conditions were determined. The effects of shading (ambient vs. shaded) on periphyton development, and on the growth performance of post-settled juveniles, were also determined in a 30-day field experiment. Food consumption in the ‘high’ food and ambient light treatment was significantly higher (2.4 ± 0.1 mg day−1) than that of juveniles reared in other treatments, including ‘low’ food and shaded culture vessels. Juveniles reared in low food conditions covered significantly greater areas when feeding (2.3 ± 0.28 cm2 day−1) than juveniles reared in high food conditions (0.41 ± 0.20 cm2 day−1). Average length and absolute growth rate (AGR) of juveniles in the shaded treatment were significantly higher by day 15, but differences between light treatments were not significant by day 30. Interestingly, juvenile survival was significantly higher in the shaded (56.9 ± 20.7%) treatment compared to the ambient light (34.4 ± 22.9%) treatment. The chlorophyll a content of periphyton was significantly higher by day 30 than at day 5 in both treatments. Total periphyton biomass (AFDW) was higher in the ambient light treatment than in the shaded treatment, but both generally decreased overtime. Results suggest that food quality is better during the early colonization of periphyton as indicated by the higher absolute growth rates of juveniles during the first 15 days of the experiment. This study generated new information on factors influencing the success of hapa net-based nursery culture of sandfish juveniles and provides a basis for improved use and management of such systems
Best practice principles for research with Aboriginal and Torres Strait Islander communities in action: Case study of a safe infant sleep strategy
No full textBackground:
Approaches to health promotion that are collaborative, support strengths inherent in Aboriginal and Torres Strait Islander culture, and demonstrate respect and understanding for individual communities, have achieved the most positive outcomes to date.
Aim:
To illustrate how the implementation and evaluation of a safe infant sleep health promotion strategy was facilitated by embedding recognised best practice principles for the conduct of research with Aboriginal and Torres Strait Islander peoples and communities.
Methods:
The Pēpi-Pod® Program was introduced across rural, remote and metropolitan locations in Queensland between 2013 and 2017. This case study discusses the partnership between the Pēpi-Pod® Program and one community-controlled maternal and child health service that employed an Aboriginal Health Worker led model of maternal and child health care for remote regions of Queensland.
Findings:
Best practice principles were embedded within the program design and adaptation, and in the approach to community consultation prior to program implementation. Collaborative partnerships based on trust, which established stakeholder expectations through transparent communication processes, together with effective engagement in achieving program goals, led to the implementation of this evidence-based health promotion initiative as intended. Consideration for locally relevant and culturally competent program delivery was key to success. The integrity of the program was maintained and embedded into ongoing service delivery.
Conclusions:
Through adherence to best practice principles for research with Aboriginal and Torres Strait Islander communities, implementation and evaluation of health promotion programs can be conducted in mutually acceptable, feasible and sustainable ways that develop capacity within participating health services