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1.
Support Care Cancer ; 32(4): 257, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38556587

RESUMO

PURPOSE: Nutrition is essential within cancer care, yet patient and carer access to nutrition care and information is variable. This study aimed to (1) investigate patient and carer access and perceptions, and health professional views and practices, relating to cancer nutrition information and care; and (2) co-design interactive resources to support optimal nutrition care. METHODS: Patients and carers completed a survey regarding access to nutrition care and information. Seven multidisciplinary health service teams were invited to participate in a survey and focus group to assess barriers and enablers in nutrition practices. Focus groups were recorded, transcribed and thematically analyzed. Eligible patients, carers, and health professionals were invited to four virtual workshops utilizing experience-based co-design methods to identify nutrition priority areas and design resources. Workshop participant acceptability of the resources was measured. RESULTS: Of 104 consumer survey respondents (n = 97 patients, n = 7 carers), 61% agreed that it "took too much time to find evidence-based nutrition and cancer information", and 46% had seen a dietitian. Thirty-four of 38 health professionals completed the survey and 30 participated in a focus group, and it was identified the greatest barriers to delivering nutrition care were lack of referral services, knowledge or skill gaps, and time. Twenty participants (n = 10 patients and carers, n = 10 health professionals) attended four workshops and co-designed a suite of 46 novel resources rated as highly acceptable. CONCLUSION: Improved communication, training, and availability of suitable resources could improve access to and support cancer nutrition information and care. New, co-designed cancer nutrition resources were created and deemed highly acceptable to patients, carers, and health professionals.


Assuntos
Neoplasias , Nutricionistas , Humanos , Pessoal de Saúde/educação , Cuidadores , Pacientes , Grupos Focais , Neoplasias/terapia
2.
Support Care Cancer ; 31(2): 99, 2023 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-36609614

RESUMO

PURPOSE: Limited practical resources exist to guide optimal nutrition care for patients, carers, and health professionals (HPs). This study aimed to co-design a cancer nutrition care pathway to guide and improve the provision of consistent, evidence-based care with consumers and HPs. METHODS: This study utilised an experienced-based co-design (EBCD) approach over five stages. Stage 1 involved stakeholder engagement and a literature review. Stage 2 included a survey and focus groups with patients/carers. Co-design workshops were conducted within stage 3, key stakeholder consultation within stage 4, and the finalisation and dissemination of the cancer nutrition care pathway formed stage 5. Results of stages 3 to 5 are the focus of this paper. RESULTS: Two co-design workshops were held with patients, carers, and HPs (n = 32 workshop 1; n = 32 workshop 2), who collectively agreed on areas of focus and key priorities. Following this, a consultation period was completed with patients, carers, and HPs (n = 45) to refine the pathway. The collective outcome of all study stages was the co-design of a cancer nutrition care pathway (the CanEAT pathway) defining optimal cancer nutrition care that combines evidence-based practice tips into a centralised suite of resources, tools, and clinical guidance. CONCLUSION: The CanEAT pathway was co-designed by patients, carers, and HPs. The EBCD approach is a meaningful way to develop targeted improvements in cancer care. The CanEAT pathway is freely available to guide and support patients, carers, and HPs to aid the implementation of optimal nutrition care into clinical practice.


Assuntos
Neoplasias , Terapia Nutricional , Humanos , Cuidadores , Procedimentos Clínicos , Pessoal de Saúde , Grupos Focais , Neoplasias/terapia
3.
BMC Health Serv Res ; 23(1): 440, 2023 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-37143117

RESUMO

BACKGROUND: The growing demands for multidisciplinary cancer survivorship care require new approaches to address the needs of people living after a cancer diagnosis. Good Life-Cancer Survivorship is a self-management support survivorship program delivered by community allied health (AH) services for people diagnosed with cancer. A pilot study established the benefits of Good Life-Cancer Survivorship to help survivors manage their health and wellbeing in the community health setting. This study expanded the program to four community health services and evaluated the implementation outcomes of the referral pathway to the survivorship program. METHODS: Eligible cancer survivors attending hospital oncology services were referred to the survivorship program. Data was collected between 19/02/2021-22/02/2022 and included allied health service utilisation, consumer surveys, and interviews to understand consumer experience with the referral pathway. Interviews and focus groups with hospital and community health professionals explored factors influencing the referral uptake. Implementation outcomes included Adoption, Acceptability, Appropriateness, Feasibility, and Sustainability. RESULTS: Of 35 eligible survivors (mean age 65.5 years, SD = 11.0; 56% women), 31 (89%) accepted the referral. Most survivors had two (n = 14/31; 45%) or more (n = 11/31; 35%) allied health needs. Of 162 AH appointments (median appointment per survivor = 4; range = 1-15; IQR:5), 142/162 (88%) were scheduled within the study period and 126/142 (89%) were attended. Consumers' interviews (n = 5) discussed the referral pathway; continuation of survivorship care in community health settings; opportunities for improvement of the survivorship program. Interviews with community health professionals (n = 5) highlighted the impact of the survivorship program; cancer survivorship care in community health; sustainability of the survivorship program. Interviews (n = 3) and focus groups (n = 7) with hospital health professionals emphasised the importance of a trusted referral process; a holistic and complementary model of care; a person-driven process; the need for promoting the survivorship program. All evaluations favourably upheld the five implementation outcomes. CONCLUSIONS: The referral pathway provided access to a survivorship program that supported survivors in self-management strategies through tailored community allied health services. The referral pathway was well adopted and demonstrated acceptability, appropriateness, and feasibility. This innovative care model supports cancer survivorship care delivery in community health settings, with clinicians recommending sustaining the referral pathway.


Assuntos
Sobreviventes de Câncer , Neoplasias , Humanos , Feminino , Idoso , Masculino , Projetos Piloto , Sobreviventes , Neoplasias/terapia , Encaminhamento e Consulta , Serviços de Saúde
5.
J Biol Chem ; 289(49): 34341-8, 2014 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-25271152

RESUMO

Class IIa histone deacetylases (HDACs) regulate the activity of many transcription factors to influence liver gluconeogenesis and the development of specialized cells, including muscle, neurons, and lymphocytes. Here, we describe a conserved role for class IIa HDACs in sustaining robust circadian behavioral rhythms in Drosophila and cellular rhythms in mammalian cells. In mouse fibroblasts, overexpression of HDAC5 severely disrupts transcriptional rhythms of core clock genes. HDAC5 overexpression decreases BMAL1 acetylation on Lys-537 and pharmacological inhibition of class IIa HDACs increases BMAL1 acetylation. Furthermore, we observe cyclical nucleocytoplasmic shuttling of HDAC5 in mouse fibroblasts that is characteristically circadian. Mutation of the Drosophila homolog HDAC4 impairs locomotor activity rhythms of flies and decreases period mRNA levels. RNAi-mediated knockdown of HDAC4 in Drosophila clock cells also dampens circadian function. Given that the localization of class IIa HDACs is signal-regulated and influenced by Ca(2+) and cAMP signals, our findings offer a mechanism by which extracellular stimuli that generate these signals can feed into the molecular clock machinery.


Assuntos
Fatores de Transcrição ARNTL/genética , Relógios Circadianos/genética , Proteínas de Drosophila/genética , Regulação da Expressão Gênica , Histona Desacetilases/genética , RNA Mensageiro/genética , Fatores de Transcrição ARNTL/metabolismo , Acetilação , Animais , Proteínas CLOCK/genética , Proteínas CLOCK/metabolismo , Cálcio/metabolismo , Sequência Conservada , AMP Cíclico , Proteínas de Drosophila/antagonistas & inibidores , Proteínas de Drosophila/metabolismo , Drosophila melanogaster/genética , Drosophila melanogaster/metabolismo , Genes Reporter , Inibidores de Histona Desacetilases/farmacologia , Histona Desacetilases/metabolismo , Luciferases/genética , Luciferases/metabolismo , Camundongos , Células NIH 3T3 , Proteínas Circadianas Period/genética , Proteínas Circadianas Period/metabolismo , RNA Mensageiro/metabolismo , RNA Interferente Pequeno/genética , RNA Interferente Pequeno/metabolismo , Transdução de Sinais
6.
Mar Pollut Bull ; 208: 116947, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39278178

RESUMO

Vessel traffic is the greatest contributor to marine anthropogenic noise pollution, and particularly affects species utilising coastal areas. Seal Rocks (Victoria), the largest Australian fur seal breeding colony, has a relatively small vessel exclusion zone during the pupping and breeding season, when vessel traffic is at its peak. It is necessary to understand the impacts of visitation at sensitive marine sites to ensure they are adequately protected from human disturbance. This study assessed the behavioural response of hauled-out Australian fur seals at Seal Rocks to controlled vessel noise exposure during peak and off-peak vessel visitation periods. High level noise exposure (76-80 dB) resulted in increased vigilance and interruption to vital behaviours in both peak and off-peak periods. These behavioural responses were limited to the period of noise exposure but are nevertheless indicative of disturbance. It is important to ensure regulations intended to protect sensitive sites are up-to-date and evidence based.


Assuntos
Otárias , Ruído , Otárias/fisiologia , Animais , Humanos , Comportamento Animal , Navios , Austrália
7.
J Wildl Dis ; 60(4): 860-873, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39141888

RESUMO

The intracellular pathogens Toxoplasma gondii, Brucella spp., and Chlamydia spp. are all known causative agents of abortion in wildlife. Both T. gondii and Brucella spp. have been identified in marine mammal abortions and a limited number of studies have detected their potential presence in Australian fur seals (Arctocephalus pusillus doriferus), but data are sparse for these pathogens in Australian fur seal breeding colonies. Australian fur seals have been shown to have a high degree of third-trimester pregnancy loss in one of their largest breeding colonies. Additionally, pup production has declined at the largest breeding colony for the species. This study surveyed the presence of T. gondii, Brucella spp., and Chlamydia spp. as potential infectious causes of this reproductive loss. Aborted fetuses were collected from two of the largest breeding colonies for the species, Seal Rocks (n=19) and Kanowna Island (n=34). These were examined grossly and through histopathological evaluation, in conjunction with molecular testing for all three pathogens. Placentas were collected from full-term births during the pupping season from Kanowna Island (n=118). These were used to compare the molecular prevalence of the three pathogens in presumed successful pregnancies. Chlamydia spp. was not detected in aborted fetuses in this study. Brucella spp. was detected with PCR in both aborted fetuses (9.4%) and placentas from full-term births (3.4%), and T. gondii was detected using routine histopathology (n=2/53), immunohistochemistry (n=3/4), and PCR (n=4/53) in tissues from aborted fetuses. Toxoplasma gondii was present in 7.5% of third-trimester abortions and absent from all full-term placentas. Brucella spp. was detected in both aborted fetuses and full-term placentas. This is the first description of vertical transmission of T. gondii in a marine mammal from the southern hemisphere.


Assuntos
Aborto Animal , Brucella , Brucelose , Infecções por Chlamydia , Chlamydia , Otárias , Toxoplasma , Toxoplasmose Animal , Animais , Feminino , Toxoplasmose Animal/epidemiologia , Toxoplasma/isolamento & purificação , Brucelose/veterinária , Brucelose/epidemiologia , Brucelose/microbiologia , Brucella/isolamento & purificação , Gravidez , Otárias/parasitologia , Otárias/microbiologia , Aborto Animal/microbiologia , Aborto Animal/parasitologia , Aborto Animal/epidemiologia , Chlamydia/isolamento & purificação , Infecções por Chlamydia/veterinária , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/microbiologia , Austrália/epidemiologia , Animais Selvagens , Feto Abortado/microbiologia , Feto Abortado/parasitologia
8.
PLoS One ; 17(1): e0258978, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35089935

RESUMO

The rapid emergence of antimicrobial resistance (AMR) is a major concern for wildlife and ecosystem health globally. Genetic determinants of AMR have become indicators of anthropogenic pollution due to their greater association with humans and rarer presence in environments less affected by humans. The objective of this study was to determine the distribution and frequency of the class 1 integron, a genetic determinant of AMR, in both the faecal microbiome and in Escherichia coli isolated from neonates of three pinniped species. Australian sea lion (Neophoca cinerea), Australian fur seal (Arctocephalus pusillus doriferus) and long-nosed fur seal (Arctocephalus forsteri) pups from eight breeding colonies along the Southern Australian coast were sampled between 2016-2019. DNA from faecal samples (n = 309) and from E. coli (n = 795) isolated from 884 faecal samples were analysed for class 1 integrons using PCRs targeting the conserved integrase gene (intI) and the gene cassette array. Class 1 integrons were detected in A. p. doriferus and N. cinerea pups sampled at seven of the eight breeding colonies investigated in 4.85% of faecal samples (n = 15) and 4.52% of E. coli isolates (n = 36). Integrons were not detected in any A. forsteri samples. DNA sequencing of the class 1 integron gene cassette array identified diverse genes conferring resistance to four antibiotic classes. The relationship between class 1 integron carriage and the concentration of five trace elements and heavy metals was also investigated, finding no significant association. The results of this study add to the growing evidence of the extent to which antimicrobial resistant bacteria are polluting the marine environment. As AMR determinants are frequently associated with bacterial pathogens, their occurrence suggests that these pinniped species are vulnerable to potential health risks. The implications for individual and population health as a consequence of AMR carriage is a critical component of ongoing health investigations.


Assuntos
Bactérias/isolamento & purificação , Farmacorresistência Bacteriana/genética , Otárias/crescimento & desenvolvimento , Leões-Marinhos/crescimento & desenvolvimento , Animais , Antibacterianos/farmacologia , Austrália , Bactérias/efeitos dos fármacos , Bactérias/genética , DNA Bacteriano/metabolismo , Farmacorresistência Bacteriana/efeitos dos fármacos , Espécies em Perigo de Extinção , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Fezes/microbiologia , Otárias/microbiologia , Integrons/genética , Metais Pesados/análise , Leões-Marinhos/microbiologia
9.
R Soc Open Sci ; 9(10): 211723, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36249336

RESUMO

Marine ecosystems in southeastern Australia are responding rapidly to climate change. We monitored the diet of the Australian fur seal (Arctocephalus pusillus doriferus), a key marine predator, over 17 years (1998-2014) to examine temporal changes. Frequency of occurrence (FO) of prey was used as a proxy for ecosystem change. Hard part analysis identified 71 prey taxa, with eight dominant taxa in greater than 70% of samples and predominantly included benthic and small pelagic fish. FO changed over time, e.g. redbait (Emmelichthys nitidus) reduced after 2005 when jack mackerel (Trachurus declivis) increased, and pilchard (Sardinops sajax) increased after 2009. Using generalized additive models, correlations between FO and environmental variables were evident at both the local (e.g. wind, sea surface temperature (SST)) and regional (e.g. El Niño-Southern Oscillation Index (SOI), Southern Annular Mode (SAM)) scales, with redbait and pilchard showing the best model fits (greater than 75% deviance explained). Positive SAM was correlated to FO for both species, and wind and season were important for redbait, while SOI and SST were important for pilchard. Both large-scale and regional processes influenced prey taxa in variable ways. We predict that the diverse and adaptable diet of the Australian fur seal will be advantageous in a rapidly changing ecosystem.

10.
PLoS One ; 17(3): e0265610, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35303037

RESUMO

Fur seal populations in the Southern Hemisphere were plundered in the late 1700s and early 1800s to provide fur for a clothing industry. Millions of seals were killed resulting in potentially major ecosystem changes across the Southern Hemisphere, the consequences of which are unknown today. Following more than a century of population suppression, partly through on-going harvesting, many of the fur seal populations started to recover in the late 1900s. Australian fur seals (Arctocephalus pusillus doriferus), one of the most geographically constrained fur seal species, followed this trend. From the 1940s to 1986, pup production remained at approximately 10,000 per year, then significant growth commenced. By 2007, live pup abundance had recovered to approximately 21,400 per year and recovery was expected to continue However, a species-wide survey in 2013 recorded a 20% decline, to approximately 16,500 live pups. It was not known if this decline was due to 2013 being a poor breeding year or a true population reduction. Here we report the results of a population-wide survey conducted in 2017 and annual monitoring at the most productive colony, Seal Rocks, Victoria that recorded a large decline in live pup abundance (-28%). Sustained lower pup numbers at Seal Rocks from annual counts between 2012-2017 (mean = 2908 ± 372 SD), as well as the population-wide estimate of 16,903 live pups in 2017, suggest that the pup numbers for the total population have remained at the lower level observed in 2013 and that the 5-yearly census results are not anomalies or representative of poor breeding seasons. Potential reasons for the decline, which did not occur range-wide but predominantly in the most populated and long-standing breeding sites, are discussed. To enhance adaptive management of this species, methods for future monitoring of the population are also presented. Australian fur seals occupy several distinct regions influenced by different currents and upwellings: range-wide pup abundance monitoring enables comparisons of ecosystem status across these regions. Forces driving change in Australian fur seal pup numbers are likely to play across other marine ecosystems, particularly in the Southern Hemisphere where most fur seals live.


Assuntos
Caniformia , Otárias , Focas Verdadeiras , Animais , Austrália , Ecossistema , Dinâmica Populacional
11.
J Am Geriatr Soc ; 70(4): 1257-1267, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35133003

RESUMO

OBJECTIVES: The number of people living with dementia is growing and most patients go years without receiving a specific diagnosis or support services, leading to suboptimal care, negative impacts on the quality of life, and increased costs of care. To address these gaps, the State of Georgia Department of Human Services collaborated with academic and community partners to create the Georgia Memory Net (GMN). DESIGN: GMN is a hub and spoke model partnered with Emory University's Cognitive Neurology Clinic and Emory Goizueta Alzheimer's Disease Research Center to provide training and support for best practices in diagnosis and management to Memory Assessment Clinics (MACs) throughout the state. SETTING: Communities across the State of Georgia. PARTICIPANTS: GMN is a mix of academic and community providers, hospital systems, state and community agencies. Patients and families are evaluated at the MACs and connected to community services. INTERVENTION: A dedicated clinic workflow: primary care providers (PCPs) identify a memory problem and refer to the MACs for diagnostic evaluation; meeting with a community services educator, and development of a care plan. The patient is reconnected with the PCP for continuity of care. MEASUREMENTS: Initial metrics include numbers of unique patients, total patient visits, and referrals to state agency partners for community services. RESULTS: GMN established five MACs across Georgia with annual state funding. Partners at Emory University provided initial training; refined patient workflows for best practices; and provide ongoing support, guidance, and continuing education for MAC teams. Local PCPs and community services partners demonstrated strong engagement with the new model. CONCLUSIONS: GMN is an innovative care model to improve access to accurate and timely diagnosis in patients with memory loss. GMN may help improve the quality of life for patients and families through preventive and early care.


Assuntos
Doença de Alzheimer , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/terapia , Georgia , Hospitais , Humanos , Qualidade de Vida
12.
Sci Total Environ ; 786: 147446, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-33971603

RESUMO

Per and polyfluorinated substances (PFAS) exposure was investigated in Australian pinnipeds. Concentrations of 16 PFAS were measured in the livers of Australian sea lion (Neophoca cinerea), Australian fur seal (Arctocephalus pusillus doriferus) and a long-nosed Fur Seal (Arctocephalus forsteri) pup sampled between 2017 and 2020 from colonies in South Australia and Victoria. Findings reported in this study are the first documented PFAS concentrations in Australian pinnipeds. Median and observed range of values in ng/g wet weight were highest for perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA) and perfluorononanoic acid (PFNA) in the liver of N. cinerea (PFOS = 7.14, 1.00-16.9; PFOA = 2.73, 0.32-11.2; PFNA = 2.96, 0.61-8.22; n = 28), A. forsteri (PFOS = 15.98, PFOA = 2.02, PFNA = 7.86; n = 1) and A. p. doriferus (PFOS = 27.4, 10.5-2119; PFOA = 0.98, 0.32-52.2; PFNA = 2.50, 0.91-44.2; n = 20). PFAS concentrations in A. p. doriferus pups were significantly greater (p < 0.05) than in N. cinerea pups for all PFAS except PFOA and were of similar magnitude to those reported in northern hemisphere marine animals. These results demonstrate exposure differences in both magnitude and PFAS profiles for N. cinerea in South Australia and A. p. doriferus in Victoria. This study reports detectable PFAS concentrations in Australian pinniped pups indicating the importance of maternal transfer of these toxicants. As N. cinerea are endangered and recent declines in pup production has been reported for A. p. doriferus at the colony sampled, investigation of potential health impacts of these toxicants on Australian pinnipeds is recommended.


Assuntos
Ácidos Alcanossulfônicos , Caniformia , Poluentes Ambientais , Fluorocarbonos , Otárias , Animais , Caprilatos , Austrália do Sul , Vitória
13.
Dis Aquat Organ ; 90(2): 135-42, 2010 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-20662370

RESUMO

Gyrodactylus salaris is a monogenean freshwater parasite that causes high mortality in wild Atlantic salmon, and a number of countries employ monitoring programmes for its presence. A TaqMan-MGB (minor groove binding) probe real-time multiplex assay targeting the internal transcribed spacer ribosomal DNA (ITS rDNA) was developed to simultaneously identify G. salaris/G. thymalli and 2 other commonly occurring Gyrodactylus species infecting salmonids in northern Europe: G. derjavinoides and G. truttae. In addition, a Gyrodactylus genus-level assay was developed to assess parasite DNA quality. The species-specific real-time PCR method correctly identified target species from a wide geographical range and from a number of salmonid hosts. It did not amplify G. lucii or G. teuchis. These species were successfully amplified using the Gyrodactylus genus real-time assay. The species-specific real-time assay proved to be significantly faster than the currently employed molecular screening method of ITS rDNA PCR amplification followed by restriction fragment length polymorphism analyses (RFLP). However, as with ITS RFLP, the real-time method did not distinguish between G. salaris and the non-pathogenic G. thymalli, its principle advantage being a significant reduction in time to achieve an initial diagnostic screen before the employment of more in-depth analyses for those specimens giving a positive G. salaris/G. thymalli real-time result.


Assuntos
Ectoparasitoses/veterinária , Doenças dos Peixes/parasitologia , Platelmintos/isolamento & purificação , Reação em Cadeia da Polimerase/veterinária , Salmonidae , Animais , Ectoparasitoses/epidemiologia , Ectoparasitoses/parasitologia , Europa (Continente)/epidemiologia , Doenças dos Peixes/epidemiologia , Platelmintos/genética , Reação em Cadeia da Polimerase/métodos , Especificidade da Espécie
14.
J Cancer Surviv ; 14(1): 36-42, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31707565

RESUMO

PURPOSE: This study aimed to establish and evaluate the referral pathway from a hospital-based oncology service to a multidisciplinary community-based health service supporting survivors to engage in self-management. METHOD: The evaluation involved understanding patterns of health service utilisation and health professionals' perspectives on the implementation of the community-based model of survivorship care, the Good Life Cancer Survivorship (GLCS) program. Survivors referred to GLCS were undergoing or had completed cancer treatment and unable to participate in intensive ambulatory oncology rehabilitation. Health service utilisation was tracked over 5 months, and the perspectives of health professionals referring to and involved in the GLCS program were recorded using semi-structured interviews. RESULTS: The oncology service made 25 referrals. The most accessed services at Carrington Health were physiotherapy with 18 appointments, followed by psychology (12) and dietitian services (11). Four themes emerged from the interviews: (1) Allied health services are relevant to people with cancer; (2) Education and information needs; (3) Communication gaps; (4) A one-stop multidisciplinary and holistic care model. CONCLUSION: This project demonstrated that community health may be a valid setting to support cancer survivors in managing their health. Supporting ongoing awareness, education and understanding of services across both community and acute care settings will foster care coordination and strengthen referral pathways. IMPLICATIONS FOR CANCER SURVIVORS: Accessing appropriate community-based allied health services can support cancer survivors in developing self-management skills to manage their own health and improve their health outcomes and wellbeing in the survivorship phase.


Assuntos
Saúde Pública/métodos , Sobrevivência , Idoso , Feminino , Humanos , Masculino , Neoplasias/mortalidade
15.
Healthcare (Basel) ; 7(4)2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31683839

RESUMO

Healthcare Organisational Culture (OC) is a major contributing factor in serious failings in healthcare delivery. Despite an increased awareness of the impact that OC is having on patient care, there is no universally accepted way to measure culture in practice. This study was undertaken to provide a snapshot as to how the English National Health Service (NHS) is currently measuring culture. Although the study is based in England, the findings have potential to influence the measurement of healthcare OC internationally. An online survey was sent to 234 NHS hospital trusts, with a response rate of 35%. Respondents who completed the online survey, on behalf of their representative organisations, were senior clinical governance leaders. The findings demonstrate that the majority of organisations, that responded, were actively measuring culture. Significantly, a wide variety of tools were in use, with variable levels of satisfaction and success. The majority of tools had a focus on patient safety, not on understanding the determining factors which impact upon healthcare OC. This paper reports the tools currently used by the respondents. It highlights that there are deficits in these tools that need to be addressed, so that organisations can interpret their own culture in a standardised, evidence-based way.

16.
Dev Cell ; 49(6): 907-919.e10, 2019 06 17.
Artigo em Inglês | MEDLINE | ID: mdl-31211994

RESUMO

During early spinal cord development, neurons of particular subtypes differentiate with a sparse periodic pattern while later neurons differentiate in the intervening space to eventually produce continuous columns of similar neurons. The mechanisms that regulate this spatiotemporal pattern are unknown. In vivo imaging in zebrafish reveals that differentiating spinal neurons transiently extend two long protrusions along the basal surface of the spinal cord before axon initiation. These protrusions express Delta protein, consistent with the hypothesis they influence Notch signaling at a distance of several cell diameters. Experimental reduction of Laminin expression leads to smaller protrusions and shorter distances between differentiating neurons. The experimental data and a theoretical model support the proposal that neuronal differentiation pattern is regulated by transient basal protrusions that deliver temporally controlled lateral inhibition mediated at a distance. This work uncovers a stereotyped protrusive activity of newborn neurons that organize long-distance spatiotemporal patterning of differentiation.


Assuntos
Padronização Corporal , Diferenciação Celular , Embrião não Mamífero/citologia , Laminina/metabolismo , Neurônios Motores/citologia , Medula Espinal/citologia , Peixe-Zebra/embriologia , Animais , Comunicação Celular , Embrião não Mamífero/metabolismo , Regulação da Expressão Gênica no Desenvolvimento , Peptídeos e Proteínas de Sinalização Intracelular/genética , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Laminina/genética , Proteínas de Membrana/genética , Proteínas de Membrana/metabolismo , Neurônios Motores/metabolismo , Neurogênese , Transdução de Sinais , Análise Espaço-Temporal , Medula Espinal/metabolismo , Peixe-Zebra/metabolismo , Proteínas de Peixe-Zebra/genética , Proteínas de Peixe-Zebra/metabolismo
17.
PLoS One ; 13(7): e0200654, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30001394

RESUMO

The development of diagnostic markers has been a long-standing interest of population geneticists as it allows clarification of taxonomic uncertainties. Historically, there has been much debate on the taxonomic status of species belonging to the Mytilus species complex (M. edulis, M. galloprovincialis and M. trossulus), and whether they are discrete species. We analysed reference pure specimens of M. edulis, M. galloprovincialis and M. trossulus, using Restriction site associated DNA (RAD) sequencing and identified over 6,000 SNP markers separating the three species unambiguously. We developed a panel of diagnostic SNP markers for the genotyping of Mytilus species complex as well as the identification of hybrids and interspecies introgression events in Mytilus species. We validated a panel of twelve diagnostic SNP markers which can be used for species genotyping. Being able to accurately identify species and hybrids within the Mytilus species complex is important for the selective mussel stock management, the exclusion of invasive species, basic physiology and bio-diversity studies.


Assuntos
Técnicas de Genotipagem , Mytilus/genética , Polimorfismo de Nucleotídeo Único , Animais , Marcadores Genéticos , Mytilus/classificação , Especificidade da Espécie
18.
PeerJ ; 6: e5814, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30386705

RESUMO

BACKGROUND: Accurate time-energy budgets summarise an animal's energy expenditure in a given environment, and are potentially a sensitive indicator of how an animal responds to changing resources. Deriving accurate time-energy budgets requires an estimate of time spent in different activities and of the energetic cost of that activity. Bio-loggers (e.g., accelerometers) may provide a solution for monitoring animals such as fur seals that make long-duration foraging trips. Using low resolution to record behaviour may aid in the transmission of data, negating the need to recover the device. METHODS: This study used controlled captive experiments and previous energetic research to derive time-energy budgets of juvenile Australian fur seals (Arctocephalus pusillus) equipped with tri-axial accelerometers. First, captive fur seals and sea lions were equipped with accelerometers recording at high (20 Hz) and low (1 Hz) resolutions, and their behaviour recorded. Using this data, machine learning models were trained to recognise four states-foraging, grooming, travelling and resting. Next, the energetic cost of each behaviour, as a function of location (land or water), season and digestive state (pre- or post-prandial) was estimated. Then, diving and movement data were collected from nine wild juvenile fur seals wearing accelerometers recording at high- and low- resolutions. Models developed from captive seals were applied to accelerometry data from wild juvenile Australian fur seals and, finally, their time-energy budgets were reconstructed. RESULTS: Behaviour classification models built with low resolution (1 Hz) data correctly classified captive seal behaviours with very high accuracy (up to 90%) and recorded without interruption. Therefore, time-energy budgets of wild fur seals were constructed with these data. The reconstructed time-energy budgets revealed that juvenile fur seals expended the same amount of energy as adults of similar species. No significant differences in daily energy expenditure (DEE) were found across sex or season (winter or summer), but fur seals rested more when their energy expenditure was expected to be higher. Juvenile fur seals used behavioural compensatory techniques to conserve energy during activities that were expected to have high energetic outputs (such as diving). DISCUSSION: As low resolution accelerometry (1 Hz) was able to classify behaviour with very high accuracy, future studies may be able to transmit more data at a lower rate, reducing the need for tag recovery. Reconstructed time-energy budgets demonstrated that juvenile fur seals appear to expend the same amount of energy as their adult counterparts. Through pairing estimates of energy expenditure with behaviour this study demonstrates the potential to understand how fur seals expend energy, and where and how behavioural compensations are made to retain constant energy expenditure over a short (dive) and long (season) period.

19.
PLoS One ; 13(9): e0200253, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30183713

RESUMO

Effective ecosystem-based management requires estimates of abundance and population trends of species of interest. Trend analyses are often limited due to sparse or short-term abundance estimates for populations that can be logistically difficult to monitor over time. Therefore it is critical to assess regularly the quality of the metrics in long-term monitoring programs. For a monitoring program to provide meaningful data and remain relevant, it needs to incorporate technological improvements and the changing requirements of stakeholders, while maintaining the integrity of the data. In this paper we critically examine the monitoring program for the Australian fur seal (AFS) Arctocephalus pusillus doriferus as an example of an ad-hoc monitoring program that was co-ordinated across multiple stakeholders as a range-wide census of live pups in the Austral summers of 2002, 2007 and 2013. This 5-yearly census, combined with historic counts at individual sites, successfully tracked increasing population trends as signs of population recovery up to 2007. The 2013 census identified the first reduction in AFS pup numbers (14,248 live pups, -4.2% change per annum since 2007), however we have limited information to understand this change. We analyse the trends at breeding colonies and perform a power analysis to critically examine the reliability of those trends. We then assess the gaps in the monitoring program and discuss how we may transition this surveillance style program to an adaptive monitoring program than can evolve over time and achieve its goals. The census results are used for ecosystem-based modelling for fisheries management and emergency response planning. The ultimate goal for this program is to obtain the data we need with minimal cost, effort and impact on the fur seals. In conclusion we identify the importance of power analyses for interpreting trends, the value of regularly assessing long-term monitoring programs and proper design so that adaptive monitoring principles can be applied.


Assuntos
Monitorização de Parâmetros Ecológicos , Ecossistema , Otárias/fisiologia , Modelos Biológicos , Animais , Austrália , Feminino , Masculino , Dinâmica Populacional
20.
Open Biol ; 7(2)2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-28148823

RESUMO

Studies of non-apical progenitors (NAPs) have been largely limited to the developing mammalian cortex. They are postulated to generate the increase in neuron numbers that underlie mammalian brain expansion. Recently, NAPs have also been reported in the retina and central nervous system of non-mammalian species; in the latter, however, they remain poorly characterized. Here, we characterize NAP location along the zebrafish central nervous system during embryonic development, and determine their cellular and molecular characteristics and renewal capacity. We identified a small population of NAPs in the spinal cord, hindbrain and telencephalon of zebrafish embryos. Live-imaging analysis revealed at least two types of mitotic behaviour in the telencephalon: one NAP subtype retains the apical attachment during division, while another divides in a subapical position disconnected from the apical surface. All NAPs observed in spinal cord lost apical contact prior to mitoses. These NAPs express HuC and produce two neurons from a single division. Manipulation of Notch activity reveals that neurons and NAPs in the spinal cord use similar regulatory mechanisms. This work suggests that the majority of spinal NAPs in zebrafish share characteristics with basal progenitors in mammalian brains.


Assuntos
Sistema Nervoso Central/embriologia , Células-Tronco Neurais/citologia , Peixe-Zebra/embriologia , Animais , Animais Geneticamente Modificados , Diferenciação Celular , Divisão Celular , Sistema Nervoso Central/citologia , Regulação da Expressão Gênica no Desenvolvimento , Receptores Notch/genética , Rombencéfalo/citologia , Rombencéfalo/embriologia , Medula Espinal/citologia , Medula Espinal/embriologia , Telencéfalo/citologia , Telencéfalo/embriologia , Peixe-Zebra/genética , Proteínas de Peixe-Zebra/genética
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