Pine disease in sheep on the Cheviots

The following conclusions are drawn from the main work of the investigation.1. Pine disease in the Cheviot region is a, nutritional anaemia caused by nineral deficiency in the soil or herbage of affected areas resulting in defective iron metabolism.2. The disease occurs in an endemic form on the Andesite formation in the East Borders. Both hill land and arable land are involved. The affected district covers an area of approximately 80 square miles and carries 40,000 head of sheep..3. There is evidence that the disease first attained serious proportions in the Cheviot region about the beginning of the nineteenth century. This was due to far-reaching changes in the system of sheep husbandry, and in sheep- breeding in particular. It is probable that the local races of sheep were formerly resistant to the malady. This view is supported by the fact that native sheep are maintained on pining land in Scotland at the present day without a change of pasture. the problem therefore has a genetic aspect which appears to offer scope for enquiry. enquiry.4. The disease is not due to iron deficiency.5. The administration of minute quantities of cobalt prevents the occurrence of the disease on. pining land and also acts as a cure. The beneficial results obtained from the feeling of iron compounds are attributable to traces of cobalt in the materials used.6. Small quantities of phosphorus, free from cobalt, are of curative and preventive value. The feeding of phosphorus compounds only, gives successful results in practice. A deficiency in this element is regarded as a predisposing cause of the malady.Both phosphorus and cobalt are presumably lacking in sufficient quantity from the produce of pining soil The precise significance of cobalt in animal nutrition, apart from its potency in assisting the utilisation. of iron, is unknown,7. Experimental evidence shows that no effect is produced by the administration of traces of copper to pining sheep.8. The condition is primarily one of mineral deficiency. The influence of parasitic infestation of the digestive tract is entirely secondary. The treatment of pining sheep for mineral deficiency alone, with materials that possess no known anthelminthic properties, is successful in well over 95 per cent of cases. This applies equally to animals which are mildly affected, and those which are in an alvanced stage of the malady.9. The disease has a close similarity with bush sickness in New Zealand, enzootic marasmus in Western Australia, coast disease in South Australia, and certain pining diseases in other countries. It appears to be different in origin from salt sickness in Florida and lecksucht in Holland.10. In the Border Counties, the nutritional anaemia represented by pine disease is not confined to the Andesite formation. it is manifested in various forms under diverse conditions of soil and of sheep-husbandry. These various types are as follows: -(1) An endemic for of the :disease is found on the Andesite and also in localised areas on many other geological formations in the Border Area. This form occurs both in hill an:i in arable districts. (2) A sporadic type is liable ' <o occur in a proportion of the flock on any hill farm, following a severe winter luring which the stock have become debilitated.(3) A type of anaemia associated with pregnancy, and also prevalent among small lambs after weaning, is found in flocks in all districts, both hill and arable, and on all types of soil.All of these types respond to the same treatment as nine disease on the Andesite.11. It is probable that the low content of available phosphorus in many soils in the area has some connection with the occurrence of these anaemias.12. It is suggested that these various forms of anaemia ray be widely distributed in other parts of Scotland.13. The system of mineral feeding worked out Luring the course of this investigation has been used upon thousands of sheep with markedly beneficial results. apart from its effect upon pine disease or anaemia, it has other advantages. There is a decrease in the proportion of tup-eild ewes, and an appreciable increase in the number of twin lambs.There is a reduction in the rate of abortion, and, in lowland flocks, the incidence of pregnancy toxaemia is lessened. 'Deaths among ewes are reduced. Lambs make bettor progress while nursing.14. In practice, pine disease and allied conditions can be prevented, and some of the above advantages secured, by an annual outlay of one penny per sheep

A Case of Embolic (? Thrombotic) Atelectasis of the Middle and Lower Lobes of the Right Lung; Survival.

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Assessing the behavioural trajectories of terrorists: The role of psychological resilience

Within studies critically examining terrorist behaviour, the examination of mental health has largely focused on the relationship with the movement towards terrorist involvement. The impact of engagement in terrorism upon mental health has rarely been studied. However, recent research has shown that there is an association between terrorist engagement and the occurrence of mental health problems across the spectrum of terrorist involvement. This work therefore expands on previous research, and disaggregates three discrete stages of terrorist involvement; pre-engagement, engagement, and disengagement, to critically examine the role of psychological resilience on mental health. To determine whether psychological resilience protects against the negative psychological repercussions of terrorist involvement, we undertake cluster analyses. Results indicate that there is a subset of actors who demonstrate psychological resilience, and appear to maintain their mental health despite their experiences during involvement in terrorism

The Chelsea Critical Care Physical Assessment Tool (CPAx): validation of an innovative new tool to measure physical morbidity in the general adult critical care population; an observational proof-of-concept pilot study.

Objective To develop a scoring system to measure physical morbidity in critical care – the Chelsea Critical Care Physical Assessment Tool (CPAx). Method The development process was iterative involving content validity indices (CVI), a focus group and an observational study of 33 patients to test construct validity against the Medical Research Council score for muscle strength, peak cough flow, Australian Therapy Outcome Measures score, Glasgow Coma Scale score, Bloomsbury sedation score, Sequential Organ Failure Assessment score, Short Form 36 (SF-36) score, days of mechanical ventilation and inter-rater reliability. Participants Trauma and general critical care patients from two London teaching hospitals. Results Users of the CPAx felt that it possessed content validity, giving a final CVI of 1.00 (P < 0.05). Construct validation data showed moderate to strong significant correlations between the CPAx score and all secondary measures, apart from the mental component of the SF-36 which demonstrated weak correlation with the CPAx score (r = 0.024, P = 0.720). Reliability testing showed internal consistency of α = 0.798 and inter-rater reliability of κ = 0.988 (95% confidence interval 0.791 to 1.000) between five raters. Conclusion This pilot work supports proof of concept of the CPAx as a measure of physical morbidity in the critical care population, and is a cogent argument for further investigation of the scoring system

‘CSA-Plan’: strategies to put Climate-Smart Agriculture (CSA) into practice

Large-scale investment is needed to create climate-smart agriculture (CSA) systems. While many government and development agencies are integrating CSA into their policies, programmes, plans and projects, there is little guidance for operational planning and implementation on ways to be climate-smart. Here we present ‘CSA-Plan’. CSA-Plan frames actions needed to design and execute CSA programmes into four components – (i) situation analysis, (ii) targeting and prioritising, (iii) programme design, and (iv) monitoring and evaluation. Each component yields concrete information to operationalise CSA development, separating it from traditional agriculture development. Already, CSA-Plan has shown the capacity to change the discussion around CSA implementation. With iterative co-development, the approaches will become ever more useful, relevant and legitimate to governments, civil society and the private sector alike

‘CSA Plan’: A guide to scaling climate-smart agriculture - Concepts and lessons from designing CSA programs and policies in sub-Saharan Africa

Large scale investment is needed to create climate-smart agriculture (CSA) systems. While many government and development agencies are integrating CSA into their policies, programmes, plans and projects, there is little guidance for operational planning and implementation on ways to be climate-smart. Here we present “CSA-Plan”. CSA-Plan frames actions needed to design and execute CSA programs into four components—1) situation analysis, 2) targeting and prioritizing, 3) program design, and 4) monitoring and evaluation. Each component yields concrete information to operationalize CSA development separating it from traditional agriculture development. Already, CSA-Plan has shown the capacity to change the discussion around CSA implementation. With iterative co-development, the approaches will become only more useful, relevant and legitimate to governments, civil society and the private sector alike

Impact of the Chelsea critical care physical assessment (CPAx) tool on clinical outcomes of surgical and trauma patients in an intensive care unit: An experimental study

Background: Critically ill patients following traumatic injury or major surgery are at risk of loss of skeletal muscle mass, which leads to decreased physical function. Early rehabilitation in an intensive care unit (ICU) is thought to preserve or restore physical functioning. The Chelsea critical care physical assessment (CPAx) is a measurement tool used to assess physical function in the ICU. Objectives: To determine whether the use of the CPAx tool as part of physiotherapy patient assessment, in two adult trauma and surgical ICU settings where early patient mobilisation forms part of standard physiotherapy practice, had an impact on ICU and hospital length of stay (LOS) through delivery of problem-oriented treatment plans. Method: A single-centred pre–post quasi-experimental study was conducted. The population was a consecutive sample of surgical and trauma ICU patients. Participants’ functional ability was assessed with the CPAx tool on alternative days during their ICU stay, and rehabilitation goals were modified according to their CPAx score. Intensive care unit and hospital LOS data were collected and compared to data of a matched historical control group. Descriptive and inferential statistics were used. Results: A total of 26 ICU patients were included in the intervention group (n = 26). They received CPAx-guided therapy, and outcomes were matched with ICU patients in the historical control group (n = 26). The median sequential organ failure assessment (SOFA) score was significantly higher in the control group (p = 0.005) (3.5 [IQR 2–6.3]) versus (2 [IQR 1.8–2.5]) for the intervention group. The median admission CPAx score for the intervention group was 33.5 (IQR 16.1–44), and the median ICU discharge score was 38 (IQR 28.5–43.8). No significant differences were found in ICU days (control 2.7 [IQR 1.1–5.2]; intervention 3.7 [IQR 2.3–5.4]; p = 0.27) or hospital LOS (control 13.5 [IQR 9.3–18.3]; intervention 11.4 [IQR 8.4–20.3], p = 0.42). Chelsea critical care physical assessment scores on ICU admission had a moderate negative correlation with hospital LOS (r = -0.58, p = 0.00, n = 23). Chelsea critical care physical assessment scores at ICU discharge had strong positive correlation with discharge SOFA scores (r = 0.7; p = 0.025; n = 10). Conclusion: Problem-oriented patient rehabilitation informed by the CPAx tool resulted in improvement of physical function but did not reduce ICU or hospital LOS. Clinical implications: A higher level of physical function at ICU admission, measured with CPAx, was associated with shorter hospital LOS.South African Society of Physiotherapy Research Foundatio

The Effect of Age of Dam and Birth Rank on the Reproductive Performance of Ewes as One- and Two-Year-Olds

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A guideline for the formation of sub-national climate-smart agriculture alliances in Tanzania

About the guideline: This document summarizes recommendations on best practices on how to form and operationalize of sustainable sub-national Climate Smart Agriculture (CSA) alliances for CSA actors in Tanzania. These are based on the experience and recommendations of existing District CSA Alliances and views from selected CSA actors in the country. It seeks to support ongoing efforts in the country to promote the adoption of CSA practices and technologies

Exenatide twice-daily does not affect renal function or albuminuria compared to titrated insulin glargine in patients with type 2 diabetes mellitus : A post-hoc analysis of a 52-week randomised trial

Aims: To compare the effects of long-term treatment with the GLP-1RA exenatide twicedaily versus titrated insulin glargine (iGlar) on renal function and albuminuria in type 2 diabetes (T2DM) patients. Methods: We post-hoc evaluated renal outcome-data of 54 overweight T2DM patients (mean +/- SD age 60 +/- 8 years, HbA1c 7.5 +/- 0.9%, eGFR 86 +/- 16 mL/min/1.73m(2), median [IQR] urinary albumin-to-creatinine-ratio (UACR) 0.75 [0.44-1.29] mg/mmol) randomised to exenatide 10 mg twice-daily or titrated iGlar on-top-of metformin for 52-weeks. Renal efficacy endpoints were change in creatinine clearance (CrCl) and albuminuria (urinary albuminexcretion [UAE] and UACR) based on 24-h urines, collected at baseline and Week-52. eGFR and exploratory endpoints were collected throughout the intervention-period, and after a 4-week wash-out. Results: HbA1c-reductions were similar with exenatide (mean +/- SEM -0.80 +/- 0.10%) and iGlar (-0.79 +/- 0.14%; treatment-difference 0.02%; 95% CI - 0.31 to 0.42%). Change from baseline to Week-52 in CrCl, UAE or UACR did not statistically differ; only iGlar reduced albuminuria (P <0.05; within-group). eGFR decreased from baseline to Week-4 with exenatide (-3.9 +/- 2.1 mL/min/1.73 m(2); P = 0.069) and iGlar (-2.7 +/- 1.2 mL/min/1.73 m(2); P = 0.034), without treatment-differences in ensuing trajectory. Exenatide versus iGlar reduced bodyweight (-5.4 kg; 2.9-7.9; P <0.001), but did not affect blood pressure, lipids or plasma uric acid. Conclusions: Among T2DM patients without overt nephropathy, one-year treatment with exenatide twice-daily does not affect renal function-decline or onset/progression of albuminuria compared to titrated iGlar. (C) 2019 Elsevier B.V. All rights reserved.Peer reviewe