Accepting or declining dialysis: considerations taken into account by elderly patients with end-stage renal disease

BACKGROUND: Elderly patients with end-stage renal disease have to make a difficult decision whether or not to start dialysis. This study explores the considerations taken into account by these patients in decision-making regarding renal replacement therapy. METHOD: In-depth interviews were conducted to gain an enhanced understanding of the considerations in treatment decision-making. Fourteen patients aged 65 years or older participated in the interviews, of whom 8 patients had made the decision to start, and 6 patients the decision to decline, dialysis. RESULTS: All participating patients had a variety of health problems, but appeared to have normal cognitive functions. Patients who declined dialysis were older and more often men and widow(er)s compared with patients who accepted dialysis. Patients chose to start dialysis because they enjoyed life, were not prepared to face the end of life, felt they had no other choice or had care-giving responsibilities for family members. Patients declined dialysis because of the speculated loss of autonomy, their age-associated decrease in vitality, distance from dialysis center and reluctance to think about the future. CONCLUSION: Results suggest that patients' decisions to decline or accept dialysis are not based on the effectiveness of the treatment, but rather on personal values, beliefs and feelings toward life, suffering and death, and the expected difficulties in fitting the treatment into their life

The influence of soil steaming on some properties of the soil and on the growth and heading of winter glasshouse lettuce. I. Changes in chemical and physical properties.

Soil steaming caused an increase of 33 ppm mineral N. There was no significant effect on water-soluble P2O5. The influence of steaming on buffer-soluble Mg content varied with the treatment but there seemed to be a negative correlation with the P content. Steaming enhanced K solubility and increased buffer-soluble Mn content. Fe and Al soluble in buffer solution were slightly increased. 44 references. (Abstract retrieved from CAB Abstracts by CABI’s permission

Validation of the Edinburgh Postnatal Depression Scale on a cohort of South African women

Posmatal depression occurs in 10 - 15% of women. The Edinburgh Postnatal Depression Scale (EPDS) is a ID-item self-report scale designed specifically as a screening instrument for the postnatal period. It was initially validated for use in the UK, but has subsequently been validated for other communities. It has not been validated for an African community.Objective. To determine whether the EPDS is a valid screening scale for depression in a Joharmesburg community cohort. Participants and setting. 103 women attending the posmatal clinic at Coronation Hospital, Johannesburg, South Africa.Method. The EPDS was validated against the· Diagnostic and Statistical Manual (DSM-IV) criteria for depression. It was administered verbally to participants and translated into one of six South African languages where necessary.Results. A threshold of 11/12 on the EPDS identified 100% of women with major depression and 70.6% of women with minor depression. For major and minor depression combined, sensitivity was 80%, specificity 76.6%, positive predictive value 52.6% and negative predictive value 92.2%.Conclusion. The EPDS, administered verbally, is a valid screening instrument in this urban South African community

A non-invasive cardiac output measurement as an alternative to the test bolus technique during CT angiography

Aim To investigate the association between a non-invasive cardiac output (CO) measurement and the scan delay, as derived from a test bolus injection protocol. The secondary objective was to determine which factors affect the relationship between the CO and scan delay. Materials and methods Fifty-five patients referred for a contrast-enhanced (thorax-)abdomen CT examination were included in this feasibility study. A test bolus examination was performed prior to the abdominal CT. During the test bolus injection, the CO of the patient was measured using a non-invasive finger-cuff measurement. Associations were analysed using linear regression analyses. Age, gender, height, weight, and blood pressure were included as potential confounders. Results Linear regression analysis showed a negative and significant association between CO and delay. The regression formula was as follows: scan delay (seconds) = 26.8–1.6 CO (l/min), with a 95% CI between −2.3 and −1.0 (p<0.001). Weight appeared to be a confounder in this relation, and gender and blood pressure were effect modifiers. There was no interaction between scan delay and age, height and weight. Conclusions There is a negative and significant association between the non-invasive CO measurement and the CT scan delay; however, to validate these findings a larger cohort study is needed to investigate whether the non-invasively determined scan delay is as accurate as the use of a test bolus

Factoid Forensics: Have “more than 40” Australian families abandoned their homes because of wind farm noise?

Background Anti wind farm activists repeatedly claim that families said to be adversely affected by noise from wind turbines “abandon” their homes. In Australia, a claim of “more than 40 families” has been made by a prominent anti wind farm activist. Methods Six sources (parliamentary submissions, media reports, an anti wind farm website, wind industry sources, correspondence with known anti wind farm activists, and with three politicians opposed to wind farms) were used to find evidence of home “abandonments”. Results Claims about 12 Australian households permanently (n=10) or periodically (n=2) leaving their homes were found. However, no house appears to have been permanently “abandoned” without sale, as the expression implies. These 12 cases need contextualizing against considerations that several of those involved were either dedicated activists against wind farms from times sometimes pre-dating their construction, were engaged in protracted negotiations for home purchase with wind companies, had pre-existing health problems, grievances with the wind company over employment or had left the area for unrelated reasons of employment elsewhere. Conclusions The statement that “more than 40” houses have been “abandoned” because of wind turbines in Australia is a factoid promoted by wind farm opponents for dramatic, rhetorical impact. Other considerations are often involved in abandonment unrelated to the claims made about wind farm noise

Sectorrapportage Duurzame Zuivelketen : prestaties 2014 in perspectief

Via het initiatief de Duurzame Zuivelketen streven zuivelondernemingen en melkveehouders gezamenlijk naar een toekomstbestendige en verantwoorde zuivelsector. De Duurzame Zuivelketen heeft doelen geformuleerd op 4 duurzaamheidsthema’s. Deze sectorrapportage doet verslag van de voortgang op deze doelen in 2014. Deze rapportage laat zien dat de Duurzame Zuivelketen sinds de nulmeting (2011) op het gebied van antibiotica, energie-efficiëntie en verantwoorde soja veel vooruitgang heeft geboekt en dat de doelen voor 2020 binnen handbereik zijn in 2014 of zelfs al gehaald. Ook bij levensduur en duurzame energie zijn er ontwikkelingen in de goede richting maar is er meer vooruitgang nodig om de doelen te kunnen halen. Op het gebied van broeikasgassen, fosfaat en ammoniak zorgt het toegenomen productievolume ervoor dat de afgesproken productieplafonds in gevaar komen. Op het thema weidegang is het vooralsnog niet gelukt om de ingezette dalende trend te keren. Voor dierenwelzijn en biodiversiteit is monitoring nog in ontwikkeling

Genetic diversity, relatedness and inbreeding of ranched and fragmented Cape buffalo populations in southern Africa

Wildlife ranching, although not considered a conventional conservation system, provides a sustainable model for wildlife utilization and could be a source of valuable genetic material. However, increased fragmentation and intensive management may threaten the evolutionary potential and conservation value of species. Disease-free Cape buffalo (Syncerus caffer caffer) in southern Africa exist in populations with a variety of histories and management practices. We compared the genetic diversity of buffalo in national parks to private ranches and found that, except for Addo Elephant National Park, genetic diversity was high and statistically equivalent. We found that relatedness and inbreeding levels were not substantially different between ranched populations and those in national parks, indicating that breeding practices likely did not yet influence genetic diversity of buffalo on private ranches in this study. High genetic differentiation between South African protected areas highlighted their fragmented nature. Structure analysis revealed private ranches comprised three gene pools, with origins from Addo Elephant National Park, Kruger National Park and a third, unsampled gene pool. Based on these results, we recommend the Addo population be supplemented with disease-free Graspan and Mokala buffalo (of Kruger origin). We highlight the need for more research to characterize the genetic diversity and composition of ranched wildlife species, in conjunction with wildlife ranchers and conservation authorities, in order to evaluate the implications for management and conservation of these species across different systems.S1 Appendix. Supplementary methods.S1 Fig. Estimated effective population size (Ne) of the buffalo population from each locality. Vertical lines indicate 95% confidence intervals. Numbers inserted for GNP and GNP-MNP indicate the value of the upper bound of the 95% CI. The dashed line indicates the lower 95% CI of GNP. Values are also shown in S3 Table. PVT: Private ranches combined.S2 Fig. Statistical support for K. The first column of graphs [L(K)] show the mean log likelihood of each value of K with its associated standard deviation, while the second column (DeltaK) shows the most likely value of K as determined by the Evanno method. Rows indicate the full data set (FDS) and the relatives removed (RR) data set. The graphs were generated using StructureHarvester and further organized in Inkscape v0.92 (https://inkscape.org/).S3 Fig. Individual assignment plots of the STRUCTURE analyses at K = 2 and K = 3. A–full data set, B–relatives removed. The plots were generated using the online version of Clumpak and further organized in Inkscape v0.92 (https://inkscape.org/).S4 Fig. Discriminant analysis of principal components (DAPC) of the full data set at K = 3. AENP Cluster: Addo Elephant National Park cluster, GNP-MNP Cluster: Graspan and Mokala National Park cluster, “Other” Cluster: Third, unknown origin cluster.S1 Table. Summary statistics of microsatellite loci used in this study. Calculated in Cervus v3.0.7.S2 Table. Mean and variance of the relatedness estimators available in COANCESTRY. TrioML (values in bold) had the lowest variance for each sampling locality and produces positive relatedness estimates between zero and one (as does DyadML).S3 Table. Population summary statistics for each sampling locality.S4 Table. Relatedness and individual inbreeding statistics.S5 Table. Mean relatedness within sexes.S6 Table. Pairwise DJOST and FST values with 95% confidence intervals.S7 Table. Hardy-Weinberg Equilibrium (HWE) probability tests of each sampling locality, with the full data set and relatives removed. Data sets from sampling localities conformed to HWE after relatives were removed.S8 Table. Original and Bonferroni-corrected linkage disequilibrium p-values of all pairs of loci in all sampling localities. Both the full data set (FDS) and relatives removed (RR) data set are shown.DdJ hereby acknowledges the financial contribution of the National Research Foundation (https://www.nrf.ac.za/), under the grant number SFH150630122321.http://www.plosone.orgam2021BiochemistryGeneticsMicrobiology and Plant Patholog

Sectorrapportage Duurzame Zuivelketen : prestaties 2017 in perspectief

Via het initiatief de Duurzame Zuivelketen streven zuivelondernemingen en melkveehouders gezamenlijk naar een toekomstbestendige en verantwoorde zuivelsector. De Duurzame Zuivelketen heeft doelen geformuleerd op het gebied van vier duurzaamheidsthema’s. Deze sectorrapportage doet verslag van de voortgang op deze doelen in 2017. De Duurzame Zuivelketen levert op alle thema’s waarop zij actief is flinke inspanningen om de gestelde doelen te realiseren. Op veel thema’s is in 2017 vooruitgang geboekt ten opzichte van 2016. Doelrealisatie vindt plaats op de thema’s verantwoord antibioticagebruik, energie-efficiëntie en verantwoorde soja. Alleen bij levensduur is het resultaat verslechterd. Het fosfaatreductieplan en de daarmee gepaard gaande daling van het aantal dieren heeft grote invloed gehad op de resultaten van 2017. Het fosfaatplafond voor de veehouderij als geheel werd niet meer overschreden in 2017, het sectorplafond voor de melkveehouderij nog wel. Een positieve ontwikkeling is dat er in 2017 voor het eerst sprake was van een dalende lijn in de broeikasgasemissies van de zuivelketen. Op basis van voorlopige cijfers geldt dit ook voor de ammoniakemissie. Voor beide thema’s geldt echter ook dat de afstand tot het doel nog groot is. Ook op het thema duurzame energie productie is de afstand tot het doel nog groot. Bij weidegang is er een stijgende trend en is het nagestreefde niveau van 81,2% bedrijven met weidegang binnen handbereik. Voor dierenwelzijn en biodiversiteit zijn nog geen doelen op sectorniveau vastgesteld in 2017, maar er is wel voortgang geboekt in het ontwikkelen van de monitoringssystematiek.---Through the Sustainable Dairy Chain (Duurzame Zuivelketen) initiative, dairy companies and dairy farmers strive for a future-proof and sustainable dairy sector together. The Sustainable Dairy Chain has formulated targets in the area of four sustainability themes. This sector report provides an overview of the progress on those objectives in 2017. The Sustainable Dairy Chain actively pursues these goals for all of the themes in which it is involved. There has been progress in many of themes when comparing 2017 to 2016. The targets are achieved in the themes of responsible use of antibiotics, energy efficiency, and sustainable soy. The results have only declined for lifespan. The phosphate reduction plan, and the associated decrease in the number of animals, had a significant impact on the 2017 results. The phosphate ceiling for livestock farming as a whole was no longer exceeded in 2017, however, the sector ceiling for dairy farming was. A positive development in 2017 is that a downward trend was visible in the greenhouse gas emissions by the dairy chain for the first time. Preliminary figures show that this is also true for ammonia emissions. However, both themes are also still a long way from their target. Sustainable energy production is also still far from the theme’s target. There is an upward trend for grazing, and the targeted level of 81.2% of farms with grazing is within reach. Animal welfare and biodiversity had no targets set at the sector level in 2017, but progress was made in the development of the monitoring system

Evoked Emotions Predict Food Choice

In the current study we show that non-verbal food-evoked emotion scores significantly improve food choice prediction over merely liking scores. Previous research has shown that liking measures correlate with choice. However, liking is no strong predictor for food choice in real life environments. Therefore, the focus within recent studies shifted towards using emotion-profiling methods that successfully can discriminate between products that are equally liked. However, it is unclear how well scores from emotion-profiling methods predict actual food choice and/or consumption. To test this, we proposed to decompose emotion scores into valence and arousal scores using Principal Component Analysis (PCA) and apply Multinomial Logit Models (MLM) to estimate food choice using liking, valence, and arousal as possible predictors. For this analysis, we used an existing data set comprised of liking and food-evoked emotions scores from 123 participants, who rated 7 unlabeled breakfast drinks. Liking scores were measured using a 100-mm visual analogue scale, while food-evoked emotions were measured using 2 existing emotion-profiling methods: a verbal and a non-verbal method (EsSense Profile and PrEmo, respectively). After 7 days, participants were asked to choose 1 breakfast drink from the experiment to consume during breakfast in a simulated restaurant environment. Cross validation showed that we were able to correctly predict individualized food choice (1 out of 7 products) for over 50% of the participants. This number increased to nearly 80% when looking at the top 2 candidates. Model comparisons showed that evoked emotions better predict food choice than perceived liking alone. However, the strongest predictive strength was achieved by the combination of evoked emotions and liking. Furthermore we showed that non-verbal food-evoked emotion scores more accurately predict food choice than verbal food-evoked emotions scores