Chapter 08: Conclusions and Recommendations

Here we review brief summaries by chapter and then derive some integrated conclusions across chapters. Recommendations are presented with respect to further research, outreach and policy consideration. Because several years have passed between the end of our field work and publication of this synthesis volume, we end with an epilogue that highlights changes and key events that happened at San José Llanga (SJL) and with collaborating institutions in Bolivia between 1996-9.https://digitalcommons.usu.edu/sustaining_agropastoralism/1007/thumbnail.jp

YouTube as a potential source of information on deep venous thrombosis

Background No work has been reported on the use of video websites to learn about deep vein thrombosis and the value of education using them. We examined the characteristics and scientific accuracy of videos related to deep vein thrombosis on YouTube.Methods YouTube was surveyed using no filter and the key words deep vein thrombosis' and leg vein clot' in June 2016. The videos evaluated were divided into three groups in terms of their scientific content, accuracy, and currency: useful, partly useful, and useless.Results Of the 1200 videos watched, 715 (59.58%) were excluded with the exclusion criteria. Although most of the videos uploaded (22.9%, n=111) were created by physicians, the number of views for website-based videos was significantly higher (p=0.002). When the uploaded videos were assessed in terms of their usefulness, videos from physicians and hospitals were statistically more useful than other videos (p<0.001).Conclusions For videos created by medical professionals to be of higher quality, we believe they should be more up-to-date and comprehensive, and contain animations about treatment modalities and early diagnosis in particular

Prevalence of alcohol use in Istanbul

The current research assessed the prevalence of alcohol use in istanbul, Turkey along with characteristics and severity of related problems. The data were collected from structured interviews including the CAGE Questionnaire to eliminate the severity of alcohol-related problems of 1,550 residents (743 women, 807 men) of Istanbul, ages 12 to 65 years. Current alcohol use was 25.6% (397 persons, 118 women wand 279 men), including 15.9% of the women and 34.5% of the men. 67% reported never having used alcohol. The rate of alcohol use was highest in the 40- to 49-yr. age group; the onset of use was reported as most common for the 16- to 19-yr.-olds. Prevalence of risky drinking was 6.8% (106 persons). Men were more likely to have an earlier initiation to alcohol use, to consume more [5.2 standard drinks (SD 3.4) vs 3.6 standard drinks (SD=2.5)] and be problem drinkers (31.5% vs 15.2%) than women. Prevalence of alcohol use seems to be relatively low in Istanbul. Data on characteristics of alcohol use are important in estimating groups at risk for problems and in planning prevention strategies

Anatomical and functional changes after aortic valve replacement with different sizes of mechanical valves

PubMed ID: 30059131Abstract Objective: To date, there is no consensus on the selection of type and size of prosthetic valve for aortic valve replacement (AVR). The aim of this study was to compare anatomical and functional changes occurring in the left ventricle after AVR with different sizes of mechanical valves. Methods: A total of 92 patients with serious aortic valve stenosis, who underwent AVR between March 2001 and June 2008 using mechanical valves of different sizes, were retrospectively analysed. The sizes of the mechanical valves were 19, 21, 23 and 25 mm. All patients were assessed pre-operatively, and at six months and in the first, third and fifth years postoperatively. The left ventricle was assessed with electrocardiography, echocardiography and telecardiography and compared in the four patient groups, constituted according to the mechanical valve size used. Results: In all groups, left ventricular mass and mass index, transvalvular aortic gradient, thicknesses of the interventricular septum and posterior wall, and left ventricular end-systolic and end-diastolic diameters had decreased significantly post surgery. Left ventricular ejection fraction and exercise capacity had increased significantly (p < 0.001). The most noteworthy anatomical and functional improvements were seen in patients who had received 23- and 25-mm mechanical valves. Conclusion: Mechanical valve replacement should not be performed with small size valves because of the higher residual gradient. © 2018 Clinics Cardive Publishing (PTY)Ltd. All Rights Reserved

YouTube as a potential source of information on deep venous thrombosis.

Background No work has been reported on the use of video websites to learn about deep vein thrombosis and the value of education using them. We examined the characteristics and scientific accuracy of videos related to deep vein thrombosis on YouTube. Methods YouTube was surveyed using no filter and the key words 'deep vein thrombosis' and 'leg vein clot' in June 2016. The videos evaluated were divided into three groups in terms of their scientific content, accuracy, and currency: useful, partly useful, and useless. Results Of the 1200 videos watched, 715 (59.58%) were excluded with the exclusion criteria. Although most of the videos uploaded (22.9%, n = 111) were created by physicians, the number of views for website-based videos was significantly higher (p = 0.002). When the uploaded videos were assessed in terms of their usefulness, videos from physicians and hospitals were statistically more useful than other videos (p < 0.001). Conclusions For videos created by medical professionals to be of higher quality, we believe they should be more up-to-date and comprehensive, and contain animations about treatment modalities and early diagnosis in particular

Correlation Between Machinability and Chip Morphology of Austempered Ductile Iron

In this work, macrostructure, microstructure, and work hardening of as-cast and austempered ductile iron chips produced by different cutting speeds were investigated. Cutting forces, surface roughness, and tool wear were also studied. After austenitizing at 900 degrees C for 90 min, samples were austempered in a salt bath at 360 degrees C for 90 min. Machinability tests were conducted with uncoated cemented carbide tools on a CNC lathe. The tests were carried out without using any lubricant. In these tests, the cutting speed was varied in the range 50-200 m/min, while the feed rate (0.12 mm/rev) and depth of cut (2 mm) were kept constant. The tangential, feed, and radial cutting force components acting on the tool holder were measured with a three-component dynamometer. The chips obtained during machining were polished by embedding into epoxy resin, examined with optical microscope and micrographs were taken. The microhardness values were measured on each chip sample. As the cutting speed was increased, deformation strengthening of the microstructure was increased, which decreased the tool life. It was also detected that during the machining, with the effect of cutting forces and stress, spheroidal graphites were broken off in the chip and lost their sphericity, so the chip became fragile and unstable and the graphite displayed a lubricant feature. At low cutting speed, a built-up edge was observed. However, as the cutting speed was increased because of heating, built-up edges were unstable

Chapter 05: The Grazing Livestock of San José Llanga: Multiple-species Resource Use and the Management and Productivity of Sheep

The main objective of the joint IBTA/SR-CRSP project in Bolivia was to assess the overall role of small ruminants in the ecological and economic sustainability of an agropastoral system. Prominent was a mandate for us to investigate: (1) Whether small ruminants were important contributors to environmental degradation; and (2) whether there were feasible improvements in management that could mitigate negative impacts of small ruminants on natural resources and increase efficiency of animal production (see Chapter 1: Project objectives and research approach). These issues are important in light of recent controversy concerning environmental degradation of the world’s rangelands. On one hand people and livestock are blamed (Sinclair and Fryxell 1985; Cloudsley-Thompson 1988) while on another hand climate, or change in climate, is cited as a key factor (Rasmusson 1987; Ellis and Swift 1988). If livestock are not to blame then efforts to de-stock traditional pastoral systems could be in error (Behnke and Scoones 1991).https://digitalcommons.usu.edu/sustaining_agropastoralism/1004/thumbnail.jp

The Grazing Livestock of San Jose Llanga: Multiple-Species Resource Use and Management and Productivity of Sheep

The main objective of the joint IBTA/SR-CRSP project in Bolivia was to assess the overall role of small ruminants in the ecological and economic sustainability of an agropastoral system. Prominent was a mandate for us to investigate: (1) Whether small ruminants were important contributors to environmental degradation; and (2) whether there were feasible improvements in management that could mitigate negative impacts of small ruminants on natural resources and increase efficiency of animal production (see Chapter 1: Project objectives and research approach). These issues are important in light of recent controversy concerning environmental degradation of the world’s rangelands. On one hand people and livestock are blamed (Sinclair and Fryxell 1985; Cloudsley-Thompson 1988) while on another hand climate, or change in climate, is cited as a key factor (Rasmusson 1987; Ellis and Swift 1988). If livestock are not to blame then efforts to de-stock traditional pastoral systems could be in error (Behnke and Scoones 1991)