Dad taught me nothing about relationships and sexuality: how contemporary Australian fathers became sex ed dads.

This mixed methods study explored Australian fathers' views about relationships and sexuality education (RSE) and their role within it. In the article we examine contemporary fathers' engagement with discussing relationships and sexuality with their children, compared to their recollections of their own fathers' involvement. We draw on survey data from 612 diverse Australian fathers of children aged 3-12 years and interview data from 10 fathers. We find that, according to participants' self-reports, fathers' involvement in RSE has increased from one generation to the next. We identify five domains that have influenced this change: shifting norms regarding the role of fathers, gender and sexuality; a rejection of their own fathers' approach; concerns for daughters; the women in their lives; and a sense of responsibility. We argue that schools and other RSE providers should engage with these domains to support fathers to take greater strides towards strengthened engagement in RSE with their children.

HealthLit4Kids: teacher experiences of health literacy professional development in an Australian primary school setting.

Health literacy (HL) is a critical asset for 21st century learners to possess given its positive impact on health outcomes and educational attainment. Concerningly, HL is an area that primary school teachers report having a lack of understanding, confidence, and ability to teach. The HealthLit4Kids initiative aimed to address this issue through a series of teacher professional development (PD) workshops. To evaluate how teachers experienced the PD, teacher evaluations collected at the completion of each of the workshops were analysed using a mixed methods approach. According to the teachers, the PD had improved their understanding of HL, including how to implement it into their practice. The study also found that the teachers perceived that collaborative practice was a key strength of the programme, and that at the end of the PD, teachers described valuing HL more in their practice. Teachers reported time as a major barrier to them implementing the professional learning and suggested further resources could help to mitigate this barrier. Additional research is required to help substantiate the claims made in this research. This study also highlights the critical need for additional HL resources for primary school teachers.

HealthLit4Kids: Supporting schools to be health literacy responsive organisations.

ISSUE ADDRESSED: To reduce inequity, services and community organisations must respond to the health literacy needs and strengths of each individual accessing their services. As a social determinant, health literacy is compounded by interactions between the service provider, the individual, and their wider community. Schools provide a critical nexus between the teacher (as service provider), the student (as learner) and their family (carers and wider community) to support the development of children's health literacy. METHODS: Five Tasmanian primary schools (84 teachers) completed an assessment of their school in relation to the domains of a health literate organisation using the HeLLOTas! (HEalth Literacy Learning Organisations Tasmania) Self-Assessment Checklist, before and after taking part in the HealthLit4Kids program. RESULTS: While the differences between pre- and post-intervention ratings were not large, they moved in a positive direction for all six domains. There was a significant main effect of time, F (1, 4) = 83.9, P < .001, ƞ2  = 0.99, showing that overall ratings increased from before to after the intervention. Teacher-recommended actions across all schools were grouped for insight into their interpretation and application of the tool in the school context. CONCLUSION: Using the HeLLOTas! Self-Assessment Checklist served a dual purpose. Teachers developed a shared understanding of the characteristics of a health-literate organisation to produce a schoolwide action plan. Simultaneously, we gained valuable insights into the processes required to support the development of organisational health literacy in schools, and we share ten propositions applicable to other schools locally, nationally and internationally. SO WHAT?: To the best of our knowledge, this is the first time that a school's health literacy responsiveness has been measured. Our key propositions will support future efforts by policy makers, researchers and school principals.

HealthLit4Kids study protocol; crossing boundaries for positive health literacy outcomes.

BACKGROUND: Health attitudes and behaviours formed during childhood greatly influence adult health patterns. This paper describes the research and development protocol for a school-based health literacy program. The program, entitled HealthLit4Kids, provides teachers with the resources and supports them to explore the concept of health literacy within their school community, through classroom activities and family and community engagement. METHODS: HealthLit4Kids is a sequential mixed methods design involving convenience sampling and pre and post intervention measures from multiple sources. Data sources include individual teacher health literacy knowledge, skills and experience; health literacy responsiveness of the school environment (HeLLO Tas); focus groups (parents and teachers); teacher reflections; workshop data and evaluations; and children's health literacy artefacts and descriptions. The HealthLit4Kids protocol draws explicitly on the eight Ophelia principles: outcomes focused, equity driven, co-designed, needs-diagnostic, driven by local wisdom, sustainable, responsive, systematically applied. By influencing on two levels: (1) whole school community; and (2) individual classroom, the HealthLit4Kids program ensures a holistic approach to health literacy, raised awareness of its importance and provides a deeper exploration of health literacy in the school environment. The school-wide health literacy assessment and resultant action plan generates the annual health literacy targets for each participating school. DISCUSSION: Health promotion cannot be meaningfully achieved in isolation from health literacy. Whilst health promotion activities are common in the school environment, health literacy is not a familiar concept. HealthLit4Kids recognizes that a one-size fits all approach seldom works to address health literacy. Long-term health outcomes are reliant on embedded, locally owned and co-designed programs which respond to local health and health literacy needs.

Escherichia coli RadD Protein Functionally Interacts with the Single-stranded DNA-binding Protein.

The bacterial single-stranded DNA binding protein (SSB) acts as an organizer of DNA repair complexes. The radD gene was recently identified as having an unspecified role in repair of radiation damage and, more specifically, DNA double-strand breaks. Purified RadD protein displays a DNA-independent ATPase activity. However, ATP hydrolytic rates are stimulated by SSB through its C terminus. The RadD and SSB proteins also directly interact in vivo in a yeast two-hybrid assay and in vitro through ammonium sulfate co-precipitation. Therefore, it is likely that the repair function of RadD is mediated through interaction with SSB at the site of damage.

Probing the Mechanism of LAL-32, a Gold Nanoparticle-Based Antibiotic Discovered through Small Molecule Variable Ligand Display.

The unrelenting rise of antimicrobial-resistant bacteria has necessitated the search for novel antibiotic solutions. Herein we describe further mechanistic studies on a 2.0-nm-diameter gold nanoparticle-based antibiotic (designated LAL-32). This antibiotic exhibits bactericidal activity against the Gram-negative bacterium Escherichia coli at 1.0 µM, a concentration significantly lower than several clinically available antibiotics (such as ampicillin and gentamicin), and acute treatment with LAL-32 does not give rise to spontaneous resistant mutants. LAL-32 treatment inhibits cellular division, daughter cell separation, and twin-arginine translocation (Tat) pathway dependent shuttling of proteins to the periplasm. Furthermore, we have found that the cedA gene imparts increased resistance to LAL-32, and shown that an E. coli cedA transposon mutant exhibits increased susceptibility to LAL-32. Taken together, these studies further implicate cell division pathways as the target for this nanoparticle-based antibiotic and demonstrate that there may be inherently higher barriers for resistance evolution against nanoscale antibiotics in comparison to their small molecule counterparts.

Implementing absolute cardiovascular disease risk assessment into pathology collection services.

BACKGROUND: Pathology services represent an ideal setting to integrate absolute cardiovascular disease (CVD) risk estimation when patients attend for routine cholesterol testing. This study aimed to explore the process of implementing CVD risk estimation into point-of-care service delivery by pathology staff to inform future implementation and sustainability. METHODS: A new service for CVD risk estimation via a self-directed screening station was implemented into 14 pathology service sites across Tasmania, Australia. Before implementation, observations at pathology services (n = 26) and semi-structured interviews were undertaken with 26 pathology staff (88% female, 77% aged 41-60 years) to identify factors that could impact implementation of the service. The process of implementation was then evaluated using participant observations and clinical trial recruitment data. Transcripts and field notes were analysed thematically according to the Medical Research Council Framework and used to develop a programme logic model to understand how the service could be adapted to be successfully integrated into routine workflow at pathology services. RESULTS: Eight key themes were identified during the pre-implementation phase as important factors that could impact upon integration of CVD risk estimation into pathology services. Themes related to factors within the organisation, including available resources, logistics and workflow, as well as having sufficient time to complete the intervention. Additional factors related to the individual motivations of staff, collaborative leadership and patient characteristics. Success of implementation varied among sites, requiring the trialling of different strategies to support uptake of the service and patient recruitment. CONCLUSIONS: Implementing CVD risk estimation into point-of-care pathology services required an understanding of the core implementation components specific to each context, and for implementation strategies to be targeted to the individual and organisational contexts. The generated programme logic model may be useful in guiding future implementation endeavours within these services and aiding the selection of apt implementation strategies. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04896021, registered 19/05/2021, https://clinicaltrials.gov/study/NCT04896021.

The imperative to develop health literacy: An ethical evaluation of HealthLit4Kids.

An imperative exists to promote health literacy (HL) development in today's young people. Included in curricula worldwide, health literacy has been recognised as a social determinant in its own right, which has the potential to redress inequity and positively impact health and educational outcomes. While it has been shown that schools provide an ideal setting to support HL development, available evidence suggests that health may be undertaught in primary schools, and further resources are required to support educators' inclusion of HL in their lessons. The aims of this paper were to (1) highlight the ethical imperative to promote HL through schools and (2) provide an ethical evaluation of an existing HL intervention. Spike's (2018) four principles for public health ethics were employed as a framework for evaluating a program's ethical status and suitability in the school setting. In this paper, one program, HealthLit4Kids, is evaluated according to Spike's framework, and shown to be an ethically acceptable approach to foster HL in young people. These results model how other HL programs may be evaluated and offer critical insights concerning how HL could be promoted in an ethically acceptable manner in the classroom.

Multiplexed VaxArray immunoassay for rapid antigen quantification in measles and rubella vaccine manufacturing.

Measles-containing vaccines (MCV), specifically vaccines against measles and rubella (MR), are extremely effective and critical for the eradication of measles and rubella diseases. In developed countries, vaccination rates are high and vaccines are readily available, but continued high prevalence of both diseases in developing countries and surges in measles deaths in recent years have highlighted the need to expand vaccination efforts. To meet demand for additional vaccines at a globally affordable price, it is highly desirable to streamline vaccine production thereby reducing cost and speeding up time to delivery. MR vaccine characterization currently relies on the 50% cell culture infectious dose (CCID50) assay, an endpoint assay with low reproducibility that requires 10-14 days to complete. For streamlining bioprocess analysis and improving measurement precision relative to CCID50, we developed the VaxArray Measles and Rubella assay kit, which is based on a multiplexed microarray immunoassay with a 5-hour time to result. Here we demonstrate vaccine-relevant sensitivity ranging from 345 to 800 IFU/mL up to 100,000 IFU/mL (infectious units per mL) and specificity that allows simultaneous analysis in bivalent vaccine samples. The assay is sensitive to antigen stability and has minimal interference from common vaccine additives. The assay exhibits high reproducibility and repeatability, with 15% CV, much lower than the typical 0.3 log10 error (∼65%) observed for the CCID50 assay. The intact protein concentration measured by VaxArray is reasonably correlated to, but not equivalent to, CCID50 infectivity measurements for harvest samples. However, the measured protein concentration exhibits equivalency to CCID50 for more purified samples, including concentrated virus pools and monovalent bulks, making the assay a useful new tool for same-day analysis of vaccine samples for bioprocess development, optimization, and monitoring.

A neuraminidase potency assay for quantitative assessment of neuraminidase in influenza vaccines.

Neuraminidase (NA) immunity leads to decreased viral shedding and reduced severity of influenza disease; however, NA content in influenza vaccines is currently not regulated, resulting in inconsistent quality and quantity of NA that can vary from manufacturer to manufacturer, from year to year, and from lot to lot. To address this problem, we have developed an assay for NA quantification that could be used by the industry to move toward developing influenza vaccines that induce a predictable immune response to NA. The VaxArray Influenza Seasonal NA Potency Assay (VXI-sNA) is a multiplexed sandwich immunoassay that relies on six subtype-specific monoclonal antibodies printed in microarray format and a suite of fluor-conjugated "label" antibodies. The performance of the assay as applied to a wide range of influenza vaccines is described herein. The assay demonstrated high NA subtype specificity and high sensitivity, with quantification limits ranging from 1 to 60 ng/mL and linear dynamic ranges of 24-500-fold. When compared to an enzymatic activity assay for samples exposed to thermal degradation conditions, the assay was able to track changes in protein stability over time and exhibited good correlation with enzyme activity. The assay also demonstrated excellent analytical precision with relative error ranging from 6 to 12% over day-to-day, user-to-user, and lot-to-lot variation. The high sensitivity and reproducibility of the assay enabled robust detection and quantification of NA in crude in-process samples and low-dose, adjuvanted vaccines with an accuracy of 100 ± 10%.

VaxArray potency assay for rapid assessment of "pandemic" influenza vaccines.

The VaxArray Influenza Pandemic HA (VXI-pHA) potency assay is a multiplexed sandwich immunoassay that consists of nine broadly reactive yet subtype-specific monoclonal capture antibodies printed in microarray format and a suite of fluor-labeled secondary antibodies that were selected to probe conserved HA epitopes. VXI-pHA was designed to optimize the probability that the ready-to-use assay would work for the most concerning, emergent influenza A strains, eliminating the need for the time-consuming process of reference reagents production. The performance of this new potency test was evaluated using a panel of 48 potentially pandemic strains of influenza viruses and vaccines spanning 16 years of antigenic drift, including the most recent pre-pandemic vaccine being developed against the "5th wave" A/H7N9 virus. The VXI-pHA assay demonstrated coverage of 93%, 92%, and 100% for H5, H7, and H9 antigens, respectively. The assay demonstrated high sensitivity with linear dynamic ranges of more than 150-fold and quantification limits ranging from 1 to 5 ng/mL. For three production lots of H7N9 monobulk drug substance, the assay exhibited excellent accuracy (100 ± 6%) and analytical precision (CV 6 ± 2%). The high assay sensitivity enabled robust detection and quantification of hemagglutinin in crude in-process samples and low-dose, adjuvanted vaccines with an accuracy of 100 ± 10%.

VaxArray for hemagglutinin and neuraminidase potency testing of influenza vaccines.

Practical methods to measure the potency of influenza vaccines are needed as alternatives for the standard single radial immunodiffusion (SRID) assay. VaxArray assays for influenza hemagglutinin (HA) and neuraminidase (NA) have been developed to address this need. In this report, we evaluate the use of these assays to assess the potency of HA and NA of an A/H3N2 subunit vaccine by determining the correlation between the amounts measured by VaxArray and the immunogenicity in mice. The antibody response after one and two doses of five formulations of the vaccine ranging from 5 µg/mL to 80 µg/mL of HA, was measured by hemagglutination inhibition (HAI) and neuraminidase inhibition (NAI) assays. For hemagglutinin, vaccine potency determined by VaxArray was equivalent to potency measured SRID and these amounts were predictive of immunogenicity, with excellent correlation between potency measured by VaxArray and the HAI geometric mean titers (GMT). Likewise, the amount of NA measured by VaxArray was predictive of the NAI GMT. The VaxArray NA assay reported non-detectable levels of intact NA for a sample that had been heat degraded at 56 °C for 20 h, demonstrating that the assay measures the native, active form of NA. Similarly, the HA potency measured by VaxArray in this heat-treated sample was very low when a monoclonal antibody was used to detect the amount of antigen bound. Importantly, the force degraded sample induced low HAI titers and the NAI titers were not measurable, supporting the conclusion that the VaxArray HA and NA assays measure the immunogenic forms of these A/H3N2 antigens. This study indicates that VaxArray assays can be used to assess the potency of HA and NA components in influenza vaccines as a proxy for immunogenicity.

How Two Small Pharmacy Schools' Competency Standards Compare with an International Competency Framework and How Well These Schools Prepare Students for International Placements.

International standards of pharmacy curricula are necessary to ensure student readiness for international placements. This paper explores whether curricula from two pharmacy programs, in Australia and Canada, are congruent with international standards and if students feel prepared for international placements. Nationally prescribed educational standards for the two schools were compared to each other and then against the International Pharmaceutical Federation (FIP) Global Competency Framework. Written student reflections complemented this analysis. Mapping results suggested substantial agreement between the FIP framework and Australia and Canada, with two gaps being identified. Moreover, the students felt their programs prepared them for their international placements. Despite differences in countries, pharmacy programs, and health-systems all students acclimatized to their new practice sites. Implications are that if pharmacy programs align well with FIP, pharmacists should be able to integrate and practise in other jurisdictions that also align with the FIP. This has implications for the mobility of pharmacy practitioners to countries not of their origin of training.

CPD Aligned to Competency Standards to Support Quality Practice.

As medication experts, pharmacists are key members of the patient's healthcare team. Pharmacists must maintain their competence to practice to remain responsive to the increasingly complex healthcare sector. This paper seeks to determine how competence training for pharmacists may enhance quality in their professional development. Results of two separately administered surveys (2012 and 2013) were compared to examine the reported continued professional development (CPD) practices of Australian pharmacists. Examination of results from both studies enabled a focus on how the competency standards inform CPD practice.In the survey administered in 2012, 91% (n = 253/278) pharmacists reported that they knew their current registration requirements. However, in the survey administered in 2013, only 43% (n = 46/107) reported utilization of the National Competency Standards Framework for Pharmacists in Australia (NCS) to self-asses their practice as part of their annual re-registration requirements. Fewer, 23% (n = 25/107), used the NCS to plan their CPD. This may be symptomatic of poor familiarity with the NCS, uncertainty around undertaking self-directed learning as part of a structured learning plan and/or misunderstandings around what CPD should include. This is supported by thematic analysis of pharmacists' social media comments. Initial and ongoing competence training to support meaningful CPD requires urgent attention in Australia. The competence (knowledge, skills and attributes) required to engage in meaningful CPD practice should be introduced and developed prior to entry into practice; other countries may find they are in a similar position.

VaxArray assessment of influenza split vaccine potency and stability.

Vaccine manufacturers require more rapid and accurate tools to characterize the potency and stability of their products. Currently, the gold standard for influenza vaccine potency is the single radial immunodiffusion (SRD) assay, which has inherent disadvantages. The primary objective of this study was to investigate the ability of the VaxArray Influenza (VXI) seasonal hemagglutinin (sHA) potency assay to accurately quantify potency and stability in finished vaccines as well as to quantify hemagglutinin protein (HA) within crude in-process samples. Monobulk intermediates and mono- and multivalent vaccines were tested using VXI. Quantification of HA in crude samples was evaluated by spiking known concentrations of HA into allantoic fluid. VXI generated SRD equivalent potency measurements with high accuracy (within ±10%) and precision (CV 10±4%) for antigen components of monobulk intermediates and multivalent split vaccines. For these vaccines and vaccine intermediates, the VXI linear dynamic range was ∼0.01-0.6µg/mL, which is 12× greater than the linear range of SRD. The measured sample limit of detection (LOD) for VXI varied from 0.005 to 0.01µg/mL for the different subtypes, which in general is ≥600× lower than the LOD for SRD. VXI was able to quantify HA in crude samples where HA only accounts for 0.02% of the total protein content. Stability indication was investigated by tracking measured potency as a function of time at elevated temperature by both SRD and VXI. After 20 h at 56°C, the ratio of VXI to SRD measured potency in a quadrivalent vaccine was 76%, 125%, 60%, and 98% for H1/California, H3/Switzerland, B/Phuket and B/Brisbane, respectively. Based on the study results, it is concluded that VXI is a rapid, multiplexed immunoassay that can be used to accurately determine flu vaccine potency and stability in finished product and in crude samples from upstream processes.

Knowledge, use and perceived relevance of a profession's Competency Standards; implications for Pharmacy Education.

OBJECTIVES: To determine the extent of use and perceived relevance of the National Competency Standards Framework for Pharmacists in Australia (NCS). Based on these findings, to suggest approaches for the enhancement of pharmacy education for the profession locally and globally. METHODS: Convenience sampling techniques were employed between November 2013 and June 2014 in conducting an online survey with Australian pharmacy students, interns, pharmacists and educators. KEY FINDINGS: Data from 527 participants were included in the final analysis. Fewer students (52%, 96/183) and interns 78% (69/88) knew the NCS framing pharmacy practice compared with pharmacists (86%, 115/134). Despite knowledge that the NCS existed most participants reported poor familiarity with and use of the NCS. Registered pharmacists reported annual use but not for Continuing Professional Development (CPD) plans or annual re-registration requirements. Respondents reported that practical use of NCS (e.g. mentoring interns) increased their use for personal needs. Some participants suggested regular instruction on self-assessment skills development would enhance meaningful use of the NCS. CONCLUSION: Despite self-assessment against NCS being mandated annually, Australia's practising pharmacists provided explanations for why this is not common in practice. The barriers provided by respondents are interconnected; their enablers are practical solutions to each barrier. The findings reinforce the notion that student pharmacists must have their competency standards, life-long learning and self-assessment skills embedded into their university curriculum to ensure a strong foundation for practice. The opportunity offered by periodic renewal of standards must prompt regular profession-wide evaluation of its education to practice nexus. Insights and author recommendations are portable to the pharmacy profession globally.

A Shared Focus: Comparing the Australian, Canadian, United Kingdom and United States Pharmacy Learning Outcome Frameworks and the Global Competency Framework.

This paper presents an analysis of the end of degree expectations, expressed as learning outcomes, for pharmacy graduates from Australia, Canada, United Kingdom and United States. The authors compare the end of degree expectations, through mapping these requirements to the International Pharmaceutical Federation (FIP) Global Competency Framework (GbCF). The anticipated end of degree expectations are similar but also reveal some individual characteristics. Irrespective of degree title, achievement of learning outcomes specified in any one of the four jurisdictions should enable students to become pharmacists who are patient-orientated medicines experts. The mapping provides impetus for cross-border institutional networking to generate a dependable set of assessment tools across national borders developing a common metric for outcome assessment irrespective of different program delivery.