Redefining dermatologists’ role in skin cancer early detection and follow-up care

Early diagnosis of melanoma leads to the best prognosis for patients and may be more likely achieved when those who are at high risk for melanoma undergo regular and systematic monitoring. However, many people rarely or never see a dermatologist. Risk prediction models (recently reviewed by Usher-Smith et al ) could assist to triage people into preventive care appropriate for their risk profile. Most risk prediction models contain measures of phenotype including skin, eye and hair colour as well as genetic mutations. Almost all also contain the number and size of naevi, as well as the presence of naevi with atypical features which are independently associated with melanoma risk. In the absence of formal population-based screening programs for melanoma in most countries worldwide, people with high risk phenotypes may need to consider regular monitoring or self-monitoring of their naevi , especially since the vast majority of melanomas are found by people themselves or their friend and relatives. Another group of patients that will require regular monitoring are patients who have been successfully treated for their first melanoma, whose risk to develop a second melanoma is greatly increased . In a US study of 89,515 melanoma survivors those with a previous diagnosis of melanoma had a 9-fold increased risk of developing subsequent melanoma compared with the general population, equating to a rate of 3.76 per 1000 person-years, while in an Australian study, risk of subsequent melanoma was 6 per 1000 person-years. Regular follow-up is therefore essential for melanoma survivors, especially during the first few years after initial melanoma diagnosis.

Effectiveness of in-office blood pressure measurement by eye care practitioners in early detection and management of hypertension

AIM To investigate the number of hypertensive patients, the optometrist is able to identify by routinely taking blood pressure (BP) measurements for patients in "at -risk" groups, and to sample patients' opinions regarding in -office BP measurement. Many of the optometrists in Saudi Arabia practice in optical stores. These stores are wide spread, easily accessible and seldom need appointments. The expanding role of the optometrist as a primary health care provider (PHCP) and the increasing global prevalence of hypertension, highlight the need for an integrated approach towards detecting and monitoring hypertension. METHODS Automated BP measurements were made twice (during the same session) at five selected optometry practices using a validated BP monitor (Omron M6) to assess the number of patients with high BP (HBP) - in at -risk groups -visiting the eye clinic routinely. Prior to data collection, practitioners underwent a two-day training workshop by a cardiologist on hypertension and how to obtain accurate BP readings. A protocol for BP measurement was distributed and retained in all participating clinics. The general attitude towards cardiovascular health of 480 patients aged 37.2 (依12.4)y and their opinion towards in-office BP measurement was assessed using a self -administered questionnaire. RESULTS A response rate of 83.6% was obtained for the survey. Ninety -three of the 443 patients (21.0% ) tested for BP in this study had HBP. Of these, (62 subjects) 67.7% were unaware of their HBP status. Thirty of the 105 subjects (28.6%) who had previously been diagnosed with HBP, still had HBP at the time of this study, and only 22 (73.3%) of these patients were on medication. Also, only 25% of the diagnosed hypertensive patients owned a BP monitor. CONCLUSION Taking BP measurements in optometry practices, we were able to identify one previously undiagnosed patient with HBP for every 8 adults tested. We also identified 30 of 105 previously diagnosed patients whose BP was poorly controlled, twenty-two of whom were on medication. The patients who participated in this study were positively disposed toward the routine measurement of BP by optometrists.

Pedagogical practices and support systems of inclusion: Empirical evidence from Chinese societies

China has a massive population of children with disabilities. To address the special needs of these children, special/inclusive education in China has developed dramatically since the early 1980s onwards. This Special Issue puts together seven empirical studies emerging from the Chinese societies. These studies analyse inclusive discourses embedded in the education policy documents; scrutinise professional competence of inclusive education teachers; evaluate inclusive education practices in physical education, mathematics education, and job-related social skills education provided to students with disabilities; debate the required in-class support for inclusive education teachers; and discuss the social attitudes towards people with disabilities. The foci, methods and theories vary across the seven studies, while their aims converge. These studies are seeking best possible approaches and best available resources that facilitate inclusion. Knowledge built and lessons learned from these studies will provide implications for future inclusive education practices in China and beyond.

Nutrition intervention approaches to reduce malnutrition in oncology patients: A systematic review

Purpose Malnutrition is a very common problem in oncology patients and is associated with many negative consequences including poorer prognosis, quality of life and survival. However, malnutrition in oncology patients is often overlooked although there is growing evidence showing that it can be prevented or reduced through nutrition intervention. This paper aims to provide an updated review on the effectiveness of different nutrition intervention approaches on nutrition status outcomes in oncology patients. Methods Randomised controlled trials (RCTs) published between 1994 and 2014 which examined the effects of nutrition intervention approaches—in particular, nutrition counselling (NC), oral nutrition supplements (ONS) and tube feeding (TF)—on nutrition status outcomes of oncology patients were identified and reviewed. Results Thirteen papers from 11 RCTs with a total of 1077 participants were included. The intervention approaches included NC (four studies), NC + ONS (five studies), ONS (three studies) and TF (three studies). The various results suggest that NC with or without ONS was associated with consistent improvements in several nutrition status outcomes. On the other hand, ONS and TF were associated with inconsistent improvements in few aspects of nutrition status outcomes. Conclusions The referral of oncology patients for NC is recommended given the strong evidence of its beneficial effects on the prevention and reduction of malnutrition. Other forms of nutrition support including ONS and TF may then be included if deemed suitable and necessary for the individual.

What parents want: Parent preference regarding sleep for their preschool child when attending Early Care and Education

Background While most children cease napping between the ages of 2 and 5 years, across a range of international settings the allocation of a mandatory naptime is a common feature of the daily routine in Early Care and Education (ECE) programs for children of this age. Evidence regarding the developmental effects of napping is limited but, beyond age 2, is consistently associated with delayed night sleep onset and increased number of awakenings. Objectives The present study examined parent preferences towards napping in ECE. Methods Participants were 750 parents of preschool-aged children attending a representative sample of Australian ECE programs across metropolitan, regional and rural sites in 2011. We analysed quantitative and open-ended questionnaire data from a large, longitudinal study of the effectiveness of Australian early education programs (E4Kids). Statistical analyses examined prevalence of parent preference for sleep and demographic correlates. Thematic analyses were employed to identify parents' rationale for this preference. Results The majority of parents (78.7%) preferred that their children did not regularly sleep while attending ECE. The dominant explanation provided by parents was that regular naps were no longer appropriate and adversely impacted their children's health and development. Parents of younger children were more likely to support regular naps. Conclusions The results highlight a disjuncture between parent preferences and current sleep policy and practices in ECE. Further research is needed to establish evidence-based guidelines to support healthy sleep-rest practices in ECE. Such evidence will guide appropriate practice and support parent-educator communication regarding sleep and rest.

Impact of automatic region-of-interest coding on perceived quality in mobile video

At present, the most reliable method to obtain end-user perceived quality is through subjective tests. In this paper, the impact of automatic region-of-interest (ROI) coding on perceived quality of mobile video is investigated. The evidence, which is based on perceptual comparison analysis, shows that the coding strategy improves perceptual quality. This is particularly true in low bit rate situations. The ROI detection method used in this paper is based on two approaches: - (1) automatic ROI by analyzing the visual contents automatically, and; - (2) eye-tracking based ROI by aggregating eye-tracking data across many users, used to both evaluate the accuracy of automatic ROI detection and the subjective quality of automatic ROI encoded video. The perceptual comparison analysis is based on subjective assessments with 54 participants, across different content types, screen resolutions, and target bit rates while comparing the two ROI detection methods. The results from the user study demonstrate that ROI-based video encoding has higher perceived quality compared to normal video encoded at a similar bit rate, particularly in the lower bit rate range.

Assessing for genetic and environmental effects on ruminant feed quality in barley ( Hordeum vulgare )

Grain samples from a combined intermediate and advanced stage barley breeding trial series, grown at two sites in two consecutive years were assessed for detailed grain quality and ruminant feed quality. The results indicated that there were significant genetic and environmental effects for “feed” traits as measured using grain hardness, acid detergent fibre (ADF), starch and in-sacco dry matter digestibility (ISDMD) assays. In addition, there was strong genotypic discrimination for the regressed feed performance traits, namely Net Energy (NE) and Average Daily Gain (ADG). There was considerable variation in genetic correlations for all traits based on variance from the cultivars used, sites or laboratory processing effects. There was a high level of heritability ranging from 89% to 88% for retention, 60% to 80% for protein and 56% to 68% for ADF. However, there were only low to moderate levels of heritability for the feed traits, with starch 30–39%, ISDMD 55–63%, ADF 56–68%, particle size 47–73%, 31–48% NE and ADG 44–51%. These results suggest that there were real differences in the feed performance of barleys and that selection for cattle feed quality is potentially a viable option for breeding programs.

Tillage and the environment in sub-tropical Australia-Tradeoffs and challenges

Tillage is defined here in a broad sense, including disturbance of the soil and crop residues, wheel traffic and sowing opportunities. In sub-tropical, semi-arid cropping areas in Australia, tillage systems have evolved from intensively tilled bare fallow systems, with high soil losses, to reduced and no tillage systems. In recent years, the use of controlled traffic has also increased. These conservation tillage systems are successful in reducing water erosion of soil and sediment-bound chemicals. Control of runoff of dissolved nutrients and weakly sorbed chemicals is less certain. Adoption of new practices appears to have been related to practical and economic considerations, and proved to be more profitable after a considerable period of research and development. However there are still challenges. One challenge is to ensure that systems that reduce soil erosion, which may involve greater use of chemicals, do not degrade water quality in streams. Another challenge is to ensure that systems that improve water entry do not increase drainage below the crop root zone, which would increase the risk of salinity. Better understanding of how tillage practices influence soil hydrology, runoff and erosion processes should lead to better tillage systems and enable better management of risks to water quality and soil health. Finally, the need to determine the effectiveness of in-field management practices in achieving stream water quality targets in large, multi-land use catchments will challenge our current knowledge base and the tools available.

Remote sensing of nitrogen and water stress in wheat

Nitrogen (N) is the largest agricultural input in many Australian cropping systems and applying the right amount of N in the right place at the right physiological stage is a significant challenge for wheat growers. Optimizing N uptake could reduce input costs and minimize potential off-site movement. Since N uptake is dependent on soil and plant water status, ideally, N should be applied only to areas within paddocks with sufficient plant available water. To quantify N and water stress, spectral and thermal crop stress detection methods were explored using hyperspectral, multispectral and thermal remote sensing data collected at a research field site in Victoria, Australia. Wheat was grown over two seasons with two levels of water inputs (rainfall/irrigation) and either four levels (in 2004; 0, 17, 39 and 163 kg/ha) or two levels (in 2005; 0 and 39 kg/ha N) of nitrogen. The Canopy Chlorophyll Content Index (CCCI) and modified Spectral Ratio planar index (mSRpi), two indices designed to measure canopy-level N, were calculated from canopy-level hyperspectral data in 2005. They accounted for 76% and 74% of the variability of crop N status, respectively, just prior to stem elongation (Zadoks 24). The Normalised Difference Red Edge (NDRE) index and CCCI, calculated from airborne multispectral imagery, accounted for 41% and 37% of variability in crop N status, respectively. Greater scatter in the airborne data was attributable to the difference in scale of the ground and aerial measurements (i.e., small area plant samples against whole-plot means from imagery). Nevertheless, the analysis demonstrated that canopy-level theory can be transferred to airborne data, which could ultimately be of more use to growers. Thermal imagery showed that mean plot temperatures of rainfed treatments were 2.7 °C warmer than irrigated treatments (P < 0.001) at full cover. For partially vegetated fields, the two-Dimensional Crop Water Stress Index (2D CWSI) was calculated using the Vegetation Index-Temperature (VIT) trapezoid method to reduce the contribution of soil background to image temperature. Results showed rainfed plots were consistently more stressed than irrigated plots. Future work is needed to improve the ability of the CCCI and VIT methods to detect N and water stress and apply both indices simultaneously at the paddock scale to test whether N can be targeted based on water status. Use of these technologies has significant potential for maximising the spatial and temporal efficiency of N applications for wheat growers. ‘Ground–breaking Stuff’- Proceedings of the 13th Australian Society of Agronomy Conference, 10-14 September 2006, Perth, Western Australia.

Regrouping unfamiliar animals in the weeks prior to slaughter has few effects on physiology and meat quality in Bos taurus feedlot steers

The response of cattle to alterations in social groupings can lead to physiological changes that affect meat quality. Feedlot practices frequently lead to a proportion of cattle in a pen being drafted for slaughter with the balance retained for a further period until they meet market specifications. An ability to regroup such retained cattle for short periods without consequences for meat quality would facilitate efficient use of feedlot pen space. The current experiment examined the impact on physiological variables and meat quality of regrouped British breed steers 4, 2 or 1 week before dispatch for slaughter. There was little effect of regrouping cattle on physiological variables associated with stress responses. Physical assessment of meat quality indicated that regrouping steers 1 week before slaughter led to higher compression and a tendency for higher peak force values in animals from one genotype than in their respective controls (1.89 v. 1.71 ± 0.05 kg, P = 0.017); however, these assessments were not matched by changes in sensory perception of meat quality. Average daily gain during feedlot finishing was negatively related to the temperament measure and flight time. It was also associated with breed, white cell count, plasma cortisol and haemoglobin at the midpoint of the 70-day finishing period. The results confirm the impact of flight time on growth rate during feedlot finishing and that regrouping cattle less than 2 weeks before slaughter may reduce meat quality.

Vermiculite improves early development and survival of low chill stone-fruit embryos rescued in vitro

There are many reports of efficient embryo germination and the method has been optimized to suit subtropical low chill genotypes. However the subsequent growth, vigor, and ability of germinated embryos to develop and survive acclimatization is rarely reported. Many germinated embryos do not survive acclimatization, develop slowly, or fail to develop normally. Methods to improve plant development from in vitro embryo cultures are needed to improve the number of plants that survive to be useful in breeding programs. This paper describes an improved method of embryo rescue that significantly increases embryo shoot and root development that leads to increased plant survival. Four treatments: Woody Plant Media (WPM) solidified with agar, vermiculite with liquid WPM, vermiculite with WPM plus agar, and conventional stratification, were evaluated for embryo growth and subsequent plantlet development and survival for two low-chill peach and one low-chill nectarine cultivar. Highly significant improvements were found for shoot and root development of seedlings germinated in vermiculite based media compared to embryos germinated in conventional agar-based media. Vermiculite with WPM and agar improved plantlet growth subsequent to in vitro culture and significantly increased survival of germinated embryos resulting in more plants reaching the field.

Early harvest and ensilage of forage sorghum infected with ergot (Claviceps africana) reduces the risk of livestock poisoning.

Sorghum ergot produces dihydroergosine (DHES) and related alkaloids, which cause hyperthermia in cattle. Proportions of infected panicles (grain heads), leaves and stems were determined in two forage sorghum crops extensively infected 2 to 4 weeks prior to sampling and the panicles were assayed for DHES. Composite samples from each crop, plus a third grain variety crop, were coarsely chopped and half of each sealed in plastic buckets for 6 weeks to simulate ensilation. The worst-infected panicles contained up to 55 mg DHES/kg, but dilution reduced average concentrations of DHES in crops to approximately 1 mg/kg, a relatively safe level for cattle. Ensilation significantly (P = 0.043) reduced mean DHES concentrations from 0.85 to 0.46 mg/kg.

Risks from plants containing pyrrolizidine alkaloids for livestock and meat quality in Northern Australia.

This chapter describes poisoning associated with consumption of pyrrolizidine alkaloid (PA)-containing plants (Crotalaria spp., Heliotropium spp. and Senecio spp.) by cattle and horses in rangelands of northern Australia, as well as the risks for meat quality of PA residues and potential health hazards to consumers.