Summary 1.Interactions during mating are thought to be an important mechanism for transmission of tuberculosis (Tb) Mycobacterium bovis in the brushtail possum Trichosurus vulpecula . However, little information is available on the frequency of contacts between males and females in oestrus during the breeding season, and the relationship between mating contacts and population density. 2. We used radio-telemetry to record contacts between male and oestrous and nonoestrous female possums, and determined paternity of offspring using DNA analysis. This was repeated following the removal of c . 70% of the resident possums to determine the effect of reducing density on the contact rate. 3. We could not detect any significant differences in the contact rate between oestrous and non-oestrous females and males, either before or after the density reduction, even when paternity was positively identified from DNA analysis. This suggests that actual mating contacts could not be distinguished from other agonistic or affiliative contact behaviours. 4. Despite this, the relationships between male-female and male-male contact rates and population density were non-linear convex-up, implying that the contact rate during the breeding season did not decrease in proportion to reductions in density. This appeared to be driven by the enlargement of male ranges and a corresponding increase in male overlap of female ranges following the density reduction. 5. The form of the contact rate function will influence predictions of disease spread in epidemiological models for Tb in wildlife. This has major implications for the development of tactical approaches to disease management based on such models.

BackgroundTraumatic injury and mental health disorders are co-associated. Early identification of depression, anxiety and stress following injury, and subsequent preventive intervention, may reduce the long-term symptoms and negative impacts associated with depression and anxiety. The purpose of the study was to determine the incidence, severity and predictors of depression, anxiety and stress in injured patients in the acute phase of care, and at six months following injury, as well as the effectiveness of an in-hospital screening tool.MethodsThis descriptive longitudinal study of trauma patients was conducted at a Level 1 Metropolitan Trauma Centre in Australia over 14 months. Participants were interviewed using the Depression Anxiety Stress Scale short-form version (DASS-21) during hospital admission then at 3 and 6 months after injury. Descriptive statistics were performed to evaluate participant characteristics and incidence of depression, anxiety and stress. Correlations and logistic regression were conducted to investigate the ability of the DASS-21 to predict symptoms of depression, anxiety and stress and to investigate factors associated with depression, anxiety and stress 6 months after injury.Results201 participants ranging in age (18–94 years) and injury severity participated in the baseline interview and 109 completed all 3 interviews over 6 months. Over half (54%) reported above normal scores for depression, anxiety and/or stress in at least one of the 3 time points. Intensive care unit admission and high levels of depression, anxiety and stress at 3 months post injury were predictors for high levels of depression, anxiety and stress at 6 months. Low scores for depression, anxiety and stress during admission were correlated with low scores for depression, anxiety and stress at 3 and 6 months.ConclusionDepression, anxiety and stress in patients hospitalised following injury is common and should be anticipated in patients who have had an intensive care admission. Screening at 3 months following injury identifies patients at risk of long-term symptoms of depression, anxiety and stress.

ChIP improved the delivery of healthcare services and reduced the rate of pneumonia among patients with isolated chest trauma.

BackgroundDespite strong evidence giving guidance for effective fall prevention interventions in community-residing older people, there is currently no clear model for engaging general medical practitioners in fall prevention and routine use of allied health professionals in fall prevention has been slow, limiting widespread dissemination. This protocol paper outlines an implementation-effectiveness study of the Integrated Solutions for Sustainable Fall Prevention (iSOLVE) intervention which has developed integrated processes and pathways to identify older people at risk of falls and engage a whole of primary care approach to fall prevention.Methods/designThis protocol paper presents the iSOLVE implementation processes and change strategies and outlines the study design of a blended type 2 hybrid design. The study consists of a two-arm cluster randomized controlled trial in 28 general practices and recruiting 560 patients in Sydney, Australia, to evaluate effectiveness of the iSOLVE intervention in changing general practitioner fall management practices and reducing patient falls and the cost effectiveness from a healthcare funder perspective. Secondary outcomes include change in medications known to increase fall risk. We will simultaneously conduct a multi-methodology evaluation to investigate the workability and utility of the implementation intervention. The implementation evaluation includes in-depth interviews and surveys with general practitioners and allied health professionals to explore acceptability and uptake of the intervention, the coherence of the proposed changes for those in the work setting, and how to facilitate the collective action needed to implement changes in practice; social network mapping will explore professional relationships and influences on referral patterns; and, a survey of GPs in the geographical intervention zone will test diffusion of evidence-based fall prevention practices. The project works in partnership with a primary care health network, state fall prevention leaders, and a community of practice of fall prevention advocates.DiscussionThe design is aimed at providing clear direction for sustainability and informing decisions about generalization of the iSOLVE intervention processes and change strategies. While challenges exist in hybrid designs, there is a potential for significant outcomes as the iSOLVE pathways project brings together practice and research to collectively solve a major national problem with implications for policy service delivery.Trial registrationAustralian New Zealand Clinial Trials Registry ACTRN12615000401550

An (Awassi × Merino) × Merino backcross family of 172 ewes was used to map quantitative trait loci (QTL) for different milk production traits on a framework map of 200 loci across all autosomes. From five previously proposed mathematical models describing lactation curves, the Wood model was considered the most appropriate due to its simplicity and its ability to determine ovine lactation curve characteristics. Derived milk traits for milk, fat, protein and lactose yield, as well as percentage composition and somatic cell score were used for single and two-QTL approaches using maximum likelihood estimation and regression analysis. A total of 15 significant (P < 0.01) and additional 25 suggestive (P < 0.05) QTL were detected across both single QTL methods and all traits. In preparation of a meta-analysis, all QTL results were compared with a meta-assembly of QTL for milk production traits in dairy ewes from various public domain sources and can be found on the ReproGen ovine gbrowser http://crcidp.vetsci.usyd.edu.au/cgi-bin/gbrowse/oaries_genome/. Many of the QTL for milk production traits have been reported on chromosomes 1, 3, 6, 16 and 20. Those on chromosomes 3 and 20 are in strong agreement with the results reported here. In addition, novel QTL were found on chromosomes 7, 8, 9, 14, 22 and 24. In a cross-species comparison, we extended the meta-assembly by comparing QTL regions of sheep and cattle, which provided strong evidence for synteny conservation of QTL regions for milk, fat, protein and somatic cell score data between cattle and sheep.

A male sheep linkage map comprising 191 microsatellites was generated from a single family of 510 Awassi-Merino backcross progeny. Except for ovine chromosomes 1, 2, 10 and 17, all other chromosomes yielded a LOD score difference greater than 3.0 between the best and second-best map order. The map is on average 11% longer than the Sheep Linkage Map v4.7 male-specific map. This map was employed in quantitative trait loci (QTL) analyses on body-weight and growth-rate traits between birth and 98 weeks of age. A custom maximum likelihood program was developed to map QTL in half-sib families for non-inbred strains (QTL-MLE) and is freely available on request. The new analysis package offers the advantage of enabling QTL × fixed effect interactions to be included in the model. Fifty-four putative QTL were identified on nine chromosomes. Significant QTL with sex-specific effects (i.e. QTL × sex interaction) in the range of 0.4 to 0.7 SD were found on ovine chromosomes 1, 3, 6, 11, 21, 23, 24 and 26.

Excessive use of the Internet is considered a problematic behaviour by clinicians and researchers. Cognitive behaviour therapy (CBT) has been advocated for a long time as a treatment approach and has been extended to include family therapy in the recent years. As eTherapy (eHealth) has become an important component in the treatment of many mental health problems, it is prudent to explore the current status of the eHealth approach as an intervention option for this problem. This systematic review aims to examine the current development of online intervention programmes for this particular condition. The PRISMA guidelines for systematic reviews and meta-analysis were employed to conduct the search for literature following a systematic and structured approach. Of the 182 articles screened, three satisfied the selection criteria. Information was extracted and analysed systematically for each study and tabulated. All these studies were pilot studies with small sample sizes. Two of these articles aimed to explore the therapeutic efficacy of newly developed online intervention programmes for Internet addiction (IA) and online gaming addiction. The third article described the design and development of an App for smartphone addiction. The results obtained from this review have provided insight into the on-going development of eHealth interventions as well as the health informatics approaches in offering a possible and practical solution to tackle this growing problem.

Aims and objectives:To investigate uptake of a Chest Injury Protocol (ChIP), examine factors influencing its implementation and identify interventions for promoting its use.Background: Failure to treat blunt chest injuries in a timely manner with sufficient analgesia, physiotherapy and respiratory support, can lead to complications such as pneumonia and respiratory failure and/or death.Design: This is a mixed-methods implementation evaluation study.Methods: Two methods were used: (i) identification and review of the characteristics of all patients eligible for the ChIP protocol, and (ii) survey of hospital staff opinions mapped to the Theoretical Domains Framework (TDF) to identify barriers and facilitators to implementation. The characteristics and treatment received between the groups were compared using the chi-square test or Fischer's exact test for proportions, and the Mann-Whitney U-test for continuous data. Quantitative survey data were analysed using descriptive statistics. Qualitative data were coded in NVivo 10 using a coding guide based on the TDF and Behaviour Change Wheel (BCW). Identification of interventions to change target behaviours was sourced from the Behaviour Change Technique Taxonomy Version 1 in consultation with stakeholders.Results: Only 68.4% of eligible patients received ChIP. Fifteen facilitators and 10 barriers were identified to influence the implementation of ChIP in the clinical setting. These themes were mapped to 10 of the 14 TDF domains and corresponded with all nine intervention functions in the BCW. Seven of these intervention functions were selected to address the target behaviours and a multi-faceted relaunch of the revised protocol developed. Following re-launch, uptake increased to 91%.Conclusions: This study demonstrated how the BCW may be used to revise and improve a clinical protocol in the ED context.Relevance to clinical practice: Newly implemented clinical protocols should incorporate clinician behaviour change assessment, strategy and interventions. Enhancing the self-efficacy of emergency nurses when performing assessments has the potential to improve patient outcomes and should be included in implementation strategy.behaviour change, behaviour change wheel, chest injury, implementation evaluation, nursing, theoretical domains frameworkThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. (Leone et al., 2008). Patients with at least three rib fractures have a significantly increased risk of in-hospital mortality (Holcomb, McMullin, Kozar, Lygas, & Moore, 2003;Testerman, 2006), an effect even more pronounced in older patients (Kent, Woods, & Bostrom, 2008) in whom each additional rib fracture increases the risk of mortality by 19% and of pneumonia by 27% (Bulger, Arneson, Mock, & Jurkovich, 2000). Much of literature around blunt chest injury advises implementation ...