The microbial content of vacuum cleaner bag dust and emitted bioaerosols : implications for human exposures indoors

Vacuum cleaners can release large concentrations of particles, both in their exhaust air and from resuspension of settled dust. However, the size, variability and microbial diversity of these emissions are unknown, despite evidence to suggest they may contribute to allergic responses and infection transmission indoors. This study aimed to evaluate bioaerosol emission from various vacuum cleaners. We sampled the air in an experimental flow tunnel where vacuum cleaners were run and their airborne emissions sampled with closed-face cassettes. Dust samples were also 35 collected from the dust bag. Total bacteria, total archaea, Penicillium/Aspergillus and total Clostridium cluster 1 were quantified with specific qPCR protocols and emission rates were calculated. Clostridium botulinum, as well as antibiotic resistance genes were detected in each sample using endpoint PCR. Bacterial diversity was also analyzed using denaturing gel electrophoresis (DGGE), image analysis and band sequencing. We demonstrated that emission of bacteria and moulds (Pen/Asp) can reach values as high as 1E05/min and that those emissions are not related to each other. The bag dust bacterial and mould content was also consistently across the vacuums we assessed, reaching up to 1E07 bacteria or moulds equivalent/g. Antibiotic resistance genes were detected in several samples. No archaea or C. botulinum were detected in any air samples. Diversity analyses showed that most bacteria are from human sources, in keeping with other recent results. These results highlight the potential capability of vacuum cleaners to disseminate appreciable quantities of moulds and human-associated bacteria indoors and their role as a source of exposure to bioaerosols.

Endotoxins in indoor air and settled dust in primary schools in a subtropical climate

Endotoxins can significantly affect the air quality in school environments. However, there is currently no reliable method for the measurement of endotoxins and there is a lack of reference values for endotoxin concentrations to aid in the interpretation of measurement results in school settings. We benchmarked the “baseline” range of endotoxin concentration in indoor air, together with endotoxin load in floor dust, and evaluated the correlation between endotoxin levels in indoor air and settled dust, as well as the effects of temperature and humidity on these levels in subtropical school settings. Bayesian hierarchical modeling indicated that the concentration in indoor air and the load in floor dust were generally (<95th percentile) < 13 EU/m3 and < 24,570 EU/m2, respectively. Exceeding these levels would indicate abnormal sources of endotoxins in the school environment, and the need for further investigation. Metaregression indicated no relationship between endotoxin concentration and load, which points to the necessity for measuring endotoxin levels in both the air and settled dust. Temperature increases were associated with lower concentrations in indoor air and higher loads in floor dust. Higher levels of humidity may be associated with lower airborne endotoxin concentrations.

Alveolar dose comparison of ultrafine particles for Australian and Italian children

Epidemiological studies have demonstrated that exposure to particulate air pollution is associated with several adverse health effects. Recently, interest has focused on ultrafine particles (UFPs, diameter ≤ 100 nm), due to the adverse health effects caused by their ability to induce inflammation and deposit in secondary organs [1]. These effects are much more pronounced in children because they inhale a higher dose of UFPs relative to both lung size (when compared with adults) [2] and increased breathing rates, since they are generally more physically active than adults ...

Women from refugee backgrounds and their experiences of attending a specialist antenatal clinic : narratives from an Australian setting

Problem: In response to an identified need, a specialist antenatal clinic for women from refugee backgrounds was introduced in 2008, with an evaluation planned and completed in 2010. Question: Can maternity care experiences for women from refugee backgrounds, attending a specialist antenatal clinic in a tertiary Australian public hospital, be improved? Methods: The evaluation employed mixed methods, generating qualitative and quantitative data from two hospital databases, a chart audit, surveys and interviews with service users, providers and stakeholders. Contributions were received from 202 participants. Findings: The clinic was highly regarded by all participants. Continuity of care throughout the antenatal period was particularly valued by newly arrived women as it afforded them security and support to negotiate an unfamiliar Western maternity system. Positive experiences decreased however; as women transitioned from the clinic to labour and postnatal wards where they reported that their traditional birthing and recuperative practices were often interrupted by the imposition of Western biomedical notions of appropriate care. The centrally located clinic was problematic, frequently requiring complex travel arrangements. Appointment schedules often impacted negatively on traditional spousal and family obligations. Conclusions: Providing comprehensive and culturally responsive maternity care for women from refugee backgrounds is achievable, however it is also resource intensive. The production of translated information which is high quality in terms of production and content, whilst also taking account of languages which are only rarely encountered, is problematic. Cultural competency programmes for staff, ideally online, require regular updating in light of new knowledge and changing political sensitivities.

Individual variability in compensatory eating following acute exercise in overweight and obese women

Background While compensatory eating following acute aerobic exercise is highly variable, little is known about the underling mechanisms that contribute to alterations in exercise-induced eating behaviour. Methods Overweight and obese women (BMI = 29.6 ± 4.0kg.m2) performed a bout of cycling individually tailored to expend 400kcal (EX), or a time-matched no exercise control condition in a randomised, counter-balanced order. Sixty minutes after the cessation of exercise, an ad libitum test meal was provided. Substrate oxidation and subjective appetite ratings were measured during exercise/time-matched rest, and during the period between the cessation of exercise and food consumption. Results While ad libitum EI did not differ between EX and the control condition (666.0 ± 203.9kcal vs. 664.6 ± 174.4kcal, respectively; ns), there was marked individual variability in compensatory energy intake (EI). The difference in EI between EX and the control condition ranged from -234.3 to +278.5kcal. Carbohydrate oxidation during exercise was positively associated with post-exercise EI, accounting for 37% of the variance in EI (r = 0.57; p = 0.02). Conclusions These data indicate that capacity of acute exercise to create a short-term energy deficit in overweight and obese women is highly variable. Furthermore, exercise-induced CHO oxidation can explain part of the variability in acute exercise-induced compensatory eating. Post-exercise compensatory eating could serve as an adaptive response to facilitate the restoration of carbohydrate balance.

Health Information Literacy and the Experience of 65 to 79 Year Old Australians

Information literacy is presented here from a relational perspective, as people’s experience of using information to learn in a particular context. A detailed practical example of such a context is provided, in the health information literacy experience of 65–79 year old Australians. A phenomenographic investigation found five qualitatively distinct ways of experiencing health information literacy: Absorbing (intuitive reception), Targeting (a planned process), Journeying (a personal quest), Liberating (equipping for independence) and Collaborating (interacting in community). These five ways of experiencing indicated expanding awareness of context (degree of orientation towards their environment), source (breadth of esteemed information), beneficiary (the scope of people who gain) and agency (amount of activity), across HIL core aspects of information, learning and health. These results illustrate the potential contribution of relational information literacy to information science.

Library Research Support in developing, testing and promoting an open cyberinfrastructure

QUT Library continues to rethink research support with eResearch as a primary driver. The support to the development of the Lens, an open global cyberinfrastructure, has been especially important in the light of technology transfer promotion, and partly in the response to researchers’ needs in following the innovation landscapes not only within the scientific but also patent literature. The Lens http://www.lens.org/lens/ project makes innovation more efficient, fair, transparent and inclusive. It is a joint effort between Cambia http://www.cambia.org.au and Queensland University of Technology (QUT). The Lens serves more than 84 million patent documents in the world as open, annotatable digital public goods that are integrated with scholarly and technical literature along with regulatory and business data. Users can link from search results to visualization and document clusters; from a patent document description to its full-text; from there, if applicable, the sequence data can also be found. Figure 1 shows a BLAST Alignment (DNA) using the Lens. A unique feature of the Lens is the ability to embed search and BLAST results into blogs and websites, and provide real-time updates to them. PatSeq Explorer http://www.lens.org/lens/bio/patseqexplorer allows users to navigate patent sequences that map onto the human genome and in the future, many other genomes. PatSeq Explorer offers three level views for the sequence information and links each group of sequences at the chromosomal level to their corresponding patent documents in the Lens. By integrating sequence and patent search and document clustering capabilities, users can now understand the big and small details on the true extent and scope of genetic sequence patents. QUT Library supported Cambia in developing, testing and promoting the Lens. This poster demonstrates QUT Library’s provision of best practice and holistic research support to a research group and how QUT Librarians have acquired new capabilities to meet the needs of the researchers beyond traditional research support practices.

Orthopaedics and trauma Queensland annual report 2012

Orthopaedics and Trauma Queensland, the Centre for Research and Education in Musculoskeletal Disorders, is an internationally recognised research group that continues to develop its reputation as an international leader in research and education. It provides a stimulus for research, education and clinical application within the international orthopaedic and trauma communities. Orthopaedics and Trauma Queensland develops and promotes the innovative use of engineering and technology, in collaboration with surgeons, to provide new techniques, materials, procedures and medical devices. Its integration with clinical practice and strong links with hospitals ensure that the research will be translated into practical outcomes for patients. The group undertakes clinical practice in orthopaedics and trauma and applies core engineering skills to challenges in medicine. The research is built on a strong foundation of knowledge in biomedical engineering, and incorporates expertise in cell biology, mathematical modelling, human anatomy and physiology and clinical medicine in orthopaedics and trauma. New knowledge is being developed and applied to the full range of orthopaedic diseases and injuries, such as knee and hip replacements, fractures and spinal deformities.

Comparison of moped, scooter and motorcycle crashes : implications for rider training and education

Scooter and moped sales have increased at a faster rate than motorcycle sales over the last decade in countries such as Australia, Canada and the United States. This may be particularly evident in jurisdictions where moped riding is permitted for car license holders and a motorcycle license is not required, such as in Queensland, Australia. Having historically comprised only a small proportion of powered two-wheelers (PTWs) outside of Europe and Asia, the safety of scooters and mopeds has received relatively little focused research attention. However, the recent trends in sales and crash involvement have stimulated greater interest in these PTW types. The current paper examines differences and similarities between scooters (over 50cc), mopeds (up to 50cc) and motorcycles in crash involvement and crash characteristics through analyses of crash and registration data from Queensland, Australia. The main findings include that moped and scooter riders are similar in terms of usage patterns, but the evidence suggests superior skills, greater experience and safer behaviour among scooter riders than moped riders. The requirement in Queensland for scooter riders but not moped riders to hold a motorcycle license, usually obtained through competency-based training and assessment, may help to explain some of this difference. Findings also suggest that scooter riders are safer than motorcycle riders in some respects, despite both being subject to the same licensing requirements which encourage participation in rider training. Safer attitudes and motivations rather than superior skills and knowledge may therefore underlie the differences between scooter and motorcycle riders. In summary, riders of larger scooters exhibit a combination of skills and behavior suggestive of safer riding than both their moped and motorcycle riding counterparts. It is reasonable to expect that mopeds and scooters will remain popular and that their usage may increase further, along with that of motorcycles. This research therefore has important practical implications regarding pathways to improved PTW safety. Future policy and planning should consider options for encouraging moped riders to acquire better riding skills and greater safety awareness, as apparent among scooter riders, including rider training, education and licensing. As is noted in recent literature and reflected in some contemporary rider training programs, motorcycle safety may be improved by addressing rider attitudes more comprehensively in addition to developing skills and knowledge.

Capturing the 'authentic voice' : challenges and opportunities for voice and self-representation in two ABC storytelling projects

In recent years there has been a noticeable move by various public institutions, such as public service broadcasters and community media organisations, to capture and disseminate the voices and viewpoints of ‘ordinary people’ through inviting them to share stories about their lives. One of the foremost objectives of many such projects is to provide under-represented individuals and groups with an opportunity to express and represent themselves; as such, the capture and broadcast of ‘authentic voices’ is a central value. This paper discusses the notion of ‘authentic voice’, and questions the framing role of public media organisations in storytelling projects that aim to provide individuals with space for self-expression and self-representation. It considers the ways in which tensions arise on multiple levels when individuals are asked to express and represent themselves within projects and spaces that are managed by institutions. This paper begins by discussing the challenges and opportunities that arise within storytelling projects that are facilitated by public institutions and community media arts organisations, and that aim to amplify the voices of “ordinary people” (Thumim, 2009). It examines ways in which ‘voice’ is facilitated, curated, broadcast and distributed within such projects, particularly questioning the ways in which project facilitation and the curation of stories for public broadcast can both help and hinder the amplification of ‘authentic voice’. Furthermore, we seek to discuss how ‘authentic voice’ is defined, and what is involved in the process of amplification. The paper moves on to discuss a case study in order to demonstrate some of the tensions that are evident within a storytelling project that is managed by a public institution – Australia’s national broadcaster – and the ways these tensions impact upon the capture and broadcast of an ‘authentic voice’ for project participants. The Australian Broadcasting Corporation’s (ABC) ‘Heywire’ project is a storytelling competition and website that aims to ‘give voice’ to 16-22 year olds who live in rural, regional and remote parts of Australia. Looking at tensions that exist on organisational, political and philosophical levels within the Heywire project reveals a number of conflicts of interest and objectives between the institution and project participants. This leads us to question whether institutionally-managed storytelling projects can effectively support individuals to have an ‘authentic voice’, and whether struggles of aims and objectives diminish the personal benefits that people may derive from expressing and representing themselves within such projects.

The safety profile of perflutren microsphere contrast echocardiography during rest and stress imaging : results from an Australian multicentre cohort

Background Contrast enhanced echocardiography (CEE) is utilised when sub-optimal image quality results in non-diagnostic echocardiograms. However, there have been numerous safety notices issued by regulatory authorities regarding rare but potentially serious adverse reactions (AR). This multi-centre, retrospective analysis was performed to assess the short-term safety of CEE in a broad range of indications. Methods All CEE performed over 58 months at three institutions were assessed for AR within 30 min. Results A total of 5956 CEE were performed in 5576 patients. A total of 4903 were stress CEE and 1053 resting CCE.Bolus administration in 5719, infusion in 237 cases; 89.9% of CCE were outpatients. Commonest CEE indication was functional stress testing (82.3%). There were 16 AR related to CEE (0.27%). All AR were mild, transient and all patients made a full recovery. No cases of serious anaphylaxis or death within 30 min of contrast administration. Comparing those with and without an AR, there were no significant differences in age, gender, BMI, LVEF, patient location, exam type or RVSP. There was a slightly increased likelihood of an AR during infusion versus bolus dosing (p = 0.02). Conclusion CEE is a safe investigation in a broad range of indications and clinical scenarios. AR are very rare, mild and transient.

Identifying and characterising crashes of returning riders - a new approach

Surveys have identified that many older motorcyclists are returning riders but it is difficult to draw conclusions about their crash risk because of discrepancies in definitions and the inability to identify returning riders in official crash databases. Analyses of NSW crash data were undertaken in which returning riders were defined as aged 25 and over, holding a full licence 10 years prior to the crash, and not the registered operator of one or more motorcycles during the 5-10 years prior to the crash. Based on this definition, there were 472 riders in casualty crashes in 2005-09 who were returning riders (5.5% of riders aged 25 and over in casualty crashes) and the characteristics of their crashes were similar to those involving continuing riders. In contrast, crashes of new riders were more likely to have characteristics suggestive of relatively more riding in urban areas, probably for transport rather than recreation. More work is recommended to assess the validity of the definition to allow a better understanding of the effects of long periods away from riding on riding skills and crash risk.

Emergency Health Services (EHS) : demand and service delivery models. monograph 3 : patients’ reasons and perceptions

Executive Summary Emergency health is a critical component of Australia’s health system and emergency departments (EDs) are increasingly congested from growing demand and blocked access to inpatient beds. The Emergency Health Services Queensland (EHSQ) study aims to identify the factors driving increased demand for emergency health and to evaluate strategies which may safely reduce the future demand growth. This monograph addresses the perspectives of users of both ambulance services and EDs. The research reported here aimed to identify the perspectives of users of emergency health services, both ambulance services and public hospital Emergency Departments and to identify the factors that they took into consideration when exercising their choice of location for acute health care. A cross-sectional survey design was used involving a survey of patients or their carers presenting to the EDs of a stratified sample of eight hospitals. A specific purpose questionnaire was developed based on a novel theoretical model which had been derived from analysis of the literature (Monograph 1). Two survey versions were developed: one for adult patients (self-complete); and one for children (to be completed by parents/guardians). The questionnaires measured perceptions of social support, health status, illness severity, self-efficacy; beliefs and attitudes towards ED and ambulance services; reasons for using these services, and actions taken prior to the service request. The survey was conducted at a stratified sample of eight hospitals representing major cities (four), inner regional (two) and outer regional and remote (two). Due to practical limitations, data were collected for ambulance and ED users within hospital EDs, while patients were waiting for or under treatment. A sample size quota was determined for each ED based on their 2009/10 presentation volumes. The data collection was conducted by four members of the research team and a group of eight interviewers between March and May 2011 (corresponding to autumn season). Of the total of 1608 patients in all eight emergency departments the interviewers were able to approach 1361 (85%) patients and seek their consent to participate in the study. In total, 911 valid surveys were available for analysis (response rate= 67%). These studies demonstrate that patients elected to attend hospital EDs in a considered fashion after weighing up alternatives and there is no evidence of deliberate or ill-informed misuse. • Patients attending ED have high levels of social support and self-efficacy that speak to the considered and purposeful nature of the exercise of choice. • About one third of patients have new conditions while two thirds have chronic illnesses • More than half the attendees (53.1%) had consulted a healthcare professional prior to making the decision. • The decision to seek urgent care at an ED was mostly constructed around the patient’s perception of the urgency and severity of their illness, reinforced by a strong perception that the hospital ED was the correct location for them (better specialised staff, better care for my condition, other options not as suitable). • 33% of the respondent held private hospital insurance but nevertheless attended a public hospital ED. Similarly patients exercised considered and rational judgements in their choice to seek help from the ambulance service. • The decision to call for ambulance assistance was based on a strong perception about the severity of the illness (too severe to use other means of transport) and that other options were not considered appropriate. • The decision also appeared influenced by a perception that the ambulance provided appropriate access to the ED which was considered most appropriate for their particular condition (too severe to go elsewhere, all facilities in one spot, better specialised and better care). • In 43.8% of cases a health care professional advised use of the ambulance. • Only a small number of people perceived that ambulance should be freely available regardless of severity or appropriateness. These findings confirm a growing understanding that the choice of professional emergency health care services is not made lightly but rather made by reasonable people exercising a judgement which is influenced by public awareness of the risks of acute health and which is most often informed by health professionals. It is also made on the basis of a rational weighing up of alternatives and a deliberate and considered choice to seek assistance from a service which the patient perceived was most appropriate to their needs at that time. These findings add weight to dispensing with public perceptions that ED and ambulance congestion is a result of inappropriate choice by patients. The challenge for health services is to better understand the patient’s needs and to design and validate services that meet those needs. The failure of our health system to do so should not be grounds for blaming the patient, claiming inappropriate patient choices.