Non-random distribution of azole resistance across the global population of Aspergillus fumigatus

The emergence of azole resistance in the pathogenic fungus Aspergillus fumigatus has continued to increase, with the dominant resistance mechanisms, consisting of a 34-nucleotide tandem repeat (TR34)/L98H and TR46/Y121F/T289A, now showing a structured global distribution. Using hierarchical clustering and multivariate analysis of 4,049 A. fumigatus isolates collected worldwide and genotyped at nine microsatellite loci using analysis of short tandem repeats of A. fumigatus (STRAf), we show that A. fumigatus can be subdivided into two broad clades and that cyp51A alleles TR34/L98H and TR46/Y121F/T289A are unevenly distributed across these two populations. Diversity indices show that azole-resistant isolates are genetically depauperate compared to their wild-type counterparts, compatible with selective sweeps accompanying the selection of beneficial mutations. Strikingly, we found that azole-resistant clones with identical microsatellite profiles were globally distributed and sourced from both clinical and environmental locations, confirming that azole resistance is an international public health concern. Our work provides a framework for the analysis of A. fumigatus isolates based on their microsatellite profile, which we have incorporated into a freely available, user-friendly R Shiny application (AfumID) that provides clinicians and researchers with a method for the fast, automated characterization of A. fumigatus genetic relatedness. Our study highlights the effect that azole drug resistance is having on the genetic diversity of A. fumigatus and emphasizes its global importance upon this medically important pathogenic fungus. IMPORTANCE Azole drug resistance in the human-pathogenic fungus Aspergillus fumigatus continues to emerge, potentially leading to untreatable aspergillosis in immunosuppressed hosts. Two dominant, environmentally associated resistance mechanisms, which are thought to have evolved through selection by the agricultural application of azole fungicides, are now distributed globally. Understanding the effect that azole resistance is having on the genetic diversity and global population of A. fumigatus will help mitigate drug-resistant aspergillosis and maintain the azole class of fungicides for future use in both medicine and crop protection

Actual and ideal roles of school staff to support students with special needs: Current needs and strategies for improvement

To optimise school-based service delivery for students with disabilities, it is important to understand roles and needs of school staff. This study aimed to clarify ideal and actual roles of school staff (teachers, special educators, administrators) working with students with special needs, and to identify potential strategies to support actual roles. Ninety-five school personnel (64% teachers) from 3 different elementary schools and school boards in Quebec completed a 14-question survey. Open-ended responses were coded and analysed thematically. Common actual roles included task adaptation, offering individualized support, being available, and teamwork. Respondents felt roles could improve through in-context professional support, continuing education, teamwork opportunities extending to partnerships with families, and access to resources. Clarifying roles and expectations within a tiered-model to best support students also emerged, emphasizing the importance of sharing responsibilities across all service providers. Findings can guide implementation strategies and processes for providing effective services, enabling inclusion for students

Co-production in distributed generation:Renewable energy and creating space for fitting infrastructure within landscapes

This review describes the infrastructural elements of the socio-technical system of power supply based on renewables and the role of landscape concerns in decision-making about emerging ‘intelligent grids’. The considerable land areas required for energy infrastructure call for sizable ‘distributed generation’ close to energy consumption. Securing community acceptance of renewables’ infrastructure, perceived impacts on the community, and ‘landscape justice’ requires two types of co-production: in power supply and in making space available. With co-production, landscape issues are prominent, for some options dominant. However, ‘objectification’ of landscape, such as the use of ‘visibility’ as proxy for ‘visual impact’, is part of lingering centralised and hierarchical approaches to the deployment of renewables. Institutional tendencies of centralisation and hierarchy, in power supply management as well as in siting, should be replaced by co-production, as follows from common pool resources theory. Co-production is the key to respecting landscape values, furthering justice, and achieving community acceptance

"The Great Event of the Fortnight”: Steamship Rhythms and Colonial Communication

This paper engages with Tim Cresswell’s ‘contellations of mobility’ in order to contribute some understanding of historical maritime rhythms. The empirical focus is upon a steamship mail service in the post-emancipation Caribbean. In examining this communications network, it is stressed that while those managing the network valorised predictable efficiency, ‘friction’ was prized by mercantile groups at the steamers’ ports of call. Thus, the different aspects of mobility signified differently across the network, and this historical case study reinforces the resonance of slowness and stoppage time. The synchronisation of steamship arrivals with sociocultural norms in the Caribbean colonies also necessitated the adaptation of mail service rhythms. Through a focus on shipping operations, this paper proposes to temper our understanding of the role of steamship technology in empire. The influence of colonies on the metropole encompassed an alteration of the rhythms of imperial circulation, and it is within the maritime arena that these realities came into sharp focus

REFERQUAL: A pilot study of a new service quality assessment instrument in the GP Exercise Referral scheme setting

Background The development of an instrument accurately assessing service quality in the GP Exercise Referral Scheme (ERS) industry could potentially inform scheme organisers of the factors that affect adherence rates leading to the implementation of strategic interventions aimed at reducing client drop-out. Methods A modified version of the SERVQUAL instrument was designed for use in the ERS setting and subsequently piloted amongst 27 ERS clients. Results Test re-test correlations were calculated via Pearson's 'r' or Spearman's 'rho', depending on whether the variables were Normally Distributed, to show a significant (mean r = 0.957, SD = 0.02, p < 0.05; mean rho = 0.934, SD = 0.03, p < 0.05) relationship between all items within the questionnaire. In addition, satisfactory internal consistency was demonstrated via Cronbach's 'α'. Furthermore, clients responded favourably towards the usability, wording and applicability of the instrument's items. Conclusion REFERQUAL is considered to represent promise as a suitable tool for future evaluation of service quality within the ERS community. Future research should further assess the validity and reliability of this instrument through the use of a confirmatory factor analysis to scrutinise the proposed dimensional structure

Normalising jurisdictional heterotopias through place branding : the cases of Christiania and Metelkova

This paper explores the political dimensions of place branding as a path to normalisation for areas where a paradoxical relationship with the law exists, places that we coin “jurisdictional heterotopias” borrowing from Foucauldian literature. We posit that place branding plays a fundamental role in facilitating scale jumping in the otherwise vertically aligned legal space, a hierarchy designed to exclude spatial multiplicity from its premise. By examining the role of place branding in such areas, we endeavour to understand and appreciate the selective application of the law, the perpetuation of unregulated and illegal activity, as well as the place – specificity of legal practice. Ultimately, we argue that strong place branding associations permit the engulfment of this type of heterotopias in the “mainstream” leading to their normalisation; such a normalisation results not only in the acceptance of their uniqueness by the institutional elements, but also in the potential nullification of the liberties their communities advocate

Cardiometabolic markers to identify cardiovascular disease risk in HIV-infected black South Africans

Background. The prevalence of HIV is the highest in sub-Saharan Africa; South Africa (SA) is one of the most affected countries with the highest number of adults living with HIV infection in the world. Besides the traditional risk factors for cardiovascular disease (CVD) in the general population, in people living with HIV there are specific factors – chronic inflammation, metabolic changes associated with the infection, therapy, and lipodystrophy – that potentially increase the risk for developing CVD. Objective. This study proposes a screening discriminant model to identify the most important risk factors for the development of CVD in a cohort of 140 HIV-infected black Africans from the North West Province, SA.Methods. Anthropometric measures, systolic blood pressure, diastolic blood pressure and the carotid-dorsalis pedis pulse wave velocity were determined. Blood was analysed to determine the levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, triglycerides (TGs) and glucose. Partial least squares discriminant analysis was performed as a supervised pattern recognition method. Independent Student’s t-tests were further employed to compare the means of risk factors on interval scales; for comparison of categorical risk factors between groups, χ2 tests were used. Results. A TG:HDL-C ratio ≥1.49, TC:HDL-C ratio ≥5.4 and an HDL-C level ≤0.76 mmol/l indicated CVD risk in this cohort of patients living with HIV.Conclusion. The results have important health implications for black Africans living with HIV as these lipid levels may be a useful indicator of the risk for CVD.

A population-modulated bibliometric measure with an application in the field of statistics

We use confirmatory factor analysis to derive a unifying measure of comparison of scientists based on bibliometric measurements, by utilizing the h-index, some similar h-type indices as well as other common measures of scientific performance. We use a real data example from nine well-known departments of statistics to demonstrate our approach and argue that our combined measure results in a better overall evaluation of a researchers' scientific work

Influence of personality and fatalistic belief on taxi driver behaviour

The religious perception among individuals in sub-Saharan Africa that the ‘Big Five’ personality dimensions and fatalism are predictors of drivers’ behaviours and road accidents has received little scientific investigations. This paucity of research in the roles of psychological factors such as personality and fatalistic beliefs in shaping positive driver behaviour and attitudes has thus provided motivation for the conduct of this quantitative study. We collected data from 203 conveniently sampled taxi drivers in Gauteng province of South Africa by means of a structured questionnaire. Our analysis, using Structural Equation Modelling, found significant positive relationships between agreeableness and positive driver behaviour, conscientiousness and positive driver behaviour, fatalism and extraversion, as well as fatalism and positive driver behaviour. The results highlighted the dimensions of being methodical, organised, and risk aversive on the road, on the one hand, and being social, cooperative, and good-natured, on the other hand. Findings of the study further indicated that fatalistic beliefs are prevalent and indeed characteristic of individuals who are sociable, gregarious, and assertive. These individuals tend to uphold their religious and spiritual beliefs in the linkages between road accidents and destiny. Insights provided by this study could assist the Department of Transport and related Road Safety Authorities in designing road safety campaigns that addresses the erroneous beliefs by drivers that road accidents are pre-destined, and not as a result of individual’s driving behaviour.DHE