RESUMO
Mycoplasma species can colonize the urogenital tract of dairy cattle. However, interrelationships between Mycoplasma spp. and reproductive performance in dairy herds are unclear. In this study, we measured apparent prevalences of Mycoplasma spp. in the vaginas of dairy cows (n = 629) pre- and post-bull exposure in dairy herds with and without Mycoplasma bovis clinical disease (n = 5 herds), and assessed associations between variables describing reproductive performance and consequent Mycoplasma spp. isolation. Mycoplasma spp. were infrequently isolated from the vagina pre- (1.9%; 12/629) and post-bull (3.2%; 20/629) exposure. Of the mycoplasmas isolated, Mycoplasma bovigenitalium was isolated most frequently (87.5%; 28/32), followed by Mycoplasma californicum (9.3%; 3/32). Mycoplasma bovis was only isolated from one cow. We were unable to provide any evidence of venereal transmission of M. bovis in cows in M. bovis-infected herds that use natural service bulls. There was an insufficient number of cows with Mycoplasma spp. in the vagina pre-bull exposure to assess effects on subsequent reproductive performance. Cows that had not conceived before post-bull exposure sampling had much greater odds (odds ratio 14.8; 95% confidence interval 4.2 to 52.3) of having a Mycoplasma sp. isolated from the vagina at this time compared with those that had conceived. Also, within those that had conceived, delayed conception increased the odds of having a Mycoplasma spp. isolated from the vagina at the post-bull exposure sampling by a factor of 1.62 for every additional week not pregnant. The likely cause of these findings is that cows that remain not pregnant for longer are more likely to be served by a bull (likely repeatedly) and subsequently become colonized with a Mycoplasma sp. (mostly M. bovigenitalium) through venereal transmission. In dairy herds that use bulls, there is a greater chance of isolating a Mycoplasma sp. (mostly M. bovigenitalium) after a period of bull breedings from the vaginas of cows that have remained nonpregnant for longer during the bull breeding period.
Assuntos
Doenças dos Bovinos/microbiologia , Infecções por Mycoplasma/veterinária , Mycoplasma/isolamento & purificação , Doenças Bacterianas Sexualmente Transmissíveis/veterinária , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/transmissão , Feminino , Fertilização , Masculino , Mycoplasma/classificação , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/microbiologia , Infecções por Mycoplasma/transmissão , Mycoplasma bovis/isolamento & purificação , Gravidez , Prevalência , Reprodução , Doenças Bacterianas Sexualmente Transmissíveis/microbiologiaRESUMO
Replacement dairy heifers exposed to Mycoplasma bovis as calves may be at risk of future clinical disease and pathogen transmission, both within and between herds; however, little information is available about these risks. We conducted a 2-yr longitudinal (panel) study starting with 450 heifer calves reared to weaning in 8 herds (7 M. bovis infected with clinical disease, 1 uninfected) under the same ownership. After weaning, heifers were commingled and managed with non-study heifers at a single heifer rearing facility. Nose, conjunctival, and vaginal swabs were collected along with a blood sample at weaning, prebreeding, precalving, and approximately 1 mo postcalving. Additionally, a colostrum sample was collected upon calving and a composite milk sample was collected 1 mo postcalving. The swabs, colostrum, and milk samples were cultured for Mycoplasma spp., and serum from the blood was evaluated for serological evidence of exposure to M. bovis using an ELISA. Despite a high M. bovis ELISA seroprevalence at weaning in the heifers from the 7 M. bovis-infected herds with clinical disease [72% (289/400); range by herd: 28-98%], M. bovis was isolated from only 4% (16/400) of the same heifers at the same time. In heifers from the uninfected herd at weaning, M. bovis seroprevalence was 2% (1/50) and M. bovis was not detected by culture. Mycoplasma bovis was isolated from 0.5% (2/414) of heifers at prebreeding, 0% (0/374) of heifers at precalving, and 0.3% (1/356) of heifers 1 mo postcalving. The nose was the predominant anatomical site of M. bovis colonization (74%; 14/19 culture positives). A single heifer (from an M. bovis-infected herd with clinical disease) was repeatedly detected with M. bovis in its nose at weaning, prebreeding, and postcalving samplings. This demonstrates the possibility, albeit rare, of a long-term M. bovis carrier state in replacement heifers exposed to M. bovis as calves, up to at least 1 mo after entry into the milking herd. No M. bovis clinical disease was detected in any heifer from weaning through to the end of the study (approximately 1 mo after calving). Acholeplasma spp. were commonly isolated throughout the study. Mycoplasma bovigenitalium, Mycoplasma bovoculi, and Mycoplasma bovirhinis were isolated infrequently. Mycoplasma bovis seroprevalences at prebreeding, precalving, and postcalving samplings were 27% (112/414), 12% (46/374), and 18% (65/356), respectively. Overall, the results show that replacement heifers from groups exposed to M. bovis preweaning can become colonized with M. bovis and that colonization can, uncommonly, be present after their first calving. For groups of 50 or more heifers exposed to M. bovis preweaning, there is at least a nontrivial probability that the group will contain at least 1 shedding heifer postcalving.
Assuntos
Doenças dos Bovinos/microbiologia , Leite/microbiologia , Infecções por Mycoplasma/veterinária , Mycoplasma bovis/imunologia , Tenericutes/isolamento & purificação , Animais , Derrame de Bactérias , Bovinos , Doenças dos Bovinos/epidemiologia , Colostro , Ensaio de Imunoadsorção Enzimática/veterinária , Feminino , Estudos Longitudinais , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/microbiologia , Mycoplasma bovis/isolamento & purificação , Gravidez , Estudos Prospectivos , Estudos Soroepidemiológicos , DesmameRESUMO
Mycoplasma bovis can have significant consequences when introduced into immunologically naïve dairy herds. Subclinically infected carrier animals are the most common way that M. bovis is introduced into herds. Although M. bovis udder infections can be detected by milk sampling lactating animals before their introduction, currently, no definitive way of identifying M. bovis carrier animals that are nonlactating (i.e., calves, heifers, dry cows, or bulls) is available. Understanding the prevalence of M. bovis shedding from various body sites in clinically infected animals could inform strategies for the detection of subclinical infection in nonlactating stock. The mucosal surfaces of the nose, eye, and vagina of 16 cows with recent clinical mastitis caused by M. bovis were examined for the presence of M. bovis shedding. Blood was collected for serological evaluation by a commercially available ELISA. Mycoplasma bovis was isolated from the vagina of only 3 (18.8%) of the cows and was not detected from the noses or eyes of any of the cows. Fifteen of the 16 (93.8%) cows were seropositive to the ELISA. With such low prevalence of detection of M. bovis from the vagina and no detections from the noses or eyes of recently clinically infected animals, it is very likely that sampling these sites would be ineffective for detecting subclinical infection in cattle. Serology using the ELISA may have some use when screening animals for biosecurity risk assessment. However, more information regarding time to seroconversion, antibody longevity, and test diagnostic sensitivity and specificity are required to define the appropriate use of this ELISA for biosecurity purposes.
Assuntos
Mastite Bovina/microbiologia , Leite/microbiologia , Infecções por Mycoplasma/veterinária , Mycoplasma bovis/imunologia , Animais , Formação de Anticorpos , Derrame de Bactérias , Bovinos , Ensaio de Imunoadsorção Enzimática/veterinária , Feminino , Lactação , Mastite Bovina/diagnóstico , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/microbiologia , Mycoplasma bovis/isolamento & purificação , Mycoplasma bovis/fisiologia , Sensibilidade e EspecificidadeRESUMO
With the common use of bulls for breeding following a period of artificial insemination in seasonally bred dairy herds, it is important to consider the potential role of the bull in transmission of Mycoplasma spp. within and between herds. This study aimed to assess the prevalence of Mycoplasma spp. in a population of bulls before and after use in Mycoplasma bovis-infected herds. The frequency of subclinical infection was also measured serologically postbreeding, and the association of Mycoplasma spp. on semen quality was evaluated. Mycoplasma bovis was isolated from 4 of 118 bulls after use in 4 herds infected with M. bovis. In the bulls, M. bovis seroprevalence increased from 9% prebreeding to 46% postbreeding with a total seroconversion rate of 44% across the 4 herds, with no evidence of clinical disease. There was no association of Mycoplasma spp. in the bulls' semen and abnormal palpation characteristics (enlarged or nodular) of seminal vesicular glands or poor semen quality attributes such as semen mass activity, sperm motility, and morphology. These results demonstrate a high degree of subclinical exposure of the bulls to M. bovis in infected herds and highlight the potential for bulls to be mycoplasma carriers within and between herds. Herd biosecurity protocols and control programs should take into account the potential role of bulls in the introduction and spread of Mycoplasma spp.
Assuntos
Anticorpos Antibacterianos/sangue , Doenças dos Bovinos/epidemiologia , Infecções por Mycoplasma/veterinária , Mycoplasma bovis/imunologia , Animais , Bovinos , Masculino , Infecções por Mycoplasma/epidemiologia , Análise do Sêmen , Estudos Soroepidemiológicos , Motilidade dos EspermatozoidesRESUMO
In Australia, one of the biosecurity recommendations to help prevent the introduction of Mycoplasma bovis into a dairy herd is to use a PCR assay on bulk tank milk (BTM) samples to evaluate the M. bovis infection status of potential source herds. An alternative approach is to assess the immunological status of the herd with respect to previous exposure to M. bovis via the use of an ELISA that is commercially available for use on cattle milk and serum. The objectives of this study were to (1) evaluate factors potentially associated with variation in the ELISA BTM optical density coefficient (ODC%) in previously exposed herds, (2) evaluate the association between the proportion of cows that are ELISA positive and the BTM ELISA ODC%, (3) assess agreement between the BTM ELISA and PCR and culture, and (4) compare BTM ELISA ODC% between the "hospital" herd and the main lactating herd on the same farm. Bulk tank milk samples (n = 192) were collected from 19 dairy herds with a history of clinical M. bovis disease and from 6 control herds (herds with no known clinical cases of mycoplasmosis). For 28 of the BTM samples collected, blood was also collected from 50 lactating cows contributing to that bulk tank sample. From 1 herd, concurrent paired BTM samples were collected from the main herd and the hospital herd on 16 occasions. All BTM samples were analyzed by ELISA (Bio-X Bio K 302, Bio-X Diagnostics, Rochefort, Belgium), PCR, and culture. The BTM ELISA ODC% was associated with time since initial M. bovis outbreak and time since the start of the herd's calving period. Following an initial outbreak of M. bovis, the BTM ELISA ODC% was highest in the first 8 mo. In split- and seasonal-calving herds, significantly higher BTM ELISA ODC% results were observed 5 to 8 wk after the commencement of the calving period. A significant association was observed between the within-herd seroprevalence for the lactating herd and BTM ELISA ODC%, but within-herd seroprevalence explained little of the variation in BTM ELISA ODC%. When comparing the BTM ELISA with a multiplex probe PCR and culture followed by 16S to 23S rRNA sequencing, there was virtually no agreement above that expected by chance; prevalence-adjusted bias-adjusted kappa values were 0.22 and 0.25 for ELISA category versus PCR category and culture, respectively. Finally, the hospital herd BTM ELISA ODC% mirrored that for the main herd BTM but was significantly higher. This study demonstrates that this commercially available ELISA used on BTM samples may complement the use of BTM PCR or culture in identifying herds from which purchase of animals may pose a higher biosecurity risk for introduction of M. bovis into noninfected herds.
Assuntos
Anticorpos Antibacterianos/análise , Doenças dos Bovinos/diagnóstico , Ensaio de Imunoadsorção Enzimática/veterinária , Leite/imunologia , Infecções por Mycoplasma/veterinária , Mycoplasma bovis/imunologia , Medidas de Segurança , Animais , Austrália , Bélgica , Bovinos , Doenças dos Bovinos/imunologia , Doenças dos Bovinos/transmissão , Feminino , Lactação , Leite/microbiologia , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/imunologia , Infecções por Mycoplasma/transmissão , Estudos SoroepidemiológicosRESUMO
Bacterial contamination of milk fed to calves compromises calf health. Several bacterial pathogens that infect cows, including Mycoplasma bovis and Salmonella enterica ssp. enterica serovar Dublin, are shed in milk, providing a possible route of transmission to calves. Milk acidification lowers the milk pH so that it is unsuitable for bacterial growth and survival. The objectives of this study were to (1) determine the growth of M. bovis and Salmonella Dublin in milk, and (2) evaluate the efficacy of milk acidification using a commercially available acidification agent (Salstop, Impextraco, Heist-op-den-Berg, Belgium) to control M. bovis and Salmonella Dublin survival in milk. For the first objective, 3 treatments and a positive control were prepared in 10 mL of milk and broth, respectively, and inoculated with M. bovis or Salmonella Dublin to an approximate concentration of 104 cfu/mL. Each treatment was retained at 5, 23, or 37°C with the positive control at 37°C. Aliquots were taken at 4, 8, 24, 28, 32, 48, 52, and 56 h after inoculation and transferred onto agar medium in triplicate following a 10-fold dilution series in sterile phosphate-buffered saline. All plates were incubated and colonies counted. For the second objective, 4 treatments and a positive control were prepared with 100 mL of milk and inoculated with M. bovis or Salmonella Dublin to an approximate concentration of 106 cfu/mL. With the use of Salstop, treatments were adjusted to an approximate pH of 6, 5, 4, or 3.5. The positive control was left untreated. At 1, 2, 4, 6, 8, and 24 h after treatment, triplicate aliquots were taken, the pH measured, and then the aliquots were transferred onto agar medium and into broth for enrichment. Following incubation, agar colonies were counted, while broths were plated and incubated prior to colonies being counted. All trials were repeated. Mycoplasma bovis did not grow in milk, but Salmonella Dublin proliferated. The pH of all acidification treatments remained stable for 24 h. No viable M. bovis organisms were detected at 1 h of exposure to pH 3.5 and 4 or at 8 h of exposure to pH 5. Following 24 h of exposure to pH 6 M. bovis remained viable. No viable Salmonella Dublin organisms were detected at 2 and 6 h of exposure to pH 3.5 and 4, respectively. Salmonella Dublin remained viable following 24 h of exposure to pH 5 and 6. These results demonstrate that milk acidification using Salstop is effective at eliminating viable M. bovis and Salmonella Dublin organisms in milk if the appropriate pH and exposure time are maintained.
Assuntos
Leite/microbiologia , Mycoplasma bovis/crescimento & desenvolvimento , Salmonella enterica/crescimento & desenvolvimento , Animais , Bovinos , Doenças dos Bovinos/microbiologia , Feminino , ÓvuloRESUMO
Researchers from Australia, New Zealand, Canada and the United States collaborated to validate their foot and mouth disease models--AusSpread, InterSpread Plus and the North American Animal Disease Spread Model--in an effort to build confidence in their use as decision-support tools. The final stage of this project involved using the three models to simulate a number of disease outbreak scenarios, with data from the Republic of Ireland. The scenarios included an uncontrolled epidemic, and epidemics managed by combinations of stamping out and vaccination. The predicted numbers of infected premises, the duration of each epidemic, and the size of predicted outbreak areas were compared. Relative within-model between-scenario changes resulting from different control strategies or resource constraints in different scenarios were quantified and compared. Although there were differences between the models in absolute outcomes, between-scenario comparisons within each model were similar. In all three models, early use of ring vaccination resulted in the largest drop in number of infected premises compared with the standard stamping-out regimen. This consistency implies that the assumptions made by each of the three modelling teams were appropriate, which in turn serves to increase end-user confidence in predictions made by these models.
Assuntos
Simulação por Computador/normas , Surtos de Doenças/veterinária , Febre Aftosa/epidemiologia , Gado , Modelos Biológicos , Criação de Animais Domésticos/normas , Criação de Animais Domésticos/estatística & dados numéricos , Animais , Austrália , Canadá , Surtos de Doenças/estatística & dados numéricos , Febre Aftosa/transmissão , Cooperação Internacional , Irlanda/epidemiologia , Nova Zelândia , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Estados UnidosRESUMO
After clinical Mycoplasma bovis mastitis outbreaks in dairy herds, M. bovis can persist as subclinical intramammary infections. Identification and culling of sub-clinically infected cows may be warranted to reduce future pathogen transmission and disease. In this study, apparent cow-level prevalences of M. bovis intramammary infection within 4 milking herds immediately following outbreaks of clinical disease due to M. bovis were determined utilising PCR and culture. All clinically affected M. bovis cows had been culled from the herds prior to herd sampling. Composite milk samples were collected once from each cow (nâ¯=â¯2,258) using a routine milk recording sampling technique. These samples were pooled for PCR screening; positive pools were analysed in different sized pools as needed from large to small, until individual PCR-positive animals could be identified. Despite M. bovis seroprevalences of 76% (herd 1), 40% (herd 2), 20% (herd 3) and 16% (herd 4), apparent prevalences of intramammary infection in the main milking group based on PCR in herds 1 to 4 were 0.2% (1/497), 0.0% (0/475), 0.1% (1/816) and 0.0% (0/444), respectively. Due to the low apparent prevalences of subclinical intramammary mycoplasma infections in these herds and the high expense associated with milk sample collection and testing, the return on diagnostic investment was very limited, particularly considering that additional cows are likely to have been colonised with mycoplasma in other anatomical sites. The results of this study suggest that pursuing identification of cows with subclinical intramammary mycoplasma infections following resolution of clinical M. bovis disease outbreaks in dairy herds may be of minimal benefit in programs designed to control or eradicate M. bovis.
Assuntos
Surtos de Doenças/veterinária , Mastite Bovina/epidemiologia , Mastite Bovina/microbiologia , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/veterinária , Mycoplasma bovis/isolamento & purificação , Animais , Infecções Assintomáticas , Bovinos , Indústria de Laticínios , Feminino , Leite/microbiologia , Infecções por Mycoplasma/epidemiologia , Estudos de Amostragem , Estudos Soroepidemiológicos , Tasmânia/epidemiologia , Vitória/epidemiologiaRESUMO
Encephalomyocarditis virus (EMCV) infection was detected by real-time reverse transcription PCR (qRT-PCR) in four adult alpacas (Vicugna pacos) from two properties on the Far North Coast of New South Wales (NSW) in April and May 2018 and in two adult alpacas from a third property on the Central Coast of NSW in October 2018. Viral RNA was detected in a range of samples, including blood, fresh body organs and mucosal swabs. EMCV was isolated from the blood and body organs of five of these alpacas. These animals displayed a range of clinical signs, including inappetence, colic, recumbency and death. Necropsy findings included multifocal to coalescing areas of myocardial pallor, pulmonary congestion and oedema, hepatic congestion and serosal effusion. Histopathological changes comprised acute, multifocal myocardial degeneration and necrosis, with mild, neutrophilic and lymphocytic inflammation (5/5 hearts) and mild, perivascular neutrophilic meningoencephalitis (1/3 brains). This is the first report of disease due to EMCV in alpacas under farm conditions, and it identifies EMCV infection as a differential diagnosis for acute disease and death in this camelid species. In addition to the samples traditionally preferred for EMCV isolation (fresh heart, brain and spleen), blood samples are also appropriate for EMCV detection by qRT-PCR assay.
Assuntos
Camelídeos Americanos , Infecções por Cardiovirus/epidemiologia , Infecções por Cardiovirus/veterinária , Infecções/veterinária , Animais , Vírus da Encefalomiocardite/genética , Coração , New South Wales/epidemiologiaRESUMO
Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a 'now window' of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.
Assuntos
Pessoal Administrativo/psicologia , Negro ou Afro-Americano/psicologia , Assistência à Saúde Culturalmente Competente/organização & administração , Tocologia/educação , Cuidados de Enfermagem/psicologia , Recursos Humanos de Enfermagem Hospitalar/psicologia , Racismo/prevenção & controle , Estudantes de Enfermagem/psicologia , Adulto , Austrália , Currículo , Bacharelado em Enfermagem , Feminino , Humanos , Liderança , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem Hospitalar/educação , Gravidez , Racismo/psicologiaRESUMO
Nursing courses in Australia are preparing graduates for comprehensive practice within Universities. The evaluation of safe and effective comprehensive nursing performance requires the consideration of a much broader range of practice competencies than has previously been the case. In particular there is a need to explore integrated assessment approaches that closely resemble the realities of the health care setting. Part 1 of this paper provides an overview of the Objective Structured Clinical Assessment (OSCA) which it is suggested is an effective way of assessing student comprehensive nursing performance. Some theoretical considerations in OSCA development are discussed and then an outline of the processes involved in designing and implementing an OSCA provided. Part 2 describes an evaluation project supported by the NSW Nurses' Registration Board. The aim of the study was to determine the validity and reliability of the use of the OSCA as an integrated assessment tool as a measurement of the extent to which a student nurse can plan and deliver safe and effective comprehensive nursing care.
Assuntos
Competência Clínica , Avaliação de Desempenho Profissional/normas , Austrália , Currículo , Avaliação de Desempenho Profissional/métodos , Humanos , Reprodutibilidade dos TestesRESUMO
Part 1 of this paper described the development of an assessment strategy used to measure the clinical performance of student nurses undertaking preparation for practice within the tertiary education sector. The challenge of developing an appropriate technique in assessment to accommodate a comprehensive nursing register was described. Features of the design and implementation were also provided. Part 2 describes an evaluation project developed by the staff and supported by a research grant from the New South Wales (NSW) Nurses Registration Board. The aim of the study was to determine the validity and reliability of the Objective Structured Clinical Assessment (OSCA) technique. The research design incorporated the use of triangulated data: student questionnaires, judgments made by a panel of experts and an analysis of the statistical correlation between the students' results in the OSCA and results in other areas of assessment.
Assuntos
Competência Clínica , Avaliação Educacional/normas , Avaliação de Desempenho Profissional/normas , Estudantes de Enfermagem , Humanos , Pesquisa em Educação em Enfermagem , Reprodutibilidade dos TestesRESUMO
The widespread availability of computer hardware and software for recording and storing disease event information means that, in theory, we have the necessary information to carry out detailed analyses of factors influencing the spatial distribution of disease in animal populations. However, the reliability of such analyses depends on data quality, with anomalous records having the potential to introduce significant bias and lead to inappropriate decision making. In this paper we promote the use of exceedance probabilities as a tool for detecting anomalies when applying hierarchical spatio-temporal models to animal health data. We illustrate this methodology through a case study data on outbreaks of foot-and-mouth disease (FMD) in Viet Nam for the period 2006-2008. A flexible binomial logistic regression was employed to model the number of FMD infected communes within each province of the country. Standard analyses of the residuals from this model failed to identify problems, but exceedance probabilities identified provinces in which the number of reported FMD outbreaks was unexpectedly low. This finding is interesting given that these provinces are on major cattle movement pathways through Viet Nam.
Assuntos
Doenças dos Bovinos/epidemiologia , Surtos de Doenças/estatística & dados numéricos , Surtos de Doenças/veterinária , Febre Aftosa/epidemiologia , Análise Espacial , Animais , Bovinos , Modelos Logísticos , Probabilidade , Reprodutibilidade dos Testes , Vietnã/epidemiologiaRESUMO
Despite its prevalence there has been little academic research into swearing, and certainly none on its impact on nurses and nursing practice. Nurses are, of all health workers, most likely to be targets of verbal aggression, and up to 100% of nurses in mental health settings report verbal abuse. The literature contains no reference to the effects on nurses of exposure to swearing. This paper reports the findings of a questionnaire study of 107 nurses working in three clinical settings, which used a mixed methods approach. Participants reported high levels of swearing by patients, 32% citing its occurrence from one to five times per week and 7% 'continuously'; a similar incidence arose across the nursing teams at all sites, but being sworn at in anger by another staff member happened rarely. The study failed to show significant differences in the frequency of swearing between mental health and paediatric settings, but did find gender-based differences in both frequency of use and offendedness. High degrees of distress among nurses subjected to swearing were evident; moreover, respondents appeared to have only a limited range of interventions to draw upon in dealing with exposure to such treatment.
Assuntos
Agressão/psicologia , Transtornos Mentais/enfermagem , Relações Enfermeiro-Paciente , Enfermagem Psiquiátrica/estatística & dados numéricos , Comportamento Verbal , Local de Trabalho/psicologia , Adulto , Idoso , Austrália , Feminino , Humanos , Relações Interprofissionais , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Tabu , Adulto JovemRESUMO
AIM: Retinal vein ophthalmodynamometric force (ODF) is predictive of future optic disc excavation in glaucoma, but it is not known if variation in ODF affects prognosis. We aimed to assess whether a change in ODF provides additional prognostic information. METHODS: 135 eyes of 75 patients with glaucoma or being glaucoma suspects had intraocular pressure (IOP), visual fields, stereo optic disc photography and ODF measured on an initial visit and a subsequent visit at mean 82 (SD 7.3) months later. Corneal thickness and blood pressure were recorded on the latter visit. When venous pulsation was spontaneous, the ODF was recorded as 0 g. Change in ODF was calculated. Flicker stereochronoscopy was used to determine the occurrence of optic disc excavation, which was modelled against the measured variables using multiple mixed effects logistic regression. RESULTS: Change in ODF (p = 0.046) was associated with increased excavation. Average IOP (p = 0.66) and other variables were not associated. Odds ratio for increased optic disc excavation of 1.045 per gram ODF change (95% CI 1.001 to 1.090) was calculated. CONCLUSION: Change in retinal vein ODF may provide additional information to assist with glaucoma prognostication and implies a significant relationship between venous change and glaucoma patho-physiology.
Assuntos
Glaucoma de Ângulo Aberto/fisiopatologia , Disco Óptico/patologia , Veia Retiniana/fisiopatologia , Idoso , Progressão da Doença , Feminino , Glaucoma de Ângulo Aberto/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Oftalmodinamometria , Prognóstico , Fluxo PulsátilRESUMO
This article reports the findings of an analysis of mental health-related news items in two Australian newspapers-one with a national readership, the other being more regionally orientated-over 1 year. The study employs both descriptive and interpretative methods in analyzing how messages about mental health and illness, mental health policy, psychiatry, mental health nursing and other mental health-related topics, are constructed and conveyed in the print media. Which stories are carried both nationally and regionally? How are these framed? Which points of view get canvassed? Which social and political interests are ignored or under-represented?
Assuntos
Atitude Frente a Saúde , Educação em Saúde , Saúde Mental , Jornais como Assunto , Austrália , Difusão de Inovações , Humanos , PolíticaRESUMO
This article considers how the issue of citizenship rights for people with serious mental problems and disorders has been constructed in recent Australian mental health policy discourse. In the first section of the paper a form of discourse analysis is employed to analyse the preferred meanings and representations that this discourse assigns to the issue of citizenship and human rights for people with serious mental health problems and disorders. The second section of the paper compares this official discourse on citizenship and mental health to other variants such as those found in medical-psychiatric discourse and in the discourse of the mental health movement(s). The paper concludes with comments regarding current prospects for extending citizenship rights to people who use mental health services.
Assuntos
Desinstitucionalização , Política de Saúde , Direitos Humanos , Transtornos Mentais/reabilitação , Defesa do Paciente , Austrália , HumanosRESUMO
This article reports the findings of a series of ethnographic research interviews conducted with psychiatric personnel in one region of Tasmania between 1995 and 1997. These interviews formed part of a more wide-ranging project examining changes in the regulatory practices of psychiatric personnel in the light of the professional, media and policy discourses that inform them, especially in relation to the impact of social justice reforms spelt out in recent Australian mental health policy. In discussing the nature of psychiatric work the personnel interviewed returned repeatedly to the themes of safety and risk management. The study presents an analysis of discourses deployed around these themes and argues that concerns over safety and risk are central to the emergence of a new institutionalism in acute in-patient psychiatric services.
Assuntos
Atitude do Pessoal de Saúde , Recursos Humanos de Enfermagem Hospitalar/psicologia , Recursos Humanos em Hospital/psicologia , Enfermagem Psiquiátrica , Gestão de Riscos , Gestão da Segurança , Antropologia Cultural , Feminino , Humanos , Masculino , Pesquisa Metodológica em Enfermagem , Poder Psicológico , Inquéritos e Questionários , TasmâniaRESUMO
This article uses a form of discourse analysis to examine a series of official reports on mental health matters in Tasmania during the period 1968-90. Drawing upon recent developments within ideology theory, and also on work that elaborates and extends Foucault's notion of governmentality, the study isolates and analyses the particular political rationalities and governmental technologies through which 'problems' of mental health in Tasmania have been rendered knowable and governable during the period in question.
Assuntos
Política de Saúde/tendências , Serviços de Saúde Mental/organização & administração , Política , Humanos , TasmâniaRESUMO
This is the third of four articles on the scoping study of the Australian mental health nursing workforce conducted on behalf of the Australian and New Zealand College of Mental Health Nurses (ANZCMHN) for the Australian Health Ministers Advisory Council (AHMAC) National Working Group on Mental Health (NWGMH). Its purpose is to focus on factors that significantly affect mental health nursing practice. The issues of advanced practice, regulation of nursing, accreditation, credentialing and demarcation with other disciplines are addressed.