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Higher order evidence (evidence about evidence) allows epidemiologists and other health data scientists to account for measurement error in validation data. Here, to illustrate the use of higher order evidence, we provide a minimal nontrivial example of estimating the proportion and show how higher order evidence can be used to construct sensitivity analyses. The proposed method provides a flexible approach to account for multiple levels of distortion in the results of epidemiologic studies.
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In brief: Standard in vitro produced (IVP) bovine embryo culture media limit embryonic development. Culturing IVP bovine embryos in standard IVP bovine embryo culture media conditioned with oviduct and/or endometrial cells improves blastocyst formation and reduces the time to formation. Abstract: In vitro embryo production in cattle greatly impacts blastomere biochemistry, embryo rate of development and pre- and post-transfer survival. In vivo, the bovine embryo migrates through the oviduct isthmus before entering the uterus on approximately day 4 of development where it remains unattached within the uterine lumen until day 20 of gestation. During this time, the embryo is sequentially exposed to oviduct followed by endometrial secretions that support embryonic development. Considering this, we tested the effect of culturing in vitro produced (IVP) bovine embryos sequentially in oviduct epithelial- (OEp; days 1-3) followed by endometrial epithelial- (EEp) or EEp and fibroblast cell (EEp/F; days 4-8)-conditioned media on embryonic development using a time-lapse monitoring system. Compared to control, culturing IVP embryos in EEp- or EEp/F-conditioned media without prior culture in OEp-conditioned media increased blastocyst formation (P < 0.05) and reduced the time to blastocyst formation (P < 0.05). Culturing IVP bovine embryos in OEp-conditioned media followed by EEp- or EEp/F-conditioned media, however, had the greatest impact on embryo developmental kinetics and increased morula and blastocyst formation (P < 0.05) and reduced time to formation (P < 0.05). Day 8 blastocyst cell numbers, diameter and quality were not significantly different, although, blastocyst quality scores were less (indicative of better quality) for all cell-conditioned media compared to control. In conclusion, IVP bovine embryo development may be improved using a sequential embryo culture system involving bovine oviduct followed by endometrial cell-conditioned media.
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Embrião de Mamíferos , Tubas Uterinas , Gravidez , Feminino , Humanos , Bovinos , Animais , Meios de Cultivo Condicionados/farmacologia , Oviductos , Blastocisto , Epitélio , Desenvolvimento Embrionário , Fertilização in vitro/veterináriaRESUMO
A novel microsporidium was observed in wild swamp guppies Micropoecilia picta from Levera Pond within Levera National Park Grenada, West Indies. Initial observations indicated similarity with Pseudoloma neurophilia, an important pathogen in zebrafish Danio rerio. P. neurophilia exhibit broad host specifity, including members of the family Poecillidae, and both parasites infect the central nervous system. However, spore morphology and molecular phylogeny based on rDNA showed that the swamp guppy microsporidium (SGM) is distinct from P. neurophilia and related microsporidia (Microsporidium cerebralis and M. luceopercae). Spores of the SGM were smaller than others in the clade (3.6 µm long). Differences were also noted in histology; the SGM formed large aggregates of spores within neural tissues along with a high incidence of numerous smaller aggregates and single spores within the surface tissue along the ventricular spaces that extended submeninx, whereas P. neurophilia and M. cerebralis infect deep into the neuropile and cause associated lesions. Analysis of small subunit ribosomal DNA sequences showed that the SGM was <93% similar to these related microsporidia. Nevertheless, one of 2 commonly used PCR tests for P. neurophilia cross reacted with tissues infected with SGM. These data suggest that there could be other related microsporidia capable of infecting zebrafish and other laboratory fishes that are not being detected by these highly specific assays. Consequently, exclusive use of these PCR tests may not accurately diagnose other related microsporidia infecting animals in laboratory and ornamental fish facilities.
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Doenças dos Peixes , Microsporídios , Microsporidiose , Filogenia , Poecilia , Animais , Doenças dos Peixes/microbiologia , Doenças dos Peixes/parasitologia , Microsporídios/genética , Microsporídios/isolamento & purificação , Microsporídios/classificação , Microsporidiose/veterinária , Microsporidiose/microbiologia , Granada/epidemiologiaRESUMO
The benefits of sufficient and high-quality sleep for people are well documented. Insufficient sleep increases the risk of accidents, injuries, and negative health implications for people. This is especially relevant for farmers, as they work with large animals and machinery. Dairy farming often requires early start times and long days, particularly over the high workload calving period in block calving, pasture-based systems. However, there is little published data quantifying the sleep quantity and quality of farmers over this period. In this study, the sleep patterns of workers (n = 33) on 10 New Zealand dairy farms was measured for 90 d over the spring calving period using a sleep measuring device (OuraTM ring, Oura Health Ltd., Oulu, Finland). Total sleep time (TST) averaged 6 h 15 min, lower than the required 7 to 9 h for optimal wellbeing and cognitive functioning. TST decreased over the calving period and was significantly correlated with both sleep start and wake times. Factors such as work start time, farm location, and role on farm influenced sleep quantity and quality; indicating adjusting these on-farm factors could positively impact TST. Further research is required to better understand sleep and its effect on dairy farmers, over both the calving period and the remaining months of the year.
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BACKGROUND: Glasgow Microenvironment Score (GMS) stratifies long-term survival into three groups based on tumour phenotype: peritumoural inflammation (Klintrup-Mäkinen (KM)) and tumour stroma percentage (TSP). However, it is not known if the location of disease recurrence is influenced by the GMS category. METHODS: Seven hundred and eighty-three TNM I-III colorectal cancers (CRC) were included. GMS (GMS0-high KM; GMS1-low KM, low TSP; GMS2-low KM, high TSP) and cancer-specific survival (CSS), overall survival (OS) and disease recurrence were assessed using Cox regression analysis. RESULTS: Of the 783 patients, 221 developed CRC recurrence; 65 developed local recurrence + systemic disease. GMS was independent for CSS (HR 1.50, 95% CI 1.17-1.92, p < 0.001) and OS (HR 1.23, 1.05-1.44, p = 0.01). Higher GMS category was associated with T-stage, N-stage, emergency presentation and venous invasion. GMS was independent for local+systemic recurrence (HR 11.53, 95% CI 1.45-91.85, p = 0.04) and distant-only recurrence (HR 3.01, 95% CI 1.59-5.71, p = 0.002). GMS 2 disease did not appear to have statistically better outcomes with adjuvant chemotherapy in high-risk disease. CONCLUSION: Although confounded by a higher rate of T4 and node-positive disease, GMS 1 and 2 are associated with an increased risk of local and distant recurrence. GMS is an independent poor prognostic indicator for recurrent colorectal cancer. Higher GMS patients may benefit from enhanced postoperative surveillance.
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Neoplasias Colorretais , Recidiva Local de Neoplasia , Humanos , Recidiva Local de Neoplasia/patologia , Neoplasias Colorretais/patologia , Prognóstico , Inflamação/patologia , Microambiente Tumoral , Estadiamento de NeoplasiasRESUMO
Alcohol-to-jet (ATJ) Synthetic Kerosene with Aromatics (SKA) fuels are produced by dehydration and refining of alcohol feed stocks. ATJ SKA fuel known as SB-8 was developed by Swedish Biofuels as a cooperative agreement between Sweden and AFRL/RQTF. SB-8 including standard additives was tested in a 90-day toxicity study with male and female Fischer 344 rats exposed to 0, 200, 700, or 2000 mg/m3 fuel in an aerosol/vapor mixture for 6 hr/day, 5 days/week. Aerosols represented 0.04 and 0.84% average fuel concentration in 700 or 2000 mg/m3 exposure groups. Examination of vaginal cytology and sperm parameters found no marked changes in reproductive health. Neurobehavioral effects were increased rearing activity (motor activity) and significantly decreased grooming (functional observational battery) in 2000 mg/m3 female rats. Hematological changes were limited to elevated platelet counts in 2000 mg/m3 exposed males. Minimal focal alveolar epithelial hyperplasia with increased number of alveolar macrophages was noted in some 2000 mg/m3 males and one female rat. Additional rats tested for genotoxicity by micronucleus (MN) formation did not detect bone marrow cell toxicity or alterations in number of MN; SB-8 was not clastogenic. Inhalation results were similar to effects reported for JP-8. Both JP-8 and SB fuels were moderately irritating under occlusive wrapped conditions but slightly irritating under semi-occlusion. Exposure to SB-8, alone or as 50:50 blend with petroleum-derived JP-8, is not likely to enhance adverse human health risks in the military workplace.
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Querosene , Sêmen , Humanos , Ratos , Masculino , Feminino , Animais , Querosene/toxicidade , Suécia , Hidrocarbonetos/toxicidade , Ratos Endogâmicos F344 , Aerossóis , EtanolRESUMO
Dairy farmers face challenges attracting and retaining staff, partly due to the difficulty meeting the desires of the modern workforce. These include flexible work hours and regular time off. The task of milking fundamentally affects the ability of dairy farmers to meet these desires. Milking contributes to a large proportion of the hours spent working on dairy farms. The number of milkings (milking frequency) and their timing (milking interval) within a day influence the number of hours spent milking and what time in the day they occur. Milking 3 times in 2 d (3-in-2) reduces the amount of time spent milking compared with milking twice a day (TAD), without reducing milk yield as much as milking once a day (OAD). However, long intervals between 3-in-2 milkings can still lead to a long workday if farmers are expected to work between milkings. The objective of this study was to determine the effect of milking interval within a 3-in-2 milking frequency on milk yield and composition at 2 stages of lactation and compare these with OAD and TAD milking. Cows (n = 200) were milked in 5 groups of 40 at 3 intervals of 3-in-2: 8-20-20 h, 10-19-19 h, and 12-18-18 h, along with 24 h (OAD), and 10 and 14 h (TAD), for 6 wk at early lactation (mean 24 d in milk ± 7 d, SD) and again at mid lactation (mean 136 d in milk ± 18 d). Milk yields were recorded at each milking and milk samples collected weekly to determine composition. At both early and mid lactation there were no significant differences in milk, fat, protein, or lactose yields between the three 3-in-2 intervals. Cows milked 3-in-2 produced 8% less milk than cows milked TAD and 14% more than cows milked OAD, with smaller differences observed at mid lactation between TAD and 3-in-2. For a 3-in-2 milking frequency, a shorter milking interval can be implemented on the days when cows are milked twice. This may allow farmers to shorten the working day when using 3-in-2, without compromising milk or component yields.
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BACKGROUND: Limited and conflicting data exist regarding the impact of first-trimester nursing occupational exposures on hypertensive disorders of pregnancy (HDP). AIMS: To investigate whether first-trimester night shift work, work hours and work-related activities are associated with HDP. METHODS: We conducted a cross-sectional analysis of 6610 women within the Nurses' Health Study II. We used multiple logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the relation of occupational exposures to HDP. RESULTS: Nine per cent of respondents reported an HDP in the index pregnancy (gestational hypertension: nâ =â 354, 5%, preeclampsia: nâ =â 222, 3%). First-trimester fixed or rotating night shift work was not significantly associated with gestational hypertension or preeclampsia compared to day shift work only. Compared to those working 21-40 h/week, working overtime (≥41 h/week) was not associated with gestational hypertension but was associated with 43% higher odds of preeclampsia (95% CI 1.02, 2.00). For part-time work (≤20 h/week), the OR was 0.76 (95% CI 0.56, 1.02) for gestational hypertension and 0.64 (95% CI 0.43, 0.97) for preeclampsia. The odds of preeclampsia were 3% higher per additional hour worked per week (95% CI 1.01-1.04). Compared to 0-4 h spent standing or walking per day, standing or walking ≥9 h daily was associated with 32% lower odds of gestational hypertension (95% CI 0.47, 0.99) but was not significantly associated with preeclampsia. Frequency of heavy lifting was not associated with either hypertensive disorder or pregnancy. CONCLUSIONS: Among nurses, working overtime was associated with higher odds of preeclampsia.
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Hipertensão Induzida pela Gravidez , Exposição Ocupacional , Pré-Eclâmpsia , Gravidez , Feminino , Humanos , Pré-Eclâmpsia/epidemiologia , Pré-Eclâmpsia/etiologia , Hipertensão Induzida pela Gravidez/epidemiologia , Hipertensão Induzida pela Gravidez/etiologia , Primeiro Trimestre da Gravidez , Estudos Transversais , Exposição Ocupacional/efeitos adversosRESUMO
The need for prehospital hemostatic dressings that exert an antibacterial effect is of interest for prolonged field care. Here, we consider a series of antibacterial and zeolite formulary treatment approaches applied to a cotton-based dressing. The design of the fabric formulations was based on the hemostatic dressing TACGauze with zeolite Y incorporated as a procoagulant with calcium and pectin to facilitate fiber adherence utilizing silver nanoparticles, and cellulose-crosslinked ascorbic acid to confer antibacterial activity. Infra-red spectra were employed to characterize the chemical modifications on the dressings. Contact angle measurements were employed to document the surface hydrophobicity of the cotton fabric which plays a role in the contact activation of the coagulation cascade. Ammonium Y zeolite-treated dressings initiated fibrin equal to the accepted standard hemorrhage control dressing and showed similar improvement with antibacterial finishes. The antibacterial activity of cotton-based technology utilizing both citrate-linked ascorbate-cellulose conjugate analogs and silver nanoparticle-embedded cotton fibers was observed against Staphylococcus aureus and Klebsiella pneumoniae at a level of 99.99 percent in the AATCC 100 assay. The hydrogen peroxide levels of the ascorbic acid-based fabrics, measured over a time period from zero up to forty-eight hours, were in line with the antibacterial activities.
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Hemostáticos , Nanopartículas Metálicas , Zeolitas , Prata/farmacologia , Prata/química , Nanopartículas Metálicas/química , Zeolitas/farmacologia , Hemostáticos/farmacologia , Ácido Ascórbico/farmacologia , Antibacterianos/farmacologia , Antibacterianos/química , Fibra de Algodão , Bandagens , Celulose/químicaRESUMO
PURPOSE: To assess whether there were differences in knee specific function, health related quality of life (HRQoL), and satisfaction between patients with a cruciate retaining (CR) or a posterior stabilised (PS) total knee arthroplasty (TKA) at 1 and 2 years postoperatively. METHODS: A retrospective review of TKA (CR and PS) patients from a prospectively collected arthroplasty database. Patient demographics, body mass index and ASA grade, Oxford knee score (OKS) and EuroQol 5-dimension (EQ-5D) 3-level, which was used to assess HRQoL, were collected preoperatively and 1 year and 2 years postoperatively. Regression was used to adjust for confounding factors. RESULTS: The sample included 3122 TKA, of which 1009 (32.3%) were CR and 2112 (67.7%) were PS. The PS group were more likely to be female (odd ratio (OR) 1.26, p = 0.003) and undergo resurfacing of the patella (OR 6.63, p < 0.001). There was a significantly greater improvement in the 1 year OKS in the PS group (mean difference (MD) 0.9, p = 0.016). The PS TKA was independently associated with a greater 1 year (MD 1.1, 95% CI 0.4 to 1.9, p = 0.001) and 2 years (MD 0.8, p = 0.037) post-operative improvements in OKS. PS TKA was also independently associated with a greater 1 year (MD 0.021, p = 0.024) and 2 years (MD 0.022, p = 0.025) post-operative and change in EQ-5D utility compared to the CR group. The PS group was more likely to be satisfied with their outcome at 1 year (OR 1.75, p < 0.001) and at 2 years (OR 1.38, p = 0.001) when adjusting for confounders. CONCLUSION: PS TKA was associated with a better knee specific function and HRQoL when compared to CR, but the clinical significance of this is not clear. However, the PS group was more likely to be satisfied with their outcome compared to the CR group.
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Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Humanos , Feminino , Masculino , Artroplastia do Joelho/métodos , Qualidade de Vida , Osteoartrite do Joelho/cirurgia , Amplitude de Movimento Articular , Articulação do JoelhoRESUMO
Adjusting end-of-milking criteria, in particular applying a maximum milking time determined by expected milk yield at an individual milking session, is one strategy to optimize parlor efficiency. However, this strategy can be difficult to apply practically on farm due to large differences in session milk yield, driven by milking interval, which affects milking routines and can be limited by in-parlor technology. The objective of this study was to test the hypothesis that a single fixed milking time (duration) could be applied at all milking sessions without compromising milk production or udder health for a range of milking intervals. To test the hypothesis, 4 experimental herds were established: (1) herd milked twice a day (TAD) using a 10- and 14-h interval, (2) herd milked TAD using an 8- and 16-h interval, (3) herd milked 3 times in 2 d using a 10-19-19-h interval, and (4) herd milked once a day (OAD). Herds consisted of 40 cows each, and were established for two 6-wk experimental periods, one in peak lactation and the other in mid-late lactation. Within each herd, half the cows had an end-of-milking criterion of 0.35 kg/min (Flow), and the other half had milking ended after a fixed period of time (FixedT) based on the average milking session yield, the daily milk yield divided by average number of milkings per day, irrespective of milking interval. We found no differences in daily milk yield between end-of-milking criteria due to residual milk from one milking likely increasing the proportion of milk in the udder cistern at the next milking session for the FixedT treatment. However, fat yield was compromised when the percentage of the herd with a truncated milking exceeded an estimated 33% at a milking session, which occurred in the TAD 8-16 herd due to the divergence from the average milking interval (in the case of TAD, 12-12 h). Applying a fixed milking time had no detrimental effects on udder health, except in the OAD herd in mid-late lactation, which had both a higher cell count and new intramammary infection rate. This warrants further investigation, although the majority of cultured bacteria were coagulase-negative staphylococci (CNS). Consequently, we conclude that, in general, with appropriate monitoring (e.g., weekly inspection) to ensure the proportion of the herd with truncated milkings does not exceed 33%, farmers in pasture-based dairy systems can use a fixed milking time to improve parlor efficiency.
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Indústria de Laticínios , Leite , Animais , Bovinos , Contagem de Células/veterinária , Feminino , Lactação , Glândulas Mamárias AnimaisRESUMO
Milking 3 times in 2 d (3-in-2) could enhance the attractiveness of the dairy workplace relative to twice-a-day milking (TAD) by reducing labor requirements for milking and increasing workforce flexibility. The objective of this study was to quantify the farm system interactions associated with milking 3-in-2 at 3 stages of lactation, with the aim of providing guidance to pasture-based dairy farmers and advisors on the likely consequences of adopting 3-in-2 milking on farm productivity and business performance. Seventy-nine multiparous and 37 primiparous cows were randomly allocated to 4 experimental farms stocked at 3.5 cows/ha. One herd was milked TAD for the whole lactation (August 2019 to May 2020), with the remaining 3 milked 3-in-2 for either the whole lactation, after December 1 when cows were an average of 101 d in milk, or after March 1 when days in milk averaged 189 d. Milking intervals over 48 h were 10-14-10-14 h for TAD and 12-18-18 h for 3-in-2. Animal, pasture, and farm system data were analyzed by linear regression, with the dependent variable being the annualized value of the performance metric of interest, and the number of days in the lactation milked 3-in-2 as the independent variable. For the proportion of the season milked 3-in-2, there was a significant effect on milk (-11%), protein (-8%), and lactose (-12%) yield per cow per year, but no effect of fat. Additionally, there was a positive effect (+6%) on body condition score before dry-off and the energy required for liveweight change (+26%), and a negative effect on the energy required for walking (-30%). There were no differences in estimated feed eaten, or pasture herbage accumulation, composition, or quality. Therefore, pasture management and feed allocation under 3-in-2 should be similar to TAD. On commercial farms, the degree to which reduced milk income can be offset by lower costs will be highly farm-specific, but opportunities for savings were identified in the results. The short walking distances on the research farm and potential to improve farm management using the time saved from fewer milkings suggests better production may be achieved with 3-in-2 milking on a commercial farm.
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Indústria de Laticínios , Leite , Animais , Bovinos , Indústria de Laticínios/métodos , Fazendas , Feminino , Lactação , Lactose/metabolismo , Leite/metabolismoRESUMO
There is growing evidence that animal personality is linked to a range of productivity traits in farm animals, including dairy cattle. To date, the methodology for assessing personality traits of dairy cattle is time consuming and often requires a test arena, which limits the opportunity for commercial farms to use personality traits of dairy cattle for individualized management. This study investigated whether personality traits of pastured dairy cattle, scored in short behavioral tests, are associated with daily behavioral patterns and milk production. Cows (n = 87) were exposed twice to each of 5 behavioral tests, where their responses to novel or putatively stressful situations were scored on an ordinal scale for investigative and reactive behavior toward a novel object and a novel human after exiting the milking parlor, response to restraint in a crush, avoidance distance from an approaching human in the paddock, and response to milking (step-kick behavior). Most behavior test scores were consistent over the 2 test repeats (using repeatability estimates, Mann-Whitney U test of difference between repeats, and Spearman rank correlation). Behavior test scores were subjected to a principal components analysis that revealed intertest relationships in 3 factors of correlated sets of test scores, interpreted as personality traits (fearful of humans, calm-investigative, and reactive to milking). Regression analyses determined how these traits were associated with daily grazing, ruminating, and lying behaviors, and milk production (after controlling for cow age, breed, lactation status, group, and climate variables). Cows that were more fearful of humans (high avoidance distance, reactive toward the novel human) had reduced lying time compared with cows that scored low on this trait. Cows that were more calm (during restraint) and investigative (toward the novel object) had greater grazing time, which likely contributed to their greater milk production compared with cows that scored low on this trait. Cows that were more reactive to milking produced less milk than cows that scored low on this trait. These results indicate that individual differences in daily behavior patterns and milk production of dairy cattle are associated with personality traits of cows, measured using several short behavioral tests. These methods may be useful for characterizing grazing dairy cattle on commercial farms, which could aid in understanding individual behavior patterns and provide opportunities for individualized management.
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Indústria de Laticínios , Lactação , Animais , Comportamento Animal/fisiologia , Bovinos , Indústria de Laticínios/métodos , Fazendas , Feminino , Lactação/fisiologia , Leite , PersonalidadeRESUMO
BACKGROUND: There is an urgent need to address high levels of work-related violence (WRV) in Britain to improve the workplace experience of both employers and employees. AIMS: This study specifically explores prevalence rates of work-related violence assaults (WRVAs) for staff at high risk that have supervisor responsibilities and work full-time. METHODS: Five years of data were used for analysis from the Crime Survey of England and Wales (CSEW). Data were filtered for victims of crime from a working population in Britain. RESULTS: Forty-four per cent of respondents who are supervisors and have full-time jobs report that they had been victims of WRVAs. This figure is higher than other previous studies of WRV. CONCLUSIONS: The current study provides further alternative evidence to support high prevalence rates of WRV by selecting for analysis specific work characteristics data that are strongly associated with WRV (supervisor responsibilities and full-time work). It is therefore recommended that future work explores different means of intervention for organizations to implement within the workplace to reduce WRV and protect workers from harm.
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Vítimas de Crime , Violência no Trabalho , Crime , Inglaterra/epidemiologia , Humanos , Violência , País de Gales/epidemiologiaRESUMO
The global burden of the SARS-CoV-2 pandemic is thought to result from a high viral transmission rate. Here, we consider mechanisms that influence host cell-virus binding between the SARS-CoV-2 spike glycoprotein (SPG) and the human angiotensin-converting enzyme 2 (ACE2) with a series of peptides designed to mimic key ACE2 hot spots through adopting a helical conformation analogous to the N-terminal α1 helix of ACE2, the region experimentally shown to bind to the SARS-CoV-2 receptor-binding domain (RBD). The approach examines putative structure/function relations by assessing SPG binding affinity with surface plasmon resonance (SPR). A cyclic peptide (c[KFNHEAEDLFEKLM]) was characterized in an α-helical conformation with micromolar affinity (KD = 500 µM) to the SPG. Thus, stabilizing the helical structure of the 14-mer through cyclization improves binding to SPG by an order of magnitude. In addition, end-group peptide analog modifications and residue substitutions mediate SPG binding, with net charge playing an apparent role. Therefore, we surveyed reported viral variants, and a correlation of increased positive charge with increased virulence lends support to the hypothesis that charge is relevant to enhanced viral fusion. Overall, the structure/function relationship informs the importance of conformation and charge for virus-binding analog design.
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Enzima de Conversão de Angiotensina 2 , Glicoproteína da Espícula de Coronavírus , Enzima de Conversão de Angiotensina 2/metabolismo , Sítios de Ligação , COVID-19 , Humanos , Peptídeos/química , Ligação Proteica , Domínios Proteicos , SARS-CoV-2 , Glicoproteína da Espícula de Coronavírus/metabolismoRESUMO
BACKGROUND: Exclusive enteral nutrition (EEN) is a first-line treatment for Crohn's disease in paediatrics with similar efficiency to corticosteroids. Benefits in adults have not been consistently observed with non-adherence cited as a limiting factor. This study aimed to gain an in depth understanding of the adult patient experience with EEN, identifying challenges and enablers to inform clinicians in the development of strategies to help increase patient adherence. METHODS: This exploratory, qualitative study utilised individual semi-structured interviews with 17 adult patients who had completed EEN. Participants were purposively recruited across a range of ages, social backgrounds and clinical experience. Interviews were audio recorded, transcribed and independently thematically analysed by two researchers to provide consensus in identifying key themes. RESULTS: Three major themes were identified. (i) Personal experience of EEN evolved over time, with the first few weeks the most challenging, becoming easier as symptoms improved, and participants became used to the EEN regimen. (ii) Participants developed coping strategies to manage challenges, including the impact on meal-based social participation and dietary restriction and monotony. (iii) Enabling factors for adherence to EEN included patient self-efficacy, health system support, supplement characteristics and access, and social support. CONCLUSIONS: This study explored the evolving experiences of patients who completed a prescribed course of EEN. Patients described the challenges they faced, how they overcame them identifying enablers for adherence. This provides useful strategies for clinicians to integrate in their assessments and share with patients starting EEN.
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Doença de Crohn , Nutrição Enteral , Adulto , Criança , Doença de Crohn/terapia , Humanos , Cooperação do Paciente , Indução de Remissão , Apoio SocialRESUMO
One aspect of a successful dairy business is attracting and retaining skilled staff. The ability to do this is influenced by workplace attractiveness, one aspect of which is worker comfort and safety. Working with heavy machinery and animals makes dairy farming a dangerous occupation relative to many other sectors. Milking is the most time-consuming task on pasture-based dairy farms, and the parlor is the logical site of a number of injuries, although little is known about their causes or their relationship to parlor design and management. To investigate worker safety further, we conducted an on-farm survey on New Zealand dairy farms between December 2018 and March 2019. The survey had 3 objectives: to identify common causes of injuries relating to milking; to describe variations in milking parlor design and management practices on dairy farms; and to identify management and parlor factors that contribute to milking injuries. Analysis of accident compensation data from the state-run accident insurer for a 5-yr period from July 2013 to June 2018 was a fourth objective. Accident claims identified as related to milking through a key word search averaged NZ$252 (NZ$1 was equivalent to US$0.60 on May 19, 2020) per claim for non-severe injuries and NZ$9,334 per claim for severe injuries, for a total of NZ$1.95 million per year. A total of 136 injuries were reported on 99 of the 560 farms surveyed, and accident insurance claims were made for 53 of these injuries. The survey found that 48% of injuries occurred while workers were attaching clusters: typically soft-tissue and fracture injuries to fingers, hands, wrists, and arms. Injuries to these body parts represented the greatest cost (51% of the annual insurance cost) and identified safe cluster attachment as an area of focus for reducing milking injuries. Potential low-cost solutions include improved cluster design and a hand-arm guard. We identified a clear seasonal trend that coincided with busy periods in a seasonal block calving system, suggesting that options to reduce fatigue in spring may be beneficial; however, the number of hours worked or number of consecutive days worked were not associated with the number of milking injuries. Those aged 20-29 yr had more injuries relative to their proportion of the workforce, indicating that more training may be beneficial (e.g., setting ergonomic milking routines). Female workers were at greater risk of injury than males; this finding may have been related to the height of the animal relative to the height of the milker.
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Indústria de Laticínios , Fazendeiros , Saúde Ocupacional , Adolescente , Adulto , Animais , Indústria de Laticínios/métodos , Ergonomia , Fazendas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Leite , Nova Zelândia , Traumatismos Ocupacionais/etiologia , Traumatismos Ocupacionais/prevenção & controle , Fatores Sexuais , Inquéritos e Questionários , Recursos Humanos , Adulto JovemRESUMO
The use of precision technology is increasingly seen as an option to improve productivity, animal welfare, resource use efficiency, and workplace features on dairy farms. There is limited research related to longitudinal adoption patterns of precision dairy technologies and reasons for any patterns. The aim of this analysis was to investigate trends in technology adoption regarding both the amount (number of farms with a technology) and intensity (number of technologies per farm) of adoption. Surveys of parlor technology adoption were conducted on New Zealand dairy farms in 2008, 2013, and 2018, with 532, 500, and 500 respondents, respectively. Technologies were grouped into labor-saving (LS, such as automatic cluster removers) or data-capture (DC, such as in-line milk meters) categories. Trends were examined for farms that had only LS, only DC, or LS+DC technologies. Technology adoption increased over time; the likelihood of technology adoption in 2018 (and 2013 in parentheses) increased by 21 (22), 7 (68), and 378% (165) for LS, DC, and LS+DC technology groups, respectively, compared to 2008. Farms with LS+DC technologies also had a greater proportion of LS technologies compared to non-LS+DC farms, although this relationship declined over the 10-yr period. The use of a rotary versus herringbone parlor was estimated to be associated with 356 and 470% increase in the likelihood of adopting LS technologies and LS+DC, respectively, from 2008 to 2018. Regional differences in adoption were also found, with the likelihood of adopting DC and LS+DC technologies found to be 46 and 59% greater, respectively, in the South Island of New Zealand, compared to the base region of Waikato. The results highlight the importance of understanding spatial and temporal farm characteristics when considering future effect and adoption of precision dairy technologies. For example, the analysis indicates the occurrence of 2 trajectories to technology investment on farms, where larger farms are able to take advantage of technology opportunities, but smaller farms may be constrained by factors such as lack of economies of scale, limited capital to invest, and inability to retrofit technology into aging parlor infrastructure.
Assuntos
Indústria de Laticínios/métodos , Bem-Estar do Animal , Animais , Bovinos , Indústria de Laticínios/estatística & dados numéricos , Indústria de Laticínios/tendências , Fazendeiros , Fazendas , Humanos , Investimentos em Saúde , Leite , Nova Zelândia , TecnologiaRESUMO
Among the most economically relevant and environmentally devastating diseases globally are those caused by Phytophthora species. In Australia, production losses in agriculture and forestry result from several well-known cosmopolitan Phytophthora species and infestation of natural ecosystems by Phytophthora cinnamomi have caused irretrievable loss to biodiversity especially in proteaceous dominated heathlands. For this review, all available records of Phytophthora in Australia were collated and curated, resulting in a database of 7 869 records, of which 2 957 have associated molecular data. Australian databases hold records for 99 species, of which 20 are undescribed. Eight species have no records linked to molecular data, and their presence in Australia is considered doubtful. The 99 species reside in 10 of the 12 clades recognised within the complete phylogeny of Phytophthora. The review includes discussion on each of these species' status and additional information provided for another 29 species of concern. The first species reported in Australia in 1900 was Phytophthora infestans. By 2000, 27 species were known, predominantly from agriculture. The significant increase in species reported in the subsequent 20 years has coincided with extensive surveys in natural ecosystems coupled with molecular taxonomy and the recognition of numerous new phylogenetically distinct but morphologically similar species. Routine and targeted surveys within Australian natural ecosystems have resulted in the description of 27 species since 2009. Due to the new species descriptions over the last 20 years, many older records have been reclassified based on molecular identification. The distribution of records is skewed toward regions with considerable activity in high productivity agriculture, horticulture and forestry, and native vegetation at risk from P. cinnamomi. Native and exotic hosts of different Phytophthora species are found throughout the phylogeny; however, species from clades 1, 7 and 8 are more likely to be associated with exotic hosts. One of the most difficult challenges to overcome when establishing a pest status is a lack of reliable data on the current state of a species in any given country or location. The database compiled here for Australia and the information provided for each species overcomes this challenge. This review will aid federal and state governments in risk assessments and trade negotiations by providing a comprehensive resource on the current status of Phytophthora species in Australia. Citation: Burgess TI, Edwards J, Drenth A, et al. 2021. Current status of Phytophthora in Australia. Persoonia 47: 151-177. https://doi.org/10.3767/persoonia.2021.47.05.
RESUMO
Among the most economically relevant and environmentally devastating diseases globally are those caused by Phytophthora species. In Australia, production losses in agriculture and forestry result from several well-known cosmopolitan Phytophthora species and infestation of natural ecosystems by Phytophthora cinnamomi have caused irretrievable loss to biodiversity especially in proteaceous dominated heathlands. For this review, all available records of Phytophthora in Australia were collated and curated, resulting in a database of 7 869 records, of which 2 957 have associated molecular data. Australian databases hold records for 99 species, of which 20 are undescribed. Eight species have no records linked to molecular data, and their presence in Australia is considered doubtful. The 99 species reside in 10 of the 12 clades recognised within the complete phylogeny of Phytophthora. The review includes discussion on each of these species' status and additional information provided for another 29 species of concern. The first species reported in Australia in 1900 was Phytophthora infestans. By 2000, 27 species were known, predominantly from agriculture. The significant increase in species reported in the subsequent 20 years has coincided with extensive surveys in natural ecosystems coupled with molecular taxonomy and the recognition of numerous new phylogenetically distinct but morphologically similar species. Routine and targeted surveys within Australian natural ecosystems have resulted in the description of 27 species since 2009. Due to the new species descriptions over the last 20 years, many older records have been reclassified based on molecular identification. The distribution of records is skewed toward regions with considerable activity in high productivity agriculture, horticulture and forestry, and native vegetation at risk from P. cinnamomi. Native and exotic hosts of different Phytophthora species are found throughout the phylogeny; however, species from clades 1, 7 and 8 are more likely to be associated with exotic hosts. One of the most difficult challenges to overcome when establishing a pest status is a lack of reliable data on the current state of a species in any given country or location. The database compiled here for Australia and the information provided for each species overcomes this challenge. This review will aid federal and state governments in risk assessments and trade negotiations by providing a comprehensive resource on the current status of Phytophthora species in Australia. Citation: Burgess TI, Edwards J, Drenth A, et al. 2021. Current status of Phytophthora in Australia. Persoonia 47: 151-177. https://doi.org/10.3767/persoonia.2021.47.05.