Factors influencing adoption of conservation tillage in Australian cropping regions

The purpose of this research is to improve understanding of conservation tillage adoption decisions by identifying key biophysical and socio-economic factors influencing no-till adoption by grain growers across four Australian cropping regions. The study is based on interviews with 384 grain growers using a questionnaire aimed at eliciting perceptions relating to a range of possible long- and short-term agronomic interactions associated with the relative economic advantage of shifting to a no-tillage cropping system. Together with other farm and farmer-specific variables, a dichotomous logistic regression analysis was used to identify opportunities for research and extension to facilitate more rapid adoption decisions. The broader systems approach to considering conservation tillage adoption identified important determinants of adoption not associated with soil conservation and erosion prevention benefits. Most growers recognised the erosion-reducing benefits of no-till but it was not an important factor in explaining whether a grower was an adopter or non-adopter. Perceptions associated with shorter-term crop production benefits under no-till, such as the relative effectiveness of pre-emergent herbicides and the ability to sow crops earlier on less rainfall were influential. Employment of a consultant and increased attendance of cropping extension activities were strongly associated with no-till adoption, confirming the information and learning-intensive nature of adopting no-till cropping systems.adoption, conservation tillage, herbicide resistance, no-till, perceptions, weed management, Farm Management,

Survivors of intensive care with type 2 diabetes and the effect of shared care follow-up clinics: study protocol for the SWEET-AS randomised controlled feasibility study

Published online: 13 October 2016Background: Many patients who survive the intensive care unit (ICU) experience long-term complications such as peripheral neuropathy and nephropathy which represent a major source of morbidity and affect quality of life adversely. Similar pathophysiological processes occur frequently in ambulant patients with diabetes mellitus who have never been critically ill. Some 25 % of all adult ICU patients have diabetes, and it is plausible that ICU survivors with co-existing diabetes are at heightened risk of sequelae from their critical illness. ICU follow-up clinics are being progressively implemented based on the concept that interventions provided in these clinics will alleviate the burdens of survivorship. However, there is only limited information about their outcomes. The few existing studies have utilised the expertise of healthcare professionals primarily trained in intensive care and evaluated heterogenous cohorts. A shared care model with an intensivist- and diabetologist-led clinic for ICU survivors with type 2 diabetes represents a novel targeted approach that has not been evaluated previously. Prior to undertaking any definitive study, it is essential to establish the feasibility of this intervention. Methods: This will be a prospective, randomised, parallel, open-label feasibility study. Eligible patients will be approached before ICU discharge and randomised to the intervention (attending a shared care follow-up clinic 1 month after hospital discharge) or standard care. At each clinic visit, patients will be assessed independently by both an intensivist and a diabetologist who will provide screening and targeted interventions. Six months after discharge, all patients will be assessed by blinded assessors for glycated haemoglobin, peripheral neuropathy, cardiovascular autonomic neuropathy, nephropathy, quality of life, frailty, employment and healthcare utilisation. The primary outcome of this study will be the recruitment and retention at 6 months of all eligible patients. Discussion: This study will provide preliminary data about the potential effects of critical illness on chronic glucose metabolism, the prevalence of microvascular complications, and the impact on healthcare utilisation and quality of life in intensive care survivors with type 2 diabetes. If feasibility is established and point estimates are indicative of benefit, funding will be sought for a larger, multi-centre study. Trial registration: ANZCTR ACTRN12616000206426Yasmine Ali Abdelhamid, Liza Phillips, Michael Horowitz and Adam Dean

Letters and telegrams on Andrew Inglis Clark's resignation from the Braddon Ministry, Tasmania, 1897-8

Letters and telegrams on Andrew Inglis Clark's resignation from the Braddon Ministry, 1897-8, from A.H. Aspinall, E.N.C. Braddon, Gilbert E. Butler, William Cooke, P.O. Fysh, G. D'Emden, H.T. Gould, John Gunning, Charles W. Hazell, John Henry, Frederick Lodge, J.H. Macfarlane, Andrew Miller, F.J. Prichard, Richard Ross, W.H. Smith, F. Stephens, C.H. Talbot, Alfred A. Taylor, H. Thomas, G.J. Walford and J.N. Woolnough. C4/C390 (1-22

Factors influencing adoption of conservation tillage in Australian cropping regions

The purpose of this research is to improve understanding of conservation tillage adoption decisions by identifying key biophysical and socio-economic factors influencing no-till adoption by grain growers across four Australian cropping regions. The study is based on interviews with 384 grain growers using a questionnaire aimed at eliciting perceptions relating to a range of possible long- and short-term agronomic interactions associated with the relative economic advantage of shifting to a no-tillage cropping system. Together with other farm and farmer-specific variables, a dichotomous logistic regression analysis was used to identify opportunities for research and extension to facilitate more rapid adoption decisions. The broader systems approach to considering conservation tillage adoption identified important determinants of adoption not associated with soil conservation and erosion prevention benefits. Most growers recognised the erosion-reducing benefits of no-till but it was not an important factor in explaining whether a grower was an adopter or non-adopter. Perceptions associated with shorter-term crop production benefits under no-till, such as the relative effectiveness of pre-emergent herbicides and the ability to sow crops earlier on less rainfall were influential. Employment of a consultant and increased attendance of cropping extension activities were strongly associated with no-till adoption, confirming the information and learning-intensive nature of adopting no-till cropping systems

Insulin requirements in late pregnancy in women with type 1 diabetes mellitus: a retrospective review

Pregnancy in women with type 1 diabetes mellitus (T1DM) is generally associated with increased insulin requirements

Efficacy and safety of atorvastatin in the prevention of cardiovascular end points in subjects with type 2 diabetes: the Atorvastatin Study for Prevention of Coronary Heart Disease Endpoints in non-insulin-dependent diabetes mellitus (ASPEN).

OBJECTIVE: Cardiovascular disease (CVD) risk is increased in type 2 diabetes. The purpose of this study was to assess the effect of 10 mg of atorvastatin versus placebo on CVD prevention in subjects with type 2 diabetes and LDL cholesterol levels below contemporary guideline targets. RESEARCH DESIGN AND METHODS: Subjects were randomly assigned to receive 10 mg of atorvastatin or placebo in a 4-year, double-blind, parallel-group study. The composite primary end point comprised cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, recanalization, coronary artery bypass surgery, resuscitated cardiac arrest, and worsening or unstable angina requiring hospitalization. RESULTS: A total of 2,410 subjects with type 2 diabetes were randomized. Mean LDL cholesterol reduction in the atorvastatin group over 4 years was 29% versus placebo (P < 0.0001). When we compared atorvastatin versus placebo, composite primary end point rates were 13.7 and 15.0%, respectively (hazard ratio 0.90 [95% CI 0.73-1.12]). In the subset of 1,905 subjects without prior myocardial infarction or interventional procedure, 10.4% of atorvastatin- and 10.8% of placebo-treated subjects experienced a primary end point (0.97 [0.74-1.28]). In the 505 subjects with prior myocardial infarction or interventional procedure, 26.2% of atorvastatin- and 30.8% of placebo-treated subjects experienced a primary end point (0.82 [0.59-1.15]). Relative risk reductions in fatal and nonfatal myocardial infarction were 27% overall (P = 0.10) and 19% (P = 0.41) and 36% (P = 0.11) for subjects without and with prior myocardial infarction or interventional procedure, respectively. CONCLUSIONS: Composite end point reductions were not statistically significant. This result may relate to the overall study design, the types of subjects recruited, the nature of the primary end point, and the protocol changes required because of changing treatment guidelines. For these reasons, the results of the Atorvastatin Study for Prevention of Coronary Heart Disease Endpoints in Non-Insulin-Dependent Diabetes Mellitus (ASPEN) did not confirm the benefit of therapy but do not detract from the imperative that the majority of diabetic patients are at risk of coronary heart disease and deserve LDL cholesterol lowering to the currently recommended targets

Gestational diabetes screening from the perspective of consumers: Insights from early in the COVID-19 pandemic and opportunities to optimise experiences

Background: Consumer perspectives are a cornerstone of value-based healthcare. Screening and diagnosis of gestational diabetes mellitus (GDM) were among many of the rapid changes to health care recommended during the COVID-19 pandemic. The changes provided a unique opportunity to add information about women's perspectives on the debate on GDM screening. Aims: The aim of this qualitative study was to explore women's perspectives and understanding of GDM screening and diagnosis comparing the modified COVID-19 recommendations to standard GDM screening and diagnostic practices. Methods: Women who had experienced both the standard and modified GDM screening and diagnostic processes were recruited for telephone interviews. Data analysis used inductive reflexive thematic analysis. Online surveys were disseminated to any registrant not included in interviews to provide an opportunity for all interested participants to provide their perspective. Results: Twenty-nine telephone interviews were conducted and 19 survey responses were received. Seven themes were determined: (1) information provision from clinicians; (2) acceptability of GDM screening; (3) individualisation of GDM screening methods; (4) safety nets to avoid a missed diagnosis; (5) informed decision making; (6) women want information and evidence; and (7) preferred GDM screening methods for the future. Conclusions: Overall, women preferred the modified GDM screening recommendations put in place due to the COVID-19 pandemic. However, their preference was influenced by their prior screening experience and perception of personal risk profile. Women expressed a strong need for clear communication from health professionals and the opportunity to be active participants in decision making.</p