Surveillance snapshot of Clostridium difficile infection in hospitals across Queensland detects binary toxin producing ribotype UK 244

In North America and Europe, the binary toxin positive Clostridium difficile strains of the ribotypes 027 and 078 have been associated with death, toxic megacolon and other adverse outcomes. Following an increase in C. difficile infections (CDIs) in Queensland, a prevalence study involving 175 hospitals was undertaken in early 2012, identifying 168 cases of CDI over a 2 month period. Patient demographics and clinical characteristics were recorded, and C. difficile isolates were ribotyped and tested for the presence of binary toxin genes. Most patients (106/168, 63.1%) were aged over 60 years. Overall, 98 (58.3%) developed symptoms after hospitalisation; 89 cases (53.0%) developed symptoms more than 48 hours after admission. Furthermore, 27 of the 62 (67.7%) patients who developed symptoms in the community ad been hospitalised within the last 3 months. Thirteen of the 168 (7.7%) cases identified had severe disease, resulting in admission to the Intensive Care Unit or death within 30 days of the onset of symptoms. The 3 most common ribotypes isolated were UK 002 (22.9%), UK 014 (13.3%) and the binary toxin-positive ribotype UK 244 (8.4%). The only other binary toxin positive ribotype isolated was UK 078 (n = 1). Of concern was the detection of the binary toxin positive ribotype UK 244, which has recently been described in other parts of Australia and New Zealand. No isolates were of the international epidemic clone of ribotype UK 027, although ribotype UK 244 is genetically related to this clone. Further studies are required to track the epidemiology of ribotype UK 244 in Australia and New Zealand. Commun Dis Intell 2014;38(4):E279–E284.

Increasing the confidence and knowledge of occupational therapy and physiotherapy students when communicating with people with aphasia: A pre–post intervention study

This study investigated occupational therapy and physiotherapy students' level of confidence and knowledge of strategies for communicating with people with aphasia (PWA) before and after a communication partner-training (CPT) program. Twenty-eight physiotherapy and occupational therapy students participated in a pre–post CPT program. Students completed a customized mixed-methods questionnaire before and after the intervention. The CPT program involved a lecture about effective communication strategies followed by a conversation with PWA to practice strategies learnt. Before CPT, students were not confident with the possibility of communicating with PWA. Students demonstrated rudimentary knowledge of supported conversation, identifying a maximum of five strategies for communicating effectively with PWA. Following intervention, students demonstrated increased confidence. Students' knowledge of effective communication strategies improved, with students identifying a maximum of 16 suitable strategies post-training. The results suggest that occupational therapy and physiotherapy students have potential to benefit from practical training in supported communication with PWA, which may assist them during placements in clinical settings with neurological patients or subsequent employment.

Demographics and discharge outcomes of dysvascular and non-vascular lower limb amputees at a subacute rehabilitation unit: A 7-year series

Objective To examine personal and social demographics, and rehabilitation discharge outcomes of dysvascular and non-vascular lower limb amputees. Methods In total, 425 lower limb amputation inpatient rehabilitation admissions (335 individuals) from 2005 to 2011 were examined. Admission and discharge descriptive statistics (frequency, percentages) were calculated and compared by aetiology. Results Participants were male (74%), aged 65 years (s.d. 14), born in Australia (72%), had predominantly dysvascular aetiology (80%) and a median length of stay 48 days (interquartile range (IQR): 25–76). Following amputation, 56% received prostheses for mobility, 21% (n = 89) changed residence and 28% (n = 116) required community services. Dysvascular amputees were older (mean 67 years, s.d. 12 vs 54 years, s.d. 16; P < 0.001) and recorded lower functional independence measure – motor scores at admission (z = 3.61, P < 0.001) and discharge (z = 4.52, P < 0.001). More nonvascular amputees worked before amputation (43% vs 11%; P < 0.001), were prescribed a prosthesis by discharge (73% vs 52%; P < 0.001) and had a shorter length of stay (7 days, 95% confidence interval: –3 to 17), although this was not statistically significant. Conclusions Differences exist in social and demographic outcomes between dysvascular and non-vascular lower limb amputees.

Non-wearing of adult seat belts in Australia: Where to next? [Austroads Publication No. AP-R346/09]

Seat belts are one of the most effective passive safety features in vehicles and there is a host of research literature attesting to the effectiveness of seat belts in protecting against death and injury. Even when use rates are high the potential gains in trauma reduction from further improvements in wearing rates are substantial. However, those currently most resistant to restraint use have also proven most difficult to target using conventional countermeasures. It is necessary to address the issues of non-wearing in order to achieve further gains in seat belt wearing. This study provide evidence-based recommendations for the way forward to tackle the problems of adult restraint non-use in light passenger vehicles in the short, medium and longer term in Australia. While there are substantial issues to be addressed for these groups, these are outside the scope of this study.

Playful interactions for people with intellectual disabilities

For people with intellectual disabilities, there are significant barriers to inclusion in socially cooperative endeavors. This paper investigates the effectiveness of Stomp, a tangible user interface (TUI) designed to provide new participatory experiences for people with intellectual disability. Results from an observational study reveal the extent to which the Stomp system supports social and physical interaction. The tangible, spatial, and embodied qualities of Stomp result in an experience that does not rely on the acquisition of specific competencies before interaction and engagement can occur.

Lung sickness in Murri kids : a cohort study in urban Indigenous children

QLD, 4Murri Health Group, Caboolture, QLD Introduction Respiratory illnesses with cough as a symptom are predominant causes of morbidity in young Australian Indigenous children. With the exception of ear disease, there are limited studies that have addressed burden and outcome. Also, there are no studies that are specific to urban Indigenous children. Aim: We aim to comprehensively investigate the incidence, aetiology, risk factors for and outcomes of acute respiratory illnesses (ARIs) in this population. Methods A cohort study of Indigenous children aged less than 5 years registered with an urban Indigenous primary health care service. Comprehensive baseline data are collected and children are followed monthly for 12 months to capture ARI events. ARI events are subsequently followed weekly for 4 weeks to determine cough outcomes, with review by a paediatric respiratory physician if cough has not resolved within 28 days. Results To date, 58 children (57% female) have been enrolled and 46 ARIs have been captured over 907 child weeks of observation (5.1 events per 100 child weeks, 95%CI 3.7–6.8). 13 ARIs (28.3%) have resulted in persistent cough for >28 days following onset. Conclusion Our early findings suggest an excess incidence of ARI in this population. The proportion of ARIs resulting in persistent cough for more than 4 weeks is the highest yet reported. Key Words: Indigenous, acute respiratory illness, paediatric.

The impact of socialisation on graduates’ public service motivation : a mixed method study

The need to attract and retain a high calibre cadre of public servants today has resulted in a renaissance of interest in public service motivation (PSM) within public management literature. This article outlines a study of PSM with graduate employees within an Australian public sector. The study extends our understanding of PSM by adopting a longitudinal, mixed method design, including surveys and individual interviews, to consider the effects of socialisation on levels of PSM. Results show an organisation's mission and values do not affect individual PSM while work type and communication style is vital and organisational socialisation can provide a negative influence.

Scaffolding multimodal literacies: Learning in and out of the classroom

This chapter presents data produced by a research project that looked at pedagogy for print and digital literacies in a high poverty, high diversity primary school. The student population included refugee, immigrant and Aboriginal and Torres Strait Islander young people. In an environment in which schools, such as the study site, are under pressure to narrow the curriculum to ‘the basics’, the project sought to support teachers as they worked to create a rich curriculum for all students. The chapter will focus on pedagogy in an after-school media club. The aim of the club, which ran weekly for several years, was to build students’ media literacy skills. The data suggest that established ways of scaffolding linguistic texts cannot be simply transferred to multimodal text production. The chapter will also address implications from the research outcomes for other teachers working with At Risk EAL students.

Inducible resistance to maize streak virus

Maize streak virus (MSV), which causes maize streak disease (MSD), is the major viral pathogenic constraint on maize production in Africa. Type member of the Mastrevirus genus in the family Geminiviridae, MSV has a 2.7 kb, single-stranded circular DNA genome encoding a coat protein, movement protein, and the two replication-associated proteins Rep and RepA. While we have previously developed MSV-resistant transgenic maize lines constitutively expressing ‘‘dominant negative mutant’’ versions of the MSV Rep, the only transgenes we could use were those that caused no developmental defects during the regeneration of plants in tissue culture. A better transgene expression system would be an inducible one, where resistance-conferring transgenes are expressed only in MSV-infected cells. However, most known inducible transgene expression systems are hampered by background or ‘‘leaky’’ expression in the absence of the inducer. Here we describe an adaptation of the recently developed INPACT system to express MSV-derived resistance genes in cell culture. Split gene cassette constructs (SGCs) were developed containing three different transgenes in combination with three different promoter sequences. In each SGC, the transgene was split such that it would be translatable only in the presence of an infecting MSV’s replication associated protein. We used a quantitative real-time PCR assay to show that one of these SGCs (pSPLITrepIII-Rb-Ubi) inducibly inhibits MSV replication as efficiently as does a constitutively expressed transgene that has previously proven effective in protecting transgenic maize from MSV. In addition, in our cell-culture based assay pSPLITrepIII-Rb-Ubi inhibited replication of diverse MSV strains, and even, albeit to a lesser extent, of a different mastrevirus species. The application of this new technology to MSV resistance in maize could allow a better, more acceptable product.

Automated sensory data alignment for environmental and epidermal change monitoring

In this paper we present research adapting a state of the art condition-invariant robotic place recognition algorithm to the role of automated inter- and intra-image alignment of sensor observations of environmental and skin change over time. The approach involves inverting the typical criteria placed upon navigation algorithms in robotics; we exploit rather than attempt to fix the limited camera viewpoint invariance of such algorithms, showing that approximate viewpoint repetition is realistic in a wide range of environments and medical applications. We demonstrate the algorithms automatically aligning challenging visual data from a range of real-world applications: ecological monitoring of environmental change, aerial observation of natural disasters including flooding, tsunamis and bushfires and tracking wound recovery and sun damage over time and present a prototype active guidance system for enforcing viewpoint repetition. We hope to provide an interesting case study for how traditional research criteria in robotics can be inverted to provide useful outcomes in applied situations.

Dancing as Knowledge Production/Dancer as Researcher in Practice-led Research

This chapter discusses research undertaken for a PhD in dance, highlighting the oscillating and ambivalent nature of practice-led research methods. Holding an unusual position within the field of practice-led research in dance, the researcher adopted the role of dancer within four creative processes led by four choreographers. Although instigating and leading this research, the author produced new knowledge of dancing practices whilst being directed creatively by the choreographers in the research environment. In line with many definitions of practice-led research, the methods used were emergent from the research arena and responsive to the requirements of the project. Deeply imbricated in the research environment, the researcher used her embodied self as a research tool, as the one who participated, discovered and recorded. This outsider/insider role of researcher/participant produced a series of meta-positions, leading to a mixed-modal outcome that encompassed live performance, a movement treatise and a written thesis.

Cytokine secretion in macrophages : SNAREs, Rabs and membrane trafficking

Macrophages have the capacity to rapidly secrete a wide range of inflammatory mediators that influence the development and extent of an inflammatory response. Newly synthesized and/or preformed stored cytokines and other inflammatory mediators are released upon stimulation, the timing, and volume of which is highly regulated. To finely tune this process, secretion is regulated at many levels; at the level of transcription and translation and post-translationally at the endoplasmic reticulum (ER), Golgi, and at or near the cell surface. Here, we discuss recent advances in deciphering these cytokine pathways in macrophages, focusing on recent discoveries regarding the cellular machinery and mechanisms implicated in the synthesis, trafficking, and secretion of cytokines. The specific roles of trafficking machinery including chaperones, GTPases, cytoskeletal proteins, and SNARE membrane fusion proteins will be discussed.