Blog and podcast watch: Pediatric emergency medicine

Introduction: By critically appraising open access, educational blogs and podcasts in emergency medicine (EM) using an objective scoring instrument, this installment of the ALiEM (Academic Life in Emergency Medicine) Blog and Podcast Watch series curated and scored relevant posts in the specific areas of pediatric EM. Methods: The Approved Instructional Resources - Professional (AIR-Pro) series is a continuously building curriculum covering a new subject area every two months. For each area, six EM chief residents identify 3-5 advanced clinical questions. Using FOAMsearch.net to search blogs and podcasts, relevant posts are scored by eight reviewers from the AIR-Pro Board, which is comprised of EM faculty and chief residents at various institutions. The scoring instrument contains five measurement outcomes based on 7-point Likert scales: recency, accuracy, educational utility, evidence based, and references. The AIR-Pro label is awarded to posts with a score of ?26 (out of 35) points. An Honorable Mention label is awarded if Board members collectively felt that the posts were valuable and the scores were \u3e 20. Results: We included a total of 41 blog posts and podcasts. Key educational pearls from the 10 high quality AIR-Pro posts and four Honorable Mentions are summarized. Conclusion: The WestJEM ALiEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. Until more objective quality indicators are developed for learners and educators, this series provides an expert-based, crowdsourced approach towards critically appraising educational social media content for EM clinicians. © 2016 Zaver et al

The rise of aquaculture by-products: Increasing food production, value, and sustainability through strategic utilisation

Since 2000, the use of wild fish inputs in the production of farm raised fish outputs, also known as the Fish In: Fish Out (FI:FO) ratio, has been a primary concern of the sustainability dialogue surrounding aquaculture production. Far less attention has been placed on the sustainability of downstream processing, including how by-products are managed. This paper contributes new information on the current utilisation of aquaculture by-products in a case study on the Scottish Atlantic salmon industry. The findings show that there is considerable potential to increase the sustainability of the industry through maximising human edible yield by strategically managing by-products. Supporting the movement towards the full utilisation of by-products, this paper goes a step further by emphasising the need to maximise their use in human consumption and select animal feeds, highlighting the economic, food security, and environmental benefits of doing so. Through exploratory scenarios based on the case study, the paper identifies that Scotland could increase food production from fish farming by over 60%, increase by-product revenue by 803%, and increase the industry bottom-line by over 5%, all without having to put any new cages in the water, or use any more marine resources. As the aquaculture industry moves into a new era of production and processing, where a diverse range of products can be produced from a single species, sustainability will be sought throughout the value chain. It is hoped that the ideas raised within this paper will encourage further discussion and collaboration on this topic going forward

Assessment and communication of the toxicological risk of consuming shrimp in the EU

The numbers of alerts from the EU's Rapid Alert System for Food and Feed (RASFF) related to crustacean products were compared to numbers of mainstream media stories related to health concerns. An internet search of "farmed shrimp" was also conducted and the content of the websites assessed for subject matter and balance. The study found that the absolute number of RASFF alerts has fallen considerably since legislation controlling testing of food being traded into and within the EU was introduced in 2002 and tracked increasing stringency of EU procedures. There were 1512 alerts from 1980 to 2015 with 44.0% and 21.2% of alerts attributed to farmed and wild shrimp respectively. There were large numbers of alerts reporting antibiotic residues in wild shrimp, which raised questions about the source of the contamination, and natural occurrence of the antimicrobial residues was considered. The number of mainstream media stories closely followed the number of alerts, but 91.2% of media articles concerning the health aspects were concerned with consumption of farmed shrimp. The internet search revealed a much more negative view of farmed shrimp compared to the mainstream media. It is suggested that the internet generally follows an historic negative narrative on farmed seafood, often with little validation which narrows the discourse on seafood production rather than empowering consumers. According to the risk assessment of RASFF data, it was concluded that farmed shrimp does not possess any more risk than wild seafood choices but producers have not been able to communicate the benefits of farmed produce to the consumer

Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices

OBJECTIVES: Overutilisation of antibiotics may contribute to the emergence of antimicrobial drug resistance, a growing international concern. This study aimed to analyse the performance of UK general practices with respect to antibiotic prescribing for respiratory tract infections (RTIs) among young and middle-aged adults.SETTING: Data are reported for 568 UK general practices contributing to the Clinical Practice Research Datalink.PARTICIPANTS: Participants were adults aged 18-59?years. Consultations were identified for acute upper RTIs including colds, cough, otitis-media, rhino-sinusitis and sore throat.PRIMARY AND SECONDARY OUTCOME MEASURES: For each consultation, we identified whether an antibiotic was prescribed. The proportion of RTI consultations with antibiotics prescribed was estimated.RESULTS: There were 568 general practices analysed. The median general practice prescribed antibiotics at 54% of RTI consultations. At the highest prescribing 10% of practices, antibiotics were prescribed at 69% of RTI consultations. At the lowest prescribing 10% of practices, antibiotics were prescribed at 39% RTI consultations. The median practice prescribed antibiotics at 38% of consultations for 'colds and upper RTIs', 48% for 'cough and bronchitis', 60% for 'sore throat', 60% for 'otitis-media' and 91% for 'rhino-sinusitis'. The highest prescribing 10% of practices issued antibiotic prescriptions at 72% of consultations for 'colds', 67% for 'cough', 78% for 'sore throat', 90% for 'otitis-media' and 100% for 'rhino-sinusitis'.CONCLUSIONS: Most UK general practices prescribe antibiotics to young and middle-aged adults with respiratory infections at rates that are considerably in excess of what is clinically justified. This will fuel antibiotic resistance.<br/

Managing aquaculture in multi-use freshwater bodies: the case of Jatiluhur reservoir

The pressure on scarce freshwater resources from intensifying human activity is rising across the globe. This study presents the case of Jatiluhur—Indonesia\u27s largest reservoir, where unregulated aquaculture expansion has contributed to environmental degradation and associated conflicts with other water-users. Aiming to identify a strategy to improve the sustainability of cage aquaculture within Jatiluhur reservoir and other freshwater bodies facing similar challenges, this study consisted of an initial analysis of time bound satellite images of the reservoir and a systematic survey of 112 aquaculture farms. The results revealed that, with more than 45 000 production units in 2020, more than half of which are placed outside government-approved aquaculture zones, the carrying capacity of the reservoir is exceeded. An analysis of the farm-level production practices, pertinent to environmental regulation, indicated the existence of three main production strategies, with significant differences in eutrophication potential among them that would lead to better articulated policy actions. A feed manufacturer-focused policy to reduce total phosphorus levels in formulated diets by more than half, but still within the optimal level for fish performance, would have the most impact. Enforcement of registration and removal of illegal production units supported by satellite-based monitoring of compliance are key recommendations to support intensive cage culture remaining an important economic activity

Beef production from feedstuffs conserved using new technologies to reduce negative environmental impacts

End of project reportMost (ca. 86%) Irish farms make some silage. Besides directly providing feed for livestock, the provision of grass silage within integrated grassland systems makes an important positive contribution to effective grazing management and improved forage utilisation by grazing animals, and to effective feed budgeting by farmers. It can also contribute to maintaining the content of desirable species in pastures, and to livestock not succumbing to parasites at sensitive times of the year. Furthermore, the optimal recycling of nutrients collected from housed livestock can often be best achieved by spreading the manures on the land used for producing the conserved feed. On most Irish farms, grass silage will remain the main conserved forage for feeding to livestock during winter for the foreseeable future. However, on some farms high yields of whole-crop (i.e. grain + straw) cereals such as wheat, barley and triticale, and of forage maize, will be an alternative option provided that losses during harvesting, storage and feedout are minimised and that input costs are restrained. These alternative forages have the potential to reliably support high levels of animal performance while avoiding the production of effluent. Their production and use however will need to advantageously integrate into ruminant production systems. A range of technologies can be employed for crop production and conservation, and for beef production, and the optimal options need to be identified. Beef cattle being finished indoors are offered concentrate feedstuffs at rates that range from modest inputs through to ad libitum access. Such concentrates frequently contain high levels of cereals such as barley or wheat. These cereals are generally between 14% to 18% moisture content and tend to be rolled shortly before being included in coarse rations or are more finely processed prior to pelleting. Farmers thinking of using ‘high-moisture grain’ techniques for preserving and processing cereal grains destined for feeding to beef cattle need to know how the yield, conservation efficiency and feeding value of such grains compares with grains conserved using more conventional techniques. European Union policy strongly encourages a sustainable and multifunctional agriculture. Therefore, in addition to providing European consumers with quality food produced within approved systems, agriculture must also contribute positively to the conservation of natural resources and the upkeep of the rural landscape. Plastics are widely used in agriculture and their post-use fate on farms must not harm the environment - they must be managed to support the enduring sustainability of farming systems. There is an absence of information on the efficacy of some new options for covering and sealing silage with plastic sheeting and tyres, and an absence of an inventory of the use, re-use and post-use fate of plastic film on farms. Irish cattle farmers operate a large number of beef production systems, half of which use dairy bred calves. In the current, continuously changing production and market conditions, new beef systems must be considered. A computer package is required that will allow the rapid, repeatable simulation and assessment of alternate beef production systems using appropriate, standardised procedures. There is thus a need to construct, evaluate and utilise computer models of components of beef production systems and to develop mathematical relationships to link system components into a network that would support their integration into an optimal system model. This will provide a framework to integrate physical and financial on-farm conditions with models for estimating feed supply and animal growth patterns. Cash flow and profit/loss results will be developed. This will help identify optimal systems, indicate the cause of failure of imperfect systems and identify areas where applied research data are currently lacking, or more basic research is required

Elasticity Theory Connection Rules for Epitaxial Interfaces

Elasticity theory provides an accurate description of the long-wavelength vibrational dynamics of homogeneous crystalline solids, and with supplemental boundary conditions on the displacement field can also be applied to abrupt heterojunctions and interfaces. The conventional interface boundary conditions, or connection rules, require that the displacement field and its associated stress field be continuous through the interface. We argue, however, that these boundary conditions are generally incorrect for epitaxial interfaces, and we give the general procedure for deriving the correct conditions, which depend essentially on the detailed microscopic structure of the interface. As a simple application of our theory we analyze in detail a one-dimensional model of an inhomogeneous crystal, a chain of harmonic oscillators with an abrupt change in mass and spring stiffness parameters. Our results have implications for phonon dynamics in nanostructures such as superlattices and nanoparticles, as well as for the thermal boundary resistance at epitaxial interfaces.Comment: 7 pages, Revte