Partial nutrient balances from agronomic and economic viewpoints: the case of corn cultivation in the acid upland soils of Isabela, the Philippines

Soil propertiesMaizeEconomic aspects

Feasibility study of student telehealth interviews

BackgroundThe COVID-19 pandemic has led to medical students being taught remote clinical communication modalities (telephone and video). Junior students have not generally been included in this and have had less patient contact than previously. This study aimed to examine the feasibility from the junior student viewpoint of conducting both modalities of patient telehealth interviews.MethodsAn electronic questionnaire was used to discover Year 1 student reasons for their preferred modality after they had conducted one telephone and one video interview in pairs with a patient volunteer. Student views on the challenge and benefits of each were also sought.FindingsA total of 55 (32.7% of the cohort) responded, of whom 82% preferred video consultation, 75.6% of those stating being able to see their patient/partner was a key factor. About 5% preferred telephone interview, and 13% had no preference. Telephone interviews were perceived as the more challenging (40% versus 12.7%); however, challenge did not directly link with lack of comfort. There were some technical/connectivity issues with both modalities, and the telephone call system was more complex to set up. Turn-taking was more difficult by telephone without visual cues.DiscussionThis is the first direct comparison study in junior medical students of real patient interviews by video or telephone. Students embraced the challenge and, although preferring video and finding telephone more challenging, valued each as an educational experience.ConclusionsTelehealth interviews with patients for junior students are feasible, give needed patient exposure, practical insights into remote modalities and consolidate communication skills learnt in the classroom

Sustainable Grazing on Saline Land in Western Australia - Multidisciplinary Research Linking Producers and Scientists

Dryland salinity is one of the most critical environmental issues challenging Western Australian farmers. Currently 10% of the cropping zone (1.8 million ha) is salt-affected and this is predicted to increase dramatically in the next 50 years (NLWRA, 2001). Animals grazing saline pasture systems represent the most likely large-scale opportunity for economic return from saline land in the short to medium term. To date, few farmers have invested in large-scale revegetation of saline land as the economic return from grazing has not been perceived to cover costs. Furthermore other benefits of saltland pasture systems, such as biodiversity, water use and improved quality of animal products have not been quantified

Revegetation guide to the central wheatbelt

The rapid development of the central wheatbelt for agriculture over the past century has produced a productive farming landscape, but one which is increasingly subject to degradation. Erosion, salinization, declining soil structure, waterlogging and acidification are all symptoms of this degradation and causes of lost agricultural production. In addition, most of the native vegetation and many of the native animals have disappeared, and the natural heritage of the area resides in small scattered patches that together make up only seven per cent of the wheatbelt region. Many farmers now recognize that replanting trees and shrubs is an effective means of reversing many of the current trends towards land degradation. However, advice on how to go about revegetation, where to plant and which species to use has been hard to obtain. This guide is an attempt to redress this by providing lists of local species grouped according to soil types. It also provides a summary of current knowledge of revegetation methods. It has been put together using information from many sources including farmers, foresters, botanists and ecologists. It has been developed as a direct result of a workshop organized by CSIRO Division.https://researchlibrary.agric.wa.gov.au/bulletins/1106/thumbnail.jp

Designing environmental research for impact

Transdisciplinary research, involving close collaboration between researchers and the users of research, has been a feature of environmental problem solving for several decades, often spurred by the need to find negotiated outcomes to intractable problems. In 2005, the Australian government allocated funding to its environment portfolio for public good research, which resulted in consecutive four-year programmes (Commonwealth Environmental Research Facilities, National Environmental Research Program). In April 2014, representatives of the funders, researchers and research users associated with these programmes met to reflect on eight years of experience with these collaborative research models.This structured reflection concluded that successful multi-institutional transdisciplinary research is necessarily a joint enterprise between funding agencies, researchers and the end users of research. The design and governance of research programmes need to explicitly recognise shared accountabilities among the participants, while respecting the different perspectives of each group. Experience shows that traditional incentive systems for academic researchers, current trends in public sector management, and loose organisation of many end users, work against sustained transdisciplinary research on intractable problems, which require continuity and adaptive learning by all three parties. The likelihood of research influencing and improving environmental policy and management is maximised when researchers, funders and research users have shared goals; there is sufficient continuity of personnel to build trust and sustain dialogue throughout the research process from issue scoping to application of findings; and there is sufficient flexibility in the funding, structure and operation of transdisciplinary research initiatives to enable the enterprise to assimilate and respond to new knowledge and situations

European Reference Network for Rare Vascular Diseases (VASCERN) position statement on cerebral screening in adults and children with hereditary haemorrhagic telangiectasia (HHT)

Hereditary haemorrhagic telangiectasia (HHT) is a multisystemic vascular dysplasia inherited as an autosomal dominant trait. Approximately 10 % of patients have cerebral vascular malformations, a proportion being cerebral arteriovenous malformations (AVMs) and fistulae that may lead to potentially devastating consequences in case of rupture. On the other hand, detection and treatment related-risks are not negligible, and immediate. While successful treatment can be undertaken in individual cases, current data do not support the treatment of unruptured AVMs, which also present a low risk of bleeding in HHT patients. Screening for these AVMs is therefore controversial. Structured discussions, distinctions of different cerebrovascular abnormalities commonly grouped into an "AVM"bracket, and clear guidance by neurosurgical and neurointerventional radiology colleagues enabled the European Reference Network for Rare Vascular Disorders (VASCERN-HHT) to develop the following agreed Position Statement on cerebral screening: 1) First, we emphasise that neurological symptoms suggestive of cerebral AVMs in HHT patients should be investigated as in general neurological and emergency care practice. Similarly, if an AVM is found accidentally, management approaches should rely on expert discussions on a case-by-case basis and individual risk-benefit evaluation of all therapeutic possibilities for a specific lesion. 2) The current evidence base does not favour the treatment of unruptured cerebral AVMs, and therefore cannot be used to support widespread screening of asymptomatic HHT patients. 3) Individual situations encompass a wide range of personal, cultural and clinical states. In order to enable informed patient choice, and avoid conflicting advice, particularly arising from non-neurovascular interpretations of the evidence base, we suggest that all HHT patients should have the opportunity to discuss knowingly brain screening issues with their healthcare provider. 4) Any screening discussions in asymptomatic individuals should be preceded by informed pre-test review of the latest evidence regarding preventative and therapeutic efficacies of any interventions. The possibility of harm due to detection of, or intervention on, a vascular malformation that would not have necessarily caused any consequence in later life should be stated explicitly. We consider this nuanced Position Statement provides a helpful, evidence-based framework for informed discussions between healthcare providers and patients in an emotionally charged area

PAPSS2‐related brachyolmia : clinical and radiological phenotype in 18 new cases

Brachyolmia is a skeletal dysplasia characterized by short spine‐short stature, platyspondyly, and minor long bone abnormalities. We describe 18 patients, from different ethnic backgrounds and ages ranging from infancy to 19 years, with the autosomal recessive form, associated with PAPSS2. The main clinical features include disproportionate short stature with short spine associated with variable symptoms of pain, stiffness, and spinal deformity. Eight patients presented prenatally with short femora, whereas later in childhood their short‐spine phenotype emerged. We observed the same pattern of changing skeletal proportion in other patients. The radiological findings included platyspondyly, irregular end plates of the elongated vertebral bodies, narrow disc spaces and short over‐faced pedicles. In the limbs, there was mild shortening of femoral necks and tibiae in some patients, whereas others had minor epiphyseal or metaphyseal changes. In all patients, exome and Sanger sequencing identified homozygous or compound heterozygous PAPSS2 variants, including c.809G>A, common to white European patients. Bi‐parental inheritance was established where possible. Low serum DHEAS, but not overt androgen excess was identified. Our study indicates that autosomal recessive brachyolmia occurs across continents and may be under‐recognized in infancy. This condition should be considered in the differential diagnosis of short femora presenting in the second trimester

LivestockPlus: The sustainable intensification of forage-based agricultural systems to improve livelihoods and ecosystem services in the tropics

As global demand for livestock products (such as meat, milk, and eggs) is expected to double by 2050, necessary increases to future production must be reconciled with negative environmental impacts that livestock cause. This paper describes the LivestockPlus concept and demonstrates how the sowing of improved forages can lead to the sustainable intensification of mixed crop–forage–livestock–tree systems in the tropics by producing multiple social, economic, and environmental benefits. Sustainable intensification not only improves the productivity of tropical forage-based systems but also reduces the ecological footprint of livestock production and generates a diversity of ecosystem services (ES), such as improved soil quality and reduced erosion, sedimentation, and greenhouse gas (GHG) emissions. Integrating improved grass and legume forages into mixed production systems (crop–livestock, tree–livestock, crop–tree–livestock) can restore degraded lands and enhance system resilience to drought and waterlogging associated with climate change. When properly managed tropical forages accumulate large amounts of carbon in soil, fix atmospheric nitrogen (legumes), inhibit nitrification in soil and reduce nitrous oxide emissions (grasses), and reduce GHG emissions per unit livestock product. The LivestockPlus concept is defined as the sustainable intensification of forage-based systems, which is based on three interrelated intensification processes: genetic intensification – the development and use of superior grass and legume cultivars for increased livestock productivity; ecological intensification – the development and application of improved farm and natural resource management practices; and socio-economic intensification – the improvement of local and national institutions and policies, which enable refinements of technologies and support their enduring use. Increases in livestock productivity will require coordinated efforts to develop supportive government, non-government organization, and private sector policies that foster investments and fair market compensation for both the products and ES provided. Effective research-for-development efforts that promote agricultural and environmental benefits of forage-based systems can contribute towards implemention of LivestockPlus across a variety of geographic, political, and socio-economic contexts