Nasal carriage of Staphylococcus aureus among healthy adults

Background and Purpose: Data on the carriage rate and antibiotic sensitivity pattern of Staphylococcus aureus strains prevalent in the community are not available for many developing countries including Malaysia. To estimate the extent of community S. aureus transmission, in particular methicillin-resistant S. aureus (MRSA), the prevalence of S. aureus nasal colonization in a population of healthy adults was determined. Factors associated with S. aureus nasal carriage and antibiotic sensitivity patterns of the isolates were also analyzed. Methods: A cross-sectional study involving 346 adults was conducted. Nasal swabs were examined for the presence of S. aureus. Epidemiological information concerning risk factors for nasal carriage was also obtained. Antibiotic susceptibility testing was performed using the disk diffusion method according to the National Committee for Clinical Laboratory Standards guidelines. MRSA strains isolated were further subjected to pulse-field gel electrophoresis analysis. Results: The prevalence of S. aureus nasal carriage was 23.4%. The findings also revealed that ex-smokers (95% confidence interval [CI] 1.08-6.32, p=0.033) and oral contraceptive users (95% CI 1.12-21.67, p=0.035) were more likely to harbor S. aureus. One person was colonized with MRSA, which was different from the hospital strain. Conclusion: MRSA nasal colonization was found to be low outside of the health care environment. Smokers and oral contraceptive users have high nasal carrier rates

A reference map of the human binary protein interactome.

Global insights into cellular organization and genome function require comprehensive understanding of the interactome networks that mediate genotype-phenotype relationships(1,2). Here we present a human 'all-by-all' reference interactome map of human binary protein interactions, or 'HuRI'. With approximately 53,000 protein-protein interactions, HuRI has approximately four times as many such interactions as there are high-quality curated interactions from small-scale studies. The integration of HuRI with genome(3), transcriptome(4) and proteome(5) data enables cellular function to be studied within most physiological or pathological cellular contexts. We demonstrate the utility of HuRI in identifying the specific subcellular roles of protein-protein interactions. Inferred tissue-specific networks reveal general principles for the formation of cellular context-specific functions and elucidate potential molecular mechanisms that might underlie tissue-specific phenotypes of Mendelian diseases. HuRI is a systematic proteome-wide reference that links genomic variation to phenotypic outcomes

Common germline polymorphisms associated with breast cancer-specific survival

Abstract Introduction Previous studies have identified common germline variants nominally associated with breast cancer survival. These associations have not been widely replicated in further studies. The purpose of this study was to evaluate the association of previously reported SNPs with breast cancer-specific survival using data from a pooled analysis of eight breast cancer survival genome-wide association studies (GWAS) from the Breast Cancer Association Consortium. Methods A literature review was conducted of all previously published associations between common germline variants and three survival outcomes: breast cancer-specific survival, overall survival and disease-free survival. All associations that reached the nominal significance level of P value <0.05 were included. Single nucleotide polymorphisms that had been previously reported as nominally associated with at least one survival outcome were evaluated in the pooled analysis of over 37,000 breast cancer cases for association with breast cancer-specific survival. Previous associations were evaluated using a one-sided test based on the reported direction of effect. Results Fifty-six variants from 45 previous publications were evaluated in the meta-analysis. Fifty-four of these were evaluated in the full set of 37,954 breast cancer cases with 2,900 events and the two additional variants were evaluated in a reduced sample size of 30,000 samples in order to ensure independence from the previously published studies. Five variants reached nominal significance (P <0.05) in the pooled GWAS data compared to 2.8 expected under the null hypothesis. Seven additional variants were associated (P <0.05) with ER-positive disease. Conclusions Although no variants reached genome-wide significance (P <5 x 10−8), these results suggest that there is some evidence of association between candidate common germline variants and breast cancer prognosis. Larger studies from multinational collaborations are necessary to increase the power to detect associations, between common variants and prognosis, at more stringent significance levels

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Promoting lifestyle changes for Chinese Australians with Type 2 diabetes

Providing translated diabetes education from English to Chinese is not enough to promote healthy lifestyle changes among Chinese Australians with type 2 diabetes. This thesis explored the behaviour patterns of Chinese patients during diabetes education and identified the most successful education approaches. The research involved a review of literature and an exploratory qualitative study across three countries. The findings suggest health professionals working with Chinese Australian patients, should modify diabetes education to be in line with the Chinese cultural process of learning and adopt collectivistic-orientated strategies to effectively promote changes for a healthier lifestyle

Effectiveness and Usability Evaluation of SimuSurvey Using Field Study Approach

在工程教學環境中，學生除了要學會理論外，也要學會實作與應用，所以一般都會有實驗課，目的讓學生可以學會應用；然而，由於環境和器材限制，為了要解決限制所引起教學上的問題和使學生有效地學習知識，教學人員會利用一些教學輔助工具來輔助教學。然而一個有用的(usefulness)輔助教學工具才能對教學有幫助，所以必須了解輔助教學工具的在教學環境下之使用性（usability）和成效性(effectiveness)。研究提出應用參與觀察法進行教學輔助工具之使用性和成效性評估的方法和步驟，以名為SimuSurvey的測量輔助教學工具應用在測量實習課為案例進行二次實作研究，第一次實作是把SimuSurvey直接導入到課堂授課中，第二次實作是應用SimuSurvey於課堂外,並配合課堂內容作預習和複習用。在實作中，研究者以我就是使用者的概念半參與半觀察在教學環境中收集相關資料，並用田野筆記方便快速收集野外觀察資料。在資料分析，綜合質化和量化資料分析方法得到電腦輔助教學工具之完整使用性和成效性的結果。過二次案例實作，可知本研究提出應用參與觀察法之方法和步驟是可行而且有效。同時發現應用參與觀察法進行使用性和成效性評估可找出隱藏的使用性問題和功能性需求。最後從二次案例實作經驗中了解應用參與觀察法所需注意之事項。A Computer-Aided Instruction (CAI) tool, called SimuSurvey, is being developed at Department of Civil Engineering, National Taiwan University for assisting surveyor training. This tool can help instructors to demonstrate theories and allow students to practice surveying all by themselves. Although SimuSurvey has been evaluated well in surveyor training and surveying teaching for its feasibility and effectiveness, its effectiveness and usability of assisting students to learn and apply the basic knowledge and instrument operation skills has not been studied in real surveying practicing situations. In this research, we applied a field study approach, called the participant observation method, to evaluate the usability and effectiveness of SimuSurvey through field observation of students’ behaviors in surveying practicing. The method and procedure required for realizing the participant observation method for evaluation of SimuSurvey and other CAI tools are designed. wo case studies are carried out in this research to investigate and demonstrate the usability and effectiveness of the proposed method and procedure. In the case studies, we not only participate in implementing SimuSurvey into teaching, but also observe the behaviors of the students. Through both of the qualitative and quantitative analyses on the observation data, questionnaires and tests, SimuSurvey is shown to be usable and effective. Also, some hidden usability problems and functional requirements are found. Besides, according to the case studies, a caution list is summarized for readers who wish to apply the participant observation method in their researches.誌謝 i要 iii目錄 xi目錄 xiii一章　緒論 1.1 研究動機與背景 1.2 研究目的 2.3 研究範圍 3.4 論文組織 4二章　使用性評估與參與觀察法 7.1 使用性評估 7.1.1 使用性 7.1.2 使用性問題 10.1.3 使用性需求 10.1.4 使用性評估方法 11.2 參與觀察法 15.2.1 研究方法概述 16.2.2 田野筆記 18.2.3 參與觀察法在使用性評估之應用 20三章　研究方法 23.1 研究對象 25.1.1 電腦輔助工具-SimuSurvey 25.1.2 測量實習課程環境 26.2 蒐集資料方法和步驟 28.2.1 學生背景問卷、單元測試和學習成效問卷 29.2.2 參與觀察法 30.3 資料分析 35.3.1 使用性評估 36.3.2 成效性評估 39四章　第一次案例實作與資料分析 43.1 案例介紹 43.1.1 電腦輔助教學工具應用情境 43.1.2 觀察及資料收集 44.2 資料分析與結果 45.2.1 學生基本資料 46.2.2 使用性評估 46.2.3 成效性評估 54.3 討論結果 62五章 第二次案例實作 65.1 案例介紹 65.1.1 電腦輔助教學工具應用情境 66.1.2 觀察及收集資料 67.2 資料分析與結果 71.2.1 學生基本資料 71.2.2 使用性評估 71.2.3 成效性評估 77.3 討論結果 85六章　結論與展望 87.1 研究成果與貢獻 87.2 未來研究建議 90考文獻 91錄 A　學生背景問卷 95錄 B　水準單元測試 97錄 C　導線單元測試 99錄 D水準作業範本 101錄 E　導線作業範本 103錄 F　輔助工具之使用性與學習成效問卷 105錄 G　SimuSurvey活動教學教材範例 10

Multi-Generational Perspectives on the Competencies Required of First-Line Nurse Managers: A Phenomenological Study

First-line nurse managers play an integral role in ensuring team and organizational effectiveness and quality of care. They are facing increasing challenges arising from the need to lead a generation-diverse workforce. Further research that examines multi-generational perspectives on the competencies of first-line nurse managers is warranted. This paper aimed to elucidate multi-generational perspectives on the competencies required of first-line nurse managers based on their lived experiences and perceptions, as well as those of frontline nurses. A descriptive phenomenological approach was adopted. A total of 48 informants were invited to individual semi-structured interviews to share their perspectives on the competencies required of first-line nurse managers. Findings were analyzed using Van Kaam&rsquo;s controlled explication method. Four themes that described four areas of competency were generated: (1) advocating for the interests of the staff, (2) allocating resources effectively, (3) building cohesive teams, and (4) embracing change and quality. The findings indicated that there were significant discrepancies among the different generations of informants in terms of their degree of commitment to work, preferred modes of team communication and collaboration, and perspectives on the role and function and preferred leadership styles of first-line nurse managers. This study fell short in examining the experiences of Generation Z nurses, and the findings are subject to further validation by larger samples. However, this study has implications for hospital administrators, nurse educators, and managers, encouraging them to rethink the notion of management competencies to develop effective strategies for leading a multi-generational workforce