Participatory Policy Making by Dairy Producers to Reduce Anti-Microbial use on Farms.

Pressures for more responsible use of anti-microbial (AM) medicines in food animals are likely to increase from policymakers and the food industry, including retailers. To address this challenge, participatory approaches to welfare interventions and disease prevention may also be necessary alongside more conventional regulatory measures. This article describes the process of enabling groups of dairy producers to use a participatory policy making approach to develop an AM stewardship policy. The policy includes measures agreed to by all producers for more responsible use of AMs, whilst maintaining or improving dairy herd health and welfare. This process provided a unique opportunity for collaboration and dialogue between producers, veterinarians, industry and researchers. Its participatory nature encouraged comprehensive learning for all involved. This integration of science with producers' knowledge and experience led to credible and practical recommendations designed to deliver real and lasting change in AM use. The multidisciplinary nature of this research marks a significant contribution to embedding social science skills and approaches into the veterinary sphere. As an initial step in creating better understanding of how participatory approaches with farmers can be applied in a UK context and more widely, this work serves as a pilot for promoting more responsible use of veterinary medicines in other livestock species.

Evidence of dose saving in routine CT practice using iterative reconstruction derived from a national diagnostic reference level survey.

OBJECTIVE: To assess the influence and significance of the use of iterative reconstruction (IR) algorithms on patient dose in CT in Australia. METHODS: We examined survey data submitted to the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) National Diagnostic Reference Level Service (NDRLS) during 2013 and 2014. We compared median survey dose metrics with categorization by scan region and use of IR. RESULTS: The use of IR results in a reduction in volume CT dose index of between 17% and 44% and a reduction in dose-length product of between 14% and 34% depending on the specific scan region. The reduction was highly significant (p < 0.001, Wilcoxon rank-sum test) for all six scan regions included in the NDRLS. Overall, 69% (806/1167) of surveys included in the analysis used IR. CONCLUSION: The use of IR in CT is achieving dose savings of 20-30% in routine practice in Australia. IR appears to be widely used by participants in the ARPANSA NDRLS with approximately 70% of surveys submitted employing this technique. ADVANCES IN KNOWLEDGE: This study examines the impact of the use of IR on patient dose in CT on a national scale.

Australian per caput dose from diagnostic imaging and nuclear medicine.

The largest man-made contributor to the ionising radiation dose to the Australian population is from diagnostic imaging and nuclear medicine. The last estimation of this dose was made in 2004 (1.3 mSv), this paper describes a recent re-evaluation of this dose to reflect the changes in imaging trends and technology. The estimation was calculated by summing the dose from five modalities, computed tomography (CT), general radiography/fluoroscopy, interventional procedures, mammography and nuclear medicine. Estimates were made using Australian frequency data and dose data from a range of Australian and international sources of average effective dose values. The ionising radiation dose to the Australian population in 2010 from diagnostic imaging and nuclear medicine is estimated to be 1.7 mSv (1.11 mSv CT, 0.30 mSv general radiography/fluoroscopy, 0.17 mSv interventional procedures, 0.03 mSv mammography and 0.10 mSv nuclear medicine). This exceeds the estimate of 1.5 mSv per person from natural background and cosmic radiation.

House calls by New Hampshire family practitioners.

We surveyed current activities and attitudes regarding house calls among New Hampshire family physicians. Fifty of a random sample of 72 eligible participants returned a brief questionnaire. They reported on 134 house calls they made during the two weeks prior to the survey. Eighty-four percent of participants offered house calls, averaging 2.68 house calls per physician over the two week study period. Most house calls were to the elderly or homebound for management purposes. Physicians thought house calls were important, but often an inefficient use of their time. Financial and time constraints were the most commonly cited limiting factors. The decision to make a house call is based on clinical judgment regarding the individual case and broader issues involving the physician's whole practice. Unless external constraints change, house calls will continue to be an uncommon event.

An ultrastructural study of the microtriches of adult Proteocephalus tidswelli (Cestoda: Proteocephalidea).

Ultrastructural observations on adult Proteocephalus tidswelli revealed a marked microtrichial polymorphism. Structural and dimensional variations of microtriches between different regions of the strobila and scolex, as well as within the same region, were observed. The authors suggest that microtriches are involved in a diversity of functions, and possible functional activities are discussed.

Practolol peritonitis with autopsy findings.

This case of practolol peritonitis was the first recognised in Australasia and fifth in the world series. At post mortem there was some indefinite indication that, in time and after withdrawal of the drug, the lesion slowly resolves.