Grant Review Process – Feeding the Reviewer

When writing a project proposal, one should always keep in mind the specific review process and more specifically the reviewers’ experience in the process. It is always good practice to structure the text in a logical manner. This helps to convey the messages clearly, concisely, and to maintain the text flow. Generally, this helps to facilitate a pleasant reading experience. After all, what stands between you and being awarded with the grant you are after is the review process. Make sure you present the reviewers with exactly what they are looking for

The quality of maternal and infant health services and their utilisation by remote dwelling aboriginal families in the top end of Australia

Aim The objective of this thesis was to investigate the quality of maternal and infant health services and their utilisation at the primary and referral level, by remote dwelling Aboriginal mothers and their infants. Methods Mixed methods were used. Health service use and the quality of service delivery were examined in a retrospective cohort study of 412 Aboriginal women during pregnancy, birth and postpartum and their infants (n=413) during the first year. In addition, 60 interviews were conducted with clinicians and 120 hours of participant observation were undertaken at regional hospital and remote health centres. Results Poor maternal and infant health outcomes, high demand for antenatal and infant care in the remote setting with insufficient staffing and system-wide deficiencies in the quality and coordination of care were identified. Conclusions The resourcing and organisation of health services and the beliefs, attitudes and practices of clinicians were important factors affecting the quality of care in these settings. A significant change to the organisation of services should be seen as a priority for health care planners. Service redesign based on continuity of care, adequate resourcing of services, work load reform including more efficient use of the Aboriginal Health Worker, child health nurse and midwifery workforce and the integration of community-based health service delivery could play a substantial role in improving outcomes

Microbial metabolism of transparent exopolymer particles during the summer months along a eutrophic estuary system

This study explores the role of transparent exopolymer particles (TEP) as an additional carbon source for heterotrophic microbial activity in the eutrophic Qishon estuary. From the coastal station and upstream the estuary; TEP concentrations, β-glucosidase activity, bacterial production and abundance have gradually increased. TEP were often found as bio-aggregates, scaffolding algae, detritus matter and bacteria that likely formed hotspots for enhance microbial activity. To further demonstrate the link between TEP and heterotrophic bacterial activity, confined incubations with ambient and polysaccharide-enriched estuary water were carried out. Following polysaccharide addition, elevated (~50%) β-glucosidase activity rates were observed, leading to TEP hydrolysis. This newly formed bioavailable carbon resulted in significantly higher growth rates, with up to a 5-fold increase in heterotrophic bacterial biomass, comprising mostly high nucleic acid content bacteria. Taking together the findings from this research, we conclude that even in highly eutrophic environments heterotrophic bacteria may still be carbon limited. Further, TEP as a polysaccharide matrix can act as a metabolic surrogate, adding fresh bioavailable carbon through tight associations with bacteria in eutrophic ecosystems such as the Qishon estuary

View Point: Economic growth and child health in Sub Saharan Africa

After independence most African countries witnessed growth in their economies and decreases in child mortality. However both economic growth and the gains in under 5 mortality slowed dramatically in the 1980s and 1990s

Uncoupling Between Dinitrogen Fixation and Primary Productivity in the Eastern Mediterranean Sea

In the nitrogen (N)-impoverished photic zones of many oceanic regions, prokaryotic organisms fixing atmospheric dinitrogen (N2; diazotrophs) supply an essential source of new nitrogen and fuel primary production. We measured dinitrogen fixation and primary productivity (PP) during the thermally stratified summer period in different water regimes of the oligotrophic eastern Mediterranean Sea, including the Cyprus Eddy and the Rhodes Gyre. Low N2 fixation rates were measured (0.8-3.2μmol N m-2 d-1) excluding 10-fold higher rates in the Rhodes Gyre and Cyprus Eddy (~20μmol N m-2 d-1). The corresponding PP increased from east to west (200-2500μmol C m-2 d-1), with relatively higher productivity recorded in the Rhodes Gyre and Cyprus Eddy (2150 and 2300μmol C m-2 d-1, respectively). These measurements demonstrate that N2 fixation in the photic zone of the eastern Mediterranean Sea contributes only negligibly by direct inputs to PP (i.e., cyanobacterial diazotrophs) and is in fact uncoupled from PP. By contrast, N2 fixation is significantly coupled to bacterial productivity and to net heterotrophic areas, suggesting that heterotrophic N2 fixation may in fact be significant in this ultraoligotrophic system. This is further substantiated by the high N2 fixation rates we measured from aphotic depths and by the results of phylogenetic analysis in other studies showing an abundance of heterotrophic diazotrophs

Minimum Incidence of Adult Invasive Pneumococcal Disease in Blantyre, Malawi an Urban African Setting: A Hospital Based Prospective Cohort Study

Invasive pneumococcal disease causes substantial morbidity and mortality in Africa. Evaluating population level indirect impact on adult disease of pneumococcal conjugate vaccine (PCV) programmes in infants requires baseline population incidence rates but these are often lacking in areas with limited disease surveillance. We used hospital based blood culture and cerebrospinal fluid surveillance to calculate minimal incidence of invasive pneumococcal disease in the adult (≥15 years old) population of Blantyre, a rapidly growing urban centre in southern Malawi, in the period preceding vaccine introduction. Invasive pneumococcal disease incidence in Blantyre district was high, mean 58.1 (95% confidence interval (CI): 53.7, 62.7) per 100,000 person years and peaking among 35 to 40 year olds at 108.8 (95%CI: 89.0, 131.7) mirroring the population age prevalence of HIV infection. For pneumococcal bacteraemia in urban Blantyre, mean incidence was 60.6 (95% CI: 55.2, 66.5) per 100,000 person years, peaking among 35 to 40 year olds at 114.8 (95%CI: 90.3, 143.9). We suspected that our surveillance may under-ascertain the true burden of disease, so we used location data from bacteraemic subjects and projected population estimates to calculate local sub-district incidence, then examined the impact of community level socio-demographic covariates as possible predictors of local sub-district incidence of pneumococcal and non-pneumococcal pathogenic bacteraemia. Geographic heterogeneity in incidence was marked with localised hotspots but ward level covariates apart from prison were not associated with pneumococcal bacteraemia incidence. Modelling suggests that the current sentinel surveillance system under-ascertains the true burden of disease. We outline a number of challenges to surveillance for pneumococcal disease in our low-resource setting. Subsequent surveillance in the vaccine era will have to account for geographic heterogeneity when evaluating population level indirect impact of PCV13 introduction to the childhood immunisation program

Possible Reasons for Limited Effectiveness of a Skills and Drills Intervention to Improve Emergency Obstetric and Newborn Care.

Youth centers, peer education, and one-off public meetings have generally been ineffective in facilitating young people’s access to sexual and reproductive health (SRH) services, changing their behaviors, or influencing social norms around adolescent SRH. Approaches that have been found to be effective when well implemented, such as comprehensive sexuality education and youth-friendly services, have tended to flounder as they have considerable implementation requirements that are seldom met. For adolescent SRH programs to be effective, we need substantial effort through coordinated and complementary approaches. Unproductive approaches should be abandoned, proven approaches should be implemented with adequate fidelity to those factors that ensure effectiveness, and new approaches should be explored, to include greater attention to prevention science, engagement of the private sector, and expanding access to a wider range of contraceptive methods that respond to adolescents’ needs

Influence of Stream-Subsurface Exchange Flux and Bacterial Biofilms on Oxygen Consumption Under Nutrient-Rich Conditions

The lack of a complete understanding of the complex reciprocal interactions between hydrological processes and the structure and function of microbial communities limits our ability to improve the predictions of microbial metabolism in streams. We report here on how overlying water velocity and losing and gaining flux interact with bacterial community structure and its activity to control oxygen consumption in a sandy streambed under high nutrient levels. We used an experimental flume packed with natural sediment and measured the bacterial biomass distribution and oxygen profiles in the streambed and across bed forms. Local oxygen consumption rates were calculated with a 1-D numerical model (GRADIENT). Bacterial abundance and production rates varied across the bed form within 1 order of magnitude, while their taxonomic classes were similar across bed forms despite variations in flow conditions and sediment disturbance events. However, bacterial production rates were not directly correlated with bacterial abundance. On the other hand, oxygen consumption rates ranged over 4 orders of magnitude across the bed forms and were highly correlated with the vertical exchange flux between the water and the streambed. The results strongly suggest that under high nutrient levels, the system is, in general, transport limited and that predicting oxygen consumption rates depends on local vertical exchange fluxes