Contribution of previous legumes to soil fertility and millet yields in West African Sahel

Studies on combined effects of 4 legume crops residues and rock phosphate application on pearl millet yield were undertaken on sandy acid soil field from 2012 to 2015 at ICRISAT Sahelian center (ISC)-Sadore, Niger. The objective of the experiment was to assess the best combination of legume species x rate of crop residue x rock phosphate doses that can sustainably improve pearl millet yield in cereal monoculture system with a low input cost and minimum soil tillage. Over 3 years, the residual effect of previous legume crop residue significantly improved not only the grain yield (P<0.001) and dry residue yields (P<0.001) but also the growth parameters of pearl millet than millet mono-cropping. Treatments with or without natural rock phosphate did not show any statistical differences on millet yield while adding a micro dose of urea improved significantly the yield (P<0.001). The interaction effects of preceding legume crops in rotation with millet and restitution of dry residue on the earlier mentioned parameters across 3 years mono-cropping were studied in this experiment

Effets des précipitations acides sur les écosystèmes aquatiques au Canada: Situation actuelle et future

Cet article représente une évaluation de l'état actuel et des tendances observées dans les écosystèmes lacustres, ainsi que de leur état futur probable lorsque les réductions d'émissions requises dans le cadre de l'Entente Canada-États-Unis sur la qualité de l'air auront été effectives. Outre une synthèse des faits saillants de ce dossier pour l'ensemble du Canada, le présent article s'appuie aussi sur l'ensemble des données physico-chimiques récentes (8874 échantillons) observées sur 2779 lacs de l'est canadien, ainsi que celles recueillies (1012 échantillons) sur 252 lacs de l'ouest canadien depuis 1985. Des données biologiques (poissons, benthos, zooplancton et oiseaux aquatiques) ont également été inventoriées pour identifier l'ampleur des dommages biologiques.Les nombreux lacs ayant subi une acidification anthropique récente sont situés pour la plupart dans l'est du Canada où les dépôts de SO- sont élevés. La sensibilité des sols influence également leur distribution spatiale. Durant la période s'échelonnant de 1981 à 1994, seulement 33% des 202 lacs faisant l'objet d'un suivi temporel dans l'est du Canada ont montré une amélioration significative de leur acidité (réduction) en réponse à la baisse des dépôts de SO- (11% des lacs ont subi une hausse d'acidité et 56% n'ont montré aucun changement). Plus de la moitié des lacs ayant récupéré se situent à proximité de Sudbury en Ontario. Plusieurs processus biogéochimiques sont responsables du retard dans la réversibilité de l'acidification. Pour cette raison, la récupération biologique a été très faible dans l'est canadien, exception faite de la région immédiate de Sudbury.Trois scénarios d'émissions ont été considérés: scénario 1: niveaux d'émission canadiens et américains de 1985; scénario 2: émissions canadiennes de 1994 et émissions américaines de 1990 ; scénario 3: réductions d'émissions américaines et canadiennes complétées. Ces scénarios de réductions d'émissions, qui ont été utilisés comme données d'entrée à des modèles stationnaires simulant la chimie des eaux de surface et qui ont été appliqués à cinq grandes zones lacustres du l'est canadien, suggèrent que la proportion de lacs "endommagés" (définis comme étant des lacs de pH<6) diminuera conséquemment aux réductions d'émissions américaines et canadiennes. De 11 à 49% des lacs acidifiés le resteront après l'ensemble des réductions prévues (scénario 3). Le Québec et l'Ontario, qui reçoivent actuellement les plus fortes retombées acides, bénéficieront le plus des réductions. Les gains environnementaux seront plus faibles dans l'est et dans l'ouest du Canada. De plus faibles dépôts acides et une contribution naturelle à l'acidité pourraient expliquer cette moins grande récupération.Il est maintenant reconnu que le pH est le principal facteur d'influence de la diversité spécifique du poisson, bien que d'autres facteurs comme la morphométrie du lac, l'altitude et les concentrations de COD soient aussi en partie responsables. Une réduction des dommages biologiques (i.e.baisse des disparitions de populations de poisson) serait donc possible, mais cette amélioration ne surviendra qu'après la hausse du pH des eaux de surface. L'importance relative des gains au plan biologique suivra une évolution similaire à celui des aspects chimiques. Des dommages significatifs aux écosystèmes lacustres subsisteront néanmoins après réalisation de l'ensemble des réductions d'émissions. Des pertes de populations de poissons devraient subsister dans 6% (Sudbury) à 15% (Kejimkujik) des lacs. Compte tenu du grand nombre de lacs situés dans le sud-est canadien, les pourcentages précédents impliquent que les ressources piscicoles perdues pourraient être très élevées. La restauration des communautés piscicoles devra passer dans bien des cas par un ré-enpoissonnement. De nouveaux programmes de contrôle visant des réductions supplémentaires d'émissions seront dès lors nécessaires pour protéger correctement les écosystèmes sensibles.This paper is an assessment of the current status and trends of Canadian lake systems, and their likely status after the effect of the emission controls required by the Canada/US Air Quality Agreement is fully realized. Many anthropogenically acidified lakes presently occur in that part of eastern Canada where SO- deposition is elevated. Terrain sensitivity also influences their spatial distribution. From 1981 to 1994, only 33% of 202 lakes monitored across eastern Canada showed a statistically significant improvement (reduction) in acidity in response to reduced SO- deposition (11% had increasing acidity and 56% showed no change). Over half of the improving lakes are near Sudbury, Ontario. Several biogeochemical processes are delaying de-acidification. As a result, there has been little biological recovery in eastern waters, except near Sudbury. Steady-state water chemistry modelling suggests that the proportion of "damaged" lakes (defined as having pH <6) will decline in response to both the Canadian and US emission controls. Reductions in biological damage (e.g. fewer lost fish populations) are expected also, but they will lag behind chemical improvement. Significant damage to aquatic ecosystems will remain after all chemical and biological improvements are realized. Further controls will be needed to protect sensitive ecosystems

Healthcare staff's experience in providing end-of-life care to children: A mixed-method review.

BACKGROUND: Staff who provide end-of-life care to children not only have to deal with their own sense of loss but also that of bereaved families. There is a dearth of knowledge on how they cope with these challenges. AIM: The aim of this review is to explore the experiences of healthcare professionals who provide end-of-life care to children in order to inform the development of interventions to support them, thereby improving the quality of paediatric care for both children and their families. DATA SOURCES: Searches included CINAHL, MEDLINE, Web of Science, EMBASE, PsychINFO and The Cochrane Library in June 2015, with no date restrictions. Additional literature was uncovered from searching reference lists of relevant studies, along with contacting experts in the field of paediatric palliative care. DESIGN: This was a systematic mixed studies review. Study selection, appraisal and data extraction were conducted by two independent researchers. Integrative thematic analysis was used to synthesise the data. RESULTS: The 16 qualitative, 6 quantitative and 8 mixed-method studies identified included healthcare professionals in a range of settings. Key themes identified rewards and challenges of providing end-of-life care to children, the impact on staff's personal and professional lives, coping strategies and key approaches to help support staff in their role. CONCLUSION: Education focusing on the unique challenges of providing end-of-life care to children and the importance of self-care, along with timely multidisciplinary debriefing, are key strategies for improving healthcare staff's experiences, and as such the quality of care they provide

The Experiences of Staff Who Support People with Intellectual Disability on Issues About Death, Dying, and Bereavement:a metasynthesis

Background: Historically, people with intellectual disabilities have tended to be excluded from knowing about death, dying, and bereavement. Staff in intellectual disability services can play a valuable role in improving understanding of these issues in those they support. This qualitative metasynthesis aimed to understand the experiences of staff supporting adults with intellectual disabilities with issues of death, dying, and bereavement. Method: Thirteen papers were identified following a systematic review of six databases. Results: Three themes were developed following a lines-of-argument synthesis: (1) Talking about death is hard: Negotiating the uncertainty in death, dying, and bereavement; (2) The commitment to promoting a “good death”; and (3) The grief behind the professional mask. “A cautious silence: The taboo of death,” was an overarching theme. Conclusions: A more open culture around issues of death, dying, and bereavement in intellectual disability settings is essential and could be promoted through staff training and support

‘Every time I see him he’s the worst he’s ever been and the best he’ll ever be’: grief and sadness in children and young people who have a parent with dementia

Research suggests that the grief experienced by the family members of persons with dementia has a distinctive nature that differentiates it from sorrow attendant on most other ill health causes. Over a variable period of time, the way in which dementia manifests in cognitive and physical changes tends to be experienced as a series of serious losses, each of which can be a source of grief leading to significant stress and emotional, mental, psychosocial and physical ill health. Research to date has focused on spouses and adult children: here we seek to add to the literature by re-presenting the grief-related perceptions and experiences of children and young people who have a parent with a young onset dementia. We draw on findings from a narrative auto/ biographical investigation to describe what dementia grief was like for study participants and to make suggestions for resources and support for those in this position

Christopher Hitchens' Public dying: Toward a Secular-Humanist Ars Moriendi?

This article explores the public dying of journalist, writer, provocateur, public intellectual, and renowned atheist, Christopher Hitchens. It does so primarily through an analysis of television interviews given by Hitchens following his diagnosis with esophageal cancer in June 2010. Four key themes are identified as emerging from analysis of the interviews: (a) Hitchens’ explicit sense of mission in challenging myths and superstitions surrounding cancer, dying, and death; (b) the personal experience of terminal illness and dying and the particular way (or style of dying) by which it is approached; (c) issues of regret and a life well lived; and (d) questions surrounding religion, the afterlife, and possibility of deathbed conversion. In light of the claim that ours is a culture in search of an ars moriendi, the article examines what we can learn from Hitchens’ auto/pathographic interviews (and writings) and the extent to which this rational-humanist, atheistic, and stoical style of dying provides a useable “template” for others nearing the end of life

Development of a universal psycho-educational intervention to prevent common postpartum mental disorders in primiparous women: a multiple method approach

<p>Abstract</p> <p>Background</p> <p>Prevention of postnatal mental disorders in women is an important component of comprehensive health service delivery because of the substantial potential benefits for population health. However, diverse approaches to prevention of postnatal depression have had limited success, possibly because anxiety and adjustment disorders are also problematic, mental health problems are multifactorially determined, and because relationships amongst psychosocial risk factors are complex and difficult to modify. The aim of this paper is to describe the development of a novel psycho-educational intervention to prevent postnatal mental disorders in mothers of firstborn infants.</p> <p>Methods</p> <p>Data from a variety of sources were synthesised: a literature review summarised epidemiological evidence about neglected modifiable risk factors; clinical research evidence identified successful psychosocial treatments for postnatal mental health problems; consultations with clinicians, health professionals, policy makers and consumers informed the proposed program and psychological and health promotion theories underpinned the proposed mechanisms of effect. The intervention was pilot-tested with small groups of mothers and fathers and their first newborn infants.</p> <p>Results</p> <p><it>What Were We Thinking! </it>is a psycho-educational intervention, designed for universal implementation, that addresses heightened learning needs of parents of first newborns. It re-conceptualises mental health problems in mothers of infants as reflecting unmet needs for adaptations in the intimate partner relationship after the birth of a baby, and skills to promote settled infant behaviour. It addresses these two risk factors in half-day seminars, facilitated by trained maternal and child health nurses using non-psychiatric language, in groups of up to five couples and their four-week old infants in primary care. It is designed to promote confidence and reduce mental disorders by providing skills in sustainable sleep and settling strategies, and the re-negotiation of the unpaid household workload in non-confrontational ways. Materials include a Facilitators' Handbook, creatively designed worksheets for use in seminars, and a book for couples to take home for reference. A website provides an alternative means of access to the intervention.</p> <p>Conclusions</p> <p><it>What Were We Thinking! </it>is a postnatal mental health intervention which has the potential to contribute to psychologically-informed routine primary postnatal health care and prevent common mental disorders in women.</p

Impact of renal impairment on atrial fibrillation: ESC-EHRA EORP-AF Long-Term General Registry

Background: Atrial fibrillation (AF) and renal impairment share a bidirectional relationship with important pathophysiological interactions. We evaluated the impact of renal impairment in a contemporary cohort of patients with AF. Methods: We utilised the ESC-EHRA EORP-AF Long-Term General Registry. Outcomes were analysed according to renal function by CKD-EPI equation. The primary endpoint was a composite of thromboembolism, major bleeding, acute coronary syndrome and all-cause death. Secondary endpoints were each of these separately including ischaemic stroke, haemorrhagic event, intracranial haemorrhage, cardiovascular death and hospital admission. Results: A total of 9306 patients were included. The distribution of patients with no, mild, moderate and severe renal impairment at baseline were 16.9%, 49.3%, 30% and 3.8%, respectively. AF patients with impaired renal function were older, more likely to be females, had worse cardiac imaging parameters and multiple comorbidities. Among patients with an indication for anticoagulation, prescription of these agents was reduced in those with severe renal impairment, p&nbsp;&lt;.001. Over 24&nbsp;months, impaired renal function was associated with significantly greater incidence of the primary composite outcome and all secondary outcomes. Multivariable Cox regression analysis demonstrated an inverse relationship between eGFR and the primary outcome (HR 1.07 [95% CI, 1.01–1.14] per 10&nbsp;ml/min/1.73&nbsp;m2 decrease), that was most notable in patients with eGFR &lt;30&nbsp;ml/min/1.73&nbsp;m2 (HR 2.21 [95% CI, 1.23–3.99] compared to eGFR ≥90&nbsp;ml/min/1.73&nbsp;m2). Conclusion: A significant proportion of patients with AF suffer from concomitant renal impairment which impacts their overall management. Furthermore, renal impairment is an independent predictor of major adverse events including thromboembolism, major bleeding, acute coronary syndrome and all-cause death in patients with AF

Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry

Background: Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The ‘Atrial fibrillation Better Care’ (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients. Methods: From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses. Results: Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58–0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52–0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58–0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56–0.98) and composite outcome (aHR: 0.76, 95%CI 0.60–0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome. Conclusions: An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients