Communicating health information to Pacific women : a thesis presented in partial fulfilment to the requirements for the degree of Masters of Business Studies in Communications Management at Massey University

The ability to acquire and use information is an essential component in the process of obtaining knowledge. It is an interesting phenomenon that people do not always access information that is beneficial for them (Chatman, 1991). As New Zealand becomes increasingly multicultural the need to communicate health messages in a culturally appropriate and effective way is expanding in importance. This study examined the nature of current methods used by Pacific women to access cervical screening information. It also explored the barriers to obtaining that information and how the participants believed communication about cervical screening should take place to reach Pacific women in a culturally appropriate way. Results are analysed in the light of the knowledge gap hypothesis. This hypothesis places emphasis on socioeconomic factors as being predictors of knowledge. Twenty Pacific women living in Palmerston North were selected for the study using the snowball sampling technique. The participants varied in age from 20 to over 50 years and their education ranged from primary to tertiary level. The third key variable was length of time in New Zealand. This ranged from three months to 33 years. Semi-structured indepth interviews of approximately two hours duration were completed. These were recorded and transcribed with the permission of the participants. Transcripts were analysed using the technique of content analysis. The study found that knowledge gaps were related to the "subject matter". The topic of cervical screening was perceived to be very sensitive because of the taboo nature of discussing topics related to sex and the sexual organs. Sensitivity appeared to be related to age and length of time in New Zealand but not to education. Socioeconomic factors did not appear to be closely linked to levels of understanding by Pacific women about cervical screening. Interest in the topic and the motivation to acquire information were more indicative of knowledge gaps. Three key barriers to successful communication were identified: cultural background, lack of confidentiality and embarrassment. Of these, cultural background was perceived by the participants to have the most significant influence on their ability to access information. Face-to-face communication was the preferred method for obtaining both health information and cervical screening information. Print, radio or visual media communications were not considered effective due to the sensitivity of the subject and the indirect nature of the media. Written communication was advocated by the participants to supplement face-to-face communication when initially finding out about cervical screening. The study suggested that holding face-to-face meetings with a health professional present, was the most effective way of reaching Pacific women. The lack of research in the area of communicating with Pacific women about health information places greater emphasis on the importance of the findings of this study. It also highlights the need to develop a subsequent body of research to ensure communication is effective, appropriate and not misdirected

Improving Heifer Development Programs Using Precision Technology and DDGS

Study Description: Heifers were stratified into two groups based on initial body weight and each group was randomly assigned to one of two treatments: a control group (n=30) and a precision group (n=30). Treatment groups are separated into different pastures to graze dormant native range from November to April. Groups are rotated monthly to reduce individual pasture influence. Heifers in the control group are supplemented as a group and bunk fed 5lb/head/day with dried distiller grain pellets (DDGS). Heifers within the precision group will be supplemented individually using the SmartFeed system (C-Lock Inc. Rapid City, SD) and offered 5lb/head/day DDGS pellets. Individual daily weight and daily rate of gain will be measured within both groups using SmartScale technology. A time series trend analysis will be used to forecast animal BW at time of breeding, ensure individual heifer gain is satisfactory and adjust amount of supplement delivered to ensure animals are achieving target weight gains

An endemic hantavirus in field voles in northern England

We report a PCR survey of hantavirus infection in the extensive field vole (Microtus agrestis) populations occurring in the Kielder Forest, northern England. A Tatenale virus-like lineage was frequently detected (~ 15% prevalence) in liver tissue. Such lineages are likely to be endemic in northern England

How Online Communities of People With Long-Term Conditions Function and Evolve: Network Analysis of the Structure and Dynamics of the Asthma UK and British Lung Foundation Online Communities.

BACKGROUND: Self-management support can improve health and reduce health care utilization by people with long-term conditions. Online communities for people with long-term conditions have the potential to influence health, usage of health care resources, and facilitate illness self-management. Only recently, however, has evidence been reported on how such communities function and evolve, and how they support self-management of long-term conditions in practice. OBJECTIVE: The aim of this study is to gain a better understanding of the mechanisms underlying online self-management support systems by analyzing the structure and dynamics of the networks connecting users who write posts over time. METHODS: We conducted a longitudinal network analysis of anonymized data from 2 patients' online communities from the United Kingdom: the Asthma UK and the British Lung Foundation (BLF) communities in 2006-2016 and 2012-2016, respectively. RESULTS: The number of users and activity grew steadily over time, reaching 3345 users and 32,780 posts in the Asthma UK community, and 19,837 users and 875,151 posts in the BLF community. People who wrote posts in the Asthma UK forum tended to write at an interval of 1-20 days and six months, while those in the BLF community wrote at an interval of two days. In both communities, most pairs of users could reach one another either directly or indirectly through other users. Those who wrote a disproportionally large number of posts (the superusers) represented 1% of the overall population of both Asthma UK and BLF communities and accounted for 32% and 49% of the posts, respectively. Sensitivity analysis showed that the removal of superusers would cause the communities to collapse. Thus, interactions were held together by very few superusers, who posted frequently and regularly, 65% of them at least every 1.7 days in the BLF community and 70% every 3.1 days in the Asthma UK community. Their posting activity indirectly facilitated tie formation between other users. Superusers were a constantly available resource, with a mean of 80 and 20 superusers active at any one time in the BLF and Asthma UK communities, respectively. Over time, the more active users became, the more likely they were to reply to other users' posts rather than to write new ones, shifting from a help-seeking to a help-giving role. This might suggest that superusers were more likely to provide than to seek advice. CONCLUSIONS: In this study, we uncover key structural properties related to the way users interact and sustain online health communities. Superusers' engagement plays a fundamental sustaining role and deserves research attention. Further studies are needed to explore network determinants of the effectiveness of online engagement concerning health-related outcomes. In resource-constrained health care systems, scaling up online communities may offer a potentially accessible, wide-reaching and cost-effective intervention facilitating greater levels of self-management

Isolation and Characterization of Klebsiella Phages for Phage Therapy

Introduction: Klebsiella is a clinically important pathogen causing a variety of antimicrobial resistant infections in both community and nosocomial settings, particularly pneumonia, urinary tract infection, and sepsis. Bacteriophage (phage) therapy is being considered a primary option for the treatment of drug-resistant infections of these types. Methods: We report the successful isolation and characterization of 30 novel, genetically diverse Klebsiella phages. Results: The isolated phages span six different phage families and nine genera, representing both lysogenic and lytic lifestyles. Individual Klebsiella phage isolates infected up to 11 of the 18 Klebsiella capsule types tested, and all 18 capsule-types were infected by at least one of the phages. Conclusions: Of the Klebsiella-infecting phages presented in this study, the lytic phages are most suitable for phage therapy, based on their broad host range, high virulence, short lysis period and given that they encode no known toxin or antimicrobial resistance genes. Phage isolates belonging to the Sugarlandvirus and Slopekvirus genera were deemed most suitable for phage therapy based on our characterization. Importantly, when applied alone, none of the characterized phages were able to suppress the growth of Klebsiella for more than 12 h, likely due to the inherent ease of Klebsiella to generate spontaneous phage-resistant mutants. This indicates that for successful phage therapy, a cocktail of multiple phages would be necessary to treat Klebsiella infections.Peer reviewe

Feasibility cluster randomised controlled trial of a within-consultation intervention to reduce antibiotic prescribing for children presenting to primary care with acute respiratory tract infection and cough

Objective To investigate recruitment and retention, data collection methods and the acceptability of a ‘within-consultation’ complex intervention designed to reduce antibiotic prescribing. Design Primary care feasibility cluster randomised controlled trial. Setting 32 general practices in South West England recruiting children from October 2014 to April 2015. Participants Children (aged 3 months to <12 years) with acute cough and respiratory tract infection (RTI). Intervention A web-based clinician-focussed clinical rule to predict risk of future hospitalisation and a printed leaflet with individualised child health information for carers, safety-netting advice and a treatment decision record. Controls Usual practice, with clinicians recording data on symptoms, signs and treatment decisions. Results Of 542 children invited, 501 (92.4%) consented to participate, a month ahead of schedule. Antibiotic prescribing data were collected for all children, follow-up data for 495 (98.8%) and the National Health Service resource use data for 494 (98.6%). The overall antibiotic prescribing rates for children’s RTIs were 25% and 15.8% (p=0.018) in intervention and control groups, respectively. We found evidence of postrandomisation differential recruitment: the number of children recruited to the intervention arm was higher (292 vs 209); over half were recruited by prescribing nurses compared with less than a third in the control arm; children in the intervention arm were younger (median age 2 vs 3 years controls, p=0.03) and appeared to be more unwell than those in the control arm with higher respiratory rates (p<0.0001), wheeze prevalence (p=0.007) and global illness severity scores assessed by carers (p=0.045) and clinicians (p=0.01). Interviews with clinicians confirmed preferential recruitment of less unwell children to the trial, more so in the control arm. Conclusion Differential recruitment may explain the paradoxical antibiotic prescribing rates. Future cluster level studies should consider designs which remove the need for individual consent postrandomisation and embed the intervention within electronic primary care records

Colour categories are reflected in sensory stages of colour perception when stimulus issues are resolved

Debate exists about the time course of the effect of colour categories on visual processing. We investigated the effect of colour categories for two groups who differed in whether they categorised a blue-green boundary colour as the same- or different-category to a reliably-named blue colour and a reliably-named green colour. Colour differences were equated in just-noticeable differences to be equally discriminable. We analysed event-related potentials for these colours elicited on a passive visual oddball task and investigated the time course of categorical effects on colour processing. Support for category effects was found 100 ms after stimulus onset, and over frontal sites around 250 ms, suggesting that colour naming affects both early sensory and later stages of chromatic processing