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1. COVID-19: Urgent actions, critical reflections and future relevance of ‘WaSH’: Lessons for the current and future pandemics

Author

Howard, G, Bartram, J, Brocklehurst, C, Colford, JM, Costa, F, Cunliffe, D, Dreibelbis, R, Eisenberg, JNS, Evans, B, Girones, R, Hrudey, S, Willetts, J, and Wright, CY

Subjects
Environmental Science and Management, Environmental Engineering, Urban and Regional Planning
Abstract

The COVID-19 pandemic placed hygiene at the centre of disease prevention. Yet, access to the levels of water supply that support good hand hygiene and institutional cleaning, our understanding of hygiene behaviours, and access to soap are deficient in low-, middle-and high-income countries. This paper reviews the role of water, sanitation and hygiene (WaSH) in disease emergence, previous outbreaks, combatting COVID-19 and in preparing for future pandemics. We consider settings where these factors are particularly important and identify key preventive contributions to disease control and gaps in the evidence base. Urgent substantial action is required to remedy deficiencies in WaSH, particularly the provision of reliable, continuous piped water on-premises for all households and settings. Hygiene promotion programmes, underpinned by behavioural science, must be adapted to high-risk populations (such as the elderly and marginalised) and settings (such as healthcare facilities, transport hubs and workplaces). WaSH must be better integrated into preparation plans and with other sectors in prevention efforts. More finance and better use of financing instruments would extend and improve WaSH services. The lessons outlined justify no-regrets investment by government in response to and recovery from the current pandemic; to improve day-to-day lives and as preparedness for future pandemics.

Published
2020

12. Bacterial adhesion at synthetic surfaces

Author

Cunliffe, D., Smart, C.A., Alexander, C., and Vulfson, E.N.

Subjects
Microbiological research -- Analysis, Bacteria -- Research, Adhesion -- Research, Surface chemistry -- Research, Biological sciences
Abstract

Research is conducted on the study of bacterial adsorption by surfaces with defined and controllable chemistry to investigate chemical and physiochemical factors that may affect adhesion. Results indicate clear correlation between surface chemistry and protein adsorption.

Published
1999

15. Microplastics in drinking water

Author

Marsden, P., Koelmans, A.A., Bourdon-Lacombe, J., Gouin, T., D'Anglada, L., Cunliffe, D., Jarvis, P., Fawell, J., and De France, Jennifer

Subjects
Aquatic Ecology and Water Quality Management, WIMEK, Life Science, Aquatische Ecologie en Waterkwaliteitsbeheer
Published
2019

16. Enterocytozoon bieneusi genotypes in cats and dogs in Victoria, Australia

Author

Zhang, Y, Koehler, A, Wang, T, Cunliffe, D, Gasser, RB, Zhang, Y, Koehler, A, Wang, T, Cunliffe, D, and Gasser, RB

Abstract

BACKGROUND: Enterocytozoon bieneusi is one of the commonest microsporidians contributing to human microsporidiosis, and is frequently found in animals in various countries. However, there is limited epidemiological information on this microorganism in Australia. Here, we undertook the first molecular epidemiological study of E. bieneusi in cats and dogs in Victoria. RESULTS: Genomic DNAs were extracted from 514 individual faecal deposits from cats (n = 172) and dogs (n = 342) and then tested using PCR-based sequencing of the internal transcribed spacer (ITS) of nuclear ribosomal DNA. Four distinct genotypes (designated D, PtEb IX, VIC_cat1 and VIC_dog1) of E. bieneusi were identified in 20 of the 514 faecal samples (3.9%). Genotype D is known to have a broad host range (humans and other animals) and has a wide geographical distribution around the world. The identification of this genotype here suggests that companion animals might represent reservoir hosts that are able to transmit E. bieneusi infection to humans in Australia. A phylogenetic analysis of ITS sequence data revealed that the novel genotype VIC_cat1 is related to the known genotype type IV within Group 1, and the new genotype VIC_dog1 is linked to a contentious "Group 3", which includes genotypes reported previously in the published literature to represent Group 2 or 3. CONCLUSIONS: A future, large-scale phylogenetic study of all known E. bieneusi genotypes, including VIC_dog1, should aid in clarifying their relationships and assignment to Groups, and in the identification of new genotypes, thus assisting epidemiological investigations.

Published
2019

23. Social firms as a means of vocational recovery for people with mental illness: a UK survey

Author

Gilbert, E, Marwaha, S, Milton, A, Johnson, S, Morant, N, Parsons, N, Fisher, A, Singh, S, Cunliffe, D, Gilbert, E, Marwaha, S, Milton, A, Johnson, S, Morant, N, Parsons, N, Fisher, A, Singh, S, and Cunliffe, D

Abstract

BACKGROUND: Employment is associated with better quality of life and wellbeing in people with mental illness. Unemployment is associated with greater levels of psychological illness and is viewed as a core part of the social exclusion faced by people with mental illness. Social Firms offer paid employment to people with mental illness but are under-investigated in the UK. The aims of this phase of the Social Firms A Route to Recovery (SoFARR) project were to describe the availability and spread of Social Firms across the UK, to outline the range of opportunities Social Firms offer people with severe mental illness and to understand the extent to which they are employed within these firms. METHOD: A UK national survey of Social Firms, other social enterprises and supported businesses was completed to understand the extent to which they provide paid employment for the mentally ill. A study-specific questionnaire was developed. It covered two broad areas asking employers about the nature of the Social Firm itself and about the employees with mental illness working there. RESULTS: We obtained returns from 76 Social Firms and social enterprises / supported businesses employing 692 people with mental illness. Forty per cent of Social Firms were in the south of England, 24% in the North and the Midlands, 18% in Scotland and 18% in Wales. Other social enterprises/supported businesses were similarly distributed. Trading activities were confined mainly to manufacturing, service industry, recycling, horticulture and catering. The number of employees with mental illness working in Social Firms and other social enterprises/supported businesses was small (median of 3 and 6.5 respectively). Over 50% employed people with schizophrenia or bipolar disorder, though the greatest proportion of employees with mental illness had depression or anxiety. Over two thirds of Social Firms liaised with mental health services and over a quarter received funding from the NHS or a mental health cha

Published
2013

24. Complications of percutaneous gastrostomy in patients with head and neck cancer--an analysis of 42 consecutive patients

Author

Cunliffe, D. R., Watt-Smith, S. R., George, B. D., and Cook, T. A.

Subjects
Gastrostomy, Medical Audit, Letter, Enteral Nutrition, Carcinoma, Squamous Cell, Humans, Surgical Wound Infection, Mouth Neoplasms, Prospective Studies, Retrospective Studies, Research Article
Abstract

A total of 42 patients, who underwent insertion of a percutaneous gastrostomy tube prior to resection for oral squamous cell carcinoma, were investigated to examine the incidence and severity of complications associated with use of this technique. The team performing the procedure and the grade of operator was noted together with any subsequent complications and their outcome. Previously reported complication rates were 2.7-2.8% and 6-7.1% for major and minor complications, respectively, but, in this series, a major complication rate of 22.5% and minor complication rate of 17.5% were identified. The findings of this study have led to the introduction of a further prospective audit of this technique in the maxillofacial unit and a more selective policy of PEG prescription for patients undergoing resection for head and neck cancer.

Published
1999

27. Case-control studies of sporadic cryptosporidiosis in Melbourne and Adelaide, Australia

Author

Robertson, B, Sinclair, MI, Forbes, AB, Veitch, M, Kirk, M, Cunliffe, D, Willis, J, Fairley, CK, Robertson, B, Sinclair, MI, Forbes, AB, Veitch, M, Kirk, M, Cunliffe, D, Willis, J, and Fairley, CK

Abstract

Few studies have assessed risk factors for sporadic cryptosporidiosis in industrialized countries, even though it may be numerically more common than outbreaks of disease. We carried out case-control studies assessing risk factors for sporadic disease in Melbourne and Adelaide, which have water supplies from different ends of the raw water spectrum. In addition to examining drinking water, we assessed several other exposures. 201 cases and 795 controls were recruited for Melbourne and 134 cases and 536 controls were recruited for Adelaide. Risk factors were similar for the two cities, with swimming in public pools and contact with a person with diarrhoea being most important. The consumption of plain tap water was not found to be associated with disease. This study emphasizes the need for regular public health messages to the public and swimming pool managers in an attempt to prevent sporadic cryptosporidiosis, as well as outbreaks of disease.

Published
2002

42. <em>In vitro</em> investigation of autoantibody-secreting peritoneal cells and their regulation.

Author

Cox, K. O., Evans, Deborah A., Brooks, D., and Cunliffe, D. A.

Subjects
CELLULAR immunity, IMMUNITY, IMMUNE response, CELLS, PERITONEUM, IMMUNOLOGY
Abstract

A high proportion of peritoneal cells from untreated mice, after 4-5 days in culture, develop into plaque-forming cells against bromelain-treated mouse red blood cells. The number of plaque-forming cells was increased significantly by exposing the peritoneal cells to ammonium chloride to lyse red blood cells before culture. Conversely, the increase was Significantly inhibited by adding before culture untreated or bromelain-treated sheep or mouse red blood cells. Treated or untreated horse or rat red blood cells did not inhibit the increase. Treating peritoneal cells or subpopulations of peritoneal cells with anti-O serum and complement before culture caused a significant increase in the number of plaque-forming cells against bromelain-treated red blood cells after 3–4 days of culture. Various procedures were used to fractionate peritoneal cells into B-cell enriched and B-cell depleted subpopulations before culture and after culture, to investigate whether some of the plaque-forming cells could be attributed to phagocytic cells. Generally, changes in the number of plaque-forming cells against bromelain-treated mouse red blood cells paralleled changes in B-cells. In some experiments the proportion of plaque-forming cells observed represented up to 85% of the B-cells present. The results suggest that the high level of autoreactivity is due to antibody production by B-cells and that phagocytic cells are not forming spurious plaques. Further, in appears that the autoimmunity is regulated by T-cells and can also be inhibited by mouse RBC. [ABSTRACT FROM AUTHOR]

Published
1979

45. Thermoresponsive Surface-Grafted Poly(N−isopropylacrylamide) Copolymers:  Effect of Phase Transitions on Protein and Bacterial Attachment

Author

Cunliffe, D., Alarcon, C. de las Heras, Peters, V., Smith, J. R., and Alexander, C.

Abstract

The ability of polymers displaying lower critical solution temperatures (LCSTs) to mediate bioadsorptive processes was assessed. Three carboxyl-terminated polymers P1−3 with LCSTs respectively of 20, 32, and 42 °C were prepared by free-radical polymerization of N-isopropylacrylamide with and without comonomers acrylamide and N-tert-butylacrylamide. The polymers were grafted to amine-functionalized glass substrates, and their surface properties were investigated by contact angle goniometry and atomic force microscopy. Increases in water contact angle of up to 24° were observed between 10 and 37 °C for polymers with LCSTs of 20 and 32 °C, whereas no change was apparent for control amine-functional and the LCST 42 °C polymer surfaces over this temperature range. Variations in topography in water were also apparent from atomic force microscopy (AFM) studies for all the polymer grafts but not the amine surfaces over these temperatures. Adsorption of 3H-labeled bovine serum albumin and cytochrome c also increased to polymer grafts above the LCST, with the greatest change in the amount of attached protein being exhibited by polymer P1 (1.13 pmol·cm-2 cytochrome c at 10 °C, 3.95 pmol·cm-2 at 37 °C):  adsorption to control surfaces varied by less than 10% in this assay. Incubation of the graft and control substrates with a gram negative and motile bacterium (Salmonella typhimurium) and gram positive, nonmotile species (Bacillus cereus) showed the same overall pattern of attachment as the protein adsorption experiments, with polymers P1 and P2 retaining more bacteria (increases of up to 1350%) at 37 °C than at temperatures below their LCST, while amine-functional and P3 polymer surfaces showed less than 20% changes in the number of attached microorganisms. Further incubations at temperatures below polymer LCST resulted in fewer adsorbed cells at the surfaces showing the reversibility of short-term attachment to these materials. The results show that protein adsorption and short-term bacterial attachment correlate well with observed changes in surface properties as determined by contact angle goniometry and indicate that control of bioadhesion is possible by grafting suitably functionalized polymers capable of temperature-mediated hydrophilic−hydrophobic switching.

Published
2003

46. Synthesis of Poly(isobutylene-b-styrene) Block Copolymers by Thermolysis of Ozonized Alkene-Ended Polyisobutylenes in the Presence of Styrene

Author

Cunliffe, D., Lockley, J. E., Ebdon, J. R., Rimmer, S., and Tabner, B. J.

Abstract

Polyisobutylene (PIB) possessing alkene end groups was ozonized. NMR spectroscopy showed that trioxolanes and tetroxolanes were the main products and that these products were relatively stable. Thermolysis of the ozonolysis products generated radicals, which were shown by ESR spin-trapping experiments to be alkyl and oxyalkyl species. Thermolysis in butyl propionate solution also generated radicals with structures consistent with those expected of species arising from hydrogen abstraction from solvent. Thermolysis in the presence of methyl methacrylate (MMA) or styrene (S) led to polymerization of both. Size exclusion chromatography (SEC) and gradient polymer elution chromatography (GPEC) were used to investigate the possibility that the newly formed polymer might be attached to PIB. In the case of MMA polymerizations, the final product was a blend of the two homopolymers:  no evidence for block copolymers could be seen by SEC or GPEC. In contrast, both SEC and GPEC indicated that a large fraction of the newly formed polystyrene was attached to PIB, most probably in the form of P(IB-b-S) block copolymer.

Published
2001

50. In vitro investigation of autoantibody-secreting peritoneal cells and their regulation

Author

Cox, K. O., Evans, D. A., Doug Brooks, and Cunliffe, D. A.

Subjects
Male, B-Lymphocytes, Mice, Inbred C3H, Receptors, Antigen, B-Cell, Cell Count, Hemolytic Plaque Technique, Mice, Phagocytosis, Animals, Ascitic Fluid, Female, Antibody-Producing Cells, Cells, Cultured, Research Article, Autoantibodies
Abstract

A high proportion of peritoneal cells from untreated mice, after 4--5 days in culture, develop into plaque-forming cells against bromelain-treated mouse red blood cells. The number of plaque-forming cells was increased significantly by exposing the peritoneal cells to ammonium chloride to lyse red blood cells before culture. Conversely, the increase was significantly inhibited by adding before culture untreated or bromelain-treated sheep or mouse red blood cells. Treated or untreated horse or rat red blood cells did not inhibit the increase. Treating peritoneal cells or subpopulations of peritoneal cells with anti-theta serum and complement before culture caused a significant increase in the number of plaque-forming cells against bromelain-treated red blood cells after 3--4 days of culture. Various procedures were used to fractionate peritoneal cells into B-cell enriched and B-cell depleted subpopulations before culture and after culture, to investigate whether some of the plaque-forming cells could be attributed to phagocytic cells. Generally, changes in the number of plaque-forming cells against bromelain-treated mouse red blood cells paralleled changes in B-cells. In some experiments the proportion of plaque-forming cells observed represented up to 85% of the B-cells present. The results suggest that the high level of autoreactivity is due to antibody production by B-cells and that phagocytic cells are not forming spurious plaques. Further, it appears that the autoimmunity is regulated by T-cells and can also be inhibited by mouse RBC.

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