Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children

Background Guidelines and clinical practice for the prevention of complications associated with central venous catheters (CVC) around the world vary greatly. Most institutions recommend the use of heparin to prevent occlusion, however there is debate regarding the need for heparin and evidence to suggest 0.9% sodium chloride (normal saline) may be as effective. The use of heparin is not without risk, may be unnecessary and is also associated with increased cost. Objectives To assess the clinical effects (benefits and harms) of intermittent flushing of heparin versus normal saline to prevent occlusion in long term central venous catheters in infants and children. Search Methods The Cochrane Vascular Trials Search Co-ordinator searched the Specialised Register (last searched April 2015) and the Cochrane Register of Studies (Issue 3, 2015). We also searched the reference lists of retrieved trials. Selection criteria Randomised controlled trials that compared the efficacy of normal saline with heparin to prevent occlusion of long term CVCs in infants and children aged up to 18 years of age were included. We excluded temporary CVCs and peripherally inserted central catheters (PICC). Data Collection and Analysis Two review authors independently assessed trial inclusion criteria, trial quality and extracted data. Rate ratios were calculated for two outcome measures - occlusion of the CVC and central line-associated blood stream infection. Other outcome measures included duration of catheter placement, inability to withdraw blood from the catheter, use of urokinase or recombinant tissue plasminogen, incidence of removal or re-insertion of the catheter, or both, and other CVC-related complications such as dislocation of CVCs, other CVC site infections and thrombosis. Main Results Three trials with a total of 245 participants were included in this review. The three trials directly compared the use of normal saline and heparin, however, between studies, all used different protocols for the standard and experimental arms with different concentrations of heparin and different frequency of flushes reported. In addition, not all studies reported on all outcomes. The quality of the evidence ranged from low to very low because there was no blinding, heterogeneity and inconsistency between studies was high and the confidence intervals were wide. CVC occlusion was assessed in all three trials (243 participants). We were able to pool the results of two trials for the outcomes of CVC occlusion and CVC-associated blood stream infection. The estimated rate ratio for CVC occlusion per 1000 catheter days between the normal saline and heparin group was 0.75 (95% CI 0.10 to 5.51, two studies, 229 participants, very low quality evidence). The estimated rate ratio for CVC-associated blood stream infection was 1.48 (95% CI 0.24 to 9.37, two studies, 231 participants; low quality evidence). The duration of catheter placement was reported to be similar between the two study arms, in one study (203 participants). Authors' Conclusions The review found that there was not enough evidence to determine the effects of intermittent flushing of heparin versus normal saline to prevent occlusion in long term central venous catheters in infants and children. Ultimately, if this evidence were available, the development of evidenced-based clinical practice guidelines and consistency of practice would be facilitated.

Long-term ambient air pollution exposure and self-reported morbidity in the Australian Longitudinal Study on Women's Health: A cross-sectional study

- Objective We sought to assess the effect of long-term exposure to ambient air pollution on the prevalence of self-reported health outcomes in Australian women. - Design Cross-sectional study - Setting and participants The geocoded residential addresses of 26 991 women across 3 age cohorts in the Australian Longitudinal Study on Women's Health between 2006 and 2011 were linked to nitrogen dioxide (NO2) exposure estimates from a land-use regression model. Annual average NO2 concentrations and residential proximity to roads were used as proxies of exposure to ambient air pollution. - Outcome measures Self-reported disease presence for diabetes mellitus, heart disease, hypertension, stroke, asthma, chronic obstructive pulmonary disease and self-reported symptoms of allergies, breathing difficulties, chest pain and palpitations. - Methods Disease prevalence was modelled by population-averaged Poisson regression models estimated by generalised estimating equations. Associations between symptoms and ambient air pollution were modelled by multilevel mixed logistic regression. Spatial clustering was accounted for at the postcode level. - Results No associations were observed between any of the outcome and exposure variables considered at the 1% significance level after adjusting for known risk factors and confounders. - Conclusions Long-term exposure to ambient air pollution was not associated with self-reported disease prevalence in Australian women. The observed results may have been due to exposure and outcome misclassification, lack of power to detect weak associations or an actual absence of associations with self-reported outcomes at the relatively low annual average air pollution exposure levels across Australia.

Long-term persistence and efficacy of spinosad against Rhyzopertha dominica (Coleoptera : Bostrychidae) in wheat

A laboratory study was undertaken to determine the persistence and efficacy of spinosad against Rhyzopertha dominica (F.) in wheat stored for 9 months at 30 degrees C and 55 and 70% relative humidity. The aim was to investigate the potential of spinosad for protecting wheat from R. dominica during long-term storage in warm climates. Wheat was treated with spinosad at 0.1, 0.5 and 1 mg kg(-1) grain and sampled after 0, 1.5, 3, 4.5, 6, 7.5 and 9 months of storage for bioassays and residue analyses. Residues were estimated to have declined by 30% during 9 months of storage at 30 degrees C and there was no effect of relative humidity. Spinosad applied at 0.5 or 1 mg kg(-1) was completely effective for 9 months, with 100% adult mortality after 14 days of exposure and no five F, adults produced. Adult mortality was < 100% in some samples of wheat treated with 0.1 mg kg(-1) of spinosad, and live progeny were produced in all samples treated at this level. The results show that spinosad is likely to be an effective grain protectant against R. dominica in wheat stored in warm climates.

Long-term impacts of harvest residue management on nutrition, growth and productivity of an exotic pine plantation of sub-tropical Australia

Residue retention is an important issue in evaluating the sustainability of production forestry. However, its long-term impacts have not been studied extensively, especially in sub-tropical environments. This study investigated the long-term impact of harvest residue retention on tree nutrition, growth and productivity of a F1 hybrid (Pinus elliottii var. elliottii × Pinus caribaea var. hondurensis) exotic pine plantation in sub-tropical Australia, under three harvest residue management regimes: (1) residue removal, RR0; (2) single residue retention, RR1; and (3) double residue retention, RR2. The experiment, established in 1996, is a randomised complete block design with 4 replicates. Tree growth measurements in this study were carried out at ages 2, 4, 6, 8 and 10 years, while foliar nutrient analyses were carried out at ages 2, 4, 6 and 10 years. Litter production and litter nitrogen (N) and phosphorus (P) measurements were carried out quarterly over a 15-month period between ages 9 and 10 years. Results showed that total tree growth was still greater in residue-retained treatments compared to the RR0 treatment. However, mean annual increments of diameter at breast height (MAID) and basal area (MAIB) declined significantly after age 4 years to about 68-78% at age 10 years. Declining foliar N and P concentrations accounted for 62% (p < 0.05) of the variation of growth rates after age 4 years, and foliar N and P concentrations were either marginal or below critical concentrations. In addition, litter production, and litter N and P contents were not significantly different among the treatments. This study suggests that the impact of residue retention on tree nutrition and growth rates might be limited over a longer period, and that the integration of alternative forest management practices is necessary to sustain the benefits of harvest residues until the end of the rotation.

Long-term response of corn to limited irrigation and crop rotations

Dwindling water supplies for irrigation are prompting alternative management choices by irrigators. Limited irrigation, where less water is applied than full crop demand, may be a viable approach. Application of limited irrigation to corn was examined in this research. Corn was grown in crop rotations with dryland, limited irrigation, or full irrigation management from 1985 to 1999. Crop rotations included corn following corn (continuous corn), corn following wheat, followed by soybean (wheat-corn-soybean), and corn following soybean (corn-soybean). Full irrigation was managed to meet crop evapotranspiration requirements (ETc). Limited irrigation was managed with a seasonal target of no more than 150 mm applied. Precipitation patterns influenced the outcomes of measured parameters. Dryland yields had the most variation, while fully irrigated yields varied the least. Limited irrigation yields were 80% to 90%> of fully irrigated yields, but the limited irrigation plots received about half the applied water. Grain yields were significantly different among irrigation treatments. Yields were not significantly different among rotation treatments for all years and water treatments. For soil water parameters, more statistical differences were detected among the water management treatments than among the crop rotation treatments. Economic projections of these management practices showed that full irrigation produced the most income if water was available. Limited irrigation increased income significantly from dryland management.

Long-term assessment of efficacy of permeable pond covers for odour reduction

Three anaerobic ponds used to store and treat piggery wastes were fully covered with permeable materials manufactured from polypropylene geofabric, polyethylene shade cloth and supported straw. The covers were assessed in terms of efficacy in reducing odour emission rates over a 40-month period. Odour samples were collected from the surface of the covers, the surface of the exposed liquor and from the surface of an uncovered (control) pond at one of the piggeries. Relative to the emission rate of the exposed liquor at each pond, the polypropylene, shade cloth and straw covers reduced average emission rates by 76%, 69% and 66%, respectively. At the piggery with an uncovered control pond, the polypropylene covers reduced average odour emission rates by 50% and 41%, respectively. A plausible hypothesis, consistent with likely mechanisms for the odour reduction and the olfactometric method used to quantifying the efficacy of the covers, is offered.

Long-term trends in fertility of soils under continuous cultivation and cereal cropping in southern Queensland. IX. Simulation of soil carbon and nitrogen pools using CENTURY model

Cultivation and cropping of soils results in a decline in soil organic carbon and soil nitrogen, and can lead to reduced crop yields. The CENTURY model was used to simulate the effects of continuous cultivation and cereal cropping on total soil organic matter (C and N), carbon pools, nitrogen mineralisation, and crop yield from 6 locations in southern Queensland. The model was calibrated for each replicate from the original datasets, allowing comparisons for each replicate rather than site averages. The CENTURY model was able to satisfactorily predict the impact of long-term cultivation and cereal cropping on total organic carbon, but was less successful in simulating the different fractions and nitrogen mineralisation. The model firstly over-predicted the initial (pre-cropping) soil carbon and nitrogen concentration of the sites. To account for the unique shrinking and swelling characteristics of the Vertosol soils, the default annual decomposition rates of the slow and passive carbon pools were doubled, and then the model accurately predicted initial conditions. The ability of the model to predict carbon pool fractions varied, demonstrating the difficulty inherent in predicting the size of these conceptual pools. The strength of the model lies in the ability to closely predict the starting soil organic matter conditions, and the ability to predict the impact of clearing, cultivation, fertiliser application, and continuous cropping on total soil carbon and nitrogen.

Sustainable and profitable grazing management in a highly variable environment-evidence and insights from a long term grazing trial in northern Australia.

Rainfall variability is a major challenge to sustainable management in semi-arid rangelands. We present empirical evidence from a large, long-term grazing trial in northern Australia on the relative performance of constant heavy stocking, moderate stocking at long-term carrying capacity and variable stocking in coping with climate variability over a range of rainfall years. Moderate stocking gave good economic returns, maintained pasture condition and minimised soil loss and runoff. Heavy stocking was neither sustainable nor profitable in the long term. Variable stocking generally performed well but suffered economic loss and some decline in pasture condition in the transition from good to poor years. Importantly, our results show that sustainable and profitable management are compatible in semi-arid rangelands.

Fish stocking programs - assessing the benefits against long term impacts

This project addresses the R&D priority for an Environmentally Sustainable Queensland through the strategy of developing and implementing ecologically sustainable fishing practices. The principal findings of this research project will be discussed at a national workshop with the twin goals of promoting an understanding of the major elements of sustainable fish stocking practices and discussing and planning the way forward for the implementation of change. The workshop participants will include fisheries managers, representatives from interested community groups and other stakeholders.

Solutions for archiving data in long-term studies: A reply to Whitlock et al.

In our recent paper [1], we discussed some potential undesirable consequences of public data archiving (PDA) with specific reference to long-term studies and proposed solutions to manage these issues. We reaffirm our commitment to data sharing and collaboration, both of which have been common and fruitful practices supported for many decades by researchers involved in long-term studies. We acknowledge the potential benefits of PDA (e.g., [2]), but believe that several potential negative consequences for science have been underestimated [1] (see also 3 and 4). The objective of our recent paper [1] was to define practices to simultaneously maximize the benefits and minimize the potential unwanted consequences of PDA.

Virus identification and development of long-term management strategies for the rhubarb industry

The purpose of this report is to present the final results of all activities conducted under HAL Project VG05053 ‘Virus identification and development of long-term management strategies for the rhubarb industry’. The report provides a summary of project findings, a description of technology transfer activities, and recommendations arising from the outcomes of the project. The overall objective of this project was to devise a strategy for the control of rhubarb decline disease through 1) knowledge of the viruses present and their epidemiology, 2) production of virus-free planting material via tissue culture, and 3) formation of a national grower group to represent industry.

Impacts of a fuel oil spill on seagrass meadows in a subtropical port, Gladstone, Australia - The value of long-term marine habitat monitoring in high risk areas.

We used an established seagrass monitoring programme to examine the short and longer-term impacts of an oil spill event on intertidal seagrass meadows. Results for potentially impacted seagrass areas were compared with existing monitoring data and with control seagrass meadows located outside of the oil spill area. Seagrass meadows were not significantly affected by the oil spill. Declines in seagrass biomass and area 1 month post-spill were consistent between control and impact meadows. Eight months post-spill, seagrass density and area increased to be within historical ranges. The declines in seagrass meadows were likely attributable to natural seasonal variation and a combination of climatic and anthropogenic impacts. The lack of impact from the oil spill was due to several mitigating factors rather than a lack of toxic effects to seagrasses. The study demonstrates the value of long-term monitoring of critical habitats in high risk areas to effectively assess impacts.

Fisheries Queensland Long Term Monitoring Program Underwater Visual Census of twenty-four reefs on the Great Barrier Reef between 1999 and 2004.

In 1999, the Department of Employment, Economic Development and Innovation (DEEDI), Fisheries Queensland undertook a new initiative to collect long term monitoring data of various important stocks including reef fish. This data and monitoring manual for the reef fish component of that program which was based on Underwater Visual Census methodology of 24 reefs on the Great Barrier Reef between 1999 and 2004. Data was collected using six 50m x 5m transects at 4 sites on 24 reefs. Benthic cover type was also recorded for 10m of each transect. The attached Access Database contains 5 tables being: SITE DETAILS TABLE Survey year Data entry complete REF survey site ID Site # (1-4) Location (reef name) Site Date (date surveyed) Observer 1 (3 initials to identify who estimated fish lengths and recorded benthic cover) TRANSECT DETAILS Survey ID Transect Number (1-6) Time (the transect was surveyed) Visibility (in metres) Minimum Depth surveyed (m) Maximum Depth surveyed (m) Percent of survey completed (%) Comments SUBSTRATE Survey ID Transect Number (1-6) then % cover of each of eth following categories of benthic cover types Dead Coral Live Coral Soft Coral Rubble Sand Sponge Algae Sea Grass Other COORDINATES (over survey sites) from -14 38.792 to -19 44.233 and from 145 21.507 to 149 55.515 SIGHTINGS ID Survey ID Transect Number (1-6) CAAB Code Scientific Name Reef Fish Length (estimated Fork Length of fish; -1 = unknown or not recorded) Outside Transect (if a fish was observed outside a transect -1 was recorded) Morph Code (F = footballer morph for Plectropomus laevis, S = Spawning colour morph displayed)

Long-term Ingham and Mackay farming system experiments: comparisons between permanent non-tilled beds and re-formed beds

Experiments involving row spacing and tillage, originally established in Mackay and Ingham in 2001, were planted to a second cycle of sugarcane in 2006 following a soybean break. Despite large yield differences, economic analysis indicated that there would be little difference in gross margins because of the much higher costs of the tilled system. It is concluded that without GPS guidance, as was the case with these experiments, cane yields are likely to be reduced with no tillage but these problems may well be overcome by implementing minimum strategic tillage to remove compaction from the planting row.