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Background: Electronic health (eHealth) services could provide a solution for monitoring the blood pressure of at-risk patients while also decreasing expensive doctor visits. However, a major barrier to their implementation is the lack of integration into organizations., Objective: Our aim was to design a Care Pathway for monitoring the blood pressure of at-risk patients, in order to increase eHealth implementation in secondary preventive care., Methods: A qualitative design study was used in this research. Data were collected by conducting visual mapping sessions including semistructured interviews with hypertension patients and doctors. The data were transcribed and coded and thereafter mapped into a Care Pathway., Results: Four themes emerged from the results: (1) the current approach to blood pressure measuring has disadvantages, (2) risk and lifestyle factors of blood pressure measuring need to be considered, (3) there are certain influences of the at-home context on measuring blood pressure, and (4) new touchpoints between patients and health professionals need to be designed. These in-depth insights combined with the visualization of the current blood pressure process resulted in our Care Pathway design for monitoring the blood pressure of at-risk patients as secondary preventive care., Conclusions: The Care Pathway guides the implementation of eHealth devices for blood pressure self-measurement. It showcases the pathway of at-risk patients and increases their involvement in managing their blood pressure. It serves as a basis for a new service using eHealth., (©Carlijn Geerse, Cher van Slobbe, Edda van Triet, Lianne Simonse. Originally published in JMIR Cardio (http://cardio.jmir.org), 03.05.2019.)

1. A study with growing chicks investigated the effects of an inclusion of an endo-xylanase preparation (LYXASAN) to a wheat- and rye-based diet on performance and nutrient digestibility in relation to the fat source. 2. The basal diet contained 500 g wheat and 100 g rye/kg of diet. The basal diet was supplemented with either 65 g soya oil/kg or 60 g blended animal fat and 5 g soya oil/kg. 3. Endo-xylanase added to the soya oil diet did not affect weight gain, but there was a numerical improvement in food conversion efficiency which was not statistically significant. When the endo-xylanase preparation was added to the blended animal fat diet, both weight gain and food utilisation were improved by 9.5% and 6.0%, respectively (P < 0.05). 4. Digestibilities of organic matter, crude fat, crude fibre and NFE were not significantly affected by adding endo-xylanase to the soya oil diet. However, when endo-xylanase was included in the blended animal fat diet, digestibility of organic matter, crude fat, crude fibre and NFE were improved (P < 0.05). The improvement in fat digestibility was the most pronounced, amounting to 9.4%. Nitrogen retention and metabolisable energy content were improved significantly by the addition of an endo-xylanase to the animal fat diet (P < 0.05), by 6.6% and 6.5% respectively. 5. From the results of this study, it can be concluded that the effects on chick performance and nutrient digestibility of a dietary endo-xylanase in a wheat- and rye-based diet are influenced to a considerable degree by the type of fat in the diet.

Twelve crossbred sows were used in an energy balance study to estimate energetic efficiency of milk production from feed. Balances were made from 7 to 14 d and from 18 to 25 d of lactation. Two feeding levels were applied (high and low). The low level (L) was meant to supply energy slightly above maintenance, with energy needed for milk to be derived from body reserves. The high level (H) was meant to supply sufficient energy for maintenance and for milk production. The low-level animals received 2.5 to 2.6 kg of feed/d and the high level animals 4.8 to 6 kg/d. The loss of weight of sows during lactation depended more on feeding level than on stage of lactation. A high level of feeding to sows resulted in heavier piglets compared with the low feeding level (significant after 10 d). At 24 d of age piglets with the high-feeding-level sows weighed 7.5 kg and those with the low-level sows, 5.7 kg. At the high level, animals excreted 1,200 to 2,800 kcal more milk energy per day than the low-level animals. Energy for milk from feed was produced with an efficiency of 67 to 69% with a maintenance requirement of 112 to 125 kcal metabolizable energy (ME) X W-.75 X d-1. Efficiency of milk production from feed was calculated as 62% and the maintenance requirement was 68 kcal. In this calculation, milk was corrected toward zero energy balance. Another way of calculating this efficiency after correcting feed toward zero energy balance resulted in estimates of 68% for efficiency and of 88 kcal ME X W-.75 X d-1 for maintenance requirement. From these data it was derived that, for each piglet, the sow needed to receive .5 to .6 kg of extra feed (ME content 3,000 kcal/kg) per day to cover milk production. Level of metabolic rate for nursing piglets was estimated as 97 kcal ME X W-.75 X d-1 for maintenance and, in addition, .195 kcal/kcal extra of milk intake above maintenance.