Multi-year antimicrobial-resistance trends in urine Escherichia coli isolates from both community-based and hospital-based laboratories of an Australian local health district.

OBJECTIVES: Efforts to monitor and combat antimicrobial resistance (AMR) are typically focused on the hospital-based laboratory setting. The aim of this study was to longitudinally examine and compare trends in AMR among urine Escherichia coli isolates from a private community-based laboratory and a public hospital-based laboratory in an Australian local health district. METHODS: A total of 108 262 urine E. coli isolates from a public hospital-based laboratory (N = 34 103) and a private community-based laboratory (N = 74 159) in a single health district between 2007-2019 were analysed. Linear regression was used to identify significance of change in AMR rates in both laboratories independently and detect any significant interaction of each setting in proportional change over the study period. RESULTS: Similar AMR trends were detected among urinary E. coli isolates in private community-based laboratory and public hospital-based laboratory settings over 12 y. AMR rates were consistently higher in the public hospital-based setting. Ampicillin was the only antibiotic for which the E. coli resistance trend did not significantly change over the time period in either laboratory setting. All other antibiotics showed a significant increase in AMR rates over time in both settings. CONCLUSIONS: AMR rates in both the private community-based laboratory and public hospital-based laboratory settings increased over time and were consistently higher in the public hospital-based laboratory setting. Since private laboratories handle the vast majority of pathology volumes in community outpatient settings in Australia, interventions incorporating the community-based laboratory setting are critical to addressing AMR in the community.

Identifying Rewards Over Difficulties Buffers the Impact of Time in COVID-19 Lockdown for Parents in Australia.

OBJECTIVE: Physical isolation measures, known as lockdown or shelter-in-place, experienced during coronavirus disease 2019 (COVID-19) have the potential to cause psychological distress. This study was conducted to examine parents' perceived stress and whether reports of rewards and challenges during lockdown impact stress. METHODS: Data were collected using a cross-sectional online survey in New South Wales, Australia, across the 4-week lockdown. The survey was completed by 158 parents of children aged under 6 years. Stress was measured using the short form of the Perceived Stress Scale (PSS-4). Rewards and challenges were reported in response to two open-ended questions. RESULTS: There was a weak negative correlation between PSS-4 scores and days in isolation (r = -0.167, p = 0.022), with parents who had spent longer in isolation reporting fewer stress symptoms. The relationship between time in isolation and stress was moderated by the degree to which parents described more rewards than challenges: parents who perceived high rewards and low challenges reported lower PSS-4 scores with more days in lockdown, whereas parents who perceived low rewards and high challenges reported higher PSS-4 scores with more days in lockdown. The moderation model examining associations between time in isolation and rewards ratio explained 13% of the variance in PSS-4 scores. CONCLUSION: Lockdowns are not uniformly or consistently negative experiences for parents. Identifying positive aspects of the experience may serve to buffer negative mental health risks across time. Understanding resilience strategies is critical for supporting current psychological wellbeing and to adequately prepare for future pandemic experiences.

The impact of diffusion and stirring on the dynamics of interacting populations.

We investigate the combined effects of diffusion and stirring on the dynamics of interacting populations which have spatial structure. Specifically we consider the marine phytoplankton and zooplankton populations, and model them as an excitable medium. The results are applicable to other biological and chemical systems. Under certain conditions the combination of diffusion and stirring is found to enhance the excitability, and hence population growth of the system. Diffusion is found to play an important role: too much and initial perturbations are smoothed away, too little and insufficient mixing takes place before the reaction is over. A key time-scale is the mix-down time, the time it takes for the spatial scale of a population to be reduced to that of a diffusively controlled filament. If the mix-down time is short compared to the reaction time-scale, then excitation of the system is suppressed. For intermediate values of the mix-down time the peak population can attain values many times that of a population without spatial structure. We highlight the importance of the spatial scale of the initial disturbance to the system.