Control Advice Research Articles

Perception of Farmers towards M-Kisan Initiative

India is an agrarian country and risk and uncertainties are omnipresent in the field of agriculture. The farmer’s exposure to risk and uncertainty is often provoked by lack of information about required inputs and crop management practices etc. This information gap has adverse impact on production as well as the income of farmers. As use of ICT has strongly influenced every socio-economic aspect to become the most significant motivation of the socio-economic development and poverty reduction, Government of India launched m-Kisan portal to deliver updated information to the farmers through SMS. It is an initiative by the Indian government to provide agricultural services and information to farmers through mobile phones. The mKisan platform allows farmers to receive updates on agricultural practices, weather forecasts, market prices, pest control, and other farming-related advice via SMS, voice messages, and mobile apps. The present study tries to identify the utility perception of the m-kisan users. Data were collected from 120 respondents, from four villages of three different talukas of Bhavnagar district through personal interview schedule during 2022 and then after data were compiled, tabulated and analysed to get proper answer for the specific objectives of the study. Slightly more than half (51.67%) of the respondents had medium utility perception.

Paramedics Providing Palliative Care at Home: A Retrospective Cohort Study Comparing Symptom Management of Breathlessness and Pain in Cancer Versus Non-Cancer Conditions.

Background Palliative care aims to alleviate pain and distressing symptoms, affirm life, and offer support to patients and their caregivers. For many, the expressed preference is to die at home. As a result, there is growing recognition that paramedics can play an integral role at the end of life for symptom relief. Paramedic comfort with symptom management in the palliative care context is suspected, based on past work, to be higher for cancer as opposed to non-cancer life advanced disease. The objective of this study was to explore the paramedic management of patients with cancer and non-cancer advanced disease, using pain and breathlessness as key symptoms. Methods A retrospective cohort study was conducted. Paramedic electronic patient care records were queried for calls with palliative goals of care between July 1, 2015, and June 30, 2016, in Nova Scotia, Canada, which was the first year of the Paramedics Providing Palliative Care program. A manual chart review of a subgroup of 100 consecutive charts was completed to gain deeper insight. A descriptive analysis was conducted to understand practice variation within this population. Results The electronic query returned 1909 calls with a palliative approach. A total of 765 (40.1%) had cancer. The most common non-cancer disease category was respiratory. The top chief complaint was respiratory distress in both cancer and non-cancer populations. Medication was administered more often for pain (80%) compared to breathlessness (46.5%). Paramedics were more likely to call Medical Oversight Physicians for pain control advice. Post-treatment pain scores were documented infrequently. In the chart review, symptom management using the patient's own medications occurred in 17% of cases while an additional 5% of cases involved a combination of the patient's medications and paramedic service formulary. Conclusion The non-cancer population was less likely to have a non-transport outcome. Opportunities for improvement of symptom management were noted for pain and particularly so for breathlessness. Increased comfort with a palliative approach in the non-cancer disease cohort as well as with this key symptom will be a key to the success of the program.

Training zones in competitive swimming: a biophysical approach.

Since swimming performance depends on both physical conditioning and technical proficiency, training zones should be built based on physiology and biomechanics inputs to dispose of structured and effective training programs. This paper presents a zone-based swimming training, supported by the oxygen uptake (O2) kinetics at low, moderate, heavy, severe and extreme intensities concurrently with lactate and heart rate values. Since technique is vital for efficiently moving through the water, upper limbs frequency and length should also be targeted during the workouts. The index of coordination was also added to our proposal since upper limbs synchronization is a key technical factor. To better establish and characterize a wide range of swimming intensities, the training methods and corresponding contents that better fit each training zone will be suggested. It will be shown that when under/at the anaerobic threshold (at low-to-moderate intensities), swimmers are at homeostasis and can maintain stable internal and external load indicators. However, above that boundary (at heavy and severe intensities), the physiological stable state is no longer observed and the anaerobic metabolism starts contributing significantly, with a technical degradation being more evident when performing near/at the O2max intensity. Then, when performing above aerobic power, on typical anaerobic intensities, O2 kinetics presents a very evident fast rise, ending abruptly due to exhaustion caused by muscle acidosis. This overall knowledge allows advancing toward more objective training programs and highlights the importance of systematic training control and swimmers' evaluation and advice.

Facilitating the role of quantity surveyors through integration of cyber-physical systems

Purpose Cyber-physical systems (CPS) enable the synergistic integration of virtual models with the physical environment. This integration is gaining recognition for its potential to enhance construction project information management, thereby contributing to improved cost management in construction. Similarly, quantity surveyor (QS) plays a key role in construction projects by estimating and monitoring construction costs. Consequently, this research aims to explore redefining the role of QSs by integrating CPS. Design/methodology/approach The research adopted an interpretivism stance to collect and analyse data. Two rounds of 21 and 19 semi-structured interviews were conducted, with experts selected through heterogeneous purposive sampling. Code-based content analysis was used to analyse the data using NVivo12. MS Visio data visualisation tool was used to present the findings. Findings It is empirically proven the potential of CPS to facilitate nine key roles of QSs in all stages of the RIBA plan of work through the identification of 15 CPS applications and technologies. Nine key roles of QSs that CPS can facilitate were identified as preliminary estimation, measurement and quantification, contract administration, preparation of BOQ, interim valuation and payments, tender and contract documentation, cost planning, cost control and procurement advice. The study explored how adopting CPS technologies can transform traditional quantity surveying practices and enhance their value within the construction industry. Originality/value The findings add to the body of knowledge by redefining the role of QS through the integration of CPS for the first time and then by highlighting the usages of CPS in the construction industry rather than limiting it to a specific sector of the construction industry, as previous studies have done. This research uncovers several other research arenas on CPS as being the very first research to evaluate CPS to facilitate key roles of QSs. The findings can enhance the awareness and the practical implementation of CPS by intervening to form more partnerships among application developers and industry leaders.

Disparities and factors affecting hypertension diagnosis from qualified doctors in Bangladesh and its impact on receiving hypertension control advice: Analysis of demographic & health survey 2017-18.

The burden of hypertension is increasing in many low- and middle-income countries, including Bangladesh, and a large proportion of Bangladeshi people seek healthcare from unqualified medical practitioners, such as paramedics, village doctors, and drug store salesmen; however, there has been limited investigation regarding diagnosis and care provided by qualified doctors. This study investigated the factors associated with hypertension diagnosis by qualified doctors (i.e., registered medically trained doctors or medical doctors with at least an MBBS degree) and how this diagnosis is related to hypertension-controlling advice and treatment among Bangladeshi adults. This cross-sectional study used data from Bangladesh Demographic and Health Survey 2017-18. After describing sample characteristics, we conducted simple and multivariable logistic regression analyses to investigate the associated factors and associations. Among 1710 participants (68.3% females, mean age: 50.1 (standard error: 0.43) years) with self-reported hypertension diagnosis, about 54.9% (95% confidence interval (CI): 51.8-58.0) had a diagnosis by qualified doctors. The following variables had significant associations with hypertension diagnoses from qualified doctors: 40-54- or 55-year-olds/above (ref: 18-29-year-olds), overweight/obesity (ref: not overweight/obese), college/above education (ref: no formal education), richest wealth quintile (ref: poorest), urban residence (ref: rural), and residence in Chittagong, Barisal, and Sylhet divisions (ref: Dhaka division). Lastly, compared to people who had not been diagnosed by qualified doctors, those with the diagnosis from qualified doctors had higher odds of receiving any hypertension-controlling advice and treatment, including drugs (1.73 (95% CI: 1.27-2.36), salt intake reduction (AOR: 2.36, 95% CI: 1.80-3.10), weight reduction (AOR: 2.58, 95% CI: 1.97-3.37), smoking cessation (AOR: 2.22, 95% CI: 1.66-2.96),), and exercise promotion (AOR: 2.34, 95% CI: 1.77-3.09). This study showed significant socioeconomic and rural-urban disparities regarding hypertension diagnosis from qualified doctors. Diagnosis by qualified doctors was also positively associated with receiving hypertension-controlling advice and treatment. Reducing these inequalities would be crucial to reducing the country's hypertension burden.

Safeguarding nursing homes in a pandemic: lessons learnt and implications for future workforce planning and development.

Introduction: COVID-19 posed formidable challenges to Singapore’s nursing home (NH) sector. Singapore’s swift implementation of non-pharmaceutical interventions, staff management protocols, and rapid rollout of vaccinations and therapeutics successfully limited COVID-19 mortality and morbidity in the sector. Additionally, the pandemic highlighted the need to strengthen workforce resilience in a crisis. In this study, we identify challenges, opportunities and ways forward to inform the NH sector’s preparation for future outbreaks and ensure sustainability of actions. Here, we present findings on workforce capacity and capability-building.
 Methods: We conducted a qualitative study in two parts to characterise the pandemic response in NHs in Singapore: (i) A rapid review of peer-reviewed and grey literature, including media reports, policy documents, and advisories to synthesise the public health measures implemented from Jan 2020 to Jun 2021 and (ii) n=42 semi-structured in-depth interviews with key stakeholders working in the NH, public health, healthcare, and integrated care sectors, with interview data thematically analysed. 
 Findings: The key challenges identified were NH sector reliance on foreign manpower, early introduction of interventions to curb transmission risks that were maintained for longer than restrictions in community settings, and high resource demands to facilitate implementation of and compliance to restrictions. Care staff reported fatigue, fear, and anxiety. Alongside, strict border controls, quarantine measures, and staff segregation policies limited the NH sector’s ability to flexibly respond to manpower attrition. 
 To cope with these challenges, NHs upskilled junior staff and cross-trained non-nursing staff to take on reassigned tasks and built new capabilities across surveillance and testing. Public hospital manpower supported the NH sector with infection prevention and control advice, tele-consultations, and knowledge-sharing on case management and diagnostics. 
 Opportunities for COVID-19 collaboration between the NH sector and health and integrated care agencies were grounded in social capital accumulated over many years of inter-agency partnerships and collaboration. Boundarylessness and open communication between organisations/agencies facilitated timely decision-making, information sharing, and flexible deployment of resources, including additional funding support. 
 Ways forward: Moving forward, findings pointed to the pandemic providing impetus to build a strong local manpower core, invest in schemes to boost competitiveness and attractiveness, consider a review of existing staffing models, and increase resourcing support to enable the NH sector to keep up with policy changes and future demands. Findings also suggested the importance of greater investment into supporting healthier work environments and prioritising staff mental and physical health.

Impact of the COVID-19 restrictions on the epidemiology of Cryptosporidium spp. in England and Wales, 2015-2021: a time series analysis.

Introduction. In England and Wales, cryptosporidiosis cases peak in spring and autumn, associated with zoonotic/environmental exposures (Cryptosporidium parvum, spring/autumn) and overseas travel/water-based activities (Cryptosporidium hominis, autumn). Coronavirus disease 2019 (COVID-19) restrictions prevented social mixing, overseas travel and access to venues (swimming pools/restaurants) for many months, potentially increasing environmental exposures as people sought alternative countryside activities.Hypothesis. COVID-19 restrictions reduced incidence of C. hominis cases and potentially increased incidence of C. parvum cases.Aim. To inform/strengthen surveillance programmes, we investigated the impact of COVID-19 restrictions on the epidemiology of C. hominis and C. parvum cases.Methodology. Cases were extracted from the Cryptosporidium Reference Unit (CRU) database (1 January 2015 to 31 December 2021). We defined two periods for pre- and post-COVID-19 restrictions implementation, corresponding to before and after the first UK-wide lockdown on 23 March 2020. We conducted a time series analysis, assessing differences in C. parvum and C. hominis incidence, trends and periodicity between these periods.Results. There were 21 304 cases (C. parvum=12 246; C. hominis=9058). Post-restrictions implementation incidence of C. hominis dropped by 97.5 % (95 % CI: 95.4-98.6 %; P<0.001). The decreasing incidence trend pre-restrictions was not observed post-restrictions implementation due to lack of cases. No periodicity change was observed post-restrictions implementation. There was a strong social gradient; there was a higher proportion of cases in deprived areas. For C. parvum, post-restrictions implementation incidence fell by 49.0 % (95 % CI: 38.4-58.3 %; P<0.001). There was no pre-restrictions incidence trend but an increasing incidence trend post-restrictions implementation. A periodicity change was observed post-restriction implementation, peaking 1 week earlier in spring and 2 weeks later in autumn. The social gradient was the inverse of that for C. hominis. Where recorded, 22 % of C. hominis and 8 % of C. parvum cases had travelled abroad.Conclusion. C. hominis cases almost entirely ceased post-restrictions implementation, reinforcing that foreign travel seeds infections. C. parvum incidence fell sharply but recovered post-restrictions implementation, consistent with relaxation of restrictions. Future exceedance reporting for C. hominis should exclude the post-restriction implementation period but retain it for C. parvum (except the first 6 weeks post-restrictions implementation). Infection prevention and control advice should be improved for people with gastrointestinal illness (GI) symptoms to ensure hand hygiene and swimming pool avoidance.

Accuracy of Artificial Intelligence-Based Photographic Detection of Gingivitis

ObjectivesGingivitis is one of the most prevalent plaque-initiated dental diseases globally. It is challenging to maintain satisfactory plaque control without continuous professional advice. Artificial intelligence may be used to provide automated visual plaque control advice based on intraoral photographs. MethodsFrontal view intraoral photographs fulfilling selection criteria were collected. Along the gingival margin, the gingival conditions of individual sites were labelled as healthy, diseased, or questionable. Photographs were randomly assigned as training or validation datasets. Training datasets were input into a novel artificial intelligence system and its accuracy in detection of gingivitis including sensitivity, specificity, and mean intersection-over-union were analysed using validation dataset. The accuracy was reported according to STARD-2015 statement. ResultsA total of 567 intraoral photographs were collected and labelled, of which 80% were used for training and 20% for validation. Regarding training datasets, there were total 113,745,208 pixels with 9,270,413; 5,711,027; and 4,596,612 pixels were labelled as healthy, diseased, and questionable respectively. Regarding validation datasets, there were 28,319,607 pixels with 1,732,031; 1,866,104; and 1,116,493 pixels were labelled as healthy, diseased, and questionable, respectively. AI correctly predicted 1,114,623 healthy and 1,183,718 diseased pixels with sensitivity of 0.92 and specificity of 0.94. The mean intersection-over-union of the system was 0.60 and above the commonly accepted threshold of 0.50. ConclusionsArtificial intelligence could identify specific sites with and without gingival inflammation, with high sensitivity and high specificity that are on par with visual examination by human dentist. This system may be used for monitoring of the effectiveness of patients’ plaque control.

Ecological and environmental impacts of mineral exploitation in urban agglomerations

The rapid development of the energy and mining industry has supported the industrialization process in China, but it has also caused a series of negative impacts on the ecological environment. As a resource concentration and regional development pivot, evaluating the impact of mineral exploitation on the ecological environment under the scope of urban agglomeration can efficiently mitigate the contradiction between mineral exploitation and ecological environment protection. Therefore, this paper chose 14 urban agglomerations under the nationally planned mining areas as the research object. This paper analyzed the characteristics and spatial distribution of ecological stress in mineral exploitation from multi-aspects, including the ecological base's vulnerability, ecological function, and the stress degree of critical environmental factors. The results of the study show as follows: (1) The distribution of the vulnerability of the ecological base is highly spatial correlated, the Yellow river basin and Yangtze-river basin are clustered with high ecological base vulnerability and low vulnerability urban agglomerations respectively; (2) More than half of the urban agglomerations are stressed by ecological functions, the threats were mainly coming from the water and land resources; (3) Highly stressed cities concentrated in the Yellow-river and Yangtze-river basins, with strong geographical concentration, the impact of mineral exploitation on the ecosystem is profound than water and air environment. (4) Comprehensive stress was the most common type for mineral cities, typically clustered in urban agglomerations with sufficient mineral resources or heavy soil and water loss, presented as a centralized distribution pattern in general. In the end, based on the results, this paper proposed three different control advice for spatial, intensity, and exploitation, respectively, to provide theoretical support and practical solutions for controlling mineral exploitations in urban agglomerations.

Identification of Risk Factors for Mastalgia and Its Relationship with Benign or Malignant Breast Diseases.

Mastalgia is a medical condition that primarily affects women of all age groups. Affected individuals experience excruciating pain, tightness, or a burning sensation in the breast tissue. The aim of this study is to observe the clinicopathologic features of women with mastalgia and compare these features with asymptomatic cases. A total of 524 female patients who applied to the general surgery outpatient clinic were prospectively evaluated. The patients were divided into two groups. Group 1 (G1) included patients with mastalgia, while Group 2 (G2) included asymptomatic patients. The two groups were compared in terms of clinical, radiological, and pathological features. This study was conducted on 524 women, among whom the prevalence of mastalgia was found to be 61.45%. There were 322 patients in G1 and 202 patients in G2. The mean age was significantly higher in G2 compared to G1 (46.33±10.33 vs. 43.58±10.33, respectively; p=0.001). Premenopausal women rates for G1 and G2 were 73.91% and 59.4%, respectively (p=0.001). The regular exercise rate in G1 was 18.01%, while it was 25.74% in G2 (p=0.034). The past history of breast cancer rate was significantly higher in G2 than in G1 (p=0.015). The consumption of analgesics was significantly lower in G2 compared to G1 (p=0.05). Non-steroidal anti-inflammatory drugs were the most commonly used analgesic drug class in both groups, with significant intergroup differences (G1: 27.63%, G2: 19.8%, p=0.043). Screening mammography with or without ultrasound examination was performed significantly more often in G2 compared to G1 (66.33% vs. 55.27% and 82.17% vs. 72.98%, p=0.012 and p=0.016, respectively). No significant difference was found concerning the frequency of benign or malignant pathologies between the groups. Breast pain is common and should be considered physiological without other breast symptoms and after excluding non-breast causes. It is safe to provide symptom control advice and reassurance to patients who have breast pain but do not have signs or symptoms indicating a possible serious underlying condition requiring further medical intervention.

Parasite roundup for 2022

The year 2022 has proven to be another tricky year for UK veterinary professionals, and parasite control has presented its own set of challenges. These have focused largely around the high numbers of rescue dogs being imported from abroad, in particular as a result of the war in Ukraine, and the challenges of ensuring responsible parasiticide use. Throughout, the European Council for Companion Animal Parasites UK &amp; Ireland has continued to give parasite control advice, raise awareness of the changing parasite landscape in the UK and promote the need for risk-based parasite control and routine diagnostic surveillance. So what did 2022 hold for parasites and their control?

Infection control in cystic fibrosis: evolving perspectives and challenges.

This article reviews the impact of some of the most recent changes in clinical care management in cystic fibrosis on infection prevention practice and advice for people with cystic fibrosis. People with cystic fibrosis (CF) consistently highlight infection control as one of their major concerns. Infection prevention guidance and practice has facilitated successful decreases in rates of many transmissible CF pathogens. The coronavirus disease 2019 pandemic highlighted the clinical significance of respiratory viral infections and has accelerated the implementation of remote monitoring and telemedicine consultations as standard practice in CF. The continued improvement in health of the CF population is being further augmented by the introduction of new therapies, in particular cystic fibrosis transmembrane conductance regulator modulators. Infection prevention will remain pertinent to CF care, but these recent changes in clinical practice will have ongoing implications for infection prevention guidance in CF. Recent changes in CF clinical care have implications that will lead to further evolution of infection control practice and advice.

Good citizens, perfect patients, and family reputation: Stigma and prolonged isolation in people with drug-resistant tuberculosis in Vietnam.

Stigma and isolation are common in people with tuberculosis (TB). Social isolation contributes to reduced health outcomes and TB treatment adherence. Stigma and the drivers of isolation in people with Drug-Resistant (DR)-TB may include modifiable advice and practices of family and Health Care Workers (HCW). This study aimed to understand the drivers of isolation and stigma from the perspective of people with DR-TB in Vietnam. A greater understanding of stigma and isolation is important to identify and balance patients' needs and disease transmission risk. In-depth interviews were conducted with 12 people with DR-TB and seven HCWs who care for people with DR-TB in two provinces in Vietnam. Interviews were audio-recorded, transcribed verbatim and translated to English. Data collection and analysis were conducted simultaneously. The data were then analysed using a thematic framework approach. Stigma and extended isolation were common experiences among people with DR-TB. To mitigate stigma, people with DR-TB used the local term 'lao lực' to describe their condition to others which is believed to be a less infectious and less stigmatising type of TB. This study identified that although HCW informed people with DR-TB of when they were no longer infectious and isolation was no longer required, their infection control advice was not always consistent. Despite knowing they were no longer infectious, most people with DR-TB continued to self-isolate to minimise the perceived repercussions of societal stigma, to protect their 'thể diện' (honour, prestige, reputation), and eliminate all risk of transmitting DR-TB to their family. This study identified three interconnected drivers of self-isolation in Vietnam, including fear of infecting others, fear of stigmatization, and to protect family reputation. TB control programmes need to better understand the social aspects of DR-TB to enable them to better support patients. Educating HCW to provide evidence-based infection control advice is vital.

Effectiveness of Web-Based Personalized Nutrition Advice for Adults Using the eNutri Web App: Evidence From the EatWellUK Randomized Controlled Trial.

BackgroundEvidence suggests that eating behaviors and adherence to dietary guidelines can be improved using nutrition-related apps. Apps delivering personalized nutrition (PN) advice to users can provide individual support at scale with relatively low cost.ObjectiveThis study aims to investigate the effectiveness of a mobile web app (eNutri) that delivers automated PN advice for improving diet quality, relative to general population food-based dietary guidelines.MethodsNondiseased UK adults (aged >18 years) were randomized to PN advice or control advice (population-based healthy eating guidelines) in a 12-week controlled, parallel, single-blinded dietary intervention, which was delivered on the web. Dietary intake was assessed using the eNutri Food Frequency Questionnaire (FFQ). An 11-item US modified Alternative Healthy Eating Index (m-AHEI), which aligned with UK dietary and nutritional recommendations, was used to derive the automated PN advice. The primary outcome was a change in diet quality (m-AHEI) at 12 weeks. Participant surveys evaluated the PN report (week 12) and longer-term impact of the PN advice (mean 5.9, SD 0.65 months, after completion of the study).ResultsFollowing the baseline FFQ, 210 participants completed at least 1 additional FFQ, and 23 outliers were excluded for unfeasible dietary intakes. The mean interval between FFQs was 10.8 weeks. A total of 96 participants were included in the PN group (mean age 43.5, SD 15.9 years; mean BMI 24.8, SD 4.4 kg/m2) and 91 in the control group (mean age 42.8, SD 14.0 years; mean BMI 24.2, SD 4.4 kg/m2). Compared with that in the control group, the overall m-AHEI score increased by 3.5 out of 100 (95% CI 1.19-5.78) in the PN group, which was equivalent to an increase of 6.1% (P=.003). Specifically, the m-AHEI components nuts and legumes and red and processed meat showed significant improvements in the PN group (P=.04). At follow-up, 64% (27/42) of PN participants agreed that, compared with baseline, they were still following some (any) of the advice received and 31% (13/42) were still motivated to improve their diet.ConclusionsThese findings suggest that the eNutri app is an effective web-based tool for the automated delivery of PN advice. Furthermore, eNutri was demonstrated to improve short-term diet quality and increase engagement in healthy eating behaviors in UK adults, as compared with population-based healthy eating guidelines. This work represents an important landmark in the field of automatically delivered web-based personalized dietary interventions.Trial RegistrationClinicalTrials.gov NCT03250858; https://clinicaltrials.gov/ct2/show/NCT03250858

Optimizing the timing of management interventions against fall armyworm in African smallholder maize: Modelling the pattern of larval population emergence and development

Since its invasion in late 2016, the fall armyworm has a widespread year-round distribution within Africa where it continues to threaten cereal production, particularly maize. Most recommended control advice emphasises the need for interventions against larvae early after colonization of a new maize crop by adults followed by a later intervention if an infestation persists. The current times for action are approximate action thresholds based on scouting which are difficult to implement as early development stages are cryptic and farmers, especially smallholders, have limited time for crop assessments. To improve the impact of controls, the modelling of early and late instar larval population emergence and development in relation to physiological time from planting was developed to enable times to action to be predicted and conveyed to farmers. The two larval population emergence models were built from field fall armyworm data from maize in Zambia and validated from similar data from multiple maize sites in Kenya. A component was included in the models to allow synchronization of maize emergence with larval development. Physiological time, in degree-days, was estimated using Earth Observation land surface temperature data sets. As precise information on action thresholds is lacking for Africa, recent published data on thresholds based on economic injury levels from Colombia were used as a guide but the models can be updated when new information becomes available for Africa. The practical implementation of the models in Africa is discussed including the outcome of some recent preliminary trials with maize farmers in Kenya.

Parasite roundup for 2021

The year 2021 has proven to be another challenging year for UK veterinary professionals in many specialities, and parasite control has presented its own set of challenges. These have focused largely around the high numbers of rescue dogs continuing to be imported from abroad and the challenges of ensuring responsible parasiticide use in increasingly busy veterinary practices. Throughout, the European Council for Companion Animal Parasites UK &amp; Ireland has continued to give parasite control advice, raise awareness of the changing parasite landscape in the UK and promote the need for risk-based parasite control and routine diagnostic surveillance. So what did 2021 hold for parasites and their control?

Parasite roundup for 2021

The year 2021 has proven to be another challenging year for UK veterinary professionals in many specialities, and parasite control has presented its own set of challenges. These have focused largely around the high numbers of rescue dogs continuing to be imported from abroad and the challenges of ensuring responsible parasiticide use in increasingly busy veterinary practices. Throughout, the European Council for Companion Animal Parasites UK &amp; Ireland has continued to give parasite control advice, raise awareness of the changing parasite landscape in the UK and promote the need for risk-based parasite control and routine diagnostic surveillance. So what did 2021 hold for parasites and their control?

295 Secondary Prevention of Cardiovascular Risk Factors in Patients Admitted Under the Vascular Service - Full Cycle Audit

Abstract Aim Peripheral arterial disease (PAD) is strongly associated with general cardiovascular morbidity and mortality. This audit aimed to monitor and improve compliance with NICE guidelines CG147 &amp; TA607 for PAD patients that presented to our vascular service. Method Patients were audited from September to October 2020. The audit reviewed prescription of anticoagulant/antiplatelet agents, lipid modification, optimisation of diabetes control and smoking cessation advice. Our intervention was to conduct a single teaching session for junior doctors that emphasised medication checks, checking HBA1c/ensuring appropriate diabetic referrals, and implementation/documentation of any smoking cessation advice. We also introduced a dedicated computer for conducting the vascular surgery morning ward round. Re-audit was undertaken between November to December 2020. Results The first audit included 32 patients. It revealed 100% compliance with anticoagulant/antiplatelet prescribing. 82% were prescribed appropriate lipid modification. There was 75% compliance with diabetic referrals for patients with high HBA1c results. There was only 19% compliance with smoking cessation advice/documentation. The re-audit process included 27 patients. There was 100% compliance with antiplatelet/anticoagulant prescriptions. 26 (96%) patients were prescribed appropriate lipid modification. There was now 100% compliance with appropriate referral to the diabetic team. There was also 100% compliance with smoking cessation advice/assistance/documentation. Conclusions A single teaching session for junior doctors familiarising them with the current national guidelines, and introduction of a dedicated computer for ward rounds significantly helped improve our compliance with national guidelines for secondary prevention of vascular disease.

Permeability structure of the horizontally-stratified dam foundation rock mass and its engineering significance

Identifying the permeability structure of the dam foundation rock mass is important for the formulation of seepage control schemes. For the horizontally-stratified red-bed rock mass of the Guxian Dam foundation, this paper adopted a continuous, high-resolution water pressure test data processing method to analyze the relationships between rock mass permeability and elevation, lithology and shear zones, clarifiy the permeability structure of the dam foundation rock mass, and propose seepage control advice. The results indicate that the Guxian Dam foundation rock mass is characterized by a structural and random permeability behavior. The structure shows that the permeability decreases with elevation. The randomness shows that the permeability randomly fluctuates due to lithology and shear zones. For the river-bed dam foundation rock mass, the bottom elevation of the weathering and unloading zone is 450 m or so, and the 1Lu bottom boundary is at the elevation of approximately 340 m. For the rock mass of the dam abutment, the 3Lu bottom boundary is located at the elevation of 560～580 m. The section of 350～360 m elevation has a certain thickness of soft rock, a poor development of shear structure, and a low permeability. It can be regarded as a confining layer and a potential target for the optimization of seepage control schemes. In view of the universal applicability, the method proposed in this paper can be used for reference in similar projects.

COVID-19 virus released from larynx might cause a higher exposure dose in indoor environment

COVID-19 virus can replicate in the infected individual's larynx independently, which is different from other viruses that replicate in lungs only, e.g. SARS. It might contribute to the fast spread of COVID-19. However, there are few scientific reports about quantitative comparison of COVID-19 exposure dose (inhalation dose and adhesion dose) for the susceptible individual when the viruses were released from the larynx or lungs. In this paper, a typical numerical model was built based on a breathing human model with real respiratory tract. By using a computational fluid dynamics (CFD) method, two kinds of virus released sites in the infected individual's respiratory tract (larynx, lungs), seven kinds of particle sizes between 1 and 50 μm, three kinds of expiratory flow rates: calm (10 L/min), moderate (30 L/min) and intense (90 L/min) were used to compare the particle deposition proportion and escape proportion. The inhalation dose and the adhesion dose of the susceptible individual were quantified. The results showed that COVID-19 virus-containing droplets and aerosols might be released into the environment at higher proportions (39.1%–44.2%) than viruses that replicate in lungs only (15.3%–37.1%). The exposure doses (inhalation dose and adhesion dose) of the susceptible individual in different situations were discussed. The susceptible individual suffered a higher exposure dose when the viruses were released from the larynx rather than lungs (the difference for 1 μm particles was 1.2–2.2 times). This study provides a possible explanation for the higher transmission risk of COVID-19 virus compared to other viruses and some control advice of COVID-19 in typical indoor environments were also discussed.