Effects of thermotherapy and meristem culture on forage production and nutrition value in elephant grass cultivars.

Elephant grass plays important role in dairy cattle production and has received special attention due to its potential in bioenergy and phytoremediation, as well as to its medicinal properties. The aim was investigating the effects of thermotherapy and meristem culture on elephant grass (Cenchrus purpureus (Schumach.) Morrone) forage production and nutritional value. Cultivars 'Mineiro', 'Taiwan A-147' and 'Pioneiro' were subjected to the methods: thermotherapy plus meristem culture, meristem culture and mature stems (control). The experiment assessed the tiller number (TN), tiller height (TH), number of leaves/tiller (NLT), leaf/stem ratio (LSR), crude protein (CP), acid detergent fiber (ADF), and neutral detergent fiber (NDF), at three cuts performed every 60 days for 180 days. It was observed beneficial influence on the evaluated traits, which indicated how cleaning methods work. Cultivar 'Mineiro', with more than 20 years of use, was more sensitive to the cleaning methods showing than cultivars 'Taiwan A-147' (15 years of use) and 'Pioneiro' (less than 10 years). It was observed that methods have affected the NT, TH, SDM, LSR, LDM, CP, and NDF. And, that the cultivars genotype effect in a different way the NT, TH, NLT, SDM, LSR, and CP. Overall, Cleaning methods produced an increase in the evaluated parameters over 100% for the cultivars Mineiro and Taiwan when compared with the traditional method and presented low or negative effect for Pioneiro cultivar This evidenced that the traditional propagation method affects forage production and quality over generations in vegetative propagated species. Basic biotechnology techniques such as meristem culture associated or not with thermotherapy can restore the productive potential being recommended for old asexually propagated cultivars with more than fifteen years of cultivation

Suicide attempts, plans, and ideation in culturally diverse sites: The WHO SUPRE-MISS community survey

Background. The objectives were to assess thoughts about suicide, plans to commit suicide and suicide attempts in the community, to investigate the use of health services following a suicide attempt, and to describe basic socio-cultural indices of the community. Method. The community su rvey was one component of the larger WHO multisite intervention study on suicidal behaviours (SUPRE-MISS). In each site, it aimed at randomly selecting and interviewing at least 500 subjects of the general population living in the catchment area of the emergency department where the intervention component of the study was conducted. Communities of eight SUPRE-MISS sites (in Brazil, China, Estonia, India, Iran, South Africa, Sri Lanka, and Viet Nam) participated plus two additional sites from Australia and Sweden conducting similar surveys. Results. Suicide attempts (0·4-4·2), plans (1·11-5·6), and ideation (2·6-25·4) varied by a factor of 10-14 across sites, but remained mostly within the ranges of previously published data. Depending on the site, the ratios between attempts, plans, and thoughts of suicide differed substantially. Medical attention following a suicide attempt varied between 22 and 88 of the attempts. Conclusions. The idea of the suicidal process as a continuous and smooth evolution from thoughts to plans and attempts of suicide needs to be further investigated as it seems to be dependent on the cultural setting. There are indications, that the burden of undetected attempted suicide is high in different cultures; an improved response from the health sector on how to identify and support these individuals is needed. © 2005 Cambridge University Press

Intervention for depression among palliative care patients and their families: A study protocol for evaluation of a training program for professional care staff

Background: Clinical depression is highly prevalent yet under-detected and under-treated in palliative care settings and is associated with a number of adverse medical and psychological outcomes for patients and their family members. This article presents a study protocol to evaluate a training intervention for non-physician palliative care staff to improve the recognition of depression and provide support for depressed patients and their family members. Details of the hypotheses and expected outcomes, study design, training program development and evaluation measures are described.Methods and Design: A randomised controlled trial will be implemented across two palliative care services to evaluate the &ldquo;Training program for professional carers to recognise and manage depression in palliative care settings&rdquo;. Pre-, post- and three-month follow-up data will be collected to assess: the impact of the training on the knowledge, attitudes, self-efficacy and perceived barriers of palliative care staff when working with depression; referral rates for depression; and changes to staff practices. Quantitative and qualitative methods, in the form of self-report questionnaires and interviews with staff and family members, will be used to evaluate the effectiveness of the intervention.Discussion: This study will determine the effectiveness of an intervention that aims to respond to the urgent need for innovative programs to target depression in the palliative care setting. The expected outcome of this study is the validation of an evidence-based training program to improve staff recognition and appropriate referrals for depression, as well as improve psychosocial support for depressed patients and their family members.<br /

Dissemination and implementation of suicide prevention training in one Scottish region

<p>Abstract</p> <p>Background</p> <p>As part of a national co-ordinated and multifaceted response to the excess suicide rate, the <it>Choose Life </it>initiative, the Highland Choose Life Group launched an ambitious programme of training for National Health Service (NHS), Council and voluntary organisation staff. In this study of the dissemination and implementation of STORM (Skills-based Training On Risk Management), we set out to explore not only the outcomes of training, but key factors involved in the processes of diffusion, dissemination and implementation of the educational intervention.</p> <p>Methods</p> <p>Participants attending STORM training in Highland Region provided by 12 trained facilitators during the period March 2004 to February 2005 were recruited. Quantitative data collection from participants took place at three time points; immediately before training, immediately post-training and six months after training. Semi-structured telephone interviews were carried out with the training facilitators and with a sample of course participants 6 months after they had been trained. We have utilized the conceptual model described by Greenhalgh and colleagues in a Framework analysis of the data, for considering the determinants of diffusion, dissemination and implementation of interventions in health service delivery and organization.</p> <p>Results</p> <p>Some 203 individuals completed a series of questionnaire measures immediately pre (time 1) and immediately post (time 2) training and there were significant improvements in attitudes and confidence of participants. Key factors in the diffusion, dissemination and implementation process were the presence of a champion or local opinion leader who supported and directed the intervention, local adaptation of the materials, commissioning of a group of facilitators who were provided with financial and administrative support, dedicated time to provide the training and regular peer-support.</p> <p>Conclusion</p> <p>Features that contributed to the success of STORM were <it>related to both the context </it>(the multi-dimensional support provided from the host organisation and the favourable policy environment) <it>and the intervention </it>(openness to local adaptation, clinical relevance and utility), and the dynamic interaction between context and the intervention.</p