Investigating Understandings of Antibiotics and Antimicrobial Resistance in Diverse Ethnic Communities in Australia: Findings from a Qualitative Study

This paper explores the understandings of antibiotics and antimicrobial resistance (AMR) among ethnically diverse informants in Melbourne, Australia. A total of 31 face-to-face semi-structured qualitative interviews were conducted with a sample of ethnic in-patients who were admitted with an acquired antimicrobial infection in a public hospital (n = 7); five hospital interpreters; and ethnic members of the general community (n = 19) as part of a broader study of lay understandings of AMR. Thematic analysis revealed there was poor understanding of AMR, even among informants being treated for AMR infections. Causes of the increasing incidence of AMR were attributed to: weather fluctuations and climate change; a lack of environmental cleanliness; and the arrival of new migrant groups. Asian informants emphasized the need for humoral balance. Antibiotics were viewed as ‘strong’ medicines that could potentially disrupt this balance and weaken the body. Travel back to countries of origin sometimes involved the use of medical services and informants noted that some community members imported antibiotics from overseas. Most used the internet and social media to source health information. There is a lack of information in their own languages. More attention needs to be given to migrant communities who are vulnerable to the development, transmission and infection with resistant bacteria to inform future interventions.

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İngiltere’den Türkiye’ye ‘Düzensiz’ Göçmen Dövizi Gönderme Davranışının Nedenleri Üzerine Nitel Bir İnceleme

GÖÇ DERGİSİ ◽

10.33182/gd.v6i2.665 ◽

2019 ◽

Vol 6 (2) ◽

pp. 173-190

Author(s):

Fethiye Tilbe

Keyword(s):

Cultural Values ◽

Host Country ◽

Regulatory Framework ◽

Face To Face ◽

Migrant Communities ◽

The United Kingdom ◽

Main Determinants ◽

Money Transfers ◽

The Uk ◽

Migrant Groups

Bu makale, göçmen dövizi akımlarında “düzensizlik” olarak ifade ettiğimiz, Türkiye’ye resmi kanallar dışında gönderilen enformel göçmen dövizlerini, Birleşik Krallık’ta (özellikle Londra’da) yaşayan Türkiye kökenli göçmenler açısından incelemektedir. Her göçmen grubu, gerek ev sahibi ülkedeki düzenleyici çerçeve ve sosyo-ekonomik koşullar, gerek göçmen topluluğunun sosyo-kültürel değerleri tarafından belirlenen biçimde, farklı göçmen dövizi transfer biçimlerine eğilim sergilemektedir. Dolayısıyla farklı ülkelerdeki aynı kökenden göçmen toplulukları, ev sahibi ülkedeki dinamikler nedeniyle göçmen dövizlerinin formel ya da enformel (düzenli ya da düzensiz) gönderiminde farklılaşabilirken, aynı ülkedeki farklı ülke kökenli göçmen grupları da pek çok örüntünün etkisiyle farklı eğilim gösterebilmektedir. Nitel araştırma tasarımı kapsamında 27 göçmen ve 7 anahtar statüdeki katılımcıyla gerçekleştirilen yüz yüze görüşmelere dayalı olan bu çalışma, Birleşik Krallık’tan Türkiye’ye göçmen dövizi gönderimindeki düzensizlik olgusunu, her iki ülkenin sosyal, ekonomik ve kültürel dinamikleriyle ilişkilendirerek incelemeyi ve nedenlerini ortaya çıkarmayı amaç edinmektedir. Elde edilen sonuçlar, göçmenlik statüsü, gönderilen para miktar ve sıklığı ile geleneksel ilişki ağlarına olan güvenin yanında, Birleşik Krallık’taki sosyal yardım ve çalışma biçimine ilişkinin düzenleyici çerçevenin ve göçmenlerin sosyo-ekonomik durumlarının Türkiye’ye enformel göçmen dövizi gönderiminde temel belirleyici olduğunu ortaya koymaktadır.ABSTRACT IN ENGLISHA Qualitative Examination of Determinants of Remittances Sending Behaviour Among Immigrants from Turkey in the UKThis article examines the causes of irregularity in remittances flows from the United Kingdom (UK) to Turkey, from the perspective of migrants from Turkey living in the UK. Each group of migrants prefers different types of remittance sending methods, as determined by the regulatory framework and socio-economic conditions in the host country and the socio-cultural values of the migrant community. Therefore, migrant communities of the same origin in different countries may differ in using formal or informal sending methods of remittances due to the dynamics in the host country. Similarly, migrant groups of different nationalities in the same country may show different tendencies due to the influence of many patterns. Similarly, migrant groups of different nationalities in the same country may show different tendencies due to the influence of many patterns. This study aims to examine the phenomenon of irregularities in sending remittances by associating with the social, economic and cultural dynamics of both countries. For this purpose, face-to-face in-depth interviews were conducted with 27 immigrants and 7 key status participants by using qualitative research method. The obtained results reveal that the regulatory framework relating to social assistance and labour market in the UK, immigration status, the frequency and the amount of money sent and confidence in traditional relationship networks is the main determinants of informal money transfers to Turkey.

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Inhibition of Bacterial Biofilm Formation by Phytotherapeutics with Focus on Overcoming Antimicrobial Resistance

Current Pharmaceutical Design ◽

10.2174/1381612826666200212121710 ◽

2020 ◽

Vol 26 (24) ◽

pp. 2807-2816 ◽

Cited By ~ 1

Author(s):

Yun Su Jang ◽

Tímea Mosolygó

Keyword(s):

Antimicrobial Resistance ◽

Biofilm Formation ◽

Antimicrobial Agents ◽

Bacterial Biofilm ◽

Experimental Investigations ◽

Resistant Bacteria ◽

Salmonella Spp ◽

Food Borne ◽

High Prevalence ◽

Scientific Attention

: Bacteria within biofilms are more resistant to antibiotics and chemical agents than planktonic bacteria in suspension. Treatment of biofilm-associated infections inevitably involves high dosages and prolonged courses of antimicrobial agents; therefore, there is a potential risk of the development of antimicrobial resistance (AMR). Due to the high prevalence of AMR and its association with biofilm formation, investigation of more effective anti-biofilm agents is required. : From ancient times, herbs and spices have been used to preserve foods, and their antimicrobial, anti-biofilm and anti-quorum sensing properties are well known. Moreover, phytochemicals exert their anti-biofilm properties at sub-inhibitory concentrations without providing the opportunity for the emergence of resistant bacteria or harming the host microbiota. : With increasing scientific attention to natural phytotherapeutic agents, numerous experimental investigations have been conducted in recent years. The present paper aims to review the articles published in the last decade in order to summarize a) our current understanding of AMR in correlation with biofilm formation and b) the evidence of phytotherapeutic agents against bacterial biofilms and their mechanisms of action. The main focus has been put on herbal anti-biofilm compounds tested to date in association with Staphylococcus aureus, Pseudomonas aeruginosa and food-borne pathogens (Salmonella spp., Campylobacter spp., Listeria monocytogenes and Escherichia coli).

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User-driven efforts in creating knowledge graph information system

Digital Library Perspectives ◽

10.1108/dlp-12-2019-0043 ◽

2020 ◽

Vol 36 (2) ◽

pp. 97-111

Author(s):

Stanislava Gardasevic

Keyword(s):

Information System ◽

Information Seeking ◽

Information Needs ◽

Resource Discovery ◽

The Body ◽

Knowledge Graph ◽

Structured Interviews ◽

Community Members ◽

Study Objective ◽

Content Type

Purpose This paper presents the results of a qualitative study that involved students of an interdisciplinary PhD program. The study objective was to gather requirements to create a knowledge graph information system. The purpose of this study was to determine information-seeking practices and information needs of this community, to inform the functionalities of a proposed system, intended to help students with relevant resource discovery and decision-making. Design/methodology/approach The study design included semi-structured interviews with eight members of the community, followed by a website usability study with the same student participants. Findings Two main information-seeking styles are recognized and reported through user personas of international and domestic (USA) students. The findings show that the useful information resides within the community and not so much on the program website. Students rely on peer communication, although they report lack of opportunities to connect. Students’ information needs and information seeking are dependent on their progress through the program, as well as their motivation and the projected timeline. Practical implications Considering the current information needs and practices, a knowledge graph hosting both information on social networks and the knowledge produced by the activities of the community members would be useful. By recording data on their activities (for example, collaboration with professors and coursework), students would reveal further useful system functionalities and facilitate transfer of tacit knowledge. Originality/value Aside from the practical value of this research that is directly influencing the design of a system, it contributes to the body of knowledge on interdisciplinary PhD programs.

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Medical Students’ Experience of Mindfulness Training in the UK: Well-Being, Coping Reserve, and Professional Development

Education Research International ◽

10.1155/2019/4021729 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 3

Author(s):

Alice Malpass ◽

Kate Binnie ◽

Lauren Robson

Keyword(s):

Medical Education ◽

Mental Health Problems ◽

Qualitative Interviews ◽

General Medical Council ◽

Well Being ◽

Mindfulness Training ◽

The Body ◽

Free Text ◽

Medical Council ◽

The Uk

Medical school can be a stressful experience for students, resulting in stress-related mental health problems. Policy recommendations from the General Medical Council (GMC), the body responsible for improving medical education in the UK, recommend the use of mindfulness training to increase well-being and resilience to stress. Students participating in an eight-week mindfulness training between Autumn 2011 and Spring 2015 were invited to complete a free text survey at the end of their mindfulness course. In addition, six qualitative interviews were conducted lasting between 60 and 90 minutes. Interviews used a topic guide and were recorded and transcribed verbatim. We used the framework approach to analyse the data. Students reported a new relationship to their thoughts and feelings which gave a greater sense of control and resiliency, an ability to manage their workload better, and more acceptance of their limitations as learners. The small group context was important. Students described improved empathy and communication skills through building inner awareness of thoughts and feelings, noticing judgments, and developing attentive observation. The findings show how resiliency and coping reserve can be developed within medical education and the role of mindfulness in this process. We present a conceptual model of a learnt cycle of specific vulnerability and describe how MBCT intercepts at various junctures in this self-reinforcing cycle through the development of new coping strategies that embrace an “allowed vulnerability.”

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The Role of Aquatic Ecosystems (River Tua, Portugal) as Reservoirs of Multidrug-Resistant Aeromonas spp.

Water ◽

10.3390/w13050698 ◽

2021 ◽

Vol 13 (5) ◽

pp. 698

Author(s):

Sónia Gomes ◽

Conceição Fernandes ◽

Sandra Monteiro ◽

Edna Cabecinha ◽

Amílcar Teixeira ◽

...

Keyword(s):

Antibiotic Resistance ◽

Antimicrobial Resistance ◽

Nalidixic Acid ◽

Water Samples ◽

Aquatic Ecosystems ◽

Anthropogenic Activities ◽

Aquatic Organisms ◽

Resistant Bacteria ◽

Anthropogenic Pressures ◽

Resistance Rates

The inappropriate use of antibiotics, one of the causes of the high incidence of antimicrobial-resistant bacteria isolated from aquatic ecosystems, represents a risk for aquatic organisms and the welfare of humans. This study aimed to determine the antimicrobial resistance rates among riverine Aeromonas spp., taken as representative of the autochthonous microbiota, to evaluate the level of antibacterial resistance in the Tua River (Douro basin). The prevalence and degree of antibiotic resistance was examined using motile aeromonads as a potential indicator of antimicrobial susceptibility for the aquatic environment. Water samples were collected from the middle sector of the river, which is most impacted area by several anthropogenic pressures. Water samples were plated on an Aeromonas-selective agar, with and without antibiotics. The activity of 19 antibiotics was studied against 30 isolates of Aeromonas spp. using the standard agar dilution susceptibility test. Antibiotic resistance rates were fosfomycin (FOS) 83.33%, nalidixic acid (NA) 60%, cefotaxime (CTX) 40%, gentamicin (CN) 26.67%, tobramycin (TOB) 26.67%, cotrimoxazole (SXT) 26.67%, chloramphenicol (C) 16.67%, and tetracycline (TE) 13.33%. Some of the nalidixic acid-resistant strains were susceptible to fluoroquinolones. Multiple resistance was also observed (83.33%). The environmental ubiquity, the natural susceptibility to antimicrobials and the zoonotic potential of Aeromonas spp. make them optimal candidates for studying antimicrobial resistance (AMR) in aquatic ecosystems. Aquatic environments may provide an ideal setting for the acquisition and dissemination of antibiotic resistance because anthropogenic activities frequently impact them. The potential risk of multi- and pan-resistant bacteria transmission between animals and humans should be considered in a “One Health—One World” concept.

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Suicide Loss Survivors: Navigating Social Stigma and Threats to Social Bonds

OMEGA - Journal of Death and Dying ◽

10.1177/00302228211026513 ◽

2021 ◽

pp. 003022282110265

Author(s):

Dorothy M. Goulah-Pabst

Keyword(s):

Social Stigma ◽

Qualitative Interviews ◽

Healing Process ◽

Personal Narratives ◽

The Body ◽

Social Solidarity ◽

Sociological Study ◽

Social Challenges ◽

The Social ◽

The Impact

The complicated grief experienced by suicide loss survivors leads to feelings of abandonment, rejection, intense self-blame, and depression. Stigma surrounding suicide further burdens survivors who can experience rejection by their community and social networks. Research in the field of psychology has delved into the grieving process of suicide loss survivors, however the effects of suicide require more sociological study to fully understand and support the impact of the suicidal bereavement process on the social interactions and relationships of those left behind after death. This study aims to contribute to the body of research exploring the social challenges faced after the suicide of a loved one. Based on the analysis of powerful personal narratives through qualitative interviews shared by 14 suicide loss survivors this study explores the social construction of the grieving and healing process for suicide loss survivors. Recognizing that the most reliable relief is in commiseration with like experienced people, this research points to the support group as a builder of social solidarity. The alienation caused by the shame and stigma of suicide loss can be reversed by the feelings of attachment to the group that listens, understands and accepts. Groups created by and for suicide loss survivors should be considered a necessary tool to be used toward healing those who suffer from loss by suicide.

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Rethinking Manure Application: Increase in Multidrug-Resistant Enterococcus spp. in Agricultural Soil Following Chicken Litter Application

Microorganisms ◽

10.3390/microorganisms9050885 ◽

2021 ◽

Vol 9 (5) ◽

pp. 885

Author(s):

Dorcas Oladayo Fatoba ◽

Akebe Luther King Abia ◽

Daniel G. Amoako ◽

Sabiha Y. Essack

Keyword(s):

Antimicrobial Resistance ◽

Agricultural Soil ◽

Multidrug Resistant ◽

Diffusion Method ◽

Resistant Bacteria ◽

Manure Application ◽

Unamended Soil ◽

Enterococcus Spp ◽

Chicken Litter ◽

Amended Soil

The current study investigated the impact of chicken litter application on the abundance of multidrug-resistant Enterococcus spp. in agricultural soil. Soil samples were collected from five different strategic places on a sugarcane farm before and after manure application for four months. Chicken litter samples were also collected. Enterococci were enumerated using the Enterolert®/Quanti-Tray 2000® system and confirm and differentiated into species using real-time PCR. The antibiotic susceptibility profile of the isolates was determined using the disk diffusion method following the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. The overall mean bacterial count was significantly higher (p < 0.05) in manure-amended soil (3.87 × 107 MPN/g) than unamended soil (2.89 × 107 MPN/g). Eight hundred and thirty-five enterococci (680 from soil and 155 from litter) were isolated, with E. casseliflavus being the most prevalent species (469; 56.2%) and E. gallinarum being the least (16; 1.2%). Approximately 56% of all the isolates were resistant to at least one antibiotic tested, with the highest resistance observed against tetracycline (33%) and the lowest against chloramphenicol (0.1%); 17% of E. faecium were resistant to quinupristin-dalfopristin. Additionally, 27.9% (130/466) of the isolates were multidrug-resistant, with litter-amended soil harbouring more multidrug-resistant (MDR) isolates (67.7%; 88/130) than unamended soil (10.0%; 13/130). All isolates were susceptible to tigecycline, linezolid and gentamicin. About 7% of the isolates had a multiple antimicrobial resistance index > 0.2, indicative of high antibiotic exposure. Although organic fertilizers are regarded as eco-friendly compared to chemical fertilizers for improving soil fertility, the application of untreated animal manure could promote the accumulation of antibiotics and their residues and antibiotic-resistant bacteria in the soil, creating an environmental reservoir of antimicrobial resistance, with potential human and environmental health risks.

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Liposomes as Antibiotic Delivery Systems: A Promising Nanotechnological Strategy against Antimicrobial Resistance

Molecules ◽

10.3390/molecules26072047 ◽

2021 ◽

Vol 26 (7) ◽

pp. 2047

Author(s):

Magda Ferreira ◽

Maria Ogren ◽

Joana N. R. Dias ◽

Marta Silva ◽

Solange Gil ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Bacterial Infections ◽

Private Investment ◽

Therapeutic Index ◽

Multidrug Resistant ◽

Current Treatment ◽

Delivery Systems ◽

Resistant Bacteria ◽

Bacterial Cells ◽

Antimicrobial Drugs

Antimicrobial drugs are key tools to prevent and treat bacterial infections. Despite the early success of antibiotics, the current treatment of bacterial infections faces serious challenges due to the emergence and spread of resistant bacteria. Moreover, the decline of research and private investment in new antibiotics further aggravates this antibiotic crisis era. Overcoming the complexity of antimicrobial resistance must go beyond the search of new classes of antibiotics and include the development of alternative solutions. The evolution of nanomedicine has allowed the design of new drug delivery systems with improved therapeutic index for the incorporated compounds. One of the most promising strategies is their association to lipid-based delivery (nano)systems. A drug’s encapsulation in liposomes has been demonstrated to increase its accumulation at the infection site, minimizing drug toxicity and protecting the antibiotic from peripheral degradation. In addition, liposomes may be designed to fuse with bacterial cells, holding the potential to overcome antimicrobial resistance and biofilm formation and constituting a promising solution for the treatment of potential fatal multidrug-resistant bacterial infections, such as methicillin resistant Staphylococcus aureus. In this review, we aim to address the applicability of antibiotic encapsulated liposomes as an effective therapeutic strategy for bacterial infections.

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The healthcare costs of antimicrobial resistance in Lebanon: a multi-centre prospective cohort study from the payer perspective

BMC Infectious Diseases ◽

10.1186/s12879-021-06084-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Katia Iskandar ◽

Christine Roques ◽

Souheil Hallit ◽

Rola Husni-Samaha ◽

Natalia Dirani ◽

...

Keyword(s):

Cohort Study ◽

Antimicrobial Resistance ◽

Hospital Mortality ◽

Hospital Stay ◽

Prospective Cohort ◽

Healthcare Costs ◽

Hospital Charges ◽

Resistant Bacteria ◽

Matched Cohort ◽

Payer Perspective

Abstract Background Our aim was to examine whether the length of stay, hospital charges and in-hospital mortality attributable to healthcare- and community-associated infections due to antimicrobial-resistant bacteria were higher compared with those due to susceptible bacteria in the Lebanese healthcare settings using different methodology of analysis from the payer perspective . Methods We performed a multi-centre prospective cohort study in ten hospitals across Lebanon. The sample size consisted of 1289 patients with documented healthcare-associated infection (HAI) or community-associated infection (CAI). We conducted three separate analysis to adjust for confounders and time-dependent bias: (1) Post-HAIs in which we included the excess LOS and hospital charges incurred after infection and (2) Matched cohort, in which we matched the patients based on propensity score estimates (3) The conventional method, in which we considered the entire hospital stay and allocated charges attributable to CAI. The linear regression models accounted for multiple confounders. Results HAIs and CAIs with resistant versus susceptible bacteria were associated with a significant excess length of hospital stay (2.69 days [95% CI,1.5–3.9]; p < 0.001) and (2.2 days [95% CI,1.2–3.3]; p < 0.001) and resulted in additional hospital charges ($1807 [95% CI, 1046–2569]; p < 0.001) and ($889 [95% CI, 378–1400]; p = 0.001) respectively. Compared with the post-HAIs analysis, the matched cohort method showed a reduction by 26 and 13% in hospital charges and LOS estimates respectively. Infections with resistant bacteria did not decrease the time to in-hospital mortality, for both healthcare- or community-associated infections. Resistant cases in the post-HAIs analysis showed a significantly higher risk of in-hospital mortality (odds ratio, 0.517 [95% CI, 0.327–0.820]; p = 0.05). Conclusion This is the first nationwide study that quantifies the healthcare costs of antimicrobial resistance in Lebanon. For cases with HAIs, matched cohort analysis showed more conservative estimates compared with post-HAIs method. The differences in estimates highlight the need for a unified methodology to estimate the burden of antimicrobial resistance in order to accurately advise health policy makers and prioritize resources expenditure.

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Why do Irish pig farmers use medications? Barriers for effective reduction of antimicrobials in Irish pig production

Irish Veterinary Journal ◽

10.1186/s13620-021-00193-3 ◽

2021 ◽

Vol 74 (1) ◽

Author(s):

Alessia Diana ◽

Sylvia Snijders ◽

Alison Rieple ◽

Laura Ann Boyle

Keyword(s):

Management Practices ◽

Structured Interviews ◽

Pig Production ◽

Face To Face ◽

Potential Barriers ◽

Eu Countries ◽

Lack Of Information ◽

Personal Action ◽

Barriers And Challenges ◽

Attitudinal Changes

Abstract Background In addressing the threat of antimicrobial resistance, it is critical to understand the barriers to the uptake of strategies for the reduction of antimicrobial use (AMU) in the pig industry. In several EU countries, factors such as education level, habits and social pressures are recognised as affecting farmers’ decision-making process in relation to AMU. However, there is a lack of information on the Irish scenario. The aim of this study was to investigate pig farmers’ perspectives and their behaviour towards AMU to identify potential barriers to effectively reduce AMU in Irish pig production. We conducted face-to-face semi-structured interviews with 30 pig farmers, 5 pig veterinarians and 4 focus groups of pig farm personnel. We employed qualitative analyses to explore the objective of the study. Results Qualitative analysis revealed six convergent themes as potential barriers: perceptions about the need for AMU on farm, concept of animal welfare and associated management practices, legislation, culture, economics and standards of communication/type of advice-network. Overall, pig farmers believed that there is poor communication between stakeholders (i.e. farmers, vets and advisors) and a lack of reliable people to approach for advice. They considered themselves as operating responsibly in terms of AMU compared to their national and international colleagues and expressed the importance of a so-called ‘Irish solution’ to the problem of AMU because it was associated with what ‘has always been done’ and was therefore considered reliable and safe. Conclusions Barriers and challenges were in line with those identified in other EU countries highlighting similarities in behavioural and attitudinal patterns among pig farmers. Overall, farmers appeared to be more likely to rely on previous experiences or to wait for an imposed change (e.g. legislation) instead of taking personal action. Thus, considerable behavioural and attitudinal changes are needed to adopt a more responsible AMU in Irish pig production and to develop effective intervention strategies.

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