Aquarium Visitors Catch Some Rays: Rays Are More Active in the Presence of More Visitors.

Humans are a constant in the lives of captive animals, but the effects of human-animal interactions vary. Research on the welfare impacts of human-animal interactions focus predominantly on mammals, whereas fish have been overlooked. To address this lack of research, we assessed the impacts of aquarium visitors on the behaviors of ten members of four elasmobranch species: an Atlantic stingray (Dasyatis sabina), four southern stingrays (Hypanus americanus), two blue-spotted maskrays (Neotrygon kuhlii), and three fiddler rays (Trygonorrhina dumerilii). The rays engaged in a significantly higher proportion of active behaviors and a lower proportion of inactive behaviors when visitor density levels were high; however, there were no significant changes for negative or social behaviors. Individual analyses indicated that all three fiddler rays and one of the southern stingrays' active behaviors differed across visitor density levels, whereas there was no association between active behavior and visitor density levels for the other rays. Further research is needed to determine whether this pattern is an adaptive or maladaptive response to visitors, but this research provides much needed initial data on activity budgets within elasmobranch species.

Diversity of the Microbiota of Traditional Izmir Tulum and Izmir Brined Tulum Cheeses and Selection of Potential Probiotics.

High-throughput DNA sequencing (HTS) was used to study the microbial diversity of commercial traditional Izmir Tulum (IT) and Izmir Brined Tulum (IBT) cheeses from Izmir, Türkiye. Simultaneously, cultivation-dependent methods were used to isolate, identify and characterize bacterial strains displaying probiotic potential. At the phylum level, Firmicutes dominated the microbiota of both cheese types comprising >98% of the population. Thirty genera were observed, with Streptococcus being the most abundant genus and with Streptococcus thermophilus and S. infantarius subsp. infantarius being the most abundant species. Genera, including Bifidobacterium and Chryseobacterium, not previously associated with IT and IBT, were detected. IT cheeses displayed higher operational taxonomic units (OTUs; Richness) and diversity index (Simpson) than IBT cheeses; however, the difference between the diversity of the microbiota of IT and IBT cheese samples was not significant. Three Lacticaseibacillus paracasei strains isolated from IBT cheeses exhibited probiotic characteristics, which included capacity to survive under in vitro simulated gastrointestinal conditions, resistance to bile salts and potential to adhere to HT-29 human intestinal cells. These findings demonstrate that Tulum cheeses harbor bacterial genera not previously reported in this cheese and that some strains display probiotic characteristics.

Refinement of an ovine-based immunoglobulin therapy against SARS-CoV-2, with comparison of whole IgG versus F(ab')2 fragments.

The development of new therapies against SARS-CoV-2 is required to extend the toolkit of intervention strategies to combat the global pandemic. In this study, hyperimmune plasma from sheep immunised with whole spike SARS-CoV-2 recombinant protein has been used to generate candidate products. In addition to purified IgG, we have refined candidate therapies by removing non-specific IgG via affinity binding along with fragmentation to eliminate the Fc region to create F(ab')2 fragments. These preparations were evaluated for in vitro activity and demonstrated to be strongly neutralising against a range of SARS-CoV-2 strains, including Omicron B2.2. In addition, their protection against disease manifestations and viral loads were assessed using a hamster SARS-CoV-2 infection model. Results demonstrated protective effects of both IgG and F(ab')2, with the latter requiring sequential dosing to maintain in vivo activity due to rapid clearance from the circulation.

A systematic review on inequalities in accessing and using community-based social care in dementia.

OBJECTIVES: To evaluate and synthesize the evidence base on barriers and facilitators to accessing and using community-based social care in dementia. DESIGN: Mixed-methods systematic review. SETTING: Community-based social care (such as day care, respite care, paid home care, and peer support groups). PARTICIPANTS: People living with dementia and unpaid carers. MEASUREMENTS: Seven databases were searched in March 2022, including English and German evidence published from 2000 focusing on inequalities in community-based social care for dementia across the globe. Titles and abstracts were screened by two reviewers, with all full texts screened by two reviewers also. Study quality was assessed using QualSyst. RESULTS: From 3,904 screened records, 39 papers were included. The majority of studies were qualitative, with 23 countries represented. Barriers and facilitators could be categorized into the following five categories/themes: situational, psychological, interpersonal, structural, and cultural. Barriers were notably more prominent than facilitators and were multifaceted, with many factors hindering or facilitating access to social care linked together. CONCLUSIONS: People with dementia and carers experience significant barriers in accessing care in the community, and a varied approach on multiple levels is required to address systemic and individual-level barriers to enable more equitable access to care for all.

Rethinking Adolescent School Nutrition Education Through a Food Systems Lens.

BACKGROUND: Obesity-driven nutrition education in schools does not appear to result in healthier adolescent food choices. This study explored food systems as an alternative pedagogical approach to engage students in nutrition education. METHODS: After playing a food systems computer game, 250 13- to 16-year-old students in 5 Western Australian secondary schools, participated in group discussions to distinguish learning and interests in food systems. Discussion records were thematically coded using constant comparative analysis. RESULTS: Students reported crop growth, food production and food waste, healthier food choices, and food systems as knowledge outcomes of game play. They requested additional content on food production, costing, handling, processing, and accessing local produce. Experiential activities were preferred pedagogical approaches. CONCLUSIONS: Cross-curricular pedagogy which embraces human and planetary health through a food systems lens, can engage adolescents in nutrition education. Transformational computer games are effective to engage, educate and stimulate inquiry in food systems education.

Barriers and enablers to the delivery and implementation of the tailored activity programme in Australia: Perspectives of occupational therapists and their managers.

BACKGROUND: Prior to implementing new programmes or practices, it is essential to understand the context, barriers and enablers to support successful use. The tailored activity programme (TAP) is an evidence-based intervention provided by occupational therapists to support community-dwelling people living with dementia and their carers. The programme was developed in the United States, and although it is not currently available for routine use in Australia, its implementation would address the needs of many Australians with dementia and their carers. AIM: The aim of the study is to understand the perspectives of occupational therapists and their managers regarding barriers and enablers to the delivery and implementation of the TAP in Queensland, Australia. METHODS: A qualitative descriptive methodology was employed. Semistructured interviews were undertaken with occupational therapists (n = 18) who work with community-dwelling people with dementia and their carers, and their managers (n = 10). Participants were recruited from a range of organisations across Queensland, and they were asked about potential barriers and enablers to implementing TAP. Interviews were recorded and transcribed verbatim. Data were mapped using framework analysis whilst remaining open to other themes. FINDINGS: Themes were identified, and facilitating factors included the close alignment of TAP with occupational therapists' scope of practice; their acceptance of, and optimism about the programme and its perceived benefits including improved client outcomes; and an opportunity for occupational therapists to further develop their skills. Managerial support and carers' readiness and willingness to participate were also identified as important factors for success, whereas barriers were cost to clients and the capacity of the occupational therapy workforce to provide TAP. CONCLUSION: Occupational therapists and their managers expressed enthusiasm for TAP and awareness of its likely benefits, while also identifying barriers that will need to be addressed if implementation of the programme is to be successful in Australia.

What Should Be Considered When Assessing Hyperacusis? A Qualitative Analysis of Problems Reported by Hyperacusis Patients.

Hyperacusis (decreased sound tolerance) is a prevalent complaint. Yet, to date, no research has qualitatively evaluated the types of problems experienced by adults with hyperacusis. Our service evaluation aims to determine the hyperacusis-related problem domains reported by patients and the degree to which these domains were reported together. Retrospective analysis was conducted on an anonymised clinical dataset from 306 patients who attended a UK tinnitus and hyperacusis treatment centre between 1994 and 2017. Conventional content analysis was used to categorise responses to the question 'Why is hyperacusis a problem?' into domains which were then subjected to a cluster analysis. Twenty-five problem domains were identified, of which 12 were further classified into three overarching categories. 'Fear', 'Reduced quality of life' and 'Physical reaction to sound' were most frequently reported problems. Cluster analysis revealed that 'Sleep difficulties' and 'Despondency', were commonly reported together. Adults with hyperacusis face many challenges in their everyday lives. The nature of these problems indicates the need to develop complex interventions and assessments to aid management of hyperacusis. Current hyperacusis questionnaires may be useful in identifying some problem domains, but further assessment thorough patient interviews is required to fully explore all potential problems and make informed decisions about treatment.

Process evaluation of in-person, news and social media engagement of a community-based programme Brown Buttabean Motivation (BBM): a research protocol.

INTRODUCTION: The community group Brown Buttabean Motivation (BBM) initially began to assist Auckland Pasifika and Maori to manage weight problems, predominantly through community-based exercise sessions and social support. BBM's activities expanded over time to include many other components of healthy living in response to community need. With advent of the COVID-19 pandemic, BBM outreach grew to include a foodbank distributing an increasing amount of donated healthy food to families in need, a community kitchen and influenza and COVID-19 vaccine drives. A strong social media presence has served as the main means of communication with the BBM community as well as use of traditional news media (written, radio, television) to further engage with vulnerable members of the community. METHODS AND ANALYSIS: The study aims to conduct mixed method process evaluation of BBM's community engagement through in-person, social and news media outreach activities with respect to the health and well-being of Pasifika and Maori over time. The project is informed by theoretical constructs including Pacific Fa'afaletui and Fonofale and Maori Te Whare Tapa Wha Maori research frameworks and principles of Kaupapa Maori. It is further framed using the concept of community-driven diffusion of knowledge and engagement through social networks. Data sources include in-person community engagement databases, social and news media outreach data from archived documents and online resources. Empirical data will undergo longitudinal and time series statistical analyses. Qualitative text thematic analyses will be conducted using the software NVivo, Leximancer and AntConc. Image and video visual data will be randomly sampled from two social media platforms. The social media dataset contains almost 8000 visual artefacts. ETHICS AND DISSEMINATION: Ethics approval obtained from University of Auckland Human Participants Ethics Committee UAHPEC 23456. Findings will be published in peer-reviewed publications, disseminated through community meetings and conferences and via BBM social network platforms. TRIAL REGISTRATION NUMBER: ACTRN 12621 00093 1875.

One health genomic surveillance and response to a university-based outbreak of the SARS-CoV-2 Delta AY.25 lineage, Arizona, 2021.

Genomic surveillance and wastewater tracking strategies were used to strengthen the public health response to an outbreak of the SARS-CoV-2 Delta AY.25 lineage associated with a university campus in Arizona. Epidemiologic and clinical data routinely gathered through contact tracing were matched to SARS-CoV-2 genomes belonging to an outbreak of AY.25 identified through ongoing phylogenomic analyses. Continued phylogenetic analyses were conducted to further describe the AY.25 outbreak. Wastewater collected twice weekly from sites across campus was tested for SARS-CoV-2 by RT-qPCR, and subsequently sequenced to identify variants. The AY.25 outbreak was defined by a single mutation (C18804T) and comprised 379 genomes from SARS-CoV-2 positive cases associated with the university and community. Several undergraduate student gatherings and congregate living settings on campus likely contributed to the rapid spread of COVID-19 across the university with secondary transmission into the community. The clade defining mutation was also found in wastewater samples collected from around student dormitories a week before the semester began, and 9 days before cases were identified. Genomic, epidemiologic, and wastewater surveillance provided evidence that an AY.25 clone was likely imported into the university setting just prior to the onset of the Fall 2021 semester, rapidly spread through a subset of the student population, and then subsequent spillover occurred in the surrounding community. The university and local public health department worked closely together to facilitate timely reporting of cases, identification of close contacts, and other necessary response and mitigation strategies. The emergence of new SARS-CoV-2 variants and potential threat of other infectious disease outbreaks on university campuses presents an opportunity for future comprehensive One Health genomic data driven, targeted interventions.

What constitutes a quality community aged care service-client perspectives: An international scoping study.

Overwhelmingly, older Australians (people aged 65 years and older or 50 years and older for Aboriginal and Torres Strait Islander people) prefer to remain living in their own home rather than moving into residential care. To enable older Australians who require assistance to remain living at home, the Federal Government provides a wide range of community care services, the provision of which has increased substantially over the last 15 years. The importance of client preferences, prefaced by the introduction of consumer directed care across community aged care services, has gathered momentum in Australia following legislation in 2015. Older peoples' preferences differ in comparison to younger people with disability and those with mental health concerns. Older people focus more on the provision of services rather than the notion of independent living itself. This scoping review aimed to explore what aspects people aged 65 years and older consider to be important qualities of aged care services delivered in the community. A computerised search in MEDLINE, CINAHL, PubMed and PsychINFO and hand searches of the Cochrane database and Google Scholar were completed in May 2022. Sixty-two articles met the selection criteria and were included in the review. Data were extracted using a fit-for-purpose protocol and analysed using the Miles and Huberman Model for thematic analysis. Results identified five themes representing quality domains that describe features that are important to clients: staff knowledge, respect for clients, a person-centred approach, a collaborative partnership with clients and clear communication. When providers of community aged care services are planning to assess the quality of their services, these findings could be used to guide their evaluation. This will ensure that future services delivered accommodate the needs and preferences of clients who receive them.

Development of a cost-effective ovine antibody-based therapy against SARS-CoV-2 infection and contribution of antibodies specific to the spike subunit proteins.

Antibodies against SARS-CoV-2 are important to generate protective immunity, with convalescent plasma one of the first therapies approved. An alternative source of polyclonal antibodies suitable for upscaling would be more amendable to regulatory approval and widespread use. In this study, sheep were immunised with SARS-CoV-2 whole spike protein or one of the subunit proteins: S1 and S2. Once substantial antibody titres were generated, plasma was collected and samples pooled for each antigen. Non-specific antibodies were removed via affinity-purification to yield candidate products for testing in a hamster model of SARS-CoV-2 infection. Affinity-purified polyclonal antibodies to whole spike, S1 and S2 proteins were evaluated for in vitro for neutralising activity against SARS-CoV-2 Wuhan-like virus (Australia/VIC01/2020) and a recent variant of concern, B.1.1.529 BA.1 (Omicron), antibody-binding, complement fixation and phagocytosis assays were also performed. All antibody preparations demonstrated an effect against SARS-CoV-2 disease in the hamster model of challenge, with those raised against the S2 subunit providing the most promise. A rapid, cost-effective therapy for COVID-19 was developed which provides a source of highly active immunoglobulin specific to SARS-CoV-2 with multi-functional activity.

Systematic review of outcome domains and instruments used in designs of clinical trials for interventions that seek to restore bilateral and binaural hearing in adults with unilateral severe to profound sensorineural hearing loss ('single-sided deafness').

BACKGROUND: This systematic review aimed to identify, compare and contrast outcome domains and outcome instruments reported in studies investigating interventions that seek to restore bilateral (two-sided) and/or binaural (both ears) hearing in adults with single-sided deafness (SSD). Findings can inform the development of evidence-based guidance to facilitate design decisions for confirmatory trials. METHODS: Records were identified by searching MEDLINE, EMBASE, PubMed, CINAHL, ClinicalTrials.gov, ISRCTN, CENTRAL, WHO ICTRP and the NIHR UK clinical trials gateway. The search included records published from 1946 to March 2020. Included studies were those as follows: (a) recruiting adults aged 18 years or older diagnosed with SSD of average threshold severity worse than 70 dB HL in the worse-hearing ear and normal (or near-normal) hearing in the better-hearing ear, (b) evaluating interventions to restore bilateral and/or binaural hearing and (c) enrolling those adults in a controlled trial, before-and-after study or cross-over study. Studies that fell just short of the participant eligibility criteria were included in a separate sensitivity analysis. RESULTS: Ninety-six studies were included (72 full inclusion, 24 sensitivity analysis). For fully included studies, 37 exclusively evaluated interventions to re-establish bilateral hearing and 29 exclusively evaluated interventions to restore binaural hearing. Overall, 520 outcome domains were identified (350 primary and 170 secondary). Speech-related outcome domains were the most common (74% of studies), followed by spatial-related domains (60% of studies). A total of 344 unique outcome instruments were reported. Speech-related outcome domains were measured by 73 different instruments and spatial-related domains by 43 different instruments. There was considerable variability in duration of follow-up, ranging from acute (baseline) testing to 10 years after the intervention. The sensitivity analysis identified no additional outcome domains. CONCLUSIONS: This review identified large variability in the reporting of outcome domains and instruments in studies evaluating the therapeutic benefits and harms of SSD interventions. Reports frequently omitted information on what domains the study intended to assess, and on what instruments were used to measure which domains. TRIAL REGISTRATION: The systematic review protocol is registered on PROSPERO (International Prospective Register of Systematic Reviews): Registration Number CRD42018084274 . Registered on 13 March 2018, last revised on 7th of May 2019.

Secukinumab as a potential trigger of inflammatory bowel disease in ankylosing spondylitis or psoriatic arthritis patients.

OBJECTIVE: Real-world secukinumab gastrointestinal-related adverse events (GIRAE) data during treatment for AS and PsA are lacking. We aimed to obtain this through baseline evaluation of pre-existing IBD rates and predictors of GIRAE. METHODS: Patient electronic and paper records commencing secukinumab from 10 UK hospitals between 2016 and 2019 were reviewed. GIRAE after initiation were defined as: definite [objective evidence of IBD (biopsy proven), clear temporal association, resolution of symptoms on drug withdrawal, no alternative explanation felt more likely], probable (as per definite, but without biopsy confirmation) or possible (gastrointestinal symptoms not fulfilling definite or probable criteria). RESULTS: Data for all 306 patients started on secukinumab were analysed: 124 (40.5%) AS and 182 (59.5%) PsA. Twenty-four of 306 (7.8%) experienced GIRAE after starting secukinumab. Amongst patients who developed GIRAE, four (1.3%) had definite, seven (2.3%) probable and 13 (4.2%) possible IBD. All definite cases were patients with AS and stopped secukinumab; two had pre-existing IBD and two (0.7%) were de novo cases of which one required surgical intervention. Seven patients (2.3%) had pre-existing diagnoses of IBD prior to initiation, of which five patients experienced GIRAE. CONCLUSION: Absolute rates of new IBD in patients starting secukinumab are low. The majority of patients developing new GIRAE did not develop objective evidence of IBD or stop therapy. For patients with pre-existing IBD and AS the risk of GIRAE is much higher, and prescribing alternatives should be considered.

Identifying Differences in Nutrition-Related Learning Interests of Adolescent Students.

BACKGROUND: In this study, we examined nutrition-related topics among adolescent students attending schools with different Indices of Community Socio-Educational Advantage (ICSEA). METHOD: Participating students (N = 206) from 5 schools in Western Australia completed a paper-based questionnaire on nutrition-related topics. Frequencies and independent chi-square tests were used to identify differences between sexes and school ICSEA. RESULTS: Of the participating students, 75% were interested in learning about 8 of 16 topics. We found statistically significant differences by sex (p < .01) for "Eating the right foods for preventing illness and disease," "Eating the right food for being active" among girls, and "Reducing food waste" among boys. We also noted differences by school ICSEA. CONCLUSION: Acknowledging sex and socioeducational differences in teaching and learning may help teachers to engage adolescent students in nutrition education.

Evaluating a New Contrast Media Injection System in Coronary CT Angiography.

PURPOSE: To evaluate a new contrast media (CM) injection system in patients undergoing coronary computed tomography angiography (CCTA). METHODS: Seventy-one consecutive patients (33 men and 38 women, mean age 59.0 ± 14.5 years) who underwent CCTA between February and April 2019 using the CT injection system MEDRAD Stellant FLEX (Bayer) were included retrospectively in this single-center study. Quantitative and qualitative image quality parameters were assessed, and the injection system's usability and operational efficiency were evaluated. Results were compared with a matched control group. RESULTS: All examinations were rated as diagnostic. Usability and operational efficiency of the new injector were rated higher than that of the standard injector system, and no significant differences were found for quantitative and qualitative image quality parameters compared with the control group (P ≥ .05). DISCUSSION: Software-based injection facilitates individualized CM application while maintaining high image quality standards in CCTA. Diagnostic accuracy analysis was not performed, but as image quality analysis showed no significant differences, no discrepancies regarding this issue are expected. CONCLUSION: This study demonstrates that the MEDRAD Stellant FLEX CT injection system allows for consistent high-quality CCTA scanning with increased usability and operational efficiency.

Chemical mismanagement and skin burns among hospitalized and outpatient department patients.

Purpose. This article attempts to elucidate the nature of chemicals causing major and minor skin burns, and their associated characterization across different industries, using Fujian provincial hospitals' admission and outpatient department records. Materials and methods. Data were collected from the provincial hospitals of Fujian through a questionnaire, sent via email, from June 1, 2017 to November 30, 2017. The collected responses were statistically analyzed using SPSS version 19 through the interquartile range, median, Mann-Whitney U test and Fisher's exact test with two-tailed significance. Results and conclusions. The results of 306 collected responses reveal that the majority of skin burn cases are due to a lack of technical education and professional training among workers handling chemicals. This study suggests that management's effective supervision and governmental regulations may help to prevent chemical skin burns at work, and can further be controlled by hiring professional workers alongside providing training to them in chemical handling as well as using protective equipment and developing appropriate management policies to improve victims' well-being and quality of life. Findings will help workers, doctors, hospitals, industries, government and other stakeholders to understand and control chemical hazards on site to minimize the risks of chemical skin burn incidents.

Self-guided behavioral skills training: A public health approach to promoting nurturing care environments.

The World Health Organization identified the promotion of "Nurturing Care Environments" as a global health priority. Responsive caregiving, 1 of 5 domains describing nurturing care, is critical for healthy child development. Relatively little research has evaluated population-level interventions aimed to increase responsive caregiving during the first 1,000 days of an infant's life. In this pilot study, we evaluated an intervention designed for population-level dissemination that targeted responsive caregiving. The self-guided behavioral skills training aimed to teach mothers to imitate infant vocalizations. The intervention was delivered within an on-line asynchronous training. All 3 mothers increased vocal imitative behavior following training without receiving coaching or behavior-specific feedback from an implementer. The results offer a preliminary proof of concept with implications for population-level intervention design and evaluation.

The Content and Quality of Information About Hyperacusis Presented Online.

Purpose Hyperacusis is a disorder characterized by reduced sound tolerance leading to ear pain, emotional distress, and reduced quality of life. Many people with hyperacusis turn to the Internet for information and support from online communities to discuss their condition. The purpose of this study was to assess the content and quality of hyperacusis information presented online. Method The three most used Internet search engines were used to identify relevant websites using the single search term hyperacusis. Fifteen websites were selected for analysis. Details of the purpose, audience, and content of each website were extracted using a bespoke data extraction form. The quality of the information on each website was rated using the validated DISCERN questionnaire. Results There was a wide disparity in the quality and content of hyperacusis information across websites. The website Hyperacusis Focus achieved the highest overall DISCERN score. Hyperacusis Focus and U.K. National Health Service websites were the most comprehensive online resources for health care professionals and patients, respectively. Wikipedia was judged useful for both health care professionals and patients. In general, hyperacusis-related information was accurate. However, no single website provided a complete account of hyperacusis, and some were judged to be selective in the information they provided. Conclusions The Internet provides an important source of information for those who have hyperacusis and those who care for them. Revisions to the websites reviewed here are needed for each to provide a complete account of hyperacusis. Supplemental Material https://doi.org/10.23641/asha.12869717.

Supporting access to activities to enhance well-being and reduce social isolation in people living with motor neurone disease.

PURPOSE: People living with Motor Neurone Disease (plwMND) have emphasised the importance of psychological support and well-being in helping them manage their condition. Social prescribing is a formal process of referring patients with largely socioeconomic and psychosocial issues to a link worker to co-design a plan to improve their health and well-being. Intervention involves supporting engagement in meaningful activities based within the individual's local community. This pilot project aimed to explore the application of social prescribing with plwMND. METHODS: A cohort of plwMND were supported by an occupational therapist and link worker to identify and access community-based activities. Qualitative interviews were completed post-intervention with the plwMND and the link workers. Findings were analysed using thematic analysis. RESULTS: A total of nine plwMND took part in this pilot service, and five plwMND and four link workers were interviewed. PlwMND valued participation and wanted to engage in community-based activities. Those with mild symptomatology were able to access activities and reported a positive impact on their well-being. Those with more complex needs, particularly reduced mobility, experienced significant barriers to participation. Barriers included transport, equipment provision, lack of company to support participation and lack of confidence using mobility aids in a community environment. Link workers valued joint working with an occupational therapist. CONCLUSION: Social prescribing aims to address the health inequalities of those living with long-term conditions, although currently it likely excludes plwMND. Future work needs to quantitatively evaluate the effects of the service on the well-being of plwMND.