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Article ; Online: Characterisation of IS1311 in Mycobacterium avium subspecies paratuberculosis genomes: Typing, continental clustering, microbial evolution and host adaptation.

Mizzi, Rachel / Plain, Karren M / Timms, Verlaine J / Marsh, Ian / Whittington, Richard J

2024 Volume 19, Issue 2, Page(s) e0294570

Abstract: Johne's disease (JD), caused by Mycobacterium avium subspecies paratuberculosis (MAP) is a global burden for livestock producers and has an association with Crohn's disease in humans. Within MAP there are two major lineages, S/Type I/TypeIII and C/Type ... ...

Abstract	Johne's disease (JD), caused by Mycobacterium avium subspecies paratuberculosis (MAP) is a global burden for livestock producers and has an association with Crohn's disease in humans. Within MAP there are two major lineages, S/Type I/TypeIII and C/Type II, that vary in phenotype including culturability, host preference and virulence. These lineages have been identified using the IS1311 element, which contains a conserved, single nucleotide polymorphism. IS1311 and the closely related IS1245 element belong to the IS256 family of insertion sequences, are dispersed throughout M. avium taxa but remain poorly characterised. To investigate the distribution and diversity of IS1311 in MAP, 805 MAP genomes were collated from public databases. IS1245 was absent, while IS1311 sequence, copy number and insertion loci were conserved between MAP S lineages and varied within the MAP C lineage. One locus was specific to the S strains, which contained nine IS1311 copies. In contrast, C strains contained either seven or eight IS1311 loci. Most insertion loci were associated with the boundaries of homologous regions that had undergone genome rearrangement between the MAP lineages, suggesting that this sequence may be a driver of recombination. Phylogenomic geographic clustering of MAP subtypes was demonstrated for the first time, at continental scale, and indicated that there may have been recent MAP transmission between Europe and North America, in contrast to Australia where importation of live ruminants is generally prohibited. This investigation confirmed the utility of IS1311 typing in epidemiological studies and resolved anomalies in past studies. The results shed light on potential mechanisms of niche/host adaptation, virulence of MAP and global transmission dynamics.
MeSH term(s)	Animals ; Humans ; Mycobacterium avium subsp. paratuberculosis/genetics ; Host Adaptation ; Paratuberculosis/microbiology ; Polymorphism, Single Nucleotide ; Ruminants/genetics ; DNA Transposable Elements
Chemical Substances	DNA Transposable Elements
Language	English
Publishing date	2024-02-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0294570
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Article ; Online: Health-related quality of life and experience measures, to assess patients' experiences of peripheral intravenous catheters: a secondary data analysis.

Larsen, Emily N / Marsh, Nicole / Rickard, Claire M / Mihala, Gabor / Walker, Rachel M / Byrnes, Joshua

Health and quality of life outcomes

2024 Volume 22, Issue 1, Page(s) 1

Abstract: Background: Peripheral intravenous catheters (PIVCs) are essential for successful administration of intravenous treatments. However, insertion failure and PIVC complications are common and negatively impact patients' health-outcomes and experiences. We ... ...

Abstract	Background: Peripheral intravenous catheters (PIVCs) are essential for successful administration of intravenous treatments. However, insertion failure and PIVC complications are common and negatively impact patients' health-outcomes and experiences. We aimed to assess whether generic (not condition-specific) quality of life and experience measures were suitable for assessing outcomes and experiences of patients with PIVCs. Methods: We undertook a secondary analysis of data collected on three existing instruments within a large randomised controlled trial, conducted at two adult tertiary hospitals in Queensland, Australia. Instruments included the EuroQol Five Dimension - Five Level (EQ5D-5L), the Functional Assessment of Chronic Illness Therapy - Treatment Satisfaction - General measure (FACIT-TS-G, eight items), and the Australian Hospital Patient Experience Question Set (AHPEQS, 12 items). Responses were compared against two clinical PIVC outcomes of interest: all-cause failure and multiple insertion attempts. Classic descriptives were reported for ceiling and floor effects. Regression analyses examined validity (discrimination). Standardised response mean and effect size (ES) assessed responsiveness (EQ5D-5L, only). Results: In total, 685 participants completed the EQ5D-5L at insertion and 526 at removal. The FACIT-TS-G was completed by 264 and the AHPEQS by 262 participants. Two FACIT-TS-G items and one AHPEQS item demonstrated ceiling effect. Instruments overall demonstrated poor discrimination, however, all-cause PIVC failure was significantly associated with several individual items in the instruments (e.g., AHPEQS, 'unexpected physical and emotional harm'). EQ5D-5L demonstrated trivial (ES < 0.20) responsiveness. Conclusions: Initial investigation of an existing health-related quality of life measure (EQ5D-5L) and two patient-reported experience measures (FACIT-TS-G; AHPEQS) suggest they are inadequate (as a summary measure) to assess outcomes and experiences for patients with PIVCs. Reliable instruments are urgently needed to inform quality improvement and benchmark standards of care.
MeSH term(s)	Adult ; Humans ; Quality of Life ; Secondary Data Analysis ; Australia ; Queensland ; Catheters
Language	English
Publishing date	2024-01-02
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2098765-1
ISSN	1477-7525 ; 1477-7525
ISSN (online)	1477-7525
ISSN	1477-7525
DOI	10.1186/s12955-023-02217-8
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Article ; Online: Educational programs for implementing ultrasound guided peripheral intravenous catheter insertion in emergency departments: A systematic integrative literature review.

Stone, Renee / Walker, Rachel M / Marsh, Nicole / Ullman, Amanda J

Australasian emergency care

2023 Volume 26, Issue 4, Page(s) 352–359

Abstract: Background: Ultrasound-guided peripheral intravenous catheter insertion has been identified as an effective method to improve the success rate of cannulation, thereby improving patient experience. However, learning this new skill is complex, and ... ...

Abstract	Background: Ultrasound-guided peripheral intravenous catheter insertion has been identified as an effective method to improve the success rate of cannulation, thereby improving patient experience. However, learning this new skill is complex, and involves training clinicians from a variety of backgrounds. The aim of this study was to appraise and compare literature on educational methods in the emergency setting used to support ultrasound guided peripheral intravenous catheter insertion by different clinicians, and how effective these current methods are. Review methods: A systematic integrative review was undertaken using Whittemore and Knafl's five stage approach. The Mixed Methods Appraisal Tool was used to assess the quality of the studies. Results: Forty-five studies met the inclusion criteria, with five themes identified. These were: the variety of educational methods and approaches; the effectiveness of the different educational methods; barriers and facilitators of education; clinician competency assessments and pathways; clinician confidence assessment and pathways. Conclusions: This review demonstrates that a variety of educational methods are being used in successfully training emergency department clinicians in using ultrasound guidance for peripheral intravenous catheter insertion. Furthermore, this training has resulted in safer and more effective vascular access. However, it is evident that there is a lack of consistency of formalised education programs available. A standardised formal education program and increased availability of ultrasound machines in the emergency department will ensure consistent practices are maintained, retained, therefore leading to safer practice as well as more satisfied patients.
MeSH term(s)	Humans ; Ultrasonography, Interventional/methods ; Ultrasonography ; Learning ; Emergency Service, Hospital ; Catheters
Language	English
Publishing date	2023-07-07
Publishing country	Australia
Document type	Systematic Review ; Journal Article ; Review
ISSN	2588-994X
ISSN (online)	2588-994X
DOI	10.1016/j.auec.2023.06.001
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Article ; Online: Non-motor effects of subthalamic nucleus stimulation in Parkinson patients.

Sammartino, Francesco / Marsh, Rachel / Rezai, Ali / Krishna, Vibhor

Brain imaging and behavior

2022 Volume 16, Issue 1, Page(s) 161–168

Abstract: The current white matter connectivity analyses of the subthalamic region have focused on the motor effects of deep brain stimulation. We investigate white matter connectivity associated with the stimulation-induced non-motor acute clinical effects in ... ...

Abstract	The current white matter connectivity analyses of the subthalamic region have focused on the motor effects of deep brain stimulation. We investigate white matter connectivity associated with the stimulation-induced non-motor acute clinical effects in three domains: mood changes, dizziness, and sweating. We performed whole-brain probabilistic tractography seeded from the domain-specific stimulation volumes. The resultant connectivity maps were statistically compared across patients. The cortical voxels associated with each non-motor domain were compared with stimulation-induced motor improvements in a multivariate model. The resulting voxel maps were thresholded for false discovery (FDR q < 0.05) and clustered using a multimodal atlas. We also performed a group-level parcellation of stimulation volumes to identify the local pathways associated with each non-motor domain. The non-motor effects were rarely observed during stimulation titration: from 1100 acute clinical effects, mood change was observed in 14, dizziness in 23, and sweating in 20. Distinct cortical clusters were associated with each domain; notably, mood change was associated with voxels in the salience network and dizziness with voxels in the visual association cortex. The subthalamic parcellation yielded a mediolateral gradient, with the motor parcel being lateral and the non-motor parcels medial. We also observed an anteroposterior organization in the medial non-motor clusters with mood changes being anterior, followed posteriorly by dizziness, and sweating. We interpret these findings based on the literature and foresee these to be useful in guiding DBS programming.
MeSH term(s)	Deep Brain Stimulation ; Humans ; Magnetic Resonance Imaging ; Parkinson Disease/diagnostic imaging ; Parkinson Disease/therapy ; Subthalamic Nucleus ; White Matter
Language	English
Publishing date	2022-01-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	2377165-3
ISSN	1931-7565 ; 1931-7557
ISSN (online)	1931-7565
ISSN	1931-7557
DOI	10.1007/s11682-021-00487-8
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Article: Randomised controlled feasibility study protocol of the Carers-ID online intervention to support the mental health of family carers of people with intellectual disabilities.

Linden, Mark A / Leonard, Rachel / Forbes, Trisha / Brown, Michael / Marsh, Lynne / Todd, Stuart / Hughes, Nathan / Truesdale, Maria

Pilot and feasibility studies

2024 Volume 10, Issue 1, Page(s) 25

Abstract: Background: Family carers play a crucial role in supporting the health and well-being of people with intellectual disabilities. Given their role and responsibilities, many family carers experience significant and ongoing stress and mental health ... ...

Abstract	Background: Family carers play a crucial role in supporting the health and well-being of people with intellectual disabilities. Given their role and responsibilities, many family carers experience significant and ongoing stress and mental health difficulties. Programmes and interventions which provide training and support to family carers have been shown to have a positive impact on levels of stress and quality of life. However, these are often face to face which can create barriers to full participation. Online interventions have been shown to offer flexibility in delivery compared with traditional face-to-face approaches. The primary objective of this study is to determine the feasibility of delivering the Carers-ID online intervention, while the secondary outcome is improved mental health in family carers of people with intellectual disabilities. Methods: Family carers (n = 120) will be randomised to receive the intervention (n = 60) or assigned to a wait-list control (n = 60) group. The intervention ( www.Carers-ID.com ) consists of 14 modules which cover topics including the following: promoting resilience, providing peer support, reducing anxiety, managing stress, accessing local supports and managing family conflict and information for siblings who are carers. The intervention has been co-produced with voluntary sector organisations and family carers and tested for acceptability. Primary outcomes for this study include acceptability and feasibility of the outcome measures, recruitment, participation and retention rates and effect sizes. Secondary outcomes will be completed at three time points (baseline, following intervention completion and 3 months after completion). These include the following: the Depression, Anxiety and Stress Scale, the Warwick-Edinburgh Mental Well-being Scale, the Resilience Scale and the Social Connectedness Scale Revised. Participants (n = 12) who have taken part in the intervention arm of the research will be invited to participate in semi-structured interviews as part of the process evaluation. Discussion: The Carers-ID intervention provides an online resource for family carers to support their mental health and well-being and promote their resilience. It represents an affordable and accessible means of delivering such support. Testing the feasibility of the intervention and related trial procedures is required to determine whether a full-scale randomised controlled trial to evaluate the intervention's effectiveness is warranted. Trial registration: ClinicalTrials.gov : NCT05737823.
Language	English
Publishing date	2024-02-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2809935-7
ISSN	2055-5784
ISSN	2055-5784
DOI	10.1186/s40814-024-01448-w
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Article: Integrated versus non-integrated peripheral intravenous catheters: a cross-sectional survey of nurse experiences.

Paterson, Rebecca S / Larsen, Emily N / Cooke, Marie / Rickard, Claire M / Walker, Rachel M / Marsh, Nicole

British journal of nursing (Mark Allen Publishing)

2023 Volume 32, Issue 2, Page(s) S6–S16

Abstract: Background: Integrated peripheral intravenous catheters (PIVCs) demonstrate clinical efficacy, however, device complexity and design differences may be a potential barrier to implementation.: Aims: To assess nurse acceptability of integrated PIVC ... ...

Abstract	Background: Integrated peripheral intravenous catheters (PIVCs) demonstrate clinical efficacy, however, device complexity and design differences may be a potential barrier to implementation. Aims: To assess nurse acceptability of integrated PIVC systems. Methods: A cross-sectional survey was nested within a multicentre randomised controlled trial. One hundred nurses caring for patients with integrated and non-integrated PIVCs completed a 17-item survey about key differences between devices (eg function and appearance, perceived patient comfort and skin injuries). Findings: Most nurses reported the integrated PIVC wings prevented device movement (80%), achieved patient comfort in areas of flexion (78%), and no patients developed skin injuries (100%). Nurses rated the ease of accessing and overall confidence using the integrated PIVC as significantly higher than the non-integrated design ( Conclusion: The integrated PIVC received positive feedback from nurses and had few barriers to implementation.
MeSH term(s)	Humans ; Cross-Sectional Studies ; Surveys and Questionnaires ; Catheterization, Peripheral ; Treatment Outcome ; Catheters
Language	English
Publishing date	2023-01-30
Publishing country	England
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article
ZDB-ID	1119191-0
ISSN	0966-0461
ISSN	0966-0461
DOI	10.12968/bjon.2023.32.2.S6
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Article ; Online: Childhood obesity in the ED: A prospective Australian study.

Marsh, Rachel / Gill, Stephen / Lowry, Nicole / Hayden, Georgina / Ryan, Matthew / Gwini, Stella-May / Allender, Steven / Stella, Julian

Emergency medicine Australasia : EMA

2024

Abstract: Objective: To determine (i) the prevalence of overweight and obesity among children presenting to all EDs in a large regional Australian city and (ii) whether age, sex, socioeconomic status (SES) or hospital setting (public vs private) were associated ... ...

Abstract	Objective: To determine (i) the prevalence of overweight and obesity among children presenting to all EDs in a large regional Australian city and (ii) whether age, sex, socioeconomic status (SES) or hospital setting (public vs private) were associated with overweight and obesity. Methods: This prospective observational study included children aged ≥2 and <18 years who presented to any of three EDs over an 18 month period who had their height and weight measured. Age, sex and residential postcode were collected. Weight category was determined by sex and age standardised body mass index (BMI) z-score. Weight category was assessed by sex, age, SES and hospital setting with chi-squared tests, and ordinal logistic regression with cluster sandwich error estimators. Results were reported using odds ratios (OR) with 95% confidence intervals (CI). Results: Data were collected for 3827 children, of which 11.6% were obese and 19.8% overweight. The prevalence of obesity was highest in those aged 8-14 years and in those from lower SES postcodes. The likelihood of obesity was higher in the public than the private hospitals (OR 0.66, 95% CI 0.51-0.86), whereas the likelihood of overweight was similar (OR 1.00, 95% CI 0.83-1.22). Conclusions: Almost one-third of children who presented to EDs were overweight or obese. Obesity was particularly high in those aged 8-14 years and those from lower SES postcodes. In the evolving obesity crisis, the high proportion of children presenting to EDs above a healthy weight might represent an opportunity for EDs to identify and refer children for body weight and lifestyle management.
Language	English
Publishing date	2024-04-22
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2161824-0
ISSN	1742-6723 ; 1742-6731 ; 1035-6851
ISSN (online)	1742-6723
ISSN	1742-6731 ; 1035-6851
DOI	10.1111/1742-6723.14414
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Article: Factors prompting and deterring suicides on the roads.

Norman, Hilary / Marzano, Lisa / Winter, Rachel / Crivatu, Ioana / Mackenzie, Jay-Marie / Marsh, Ian

BJPsych open

2023 Volume 9, Issue 3, Page(s) e81

Abstract: Background: In addition to the devastating impact on the individual and their families, suicides on the roads can cause distress and harm to other people who might be involved in a collision or witness an attempt. Despite an increased focus on the ... ...

Abstract	Background: In addition to the devastating impact on the individual and their families, suicides on the roads can cause distress and harm to other people who might be involved in a collision or witness an attempt. Despite an increased focus on the characteristics and circumstances of road-related suicides, little is known about why people choose to end their lives in this way. Aims: The aim of the current study was to investigate the factors prompting and deterring the decision to attempt suicide on the roads. Method: We conducted a secondary analysis of survey data, as well as seven in-depth qualitative interviews. Participants had lived experience of suicidal ideation or behaviour at a bridge or road location. We also carried out an online ethnography to explore interactions in different online communities relating to this method of suicide. Results: Participants perceived a road-related suicide to be quick, lethal, easy and accessible and to have the potential to appear accidental. The proportion of participants who described their thoughts and attempts as impulsive appeared to be higher than had been observed with other method choices. The potential impact on other people was a strongly dissuasive factor. Conclusions: Measures designed to prevent access to potentially lethal sites may be particularly important, given that many participants described their thoughts and behaviour as impulsive. In addition, fostering a culture of care and consideration for other road users may help to dissuade people from taking action on the roads.
Language	English
Publishing date	2023-05-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2829557-2
ISSN	2056-4724
ISSN	2056-4724
DOI	10.1192/bjo.2023.52
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Article: Predictors of EX/RP alone versus EX/RP with medication for adults with OCD: does medication status moderate outcomes?

Wheaton, Michael G / Rosenfield, Benjamin / Rosenfield, David / Marsh, Rachel / Foa, Edna B / Simpson, H Blair

Journal of obsessive-compulsive and related disorders

2023 Volume 39

Abstract: Exposure and response prevention (EX/RP) can be delivered as monotherapy or to augment serotonin reuptake inhibitors (SRIs). While both options are considered effective OCD treatments, responses are heterogenous. Substantial work has investigated EX/RP ... ...

Abstract	Exposure and response prevention (EX/RP) can be delivered as monotherapy or to augment serotonin reuptake inhibitors (SRIs). While both options are considered effective OCD treatments, responses are heterogenous. Substantial work has investigated EX/RP predictors to account for this variability in responses, with mixed findings. Little research has studied whether EX/RP predictors may differ in medicated versus non-medicated samples (i.e., medication status as a moderator). We pooled data from two clinical trials conducted concurrently in the same specialty OCD clinic. One enrolled patients who were on stable SRI doses (EX/RP as SRI augmentation, n=58) while the other enrolled non-medicated patients (EX/RP monotherapy, n=38). Both trials used the same manualized EX/RP protocol and blinded independent evaluators. LASSO regression derived predictors and moderators of outcome. Improvement did not significantly differ between the EX/RP alone group and the SRI+EX/RP group. In both groups, higher baseline OCD severity and worse quality of life predicted poorer outcome. OCPD traits moderated results: Patients with more severe OCPD traits had better outcomes from EX/RP monotherapy than those receiving EX/RP with SRIs. Patient adherence to EX/RP homework mediated the associations between the baseline variables and outcome. The effect of OCPD traits on outcome warrants future study to improve care.
Language	English
Publishing date	2023-11-07
Publishing country	England
Document type	Journal Article
ISSN	2211-3649
ISSN	2211-3649
DOI	10.1016/j.jocrd.2023.100850
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Article ; Online: Groin pain in athletes.

Rolph, Rachel / Morgan, Catrin / Chapman, Gareth / Marsh, Simon

BMJ (Clinical research ed.)

2020 Volume 368, Page(s) m559

MeSH term(s)	Athletic Injuries/diagnosis ; Diagnosis, Differential ; Groin ; Humans ; Musculoskeletal Pain/diagnosis ; Pelvic Pain/diagnosis
Language	English
Publishing date	2020-03-04
Publishing country	England
Document type	Journal Article
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.m559
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