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Abstract Water clarity on the inshore Great Barrier Reef (GBR) is greatly influenced by terrestrial runoff of suspended particulate matter (SPM). Catchment sediment tracing studies often do not extend into the marine environment, preventing the analysis of preferential marine transport. This study employs novel collection and sediment tracing techniques to examine the transport of the terrigenous ‘mineral’ component of plume SPM within the GBR lagoon for two flood events. Utilising geochemical, radionuclide and clay mineral analysis, we trace terrigenous mineral sediments > 100 km from the river mouth. We show that the SPM geochemistry is highly influenced by particle-size fractionation, desorption, and dilution within the plume, rendering traditional tracing methods unviable. However, the ratios of rare earth elements (REE) to thorium (Th) provide stable tracers of mineral SPM transported across the catchment to marine continuum and allow the identification of discrete catchment sources for each flood event. Plume sediment radionuclides are also stable and consistent with sub-surface erosion sources.

Abstract Background Learning environment (LE) research has been given priority in higher education institutions globally because of its influence on learning processes and outcomes. Although studies reporting the perceptions of health science students about LE in Nigeria are available, none have compared the perceptions of students from different health professions. Therefore, this study aimed to assess final-year clinical students’ perceptions of their LE from four programs (dentistry, medicine, nursing, and physiotherapy) and compared their LE perceptions. Methods This study adopted a cross-sectional study design using a mixed method approach. The quantitative survey involved all the final-year clinical students at the University of Ibadan, and they completed the Dundee Ready Education Environment Measure (DREEM) questionnaire. The qualitative aspect involved 24 consenting students in four focus group discussions. Results A total of 214 out of 223 copies of the DREEM questionnaire were duly completed and returned, yielding 96.0% response rate. The participants’ mean age was 24 ± 2.3 years (ranged between 22 and 25 years, p = 0.001). The mean DREEM scores of the students from the four programs ranged between 119.68 ± 18.02 and 147.65 ± 15.89 out of a maximum of 200, interpreted as more positive than negative perceptions of LE. Physiotherapy students’ DREEM score was significantly higher than those of medical, dental, and nursing students (p 0.05). Dental and medical students had similar positive perceptions. The qualitative aspect revealed that the students had positive perceptions of their teachers’ knowledge base and self-acquisition of knowledge but negative perceptions of their teachers’ communication skills, infrastructural facilities, lecturer-student relationships, and hostel accommodations. Conclusion Although the survey indicated that these clinical students had more positive than negative perceptions of their learning environment, the qualitative aspect of the study revealed many challenges that the students were confronted with. The clinical students’ perception of their learning environment could be improved if the university authorities would address these challenges.

Missed care is any aspect of required care that is omitted (either in part or whole) or delayed. Residential Aged Care Facilities (RACFs) are susceptible to missed care due to a range of factors, including residents’ complex needs, workforce composition, and constraints placed on resource availability. This focused literature review aims to evaluate the current evidence on missed care, including an analysis of the concept, causes, and outcomes of missed care in residential aged care in Australia. Within most of the available literature, missed care is typically considered only within the context of nursing. It is noted that although the nature and identification of missed care were discussed extensively to provide a broad picture of the phenomenon, including possible prevalence and outcomes, they need to explicitly discuss the impact of missed care on residents, families, and other clinical and operational staff. Further research is needed to inform and improve the care of the elders in RACFs, considering this gap in the literature. This review has identified potential areas for enquiry into missed care to inform policy and practice to improve the care of elderly residents in RACFs.

Abstract Cysteine metabolism occurs across cellular compartments to support diverse biological functions and prevent the induction of ferroptosis. Though the disruption of cytosolic cysteine metabolism is implicated in this form of cell death, it is unknown whether the substantial cysteine metabolism resident within the mitochondria is similarly pertinent to ferroptosis. Here, we show that despite the rapid depletion of intracellular cysteine upon loss of extracellular cystine, cysteine-dependent synthesis of Fe-S clusters persists in the mitochondria of lung cancer cells. This promotes a retention of respiratory function and a maintenance of the mitochondrial redox state. Under these limiting conditions, we find that glutathione catabolism by CHAC1 supports the mitochondrial cysteine pool to sustain the function of the Fe-S proteins critical to oxidative metabolism. We find that disrupting Fe-S cluster synthesis under cysteine restriction protects against the induction of ferroptosis, suggesting that the preservation of mitochondrial function is antagonistic to survival under starved conditions. Overall, our findings implicate mitochondrial cysteine metabolism in the induction of ferroptosis and reveal a mechanism of mitochondrial resilience in response to nutrient stress.

Objectives and importance of study: The objective of this systematic review of the literature was to examine the evidence relating to consumer-directed care (CDC) in the aged care environment. CDC entails providing individuals with the option of choice and flexibility in their care, to empower aged care recipients with autonomous decisions over their healthcare choices. Additionally, the researchers found evidence relating to the vulnerability of users of aged care services and the lack of understanding towards a true consumer-oriented approach which was highlighted during the Royal Commission into Aged Care Safety and Quality. Study type and method: The research team used the PRISMA Method to review the available literature systematically. This qualitative review of the literature on consumer choice in the aged and social care sectors assessed sixteen high-quality research papers and identified themes that emerged to promote authentic consumer voice in aged care services. These articles provided insight into what aged care providers require to increase transparency and facilitate effective, meaningful consumer choice. Results: Six themes emerged from the literature reviewed: Informed Choice, See Me Hear Me, Funding My Choices, My Choice My Way, Policy, and Know Me, Include Me. The authors found significant challenges to authentic consumer voice in terms of reliable information, complex, inflexible service provision, and a trusted and skilled carer workforce. Conclusion: Authentic consumer choice requires collaboratively designed care plans with consumers, integrating their care-related preferences and values. Providers who have embraced CDC principles, and innovative practices have enhanced person-centred care, and consumer experience and autonomy. Cultivating inclusive, transparent, and collaborative environments to empower older Australians to shape and control their care provision and wellbeing is a key challenge for providers.

The Evidence and Conclusion Ontology (ECO) is a community resource that provides an ontology of terms used to capture the type of evidence that supports biomedical annotations and assertions. Consistent capture of evidence information with ECO allows tracking of annotation provenance, establishment of quality control measures, and evidence-based data mining. ECO is in use by dozens of data repositories and resources with both specific and general areas of focus. ECO is continually being expanded and enhanced in response to user requests as well as our aim to adhere to community best-practices for ontology development. The ECO support team engages in multiple collaborations with other ontologies and annotating groups. Here we report on recent updates to the ECO ontology itself as well as associated resources that are available through this project. ECO project products are freely available for download from the project website (https://evidenceontology.org/) and GitHub (https://github.com/evidenceontology/evidenceontology). ECO is released into the public domain under a CC0 1.0 Universal license.

Infectious disease outbreaks in aged care services present challenges for consumers and staff. The vulnerability of users of aged care services and a lack of preparedness on the part of aged care services to manage the risk associated with viral disease transmission was particularly evident during the COVID-19 pandemic. We used the PRISMA Method to review the available literature systematically. This qualitative review of the literature on pandemic preparedness assessed eight high-quality research papers and identified themes that emerged to support aged care services in preparing for future pandemics. These articles provided insight into what aged care services require to increase their capacity to respond to communicable disease outbreaks. Four themes emerged from the literature reviewed: Staff Training and Development, Safety Culture, Creating a Safe Environment by planning for contingencies and Risk and Resource Management (including resourcing for Personal Protective Equipment (PPE), Leader Presence and Time Responses and Clear, Consistent Messaging) were the dominant themes in the literature. The researchers found that using guidelines and checklists is helpful but only if they are clear, not complex and do not take too long to read. Risk strategies in future must also focus on the resources required to protect staff, families, and consumers. This paper also provides recommendations that will allow aged care services to respond to future communicable disease outbreaks more effectively. Such measures include the need for a planning methodology that incorporates ready access to PPE, the use of meaningful communication, increased hazard and risk awareness and the need to create a safety culture within the service based on sound values, attitudes and behaviours of leaders and staff.

Background: Children are among the major targets of fast-food producers but parents are the ones who pay for the purchase of such products. Therefore, it is essential to understand how parents perceive children’s reactions to fast food advertisements. Objectives: The general objective of this study was to ascertain the contributing role of parents’ demographics on their perception of children’s reactions to noodles advertisements in Uyo municipality in Akwa Ibom State of Nigeria. Methodology: The survey research design was used for the study while a structured questionnaire was employed to collect data. A sample size of 400 respondents were drawn from the population while purposive sampling technique was adopted for the administration of the research instrument. The data were presented in tables and analysed using Likert Scale. The null hypotheses were tested using independent t-test and one way analysis of variance (ANOVA). Results: Parents perceive that exposure to advertisements on noodles elicits a high level of excitement from the children. It was also found that parents perceive that noodles advertisements influence children’s preference of food items. However, parents’ demographics (gender, marital status and educational qualifications) have no significant influence on their perception of children’s reactions to noodles advertisements. Conclusion: The study concludes that exposure to noodles advertisements has a significant influence on children which leads to their demands for the product. Unique contribution: This study has offered empirical evidence regarding parents’ perception of advertisements that appeal to children.

Abstract Flow resistance through riparian forests due to drag on trees is often expressed in hydraulic models with an increase in a boundary resistance factor such as Manning's n. However, when Manning's n is used as a proxy for vegetation drag, this parameter is dependent on flow conditions and a single, uniform value may be inadequate for simulating a broad range of flood magnitudes. To investigate this issue, flow resistance, and the commensurate Manning's n values through a riparian forest were computed using measured drag forces and estimates of the forest structure and tree morphology. The computed Manning's n values were applied to a 2D hydraulic model (TUFLOW) to simulate an observed flood and a range of design floods. Modelled peak flood levels for the observed flood were 0.16 m lower on average than that recorded at debris marks. There was little difference in modelled flood levels when using the computed Manning's n compared to a traditional, uniform Manning's n. Reassuringly, the traditional method appears adequate when reliable calibration data is available. Otherwise, the method developed here provides a useful alternative in cases where calibration data is limited or for testing reforestation as a nature‐based solution in river or flood management.

The Evidence and Conclusion Ontology (ECO) contains terms (classes) that describe types of evidence and assertion methods. ECO terms are used in the process of biocuration to capture the evidence that supports biological assertions (e.g. gene product X has function Y as supported by evidence Z). Capture of this information allows tracking of annotation provenance, establishment of quality control measures and query of evidence. ECO contains over 1500 terms and is in use by many leading biological resources including the Gene Ontology, UniProt and several model organism databases. ECO is continually being expanded and revised based on the needs of the biocuration community. The ontology is freely available for download from GitHub (https://github.com/evidenceontology/) or the project's website (http://evidenceontology.org/). Users can request new terms or changes to existing terms through the project's GitHub site. ECO is released into the public domain under CC0 1.0 Universal.

The digitalisation of healthcare represents another change challenge for clinicians, and the most prominent of these is the Electronic Health Record (EHR). Adopting the EHR, including the training of clinicians of all disciplines, often does not occur effectively, which increases the risk of adverse events and the reduction in the quality and safety of clinical care. The competent use of the EHR requires clinician user training. One form of training is scenario-based. The questions asked of the literature in this SLR are what evidence exists as to the effectiveness of using scenarios to train clinicians in using the EHR, and is there a research gap in this evidence to inform future research? To undertake this systematic review of the literature, the researchers implemented the PRISMA Method. Only highly ranked, health-related academic databases accessed through an electronic library catalogue were used to search for relevant peer-reviewed/refereed articles. The decision to apply the PRISMA method was based on the PRISMA statement, which safeguards comprehensive reporting and transparency to ensure inferred recommendations and interventions are based on the best available evidence. 6,898 records were returned from Boolean searches for articles published between November 2018 to November 2021. Five articles were included for greater analysis following exclusions by title review, abstract review, and quality assessment. Quality assessment of articles reporting empirical studies relating to the effectiveness of using scenarios in this type of training was performed using the standard quality assessment scoresheet by Kmet [48]. Three themes emerged from the literature. The centrality of workflow, Clinician engagement are key, and scenario-based training is one of many training strategies implemented. The authors found that further rigorous research studies are required to enhance the evidence body for the continued usage of scenario-based training of clinicians to effectively use the EHR, particularly as the digital landscape within health continues to evolve. Moreover, the authors posit that further research on scenario-based EHR training of clinicians should include: • Scenario-based training is just one part of a broader and blended EHR training suite. • Ensuring future studies encompass a diversity of all fields of clinical roles within the research and, • Include standardised terminology naming for clinicians' scenario-based EHR training within the studies.

Objective: This qualitative review aims to identify and list the barriers and facilitators to accessing medical services for rural and remote Australians, within the current literature to inform policy development and highlight the need for further research. Methods: The review was guided by the PRISMA method. Boolean search strings identified relevant articles using the Griffith University Library electronic catalogue. The study included only English language research articles published between August 31st, 2018 and August 31st, 2021, focusing on facilitators and barriers within the Australian context considering both access and rurality/remoteness. Results: Thematic analysis of six articles identified ten barriers: communication, confidentiality, fear and shame, funding, geography, health behaviours, reliance on others, service provision, staffing, transport; and eight facilitators: collaboration/partnerships, communication, cultural safety funding, service provision, staffing, and telehealth, to accessing medical services in rural and remote Australia. Conclusion: Ten barriers and eight facilitators to accessing medical services in rural and remote Australia were identified and listed from six articles identified through a qualitative review. This review identified a research gap regarding understanding the underlying challenges behind these barriers and facilitators and the implications for policy implementation to improve access to medical services.

On March 13, 2020, following the directives given on March 12 by the State Superintendent of Education in Maryland (Dr. Karen Salmon), all public schools across the state were to be closed for 2 weeks beginning March 16 following the World Health Organization declaring COVID-19 a pandemic. It was hard to believe that a new pandemic would be any worse than SARS (Severe Acute Respiratory Syndrome), which emerged in 2002 and spread worldwide within a few months. SARS and COVID-19 are both coronaviruses. The SARS pandemic to Americans did not seem that bad. With that attitude, it was thought that perhaps COVID-19 would mean a couple of weeks off and everything would return to normal. It did not. On March 12, there were 12 confirmed cases in Maryland. By August 13, there were 100,212 confirmed cases and 3,502 deaths. Maryland districts, like many across the country, had to quickly put together a whole new way to deliver education and psychological services. Maryland has six of the top 75 large school districts in the country: Prince Georges County, Anne Arundel County, Baltimore County, Baltimore City, Howard County, and Montgomery County (one of the largest in the United States). Each county has school psychology directors, supervisors, and/or coordinators who oversee the work of school psychologists within the district. Maryland is fortunate to have a strong state organization and many leaders in National Association of School Psychologists (NASP) past and present. Many leaders in NASP have assumed leadership roles in districts across the state and currently active members include Christina Conolly, Cynthia Schulmeyer, and Rivka Olley. There are 24 school districts in the state of Maryland. This article will present some of the issues dealt with through the eyes of some of the supervisors of Maryland's urban, suburban, and more rural districts. It is also aimed at talking about the unique support that all the district school psychologist leaders provide to one another via regular emails and periodic videoconference meetings.

Study Design: This paper is an output from a mixed methods study of aged care employees in which the quantitative results examining the effects of leadership style on organisational identification (OID) and job satisfaction (JS) of aged care employees populated the agenda for semi-structured interviews and the transcripts subjected to interpretative phenomenological analysis (IPA). Purpose: The purpose of this paper is to identify the influencing functions and relate them to associated influencing behaviours of authentic leaders to assist in reducing the intention-experience disparity (IED) found in the thematic analysis of the transcripts of semi-structured interviews of the study participants. Findings and Research Outcomes: Job burnout and organisational disengagement were prevalent in participants. The researcher identified that while aged care leaders worked assiduously to engage their staff, an Intention-Experience Disparity (IED) was operating. Leaders' influencing functions and behaviours are documented from the evidence-based literature and a conceptual model based on authentic leadership principles developed. Research Limitations/Implications: The research deployed quantitative measurements to determine the differences in responses to an on online questionnaire that deployed the Multifactor Leadership Questionnaire™ (MLQ5X[Short]), the Identification with a Psychological Group Scale (IDPG) and the Measure of Job Satisfaction (MJS) and differences between responses from leaders and their raters between measured. These differences were used to explore participants' lived experiences and how they made sense of their personal and social worlds at work. In the quantitative study, there may be an overstatement of the strength of the relationship between variables among those motivated to participate in the study. The qualitative study required the researcher to describe the research context thoroughly. Those who wish to transfer the results of this study to a different context than aged care must judge the transferability of findings.

Telehealth has been used to care for patients at a distance in specific clinical and demographic situations, but the demand for physical isolation during the COVID-19 pandemic has expanded its application to the broader community. This systematic literature review, of very recent publications, elucidates the new ways telehealth has been implemented, confirms it’s acceptability, accessibility and safety by collating reviews, trial and cohort studies from peer reviewed journals meeting defined risk of bias criteria. Five literature reviews, three qualitative studies and 22 quantitative studies were included, which confirmed that telehealth is a safe medium for delivery of surgical health care, is accessible and efficient for the majority of patients and clinicians across the age and socioeconomic spectrum. It is time and resource efficient for providers and recipients and improves the delivery of patient-centred care. Many providers have published innovative solutions to the difficulties of telehealth, such as conducting a physical examination or technological limitations at the remote site. Health care can now be delivered directly to the home or the workplace. Routine in-person postoperative review of patients should be replaced by patient-led telehealth unless there is a specific reason for face-to-face review. Assessment and management of new cases could be managed more efficiently if a carefully planned digital referral process is developed and adopted.

The administrative position is management and includes delegation of resources within a budget, logistics, recruiting, orienting, and monitoring the work of the supervisee(s) who are providing services to the school administration, school staff, students, and the community at large. Administrative supervision also involves staff evaluation and professional development. It is an active process concerned with ensuring consumer satisfaction of stakeholders (educational staff, including building administrators, teachers, and parents) and ensuring positive student outcomes. Most often, it includes systems change, whether in implementing current district initiatives or those stemming from the profession of school psychology and a body of evidence-based changes needed to enhance student learning. In this article, the author reflects on opportunities, challenges, and the role of support as an administrator of school psychological services.

There have been fundamental shifts in the shipment of waste around the world over the last two decades. This article describes these, their causes, and the recent acceleration in the shift in illegal shipments to countries least able to deal with them. It also discusses enforcement gaps and how they might be addressed.

This paper reports on one finding of a qualitative study using interpretive phenomenological analysis (IPA) in a mixed-methods study examining the relationship between leadership style and job satisfaction in Australian aged care employees. The qualitative data suggest that aged care employees are experiencing moral distress relating to the regulatory environment that governs the aged care sector and the compliance processes adopted by regulators and accreditors. One of the reasons for the design and operationalisation of the regulatory environment is to protect vulnerable consumers, the public and the workforce. However, the findings of this research are that it is this environment that also causes damage to the aged care workforce. The question is whether compliance requirements and the regulatory scheme are a shield or sword. The causes of the moral distress were different for leaders and raters. This paper reports on this finding. Moral distress is one of three undesirable outcomes identified in the study and labelled as Workplace Maladies. Moral distress due to regulatory systems and processes experienced by leaders appears to be caused by different factors than the moral distress experienced by raters. Leaders experienced moral distress because of the system and methods of regulatory and standards compliance. In contrast, their followership experienced other regulatory processes such as the scope of practice for health professionals and the requirement to supervise and accept responsibility for unregulated workers who do not have a scope of practice. Unregulated workers reported that the absence of scope of practice is a cause of moral distress. Recommendations are made for changes to the system and processes of compliance assessment and action and for developing a scope of practice for unregulated workers to reduce the moral distress experienced by aged care employees and thus reduce workforce turnover in an already scarce workforce.

Cornelia de Lange syndrome is a developmental disorder typically caused by mutations in the gene encoding the cohesin loader NIPBL. The authors, here, by analysing previously identified mutations in BRD4 associated with the disease, reveal that a BRD4 mutation affects DNA damage signalling, and perturbs regulation of DNA repair in mutant cells.

Background and Objective: Asymptomatic bacteriuria is bacteria in the properly collected urine of a patient, leading to a urinary tract infection with no symptoms. Asymptomatic bacteriuria is a common complication in clinical practice with an increasing prevalence due to increase of age. The present study investigated the prevalence of asymptomatic bacteriuria among pregnant women receiving antenatal care in Ovia North East Local Government Area, Edo State, Nigeria. Materials and Methods: A total of 201 urine samples were collected randomly from pregnant women at Igbinedion University Teaching Hospital, Okha Maternity and Usen General Hospital in in Ovia North East Local Government Area. The bacteria isolation was carried out using the pour plate technique. The bacteria identification was conducted by gram staining and biochemical tests and the antibiotic susceptibility pattern of the bacterial isolates was determined by Kirby-Bauer disc diffusion technique. Results: Eighty-one of the subjects had significant bacteriuria, with a prevalence of 40.3 %. The bacteria isolated in the samples were Streptococcus, Proteus, Klebsiella and Micrococcus species as well as Staphylococcus epidermidis, Escherichia coli and Staphylococcus aureus. Streptococcus spp. occurred more frequently (42.0 %) while S. aureus had the lowest frequency of occurrence (2.5 %) in the samples. The infection was most prevalent among women aged between 28 and 37 years (74.5 %). Pregnant women in their third trimester in this study had the highest prevalence of asymptomatic bacteriuria (55.2 %). Ciprofloxacin was found to be the most effective antibiotic against the urinary isolates. Conclusion: Pregnancy promotes the progression from symptomatic to asymptomatic bacteriuria with its consequences such as pyelonephritis and increased fetal mortality. Therefore, routine culture test should be carried out for all antenatal women to detect asymptomatic bacteriuria and all positive cases should be treated with appropriate antibiotic therapy to prevent any obstetric complications which are associated with pregnancy.

Tooth wear has profound consequences for a patient's oral health and quality of life. Education on preventive advice has been suggested as a method of reducing the burden of tooth wear in the population. This review provides an update on preventive advice regarding the mitigation of tooth wear, and presents evidence-based clinical recommendations that dental professionals can use chairside. CPD/Clinical Relevance: Preventive advice for tooth wear patients may help prevent tooth wear and its progression. [ABSTRACT FROM AUTHOR]

Dental centers have been referred to as a hub or reservoir for infection, where healthcare professionals and other staff, patients and the public together may potentially spread pathogenic microorganisms. This may occur via saliva, skin or indirectly through air, water, and contaminated surfaces or instruments. Everyone should therefore be considered as potential sources of infection. During a pandemic, limiting unnecessary care has been adopted as a clinical measure for some patient’s, to reduce the risk of cross-infection in the short term. However, in order to enable continuation of necessary and qualified care, dental processes need to follow specific infection control strategies in order to prevent transmission of emerging pandemic risks following COVID-19. In this article, we develop a tool with practical recommendations to mitigate infection risks before, during and following pandemics to enable ongoing dental care provision in primary and secondary care based on national and global recommendations.

The causes of the Upper Pleistocene megafauna extinction in Australia and New Guinea are debated, but fossil data are lacking for much of this region. Here, Hocknull and colleagues report a new, diverse megafauna assemblage from north-eastern Australia that persisted until ~40,000 years ago.

Objective: The purpose of this systematic literature review is to appraise contemporary research literature examining the effects of mentoring on graduate registered nurses’ transition to practice objectively and systematically. These areas, specifically examined, are competence, job satisfaction, and retention. Three themes emerged from the research in this area. The themes are informal mentoring effectiveness, the extent of mentoring, and mentoring efficacy. Methods: The PRISMA method was implemented. Articles reviewed were written in English and published between December 2015 and December 2020 and obtained from the Griffith University Library electronic catalogue. A quality assessment of each record not excluded in the title and abstract analysis was undertaken using the method described by Kmet.[1] Those with a quality rating of 16 as a minimum are included in this systematic literature review. Results: Three quantitative, two qualitative and two - method research studies emerged after applying inclusion criteria, selection, and quality assessment. The analysis demonstrated the positive effects of mentoring on all three avenues with one mixed-method study that documented a downward trend in job satisfaction at six months. Conclusions: Mentoring is an effective transition to practice strategy for novice nurses. It affects competence, job satisfaction and retention positively. Retention and resignation rates worsen following 12 months of employment. Robust and rigorous studies are essential to justify long-term mentoring programs’ cost-effectiveness.

This Narrative Theoretical Literature Review relates to the evolution and translation of two contemporary leadership theories and anchors these to a leadership theory framework that demonstrates where they fit within the leadership theory body of knowledge. This literature review was an integral part of the preparation for a mixed-methods study related to leadership in the aged care sector which has successfully concluded and one of the major findings of that yet unpublished study is that the followership is positively influenced in their work performance with a reduced turnover intention if they considered that their leader was authentic and ethical. Authentic and ethical leadership appear to be escalating in importance and translatability to the health and social care environments struggling with unmet workforce demands and high consumer expectations. The review contains a description and timeline of the development of each of the theories included. This literature review is useful for investigating either or both leadership theories or their application to health and social care or designing leadership training programs or leader performance assessment tools.

The increasing emergence of multidrug-resistant infection causing microorganisms has become a significant burden globally. Despite the efforts of pharmaceuticals in producing relatively new antimicrobial drugs, they have resulted in a high rate of mortality, disability and diseases across the world especially in developing countries. Supporting this claim was the report of the Centre for Disease Control and Prevention (CDC) who estimated that over 2 million illnesses and 23,000 deaths per year are attributable to antibiotic resistant pathogens in the United States. They include Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-intermediate Staphylococcus aureus (VISA), Vancomycin-resistant Staphylococcus aureus (VRSA), Vancomycin-resistant enterococci (VRE), Extended spectrum beta-lactamases (ESBLs) producing gram-negative bacilli, Multidrug-resistant Streptococcus pneumoniae (MDRSP), Carbapenem-resistant Enterobacteriaceae (CRE) and Multidrug-resistant Acinetobacter baumannii. For MRSA, resistance is as a result of Methicillin-sensitive S. aureus (MSSA) strains that have acquired Staphylococcal Cassette Chromosome mec (SCCmec) which carries mecA gene. The gene encodes the penicillin-binding protein (PBP2a) which confers resistance to all β-lactam antibiotics. Vancomycin was previously the widely preferred drug for the treatment of MRSA infections. It is no longer the case with the emergence of S. aureus strains with reduced vancomycin sensitivity limiting the conventional treatment options for MRSA infections to very scanty expensive drugs. Presently, many researchers have reported the antibacterial activity of many plant extracts on MRSA. Hence, these medicinal plants might be promising candidates for treatment of MRSA infections. This work is a brief review on Methicillin-resistant Staphylococcus aureus (MRSA) and the anti-MRSA activities of extracts of selected medicinal plants.

Objective: An effective method for preventing the Human Immunodeficiency Virus (HIV) is condom use. Yet, research shows limited effects of education on increasing condom use. This research examined the effects of psychological inoculation (PI) versus education on condom use -barriers and –tendencies, using a fully automatized online system. Design: Two randomized controlled trials. In Study 1, 59 Sub-Saharan students were included while Study 2 20 European students were included. In both studies, participants were randomly assigned to PI or control conditions. In Study 2, we additionally matched pairs on gender and condom barriers. In the PI, participants received challenging sentences they had to refute. Main outcome measures: An indirect condom use test (I-CUTE) and a condom use barriers questionnaire, assessed at baseline and a month later. Results: In Study 1, a significant increase in I-CUTE scores and no change in barriers was found in the PI condition. Controls did not change on either outcome. In Study 2, two sub-scales of condom barriers (concerning partner and satisfaction) were significantly decreased in the PI group, while in controls, barriers significantly increased over time. In both groups, I-CUTE scores tended to increase. Conclusions: These results replicate previous studies and extend them to a fully automatized system without counselors.

Background: An outbreak of Extensively Drug Resistant (XDR) Salmonella Typhi (S. Typhi) has recently emerged from Pakistan. The strain is resistant to most first-line antibiotics, including cephalosporins, and has become a significant public health threat due to limited treatment options. We report one such case of S. Typhi in a 48-year-old female presenting to our West London ambulatory emergency care department. Case Report: The patient, who had recently travelled to Pakistan, presented with symptoms of a dry cough, fever, maculopapular rash, and dysuria. Blood cultures initially isolated Salmonella spp, serotype Typhi and empirical ceftriaxone was commenced. Antibiotic sensitivity testing (AST) identified Salmonella spp. ESBL (Extended Spectrum Beta Lactamase-producing) subspecies I (ST1 EBG:13), with cephalosporin and fluoroquinolone resistance (ciprofloxacin MIC 2 mg/L), hence labelling it XDR. It retained susceptibility to meropenem and azithromycin (azithromycin MIC 12 mg/L). An ESBL Escherichia coli was concurrently grown in urine cultures. Once antibiotic sensitivities were available, the patient was converted from ceftriaxone to a course of azithromycin orally and ertapenem intravenously. The patient defervesced promptly, demonstrated blood and urine clearance on follow up and was successful treated. Conclusions: This case report highlights the limitations of ceftriaxone in our empirical management of suspected typhoid fever, especially in those returning from high-risk regions. Increased prevalence of these resistant salmonella will lead to failures of the current treatment practices and continuous surveillance and improving infection control measures are required to mitigate the spread of these XDR S. Typhi. Azithromycin and carbapenems retain in vitro activity and play an important role in treatment of XDR S. Typhi; loss of the organism’s sensitivity to these agents presents a serious public health threat. Further studies are warranted to confirm in vivo efficacy of ertapenem particularly when used as monotherapy.

Introduction There are few robust and directly comparable studies of the epidemiology of psychotic disorders in the Global South. INTREPID II is designed to investigate variations in untreated psychotic disorders in the Global South in (1) incidence and presentation (2) 2-year course and outcome, (3) help-seeking and impact, and (4) physical health.Methods INTREPID II is a programme of research incorporating incidence, case–control and cohort studies of psychoses in contiguous urban and rural areas in India, Nigeria and Trinidad. In each country, the target samples are 240 untreated cases with a psychotic disorder, 240 age-matched, sex-matched and neighbourhood-matched controls, and 240 relatives or caregivers. Participants will be followed, in the first instance, for 2 years. In each setting, we have developed and are employing comprehensive case-finding methods to ensure cohorts are representative of the target populations. Using methods developed during pilot work, extensive data are being collected at baseline and 2-year follow-up across several domains: clinical, social, help-seeking and impact, and biological.Ethics and dissemination Informed consent is sought, and participants are free to withdraw from the study at any time. Participants are referred to mental health services if not already in contact with these and emergency treatment arranged where necessary. All data collected are confidential, except when a participant presents a serious risk to either themselves or others. This programme has been approved by ethical review boards at all participating centres. Findings will be disseminated through international conferences, publications in international journals, and through local events for key stakeholders.

Syphilis is a blood borne and sexually transmitted disease of global distribution. This study was aimed at determining the trend and prevalence of syphilis across the years among patients attending the Igbinedion University Teaching Hospital, Okada, Nigeria. A retrospective analysis of data of patients attending the Out patients department as well as those attending the anti natal clinic of Igbinedion University Teaching Hospital, Okada, Nigeria from January 2015 to December 2019.Sera samples were screened for Treponema palladium antibody using commercially available immunochromatic rapid Syphilis based test kits. Out of the 741 screened sera in the 2015 – 2019 study period, 8 (1.1%) were positive for Treponema pallidium antibodies. The prevalence are 0.4%, 1.3%, 0%, 3.8% and 2.8% respectively for the year 2015, 2016, 2017, 2018 and 2019 respectively. The gender related distribution for the study periods are not statistically significant with p- values all greater than 0.05. The prevalence of syphilis is low within this community which is an indication of adherence to preventive measures never the less public awareness remains a medium for eradication of syphilis. Keywords: Rapid Syphilis test kit, Immunochramatogenic, Treponema pallidium

Objectives: To validate novel non-contacting Confocal-Laser-Scanning-Microscopy (CLSM) methodology with conventional Contacting Profilometry (CP) measures investigating brushing or dab-on of stannous-fluoride dentifrice on early aggressive dentine erosion. Methods: 75 polished human dentine samples were prepared and eroded in agitated 6% citric acid then randomly allocated into 5 intervention groups; artificial saliva control (1); controlled use of a pressure sensitive counter-rotating oscillatory powered toothbrush with sodium-fluoride NaF (2) or stannous-fluoride SnF2 (3), and dab-on application of NaF (4) or SnF2 (5). Samples underwent three cycles of intervention and 2-min agitated 6 % citric acid challenges. CLSM images were taken and 3D reconstructions produced of step height using a developed software algorithm. In addition, 20 % samples were randomised and profiled using CP to measure step height and surface roughness. Vickers's diamond micro-hardness testing was carried out on all samples. Results: Comparing CLSM and CP; Pearson correlation was 0.77 and Intra-class correlation 0.81 (p = 0.01). There were no significant statistical differences in step height between groups using both CLSM and CP. From baseline, SnF2 brushing (3) increased micro-hardness more than control (1) (p = 0.03), NaF (4) and SnF2 dab-on (5) (p ≤ 0.001), and increased surface roughness more than control (p = 0.02), NaF brushing (2) and NaF dab-on (4) (p ≤ 0.017). Dab-on of SnF2 (5) produced rougher surfaces than control (1) (p = 0.014) and reduced hardness compared with NaF brushing (p = 0.04). Conclusions: Good agreement and correlation exists between CLSM and CP measures in dentine. There were no significant differences in surface loss after interventions between groups. Compared with control, SnF2 application increased dentine surface roughness and SnF2 controlled powered brushing application increased dentine hardness, likely caused by exposure of uneroded dentine. Clinical significance: Isosurfaces produced using CLSM can be used to represent dentine step height loss. They show good correlation and agreement with conventional CP measures, following early aggressive erosion-abrasion cycles of dentine. The CLSM and computer algorithm therefore provides an accurate, standalone and non-contacting three-dimensional measurement of early dentine wear. Stannous-fluoride brushing, and dab-on application offer no benefits following early aggressive erosion in dentine. To reduce dentine wear, limiting erosive challenges and avoiding brushing post-erosion is advised.

ABSTRACT To better understand the transcriptomic interplay of organisms associated with lymphatic filariasis, we conducted multispecies transcriptome sequencing (RNA-Seq) on the filarial nematode Brugia malayi, its Wolbachia endosymbiont wBm, and its laboratory vector Aedes aegypti across the entire B. malayi life cycle. In wBm, transcription of the noncoding 6S RNA suggests that it may be a regulator of bacterial cell growth, as its transcript levels correlate with bacterial replication rates. For A. aegypti, the transcriptional response reflects the stress that B. malayi infection exerts on the mosquito with indicators of increased energy demand. In B. malayi, expression modules associated with adult female samples consistently contained an overrepresentation of genes involved in chromatin remodeling, such as the bromodomain-containing proteins. All bromodomain-containing proteins encoded by B. malayi were observed to be upregulated in the adult female, embryo, and microfilaria life stages, including 2 members of the bromodomain and extraterminal (BET) protein family. The BET inhibitor JQ1(+), originally developed as a cancer therapeutic, caused lethality of adult worms in vitro, suggesting that it may be a potential therapeutic that can be repurposed for treating lymphatic filariasis. IMPORTANCE The current treatment regimen for lymphatic filariasis is mostly microfilaricidal. In an effort to identify new drug candidates for lymphatic filariasis, we conducted a three-way transcriptomics/systems biology study of one of the causative agents of lymphatic filariasis, Brugia malayi, its Wolbachia endosymbiont wBm, and its vector host Aedes aegypti at 16 distinct B. malayi life stages. B. malayi upregulates the expression of bromodomain-containing proteins in the adult female, embryo, and microfilaria stages. In vitro, we find that the existing cancer therapeutic JQ1(+), which is a bromodomain and extraterminal protein inhibitor, has adulticidal activity in B. malayi.