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Adherence to antibiotic guidelines and reported penicillin allergy: pooled cohort data on prescribing and allergy documentation from two English National Health Service (NHS) trusts
Full text linkCopyright information: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.Objective To investigate documentation of antimicrobial allergy and to determine prescribing adherence to local antibiotic guidelines for inpatients with and without reported penicillin allergy treated for infection in a National Health Service (NHS) context.
Setting Data were collected at two English hospital NHS trusts over two time-periods: June 2016 and February 2017.
Design Cohort study. Trust 1 data were sourced from prospective point prevalence surveys. Trust 2 data were extracted retrospectively from an electronic report.
Participants Inpatients treated for urinary tract infection (UTI), community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP) and skin and soft tissue infection (SSTI). Data on allergy were collected, and antibiotic selection assessed for adherence to trust guidelines with differences between groups presented as adjusted ORs.
Results A total of 1497 patients were included, with 2645 antibiotics orders. Patients were treated for CAP (n=495; 33.1%), UTI (407; 27.2%), HAP (330; 22%) and SSTI (265; 17.7%). There were 240 (16%) patients with penicillin allergy. Penicillin allergy was recorded as allergy (n=52; 21.7%), side effect (27; 11.3%) and no documentation (161; 67.1%). Overall, 2184 (82.6%) antibiotic orders were guideline-adherent. Adherence was greatest for those labelled penicillin allergy (453 of 517; 87.6%) versus no allergy (1731 of 2128; 81.3%) (OR 0.52 (95% CI 0.37 to 0.73) p<0.001). Guideline-adherence for CAP was higher if penicillin allergy (151 of 163; 92.6%) versus no allergy (582 of 810; 71.9%) (OR 0.20 (95% CI 0.10 to 0.37) p<0.001). There was no difference in adherence between those with and without penicillin allergy for UTI, HAP or SSTI treatment.
Conclusions A relatively high proportion of patients had a penicillin allergy and two thirds of these had no description of their allergy, which has important implications for patient safety. Patients with penicillin allergy treated for CAP, received more guideline adherent antibiotics than those without allergy. Future studies investigating the clinical impact of penicillin allergy should include data on adherence to antibiotic guidelines
Theoretical Streamflow Generation Modelling
No full textTotal data is approximately 6 Gb zipped (38 Gb unzipped).
This folder contains the all the input files, simulation output and pre and post processing scripts
used to perfom all the analysis for the paper:
"What triggers streamflow for Intermittent Rivers and Ephemeral Streams
in Low-Gradient Catchments in Mediterranean Climates"
Folders and files descriptions are as follows:
1_Model_input_files -- contains all the necesary files to re-create the 1620 different.
model scenarios.
2_Sand_Output_hydrographs -- Contains 9 subfolders, one for each of the 9 rainfall scenarios containing all
the output hydrographs (for the 4 hydrograph locations) for the 60 different
initial groundwater heads. The folders are named by the rainfall scenario.
For instance the folder named 2mmHr_24hr_rainfall_output contains 300 hydrograph files
corresponding to the 4 hydrograph locations for the 60 initial GW heads for the 2mm/h for
24 h rainfall for the sandy soil.
3_SandyGravel_Output_hydrographs -- Contains the same data as explained above but for the sandy gravel scenarios
4_SandyLoam_Output_hydrographs -- Contains the same data as explained above but for the sandy loam scenarios
5_Sand_Active_areas_models -- Contains 3 subfolders, one for each of the model scenarios selected to be rerun.
Each subfolder contains:
abdulo.olf.dat -- Overlandflow output
abdulo.pm.dat -- Porous media output
6_SandyGravel_Active_areas_models -- Contains the same data as explained above but for the sandy loam scenarios
7_SandyLoam_Active_areas_models -- Contains the same data as explained above but for the sandy loam scenarios
merge_DF_firstflows.py -- Script to merge all the summary hydrograph files for the three
soils into a single file.
First_flows_ALL.xlsx -- Final summary outputted by the aforementioned script which contains the
information of the ALL the first flows.
Active_area_post_process_results.py -- Python script that is used to post process the overland
flow output file to add a new output column specifiying
the dominant HMC fraction.
CC BY: Attribution 3.0 AUInput files for the theoretical modelling excercise and selected simulation outputs used to perform the analysis for the article “What triggers streamflow for Intermittent Rivers and Ephemeral Streams?
Interagency collaboration in primary mental health care: lessons from the Partners in Recovery program
Full text link© The Author(s) 2019 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.BACKGROUND: Collaborative care is a means of improving outcomes particularly for people with complex needs. The Partners in Recovery (PIR) program, established in Australia in 2012, provides care coordination to facilitate access to health and social support services for people with severe and persistent mental illness. Of the 48 PIR programs across Australia, 35 were led by Medicare Locals, the previous Australian regional primary health care organisation and nine involved Medicare Locals as partner organisations. AIMS: To identify features which enabled and hindered collaboration in PIR programs involving Medicare Locals and determine what can be learnt about delivering care to this population. METHODS: Data were collected from 50 interviews with senior staff at Medicare Locals and from eight focus groups with 51 mental health stakeholders in different Australian jurisdictions. RESULTS: Successful PIR programs were based upon effective collaboration. Collaboration was facilitated by dedicated funding, a shared understanding of PIR aims, joint planning, effective network management, mutual respect and effective communication. Collaboration was also enhanced by the local knowledge and population health planning functions of Medicare Locals. Jurisdictional boundaries and funding discontinuity were the primary barriers to collaboration
Grief and Consolation in Greece and Rome: Ancient and Modern Perspectives
Full text link© 2019 the author.In this talk I surveyed various ancient and modern approaches to grief in order to study the enduring problem of how we humans cope with grief and how these can be productively studied from a comparative angle. The recent upsurge in the study of grief and consoling strategies is especially interested in the healing arts, which is making use of various mechanisms from the humanistic tradition to cope with grief and loss. The paper hopes to spark new debates on how a diachronic analysis can allow for discovering new approaches. It will become clear that we need a great variety of solutions to allow for the processing of grief across a broad spectrum of personalities
Evangelising Zeus: the Iliad according to Loukanes
Full text link© 2019 the authorAs early as the fourth century AD, and despite the unflagging efforts of the emperor Julian, known by the sobriquet the Apostate, to thwart the Christians from forging an abiding bond with classical literature, the process of amalgamation of the Greek literary heritage with the emerging Christian culture was already underway spawned primarily by the writings of the Cappadocian Church Fathers, for whom Homer continued to hold the highly esteemed position of the educator of the Greeks. Against this rich backdrop of Christian détournement of the Homeric legacy, the present article seeks to explore the Christian resonances in Nikolaos Loukanes’ 1526 Iliad. Rather than banishing the Olympian gods from his Iliad, as his Byzantine predecessor Konstantinos Hermoniakos had done in the fourteenth century cleaving to his faith, Loukanes opts to depict the gods, albeit through the lens of contemporary Christian beliefs
Australians in Crete in World War II
Full text link© 2019 the author.This paper argues that the Australian involvement in wartime Crete took place in three main phases. In the first phase Australian forces participated in the defence of Crete against German invasion over twelve days in May/June 1941. The second phase began with the surrender of the Allied forces and the stranding on the island of perhaps a thousand Allied soldiers, including Australians. These men “on the run” were forced to rely on the assistance of Cretans for their very survival, and they found the local population remarkably receptive to their needs. The third and final phase grew out of the previous two phases and comprised Australian participation in resistance activities in collaboration with local resistance elements and British forces. The key figure in this regard was Tom Dunbabin, an Australian who became a senior officer with the British Special Operations Executive and who did much to shape the conduct of “irregular” warfare in Crete
Greek-Australian women's love poetry: of terrain and transnationalism
Full text link© 2019 the authorThis paper seeks to showcase the various facets of love, romantic and otherwise, explored by Greek-Australian women writers in their poetry and prose. It reinforces the paramount significance of contextuality in relation to women’s experiences if verbal privilege is, indeed, going to have the effect of breaking through community-engendered silences. To that end, being cognizant of the socio-historical context of these poems, particularly those of first-generation women writers of the 1950s, 60s and 70s, gives to these works a certain resonant depth, thus saving them from the charge of being merely facile fancies. Further, this paper seeks to demonstrate that those writings emanating from their second-generation daughters reflect persistent intersections with a keenly experienced transnationalism, the traversing of terrain, in all its tangible and intangible complexity, a central feature throughout
South Australian Allied Health Rural Generalist Pathway Evaluation: Phase 1 Report
Full text link© 2020 Flinders UniversityIn 2019 Rural Health Workforce Strategy funding, provided by the Government of South Australia, supported the introduction of the Allied Health Rural Generalist Pathway (AHRGP) as a strategy for improving allied health workforce and quality outcomes for rural and remote South Australians. This pathway was originally developed through a collaboration between the Allied Health Professions Office of Queensland, Services for Rural and Remote Allied Health (SARRAH), Australian state and territory healthcare sectors, and other stakeholders including universities and the Australian Healthcare and Hospitals Association. The education component of the AHRGP is provided by James Cook University in two levels for newly qualified and more experienced Allied Health Professionals (AHPs). Rural generalist trainees enrolled in the program undertake course work and work-based projects throughout the program. They have protected time within their workload to study as well as dedicated profession specific supervision
Parent’s Cardiorespiratory Fitness, Body Mass, and Chronic Disease Status Is Associated with Metabolic Syndrome in Young Adults: A Preliminary Study
Full text link© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).We sought to determine if there was an intergenerational association between parental weight, cardiorespiratory fitness (CRF), and disease status, with the prevalence of metabolic syndrome (MetSyn) in their young adult o spring. Young adults (n = 270, 21 1 years, 53.3% female) were assessed for MetSyn and self-reported parent’s CRF, body mass status, and disease status. MetSyn was present in 11.9% of participants, 27.4% had one or two components, and 58.5% had no components. A significantly higher percentage (93.9%) of young adults with MetSyn identified at least one parent
as being overweight or obese, 84.8% reported low parental CRF and 87.9% reported a parent with disease (all p < 0.017). MetSyn in o spring is more likely when parents are perceived to have low CRF, increased body mass, and a diagnosis of disease. Evaluating the o spring of people with low CRF, elevated body mass, or who have a history of cardiovascular disease (CVD) or diabetes should be considered to promote early identification and treatment of young adults to reduce future premature CVD in these at-risk individuals
Loss of ciliary zonule protein hydroxylation and lens stability as a predicted consequence of biallelic ASPH variation
Full text linkThis author accepted manuscript is made available following 12 month embargo from date of publication (January 2019) in accordance with the publisher’s archiving policy
“This is an Accepted Manuscript of an article published by Taylor & Francis in Ophthalmic Genetics on 2 January 2019, available online: http://www.tandfonline.com/10.1080/13816810.2018.1561904”Purpose: Stability of the crystalline lens requires formation of microfibril bundles and their higher-order structures of ciliary zonules. Trauma, malformation, or degeneration of the ciliary zonules can lead to dislocation or displacement of the lens, which in turn can cause transient or permanent loss of visual acuity. The purpose of this study was to identify the predicted substrates of ASPH, a 2-oxoglutarate- and Fe2+-dependent hydroxylase, which may account for the lens instability phenotype of ASPH-associated syndromes.
Methods: A single proband of European ancestry with spherophakia and high myopia was subjected to exome sequencing. Proteins containing the ASPH hydroxylation motif were identified within the SwissProt protein database.
Results: We identified 105 putative substrates of ASPH-mediated hydroxylation in the human proteome, of which two (FBN1 and LTBP2) are associated with inherited ectopia lentis syndromes, and are essential for microfibril and ciliary zonule development.
Conclusion: Our results implicate ASPH-mediated hydroxylation in the formation of
FBN1/LTBP2 microfibril bundles and competent ciliary zonules