Effectiveness of an electronic patient-centred self-management tool for gout sufferers: A cluster randomised controlled trail protocol

© © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. Introduction Gout is increasing despite effective therapies to lower serum urate concentrations to 0.36 mmol/L or less, which, if sustained, significantly reduces acute attacks of gout. Adherence to urate-lowering therapy (ULT) is poor, with rates of less than 50% 1 year after initiation of ULT. Attempts to increase adherence in gout patients have been disappointing. We aim to evaluate the effectiveness of use of a personal, self-management, a'smartphone' application (app) to achieve target serum urate concentrations in people with gout. We hypothesise that personalised feedback of serum urate concentrations will improve adherence to ULT. Methods and analysisSetting and design Primary care. A prospective, cluster randomised (by general practitioner (GP) practices), controlled trial. Participants GP practices will be randomised to either intervention or control clusters with their patients allocated to the same cluster. Intervention The intervention group will have access to the Healthy.me app tailored for the self-management of gout. The control group patients will have access to the same app modified to remove all functions except the Gout Attack Diary. Primary and secondary outcomes The proportion of patients whose serum urate concentrations are less than or equal to 0.36 mmol/L after 6 months. Secondary outcomes will be proportions of patients achieving target urate concentrations at 12 months, ULT adherence rates, serum urate concentrations at 6 and 12 months, rates of attacks of gout, quality of life estimations and process and economic evaluations. The study is designed to detect a ≥30% improvement in the intervention group above the expected 50% achievement of target serum urate at 6 months in the control group: power 0.80, significance level 0.05, assumed a'dropout' rate 20%. Ethics and dissemination This study has been approved by the University of New South Wales Human Research Ethics Committee. Study findings will be disseminated in international conferences and peer-reviewed journal. Trial registration number ACTRN12616000455460

Estimated breeding values and association mapping for persistency and total milk yield using natural cubic smoothing splines

BackgroundFor dairy producers, a reliable description of lactation curves is a valuable tool for management and selection. From a breeding and production viewpoint, milk yield persistency and total milk yield are important traits. Understanding the genetic drivers for the phenotypic variation of both these traits could provide a means for improving these traits in commercial production.MethodsIt has been shown that Natural Cubic Smoothing Splines (NCSS) can model the features of lactation curves with greater flexibility than the traditional parametric methods. NCSS were used to model the sire effect on the lactation curves of cows. The sire solutions for persistency and total milk yield were derived using NCSS and a whole-genome approach based on a hierarchical model was developed for a large association study using single nucleotide polymorphisms (SNP).ResultsEstimated sire breeding values (EBV) for persistency and milk yield were calculated using NCSS. Persistency EBV were correlated with peak yield but not with total milk yield. Several SNP were found to be associated with both traits and these were used to identify candidate genes for further investigation.ConclusionNCSS can be used to estimate EBV for lactation persistency and total milk yield, which in turn can be used in whole-genome association studies.Klara L. Verbyla and Arunas P. Verbyl

Effect of postinfection application of phosphorous (phosphonic) acid on the incidence and sporulation of Plasmopara viticola on grapevine

Phosphorous acid (H3P03) applied at 1.2 gIL up to 12 days after infection reduced the incidence and severity of Plasmopara vitieola. When applied up to 13 days after infection, H3P03 reduced sporulation. In some experiments, the postinfection activity of H3P03 was better than metalaxyl, while in other experiments it was less effective. Both fungicides applied after infection reduced the incidence and severity of disease on leaves and flower clusters, indicating that postinfection applications should reduce the production of inoculum and the consequent spread of disease within a vineyard. In most cases, the addition of copper oxychloride did not affect the efficacy of H3P03

Revista de estudios andaluces

Sim carnation has the ability to withstand prolonged storage at 0-1°C in bud form with appropriate chemical pretreatments. Buds can be opened with sucrose solutions after storage and acceptable vase-life periods achieved. In Australia, growers have reported erratic results with carnation bud-storage. Variables relate to condition of stock plants, developmental stage of bud that is stored, and conditions applied during the opening period. This trial was established to store carnations produced during the spring flush period when overproduction depresses markets. Carnation buds were harvested in 3 stages of development and stored for 2 and 4 month periods. After storage, buds were opened at shed temperatures of either 180 or 250C in 2 bud-opening solutions. Results showed that an opening temperature of 250C and 10% sucrose solution is clearly superior to 180C opening temperature and Chrysal solution. These 2 variables are considered to be the most important factors which influence the days to open buds and total vase-life of flowers at all stages of development and both storage times. Buds stored for 4 months opened quicker than those stored for 2 months, although total vase-life was less. Tighter bud stages are recommended for longer storage periods as a degree of maturation occurs during storage. Growers can safely use 2 or 4 month storage periods to target specific markets, if shed conditions are optimal during bud opening

Effects of relocation on production in caged layers

1. Two experiments were conducted to determine the effects on laying performance of relocating caged hens at 30, 42 and 54 weeks of age. 2. In experiment 1 with hens caged individually, treatment groups comprised relocated hens given 5 new neighbours and hens not relocated but given 0, 2 or 4 new neighbours. 3. In experiment 2 with hens housed two per cage, treatment groups comprised relocation with or without that hen which shared the cage before the move. 4. In both experiments relocated hens laid fewer eggs in the week following social reorganisation. 5. Relocated hens in experiment 1 ate less food in the week following the shift at 42 weeks of age than did hens not moved. In experiment 2 in which all hens were moved, food consumption was not affected

“It's just common sense”: preconceptions and myths regarding fundamental care

Fundamental care has come under increased scrutiny due to high-profile reports globally of poor nursing care. The reasons for these documented care failures are widely debated, with some scholars identifying issues with how fundamental care is valued within healthcare systems and by nurses. During focus groups designed to evaluate a fundamental care education intervention, we identified a perception commonly held by first-year pre-registration (pre-licensure) students that appeared indicative of a de-valuing of fundamental care: students routinely described fundamental care as 'common sense' and doubted that such care should form a key part of their education. In this paper, we explore this perception and its potential consequences for nursing education, clinical practice, and research. We argue that a perception of fundamental care as 'common sense' is a myth; it undermines the inherent complexity of providing such care to a consistently high standard and has negative implications for nursing education and continuing professional development, patient experiences and outcomes, and the advancement of nursing science. It is a perception that must be challenged.Rebecca Feo, Lauren J. Frensham,Tiffany Conroy, Alison Kitso

A survey of the cadmium concentration in kidney, liver and muscle of Aough Australian cattle

A survey to assess the extent of cadmium accumulation in South Australian cattle was undertaken in 1989–91. Of the 8635 cattle sampled, about 12% of the kidney samples and 1% of the liver samples contained cadmium concentrations above the maximum permitted concentration for human consumption of 2.5 mg/kg wet weight for kidney and 1.25 mg/kg wet weight for liver. None of the 262 muscle samples assayed contained cadmium concentrations above the maximum permitted concentration of 0.2 mg/kg wet weight. There was a significant effect of location, gender and season on the extent of non-compliance. Of the regions examined, non-compliance rates for Kangaroo Island, Lower Eyre, South East and Lower Central were significantly higher than for the other regions. In general, non-compliance rates were higher in female cattle than in male cattle, increased with age and were lowest in spring. After adjustment for these factors, non-compliance rates were similar across farm types, namely dairy, beef and feedlot. Although there was a significant correlation between cadmium concentrations in liver and in whole kidney, the confidence limit was considered excessive, rendering liver cadmium values an unreliable predictor of cadmium values in kidney