The effect of a period of intensive exercise on the isoform test to detect growth hormone doping in sports.

OBJECTIVE: The major objective of this study was to investigate the effects of several days of intense exercise on growth hormone (hGH) testing using the World Anti-Doping Agencies hGH isoform differential immunoassays. Additionally the effects of circadian variation and exercise type on the isoform ratios were also investigated. STUDY DESIGN: 15 male athletes performed a simulated nine day cycling stage race. Blood samples were collected twice daily over a period of 15days (stage race+three days before and after). hGH isoforms were analysed by the official WADA immunoassays (CMZ Assay GmbH). RESULTS: All measured isoform ratios were far below the WADA decision limits for an adverse analytical finding. Changes in the isoform ratios could not be clearly connected to circadian variation, exercise duration or intensity. CONCLUSIONS: The present study demonstrates that the hGH isoform ratios are not significantly affected by exercise or circadian variation. We demonstrated that heavy, long term exercise does not interfere with the decision limits for an adverse analytical finding.

Heavy Agricultural Loads on Pavements and Bridges, HR-1073, 1999

During the harvest season in Iowa, it is common to have single axle loads on secondary roads and bridges that are excessive (typical examples are grain carts) and well beyond normal load limits. Even though these excessive loads occur only during a short time of the year, they may do significant damage to pavements and bridges. In addition, the safety of some bridges may be compromised because of the excessive loads, and sometimes there may be little indication to the users that damage may be imminent. At this time there are no Iowa laws regulating axle loads allowed for agricultural equipment. This study looks at the potential problems this may cause on secondary roads and timber stringer bridges. Both highway pavement and timber bridges are evaluated in this report. A section (panel) of Iowa PCC paved county road was chosen to study the effects of heavy agricultural loads on pavements. Instrumentation was applied to the panel and a heavily loaded grain cart was rolled across. The collected data were analyzed for any indication of excessive stresses of the concrete. The second study, concerning excessive loads on timber stringer bridges, was conducted in the laboratory. Four bridge sections were constructed and tested. Two of the sections contained five stringers and two sections had three stringers. Timber for the bridges came from a dismantled bridge, and deck panels were cut from new stock. All timber was treated with creosote. A hydraulic load was applied at the deck mid-span using a foot print representing a tire from a typical grain cart. Force was applied until failure of the system resulted. The collected data were evaluated to provide indications of load distribution and for comparison with expected wheel loads for a typical heavily loaded single axle grain cart. Results of the pavement tests showed that the potential of over-stressing the pavement is a possibility. Even though most of the tension stress levels recorded were below the rupture strength of the concrete, there were a few instances where the indicated tension stress level exceeded the concrete rupture strength. Results of the bridge tests showed that when the static ultimate load capacity of the timber stringer bridge sections was reached, there was sudden loss of capacity. Prior to reaching this ultimate capacity, the load sharing between the stringers was very uniform. The failure was characterized by loss of flexural capacity of the stringers. In all tests, the ultimate test load exceeded the wheel load that would be applied by an 875 bushel single axle grain cart.

Water scarcity management and agricultural production (What we can do to produce more with less water)

Crop seasonal sensitivity to water stress is concerned with how to control water stress levels to optimise yield or profitability. It deals with when we can reduce irrigation and impose moderate water deficits without affecting our target, and when we can apply water to avoid too much stress.

Effects of competing vegetation and post-planting weed control on the mortality, growth and vole damages to Betula pendula planted on former agricultural land

Abstract

Réactualisation de la douzième conférence de consensus de la Société de réanimation de langue française (SRLF) : infections liées aux cathéters veineux centraux en réanimation [Updating of the 12th consensus conference of the Société de Réanimation de langue française (SRLF) : catheter related infections in Intensive Care unit]

Concerning catheter-related infections, many studies have been conducted until the last consensus conference of the Sociétéde réanimation de langue française (SRLF) in 1994. This text is the synthesis of the considerable amount of work performed by the experts of the society to review recent studies. The experts' texts as well as extensive bibliography are available at http://www.srlf.org.

Audit report on the Muscatine Agricultural Learning Center for the year ended December 31, 2014

Audit report on the Muscatine Agricultural Learning Center for the year ended December 31, 2014

Sources d'exposition aux phtalates dans une unité de soins néonatals [Phthalate exposure in the neonatal intensive care unit].

There are growing concerns on long-term health consequences, notably on fertility rates, of plasticizers such as phthalates. While di(2-ethylhexyl)phthalate (DEHP) is currently used in several medical devices, newborns in the neonatal intensive care unit are both more exposed and more vulnerable to DEHP. The objectives of this study were to identify, count, and describe possible sources of DEHP in a neonatal care unit. Our method consisted in the listing and the inspection of the information on packaging, complemented by contact with manufacturers when necessary. According to the results, 6% of all products and 10% of plastic products contained some DEHP; 71% of these involved respiratory support devices. A vast majority of the items showed no information on the content of DEHP. Further research is needed, particularly to determine the effects of such an early exposure and to study and develop safer alternatives.

Can the impact of bed closure in intensive care units be reliably monitored?

OBJECTIVE: To assess the properties of various indicators aimed at monitoring the impact on the activity and patient outcome of a bed closure in a surgical intensive care unit (ICU). DESIGN: Comparison before and after the intervention. SETTING: A surgical ICU at a university hospital. PATIENTS: All patients admitted to the unit over two periods of 10 months. INTERVENTION: Closure of one bed out of 17. MEASUREMENTS AND RESULTS: Activity and outcome indicators in the ICU and the structures upstream from it (emergency department, operative theater, recovery room) and downstream from it (intermediate care units). After the bed closure, the monthly medians of admitted patients and ICU hospital days increased from 107 (interquartile range 94-112) to 113 (106-121, P=0.07) and from 360 (325-443) to 395 (345-436, P=0.48), respectively, along with the linear trend observed in our institution. All indicators of workload, patient severity, and outcome remained stable except for SAPS II score, emergency admissions, and ICU readmissions, which increased not only transiently but also on a mid-term basis (10 months), indicating that the process of patient care delivery was no longer predictable. CONCLUSIONS: Health care systems, including ICUs, are extraordinary flexible, and can adapt to multiple external constraints without altering commonly used activity and outcome indicators. It is therefore necessary to set up multiple indicators to be able to reliably monitor the impact of external interventions and intervene rapidly when the system is no longer under control.

1016-010 Iowa Great Lakes Watershed Final Report

Part of a phased approach, an intensive information and education program, construction of erosion control practices, and sediment control on construction sites is proposed. These proposed practices will manage sediment runoff and nutrient runoff on agricultural and urban areas. Sediment control “structures” such as waterways, wetlands, modified terraces, grade stabilization structures, sediment basins, and rain gardens is proposed and will be combined with nutrient and pesticide management and reduced tillage to reduce non-point source pollution. A reduction of 15% of the sediment and phosphorus delivered to a water body from priority areas will be looked at as a success in this short-term project focused primarily at education within the project area which is also, for the most part, the top 25% sediment load producing sub-watersheds. In addition, four urban areas have been identified as part of this project as needing immediate assistance. A combination of urban and agricultural conservation practices, shoreline revegetation, and education of landowners will be used to achieve these results on both the urban and the agricultural arena.

1204-003 North Fork Maquoketa Watershed Final Report

The Headwaters North Fork Maquoketa River Project encompasses the Hewitt Creek, Bear Creek, and the Coffee Creek-North Fork Maquoketa subwatersheds. These three.sub-watersheds have intensive livestock agriculture production with manures applied generously on the landscape. Approximately 85% of the watershed area is cropland. Although livestock operations are not permitted to discharge waste directly into surface waters, the mishandling and over-application of animal waste and fertilizer have impacted water quality. Each of the subwatersheds has a strong locally led effort, concentrating significant efforts on monitoring, education, and conservation practice adoption. The original MRBI application was accepted by USDA with funding being extended to producers through FY14. A large component of this effort was the IJOBS funds awarded by IDALS to support the Project Coordinator for the first two years of this project. As previous funding for the support of the Project Coordinator has been exhausted, the local partners identified WIRB as a potential replacement funding source. The goal of the existing MRBI effort, in being consistent with this WIRB application, will help landowners and operators in the three selected watersheds voluntarily implement conservation systems that reduce nutrient loss; protect, restore, and enhance wetlands; maintain agricultural productivity; improve wildlife habitat; and achieve other objectives, such as flood reduction.

ESPEN Guidelines on Enteral Nutrition: Intensive care.

Enteral nutrition (EN) via tube feeding is, today, the preferred way of feeding the critically ill patient and an important means of counteracting for the catabolic state induced by severe diseases. These guidelines are intended to give evidence-based recommendations for the use of EN in patients who have a complicated course during their ICU stay, focusing particularly on those who develop a severe inflammatory response, i.e. patients who have failure of at least one organ during their ICU stay. These guidelines were developed by an interdisciplinary expert group in accordance with officially accepted standards and are based on all relevant publications since 1985. They were discussed and accepted in a consensus conference. EN should be given to all ICU patients who are not expected to be taking a full oral diet within three days. It should have begun during the first 24h using a standard high-protein formula. During the acute and initial phases of critical illness an exogenous energy supply in excess of 20-25 kcal/kg BW/day should be avoided, whereas, during recovery, the aim should be to provide values of 25-30 total kcal/kg BW/day. Supplementary parenteral nutrition remains a reserve tool and should be given only to those patients who do not reach their target nutrient intake on EN alone. There is no general indication for immune-modulating formulae in patients with severe illness or sepsis and an APACHE II Score >15. Glutamine should be supplemented in patients suffering from burns or trauma.

Prospective study of the barriers to nutritional support in a paediatric intensive care unit : P16

Introduction and aim: Children hospitalised in a paediatric intensive care unit (PICU) are mainly fed by nutritional support (NS) which may often be interrupted. The aims of the study were to verify the relationship between prescribed (PEI) and actual energy intake (AEI) and to identify the reasons for NS interruption. Methods: Prospective study in a PICU. PEI and AEI from day 1 to 15, type of NS (enteral, parenteral, mixed), position of the feeding tube, interruptions in NS and reasons for these were noted. Inter - ruptions were classified in categories of barriers and their frequency and duration were analysed. Results: Fifteen children (24 ± 25.2 months) were studied for 84 days. The NS was exclusively enteral (69%) or mixed (31%). PEI were significantly higher than AEI (54.7 ± 32.9 vs 49.2 ± 33.6 kcal/kg, p = 0.0011). AEI represented 93% of the PEI. Ninety-eight interruptions were noted and lasted 189 h, i.e. 9.4% of the evaluated time. The most frequent barriers were nursing procedures, respiratory physiotherapy and unavailability of intravenous access. The longest were caused by the necessity to stop NS for surgery or diagnostic studies, to treat burns or to carry out medical procedures. Conclusion: AEI in PICU were inferior by 7% to PEI, considerably lower than in adult studies. Making these results available to medical staff for greater anticipation and compensation could reduce NS interruptions. Starving protocols should be reconsidered.

Drug utilisation in a neonatal intensive care unit of a swiss university hospital

Introduction Medication errors in hospitalsmay occur at any step of the medication process including prescription, transcription, preparation and administration, and may originate with any of the actors involved. Neonatal intensive care units (NICU) take care of extremely frail patients in whom errors could have dramatic consequences. Our objective was to assess the frequency and nature of medication errors in the NICU of a university hospital in order to propose measures for improvement.Materials & Methods The design was that of an observational prospective study over 4 consecutivemonths. All patients receiving C 3drugs were included. For each patient, observations during the different stages were compiled in a computer formulary and compared with the litterature. Setting: The 11-bed NICU of our university hospital.Main outcome measures:(a) Frequency and nature of medication errors in prescription,transcription, preparation and administration.(b) Drugs affected by errors.Results 83 patients were included. 505 prescriptions and transcriptions, 447 preparations and 464 administrations were analyzed. 220 medications errors were observed: 102 (46.4%) at prescription, 25 (11.4%) at transcription, 19 (8.6%) at preparation and 73 (33.2%) at administration. Uncomplete/ambiguous orders (24; 23.5%) were the most common errors observed at prescription, followed by wrong name (21; 20.6%), wrong dose (17; 16.7%) and omission (15; 14.7%). Wrong time (33; 45.2%) and wrong administration technique (31; 42.5%) were the most important medication errors during administration. According to the ATC classification, systemic antibacterials (53; 24.1%) were the most implicated, followed by perfusion solutions (40; 18.2%), respiratory system products (30; 13.6%), and mineral supplements and antithrombotic agents (20; 9.1%).Discussions, Conclusion Proposed recommendations: ? Better teaching of neonatal prescription to medical interns;? Improved prescription form to avoid omissions and ambiguities;? Development of a neonatal drug formulary, including prescription,preparation and administration modalities to reduce errors at different stages;? Presence of a clinical pharmacist in the NICU.Disclosure of Interest None Declared

Iowa Rural and Agricultural Health and Safety Resource Plan, 2011

The Iowa Department of Public Health (IDPH) convened the Health and Long-Term Care Advisory Council (HLTCAC) to assist in the development of its strategic plan. One component of the strategic plan is a rural health care resource plan. The intent of this document is to present reliable information and data as a valuable resource for the officials, agencies, and organizations responsible for strengthening and supporting the rural health systems vital to 43 percent of Iowa residents.

Audit report on America’s Agricultural Industrial Heritage Landscape, Inc., d/b/a Silos and Smokestacks National Heritage Area and Silos and Smokestacks Natural Heritage Area Foundation in Waterloo, Iowa for the years ended December 31, 2015 and 2014

Audit report on America’s Agricultural Industrial Heritage Landscape, Inc., d/b/a Silos and Smokestacks National Heritage Area and Silos and Smokestacks Natural Heritage Area Foundation in Waterloo, Iowa for the years ended December 31, 2015 and 2014