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Background: Human rhinovirus (HRV) species C (HRV-C) have been associated with frequent and severe acute lower respiratory infections and asthma in hospitalized children. The prevalence of HRV-C among healthy children and whether this varies with ethnicity is unknown. Objective: To describe the prevalence of HRV species and their associations with demographic, environmental and socioeconomic factors in healthy Aboriginal and non-Aboriginal children. Methods: Respiratory viruses and bacteria were identified in 1006 nasopharyngeal aspirates collected from a cohort of 79 Aboriginal and 88 non-Aboriginal Western Australian children before 2 years of age. HRV-positive nasopharyngeal aspirates were typed for HRV species and genotypes. Longitudinal growth models incorporating generalized estimating equations were used to investigate associations between HRV species and potential risk factors. Results: Of the 159 typed specimens, we identified 83 (52.2%) human rhinovirus species A (HRV-A), 26 (16.4%), human rhinovirus species B and 50 (31.4%) HRV-C. HRV-C was associated with upper respiratory symptoms in Aboriginal (odds ratio, 3.77; 95% confidence interval:1.05-13.55) and non-Aboriginal children (odds ratio, 5.85; 95% confidence interval: 2.33-14.66). HRV-A and HRV-C were associated with carriage of respiratory bacteria. In Aboriginal children, HRV-A was more common in the summer and in those whose mothers were employed prior to delivery. In non-Aboriginal children, day-care attendance and exclusive breast-feeding at age 6-8 weeks were associated with detection of HRV-A, and gestational smoking with detection of HRV-C. Conclusions: Factors associated with the presence of HRV differ between Aboriginal and non-Aboriginal children. In contrast to HRV-A, HRV-C is associated with upper respiratory symptoms suggesting that HRV-C is likely to be implicated in respiratory illness. © 2012 by Lippincott Williams ? Wilkins.

MassTag PCR is a novel technology for the rapid, sensitive and simultaneous detection of multiple gene sequences. This technique utilises a library of molecular tags, each unique in its molecular weight. MassTags are conjugated to oligonucleotide primers using a UV-cleavable linker that enables separation of primer and tag. Different primers are labelled each with a different molecular weight tag and are used to amplify target nucleic acids in a multiplex RT-PCR. After removing unincorporated primers, tags are released by UV irradiation and analysed using a single quadrupole liquid chromatography mass spectrometer (LC/MS). Thus, amplification of the gene target produces a unique dual signal in LC/MS analysis that allows its identification. Neurological disease represents a diagnostic challenge, with over 100 microbial agents associated with infection of the central nervous system (CNS). We have developed a panel of multiplex MassTag PCR assays to specifically detect >30 microbial agents that cause CNS infections, relevant to an Australasian diagnostic setting. Three assays were developed using optimised PCR chemistry and thermocycling conditions to detect: (i) common microbial causes of disease (11-plex); (ii) arthropod-borne and zoonotic infections (14-plex); and (iii) rare or uncommon causes (11-plex). The performance of these assays was evaluated in a clinical diagnostic laboratory using CSF specimens and sensitivity estimates for each target were established using synthetic nucleic acids. Our findings indicate that MassTag PCR offers an inexpensive and sensitive diagnostic platform suitable for high-throughput testing.

Background: Associations between respiratory viruses and the bacterial pathogens Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis may be important in the pathogenesis of otitis media (OM). However, data on asymptomatic identification rates of respiratory viruses are limited, particularly in Indigenous populations, who suffer a high burden of OM. Methods: We describe the identification of respiratory viruses alone and in combination with pathogenic OM bacteria in 1006 nasopharyngeal aspirates collected from asymptomatic Aboriginal and non-Aboriginal children in a longitudinal community-based cohort study in rural Western Australia. Results: Viruses were identified in 42% of samples from Aboriginal and 32% from non-Aboriginal children. Rhinoviruses were the most frequently identified virus with higher identification rates in Aboriginal (23.6%) than non-Aboriginal children (16.5%; P = 0.003). Rhinoviruses were associated with H. influenzae (odds ratio [OR], 2.24; 95% CI, 1.24-4.07 for Aboriginal children) and M. catarrhalis (OR, 1.94; 95% CI, 1.05-3.57 for Aboriginal children). Adenoviruses were positively associated with H. influenzae in Aboriginal children (OR, 3.30; 95% CI, 1.19-9.09) and M. catarrhalis in non-Aboriginal children (OR, 5.75; 95% CI, 1.74-19.23), but negatively associated with S. pneumoniae in Aboriginal children (OR, 0.39; 95% CI, 0.18-0.84). Conclusions: We found a high identification rate of rhinoviruses and adenoviruses in asymptomatic children. The associations between these viruses and OM bacteria have implications for preventive strategies targeted at specific pathogens.

Background: Otitis media (OM) is the most common paediatric illness for which antibiotics are prescribed. In Australian Aboriginal children OM is frequently asymptomatic and starts at a younger age, is more common and more likely to result in hearing loss than in non-Aboriginal children. Absent transient evoked otoacoustic emissions (TEOAEs) may predict subsequent risk of OM. Methods: 100 Aboriginal and 180 non-Aboriginal children in a semi-arid zone of Western Australia were followed regularly from birth to age 2 years. Tympanometry was conducted at routine field follow-up from age 3 months. Routine clinical examination by an ENT specialist was to be done 3 times and hearing assessment by an audiologist twice. TEOAEs were measured at ages <1 and 1-2 months. Cox proportional hazards model was used to investigate the association between absent TEOAEs and subsequent risk of OM. Results: At routine ENT specialist clinics, OM was detected in 55% of 184 examinations in Aboriginal children and 26% of 392 examinations in non-Aboriginal children; peak prevalence was 72% at age 5-9 months in Aboriginal children and 40% at 10-14 months in non-Aboriginal children. Moderate-severe hearing loss was present in 32% of 47 Aboriginal children and 7% of 120 non-Aboriginal children aged 12 months or more. TEOAE responses were present in 90% (46/51) of Aboriginal children and 99% (120/121) of non-Aboriginal children aged <1 month and in 62% (21/ 34) and 93% (108/116), respectively, in Aboriginal and non-Aboriginal children at age 1-2 months. Aboriginal children who failed TEOAE at age 1-2 months were 2.6 times more likely to develop OM subsequently than those who passed. Overall prevalence of type B tympanograms at field follow-up was 50% (n = 78) in Aboriginal children and 20% (n = 95) in non-Aboriginal children. Conclusion: The burden of middle ear disease is high in all children, but particularly in Aboriginal children, one-third of whom suffer from moderate-severe hearing loss. In

Melioidosis is a fatal bacterial infection found in many parts of the tropical belt, particularly in Southeast Asia and northern Australia. Sporadic cases of the disease have been reported previously in Central and South America. In 2003 septicemic melioidosis was diagnosed for the first time in northeastern Brazil by culture of the causal agent, Burkholderia pseudomallei from a 10-year-old boy. That case is believed to be the first culture-confirmed case of melioidosis in Brazil and was part of a small cluster of cases (hereafter termed Brazil outbreak 1). At first, evidence that >1 case of melioidosis had occurred was circumstantial. The diagnosis relied entirely on the phenotypic features of a blood culture isolate from the 10-year-old boy. A more detailed, multidisciplinary investigation obtained further evidence for the case cluster and clarified its likely relationship to infection in the surrounding population.

Aim Strengthening the future of the nursing workforce through nurturing leadership development in novice and newly qualified nurses through educational programmes is viewed as crucial internationally. Enabling and developing leadership skills is challenging, and nursing students require clinical and academic support throughout their degree programmes. This study aimed to measure undergraduate nursing students’ self-perceptions of clinical leadership behaviours between two countries. Methods: A cross-sectional observational study was completed with two cohorts of undergraduate nursing students in England and Israel following ethical approval. The Spanish version of Self-Assessment Leadership 40 item Instrument (SALI) ES-SALI measuring four leadership dimensions was used following translation into English and Hebrew. A web-based anonymous survey using Qualtrics online software was distributed from October 2021 to April 2022. Results: The overall response rate was 22.5% (n=138) [27% (Israel); 18% (England)]—Cronbach’s Alpha= 0.94 overall and >0.7 in each dimension. Demographic differences noted older aged students: (>32 years) in England 50.1% V Israel 6.6% p <0.001; and previous work experience: England 84.8% V Israel 44.3% p<0.001. Significant differences were identified in two leadership dimensions, with English students reporting higher scores: “Emotional Intelligence” England M= 3.22 (SD 0.54) V Israel M= 3.02 (SD 0.54) and “Impact and Influence” England M= 3.13 (SD 0.58) V Israeli M= 2.97 (SD 0.53). Year of study was consistent with higher leadership scores for both cohorts in the middle year of study. Conclusions: Previous evidence establishes the importance of emotional intelligence in leadership development and providing quality care. This study demonstrates differences in perceptions of leadership among nursing students in two countries with implications for the profession and workforce development. Nurse educators should consider enhanced leadership skill de

Background: Effective leadership has been associated with high-quality and compassionate care provision in health and social care contexts. This has led to a common acceptance that the teaching of leadership in nursing education is essential if students are to develop competencies in this area. To date, there is limited research on nursing students’ perception of clinical leadership behaviours worldwide. Objectives: To explore a) pre-registration students’ self-perceptions of clinical leadership behaviours and b) differences in students’ self-perceptions of leadership behaviours between countries (UK and Israel). Design and Methods: A cross-sectional survey design was used among two convenience samples of UK and Israeli pre-registration nursing students. Closed questionnaires were uploaded in the format of a commercial internet survey provider (Qualtrics.com) and distributed through the virtual learning platforms in both universities. Results: Overall 138 students completed the questionnaires. Significant differences were found between the two sites in the leadership dimensions “Emotional Intelligence” and “Impact and Influence” (p<.05), with UK students scoring higher than Israeli students. Among the Israeli sample, significant differences were found in leadership dimensions according to years of study, with the presence of higher scores in the 3rd year and 4th year students when compared with the 1st and 2nd Year students in the referred dimensions (p<.05). Conclusions: Differences in students’ clinical leadership perception exist between the two cohorts examined and between study years within the Israeli sample. Nurse educators should continue and expand the international research on this subject, in order to identify possible antecedents in the development of clinical leadership behaviours. At the same time, there is a need to continue efforts in enhancing the development of clinical leadership behaviours during all study years, through curricula updating in ord

Background: Effective leadership is associated with high-quality and compassionate care. Teaching leadership in nursing education is essential if students are to develop competencies in this area (Brown et al., 2016, Jack et al., 2022). Objectives: To explore undergraduate students’ self-perceptions of clinical leadership behaviours and differences in self-perceptions of leadership behaviours between countries. Design and Methods: A cross-sectional anonymous online survey design was used with two cohorts of undergraduate nursing students in UK and Israel following ethical approval. The Self-Assessment Leadership Instrument (SALI) (Es-SALI, Linares et al. 2020) measuring four leadership dimensions was used in English and Hebrew. A web-based survey using Qualtrics online software was emailed to students during October 2021-April 2022. Ethics: Ethical approval was granted by both sites, England and Israel. Results: The response rate was 27% (Israel) and 18% (England) with 138 responses overall. Significant differences were found between the two cohorts in the leadership dimensions: “Emotional Intelligence” England M= 3.22 (SD 0.54) V Israeli M= 3.02 (SD 0.54) and “Impact and Influence” England M= 3.13 (SD 0.58) V Israeli M= 2.97 (SD 0.53) (p<.05), with UK students scoring higher across both dimensions. In the Israeli cohort only, significant differences were found in leadership dimensions according to year of study, reporting higher scores in 3rd and 4th year students when compared with 1st and 2nd years in each of the four dimensions (p<.05). Conclusions: This study confirms differences in students’ clinical leadership perception between two international cohorts of nursing students, with statistical differences between study years noted within the Israeli cohort only. The need for enhanced leadership skills to prepare future nurses to provide quality, safe and person-centred care is strengthened. More evidence is needed to understand antecedents in the development of