Adubação orgânica da batata com esterco e, ou, Crotalaria juncea: I - produtividade vegetal e estoque de nutrientes no solo em longo prazo

No Agreste paraibano, a batata (Solanum tuberosum L.) é importante cultura comercial, embora seja limitada pela variabilidade e escassez de chuvas e pela baixa fertilidade do solo. O esterco é a principal fonte de nutrientes utilizada para fertilização do solo, porém geralmente não é disponível em quantidade suficiente nas propriedades rurais para suprir a demanda das culturas agrícolas. Como alternativa tem sido recomendada a adubação verde com Crotalaria juncea L. Realizou-se um experimento, de 1996 a 2002, em um Neossolo Regolítico, com o objetivo de quantificar a produtividade da batata e o estoque de nutrientes no solo, após incorporações anuais de esterco e, ou, crotalária. Os tratamentos consistiram de: incorporação da crotalária (C), adição de 15 t ha-1 de esterco caprino (E), incorporação de crotalária + 7,5 t ha-1 de esterco (CE) e testemunha (T). No final do experimento, o tratamento E promoveu aumentos de 73, 45, 221 e 43 % nos teores de N total, P total, P e K extraíveis (Mehlich-1) do solo, respectivamente, em relação à testemunha. Os tratamentos C e CE aumentaram o N total do solo em 76 e 63 %, mas não aumentaram o teor dos outros nutrientes. Os acúmulos médios de massa seca, N, P e K na parte aérea da crotalária nos tratamentos, ao longo dos cinco anos, foram de 3.550, 69, 6 e 55 kg ha-1, respectivamente. As produtividades médias de tubérculos, ao longo dos cinco anos de colheita, foram de 15.204, 12.053, 11.085 e 7.926 kg ha-1 nos tratamentos CE, C, E e T, respectivamente. Apesar de a adição de 15 t ha-1 de esterco ter proporcionado os maiores aumentos nos nutrientes do solo, as maiores produtividades de tubérculos ao longo do período do estudo foram obtidas quando se combinou o plantio e a incorporação de crotalária com a adição de 7,5 t ha-1 de esterco.

Adubação orgânica da batata com esterco e, ou, Crotalaria juncea: II - disponibilidade de N, P e K no solo ao longo do ciclo de cultivo

Os solos do Agreste paraibano têm baixa fertilidade e a prática usual de adubação é a incorporação de esterco na época do plantio. Entretanto, dependendo da qualidade do esterco, essa prática pode causar a imobilização de nutrientes do solo durante os primeiros meses de cultivo. É possível que o cultivo e incorporação de Crotalaria juncea, combinado com o esterco, possa promover mineralização mais sincronizada com a demanda de nutrientes pelas plantas. No presente estudo, realizado em 2003, foram conduzidos experimentos de campo e em casa de vegetação para testar essa hipótese. As parcelas de campo foram previamente cultivadas com batata no período de 1996 a 2002 e submetidas anualmente aos seguintes tratamentos: plantio e incorporação da crotalária na época da floração (C); adição de 15 t ha-1 de esterco (E); plantio e incorporação de crotalária + 7,5 t ha-1 de esterco (CE); e testemunha, sem esterco ou crotalária (T). Em 2003, foram aplicados os mesmos tratamentos de adubação orgânica e foi avaliada a dinâmica da decomposição e liberação de nutrientes pelo material vegetal e esterco contidos em sacolas de náilon incorporadas ao solo das parcelas de campo. Também se avaliou a dinâmica da disponibilidade de N, P e K no solo das parcelas de campo, por meio de coletas periódicas de solo. No ensaio em casa de vegetação, foram realizados cultivos sucessivos de capim-buffel (Cenchrus ciliaris L.) por um período de 300 dias, utilizando-se amostras do solo das parcelas de campo. As perdas de massa e nutrientes do material incorporado ao solo foram maiores nos primeiros 30 dias da incubação, em todos os tratamentos. No final do ensaio, as proporções de matéria seca e nutrientes remanescentes foram maiores nos tratamentos E e CE que nos tratamentos C e T. No solo das parcelas de campo, o tratamento E aumentou os teores de P e K extraíveis (Mehlich-1) do solo ao longo do período do estudo, porém provocou a imobilização de N do solo nas primeiras semanas. O tratamento C aumentou o teor de N mineral do solo no período imediatamente após a incorporação, mas não aumentou o teor de P e K extraíveis. No ensaio em casa de vegetação, o capim-buffel acumulou mais biomassa aérea e nutrientes no primeiro corte, 35 dias após o transplantio do capim, no solo do tratamento CE. Nos cortes subseqüentes, o tratamento E levou à maior produção de biomassa e acumulação de nutrientes, indicando que a limitação de N no período inicial após a incorporação de esterco ao solo prejudicou o crescimento do buffel. Os resultados corroboram a hipótese de que o plantio e incorporação da crotalária, combinado com a aplicação de apenas a metade da dose usual de esterco caprino, promoveu mineralização de nutrientes mais sincronizada com as necessidades das culturas agrícolas, pois foi capaz de evitar a imobilização de N do solo no período inicial de cultivo e elevou os teores de P e K disponíveis ao longo de todo o período.

Report on the Department of Commerce, Alcoholic Beverages Division for the month ended May 31, 2010

Report on the Department of Commerce, Alcoholic Beverages Division for the month ended May 31, 2010

Role of physical exercise in low back pain rehabilitation: a randomized controlled trial of a three-month exercise program in patients who have completed multidisciplinary rehabilitation.

STUDY DESIGN: Randomized controlled trial with 1-year follow-up. OBJECTIVE: To analyze the effects of an exercise program or routine follow-up on patients with chronic low back pain who have completed functional multidisciplinary rehabilitation. The short- and long-term outcome in terms of symptoms and physical and social functioning was compared. SUMMARY OF BACKGROUND DATA: Systematic reviews have shown that functional multidisciplinary rehabilitation improves physical function and reduces pain in patients with chronic low back pain. However, long-term maintenance of these improvements is inconsistent and the role of exercise in achieving this goal is unclear. METHODS: One hundred five chronic patients with low back pain who had completed a 3-week functional multidisciplinary rehabilitation program were randomized to either a 3-month exercise program (n = 56) or routine follow-up (n = 49). The exercise program consisted of 24 training sessions during 12 weeks. Patients underwent evaluations of trunk muscle endurance, cardiovascular endurance, lumbar spine mobility (flexion and extension range-of-motion, fingertip-to-floor distance), pain and perceived functional ability at the beginning and the end of functional multidisciplinary rehabilitation, at the end of the exercise program (3 months) and at 1-year follow-up. Disability was also assessed at the same time points except at the beginning of functional multidisciplinary rehabilitation. RESULTS: At the end of the functional multidisciplinary rehabilitation, both groups improved significantly in all physical parameters except flexion and extension range-of-motion. At the 3 month and 1 year follow-up, both groups maintained improvements in all parameters except for cardiovascular endurance. Only the exercise program group improved in disability score and trunk muscle endurance. No differences between groups were found. CONCLUSION: A favorable long-term outcome was observed after functional multidisciplinary rehabilitation in both patient groups. Patients who participated in an exercise program obtained some additional benefits. The relevance of these benefits to overall health status need to be further investigated.

Patient-perceived health-related quality of life during recovery after total hip arthroplasty – a 6-month follow-up study

Potilaiden käsitys terveyteen liittyvästä elämänlaadusta lonkan tekonivelleikkauksen jälkeisenä toipumisaikana – kuuden kuukauden seurantatutkimus Tässä kaksivaiheisessa seurantatutkimuksessa tarkasteltiin potilaiden käsitystä terveyteen liittyvästä elämänlaadusta lonkan tekonivelleikkauksen jälkeisenä toipumisaikana. Tutkimuksen ensimmäisessä vaiheessa tarkoituksena oli sekä kuvailla potilaiden kokemuksia potilaana olosta, saamastaan hoidosta ja terveyspalveluorganisaatiosta että analysoida aikaisempien tutkimusten perusteella leikkauksen tuloksia potilaan kannalta. Toisessa vaiheessa tarkoituksena oli arvioida potilaiden kokemaa elämänlaatua leikkauksen jälkeen, ja sitä vaikuttivatko primaaritulokset (fyysinen toimintakyky, kipu, ahdistus) tai taloudelliset seuraukset (potilaiden itsensämaksamat kustannukset, palvelujen käyttö) terveyteen liittyvään elämänlaatuun. Tutkimuksen tavoitteena oli löytää mahdolliset kriittiset ajankohdat tai tekijät, jotka saattavat hidastaa toipumista ja siten huonontaa potilaiden elämänlaatua. Tätä tietoa voidaan käyttää hoitotyössä kun suunnitellaan sopivaa hoitoa ja tukea toipumisajalle. Tutkimuksen ensimmäisessä vaiheessa primaarileikkaukseen tulevat potilaat (n = 17) kuvailivat teemahaastatteluissa kokemuksiaan kahdesti leikkauksen jälkeen. Haastatteluaineisto analysoitiin induktiivisella sisällönanalyysilla. Lisäksi 17 tutkimusartikkelista analysoitiin deduktiivisella sisällönanalyysilla leikkauksen tuloksia potilaalle, tuloksiin vaikuttavia tekijöitä ja käytetyt tutkimusmetodit. Toisessa vaiheessa primaari- tai revisioleikkaukseen tulevat potilaat (n = 100) arvioivat leikkauksen tuloksia kuuden kuukauden ajan leikkauksen jälkeen: terveyteen liittyvää elämänlaatua, primaarituloksia ja taloudellisia seurauksia. Aineisto kerättiin erilaisilla mittareilla: Sickness Impact Profile, Finnish Version, Stait-Trait Anxiety Inventory, ja Numeric Rating Scale. Lisäksi käytettiin tätä tutkimusta varten tehtyjä kyselylomakkeita: Fyysinen toimintakyky-mittari, Palvelujen käyttö-mittari ja Kustannusmittari. Tutkimuksen toiseen vaiheen tulokset analysoitiin tilastollisilla menetelmillä. Potilaiden terveyteen liittyvä elämänlaatu parani ja kipu lievittyi leikkauksen jälkeen ja fyysinen toimintakyky lisääntyi toipumisaikana. Positiivisista muutoksista huolimatta potilaat kokivat ahdistusta samassa määrin kuin ennen leikkaustakin. Palvelujen käyttö vaihteli toipumisajan kuluessa ja potilaiden maksamissa kustannuksissa oli suuria vaihteluita. Fyysisen toimintakyvyn lisääntyminen ja kivun lieveneminen paransivat terveyteen liittyvää elämänlaatua. Sen sijaan huonompi elämänlaatu toipumisaikana oli yhteydessä suurempaan palvelujen käyttöön, kun taas kustannuksilla ei ollut yhteyttä elämänlaatuun. Potilaiden ominaispiirteet tulisi ottaa enemmän huomioon suunniteltaessa sopivaa leikkauksenjälkeistä hoitoa ja tukea. Potilaat tarvitsevat yksilöllisiä ohjeita, sillä monet taustatekijät (esim. ikä, sukupuoli, preoperatiivinen kipu, siviilisääty, ja leikkaustyyppi) vaikuttavat toipumiseen.

Impact of electronic monitoring of drug adherence on blood pressure control in primary care: a cluster 12-month randomised controlled study.

BACKGROUND: Poor long-term adherence is an important cause of uncontrolled hypertension. We examined whether monitoring drug adherence with an electronic system improves long-term blood pressure (BP) control in hypertensive patients followed by general practitioners (GPs). METHODS: A pragmatic cluster randomised controlled study was conducted over one year in community pharmacists/GPs' networks randomly assigned either to usual care (UC) where drugs were dispensed as usual, or to intervention (INT) group where drug adherence could be monitored with an electronic system (Medication Event Monitoring System). No therapy change was allowed during the first 2 months in both groups. Thereafter, GPs could modify therapy and use electronic monitors freely in the INT group. The primary outcome was a target office BP<140/90 mmHg. RESULTS: Sixty-eight treated uncontrolled hypertensive patients (UC: 34; INT: 34) were enrolled. Over the 12-month period, the likelihood of reaching the target BP was higher in the INT group compared to the UC group (p<0.05). At 4 months, 38% in the INT group reached the target BP vs. 12% in the UC group (p<0.05), and 21% vs. 9% at 12 months (p: ns). Multivariate analyses, taking account of baseline characteristics, therapy modification during follow-up, and clustering effects by network, indicate that being allocated to the INT group was associated with a greater odds of reaching the target BP at 4 months (p<0.01) and at 12 months (p=0.051). CONCLUSION: GPs monitoring drug adherence in collaboration with pharmacists achieved a better BP control in hypertensive patients, although the impact of monitoring decreased with time.

Cost-utility analysis of a three-month exercise programme vs usual care following multidisciplinary rehabilitation for chronic low back pain.

OBJECTIVE: To assess the cost-utility of an exercise programme vs usual care after functional multidisciplinary rehabilitation in patients with chronic low back pain. DESIGN: Cost-utility analysis alongside a randomized controlled trial. SUBJECTS/PATIENTS: A total of 105 patients with chronic low back pain. METHODS: Chronic low back pain patients completing a 3-week functional multidisciplinary rehabilitation were randomized to either a 3-month exercise programme (n = 56) or usual care (n = 49). The exercise programme consisted of 24 training sessions during 12 weeks. At the end of functional multidisciplinary rehabilitation and at 1-year follow-up quality of life was measured with the SF-36 questionnaire, converted into utilities and transformed into quality--adjusted life years. Direct and indirect monthly costs were measured using cost diaries. The incremental cost-effectiveness ratio was calculated as the incremental cost of the exercise programme divided by the difference in quality-adjusted life years between both groups. RESULTS: Quality of life improved significantly at 1-year follow-up in both groups. Similarly, both groups significantly reduced total monthly costs over time. No significant difference was observed between groups. The incremental cost-effectiveness ratio was 79,270 euros. CONCLUSION: Adding an exercise programme after functional multidisciplinary rehabilitation compared with usual care does not offer significant long-term benefits in quality of life and direct and indirect costs.

Drinking Patterns and Their Predictive Factors in CONTROL: a 12-Month Prospective Study in a Sample of Alcohol-Dependent Patients Initiating Treatment.

Aims: To describe the drinking patterns and their baseline predictive factors during a 12-month period after an initial evaluation for alcohol treatment. Methods CONTROL is a single-center, prospective, observational study evaluating consecutive alcohol-dependent patients. Using a curve clustering methodology based on a polynomial regression mixture model, we identified three clusters of patients with dominant alcohol use patterns described as mostly abstainers, mostly moderate drinkers and mostly heavy drinkers. Multinomial logistic regression analysis was used to identify baseline factors (socio-demographic, alcohol dependence consequences and related factors) predictive of belonging to each drinking cluster. ResultsThe sample included 143 alcohol-dependent adults (63.6% males), mean age 44.6 ± 11.8 years. The clustering method identified 47 (32.9%) mostly abstainers, 56 (39.2%) mostly moderate drinkers and 40 (28.0%) mostly heavy drinkers. Multivariate analyses indicated that mild or severe depression at baseline predicted belonging to the mostly moderate drinkers cluster during follow-up (relative risk ratio (RRR) 2.42, CI [1.02-5.73, P = 0.045] P = 0.045), while living alone (RRR 2.78, CI [1.03-7.50], P = 0.044) and reporting more alcohol-related consequences (RRR 1.03, CI [1.01-1.05], P = 0.004) predicted belonging to the mostly heavy drinkers cluster during follow-up. Conclusion In this sample, the drinking patterns of alcohol-dependent patients were predicted by baseline factors, i.e. depression, living alone or alcohol-related consequences and findings that may inform clinicians about the likely drinking patterns of their alcohol-dependent patient over the year following the initial evaluation for alcohol treatment.

Iowa Crop and Weather Report, Issued January 6, 2014 for the month of December 2013

Report produced by the The Department of Agriculture and Land Stewardship, Climatology Bureau. Iowa Secretary of Agriculture Bill Northey today commented on the Iowa Crops and Weather report released by the USDA National Agricultural Statistical Service. The report is released weekly from April through October.

Iowa Crop and Weather Report, Issued February 4, 2014, For the month of January 2014

Report produced by the The Department of Agriculture and Land Stewardship, Climatology Bureau. Iowa Secretary of Agriculture Bill Northey today commented on the Iowa Crops and Weather report released by the USDA National Agricultural Statistical Service. The report is released weekly from April through October. Issued February 4, 2014 For the month of January 2014

Iowa Crop and Weather Report, Issued March 4, 2014 For the month of February 2014

Report produced by the The Department of Agriculture and Land Stewardship, Climatology Bureau. Iowa Secretary of Agriculture Bill Northey today commented on the Iowa Crops and Weather report released by the USDA National Agricultural Statistical Service. The report is released weekly from April through October. Issued March 4, 2014 For the month of February 2014

Cognitive impairment in elderly medical inpatients: detection and associated six-month outcomes.

OBJECTIVE: The authors examined the relationship of cognitive impairment at hospital admission to 6-month outcome (hospital readmission, nursing home admission, and death) in a cohort of elderly medical inpatients. METHODS: A group of 401 medical inpatients age 75 and older underwent a comprehensive geriatric assessment at hospital admission and were followed up for 6 months. Cognitive impairment was defined as a score <24 on the Mini-Mental State Exam. Detection was assessed through blinded review of discharge summary. Follow-up data were gathered from the centralized billing system (hospital and nursing home admissions) and from proxies (death). RESULTS: Cognitive impairment was present in 129 patients (32.3%). Only 48 (37.2%) were detected; these had more severe impairment than undetected cases. During follow-up, cognitive impairment, whether detected or not, was associated with death and nursing home admission. After adjustment for health, functional, and socioeconomic status, an independent association remained only for nursing home admission in subjects with detected impairment. Those with undetected impairment appeared to be at intermediate risk, but this relationship was not statistically significant. CONCLUSION: In these elderly medical inpatients, cognitive impairment was frequent, rarely detected, and associated with nursing home admission during follow-up. Although this association was stronger in those with detected impairment, these results support the view that acute hospitalization presents an opportunity to better detect cognitive impairment in elderly patients and target further interventions to prevent adverse outcomes such as nursing home admission.