RESUMO
AIMS: The main objective of the present work was to evaluate plant growth-promoting abilities of bacterial strains from the rhizosphere of halophytes and their effect on maize growth under salinity stress. METHODS AND RESULTS: Halophilic bacteria were identified using 16S rRNA sequence analysis and their plant growth-promoting abilities were characterized. Phylogenetic analysis showed that bacterial strains belonging to Bacillus, Halobacillus and Pseudomonas were dominant in the rhizosphere of halophytes. More than 93% strains showed P-solubilization activity and IAA production. About 54% strains were able to produce ACC deaminase, 29% strains showed positive results for nitrogen fixation, 41 and 21% strains showed siderophores and HCN production ability respectively. More than 90% strains showed antifungal activity against more than two fungal pathogens and production of different hydrolytic enzymes. To study the plant growth-promoting effect on maize, five bacterial strains Bacillus safensis HL1HP11 and Bacillus pumilus HL3RS14, Kocuria rosea HL1RP8, Enterobacter aerogenes AT1HP4 and Aeromonas veronii AT1RP10 were used as inoculants; in the form of seed coat and enriched soil-based phosphate biofertilizers. All bacterial strains positively affected the maize growth as compared to non-inoculated control + NaCl plants. Plants inoculated with Bacillus HL3RS14-based soil biofertilizers showed maximum increase in dry weights of root (48-124%) and shoot (52-131%) as compared to control + NaCl (soil + rock phosphate, no inoculum). PGPR inoculations under salinity stress conditions showed high concentrations of proline, glycine betaine and malondialdehyde. CONCLUSION: These results indicated that under saline soil conditions, halophilic PGPR strains combined with carrier materials are promising candidates as biofertilizers.
Assuntos
Bactérias/isolamento & purificação , Bactérias/metabolismo , Fosfatos/metabolismo , Filogenia , Cloreto de Sódio/metabolismo , Microbiologia do Solo , Zea mays/microbiologia , Bactérias/classificação , Bactérias/genética , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Carbono-Carbono Liases/genética , Carbono-Carbono Liases/metabolismo , Fertilizantes/análise , Fixação de Nitrogênio , Raízes de Plantas/microbiologia , RNA Ribossômico 16S/genética , Rizosfera , Salinidade , Plantas Tolerantes a Sal/microbiologia , Sementes/crescimento & desenvolvimento , Sementes/metabolismo , Sementes/microbiologia , Solo/química , Zea mays/crescimento & desenvolvimento , Zea mays/metabolismoRESUMO
Importance: Maternal hypothyroidism and hyperthyroidism are risk factors for preterm birth. Milder thyroid function test abnormalities and thyroid autoimmunity are more prevalent, but it remains controversial if these are associated with preterm birth. Objective: To study if maternal thyroid function test abnormalities and thyroid autoimmunity are risk factors for preterm birth. Data Sources and Study Selection: Studies were identified through a search of the Ovid MEDLINE, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, and Google Scholar databases from inception to March 18, 2018, and by publishing open invitations in relevant journals. Data sets from published and unpublished prospective cohort studies with data on thyroid function tests (thyrotropin [often referred to as thyroid-stimulating hormone or TSH] and free thyroxine [FT4] concentrations) or thyroid peroxidase (TPO) antibody measurements and gestational age at birth were screened for eligibility by 2 independent reviewers. Studies in which participants received treatment based on abnormal thyroid function tests were excluded. Data Extraction and Synthesis: The primary authors provided individual participant data that were analyzed using mixed-effects models. Main Outcomes and Measures: The primary outcome was preterm birth (<37 weeks' gestational age). Results: From 2526 published reports, 35 cohorts were invited to participate. After the addition of 5 unpublished data sets, a total of 19 cohorts were included. The study population included 47â¯045 pregnant women (mean age, 29 years; median gestational age at blood sampling, 12.9 weeks), of whom 1234 (3.1%) had subclinical hypothyroidism (increased thyrotropin concentration with normal FT4 concentration), 904 (2.2%) had isolated hypothyroxinemia (decreased FT4 concentration with normal thyrotropin concentration), and 3043 (7.5%) were TPO antibody positive; 2357 (5.0%) had a preterm birth. The risk of preterm birth was higher for women with subclinical hypothyroidism than euthyroid women (6.1% vs 5.0%, respectively; absolute risk difference, 1.4% [95% CI, 0%-3.2%]; odds ratio [OR], 1.29 [95% CI, 1.01-1.64]). Among women with isolated hypothyroxinemia, the risk of preterm birth was 7.1% vs 5.0% in euthyroid women (absolute risk difference, 2.3% [95% CI, 0.6%-4.5%]; OR, 1.46 [95% CI, 1.12-1.90]). In continuous analyses, each 1-SD higher maternal thyrotropin concentration was associated with a higher risk of preterm birth (absolute risk difference, 0.2% [95% CI, 0%-0.4%] per 1 SD; OR, 1.04 [95% CI, 1.00-1.09] per 1 SD). Thyroid peroxidase antibody-positive women had a higher risk of preterm birth vs TPO antibody-negative women (6.6% vs 4.9%, respectively; absolute risk difference, 1.6% [95% CI, 0.7%-2.8%]; OR, 1.33 [95% CI, 1.15-1.56]). Conclusions and Relevance: Among pregnant women without overt thyroid disease, subclinical hypothyroidism, isolated hypothyroxinemia, and TPO antibody positivity were significantly associated with higher risk of preterm birth. These results provide insights toward optimizing clinical decision-making strategies that should consider the potential harms and benefits of screening programs and levothyroxine treatment during pregnancy.
Assuntos
Doenças Autoimunes/diagnóstico , Iodeto Peroxidase/imunologia , Complicações na Gravidez/diagnóstico , Nascimento Prematuro/etiologia , Doenças da Glândula Tireoide/diagnóstico , Testes de Função Tireóidea , Adulto , Autoanticorpos/sangue , Doenças Autoimunes/sangue , Doenças Autoimunes/complicações , Feminino , Idade Gestacional , Humanos , Hipotireoidismo/complicações , Hipotireoidismo/diagnóstico , Recém-Nascido , Gravidez , Complicações na Gravidez/sangue , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/complicações , Tireotropina/sangue , Tiroxina/sangueRESUMO
OBJECTIVES: To investigate changes in the antibiotic susceptibility of Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus pyogenes from the Survey of Antibiotic Resistance (SOAR) in community-acquired respiratory tract infections (CA-RTIs) between 2002 and 2015 in Pakistan. METHODS: This is a review based on previously published studies from 2002-03, 2004-06 and 2007-09 and also new data from 2014-15. Susceptibility was determined by Etest(®) or disc diffusion according to CLSI and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. RESULTS: A total of 706 isolates from CA-RTIs comprising 381 S. pneumoniae, 230 H. influenzae and 95 S. pyogenes were collected between 2002 and 2015 and tested against a range of antibiotics. Antibiotic resistance in S. pneumoniae rose steeply from 2002 to 2009, with isolates non-susceptible to penicillin and macrolides increasing from 10% to 34.1% and from 13%-14% to 29.7%, respectively. Susceptibility to amoxicillin/clavulanic acid (and by inference amoxicillin) remained between 99.4% and 100% from 2002 to 2015. Over the years, the prevalence of susceptibility to cefuroxime was 98%-100% among S. pneumoniae. Resistance in S. pneumoniae to some older antibiotics between 2007 and 2009 was high (86.8% for trimethoprim/sulfamethoxazole and 57.2% for tetracycline). Between 2002 and 2015, ampicillin resistance (ß-lactamase-positive strains) among H. influenzae has remained low (between 2.6% and 3.2%) and almost unchanged over the years (H. influenzae was not tested during 2004-06). For S. pyogenes isolates, macrolide resistance reached 22%; however, susceptibility to penicillin, amoxicillin/clavulanic acid and cefuroxime remained stable at 100%. CONCLUSIONS: In S. pneumoniae from Pakistan, there has been a clear reduction in susceptibility to key antibiotics since 2002, but not to amoxicillin/clavulanic acid (amoxicillin) or cefuroxime. However, susceptibility in H. influenzae has remained stable. Local antibiotic susceptibility/resistance data are essential to support informed prescribing for CA-RTIs and other infections.
Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Haemophilus influenzae/efeitos dos fármacos , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pyogenes/efeitos dos fármacos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Feminino , Infecções por Haemophilus/epidemiologia , Infecções por Haemophilus/microbiologia , Haemophilus influenzae/isolamento & purificação , Humanos , Lactente , Recém-Nascido , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Paquistão/epidemiologia , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/microbiologia , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/microbiologia , Streptococcus pneumoniae/isolamento & purificação , Streptococcus pyogenes/isolamento & purificação , Adulto JovemRESUMO
BACKGROUND: We describe the implementation and impact of a patient blood management program (PBMP) in an Australian teaching hospital. STUDY DESIGN AND METHODS: A PBMP was introduced at a single tertiary care hospital in 2009 as a pilot for the Western Australian Health Department statewide PBMP. The first 3 years of interventions aimed to make effective use of preoperative clinics, manage perioperative anemia, improve perioperative hemostasis, reduce blood sample volumes, and implement restrictive transfusion triggers and a single-unit transfusion policy. RESULTS: Between 2008 and 2011, admissions to Fremantle Hospital and Health Services increased by 22%. Using 2008 as a reference year, the mean number of red blood cell (RBC) units per admission declined 26% by 2011. Use of fresh-frozen plasma and platelets showed 38 and 16% declines, respectively. Cryoprecipitate increased 7% over the 4-year period. For elective admissions between 2008 and 2011, the leading decline in RBC transfusion rate was seen in cardiothoracic surgery (27.5% to 12.8%). The proportion of single RBC unit use increased from 13% to 28% (p < 0.001), and the proportion of double units decreased from 48% to 37% (p < 0.001). CONCLUSION: This is the first tertiary hospital in Australia to establish a multidisciplinary multimodal PBMP. Interventions across disciplines resulted in decreased use of RBC units especially in orthopedic and cardiothoracic surgery. Continuing education and feedback to specialties will maintain the program, improve patient outcomes, and decrease the transfusion rate.
Assuntos
Bancos de Sangue/organização & administração , Transfusão de Sangue/estatística & dados numéricos , Implementação de Plano de Saúde , Pacientes Internados , Centros de Atenção Terciária/organização & administração , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Bancos de Sangue/normas , Bancos de Sangue/estatística & dados numéricos , Transfusão de Sangue/normas , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Comunicação Interdisciplinar , Corpo Clínico Hospitalar/educação , Pessoa de Meia-Idade , Hemorragia Pós-Operatória/epidemiologia , Hemorragia Pós-Operatória/prevenção & controle , Medicina Transfusional/educação , Adulto JovemRESUMO
BACKGROUND: Bovine brucellosis is an important disease affecting cattle characterised by abortion, still birth, reduced milk production, weak foetus and infertility in both males and females. There is wide distribution of the disease among cattle and several wildlife species. Bovine brucellosis is commonly caused by B. abortus and very occasionally B. melitensis and B. suis. The distribution of bovine brucellosis in cattle has not been described in Malaysia. In this paper we describe the distribution, pattern and trend of bovine brucellosis in Peninsular Malaysia between 2000 and 2008 based on serological data obtained from nationwide B. abortus serosurveillance activities in cattle populations. RESULTS: Brucella antibodies were detected in 21.8% of sampled herds (95% CI, 21.01-22.59) and 2.5% (95% CI; 2.45-2.55) of sampled cattle. The state of Pahang had the highest animal and herd-level seroprevalence of 5.3 and 43.6%, respectively. The herd-level seroprevalence varied but remained high (18-26%) over the period of study and generally increased from 2000 to 2008. Seropositive herds clustered around the central part of the peninsula within the period of the study. The months of September, October and November illustrated the highest rates with corresponding seroprevalences of 33.2, 38.4 and 33.9%, respectively. A noticeable variation was observed in the cattle-level seroprevalence, but the rate remained relatively low (<5%). The chi-square statistics showed herd size (χ2 = 1206.077, df = 2, p = 0.001), breed (χ2 = 37.429, df = 1, p = 0.001), month of sampling (χ2 = 51.596, df = 11 p = 0.001), year (χ2 = 40.08, df = 8, p = 0.001) and state (χ2 = 541.038, df = 10, p = 0.001) to be associated with increased seropositivity. CONCLUSION: Bovine brucellosis is widespread among herds in Peninsular Malaysia at a low within-herd seroprevalence rate.
Assuntos
Brucelose Bovina/epidemiologia , Animais , Brucella abortus , Brucelose Bovina/microbiologia , Bovinos , Feminino , Malásia/epidemiologia , Masculino , Estudos SoroepidemiológicosRESUMO
INTRODUCTION: Flexible ureteroscopes are expensive and delicate instruments that are integral in the offering of a minimally invasive technique of diagnosis and treatment of urolithiasis. Published literature has identified the importance of early damage recognition in preventing frequent use of the scope that would lead to further damage and high repair and replacement costs. Our study was designed to examine the outcome of the pressure leak test on the condition of flexible ureteroscopes after every use and analysing the damage and costs of maintenance. PATIENTS AND METHODS: A prospective study was designed with two treatment groups. Group 1, 95 consecutive procedures (n = 95) of flexible ureterorenoscopy and laser fragmentation of renal calculi were performed with ACMI DUR 8, (a scope with no in-built leak test facility). This was compared against group 2, where 98 procedures of laser fragmentation of renal calculi (n = 98) were performed using Storz Flex X(2) Ureteroscopes (with a in-built leak test facility). All scopes in Group 2 were tested for pressure leak after every procedure and the outcome of the tests recorded. RESULTS: Both groups were comparable for grade of surgeon; stone location, size & number; access sheath usage and duration of lasering. In Group 1, there were seven scope damages resulting in repairs/replacement amounting to costs $46264.40 (7.1% damage). In Group 2, three scopes revealed a positive pressure leak test, implying damage with repair costs of $9952.80 (3.1% damage) (p < 0.05). Significant cost savings and reduction in downtime were made in Group 2. CONCLUSIONS: Pressure leak testing following flexible ureterorenoscopy helped to significantly control costs of maintenance and repair. Newer scopes should have a leak testing mechanism as it prevents further detrimental damage to the scope, build-up of repair costs are avoided and there is an increase in the longevity of these delicate instruments.
Assuntos
Ureteroscópios/normas , Desenho de Equipamento , Falha de Equipamento , Humanos , Pressão , Estudos ProspectivosRESUMO
The ageing population in developed countries, including Australia, is putting increasing demands on blood transfusion services. With a falling donor pool there is likely to be a shortage of blood and blood products in the next 20 to 30 years unless there are significant changes in medical practice. The National Health and Medical Research Council/Australasian Society of Blood Transfusion Clinical Practice Guidelines on the Use of Blood Components from 2001 are being redeveloped by the National Health and Medical Research Council/Australian and New Zealand Society of Blood Transfusion as evidence-based patient-focused Patient Blood Management guidelines with the aim of improving patient outcomes by reducing inappropriate blood and blood product use and targeting therapies for improving the management of anaemia and coagulopathies.
Assuntos
Bancos de Sangue/economia , Transfusão de Sangue , Custos e Análise de Custo , Gerenciamento Clínico , Idoso , Anemia/tratamento farmacológico , Anemia/terapia , Austrália , Bancos de Sangue/organização & administração , Bancos de Sangue/provisão & distribuição , Bancos de Sangue/tendências , Transfusão de Sangue/economia , Transfusão de Sangue/estatística & dados numéricos , Cuidados Críticos , Prática Clínica Baseada em Evidências , Compostos Férricos/uso terapêutico , Doenças Hematológicas/terapia , Humanos , Prescrição Inadequada , Modelos Teóricos , Assistência Centrada no Paciente , Assistência Perioperatória , Plasma , Transfusão de Plaquetas/economia , Transfusão de Plaquetas/estatística & dados numéricos , Dinâmica Populacional , Guias de Prática Clínica como Assunto , PrescriçõesRESUMO
Although there are more than 200 odor-causing volatile organic compounds (VOCs), phenol and p-cresol are two prominent odor-causing VOCs found downwind from concentrated animal feeding operations (CAFOs). The VOC emissions from cattle and dairy production are difficult to quantify accurately because of their low concentrations, spatial variability, and limitations of available instruments. To quantify VOCs, a protocol following US. Environmental Protection Agency (EPA) Method TO-14A has been established based on the isolation flux chamber method and a portable gas chromatograph (GC) coupled with a purge-and-trap system. The general objective of this research was to quantify phenol and p-cresol emission rates (ERs) from different ground-level area sources (GLASs) in a free-stall dairy during summer and winter seasons using this protocol. Two-week-long sampling campaigns were conducted in a dairy operation in central Texas. Twenty-nine air samples were collected during winter and 37 samples were collected during summer from six specifically delineated GLASs (barn, loafing pen, lagoon, settling basin, silage pile, and walkway) at the free-stall dairy. Thirteen VOCs were identified during the sampling period and the GC was calibrated for phenol and p-cresol, the primary odorous VOCs identified. The overall calculated ERs for phenol and p-cresol were 2656 +/- 728 and 763 +/- 212 mg hd(-1) day(-1), respectively, during winter. Overall phenol and p-cresol ERs were calculated to be 1183 +/- 361 and 551 +/- 214 mg hd(-1) day(-1), respectively, during summer. In general, overall phenol and p-cresol ERs during winter were about 2.3 and 1.4 times, respectively, higher than those during summer.
Assuntos
Poluentes Atmosféricos/química , Bovinos , Cresóis/química , Indústria de Laticínios , Monitoramento Ambiental/métodos , Fenol/química , Animais , Abrigo para Animais , Odorantes , Estações do Ano , Texas , Compostos Orgânicos VoláteisRESUMO
Inadequate social protection, stagnant wages, unemployment, and homelessness are associated with Australian household food insecurity. Little is known about the recipients of food charity and whether their needs are being met. This cross-sectional study of 101 food charity recipients in Perth, Western Australia, measured food security, weight status, sociodemographic characteristics and food acquisition practices. Seventy-nine percent were male, aged 21-79 years, 90% were unemployed, 87% received social assistance payments, and 38% were homeless. Ninety-one percent were food insecure, 80% with hunger, and 56% had gone a day or more without eating in the previous week. Fifty-seven percent had used food charity for ≥1 year, and, of those, 7.5 years was the mode. Charitable services were the main food source in the previous week, however 76% used multiple sources. Begging for money for food (36%), begging for food (32%), stealing food or beverages (34%), and taking food from bins (28%) was commonplace. The omnipresence and chronicity of food insecurity, reliance on social security payments, and risky food acquisition suggest that both the social protection and charitable food systems are failing. Urgent reforms are needed to address the determinants of food insecurity (e.g., increased social assistance payments, employment and housing support) and the adequacy, appropriateness and effectiveness of food charity.
Assuntos
Instituições de Caridade , Inocuidade dos Alimentos , Serviços de Alimentação , Abastecimento de Alimentos , Fome , Seguridade Social , Adulto , Idoso , Austrália , Cidades , Estudos Transversais , Feminino , Pessoas Mal Alojadas , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza , Austrália Ocidental , Adulto JovemRESUMO
Potential water quality impacts associated with using bottom ash (BA) and composted dairy manure (CM) as a soil amendment were evaluated in this study. Two column studies were conducted to evaluate three blends of acidic BA and CM (BA:CM, v/v) namely, B1ac (95:5), B2ac (90:10), and B3ac (80:20) and three blends of alkaline BA and CM (BA:CM, v/v), namely, B1al (95:5), B2al (90:10), and B3al (80:20) under constant head water table conditions. Samples from standing water (top) and leachate (bottom) were collected at weekly intervals until day 49 to evaluate the effects of different blend ratios and elapsed time on standing water and leachate chemical and physical properties. A higher CM content in both acidic and alkaline blends resulted in higher leachate concentrations for solids and nutrients tested in this study. Alkaline blends had higher standing water and leachate nutrients concentration compared to acidic blends. After day 28, standing water total dissolved solids (TDS) concentrations for all acidic blends was below the USEPA drinking water standard however, TDS value for alkaline blend was always below the standard. Similar trends were also observed for NO3-N and phosphorus (P) concentrations for both blends. Based on these findings, it was concluded that acidic and alkaline blends B1ac, B1al, B2ac and B2al may be considered as a soil amendment material.
Assuntos
Esterco/análise , Solo/normas , Biodegradação Ambiental , Concentração de Íons de Hidrogênio , Nitrogênio/análise , Fósforo/análise , Água/normasRESUMO
OBJECTIVES: To i) describe the demographic and assault characteristics of males alleging recent sexual assault, ii) determine the severity and frequency of general body injury and the frequency of anal and genital injury, iii) identify vulnerability factors and assault characteristics associated with injury. DESIGN: Cross-sectional study. SETTING: Sexual Assault Resource Centre (SARC), Western Australia. PARTICIPANTS: Total of 103 post-pubertal males attending SARC from Jan-2009 to Dec-2016. METHODS: Men underwent a standardised medical examination and data collection by forensically trained doctors following consent for general body and/or ano-genital examination. Men were considered vulnerable if at least one of the following factors was present: current mental illness; intellectual or physical disability; alcohol intoxication; previous sexual victimization; living in prison or homeless (no fixed address), agedâ¯<â¯18 years. Statistical analysis was performed by Fisher exact test. An algorithm was used to classify general body injuries as mild, moderate or severe. RESULTS: At least one vulnerability factor was present in 88.3% of the 103 men. More than one factor was present in 54.4%. General body injury was observed in 58.0% (40/69) of men consenting to general body examination; 46.4%, 10.1% and 1.4% were classified as having respectively, mild, moderate and severe injuries. Three assault characteristics were associated with general body injury: the use of blunt force (pâ¯=â¯0.002), multiple assailants (pâ¯=â¯0.049) and deprivation of liberty (pâ¯=â¯0.040). Genital injury and anal injury was observed in, respectively, 6.5% (5/77) and 14.3% (11/77) of men consenting to ano-genital examination. Of the 49 men examined following completed penetrative anal assault, 18.4% (9/49) had anal injuries. In these 49 men, those assaulted by strangers were more likely to have an anal injury compared to non-stranger assaults (pâ¯=â¯0.019). No demographic, clinical or vulnerability characteristics of the sexually assaulted men were associated with general body, genital and/or anal injury. CONCLUSION: Although general body injuries were more frequent than genital and anal injuries, most of the body injuries were mild in severity. While the majority of men in our study presented with one or more vulnerabilities only assault characteristics (not vulnerabilities) were associated with injury.
Assuntos
Vítimas de Crime/estatística & dados numéricos , Delitos Sexuais , Populações Vulneráveis , Adolescente , Adulto , Intoxicação Alcoólica/epidemiologia , Canal Anal/lesões , Austrália/epidemiologia , Estudos Transversais , Pessoas com Deficiência/estatística & dados numéricos , Medicina Legal , Genitália Masculina/lesões , Pessoas Mal Alojadas/estatística & dados numéricos , Humanos , Escala de Gravidade do Ferimento , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Boca/lesões , Exame Físico , Prisioneiros/estatística & dados numéricos , Adulto JovemRESUMO
BACKGROUND: The Sexual Assault Resource Center (SARC) in Perth, Western Australia provides free 24-hour medical, forensic, and counseling services to persons aged over 13 years following sexual assault. OBJECTIVE: The aim of this research was to design a data management system that maintains accurate quality information on all sexual assault cases referred to SARC, facilitating audit and peer-reviewed research. METHODS: The work to develop SARC Medical Services Clinical Information System (SARC-MSCIS) took place during 2007-2009 as a collaboration between SARC and Curtin University, Perth, Western Australia. Patient demographics, assault details, including injury documentation, and counseling sessions were identified as core data sections. A user authentication system was set up for data security. Data quality checks were incorporated to ensure high-quality data. RESULTS: An SARC-MSCIS was developed containing three core data sections having 427 data elements to capture patient's data. Development of the SARC-MSCIS has resulted in comprehensive capacity to support sexual assault research. Four additional projects are underway to explore both the public health and criminal justice considerations in responding to sexual violence. The data showed that 1,933 sexual assault episodes had occurred among 1881 patients between January 1, 2009 and December 31, 2015. Sexual assault patients knew the assailant as a friend, carer, acquaintance, relative, partner, or ex-partner in 70% of cases, with 16% assailants being a stranger to the patient. CONCLUSION: This project has resulted in the development of a high-quality data management system to maintain information for medical and forensic services offered by SARC. This system has also proven to be a reliable resource enabling research in the area of sexual violence.
Assuntos
Documentação/métodos , Medicina Legal , Sistemas de Informação Hospitalar/organização & administração , Pesquisadores , Delitos Sexuais , Adolescente , Adulto , Confiabilidade dos Dados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desenvolvimento de Programas , Austrália Ocidental , Adulto JovemRESUMO
Increasing emphasis on maintaining environmental integrity by dairy operations warrants examination of management influence on waste characteristics. Complete profiles of anaerobic dairy lagoons for eleven operations in central Texas, distinguished by use of dry-lot and hybrid (i.e., facilities comprised of free stalls with smaller dry-lot areas) management systems, were analyzed for 15 physicochemical parameters. Although solids, pH and TKN values were similar between housing type, statistical differences in NH4-N, P, K, Mg, Na, Mn, Cu and electrical conductivity (EC) were observed. The discrepancies were attributed to dissimilar cattle activity, where cows spend more time near flush alleys in hybrid systems than dry-lot systems, which facilitates waste transport to anaerobic lagoons. These results suggest a possible difference in N dynamics between lagoon types, which in turn would have implications for NH3 volatilization. Potential salt-stress impact on both lagoon effectiveness and pastures receiving land-applied lagoon effluent may also be enhanced by hybrid systems. This study not only contributes data on anaerobic lagoon characteristics, but also provides additional considerations for dairy producers striving to meet more rigorous regulations while attempting to protect soil resources for crop production.
Assuntos
Indústria de Laticínios , Nitrogênio/química , Poluentes da Água , Concentração de Íons de Hidrogênio , SaisRESUMO
OBJECTIVES: To describe the frequency of genital and anal injury and associated demographic and assault characteristics in women alleging sexual assault. DESIGN: Cross-sectional study. SETTING: Sexual Assault Resource Centre (SARC), Western Australia. PARTICIPANTS: Total of 1266 women attending SARC from Jan-2009 to Mar-2015. METHODS: Women underwent a standardised data collection procedure by forensically trained doctors. Multivariate logistic regression analyses were performed. MAIN OUTCOME MEASURES: (1) Frequency of genital and anal injuries by type of sexual assault. (2) Identification of independent factors associated with genital and anal injuries following, respectively, completed vaginal and anal penetration. RESULTS: Genital injury was observed in 24.5% of all women with reported completed vaginal penetration; in a subset with no prior sexual intercourse 52.1% had genital injury. Genital injury was more likely with no prior sexual intercourse (adjusted odds ratio [adj. OR] 4.4, 95% confidence interval [95%CI] 2.4-8.0), multiple types of penetrants (adj. OR 1.5, 95%CI 1.0-2.1), if general body injury present and less likely with sedative use and delayed examination. Anal injury, observed in 27.0% of reported completed anal penetrations, was more likely with multiple types of penetrants (adjusted OR 5.0, 95%CI 1.2-21.0), if general body injury present and less likely with delayed examination. CONCLUSION: This study separately quantifies the frequency of both genital and anal injuries in sexually assaulted women. Genital injuries were absent in a large proportion of women regardless of prior vaginal intercourse status. It is anticipated that findings will better inform the community, police and medico-legal evidence to the criminal justice system.
Assuntos
Canal Anal/lesões , Estupro , Vagina/lesões , Vulva/lesões , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Vítimas de Crime/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Análise Multivariada , Exame Físico , Adulto JovemRESUMO
OBJECTIVES: To describe the frequency and severity of general body injury in women alleging recent sexual assault and then identify demographic and assault characteristics associated with injury severity. DESIGN: Cross-sectional study. SETTING: Sexual Assault Resource Centre (SARC), Western Australia. PARTICIPANTS: Total of 1163 women attending SARC from Jan-2009 to Mar-2015. METHODS: Women underwent a standardised medical examination and data collection by forensically trained doctors. Multivariate ordinal logistic regression analyses were performed. An algorithm was used to classify general body injuries as mild, moderate or severe. RESULTS: General body injury was observed in 71% of women; 52%, 17% and 2% were classified as having respectively, mild, moderate and severe injuries. Moderate or severe injury was observed in 30.4% of women assaulted by intimate partners, 16.4% of women assaulted by strangers and 14.9% of women assaulted by friends/acquaintances. In regression analysis, an interaction between mental illness and assailant type existed after adjusting for age, intellectual disability, time-to-examination, number of assailants and location. Mental illness was an independent predictor for lower injury severity (adjusted odds ratio=0.5, 95% CI 0.3, 0.9) in women assaulted by strangers and higher injury severity in women assaulted by a friend/acquaintance (adjusted odds ratio=2.4, 95% CI 1.6, 3.6). While women assaulted by intimate partners had more frequent moderate-to-severe injuries than other women their current mental illness status was not associated with risk of injury severity. CONCLUSION: This study highlights the increased injury severity in women assaulted by intimate partners. The risk of moderate/severe injury for women with mental illness assaulted by their acquaintances was unexpected and requires further investigation.
Assuntos
Delitos Sexuais/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Estudos Transversais , Feminino , Humanos , Escala de Gravidade do Ferimento , Violência por Parceiro Íntimo/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Análise Multivariada , Abuso Físico/estatística & dados numéricos , Exame Físico , Adulto JovemRESUMO
BACKGROUND: The Western Australian Audit of Surgical Mortality (WAASM) was established in June 2001 to independently peer-review all surgical deaths in Western Australia. The objectives of this study were (i) to evaluate whether participation in the WAASM has influenced clinical and hospital practice; and (ii) to ascertain the support and relevance of the WAASM to surgeons, hospitals and consumers. METHODS: Three qualitative questionnaires were designed to evaluate the response of surgeons, hospital administrators and consumers to the WAASM. The outcomes measured included audit participation, value and use of feedback provided, changes to clinical and hospital practice and the future role of the WAASM. RESULTS: The key findings were that 138 (73%) of 190 surgeons participating in the WAASM had changed their clinical practice in at least one way, 44 (24%) were aware of changes in hospital practice and 21 (11%) were aware of changes in a colleague's practice. Particular areas where changes in surgical practice had occurred included attention to deep vein thrombosis prophylaxis (81, 44%), increased constructive discussion among peers (78, 42%) and quality of documentation in case notes (68, 37%). All groups supported the continuation of the WAASM. Hospital executives and consumers recommended that the WAASM be included in accreditation. CONCLUSION: Surgeons, hospitals and consumers supported the concept of independent peer review of surgical care. They confirmed the ability of audit to influence and change surgical and hospital practice. It strengthens the intention of the Royal Australasian College of Surgeons to extend the WAASM project throughout Australia and New Zealand.
Assuntos
Auditoria Médica , Procedimentos Cirúrgicos Operatórios/mortalidade , Atitude do Pessoal de Saúde , Comportamento do Consumidor , Humanos , Padrões de Prática Médica , Avaliação de Programas e Projetos de Saúde , Centro Cirúrgico Hospitalar/organização & administração , Austrália OcidentalRESUMO
OBJECTIVE: To describe the prevalence, risk factors, signs and symptoms of non-fatal strangulation (NFS) in women referred to a Sexual Assault Resource Centre (SARC) following recent sexual assault. METHODS: A cross-sectional study using data routinely collected at time of forensic examination of women (age ≥ 13 years) referred to the Western Australian SARC between Jan-2009 and Mar-2015 alleging a recent sexual assault. Data on demographics, assault characteristics and forensic findings were available. RESULTS: A total of 1064 women were included in the study; 79 (7.4%) alleged NFS during the sexual assault. The prevalence of NFS varied significantly by age-group and assailant type. Of women aged 30-39 years 15.1% gave a history of NFS compared to less than 8.2% in all other age groups. Of women assaulted by an intimate partner, 22.5% gave a history of NFS compared to less than 6% of women assaulted by other assailant types. Of all sexual assaults with NFS, intimate partners were the assailant in 58.2% of cases, whereas in sexual assault cases without NFS, intimate partners were the assailant in 15.9% of cases. Odds of NFS were 8.4 times higher in women sexually assaulted by an intimate partner compared to women assaulted by an acquaintance/friend and 4.9 times higher compared to women assaulted by a stranger. When considering both age and assailant type the highest proportion of NFS (33.9%) was in women aged 30-39 years sexually assaulted by an intimate partner. Other factors associated with NFS during sexual assault included deprivation of liberty, verbal threats, being assaulted in the woman's home and use of additional blunt force. External physical signs of NFS were absent in 49.4% of all NFS sexual assault cases. CONCLUSIONS: This study identifies and quantifies NFS risk factors in female sexual assault and highlights the strong association with intimate partner sexual assault. Greater awareness of NFS in sexual assault should lead to improvement in medical screening, forensic management and safety risk assessment by sexual assault and domestic violence services, emergency departments and police.
Assuntos
Asfixia/etiologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Lesões do Pescoço/etiologia , Delitos Sexuais/estatística & dados numéricos , Adulto , Estudos Transversais , Transtornos de Deglutição/etiologia , Feminino , Humanos , Cervicalgia/etiologia , Prevalência , Fatores de Risco , Adulto JovemRESUMO
The long-term goal of this project was to find alternative uses for bottom ash (BA) and composted dairy manure (CM), by-products of coal combustion and livestock production, respectively. The study discussed in this paper focused on potential water quality impacts associated with using blended BA and CM as a soil amendment. The constituents of BA and CM include heavy metals and other chemicals that, while essential nutrients for plant growth, also pose a potential threat to water quality. Four blends (BA:CM, v/v) namely, B1 (100%:0%), B2 (70%:30%), B3 (50%:50%) and B4 (0%:100%), were subjected to flow-through water table management and two blends, B2 (70%:30%) and B3 (50%:50%), were subjected to constant head water table management using de-ionized water. Leachate and standing water from saturated and flooded blends of BA and CM were examined for total solids (TS), volatile solids (VS), COD, pH, total Kjeldahl nitrogen (TKN), NO(3)-N, total P, total K as well as selected metals over a 5 and 7 week period for flow-through and constant head watertables, respectively. The results showed that higher CM content resulted in higher TS, VS, TKN, P and K concentrations in the leachate and standing water. Concentrations of these constituents were higher in leachate than in the standing water. Even though, marked reductions of most chemicals in the leachate and standing water were realized within one to three weeks, initially high concentrations of chemicals in leachate and standing water from these particular blends made them unsuitable as soil amendment material. Based upon these results, it was concluded that additional column studies of BA and CM blends with reduced CM content (5%, 10% and 20%) should be performed to further assess the feasibility of BA and CM blends as an environmentally safe soil amendment material.
Assuntos
Carvão Mineral , Esterco , Solo , Água/química , Carbono , Cinza de Carvão , Indústria de Laticínios , Filtração , Material Particulado , Fatores de Tempo , Água/normas , Poluição da ÁguaRESUMO
The current epidemic of cotton leaf curl disease (CLCuD) in Pakistan started in 1988 with the natural host range limited to a few plant species in the family Malvaceae. However, we have observed expansion in the host range of the virus, and several non-Malvaceous plants were found to be infected with the virus. Characteristic symptoms of CLCuD such as leaf curl and enations have been observed on radish plants, primarily in kitchen gardens. However, in 1999, levels of infection of 10 to 90% were observed both in commercial fields and kitchen gardens in the Punjab province of Pakistan. Both symptomatic and nonsymptomatic samples were collected from five different locations. Total DNA was isolated, dot-blotted on nylon membrane, and a full-length clone corresponding to DNA A of cotton leaf curl virus was labeled with 32P dCTP and used as a probe for the detection of a begomovirus. Strong signals were observed in symptomatic plants while no signals were observed in nonsymptomatic plants. Infection with a begomovirus was further confirmed by polymerase chain reaction (PCR) using degenerate primers for DNA A (1). Primers specific for the two distinct begomoviruses associated with CLCuD were also used in PCR reactions (2), and products of the expected size were obtained from all symptomatic samples, confirming infection with begomoviruses similar to those associated with CLCuD. A full-length probe of a nanovirus-like molecule associated with cotton leaf disease (3), called DNA 1 was labeled with 32P dCTP and detected the virus only in symptomatic plants. Similarly, primers specific for DNA 1 (3) amplified a product of expected size when used in PCR. On the basis of symptomatology and the detection of specific viral components associated with the disease, we confirmed that radish plants are infected with Cotton leaf curl virus (CLCuV). Since radish is a short duration crop, infection of CLCuV in radish may not serve as a direct source of infection for the next cotton crop. However, it is a potential threat to tomato crops which overlap with radish in the Punjab province. The detection of CLCuD in radish is another example of the mobilization of begomoviruses to previously unknown hosts. References: (1) M. R. Rojas et al. Plant Dis. 77:340, 1993. (2) S. Mansoor et al. Pak. J. Bot. 31:115, 1999. (3) Mansoor et al. Virology 259:190, 1999.
RESUMO
AIMS: The main purpose of the study was to present a baseline audit of reporting of colorectal cancers resection specimens in Scotland, audited against the Royal College of Pathologists (RCPath) standards (2007) and NHS Quality Improvement Scotland (NHS QIS) standards. METHODS: 50 consecutive rectal and 50 consecutive colonic cancer cases from 2011 were audited from 10 Scottish health boards involved in colorectal cancer reporting (n=953). The rates of reporting of serosal involvement, extramural venous invasion (EMVI) and the mean numbers of lymph nodes found were audited against RCPath standards and compared between units that routinely used a reporting proforma versus those that did not. RESULTS: The performance in reporting of rectal cancer was generally worse than for colonic cancer, with only three units meeting the RCPath standards for reporting of rectal cancer. There were significant differences between units that routinely used a proforma, with the non-proforma group failing to meet the minimum standards for both serosal involvement (6%) and EMVI (24%). In the non-proforma group, 56% of rectal cases had a mean lymph node count of 12 or more compared with 81% in the proforma group. CONCLUSIONS: Significant differences exist in the frequencies with which important adverse prognostic features are reported by pathologists across 10 Scottish health boards. This has potential implications for patient care. Health boards that make routine use of reporting proformas are more likely to meet RCPath guidelines for reporting of these important pathological parameters.