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Context: Low-protein tropical forages required protein supplementation, which might affect growth of meat goats. Aims: This study was aimed to compare liveweight gain, carcass/non-carcass yields and meat quality in crossbred Boer kids fed isonitrogenous diets varying in undegradable (UDP) and rumen-degradable (RDP) dietary protein sources. Methods: Twenty-five female crossbred Boer kids were randomly allocated into the following five dietary treatments: Rhodes grass (Chloris gayana) hay supplemented with urea (U), urea plus cottonseed meal (UCSM), cottonseed meal (CSM), gliricidia (Gliricidia sepium) (Gliri) or Desmanthus (Desmanthus leptophyllus) only (Desman). The diets were formulated to supply 135 and 195 g crude protein/kg DM for the two experiments. Experiment 1 lasted 78 days and the dietary UDP:RDP ratio (g/kg DM) was 35:102 (U), 37:100 (UCSM), 40:97 (CSM), 55:82 (Desman) and 46:91 (Gliri). Experiment 2 lasted 138 days and the dietary UDP:RDP ratio (g/kg DM) was 45:150 (U), 52:143 (UCSM), 58:137 (CSM), 83:112 (Desman) and 71:124 (Gliri) respectively. Data were subjected to one-way ANOVA and general linear model. Key results: After 138 days of supplementation, the Desman goats had the highest liveweight gain (83 g/day) and heaviest cold carcass weight (12.1 kg) in Experiment 2. This was followed, in descending order, by CSM (58 g/day and 9.6 kg), UCSM (48 g/day and 7.8 kg), Gliri (41 g/day and 7.6 kg) and U (6 g/day and 6.0 kg). Heavier carcass weight was associated with larger eye-muscle area and fat depth at the 12th rib. Aus-meat Beef Colour Standard scores of 3–4 for the eye muscle of the Desman and CSM goats compared with scores of 1C-2 in the other goats meant that the darker meat in Desman and CSM diets was associated with heavier carcass weight and a more rapid rate of decline in carcass pH. Conclusions: Crossbred Boer kids fed high dietary UDP had higher intakes of UDP, RDP, metabolisable protein (MP) and metabolisable energy (ME), even though an isonitrogenous diet was offered. The Desman kids had higher liveweight gain, heavier carcass yield, greater eye-muscle area, thicker fat depth and heavier mass of non-carcass components. Implications: The higher liveweight gain and carcass/non-carcass yields for Desman goats than for others was associated with increased DM, UDP, RDP, MP and ME intakes. Growth and carcass weight of meat goats on tropical pastures is determined by forage, and especially grass, quality. Supplementation of urea or cottonseed meal in Australian farms is common, but Desmanthus , as a shrub tropical legume that is rich in true protein, was also found to greatly increase bodyweight and yield heavier carcasses when fed to Boer goats. More work is required to identify alternate sources of true protein in tropical regions. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify barriers and mechanisms in the development of palliative care in the province of Aceh, North West Indonesia. Several factors, including an ageing population, have increased palliative care needs in the region; however, as with many low to middle income countries (LMICs), palliative care is not well established or integrated into mainstream health care services. Consequently, many people may experience serious health-related suffering (SHRS) at the end-of-life. Qualitative semi-structured interviews and focus groups were conducted with key stakeholders in Aceh, Indonesia and a semi-structured interview guide prompted an exploration of palliative care provision, including barriers and enablers. Interviews were digitally recorded, transcribed, and analysed using the principles of thematic analysis. Eight interviews and two focus groups were conducted with medics (n = 6), nurses (n = 7), hospital management (n = 1) and religious/cultural leaders (n = 2). The findings indicate that all participants recognise a need to reduce SHRS and a growing impetus to embed a culturally salient and sustainable model of palliative care within the Aceh healthcare system. The following four themes indicate key areas for further focus: (1) Local vision and leadership, (2) Prioritisation of palliative care policy and funding, (3) Access to palliative care in community and public services, and (4) supporting palliative care in the cultural context of Sharia law, family, and faith. Future expansion requires the identification of a culturally and socioeconomically salient package of palliative care which operates across rural community and acute care settings and is informed by further evaluation and evidence. [ABSTRACT FROM AUTHOR]

Background: Palliative care services seek to improve the wellbeing of family carers of people living with serious and life-limiting illness. To help achieve this goal, systematic reviews have recommended priority areas for family carer research and the need to improve the quality of study design. Policy makers have also advocated for enhanced family carer support. However, there are specific methodological considerations and challenges in designing and conducting carer research conducted during the course of the serious illness trajectory and in bereavement. Aim: To develop strategies to improve the design and conduct of research with family carers. Design: Expert elicitation study using an adapted version of the 'Identify, Discuss, Estimate and Aggregate' elicitation protocol, supplemented with strategies from peer-reviewed literature. Setting/participants: Nine members of the management committee of the European Association for Palliative Care's Reference group on family carer research, comprising international senior research academics in family caregiving. Results: A compilation of recommended strategies and checklist was created to: (a) help researchers plan research involving family carers focussing on: preparation, conduct and dissemination and (b) assist ethics committees and funding bodies to evaluate proposals. Conclusions: The strategies and checklist for conducting research with family carers may enhance methodologically rigorous research. Consequently, researchers, practitioners and policy makers will not only gain a more comprehensive understanding of the unmet needs of family carers but also promote the development of empirically sound interventions. [ABSTRACT FROM AUTHOR]