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Objectives: Scabies is a neglected skin disease that disproportionately affects people from resource poor and overcrowded countries. Global data on prevalence and risk factors are limited. This article aims to estimate the global burden of scabies and identifies the risks associated with it. Methods: Databases (PubMed, Scopus and Cochrane Reviews) were accessed to identify studies of scabies prevalence published between 2000 and 2024. Results were pooled to estimate prevalence and identify factors, which explained between‐study heterogeneity. Odds ratios (ORs), risk of bias, subgroup analyses and meta‐regression were used to describe variation in effect size and heterogeneity based on country‐level demographic and economic variables. Results: Seventy studies yielded a pooled prevalence of 11.9% (95% confidence interval [CI]: 9.60–14.7) with substantial heterogeneity I2=100%τ2=1.04. Prevalence was highest in Oceania (17.9%; 95% CI: 13.9–22.8) compared to other regions. Pooled risk factors for scabies showed significant associations for demographic and behavioural factors including contact history with household members with itch (OR 11.3; 95% CI 4.82–26.51; I2=96%; n = 7), lack of soap use (OR 3.41; 95% CI: 2.56–4.54; I2=44%; n = 7), bed‐sharing (OR 2.64; 95% CI: 1.50–4.63; I2=76%; n = 7), sharing of clothes (OR 2.52; 95% CI: 1.58–4.03; I2=85%; n = 7), infrequent bathing (OR 2.13; 95% CI: 1.41–3.22; I2=77%; n = 6), presence of pets (OR 1.76; 95% CI: 1.08–2.87; I2=84%; n = 4) and being a male (OR = 1.19; 95% CI: 1.04–1.37; I2=83%; n = 22). Socioeconomic factors were not convincingly associated with scabies prevalence. Conclusion: Prevalence of scabies is associated with geographic location and behavioural factors, but not between‐country socioeconomic status. In addition to mass drug administration, risk factors are identified which may be included in health promotion programmes to reduce scabies prevalence and its sequelae in the long term. [ABSTRACT FROM AUTHOR]

Aim: Here, we present results of a survey of scabies prevalence in childcare centres and primary schools in Auckland. Methods: Children whose parents agreed to take part in participating centres in the Auckland region were examined for scabies by general practitioners and given questionnaires of relevant symptoms. Diagnoses of clinical or suspected scabies were made according to the International Alliance for the Control of Scabies (IACS) criteria. The survey was a stratified random sample of schools and early childcare centres. A quantitative polymerase chain reaction (PCR) test was also used to complement the IACS criteria. Results: A total of 181 children were examined, with 145 children with history information, 16 of whom (11.0%) met the criteria for 'clinical' or 'suspected' scabies. Weighted analysis, accounting for the survey design, indicated that the prevalence of scabies in early childcare centres was 13.2% (95% CI: 4.3 to 22.1), with no school‐aged children fulfilling these criteria. A higher proportion had clinical signs of scabies with 23 (12.7%) having typical scabies lesions and a further 43 (23.8%) had atypical lesions. A total of 64 PCR tests were taken and 15 (23%) were positive. None of these cases were receiving treatment for scabies. Five were undergoing topical skin treatment: three with topical steroid and two with calamine lotion. Conclusions: The prevalence of children with scabies is high in early childcare centres in Auckland. Misdiagnosis is suggested by several PCR positive cases being treated by topical agents used to treat other skin conditions. [ABSTRACT FROM AUTHOR]

Patients with haematological malignancies, haemopoietic stem cell transplant recipients and patients requiring admission to intensive care settings are at high risk for invasive candidiasis (IC). Over the past decade, there has been increased reporting of non‐albicans species and fluconazole resistance in Australia. These guidelines provide updated evidence‐based recommendations for the diagnosis and management of IC in adult and paediatric haematology, oncology and intensive care settings. Optimal pharmacological and non‐pharmacological management are discussed. Recent studies strengthen the recommendation for an echinocandin agent as first‐line therapy for high‐risk patients with IC. Mortality benefit has also been demonstrated for non‐pharmacological management, including removal of central venous catheters, infectious diseases consultation and use of care bundles. Healthcare facilities managing immunocompromised patient populations should therefore adopt implementation strategies for these multimodal interventions. [ABSTRACT FROM AUTHOR]

Background: Registry‐based studies have become more common due to the availability of a large study cohort. However, the validity of findings is dependent on the completeness of the registry. This study aimed to validate the capture rate of the New Zealand Joint Registry (NZJR) by matching procedures that have been recorded separately via clinical coding by the New Zealand Government's National Surgical Site Infection Improvement Programme (SSIIP). Methods: The National Health Index, a unique identification code for all patients, was combined with the arthroplasty procedure performed (primary total knee arthroplasty (TKA), primary total hip arthroplasty (THA), revision TKA or revision THA) and operation side. Publicly funded procedures recorded in the NZJR were matched with procedures recorded by the SSIIP on a record‐by‐record basis. This identified the total number of arthroplasty procedures performed in New Zealand, which was used as the denominator value to calculate the procedure capture rate of the NZJR. Results: Between 2013 and 2018, 24 556 primary TKA, 28 970 primary THA, 2107 revision TKA and 4263 revision THA procedures were recorded by both datasets. The NZJR recorded 95.5% of primary TKA procedures, 96.3% of primary THA procedures, 97.1% of revision TKA procedures and 95.2% of revision THA procedures. Conclusion: The NZJR recorded >95% of publicly funded arthroplasty procedures. In contrast, there were inaccuracies in clinical coding by hospitals, particularly with revision procedures, demonstrating the benefits of an arthroplasty registry. However, data recorded by an infection surveillance programme may supplement arthroplasty registry data to strengthen the quality of research. [ABSTRACT FROM AUTHOR]

Candida auris is an emerging drug‐resistant yeast responsible for hospital outbreaks. This statement reviews the evidence regarding diagnosis, treatment and prevention of this organism and provides consensus recommendations for clinicians and microbiologists in Australia and New Zealand. C. auris has been isolated in over 30 countries (including Australia). Bloodstream infections are the most frequently reported infections. Infections have crude mortality of 30–60%. Acquisition is generally healthcare‐associated and risks include underlying chronic disease, immunocompromise and presence of indwelling medical devices. C. auris may be misidentified by conventional phenotypic methods. Matrix‐assisted laser desorption ionisation time‐of‐flight mass spectrometry or sequencing of the internal transcribed spacer regions and/or the D1/D2 regions of the 28S ribosomal DNA are therefore required for definitive laboratory identification. Antifungal drug resistance, particularly to fluconazole, is common, with variable resistance to amphotericin B and echinocandins. Echinocandins are currently recommended as first‐line therapy for infection in adults and children ≥2 months of age. For neonates and infants <2 months of age, amphotericin B deoxycholate is recommended. Healthcare facilities with C. auris should implement a multimodal control response. Colonised or infected patients should be isolated in single rooms with Standard and Contact Precautions. Close contacts, patients transferred from facilities with endemic C. auris or admitted following stay in overseas healthcare institutions should be pre‐emptively isolated and screened for colonisation. Composite swabs of the axilla and groin should be collected. Routine screening of healthcare workers and the environment is not recommended. Detergents and sporicidal disinfectants should be used for environmental decontamination. [ABSTRACT FROM AUTHOR]

Surgical site infections ( SSIs) are serious adverse events hindering surgical patients' recovery. In Australia and New Zealand, SSIs are a huge burden to patients and healthcare systems. A bundled approach, including pre-theatre nasal and/or skin decolonization has been used to reduce the risk of staphylococcal infection. The aim of this review is to assess the effectiveness of the bundle in preventing SSIs for cardiac and orthopaedic surgeries. The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Published literature was searched in PubMed, Embase and Cochrane Library of Systematic reviews. Identified articles were selected and extracted based on a priori defined Population-Intervention-Comparator-Outcome and eligibility criteria. Data of randomized controlled trials ( RCTs) and comparative observational studies were synthesized by meta-analyses. Quality appraisal tools were used to assess the evidence quality. The review included six RCTs and 19 observational studies. The bundled treatment regimens varied substantially across all studies. RCTs showed a trend of Staphylococcus aureus SSIs reduction due to the bundle ( relative risk = 0.59, 95% confidence interval ( CI) = 0.33, 1.06) with moderate heterogeneity. Observational studies showed statistically significant reduction in all-cause and S. aureus SSIs, with 51% (95% CI = 0.41, 0.59) and 47% (95% CI = 0.35, 0.65), respectively. No publication biases were detected. SSIs in major cardiac and orthopaedic surgeries can be effectively reduced by approximately 50% with a pre-theatre patient care bundle approach. [ABSTRACT FROM AUTHOR]

Wood in streams functions as fish habitat, but relationships between fish abundance (or size) and large wood in streams are not consistent. One possible reason for variable relationships between fish and wood in streams is that the association of fish with wood habitat may depend on ecological context such as large-scale geomorphology. We studied the relationship between salmonid assemblages and large wood jams ( LWJ) in four settings that differed geomorphically at the scale of the stream corridor along a tributary to Lake Superior in old-growth conifer-hardwood forest in northern Michigan. The focal fish species of this study were brook trout ( Salvelinus fontinalis), which were wild in the stream. Relocation efforts for coaster brook trout (an adfluvial life history variant of brook trout) were ongoing in the study stream. We measured fish abundance and length in pairs of pools of similar size and substrate, but varying in the presence of LWJ; this allowed us to evaluate associations of fish simply with the presence of LWJ rather than with other channel or flow-shaping functions of LWJ. The length of Oncorhynchus spp. and young introduced brook trout was not strongly correlated with LWJ presence; however, the presence of LWJ in pools was positively correlated with larger wild brook trout. We also found that the correspondence of LWJ with the abundance of salmonids appears to be moderated by the presence of alternative habitat in this relatively natural, old-growth forest stream. [ABSTRACT FROM AUTHOR]

Large wood (LW; pieces with diameter greater than 10 cm and length greater than 1 m) and large-wood jams (LWJs; two or more pieces of LW in contact with each other) are important components of stream ecosystems that are often distributed along stream channels in response to geomorphic and riparian forest factors that interact hierarchically. As a result, information on these relationships is valuable for predicting patterns of wood accumulation and characteristics of individual pieces of wood. We studied relationships between geomorphic and riparian factors and LW and LWJ structure in different geomorphic settings associated with old-growth and second-growth settings in Upper Michigan. We used redundancy analysis (RDA) and regression tree analysis to evaluate changes in LW and LWJ structural characteristics among geomorphic and riparian forest settings. Geomorphic factors explained 38!5% of the variability in LW and LWJ characteristics, riparian forest factors uniquely explained 184% of the variance and the intersection of the two categories of environmental factors (i.e. the redundant portion) was 29-8%. At the landscape scale, our multivariate analyses suggest that the presence of rock-plane bedding was an important predictor of the number of LWJs and the percent of channel spanned by LWJs. Our analyses suggest differences in relationships between geomorphic factors and LW and LWJ structure. Channel width, distance from headwaters, gradient and sinuosity were identified by regression tree analyses as the most important variables for predicting LW characteristics, while channel width and confinement were the most important variables for predicting LWJ characteristics. Old-growth settings generally contained a higher proportion of conifer and LW (both in and out of LWJs) with greater diameter and volume than in second-growth settings. Our study supports the view that restoration of wood to streams will benefit from considering the associations of wood structure with landscape and reach-scale geomorphology. [ABSTRACT FROM AUTHOR]

The reported rate of post-sternotomy mediastinitis is between 0.8 and 2.3%, with up to 79% of cases caused by staphylococci. Mediastinitis is associated with significant morbidity and mortality. Obesity and diabetes are the only risk factors consistently identified. The aims of the present study were to determine the incidence and risk factors for staphylococci post-sternotomy mediastinitis and to audit its management. The clinical records of patients with staphylococcal post-sternotomy mediastinitis between 1 January 1998 and 31 May 2003 were retrospectively reviewed. Information collected included patient demographics, comorbidities, operation type, microbiology findings, surgical and medical management, and outcome. Data collected on cases were compared with data collected in a prospective database of all patients undergoing cardiac surgery. The incidence of staphylococcal post-sternotomy mediastinitis was 1.2% (60 cases in 5176 median sternotomies). Staphylococcus aureus was isolated in 49 (82%) cases and coagulase-negative staphylococci in 11 (18%) cases. Eight (16%) S. aureus isolates were methicillin-resistant. Risk factors associated with mediastinitis were ethnicity, diabetes mellitus, emergency surgery, ejection fraction and length of preoperative hospital stay. In-hospital mortality was 15%. Eighteen per cent of cases were not cured by initial therapy. Staphylococcal mediastinitis is a serious complication with significant rates of relapse and mortality. This audit has lead to an evaluation of our clinical pathways to ensure that prevention and management of surgical site infection is optimized. [ABSTRACT FROM AUTHOR]

To review the demographic characteristics, antecedents and outcome for early neonatalEscherichia colisepsis. Secondary aims were to identify antenatal antibiotic use and to review the antimicrobial susceptibility.A retrospective chart review was performed for all infants with a positive culture forE. colifrom either blood or CSF samples obtained between January 1998 and October 2002.Nineteen liveborn infants with early onset sepsis and one stillborn baby with a positive maternal blood culture forE. coliwere identified. Pregnancy complications included multiple pregnancy in five (25%), preterm rupture of membranes 10 (50%) and maternal urinary tract infection in five (25%). Eighteen of the cases were born preterm and two at term. The mortality was 8/20 (40%), and for nine cases with developmental outcome data available, 67% were within normal limits and 33% were abnormal. Of the 20E. coliisolates 11 (55%) were resistant to amoxycillin and 1 (5%) was resistant to gentamicin.Infants with early onsetE. colisepsis had a poor outcome with high mortality and a third of the survivors manifesting neurodevelopmental impairment. Although amoxycillin resistance is common, there is a low prevalence of gentamicin resistance in local isolates. [ABSTRACT FROM AUTHOR]

This report describes the epidemiology of culture-proven dermatophyte infection in Auckland, New Zealand. The authors undertook a retrospective review of laboratory data for the period from June 1999 to July 2002. There were 10 004 dermatophyte isolates. The most common isolates were Trichophyton rubrum (69%) and Trichophyton mentagrophytes (19%). Microsporum canis was mainly isolated from children. The prevalence of T.Šmentagrophytes increased with patient age ( P < 0.001) . Trichophyton rubrum was most common in those aged between 20 and 59 years. The incidence of culture-proven dermatophyte infection was 2.9/1000 population for the year 2000, and the incidence increased with patient age ( P < 0.001). It is concluded that dermatophytes causing superficial mycoses in the Auckland region are essentially similar to Australia and other Western countries, although some new organisms are seen as a result of the migration of people from other countries. The incidence of local dermatophyte infection increases with age. [ABSTRACT FROM AUTHOR]

Describes an anti-yersinia release plasmid-encoded virulence proteins immunoglobulin A immunoassay that can detect yersinia-infected blood donors. Prevalence of gastrointestinal infection rate caused by yersinia enterocolitica bacteria at the time of blood donation; Suitability for the detection of other pathogenic serotype infections; Usefulness of the immunoassay in testing populations with endemic or sporadic posttransfusion endotoxemia caused by yersinia.

Aim Methods Results Conclusion We sought to determine the degree of agreement between clinical and laboratory methods for diagnosing scabies in school‐aged children.Clinical information and samples were collected from children aged 7 months to 14 years attending educational institutions in Auckland, New Zealand. Two methods determined scabies status: the International Alliance for the Control of Scabies clinical criteria (IACS) and quantitative polymerase chain reaction (qPCR). Sensitivity and specificity of each method, as the reference or index standard, were estimated and agreement was determined using Cohen's kappa statistic.Sixteen of 145 children were positive based on IACS criteria and 15 of 64 with a suspicious skin lesion returned a positive qPCR test. IACS sensitivity and specificity were 66.7% (95% confidence interval (CI): 39.9–93.3) and 94% (95% CI: 89.9–98.0), respectively (with qPCR as the reference). For qPCR, sensitivity and specificity were 50% (95% CI: 25.5–74.5) and 96.9% (95% CI: 94.0–100.0), respectively (with IACS as the reference). The kappa value was 0.53.Agreement between clinical and laboratory methods in the identification of scabies diagnosis was moderate. Both methods had low sensitivity but high specificity. Scabies diagnosis might be improved, thereby enhancing control measures, by relaxing the IACS criteria (as some IACS‐negative participants returned positive qPCR tests, indicating mite DNA was present) and conversely supplementing clinical assessment with qPCR testing. [ABSTRACT FROM AUTHOR]

Presents a study which focused on the pre-Incan Andean cultures and civilizations in Peru. How the ancient civilizations could have built a population supporting both city life and a highly organized social and economic society; Stages of understanding the Andean cultures.

A technique using a coaxial diode test fixture for the mount-independent characterization of potentially unstable two-terminal devices is presented. A standard three-terminal calibration procedure using reference packages is used to calibrate to the surface of the packaged device. The test fixture is designed to present a low, nonresonant impedance to the device so that measurement resolution is enhanced. The characterization of an IMPATT diode is presented us an example. [ABSTRACT FROM AUTHOR]

In this article the concept is applied in a third world area and supported as a form of industrial organization definitely in existence. and with some merits as a model for other comparable areas and industries. It must be emphasized at the outset that the focus of the article, as of the concept, is not on the individual firm, nor on the national economy, but at a meso-scale. looking at city and region. It is also sited between the two extremes which are commonly tackled in studies of third world economies, the multinational corporations and the informal sector. Although some comment on both of these will be necessary, the article is chiefly about ordinary industries operating together in intermediate cities, and the applicability of theory from other countries. Flexible specialization may be described first in terms of firms. Flexibility of the new type of firm is achieved in the labor market by subcontracting out work to competing or complementary firms in the same sector, and by using the labor pool that is available through the extended family. as well as the more traditional flexible hours worked by the small-firm workers. In the production process, flexibility is achieved through the use of simple technology, with general-purpose machines rather than specialized ones which cannot be used for slightly different tasks. Flexibility is also achieved through the external economies which are available within an industrial district, either through the subcontracting already mentioned, or through the use of a variety of skills and services only available within such a district.