Congruence between nuclear and mitochondrial genes in Demospongiae: a new hypothesis for relationships within the G4 clade (Porifera: Demospongiae).

The current morphological classification of the Demospongiae G4 clade was tested using large subunit ribosomal RNA (LSU rRNA) sequences from 119 taxa. Fifty-three mitochondrial cytochrome oxidase 1 (CO1) barcoding sequences were also analysed to test whether the 28S phylogeny could be recovered using an independent gene. This is the largest and most comprehensive study of the Demospongiae G4 clade. The 28S and CO1 genetrees result in congruent clades but conflict with the current morphological classification. The results confirm the polyphyly of Halichondrida, Hadromerida, Dictyonellidae, Axinellidae and Poecilosclerida and show that several of the characters used in morphological classifications are homoplasious. Robust clades are clearly shown and a new hypothesis for relationships of taxa allocated to G4 is proposed.

Evaluating an intervention to reduce lameness in dairy cattle.

Lameness in dairy cattle remains a significant welfare concern for the UK dairy industry. Farms were recruited into a 3-yr study evaluating novel intervention approaches designed to encourage farmers to implement husbandry changes targeted toward reducing lameness. All farms completing the study were visited at least annually and received either monitoring only (MO, n=72) or monitoring and additional support (MS, n = 117) from the research team. The additional support included traditional technical advice on farm-specific solutions, facilitation techniques to encourage farmer participation, and application of social marketing principles to promote implementation of change. Lameness prevalence was lower in the MO (27.0 ± 1.94 SEM) and MS (21.4 ± 1.28) farms at the final visit compared with the same MO (38.9 ± 2.06) and MS (33.3 ± 1.76) farms on the initial visit. After accounting for initial lameness, intervention group status, and year of visit within a multilevel model, we observed an interaction between year and provision of support, with the reduction in lameness over time being greater in the MS group compared with the MO group. Farms in the MS group made a greater number of changes to their husbandry practices over the duration of the project (8.2 ± 0.39) compared with those farms in the MO group (6.5 ± 0.54). Because the lameness prevalence was lower in the MS group than the MO group at the start of the study, the contribution of the additional support was difficult to define. Lameness can be reduced on UK dairy farms although further work is needed to identify the optimum approaches.

A study of the relationship between process conditions and mechanical strength of mineralized red algae in the preparation of a marine-derived bone void filler.

Bone void fillers that can enhance biological function to augment skeletal repair have significant therapeutic potential in bone replacement surgery. This work focuses on the development of a unique microporous (0.5-10 microm) marine-derived calcium phosphate bioceramic granule. It was prepared from Corallina officinalis, a mineralized red alga, using a novel manufacturing process. This involved thermal processing, followed by a low pressure-temperature chemical synthesis reaction. The study found that the ability to maintain the unique algal morphology was dependent on the thermal processing conditions. This study investigates the effect of thermal heat treatment on the physiochemical properties of the alga. Thermogravimetric analysis was used to monitor its thermal decomposition. The resultant thermograms indicated the presence of a residual organic phase at temperatures below 500 degrees C and an irreversible solid-state phase transition from mg-rich-calcite to calcium oxide at temperatures over 850 degrees C. Algae and synthetic calcite were evaluated following heat treatment in an air-circulating furnace at temperatures ranging from 400 to 800 degrees C. The highest levels of mass loss occurred between 400-500 degrees C and 700-800 degrees C, which were attributed to the organic and carbonate decomposition respectively. The changes in mechanical strength were quantified using a simple mechanical test, which measured the bulk compressive strength of the algae. The mechanical test used may provide a useful evaluation of the compressive properties of similar bone void fillers that are in granular form. The study concluded that soak temperatures in the range of 600 to 700 degrees C provided the optimum physiochemical properties as a precursor to conversion to hydroxyapatite (HA). At these temperatures, a partial phase transition to calcium oxide occurred and the original skeletal morphology of the alga remained intact.

Thermal preparation of highly porous calcium phosphate bone filler derived from marine algae.

A sustainable marine-derived bioceramic with a unique porous structure has been developed for hard tissue repair. The conversion of alga was achieved through a novel technique, involving well controlled thermal processing followed by low pressure-temperature hydrothermal synthesis. In its preparation, a heat treatment step was required to remove the organic compounds from the algae, which reinforces the mineralised matrices. Its removal is necessary to prevent issue such as immune biocompatibility and ensure phase purity of the resultant biomaterial. This paper investigates the hydrothermal technique used for the transformation of mineralised red algae to hydroxyapatite that preserves the algae's unique structure. It specifically focuses on the effects of heat treatment on the morphology of the algae, TGA, SEM and hot stage XRD to quantity the changes.

Towards a philosophy of continuing professional education in nursing, midwifery and health visiting.

This paper outlines a justification for developing and articulating a belief system which encompasses continuing professional education and the theory and practice of nursing. It describes the nature and rationale for such a belief system, distinguishing it from the pursuit of an absolute or philosophy. Nevertheless, it is suggested that such a belief system owes and contributes much to both a philosophy of education and of nursing.

Mentorship in nursing and midwifery education: issues for research.

Despite an apparent concensus that mentorship is an important aspect of learning in the practice continuum, there has been no real critical appraisal of the literature for its research base. References to published work on mentorship may merely uncritically repeat non-researched statements which, in turn, may not always be relevant to nursing and midwifery education in the UK. This paper sets out to begin to construct a research agenda for mentorship, free of statutory and regulatory constraints about meaning and practice.

Decision-making in clinical practice: how do expert nurses, midwives and health visitors make decisions?

Decision-making is an essential and integral aspect of clinical practice. Preparation for clinical decision-making is haphazard and unplanned, in part because the process of making clinical decisions is not fully understood. This is one study of how expert nurses, midwives and health visitors make clinical decisions. The project involved a literature review and a series of workshops with expert practitioners to uncover the decision-making process in clinical practice. The study found that decision-making is an essential attribute of the expert practitioner, must be based on sound knowledge, may involve risk-taking and can only flourish in a supportive environment. Most importantly, clinical decision-making must take place within the context of a philosophy of care. Without such a philosophy, decisions will be arbitrary, uninformed and probably unsafe.

Informed opinion: an exercise in gathering the opinions of experts to facilitate the planning of continuing professional education.

In 1989 The English National Board for Nursing Midwifery and Health Visiting reviewed the organisation and provision of continuing professional education in order to identify a new structure which would meet most effectively the changing health care needs of clients and patients. Researchers were engaged in conducting a series of projects looking at key areas of concern in continuing professional education. During the research concern was expressed about levels of practice and preparation for practice. Respondents suggested that practitioners make highly complex decisions for which there is no apparent continuing education preparation. The research director decided that this issue should be explored further by selected individuals from the research team. This paper describes one of the approaches used to explore this area. Using the work of Benner (1984) as a framework for debate during three 1-day workshops, a panel of experts in nursing education and practice explored skill acquisition and attainment of expert clinical practice and considered these in relation to potential continuing educational development strategies for nursing, midwifery and health visiting. The conclusions drawn from this exercise were then 'fed' back to the research team. This paper examines the process of utilising experts in facilitating planning.

The patient's view: the benefits and limitations of nurse prescribing.

This study was undertaken in a primary care group to explore nurse prescribing from the patient/client's viewpoint. All prescribing health visitors, district nurses and practice nurses were asked to recruit five patients for whom they had prescribed; 50 patients/clients participated in the study. Identified benefits of nurse prescribing included a more effective use of the nurse's and doctor's time; a quality relationship between the nurse and patient; nurses' awareness of their own professional limitations; their expertise in certain types of care; and their providing timely, convenient, practical and successful treatment. Limitations and the proposed options for change included the training and competency of nurse prescribers and the limitations of the Nurse Prescribers' Formulary. On a local level the study informs nurse prescribers that they are currently meeting the needs of the majority of recipients, and provides evidence of some of the benefits and limitations of nurse prescribing.

Nurse prescribing: what do patients think?

AIM: To explore nurse prescribing from the patient's viewpoint. METHOD: This study was undertaken in one primary care group in Leicestershire. All prescribing health visitors (n = 17), district nurses (n = 9) and practice nurses (n = 1) were asked to recruit five patients for whom they had prescribed. Fifty patients took part in a telephone or face-to-face interview. Participants were predominantly low or new users of nurse prescribing, while the nurse prescribers were experienced. RESULTS: Participants identified that nurse prescribers had key skills in assessment, observation, diagnosing and providing information. Nurse prescribing was accepted by all participants as a practical and responsive method of service delivery. Gains identified were better use of the nurse's and doctor's time, convenience, a quality relationship with the nurse and expertise of the nurse. Disadvantages identified included the limitations of the Nurse Prescribers' Formulary and the training and competence of nurse prescribers. CONCLUSION: This study helps affirm that nurse prescribers meet the needs of patients, with positive experiences in terms of the process and outcomes. Future developments suggested by participants appear to reflect government concerns. Such changes include the need to develop and maintain competence to uphold public safety and for the formulary to be expanded. To ensure that the NHS workforce is used more effectively, participants agreed with providing patient-centred services and the renegotiation of traditional roles.

Reducing lameness in dairy herds--overcoming some barriers.

Incomplete detection, high tolerance of lameness, and shortage of time and labour have been identified as barriers to reducing lameness in dairy herds. The effects of farmer participation in a project aimed at reducing lameness in dairy cattle on these factors were investigated. Over the course of the project farmers' detection of lameness improved and tolerance decreased. On farms entering the study with lameness prevalence below the median of 35%, improved detection was correlated with a reduction in lameness prevalence, but this was not the case for farms entering above the median prevalence. Lowered tolerance of lameness was correlated with reduced lameness regardless of initial prevalence. A greater importance given to lack of time as an initial barrier to progress was correlated with a greater reduction in lameness over the course of the project, suggesting that farmers who recognised limited time as a barrier were able to overcome this to some extent.

Designs from the deep: marine organisms for bone tissue engineering.

Current strategies for bone repair have accepted limitations and the search for synthetic graft materials or for scaffolds that will support ex vivo bone tissue engineering continues. Biomimetic strategies have led to the investigation of naturally occurring porous structures as templates for bone growth. The marine environment is rich in mineralizing organisms with porous structures, some of which are currently being used as bone graft materials and others that are in early stages of development. This review describes the current evidence available for these organisms, considers the relative promise of each and suggests potential future directions.

Working towards a reduction in cattle lameness: 2. Understanding dairy farmers' motivations.

Reducing lameness in dairy herds requires farmers to adapt or change existing practices or resources. Those who seek to improve animal welfare by influencing the actions of farmers need to understand farmers' motivations. To investigate why farmers see lameness as a problem and what motivates their efforts to reduce lameness, a questionnaire was carried out with 222 UK dairy farmers. Farmers considered pain and suffering for the cows to be an important outcome of lameness, but reduced performance by lame cows was also seen as a considerable problem. The motivator most commonly given high importance was pride in a healthy herd. Factors incorporating accreditation issues, public image and costs of treatment were generally seen to be of some, but lesser importance. Advisors need to take all these areas into consideration when working to encourage farmers to act to reduce lameness and thereby improve animal welfare.

Working towards a reduction in cattle lameness: 1. Understanding barriers to lameness control on dairy farms.

On 222 dairy farms, the farmer's perception of the scale of the herd lameness problem was compared with the prevalence detected by observation of the milking herd, and a questionnaire explored the barriers to lameness reduction. Ninety percent of farmers did not perceive lameness to be a major problem on their farm, although the average prevalence of lameness was 36%. For 62% of the sample, lameness was not the top priority for efforts made to improve herd health. Time and labour were important limiting factors for lameness control activities and financial constraints prevented farmers taking action on advice in 30% of cases. Farmers' understanding the implications of lameness for the farm business was limited. Lameness reduction is restricted by farmers' perception of lameness, but also by time, labour and finance; these issues need to be addressed at the industry level to support animal welfare improvement.