Impacts of plastic-free materials on coral-associated bacterial communities during reef restoration.

Coral propagation and out-planting based restoration approaches are increasingly being applied to assist natural recovery of coral reefs. However, many restoration methods rely on plastic zip-ties to secure coral material which is potentially problematic for the marine environment. Plastic-free biodegradable alternatives may however pose unique risks to coral-associated bacterial communities integral to coral health. Therefore, to identify whether biodegradable materials differentially impact coral-associated bacterial communities we examined Acropora millepora coral-associated bacterial communities during propagation in two experiments on the Great Barrier Reef. Coral fragments were secured to coral nurseries with conventional plastic, metal, or biodegradable (polyester and polycaprolactone) ties. Tie failure and coral-associated bacterial communities were then characterized over six months. Minimal coral mortality was observed (3.6%-8%) and all ties had low failure rates (0%-4.2%) except for biodegradable polyester ties (29.2% failure). No differences were observed between coral-associated bacterial communities of fragments secured with different ties, and no proliferation of putatively pathogenic bacteria was recorded. Overall, our findings suggest that reducing reliance on conventional plastic is feasible through transitions to biodegradable materials, without any notable impacts on coral-associated bacterial communities. However, we caution the need to examine more coral taxa of different morphologies and new plastic-free materials prior to application.

Two-Step Process for ED UTI Screening in Febrile Young Children: Reducing Catheterization Rates.

BACKGROUND AND OBJECTIVES: Urinary tract infection (UTI) screening in febrile young children can be painful and time consuming. We implemented a screening protocol for UTI in a high-volume pediatric emergency department (ED) to reduce urethral catheterization, limiting catheterization to children with positive screens from urine bag specimens. METHODS: This quality-improvement initiative was implemented using 3 Plan-Do-Study-Act cycles, beginning with a small test of the proposed change in 1 ED area. To ensure appropriate patients received timely screening, care teams discussed patient risk factors and created patient-specific, appropriate procedures. The intervention was extended to the entire ED after providing education. Finally, visual cues were added into the electronic health record, and nursing scripts were developed to enlist family participation. A time-series design was used to study the impact of the 6-month intervention by using a p-chart to determine special cause variation. The primary outcome measure for the study was defined as the catheterization rate in febrile children ages 6 to 24 months. RESULTS: The ED reduced catheterization rates among febrile young children from 63% to <30% over a 6-month period with sustained results. More than 350 patients were spared catheterization without prolonging ED length of stay. Additionally, there was no change in the revisit rate or missed UTIs among those followed within the hospital's network. CONCLUSIONS: A 2-step less-invasive process for screening febrile young children for UTI can be instituted in a high-volume ED without increasing length of stay or missing cases of UTI.