The variation in morphology of perennial ryegrass cultivars throughout the grazing season and effects on organic matter digestibility

peer-reviewedThe grass plant comprises leaf, pseudostem, true stem (including inflorescence) and dead material. These components differ in digestibility, and variations in their relative proportions can affect sward quality. The objective of this study was to determine the change in the proportion and organic matter digestibility (OMD) of leaf, pseudostem, true stem and dead components of four perennial ryegrass cultivars (two tetraploids: Astonenergy and Bealey and two diploids: Abermagic and Spelga) throughout a grazing season. The DM proportions and in vitro OMD of leaf, pseudostem, true stem and dead in all cultivars were determined during ten grazing rotations between May 2011 and March 2012. There was an interaction between rotation and cultivar for leaf, pseudostem, true stem and dead proportions. In May and June, Astonenergy had the highest leaf and lowest true stem proportion (P pseudostem > true stem > dead. Bealey had the highest combined leaf and pseudostem proportion 0·92, which explains why it had the highest OMD. In this study, the tetraploid cultivars had the highest leaf and pseudostem proportion and OMD. For accurate descriptions of a sward in grazing studies and to accurately determine sward morphological composition, pseudostem should be separated from true stem, particularly during the reproductive stage when true stem is present

Comparing Drying Protocols for Perennial Ryegrass Samples in Preparation for Chemical Analysis

Diet formulation for animals requires accurate estimation of feed nutritive value. In order to determine the nutritive value of grass, the moisture in the samples must be removed, with minimum damage to cell structure, and then the dried samples milled, prior to chemical analysis. Generally samples are oven dried. The aim of this study was to verify if differing drying protocols gave diverging results when drying grass samples. The drying protocols investigated were 40°C for 48 hours, 60°C for 48 hours and 95°C for 15 hours in forced convection ovens. Four perennial ryegrass samples were cut to 4 cm from ground level on three occasions in 2012. On each occasion the four grass samples were mixed together thoroughly and divided into four replicates. Each replicate was divided into three sub-samples to give one 100 g-sample per drying treatment. At regular intervals the samples were removed from the oven and the weight recorded. The data were analysed using a mixed model repeated measures procedure in SAS. Time (hours) was used as the repeated measure. A separate dataset of 12 grass samples were dried using both the 40°C and 60°C protocols and then chemically analysed. This dataset was analysed using PROC GLM in SAS. Samples were assumed dry when there was no significant difference in weight between times. All drying protocols gave a similar final dry matter of approximately 156 g/kg. All drying protocols did dry the grass samples adequately as samples dried at 40°C and 60°C were not significantly lighter after 24 hours and samples dried at 95°C were not significantly lighter after 15 hours. There were no differences in ash or crude protein concentration of the samples dried using the 40°C and 60°C protocols. There were differences in the organic matter digestibility, neutral detergent fibre and acid detergent fibre concentrations between the grass samples dried using the different drying protocols

Presenting evidence-based health information for people with multiple sclerosis : the IN-DEEP project protocol

Background - Increasingly, evidence-based health information, in particular evidence from systematic reviews, is being made available to lay audiences, in addition to health professionals. Research efforts have focused on different formats for the lay presentation of health information. However, there is a paucity of data on how patients integrate evidence-based health information with other factors such as their preferences for information and experiences with information-seeking. The aim of this project is to explore how people with multiple sclerosis (MS) integrate health information with their needs, experiences, preferences and values and how these factors can be incorporated into an online resource of evidence-based health information provision for people with MS and their families.Methods - This project is an Australian-Italian collaboration between researchers, MS societies and people with MS. Using a four-stage mixed methods design, a model will be developed for presenting evidence-based health information on the Internet for people with MS and their families. This evidence-based health information will draw upon systematic reviews of MS interventions from The Cochrane Library. Each stage of the project will build on the last. After conducting focus groups with people with MS and their family members (Stage 1), we will develop a model for summarising and presenting Cochrane MS reviews that is integrated with supporting information to aid understanding and decision making. This will be reviewed and finalised with people with MS, family members, health professionals and MS Society staff (Stage 2), before being uploaded to the Internet and evaluated (Stages 3 and 4).Discussion - This project aims to produce accessible and meaningful evidence-based health information about MS for use in the varied decision making and management situations people encounter in everyday life. It is expected that the findings will be relevant to broader efforts to provide evidence-based health information for patients and the general public. The international collaboration also permits exploration of cultural differences that could inform international practice.<br /

Helicopter emergency medical services for adults with major trauma.

BACKGROUND: Although helicopters are presently an integral part of trauma systems in most developed nations, previous reviews and studies to date have raised questions about which groups of traumatically injured people derive the greatest benefit. OBJECTIVES: To determine if helicopter emergency medical services (HEMS) transport, compared with ground emergency medical services (GEMS) transport, is associated with improved morbidity and mortality for adults with major trauma. SEARCH METHODS: We ran the most recent search on 29 April 2015. We searched the Cochrane Injuries Group's Specialised Register, The Cochrane Library (Cochrane Central Register of Controlled Trials; CENTRAL), MEDLINE (OvidSP), EMBASE Classic + EMBASE (OvidSP), CINAHL Plus (EBSCOhost), four other sources, and clinical trials registers. We screened reference lists. SELECTION CRITERIA: Eligible trials included randomized controlled trials (RCTs) and nonrandomized intervention studies. We also evaluated nonrandomized studies (NRS), including controlled trials and cohort studies. Each study was required to have a GEMS comparison group. An Injury Severity Score (ISS) of at least 15 or an equivalent marker for injury severity was required. We included adults age 16 years or older. DATA COLLECTION AND ANALYSIS: Three review authors independently extracted data and assessed the risk of bias of included studies. We applied the Downs and Black quality assessment tool for NRS. We analyzed the results in a narrative review, and with studies grouped by methodology and injury type. We constructed 'Summary of findings' tables in accordance with the GRADE Working Group criteria. MAIN RESULTS: This review includes 38 studies, of which 34 studies examined survival following transportation by HEMS compared with GEMS for adults with major trauma. Four studies were of inter-facility transfer to a higher level trauma center by HEMS compared with GEMS. All studies were NRS; we found no RCTs. The primary outcome was survival at hospital discharge. We calculated unadjusted mortality using data from 282,258 people from 28 of the 38 studies included in the primary analysis. Overall, there was considerable heterogeneity and we could not determine an accurate estimate of overall effect.Based on the unadjusted mortality data from six trials that focused on traumatic brain injury, there was no decreased risk of death with HEMS. Twenty-one studies used multivariate regression to adjust for confounding. Results varied, some studies found a benefit of HEMS while others did not. Trauma-Related Injury Severity Score (TRISS)-based analysis methods were used in 14 studies; studies showed survival benefits in both the HEMS and GEMS groups as compared with MTOS. We found no studies evaluating the secondary outcome, morbidity, as assessed by quality-adjusted life years (QALYs) and disability-adjusted life years (DALYs). Four studies suggested a small to moderate benefit when HEMS was used to transfer people to higher level trauma centers. Road traffic and helicopter crashes are adverse effects which can occur with either method of transport. Data regarding safety were not available in any of the included studies. Overall, the quality of the included studies was very low as assessed by the GRADE Working Group criteria. AUTHORS' CONCLUSIONS: Due to the methodological weakness of the available literature, and the considerable heterogeneity of effects and study methodologies, we could not determine an accurate composite estimate of the benefit of HEMS. Although some of the 19 multivariate regression studies indicated improved survival associated with HEMS, others did not. This was also the case for the TRISS-based studies. All were subject to a low quality of evidence as assessed by the GRADE Working Group criteria due to their nonrandomized design. The question of which elements of HEMS may be beneficial has not been fully answered. The results from this review provide motivation for future work in this area. This includes an ongoing need for diligent reporting of research methods, which is imperative for transparency and to maximize the potential utility of results. Large, multicenter studies are warranted as these will help produce more robust estimates of treatment effects. Future work in this area should also examine the costs and safety of HEMS, since multiple contextual determinants must be considered when evaluating the effects of HEMS for adults with major trauma

The Variation in Morphological Fractions of Perennial Ryegrass Cultivars throughout the Grazing Season and Subsequent Impacts on Organic Matter Digestibility

The grass plant is comprised of leaf blades, leaf sheath (pseudostem), true stem and dead material each differing in digestibility and their relative proportions can impact significantly on sward quality. The objective of this study was to determine the change in the proportion and organic matter digestibility (OMD) of leaf, pseudostem, true stem and dead fractions of four perennial ryegrass cultivars throughout a grazing season

Personal security alarms for the prevention of assaults against healthcare staff

Background: Personal security alarms have been used to try to reduce violence against healthcare staff, some of whose members face relatively high risks of assault. This systematic review focused on the effect of alarms in reducing the incidence and/or severity of assaults. Methods: Electronic databases, including Cochrane Library, Ovid MEDLINE(R); CINAHL Plus (EBSCO); PubMed; PsycINFO (OvidSP) PsycEXTRA; Applied Social Sciences Index and Abstracts (ProQuest) (1987 to current); Criminal Justice Abstracts (EBSCOhost); Psychology and Behavioural Science Collection (EBSCOhost); Social Policy and Practice (OvidSP) Sociological Abstracts; ProQuest theses and dissertations, were searched. Study designs eligible for inclusion were randomised controlled trials, interrupted time series and controlled before-after studies that assessed the impact of personal security alarms on assaults. Searches were undertaken for studies of healthcare staff in all settings (i.e. including staff working in confined spaces such as hospitals and also field personnel such as community health workers). Workplace violence between colleagues (lateral violence and bullying) and other uses of personal alarms (e.g. fall alarms for the elderly, domestic violence prevention) were excluded. Search results were screened by title, abstracts and keywords for possible inclusion. Full text reports for all potentially relevant studies were obtained and independently assessed for final inclusion. The primary outcome was physical assaults (recorded or self-reported). Secondary outcomes included increased confidence or self-efficacy in violence prevention (recorded or self-reported). Main results: No studies were found that met all inclusion criteria. Four reported associations of personal alarms (and other variables) with risks of assault in healthcare settings. These were described narratively. Conclusions: Healthcare workers in emergency departments, psychiatric units and geriatric facilities face much higher risks of assault than those in other healthcare settings. Alarm systems vary widely. Alarm systems form one of a range of measures, which may interact with one another, that are used to reduce the risks of assault. Given this complexity and diversity, prior to field trials EMMIE orientated efficacy trials are recommended to try to establish whether alarms can be introduced and operated in ways that can contribute to reducing assaults in specific high-risk settings. In relation to findings relating to any given intervention, EMMIE refers to effects produced, mechanisms activated to produce the effects, moderators or contexts relevant to the activation of mechanisms, implementation issues that arise, and economic costs and benefits

Presenting evidence-based health information for people with multiple sclerosis: the IN-DEEP project protocol.

BACKGROUND: Increasingly, evidence-based health information, in particular evidence from systematic reviews, is being made available to lay audiences, in addition to health professionals. Research efforts have focused on different formats for the lay presentation of health information. However, there is a paucity of data on how patients integrate evidence-based health information with other factors such as their preferences for information and experiences with information-seeking. The aim of this project is to explore how people with multiple sclerosis (MS) integrate health information with their needs, experiences, preferences and values and how these factors can be incorporated into an online resource of evidence-based health information provision for people with MS and their families. METHODS: This project is an Australian-Italian collaboration between researchers, MS societies and people with MS. Using a four-stage mixed methods design, a model will be developed for presenting evidence-based health information on the Internet for people with MS and their families. This evidence-based health information will draw upon systematic reviews of MS interventions from The Cochrane Library. Each stage of the project will build on the last. After conducting focus groups with people with MS and their family members (Stage 1), we will develop a model for summarising and presenting Cochrane MS reviews that is integrated with supporting information to aid understanding and decision making. This will be reviewed and finalised with people with MS, family members, health professionals and MS Society staff (Stage 2), before being uploaded to the Internet and evaluated (Stages 3 and 4). DISCUSSION: This project aims to produce accessible and meaningful evidence-based health information about MS for use in the varied decision making and management situations people encounter in everyday life. It is expected that the findings will be relevant to broader efforts to provide evidence-based health information for patients and the general public. The international collaboration also permits exploration of cultural differences that could inform international practice

Glucocorticoid with cyclophosphamide for paraquat-induced lung fibrosis.

BACKGROUND: Paraquat is an effective and widely used herbicide but is also a lethal poison. In many developing countries paraquat is widely available and inexpensive, making poisoning prevention difficult. However most of the people who become poisoned from paraquat have taken it as a means of suicide.Standard treatment for paraquat poisoning both prevents further absorption and reduces the load of paraquat in the blood through haemoperfusion or haemodialysis. The effectiveness of standard treatments is extremely limited.The immune system plays an important role in exacerbating paraquat-induced lung fibrosis. Immunosuppressive treatment using glucocorticoid and cyclophosphamide in combination is being developed and studied. OBJECTIVES: To assess the effects of glucocorticoid with cyclophosphamide on mortality in patients with paraquat-induced lung fibrosis. SEARCH METHODS: The most recent search was run on the 15th April 2014. We searched the Cochrane Injuries Group's Specialised Register, The Cochrane Library, Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), Embase Classic+Embase (Ovid), ISI WOS (SCI-EXPANDED, SSCI, CPCI-S & CPSI-SSH), trials registries, Chinese databases (, , ) and reference lists. SELECTION CRITERIA: RCTs were included in this review. All patients were to receive standard care, plus the intervention or control. The intervention was glucocorticoid with cyclophosphamide in combination versus a control of a placebo, standard care alone or any other therapy in addition to standard care. DATA COLLECTION AND ANALYSIS: The mortality risk ratio (RR) and 95% confidence interval (CI) was calculated for each study on an intention-to-treat basis. Data for all-cause mortality at final follow-up were summarised in a meta-analysis using a fixed-effect model. MAIN RESULTS: This systematic review includes three trials with a combined total of 164 participants who had moderate to severe paraquat poisoning. Patients who received glucocorticoid with cyclophosphamide in addition to standard care had a lower risk of death at final follow-up than those receiving standard care only (RR 0.72; 95% CI 0.59 to 0.89). AUTHORS' CONCLUSIONS: Based on the findings of three small RCTs of moderate to severely poisoned patients, glucocorticoid with cyclophosphamide in addition to standard care may be a beneficial treatment for patients with paraquat-induced lung fibrosis. To enable further study of the effects of glucocorticoid with cyclophosphamide for patients with moderate to severe paraquat poisoning, hospitals may provide this treatment as part of an RCT with allocation concealment