RESUMO
During a large outbreak of Shiga toxin-producing Escherichia coli illness associated with an agricultural show in Australia, we used whole-genome sequencing to detect an IS1203v insertion in the Shiga toxin 2c subunit A gene of Shiga toxin-producing E. coli. Our study showed that clinical illness was mild, and hemolytic uremic syndrome was not detected.
Assuntos
Diarreia/epidemiologia , Surtos de Doenças , Infecções por Escherichia coli/epidemiologia , Escherichia coli O157/genética , Genoma Bacteriano , Toxina Shiga I/genética , Adolescente , Adulto , Idoso , Animais , Austrália/epidemiologia , Criança , Pré-Escolar , Busca de Comunicante , Diarreia/diagnóstico , Diarreia/microbiologia , Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/microbiologia , Escherichia coli O157/classificação , Escherichia coli O157/isolamento & purificação , Escherichia coli O157/patogenicidade , Fezes/microbiologia , Feminino , Cabras/microbiologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Sorotipagem , Índice de Gravidade de Doença , Ovinos/microbiologia , Toxina Shiga I/classificação , Toxina Shiga I/isolamento & purificação , Sequenciamento Completo do GenomaAssuntos
Vírus Hendra , Infecções por Henipavirus/mortalidade , Infecções por Henipavirus/prevenção & controle , Zoonoses/transmissão , Animais , Austrália , Quirópteros , Infecções por Henipavirus/transmissão , Doenças dos Cavalos/mortalidade , Doenças dos Cavalos/prevenção & controle , Doenças dos Cavalos/transmissão , Cavalos , HumanosRESUMO
OBJECTIVE: To identify the relative importance of extrinsic determinants of doctors' choice of specialty. DESIGN: A self-administered postal questionnaire. SETTING: Australian vocational training programs. PARTICIPANTS: 4259 Australian medical graduates registered in September 2002 with one of 16 Australian clinical colleges providing vocational training programs. MAIN OUTCOME MEASURES: Choice of specialist vocational training program; extrinsic factors influencing choice of program, and variation by sex, age, marital status and country of birth. RESULTS: In total, 79% of respondents rated "appraisal of own skills and aptitudes" as influential in their choice of specialty followed by "intellectual content of the specialty" (75%). Extrinsic factors rated as most influential were "work culture" (72%), "flexibility of working arrangements" (56%) and "hours of work" (54%). We observed variation across training programs in the importance ascribed to factors influencing choice of specialty, and by sex, age and marital status. Factors of particular importance to women, compared with men, were "appraisal of domestic circumstances" (odds ratio [OR], 1.9), "hours of work" (OR, 1.8) and "opportunity to work flexible hours" (OR, 2.6). Partnered doctors, compared with single doctors, rated "hours of work" and "opportunity to work flexible hours" as more important (OR, 1.3), while "domestic circumstances" was more important to doctors with children than those without children (OR, 1.7). In total, 80% of doctors had chosen their specialty by the end of the third year after graduation. CONCLUSIONS: Experience with discipline-based work cultures and working conditions occurs throughout medical school and the early postgraduate years, and most doctors choose their specialty during these years. It follows that interventions to influence doctors' choice of specialty need to target these critical years.