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This research addresses dementia and driving cessation, a major life event for affected individuals, and an immense challenge in primary care. In Australia, as with many other countries, it is primarily general practitioners (GPs) who identify changes in cognitive functioning and monitor driving issues with their patients with dementia. Qualitative evidence from studies with family members and other health professionals shows it is a complicated area of practice. However we still know little from GPs about how they manage the challenges with their patients and the strategies that they use to facilitate driving cessation.
Data were collected through five focus groups with 29 GPs at their primary care practices in metropolitan and regional Queensland, Australia. A semi-structured topic guide was used to direct questions addressing decision factors and management strategies. Discussions were audio recorded, transcribed verbatim and thematically analyzed.
Regarding the challenges of raising driving cessation, four key themes emerged. These included: (i) Considering the individual; (ii) GP-patient relationships may hinder or help; (iii) Resources to support raising driver retirement; and (iv) Ethical dilemmas and ethical considerations. The impact of discussing driving cessation on GPs is discussed.
The findings of this study contribute to further understanding the experiences and needs of primary care physicians related to managing driving retirement with their patients with dementia. Results support a need for programs regarding identification and assessment of fitness to drive, to upskill health professionals and particularly GPs to manage the complex issues around dementia and driving cessation, and explore cost-effective and timely delivery of such support to patients.
To examine similarities and differences in the demographic and clinical profiles of young people (15–25 years of age) referred between the mental health services (MHS) and Jigsaw Galway.
A retrospective chart review was conducted of clinical files of individuals attending secondary MHS who had been referred to or from Jigsaw Galway over a 5-year period. Differences in demographic and clinical data between individuals referred to or from Jigsaw Galway were compared.
A recent act of self-harm was more prevalent in individuals referred from Jigsaw to the adult MHS (p=0.02). No other demographic or clinical differences were detected between individuals attending Jigsaw Galway and the MHS.
Education sessions for clinical staff working in primary care, Jigsaw Galway and the MHS are suggested to support clinicians in choosing the best referral pathway, which may more optimally address young people’s mental health difficulties.
Introduction: The diagnosis of Salter-Harris Type 1 fractures in the Emergency Department (ED) is primarily clinical, as radiographs are usually unrevealing. We hypothesize that bilateral asymmetry of the growth plate, detected using bedside ultrasound (US), could improve the accuracy of this diagnosis in the ED. This study seeks to determine growth plate size according to age, and to establish normal variation in bilateral symmetry of growth plate cartilage, for the ulna, radius, tibia, and fibula, using bedside US in normal healthy children. Methods: This prospective observational study was conducted in a convenience sample of children ages 0-17 during planned visits to an elementary school, high school, and an outpatient pediatric clinic. A sample size of 177 was determined with a linear regression model using previously published data on the subject. The study was approved by the hospital and universitys ethics board. After a medical questionnaire with a research nurse, the participants underwent ultrasound evaluation of bilateral ulnae, radii, fibulae, and tibiae, to obtain still images of the physes from two orthogonal views. The evaluations were performed by 3 medical residents, 1 medical student, and by the supervising emergency physician. All ultrasonographers were EDE1 certified and specifically trained for growth plate imagery. The still images were evaluated ulteriorly and measurements taken of the physeal cartilage. Ten percent of the patients had their images re-evaluated by the supervising physician to determine inter-rater reliability. Results: A total of 227 patients were recruited. The median age was 8 years old with an interquartile range of (3;14). Mean growth plate size by age was determined, confirming decreasing growth plate size with advancing age for all articulations. The percentage of absolute difference between right and left, for all growth plates together, was a mean of 17% with a 95% CI of 16-19%. The overall inter-rater reliability was excellent at 0.84. Conclusion: This study establishes a reproducible technique of measuring growth plates with ultrasound. We suspect that increased asymmetry at the growth plate, beyond this established normal variation, may signify a physis widening or hematoma consistent with a Salter-Harris Type 1 fracture; this will be evaluated in a second study.
With the ban on the use of mammalian protein in the EU and the implementation of restrictive use of fishmeal in animal diets coupled with the increased legislative pressures to reduce nitrogen output from animal production, there is an increased requirement for an alternative protein source, which is lower in overall crude protein percentage while still meeting the animal’s optimum amino acid requirement. Natupro is an alternative nutritionally enhanced GMO free vegetable protein, which carefully matches all of the above criteria, as it is low in crude protein (36%) with a controlled release of amino acid mechanism (Natupro amino acid analysis Table 2). Glucosamine is the inspiration behind Natupro, the combination of sugars and amine moites gave rise to the concept of a sugar carrier, which is the mechanism Natupro uses for the consistent controlled release of amino acids over time. The objective of this current experiment is to access the effect of inclusion of Natupro in the grower pigs diet on nitrogen retention, utilisation, excretion and digestibility.
Oil supplementation of by-product based diets is a common method of increasing the energy content of pig diets to levels equivalent to those of cereal-based diets (Overland et al 1999). However, by-product based diets supplemented with oil have been reported to reduce feed intake and digestible energy intake when compared with cereal-based diets (Magowan et al 2004). It is not known whether this effect occurs as a result of the higher levels of fibre in by-product-based diets or as a result of a reduction in palatability arising from the inclusion of oil in the pellet. The aim of this experiment was to investigate the effect of method of vegetable oil blend application (either incorporated directly into the pellet (IN), or sprayed on after pelleting (SP)) on the performance and carcass characteristics of commercially housed finishing pigs.
By-product-based diets generally contain lower levels of energy than cereal-based diets due to higher levels of fibre (Bakker et al., 1995). Supplementation with oil is a common method of improving the digestible energy content of by-product-based diets and it has been reported that this practice may also improve energy digestibility. However, the results of McCann et al., (2004) suggested that the method of oil application to finishing pig diets may affect the digestibility of dietary nutrients. The aim of this experiment was to compare apparent digestibility coefficients determined in finishing pigs offered either by-product based diets or cereal-based diets, with and without vegetable oil blend supplementation applied using two different methods (either directly incorporated into the pellet (IN) or sprayed (SP) on after pelleting).
Large variations in weight within groups of pigs at slaughter lead to either (1) inefficient use of resources as some pigs have to be retained for longer periods in finishing accommodation than others, or (2) large variation in carcass weights, which creates problems for processors. The aim of this study was to assess the effect of creating uniform weight groups at weaning at 4 weeks of age, or at the start of the finishing period at 10 weeks of age, on coefficient of variation in slaughter and carcass weight. The effect of these regrouping strategies on mean production performance during the growing and/or finishing periods was also assessed. In addition, the effect of regrouping pigs at the start of the finishing period on aggressive behaviour was assessed.
Iodine value (IV) indicates the degree of unsaturation of milk fat, thus reflecting the presence of long chain unsaturated fatty acids (LCUFA), especially C18:1c. The higher the IV the greater the degree of unsaturation. Changes in dietary lipid content and composition can have a major effect on the IV of milk fat. The principal fatty acid in the forage component of the diet, namely grass or grass silage, is C18:3 (Murphy, 2000) while concentrate supplements contain varying proportions of C18:1 or C18:2 fatty acids. LCUFA undergo hydrolysis and biohydrogenation in the cow’s rumen producing mainly C18:0, the majority of which is converted to C18:1c by the desaturase enzyme systems, mainly in the mammary gland (Murphy, 2000). This experiment aimed to examine the relationship between milk fat IV and dietary lipid content, composition and diet type.
This study was based on research to identify particular pig breeds, which produce high quality eating pork. Duroc in particular is thought to improve meat quality of progeny when crossed with Large White/Landrace (LW/Lr) hybrid dams by altering the intra-muscular fat (IMF) content of the lean, which is positively related to eating quality (McGloughlin et al., 1988). The extraction of IMF is slow and laborious with harmful solvents involved. Eichinger and Beck (1991) have successfully used NIRS to measure IMF ranging from 1-11% in 39 beef carcases. Ground beef and pork samples have also been predicted for fat, water and protein by NIRS, with prediction errors of 0.82-1.49%, 0.94-1.33% and 0.35-0.70% respectively (Togersen et al.,1999). Instrumental measurements of pork are accepted as indicators of tenderness. Sensory variables such as juiciness, tenderness and flavour are important characteristics for the consumer. Therefore the objective of this study was to explore the potential of NIRS to estimate the chemical, physical and sensory parameters of homogenized fresh pork eye muscle.
Cereals are commonly used in pig diets as the main sources of energy. However, depending on price and availability, diets of equivalent energy content can be formulated using combinations of oil and cereal by-products. The use of oil as an energy source has been shown to improve average daily gain (ADG) feed efficiency and increase digestible energy intake (DEI) (Overland et al 1999). However, there is a need to examine the response in pig performance to incremental levels of oil inclusion compared with the performance of pigs offered cereal-based diets. Therefore, the aim this study was to examine the effects of offering cereal-based diets or diets containing by-products and oil on the growth performance of commercially housed growing pigs.
Cereals have traditionally been used in the pig industry as the main source of energy in pig diets. However, as a result of cereal availability and price, alternative sources of energy have been considered, for example the addition of oil to cereal by-product-based diets. By-product-based diets commonly contain higher levels of fibre than cereal-based diets and several studies (e.g. Bakker et al 1995) have reported them to be less digestible in terms of dry matter (DM), energy, crude protein (CP) and oil. The lower DM digestibility of by-product-based diets may lead to a higher level of slurry output, which is an increasing environmental concern. The aim of this work was to examine the differences in digestibility between by-product-based diets supplemented with oil and cereal-based diets.
Evidence suggests that pigs prefer to associate with their mother and littermates over other group members (e.g. Newberry & Wood-Gush, 1986) and with pigs introduced with them into an established group over resident pigs (Durrell et al., 2000). Few studies, however, have examined whether long-term preferential associations or ‘friendships’ are formed between pairs of pigs within a group. Those studies that have been carried out have either involved observations carried out over extremely limited time periods (e.g. Stookey & Gonyou, 1998) or have simply identified pairs that spend the most time together instead of examining statistically whether some pairs associate significantly more than others (Newberry & Wood-Gush, 1986). The aim of this investigation was to determine whether pairs of pigs form preferential associations, based on statistical analyses of long-term lying partner preferences.
Manipulation of the dairy cow’s diet at pasture using high-lipid concentrate is an effective natural means of enhancing the composition and physical properties of milk fat and has been applied in several countries to improve the spreadability of butter. However, because of dietary energy deficits deriving from high yield potential of cows or grass of retarded or poor quality, dairy cows are frequently offered supplementary feeds or buffers e.g. silage or additional concentrates, while at pasture. The study investigated the effect on milk fat composition when providing dairy cows with buffer feeds while they received a diet of a high-lipid concentrate and grazed grass which aimed to increase the proportion of unsaturated fatty acids.
The paper presents data on the snow cover in the Cairngorm Mountains, Scotland, and compares typical Scottish snow profiles with those measured in alpine, continental, and polar areas. The paper shows that in the Cairngorms snow temperatures are higher and as a result densities and ram penetration resistances are also higher. Typical densities are between 350 and 500 kg m−3 and ram resistances are frequently above 50 or even 100 kg. Typical profiles show large masses of windslab above an equigranular basal layer of old snow, and ice layers are common throughout the profile. Avalanche activity is related to two types of profile both of which share low ram resistance in common. Dry-slab avalanches release when densities are of the order of 250 kg m−3 or less and snow temperatures down to – 10° C in the upper layers. Wet slabs and sluffs fall when the snow is isothermal at the melting point. Densities are usually over 450 kg m−3 and may reach over 600 kgm−3 in slush layers supported by ice lenses.
Memory is an integral part of language processing. Given this, a better understanding of how people learn, represent and process language requires considerations of the principles of memory that support language comprehension. Cunnings’ paper (Cunnings, 2016) does just this. The core of his proposal is that second language (L2) processing that is non-target like can be explained in terms of memory operations rather than by invoking a shallow processor (cf. Clahsen & Felser, 2006).
The main object of the experiments was to obtain an indication of the manner in which fatigue of the eye by exposure to illumination of a given intensity, for various periods of time, affected the response of the eye to a rapidly intermittent illumination of constant strength. Expressed otherwise, the object may be stated to be that of determining the effect of fatigue upon the threshold values as made apparent in the flicker test.
A new dromomerycine palaeomerycid artiodactyl, Surameryx acrensis new genus new species, from upper Miocene deposits of the Amazon Basin documents the first and only known occurrence of this Northern Hemisphere group in South America. Osteological characters place the new taxon among the earliest known dromomerycine artiodactyls, most similar to Barbouromeryx trigonocorneus, which lived in North America during the early to middle Miocene, 20–16 Ma. Although it has long been assumed that the Great American Biotic Interchange (GABI) began with the closure of the Isthmus of Panama in the late Pliocene, or ca. 3.0–2.5 Ma, the presence of this North American immigrant in Amazonia is further evidence that terrestrial connections between North America and South America through Panama existed as early as the early late Miocene, or ca. 9.5 Ma. This early interchange date was previously indicated by approximately coeval specimens of proboscideans, peccaries, and tapirs in South America and ground sloths in North America. Although palaeomerycids apparently never flourished in South America, proboscideans thrived there until the end of the Pleistocene, and peccaries and tapirs diversified and still live there today.