Knowledge and perceptions of Australian postgraduate veterinary students prior to formal education of antimicrobial use and antimicrobial resistance.

Antimicrobial resistance (AMR) is widely perceived as a threat to human and animal health and a significant One Health issue with extensive and complex factors contributing to its occurrence and spread. Previous studies have surveyed human and animal health professionals to determine their perceptions regarding AMR and antimicrobial use (AMU). There are limited studies exploring the understanding of veterinary students despite their critical role as future antimicrobial prescribers. A cross-sectional survey was administered to an entire cohort of Doctor of Veterinary Medicine Year 2 (DVM2) students (n = 136) to investigate their knowledge and perceptions regarding AMR and AMU prior to formal education on this issue. Ninety students (66.2% of the cohort) completed the survey. There was overwhelming agreement regarding the immediacy of the problem, with 84.4% of students indicating that 'We must take action on AMR'. Despite more than 94.4% of students correctly defining AMR, specific knowledge regarding AMR impact, contributory causes to AMR and strategies to solve the challenge of AMR was variable. Most students perceived livestock producers to have a significant role in the perpetuation of AMR due to AMU for prophylaxis (71.1% substantial/moderate contribution) and treatment (56.7% substantial/moderate contribution). Over a third of respondents (37.8%) were unsure if AMR could spread from animals to humans. Respondents perceived that various groups (dentists, doctors, veterinarians, professional organisations) are all important in ameliorating the issue of AMR. The implementation of restrictive measures to reduce veterinary prescription of antimicrobials was viewed as less important than strategies involving education, hygiene, surveillance, and guideline development/availability. To encourage the development of good antimicrobial stewardship (AMS) practices, professional veterinary education needs to foster an understanding of the scientific, behavioural and social issues that contribute to AMR and inappropriate AMU, as well as prescribers' personal contribution to AMR perpetuation and amelioration.

Correction: Factors influencing the behaviour and perceptions of Australian veterinarians towards antibiotic use and antimicrobial resistance.

[This corrects the article DOI: 10.1371/journal.pone.0223534.].

Factors influencing the behaviour and perceptions of Australian veterinarians towards antibiotic use and antimicrobial resistance.

Antimicrobial resistance (AMR) is a global crisis with impacts on the future health and welfare of humans and animals. Determining key factors that influence veterinarians' antimicrobial prescribing behaviours can bridge the gap between prescribing guidelines and clinical usage. Veterinarians practicing in Australia were surveyed on their frequency in prescribing different antibiotics; factors influencing their antibiotic prescribing behaviours; and their perceptions of current drivers of AMR. Antibiotics were prescribed in a third of consultations with key differences in the frequency of use of specific antibiotics by small companion animal (SCA), equine and livestock veterinarians, which broadly aligned with antibiotic registration restrictions in Australia. SCA veterinarians reported prescribing broad-spectrum antibiotics of higher importance to human health more frequently than livestock veterinarians. Factors that were reported as 'strong' or 'moderate' barriers to appropriate antibiotic prescribing were the 1) cost of culture and susceptibility testing and 2) lack of access to rapid and affordable diagnostic tests. Fear of losing clients, colleague pressure, and lack of their own understanding about antibiotics were considered to be 'no' or 'somewhat' of a barrier to appropriate prescribing by respondents. SCA veterinarians placed greater importance on the contribution of antibiotic use in livestock to AMR, than antibiotic use in companion animals. Despite reporting use of fewer, mostly narrow spectrum antibiotics of lower importance to human and animal health, livestock veterinarians were generally more aware of their potential contribution to AMR. This study provides insights into the similarities and differences in SCA, equine and livestock veterinarians practicing in Australia and informs sector-specific strategies to improve antimicrobial stewardship.

Opportunities and challenges to improving antibiotic prescribing practices through a One Health approach: results of a comparative survey of doctors, dentists and veterinarians in Australia.

OBJECTIVES: To explore and compare the knowledge, attitudes and experiences of doctors, dentists and veterinarians (as prescribers) in relation to antibiotic use and antibiotic resistance (AbR), and to consider the implications of these for policy-making that support a One Health approach. DESIGN: A cross-sectional survey conducted online. SETTING: Doctors, dentists and veterinarians practising in primary, secondary or tertiary care in Australia. PARTICIPANTS: 547 doctors, 380 dentists and 403 veterinarians completed the survey. MAIN OUTCOME MEASURES: Prescribers' knowledge, attitudes and perceptions of AbR, the extent to which a range of factors are perceived as barriers to appropriate prescribing practices, and perceived helpfulness of potential strategies to improve antibiotic prescribing in practice. RESULTS: There was substantial agreement across prescriber groups that action on AbR is required by multiple sectors and stakeholders. However, prescribers externalised responsibility to some extent by seeing the roles of others as more important than their own in relation to AbR. There were common and context-specific barriers to optimal prescribing across the prescriber groups. Prescriber groups generally perceived restrictive policies as unhelpful to supporting appropriate prescribing in their practice. CONCLUSIONS: The results have implications for implementing a One Health approach that involves doctors, dentists and veterinarians as key players to tackling the crisis of AbR. The findings are that (1) prescribers understand and are likely receptive to a One Health policy approach to AbR, (2) policy development should be sensitive to barriers that are specific to individual prescriber groups and (3) the development and introduction of interventions that might be perceived as reducing prescriber autonomy will need to be carefully designed and implemented.

Disasters, Queer Narratives, and the News: How Are LGBTI Disaster Experiences Reported by the Mainstream and LGBTI Media?

The media plays a significant role in constructing the public meanings of disasters and influencing disaster management policy. In this article, we investigate how the mainstream and LGBTI media reported-or failed to report-the experiences of lesbian, gay, bisexual, transgender, and intersex (LGBTI) populations during disasters in Brisbane, Australia and Christchurch, New Zealand. The implications of our work lie within recent disasters research suggesting that marginalized populations-including LGBTI peoples-may experience a range of specific vulnerabilities during disasters on the basis of their social marginality. In this article, we argue that LGBTI experiences were largely absent from mainstream media reporting of the Brisbane floods and Christchurch earthquake of 2011. Media produced by and about the LGBTI community did take steps to redress this imbalance, although with uneven results in terms of inclusivity across that community. We conclude by raising the possibility that the exclusion or absence of queer disaster narratives may contribute to marginality through the media's construction of disasters as experienced exclusively by heterosexual family groups.

Effects of cyclone-generated disturbance on a tropical reef foraminifera assemblage.

The sedimentary record, and associated micropalaeontological proxies, is one tool that has been employed to quantify a region's tropical cyclone history. Doing so has largely relied on the identification of allochthonous deposits (sediments and microfossils), sourced from deeper water and entrained by tropical cyclone waves and currents, in a shallow-water or terrestrial setting. In this study, we examine microfossil assemblages before and after a known tropical cyclone event (Cyclone Hamish) with the aim to better resolve the characteristics of this known signal. Our results identify no allochthonous material associated with Cyclone Hamish. Instead, using a swathe of statistical tools typical of ecological studies but rarely employed in the geosciences, we identify new, previously unidentified, signal types. These signals include a homogenising effect, with the level of differentiation between sample sites greatly reduced immediately following Cyclone Hamish, and discernible shifts in assemblage diversity. In the subsequent years following Hamish, the surface assemblage returns to its pre-cyclone form, but results imply that it is unlikely the community ever reaches steady state.

Applying the emergency risk management process to tackle the crisis of antibiotic resistance.

We advocate that antibiotic resistance be reframed as a disaster risk management problem. Antibiotic-resistant infections represent a risk to life as significant as other commonly occurring natural disasters (e.g., earthquakes). Despite efforts by global health authorities, antibiotic resistance continues to escalate. Therefore, new approaches and expertise are needed to manage the issue. In this perspective we: (1) make a call for the emergency management community to recognize the antibiotic resistance risk and join in addressing this problem; (2) suggest using the risk management process to help tackle antibiotic resistance; (3) show why this approach has value and why it is different to existing approaches; and (4) identify public perception of antibiotic resistance as an important issue that warrants exploration.

The antimicrobial resistance crisis: causes, consequences, and management.

The antimicrobial resistance (AMR) crisis is the increasing global incidence of infectious diseases affecting the human population, which are untreatable with any known antimicrobial agent. This crisis will have a devastating cost on human society as both debilitating and lethal diseases increase in frequency and scope. Three major factors determine this crisis: (1) the increasing frequency of AMR phenotypes among microbes is an evolutionary response to the widespread use of antimicrobials; (2) the large and globally connected human population allows pathogens in any environment access to all of humanity; and (3) the extensive and often unnecessary use of antimicrobials by humanity provides the strong selective pressure that is driving the evolutionary response in the microbial world. Of these factors, the size of the human population is least amenable to rapid change. In contrast, the remaining two factors may be affected, so offering a means of managing the crisis: the rate at which AMR, as well as virulence factors evolve in microbial world may be slowed by reducing the applied selective pressure. This may be accomplished by radically reducing the global use of current and prospective antimicrobials. Current management measures to legislate the use of antimicrobials and to educate the healthcare world in the issues, while useful, have not comprehensively addressed the problem of achieving an overall reduction in the human use of antimicrobials. We propose that in addition to current measures and increased research into new antimicrobials and diagnostics, a comprehensive education program will be required to change the public paradigm of antimicrobial usage from that of a first line treatment to that of a last resort when all other therapeutic options have failed.

Deposits, flow characteristics, and landscape change resulting from the September 2009 South Pacific tsunami in the Samoan islands.

The September 29th 2009 tsunami caused widespread coastal modification within the islands of Samoa and northern Tonga in the South Pacific. Preliminary measurements indicate maximum runup values of around 17 m (Okal et al., 2010) and shore-normal inundation distances of up to ~ 620 m (Jaffe et al., 2010). Geological field reconnaissance studies were conducted as part of an UNESCO-IOC International Tsunami Survey Team survey within three weeks of the event in order to document the erosion, transport, and deposition of sediment by the tsunami. Data collected included: a) general morphology and geological characteristics of the coast, b) evidence of tsunami flow (inundation, flow depth and direction, wave height and runup), c) surficial and subsurface sediment samples including deposit thickness and extent, d) topographic mapping, and e) boulder size and location measurements. Four main types of sedimentary deposits were identified: a) gravel fields consisting mostly of isolated cobbles and boulders, b) sand sheets from a few to ~ 25 cm thick, c) piles of organic (mostly vegetation) and man-made material forming debris ramparts, and d) surface mud deposits that settled from suspension from standing water in the tsunami aftermath. Tsunami deposits within the reef system were not widespread, however, surficial changes to the reefs were observed.

Operational challenges to community participation in post-disaster damage assessments: observations from Fiji.

Community participation is becoming increasingly popular within the field of disaster management. International disaster policies, frameworks and charters embrace the notion that communities should play an active role in initiatives to identify vulnerabilities and risks and to mitigate those dangers, and, in the event of a disaster, that they should play a proactive part in response and recovery (see, for example, UNISDR, 1994; The Sphere Project, 2004; United Nations, 2005). A number of studies have investigated the participation of communities in disaster preparedness and mitigation efforts (see, for instance, Scott-Villiers, 2000; Andharia, 2002; Godschalk, Brody and Burby, 2003), There is, however, limited reflection on the challenges to ensuring participation in the operational context of disaster response. This paper draws on a study of the policy and practice of participatory damage assessment in Fiji to identify and discuss the barriers to formal implementation of community participation in a post-disaster context.