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A pen feeding study was carried out over 70 days to determine the effects of monensin (M) inclusion in two commercial supplements designed to provide different planes of nutrition to recently weaned steers. Thirty Bos indicus crossbred steers (191.4 ± s.d. 7.1 kg) were individually fed a low quality pangola grass hay (57 g crude protein/kg DM; 497 g/kg DM digestibility) ad libitum (Control) with either a urea/molasses-based supplement of Rumevite Maxi-graze 60 Block (B), fed at 100 g/day, or grain-based Rumevite Weaner Pellets (WP), fed at 7.5 g/kg liveweight (W).day, both with and without M, viz. B, B+M, WP and WP+M, respectively. There were no significant interactions between supplement type and M inclusion for any measurement. Growth rates (main effects) averaged 0.17, 0.35 and 0.58 kg/day for the Control, B and WP supplements, respectively, with all means different (P < 0.05), while the response (P < 0.05) to M across supplement type was 0.11 kg/day. Hay DM intake was similar for the Control and B treatments (18.6 and 19.6 g/kg W.day) but was reduced (P < 0.05) with the WP supplement (16.8 g/kg W.day) while corresponding total DM intakes increased from 18.6 to 20.0 to 23.5 g/kg W.day (all differences P < 0.05), respectively. Monensin inclusion in the supplements did not affect supplement, hay or total DM intake. Inclusion of M in supplements for grazing weaners in northern Australia may increase survival rates although the effect of M with cattle at liveweight maintenance or below requires further investigation. Poor dry season nutrition coupled with diseases such as coccidiosis leads to reduced survival of young cattle in northern Australia. A pen feeding experiment carried out to determine the effect of dietary monensin inclusion showed a growth response of about 0.1 kg/day in steers fed supplements promoting either a low or medium plane of nutrition. Monensin has a key role in improving the nutrition and welfare of young grazing cattle. [ABSTRACT FROM AUTHOR]

BACKGROUND: Heart Failure Management Programs (HFMPs) have proven to be cost-effective in minimising recurrent hospitalisations, morbidity and mortality. However, variability between the programs exists which could translate into variable health outcomes. OBJECTIVE: To survey the characteristics of HFMPs throughout Australia and to identify potential heterogeneity in their organisation and structure. METHOD: Thirty-nine post-discharge HFMPs were identified from a systematic search of the Australian health-care system in 2002. A comprehensive 19-item questionnaire specifically examining characteristics of HFMPs was sent to co-ordinators of identified programs in early 2003. RESULTS: All participants responded with six institutions (15%) indicating that their HFMP had ceased operations due to a lack of funding. The survey revealed an uneven distribution of the 33 active HFMPs operating throughout Australia. Overall, 4450 post-discharge HF patients (median: 74; IQR: 24-147) were managed via these programs, representing only 11% of the potential caseload for an Australia-wide network of HFMPs. Heterogeneity of these programs existed in respect to the model of care applied within the program (70% applied a home-based program and 18% a specialist HF clinic) and applied interventions (30% of programs had no discharge criteria and 45% of programs prevented nurses administering/titrating medications). Sustained funding was available to only 52% of the active HFMPs. CONCLUSION: Inequity of access to HFMPs in Australia is evident in relation to locality and high service demand, further complicated by inadequate funding. Heterogeneity between these programs is substantial. The development of national benchmarks for evidence-based HFMPs is required to address program variability and funding issues to realise their potential to improve health outcomes. [ABSTRACT FROM AUTHOR]

Context: High international demand for goat meat and high prices for goat in Australia have resulted in a transition from opportunistic harvesting to more managed production systems for Rangeland goats. There is limited information available to establish feeding strategies to maximise growth rates of Rangeland goats within these developing managed production systems. Aims: The aim of these experiments was to determine the response to supplements and the metabolisable energy requirements for maintenance and liveweight gain of young entire male Rangeland goats. Methods: Dose–response relationships to various supplements were established in two experiments with young entire male Rangeland goats. In Experiment 1, 54 goats were allocated to rolled-wheat grain, rolled-sorghum grain, or lucerne pellet supplements offered from 0 (control) to 24 g dry matter/kg liveweight.day. In Experiment 2, 24 goats were allocated to a commercial starch-based pellet offered from 0 (control) to ad libitum. In both experiments, goats were held in individual pens and offered their daily supplement allowances with ad libitum access to Mitchell grass hay and drinking water for 70 days. Key results: Total intake (30 to 32 g dry matter/kg liveweight.day) increased in a linear fashion with an increasing intake of all supplements. Maximum intake of rolled-wheat, rolled-sorghum, lucerne pellets and the commercial starch-based pellet supplements ranged from 18 to 22 g dry matter/kg liveweight.day. Unsupplemented goats lost liveweight (−20 to −32 g/day), while supplemented goats gained liveweight (0 to 126 g/day) in a linear fashion with an increasing supplement and metabolisable energy intake for all supplements, with the highest response in goats supplemented with the commercial starch-based pellets. Estimated metabolisable energy requirements to maintain liveweight (372 kJ/kg liveweight0.75.day) and for liveweight gain (35 kJ/g) of the goats were the same in both experiments. Conclusion: Liveweight gain increased in a linear fashion with metabolisable energy intake, with the maximum rates of liveweight gain occurring when starch-based supplement intake was approximately 20 g dry matter/kg liveweight.day. Implications: Supplementation with starch-based rations will increase liveweight gain and decrease age at turn-off of young entire male Rangeland goats; however, the local availability and cost of these supplements need to be considered. High prices for goats in Australia due to high international demand has resulted in a transition from opportunistic harvesting to more managed production systems for Rangeland goats. There is limited information available to establish feeding strategies to maximise growth rates of goats within these managed production systems. The present paper demonstrates that the highest rates of liveweight gain of young male Rangeland goats is when they are offered a high energy supplement. [ABSTRACT FROM AUTHOR]

Introduction: Acute kidney injury (AKI) requiring treatment with renal replacement therapy (RRT) is a common complication after admission to an intensive care unit (ICU) and is associated with significant morbidity and mortality. However, the prevalence of RRT use and the associated outcomes in critically patients across the globe are not well described. Therefore, we describe the epidemiology and outcomes of patients receiving RRT for AKI in ICUs across several large health system jurisdictions., Methods: Retrospective cohort analysis using nationally representative and comparable databases from seven health jurisdictions in Australia, Brazil, Canada, Denmark, New Zealand, Scotland, and the USA between 2006 and 2023, depending on data availability of each dataset. Patients with a history of end-stage kidney disease receiving chronic RRT and patients with a history of renal transplant were excluded., Results: A total of 4,104,480 patients in the ICU cohort and 3,520,516 patients in the mechanical ventilation cohort were included. Overall, 156,403 (3.8%) patients in the ICU cohort and 240,824 (6.8%) patients in the mechanical ventilation cohort were treated with RRT for AKI. In the ICU cohort, the proportion of patients treated with RRT was lowest in Australia and Brazil (3.3%) and highest in Scotland (9.2%). The in-hospital mortality for critically ill patients treated with RRT was almost fourfold higher (57.1%) than those not receiving RRT (16.8%). The mortality of patients treated with RRT varied across the health jurisdictions from 37 to 65%., Conclusion: The outcomes of patients who receive RRT in ICUs throughout the world vary widely. Our research suggests that differences in access to and provision of this therapy are contributing factors., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Background: Hosting social work placements within general practice can provide opportunities to extend interdisciplinary skills, increase the ability to meet patient needs and improve understanding of social work as a discipline., Objective: This paper is based on an Australian pilot project involving social work students being placed in general practice for their 500-hour placements. Collaboratively written by academics and practitioners from social work and general practice, it provides key strategies guiding practices to optimise implementing social work student placements. It identifies strategies to design the placement, select students and to prepare practices, supervisors and students to benefit student learning and the general practice., Discussion: Preparing key stakeholders, providing targeted supervision, longer appointments for social work students and involving all stakeholders are key strategies to successfully facilitate social work placements in general practice. Hosting social work students effectively can further develop multidisciplinary practice, connecting general practices even more with best practice, research and community.

Objective: To compare the location and accessibility of current Australian chronic heart failure (CHF) management programs and general practice services with the probable distribution of the population with CHF., Design and Setting: Data on the prevalence and distribution of the CHF population throughout Australia, and the locations of CHF management programs and general practice services from 1 January 2004 to 31 December 2005 were analysed using geographic information systems (GIS) technology., Outcome Measures: Distance of populations with CHF to CHF management programs and general practice services., Results: The highest prevalence of CHF (20.3-79.8 per 1000 population) occurred in areas with high concentrations of people over 65 years of age and in areas with higher proportions of Indigenous people. Five thousand CHF patients (8%) discharged from hospital in 2004-2005 were managed in one of the 62 identified CHF management programs. There were no CHF management programs in the Northern Territory or Tasmania. Only four CHF management programs were located outside major cities, with a total case load of 80 patients (0.7%). The mean distance from any Australian population centre to the nearest CHF management program was 332 km (median, 163 km; range, 0.15-3246 km). In rural areas, where the burden of CHF management falls upon general practitioners, the mean distance to general practice services was 37 km (median, 20 km; range, 0-656 km)., Conclusion: There is an inequity in the provision of CHF management programs to rural Australians.

Introduction: Chronic heart failure (CHF) develops in frail elderly individuals who have suffered an acute or sustained insult to the structural efficiency of the heart due to the presence of underlying heart disease and/or hypertension. It is also more common in individuals with disproportionately high levels of cardiac disease or its risk factors, for example lower socioeconomic status. As such, this epidemic is particularly significant for older people, males and Aboriginal people; groups who comprise a greater proportion of the population in rural and remote Australia. The aim of this study is to determine if the rates of CHF differ between urban and rural Australia., Method: CHF prevalence rates derived from well validated international CHF prevalence data were applied to the Australian Bureau of Statistics Census data for 2001 and weighted to reflect the proportion of Aboriginal people in each geographical stratum., Results: Australia wide, the estimated prevalence of CHF was 17.87 per 1000, ranging from 13.98/1000 in the Australian Capital Territory to 29.50/1000 in rural Northern Territory. Overall, CHF was more prevalent in rural and remote regions (19.84/1000) and large urban centres (19.01/1000) than in capital cities (16.94/1000) (p<0.001). High prevalence rates were also noted in the idyllic rural locations favoured by retirees. In Victoria, Western Australia, South Australia and the Australian Capital Territory over 70% of the estimated individual cases were located in capital cities. In New South Wales, Queensland, Tasmania and the Northern Territory the highest proportion of cases occurred outside capital cities., Conclusion: The main significance of these findings is that while a majority of heart failure may occur among people living in cities (because that is where most people live), a disproportionate number of cases occur among people living outside these cities (due to age and other socio-demographic risk factors) where services may be fewer and less accessible.