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One of Tom Dishion's most significant contributions to prevention science was the development of affordable, ecologically valid interventions, such as the Family Check-Up, that screen for child and family risk factors broadly, but concentrate family-specific interventions on those with greatest potential for population impact. In the spirit of this approach, investigators examined effects of a brief, universal postnatal home visiting program on child emergency medical care and billing costs from birth to age 24 months. Family Connects is a community-wide public health intervention that combines identification and alignment of community services and resources with brief, postpartum nurse home visits designed to assess risk, provide supportive guidance, and connect families with identified risk to community resources. Over 18 months, families of all 4,777 resident Durham County, North Carolina, births were randomly assigned based on even or odd birth date to receive a postnatal nurse home visiting intervention or services as usual (control). Independently, 549 of these families were randomly selected and participated in an impact evaluation study. Families, blind to study goals, provided written consent to access hospital administrative records. Results indicate that children randomly assigned to Family Connects had significantly less total emergency medical care (by 37%) through age 24 months, with results observed across almost all subgroups. Examination of billing records indicate a $3.17 decrease in total billing costs for each $1 in program costs. Overall, results suggest that community-wide postpartum support program can significantly reduce population rates of child emergency medical care through age 24 months while being cost-beneficial to communities.
Anecdotal evidence suggests the use of bolus tube feeding is increasing in long term home enteral tube feed (HETF) patients. A cross-sectional survey to assess the prevalence of bolus tube feeding and to characterise these patients was undertaken. Dietitians from 10 centres across the UK collected data on all adult HETF patients on the dietetic caseload receiving bolus tube feeding, (n=604, 60% male, age 58years). Demographic data, reasons for tube and bolus feeding, tube and equipment types, feeding method and patients’ complete tube feeding regimens were recorded. Over a third of patients receiving HETF used bolus feeding (37%). Patients were long-term tube fed (4.1years tube feeding, 3.5years bolus tube feeding), living at home (71%) and sedentary (70%). The majority were head and neck cancer patients (22%) who were significantly more active (79%) and lived at home (97%), while those with cerebral palsy (12%) were typically younger (age 31years) but sedentary (94%). Most patients used bolus feeding as their sole feeding method (46%), because it was quick and easy to use, as a top up to oral diet or to mimic meal times. Importantly, oral nutritional supplements (ONS) were used for bolus feeding in 85% of patients, with 51% of these being compact-style ONS (2.4kcal/ml, 125ml). This survey shows that bolus tube feeding is common amongst UK HETF patients, is used by a wide variety of patient groups and can be adapted to meet the needs of a variety of patients, clinical conditions, nutritional requirements and lifestyles.
Intertidal biofilms are a diverse mixture of bacteria, algae as well as sporelings of macroalgae embedded in a polysaccharid matrix. As the primary colonisers of newly formed surfaces, biofilms undergo a succession of different microbe assemblage until the mature state is reached. A biofilm can act as primary producers and as such recycle nutrients in a habitat. It will influence macrobiota by providing a food source or sending out cues to settlers. Biofilms themselves will be controlled by these settlers. This interaction between bottom-up and top-down plays a crucial part for the functioning of the rocky shore ecosystems. However, the diversity of biolfilms as well as it nature to react quickly to environmental changes makes identification and quantification of the individual compounds a difficult task. Subsequently, the understanding of biofilms in general and intertidal, rocky shore microbe assemblages has always tied to techniques and methods available at the time of study. This chapter focusses on the techniques that have greatly contributed to increasing knowledge of biofilms and discusses their findings. Nonetheless, newly developed methods promise to further this knowledge of the ecological role of biofilms on rocky coastlines.
There are a variety of causes of acute heart failure in children including myocarditis, genetic/metabolic conditions, and congenital heart defects. In cases with a structurally normal heart and a negative personal and family history, myocarditis is often presumed to be the cause, but we hypothesise that genetic disorders contribute to a significant portion of these cases. We reviewed our cases of children who presented with acute heart failure and underwent genetic testing from 2008 to 2017. Eighty-seven percent of these individuals were found to have either a genetic syndrome or pathogenic or likely pathogenic variant in a cardiac-related gene. None of these individuals had a personal or family history of cardiomyopathy that was suggestive of a genetic aetiology prior to presentation. All of these individuals either passed away or were listed for cardiac transplantation indicating genetic testing may provide important information regarding prognosis in addition to providing information critical to assessment of family members.
Global inequity in access to and availability of essential mental health services is well recognized. The mental health treatment gap is approximately 50% in all countries, with up to 90% of people in the lowest-income countries lacking access to required mental health services. Increased investment in global mental health (GMH) has increased innovation in mental health service delivery in LMICs. Situational analyses in areas where mental health services and systems are poorly developed and resourced are essential when planning for research and implementation, however, little guidance is available to inform methodological approaches to conducting these types of studies. This scoping review provides an analysis of methodological approaches to situational analysis in GMH, including an assessment of the extent to which situational analyses include equity in study designs. It is intended as a resource that identifies current gaps and areas for future development in GMH. Formative research, including situational analysis, is an essential first step in conducting robust implementation research, an essential area of study in GMH that will help to promote improved availability of, access to and reach of mental health services for people living with mental illness in low- and middle-income countries (LMICs). While strong leadership in this field exists, there remain significant opportunities for enhanced research representing different LMICs and regions.
The Mediterranean diet offers a range of health benefits. However, previous studies indicate that the restricted consumption of red meat in the diet may affect long-term sustainability in non-Mediterranean countries. A 24-week randomised controlled parallel cross-over design compared a Mediterranean diet supplemented with 2–3 serves per week of fresh, lean pork (MedPork) with a low-fat control diet (LF). Thirty-three participants at risk of CVD followed each intervention for 8 weeks, with an 8-week washout period separating interventions. The primary outcome was home-measured systolic blood pressure. Secondary outcomes included diastolic blood pressure, fasting lipids, glucose, insulin, C-reactive protein (CRP), body composition and dietary adherence. During the MedPork intervention, participants achieved high adherence to dietary guidelines. Compared with the MedPork intervention, the LF intervention led to greater reductions in weight (Δ = 0·65; 95 % CI: 0·04, 1·25 kg, P = 0·04), BMI (Δ = 0·25; 95 % CI: 0·03, 0·47 kg/m2, P = 0·01) and waist circumference (Δ = 1·40; 95 % CI: 0·45, 2·34 cm, P < 0·01). No significant differences were observed for blood pressure, lipids, glucose, insulin or CRP. These findings indicate that Australians are capable of adhering to a Mediterranean diet with 2–3 weekly serves of fresh, lean pork, which may offer a healthy alternative to LF diets in Australians at risk of CVD. Larger intervention studies are now required to demonstrate clinical efficacy of the diet in populations with elevated blood pressure.
Introduction: Cardioactive steroid poisoning occurs worldwide with the use of pharmaceutical digoxin and botanical cardiac glycosides. The wholesale price of the antidote, digoxin immune fab, has increased over 300% from 2010 to 2015. Our objective was to identify gaps in the existing literature with respect to the use of digoxin immune fab in cardioactive steroid toxicity in acute care settings. Methods: We used scoping study methodology, as described by Arksey and O'Malley, to assess the range and scope of empiric research and will report: 1) sources of cardioactive steroid toxicity in acute settings; 2) doses of digoxin immune fab used in treatment; and, 3) intervention outcomes of acute cardioactive steroid toxicity following the administration of digoxin immune fab as first or second-line therapy. We collaborated with a library scientist to devise search strategies for PubMed, CINAHL, EMBASE, CENTRAL and Toxnet. We sought unpublished literature through the Canadian Electronic Library, Proquest, and Scopus and searched reference lists of included studies. We hand searched relevant conference proceedings and applicable guidelines. Two reviewers independently reviewed titles and abstracts using predetermined criteria. Using a structured data abstraction form, two reviewers independently extracted data. All discrepancies were resolved through consensus. Results: Our search strategy yielded 3458 results. After screening titles and abstracts 384 underwent full text screening. We included 147 studies and are currently extracting data from 12 French studies and 135 English studies. To date we have extracted data from 90 case reports and case series. Conclusion: Given concerns over rising costs, our findings will shed light on the extent of the evidence for use of digoxin immune fab in acute care settings.
Downy brome (Bromus tectorum L.) is a common impediment to ecological restoration, because its seedbank remains viable after repeated treatment with herbicides. Soil solarization has been used in ecological restoration to control seedbanks of invasive plants. Here we test the efficacy of soil solarization to reduce B. tectorum cover and establish native plants at a site in B. tectorum’s core invasive range with a long history of disturbance and infestation. Solarization raised soil temperatures by as much as 13 C and reduced B. tectorum densities by approximately 20-fold. In 30 plots solarized for 0 to 101 d, B. tectorum emerged in inverse abundance to treatment duration. Broadleaf weeds were less abundant than B. tectorum before treatment, and diminished under solarization, but their response to solarization was weaker than B. tectorum’s, and they emerged in greater numbers than B. tectorum 2 to 3 yr after treatment. When seeded after solarization, a native perennial bunchgrass, squirreltail [Elymus elymoides (Raf.) Swezey], did not differ in abundance between solarized and control plots. Solarization may facilitate B. tectorum control on a small scale without jeopardizing the establishment of native plants, but only if treatment durations are long and subsequent management of broadleaf weeds and remnant B. tectorum is planned.
We illustrate the extraordinary potential of the (far-IR) Origins Survey Spectrometer (OSS) on board the Origins Space Telescope (OST) to address a variety of open issues on the co-evolution of galaxies and AGNs. We present predictions for blind surveys, each of 1000 h, with different mapped areas (a shallow survey covering an area of 10 deg2 and a deep survey of 1 deg2) and two different concepts of the OST/OSS: with a 5.9 m telescope (Concept 2, our reference configuration) and with a 9.1 m telescope (Concept 1, previous configuration). In 1 000 h, surveys with the reference concept will detect from ∼1.9×106 to ∼8.7×106 lines from ∼4.8×105 to 2.7×106 star-forming galaxies and from ∼1.4×104 to ∼3.8×104 lines from ∼1.3×104 to 3.5×104 AGNs. The shallow survey will detect substantially more sources than the deep one; the advantage of the latter in pushing detections to lower luminosities/higher redshifts turns out to be quite limited. The OST/OSS will reach, in the same observing time, line fluxes more than one order of magnitude fainter than the SPICA/SMI and will cover a much broader redshift range. In particular it will detect tens of thousands of galaxies at z ≥ 5, beyond the reach of that instrument. The polycyclic aromatic hydrocarbons lines are potentially bright enough to allow the detection of hundreds of thousands of star-forming galaxies up to z ∼ 8.5, i.e. all the way through the reionisation epoch. The proposed surveys will allow us to explore the galaxy–AGN co-evolution up to z ∼ 5.5−6 with very good statistics. OST Concept 1 does not offer significant advantages for the scientific goals presented here.
We conducted research to evaluate various herbicides for POST false-green kyllinga control in cool-season turfgrass (primarily creeping bentgrass). In a preliminary evaluation, single and sequential applications of halosulfuron-methyl (70 g ai ha−1), mesotrione (175 g ai ha−1), and sulfentrazone (140 g ai ha−1), as well as a single application of imazosulfuron (740 g ai ha−1), were evaluated in New Jersey. Imazosulfuron and sequential applications of halosulfuron-methyl controlled false-green kyllinga >93% at 9 and 18 wk after initial treatment (WAIT). Sulfentrazone and mesotrione controlled false-green kyllinga <50%. Additional experiments were conducted to evaluate single and sequential applications of halosulfuron-methyl (70 g ha−1), imazosulfuron (420 and 740 g ha−1), and sulfentrazone (140 g ha−1) in New Jersey and Indiana at two locations in each state. At 12 WAIT, imazosulfuron generally controlled false-green kyllinga more effectively than other treatments at all locations. Sequential applications of imazosulfuron controlled false-green kyllinga 100% at 12 WAIT. Halosulfuron-methyl was less effective in Indiana than in New Jersey. Sulfentrazone controlled false-green kyllinga <40% at 12 WAIT. This research demonstrates that imazosulfuron is more effective than halosulfuron-methyl and sulfentrazone for POST false-green kyllinga control in cool-season turf.
Barley is an important crop worldwide with production largely used for animal feed and alcoholic beverages. Diseases are a major limiting factor to its production. These have, up until recently, been controlled by agrochemicals. However, legislation on the use of agrochemicals, especially within the European Union, is being tightened and there is growing interest in integrated pest management. This means that there is an increasing focus on controlling diseases using biological control. Living microorganisms that are applied as biological control agents (BCAs) to either soil, seed or leaves can have difficulty in persisting. Therefore, the focus of this review is on endophytes, which are microorganisms that live inside the plant without causing symptoms of disease and have the potential of staying protected as well as being beneficial to the plant and effective against multiple diseases. In this review, we discuss the different approaches for finding and testing beneficial endophytes and for determining the endophyte host range. Furthermore, we undertook a literature search to summarise previous studies that have investigated the use of endophytes as well as BCAs against barley diseases.
The book brings together papers covering the most recent scientific research from the top endophyte researchers in the world. It presents the state of the art in our knowledge and technical capacity and explores future directions of this work. It is highly relevant and timely because of the need to improve global food security and its sustainability, and also to provide novel bioactive molecules for medicine. There is also a need to protect forestry in a changing and growing world. Endophytes offer a huge potential to reduce environmentally damaging agricultural inputs such as fertilisers and pesticides. They are also a largely overlooked group of organisms where much basic science remains to be undertaken. For example, new molecular tools of DNA profiling using high throughput environmental sequencing are allowing the exploration of a previously largely unknown resource. There is a pressing need to convert scientific research on endophytes into practical application. This book describes how that will be achieved.
In some environments, the survival and production of ryegrass and fescue is heavily reliant on its mutualistic association with Epichloë endophytes. Epichloë endophytes produce a range of bioactive alkaloids, or secondary metabolites that can be effective in deterring insect pests, although some have also been shown to be toxic to grazing animals. These endophytes are being used in grassland farming systems in Australia, New Zealand, USA and some parts of South America. However, to achieve this outcome there has been considerable investment into developing a research pipeline for delivery of animal-safe endophyte strains that are still capable of deterring insect pests and providing protection against abiotic stresses. The pipeline starts with the discovery and isolation of endophytes from wild populations of ryegrass and fescue, characterisation of the known alkaloids they produce, use of genetic markers to determine the relationship between known well-characterised strains and new strains entering the collection, determination of their bioactivity against insect pests of economic significance, understanding issues of compatibility of a strain of interest with the elite germplasm into which it has been inoculated, determining ease of transmission to subsequent seed generations, and ensuring there will be no or minimal animal health and welfare issues associated with using the strain in grazing systems.
The fortuitous discovery of penicillin from Penicillium chrysogenum heralded the golden era of antibiotics. Since then, fungi have significantly contributed to the welfare of humans by producing bioactive compounds which have been used as antibacterial, anticancer, antioxidant and immunomodulatory agents. However, in recent years, microorganisms associated with plants have emerged as fountainheads of bioactive molecules with high therapeutic potential. In general terms, endophytes are an extremely diverse and ubiquitous group of microorganisms that resides within the living internal tissues of a host plant in a non-invasive manner. Endophytes communicate with their host plant through metabolic interactions which enables them to produce signal molecules with interesting biological activities. Further, the genetic recombination of endophytes with the host plant enables them to mimic the biological properties of the host and produce analogous bioactive compounds. Thus, they start producing the host plant phytochemicals when cultured independently. The endless need for potent drugs has prompted researchers to explore alternative avenues for finding novel bioactive molecules, and endophytes appear to be a plausible target for drug discovery. This chapter reviews the current research trends with these promising organisms.
A study to detect the diversity of endophytic Actinobacteria from Australian rice was conducted using culture-dependent and culture-independent methods. Rice samples were collected from the rice growing area near Yanco, New South Wales, Australia. Isolation of the endophytic Actinobacteria was done over two consecutive growing seasons. The results demonstrated that most isolates were obtained from plants 10 weeks and older, and only a few were found in younger plants. Microbispora spp. were the most commonly isolated endophytic Actinobacteria (94%) with Streptomyces spp. and other genera present at lower numbers (6%). The culture-dependent method findings were confirmed by T-RFLP profile analysis. Restriction digests using HhaI and RsaI also showed an abundance of terminal restriction fragments (TRFs) profiles related to the genus Microbispora. Furthermore, other biological properties of the endophytic Actinobacteria isolates were also determined. Four isolates, Saccharothrix OSH21, Saccharopolyspora OSR26, Streptomyces OSR46 and Microbispora OSR61, were found to suppress the growth of the pathogenic fungus Rhizoctonia solani. Moreover, these isolates might be able to promote plant growth by producing indole acetic acid or to solubilise phosphate making this nutrient available for plant uptake.
There are increasing efforts aiming to utilise endophytes as biological control agents (BCAs) to improve crop production. However, reliability remains a major practical constraint for the development of novel BCAs. Many organisms are adapted to their specific habitat; it is optimistic to expect that a new organism added can find a niche or even out-compete those adapted and already present. Our approach for isolating novel BCAs for specific plant diseases is therefore to look in healthy plants in a habitat where disease is a problem, since we predict that it is more likely to find competitive strains among those present and adapted. In vitro inhibitory activities often do not correlate with in planta efficacy, especially since endophytes rely on intimate plant contact. They can, however, be useful to indicate modes of action. We therefore screen for in planta biological activity as early as possible in the process in order to minimise the risk of discarding valuable strains. Finally, some fungi are endophytic in one situation and pathogenic in another (the mutualism–parasitism continuum). This depends on their biology, environmental conditions, the formulation of inoculum, the health, developmental stage and cultivar of the host plant, and the structure of the plant microbiome.