Isotope partitioning between cow milk and farm water: A tool for verification of milk provenance

Rationale: The oxygen and hydrogen isotope compositions of the water component of the milk from nine Italian dairy farms were studied together with the farm water for one year. The aim was to verify the importance of farm water and seasonal temperature variation on milk isotope values and propose mathematical relations as new tools to identify the milk origin. Methods: Milk was centrifuged to separate the solids and then distilled under vacuum to separate water. δ(18O/16O) and δ(2H/1H) analyses of the water molecules were carried out using a water equilibrator online with a mass spectrometer. For oxygen and hydrogen isotope determination, water was equilibrated with pure CO2 for 7.5 h and with pure H2 for 5 h, respectively. The isotope ratio value is indicated with δ (expressed on the VSMOW/SLAP scale) as defined by IUPAC. Results: The average annual isotope value of milk at the different cattle sheds is mostly related to the farm water suggesting that the drinking water is the most important factor influencing the isotopic values of the milk water. The milk/water fractionation factor correlates with the milking time and, thus, the seasonal temperature is best described by a 4th order polynomial regression line. A two-level check model was used to verify the milking provenance. Conclusions: This study shows that it is essential to analyze both milk and farm water to indicate provenance. A two-step verification tool, based on the difference between the measured and calculated δ(18O/16O)M values, and the difference between the calculated and estimated milk-water fractionation factors, allowed the source determination of milk. Both conditions must be met if the milk is considered to be from the Parmigiano-Reggiano production region. Although this approach was developed for this region, it can easily be tested and adapted to other dairy production areas

Publication guidelines for quality improvement in health care: evolution of the SQUIRE project

In 2005, draft guidelines were published for reporting studies of quality improvement interventions as the initial step in a consensus process for development of a more definitive version. This article contains the full revised version of the guidelines, which the authors refer to as SQUIRE (Standards for QUality Improvement Reporting Excellence). This paper also describes the consensus process, which included informal feedback from authors, editors and peer reviewers who used the guidelines; formal written commentaries; input from a group of publication guideline developers; ongoing review of the literature on the epistemology of improvement and methods for evaluating complex social programmes; a two-day meeting of stakeholders for critical discussion and debate of the guidelines’ content and wording; and commentary on sequential versions of the guidelines from an expert consultant group. Finally, the authors consider the major differences between SQUIRE and the initial draft guidelines; limitations of and unresolved questions about SQUIRE; ancillary supporting documents and alternative versions that are under development; and plans for dissemination, testing and further development of SQUIRE

Preface: proceedings of the 13th IASWS international conference

This short article forms the preface to the Proceedings of the 13th IASWS conference held in Grahamstown in July 2014. It provides a background to the conference, a synthesis of the 15 published papers published in the special issue of JSS and a poem - written and read by Harry Owen on the opening night of the conference

Recent Sediments of Makirina Cove (Northern Dalmatia, Croatia): Their Origin Viewed Through a Multidisciplinary Approach

Makirina Cove was formed by the Holocene sea-level rise which caused a marine ingression into the depression formed within Albian–Cenomanian dolomites at approximately 4.5 ka B.P. At present, Makirina Cove represents an restricted, stressed, shallow-marine (<2m) ecosystem characterized by varying seawater temperatures (0–35°C) as well as fluctuating salinities (up to 41‰) affected by seasonally enhanced evaporation, continuous freshwater supply through on-shore and submarine springs associated with the coastal karst area and surface run-off episodes. These environmental conditions have been conducive to high primary production of organic matter resulting in the formation of organic-rich deposits which contain up to 5 wt.% of organic carbon. Up to the present times, 3.5 m of sediments have been deposited indicating a relatively high sedimentation rate estimated at 0.75 m/1.0 ka in the northern central part of the Cove. The sediments are being deposited mostly as poorly sorted clayey–sandy silts. The distribution and concentration of most of the chemical elements is dependant on the mineralogical composition and granulometric features of the Makirina sediments, which show values more or less similar to those from the Central Adriatic. Accordingly, there is a positive correlation with Al and K concentrations increasing off-shore and with the depth being associated with increasing concentrations of clay minerals within the clay fraction. The same holds true for concentrations of some trace elements, especially Mo and Se which is consistent with the distribution pattern of sulphides. Selenium is preferentially enriched in authigenic pyrite and it is probably the major source of Se in the Makirina Cove sediments. The concentrations of Ca, Mg and Sr decrease off-shore and they are linked to the composition of the surrounding carbonate rocks. The saturation indices show that the water is supersaturated with respect to carbonates enabling the precipitation of authigenic amorphous or crystalline carbonate phases from the pore water in the upper segment of the sediment column. According to the oxygen isotopic (δ18O) composition, molluscs precipitated their carbonate shells mostly during warmer periods (May to November) at or near isotopic equilibrium with their ambient waters. The carbon isotopic δ13C composition of mollusc carbonate shells is environmentally affected due to oxidation and decomposition of organic matter as well as influxes of fresh water into the Cove, indicating their formation out of the predicted isotopic equilibrium with atmospheric CO2. Palynological and organic carbon isotopic (δ13C) composition shows that the sedimentary organic matter (SOM) is 70–90% lipid- and hydrogen-rich and on average 2/3 marine derived (mainly phytoplankton, bacteria and marine macrophytes) and 1/3 terrestrially derived (mainly woody tissue). The variations in composition of SOM have been noted as a function of the distance from the shore. The type and the preservation state of SOM and pyrite as well as the measurements of Eh, pH, total alkalinity, dissolved inorganic carbon (DIC) and the enrichment of redox-sensitive trace elements, indicate oxygen-depleted depositional conditions and that the sediment is highly reductive even in the uppermost segment at the sediment/water interface. According to the results obtained from the applied methods, the features of Makirina sediments strongly reflect the given depositional conditions within this restricted, stressed, shallow-marine environment where these organic-rich sediments originate, and may therefore serve as a calibration standard in further investigations

Introducing EMMIE: An evidence rating scale to encourage mixed-method crime prevention synthesis reviews

Objectives This short report describes the need for, and the development of, a coding system to distil the quality and coverage of systematic reviews of the evidence relating to crime prevention interventions. The starting point for the coding system concerns the evidence needs of policymakers and practitioners. Methods The coding scheme (EMMIE) proposed builds on previous scales that have been developed to assess the probity, coverage and utility of evidence both in health and criminal justice. It also draws on the principles of realist synthesis and review. Results The proposed EMMIE scale identifies five dimensions to which systematic reviews intended to inform crime prevention should speak. These are the Effect of intervention, the identification of the causal Mechanism(s) through which interventions are intended to work, the factors that Moderate their impact, the articulation of practical Implementation issues, and the Economic costs of intervention

Recent Sediments of Makirina Cove (Northern Dalmatia, Croatia): Their Origin Viewed Through a Multidisciplinary Approach

Makirina Cove was formed by the Holocene sea-level rise which caused a marine ingression into the depression formed within Albian–Cenomanian dolomites at approximately 4.5 ka B.P. At present, Makirina Cove represents an restricted, stressed, shallow-marine (<2m) ecosystem characterized by varying seawater temperatures (0–35°C) as well as fluctuating salinities (up to 41‰) affected by seasonally enhanced evaporation, continuous freshwater supply through on-shore and submarine springs associated with the coastal karst area and surface run-off episodes. These environmental conditions have been conducive to high primary production of organic matter resulting in the formation of organic-rich deposits which contain up to 5 wt.% of organic carbon. Up to the present times, 3.5 m of sediments have been deposited indicating a relatively high sedimentation rate estimated at 0.75 m/1.0 ka in the northern central part of the Cove. The sediments are being deposited mostly as poorly sorted clayey–sandy silts. The distribution and concentration of most of the chemical elements is dependant on the mineralogical composition and granulometric features of the Makirina sediments, which show values more or less similar to those from the Central Adriatic. Accordingly, there is a positive correlation with Al and K concentrations increasing off-shore and with the depth being associated with increasing concentrations of clay minerals within the clay fraction. The same holds true for concentrations of some trace elements, especially Mo and Se which is consistent with the distribution pattern of sulphides. Selenium is preferentially enriched in authigenic pyrite and it is probably the major source of Se in the Makirina Cove sediments. The concentrations of Ca, Mg and Sr decrease off-shore and they are linked to the composition of the surrounding carbonate rocks. The saturation indices show that the water is supersaturated with respect to carbonates enabling the precipitation of authigenic amorphous or crystalline carbonate phases from the pore water in the upper segment of the sediment column. According to the oxygen isotopic (δ18O) composition, molluscs precipitated their carbonate shells mostly during warmer periods (May to November) at or near isotopic equilibrium with their ambient waters. The carbon isotopic δ13C composition of mollusc carbonate shells is environmentally affected due to oxidation and decomposition of organic matter as well as influxes of fresh water into the Cove, indicating their formation out of the predicted isotopic equilibrium with atmospheric CO2. Palynological and organic carbon isotopic (δ13C) composition shows that the sedimentary organic matter (SOM) is 70–90% lipid- and hydrogen-rich and on average 2/3 marine derived (mainly phytoplankton, bacteria and marine macrophytes) and 1/3 terrestrially derived (mainly woody tissue). The variations in composition of SOM have been noted as a function of the distance from the shore. The type and the preservation state of SOM and pyrite as well as the measurements of Eh, pH, total alkalinity, dissolved inorganic carbon (DIC) and the enrichment of redox-sensitive trace elements, indicate oxygen-depleted depositional conditions and that the sediment is highly reductive even in the uppermost segment at the sediment/water interface. According to the results obtained from the applied methods, the features of Makirina sediments strongly reflect the given depositional conditions within this restricted, stressed, shallow-marine environment where these organic-rich sediments originate, and may therefore serve as a calibration standard in further investigations

Development of a Web-based Resident Profiling Tool to Support Training in Practice-based Learning and Improvement

Multiple factors are driving residency programs to explicitly address practice-based learning and improvement (PBLI), yet few information systems exist to facilitate such training. We developed, implemented, and evaluated a Web-based tool that provides Internal Medicine residents at the University of Virginia Health System with population-based reports about their ambulatory clinical experiences. Residents use Systems and Practice Analysis for Resident Competencies (SPARC) to identify potential areas for practice improvement. Thirty-three (65%) of 51 residents completed a survey assessing SPARC’s usefulness, with 94% agreeing that it was a useful educational tool. Twenty-six residents (51%) completed a before–after study indicating increased agreement (5-point Likert scale, with 5=strongly agree) with statements regarding confidence in ability to access population-based data about chronic disease management (mean [SD] 2.5 [1.2] vs. 4.5 [0.5], p < .001, sign test) and information comparing their practice style to that of their peers (2.2 [1.2] vs. 4.6 [0.5], p < .001)

Explanation and elaboration of the SQUIRE (Standards for Quality Improvement Reporting Excellence) Guidelines, V.2.0: examples of SQUIRE elements in the healthcare improvement literature

Since its publication in 2008, SQUIRE (Standards for Quality Improvement Reporting Excellence) has contributed to the completeness and transparency of reporting of quality improvement work, providing guidance to authors and reviewers of reports on healthcare improvement work. In the interim, enormous growth has occurred in understanding factors that influence the success, and failure, of healthcare improvement efforts. Progress has been particularly strong in three areas: the understanding of the theoretical basis for improvement work; the impact of contextual factors on outcomes; and the development of methodologies for studying improvement work. Consequently, there is now a need to revise the original publication guidelines. To reflect the breadth of knowledge and experience in the field, we solicited input from a wide variety of authors, editors and improvement professionals during the guideline revision process. This Explanation and Elaboration document (E&E) is a companion to the revised SQUIRE guidelines, SQUIRE 2.0. The product of collaboration by an international and interprofessional group of authors, this document provides examples from the published literature, and an explanation of how each reflects the intent of a specific item in SQUIRE. The purpose of the guidelines is to assist authors in writing clearly, precisely and completely about systematic efforts to improve the quality, safety and value of healthcare services. Authors can explore the SQUIRE statement, this E&E and related documents in detail at http://www.squire-statement.org

Basic Biomedical Sciences and the Future of Medical Education: Implications for Internal Medicine

The academic model of medical education in the United States is facing substantial challenges. Apprenticeship experiences with clinical faculty are increasingly important in most medical schools and residency programs. This trend threatens to separate clinical education from the scientific foundations of medical practice. Paradoxically, this devaluation of biomedical science is occurring as the ability to use new discoveries to rationalize clinical decision making is rapidly expanding. Understanding the scientific foundations of medical practice and the ability to apply them in the care of patients separates the physician from other health care professionals. The de-emphasis of biomedical science in medical education poses particular dangers for the future of internal medicine as the satisfaction derived from the application of science to the solving of a clinical problem has been a central attraction of the specialty. Internists should be engaged in the ongoing discussions of medical education reform and provide a strong voice in support of rigorous scientific training for the profession