Factors influencing antimicrobial prescribing by veterinarians and usage by dairy farmers in New Zealand.

AIMS: To determine the factors associated with the selection of antimicrobials by dairy veterinarians, and the attitudes of those veterinarians and dairy farmers to antimicrobial usage and resistance. METHODS: Facilitated focus groups of dairy farmers (n=22) and an anonymous online survey of dairy cattle veterinarians (n=206 respondents) were used to determine prescribing behaviour, factors affecting prescribing of antimicrobials, and the attitudes of veterinarians and farmers to the use of antimicrobials and the risk of antimicrobial resistance (AMR). RESULTS: Amongst the 22 farmers, the most common primary reason for choosing an antimicrobial was veterinary advice (87%) followed by personal experience (68%). Farmers had limited knowledge or concern about the risk of AMR, particularly outside their farm, with only 47% and 26% agreeing or strongly agreeing that use of antimicrobials on their farm would increase the risk of resistance in their herd and in humans, respectively. Prescribing of antimicrobials by veterinarians was predominantly based on diagnosis (168/206; 82%), and response to previous therapy (134/206; 65%), while duration above the minimum inhibitory concentration (43/206; 21%) was also considered important. Non-clinical factors such as withholding period (52/206; 25%) and farmers' preferences (45/206; 22%) also influenced prescribing. Antimicrobial culture and susceptibility testing was not widely used, with 126/166 (76%) having culture results for less than four of the last 10 clinical mastitis cases for which they prescribed antimicrobials. Attitudes about prescribing and AMR varied with years of practice, gender and employment status. CONCLUSIONS: Veterinarians primarily considered technical reasons when prescribing antimicrobials. However non-technical factors did influence prescribing, in particular client feedback about perceived efficacy and perceptions of cost/benefit. Farmers stated that veterinarians were the most credible source of advice for selection of antimicrobials, but that personal experience on their farm was also important. CLINICAL RELEVANCE: Farmers' perception of efficacy of antimicrobials, based on clinical outcomes, is an important determinant of their preferred choice of product. Hence, where changes in on-farm use patterns are required, clear communication by veterinarians about prudent antimicrobial choice and usage will require initial education around classes of antimicrobials and risk of resistance, as well as information around assessing efficacy of antimicrobial usage. Many veterinarians are in businesses that do not have practice prescribing policies. Such policies would likely lead to more consistent and judicious use of antimicrobials.

Physical properties of computationally informed phyto-engineered 2-D nanoscaled hydronium jarosite.

This study describes a molecular dynamics computational modelling informed bioengineering of nano-scaled 2-D hydronium jarosite. More specifically, a phyto-engineering approach using green nano-chemistry and agro-waste in the form of avocado seed natural extract was utilized as a green, economic, and eco-friendly approach to synthesize this unique mineral at the nanoscale via the reduction of iron (II) sulphate heptahydrate. The nanoproduct which was found to exhibit a quasi-2D structure was characterized using a multi-technique approach to describe its morphological, optical, electrochemical, and magnetic properties. Radial distribution function and electrostatic potential maps revealed that flavone, a phenolic compound within the avocado seed natural extract, has a higher affinity of interaction with the nanoparticle's surface, whilst vanillic acid has a higher wetting tendency and thus a lower affinity for interacting with the hydronium jarosite nanoparticle surface compared to other phytoactive compounds. XRD and HRTEM results indicated that the nanoscale product was representative of crystalline rhombohedral hydronium jarosite in the form of quasi-triangular nanosheets decorated on the edges with nanoparticles of approximately 5.4 nm diameter that exhibited significant electrochemical and electroconductive behaviours. Magnetic studies further showed a diamagnetic behaviour based on the relationship of the inverse susceptibility of the nanomaterial with temperature sweep.

Room temperature bio-engineered multifunctional carbonates for CO2 sequestration and valorization.

This contribution reports, for the first time, on an entirely green bio-engineering approach for the biosynthesis of single phase crystalline 1-D nano-scaled calcite CaCO3. This was validated using H2O as the universal solvent and natural extract of Hyphaene thebaica fruit as an effective chelating agent. In this room temperature green process, CaCl2 and CO2 are used as the unique source of Ca and CO3 respectively in view of forming nano-scaled CaCO3 with a significant shape anisotropy and an elevated surface to volume ratio. In terms of novelty, and relatively to the reported scientific and patented literature in relation to the fabrication of CaCO3 by green nano-chemistry, the current cost effective room temperature green process can be singled out as per the following specificities: only water as universal solvent is used, No additional base or acid chemicals for pH control, No additional catalyst, No critical or supercritical CO2 usage conditions, Only natural extract of thebaica as a green effective chelating agent through its phytochemicals and proper enzematic compounds, room Temperature processing, atmospheric pressure processing, Nanoscaled size particles, and Nanoparticles with a significant shape anisotropy (1-D like nanoparticles). Beyond and in addition to the validation of the 1-D synthesis aspect, the bio-engineered CaCO3 exhibited a wide-ranging functionalities in terms of highly reflecting pigment, an effective nanofertilizer as well as a potential binder in cement industry.

Delivery of pharmaceutical services at ward level in a teaching hospital.

Poor management of pharmaceuticals could lead to wastage of financial resources and poor services in the public sector. The main aim of the study was to investigate the quality of pharmaceutical services at ward level in a teaching hospital. The design of the study was descriptive. Three data collection instruments were designed and pilot-tested prior to the actual data collection. Two structured questionnaires were used to interview the sister-in-charge of each ward and the stock and drug controller at the pharmacy. A checklist for the management of pharmaceuticals was completed for each ward. Descriptive statistics were used to describe and summarise the data. Sisters-in-charge of 30 wards and the stock and drug controller at the pharmacy participated in the study. The relationship with the pharmacy was perceived to be average by 54% (n = 30) of the sisters-in-charge of the wards. Communication with the pharmacy was mainly by telephone and 57% of the sisters-in-charge mentioned that they experienced difficulties in conveying messages to the pharmacy. Ten of the wards received regular ward visits by a pharmacist. Expiry dates were checked by all wards but at different intervals. The majority of the wards (90%) used patient cards, which refer to prescription charts, for stock control and ordering from the pharmacy. Fridge temperatures were checked and charted on a daily basis by 30% of the wards. Written standard operating procedures (SOPs) were used by the pharmacy for issuing ward stock. Although 83% of the wards indicated that they used SOPs, evidence of written SOPs was not available. The results indicated that the management of pharmaceutical services at ward level could be improved. Implementation of appropriate communication systems will enhance cooperation between the pharmacy and the wards. A uniform ward stock control system, either by computer or stock cards, should be introduced. Regular ward visits by a pharmacist to oversee ward stock management are recommended. Standard operating procedures for use in the wards should be developed and implemented.

The prevalence of alcohol dependence in burned adult patients.

This study determined the prevalence of alcohol dependence in burned adult patients at the Tygerberg Hospital in Cape Town and describes patterns of alcohol consumption, socioeconomic adjustment and attitudes towards drinking. The subjects of the study were patients over the age of 18 years who were admitted consecutively to the Burns Unit between 21 March 1992 and 19 June 1992. Patients were screened for alcohol problems with the Michigan Alcoholism Screening Test. Thirty patients screened positively for alcohol dependence. A more comprehensive interview schedule was administered to these patients to obtain additional information. The incidence of alcohol dependence in the study group was high (57 per cent). Most patients indicated that they were regular weekend drinkers. More than half of the patients reported previous alcohol-related accidents and 57 per cent attributed their present injuries to alcohol intoxication. Ninety per cent of patients were motivated to change their drinking behaviour and 40 per cent were willing to accept some form of treatment. It was found that the burn injury represents a crisis during which treatment for alcohol problems can be introduced. The burn care team has a responsibility to address the patients' alcohol problems to prevent recurrent alcohol-related traumatic accidents.

Calibrating corneal material model parameters using only inflation data: an ill-posed problem.

Goldmann applanation tonometry (GAT) is a method used to estimate the intraocular pressure by measuring the indentation resistance of the cornea. A popular approach to investigate the sensitivity of GAT results to material and geometry variations is to perform numerical modelling using the finite element method, for which a calibrated material model is required. These material models are typically calibrated using experimental inflation data by solving an inverse problem. In the inverse problem, the underlying material constitutive behaviour is inferred from the measured macroscopic response (chamber pressure versus apical displacement). In this study, a biomechanically motivated elastic fibre-reinforced corneal material model is chosen. The inverse problem of calibrating the corneal material model parameters using only experimental inflation data is demonstrated to be ill-posed, with small variations in the experimental data leading to large differences in the calibrated model parameters. This can result in different groups of researchers, calibrating their material model with the same inflation test data, drawing vastly different conclusions about the effect of material parameters on GAT results. It is further demonstrated that multiple loading scenarios, such as inflation as well as bending, would be required to reliably calibrate such a corneal material model.

High-energy-resolution inelastic electron and proton scattering and the multiphonon nature of mixed-symmetry 2+ states in 94Mo.

High-energy-resolution inelastic electron scattering (at the S-DALINAC) and proton scattering (at iThemba LABS) experiments permit a thorough test of the nature of proposed one- and two-phonon symmetric and mixed-symmetric 2+ states of the nucleus 94Mo. The combined analysis reveals the one-phonon content of the mixed-symmetry state and its isovector character suggested by microscopic nuclear model calculations. The purity of two-phonon 2+ states is extracted.