Background As older adults approach the end‐of‐life (EOL), many are faced with complex decisions including whether to use medical advances to prolong life. Limited information exists on the priorities of older adults at the EOL. Objective This study aimed to explore patient and family experiences and identify factors deemed important to quality EOL care. Method A descriptive qualitative study involving three focus group discussions (n = 18) and six in‐depth interviews with older adults suffering from either a terminal condition and/or caregivers were conducted in NSW, Australia. Data were analysed thematically. Results Seven major themes were identified as follows: quality as a priority, sense of control, life on hold, need for health system support, being at home, talking about death and competent and caring health professionals. An underpinning priority throughout the seven themes was knowing and adhering to patient's wishes. Conclusion Our study highlights that to better adhere to EOL patient's wishes a reorganization of care needs is required. The readiness of the health system to cater for this expectation is questionable as real choices may not be available in acute hospital settings. With an ageing population, a reorganization of care which influences the way we manage terminal patients is required.
Organometallic copper, consisting of a mixture of copper abietate, copper linoleate, and copper oleate (CuALO), is important for postbloom management of bacterial spot in New Jersey peach and nectarine orchards. Rotation of CuALO with oxytetracycline reduces cost and helps prevent (or delay) resistant organisms. However, because copper is also phytotoxic, higher rates and inorganic coppers have not been utilized. A study was conducted on ‘Encore’ peach and ‘Redgold’ nectarine to determine the quantitative relationship between copper concentration (metallic equivalent) and phytotoxicity. Different rates of CuALO and copper hydroxide (CuOH) were applied seven times postbloom. Foliar injury and defoliation increased with number of applications and copper concentration. Maximum ‘Encore’ defoliation was 10 to 17%, while ‘Redgold’ sustained 30 to 35% leaf loss. CuOH caused similar or less leaf injury and defoliation than CuALO. No injury was observed on fruit, even at three times the labeled metallic copper rate of CuALO. Fruit size and soluble solids were not influenced by copper. Estimates of foliar density and tree volume indicated that sufficient photosynthetic capacity existed to allow acceptable leaf damage and loss from copper applications. These results showed that inorganic coppers may be viable alternatives to organometallic copper for postbloom bacterial spot control; nectarine may be more sensitive to copper injury than peach; and higher rates of metallic copper, above the current commercial rate, can be applied to peach. In the latter case, greater amounts of copper may provide longer residual activity and improved bacterial spot control on highly susceptible cultivars.
The production of conidia by Fusicladium carpophilum on twig lesions was quantitatively modeled as a function of temperature and duration of high relative humidity. During peak sporulation periods in 2007, 2008, and 2009, 1-year-old twigs bearing abundant overwintering lesions were removed from a heavily infected 'Redgold' nectarine orchard, placed in trays at high relative humidity (>95%), and incubated at eight constant temperatures for seven durations, resulting in a factorial design of 56 treatment combinations. Conidia numbers were estimated with a hemacytometer. Results from a six-stage modeling process indicated that, at any given temperature, spore production during high relative humidity periods increased in a monomolecular- to Gompertz-like pattern. The Richards model, with shape parameters of 0.79 to 0.90, was found to provide the best overall fit. When the asymptote and rate parameters were derived as functions of temperature using Gaussian and quadratic models, respectively, the duration of high relative humidity and temperature described 90 to 94% of the variation in conidia production. Predictions of the final models were highly correlated with observed levels of sporulation (r > 0.94; P < 0.0001), indicating an excellent fit to the data. The optimum temperature for sporulation, based on fitting a Gaussian model to the maximum sporulation levels at each temperature, was 17.9 to 20.2°C, with an overall average of 18.8°C. The derived models give a quantitative description of sporulation by F. carpophilum and may have potential use in simulators and forecasting systems.
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