Human capital, innovation and the productive ageing: growth and senior aged health in the regional community through engaged higher education

[Abstract]: This paper examines how low relative economic growth and high service and infrastructure costs in non-metropolitan regions that are increasingly attractive to lifestyle-seeking seniors, can be offset by focussing more positively on the human capital dimension of this cohort through closer engagement with higher education learning and innovation. At present, many senior-aged persons attracted to ‘lifestyle’ locations are allowed to let their knowledge, networks and skills ossify through a lack of engagement with processes of learning and innovation and institutional impediments of a structural and attitudinal nature. It represents poor return on sunk investment in human capital, has cost impacts on enabling health and community services and infrastructure and does not contribute as positively as it could to regional growth outcomes through productivity gains. The spatial impact of this will exacerbate as the demographic profile of the nation continues to age. Higher education in these places could be a key instrument in the learning and innovation required to realise the greater productivity gains from senior-aged human capital and the consequential growth and health outcomes at the local and regional scale. The paper reports on the literature, research undertaken and analysis to understand these potentially important issues of policy and practice. The paper has a particular focus on the Sunshine Coast and Wide Bay Burnett regions of Queensland which have some of the highest concentrations of senior aged people in Australia

Toward an Ideal Relational Ethic: Re-thinking university-community engagement

This article argues for the importance of developing a relational ethic to guide university-community engagement practices and processes. Our objective is to demonstrate that ethical \u27engagement bridges\u27 can be formed to link higher education institutions (HEis), human capital at the community level, and the important global questions of our day that resonate with regional communities. Taking centre place in this triad is the notion of being-for, an ideal form of togetherness put forward by Zygmunt Bauman (1995) in his early work on globalisation and post-modernity. Being-for is presented in this article as a moral aspiration that, if embraced, can tie together engagement scholarship with the development of enterprising human capital, and result in ethical outcomes in the university-community engagement arena

Toward an Ideal Relational Ethic: Rethinking university-community engagement

This paper explores how an ideal relational ethic based on Zygmunt Bauman’s (1995) notion of forms of togetherness is needed to underpin university-community engagement processes and practices. We focus on the notion of being-for, and suggest that it can be used as an ‘engagement bridge’ between higher education institutions, the creation of human capital and communities, and can be a means to achieve ethical outcomes to local concerns. Much of Bauman’s (1995; 2001; 2007) theoretical development has focussed on the liquidity of modernity, to give the impression that community - in the spatially, physically located and fixed sense of the term - no longer exists. This paper proposes that spatial dimensions, particularly in the context of developing relational ethics, are important. This is particularly so for paying adequate attention to context-specific values, principles and issues in communities, for developing enterprising human capital via engagement, and for addressing matters of socio-political importance such as the environment. Contemporary neo-liberal times require ethical and moral leadership from universities. This paper suggests that such leadership can be developed from focussing attention on the forms of togetherness fostered by university-community engagement

Gastrointestinal Carriage Is a Major Reservoir of Klebsiella pneumoniae Infection in Intensive Care Patients.

BACKGROUND: Klebsiella pneumoniae is an opportunistic pathogen and leading cause of hospital-associated infections. Intensive care unit (ICU) patients are particularly at risk. Klebsiella pneumoniae is part of the healthy human microbiome, providing a potential reservoir for infection. However, the frequency of gut colonization and its contribution to infections are not well characterized. METHODS: We conducted a 1-year prospective cohort study in which 498 ICU patients were screened for rectal and throat carriage of K. pneumoniae shortly after admission. Klebsiella pneumoniae isolated from screening swabs and clinical diagnostic samples were characterized using whole genome sequencing and combined with epidemiological data to identify likely transmission events. RESULTS: Klebsiella pneumoniae carriage frequencies were estimated at 6% (95% confidence interval [CI], 3%-8%) among ICU patients admitted direct from the community, and 19% (95% CI, 14%-51%) among those with recent healthcare contact. Gut colonization on admission was significantly associated with subsequent infection (infection risk 16% vs 3%, odds ratio [OR] = 6.9, P < .001), and genome data indicated matching carriage and infection isolates in 80% of isolate pairs. Five likely transmission chains were identified, responsible for 12% of K. pneumoniae infections in ICU. In sum, 49% of K. pneumoniae infections were caused by the patients' own unique strain, and 48% of screened patients with infections were positive for prior colonization. CONCLUSIONS: These data confirm K. pneumoniae colonization is a significant risk factor for infection in ICU, and indicate ~50% of K. pneumoniae infections result from patients' own microbiota. Screening for colonization on admission could limit risk of infection in the colonized patient and others

Antimicrobial resistant <i>Klebsiella pneumoniae</i> carriage and infection in specialized geriatric care wards linked to acquisition in the referring hospital

AbstractBackgroundKlebsiella pneumoniae is a leading cause of extended-spectrum beta-lactamase (ESBL) producing hospital-associated infections, for which elderly patients are at increased risk.MethodsWe conducted a 1-year prospective cohort study, in which a third of patients admitted to two geriatric wards in a specialized hospital were recruited and screened for carriage of K. pneumoniae by microbiological culture. Clinical isolates were monitored via the hospital laboratory. Colonizing and clinical isolates were subjected to whole genome sequencing and antimicrobial susceptibility testing.ResultsK. pneumoniae throat carriage prevalence was 4.1%, rectal carriage 10.8% and ESBL carriage 1.7%. K. pneumoniae infection incidence was 1.2%. The isolates were diverse, and most patients were colonized or infected with a unique phylogenetic lineage, with no evidence of transmission in the wards. ESBL strains carried blaCTX-M-15and belonged to clones associated with hospital-acquired ESBL infections in other countries (ST29, ST323, ST340).One also carried the carbapenemase blaIMP-26. Genomic and epidemiological data provided evidence that ESBL strains were acquired in the referring hospital. Nanopore sequencing also identified strain-to-strain transmission of a blaCTX-M-15 FIBK/FIIK plasmid in the referring hospital.ConclusionsThe data suggest the major source of K. pneumoniae was the patient’s own gut microbiome, but ESBL strains were acquired in the referring hospital. This highlights the importance of the wider hospital network to understanding K. pneumoniae risk and infection control. Rectal screening for ESBL organisms upon admission to geriatric wards could help inform patient management and infection control in such facilities.SummaryPatients’ own gut microbiota were the major source of K. pneumoniae, but extended-spectrum beta-lactamase strains were acquired in the referring hospital. This highlights the potential for rectal screening, and the importance of the wider hospital network, for local risk management.</jats:sec

Genomic dissection of Klebsiella pneumoniae infections in hospital patients reveals insights into an opportunistic pathogen.

Klebsiella pneumoniae is a major cause of opportunistic healthcare-associated infections, which are increasingly complicated by the presence of extended-spectrum beta-lactamases (ESBLs) and carbapenem resistance. We conducted a year-long prospective surveillance study of K. pneumoniae clinical isolates in hospital patients. Whole-genome sequence (WGS) data reveals a diverse pathogen population, including other species within the K. pneumoniae species complex (18%). Several infections were caused by K. variicola/K. pneumoniae hybrids, one of which shows evidence of nosocomial transmission. A wide range of antimicrobial resistance (AMR) phenotypes are observed, and diverse genetic mechanisms identified (mainly plasmid-borne genes). ESBLs are correlated with presence of other acquired AMR genes (median n = 10). Bacterial genomic features associated with nosocomial onset are ESBLs (OR 2.34, p = 0.015) and rhamnose-positive capsules (OR 3.12, p < 0.001). Virulence plasmid-encoded features (aerobactin, hypermucoidy) are observed at low-prevalence (<3%), mostly in community-onset cases. WGS-confirmed nosocomial transmission is implicated in just 10% of cases, but strongly associated with ESBLs (OR 21, p < 1 × 10-11). We estimate 28% risk of onward nosocomial transmission for ESBL-positive strains vs 1.7% for ESBL-negative strains. These data indicate that K. pneumoniae infections in hospitalised patients are due largely to opportunistic infections with diverse strains, with an additional burden from nosocomially-transmitted AMR strains and community-acquired hypervirulent strains

Human capital, innovation and the productive ageing: growth and senior aged health in the regional community through engaged higher education

[Abstract]: This paper examines how low relative economic growth and high service and infrastructure costs in non-metropolitan regions that are increasingly attractive to lifestyle-seeking seniors, can be offset by focussing more positively on the human capital dimension of this cohort through closer engagement with higher education learning and innovation. At present, many senior-aged persons attracted to ‘lifestyle’ locations are allowed to let their knowledge, networks and skills ossify through a lack of engagement with processes of learning and innovation and institutional impediments of a structural and attitudinal nature. It represents poor return on sunk investment in human capital, has cost impacts on enabling health and community services and infrastructure and does not contribute as positively as it could to regional growth outcomes through productivity gains. The spatial impact of this will exacerbate as the demographic profile of the nation continues to age. Higher education in these places could be a key instrument in the learning and innovation required to realise the greater productivity gains from senior-aged human capital and the consequential growth and health outcomes at the local and regional scale. The paper reports on the literature, research undertaken and analysis to understand these potentially important issues of policy and practice. The paper has a particular focus on the Sunshine Coast and Wide Bay Burnett regions of Queensland which have some of the highest concentrations of senior aged people in Australia

Innovation in ageing for regional communities: planning for productive ageing in the Wide Bay/Burnett region of Queensland

The purpose of this paper is to present and invite comment on a Program of Innovation in Ageing for Regional Communities. This research-in-progress has been developed as a product of collaboration by researchers from two universities with campuses in the Wide Bay/Burnett region of Queensland (the University of the Sunshine Coast and the University of Southern Queensland). This region has one of the fastest growing populations of retirees and is one of the poorer performers economically. The research was informed from information gathered in consultations with stakeholder organisations. The aims of the Program are to assist regional communities in better understanding and addressing increases in the percentage of older people in their populations including the use of technologies. GIS (Geographical Information Systems) are a key tool used for understanding the spatial context of older people. The focus is on practical steps of experimentation, demonstrator projects, evaluating technology, development and implementation of standards, change management, and the development of rigorous financial cases for investment incorporating how benefits will be realised