The effect of meloxicam at the time of treatment of hoof-horn lameness in pasture-grazing dairy cattle on time to lameness soundness, pregnancy risk and time to conception; a randomized control trial.

The aims of this study were to assess the effect of meloxicam at the time of lameness treatment for hoof-horn (HH) lesions in dairy cattle on 1) time to lameness soundness post trimming and block application and 2) reproductive success Five seasonal-calving pasture-based dairy farms located in the Waikato region of New Zealand were enrolled into a randomized clinical interventional trial. Farmers were tasked with identifying lame animals over a period of approximately -4 to 6 weeks relative to the herd start of mating (HSM), with lameness subsequently confirmed with lameness score (LS) by trained technicians (0-3 scale, where ≥2 are considered lame). Animals with a LS ≥2 were examined by a veterinarian who then enrolled animals if they presented lame with HH (white-line or sole) lesions.

A multicentre cross-sectional observational study to determine the effect of living with frailty on digital exclusion from video consultations: (Access-VIGIL).

Objectives: Many older people regularly access digital services, but many others are totally excluded. Age alone may not explain these discrepancies. As health care services offer more video consultations, we aimed to determine if living with frailty is a significant risk factor for digital exclusion in accessing video consultations, and if this changes if a person has a support network to help with access.

Early minimally invasive intracerebral hemorrhage evacuation: a phase 2a feasibility, safety, and promise of surgical efficacy study.

Background: Surgical treatment of intracerebral hemorrhage (ICH) is unproven, although meta-analyses suggest that both early conventional surgery with craniotomy and minimally invasive surgery (MIS) may be beneficial. We aimed to demonstrate the safety, feasibility, and promise of efficacy of early MIS for ICH using the Aurora Surgiscope and Evacuator.

Methods: We performed a prospective, single arm, phase IIa Simon's two stage design study at two stroke centers (10 patients with supratentorial ICH volumes ≥20 mL and National Institutes of Health Stroke Scale (NIHSS) score of ≥6, and surgery commencing <12 hours after onset).

Design and CT imaging of casper, an anthropomorphic breathing thorax phantom.

The goal of this work was to build an anthropomorphic thorax phantom capable of breathing motion with materials mimicking human tissues in x-ray imaging applications. The thorax phantom, named Casper, was composed of resin (body), foam (lungs), glow polyactic acid (bones) and natural polyactic acid (tumours placed in the lungs). X-ray attenuation properties of all materials prior to manufacturing were evaluated by means of photon-counting computed tomography (CT) imaging on a table-top system.

New insights into the neural network of the nongravid uterus.

The human uterus is exposed to epigenetic factors during maturation, which might influence its neural network. The mesh muscle is formed from the circular muscle during development and maturation, and it coordinates the longitudinal and circular muscle function. The uterus has an autonomous neural network with contractility and propagation patterns that determine its reproductive potential and health during pregnancy and delivery.

Development and Initial Evaluation of a Nurse-Led Healthcare Clinic for Homeless and At-Risk Populations in Tasmania, Australia: A Collaborative Initiative.

People who are homeless experience significantly poorer health than the general population and often face multifaceted challenges engaging with public healthcare services. Mission Health Nurse-led Clinic (MHNC) was established in 2019 to meet the healthcare needs of this marginalised population in Launceston, Tasmania. This study examines barriers to healthcare access amongst individuals who experience homelessness, client and staff perceptions of the MHNC services and explored opportunities for service expansion.

COVID-19: A systematic evaluation of personal protective equipment (PPE) performance during restraint.

Background: Restraint is widely practised within inpatient mental health services and is considered a higher-risk procedure for patients and staff. There is a sparsity of evidence in respect of the efficacy of personal protective equipment (PPE) used during restraint for reducing risk of infection.

Methods: A series of choreographed restraint episodes were used to simulate contact contamination in research participants playing the roles of staff members and a patient.

Association of copeptin, a surrogate marker of arginine vasopressin, with cerebral vasospasm and delayed ischemic neurologic deficit after aneurysmal subarachnoid hemorrhage.

Objective: Delayed ischemic neurological deficit (DIND) is a leading cause of mortality and morbidity after aneurysmal subarachnoid hemorrhage (aSAH). Arginine vasopressin (AVP) is a hormone released by the posterior pituitary. It is known to cause cerebral vasoconstriction and has been implicated in hyponatremia secondary to the syndrome of inappropriate antidiuretic hormone secretion.

A case of conus medullaris teratoma.

In this report, we present a case of an adult patient with a mature teratoma of the conus medullaris. The patient was a 29-year-old postpartum female patient who developed unexplained urinary retention. Lumbar spine magnetic resonance imaging (MRI) examination revealed an intradural partly enhancing mixed cystic and solid lesion with intralesional intrinsic T1 hyperintense components that were suppressed on fat suppressed sequences, inseparable from the conus medullaris.

Searching for prohibited items in mental-health hospitals: A randomised controlled trial of two metal-detecting technologies.

Weapons and other items with potential to cause harm are usually prohibited in mental-health hospitals and other psychiatric facilities. Detecting such prohibited items (PIs) can be problematic, particularly if concealed, and metal detectors are commonly used to search for such items. Our study compared two types of metal detection: continuous wave detection (CWD) by hand-held metal detector (HHMD) and magnetic anomaly detection (MAD) by a static pole device.

Anguish at outliving our adult children.

'Old age ain't no place for sissies', film star Bette Davis (pictured) once said, and how right she was.

Cerebral vasospasm and delayed ischaemic deficit following elective aneurysm clipping.

Although common after subarachnoid haemorrhage, cerebral vasospasm (CVS) and delayed ischaemic neurological deficit (DIND) rarely occur following elective clipping of unruptured aneurysms. The onset of this complication is variable and its pathophysiology is poorly understood. We report two patients with CVS associated with DIND following unruptured aneurysmal clipping.

Inter-professional delirium education and care: a qualitative feasibility study of implementing a delirium Smartphone application.

Background: Delirium is a common medical condition with a high prevalence in hospital settings. Effective delirium management requires a multi-component intervention, including the use of Interprofessional teams and evidence-based interventions at the point of care. One vehicle for increasing access of delirium practice tools at the point of care is E-health.

A Flipped Classroom Approach to Improving the Quality of Delirium Care Using an Interprofessional Train-the-Trainer Program.

Introduction: Given the prevalence and morbidity associated with delirium, there is a need for effective and efficient institutional approaches to delirium training in health care settings. Novel education methods, specifically the "flipped classroom" (FC) and "train-the-trainer" (TTT), have the potential to address these delirium training gaps. This study evaluates the effect of a TTT FC interprofessional delirium training program on participants' perceived ability to manage delirium, delirium knowledge, and clinicians' delirium assessment behaviors.

Sections 135 and 136: Running a health-based place of safety in Gloucestershire.

The Maxwell Centre, a health-based place of safety (POS) adjacent to a psychiatric hospital, was opened in Gloucestershire in February 2009. It provides a POS for people detained under Sections 135 and 136 of the Mental Health Act 1983 as amended in 2007. Prior to the opening of the Maxwell Centre, police cells were the only designated POSs.

Unique experiences with intercontinental trials in stroke - part II.

Supported by the Canadian Medical Research Council we performed a randomized trial extending from Newfoundland to British Columbia. With others a number of observations showed that aspirin will reduce stroke. With National Institute of Neurological Disorders and Stroke support we learned who would benefit and not from surgery in these stroke threatened carotid diseased patients.

Comparison of microsurgery and endovascular treatment on clinical outcome following poor-grade subarachnoid hemorrhage.

Poor-grade (World Federation of Neurological Surgeons [WFNS] clinical grading scale grades IV and V) subarachnoid hemorrhage (SAH) is associated with significant morbidity and mortality. However, the correlation between the timing, modality of intervention (clipping or coiling) and the clinical outcome is not clear. This study aims to examine this correlation.

Be FAIR to students: four principles that lead to more effective learning.

A teacher is a professional not a technician. An understanding of some basic principles about learning can inform the teacher or trainer in their day-to-day practice as a teacher or a trainer. The FAIR principles are: provide feedback to the student, engage the student in active learning, individualise the learning to the personal needs of the student and make the learning relevant.

'A frightening experience': detainees' and carers' experiences of being detained under Section 136 of the Mental Health Act.

Aims: This research reports on the views of detainees and their carers of their experiences of being detained under Section 136 (S136) of the Mental Health Act 1983. Individual interviews were conducted with 18 detainees and six carers.

Method: A semi-structured questionnaire was administered face-to-face to gather qualitative data, which was analysed using a grounded theory approach.

Does treatment of ruptured intracranial aneurysms within 24 hours improve clinical outcome?

Background And Purpose: The purpose of this study was to analyze whether treating ruptured intracranial aneurysms within 24 hours of subarachnoid hemorrhage improves clinical outcome.

Methods: An 11-year database of consecutive ruptured intracranial aneurysms treated with endovascular coiling or craniotomy and clipping was analyzed. Outcome was measured by the modified Rankin Scale at 6 months.

The responses of professional groups to the use of Section 136 of the Mental Health Act (1983, as amended by the 2007 Act) in Gloucestershire.

Background: Section 136 (S136) of the Mental Health Act (1983, as amended by the 2007 Act) empowers the police to detain those suspected of being mentally disordered in a public place and to convey them to a place of safety (POS) for further assessment. Gloucestershire has not had a specialist facility for S136 detentions and individuals were taken to the police cells or occasionally A&E departments for assessment.

Aims: This paper forms one part of three aspects under investigation.