Inverurie Hospital

1. The effect of the dietary inclusion of 5 culinary herbs or their essential oils on the growth, digestibility and intestinal microflora status in female broiler chicks was assessed. From 7 to 28 d of age, either a basal control diet without supplement was given or one of 10 others, consisting of the basal diet with either 10 g/kg herb (thyme, oregano, marjoram, rosemary or yarrow) or 1 g/kg of essential oil. 2. Body mass (BM) and feed consumption (AFC) were measured on a weekly basis and used to calculate chick performance. Total viable counts of lactic acid bacteria, coliforms, anaerobes and Clostridium perfringens were determined at 25 d. Apparent nutrient digestibilities were calculated from the measured values for gross energy, nitrogen (N), dry matter (DM) and organic matter, and sialic acid concentration was also measured. 3. Generally, dietary thyme oil or yarrow herb inclusion had the most positive effects on chick performance, while oregano herb and yarrow oil were the poorest supplements. Only thyme and yarrow in these diets had a different effect when used as a herb or oil on weight gain and BM. 4. Dietary treatment had no effect on the intestinal microflora populations, apparent metabolisable energy (AME) or the calculated coefficients of digestibility. Sialic acid concentration was greatest in the birds given dietary thyme oil, compared with all other treatments except those birds receiving marjoram oil, rosemary herb and the controls. However, less sialic acid was excreted in those birds given diets with oregano or rosemary oils, or oregano herb, than in the controls. 5. Plant extracts in diets may therefore affect chick performance, gut health and endogenous secretions, although the chemical composition of the extract appears to be important in obtaining the optimal effects.

Interviews were conducted with the co-resident supporters of 79 elderly subjects. Forty of these elderly subjects had been diagnosed as being demented (20 mildly, 12 moderately and eight severely) following psychiatric assessment. The supporters were screened for psychological well-being with the 60-item General Health Questionnaire (GHQ) and the Relatives' Stress Scale (RSS). Supporters of demented relatives showed significantly raised levels of stress on the RSS, but no increase in psychiatric morbidity on the GHQ, when compared with the supporters of non-demented relatives. The implications of these findings are discussed.

Abstract A prospective cohort study of 2357 women eligible for participation in the UK National Breast Screening Programme was carried out to evaluate the immediate emotional and behavioural effects of attending for routine mammography. Women completed the Hospital Anxiety and Depression Scale (HADS) in the context of a survey by their General Practitioner before they knew they were to receive an invitation to attend screening and again at screening some 6 weeks later. In addition, an ad hoc Health Questionnaire was administered when the women attended for screening to assess possible self‐perceived stress‐related behaviour changes in the previous week. 2110 (89.5% response rate) women returned the initial postal baseline HADS and 1635 completed the HADS again at screening. Anxiety and depression scales were significantly lower at screening than at baseline ( t = 3.16, p < 0.002, 95% CI = 0.07 to 0.31) and ( t = 8.46, p < 0.0001, 95% CI = 0.32 to 0.52) respectively. Women scoring in the borderline range at baseline were more likely to move into the normal than the clinically significant range for anxiety (χ 2 = 40.36, p < 0.001) and also for depression (χ 2 = 56.04, p < 0.001), and women scoring in the clinically significant range for anxiety were more likely to become normal than vice versa (χ 2 = 5.95, p < 0.02). The Health Questionnaire indicated that some women reported stress‐related behaviour changes in the week prior to screening, especially those who were most anxious or depressed.

BACKGROUND: The care of drug-using pregnant women is a growing health and social care concern in many countries. A specialist clinic was established offering multidisciplinary care and advice to pregnant drug users in and around Aberdeen (UK) in 1997. The majority of women stabilise and reduce their drug use. By determining the needs and views of the women more appropriate services and prevention strategies may be developed. There has been little research conducted in this area and none in Scotland. METHODS: This is a qualitative study that aimed to gain an understanding of the experiences of women drug users, seeking and receiving prenatal care and drug services from a specialist clinic. Twelve women participated in semi-structured one-to-one interviews. RESULTS: The women preferred the multidisciplinary clinic (one-stop shop) to traditional prenatal care centred within General Practice. The relationships of the clients to the range of Clinic professionals and in hospital were explored as well as attitudes to Clinic care. The study participants attributed success in reducing their drug use to the combination of different aspects of care of the multi-agency clinic, especially the high level prenatal support. It is this arrangement of all aspects of care together that seem to produce better outcomes for mother and child than single care elements delivered separately. Some women reported that their pregnancy encouraged them to rapidly detoxify due to the guilt experienced. The most important aspects of the Clinic care were found to be non-judgemental attitude of staff, consistent staff, high level of support, reliable information and multi-agency integrated care. CONCLUSION: There is an impetus for women drug users to change lifestyle during pregnancy. The study highlighted a need for women to have access to reliable information on the effects of drugs on the baby. Further research is required to determine whether positive outcomes related to clinic attendance in the prenatal period are sustained in the postnatal period. Early referral to a specialist clinic is of benefit to the women, as they reported to receive more appropriate care, especially in relation to their drug use. A greater awareness of needs of the pregnant drug user could help the design of more effective prevention strategies.

In a general practice population, 274 elderly married couples completed the Mental Status Questionnaire (MSQ), the 60-item General Health Questionnaire (GHQ) and the Leeds General Scales for the Self-assessment of Depression and Anxiety. The only relationship detected between cognitive impairment on the MSQ and psychiatric morbidity in the partner was a fairly weak negative correlation between the wives' MSQ and the Leeds Depression score of their husbands. These findings differ from those of previous studies, which have found high rates of psychiatric morbidity in the relatives of demented patients, and the possible reasons for these differences are discussed. Most importantly, other studies have involved the relatives of patients referred to psychiatric services, and these families may be quite different from those in which the demented relative is not referred to a psychiatrist.

Purpose This paper aims to argue that, while destination benchmarking and visitor surveys seek to measure the visitor experience, they privilege the destination manager or researcher rather than taking the visitor's viewpoint. It seeks to suggest that capturing and analysing visitor stories while in the destination can facilitate understanding of how destination image changes with actual experience, and what factors or attributes are important, thereby offering a deeper insight into the process through which destination experience is transformed (sense making) and transmitted (sense giving) via those stories, that all important word of mouth publicity. Design/methodology/approach Unstructured interviews were recorded with visitors in Edinburgh and Greenwich. An interpretive approach was employed in analysing the interview data to uncover facets of visitor experience affecting the image conveyed through the narrative. Findings The research reveals three elements involved in the sense making and sense giving process and sets out the three categories of visitor consumption characteristics which are implicated in the process. Research limitations/implications Although the outcomes of the sense making and sense giving process are mediated by the incidents, interactions and characteristics of the individual visitor, the process itself is common to all visitors. Analysing visitor narratives to uncover the mediating factors illuminates the visitor's actual destination experience and its impact on their understanding or image of a destination. Narratives proved to be a useful research tool. Practical implications The interview and analysis techniques used could be readily adapted for use alongside existing standardised visitor survey tools to provide destination managers and marketers a greater understanding of the impact of customer care and visitor management programmes and how narrative may be useful in tailoring destination marketing to meet the requirements of specific visitor groups. Originality/value The paper demonstrates the utility of capturing and analysing visitor narratives at the point of destination consumption for understanding actual destination experience and the way in which it is transmitted as word of mouth information to others.

A community sample of elderly married couples completed the 60-item General Health Questionnaire and the Leeds General Scales for the Self-Assessment of Depression and Anxiety. Significant concordance was demonstrated between the spouses' scores on these scales. Concordance was higher for depression than for anxiety. There was little to support previous findings that wives are more likely than husbands to be concordant with an ill spouse. The spouse concordance rates for psychiatric morbidity were similar to those found in studies of younger married couples.

BACKGROUND: Dementia is very common in Down syndrome (trisomy 21) adults. Statins may slow brain amyloid β (Aβ, coded on chromosome 21) deposition and, therefore, delay Alzheimer disease onset. One prospective cohort study with Down syndrome adults found participants on statins had reduced risk of incident dementia, but there are no randomised controlled trials (RCTs) on this issue. Evidence is sparse on the best instruments to detect longitudinal cognitive decline in older Down syndrome adults. METHODS: TOP-COG was a feasibility/pilot, double-blind RCT of 12 months simvastatin 40 mg versus placebo for the primary prevention of dementia in Alzheimer disease in Down syndrome adults aged 50 years or older. Group allocation was stratified by age, apolipoprotein E (APOE) ε4 allele status, and cholesterol level. Recruitment was from multiple general community sources over 12 months. Adults with dementia, or simvastatin contraindications, were excluded. Main outcomes were recruitment and retention rates. Cognitive decline was measured with a battery of tests; secondary measures were adaptive behaviour skills, general health, and quality of life. Assessments were conducted pre randomisation and at 12 months post randomisation. Blood Aβ40/Aβ42 levels were investigated as a putative biomarker. Results were analysed on an intention-to-treat basis. A qualitative sub-study was conducted and analysed using the Framework Approach to determine recruitment motivators/barriers, and participation experience. RESULTS: We identified 181 (78 %) of the likely eligible Down syndrome population, and recruited 21 (11.6 %), from an area with a general population size of 3,135,974. Recruitment was highly labour-intensive. Thirteen (62 %) participants completed the full year. Results favoured the simvastatin group. The most appropriate cognitive instrument (regarding ease of completion and detecting change over time) was the Memory for Objects test from the Neuropsychological Assessment of Dementia in Individuals with Intellectual Disabilities battery. Cognitive testing appeared more sensitive than proxy-rated adaptive behaviour, quality of life, or general health scores. Aβ40 levels changed less for the simvastatin group (not statistically significant). People mostly declined to participate because of not wanting to take medication, and not knowing if they would receive simvastatin or placebo. Participants reported enjoying taking part. CONCLUSION: A full-scale RCT is feasible. It will need 37 % UK population coverage to recruit the required 160 participants. Information/education about the importance of RCT participation is needed for this population. TRIAL REGISTRATION: ISRCTN67338640 .

AIM: To obtain a snapshot of how patients with potentially life-threatening allergies are managed within a Primary Care setting. METHODOLOGY: A questionnaire-based survey sent to all General Practitioners in Scotland. RESULTS: Six hundred and thirteen replies were suitable for analysis. Ninety percent of respondents had prescribed adrenaline auto-injector pens, almost exclusively the EpiPen device. Less than half were personally confident in their use and only 17% had access to a dummy trainer pen for demonstration purposes. Twenty seven percent would prescribe one auto-injector only. Six percent reported accidental mis-firing of adrenaline pens, although with no serious sequelae. Refusal of pens by patients was noted by 1%. In the event of an anaphylactic emergency, 90% of respondents would use adrenaline as first-line treatment, although only half would use the UK Resuscitation Council recommended adult dose of 0.5mg by the intramuscular route (or 0.3mg by auto-injector). Eleven percent would give adrenaline by the slower subcutaneous route and 3% by the intravenous route. Thirty six percent had themselves treated such a case outside of hospital. Sixty two percent of respondents would seek specialist investigation of anaphylaxis, although only 31% felt that ready access was available. Frequent concerns were raised about current provision of care for patients with allergic disease and their own ability to deal with this. CONCLUSION: Investment is required, both to provide basic training and ongoing support for Primary healthcare staff in the management of allergic disease, and also for necessary accompanying specialist support.

Synthesis of Terminal Acetylenic Sugars Derivatives and Ynuronic Acids Derivatives by Use of a Wittig Reaction The method described for the preparation of terminal acetylenic sugars presents two advantages over earlier procedures: no new asymmetric center is created and the chain can be extended by one or more C‐atoms. The method also allows preparation of ynuronic acids. The aldehydosugars derivatives 1–7 gave in good to excellent yields the corresponding gem ‐dibromoenoses 8–14 from which either the terminal acetylenic sugars derivatives 15–21 or the ynuronic acids 22–24 were easily prepared. A few examples of 1,3‐dipolar cycloadditions (leading to 28–30 ) with these acetylenic sugar derivatives are also described.

OBJECTIVE: To develop and validate an assessment tool, based on the 'Royal College of General Practitioners' (RCGP) Video Assessment Tool', for assessment of pharmacist prescribers' consultation skills. METHODS: Competency areas of the RCGP tool were left unchanged but performance criteria for each were modified to reflect pharmacist prescribing. Each criterion and the overall consultation were rated from 1 (poor) to 5 (excellent). A purposive sample of 10 experienced prescribing pharmacists was selected. Each pharmacist identified, recruited and consented two patients. Video recordings of consultations were assessed independently by two randomly assigned GPs, experienced in the use of the RCGP tool, using the newly developed scale. Inter-rater reliability was assessed. Construct validity was assessed by comparing the assessor score with a patient satisfaction score. Spearman's rho was used to test the correlation between the two scores. RESULTS: The RCGP tool was modified to give the 'Pharmacist Consultation Assessment Tool' (PharmaCAT). The median overall PharmaCAT consultation rating was 3. There was good agreement between the two assessors for total scores (intraclass correlation coefficient=0.694). Fourteen (78%) patient satisfaction questionnaires were returned; most (n=13, 93%) agreed/strongly agreed that they were entirely satisfied with the consultation. Correlations between average total scores on PharmaCAT and the patient satisfaction questionnaire were weak (Spearman's rho=0.142 and 0.242 for both assessors). CONCLUSIONS: The PharmaCAT has been tested in the pharmacist prescriber setting. The tool had discriminatory power across different domains and inter-rater reliability. The PharmaCAT has potential to be used as a formative and/or summative assessment tool.

One of the most common pharmaceutical substances present in natural water is carbamazepine, a drug given to persons suffering from epilepsies or pain in their cerebral nervous system, and eliminated intact by the kidneys through sewage systems into rivers. This substance may affect macroinvertebrates and vertebrates depending on watercourses. We thus studied its physiological and ethological effects on ants used as biological models. Carbamazepine decreased the ants’ speed of locomotion, increasing so their sinuosity of movement. It decreased the precision of their reaction, their ‘audacity’, their research activity for food, their cognitive ability in navigating through chicanes, and slightly reduced their olfactory perception. It did not impact their response to pheromones, their brood caring behavior, and their visual perception. It somewhat reduced their tactile perception, induced aggressiveness between congeners while slightly reducing that towards aliens. Carbamazepine largely increased the ants’ ability in acquiring visual and olfactory conditioning, as well as their visual and olfactory memory. Ants never developed dependence on, or habituation to, that drug consumption. After its consumption ended, the effects of carbamazepine vanished in 20 hrs (for the linear speed), 26 hrs (for the sinuosity), and 32 hrs (for the orientation towards an alarm signal). These different physiological and ethological effects, revealed on ants, may occur for persons consuming that drug, and for living organisms depending on natural water contaminated by that drug. Attention should so be paid, as for these effects, to persons cared of with carbamazepine, and improved systems of depuration should be set up for eliminating that drug (as well as several other pharmaceutical pollutant substances) from the (yet not sufficiently) treated waste waters.

In the commercial dairy industry worldwide, it is common practice to periodically regroup cows as part of their management strategy within housed systems. While this animal husbandry practice is intended to improve management efficiency, cows may experience social stress as a result of the social environment changes, which may have an impact on their behavioural patterns, performance, and welfare. We investigated whether regrouping altered dairy cows' behaviour and impacted their cortisol concentration (a physiological marker of stress), oxytocin, milk yield, and quality in a robotic milking system. Fifty-two lactating cows (17 primiparous; 35 multiparous) were moved in groups of 3-5 individuals into established pens of approximately 100 cows. Behaviour of the regrouped cows was directly observed continuously for 4 h/day across 4-time blocks (day-prior (d-1), day-of regrouping (d0), day-after (d + 1), and 6-days after (d + 6) regrouping). Cows were categorised as being with others, alone, or feeding every 2.5 min prior to the assessment of behavioural dynamics. Milk yield (MY) and composition, total daily activity, and rumination time (RUM) data were extracted from the Lely T4C management program (Lely Industries, Maassluis, the Netherlands), and milk samples were collected for cortisol and oxytocin concentration analyses; data were analysed using linear mixed-effect modelling. Primiparous cows were less likely to be interacting with others on d + 1 than d-1 compared with multiparous. However, average bout duration (minutes) between being alone and feeding activity states were similar on d-1, d + 1, and d + 6, for both primiparous and multiparous cows. A reduction in the average alone and feeding bout duration was observed on d0. Multiparous cows spent significantly more total time being alone on d0 compared to d-1. Neither regrouping nor parity statistically influenced milk DM content, energy, or cortisol concentration. Primiparous cows produced 3.80 ± 2.42 kg (12.2%) less MY on d + 1 compared to their d-1, whereas multiparous cows did not change MY. A significant decrease of 0.2% fat was found in both parity groups following regrouping and remained low up to d + 6. Daily activity in both parity groups increased significantly and RUM reduced after regrouping. A significant decrease in oxytocin concentration was observed in all cows on d + 1. The results, specifically for primiparous cows, indicated a negative impact of regrouping on social interactions, due to changes in the social environment which may lead to short-term social instability. Multiparous cows may benefit from previous regrouping experiences.

Strong individual variation was observed in the responses of Black-legged Kittiwakes Rissa tridactyla to environmental covariates related to foraging behaviour and habitat selection, and in the overlap with nearby offshore windfarms (OWFs).

A Novel Example of Reversible Ring Opening: The Epimerization at C(3) of Sugar 3‐Hydroxy‐Δ 1 ‐pyrazolines Reaction of 1 (either geometrical isomer) with hydrazine followed by in situ Ag 2 O oxidation led to two pairs of interconverting isomers 4 ⇄ 5 and 6 ⇄ 7 . By the same treatment, (Z)‐ 10 and (or) ( E )‐ 10 gave the pair 11 ⇄ 12 . Acetylation of 4 ⇄ 5 led to a non interconverting mixture of 8 and 9 . This fact, and the lack of incorporation of 18 O when the epimerization took place in the presence of H 2 18 O indicated that the most probable mechanism consisted in a reversible ring opening ( D ⇄ E ⇄ F ). The kinetic parameters of these reactions are given and structural assignments proposed for the new compounds.

Clinicians will argue that cancer can only really receive the treatment that is needed through thorough understanding of medicine. However, even empirical approaches to therapy result in experimental analysis of the agencies involved on test cells, usually in culture. From the obverse perspective, cell biologists will argue that until we fully understand cell cycle regulation, tumour management will be too imprecise to make the best advances. A forum is needed whereby the fundamental studies on cells prior to, during and after transformation in vitro can be freely reported (open access) and discussed. The action of anticancer agents and cancer preventative substances can more easily be studied in vitro before the often excessive complexity of making similar studies in experimental and human cancers is tackled. Cancer Cell International is committed to providing such a forum. Ironically within a few months of launching this open access journal, Elsevier had much the same idea, and there one has to pay for the privilege of downloading vital papers in this biomedical field.

OBJECTIVE: The objective of this study was to assess the effectiveness of extracorporeal shock wave therapy (ESWT) in the treatment of chronic adhesive capsulitis (AC) in the type 2 diabetes population. DESIGN: This study is a systematic review with meta-analysis. The search was conducted in MEDLINE, EMBASE, CINAHL, PEDro, Cochrane Database of Systematic Reviews, UK Clinical Trial Gateway and gray literature from 2012 to 2023. Two reviewers independently screened and extracted data through Covidence and the quality was evaluated using Cochrane risk-of-bias tool for randomized trials. Meta-analyses were conducted to quantify within-group change and comparative effectiveness. Five hundred and seventy-four studies were identified, and 7 studies included (n = 352 participants). PARTICIPANTS: This study included type 2 diabetic adults (>18 years) diagnosed with primary or secondary AC. INTERVENTIONS: This review and meta-analysis included studies comparing ESWT with conservative management. MAIN OUTCOMES: The primary outcome was pain. Secondary outcomes included range of movement (ROM) and disability. RESULTS: Meta-analysis using Bayesian method of within group change showed consistent improvement for pain (-5.7 [95% credible interval (CrI) = -7 to -4.5] cm), ROM (2.6 [95% CrI = 1.4 - 3.8]), and disability (3.6 [95% CrI = 2.3-4.9]). Consistent evidence of improvements favoring ESWT over conservative management was identified for all outcomes. Study heterogeneity had limited influence on non-controlled effect sizes, whereas limited controlled effect sizes lowered the confidence for outcomes of ROM and disability. Limitations included low number of studies, poor methodological quality, and non-adherence to reporting guidelines. CONCLUSIONS: Extracorporeal shock wave therapy for treatment of AC was shown to reduce pain and improve range of motion and disability in the type 2 diabetes population. These results should be interpreted with caution and high-quality randomized controlled studies are required to establish best-practice ESWT protocols regarding application position, dosage, and duration. RELEVANCE: Extracorporeal shock wave therapy may improve pain, ROM, and disability in type 2 diabetics with AC.

L'urbanisation croissante du domaine ctier et les changements de climat attendus et les effets induits, comme par exemple, l'lvation du niveau de la mer, la probabilit de l'intrusion d'eau sale, l'augmentation des orages et des temptes etc., et leur interaction avec la population humaine sont susceptibles de dgrader l'environnement de manire complexe. Afin d'avoir un plan efficace de lutte et de rduction du risque, il faut laborer un plan de surveillance adquat qui soit possible et conomique. L'utilisation des technologies de pntration au cne (CPT) offre de telles possibilits. L'essai de pntration au cne a fait beaucoup de progrs durant les dernires quinze annes et les interprtations des rsultats obtenus qui en dcoulent sont bases sur des principes bien tablis. L'incorporation des techniques gophysiques dans les technologies CPT ouvre une nouvelle voie pour caractriser les conditions du sous-sol dans le domaine ctier. Dans cet article, les auteurs passent en revue certaines de ces technologies pour dlimiter et dterminer les caractristiques du sol. Deux tudes de cas sont prsentes. D'une part, on compare les performances de l'instrumentation classique d'un forage avec celles que permet le pntromtre au cne et d'autre part, on value l'apport de la fluorescence induite par laser utilisant les technologies CPT pour dtailler entre autres la concentration en hydrocarbures polyaromatiques (HAP) dans les sdiments de portuaires.

The axe illustrated on PI.LV, 4 was found about a century ago in Loch Kinord, near

On s'attend ce que le niveau de la mer relatif monte entre 0.09 m 0.88 m avec le changement de climat prvu. Par consquent, l'environnement ctier sera svrement affect. Avec l'extension dmesure des rgions ctires, il est important que les acteurs politiques et les amnageurs du littoral comprennent ces changements pour les incorporer aux futurs plans de dveloppement du secteur ctier. Une tude de cas comme celle de Rochefort, dans le secteur de delta de Rhne est prsente.