scholarly journals A Q study: exploring the purpose of transdisciplinary dairy advisory services in Denmark

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Wendy Holm ◽  
Dorte Bay Lastein
Keyword(s):  
Production Management ◽  
Structural Changes ◽  
Academic Disciplines ◽  
Mutual Understanding ◽  
Herd Health ◽  
Complex Situation ◽  
Advisory Services ◽  
Advisory Service ◽  
Teamwork Process

Abstract Background Structural changes in dairy farming increase farm complexity, thereby inducing a need to combine herd health management, technological solutions, legislation, and human relations among farmers, farm workers, and advisors. This complex situation may require ‘transdisciplinary advisory service’, i.e., a highly integrated network of both non-academic and different academic disciplines. While working in these networks, advisors need to offer specialized knowledge from their own field, interact in a dynamic relationship between different types of professions and facilitate complex processes. The objectives of this study were: (1) to identify and describe different advisor and farmer styles based on their reasons to engage in transdisciplinary advisory services at farm-level, (2) to identify any possible conflicting perspectives between advisors and farmers’ demand, and (3) to discuss these styles and conflicts in the context and future of advisory services for dairy herd health and production management. Results Using Q methodology, we explored the purpose of transdisciplinary advisory service on dairy farms. The results were derived from correlations between 40 statements for 25 advisors and 33 statements for nine farmers. We identified three similar styles among advisors and farmers, characterized as: (1) the teamwork and knowledge-focused style, (2) the production and economy-focused style, and (3) the economy and strategy-focused style. These styles included reflections on financial aspects, production, knowledge-exchange and the teamwork process itself. In addition, different emphasis on animal welfare, farm strategy and follow-up procedures between the styles became evident. Conclusions This Q-study suggests three comparable styles between advisors and farmers. The main differences between the styles related to the teamwork process and purpose, follow-up process, financial aspects, farm strategy, and operational production objectives. Therefore, styles and expectations should be explored and discussed to create a mutual understanding within a farmer-advisor(s)-team, and to clarify the farmer’s needs and demands, and how the advisors can best meet these expectations. This study illustrates the importance of exploring different advisor and farmer styles to get a mutual understanding of the purpose of the transdisciplinary collaboration.

The diagnosis of hepatitis C viral infection

2014 ◽  
Vol 155 (26) ◽  
pp. 1019-1023
Author(s):  
Judit Gervain
Keyword(s):  
Hepatitis C ◽  
Nucleic Acid ◽  
Viral Infection ◽  
Structural Changes ◽  
Viral Infections ◽  
Transient Elastography ◽  
Viral Nucleic Acid ◽  
Length Of Treatment ◽  
Subtype B

The successful therapy of hepatitis C viral infection requires that the illness is diagnosed before the development of structural changes of the liver. Testing is stepwise consisting of screening, diagnosis, and anti-viral therapy follow-up. For these steps there are different biochemical, serological, histological and molecular biological methods available. For screening, alanine aminotransferase and anti-HCV tests are used. The diagnosis of infection is confirmed using real-time polymerase chain reaction of the viral nucleic acid. Before initiation of the therapy liver biopsy is recommended to determine the level of structural changes in the liver. Alternatively, transient elastography or blood biomarkers may be also used for this purpose. Differential diagnosis should exclude the co-existence of other viral infections and chronic hepatitis due to other origin, with special attention to the presence of autoantibodies. The outcome of the antiviral therapy and the length of treatment are mainly determined by the viral genotype. In Hungary, most patients are infected with genotype 1, subtype b. The polymorphism type that occurs in the single nucleotide located next to the interleukin 28B region in chromosome 19 and the viral polymorphism type Q80K for infection with HCV 1a serve as predictive therapeutic markers. The follow-up of therapy is based on the quantitative determination of viral nucleic acid according to national and international protocols and should use the same method and laboratory throughout the treatment of an individual patient. Orv. Hetil., 2014, 155(26), 1019–1023.

scholarly journals THU0319 DEVELOPMENT AND OUTCOME OF AORTIC COMPLICATIONS DURING TOCILIZUMAB TREATMENT OF GCA AND HISTOPATHOLOGIC EVIDENCE OF RESIDUAL INFLAMMATION-A CASE SERIES.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 388.2-389
Author(s):  
A. Rubbert-Roth ◽  
P. K. Bode ◽  
T. Langenegger ◽  
C. Pfofe ◽  
T. Neumann ◽  
...  
Keyword(s):  
Structural Changes ◽  
Case Series ◽  
Aortic Aneurysms ◽  
Imaging Data ◽  
Limited Data ◽  
Retrospective Case ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Pet Ct Scan

Background:Giant cell arteritis (GCA) may affect the aorta and the large aortic branches and lead to dissections and aortic aneurysms. Tocilizumab (TCZ) treatment has the capacity to control aortic inflammation as has been demonstrated by CRP normalization and imaging data. However, limited data are available on the histopathological findings obtained from patients who underwent surgery because of aortic complications during TCZ treatment.Objectives:We report on 5 patients with aortitis who were treated with TCZ and developed aortic complications.Methods:We describe a retrospective case series of patients with GCA treated with TCZ, who presented in our clinic between 2011 and 2019. Three patients underwent surgery. Histopathologic examination was performed in specimen from all of them.Results:Five female patients were diagnosed with GCA (4/5) or Takaysu arteritis (1/5) involving the aorta, all them diagnosed by MR angiography and/or FDG PET CT scan. Three patients (one with aortic aneurysm, one with dissection) underwent surgery after having been treated with TCZ for seven weeks, nine months and four years, respectively. Imaging before surgery showed remission on MRI and/or PET-CT in all cases. At the time of surgery, all patients showed normalized CRP and ESR values. Histopathological evaluation of the aortic wall revealed infiltrates, consisting predominantly of CD3+CD4+ T cells. Enlargement of pre-existing aneuryms was observed in the other two patients 10 weeks and 4 months after discontinuation of TCZ, respectively. Both patients were not eligible for surgical intervention and died during follow-up.Conclusion:Our case series suggests that during treatment with TCZ, regular imaging is necessary in this patient population to detect development of structural changes such as aneurysms or dissections. Despite treatment, residual inflammation might persist which could contribute to eventual aortic complications.Disclosure of Interests:Andrea Rubbert-Roth Consultant of: Abbvie, BMS, Chugai, Pfizer, Roche, Janssen, Lilly, Sanofi, Amgen, Novartis, Peter Karl Bode: None declared, Thomas Langenegger: None declared, Claudia Pfofe: None declared, Thomas Neumann: None declared, Olaf Chan-Hi Kim: None declared, Johannes von Kempis Consultant of: Roche

scholarly journals Strain Elastography and Tendon Response to an Exercise Program in Patients With Supraspinatus Tendinopathy: An Exploratory Study

2020 ◽  
Vol 8 (12) ◽  
pp. 232596712096518
Author(s):  
Karen Brage ◽  
Birgit Juul-Kristensen ◽  
John Hjarbaek ◽  
Eleanor Boyle ◽  
Per Kjaer ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Structural Changes ◽  
Supraspinatus Tendon ◽  
Patient Reported Outcome ◽  
Minimal Detectable Change ◽  
Detectable Change ◽  
Tendon Stiffness ◽  
Patient Reported ◽  
Tendon Thickness

Background: Shoulder pain is common, with a lifetime prevalence of up to 67%. Evidence is conflicting in relation to imaging findings and pain in the shoulder. Sonoelastography can be used to estimate tissue stiffness and may be a clinically relevant technique for diagnosing and monitoring tendon healing. Purpose: To evaluate changes in supraspinatus tendon stiffness using strain elastography (SEL) and associations with changes in patient-reported outcomes, supraspinatus tendon thickness, and grade of tendinopathy after 12 weeks of unilateral shoulder exercises in patients with supraspinatus tendinopathy. Study Design: Controlled laboratory study. Methods: A total of 23 patients with unilateral clinical supraspinatus tendinopathy performed 12 weeks of “standard care” exercises. At baseline and follow-up, supraspinatus tendon stiffness was measured bilaterally using SEL and compared with tendinopathy grading on magnetic resonance imaging scans and tendon thickness measured using conventional ultrasound. Patient-reported outcome measures included physical function and symptoms from the Disabilities of the Arm, Shoulder and Hand questionnaire and pain rating (visual analog scale). Results: No significant changes in SEL within or between groups (asymptomatic vs symptomatic tendon) were seen. All patient-reported outcomes showed significant improvement from baseline to follow-up, but with no change in tendinopathy grading and tendon thickness. No significant differences in the proportion of patients changing above the minimal detectable change in SEL and PROM were seen, except for discomfort while sleeping. Conclusion: Despite no significant within-group or between-group changes in SEL, significant improvements were found in patient-reported outcomes. An acceptable agreement between patients changing above the minimal detectable change in SEL and patient-reported outcome measure was seen. Further studies should explore the use of SEL to detect changes after tendon repair and long-term training potentially in subgroups of different tendinopathy phases. Clinical Relevance: In the short term, structural changes in supraspinatus tendons could not be visualized using SEL, indicating that a longer time span should be expected in order to observe structural changes, which should be considered before return to sports. Subgrouping based on stage of tendinopathy may also be important in order to evaluate changes over time with SEL among patients with supraspinatus tendinopathy. Registration: NCT03425357 ( ClinicalTrials.gov identifier).

Abstract 18601: Impact of Right and Left Atrial Remodeling on Outcomes From Atrial Fibrillation Rotor Ablation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Amir Schricker ◽  
Tina Baykaner ◽  
Junaid Zaman ◽  
Gautam Lalani ◽  
Kenneth Hopper ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Structural Changes ◽  
Unknown Etiology ◽  
Atrial Remodeling ◽  
Left Atrial Remodeling ◽  
Single Procedure ◽  
Clinical Indices ◽  
The Right

Introduction: Targets for the ablation of atrial fibrillation (AF) are debated. In particular, recent studies questioning fractionated electrograms and lines has increased focus on AF substrates of rotors and focal impulses. These AF sources are seen in both atria, but have unknown etiology. We hypothesized that differential remodeling between the right atrium (RA), whose structural changes are largely undefined, and left atrium (LA) influence the distribution of AF sources and the outcomes from AF source ablation. Methods: In 60 patients at AF ablation (62±10 years, 60% persistent, 5% long-standing persistent), we compared size differences between RA and LA to the number of sources in each chamber and outcomes from AF source-guide ablation. We studied if a 64-pole basket differentially fit the LA or RA, judged by deformation of its splines by the atria (fig. A, B) over multiple cardiac cycles on fluoroscopy. Ablation targeted sources in both atria and was followed by PVI, with follow-up per guidelines. Results: Using baskets in both atria, 205 sources (LA 138; RA 67) were identified and ablated. Notably, the same basket in each patient was dynamically deformed by RA in 51 (85%) of cases but in the LA in only 39 (65%), indicating greater LA remodeling. The number of AF sources was higher in the presence of basket deformation of RA (n=174) than LA (n=130). LA deformation correlated with LVEF (p=0.05). Freedom from AF at 1 year was reduced in patients with no basket deformation (i.e. dilation) in LA (p=0.07) or RA (p=0.06). Notably, single procedure AF freedom was substantially lower in patients with differential remodeling (deformation in only 1 chamber) of 84% vs. 60% (fig C). Conclusions: Structural atrial remodeling influences the number of electrical rotors and focal sources in each chamber. A mismatch between right and left atrial remodeling predicts lower success from rotor ablation. These data also provide novel clinical indices of effective basket positioning.

Innovation and SMEs

2000 ◽  
Vol 14 (4) ◽  
pp. 244-248 ◽  
Author(s):  
C. Carmichael ◽  
C. Turgoose ◽  
M. Older Gray ◽  
C. Todd ◽  
S. Nadin
Keyword(s):  
Product Innovation ◽  
Telephone Survey ◽  
Innovation Capability ◽  
Manufacturing Companies ◽  
Advisory Service ◽  
Business Support ◽  
Local Manufacturing ◽  
Ongoing Development

In this paper the authors describe the ongoing development of a specialized advisory service aimed at promoting innovation in local manufacturing SMEs. The first stage studies the levels of process and product innovation, and level of innovation need, through a telephone survey of 156 small and medium-sized manufacturing companies and a number of follow-up interviews. The following stage involves the development of audit tools designed to identify gaps in innovation capability, and a change methodology to help companies become more innovative. These tools will be piloted with a number of local SMEs and then disseminated more widely to companies and business support agencies. The paper focuses on issues related to innovation in small and medium-sized manufacturing companies and explores these in relation to the initial findings of the survey.

Action cameras and the Roter interaction analysis system to assess veterinarian-producer interactions in a dairy setting

2017 ◽  
Vol 182 (8) ◽  
pp. 227-227 ◽  
Author(s):  
Caroline Ritter ◽  
Herman W Barkema ◽  
Cindy L Adams
Keyword(s):  
Production Management ◽  
Interaction Analysis ◽  
Relationship Building ◽  
Herd Health ◽  
Veterinary Education ◽  
Clinical Communication ◽  
Roter Interaction Analysis System ◽  
Farmer Education ◽  
Analysis System ◽  
On Farm

Herd health and production management (HH&PM) are critical aspects of production animal veterinary practice; therefore, dairy veterinarians need to effectively deliver these services. However, limited research that can inform veterinary education has been conducted to characterise these farm visits. The aim of the present study was to assess the applicability of action cameras (eg, GoPro cameras) worn by veterinarians to provide on-farm recordings, and the suitability of these recordings for comprehensive communication analyses. Seven veterinarians each recorded three dairy HH&PM visits. Recordings were analysed using the Roter interaction analysis system (RIAS), which has been used to evaluate medical conversations in human and companion animal contexts, and provided insights regarding the importance of effective clinical communication. However, the RIAS has never been used in a production animal environment. Results of this pilot study indicate that on-farm recordings were suitable for RIAS coding. Dairy practitioners use a substantial amount of talk allocated to relationship-building and farmer education but that communication patterns of the same veterinarian vary considerably between farm visits. Consecutive studies using this method will provide observational data for research purposes and promise to aid in the improvement of veterinary education through identification of communication priorities and gaps in dairy advisory discussions.

27Al-MAS-NMR-Untersuchungen des thermischen Abbaus von NH4Al(SO4)2·12H2O / 27Al-MAS-NMR Studies on the Thermolysis of NH4Al(SO4)2· 12H2O

1991 ◽  
Vol 46 (11) ◽  
pp. 1515-1518 ◽  
Author(s):  
Gerhard Wegner ◽  
Gert Blumenthal ◽  
Dirk Müller ◽  
Dirk-Henning Menz ◽  
Antje Schmalstieg
Keyword(s):  
Nmr Spectroscopy ◽  
Structural Changes ◽  
Chemical Shifts ◽  
Mas Nmr ◽  
Nmr Studies ◽  
High Stage ◽  
27Al Mas Nmr ◽  
High Resolution Nmr ◽  
First Time

Products of the thermolysis of NH4Al-alum were prepared under dried air and characterized by X-ray powder diffraction, thermogravimetry, and for the first time by solid-state 27Al-MAS-NMR spectroscopy. It was found, that high resolution NMR spectroscopy is applicable to follow up the thermal decomposition and to indicate even minor structural changes. 27Al-MAS-NMR spectra show peaks with characteristic chemical shifts for octahedral Al-units up to a high stage of thermolysis. During the decomposition of Al2(SO4)3 to γ-Al2O3 we again observed three-peak spectra with the specific signal at ≈ 35 ppm for penta-coordinated Al ions as recently proved for the thermolysis of AlCl3 · 6 H2O.

Abstract 5999: Optical Coherence Tomography Findings At Two Years Follow Up In Fully Biodegradable Everolimus Eluting Stents

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Nieves Gonzalo ◽  
Patrick W Serruys ◽  
Rafael Freire ◽  
Jurgen Ligthart ◽  
Wim vd Giessen ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Vessel Wall ◽  
Structural Changes ◽  
Optical Coherence ◽  
Very Late Stent Thrombosis ◽  
Degradable Polymer ◽  
Full Dataset ◽  
Biodegradable Stents ◽  
Time Of Presentation

Fully biodegradable stents may avoid the potential long-term complications of metallic drug-eluting stents such as late and very late stent thrombosis. We sought to evaluate the structural changes in a bioabsorbable DES and its interaction with the coronary vessel wall over time using optical coherence tomography (OCT). We investigated 14 consecutive patients undergoing implantation of a bioabsorbable everolimus-eluting coronary stent (BVS: Abbott Laboratories, IL, USA), composed of a poly-L-lactic acid backbone, coated with a degradable polymer/everolimus matrix. OCT (LightLab Imaging, Inc., Westford, MA) was performed immediately after stent implantation, at 6 months and at 24 months follow-up. All patients tolerated OCT imaging without complications. At baseline, OCT could detect the interface between the BVS stent and other tissues or fluid, but the inside of the strut appeared black, giving a unique box appearance. After 6 months, the struts were still clearly visible; however, their optical properties had changed considerably. In patients undergoing two years follow up (n=5, full dataset will be available at time of presentation) the majority of struts was not visible anymore and all visible struts were embedded into the vessel wall with complete tissue coverage. In contrast to 6months follow-up, at 2 years no intraluminal thrombi or dissections were visible. At 2 years follow-up the majority of stent struts were not visible by OCT. All the visible struts were covered and apposed. The lumen surface was smooth without intraluminal thrombi or dissections.

Guest Editorial: Three Pathways to Relevance and Profitability

2020 ◽  
Vol 72 (12) ◽  
pp. 11-13
Author(s):  
Manas Satapathy ◽  
Herve Wilczynski
Keyword(s):  
Value Chain ◽  
Production Management ◽  
Structural Changes ◽  
Oil And Gas ◽  
Supply And Demand ◽  
Half Cycle ◽  
Development Costs ◽  
Economic Climate ◽  
Exploration And Production ◽  
Primary Focus

For most of the past 160 years, the exploration and production (E&P) sector earned outsized economic rent for finding new oil and gas (O&G) resources and making them economically viable for production. This was possible because of the perceived scarcity of such resources; demand expectations for hydrocarbon products far exceeded their likely supply. During that period, E&P companies focused on building functional expertise to enable growth and operate assets safely. Exploration and appraisal capabilities were particularly revered as key drivers of value. Other areas of the value chain such as field production management, logistics, or even marketing were not seen as critically differentiating. Understandably, building expertise in those areas was never made the primary focus. What a difference a decade makes. Perpetual Disruption Is the New Normal Today, we live in a completely different world. The challenges facing upstream companies simply did not exist 10 years ago. Six compressive forces, in particular, are bringing about a sea change in the industry. Earlier this year, COVID-19 brought with it a sharp and palpable drop in demand for transportation-related crude. With the dramatic structural changes we have made to the ways we live and work in response to the pandemic, low crude demand is expected to continue. This will only exacerbate resource holders’ concerns about supply overabundance. E&P companies that hold hydrocarbon resources were already worried that the resources they own could go unmonetized. Now, that threat is stronger than ever. So is the incentive to monetize their resources as quickly as possible. Ironically, their actions to do so will make the oversupply situation worse. Beyond the issues of supply and demand, the industry’s general economic climate is wreaking havoc. O&G companies typically focus on half-cycle economics or lifting costs when making production decisions. That is because land acquisition and development costs are considered sunk. If oil prices stay in the $40-50/bbl range, many asset classes will simply be uneconomical from a full-cycle standpoint.

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