From dust bowl to dust bowl:soils are still very much a frontier of science

When the Soil Science Society of America was created, 75 yr ago, the USA was suffering from major dust storms, causing the loss of enormous amounts of topsoil as well as human lives. These catastrophic events reminded public officials that soils are essential to society’s well-being. The Soil Conservation Service was founded and farmers were encouraged to implement erosion mitigation practices. Still, many questions about soil processes remained poorly understood and controversial. In this article, we argue that the current status of soils worldwide parallels that in the USA at the beginning of the 20th century. Dust bowls and large-scale soil degradation occur over vast regions in a number of countries. Perhaps more so even than in the past, soils currently have the potential to affect populations critically in several other ways as well, from their effect on global climate change, to the toxicity of brownfield soils in urban settings. Even though our collective understanding of soil processes has experienced significant advances since 1936, many basic questions still remain unanswered, for example whether or not a switch to no-till agriculture promotes C sequestration in soils, or how to account for microscale heterogeneity in the modeling of soil organic matter transformation. Given the enormity of the challenges raised by our (ab)uses of soils, one may consider that if we do not address them rapidly, and in the process heed the example of U.S. public officials in the 1930s who took swift action, humanity may not get a chance to explore other frontiers of science in the future. From this perspective, insistence on the fact that soils are critical to life on earth, and indeed to the survival of humans, may again stimulate interest in soils among the public, generate support for soil research, and attract new generations of students to study soils

Participant preferences for an aboriginal-specific fall prevention program: Measuring the value of culturally-appropriate care

© 2018 Angell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background Culturally-specific services are central to efforts to improve the health of Aboriginal Australians. Few empirical studies have demonstrated the value of such services relative to mainstream alternatives. Objective To assess the preferences and willingness to pay (WTP) of participants for attending a class and the relative importance of transport, cost and cultural-appropriateness in the choices made by participants. Design A discrete choice experiment (DCE) was conducted alongside a study of a culturally-specific fall-prevention service. Attributes that were assessed were out-of-pocket costs, whether transport was provided and whether the class was Aboriginal-specific. Choices of participants were modelled using panel-mixed logit methods. Results 60 patients completed the DCE. Attending a service was strongly preferred over no service (selected 99% of the time). Assuming equivalent efficacy of fall-prevention programs, participants indicated a preference for services that were culturally-specific (OR 1.25 95% CI: 1.00–1.55) and incurred lower out-of-pocket participant costs (OR 1.19 95% CI 1.11–1.27). The provision of transport did not have a statistically significant influence on service choice (p = 0.57). Discussion and conclusions This represents the first published DCE in the health field examining preferences amongst an Aboriginal population. The results empirically demonstrate the value of the culturally-specific element of a program has to this cohort and the potential that stated-preference methods can have in incorporating the preferences of Aboriginal Australians and valuing cultural components of health services. Note on terminology As the majority of the NSW Aboriginal and Torres Strait Islander population is Aboriginal (97.2%), this population will be referred to as ‘Aboriginal’ in this manuscript

Process evaluation of a randomised controlled trial of a pharmacological strategy to improve hypertension control: Protocol for a qualitative study

© 2018 Author(s) (or their employer(s)). Introduction Globally, the prevalence of uncontrolled hypertension is high, particularly in low- and middle-income countries. There is a critical need for strategies to improve hypertension control. The early use of a fixed low-dose combination of three antihypertensive drugs (triple pill) has the potential to significantly improve hypertension control. The TRI ple Pill vs. U sual care M anagement for P atients with mild-to- moderate H ypertension (TRIUMPH) randomised controlled trial (RCT) is designed to test the effects of this strategy compared with usual care in patients with mild-to-moderate hypertension. This paper reports the protocol of a process evaluation of the TRIUMPH RCT. The objectives are to understand factors related to implementation of the intervention, mechanisms of effect, contextual factors that underpin the effectiveness of the triple pill strategy and the potential barriers and facilitators to implementing the strategy in clinical practice. Methods and analysis Face-to-face semistructured in-depth interviews with a purposive sample of TRIUMPH RCT participants and healthcare professionals in Sri Lanka will be conducted. Healthcare professionals will include physicians and their staff who were involved in conducting the TRIUMPH RCT. Interviewees will be recruited sequentially until thematic saturation is achieved. Interviews will be audio recorded, transcribed verbatim and analysed in NVivo using framework analysis methods. Ethics and dissemination The TRIUMPH RCT and process evaluation have received approval from the relevant Ethics Review Committee. All participants will be asked to provide written consent before participation. Findings from the study will be disseminated through publications and conference presentations

PCV54 Can A Cvd Polypill Save Money In The ‘Real World'?

Digitalitzat per Artypla

Biochemical Changes of Chickpea Genotypesbefore and After Infestation of Pulse Beetle, Callosobruchus Chinensis L. (Coleoptera: Bruchidae) During Storage

The pulse beetle is a field-to-store pest as its infestation on pulses often begins in the field itself as adults lay eggs on mature pods and when such seed is harvested and stored, the pest population increases rapidly and results in total destruction within a short period of 3-4 months. Keeping in view,varietal screening of fifty chickpea genotypes was carried outin the storage laboratory, Department of Entomology, OUAT, BBSR and the performance of the genotypes was assessed based on various biological parameters of test insect, damage and infestation by C. chinensis. The results indicated that none of the genotypes was completely resistant to pest attack whereas 4 genotypes (Himachal Chana 1, Dheera (NBeG-47), JG-14 and Dilaji) were found moderately resistant, 8 genotypes (Phule Vikram, JG 11, ICCV-181108, ICCV-181107, ICCV-181605, C-18203, C-18205 and C-18252) were moderately susceptible,11 genotypes (RVG-204, RVG-203, JAKI-9218, Pratap Chana, Bharati, ICCC 4, ICCV-181106, ICCV-181612, C-18206, ICCV-181101 and Radhey) were susceptible and 27 genotypes (NBeG-49, Himachal Chana 2, JG-16, JG-130, CO 4, Vishal, Kranthi, NBeG-3, ICCV-14102, ICCV-171117, C-18175, ICCV-181611,ICCV-14106, Kalahandi Local, ICC 3137, ICCL 86111, C-19162, C-19168,GNG 2207, BG 3043, GG 3, Birsa Chana 3, C 19199, RSG 963, C 19200, KPG 59and NBeG 119) were noticed to be highly susceptible. The bio-chemicalconstituents analyzed in the present studies viz., protein, phenol, ash and fibre contents of the genotypes contributed to the resistance / susceptibility of C. chinensis. Among the biochemical parameters, protein exerted significant positive effect whereas phenol, ash and fibre contents exhibited negative influence on pest infestation and development

Strichartz estimates on Schwarzschild black hole backgrounds

We study dispersive properties for the wave equation in the Schwarzschild space-time. The first result we obtain is a local energy estimate. This is then used, following the spirit of earlier work of Metcalfe-Tataru, in order to establish global-in-time Strichartz estimates. A considerable part of the paper is devoted to a precise analysis of solutions near the trapping region, namely the photon sphere.Comment: 44 pages; typos fixed, minor modifications in several place

Data-driven quality improvement program to prevent hospitalisation and improve care of people living with coronary heart disease: Protocol for a process evaluation

Background: Practice-level quality improvement initiatives using rapidly advancing technology offers a multidimensional approach to reduce cardiovascular disease burden. For the “QUality improvement in primary care to prevent hospitalisations and improve Effectiveness and efficiency of care for people Living with heart disease” (QUEL) cluster randomised controlled trial, a 12-month quality improvement intervention was designed for primary care practices to use data and implement progressive changes using “Plan, Do, Study, Act” cycles within their practices with training in a series of interactive workshops. This protocol aims to describe the systematic methods to conduct a process evaluation of the data-driven intervention within the QUEL study. Methods: A mixed-method approach will be used to conduct the evaluation. Quantitative data collected throughout the intervention period, via surveys and intervention materials, will be used to (1) identify the key elements of the intervention and how, for whom and in what context it was effective; (2) determine if the intervention is delivered as intended; and (3) describe practice engagement, commitment and capacity associated with various intervention components. Qualitative data, collected via semi-structured interviews and open-ended questions, will be used to gather in-depth understanding of the (1) satisfaction, utility, barriers and enablers; (2) acceptability, uptake and feasibility, and (3) effect of the COVID-19 pandemic on the implementation of the intervention. Conclusion: Findings from the evaluation will provide new knowledge on the implementation of a complex, multi-component intervention at practice-level using their own electronic patient data to enhance secondary prevention of cardiovascular disease. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR) number ACTRN12619001790134

Effectiveness of an electronic patient-centred self-management tool for gout sufferers: A cluster randomised controlled trail protocol

© © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. Introduction Gout is increasing despite effective therapies to lower serum urate concentrations to 0.36 mmol/L or less, which, if sustained, significantly reduces acute attacks of gout. Adherence to urate-lowering therapy (ULT) is poor, with rates of less than 50% 1 year after initiation of ULT. Attempts to increase adherence in gout patients have been disappointing. We aim to evaluate the effectiveness of use of a personal, self-management, a'smartphone' application (app) to achieve target serum urate concentrations in people with gout. We hypothesise that personalised feedback of serum urate concentrations will improve adherence to ULT. Methods and analysisSetting and design Primary care. A prospective, cluster randomised (by general practitioner (GP) practices), controlled trial. Participants GP practices will be randomised to either intervention or control clusters with their patients allocated to the same cluster. Intervention The intervention group will have access to the Healthy.me app tailored for the self-management of gout. The control group patients will have access to the same app modified to remove all functions except the Gout Attack Diary. Primary and secondary outcomes The proportion of patients whose serum urate concentrations are less than or equal to 0.36 mmol/L after 6 months. Secondary outcomes will be proportions of patients achieving target urate concentrations at 12 months, ULT adherence rates, serum urate concentrations at 6 and 12 months, rates of attacks of gout, quality of life estimations and process and economic evaluations. The study is designed to detect a ≥30% improvement in the intervention group above the expected 50% achievement of target serum urate at 6 months in the control group: power 0.80, significance level 0.05, assumed a'dropout' rate 20%. Ethics and dissemination This study has been approved by the University of New South Wales Human Research Ethics Committee. Study findings will be disseminated in international conferences and peer-reviewed journal. Trial registration number ACTRN12616000455460

An integrated general practice and pharmacy-based intervention to promote the use of appropriate preventive medications among individuals at high cardiovascular disease risk: protocol for a cluster randomized controlled trial

Background: Cardiovascular diseases (CVD) are responsible for significant morbidity, premature mortality, and economic burden. Despite established evidence that supports the use of preventive medications among patients at high CVD risk, treatment gaps remain. Building on prior evidence and a theoretical framework, a complex intervention has been designed to address these gaps among high-risk, under-treated patients in the Australian primary care setting. This intervention comprises a general practice quality improvement tool incorporating clinical decision support and audit/feedback capabilities; availability of a range of CVD polypills (fixed-dose combinations of two blood pressure lowering agents, a statin ± aspirin) for prescription when appropriate; and access to a pharmacy-based program to support long-term medication adherence and lifestyle modification. Methods: Following a systematic development process, the intervention will be evaluated in a pragmatic cluster randomized controlled trial including 70 general practices for a median period of 18 months. The 35 general practices in the intervention group will work with a nominated partner pharmacy, whereas those in the control group will provide usual care without access to the intervention tools. The primary outcome is the proportion of patients at high CVD risk who were inadequately treated at baseline who achieve target blood pressure (BP) and low-density lipoprotein cholesterol (LDL-C) levels at the study end. The outcomes will be analyzed using data from electronic medical records, utilizing a validated extraction tool. Detailed process and economic evaluations will also be performed. Discussion: The study intends to establish evidence about an intervention that combines technological innovation with team collaboration between patients, pharmacists, and general practitioners (GPs) for CVD prevention. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN1261600023342