Linking scientific evidence and decision making : A case study of hand hygiene interventions

We consider how data from scientific research should be used for decision making in health services. Whether a hand hygiene intervention to reduce risk of nosocomial infection should be widely adopted is the case study. Improving hand hygiene has been described as the most important measure to prevent nosocomial infection. 1 Transmission of microorganisms is reduced, and fewer infections arise, which leads to a reduction in mortality2 and cost savings.3 Implementing a hand hygiene program is itself costly, so the extra investment should be tested for cost-effectiveness.4,5 The first part of our commentary is about cost-effectiveness models and how they inform decision making for health services. The second part is about how data on the effectiveness of hand hygiene programs arising from scientific studies are used, and 2 points are made: the threshold for statistical inference of .05 used to judge effectiveness studies is not important for decision making,6,7 and potentially valuable evidence about effectiveness might be excluded by decision makers because it is deemed low quality.8 The ideas put forward will help researchers and health services decision makers to appraise scientific evidence in a more powerful way.

Ureaplasma species multiple banded antigen (MBA) variation is associated with the severity of chorioamnionitis in late preterm placentas

Background: Intra-amniotic infection accounts for 30% of all preterm births (PTB), with the human Ureaplasma species being the most frequently identified microorganism from the placentas of women who deliver preterm. The highest prevalence of PTB occurs late preterm (32-36 weeks) but no studies have investigated the role of infectious aetiologies associated with late preterm birth. Method: Placentas from women with late PTB were dissected aseptically and samples of chorioamnion tissue and membrane swabs were collected. These were tested for Ureaplasma spp. and aerobic/anaerobic bacteria by culture and real-time PCR. Western blot was used to assess MBA variation in ureaplasma clinical isolates. The presence of microorganisms was correlated with histological chorioamnionitis. Results: Ureaplasma spp. were isolated from 33/466 (7%) of placentas by culture or PCR. The presence of ureaplasmas, but not other microorganisms, was associated with histological chorioamnionitis (21/33 ureaplasma-positive vs. 8/42 other bacteria; p= 0.001). Ureaplasma clinical isolates demonstrating no MBA variation were associated with histological chorioamnionitis. By contrast, ureaplasmas displaying MBA variation were isolated from placentas with no significant histological chorioamnionitis (p= 0.001). Conclusion: Ureaplasma spp. within placentas delivered late preterm (7%) is associated with histological chorioamnionitis (p = 0.001). Decreased inflammation within chorioamnion was observed when the clinical ureaplasma isolates demonstrated variation of their surface-exposed lipoproteins (MBA). This variation may be a mechanism by which ureaplasmas modulate and evade the host immune response. So whilst ureaplasmas are present intra-amniotically they are not suspected because of the normal macroscopic appearance of the placentas and the amniotic fluid.

Microbial colonisation of follicular fluid : alterations in cytokine expression and adverse assisted reproductive technology outcomes

Previous studies have measured cytokine expression within follicular fluid collected at the time of trans-vaginal oocyte retrieval and compared the profiles with the aetiology of infertility and/or successful or unsuccessful assisted reproductive technology (ART) outcomes. Seventy-one paired follicular fluid and vaginal swab specimens collected from ART patients were cultured to detect microorganisms and then were tested for the presence of cytokines by multiplex fluorescence bead assays. Specimen selection was based on two criteria: whether the follicular fluid specimen was colonised (with microorganisms prior to oocyte retrieval) or contaminated by lower genital tract microflora at the time of oocyte retrieval and; the aetiology of infertility...

Changing relationships : Re-activating student and staff engagement in the design studio learning environment

QUT Teaching and Learning Support Services 'Revisiting University Teaching’program for mid-career academics. 'Innovations in Teaching at QUT' presentations. Presentations were part of a 2 day program that provides opportunities for experienced academic staff with responsibilities for teaching to review their current teaching practices and explore innovations in teaching that will assist them to enhance student learning and develop their own scholarship of teaching. The presenter responded to the following: 1.What is the innovation you have incorporated into your teaching? - give a brief overview/ description/ demonstration of the innovation 2.What challenges/issues prompted you to make changes in your approach? Were they discipline specific? Operational? Opportunistic? 3.What factors did you need to consider in implementing these changes? Which factors enabled success or hindered? 4.What has this innovation achieved so far? How have learners responded? How have the broader teaching team and academic staff from other units in your course responded? 5.How could this innovation be used by other academics in their teaching? What do you see as the possibilities for further expansion of this innovation? (NB. This question could be answered as part of a final sharing of group discussion). Presenter: Shannon Satherley

Metabolic and ecological study of environmental pentose utilizing bacteria (E-PUB)

Lignocellulosic materials, such as sugar cane bagasse, a waste product of the sugarcane processing industry, agricultural residues and herbaceous crops, may serve as an abundant and comparatively cheap feedstock for largescale industrial fermentation, resulting in the production of marketable end-products. However, the complex structure of lignocellulosic materials, the presence of various hexose and pentose sugars in the hemicellulose component, and the presence of various compounds that inhibit the organisms selected for the fermentation process, all constitute barriers that add to the production costs and make full scale industrial production economically less feasible. The work presented in this thesis was conducted in order to screen microorganisms for ability to utilize pentose sugars derived from the sugar mill industrial waste. A large number of individual bacterial strains were investigated from hemi-cellulose rich material collected at the Proserpine and Maryborough sugar mills, notably soil samples from the mill sites. The research conducted to isolation of six pentose-capable Gram-positive organisms from the actinomycetes group by using pentose as a sole carbon source in the cultivation process. The isolates were identified as Corynebacterium glutamicum, Actinomyces odontolyticus, Nocardia elegans, and Propionibacterium freudenreichii all of which were isolated from the hemicellulose-enriched soil. Pentose degrading microbes are very rare in the environment, so this was a significant discovery. Previous research indicated that microbes could degrade pentose after genetic modification but the microbes discovered in this research were able to naturally utilize pentose. Six isolates, identified as four different genera, were investigated for their ability to utilize single sugars as substrates (glucose, xylose, arabinose or ribose), and also dual sugars as substrates (a hexose plus a pentose). The results demonstrated that C. glutamicum, A. odontolyticus, N. elegans, and P. freudenreichii were pentose-capable (able to grow using xylose or other pentose sugar), and also showed diauxie growth characteristics during the dual-sugar (glucose, in combination with xylose, arabinose or ribose) carbon source tests. In addition, it was shown that the isolates displayed very small differences in growth rates when grown on dual sugars as compared to single sugars, whether pentose or hexose in nature. The anabolic characteristics of C. glutamicum, A. odontolyticus, N. elegans and P. freudenreichii were subsequently investigated by qualitative analysis of their end-products, using high performance liquid chromatography (HPLC). All of the organisms produced arginine and cysteine after utilization of the pentose substrates alone. In addition, P. freudenreichii produced alanine and glycine. The end-product profile arising from culture with dual carbon sources was also tested. Interestingly, this time the product was different. All of them produced the amino acid glycine, when grown on a combination substrate-mix of glucose with xylose, and also glucose with arabinose. Only N. elegans was able to break down ribose, either singly or in combination with glucose, and the end-product of metabolism of the glucose plus ribose substrate combination was glutamic acid. The ecological analysis of microbial abundance in sugar mill waste was performed using denaturing gradient gel electrophoresis (DGGE) and also the metagenomic microarray PhyloChip method. Eleven solid samples and seven liquid samples were investigated. A very complex bacterial ecosystem was demonstrated in the seven liquid samples after testing with the PhyloChip method. It was also shown that bagasse leachate was the most different, compared to all of the other samples, by virtue of its richness in variety of taxa and the complexity of its bacterial community. The bacterial community in solid samples from Proserpine, Mackay and Maryborough sugar mills showed huge diversity. The information found from 16S rDNA sequencing results was that the bacterial genera Brevibacillus, Rhodospirillaceae, Bacillus, Vibrio and Pseudomonas were present in greatest abundance. In addition, Corynebacterium was also found in the soil samples. The metagenomic studies of the sugar mill samples demonstrate two important outcomes: firstly that the bagasse leachate, as potentially the most pentose-rich sample tested, had the most complex and diverse bacterial community; and secondly that the pentose-capable isolates that were initially discovered at the beginning of this study, were not amongst the most abundant taxonomic groups discovered in the sugar mill samples, and in fact were, as suspected, very rare. As a bioprospecting exercise, therefore, the study has discovered organisms that are naturally present, but in very small numbers, in the appropriate natural environment. This has implications for the industrial application of E-PUB, in that a seeding process using a starter culture will be necessary for industrial purposes, rather than simply assuming that natural fermentation might occur.

Effect of moisture and temperature distribution on dried food microstructure and porosity

Dehydration of food materials requires water removal from it. This removal of moisture prevents the growth and reproduction of microorganisms that cause decay and minimizes many of the moisture-driven deterioration reactions (Brennan, 1994). However, during food drying, many other changes occur simultaneously resulting in a modified overall quality (Kompany et al., 1993). Among the physical attributes of dried food material porosity and microstructure are the important ones that can dominant other quality of dried foods (Aguilera et al., 2000). In addition, this two concerned quality attributes affected by process conditions, material components and raw structure of food stuff. In this work, temperature moisture distribution within food materials during microwave drying will be taken into consideration to observe its participation on the microstructure and porosity of the finished product. Apple is the selective materials for this work. Generally, most of the food materials are found in non-uniformed moisture contained condition. To develop non uniform temperature distribution, food materials have been dried in a microwave oven with different power levels (Chua et al., 2000). First of all, temperature and moisture model is simulated by COMSOL Multiphysics. Later on, digital imaging camera and Image Pro Premier software have been deployed to observation moisture distribution and thermal imaging camera for temperature distribution. Finally, Microstructure and porosity of the food materials are obtained from scanning electron microscope and porosity measuring devices respectively . Moisture distribution and temperature during drying influence the microstructure and porosity significantly. Specially, High temperature and moisture contained regions show less porosity and more rupture. These findings support other literatures of Halder et al. (2011) and Rahman et al (1990). On the other hand, low temperature and moisture regions depict uniform microstructure and high porosity. This work therefore assists in better understanding of the role of moisture and temperature distribution to a prediction of micro structure and porosity of dried food materials.

Social Media Sites as Online Information Grounds : An exploratory study of the ways in which Information Technology (IT) professionals experience social media

Social media tools are often the result of innovations in Information Technology and developed by IT professionals and innovators. Nevertheless, IT professionals, many of whom are responsible for designing and building social media technologies, have not been investigated on how they themselves use or experience social media for professional purposes. This study will use Information Grounds Theory (Pettigrew, 1998) as a framework to study IT professionals’ experience in using social media for professional purposes. Information grounds facilitates the opportunistic discovery of information within social settings created temporarily at a place where people gather for a specific purpose (e.g., doctors’ waiting rooms, office tea rooms etc.), but the social atmosphere stimulates spontaneous sharing of information (Pettigrew, 1999). This study proposes that social media has the qualities that make it a rich information grounds; people participate from separate “places” in cyberspace in a synchronous manner in real-time, making it almost as dynamic and unplanned as physical information grounds. There is limited research on how social media platforms are perceived as a “place,” (a place to go to, a place to gather, or a place to be seen in) that is comparable to physical spaces. There is also no empirical study on how IT professionals use or “experience” social media. The data for this study is being collected through a study of IT professionals who currently use Twitter. A digital ethnography approach is being taken wherein the researcher uses online observations and “follows” the participants online and observes their behaviours and interactions on social media. Next, a sub-set of participants will be interviewed on their experiences with and within social media and how social media compares with traditional methods of information grounds, information communication, and collaborative environments. An Evolved Grounded Theory (Glaser, 1992) approach will be used to analyse tweets data and interviews and to map the findings against the Information Ground Theory. Findings from this study will provide foundational understanding of IT professionals’ experiences within social media, and can help both professionals and researchers understand this fast-evolving method of communications.

Nutritional status of Ugandan women living with HIV/AIDS : anthropometry and body composition assessment

Human immunodeficiency virus (HIV) that leads to acquired immune deficiency syndrome (AIDs) reduces immune function, resulting in opportunistic infections and later death. Use of antiretroviral therapy (ART) increases chances of survival, however, with some concerns regarding fat re-distribution (lipodystrophy) which may encompass subcutaneous fat loss (lipoatrophy) and/or fat accumulation (lipohypertrophy), in the same individual. This problem has been linked to Antiretroviral drugs (ARVs), majorly, in the class of protease inhibitors (PIs), in addition to older age and being female. An additional concern is that the problem exists together with the metabolic syndrome, even when nutritional status/ body composition, and lipodystrophy/metabolic syndrome are unclear in Uganda where the use of ARVs is on the increase. In line with the literature, the overall aim of the study was to assess physical characteristics of HIV-infected patients using a comprehensive anthropometric protocol and to predict body composition based on these measurements and other standardised techniques. The other aim was to establish the existence of lipodystrophy, the metabolic syndrome, andassociated risk factors. Thus, three studies were conducted on 211 (88 ART-naïve) HIV-infected, 15-49 year-old women, using a cross-sectional approach, together with a qualitative study of secondary information on patient HIV and medication status. In addition, face-to-face interviews were used to extract information concerning morphological experiences and life style. The study revealed that participants were on average 34.1±7.65 years old, had lived 4.63±4.78 years with HIV infection and had spent 2.8±1.9 years receiving ARVs. Only 8.1% of participants were receiving PIs and 26% of those receiving ART had ever changed drug regimen, 15.5% of whom changed drugs due to lipodystrophy. Study 1 hypothesised that the mean nutritional status and predicted percent body fat values of study participants was within acceptable ranges; different for participants receiving ARVs and the HIV-infected ART-naïve participants and that percent body fat estimated by anthropometric measures (BMI and skinfold thickness) and the BIA technique was not different from that predicted by the deuterium oxide dilution technique. Using the Body Mass Index (BMI), 7.1% of patients were underweight (<18.5 kg/m2) and 46.4% were overweight/obese (≥25.0 kg/m2). Based on waist circumference (WC), approximately 40% of the cohort was characterized as centrally obese. Moreover, the deuterium dilution technique showed that there was no between-group difference in the total body water (TBW), fat mass (FM) and fat-free mass (FFM). However, the technique was the only approach to predict a between-group difference in percent body fat (p = .045), but, with a very small effect (0.021). Older age (β = 0.430, se = 0.089, p = .000), time spent receiving ARVs (β = 0.972, se = 0.089, p = .006), time with the infection (β = 0.551, se = 0.089, p = .000) and receiving ARVs (β = 2.940, se = 1.441, p = .043) were independently associated with percent body fat. Older age was the greatest single predictor of body fat. Furthermore, BMI gave better information than weight alone could; in that, mean percentage body fat per unit BMI (N = 192) was significantly higher in patients receiving treatment (1.11±0.31) vs. the exposed group (0.99±0.38, p = .025). For the assessment of obesity, percent fat measures did not greatly alter the accuracy of BMI as a measure for classifying individuals into the broad categories of underweight, normal and overweight. Briefly, Study 1 revealed that there were more overweight/obese participants than in the general Ugandan population, the problem was associated with ART status and that BMI broader classification categories were maintained when compared with the gold standard technique. Study 2 hypothesized that the presence of lipodystrophy in participants receiving ARVs was not different from that of HIV-infected ART-naïve participants. Results showed that 112 (53.1%) patients had experienced at least one morphological alteration including lipohypertrophy (7.6%), lipoatrophy (10.9%), and mixed alterations (34.6%). The majority of these subjects (90%) were receiving ARVs; in fact, all patients receiving PIs reported lipodystrophy. Period spent receiving ARVs (t209 = 6.739, p = .000), being on ART (χ2 = 94.482, p = .000), receiving PIs (Fisher’s exact χ2 = 113.591, p = .000), recent T4 count (CD4 counts) (t207 = 3.694, p = .000), time with HIV (t125 = 1.915, p = .045), as well as older age (t209 = 2.013, p = .045) were independently associated with lipodystrophy. Receiving ARVs was the greatest predictor of lipodystrophy (p = .000). In other analysis, aside from skinfolds at the subscapular (p = .004), there were no differences with the rest of the skinfold sites and the circumferences between participants with lipodystrophy and those without the problem. Similarly, there was no difference in Waist: Hip ratio (WHR) (p = .186) and Waist: Height ratio (WHtR) (p = .257) among participants with lipodystrophy and those without the problem. Further examination showed that none of the 4.1% patients receiving stavudine (d4T) did experience lipoatrophy. However, 17.9% of patients receiving EFV, a non-nucleoside reverse transcriptase inhibitor (NNRTI) had lipoatrophy. Study 2 findings showed that presence of lipodystrophy in participants receiving ARVs was in fact far higher than that of HIV-infected ART-naïve participants. A final hypothesis was that the prevalence of the metabolic syndrome in participants receiving ARVs was not different from that of HIV-infected ART-naïve participants. Moreover, data showed that many patients (69.2%) lived with at least one feature of the metabolic syndrome based on International Diabetic Federation (IDF, 2006) definition. However, there was no single anthropometric predictor of components of the syndrome, thus, the best anthropometric predictor varied as the component varied. The metabolic syndrome was diagnosed in 15.2% of the subjects, lower than commonly reported in this population, and was similar between the medicated and the exposed groups (χ 21 = 0.018, p = .893). Moreover, the syndrome was associated with older age (p = .031) and percent body fat (p = .012). In addition, participants with the syndrome were heavier according to BMI (p = .000), larger at the waist (p = .000) and abdomen (p = .000), and were at central obesity risk even when hip circumference (p = .000) and height (p = .000) were accounted for. In spite of those associations, results showed that the period with disease (p = .13), CD4 counts (p = .836), receiving ART (p = .442) or PIs (p = .678) were not associated with the metabolic syndrome. While the prevalence of the syndrome was highest amongst the older, larger and fatter participants, WC was the best predictor of the metabolic syndrome (p = .001). Another novel finding was that participants with the metabolic syndrome had greater arm muscle circumference (AMC) (p = .000) and arm muscle area (AMA) (p = .000), but the former was most influential. Accordingly, the easiest and cheapest indicator to assess risk in this study sample was WC should routine laboratory services not be feasible. In addition, the final study illustrated that the prevalence of the metabolic syndrome in participants receiving ARVs was not different from that of HIV-infected ART-naïve participants.

Gelatine : making coworking places gel for better collaboration and social learning

Public libraries and coworking spaces seek for means to facilitate peer collaboration, peer inspiration and cross-pollination of skills and creativity. However, social learning, inspiration and collaboration between coworkers do not come naturally. In particular in (semi-) public spaces, the behavioural norm among unacquainted coworkers is to work in individual silos without taking advantage of social learning or collaboration opportunities. This paper presents results from a pilot study of ‘Gelatine’ – a system that facilitates shared encounters between coworkers by allowing them to digitally ‘check in’ at a work space. Gelatine displays skills, areas of interest, and needs of currently present coworkers on a public screen. The results indicate that the system amplifies users’ sense of place and awareness of other coworkers, and serves as an interface for social learning through exploratory, opportunistic and serendipitous inspirations, as well as through helping users identify like-minded peers for follow-up face-to-face encounters. We discuss how Gelatine is perceived by users with different pre-entry motivations, and discuss users’ challenges as well as non-use of the system.

Aqueous phase synthesis of copper nanoparticles : a link between heavy metal resistance and nanoparticle synthesis ability in bacterial systems

We demonstrate aqueous phase biosynthesis of phase-pure metallic copper nanoparticles (CuNPs) using a silver resistant bacterium Morganella morganii. This is particularly important considering that there has been no report that demonstrates biosynthesis and stabilization of pure copper nanoparticles in the aqueous phase. Electrochemical analysis of bacterial cells exposed to Cu2+ ions provides new insights into the mechanistic aspect of Cu2+ ion reduction within the bacterial cell and indicates a strong link between the silver and copper resistance machinery of bacteria in the context of metal ion reduction. The outcomes of this study take us a step closer towards designing rational strategies for biosynthesis of different metal nanoparticles using microorganisms.

Misperceptions about child sex offenders

Sexual offending against children is a highly emotive issue. It is nonetheless important that public policy initiatives to prevent and/or respond to child sexual abuse are based on the available evidence about child sex offenders. This paper addresses five common misperceptions about the perpetrators of sexual offences against children. Specifically, the issues addressed include whether all child sex offenders are ‘paedophiles’, who sexually abuse children, whether most child sex offenders were victims of sexual abuse themselves, rates of recidivism among child sex offenders and the number of children sex offenders typically abuse before they are detected by police. The evidence outlined in this paper highlights that there are few black and white answers to these questions. Perpetrators of sexual crimes against children are not, contrary to widespread opinion, a homogenous group. Rather, there are a number of varied offending profiles that characterise child sex offenders. Gaining an understanding of the nuances of this offender population is critical if children are to be protected from sexual abuse.

Educating for digital futures : what the learning strategies of digital content professionals can teach higher education

Beginning in the second half of the 20th century, ICTs transformed many societies from industrial societies in which manufacturing was the central focus, into knowledge societies in which dealing effectively with data and information has become a central element of work (Anderson, 2008). To meet the needs of the knowledge society, universities must reinvent their structures and processes, their curricula and pedagogic practices. In addition to this, of course higher education is itself subject to the sweeping influence of ICTs. But what might effective higher education look like in the 21st century? In designing higher education systems and learning experiences which are responsive to the learning needs of the future and exploit the possibilities offered by ICTs, we can learn much from the existing professional development strategies of people who are already successful in 21st century fields, such as digital media. In this study, I ask: (1) what are the learning challenges faced by digital media professionals in the 21st century? (2) what are the various roles of formal and informal education in their professional learning strategies at present? (3) how do they prefer to acquire needed capabilities? In-depth interviews were undertaken with successful Australian digital media professionals working in micro businesses and SMEs to answer these questions. The strongest thematic grouping that emerged from the interviews related to the need for continual learning and relearning because of the sheer rate of change in the digital media industries. Four dialectical relationships became apparent from the interviewees’ commentaries around the learning imperatives arising out of the immense and continual changes occurring in the digital content industries: (1) currency vs best practice (2) diversification vs specialisation of products and services (3) creative outputs vs commercial outcomes (4) more learning opportunities vs less opportunity to learn. These findings point to the importance of ‘learning how to learn’ as a 21st century capability. The interviewees were ambivalent about university courses as preparation for professional life in their fields. Higher education was described by several interviewees as having relatively little value-add beyond what one described as “really expensive credentialling services.” For all interviewees in this study, informal learning strategies were the preferred methods of acquiring the majority of knowledge and skills, both for ongoing and initial professional development. Informal learning has no ‘curriculum’ per se, and tends to be opportunistic, unstructured, pedagogically agile and far more self-directed than formal learning (Eraut, 2004). In an industry impacted by constant change, informal learning is clearly both essential and ubiquitous. Inspired by the professional development strategies of the digital media professionals in this study, I propose a 21st century model of the university as a broad, open learning ecology, which also includes industry, professionals, users, and university researchers. If created and managed appropriately, the university learning network becomes the conduit and knowledge integrator for the latest research and industry trends, which students and professionals alike can access as needed.

Defense and counterdefense in the plant world

An important role of RNA interference (RNAi)-like pathways in plants is defense against viral infection. Viruses can overcome this defense by expressing proteins that suppress the pathway. A new study of Agrobacterium tumefaciens infection reveals that this plant pathogen, although a bacterium, also induces and then suppresses the host RNAi response. © 2006 Nature Publishing Group.

Exploring plant genomes by RNA-induced gene silencing

The nucleotide sequences of several animal, plant and bacterial genomes are now known, but the functions of many of the proteins that they are predicted to encode remain unclear. RNA interference is a gene-silencing technology that is being used successfully to investigate gene function in several organisms - for example, Caenorhabditis elegans. We discuss here that RNA-induced gene silencing approaches are also likely to be effective for investigating plant gene function in a high-throughput, genome-wide manner.

Expression patterns of vascular-specific promoters RolC and Sh in transgenic potatoes and their use in engineering PLRV-resistant plants

The expression patterns of GUS fusion constructs driven by the Agrobacterium rhizogenes RolC and the maize Sh (Shrunken: sucrose synthase-1) promoters were examined in transgenic potatoes (cv. Atlantic). RolC drove high-level gene expression in phloem tissue, bundle sheath cells and vascular parenchyma, but not in xylem or non-vascular tissues. Sh expression was exclusively confined to phloem tissue. Potato leafroll luteovirus (PLRV) replicates only in phloem tissues, and we show that when RolC is used to drive expression of the PLRV coat protein gene, virus-resistant lines can be obtained. In contrast, no significant resistance was observed when the Sh promoter was used.