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Responding to increasing concerns regarding human-induced climate change and shared commitment as environmental educators to support climate action, we crafted this article as a composite piece — an emerging method of inquiry. We are eleven contributors: the Editorial Executive of the Australian Journal of Environmental Education and two colleagues who each respond to prompts concerning our experience of climate change and our practices of climate change education. The responses provide insights regarding how we strive to enact meaningful climate action, education, advocacy and agency. This article presents the reader with various ways environmental educators work through eco-anxiety and engage in active hope when supporting climate change education/agency/action. The following insights emerged, illustrating 1. the significance of embracing diverse perspectives and knowledge systems; 2. Emotions as catalysts for action and activism; 3. the value of fostering collaborative spaces/relationships/communities that empower people; 4. the importance of integrating ethical responses and critical climate literacy in climate change education/research; 5. learning from places and multi-species entanglements; 6. acknowledging tensions. We offer these six insights not as a solution but as a potentially generative heuristic for navigating the complexity and uncertainty of climate change education in contemporary times.
This study assessed the potential of using dichlobenil to manage hair fescue in lowbush blueberry crops when targeted or broadcast-applied (7,000 g ai ha−1) as justification for developing a precision-targeted applicator. A randomized complete block design was used to assess both application methods, and results were compared with industry-standard propanamide (2,240 g ai ha−1). Targeted and broadcast-applied dichlobenil in fall 2020 significantly reduced average total tuft density in the nonbearing year (2021) by 75% and 67%, respectively, and in the bearing year (2022) by 61% and 59%, respectively. Broadcast pronamide applications in fall 2020 significantly reduced total tuft density by 84% in the nonbearing year (2021) and 81% in the bearing year (2022). These reductions in total tuft density resulted in average lowbush blueberry yields of 416, 557, 573, and 617 g m−2 for the control, pronamide applications, and targeted and broadcast-applied dichlobenil, respectively. Increases in yield were not significant, though the large variation within the sample is the probable cause. The similarities between targeted and broadcast-applied treatments demonstrate the potential of using targeted dichlobenil. Given the high product cost of dichlobenil at Can$1,873 ha−1, hair fescue’s non-uniform distribution in lowbush blueberry fields and the lowbush blueberry industry’s overreliance on pronamide, targeted application of dichlobenil has significant potential. This work justifies the development of a mechanized precision-targeted applicator for use in lowbush blueberry cropping systems.
Translational research (TR) is the movement of fundamental scientific discoveries into healthcare settings and population health policy, and parallels the goals of DOHaD research. Unfortunately, there is little guidance on how to become a translational researcher. To understand the opinions of DOHaD trainees towards TR, we conducted a workshop at the DOHaD World Congress 2022. We found that trainees were enthusiastic for their work to have translational impact, and that they feel that holistic, multidisciplinary solutions may lead to more generalisable research. However, there lacks support for TR career pathways, which may stall the execution of the long-term vision of the DOHaD agenda. We put forward recommendations for trainees to clarify their purpose in pursuing TR and for seeking relevant people and patronages to support their training paths. For mentors, training institutions, and scientific societies, we recommend developing TR-specific programmes, and implementing training opportunities, networking events, and funding to support these endeavours.
Background: Antibiotic overuse and the resulting patient outcomes span all hospitals. However, although antibiotic stewardship can improve antibiotic use, effective stewardship programs require expertise and an infrastructure that are not present in all hospitals. Rural hospitals have less access to resources, infectious disease expertise, and participation in academic research. Thus, we compared antibiotic overuse at discharge between rural and nonrural hospitals for patients diagnosed with community-associated pneumonia (CAP) or urinary tract infection (UTI)—the 2 most common hospital infections. Methods: To determine whether antibiotic overuse at discharge was higher among rural versus nonrural hospitals, we analyzed data from a 41-hospital prospective cohort of patients treated for CAP or UTI between July 1, 2017, and July 30, 2019, in Michigan. Antibiotic overuse was defined as treatment that was unnecessary (ie, patient did not have an infection), excessive (ie, duration >4 days for CAP), or included suboptimal fluoroquinolone use (ie, safer alternative available). Overuse was determined based on patient risk factors, symptoms, allergies, diagnostic results, and time to stability. Hospital rurality was defined using the Rural–Urban Continuum Codes (RUCC) score. We defined rural as a score ≥4 and very rural as a score of 7–9. We used t tests to compare the mean percentage of patients with antibiotic overuse at discharge between nonrural and rural (and very rural) hospitals. Results: Across 41 hospitals, we included 23,449 patients with CAP or UTI. There were 5 rural (and 3 very rural) hospitals with 2,039 (and 1,082) patients. Antibiotic overuse at discharge was present in 43.1% of patient cases in nonrural hospitals, 52.5% in rural hospitals (P = .04 vs nonrural) and 58.1% in very rural hospitals (P = .007 vs nonrural). Compared to nonrural hospitals, the mean percentage of cases with antibiotic overuse at discharge in rural hospitals was 9.4% higher (15.1% higher in very rural hospitals). Results were similar in a subgroup analysis of only patients with UTI (47.0% in rural vs 37.5% in nonrural, mean difference, 9.5%; P = .03) but were not statistically significant in patients with CAP (53.8% vs 48.0%, respectively; mean difference, 5.8%; P = 0.23). Conclusions: In this retrospective study, rural hospitals—especially very rural hospitals, had higher rates of antibiotic overuse at discharge than nonrural hospitals. Our findings suggest that antibiotic stewardship interventions tailored toward the unique differences in infrastructure, resources, and needs of rural hospitals are essential to community health.
Potato producers in Canada’s Atlantic provinces of Prince Edward Island (PE) and New Brunswick rely on photosystem II (PSII)-inhibiting herbicides to provide season-long weed control. Despite this fact, a high proportion of common lambsquarters populations in the region have been identified as resistant to this class of herbicides. Crop-topping is a late-season weed management practice that exploits the height differential between weeds and a developing crop canopy. Two field experiments were conducted in Harrington, PE, in 2020 and 2021, one each to evaluate the efficacy of a different crop-topping strategy, above-canopy mowing or wick-applied glyphosate, at two potato phenological stages, on common lambsquarters viable seed production and potato yield and quality. Mowing common lambsquarters postflowering decreased viable seed production (72% to 91%) in 2020 but increased seed production (78% to 278%) in 2021. Mowing had minimal impact on potato marketable yield across cultivars in both years. In contrast, treating common lambsquarters with wick-applied glyphosate had variable impacts on seed output in 2020 but dramatically reduced seed production (up to 95%) in 2021 when treatments were applied preflowering. Glyphosate damage to potato tubers was not influenced by timing and resulted in a 14% to 15% increase in culled tubers due to black spotting and rot. Our results highlight the importance of potato and common lambsquarters phenology when selecting a crop-topping strategy and demonstrate that above-canopy mowing and wick-applied glyphosate can be utilized for seedbank management of herbicide-resistant common lambsquarters in potato production systems.
Advances in translational science require innovative solutions, and engagement of productive transdisciplinary teams play a critical role. While various forms of scientific meetings have long provided venues for sharing scientific findings and generating new collaborations, many conferences lack opportunities for active discussions. We describe the use of an Un-Meeting to foster innovative translational science teams through engaged discussions across multidisciplinary groups addressing a shared theme. The Un-Meeting was delivered by the University of Rochester Center for Leading Innovation and Collaboration, the national coordinating center for the National Institutes of Health Clinical and Translational Science Awards (CTSA) program. This pilot CTSA program Un-Meeting focused on engaging translational scientists, policy-makers, community members, advocates, and public health professionals to address the opioid crisis. The participant-driven format leveraged lightning talks, attendee-led idea generation, and extensive breakout discussions to foster multidisciplinary networking. Results indicated participation by a broad set of attendees and a high level of networking during the meeting. These results, coupled with the growth of the Un-Meeting across the CTSA Consortium, provide practices and models to potentially advance team and translational science. While future work will further assess the impact of Un-Meetings, this format presents a promising approach to enhance translational science.
Team development and idea generation are key intertwined steps in translational science that need a framework to accommodate unstructured, participatory interactions. To this end, we introduced Un-Meetings to the Clinical and Translational Science Awards (CTSA) Program, innovative events that facilitate cross-disciplinary idea generation and informal discussions between translational scientists, policy makers, community members, advocates, and public health professionals. Here we describe a mixed methods study to characterize the conceptual diversity and clusterization of ideas generated through an Opioid Crisis Un-Meeting.
Methods:
An Un-Meeting targeting translation science approaches to the opioid crisis were hosted at the University of Rochester Center for Leading Innovation and Collaboration (CLIC). We used semantic analysis and conceptual mapping of keywords to analyze how attendee-led idea generation sessions identified topics for breakout discussions.
Results:
One hundred and two individuals from 40 institutions proposed 150 unique ideas that were grouped into 23 breakout sessions. Network analysis showed that diverse pools of experts were bridged by topics addressing the complexities of the opioid crisis. Two clusters emerged: (1) systems, contexts, and community engagement, and (2) technologies, innovations, and treatment advancements.
Conclusions:
The cross-disciplinary nature of topic areas that bridge across thematic communities provide opportunities for CTSA programs to engage and support development of diverse translational teams. Potential opportunities for team building include technological advancements of opioid prevention, treatment, surveillance, systems approaches, and studies focusing on special populations and health disparities. The analysis method here may be useful in identifying naturally emerging teams of experts and community gaps when addressing large problems.
Hair fescue is a perennial grass weed in lowbush blueberry fields that forms dense sods and reduces yield. As a result of natural tolerance or resistance of this grass to other currently registered herbicides growers rely on preemergence (PRE) applications of pronamide and postemergence (POST) applications of the Group 2 herbicides foramsulfuron and nicosulfuron + rimsulfuron for hair fescue management. This causes repeated application of Group 2 herbicides, which is compounded by the recent registration of flazasulfuron for POST suppression of hair fescue in lowbush blueberry. Mixtures of Group 2 herbicides with the amino acid–inhibiting herbicides glyphosate (Group 9) and glufosinate (Group 10), however, can improve weed control and may delay herbicide resistance development. This research used a factorial arrangement of Group 2 herbicides (none, foramsulfuron [35 g ai ha−1], nicosulfuron + rimsulfuron [13 + 13 g ai ha−1], flazasulfuron [50 g ai ha−1]) and mixtures (none, with glyphosate [902 g ae ha−1], and with glufosinate [750 g ai ha−1]) to identify possible mixtures that improve weed control and delay resistance development. Herbicides were applied in spring nonbearing year, fall bearing year, and fall nonbearing year, with each application timing conducted as a separate experiment. Foramsulfuron and nicosulfuron + rimsulfuron were not effective as fall applications, and spring applications of these herbicides with glyphosate or glufosinate improved hair fescue suppression. Glyphosate and glufosinate were more effective as fall rather than spring applications. Flazasulfuron was effective across all application timings, although its mixture with glufosinate generally improved hair fescue suppression. Flazasulfuron + glufosinate is tentatively recommended as an effective mixture for management of spring nonbearing-year and fall bearing-year hair fescue in lowbush blueberry.
Cultivation of lowbush blueberry (Vaccinium angustifolium Aiton), an important crop in the eastern part of North America, is unique, as it is carried out over the course of two consecutive growing seasons. Pest management, particularly weed management, is impacted by this biennial cultural practice. The choice of methods to control weeds is narrow, and such a system relies heavily on herbicides for weed management. Availability of unique herbicide active ingredients for weed management is limited, and available herbicides are used repeatedly, so the risk of developing resistance is acute. Hair fescue (Festuca filiformis Pourr.), a perennial grass weed, has evolved resistance to hexazinone, a photosystem II inhibitor frequently used in lowbush blueberry production. We show that substitution of phenylalanine to isoleucine at position 255 is responsible for a decreased sensitivity to hexazinone by a factor of 6.12. Early diagnosis of resistance based on the detection of the mutation will alert growers to use alternative control methods and thus help to increase the sustainability of the cropping system.
Causes of childhood behavior problems remain poorly understood. Enriched family environments and corresponding brain development may reduce the risk of their onset, but research investigating white matter neurodevelopmental pathways explaining associations between the family environment and behavior remains limited. We hypothesized that more positive prenatal and mid-childhood family functioning – a measure of a family's problem solving and supportive capacity – would be associated with two markers of preadolescent white matter neurodevelopment related to reduced behavior problems: higher global fractional anisotropy (FA) and lower global mean diffusivity (MD).
Methods
Data are from 2727 families in the Generation R Study, the Netherlands. Mothers reported family functioning (McMaster Family Assessment Device, range 1–4, higher scores indicate healthier functioning) prenatally and in mid-childhood (mean age 6.1 years). In preadolescence (mean age 10.1), the study collected diffusion-weighted scans. We computed standardized global MD and FA values by averaging metrics from 27 white matter tracts, and we fit linear models adjusting for possible confounders to examine global and tract-specific outcomes.
Results
Prenatal and mid-childhood family functioning scores were moderately correlated, r = 0.38. However, only prenatal family functioning – and not mid-childhood functioning – was associated with higher global FA and lower global MD in preadolescence in fully adjusted models: βglobal FA = 0.11 (95% CI 0.00, 0.21) and βglobal MD = −0.15 (95% CI −0.28, −0.03) per one-unit increase in functioning score. Sensitivity and tract-specific analyses supported these global findings.
Conclusions
These results suggest high-functioning prenatal or perinatal family environments may confer lasting white matter neurodevelopmental benefits into preadolescence.
Background: Antibiotics are frequently prescribed–and overprescribed–at hospital discharge, leading to adverse-events and patient harm. Our understanding of how to optimize prescribing at discharge is limited. Recently, we published the ROAD (Reducing Overuse of Antibiotics at Discharge) Home Framework, which identified potential strategies to improve antibiotic prescribing at discharge across 3 tiers: Tier 1–Critical infrastructure, Tier 2–Broad inpatient interventions, Tier 3–Discharge-specific strategies. Here, we used the ROAD Home Framework to assess the association of stewardship strategies with antibiotic overuse at discharge and to describe pathways toward improved discharge prescribing. Methods: In fall 2019, we surveyed 39 Michigan hospitals on their antibiotic stewardship strategies. For patients hospitalized at participating hospitals July 1, 2017, through July 30, 2019, and treated for community-acquired pneumonia (CAP) and urinary tract infection (UTI), we assessed the association of reported strategies with days of antibiotic overuse at discharge. Days of antibiotic overuse at discharge were defined based on national guidelines and included unnecessary therapy, excess duration, and suboptimal fluoroquinolone use. We evaluated the association of stewardship strategies with days of discharge antibiotic overuse 2 ways: (1) all stewardship strategies were assumed to have equal weight, and (2) strategies weighted using the ROAD Home Framework with tier 3 (discharge-specific) strategies had the highest weight. Results: Overall, 39 hospitals with 20,444 patients (56.5% CAP; 43.5% UTI) were included. The survey response rate was 100% (39 of 39). Hospitals reported a median of 12 (IQR, 9–14) of 33 possible stewardship strategies (Fig. 1). On bivariable analyses, review of antibiotics prior to discharge was the only strategy consistently associated with lower antibiotic overuse at discharge (aIRR, 0.543; 95% CI, 0.335–0.878). On multivariable analysis, weighting by ROAD Home tier predicted antibiotic overuse at discharge for both CAP and UTI. For diseases combined, having more weighted strategies was associated with lower antibiotic overuse at discharge (aIRR per weighted intervention, 0.957; 95% CI, 0.927–0.987). Discharge-specific stewardship strategies were associated with a 12.4% relative decrease in antibiotic overuse days at discharge. Based on these findings, 3 pathways emerged to improve antibiotic use at discharge (Fig. 2): inpatient-focused strategies, “doing it all,” and discharge-focused strategies. Conclusions: The more stewardship strategies reported, the lower a hospitals’ antibiotic overuse at discharge. However, different pathways to improve discharge antibiotic use exist. Thus, discharge stewardship strategies should be tailored. Specifically, hospitals with limited stewardship resources and infrastructure should consider implementing a discharge-specific strategy straightaway. In contrast, hospitals that already have substantial inpatient infrastructure may benefit from proactively incorporating discharge into their existing strategies.
Yellow toadflax (Linaria vulgaris Mill.; Scrophulariaceae) is an invasive herbaceous perennial weed of agricultural and natural habitats throughout North America. In pastures or native rangelands, use of biological control is an attractive option, particularly if the agent can be established quickly. Rhinusa pilosa (Gyllenhal) (Coleoptera: Curculionidae), a stem-galling weevil, was first released in Canada in 2014 to evaluate its potential to control L. vulgaris. Rhinusa pilosa requires young, vigorously growing shoots to establish. Ability to estimate when adequate shoots will be available could inform release timing, thus improving establishment success. There is currently no growing degree-day (GDD) model for L. vulgaris. Our main objective was to develop a GDD model for the emergence of L. vulgaris shoots and discuss the utility of such a model in relation to the establishment of R. pilosa in Nova Scotia. Four sites containing five randomly placed 1-m2 quadrats were monitored for the emergence of L. vulgaris shoots twice weekly in spring to summer 2017 and 2018 by recording number of shoots and shoots with flower buds. A GDD (Tbase 2 C) model for shoot emergence of L. vulgaris was developed and validated using independent shoot emergence data. Shoots emerged in the spring between 124 and 244 GDD with 90% of all shoots emerged between 681 and 1,117 GDD. Model estimation for the initiation of shoot emergence was 74 GDD, with 10%, 50%, and 90% shoot emergence estimated to occur at 179, 409, and 811 GDD, respectively. Rhinusa pilosa adults were released in 2016 (three sites) and 2017 (one site), and number of shoots with galls was recorded. Galls were observed in all three sites in 2016 and in three of the four sites in 2017, with none found in 2018. Timing of release and soil moisture are discussed as factors affecting establishment of R. pilosa in Nova Scotia.
From 2014 to 2020, we compiled radiocarbon ages from the lower 48 states, creating a database of more than 100,000 archaeological, geological, and paleontological ages that will be freely available to researchers through the Canadian Archaeological Radiocarbon Database. Here, we discuss the process used to compile ages, general characteristics of the database, and lessons learned from this exercise in “big data” compilation.
Globally, the availability and formulations for the administration of cannabis are changing with decriminalization or legalization of recreational use in some jurisdictions, and the prescription of cannabis also occurring. These changes are likely to affect the prevalence of use, including by women of childbearing age. The effects of in utero and infant alcohol and tobacco exposure are well-documented, but the outcomes of cannabis exposure are less certain. The content of delta-9-tetrahydrocannabinol (THC), the psychoactive component of cannabis has progressively increased over several decades. This review explores the limited knowledge surrounding the epidemiology of gestational and postnatal cannabis exposure and implications for the mother–placenta–fetus/neonate triad. We examine cannabis’ effects from antenatal and lactation exposure on (a) pregnancy and perinatal outcomes, (b) placental health, and (c) longer term cardiometabolic and neurodevelopmental risks and outcomes. Though definitive outcomes are lacking, gestational cannabis has been associated with increased risk of other substance use during pregnancy; impaired placental blood flow; increased risk of small for gestational age births; and associated complications. Childhood and adolescent outcomes are sparsely assessed, with suggested outcomes including increased risk of depression and attention-deficit hyperactivity disorder. Cardiometabolic implications of gestational cannabis use may include maternal fatty liver, obesity, insulin resistance, and increased risk of gestational diabetes mellitus (GDM), with potential consequences for the fetus. Clinical implications for pediatric practice were explored in a bid to understand any potential risk or impact on child health and development.
Hair fescue is a common perennial grass that reduces yields in lowbush blueberry fields. This grass is suppressed with nonbearing-year foramsulfuron applications, though suppression may be improved through use of sequential glufosinate and foramsulfuron applications. The objective of this research was to determine the main and interactive effects of fall bearing-year glufosinate applications, spring nonbearing-year glufosinate applications, and spring nonbearing-year foramsulfuron applications on hair fescue. The experiment was a 2 by 2 by 2 factorial arrangement of fall bearing-year glufosinate application (0, 750 g ai ha–1), spring nonbearing-year glufosinate application (0, 750 g ai ha–1), and spring nonbearing-year foramsulfuron application (0, 35 g ai ha–1) arranged in a randomized complete block design at lowbush blueberry fields located in Parrsboro and Portapique, NS, Canada. Fall bearing-year glufosinate applications, spring nonbearing-year glufosinate applications, and spring nonbearing-year foramsulfuron applications alone provided inconsistent hair fescue suppression. Fall bearing-year glufosinate applications followed by spring nonbearing-year foramsulfuron applications, however, reduced nonbearing-year total tuft density, flowering-tuft density, and flowering-tuft inflorescence number at each site and reduced seed production at Portapique. Sequential fall bearing-year and spring nonbearing-year glufosinate applications or sequential spring nonbearing-year glufosinate and foramsulfuron applications reduced flowering-tuft density and flowering-tuft inflorescence number at each site but did not consistently reduce total tuft density. Sequential herbicide treatments reduced bearing-year seedling density and may therefore contribute to hair fescue seed bank management in lowbush blueberry.
Hair fescue is a common tuft-forming perennial grass weed that reduces yields and hinders mechanical harvest in lowbush blueberry fields. PRE terbacil applications traditionally controlled hair fescue but currently only provide suppression in most fields. Terbacil use has not, however, been evaluated in conjunction with other currently registered herbicides in lowbush blueberry. The objective of this research was to evaluate a range of terbacil-based herbicide treatments for hair fescue management in lowbush blueberry. The experiment was conducted at three lowbush blueberry fields in Nova Scotia, Canada. Spring nonbearing-year terbacil applications (2,000 g ai ha–1) exhibited variable efficacy on hair fescue with reduced total tuft density at one site and reduced flowering-tuft density and flowering-tuft inflorescence number at two sites. Suppression was limited to the year of application only. Terbacil followed by (fb) foramsulfuron (35 g ai ha–1) did not improve suppression. A terbacil tank mixture with glufosinate (750 ai ha–1), however, reduced flowering-tuft density and flowering-tuft inflorescence number at each site and reduced total tuft density at one site, suggesting improved suppression with terbacil + glufosinate relative to terbacil alone. Terbacil + glufosinate fb foramsulfuron gave additional reductions in total tuft density at two sites and reduced bearing-year flowering-tuft density at two sites, indicating that hair fescue suppression with this herbicide combination extends into the bearing year. Although less effective than the industry standard pronamide applications, terbacil + glufosinate or terbacil + glufosinate fb foramsulfuron could be used as part of a weed management program for hair fescue in lowbush blueberry.
Carrot weevil, Listronotus oregonensis (LeConte) (Coleoptera: Curculionidae), is a pest of carrot (Daucus carota var. sativus Hoffmann; Apiaceae) throughout eastern Canada. Carrot weevil emergence and oviposition were monitored in commercial carrot fields in Nova Scotia. Cumulative degree days were calculated using a base temperature of 7 °C (DD7), and models were developed to predict cumulative emergence and oviposition using nonlinear regression. Cumulative emergence and oviposition were adequately explained as functions of DD7 by a three-parameter sigmoidal Hill equation. Our emergence model predicted initial and peak adult emergence at 35 and 387 DD7, respectively, with oviposition on carrot baits occurring as early as 42 DD7. Models were then validated to evaluate how well they performed. Oviposition on carrot plants began at the fourth true-leaf stage (342 DD7) and continued until eleventh true-leaf stage. Growers using these models can identify their window of opportunity to manage their carrot weevil populations targeting the majority of emerged adults before oviposition begins in the field.
Neurocognitive impairments robustly predict functional outcome. However, heterogeneity in neurocognition is common within diagnostic groups, and data-driven analyses reveal homogeneous neurocognitive subgroups cutting across diagnostic boundaries.
Aims
To determine whether data-driven neurocognitive subgroups of young people with emerging mental disorders are associated with 3-year functional course.
Method
Model-based cluster analysis was applied to neurocognitive test scores across nine domains from 629 young people accessing mental health clinics. Cluster groups were compared on demographic, clinical and substance-use measures. Mixed-effects models explored associations between cluster-group membership and socio-occupational functioning (using the Social and Occupational Functioning Assessment Scale) over 3 years, adjusted for gender, premorbid IQ, level of education, depressive, positive, negative and manic symptoms, and diagnosis of a primary psychotic disorder.
Results
Cluster analysis of neurocognitive test scores derived three subgroups described as ‘normal range’ (n = 243, 38.6%), ‘intermediate impairment’ (n = 252, 40.1%), and ‘global impairment’ (n = 134, 21.3%). The major mental disorder categories (depressive, anxiety, bipolar, psychotic and other) were represented in each neurocognitive subgroup. The global impairment subgroup had lower functioning for 3 years of follow-up; however, neither the global impairment (B = 0.26, 95% CI −0.67 to 1.20; P = 0.581) or intermediate impairment (B = 0.46, 95% CI −0.26 to 1.19; P = 0.211) subgroups differed from the normal range subgroup in their rate of change in functioning over time.
Conclusions
Neurocognitive impairment may follow a continuum of severity across the major syndrome-based mental disorders, with data-driven neurocognitive subgroups predictive of functional course. Of note, the global impairment subgroup had longstanding functional impairment despite continuing engagement with clinical services.
We conducted a systematic review and network meta-analysis to determine the comparative efficacy of antibiotics used to control bovine respiratory disease (BRD) in beef cattle on feedlots. The information sources for the review were: MEDLINE®, MEDLINE In-Process and MEDLINE® Daily, AGRICOLA, Epub Ahead of Print, Cambridge Agricultural and Biological Index, Science Citation Index, Conference Proceedings Citation Index – Science, the Proceedings of the American Association of Bovine Practitioners, World Buiatrics Conference, and the United States Food and Drug Administration Freedom of Information New Animal Drug Applications summaries. The eligible population was weaned beef cattle raised in intensive systems. The interventions of interest were injectable antibiotics used at the time the cattle arrived at the feedlot. The outcome of interest was the diagnosis of BRD within 45 days of arrival at the feedlot. The network meta-analysis included data from 46 studies and 167 study arms identified in the review. The results suggest that macrolides are the most effective antibiotics for the reduction of BRD incidence. Injectable oxytetracycline effectively controlled BRD compared with no antibiotics; however, it was less effective than macrolide treatment. Because oxytetracycline is already commonly used to prevent, control, and treat BRD in groups of feedlot cattle, the use of injectable oxytetracycline for BRD control might have advantages from an antibiotic stewardship perspective.
Vaccination against putative causal organisms is a frequently used and preferred approach to controlling bovine respiratory disease complex (BRD) because it reduces the need for antibiotic use. Because approximately 90% of feedlots use and 90% of beef cattle receive vaccines in the USA, information about their comparative efficacy would be useful for selecting a vaccine. We conducted a systematic review and network meta-analysis of studies assessing the comparative efficacy of vaccines to control BRD when administered to beef cattle at or near their arrival at the feedlot. We searched MEDLINE, MEDLINE In-Process, MEDLINE Daily Epub Ahead of Print, AGRICOLA, Cambridge Agricultural and Biological Index, Science Citation Index, and Conference Proceedings Citation Index – Science and hand-searched the conference proceedings of the American Association of Bovine Practitioners and World Buiatrics Congress. We found 53 studies that reported BRD morbidity within 45 days of feedlot arrival. The largest connected network of studies, which involved 17 vaccine protocols from 14 studies, was included in the meta-analysis. Consistent with previous reviews, we found little compelling evidence that vaccines used at or near arrival at the feedlot reduce the incidence of BRD diagnosis.