34 research outputs found
An integrated metagenomic approach to investigating disease heterogeneity in sepsis due to community-acquired pneumonia
No full textSepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. There is an increasing global burden of disease and it is associated with high mortality, long-term disability and shortened life expectancy. Clinical management of sepsis remains supportive rather than curative and progress in sepsis research has been severely constrained by a heterogeneous disease phenotype, limiting the interpretation of clinical trials and the development of effective therapeutic interventions. One source of heterogeneity is the pathogen but the frequent failure of clinical microbiology to identify the infecting organism in sepsis has limited efforts to understand the effect of disease heterogeneity involving the pathogen. Community-acquired pneumonia (CAP) is the most common cause of sepsis and clinical microbiology is unable to provide a diagnosis in 47% of such cases, suggesting that alternative methods such as clinical metagenomics may enable improved diagnostics.
Clinical metagenomics involves the application of next-generation sequencing technologies to characterise all the DNA and/or RNA present in a sample, enabling analysis of the entire microbiome as well as the human host genome or transcriptome from patient samples. This thesis presents the development and validation of Castanet, a method for targeted metagenomic sequencing using probe-based enrichment. Clinical metagenomic data is presented for 573 patients admitted to intensive care with sepsis due to CAP, including 447 patients for whom clinical microbiology did not identify a pathogen. In addition, digital droplet PCR data is presented for the most frequently identified causative bacteria (Streptococcus pneumoniae) and reactivated virus (Epstein-Barr virus) in the metagenomic cohort. Finally, this thesis explores how improved resolution of microbiology in the sepsis cohort can be applied to transcriptomic and genomic-based approaches to understand the host response in sepsis. This includes exploration of Epstein-Barr virus reactivation, differential gene expression analysis for different pathogens, and analysis of the association between specific HLA alleles and susceptibility to different pathogens.
This thesis demonstrates the utility of integrating metagenomic data with other omic methods to enable improved understanding of the heterogeneous host response in sepsis, with opportunities for a precision medicine approach
Creating upstream change in mental health through Photovoice
No full textPeople with serious mental illness die an average of 25 years younger than the general population (Flanagan, et al., 2016). Social exclusion and stigma have been identified as being at the core of health disparities and barriers to meaningful community involvement for people with serious mental illness (Reid & Alonso, 2018). To address the complex and detrimental effects of stigma and social exclusion, Imagining Inclusion used Community Based Participatory Research methodology, Photovoice, to explore experiences of community inclusion, health and well-being for individuals with serious mental illness and will use the findings to foster organizational and societal change. With Photovoice research, participants take photos about their lived experience and speak about how they relate to themselves, community and society (Reid & Alonso, 2018). In Imagining Inclusion Phase 3 we will examine the characteristics and outcomes of the Photovoice process, and the role of peers and therapeutic recreation in helping to create stigma resistance at the personal, peer, and public levels. We will develop an evidence-based toolkit that can be used to adopt and sustain the key elements of the Photovoice process across allied health and therapeutic recreation services for people with serious mental illness.Not peer reviewedStudent Research Day Poster (2019
Enhanced understanding of the host-pathogen interaction in sepsis: new opportunities for omic approaches.
No full textProgress in sepsis research has been severely hampered by a heterogeneous disease phenotype, limiting the interpretation of clinical trials and the development of effective therapeutic interventions. Application of omics-based methodologies is advancing understanding of the dysregulated host immune response to infection in sepsis. However, the frequently elusive nature of the infecting organism in sepsis has limited efforts to understand the effect of disease heterogeneity involving the pathogen. Recent advances in nucleic acid sequencing-based pathogen analysis provide the opportunity for more accurate and comprehensive microbiological diagnosis. In this Review, we explore how better understanding of the host-pathogen interaction can substantially enhance, and in turn benefit from, current and future application of omics-based approaches to understand the host response in sepsis. We illustrate this using recent work accounting for heterogeneity involving the pathogen. We propose that there is a timely opportunity to further resolve sepsis heterogeneity by considering host-pathogen interactions, enabling progress towards a precision medicine approach
Persistent orocutaneous and anal fistulae induced by nicorandil: a case report
No full textAbstract Introduction Although nicorandil is prescribed widely, awareness of its potential to cause serious complications to the gastrointestinal tract mucosa is limited. Whilst nicorandil-induced oral and anal ulceration is well documented in the literature, nicorandil-induced fistulation is not. This is the first report in the literature of a single patient demonstrating simultaneous orocutaneous and anal fistulae during nicorandil therapy. Two separate cases of orocutaneous and anal fistulae associated nicorandil usage have previously been documented in specialist journals. Case presentation A 71-year-old Caucasian man presented with a 3-year history of concurrent orocutaneous and anal fistulae. He had been exposed to 30 mg twice-daily nicorandil therapy for 4 years. Both fistulae responded poorly to intensive and prolonged conventional treatment but healed promptly on reduction and eventual withdrawal of nicorandil therapy. Conclusion Management of resistant cases of orocutaneous and anal fistulae in patients on high-dose nicorandil therapy may be impossible without reduction or even withdrawal of nicorandil.</p
Outside Our Wheelhouse: Reflections from Technical Librarians Serving as Interim Public Services Managers
No full textLibraries often utilize interim leaders to fill essential vacancies. Most literature on interim leadership focuses on the top library administrator position and relatively few articles address the experiences of interim middle managers or discuss the value of librarians leading departments outside their areas of expertise. In this article, Author 1 and Author 2, a systems librarian and a special collections and archives technical services librarian respectively, discuss how they leveraged their technical knowledge and soft skills while leading departments that were not within their fields of expertise. They explain how serving outside their wheelhouses benefitted the organization and enriched their job satisfaction
NUTRIENTS AND BONE MINERAL DENSITY IN POSTMENOPAUSAL WOMEN
No full textRights Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author
Quest to Belong
No full textThis paper describes some components of intercultural communication theory that individuals face in an attempt to discover where they belong. It addresses how individuals with disabilities try to decrease the negativity of their social identity. The author further deals with negative attitudes of prejudice through a discussion of language attitudes and intercultural marriages. The paper concludes with a section on the characteristics of true communities
Guided imagery for acute pain after cardiac surgery
No full textAcute pain after cardiac surgery can progress to persistent pain if not managed effectively, which can negatively affect full recovery. This study examined the effectiveness of a nonpharmacological therapy, guided imagery, in reducing acute pain among postoperative open-heart patients in the cardiothoracic intensive care unit. The study also examined the effect of the guided imagery in anxiety, sleep, and vital signs of the participants. A quasi-experimental design was employed in this study. The participants (n= 24) from a regional hospital in New Jersey who had open heart surgery were recruited from January to July 2018. By using convenience sampling, they were assigned to interventional (n= 15) and control (n= 9) group. The interventional group received the guided imagery therapy in addition to the usual pain management in the unit, while the control group received the usual pain management only. Their pain and anxiety levels were obtained using the Numeric Rating Scale and State-Trait Anxiety Inventory questionnaires. The interventional group were also monitored for their vital signs and quality of sleep after receiving the therapy. The key findings include the significant decrease in pain and anxiety levels after the guided imagery therapy was offered on days 1, 2, 3, day of discharge, and one week after discharge (p 0.05). Patients reported that they used the guided imagery for pain, anxiety, and sleep. Based on the findings, guided imagery could be incorporated into the clinical practice in cardiothoracic intensive care unit to manage acute pain among open-heart surgical patients.DNPIncludes bibliographical reference
Victims in the Village: Aspects of Restorative Justice on Papua New Guinea
No full text In the villages of Vanimo West Coast, Papua New Guinea, restorative justice processes continue to adhere to traditional practices and beliefs. To a great extent the modern concept of restorative justice or community justice is grounded in the practices of traditional societies such as those of the Maori in New Zealand. One question which arises through the modernisation process is how modernisation has impacted traditional restorative practices and in particular how the criminal justice system is perceived and used by indigenous peoples. Through an exploration of research undertaken by the author in Vanimo West Coast villages the kinds of acts considered injurious are identified, as are traditional restorative justice processes and modern attitudes and practices by victims seeking justice. The research illustrates that villages have maintained a private/public distinction in their disputes, keeping disputes between close kin private and publicising others. Whereas traditionally, disputes made public would be taken to the Chief, nowadays in some cases, the courts and the community government council are the chosen forums for publication. Sometimes a victim seeks only to shame the offender by making the dispute public, this being an end in itself. Overall, the research makes explicit the capacity of victims for adaptation and the continued resilience of custom in resolving grievances. </jats:p
The Read Aloud Revolution: An Examination of the Read Aloud Practice and the Roles Fathers Play
No full textabstract: Reading aloud is an experience that provides children with cognitive and social emotional
benefits. Fathers are often not a part of this experience due to outdated gender roles that have led
to the classification of reading as a feminized activity. This review discusses the literature
surrounding the cognitive and social-emotional benefits of reading aloud to children. In addition
to academic literature, this paper takes into account the experiences of educators and parents
shared through social media and literacy organizations external to academia due to their presence
on the front lines of the reading aloud. This paper is divided into five sections, each of which
addresses a different domain of the read aloud practice. The first section is a personal narrative in
which the author shares a story surrounding her experience with read alouds to provide context
on why this topic was chosen for her undergraduate thesis. Section two addresses the importance
of read alouds in a child’s literacy journey and serves as a framework for the remainder of the
review. Section three discusses the vitality of the participation of fathers in the practice and
includes the explanation of the feminization of reading and the implications of the lack of fathers
within the read aloud experience. Section four discusses the implications of fathers taking an
active role in reading aloud. Lastly, section five serves as a resource pool for fathers, including
tips, a guide to community resources, and sample book lists.
Keywords: read aloud, gender roles, educator, literacy, parents, father
