Optimal management of the critically Ill: Anaesthesia, monitoring, data capture, and point-of-care technological practices in ovine models of critical care

Animal models of critical illness are vital in biomedical research. They provide possibilities for the investigation of pathophysiological processes that may not otherwise be possible in humans. In order to be clinically applicable, the model should simulate the critical care situation realistically, including anaesthesia, monitoring, sampling, utilising appropriate personnel skill mix, and therapeutic interventions. There are limited data documenting the constitution of ideal technologically advanced large animal critical care practices and all the processes of the animal model. In this paper, we describe the procedure of animal preparation, anaesthesia induction and maintenance, physiologic monitoring, data capture, point-of-care technology, and animal aftercare that has been successfully used to study several novel ovine models of critical illness. The relevant investigations are on respiratory failure due to smoke inhalation, transfusion related acute lung injury, endotoxin-induced proteogenomic alterations, haemorrhagic shock, septic shock, brain death, cerebral microcirculation, and artificial heart studies. We have demonstrated the functionality of monitoring practices during anaesthesia required to provide a platform for undertaking systematic investigations in complex ovine models of critical illness.

The in vivo fate of nanoparticles and nanoparticle-loaded microcapsules after oral administration in mice: Evaluation of their potential for colon-specific delivery

Anti-cancer drug loaded-nanoparticles (NPs) or encapsulation of NPs in colon-targeted delivery systems shows potential for increasing the local drug concentration in the colon leading to improved treatment of colorectal cancer. To investigate the potential of the NP-based strategies for colon-specific delivery, two formulations, free Eudragit® NPs and enteric-coated NP-loaded chitosan–hypromellose microcapsules (MCs) were fluorescently-labelled and their tissue distribution in mice after oral administration was monitored by multispectral small animal imaging. The free NPs showed a shorter transit time throughout the mouse digestive tract than the MCs, with extensive excretion of NPs in faeces at 5 h. Conversely, the MCs showed complete NP release in the lower region of the mouse small intestine at 8 h post-administration. Overall, the encapsulation of NPs in MCs resulted in a higher colonic NP intensity from 8 h to 24 h post-administration compared to the free NPs, due to a NP ‘guarding’ effect of MCs during their transit along mouse gastrointestinal tract which decreased NP excretion in faeces. These imaging data revealed that this widely-utilised colon-targeting MC formulation lacked site-precision for releasing its NP load in the colon, but the increased residence time of the NPs in the lower gastrointestinal tract suggests that it is still useful for localised release of chemotherapeutics, compared to NP administration alone. In addition, both formulations resided in the stomach of mice at considerable concentrations over 24 h. Thus, adhesion of NP- or MC-based oral delivery systems to gastric mucosa may be problematic for colon-specific delivery of the cargo to the colon and should be carefully investigated for a full evaluation of particulate delivery systems.

Curriculum and pedagogical practices in four Hong Kong kindergartens

This thesis uses a qualitative case study methodology to investigate kindergarten teachers' pedagogical practices in four Hong Kong (HK) kindergarten classrooms. It considers the transfer of early years teaching and learning approaches from Western cultural contexts to the predominantly Chinese, Confucian heritage culture, of Hong Kong. The study will be of particular interest in countries and contexts in which elements of traditional early childhood curricula are accorded different status.

Breastfeeding duration and authoritative feeding practices in first-time mothers

Background Longer breastfeeding duration appears to have a protective effect against childhood obesity. This effect may be partially mediated by maternal feeding practices during the first years of life. However, the few studies that have examined links between breastfeeding duration and subsequent feeding practices have yielded conflicting results. Objective Using a large sample of first-time mothers and a newly validated, comprehensive measure of maternal feeding (the Feeding Practices and Structure Questionnaire1), this study examined associations between breastfeeding duration and maternal feeding practices at child age 24 months. Methods Mothers (n = 458) enrolled in the NOURISH trial2 provided data on breastfeeding at child age 4, 14 and 24 months, and on feeding practices at 24 months. Structural Equation Modelling was used to examine associations between breastfeeding duration and five non-responsive and four structure-related ‘authoritative’ feeding practices, adjusting for a range of maternal and child characteristics. Results The model showed acceptable fit (χ2/df = 1.68; RMSEA = .04, CFI = .91 and TLI = .89) and longer breastfeeding duration was negatively associated with four out of five non-responsive feeding practices and positively associated with three out of four structure-related feeding practices. Overall, these results suggest that mothers who breastfeed longer reported using more appropriate feeding practices. Conclusion These data demonstrate an association between longer breastfeeding duration and authoritative feeding practices characterised by responsiveness and structure, which may partly account for the apparent protective effect of breastfeeding on childhood obesity.

Improving Knowledge and Practices in Mango Supply Chains

Mangoes consigned to domestic markets suffered from fruit quality problems from 1997 to 2000. A high incidence of disease breakdown and green-ripe fruit resulted in loss of confidence by marketers, and reduced profits for everyone from grower to retailer. The ‘Better Mangoes’ project was initiated to identify where, and why quality was being lost, and to use this information to improve the knowledge and practices of supply chain businesses.

Breastmilk-saliva interactions boost innate immunity by regulating the oral microbiome in early infancy

Introduction Xanthine oxidase (XO) is distributed in mammals largely in the liver and small intestine, but also is highly active in milk where it generates hydrogen peroxide (H2O2). Adult human saliva is low in hypoxanthine and xanthine, the substrates of XO, and high in the lactoperoxidase substrate thiocyanate, but saliva of neonates has not been examined. Results Median concentrations of hypoxanthine and xanthine in neonatal saliva (27 and 19 μM respectively) were ten-fold higher than in adult saliva (2.1 and 1.7 μM). Fresh breastmilk contained 27.3±12.2 μM H2O2 but mixing baby saliva with breastmilk additionally generated >40 μM H2O2, sufficient to inhibit growth of the opportunistic pathogens Staphylococcus aureus and Salmonella spp. Oral peroxidase activity in neonatal saliva was variable but low (median 7 U/L, range 2–449) compared to adults (620 U/L, 48–1348), while peroxidase substrate thiocyanate in neonatal saliva was surprisingly high. Baby but not adult saliva also contained nucleosides and nucleobases that encouraged growth of the commensal bacteria Lactobacillus, but inhibited opportunistic pathogens; these nucleosides/bases may also promote growth of immature gut cells. Transition from neonatal to adult saliva pattern occurred during the weaning period. A survey of saliva from domesticated mammals revealed wide variation in nucleoside/base patterns. Discussion and Conclusion During breast-feeding, baby saliva reacts with breastmilk to produce reactive oxygen species, while simultaneously providing growth-promoting nucleotide precursors. Milk thus plays more than a simply nutritional role in mammals, interacting with infant saliva to produce a potent combination of stimulatory and inhibitory metabolites that regulate early oral–and hence gut–microbiota. Consequently, milk-saliva mixing appears to represent unique biochemical synergism which boosts early innate immunity.

Variation in health care-associated infection surveillance practices in Australia

In the absence of a national health care-associated infection surveillance program in Australia, differences between existing state-based programs were explored using an online survey. Only 51% of respondents who undertake surveillance have been trained, fewer than half perform surgical site infection surveillance prospectively, and only 41% indicated they risk adjust surgical site infection data. Wide- spread variation of surveillance methods highlights future challenges when considering the development and implementation of a national program in Australia.

Grower group case study on new farming practices in the Herbert region, Australia

Growers working together have proven to be a successful method for improving the utilization of farm resources and accelerating the adoption of the Sugar Yield Decline Joint Venture principles (SYDJV). The Pinnacle Precision Farming Group was formed in 2004 with the aim to bring together the ideas, knowledge and resources of growers in the Herbert region. Along with their common interest in controlled traffic, minimal tillage and crop rotations, the grower group utilize a farm machinery contractor to provide some of their major farming operations. This paper provides an insight into the changes made by the Pinnacle Precision Farming Group and their journey to adopt the new farming system practices. This paper also details the changes made by the group machinery contractor and a comparison of the old and new farming systems used by a group member. A focus point of the document is the impact of the new farming system on the economic, social and environmental components of the farming business. Analysis of the new farming system with a legume crop rotation revealed an increase in the farm gross margin by AU$22 024 and, in addition, a reduction in tractor operation time by 38% across the whole farm. This represents a return on marginal capital of 14.68 times the original capital outlay required by the group member. Using the new farming system without a legume crop will still improve the group members whole of farm gross margin by AU$6 839 and reduce tractor operation time by 43% across the whole farm. The Pinnacle Precision Farming group recognize the need to continually improve their farming businesses and believe that the new farming system principles are critical for the long term viability of the industry. [U$1 = AU$1.19].

Improving knowledge and practices in fresh produce chains

A successful supply chain must delivery the right product, value and satisfaction to the end customer, and profitability for its participants. Critical to getting the product right is the practices used to produce and maintain product quality through the supply chain from production to sale to the end customer. This paper describes the approach used by a R&D team to add value to supply chains through improving knowledge and practices. The desired outcome is better produce quality for consumers and more control and less wastage for chain participants. The team worked with specific supply chains to identify areas for improvement and to develop, test and implement improved practices. The knowledge gained was communicated to the industry to gain wider adoption of results. Three conditions were identified as critical for practice change - motivation, knowledge, and capacity for change. For improvement in practices to occur, a business must be motivated and have the knowledge and capacity to improve. Two case studies of working with Australian supply chains (mango and melons) are presented to illustrate our participatory methodology. A key activity is monitoring produce quality and handling practices and conditions to demonstrate to participants the points where quality deterioration occurs in the supply chain. This participatory approach is successful because working with supply chain participants generates knowledge and solutions to real problems. It enables the participants to observe the effect of handling practices and conditions on produce quality, gain knowledge and assess the benefits of improvements. Where existing knowledge is not present, research is conducted to fill the knowledge gaps. IV International Conference on Managing Quality in Chains - The Integrated View on Fruits and Vegetables Quality

Disability employment practices in the Australian retail sector

The persistent low employment rate of people with disability has emerged as a concern for the Australian Government and society in general. The research addressed the gap between the supply and demand sides of disability employment by exploring organisational mechanisms underlying the proactive employment of people with disability. Data was collected from a large Australian retail organisation that currently employs people with disability. The findings revealed how the organisation legitimises disability employment practices, within its internal and external operating environments. The research informs the areas of government policy and organisational practices concerning future employment opportunities for people with disability.

Survey of weed flora and management relative to cropping practices in the north-eastern grain region of Australia

The main weeds and weed management practices undertaken in broad acre dryland cropping areas of north-eastern Australia have been identified. The information was collected in a comprehensive postal survey of both growers and agronomists from Dubbo in New South Wales (NSW) through to Clermont in central Queensland, where 237 surveys were returned. A very diverse weed flora of 105 weeds from 91 genera was identified for the three cropping zones within the region (central Queensland, southern Queensland and northern NSW). Twenty-three weeds were common to all cropping zones. The major common weeds were Sonchus oleraceus, Rapistrum rugosum, Echinochloa spp. and Urochloa panicoides. The main weeds were identified for both summer and winter fallows, and sorghum, wheat and chickpea crops for each of the zones, with some commonality as well as floral uniqueness recorded. More genera were recorded in the fallows than in crops, and those in summer fallows exceeded the number in winter. Across the region, weed management relied heavily on herbicides. In fallows, glyphosate and mixes with glyphosate were very common, although the importance of the glyphosate mix partner differed among the cropping zones. Use and importance of pre-emergence herbicides in-crop varied considerably among the zones. In wheat, more graminicides were used in northern NSW than in southern Queensland, and virtually none were used in central Queensland, reflecting the differences in winter grass weed flora across the region. Atrazine was the major herbicide used in sorghum, although metolachlor was also used predominantly in northern NSW. Fallow and inter-row cultivation were used more often in the southern areas of the region. Grazing of fallows was more prominent in northern NSW. High crop seeding rates were not commonly recorded indicating that growers are not using crop competition as a tool for weed management. Although many management practices were recorded overall, few growers were using integrated weed management, and herbicide resistance has been and continues to be an issue for the region.

The adoption of sustainable grazing land management practices in the Burdekin Rangelands of northern Australia.

The Burdekin Rangelands is a diverse area of semi-arid eucalypt and acacia savannah covering six million hectares in north eastern Australia. The major land use is cattle grazing on 220 commercial cattle properties (average size 26,000 ha) each carrying on average 2600 adult equivalents. Production was the focus of the beef industry and support agencies prior to the mid 1980's. Widespread land degradation during the 1980's led to a grassroots realisation that environmental impacts, including water quality had to be addressed for the beef industry to attain sustainability. The formation of a series of producer based landcare gropus and the support of several Queensland and Australian government research and extension agencies led to a greater awareness and adoption of sound grazing land management practices (Shepherd 2005).