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The Rapid ASKAP Continuum Survey (RACS) is the first large-area survey to be conducted with the full 36-antenna Australian Square Kilometre Array Pathfinder (ASKAP) telescope. RACS will provide a shallow model of the ASKAP sky that will aid the calibration of future deep ASKAP surveys. RACS will cover the whole sky visible from the ASKAP site in Western Australia and will cover the full ASKAP band of 700–1800 MHz. The RACS images are generally deeper than the existing NRAO VLA Sky Survey and Sydney University Molonglo Sky Survey radio surveys and have better spatial resolution. All RACS survey products will be public, including radio images (with
15 arcsec resolution) and catalogues of about three million source components with spectral index and polarisation information. In this paper, we present a description of the RACS survey and the first data release of 903 images covering the sky south of declination
made over a 288-MHz band centred at 887.5 MHz.
Agricultural intensification within forage systems has reduced grassland floral diversity by promoting ryegrass (Lolium spp.), damaging soil functionality which underpins critical ecosystem services. Diverse forage mixtures may enhance environmental benefits of pastures by decreasing nutrient leaching, increasing soil carbon storage, and with legume inclusion, reduce nitrogen fertilizer input. This UK study reports on how species-rich forage mixtures affect soil carbon, phosphorus, and nitrogen at dry, medium and wet soil moisture sites, compared to ryegrass monoculture. Increasing forage mixture diversity (from 1 to 17 species) affected soil carbon at the dry site. No effect of forage mixture on soil phosphorus was found, while forage mixture and site did interact to affect soil nitrate/nitrite availability. Results suggest that forage mixtures could be used to improve soil function, but longer-term studies are needed to conclusively demonstrate environmental and production benefits of high-diversity forages.
Post-tonsillectomy bleeding is the most frequent complication of tonsillectomy. Inherited platelet function disorders have an estimated prevalence of 1 per cent. Any association between post-tonsillectomy bleeds and undiagnosed inherited platelet function disorders has not been investigated before.
To assess the prevalence of inherited platelet function disorders in a cohort of post-tonsillectomy bleed patients.
An observational cohort study was conducted using hospital digital records. Platelet function analyser 100 (‘PFA-100’) closure time was tested on post-tonsillectomy bleed patients who presented to hospital.
Between 2013 and 2017, 9 of 91 post-tonsillectomy bleed patients who underwent platelet function analyser 100 testing (9.89 per cent) had positive results. Five patients (5.49 per cent) had undiagnosed inherited platelet function disorders. Four patients had false positive results secondary to a non-steroidal anti-inflammatory drug effect (specificity of 95.3 per cent) proven by repeat testing six weeks later, off medication. The false negative rate was 0 per cent.
The prevalence of inherited platelet function disorders in our post-tonsillectomy bleed cohort is five-fold higher than in the general population. Platelet function analyser 100 testing when patients present with a post-tonsillectomy bleed allows management of their inherited platelet function disorder.
Assessment of individuals at risk for falling entails comprehensive neurological and vestibular examinations. Chronic limitation in cervical mobility reduces gaze accuracy, potentially impairing navigation through complex visual environments. Additionally, humans with scoliosis have altered otolithic vestibular responses, causing imbalance. We sought to determine whether dynamic cervical mobility restrictions or static cervicothoracic impairments are also fall risk factors.
We examined 435 patients referred for soft-tissue musculoskeletal complaints; 376 met criteria for inclusion (mean age 52; 266 women). Patients were divided into nonfallers, single fallers, and multiple fallers, less or greater than 65 years old. Subject characteristics, dynamic cervical rotations, and static cervicothoracic axial measurements were compared between groups. Fear of falling was evaluated using the Falls Efficacy Scale-International questionnaire.
Long-standing cervicothoracic pain and stiffness conferred increased risk of falling. Neck rotation amplitudes decreased with longer duration musculoskeletal symptoms and were significantly more restricted in fallers, doubling the risk of falling and contributing to increased fear of falling. Mid-thoracic scoliosis amplitudes increased over time, but static axial abnormalities were not greater among fallers, although thoracic kyphoscoliosis heightened fear of falling.
In patients at fall risk, thoracic kyphoscoliosis and dynamic neck movements should be assessed, in addition to standard vestibular and neurological evaluations. Additionally, patients with soft tissue cervicothoracic pain and restricted mobility have increased fall frequency and fear of falling, independent of other fall risk factors and should undergo complete fall risk appraisal.
Having been tasked with developing Standards for integrated care pathways for mental health (ICP), successfully publishing in 2007, NHS Quality Improvement Scotland (NHS QIS) now supports NHS Boards in developing and implementing these standards. Support is available via three National ICP Coordinators and local ICP facilitators.
The main objective is for Boards to achieve ICP accreditation, resulting in demonstration of a robust and responsive mental health system through implementation of their local ICPs supporting continuous cycles of quality improvement embedded in a culture that ensures delivery of person-centred care and reflective practice.
A model of and process for accreditation was developed considering: § Developing the project plan§ Reaching consensus on the goal of the accreditation initiative.§ Defining incentives for stakeholders in having ICPs accredited § Reviewing literature on existing accreditation systems in UK and internationally § Developing a range of options§ Carrying out an option appraisal§ Agreeing one preferred option § Obtaining NHS QIS and Scottish Government approval for preferred option§ Further development of support mechanisms and implementation of a longer term accreditation framework
A phased and incremental accreditation system was developed.
The first phase - “foundation level” - focuses on ensuring that appropriate infrastructures are in place to support full ICP development and implementation in NHS Board.
All 14 NHS Boards in Scotland achieved foundation level accreditation.
Reflection on this first phase are helping to inform NHS QIS on how best to structure future levels of accreditation and ongoing support over the next few years.
Following the National Review of Mental Health Nursing in Scotland (2006), an action plan was developed to improve recovery focused mental health services. It was advocated that a method of sharing evidence based, positive and innovative practice in mental health be created. NHS Quality Improvement Scotland supported by the Scottish Government, was tasked to develop the database and successfully launched the PIRAMHIDS resource in September 2008, now providing the platform to share information at local, national and international levels.
PIRAMHIDS ensures equitable opportunity to share examples of practice from statutory, non statutory services and the voluntary sector. Contribution to the database is made easy by an intuitive online submission process. A quality assurance process is then followed in achieving publication approval. Submissions are passed to an external review body. External reviewers consist of professionals from a range of disciplines including Psychiatry, Mental Health Nursing, Occupational Therapy, Higher Education, service improvement, etc. The selected reviewers consider the submission in context of the publication criteria which includes:
Detail of practice deliverable
Evidence base-current/existing or potential to inform evidence
Challenges and resolves
Quality assurance considerations and impact assessment on the patient experience
PIRAMHIDS is the resource to share your practice. In addition there is an online forum encouraging networking, up to date mental health information feeds and direct links to other useful resources such as Integrated Care Pathways for mental health toolkit. Now accessed by thousands world wide, take the credit and share your care.
PIRAMHIDS is a multidisciplinary, multi agency database designed as a vehicle to promote and support the sharing of positive and innovative practice in mental health that is evidence based and quality assured. The use of technology as an information-sharing tool contributes to improved patient care by promoting an improved equitable service throughout Scotland and beyond.
The resource promotes a culture of local ownership of a national resource and encourages contribution from statutory and non statutory services. Consideration is given to the quality of submission in terms of identifying underpinning evidence and quality assurance processes. Networking opportunities are also promoted by encouraging contact with contributors from those considering adopting the examples of practice or developing services.
The Practice Development Unit of NHS Quality Improvement Scotland is leading this work following recommendation from the National Review of Mental Health Nursing in Scotland, ‘Rights, Relationships and Recovery’ (2006). The database ensures sharing of evidence based practice in a manner which is useful, accessible and user friendly with open access to all. Initial response is enthusiastic from service users, clinicians and educators. This model of sharing practice may be adopted across any national service and have value when sharing practice on an international plane. A process of evaluation including impact on care outcomes is considered and ongoing.
Given the common view that pre-exercise nutrition/breakfast is important for performance, the present study investigated whether breakfast influences resistance exercise performance via a physiological or psychological effect. Twenty-two resistance-trained, breakfast-consuming men completed three experimental trials, consuming water-only (WAT), or semi-solid breakfasts containing 0 g/kg (PLA) or 1·5 g/kg (CHO) maltodextrin. PLA and CHO meals contained xanthan gum and low-energy flavouring (approximately 122 kJ), and subjects were told both ‘contained energy’. At 2 h post-meal, subjects completed four sets of back squat and bench press to failure at 90 % ten repetition maximum. Blood samples were taken pre-meal, 45 min and 105 min post-meal to measure serum/plasma glucose, insulin, ghrelin, glucagon-like peptide-1 and peptide tyrosine-tyrosine concentrations. Subjective hunger/fullness was also measured. Total back squat repetitions were greater in CHO (44 (sd 10) repetitions) and PLA (43 (sd 10) repetitions) than WAT (38 (sd 10) repetitions; P < 0·001). Total bench press repetitions were similar between trials (WAT 37 (sd 7) repetitions; CHO 39 (sd 7) repetitions; PLA 38 (sd 7) repetitions; P = 0·130). Performance was similar between CHO and PLA trials. Hunger was suppressed and fullness increased similarly in PLA and CHO, relative to WAT (P < 0·001). During CHO, plasma glucose was elevated at 45 min (P < 0·05), whilst serum insulin was elevated (P < 0·05) and plasma ghrelin suppressed at 45 and 105 min (P < 0·05). These results suggest that breakfast/pre-exercise nutrition enhances resistance exercise performance via a psychological effect, although a potential mediating role of hunger cannot be discounted.
Sub-acute ruminal acidosis (SARA) can reduce the production efficiency and impair the welfare of cattle, potentially in all production systems. The aim of this study was to characterise measurable postmortem observations from divergently managed intensive beef finishing farms with high rates of concentrate feeding. At the time of slaughter, we obtained samples from 19 to 20 animals on each of 6 beef finishing units (119 animals in total) with diverse feeding practices, which had been subjectively classified as being high risk (three farms) or low risk (three farms) for SARA on the basis of the proportions of barley, silage and straw in the ration. We measured the concentrations of histamine, lipopolysaccharide (LPS), lactate and other short-chain fatty acids (SCFAs) in ruminal fluid, LPS and SCFA in caecal fluid. We also took samples of the ventral blind sac of the rumen for histopathology, immunohistopathology and gene expression. Subjective assessments were made of the presence of lesions on the ruminal wall, the colour of the lining of the ruminal wall and the shape of the ruminal papillae. Almost all variables differed significantly and substantially among farms. Very few pathological changes were detected in any of the rumens examined. The animals on the high-risk diets had lower concentrations of SCFA and higher concentrations of lactate and LPS in the ruminal fluid. Higher LPS concentrations were found in the caecum than the rumen but were not related to the risk status of the farm. The diameters of the stratum granulosum, stratum corneum and of the vasculature of the papillae, and the expression of the gene TLR4 in the ruminal epithelium were all increased on the high-risk farms. The expression of IFN-γ and IL-1β and the counts of cluster of differentiation 3 positive and major histocompatibility complex class two positive cells were lower on the high-risk farms. High among-farm variation and the unbalanced design inherent in this type of study in the field prevented confident assignment of variation in the dependent variables to individual dietary components; however, the CP percentage of the total mixed ration DM was the factor that was most consistently associated with the variables of interest. Despite the strong effect of farm on the measured variables, there was wide inter-animal variation.
This volume endeavors to explain the most important developments in philosophy since the end of the Second World War. Yet even when we restrict our focus primarily to those insights and movements that most profoundly shaped the English-speaking philosophical world (as we reluctantly found it necessary to do), it still remains the case that no one – and no one volume (not even a volume like ours, filled with more than fifty chapters from a diverse range of leading philosophers) – can tell this whole story. This is not only because there is no one single overarching story to tell, but also because the overlapping and sometimes conflicting stories that together constitute this complex history are still being written – here in this book, for example. Two of the reasons for the history of philosophy’s necessary incompleteness came to the fore of (what we risk calling) the general self-understanding of Western philosophy during this historical period. These interconnected philosophical reasons (or self-realizations) merit emphasis here, especially because they remain subtle undercurrents throughout the book.