Evidence of amphotericin B resistance in Macrorhabdus ornithogaster in Australian cage-birds.

Amphotericin B is widely used for the treatment of Macrorhabdus ornithogaster infections. To date, however, there have been no randomized controlled trials confirming its efficacy where cure was confirmed by postmortem examination. To determine the efficacy of amphotericin B against M. ornithogaster, a three-part study was undertaken. Treatment outcomes of M. ornithogaster infected birds treated amphotericin B were reviewed. A pilot treatment trial with two naturally infected birds (Melopsittacus undulatus and Agapornis roseicollis) was undertaken, administering amphotericin B at 100 mg/kg twice daily for 30 days. Finally, a randomized controlled trial using experimentally infected chickens treated with amphotericin B at 25 mg/kg and 100 mg/kg twice daily for 10 days was performed. Retrospective analysis indicated treatment failure in 80.4% of 36 cases that met the inclusion criteria. The pilot study showed that amphotericin B did not clear, but significantly decreased Macrorhabdus ornithogaster burden, followed by profound rebound effect of the number of organisms shed in the feces. Finally, the randomized controlled trial found that amphotericin B given at 100 mg/kg did not clear, but significantly decreased the burden of M. ornithogaster compared with both the 25 mg/kg group (P = .037) and the no treatment control group (P = .001). A strong curvilinear correlation between body weight and M. ornithogaster infection burden was present in the infected chickens. These findings represent treatment failure in three scenarios and indicate that treatment with amphotericin B has poor efficacy against Macrorhabdus ornithogaster.

The Effectiveness of Self-Management Interventions for Individuals with Low Health Literacy and/or Low Income: A Descriptive Systematic Review.

BACKGROUND: With the burden of chronic illness increasing globally, self-management is a crucial strategy in reducing healthcare costs and increasing patient quality of life. Low income and low health literacy are both associated with poorer health outcomes and higher rates of chronic disease. Thus, self-management represents an important healthcare strategy for these populations. The purpose of this study is to review self-management interventions in populations with low income or low health literacy and synthesize the efficacy of these interventions. METHODS: A systematic review of trials evaluating the efficacy of self-management interventions in populations with low income or low health literacy diagnosed with a chronic illness was conducted. Electronic databases were primarily searched to identify eligible studies. Data were extracted and efficacy summarized by self-management skills, outcomes, and content tailoring. RESULTS: 23 studies were reviewed, with ten reporting an overall positive effect on at least one primary outcome. Effective interventions most often included problem-solving as well as taking action and/or resource utilization. A wide range of health-related outcomes were considered, were efficacious empowerment and disease-specific quality of life were found to be significant. The efficacy of interventions did not seem to vary by duration, format, or mode of delivery or whether these included individuals with low health literacy and/or low income. Tailoring did not seem to impact on efficacy. DISCUSSION: Findings suggest that self-management interventions in populations with low income or low health literacy are most effective when three to four self-management skills are utilized, particularly when problem-solving is targeted. Healthcare providers and researchers can use these findings to develop education strategies and tools for populations with low income or low health literacy to improve chronic illness self-management.

Exotic Animal Practice in East Asia: A Retrospective Study of Species Distribution and Their Common Diseases at 2 Exotics-only Veterinary Clinics in the East Asia Region.

The objective of this clinical retrospective study was to analyze the prevalence and distribution of different avian and exotic animals presented to 2 exotics-only veterinary hospital in Hong Kong and Taiwan over a 1 year period. Exotic companion mammals, predominated by rabbits (Oryctolagus cuniculus) that were often diagnosed with fractures, were the most commonly presented group of patients in the hospital in Hong Kong while second most of that in Taiwan, with dental disease being commonly presented in the species. This study provided a general overview of avian and exotic patients presented to exotics-only practices in the East Asia region.

The effect of culturally-adapted health education interventions among culturally and linguistically diverse (CALD) patients with a chronic illness: A meta-analysis and descriptive systematic review.

OBJECTIVE: To review the effectiveness of health education interventions adapted for culturally and linguistically diverse (CALD) populations with a chronic illness. METHODS: A systematic review and meta-analysis were conducted. Eligible studies were identified across six databases. Data were extracted and intervention effect was summarized using standardized mean difference. If there were insufficient data for meta-analysis, a descriptive summary was included. Modifying effects of intervention format, length, intensity, provider, self-management skills taught, and behavioral change techniques (BCTs) utilized were examined. RESULTS: 58 studies were reviewed and data were extracted for 36 outcomes. Most interventions used multiple modes of delivery and were facilitated by bilingual health care professionals (HCPs). On average, interventions included 5.19 self-management skills and 4.82 BCTs. Interventions were effective in reducing BMI, cholesterol, triglycerides, blood glucose, HbA1C, and depression, and in increasing knowledge. Effectiveness was influenced partly by provider, with HCPs favored over lay providers or paraprofessionals in increasing knowledge; however, the opposite was noted for HbA1c. CONCLUSIONS: Health education interventions are effective among CALD populations, particularly at improving objective, distal outcomes (e.g., anthropometric measures). These interventions may be equally effective in improving proximal patient-reported outcomes (PROs); however, diversity in PROs limited analyses. PRACTICE IMPLICATIONS: Core outcome sets (COS) are needed to further investigate and compare health education intervention effectiveness on PROs.

Exploring the Student Peer Mentor's Experience in a Nursing Peer Mentorship Program.

BACKGROUND: The mentor's role is often underreported in the literature. Given the pivotal role peer mentors play in mentorship efforts, the current study sought to explore the experiences and perceptions of peer mentors enrolled in a university-affiliated, nursing student, peer mentorship program. METHOD: A qualitative descriptive design was conducted using purposive and snowball sampling techniques. A one-time interview was conducted with participants using a semistructured interview guide. Inductive thematic content analysis occurred concurrently with data collection. RESULTS: Eight mentors participated revealing four major themes: Doing What I Wish Someone Had Done for Me, Initial Face-to-Face Contact Is Key, Being Thrown to the Wind, and Practicing What I Will Use as a Nurse. CONCLUSION: Aspects of self-directed learning may benefit future careers for student peer mentors. Opportunities for program enhancement include coping and communication skills for peer mentors. Future "scaled-up" evaluations are needed for ongoing quality improvements using multimethod approaches. [J Nurs Educ. 2018;57(7):422-425.].