The inclusion of companion forages in the diet alongside perennial ryegrass increased dry matter intake and organic matter digestibility in sheep

The inclusion of companion forages in the diet of ruminant animals is gaining popularity in temperate regions due to observed improvements in animal performance. The aim of this study was to assess the effect of diet type on DM intake (DMI) and organic matter digestibility (OMD) in sheep. Furthermore, the effect of sward type on diet nutritive quality was investigated. Five dietary treatments were investigated using a 5 × 5 Latin square design experiment: Perennial ryegrass (Lolium perenne L.; PRG) only or PRG plus white clover (Trifolium repens L.;PRG + WC), red clover (Trifolium pratense L.; PRG + RC), chicory (Chicorium intybus L.; PRG + Chic) or plantain (Plantago lanceolata L.; PRG + Plan) at a ratio of 75% PRG and 25% of the respective companion forage and 100% PRG for the grass only treatment on a DM basis. Twenty Belclare castrated male (wether) sheep were housed in metabolism crates across five feeding periods. Individual DMI and faecal output were recorded daily and digestibility parameters were subsequently calculated. Results show that the inclusion of any companion forage increased DMI (kg/day DM) which ranged from 1.55 ± 0.038 (PRG) to 1.76 ± 0.038 (PRG + Chic) (P < 0.001). The PRG + WC (825 ± 1.1), PRG + RC (823 ± 1.1) and PRG + Chic (826 ± 1.1) diets had a greater in vitro OMD (g/kg DM) when compared to PRG (819 ± 1.1) or PRG + Plan (816 ± 1.1) (P < 0.001). Furthermore, the PRG + Chic (830 ± 2.9) diet had a greater in vivo OMD (g/kg DM) (P < 0.01) when compared to the PRG, PRG + RC, and PRG + Plan diets. Regression analysis showed that in vitro estimates moderately reflected in vivo measurements (r2 = 0.61). The inclusion of any companion forage increased dietary CP content and reduced the proportion of NDF in the diet. Crude protein concentration increased by an average of 16.5 g/kg DM and NDF content was reduced by 25.3 g/kg DM, on average, with companion forage inclusion (P < 0.001). Results suggest that binary sward mixtures benefit pasture-based sheep production systems, boosting sward quality, aiding increased DM intakes of a more digestible diet in the summer period.

Evaluation of a pilot school-based physical activity challenge for primary students

Issue addressed Physical inactivity and sedentary behaviour among children are growing public health concerns. The Culture Health Communities Activity Challenge (hereafter known as the Challenge) is a school-based pedometer program in which classes compete to achieve the highest class average daily steps in an 8-week period. The Challenge aims to encourage physical activity in primary school students, with a focus on engaging Aboriginal students. The program was piloted in 15 classes in New South Wales in 2014. Methods The evaluation aimed to explore students' and teachers' experiences of the Challenge, and assess its impact on the students' physical activity levels. Data sources were a pre- and post-intervention survey of students' physical activity levels and sedentary time (n=209), qualitative interviews with teachers (n=11) and discussions with 10 classes. Results Fifteen Year 5 and 6 classes comprising 318 students participated. Fifty percent of participants were girls, the average age was 11 years and the majority (57%) were Aboriginal students. Participation in the Challenge was associated with a slight but statistically significant increase in students' physical activity levels (P<0.05), and a significant decrease in weekend screen time (P<0.05). However, when stratified by Aboriginality these changes were not statistically significant for Aboriginal students. Qualitative feedback from teachers and students indicated high levels of engagement and satisfaction with the Challenge. Teachers and students reported positive impacts, including increased motivation to be physically active, and improved student attendance and engagement in class activities and teamwork. Conclusions Participation in the Challenge was associated with increased physical activity and decreased screen time for some students. Students and teachers also reported a range of positive social and educational outcomes. So what? The findings highlight the importance of primary schools as a setting for health promotion activities, and demonstrate that school-based physical activity programs can be engaging and appropriate for classes with high proportions of Aboriginal students.

'Her cry is my cry': resettlement experiences of refugee women at risk recently resettled in Australia

OBJECTIVES

Refugee women entering resettlement countries on woman-at-risk visas represent a particularly vulnerable population. While their specific gender-based resettlement will likely differ from the general refugee population, little is known about their experiences of early resettlement, with which to inform resettlement policy and practice. This research aimed to explore lived experiences of recently resettled refugee women at risk in Australia.

STUDY DESIGN

Qualitative research used focus groups and a framework approach to identify and explicate common themes in participants' experience.

METHODS

Two focus groups with a purposive sample of African and Afghan refugee women at risk (N = 10), aged 22-53 years, were conducted in South East Queensland, Australia (October 2016), recruited with the assistance of a local resettlement service. Discussions were audiotaped, transcribed, and themes explicated.

RESULTS

Six superordinate themes emerged: (1) sentiment of gratitude; (2) sense of loneliness and disconnection; (3) feeling incapable; (4) experiencing distress and help-seeking; (5) experiencing financial hardship; and (6) anticipating the future.

CONCLUSIONS

Findings indicate that resettlement policy, programs, and practice that explicitly target the needs of women-at-risk refugees are warranted, including a longer period of active service provision with specific attention to strategies that address the women's social connection, self-efficacy, emotional well-being, and financial hardships.

Virtual evidence: helping primary care practitioners access and implement evidence-based information

e-STABLISH is a two-year pilot project funded by the UK’s NHS Executive (North West) to set up a Local Multidisciplinary Evidence Centre (LMEC) across Salford and Trafford district. The aim of e-STABLISH is to provide primary healthcare team members (PHCTs) and community staff based at 12 sites across the district with improved access to evidence-based information sources from their workplaces. During our first year (April 1998- March 1999) sites were linked and personnel trained - the second year will determine whether access to evidence-based information has been improved through an effective structure. The paper begins with an overview of the project, and then goes on to discuss its objectives in more detail, namely, the Information Technology infrstructure that has been set up, the training courses provided, and the library services that have been developed. We conclude with details of the major lessons learnt and evaluations that will be taking place.

Vitamin A provision for preterm infants: are we meeting current guidelines?

BACKGROUND

Preterm infants have reduced liver stores of vitamin A at birth compared to term born infants. Current guidelines recommend an intake of 700-1500 IU/kg/day vitamin A, and there is evidence to support higher doses for infants with significant lung disease. The importance of appropriate early nutrition for preterm infants is increasingly becoming apparent.

OBJECTIVES

To examine whether preterm infants admitted to a UK neonatal unit received the currently recommended amounts of vitamin A during the first 4 weeks of life, and to identify the feeding patterns associated with optimal vitamin A intake.

DESIGN

Retrospective case note review.

SETTING

UK tertiary neonatal unit.

POPULATION

36 preterm infants with a median gestation of 30 weeks (range 26-33 weeks) and median birth weight of 1305 g (range 880-1800 g).

MAIN OUTCOME MEASURE

Mean daily total intake of vitamin A in each of the first 4 weeks of life.

RESULTS

Despite a policy of introducing intravenous lipid supplemented with fat soluble vitamins on day 2, only four infants (11%) consistently met the recommended daily intake of vitamin A during the first 2 weeks of life. Adequacy of vitamin A intake in the first 2 weeks of life was not predicted by gestation or pattern of feeding.

CONCLUSION

Recommendations for intravenous vitamin A supplementation in parenterally fed preterm infants require revision. Intravenous lipid with added fat soluble vitamins should be started as soon as possible after birth, and consideration given to early oral vitamin A supplementation in those infants tolerant of enteral feeds.

Association of maternal killer-cell immunoglobulin-like receptors and parental HLA-C genotypes with recurrent miscarriage

BACKGROUND

The natural killer (NK) cells at the site of placentation express killer-cell immunoglobulin-like receptors (KIR) that can bind to human leukocyte antigen (HLA)-C molecules on trophoblast cells. Both these gene systems are polymorphic and an association of particular maternal KIR/fetal HLA-C genotypes has been shown in pre-eclampsia. Pre-eclampsia and recurrent miscarriage (RM) share the pathogenesis of defective placentation and therefore we have now genotyped couples with RM.

METHODS AND RESULTS

DNA was obtained from the male (n = 67) and female (n = 95) partners of couples with three or more spontaneous miscarriages and genotyped for HLA-C groups and 11 KIR genes using the PCR-sequence-specific primer method (SSP). The frequency of the HLA-C2 group was increased in both parents (reaching significance only in the male partners, P = 0.018) compared with a parous control population. The KIR gene frequencies of the male partners were similar to controls, but the women had a high frequency of KIR AA haplotypes that lack activating KIR. In particular, the activating KIR for HLA-C2 groups (KIR2DS1) was significantly lower in these women (P = 0.00035, odds ratio 2.63, confidence interval 1.54-4.49).

CONCLUSIONS

This is the first report to identify a genetic male factor that confers risk in RM. These findings support the idea that successful placentation depends on the correct balance of NK cell inhibition and activation in response to trophoblast.

Exploring opportunities for collaboration between the corporate sector and the dental education community

The ultimate purpose of both dental industry and dental education is to improve the oral health of the public. This report provides background information on the different roles and objectives of the dental industry and dental education communities, the different operating environment of each sector and also areas of common interest where collaboration will be of mutual benefit. The report addresses five areas for potential collaboration between the dental industry and the dental education communities: 1. Contribution to joint activities. 2. Effectiveness and efficiency. 3. Workforce needs. 4. Middle- and low-income countries. 5. The future of International Federation of Dental Educators and Associations (IFDEA). The traditional areas of support and their limitations that have been provided by industry are outlined in the report and some new approaches for collaboration are considered. Industry-based research has been an important factor in developing new products and technologies and in promoting oral health. However there is a need to facilitate the introduction of these developments at an early stage in the education process. Industry has to operate in an efficient manner to remain competitive and maximise its returns and therefore survive. The academic sector operates in a different environment and under different governance structures; although some trends are noted towards adoption of greater efficiency and financial accountability similar to industry. Opportunities to jointly develop best business practices should be explored. Industry has responded well to the oral health needs of the public through the development of new products and technologies. The education community needs to respond in a similar way by examining different healthcare delivery models worldwide and developing programmes to train members of the dental team to cater for future needs and demands of communities in different regions of the world. The reputation of industry-based scientists and clinicians is high, and their role in contributing to the dental education process in practical ways needs to be explored and further developed. Closer relationships between industry scientists and faculty and students could assist industrys need and desire to develop new technologies for the broader dental care system. The corporate sector can play a key role in the future success of IFDEA by providing support and expertise in developing areas such as regional leadership institutes, a Global Faculty and Network and in collaborating in developing continuing education programmes as well as involvement in its governance. Thirteen recommendations are made in the report. These are considered to be important initial steps in developing the already strong relationship between the education and corporate sectors. Partnership and collaborating more effectively along the lines suggested should, almost certainly, generate mutually beneficial outcomes, whilst serving over the long term to elevate the publics oral health status on a global basis.

Acromegaly secondary to growth hormone releasing hormone secretion

BACKGROUND

Acromegaly secondary to growth hormone releasing hormone (GHRH) secretion is exceptionally rare.

AIM

To report a case of acromegaly diagnosed in 1984 and assumed to be pituitary in origin. Sixteen years later, the cause was found to be a GHRH secreting neuroendocrine pancreatic tumour.

METHOD

A case report.

CONCLUSION

Although ectopic GHRH production is very rare, endocrinologists should be aware of this possibility in acromegaly patients if a pituitary tumour was not detected using pituitary imaging.

Injuries in women's professional soccer

OBJECTIVE

The injury data from the first two seasons of the Women's United Soccer Association (WUSA) were analysed to determine the injury incidence, anatomic location of injuries, and relation of player position.

METHODS

Injury data on 202 players from eight teams during the first two seasons of the WUSA were prospectively collected and analysed.

RESULTS

A total of 173 injuries occurred in 110 players with an overall injury incidence rate of 1.93 injuries per 1000 player hours. The incidence of injury during practice and games was 1.17 and 12.63 per 1000 player hours, respectively. Of the injuries 82% were acute and 16% were chronic. Most of the injuries (60%) were located in the lower extremities. Strains (30.7%), sprains (19.1%), contusions (16.2%), and fractures (11.6%) were the most common diagnoses and the knee (31.8%) and head (10.9%) were the most common sites of injury. Anterior cruciate ligament (ACL) injuries accounted for 4.6% of all injuries and the incidence of ACL tears was 0.09 per 1000 player hours (practice 0.04, game 0.90). Midfielders suffered the most injuries (p<0.007).

CONCLUSION

We conclude that the injury incidence in the WUSA is lower than the 6.2 injuries per 1000 player hours found in the corresponding male professional league (Major League Soccer); however, knee injuries predominate even in these elite female athletes.