A psychometric investigation of health-related quality of life measures for paediatric neurodevelopment assessment: Reliability and concurrent validity of the PEDS-QL, CHU-9D, and the EQ-5D-Y

There is a need for tools that can provide a brief assessment of functioning for children with neurodevelopmental conditions, including health-related quality of life (HR-QoL). This study evaluated the psychometric properties of three commonly used and well known HR-QoL measures in a cohort of children presenting to clinical developmental assessment services. The most common diagnoses received in these assessment services were autism spectrum disorders. Findings showed good internal consistency for the PedsQL and the CHU-9D, but not the EQ-5D-Y. This research also found that the CHU-9D, EQ-5D-Y, and PedsQL correlated with relevant functioning domains assessed by the VABS-III. Overall, the measures showed that children with neurodevelopmental conditions experienced poor HR-QoL. The majority of children (>86%) met cut-off criteria for significant health concerns on the PedsQL. On the EQ-5D-Y and CHU-9D, they showed reduced HR-QoL particularly on domains relating to school and homework, being able to join in activities, looking after self, and doing usual activities. This study supports the use of the CHU-9D and PedsQL in this population to assess and potentially track HR-QoL in a broad neurodevelopment paediatric population.

Metabolic-associated fatty liver disease and hepatocellular carcinoma: a prospective study of characteristics and response to therapy

BACKGROUND AND AIM

The rising incidence of hepatocellular carcinoma (HCC) in Australia is related to increasing rates of metabolic-associated fatty liver disease (MAFLD). This study aimed to prospectively characterize the metabolic profile, lifestyle, biometric features, and response to treatment of HCC patients in an Australian population.

METHOD

Multicenter prospective cohort analysis of newly diagnosed HCC patients at six multidisciplinary team meetings over a 2-year period.

RESULTS

Three hundred and thirteen (313) newly diagnosed HCC patients with MAFLD (n = 77), MAFLD plus other liver disease (n = 57) (the "mixed" group), and non-MAFLD (n = 179) were included in the study. Alcohol-associated liver disease (ALD) (43%) and MAFLD (43%) were the most common underlying liver diseases. MAFLD-HCC patients were older (73 years vs 67 years vs 63 years), more likely to be female (40% vs 14% vs 20%), less likely to have cirrhosis (69% vs 88% vs 85%), showed higher ECOG, and were less likely to be identified by screening (29% vs 53% vs 45%). Metabolic syndrome was more prevalent in the MAFLD and mixed groups. The severity of underlying liver disease and HCC characteristics were the same across groups. While the MAFLD population self-reported more sedentary lifestyles, reported dietary patterns were no different across the groups. Dyslipidemia was associated with tumor size, and those taking statins had a lower recurrence rate.

CONCLUSION

Equal to ALD, MAFLD is now the most common underlying liver disease seen in HCC patients in Australia. Future HCC prevention screening and treatment strategies need to take this important group of patients into consideration.

A Pilot Study of Reducing Test Anxiety in a Cohort of Underrepresented in Medicine MCAT Students Using Near-Peer Coaching

Background: The Medical College Admission Test (MCAT) is a standardized exam taken by prospective medical students. The MCAT is critical for success in most of the US and parts of Canada, and such pressures may enhance test anxiety. For students from Underrepresented in Medicine (URM) backgrounds, this is often compounded by being the first in their family to take the MCAT. Methods: We conducted a literature review for interventions on test-related anxiety. Based on our findings, we elected to establish a pilot near-peer coaching (NPC) program for URM students enrolled at the Medical College of Wisconsin MCAT program. We quantified baseline and specific time point test-anxieties using the validated Westside test anxiety scale. We asked about MCAT concerns and program impressions via a free-response section and analyzed results with inductive analysis. Results: Our review could find no other studies examining MCAT related test anxiety in the prospective medical student population. NPC was chosen because of its accessibility. At baseline, approximately 50% of students had at least moderately high-test anxiety; meeting the threshold for intervention. Most students perceived themselves as unconfident in their ability to do well on the MCAT. We observed a decrease in test anxiety after coaching sessions. Students received the program well however, wanted to be able to choose the content and have more meetings. Conclusion: This observational pilot study suggests that URM pre-medical students have MCAT related test anxieties high enough to warrant intervention and that NPC is well-received and correlates to reduced test anxiety levels.

A survey of mastitis pathogens including antimicrobial susceptibility in southeastern Australian dairy herds

The objectives for this study were to (1) describe the pathogen profile in quarters from cows with clinical mastitis and in cows with subclinical mastitis in southeastern Australia; and (2) describe antimicrobial susceptibility among isolated pathogens. As a secondary objective, we aimed to compare antimicrobial resistance prevalence in pathogens isolated from clinical and subclinical mastitis samples. A convenience sample of dairy herds (n = 65) from 4 regions in southeastern Australia (Gippsland, Northern Victoria, Tasmania, Western Victoria) were invited to submit milk samples from cows with clinical and subclinical mastitis over a 14-mo period (January 2011 to March 2012). Farmers were instructed to collect aseptic quarter milk samples from the first 10 cases of clinical mastitis for each month of the study. In addition, farmers submitted composite milk samples from cows with subclinical mastitis at 1 or 2 sampling occasions during the study period. Aerobic culture and biochemical tests were used to identify isolates. Isolates were classified as susceptible, intermediate, or resistant to a panel of antimicrobial agents based on the zone of growth inhibition around antimicrobial-impregnated disks, with antimicrobial resistance (AMR) classified as nonsusceptibility by combining intermediate and resistant groups into a single category. Generalized linear mixed models were used to compare the prevalence of AMR between clinical and subclinical mastitis isolates. For clinical mastitis samples (n = 3,044), 472 samples (15.5%) were excluded for contamination. Of the remaining samples (n = 2,572), the most common results were Streptococcus uberis (39.2%), no growth (27.5%), Staphylococcus aureus (10.6%), Escherichia coli (8.4%), and Streptococcus dysgalactiae (6.4%). For subclinical mastitis samples (n = 1,072), 425 (39.6%) were excluded due to contamination. Of the remaining samples (n = 647), the most common results were no growth (29.1%), Staph. aureus (29.1%), and Strep. uberis (21.6%). The prevalence of AMR among common isolates was low for the majority of antimicrobial agents. Exploratory analysis found that the probability of Staph. aureus demonstrating resistance to penicillin was 5.16 times higher (95% confidence interval: 1.68, 15.88) in subclinical isolates relative to clinical Staph. aureus isolates. A similar association was observed for amoxicillin with subclinical Staph. aureus isolates being 4.70 times (95% confidence interval: 1.49, 14.75) more likely to be resistant than clinical Staph. aureus isolates. We concluded that the most common bacteria causing clinical mastitis in dairy herds in Australia is likely to be Strep. uberis, whereas Staph. aureus is likely to be the most common cause of subclinical mastitis. Despite decades of antimicrobial use to control these organisms, AMR appears to be uncommon.

Lamb mortality and clostridial disease

AIMS

To determine the level and timing of lamb loss that occurs during the first year of life on a typical hill country sheep and beef farm in the central North Island of New Zealand and to determine how much of this loss can be prevented through vaccination against the five main clostridial diseases using a commercially available multivalent clostridial vaccine.

METHODS

The study was conducted on a single commercial hill country sheep and beef farm in the central North Island of New Zealand, with a history of never vaccinating their stock against clostridial disease. Lambs were blocked on sex and randomly selected at docking into treatment (n = 1,705 lambs) and control (n = 1,709 lambs) groups. Treated lambs were vaccinated at docking and 4 weeks later with 1 mL of multivalent clostridial vaccine. Control lambs were not vaccinated. Different coloured ear tags were used to identify the lambs in the treatment and control groups. All lambs were counted at docking (October 2019) and at six other management event times between docking and when the replacement hoggets were set stocked for lambing (August 2020). The number of lambs sold between each management event, from each group was also counted. The difference in the number of lambs from one management event to another, minus the lambs sold between these events was regarded as the lamb losses for that period.

RESULTS

The total percentage of lamb losses from docking to pre-lamb was 4.8% (81/1,705) and 6.2% (106/1,709) in the vaccinated and unvaccinated lambs respectively OR = 0.75 (95% CI = 0.56-1.02; p = 0.06). Most lamb loss occurred in the period after docking, followed by the period between weaning and the first post-weaning drench. Less lamb loss occurred in the vaccinated lambs (27/1,705; 1.6%) after docking than in the unvaccinated lambs (66/1,709; 3.9%). This was mainly due to lower female lamb losses in the vaccinated (5/868; 0.6%) compared to the unvaccinated (38/868; 4.4%) group (p < 0.001).

CONCLUSIONS

Vaccination of lambs at docking and 4 weeks later, with a multivalent 5-in-1 clostridial vaccine was associated with a 23.6% (25/106) reduction in total lamb loss from docking to pre-lambing. In female lambs, vaccination was associated with an 87% (33/38) reduction in lamb loss after docking and a 37% (22/59) reduction over the total trial period.

Exploring multiple myeloma survivor interest in lifestyle interventions

e20558

Background: Multiple Myeloma (MM) is the second most common hematological malignancy in the U.S., with higher rates observed in older adults and African Americans (AA). Given treatment advances, most individuals survive at least 5-10 years, making symptom management important. Many survivors struggle with pain, fatigue and limited physical function, all of which may be improved through lifestyle changes. Due to concerns about safety and patient interest, few efforts have considered such interventions. We report the results of an exploratory study to inform a lifestyle program tailored to the needs of the diverse MM survivor community. Methods: MM survivors at least 100 days post-auto transplant with ECOG status of 0-1 completed validated questionnaires and a qualitative interview assessing quality of life, physical activity patterns, social support and interests for a lifestyle program. Results: We recruited 20 survivors, mean age 70 (7.0) years, 70% women, 40% African American, 75% married, 60% college educated. Eighty-three percent were overweight or obese, mean Godin score was 17.56 (18.1) representing insufficient physical activity and 78% did not engage in resistance training at least twice weekly. PROMIS-29 scores indicated that MM survivors had worse physical function, fatigue and pain interference than the general population. However, they reported less social isolation and more social support (informational, instrumental, emotional, companionship). Qualitative data highlighted barriers to healthy lifestyles including “not knowing what dietary changes to make,” fatigue, and safety concerns related to physical activity. Although 67% reported that their oncology team had discussed lifestyle changes with them, most related minimal guidance was given, leaving them confused and wanting more information. All participants acknowledged the potential benefits of healthy eating and exercise on function, fatigue, pain and mood. Particular interests for a lifestyle program included: 1) focused dietary counseling with recipes and cooking guidance; 2) health coach to motivate, and to model and monitor safe exercise; 3) healthcare provider engagement to address health concerns; and 4) preference for in-person with opportunity for web-based program if unable to attend. Many were interested in joining an advisory group to inform intervention development and survivor engagement. Conclusions: MM survivors emphasized their strong interest in having a program where they could meet other MM survivors, discuss their concerns, but also focus on positive behavior changes.

Impact of a single treatment of injectable doramectin on weight gain post weaning in beef heifers and steers in central Queensland, Australia

OBJECTIVES

To demonstrate the impact of a single drench with a label dose of injectable doramectin subsequent to weaning on the growth and performance of heifers and steers in central Queensland beef herds.

METHODS

Three studies were undertaken on recently-weaned Bos indicus-cross beef calves with ≥ 75% B. indicus content on two farms in central Queensland, just north of the Tropic of Capricorn. Farm 1 was located 50 km north and Farm 2 75 km north-west of Rockhampton. In each study, half of a group of recently-weaned beef calves were treated by random allocation with 0.2 mg/kg of injectable doramectin, and the remainder acting as untreated controls. Study 1 (Farm 1) enrolled 250 heifers, while studies 2 and 3 (Farm 2) both enrolled 200 steers and 200 heifers. The farms involved did not historically use macrocyclic lactone-based drenches on their cattle. There were varying periods of follow-up, with treated and control cattle pastured as one group throughout the study period. Worm burdens were monitored using standard faecal egg counts and larval differentiation procedures. In all studies, the worm genera present were a mix of Cooperia spp., Haemonchus spp. and Oesophagostomum spp.

RESULTS

In study 1, conducted on Farm 1 beginning 9 July 2012, doramectin-treated cattle gained an average of 0.27 kg/day while control cattle gained 0.19 kg/day over a monitoring period of 121 days (P < 0.0001). In study 2, conducted on Farm 2 beginning 28 July 2015, doramectin-treated cattle gained an average of 0.15 kg/day versus 0.145 kg/day in the control group (P = 0.44) over a 231-day study period. In study 3, conducted on Farm 2 beginning 4 August 2016, doramectin-treated steers and heifers gained an average of 0.431 and 0.402 kg/day versus 0.342 and 0.311 kg/day in the control group, respectively, over the first 91 days of the study (P < 0.0001 in both cases). The differences in average daily gain (ADG) in subsequent time periods were not statistically significant for steers or heifers. However, overall differences in ADG from day 0 remained statistically significant out to day 258, when the study ended for the heifers. By day 594, when the study ended for the steers, the difference in ADG was no longer significant.

CONCLUSION

Treatment with injectable doramectin soon after weaning resulted in improved weight gain in the 3 months after weaning in two of the three studies.

Vitamin B6 catabolism and lung cancer risk: results from the Lung Cancer Cohort Consortium (LC3)

BACKGROUND

Increased vitamin B6 catabolism related to inflammation, as measured by the PAr index (the ratio of 4-pyridoxic acid over the sum of pyridoxal and pyridoxal-5'-phosphate), has been positively associated with lung cancer risk in two prospective European studies. However, the extent to which this association translates to more diverse populations is not known.

MATERIALS AND METHODS

For this study, we included 5323 incident lung cancer cases and 5323 controls individually matched by age, sex, and smoking status within each of 20 prospective cohorts from the Lung Cancer Cohort Consortium. Cohort-specific odds ratios (ORs) and 95% confidence intervals (CIs) for the association between PAr and lung cancer risk were calculated using conditional logistic regression and pooled using random-effects models.

RESULTS

PAr was positively associated with lung cancer risk in a dose-response fashion. Comparing the fourth versus first quartiles of PAr resulted in an OR of 1.38 (95% CI: 1.19-1.59) for overall lung cancer risk. The association between PAr and lung cancer risk was most prominent in former smokers (OR: 1.69, 95% CI: 1.36-2.10), men (OR: 1.60, 95% CI: 1.28-2.00), and for cancers diagnosed within 3 years of blood draw (OR: 1.73, 95% CI: 1.34-2.23).

CONCLUSION

Based on pre-diagnostic data from 20 cohorts across 4 continents, this study confirms that increased vitamin B6 catabolism related to inflammation and immune activation is associated with a higher risk of developing lung cancer. Moreover, PAr may be a pre-diagnostic marker of lung cancer rather than a causal factor.

Axoneme polyglutamylation regulated by Joubert syndrome protein ARL13B controls ciliary targeting of signaling molecules

Tubulin polyglutamylation is a predominant axonemal post-translational modification. However, if and how axoneme polyglutamylation is essential for primary cilia and contribute to ciliopathies are unknown. Here, we report that Joubert syndrome protein ARL13B controls axoneme polyglutamylation, which is marginally required for cilia stability but essential for cilia signaling. ARL13B interacts with RAB11 effector FIP5 to promote cilia import of glutamylase TTLL5 and TTLL6. Hypoglutamylation caused by a deficient ARL13B-RAB11-FIP5 trafficking pathway shows no effect on ciliogenesis, but promotes cilia disassembly and, importantly, impairs cilia signaling by disrupting the proper anchoring of sensory receptors and trafficking of signaling molecules. Remarkably, depletion of deglutamylase CCP5, the predominant cilia deglutamylase, effectively restores hypoglutamylation-induced cilia defects. Our study reveals a paradigm that tubulin polyglutamylation is a major contributor for cilia signaling and suggests a potential therapeutic strategy by targeting polyglutamylation machinery to promote ciliary targeting of signaling machineries and correct signaling defects in ciliopathies.

Protection of sheep by vaccination against experimental challenge with Leptospira borgpetersenii serovar Hardjo and L. interrogans serovar Pomona

AIMS

To evaluate a multivalent leptospiral and clostridial vaccine for prevention of renal colonisation and urinary shedding in sheep, following experimental challenge with New Zealand strains of Leptospira borgpetersenii serovar Hardjo type Hardjobovis and L. interrogans serovar Pomona.

METHODS

Two separate but similarly designed studies were conducted. In both studies, Romney-cross lambs, aged 9-11 weeks, were randomly allocated to a vaccinated group and a control group. Vaccinated lambs each received two 1.5-mL S/C doses of a multivalent leptospiral and clostridial vaccine, 4 weeks apart, and animals in the control groups received the same dose of saline. Groups of 12 vaccinated and 12 control lambs were randomly selected in each study for challenge with serovars Hardjo or Pomona. Challenge was initiated 16 weeks following the second vaccination with three daily doses of live leptospires by intranasal and conjunctival routes. Following challenge, urine samples were collected weekly for 6 weeks, for dark field microscopy and leptospiral culture; 6 weeks after challenge the lambs were slaughtered and kidneys collected for leptospiral culture.

RESULTS

In lambs challenged with serovar Hardjo, 8/12 unvaccinated lambs had ≥1 urine or kidney sample that was positive for leptospires following culture, compared with 0/12 lambs in the vaccinated group (p=0.001). In lambs challenged with serovar Pomona, 9/12 unvaccinated lambs had ≥1 urine or kidney sample that was positive following culture, compared with 0/12 lambs in the vaccinated group (p<0.001). Prevention of renal colonisation and urinary shedding, expressed as the prevented fraction, was 100 (95% CI=61.7-100)% and 100 (95% CI=68.3-100)% against challenge with serovars Hardjo and Pomona, respectively, at 4 months after vaccination.

CONCLUSIONS AND CLINICAL RELEVANCE

Use of a multivalent leptospiral and clostridial vaccine demonstrated protection against challenge from New Zealand strains of serovars of Hardjo and Pomona 4 months after vaccination in lambs first vaccinated at 9-11 weeks of age. Further studies are required to assess the duration of immunity against challenge in sheep.

Exploring the provision of alcohol advice by clinicians to breast cancer patients

Interactions between clinicians and patients along the cancer trajectory provide an opportunity to deliver key messages regarding drinking behaviours and long-term health. This study aimed to explore the extent and nature of clinician-patient discussions regarding alcohol intake and cancer outcomes in the clinical breast cancer setting, using a qualitative research design involving semi-structured interviews. Purposive sampling was used to recruit 27 breast cancer clinicians (eight dietitians, nine breast care nurses, 10 oncologists) across Victoria, Australia. Interview data were analysed using descriptive statistics and a content analysis approach. Clinicians' knowledge of national alcohol recommendations was found to be inconsistent. Clinicians reported a lack of patient awareness of the link between alcohol and breast cancer. Current frameworks for assessing and advising on patient alcohol intake were felt to be impractical. The extent and nature of advice provided about alcohol was influenced by several patient and clinician factors. The provision of alcohol advice in the clinical breast cancer setting is not practiced systematically by any professional group. New approaches are needed to support patient education about alcohol intake and survivorship in the clinical oncology setting.

Associations between hip bone mineral density, aortic calcification and cardiac workload in community-dwelling older Australians

In older adults, lower bone density in the proximal femur was associated with increased heart burden, and this association was linked to calcification in the aorta. These results were seen in women but not in men.

PURPOSE

To determine whether there is an association between lower bone mineral density (BMD) and increased cardiac workload in older adults, and if this association was independent of abdominal aortic calcification (AAC).

METHODS

Three hundred thirty-seven participants [mean ± SD age = 70 ± 5 years and BMI = 28 ± 5 kg/m², 61% females] had BMD determined by dual-energy X-ray absorptiometry and AAC determined by radiography. Aortic calcification score (ACS) was determined visually in the L1-L4 vertebrae (range 0-24). Systolic blood pressure (BP) and heart rate (HR) were measured. The rate pressure product (RPP), a measure of cardiac workload, was determined by multiplying BP and HR.

RESULTS

AAC was present in 205 (61%) participants. Mean ± SD RPP was 9120 ± 1823; range was 5424-18,537. In all participants, ACS was positively associated with log-transformed RPP [LnRPP] (β = 0.011, p < 0.001), and severe calcification was positively associated with LnRPP (β = 0.083, p = 0.004 relative to no calcification). In sex-stratified analyses, these associations were significant only in females. Lower odds of any AAC were observed per 1 g/cm² increment in femoral neck BMD (OR = 0.08, 95% CI 0.01-0.95). A similar trend was evident in women separately (OR = 0.05, 95% CI 0-1.17) but not men. In all participants, femoral neck (β = -0.20, p = 0.04) and total hip BMD (β = -0.17, p = 0.04) were inversely associated with LnRPP after multivariate adjustment. Adjusting additionally for AAC reduced the strength of the association in femoral neck (β = -0.19, p = 0.05) but not total hip BMD (β = -0.17, p = 0.04).

CONCLUSION

Lower BMD was marginally, but significantly with increased LnRPP, and this relationship was partially mediated by AAC suggesting that older adults, particularly females, with osteoporosis may have an increased cardiovascular risk.

Prevention of fetal infection in heifers challenged with bovine viral diarrhoea virus type 1a by vaccination with a type 1c or type 1a vaccine

AIMS

To evaluate a vaccine containing type 1c bovine viral diarrhoea (BVD) virus for prevention of fetal infection in pregnant heifers when challenged with New Zealand BVD virus type 1a 6 months after vaccination, compared to unvaccinated heifers and heifers vaccinated with a vaccine containing type 1a BVD virus.

METHODS

Fifty five crossbred Friesian heifers, free from BVD virus and antibody, were randomly allocated to three groups. Twenty five heifers were vaccinated twice with a vaccine containing type 1c BVD virus (T1c group), and 10 heifers with a vaccine containing type 1a BVD virus (T1a group), and 20 heifers were unvaccinated (NC group). After oestrus synchronisation the heifers were bred by artificial insemination followed by natural bull mating. Six months after booster vaccination 15 heifers from the T1c group, eight from the T1a group, and 15 from the NC group, were exposed to four calves that were persistently infected with type 1a BVD virus, for 4 weeks. At the beginning of the challenge phase 36/38 heifers were 72-74 days pregnant and 2/38 heifers were approximately 53 days pregnant. Approximately 52 days after the start of the challenge the heifers were subjected to euthanasia and fetal tissues were collected for the detection of BVD virus by ELISA in fetal heart blood and PCR in fetal tissues.

RESULTS

Based on PCR results, BVD virus was detected in 15/15 fetuses in the NC group, compared to 4/14 fetuses in the T1c group and 3/8 fetuses in the T1a group. The proportion of BVD virus-positive fetuses was lower in both vaccinated groups compared to the NC group (p<0.002), but there was no difference in proportions between the vaccinated groups (p=1.00). Fetal protection, expressed as the prevented fraction, was 71.4 (95% CI=41.9-91.6)% and 62.5 (95% CI=24.5-91.5)% for the T1c and T1a groups, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

The vaccines containing killed type 1c and type 1a BVD viruses significantly reduced fetal infection following challenge with a New Zealand type 1a BVD virus. Prevention of fetal infection by vaccination may not be 100%, and the risk of persistently infected calves being born to some vaccinated cattle should be acknowledged and managed as part of a BVD control programme.

Dietary Quality Is Associated with Abdominal Aortic Calcification: A Mean of 18-Year Longitudinal Study in Community-Dwelling Older Adults

OBJECTIVE

This study aimed to examine the association between baseline and changes in dietary quality assessed by the Alternative Healthy Eating Index-2010 (AHEI-2010) and abdominal aortic calcification (AAC) among community-dwelling older adults.

DESIGN

Population-based longitudinal study.

SETTING

A subset of the Melbourne Collaborative Cohort Study (MCCS).

PARTICIPANTS

262 community-dwelling adults (60% female) aged 53 ± 5 years at baseline.

MEASUREMENTS

Dietary intake was assessed using validated Food Frequency Questionnaires at baseline (1990-1994) and follow-up (2010-2011). AAC was evaluated by radiography and dual-energy x-ray absorptiometry (DXA) at follow-up.

RESULTS

Higher baseline AHEI-2010 score was associated with lower AAC severity by radiography [OR (95% CI) for Tertile 3 VS Tertile 1: 0.53 (0.29-0.99)] after adjustment for gender, age, physical activity, smoking, BMI, systolic blood pressure, plasma total cholesterol, calcium and energy intake. The association between AHEI-2010 and AAC severity by DXA was also significant in the multivariate-adjusted model [OR (95% CI) for Tertile 3 VS Tertile 1: 0.38 (0.20-0.70)]. Changes in AHEI-2010 over 18 years were not associated with AAC severity.

CONCLUSION

Baseline but not the changes in AHEI-2010 was inversely associated with the risk of AAC severity suggesting that a high quality diet might help prevent or delay the progression of AAC in community-dwelling older adults and the benefits might be manifested over the long-term.

Comparison of two long acting pre-lambing anthelmintic treatments on the productivity of ewes in low body condition

AIM

To determine if there was a benefit from treating ewes with a low body condition score (BCS) with long acting anthelmintic products pre-lambing and to compare the effects of two commonly used treatment options.

METHODS

The study was conducted on a single commercial hill country sheep and beef property in the central North Island of New Zealand. Mixed age twin-bearing ewes were preselected by the farmer as being in poor condition 4 weeks before the planned start of lambing, and were sequentially drafted into three equal groups identified with coloured ear tags. The negative control group (n=199) received no anthelmintic treatment; the other two groups received either a controlled release capsule (CRC) containing abamectin, albendazole, Se and Co (n=200) or a long-acting injection of moxidectin (n=200). All ewes were body condition scored (1-5 scale) and weighed at pre-lambing, docking (65 days after treatment) and at weaning (127 days after treatment). Faecal nematode egg counts (FEC) were carried out on 10 ewes from each group at these three times. Most lambs were matched to the ewe treatment groups at weaning, and weighed.

RESULTS

At weaning the mean body weight of ewes treated with moxidectin was 3.2 (95% CI=2.3-4.3) kg heavier than controls, and of ewes treated with CRC was 3.6 (95% CI=2.5-4.5) kg heavier than control ewes (p<0.001). At the start of the trial only 61/599 (10.2%) ewes had a BCS≥3. At weaning, more ewes treated with CRC (140/194; 72%) or moxidectin (122/187; 65%) had a BCS≥3 than control ewes (55/179 (31%); p<0.001). In lambs that were matched with ewes from the treatment groups, the mean weight at weaning of lambs from ewes treated with moxidectin was 2.6 (95% CI=1.9-3.3) kg heavier, and from ewes treated with CRC was 2.6 (95% CI=1.9-3.4) kg heavier than lambs from control ewes (p<0.001).

CONCLUSIONS AND CLINICAL RELEVANCE

Treating twin-bearing ewes with low BCS pre-lambing with long acting anthelmintic treatments (moxidectin long acting injection or CRC) resulted in an increase in mean body weight of the ewes and lambs at weaning. There were no significant differences between the two pre-lambing treatments used. These results were based on a single property and thus cannot be generalised to all properties where management conditions and parasite populations may differ.

Duration of serological response to canine parvovirus-type 2, canine distemper virus, canine adenovirus type 1 and canine parainfluenza virus in client-owned dogs in Australia

OBJECTIVE

To determine whether client-owned dogs in Australia, last vaccinated with Canvac(®) vaccines containing canine parvovirus-type 2 (CPV-2), canine distemper virus (CDV), canine adenovirus type 2 (CAV-2) ± canine parainfluenza virus (CPiV) at least 18 months ago, were seropositive or responded serologically to revaccination.

METHODS

A total of 235 dogs were recruited from 23 veterinary clinics, representing a variety of breeds, ages and time since last vaccination (TSLV: range 1.5-9 years, mean 2.8 years). Dogs had a blood sample taken and were revaccinated on day 0. A second blood sample was taken 7-14 days later. Blood samples were assessed for antibody titres to CPV-2 (by haemagglutination inhibition) and CDV, CAV type 1 (CAV-1) and CPiV (by virus neutralisation). Dogs with a day 0 titre >10 or a four-fold increase in titre following revaccination were considered to be serological responders.

RESULTS

The overall percentage of dogs classified as serological responders was 98.7% for CPV-2, 96.6% for CDV, 99.6% for CAV-1 and 90.3% for CPiV.

CONCLUSIONS

These results suggest that the duration of serological response induced by modified-live vaccines against CPV-2, CDV, CAV-1 and CPiV, including Canvac(®) vaccines, is beyond 18 months and may extend up to 9 years. Accordingly, these vaccines may be considered for use in extended revaccination interval protocols as recommended by current canine vaccine guidelines.

Growth, respiration and nutrient acquisition by the arbuscular mycorrhizal fungus Glomus mosseae and its host plant Plantago lanceolata in cooled soil

Although plant phosphate uptake is reduced by low soil temperature, arbuscular mycorrhizal (AM) fungi are responsible for P uptake in many plants. We investigated growth and carbon allocation of the AM fungus Glomus mosseae and a host plant (Plantago lanceolata) under reduced soil temperature. Plants were grown in compartmented microcosm units to determine the impact on both fungus and roots of a constant 2.7 °C reduction in soil temperature for 16 d. C allocation was measured using two (13)CO(2) pulse labels. Although root growth was reduced by cooling, AM colonization, growth and respiration of the extraradical mycelium (ERM) and allocation of assimilated (13)C to the ERM were all unaffected; the frequency of arbuscules increased. In contrast, root respiration and (13)C content and plant P and Zn content were all reduced by cooling. Cooling had less effect on N and K, and none on Ca and Mg content. The AM fungus G. mosseae was more able to sustain activity in cooled soil than were the roots of P. lanceolata, and so enhanced plant P content under a realistic degree of soil cooling that reduced plant growth. AM fungi may therefore be an effective means to promote plant nutrition under low soil temperatures.

Factors contributing to burnout among perfusionists in the United States

Introduction: As the job climate continues to change, many perfusionists are faced with high employee turnover rates, working longer hours, and increased stress related to more complex surgeries. Understanding the sources of professional burnout and stress may allow the formulation of a strategy to help prevent such negative outcomes. The purpose of this study was to determine the current level of stress and burnout among perfusionists.

Methods: A questionnaire was constructed with the use of SurveyMonkey®. Invitations requesting participation in the survey were distributed by electronic mail to members of PerfList and PerfMail. To assess burnout, components of the well-established Maslach Burnout Inventory (MBI) tool were used.

Results: At p<0.05, job demand variables such as stress level, conflict, call duties, hours worked, and case load were all shown to have a statistically significant relationship to burnout.

Conclusion: The study found that, among the various factors, job demands were the most likely culprit contributing to burnout. Stress level and conflict, in particular, had the strongest association to burnout.

Dietary patterns and risk of breast cancer

Background:

Evidence is emerging that prudent/healthy dietary patterns might be associated with a reduced risk of breast cancer.

Methods:

Using data from the prospective Melbourne Collaborative Cohort Study, we applied principal factor analysis to 124 foods and beverages to identify dietary patterns and estimated their association with breast cancer risk overall and by tumour characteristics using Cox regression.

Results:

During an average of 14.1 years of follow-up of 20 967 women participants, 815 invasive breast cancers were diagnosed. Among the four dietary factors that we identified, only that characterised by high consumption of fruit and salad was associated with a reduced risk, with stronger associations observed for tumours not expressing oestrogen (ER) and progesterone receptors (PR). Compared with women in the lowest quintile of the factor score, the hazard ratio for women in the highest quintile was 0.92 (95% confidence interval (CI)=0.70–1.21; test for trend, P=0.5) for ER-positive or PR-positive tumours and 0.48 (95% CI=0.26–0.86; test for trend, P=0.002) for ER-negative and PR-negative tumours (test for homogeneity, P=0.01).

Conclusion:

Our study provides additional support for the hypothesis that a dietary pattern rich in fruit and salad might protect against invasive breast cancer and that the effect might be stronger for ER- and PR-negative tumours.

Risk factors for cardiovascular disease do not fully explain differences in carotid intima-media thickness between Indigenous and European Australians without diabetes

OBJECTIVE

To investigate whether cardiovascular risk factors can explain the higher carotid intima-media thickness (CIMT) in Indigenous compared with European Australians.

DESIGN

Cross-sectional study in three subgroups.

PATIENTS

Non-diabetic urban European (n = 86), urban Indigenous (n = 69), and remote Indigenous (n = 60) Australians aged 25-64 years.

MEASUREMENTS

CIMT, age, sex, anthropometry, blood pressure, smoking status, fasting glucose and insulin, haemoglobin (Hb)A1c, homocysteine, C-reactive protein (CRP), lipids, urinary albumin and creatinine.

RESULTS

CIMT and levels of risk factors, except fasting glucose and total cholesterol, worsened across the three groups. Log(n) fasting insulin [beta = 0.022, 95% confidence interval (CI) 0-0.0439], age (beta = 0.006, 95% CI 0.004-0.007), gender (female beta = -0.005 vs. male, 95% CI -0.084 to -0.026), mean arterial pressure (MAP) (beta = 0.001, 95% CI 0.001-0.002) and ethnicity/location [urban Indigenous (beta = 0.027, 95% CI -0.010 to 0.064 vs. European); remote Indigenous (beta = 0.083, 95% CI 0.042-0.123 vs. European)] explained 41% of variance in CIMT. Significant interactions were seen for ethnicity/location with age (P = 0.014) and MAP (P = 0.018). Age was consistently associated with CIMT across the three populations, and was associated with larger increments in CIMT for the Indigenous subgroups (beta = 0.007, 95% CI 0.005-0.009 urban; beta = 0.007, 95% CI 0.004-0.010 remote) compared with Europeans (beta = 0.003, 95% CI 0.002-0.006) in models including age, sex and MAP. MAP was only associated with CIMT in the remote Indigenous subgroup.

CONCLUSION

After adjusting for selected risk factors, CIMT in remote Indigenous participants was still higher than in Europeans. The slope of the association between age and CIMT steepened from urban Europeans to remote Indigenous.

Neuronal network models of phase separation between limb CPGs of digging sand crabs

Ordinary differential equations are used to model a peculiar motor behaviour in the anomuran decapod crustacean Emerita analoga. Little is known about the neural circuitry that permits E. analoga to control the phase relationships between movements of the fourth legs and pair of uropods as it digs into sand, so mathematical models might aid in identifying features of the neural structures involved. The geometric arrangement of segmental ganglia controlling the movements of each limb provides an intuitive framework for modelling. Specifically, due to the rhythmic nature of movement, the network controlling the fourth legs and uropods is viewed as three coupled identical oscillators, one dedicated to the control of each fourth leg and one for the pair of uropods, which always move in bilateral synchrony. Systems of Morris-Lecar equations describe the voltage and ion channel dynamics of neurons. Each central pattern generator for a limb is first modelled as a single neuron and then, more realistically as a multi-neuron oscillator. This process results in high-dimensional systems of equations that are difficult to analyse. In either case, reduction to phase equations by averaging yields a two-dimensional system of equations where variables describe only each oscillator's phase along its limit cycle. The behaviour observed in the reduced equations approximates that of the original system. Results suggest that the phase response function in the two dimensional system, together with minimal input from asymmetric bilateral coupling parameters, is sufficient to account for the observed behaviour.

Influence of forage legume species, seeding rate and seed size on competitiveness with annual ryegrass (Lolium rigidum) seedlings

Annual legumes sown as short-term forage crops are an important non-chemical option for the control of herbicide-resistant annual ryegrass (Lolium rigidum L.). The relative ability of 5 annual forage legume species (Trifolium subterraneum L., T. michelianum Savi., T. alexandrinum L., Medicago murex Wild and Vicia benghalensis L.) to suppress annual ryegrass seedlings was examined in a glasshouse study. The experiment investigated the importance of legume species, seed size and seeding rate in influencing the relative competitiveness of the legumes. Balansa clover (T. michelianum) and berseem clover (T. alexandrinum), the smallest seeded of the legume species, were the most effective of the 5 legume species, when compared at equivalent seeding rates, at reducing ryegrass biomass. Legume leaf area and biomass were the 2 factors measured that were most closely associated with depressing ryegrass biomass and were themselves most influenced by legume species and seeding rate. Balansa clover and vetch (V. benghalensis) were the most effective at restricting the amount of light penetrating to 50% of the height of the canopy over a range of seeding rates. The study showed that the competitiveness of forage break crops can be optimised by maximising legume biomass through selecting small-seeded legume species with high relative growth rates and dense canopies and by increasing the seeding rate where seed costs are low.

[The intercontinental schizophrenia outpatient health outcomes study (IC-SOHO): initial 6 month findings of the sample in Latin America]

The IC-SOHO study was designed to supply information on antipsychotic treatments in the real clinical practice by assessment of a large and diverse sample population with schizophrenia. This document describes the findings of the first 6 months of IC-SOHO in Latin America. To date, this is the largest observational study of its type in this region. In this observational and prospective study, those out-patients with schizophrenia, who require a change or initiation of antipsychotic medication are hospitalized. Effectiveness was evaluated using the Clinical Global Impression-Seriousness (CGI-S) grading scale. Tolerability was assessed by questionnaires on adverse events and weight measurements. Herein, the comparisons between olanzapine (monotherapy), risperidone (monotherapy) and conventional antipsychotics (monotherapy and combined therapy) are presented. As a whole, 7,658 patients participated in the ICSOHO; n=2,671 from 11 countries of Latin America that were included in this report. At 6 months, the proportion of patients who responded to olanzapine was significantly greater than those who responded to risperidone or conventional antipsychotics (p<0.001). Patients from the olanzapine group had greater improvements in all the symptom domains, including general, positive, negative, depressive and cognitive symptoms in comparison with risperidone (p<0.05) or conventional antipsychotics (p < 0.001). Extrapyramidal symptoms (EPS) and tardive dyskinesia (TD) decreased from baseline in the groups treated with olanzapine and risperidone, but increased in the conventional group. The adverse events related with the sexual function were more prominent in the conventional group. Weight gain was observed in each treatment group, although the patients from the olanzapine group had greater weight grain followed by those of risperidone and then by those of conventional antipsychotics. Our findings in this population of the Latin American sample emulate the results of other studies in different samples, where it was found that olanzapine was more effective and better tolerated than risperidone or conventional antipsychotics.

Plastic plants and patchy soils

Soil nutrients are distributed in a non-uniform or 'patchy' manner. It is well established that the modular nature of root systems allows them to show both morphological and/or physiological plasticity upon encountering nutrient-rich patches. These plastic responses are widely believed to be foraging mechanisms by the plant to enhance nutrient resource capture. Although morphological plasticity has traditionally been viewed as the more expensive option as it requires new root construction, more recent evidence suggests this may not necessarily be the case. Moreover, plants may be able to recapture most of the initial outlay involved in new root construction, again lowering the overall cost to the plant. Under natural conditions the roots of most plant species have an additional nutrient acquisition mechanism namely mycorrhizal symbiosis. However, the impact of these important symbiotic associations upon the host plant's response to nutrient patches has received relatively little attention. The mycorrhizal fungal symbiont should, in theory, be better able to compete directly with the rest of the microbial community for the nutrients in the patch. This could potentially be important to the host plant, as generally, root proliferation responses are more important for interspecific plant, than plant-microbial, competition.

Socio-demographic inequalities in the diets of mid-aged Australian women

OBJECTIVES

This study reports on the distributions of food and nutrient intakes by socio-demographic factors for a large population sample of mid-aged Australian women participating in the Australian Longitudinal Study on Women's Health.

DESIGN

This cross-sectional population-based study used the Cancer Council of Victoria food frequency questionnaires to derive estimates of food and nutrient intakes.

SETTING

Nationwide community-based survey.

SUBJECTS

A total of 10561 women aged 50-55 y, at the time of the survey in 2001.

RESULTS

Analysis showed favourable patterns of food intake, with frequent consumption of many foods that are promoted as components of a healthy diet (eg, fresh fruit, leafy green and other vegetables, bread, cereals, milk and meat). Intakes of both foods and nutrients varied significantly across socio-demographic groups, with unmarried women, and women in 'labouring' occupations (eg, cleaner, factory worker, kitchenhand) having poorer nutrient intake.

CONCLUSIONS

Although many mid-aged women in this sample had generally healthful diets, women in certain socio-demographic groups (particularly unmarried women and those in labouring occupations) had nutrient intakes of concern. As well as helping to address the dearth of current data on dietary intakes in the Australian population, the results highlight the need for continued targeted public health strategies aimed at improving diet of women from the various socio-economic backgrounds.

N capture by Plantago lanceolata and Brassica napus from organic material: the influence of spatial dispersion, plant competition and an arbuscular mycorrhizal fungus

This study investigated N capture by Plantago lanceolata L. and Brassica napus L. from complex organic material (dual-labelled with 15N/13C) added either as a thin concentrated layer (discrete patch treatment) or dispersed uniformly with the background sand:soil mix in a 10 cm band (dispersed treatment) when grown in monoculture or in interspecific competition and in the presence or absence of a mycorrhizal inoculum (Glomus mosseae). No 13C enrichments from the organic material were detected in the plant tissues, but 15N enrichments were present. Total plant uptake of N from the organic material on a microcosm basis was not affected by the spatial placement of the organic material, but Plantago monocultures captured less N than the species in interspecific competition (i.e. 23% versus 38% of the N originally added). N capture from Brassica monocultures was no different to either Plantago monocultures or both species in mixture. However, N capture from the organic material by both individual Plantago and Brassica plants was reduced when grown with Brassica plants (by 10-fold and by more than half, respectively). N capture from the organic material was directly related to the estimated root length produced in the sections containing the organic material: the individual that produced the greatest root length captured most N. Strikingly, when the organic material was added as a discrete patch the N captured by Brassica, a non-mycorrhizal species, actually increased when the G. mosseae inoculum was present compared to when G. mosseae was absent (i.e. 35% versus 19% of the N originally added).

An arbuscular mycorrhizal fungus accelerates decomposition and acquires nitrogen directly from organic material

Arbuscular mycorrhizal fungi (order Glomales), which form mycorrhizal symbioses with two out of three of all plant species, are believed to be obligate biotrophs that are wholly dependent on the plant partner for their carbon supply. It is thought that they possess no degradative capability and that they are unable to decompose complex organic molecules, the form in which most soil nutrients occur. Earlier suggestions that they could exist saprotrophically were based on observation of hyphal proliferation on organic materials. In contrast, other mycorrhizal types have been shown to acquire nitrogen directly from organic sources. Here we show that the arbuscular mycorrhizal symbiosis can both enhance decomposition of and increase nitrogen capture from complex organic material (grass leaves) in soil. Hyphal growth of the fungal partner was increased in the presence of the organic material, independently of the host plant.

Effect of monensin on milk production of Holstein-Friesian dairy cows

We examined the effects of monensin on feed intake and milk production in Holstein-Friesian cows receiving a total mixed rations in two experiments. In experiment 1, 60 individually fed cows consumed, during wk 7 to 26 of lactation, 1 kg/d of supplement containing either 0, 150,300, or 450 mg of monensin. In experiment 2, 98 group-fed cows also received 1 kg/d of a supplement with either 0 or 300 mg/d of monensin for two consecutive lactations. In lactations 1 and 2, treatment started at wk 8 and 3 wk prior to calving, and continued for 32 wk. In experiment 1, 150, 300, and 450 mg of monensin/d produced a small decrease in feed intake and milk yield responses of 2.8, 2.5 and 1.5 kg/d, respectively. In experiment 2, milk yield responses of 0.8 and 1.1 kg/d were recorded in lactations 1 and 2. Milk fat and milk protein content declined in experiments 1 and 2, lactations 1 and 2 by 0.46, 0.38 and 0.27%, and 0.16, 0.16 and 0.11%, respectively. Yield of milk constituents was unaffected. Efficiency of milk production was increased by 5% in experiment 1. In experiment 2, lactation 2, monensin decreased beta-hydroxybutyrate and acetoacetate but increased blood glucose concentration.

The Anti Cancer Council of Victoria FFQ: relative validity of nutrient intakes compared with weighed food records in young to middle-aged women in a study of iron supplementation

OBJECTIVE

To assess the validity of the Anti Cancer Council of Victoria food frequency questionnaire (ACCVFFQ) relative to seven-day weighed food records (WFRs) in 63 women of child-bearing age.

METHOD

63 women completed WFRs to assess iron intake as part of a study on iron deficiency. These women also completed the ACCVFFQ. Nutrient intakes were computed independently for the WFRs and FFQs. Intakes were compared as group means, by correlation and by quintile classification, adjusting for day-to-day variation in intakes, and for energy intake. Individual differences in results were also examined.

RESULTS

The strongest associations between WFR and FFQ results were energy-adjusted, log-transformed and adjusted for day-to-day variability in intake. Correlation coefficients ranged from 0.28 for vitamin A to 0.78 for carbohydrate. Mean intakes from the WFRs and FFQs were within +/- 20% for 21 of 27 nutrients. Poor agreement between FFQs and WFRs for retinol intake was due to the inclusion of liver in two WFRs, an item which is not included in the FFQ.

CONCLUSION

The ACCVFFQ performs as well as other FFQs for which validation data are available. The relatively poor measurement of retinol is consistent with other data, and with the limited number of foods in which this nutrient is abundant.

IMPLICATIONS

The availability of an optically scannable valid instrument for assessing dietary intake will facilitate epidemiological studies of diet and disease, an area of current research priority.