Influence of Nutritional Regime on Age at Puberty in Gilts

Age at puberty was determined for 205 Gene Pool gilts; 68 fed a 10% protein diet (HLC) consisting of high-lysine corn, minerals and vitamins and 137 fed a 14% protein corn soybeam meal diet (CS). Gilts fed the CS diet reached puberty 18.7 days earlier than gilts fed the HLC diet. Use of post-weaning daily gain as a covariable reduced the difference between diets to 9 days. The pooled within diet regression of age at puberty on post-weaning gain was -22.75 days per kilogram. The correlation between pubertal age and daily gain was significantly higher on the HLC diet (-.30 vs. -.57; P \u3c .025) but the regressions for the two diets did not differ significantly (-26.0 vs. -18.4 days per kilogram)

Comprehensive care and HIV prophylaxis after sexual assault in rural South Africa: the Refentse intervention study.

PROBLEM: Although international guidelines specify the central role of the health sector in providing comprehensive care, including HIV post-exposure prophylaxis (PEP), after sexual assault, in both industrialised and developing countries there are many challenges to providing timely and comprehensive services. DESIGN: A nurse driven model of post-rape care was integrated into existing hospital services; the before and after study design evaluated impacts on quality of care, reviewing 334 hospital charts and conducting interviews with 16 service providers and 109 patients. SETTING: 450 bed district hospital in rural South Africa. KEY MEASURES FOR IMPROVEMENT: Quality of care after rape (forensic history and examination, provision of emergency contraception, prophylaxis for sexually transmitted infections, referrals); provision of HIV counselling and testing and provision and completion of full 28 day course of PEP; and service utilisation (number of service providers seen on first visit and number of rape cases presenting to hospital per month). STRATEGIES FOR CHANGE: After completing baseline research, we introduced a five part intervention model, consisting of a sexual violence advisory committee, hospital rape management policy, training workshop for service providers, designated examining room, and community awareness campaigns. Effect of change Existing services were fragmented and of poor quality. After the intervention, there were considerable improvements in clinical history and examination, pregnancy testing, emergency contraception, prophylaxis for sexually transmitted infections; HIV counselling and testing, PEP, trauma counselling, and referrals. Completion of the 28 day course of PEP drugs increased from 20% to 58%. LESSONS LEARNT: It is possible to improve the quality of care after sexual assault, including HIV prophylaxis, within a rural South African hospital at modest cost, using existing staff. With additional training, nurses can become the primary providers of this care

Larval distribution of commercial fish species in waters around Ireland

In April 2000 a base line survey was conducted on the larval distribution of commercial fish species off the west, north and south coasts of Ireland. Ichthyoplankton samples and in situ CTD data were collected, whilst simultaneously capturing remote sensing images of chlorophyll and sea surface temperatures. The survey sampling area covered the Celtic Sea from the Irish south coast to 49 degree N, the western shelf including the Porcupine Bank and the northern shelf up to the Stanton Bank. The sample grid design was based on the international mackerel & horse mackerel egg survey with station spacings of 0.5 degree latitude and 0.5 degree longitude. Ichthyoplankton samples were collected with a Gulf III plankton sampler, which was deployed on oblique tows from the surface to within 5 metres of the bottom (200m max). A self-logging CTD sensor (Promonitor) was attached to the Gulf and recorded depth, temperature and salinity profiles for each deployment. Results from the Promonitor CTD showed that strong temperature and salinity gradients were encountered during the survey. Lowest temperatures coincided with lowest salinity in the North Channel of the Irish Sea while highest salinities and temperatures were found to the south west of Ireland.Thermal fronts were found in the eastern Celtic Sea and on the north west coast of Ireland.The AVHRR images showed a progressive increase in surface temperatures in the Celtic Sea and west of Ireland. Highest surface chlorophyll concentrations were associated with cooler less saline water in the Irish Sea and the coastal areas around Ireland. In the western Celtic Sea surface chlorophyll concentrations increased as the survey progressed to form a phytoplankton bloom towards the end of the survey. Larvae of interest showed distinct distribution patterns, with some species being confined to particular areas or spawning grounds while others were spread over the whole survey area. The survey identified two important larval hotspots: Cod larvae were concentrated in the eastern Celtic Sea, where other gadoid species such as haddock, whiting, pollack and saithe were also found in high numbers.This area is associated with the Celtic Sea front and shows increased primary productivity, which could present a favourable environment for successful larval survival. Stations in the southwest of Ireland sustained high concentrations of hake, megrim and mackerel larvae. The waters with high numbers of these three species stretched from shallow inshore stations to deeper ones along the continental shelf and were characterised by high temperatures and salinities. SeaWIFS satellite images suggest the formation of a phytoplankton bloom within this larval hotspot, which would provide the necessary resources for successful larval growth.Funder: Marine Institut

The Refentse model for post-rape care: Strengthening sexual assault care and HIV post-exposure prophylaxis in a district hospital in rural South Africa

The Refentse study aimed to develop a nurse-driven, post-rape care model that could be integrated into existing reproductive health/HIV services within a rural South African hospital, and to evaluate the impact of this model on the quality of care delivered. Following the intervention, there were significant improvements in the quality of clinical history and examination, and the provision of pregnancy testing, emergency contraception, STI treatment, HIV counseling and testing, post-exposure prophylaxis (PEP), trauma counseling, and referrals. The report concludes that it is possible to improve sexual assault services including PEP within a rural South African hospital at modest cost, using existing staff and infrastructure. With additional training, nurses can play a central role in this care

Factors predicting hospital length-of-stay and readmission after colorectal resection: a population-based study of elective and emergency admissions

<p>Abstract</p> <p>Background</p> <p>The impact of developments in colorectal cancer surgery on length-of-stay (LOS) and re-admission have not been well described. In a population-based analysis, we investigated predictors of LOS and emergency readmission after the initial surgery episode.</p> <p>Methods</p> <p>Incident colorectal cancers (ICD-O2: C18-C20), diagnosed 2002-2008, were identified from the National Cancer Registry Ireland, and linked to hospital in-patient episodes. For those who underwent colorectal resection, the associated hospital episode was identified. Factors predicting longer LOS (upper-quartile, > 24 days) for elective and emergency admissions separately, and whether LOS predicted emergency readmission within 28 days of discharge, were investigated using logistic regression.</p> <p>Results</p> <p>8197 patients underwent resection, 63% (n = 5133) elective and 37% (n = 3063) emergency admissions. Median LOS was 14 days (inter-quartile range (IQR) = 11-20) for elective and 21 (15-33) for emergency admissions. For both emergency and elective admissions, likelihood of longer LOS was significantly higher in patients who were older, had co-morbidities and were unmarried; it was reduced for private patients. For emergency patients only the likelihood of longer LOS was lower for patients admitted to higher-volume hospitals. Longer LOS was associated with increased risk of emergency readmission.</p> <p>Conclusions</p> <p>One quarter of patients stay in hospital for at least 25 days following colorectal resection. Over one third of resected patients are emergency admissions and these have a significantly longer median LOS. Patient- and health service-related factors were associated with prolonged LOS. Longer LOS was associated with increased risk of emergency readmission. The cost implications of these findings are significant.</p