Culture-independent bacterial community profiling of carbon dioxide treated raw milk

Due to technical simplicity and strong inhibition against the growth of psychrotrophic bacteria in milk, CO treatment has emerged as an attractive processing aid to increase the storage time of raw milk before downstream processing. However, it is yet to be adopted by the industry. In order to further explore the suitability of CO treatment for raw milk processing, the bacterial populations of carbonated raw milk collected locally from five different sources in Australia were analysed with next-generation sequencing. Growth inhibition by CO was confirmed, with spoilage delayed by at least 7\ua0days compared with non-carbonated controls. All non-carbonated controls were spoiled by Gammaproteobacteria, namely Pseudomonas fluorescens group bacteria, Serratia and Erwinia. Two out of the five carbonated samples shared the same spoilage bacteria as their corresponding controls. The rest of the three carbonated samples were spoiled by the lactic acid bacterium (LAB) Leuconostoc. This is consistent with higher tolerance of LAB towards CO and selection of LAB in meat products stored in CO-enriched modified atmosphere packaging. No harmful bacteria were found to be selected by CO. LAB are generally regarded as safe (GRAS), thus the selection for Leuconostoc by CO in some of the samples poses no safety concern. In addition, we have confirmed previous findings that 454 pyrosequencing and Illumina sequencing of 16S rRNA gene amplicons from the same sample yield highly similar results. This supports comparison of results obtained with the two different sequencing platforms, which may be necessary considering the imminent discontinuation of 454 pyrosequencing

Evaluation of acute coronary syndrome risk by hospitalists to expedite discharge of low risk patients

Chest pain is a leading cause of Emergency Department (ED) visits. Risk stratification of risk for Acute Coronary Syndrome (ACS) is applied with variability. Revaluation of ACS risk by hospitalists may provide the opportunity to identify patients eligible for expedited discharge

Exploring the third delay: an audit evaluating obstetric triage at Mulago National Referral Hospital

BACKGROUND: Mulago National Referral Hospital has the largest maternity unit in sub-Saharan Africa. It is situated in Uganda, where the maternal mortality ratio is 310 per 100,000 live births. In 2010 a ‘Traffic Light System’ was set up to rapidly triage the vast number of patients who present to the hospital every day. The aim of this study was to evaluate the effectiveness of the obstetric department’s triage system at Mulago Hospital with regard to time spent in admissions and to identify urgent cases and factors adversely affecting the system. METHODS: A prospective audit of the obstetric admissions department was carried out at the Mulago Hospital. Data were obtained from tagged patient journeys using two data collection tools and compiled using Microsoft Excel. StatsDirect was used to compose graphs to illustrate the results. RESULTS: Informal triage was occurring 46 % of the time at the first checkpoint in a woman’s journey, but the ‘Traffic Light System’ was not being used and many of the patient’s vital signs were not being recorded. CONCLUSIONS: It is hypothesised that the ‘Traffic Light System’ is not being used due to its focus on examination finding and diagnosis, implying that it is not suitable for an early stage in the patient’s journey. Replacing it with a simple algorithm to categorise women into the urgency with which they need to be seen could rectify this

Mental capacity and traumatic brain injury. A critical comparison of England and New Zealand’s legislative responses

The problem To conduct a critical cross-national comparison of the strengths and weaknesses of mental capacity legislation in England and New Zealand as applied to people with traumatic brain injury. Method A policy map, using Arksey and O’Malley’s (2005) scoping methodology was developed to explore the legislation, policy and guidance from the two countries. These were thematically reviewed to identify their central tenets, which were critically considered and contrasted from a practice perspective. Results UK legislation focuses on individual decisions in isolation, compared to NZ’s broader perspective and recognition of potential influence from others. Both neglect the influence of other environmental factors on individual’s real world decisions. Practitioners can misunderstand the legislation and NZ lacks the UK’s detailed national guidance, producing localised policy variations. Assessment in NZ, unlike the UK, is based on medical opinion, this has the strength of a better understanding of neurology, but in both countries professionals may misunderstand the impact of TBI in practice. Conclusions The two approaches to determining capacity were found to have contrasting strengths. Social workers in both countries can contribute to ensuring more accurate capacity assessment and support after TBI

Mental health among healthcare workers and other vulnerable groups during the COVID-19 pandemic and other coronavirus outbreaks: A rapid systematic review.

INTRODUCTION: Although most countries and healthcare systems worldwide have been affected by the COVID-19 pandemic, some groups of the population may be more vulnerable to detrimental effects of the pandemic on mental health than others. The aim of this systematic review was to synthesise evidence currently available from systematic reviews on the impact of COVID-19 and other coronavirus outbreaks on mental health for groups of the population thought to be at increased risk of detrimental mental health impacts. MATERIALS AND METHODS: We conducted a systematic review of reviews on adults and children residing in a country affected by a coronavirus outbreak and belonging to a group considered to be at risk of experiencing mental health inequalities. Data were collected on symptoms or diagnoses of any mental health condition, quality of life, suicide or attempted suicide. The protocol for this systematic review was registered in the online PROSPERO database prior to commencing the review (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=194264). RESULTS: We included 25 systematic reviews. Most reviews included primary studies of hospital workers from multiple countries. Reviews reported variable estimates for the burden of symptoms of mental health problems among acute healthcare workers, COVID-19 patients with physical comorbidities, and children and adolescents. No evaluations of interventions were identified. Risk- and protective factors, mostly for healthcare workers, showed the importance of personal factors, the work environment, and social networks for mental health. CONCLUSIONS: This review of reviews based on primary studies conducted in the early months of the COVID-19 pandemic shows a lack of evidence on mental health interventions and mental health impacts on vulnerable groups in the population

Foehn jets over the Larsen C Ice Shelf, Antarctica

Previously unknown foehn jets have been identified to the east of the Antarctic Peninsula (AP) above the Larsen C Ice Shelf. These jets have major implications for the east coast of the AP, a region of rapid climatic warming and where two large sections of ice shelf have collapsed in recent years. During three foehn events across the AP, leeside warming and drying is seen in new aircraft observations and simulated well by the Met Office Unified Model (MetUM) at ∼1.5 km grid spacing. In case A, weak southwesterly flow and an elevated upwind inversion characterise a highly nonlinear flow regime with upwind flow blocking. In case C strong northwesterly winds characterise a relatively linear case with little upwind flow blocking. Case B resides somewhere between the two in flow regime linearity. The foehn jets – apparent in aircraft observations where available and MetUM simulations of all three cases – are mesoscale features (up to 60 km in width) originating from the mouths of leeside inlets. Through back trajectory analysis they are identified as a type of gap flow. In cases A and B the jets are distinct, being strongly accelerated relative to the background flow, and confined to low levels above the Larsen C Ice Shelf. They resemble the ‘shallow foehn’ of the Alps. Case C resembles a case of ‘deep foehn’, with the jets less distinct. The foehn jets are considerably cooler and moister relative to adjacent regions of calmer foehn air. This is due to a dampened foehn effect in the jet regions: in case A the jets have lower upwind source regions, and in the more linear case C there is less diabatic warming and precipitation along jet trajectories due to the reduced orographic uplift across the mountain passes