The Impact of Admissions for the Management of End-stage renal disease on hospital bed occupancy

BACKGROUND:

End-stage renal disease (ESRD) is increasingly prevalent but the inpatient costs associated with this condition are poorly defined due to limitations with data extraction and failure to differentiate between hospitalisation for renal and non-renal disease reasons. The impact of admissions primarily for the management of ESRD on hospital bed utilisation was assessed over a 5-year period in a large teaching hospital.

METHODS:

All admission episodes were reviewed and the ESRD group was identified by a primary International Classification of Diseases code for ESRD or a non-specific primary renal failure code with a secondary code for ESRD. The frequency and duration of hospitalisation and contribution to bed day occupancy of this group with ESRD was determined.

RESULTS:

There were 70,808 patients responsible for a total of 116,915 admissions and 919,212 bed days over the study period. Of these, 988 (1.4%) patients were admitted for the management of ESRD, accounting for 2,387 (2.0%) of admissions and utilisation of 23,011 (2.5%) bed days. After adjustment for age and gender, those admitted for ESRD management were significantly more likely to have a prolonged admission exceeding 30 days (odds ratio 1.46, 95% confidence interval 1.23-1.72, p < 0.001). When the admission was an emergency rather than an elective event, the patient was 4.6 times more likely to be hospitalised for over 30 days.

CONCLUSIONS:

Persons admitted for ESRD management are hospitalised more frequently and for longer than the overall inpatient population, occupying a substantial number of bed days.

Short interfering RNA-mediated gene silencing in Globodera pallida and Meloidogyne incognita infective stage juveniles

The analysis of gene function through RNA interference (RNAi)-based reverse genetics in plant parasitic nematodes (PPNs) remains inexplicably reliant on the use of long double-stranded RNA (dsRNA) silencing triggers; a practice inherently disadvantageous due to the introduction of superfluous dsRNA sequence. increasing chances of aberrant or off-target gene silencing through interactions between nascent short interfering RNAs (siRNAs) and non-cognate mRNA targets. Recently, we have shown that non-nematode, long dsRNAs have a propensity to elicit profound impacts on the phenotype and migrational abilities of both root knot and cyst nematodes. This study presents, to our knowledge for the first time, gene-specific knockdown of FMRFamide-like peptide (flp) transcripts, using discrete 21 bp siRNAs in potato cyst nematode Globodera pallida, and root knot nematode Meloidogyne incognita infective (J2) stage juveniles. Both knockdown at the transcript level through quantitative (q)PCR analysis and functional data derived from migration assay, indicate that siRNAs targeting certain areas of the FMRFamide-like peptide (FLP) transcripts are potent and specific in the silencing of gene function. In addition, we present a method of manipulating siRNA activity through the management of strand thermodynamics. Initial evaluation of strand thermodynamics as a determinant of RNA-induced Silencing Complex (RISC) strand selection (inferred from knockdown efficacy) in the siRNAs presented here suggested that the purported influence of 5' stand stability on guide incorporation may be somewhat promiscuous. However, we have found that on strategically incorporating base mismatches in the sense strand of a G. pallida-specific siRNA we could specifically increase or decrease the knockdown of its target (specific to the antisense strand), presumably through creating more favourable thermodynamic profiles for incorporation of either the sense (non-target-specific) or antisense (target-specific) strand into a cleavage-competent RISC. Whilst the efficacy of similar approaches to siRNA modification has been demonstrated in the context of Drosophila whole-cell lysate preparations and in mammalian cell cultures, it remained to be seen how these sense strand mismatches may impact on gene silencing in vivo, in relation to different targets and in different sequence contexts. This work presents the first application of such an approach in a whole organism; initial results show promise. (C) 2009 Australian Society for Parasitology Inc. Published by Elsevier Ltd. All rights reserved.

The effect of feeder type and change of feeder type on growing and finishing pig performance and behaviour

Reduced feed intake and hence lower growth rates commonly occur when the environment of the pig changes, e.g. at weaning and when pigs are moved from growing accommodation to finishing accommodation. It is hypothesised that if environmental factors, such as feeder type, remain the same in the weaning and finishing accommodation this 'growth check' may be reduced. A total of 640 pigs in 32 pens of 20 pigs per pen were used to investigate the effects of two feeder types and changing or not changing the feeder type at 10 weeks of age on growth performance and behaviour in the periods from 4 to 10, 10 to finish (22) and from 4 to finish (22) weeks of age, respectively. The two feeder types tested were a 'wet and dry' single-space (S) feeder and a 'dry' multi-space feeder (M).

Influence of social status on the welfare of growing pigs housed in barren and enriched environments

One hundred and twenty-eight pigs were reared in barren or enriched environments from birth to slaughter at 21 weeks of age. Pigs remained as litter-mate groups until 8 weeks of age when they were mixed into groups of eight animals. These groups were balanced for gender and weight and contained two pigs from each of four different litters. Each pig was assigned high or low social status on the basis of relative success in aggressive interactions at mixing. Injury levels were assessed on a weekly basis from 8 to 2 1 weeks of age. Pigs were exposed to two group food competition tests after a period of food restriction at 10 weeks of age, and to an individual novel pen test at 11 weeks of age. Behavioural and plasma cortisol responses to both types of test were recorded. Low social status was associated with increased injuries to the head, neck and ears, and therefore reduced welfare. Pigs with low social status showed reduced resource-holding ability in the food competition test, and greater avoidance of a novel object during the novel pen test. It is suggested that avoidance of the novel object reflected 'learned' fearfulness in these individuals. Environmental enrichment did not negate the effect of low social status on injury levels, but did appear to reduce the negative influence of low social status on stress during food restriction, and led to a reduction in fearfulness in response to the novel pen test. These results suggest that environmental enrichment may improve the we/fare of growing pigs with low social status.

Relationship between rooting behaviour and foraging in growing pigs

The objective of the present study was to investigate the relationship between rooting behaviour and foraging in growing pigs. In study 1, forty-eight 11-week-old pigs were housed in eight groups of six with access to a rooting substrate in the form of spent mushroom compost. In half of the groups the rooting substrate contained food rewards, and in the other half of the groups it did not. All pigs had ad libitum access to feed. In study 2, one hundred and ninety-two 11-week-old pigs were housed in thirty-two groups of six, all with access to spent mushroom compost, and eight groups were each fed to 70, 80, 90 or 100% appetite. Treatments were applied over a two-week period in both studies. The number of pigs involved in active rooting (rooting in substrate while standing), inactive rooting (rooting in substrate while sitting or lying) or non-rooting activity (standing in substrate area and involved in any activity except rooting) was recorded by scan sampling. These behaviours tended to reach a peak in the morning and again in the afternoon. Inactive rooting was not significantly affected by treatments in study I or study 2. Food rewards in the rooting substrate led to a significant reduction in active rooting behaviour and in non-rooting activity during peak periods of the day (P

Influence of environmental enrichment on welfare-related behavioural and physiological parameters in growing pigs

Three hundred and twenty pigs were reared from birth to slaughter at 21 weeks in either barren or enriched environments. The barren environments were defined as intensive housing (slatted floors and minimum recommended space allowances) and the enriched environments incorporated extra space including an area which contained peat and straw in a rack. Behavioural observations showed that environmental enrichment reduced time spent inactive and rime spent involved in harmful social and aggressive behaviour (P

The growing visibility of creationism in Northern Ireland: are new science teachers equipped to deal with the issues?

The growing visibility of various forms of creationism in Northern Ireland raises issues for science education. Attempts have been made at political levels to have such “alternatives” to evolution taught in the science classroom, and the issue has received coverage in local press and media. A sample of 112 pre-service science teachers answered a survey on attitudes toward evolution. Preliminary analysis revealed many of these new teachers held views contrary to scientific consensus—over one fifth doubt the evidence for human evolution, and over one quarter dispute the common ancestry of life. Over two thirds indicated a preference for teaching a “range of theories” regarding these issues in science. In addition, 49 pre-service biology teachers viewed a DVD resource promoting “intelligent design” and completed an evaluation of it. The biology teachers also took part in either focus groups or additional questionnaires. A majority took the resource at face value and made positive comments regarding its utility. Many articulated views contrary to the stated positions of science academies, professional associations, and the UK government teaching directives regarding creationism. Most indicated a perception that intelligent design is legitimate science and that there is a scientific “controversy” regarding the legitimacy of evolution. Concern is raised over the ability of these new teachers to distinguish between scientific and non-scientific theories. The suggestion is made that the issue should be addressed directly with pre-service science teachers to make clear the status of such “alternatives.” The paper raises implications for science education and questions for further research.

Evaluation of Five Interleukin Genes for Association with End-Stage Renal Disease in White Europeans

Background: Genetic variation within interleukin genes has been reported to be associated with end-stage renal disease (ESRD). These findings have not been consistently replicated. No study has yet reported the comprehensive investigation of IL1A, IL1B, IL1RN, IL6 and IL10 genes. Methods: 664 kidney transplant recipients (cases) and 577 kidney donors (controls) were genotyped to establish if common variants in interleukin genes are associated with ESRD. Single nucleotide polymorphism (SNP) genotype data for each gene were downloaded for a northern and western European population from the International HapMap Project. Haploview was used to visualize linkage disequilibrium and select tag SNPs. Thirty SNPs were genotyped using MassARRAY (R) iPLEX Gold technology and data were analyzed using the chi(2) test for trend. Independent replication was conducted in 1,269 individuals with similar phenotypic characteristics. Results: Investigating all common variants in IL1A, IL1B, IL1RN, IL6 and IL10 genes revealed a statistically significant association (rs452204 p(empirical) = 0.02) with one IL1RN variant and ESRD. This IL1RN SNP tags three other variants, none of which have previously been reported to be associated with renal disease. Independent replication in a separate transplant population of comparable size did not confirm the original observation. Conclusions: Common variants in these five candidate interleukin genes are not major risk factors for ESRD in white Europeans. Copyright (C) 2010 S. Karger AG, Basel