Integrating Camelina Into Organic Pig Production—Impact on Growth Performance of Pigs, Costs, and Returns

The sustainability of organic production and cover crops depends on production costs and the economic value of products. Feed cost, contributing 65–75% of the total production cost, has a significant impact on profitability of organic pig farming. Utilizing grains harvested from cover crops as a feed ingredient for organic pigs can potentially protect the environment and increase the economic value of cover crops. This study was the first to evaluate the viability of integrating winter cover crop, camelina, into organic pig production. Winter camelina was grown organically in single or relay with soybeans to increase the total yield per hectare. Camelina yields in monocrop and in relay-crop fields were 1,394 and 684 kg ha−1, respectively. Although the total yield of camelina and soybean (1,894 kg ha−1) in the relay-crop field was higher than camelina yield in the monocrop field, monocropping camelina is more economical than relay-planting with soybeans due to the difference in production costs. Camelina press-cake was supplemented in diets fed to pigs raised under near-organic standards. Supplementing 10% camelina press-cake in diets reduced feed intake, weight gain, final weight at market, carcass weight, and dressing percent of pigs, but did not affect feed efficiency, belly firmness or pork quality. The viability of integrating camelina into organic pig production depends on marketing organic pigs for $2.4 kg−1 of live weight and marketing camelina oil for $3.59 kg−1 or more if monocropping.

A kidney-selective biopolymer for targeted drug delivery

Improving drug delivery to the kidney using renal-targeted therapeutics is a promising but underdeveloped area. We aimed to develop a kidney-targeting construct for renal-specific drug delivery. Elastin-like polypeptides (ELPs) are nonimmunogenic protein-based carriers that can stabilize attached small-molecule and peptide therapeutics. We modified ELP at its NH₂-terminus with a cyclic, seven-amino acid kidney-targeting peptide (KTP) and at its COOH-terminus with a cysteine residue for tracer conjugation. Comparative in vivo pharmacokinetics and biodistribution in rat and swine models and in vitro cell binding studies using human renal cells were performed. KTP-ELP had a longer plasma half-life than ELP in both animal models and was similarly accumulated in kidneys at levels fivefold higher than untargeted ELP, showing renal levels 15- to over 150-fold higher than in other major organs. Renal fluorescence histology demonstrated high accumulation of KTP-ELP in proximal tubules and vascular endothelium. Furthermore, a 14-day infusion of a high dose of ELP or KTP-ELP did not affect body weight, glomerular filtration rate, or albuminuria, or induce renal tissue damage compared with saline-treated controls. In vitro experiments showed higher binding of KTP-ELP to human podocytes, proximal tubule epithelial, and glomerular microvascular endothelial cells than untargeted ELP. These results show the high renal selectivity of KTP-ELP, support the notion that the construct is not species specific, and demonstrate that it does not induce acute renal toxicity. The plasticity of ELP for attachment of any class of therapeutics unlocks the possibility of applying ELP technology for targeted treatment of renal disease in future studies.

[Development of Practice Guidelines for Psychological Interventions in the Rehabilitation of Patients with Type 2 Diabetes: Methods and Results]

Purpose: The goal of the project was to develop evidence- and consensus-based practice guidelines for psychological interventions in the rehabilitation of patients with type 2 diabetes. Method: The practice guidelines were developed in several steps including a literature search, surveys of clinicians (psychologists and head physicians from rehabilitation centres) and an expert workshop. National experts from scientific departments, rehabilitation centres and patients were engaged in the development of the practice guidelines. Results: The recommendations refer to problems in the field of mental functions, body functions, environmental and personal factors. It is described (a) how specific problem areas can be detected (e. g., using screening-instruments), and (b) which psychological interventions are indicated when a specific problem area has been identified. Conclusions: The practice guidelines offer a practical decision support for psychological interventions in the rehabilitation of patients with type 2 diabetes.

[(Neuro)psychological Rehabilitation after Stroke: a National Survey of Structures and Practice in Inpatient and Outpatient Neurological Rehabilitation]

STUDY OBJECTIVE

Structures and practice of psychological units in neurological rehabilitation centres treating post-stroke patients are described.

METHODS

A nationwide survey of psychological services in neurological rehabilitation centres was conducted.

RESULTS

Psychologist-patient ratios differed greatly among rehabilitation centres. Post-stroke patients showed a variety of complex problems. Psychological interventions mainly comprised diagnostic evaluation as well as individual interventions and cognitive training.

CONCLUSION

The complex and manifold problems of patients in neurological rehabilitation require a comprehensive knowledge of (neuro)psychological functioning. In order to support appropriate and individual treatment decisions, practice guidelines for psychological interventions in the rehabilitation of post-stroke patients are necessary. The present survey constitutes the basis for developing such practice guidelines.

[Professional self-perception, resources, stress and job satisfaction of psychologists in rehabilitation centres]

OBJECTIVE

Psychologists from rehabilitation centres were surveyed about their current job situation. Following areas were included: (a) professional self-perception, (b) occupational resources and stress, (c) job satisfaction.

METHODS

A nationwide survey of psychologists of all rehabilitation centres in Germany was conducted. Overall, 1,461 rehabilitation centres of all specialties were contacted in writing, of which 623 psychologists participated in the survey. Some of the results can be compared with reference data from previous surveys.

RESULTS

The professional self-perception has hardly changed over the last 10 years. Counselling and psychotherapy in one-to-one sessions and group interventions still play an essential role. Overall, job satisfaction and resources are high. General job satisfaction can be best predicted by career opportunities and opportunities for qualification.

CONCLUSIONS

The results of the study indicate which resources should be strengthened in order to enhance job satisfaction of psychologists in medical rehabilitation. Particular thought should be given to improving career opportunities for psychologists in rehabilitation centres.

[The development of practice guidelines for psychological interventions in the rehabilitation of patients with coronary heart disease: methods and results]

Available guidelines and treatment standards are not sufficiently detailed to give practical guidance for psychological interventions in the rehabilitation of patients with coronary heart disease. We therefore aimed at developing evidence- and consensus-based practice guidelines for psychological interventions in the rehabilitation of individual patients with coronary heart disease. The following steps were taken: (1) A systematic search for guidelines and reviews, and a survey of rehabilitation centres concerning present structures and the practice of psychological services, (2) development of a first draft of the practice guidelines in an expert workshop, (3) a survey of all senior psychologists and chief physicians of the rehab centres for their approval, as well as focus groups with rehab patients, and (4) revision of the recommendations and final consensus development in an expert workshop. Significant aspects of the guidelines that go beyond present practice are routine screening for psychological comorbidity, neuropsychological screening for cognitive dysfunction in particular patients, and employment of defined psychologically grounded interventions by the entire rehab team. So far, the practice guidelines have been widely accepted by professionals in the field of rehabilitation.

[Psychological interventions in the rehabilitation of patients with coronary heart disease: summary of evidence and recommendations from systematic reviews and guidelines]

OBJECTIVE

To summarize national and international evidence and recommendations for psychological interventions in the rehabilitation of patients with coronary heart disease. Background is a project for the development of evidence-based practice guidelines for psychological interventions in the rehabilitation of patients with coronary heart disease.

METHODS

A systematic literature search in several databases and on the websites of professional associations was conducted in order to identify relevant reviews and guidelines. A handsearch was conducted in addition to the electronic search. Eligible publications were selected, and evidence for psychological interventions was extracted as well as recommendations relative to psychological diagnostics or interventions.

RESULTS

5 systematic reviews and 34 guidelines were included. Recommendations and (partially restricted) evidence from systematic reviews was found for the following psychological interventions: patient counselling and health education; screening and treatment of comorbid psychological disorders; occupational counselling; stress management; relaxation training; interventions for smoking cessation; interventions promoting appropriate nutrition and weight management; interventions enhancing sufficient, regular physical activity; interventions enhancing social support; specific interventions for women; involvement of family members or partners; discussion of sexual activity.

DISCUSSION/CONCLUSION

For several psychological interventions in the treatment of patients with coronary heart disease we found empirical evidence from systematic reviews. For other psychological interventions, no empirical evidence from systematic reviews was found. The summary of guidelines shows that both in Germany and abroad, a number of psychologically grounded interventions are an inherent part of cardiac rehabilitation. However, many recommendations which refer to psychological diagnostics and interventions are not precise enough to guide psychological care of individual patients. In particular, there are no statements in many guidelines on which (psychological) treatments should be considered for which problems. Moreover, hardly any evidence or recommendations were found for specific interventions referring to special groups of patients (e.g., women, patients with low socio-economic status or migration background). Further research is needed in these respects in order to answer questions concerning the indication and effectiveness of such tailored interventions.

[Somatic rehabilitation as a field of work for psychologists: results of a nationwide survey of structures and practice in orthopaedic and cardiac inpatient medical rehabilitation]

OBJECTIVE

A detailed analysis of the present structural quality and practice of psychological services in inpatient medical rehabilitation facilities was conducted. The study was carried out for the indications chronic back pain and coronary heart disease.

METHODS

A nationwide postal survey of psychological services in orthopaedic and cardiac inpatient rehabilitation facilities was carried out.

RESULTS

Data from psychology departments of 169 orthopaedic and 75 cardiac inpatient rehabilitation facilities are available. In both indication areas an average of one psychologist is in charge of 100 patients. In the treatment of patients with chronic back pain and coronary heart disease, several methods of psychological assessment and a wide range of psychological interventions are being applied. On the whole, there are notable parallels between the psychological interventions provided to patients with chronic back pain and coronary heart disease. At the same time, however, there is considerable heterogeneity among rehabilitation facilities as to the psychological interventions carried out.

DISCUSSION/CONCLUSION

The heterogeneity found reveals the low degree of standardization of psychological practice in medical rehabilitation of patients with chronic back pain or coronary heart disease. This emphasizes the need for developing and implementing recommendations or practice guidelines for psychological interventions.

Genetic mapping of QTLs associated with greenbug resistance and tolerance in Sorghum bicolor

Ninety three recombinant inbreds of Sorghum bicolor (L. Moench) were derived from a cross between two sorghum lines GBIK and Redlan. This population was used to identify quantitative trait loci (QTLs) for resistance and tolerance to greenbug ( Schizaphids graminum Rondani) Biotypes I and K. One hundred and thirteen loci (38 SSRs and 75 RAPDs) were mapped in 12 linkage groups covering 1,530 cM. In general, nine QTLs were detected affecting both resistance and tolerance to greenbug (GB) Biotypes I and K. The phenotypic variance explained by each QTL ranged from 5.6% to 38.4%. Four SSRs and one RAPD marker were associated with the expression of all resistance and tolerance traits. These markers appear to be linked to biotype non-specific resistance and tolerance genes. Four additional markers were associated with biotype-specific resistance or tolerance traits. The detection of more than one locus for each biotype supports the hypothesis that several regions, which represent different genes, control the expression of resistance and tolerance to greenbug in sorghum. The results can be used for marker-assisted selection and the breeding of greenbug-tolerant sorghum cultivars.

Facilitating factors for, barriers to, and outcomes of interdisciplinary education projects in the health sciences

Appropriate collaboration and communication among health professionals is viewed as increasingly important in meeting the challenges of today's health care system. Student socialization to interdisciplinary practice is thought to be facilitated through interdisciplinary academic and clinical learning experiences during the educational program. The purpose of this article is to identify factors commonly cited as facilitating and inhibiting interdisciplinary education, to provide insight for the development of successful interdisciplinary education projects.

Interdisciplinary health professional education: a historical review

A historical review was conducted to examine the advances made, nationally and internationally, in interdisciplinary health professional education since the mid-1960s. One hundred and nineteen articles were reviewed and divided by decade into the following subheadings: models, courses, communication/group process issues, and international perspectives. Twenty-seven articles, categorized as models, defined the conceptual field, described curriculum and program development, or provided a framework for evaluation. Thirty-two articles dealt with interdisciplinary courses, focusing on objectives, content areas, or innovative methods. Nine articles contributed content on interdisciplinary communication and group process issues, from which guidelines were abstracted. Fifty-one articles contributed an international perspective, leading to the recognition that interdisciplinary health professional education, practice, and research is a global movement.

End-of-life decisions and advance directives in palliative care: a cross-cultural survey of patients and health-care professionals

In order to explore possible differences in the scope of end-of-life decisions and attitudes toward advance directives (AD) in palliative care, we conducted a survey of 159 patients in palliative care institutions and 93 health-care professionals experienced in palliative care in the United States, Germany, and Japan. Giving an AD in this clinical setting was considered important by patients and professionals. The prevalence of a formal written AD was 79% in the United States, 18% in Germany, and 9% in Japan. In Japan, there was a high prevalence of entrusting all decisions to the family (known as omakase). More than 80% of the patients had negative feelings toward their future decisions in the United States and Germany, in contrast to only 45% in Japan. Although favored by the professionals, there were no specific instruments for obtaining ADs. In Germany and Japan, some patients had given an informal AD. As a pilot content validity step, survey results were used to derive a checklist for content and procedural aspects in end-of-life decision-making. This checklist may provide the basis for developing an instrument to guide physicians, especially non-palliative care specialists, in communication with their patients and their families in this difficult clinical situation.

Dangers of delay of initiation of either thrombolysis or primary angioplasty in acute myocardial infarction with increasing use of primary angioplasty

We observed treatment delays and suboptimal outcomes when beginning to treat patients with acute myocardial infarction (AMI) with primary angioplasty. Of the 37 patients treated during a 12-month period, 12 (32%) required either emergency bypass surgery or died. Delayed time intervals to balloon reperfusion (mean 134 minutes) probably contributed to these adverse outcomes, with hemodynamic instability requiring pressors or intra-aortic balloon pumping in 15 patients, 12 (75%) before the first balloon inflation. Eleven of the 12 patients with significant adverse outcomes required such intervention. As angioplasty use increased, time intervals to thrombolysis in those not treated with angioplasty increased from an average of 29 minutes (53% treated less than the national standard of 30 minutes) to 39 minutes (32% treated <30 minutes, p <0.001). During the last 2 months of the study period, the time intervals had increased to 48 minutes (14% treated <30 minutes, p <0.0001). There was no change in thrombolytic time intervals at a local community hospital that did not offer primary angioplasty. Emergency Department physician confusion about the best therapy (angioplasty or thrombolysis) was documented in the medical records in 42% of cases (53 of 127). Confusion regarding therapy of AMI led to unacceptable delays in the administration of thrombolytic agents and probably contributed to the adverse outcomes in patients receiving primary angioplasty.

Organization and patients' perception of palliative care: a crosscultural comparison

The hospice model of care for patients with advanced diseases exists in almost all industrialized countries. To date, there have been no international or crosscultural comparisons of the organization and patient outcomes associated with hospice services in different parts of the world. This survey evaluated 159 patients in the USA, Germany and Japan. There were differences between countries in the time of first contact, who recommended palliative care first, the underlying diagnoses, the location of patients, and how consent for hospice care was obtained. Across all countries, there were similar levels of comfort and satisfaction with care. We conclude that the hospice philosophy addresses the basic needs of dying patients which are independent of cultural background, but may be adapted to very different cultures.

Evidence from Earthquake Data for a Partially Molten Crustal Layer in Southern Tibet

Earthquake data collected by the INDEPTH-II Passive-Source Experiment show that there is a substantial south to north variation in the velocity structure of the crust beneath southern Tibet. North of the Zangbo suture, beneath the southern Lhasa block, a midcrustal low-velocity zone is revealed by inversion of receiver functions, Rayleigh-wave phase velocities, and modeling of the radial component of teleseismic P-waveforms. Conversely, to the south beneath the Tethyan Himalaya, no low-velocity zone was observed. The presence of the midcrustal low-velocity zone in the north implies that a partially molten layer is in the middle crust beneath the northern Yadong-Gulu rift and possibly much of southern Tibet.

Aggregate/community-centered undergraduate community health nursing clinical experience

Debate continues about the appropriateness of clinical experiences targeting aggregates in undergraduate community health nursing education. This paper describes a practical model to teach, through experience, the concepts of aggregate/community-centered practice at the baccalaureate level. As a voluntary alternative to the usual community assessment paper, groups of students worked in partnership with community groups to define health needs and to address one need. Sequential student groups focused the assessment and implemented a plan. The required time for each project varied. One project is described to illustrate the model. While independent community-centered practice is not expected of the B.S.N. graduate, the model described here develops comprehension of the concepts and process of such practice.

Guidelines for developing a new standard in hospice care

Hospice care has been overlooked by many in the medical community. This is partly due to the nature of medical training; it could be overcome by the development of industry guidelines by which to measure quality of care.

Marchiafava-Bignami disease. Premortem diagnosis of an acute case utilizing magnetic resonance imaging

Marchiafava-Bignami disease is a rare demyelinating disease involving the corpus callosum and other central white matter tracts. In the patient described here, the disease produced extensive demyelination of the corpus callosum and deep cerebral white matter. This widespread demyelination, confirmed pathologically, was associated with a fulminant fatal course. The magnetic resonance imaging appearance is quite suggestive of Marchiafava-Bignami disease and plays an important role in the premortem diagnosis.

Age-related chemosensitivity of stem cells from human malignant brain tumours

After radiation therapy and chemotherapy for malignant glioma, patients aged 50 or under survive longer than patients over 50. Data from Brain Tumor Study Group trials show that, without treatment, these age groups have similar survival; therefore unperturbed tumour growth does not account for the difference. Sixteen consecutive patients with malignant glioma were studied, half of whom were less than or equal to 50 years of age; none had been treated before initial surgery, and all were subsequently treated with radiation and chemotherapeutic agents (in all but two patients, with nitrosoureas). Median survival of those aged greater than 50 was less than or equal to 50 years was 54 + weeks whereas that of those aged greater than 50 was 37 weeks. The longer survival for younger patients could not be attributed to tumour type, size, or location, pretreatment Karnofsky status, or mode of treatment. In-vitro sensitivity testing of clonogenic cells obtained from biopsy specimens showed that tumour cells from seven of eight patients aged less than or equal to 50 years were sensitive to 1,3-bis (2-chloroethyl)-1-nitrosourea (greater than 40% cell kill at clinically achievable concentrations) compared with only one patient with sensitive cells out of eight older patients. Patient age was inversely correlated with in-vitro cell kill, and patients with sensitive cells were significantly younger than those with resistant cells. Therefore influence of age on survival after treatment of malignant gliomas is probably due to inherent differences in the sensitivity of clonogenic cells to radiation and/or chemotherapeutic agents.

Potentials and possible pitfalls of human stem cell analysis

A clonogenic cell assay for malignant brain tumors that permits the evaluation of tumor cell sensitivity to BCNU and that correlates with patient response to BCNU has been developed. The potential for a stem cell analysis of human tumors has been demonstrated by studies of the reasons for clinical drug failure, tumor heterogeneity, and age-response relationships. The basic requirements of a stem cell assay include the ability to dissociate representative single cells from solid tumors, to optimize culture conditions, and to characterize the growth of colonies. Exposure of cells to a drug in vitro must be comparable to the in situ situation; possible significant differences between short-term and "continuous" treatment methods are emphasized. Also discussed are criteria for in vitro sensitivity of cells, problems inherent in the "early" evaluation of cultures (at the cell "cluster" stage), and the effects of system errors, which if overcome should lead to the development of analytic methods with a maximum sensitivity and predictive value.

Studies on an oncofetal antigen, POA

This paper describes the purification and partial characteristics of a putative oncofetal antigen, POA, which appears to be associated with the pancreas. POA is a glycoprotein of molecular weight between 800,000 and 900,000 daltons. It is found in fetal pancreas and pancreas cancer tissue, but not in normal adult pancreas. It is clearly different from carcinoembryonic antigen, other known tumor associated antigens, acute phase reactants and normal serum proteins. A quantitative rocket immunoelectrophoresis assay was developed for POA. Its specificity was monitored routinely by double immunodiffusion against known fetal and adult standards. The assay was performed on sera from over 700 patients. The results demonstrate that POA is found in the sera of most individuals. However, by far the highest absolute levels and the highest frequency of elevated levels was found in sera of patients with carcinoma of the pancreas. Elevated levels of POA were also found in the serum of a proportion of patients with carcinomas of the lung, stomach, colon, biliary tract, and breast and in a few other individuals with benign conditions. The spectrum of patients who have elevated levels of POA in their serum is quite different from that found with CEA or other known tumor markers.

Acute monocytic leukemia. Cytologic, histologic, cytochemical, ultrastructural, and cytogenetic observations

A case of acute monocytic leukemia (AMoL) studied by cytologic, histologic, cytochemical, ultrastructural, and cytogenetic technics is reported. The immature monocytes were characterized by strong fluoride-sensitive nonspecific esterase activity. Nuclear irregularity, prominent nucleoli, erythrophagocytosis, and pinocytosis were observed on transmission electron microscopy, whereas broad-based ruffles, similar to those found on normal monocytes, were identified with scanning electron microscopy. Cytogenetic analysis showed an 8/9 translocation and four or five identical 8p- marker chromosomes in most bone marrow cells.

Human cord blood lymphocytes. Ultrastructural and immunologic surface marker characteristics; a comparison with B- and T-cell lymphomas

The ultrastructural and surface marker characteristics of human cord blood lymphocytes were studied. These properties were compared with those in cells of patients in the leukemic phase of both malignant lymphoma, poorly differentiated lymphocytic type, and mycosis fungoides. Nuclear folding in cord blood lymphocytes was similar to that seen in lymphocytes of patients with malignant lymphoma, poorly differentiated lymphocytic type and mycosis fungoides. Surface marker characteristics of cord blood lymphocytes included increased percentages of surface IgD on cells bearing surface immunoglobulins and decreased percentages of E-rosette-forming cells. The hypothesis that both malignant lymphoma, poorly differentiated lymphocytic type and mycosis fungoides represent an arrest in the normal lymphocyte maturation sequence is discussed.

The Sézary syndrome cell: surface ultrastructural characteristics

Peripheral blood mononuclear cells from a patient with Sézary syndrome which lacked E-rosette-forming ability and surface immunoglobulins, and which displayed a markedly depressed response to a variety of mitogens, were studied by scanning electron microscopy (SEM) and transmission electron microscopy (TEM) on 3 occasions. The first peripheral blood sample (smooth) differed significantly from two later samples (moderate numbers of microvilli) when surface characteristics were examined by SEM; these differences were confirmed by TEM. The Sézary syndrome cells in this patient may be related to a T lymphocyte which has lost certain surface markers and mitogen response characteristics through a process of de-differentiation.