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Abstract This paper describes a two-year high-fidelity dataset for an ultra-low energy office building and living laboratory called HouseZero ®. The building integrates multiple low-energy technologies, such as natural ventilation with automatic windows, ground source heat pump, and thermally activated building systems. The building’s performance is continuously monitored with an extensive sensor network. The dataset consists of breakdown energy end uses, photovoltaic (PV) production, zone-level indoor environment including indoor air temperature, CO2 concentration, and relative humidity, micro-climatical conditions, building façade temperature, and detailed system operations including zone-level BTU meter, valve status, slab temperature, window/skylight opening status, heat pump, and geothermal well operations. The data can be used to support data analytics of ultra-low-energy building operations, and data-driven modeling of low-energy building systems.

Abstract The worldwide COVID-19 pandemic caused by the SARS-CoV-2 betacoronavirus has highlighted the need for a synthetic biology approach to create reliable and scalable sources of viral antigen for uses in diagnostics, therapeutics and basic biomedical research. Here, we adapt plasmid-based systems in the eukaryotic microalgae Phaeodactylum tricornutum to develop an inducible overexpression system for SARS-CoV-2 proteins. Limiting phosphate and iron in growth media induced expression of the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein from the P. tricornutum HASP1 promoter in the wild-type strain and in a histidine auxotrophic strain that alleviates the requirement for antibiotic selection of expression plasmids. The RBD was purified from whole cell extracts (algae-RBD) with yield compromised by the finding that 90–95% of expressed RBD lacked the genetically encoded C-terminal 6X-histidine tag. Constructs that lacked the TEV protease site between the RBD and C-terminal 6X-histidine tag retained the tag, increasing yield. Purified algae-RBD was found to be N-linked glycosylated by treatment with endoglycosidases, was cross-reactive with anti-RBD polyclonal antibodies, and inhibited binding of recombinant RBD purified from mammalian cell lines to the human ACE2 receptor. We also show that the algae-RBD can be used in a lateral flow assay device to detect SARS-CoV-2 specific IgG antibodies from donor serum at sensitivity equivalent to assays performed with RBD made in mammalian cell lines. Our study shows that P. tricornutum is a scalable system with minimal biocontainment requirements for the inducible production of SARS-CoV-2 or other coronavirus antigens for pandemic diagnostics.

Abstract Background Patient-centred care and patient autonomy is one of the key factors to better quality of service provision, hence patient outcomes. It enables the development of patients’ trusts which is an important element to a better doctor-patient relationship. Given the increasing number of patient disputes and conflicts between patients and doctors in Chinese public hospital, it is timely to ensure patient-centred care is fully and successfully implemented. However, limited studies have examined the views and practice in different aspects of patient-centred care among doctors in the Chinese public hospitals. Methods A quantitative approach was adopted by distributing paper-based questionnaires to doctors and patients in two hospitals (Level III and Level II) in Jinan, Shandong province, China. Results In total, 614 doctors from the surgical and internal medicine units of the two hospitals participated in the survey yielding 90% response rates. The study confirmed the inconsistent views among doctors in terms of their perception and practice in various aspects patient-centred care and patient autonomy regardless of the hospital where they work (category II or category III), their unit speciality (surgical or non-surgical), their gender or seniority. The high proportion of doctors (more than 20%) who did not perceive the importance of patient consultation prior to determining diagnostic and treatment procedure is alarming. This in in part due to the belief held by more than half of the doctors that patients were unable to make rational decisions and their involvement in treatment planning process did not necessarily lead to better treatment outcomes. Conclusion The study calls for the development of system level policy and organisation wide strategies in encouraging and enabling the practice of patient-centred care and patient autonomy with the purposes of improving the quality of the service provided to patients by Chinese hospitals.

We report a multistate Salmonella enterica serovar Heidelberg outbreak in Australia during 2018–2019. Laboratory investigation of cases reported across 5 jurisdictions over a 7-month period could not identify a source of infection but detected indicators of severity and invasiveness. The hospitalization rate of 36% suggested a moderately severe clinical picture.

Salmonella enterica serovar Typhi (S. Typhi) causes typhoid fever and, in some cases, chronic carriage after resolution of acute disease. This study examined sequential isolates of S. Typhi from a single host with persistent asymptomatic infection. These isolates, along with another S. Typhi isolate recovered from a household contact with typhoid fever, were subjected to whole genome sequencing and analysis. In addition, direct sequencing of the bile fluid from the host with persistent infection was also performed. Comparative analysis of isolates revealed three sub-populations of S. Typhi with distinct genetic patterns. Metagenomic sequencing recognised only two of the three sub-populations within the bile fluid. The detection and investigation of insertion sequences IS10R and associated deletions complemented analysis of single nucleotide polymorphisms. These findings improve our understanding of within-host dynamics of S. Typhi in cases of persistent infection and inform epidemiological investigations of transmission events associated with chronic carriers.

Abstract Background Health service managers are integral to supporting the effective and efficient delivery of services. Understanding their competencies is essential to support reform and improvement of healthcare provision in China. This paper examines the characteristics and educational background of senior managers working in the community health and hospital sectors in China. We also examine their levels of commitment to continued professional development and continuous education. Methods A self-administered paper-based questionnaire was administered to 477 level I, II and III managers in community health services and public hospitals in China. The response rate was over 80%. Results Findings demonstrate significant differences in terms of educational background and commitment to ongoing professional development between the managers in China across levels of management, and between the community and hospital sectors. Hospital managers tend to be older; hospital managers at higher management levels are predominantly male but predominantly female in the community health services. A greater proportion of hospital managers have postgraduate qualifications. In addition, the participants identified specific management tasks that they considered important. Conclusions This is the first large scale study examining the educational background and commitment to professional development of senior health service managers in China. This study determined that there are differences between the demographics of managers in China across levels of management, but more importantly between the CHC and the hospital sectors. The identification of important managerial tasks will facilitate the development of appropriate education and training for Chinese healthcare managers. All sectors and levels reported the need for informal education focussed on the core roles of developing organisation image and public relations, improving quality and safety of service provision and provision of leadership. Further research to explore the underlying reasons for the above differences is needed to design appropriate professional development for China’s health services managers. In addition, the importance of managerial tasks across sectors and management levels requires further investigation.

Abstract Background To improve the effectiveness and efficiency of health service provision in China, the National Health Commission has emphasised that training of all health service managers is essential. However, the implementation of that policy has proven challenging for various reasons, one of which is the lack of understanding of the competency requirements and gaps. The aims of the study were to develop an understanding of the characteristics and training experience of hospital managers in one major Chinese city, explore the difficulties they experience and relate them to their perceived importance of management competencies and the perceived level of their management competency. Methods A cross-sectional, descriptive study with a three-component survey including the use of a validated management competency assessment tool was conducted with three senior executive groups (n = 498) from three categories of hospital in Jinan, Shandong Province, China. Results The survey confirmed that formal and informal management training amongst participants before commencing their management positions was inadequate. The core competencies identified in the Australia context were applicable to the management roles in Chinese hospitals. In addition, the senior executives had low levels of confidence in their management competence. Furthermore, the data showed significant differences between hospital categories and management levels in terms of their commitment to formal and informal training and self-perceived management competence. Conclusions The study suggests that management training and support should be provided using a systematic approach with specific consideration to hospital types and management levels and positions. Such an approach should include clear competency requirements to guide management position recruitment and performance management.

The disease caused by Shiga toxin-producing Escherichia coli (STEC) remains a significant public health challenge globally, but the incidence of human STEC infections in Australia remains relatively low. This study examined the virulence characteristics and diversity of STEC isolates in the state of New South Wales between December 2017 and May 2020. Utilisation of both whole and core genome multi-locus sequence typing (MLST) allowed for the inference of genomic diversity and detection of isolates that were likely to be epidemiologically linked. The most common STEC serotype and stx subtype detected in this study were O157:H7 and stx1a, respectively. A genomic scan of other virulence factors present in STEC suggested interplay between iron uptake system and virulence factors that mediate either iron release or countermeasures against host defence that could result in a reduction of stx1a expression. This reduced expression of the dominant stx genotype could contribute to the reduced incidence of STEC-related illness in Australia. Genomic surveillance of STEC becomes an important part of public health response and ongoing interrogation of virulence factors in STEC offers additional insights for the public health risk assessment.

Abstract The health impacts of climate change are substantial and represent a primary motivating factor to mitigate climate change. However, the health impacts in economic models that estimate the social cost of carbon dioxide (SC‐CO2) have generally been made in isolation from health experts and have never been rigorously evaluated. Version 3.10 of the Framework for Uncertainty, Negotiation and Distribution (FUND) model was used to estimate the health‐based portion of current SC‐CO2 estimates across low‐, middle‐, and high‐income regions. In addition to the base model, three additional experiments assessed the sensitivity of these estimates to changes in the socio‐economic assumptions in the model. Economic impacts from adverse health outcomes represent ∼8.7% of current SC‐CO2 estimates. The majority of these health impacts (74%) were attributable to diarrhea mortality (from both low‐ and high‐income regions) followed by diarrhea morbidity (12%) and malaria mortality (11%); no other health impact makes a meaningful contribution to SC‐CO2 estimates in current economic models. The results of the socio‐economic experiments show that the health‐based portion of SC‐CO2 estimates are highly sensitive to assumptions regarding income elasticity of health effects, income growth, and use of equity weights. Improving the health‐based portion of SC‐CO2 estimates could have substantial impacts on magnitude of the SC‐CO2. Incorporating additional health impacts not previously included in estimates of SC‐CO2 will be a critical component of model updates. This effort will be most successful through coordination between economists and health researchers and should focus on updating the form and function of concentration‐response functions.

We examined the population dynamics of Salmonella enterica serovar Typhimurium during seasonal salmonellosis epidemics in New South Wales, Australia, during 2009–2016. Of 15,626 isolates, 5%–20% consisted of novel genotypes. Seasons with salmonellosis epidemics were associated with a reduction in novel genotypes in the preceding winter and spring.

Introduction: Salmonella enterica serovar Mbandaka is an infrequent cause of salmonellosis in New South Wales (NSW) with an average of 17 cases reported annually. This study examined the added value of whole genome sequencing (WGS) for investigating a non-point source outbreak of Salmonella ser. Mbandaka with limited geographical spread. Methods: In February 2016, an increase in Salmonella ser. Mbandaka was noted in New South Wales, and an investigation was initiated. A WGS study was conducted three months after the initial investigation, analysing the outbreak Salmonella ser. Mbandaka isolates along with 17 human and non-human reference strains from 2010 to 2015. Results: WGS analysis distinguished the original outbreak cases (n = 29) into two main clusters: Cluster A (n = 11) and Cluster B (n = 6); there were also 12 sporadic cases. Reanalysis of food consumption histories of cases by WGS cluster provided additional specificity when assessing associations. Discussion: WGS has been widely acknowledged as a promising high-resolution typing tool for enteric pathogens. This study was one of the first to apply WGS to a geographically limited cluster of salmonellosis in Australia. WGS clearly distinguished the outbreak cases into distinct clusters, demonstrating its potential value for use in real time to support non-point source foodborne disease outbreaks of limited geographical spread.

Multidrug- and colistin-resistant Salmonella enterica serotype 4,[5],12:i:- sequence type 34 is present in Europe and Asia. Using genomic surveillance, we determined that this sequence type is also endemic to Australia. Our findings highlight the public health benefits of genome sequencing–guided surveillance for monitoring the spread of multidrug-resistant mobile genes and isolates.

Abstract Background Osteoporosis is a debilitating disease. Adequate calcium consumption and physical activity are the two major modifiable risk factors. This paper describes the major outcomes and efficacy of a workplace-based targeted behaviour change intervention to improve the dietary and physical activity behaviours of working women in sedentary occupations in Singapore. Methods A cluster-randomized design was used, comparing the efficacy of a tailored intervention to standard care. Workplaces were the units of randomization and intervention. Sixteen workplaces were recruited from a pool of 97, and randomly assigned to intervention and control arms (eight workplaces in each). Women meeting specified inclusion criteria were then recruited to participate. Workplaces in the intervention arm received three participatory workshops and organization-wide educational activities. Workplaces in the control/standard care arm received print resources. Outcome measures were calcium intake (milligrams/day) and physical activity level (duration: minutes/week), measured at baseline, 4 weeks and 6 months post intervention. Adjusted cluster-level analyses were conducted comparing changes in intervention versus control groups, following intention-to-treat principles and CONSORT guidelines. Results Workplaces in the intervention group reported a significantly greater increase in calcium intake and duration of load-bearing moderate to vigorous physical activity (MVPA) compared with the standard care control group. Four weeks after intervention, the difference in adjusted mean calcium intake was 343.2 mg/day (95 % CI = 337.4 to 349.0, p

Objective: Evidence-informed decision-making (EIDM) amongst health service managers has been positively linked to better decision outcome, hence more effective healthcare provision. Efforts to improve EIDM practice are required to meet the current challenging healthcare environment. One key step to improve such practices is skill enhancement. The purpose of the study is the measure the competence of mid-level managers in two Victorian hospitals in applying EIDM in their roles. Design: The competence of 25 mid-level managers in applying EIDM in their roles was assessed via a 360° process using an online management competency assessment tool (MCAP Tool) and case-study objective assessment tool. Setting: Mid-level managers working in Victorian hospitals were selected. Main outcome measures: The competence of mid-level managers in applying the competency of EIDM was assessed. This paper discusses the areas of improvement identified in enhancing the competence of EIDM amongst mid-level managers in the group, organisational and individual levels Results: EIDM is an important competency for health service managers. Managers who participated in the assessment are competent in applying EIDM in their roles, but require guidance and improvements. Strengths and weaknesses of managers in applying EIDM in their roles varied between organisations. Conclusion: This paper suggests that not only improvement of specific aspects of evidenceinformed decision-making amongst health service managers are required, additional more systematic changes at the organisational and individual management level are essential to achieve competent evidence-informed decision-making practices amongst health service managers. Abbreviations: CCA – Combined Colleagues; CEO – Chief Executive Officer; EIDM – Evidence Informed Decision Making; OA – Objective Assessment; SA – Self Assessment.

A program pioneered by Earl Shorris in New York for educating the poor and marginalised in the humanities has been employed successfully in Australia under the title Clemente Australia for promoting both personal agency and social inclusion. Personal agency and social inclusion are ever present goals for societies and communities but they are particularly relevant today, at a time of increasing number of people who are unemployed, homeless, refugees or are experiencing multiple disadvantage. Students and staff involved in the program have reported upon student self improvements which are indicators of enhanced personal agency and social inclusion. A number of rationales have been advanced for these successes of the program, ranging from empowerment and engagement to changing habitus. The paper, drawing upon social cognitive theory, presents an integrative rationale and framework explaining the development of personal agency and social inclusion promoted by the program and expressed in their becoming “political”, engaged with people at every level of society. In terms of this integrative rationale, Clemente Australia builds ideas of hope, meaning, and identity into the personal narratives of participants through reflection on their personal and vicarious experiences in the program and the competencies and changed expectancies that these bring. This integrative view can illuminate participants’ reports of the program and suggest ways of making it more effective.

In 2008–2010, the Australian Government’s social inclusion agenda and the Bradley Review of Higher Education profiled the importance of education for people from disadvantaged backgrounds. This education needs to be transformative in both its nature and its outcomes. The Clemente Australia program is presented here as a means of providing such transformative education for people who are disadvantaged or socially isolated. This case study of Clemente Australia shows how the program is built upon a psychology of hope and provides pathways not only to new hope but also to a new sense of identity and independence. Clemente Australia (CA) is an example of community embedded, socially supported university education (CESS). Essential elements of CA are respecting people for who they are and for where they are within their individual life journeys; building student capacity to be more proactive in reflecting upon and engaging with the world; learning with and relating to others; and promoting educative justice through the recognition of the students’ human rights to participate in tertiary education in a way that meets their personal and academic learning needs. For the students, the university (Australian Catholic University) and other partners in CA, it is evident that there has been an ongoing shift from dependence upon the provision of materials and services to empowerment and enhanced capabilities in identifying the supports and processes required to meet the personal and professional needs of students, staff and community agencies. This shift has occurred through the scaffolding processes provided, the establishment of innovative partnerships and purposeful reflection. It has involved listening to one another, welcoming people into new worlds and challenging one another in the provision of transformative education to realise the fulfilment of hope for many Australians experiencing disadvantage. key words: transformation; education; community; hope; homelessness; disadvantage

In the School of Physics and Astronomy at the University of Glasgow a wide variety of teaching and learning methods are employed in our undergraduate degree courses.àIncluded in this are a series of peer-led tutorials, known as the ââ¬ÅPeer to Peerââ¬Â tutorial scheme. This sees Honours level students in the third, fourth or fifth years of their degrees assisting students in years one and two.àThe senior students act as tutors, assisting the level one and two students with questions from their coursework and life as students in the subject. This paper details the Peer to Peer scheme, providing a clear description of a model that could be applied to any discipline.àIt then reports on an in-depth study of the attitudes and experiences of the student-tutors involved. Student-tutors reported a positive experience of the tutorials. They had taken part in the scheme to improve their own skills and to assist both younger students and the School.àTheir reflections on the tutorials showed that these goals were met.àThe scheme, whilst not perfect, did contribute to the learning of the students, whilst improving the skills base of the student-tutors.

La configuración de este teatro se establece a partir de un octágono regular, en cuyo interior se han organizado la plataforma escénica y un auditorio para 1.000 espectadores. Rodeando el octágono se han distribuido las restantes dependencias y los servicios auxiliares, tales como: un pequeño estudio con capacidad para 300 personas sentadas, oficinas de administración, talleres de carpintería y pintura, camerinos y vestuarios, cafeterías, bares y amplias antesalas interiores adaptables a distintas funciones complementarias al teatro —recitales, conferencias, etcétera—. La construcción se ha realizado en su totalidad con una estructura de hormigón armado, revestido o dejado visto según los casos. El edificio cuenta con una variada serie de instalaciones: unas tienden a lograr la adecuada ambientación de los distintos espacios de acuerdo con sus características; mientras que las otras, más específicas, satisfacen las necesidades de las funciones teatrales, como la iluminación, el sonido y los recursos escenográficos.

This research was conducted to explore the understudied population of the elder LGBT. To identify their challenges and how do their life stories reflect Erik Erikson's psychosocial development Integrity vs. Despair and the community support program be provided to the LGBT elders. The participants of the study were twelve self-identified gay and lesbian elders. The participants were also chosen using purposeful sampling to ensure they will meet the inclusion and exclusion criteria. The inclusion criteria consisted of the following: 1. self-identified gay and lesbian; 2. must be 65 years of age or older; 3. single or without partner; 4. professionals and/or non-professionals; and 5. with part-time, full time and/or unemployed status during the interview. The exclusion criteria of the participants composed of aging lesbian and gays who cannot articulate and/or verbalize their answers, feelings and emotions, inability to remember some events and stories of their lives and with mental condition. Qualitative narrative research design was used and in-depth interview generated rich narratives of the rainbow elderly. Results showed that the challenges faced by gay and lesbian elders are health issues, basic needs, financial sustainability, need for companionship, fear of dependency and their clamor for support from the government. The majority of the participants' life narratives reflected sense of integrity over few who expressed their regrets. Various themes from the study became the basis of several recommendations. [ABSTRACT FROM AUTHOR]