Farmers\u27 estimations of sheep weights to calculate drench dose

Undersosing with drenches is a mojor cause of anthelmintic (drench) resistance in worm parasites of sheep. When farmers use a drench at less than the recommended dose rate, some worms may survive, and their ability to resist treatment with the chemical involved is passed to their offspring. Over a period of time, matings between worms with different degrees of resistance can produce individuals able to resist the drench at the recommended dose rate or even higher. Farmers must use adequate dose rates so that worms do not have a chance to survive treatment

Antimicrobial Stewardship Programmes in Community Healthcare Organisations in England: A Cross-Sectional Survey to Assess Implementation of Programmes and National Toolkits

Objective: The aim of this study was to assess antimicrobial stewardship activities in Community Healthcare Organisations (CHOs) with focus on the implementation of the two national antimicrobial stewardship toolkits, TARGET (Treat Antibiotics Responsibly, Guidance, Education, Tools) and SSTF (Start Smart, then Focus). The study utilised a web-based survey comprising 34 questions concerning antimicrobial policies and awareness and implementation of antimicrobial stewardship toolkits. This was distributed to pharmacy teams in all 26 CHOs in England. Twenty CHOs (77%) responded. An antimicrobial stewardship (AMS) committee was active in 50% of CHOs; 25% employed a substantive pharmacist post and 70% had a local antibiotic policy. Fourteen of the responding CHOs were aware of both AMS toolkits, five organisations were aware of either SSTF or TARGET, and one organisation was not aware of either toolkit. Of the organisations aware of SSTF and TARGET, eight had formally reviewed both toolkits, though three had not reviewed either. Less than half of the respondents had developed local action plans for either toolkit. National guidance in England has focused attention on initiatives to improve AMS implementation in primary and secondary care; more work is required to embed AMS activities and the implementation of national AMS toolkit recommendations within CHOs.Peer reviewedFinal Published versio

Personal Finance Goals Creation and Progress Tracking Using A Payment Application

A sizable fraction of the population does not have high-yield savings accounts, thereby missing out on the opportunity for earning interest. Savings accounts are liquid, making them a good vehicle for an emergency fund and for meeting short-term goals (vacation, wedding, etc.) while enabling the growth of money. This disclosure describes a savings account that can be signed up and accessed from a payment application on a mobile device. The described savings account, interfaced to the user via a familiar payment application, enables users to learn the benefits of, gain trust in, and readily access savings accounts, thereby enjoying a higher interest on their savings while maintaining liquidity. The described savings account and payment application also enables users to set and track financial goals

Geochemical Signatures in Zircons as Probes of the Impact History of the Inner Solar System

Understanding the origin and evolution of the planets requires better constraints on the timing and intensity of early thermal events in the asteroid belt and Moon, including the proposed \u22Late Heavy Bombardment\u22 (LHB) at ca. 3900 Ma. Both the eucrite meteorites (from asteroid 4 Vesta) and lunar impact breccias contain accessory minerals (e.g. zircon, apatite, baddeleyite, zirconolite) with U-Pb ages that may not have been wholly re-set by thermal events subsequent to their original formation; many of these pre-date the LHB epoch and yield complex histories attributable to multiple thermal events of uncertain affinity. Further detailed geochronological analyses are therefore warranted to uncover a cryptic record of \u22pre-LHB\u22 bombardments. Zircons are useful in this regard because they are cited as the most reliable chronometers despite (sometimes significant) thermal metamorphism. A suite of criteria used to elucidate the petrogenetic history of zircon include: determination whether they are the products of a purely crustal igneous process; crystallized from impact melts; or experienced diffusion-controlled age resetting from impact shock-heating resulting in the partial re-equilibration of primary igneous zircon. Geochemical tools to distinguish between these different scenarios include U-Pb geochronology, trace element geochemistry, Ti-in-zircon thermometry and zircon-melt trace element partition modeling. Ultra-high resolution (sub-µm) U-Th-Pb depth profiles in eucritic zircons reveal different age domains correlative to mineral chemistry in cores and mantles within individual zircons. Results from eucrite zircons confirm previous ages determined for the solidification 4 Vesta\u27s crust within a few million years after the formation of CAIs (4561±13 Ma), while younger ages may be the result of either shock metamorphism via impact heating, or are associated with protracted basaltic magmatism. Furthermore, U-Th-Pb-Ti abundances for 106 lunar zircons from lunar impact breccia 14311 show three distinct age populations of 4334 ± 5 Ma, 4245 ± 5 Ma, and 3954 ± 5 Ma. Thermometry results reveal temperatures that range from 800-1200 ⁰C. A significant number of these zircons yield temperatures within the range of modeled impact melt values for the Moon. Taken together, U-Pb ages, geochemistry and partition modeling suggest that the oldest lunar zircon population represents primary igneous crustal formation at ca. 4350 Ma, while the ca. 4250 Ma zircons may be a mixture of igneous and impact-produced zircons. Impact-generated or altered lunar zircons at about 4000 and 4200 Ma coincide with \u22LHB\u22 and \u22pre-LHB\u22 events reported in other radiogenic systems, other zircon ages from lunar impact breccias, as well as the oldest terrestrial zircons. These results support a longer period of bombardment akin to the proposed dynamical \u22Sawtooth\u22 model

Knowledge and attitudes about antibiotics and antibiotic resistance of 2404 UK healthcare workers

Background: Using the COM-B model as a framework, an EU-wide survey aimed to ascertain multidisciplinary healthcare workers’ (HCWs’) knowledge, attitudes and behaviours towards antibiotics, antibiotic use and antibiotic resistance. The UK findings are presented here. Methods: A 43-item questionnaire was developed through a two-round modified Delphi consensus process. The UK target quota was 1315 respondents. Results: In total, 2404 participants responded. The highest proportion were nursing and midwifery professionals (42%), pharmacists (23%) and medical doctors (18%). HCWs correctly answered that antibiotics are not effective against viruses (97%), they have associated side effects (97%), unnecessary use makes antibiotics ineffective (97%) and healthy people can carry antibiotic-resistant bacteria (90%). However, fewer than 80% correctly answered that using antibiotics increases a patient’s risk of antimicrobial resistant infection or that resistant bacteria can spread from person to person. Whilst the majority of HCWs (81%) agreed there is a connection between their antibiotic prescribing behaviour and the spread of antibiotic-resistant bacteria, only 64% felt that they have a key role in controlling antibiotic resistance. The top three barriers to providing advice or resources were lack of resources (19%), insufficient time (11%) and the patient being uninterested in the information (7%). Approximately 35% of UK respondents who were prescribers prescribed an antibiotic at least once in the previous week to responding to the survey due to a fear of patient deterioration or complications. Conclusion: These findings highlight that a multifaceted approach to tackling the barriers to prudent antibiotic use in the UK is required and provides evidence for guiding targeted policy, intervention development and future research. Education and training should focus on patient communication, information on spreading resistant bacteria and increased risk for individuals

Let Them In: Family Presence During Intensive Care Unit Procedures

Families have for decades advocated for full access to intensive care units (ICUs) and meaningful partnership with clinicians, resulting in gradual improvements in family access and collaboration with ICU clinicians. Despite such advances, family members in adult ICUs are still commonly asked to leave the patient’s room during invasive bedside procedures, regardless of whether the patient would prefer family to be present. Physicians may be resistant to having family members at the bedside due to concerns about trainee education, medicolegal implications, possible effects on the technical quality of procedures due to distractions, and procedural sterility. Limited evidence from parallel settings does not support these concerns. Family presence during ICU procedures, when the patient and family member both desire it, fulfills the mandates of patient-centered care. We anticipate that such inclusion will increase family engagement, improve patient and family satisfaction, and may, on the basis of studies of open visitation, pediatric ICU experience, and family presence during cardiopulmonary resuscitation, decrease psychological distress in patients and family members. We believe these goals can be achieved without compromising the quality of patient care, increasing provider burden significantly, or increasing risks of litigation. In this article, we weigh current evidence, consider historical objections to family presence at ICU procedures, and report our clinical experience with the practice. An outline for implementing family procedural presence in the ICU is also presented