A narrative review of the epidemiology and economics of chronic wounds.

Chronic wounds have a debilitating effect on the quality of life of many individuals, and the large economic impact on health system budgets warrants greater attention in policy making and condition management than is currently evident. The aim of this narrative review is to summarize the nature and extent of the chronic wound problem that confronts health systems across the world. The first section is used to highlight the underlying epidemiology relating to chronic wounds, while the second explores the economic costs associated with them and the relative efficiency of measures designed to manage them.

Behavioral and endocrine responses to season and social dynamics of captive male southern hairy-nosed wombats (Lasiorhinus latifrons).

Although southern hairy-nosed wombats (SHN wombats; Lasiorhinus latifrons) rarely breed in captivity, further knowledge of their reproductive physiology and behavior is likely to improve their breeding potential. This study examined the effect of seasonal variation and changes in social dynamics on the physiology and behavior of a captive population of male SHN wombats (n = 6). Seasonal changes in urinary testosterone metabolites (UTM), urinary cortisol metabolites (UCM), qualitative estimates of spermatorrhoea (QS), aggressive behavior and reproductive behavior were measured over an 11-month period. While there was no effect of month on QS (GLM ANOVA, P = 0.27), reproductive behavior (GLM ANOVA, P = 0.19) or aggressive behavior (Tukey pairwise comparisons), the secretion of UTM (GLM ANOVA, P = 0.051) was only marginally affected by season, compared to that reported for wild male SHN wombats. Mean UCM concentrations of July and August 2016 were significantly higher than those between October 2015 and January 2016 (Tukey pairwise comparisons). To examine social dynamics, two trials of animal positioning exchange with the enclosure system were implemented and behavioral data were examined for each trial over a six week period; UTM, UCM and general behaviors (n = 27) were measured for each trial. Neither UTM nor UCM concentration varied significantly (P ≥ 0.45) before and after the exchanges. "Scratching" decreased at the group level following the animal exchange in both trials, suggesting reduction in self-grooming may be a behavioral response to novel stimuli. UCM and UTM concentrations were both positively correlated with "standing still" and "body rub" behaviors. This may be evidence of a hormonal control of a "freezing behavioral response" to external stimuli and marking behavior, respectively. As there was no evidence that changing the social dynamics affected reproductive or agonistic behavior or hormone concentrations, it was concluded that captive male wombats in this study showed reduced reproductive seasonality compared to wild wombats and that animal exchange resulted in a behavioral response to novel stimuli but was not sufficient to affect testosterone or cortisol secretion, within the context of our study.

Lateralization of behavior in dairy cows in response to conspecifics and novel persons.

The right brain hemisphere, connected to the left eye, coordinates fight and flight behaviors in a wide variety of vertebrate species. We investigated whether left eye vision predominates in dairy cows' interactions with other cows and humans, and whether dominance status affects the extent of visual lateralization. Although we found no overall lateralization of eye use to view other cows during interactions, cows that were submissive in an interaction were more likely to use their left eye to view a dominant animal. Both subordinate and older cows were more likely to use their left eye to view other cattle during interactions. Cows that predominantly used their left eye during aggressive interactions were more likely to use their left eye to view a person in unfamiliar clothing in the middle of a track by passing them on the right side. However, a person in familiar clothing was viewed predominantly with the right eye when they passed mainly on the left side. Cows predominantly using their left eyes in cow-to-cow interactions showed more overt responses to restraint in a crush compared with cows who predominantly used their right eyes during interactions (crush scores: left eye users 7.9, right eye users 6.4, standard error of the difference=0.72). Thus, interactions between 2 cows and between cows and people were visually lateralized, with losing and subordinate cows being more likely to use their left eyes to view winning and dominant cattle and unfamiliar humans.

Faecal cortisol metabolites, body temperature, and behaviour of beef cattle exposed to a heat load.

Feedlot cattle are at times exposed to high environmental temperatures. Faecal cortisol metabolites were related to possible indicators of heat stress that could be measured under field conditions: respiratory dynamics (respiration rate), body surface temperature and adaptive behaviours, such as water consumption, posture (standing, lying), and activity (eating, drinking and rumination). Twelve (12) yearling Black Angus steers were divided into two treatment groups: a hot treatment (HOT; n = 6) and a thermoneutral-treatment (TN; n = 6) and individually housed in a climate-controlled facility at The University of Queensland, Australia. In the TN treatment, all animals were exposed to an ambient temperature of 20.34 ± 0.25 °C, relative humidity 71.51 ± 3.26% and Temperature humidity index (THI) 66.91 ± 0.33 throughout. In the HOT treatment group, environmental conditions were exposed to different climatic phases from thermoneutral to hot conditions, where they remained for 7 d, and then returned to TN conditions in the recovery period. The dry bulb ambient temperature (TA) and relative humidity (RH) in the pens of cattle in the HOT treatment were increased from 28 °C (daily maximum ambient temperature) and 45% RH at 0700 h to a daily maximum TA and RH of 35 °C (daily maximum ambient temperature) and 50% (THI 77) at 1100 h, which was maintained until 1600 h, after which it declined until it reached the baseline at 2000 h. In both treatments, there was a significant decrease in faecal cortisol metabolite concentration from the start to the end of the experiments they adapted to the experimental facility. The concentration of faecal cortisol metabolites was greater in the HOT treatment, compared to the TN treatment during the heat exposure period, but there was no difference in the transition or recovery periods. Respiration rate was greater in the HOT treatment during heat exposure, and it increased with ambient dry bulb temperature above 26 °C, the latter being the upper critical temperature. Although positive correlations were detected between faecal cortisol metabolites and body surface temperature measurements, particularly the shoulder and rump, as well as standing time, panting score and drinking, a stepwise regression found that faecal cortisol metabolites were only significantly correlated with one variable, respiration rate. It is concluded that respiration rate is the best indicator of the stress induced by hot conditions for cattle.

A decision impact, decision conflict and economic assessment of routine Oncotype DX testing of 146 women with node-negative or pNImi, ER-positive breast cancer in the U.K.

BACKGROUND: Tumour gene expression analysis is useful in predicting adjuvant chemotherapy benefit in early breast cancer patients. This study aims to examine the implications of routine Oncotype DX testing in the U.K. METHODS: Women with oestrogen receptor positive (ER+), pNO or pN1mi breast cancer were assessed for adjuvant chemotherapy and subsequently offered Oncotype DX testing, with changes in chemotherapy decisions recorded. A subset of patients completed questionnaires about their uncertainties regarding chemotherapy decisions pre- and post-testing. All patients were asked to complete a diary of medical interactions over the next 6 months, from which economic data were extracted to model the cost-effectiveness of testing. RESULTS: Oncotype DX testing resulted in changes in chemotherapy decisions in 38 of 142 (26.8%) women, with 26 of 57 (45.6%) spared chemotherapy and 12 of 85 (14.1%) requiring chemotherapy when not initially recommended (9.9% reduction overall). Decision conflict analysis showed that Oncotype DX testing increased patients' confidence in treatment decision making. Economic analysis showed that routine Oncotype DX testing costs £6232 per quality-adjusted life year gained. CONCLUSION: Oncotype DX decreased chemotherapy use and increased confidence in treatment decision making in patients with ER+ early-stage breast cancer. Based on these findings, Oncotype DX is cost-effective in the UK setting.

Auditory laterality in a nocturnal, fossorial marsupial (Lasiorhinus latifrons) in response to bilateral stimuli.

Behavioural lateralisation is evident across most animal taxa, although few marsupial and no fossorial species have been studied. Twelve wombats (Lasiorhinus latifrons) were bilaterally presented with eight sounds from different contexts (threat, neutral, food) to test for auditory laterality. Head turns were recorded prior to and immediately following sound presentation. Behaviour was recorded for 150 seconds after presentation. Although sound differentiation was evident by the amount of exploration, vigilance, and grooming performed after different sound types, this did not result in different patterns of head turn direction. Similarly, left-right proportions of head turns, walking events, and food approaches in the post-sound period were comparable across sound types. A comparison of head turns performed before and after sound showed a significant change in turn direction (χ(2) (1)=10.65, p=.001) from a left preference during the pre-sound period (mean 58% left head turns, CI 49-66%) to a right preference in the post-sound (mean 43% left head turns, CI 40-45%). This provides evidence of a right auditory bias in response to the presentation of the sound. This study therefore demonstrates that laterality is evident in southern hairy-nosed wombats in response to a sound stimulus, although side biases were not altered by sounds of varying context.

The influence of erosion sources on sediment-related water quality attributes.

Suspended fine sediment has a significant impact on freshwater quality variables such as visual clarity (VC). However, freshwater quality is related to the attributes of the catchment sources contributing fine sediment to the stream network. Here, the extent to which an array of sources defined spatially according to erosion process and geological parent material may be discriminated and classified based on sediment-related water quality (SRWQ) attributes that potentially affect VC was examined. Erosion sources were sampled across two New Zealand catchments representing six types of erosion and eight parent materials. Erosion source measurements focused on particle size, organic matter content, and light beam attenuation (which is convertible to VC). The source data were analysed to: 1) evaluate source variability using a combination of Kruskal-Wallis and principal component analysis; 2) reclassify sources using a Random Forest model; and 3) demonstrate how erosion source affects VC for a range of theoretical sediment concentrations (SC) using a simple empirical model. The results indicate that SRWQ attributes show significant variation across erosion sources. The extent to which attributes differed between sources often related to whether there was a strong association between a specific erosion process and parent material. The 19 a priori source classifications were reduced to 5 distinct sources that combined erosion process and parent material (i.e., bank erosion-alluvium; mass movement-ancient volcanics; mass movement-sedimentary; surficial erosion; gully-unconsolidated sandstone). At low SC, the impact of erosion source on VC became most evident ranging from 2.6 to 5.6 m at SC of 5 g m-3. These findings show how catchment sources of sediment, in addition to sediment concentration, influence VC, and highlight the need to consider quality as well as quantity of material supplied to stream networks when planning erosion control.

Impacts on work performance; what matters 6 months on?

BACKGROUND: Presenteeism often precedes and follows a period of work absence. Cross-sectional analysis of a workforce survey highlighted health, psychosocial and work characteristics as being particularly important in understanding current work performance, but it is unclear whether these variables predict future work performance. AIMS: To establish whether self-reported health, perceptions of work and objective characteristics of work measured at baseline can predict performance at 6 months follow-up. METHODS: Self-completed questionnaires to assess health, objective characteristics of work and perceptions of work were completed at two public sector organizations. Follow-up questionnaires were completed at 6 months to assess workplace performance using a visual analogue scale for self-rated performance and the Stanford Presenteeism Scale 6 (SPS6). RESULTS: Five hundred and five employees completed questionnaires at baseline and 310 (61%) of these completed follow-up questionnaires. Psychological distress as measured with the General Health Questionnaire and perceptions of work predicted both self-rated performance and SPS6 score. Objective characteristics of work were relatively unimportant in the prediction of future performance. CONCLUSIONS: This study has provided an initial indication of the factors that may predict performance at follow-up in the population studied. These findings may be used to generate hypotheses for future studies and highlights the need to assess a range of factors in relation to an individual's performance at work including health and perceptions of work.

Accumulation of ammonia and other potentially noxious gases on live export shipments from Australia to the Middle East.

Noxious gases on ships are irritant pollutants that have potential impacts on the comfort and health of both livestock and humans. Identification of environmental influences on the pollutants will assist live exporters to control them. Ammonia, hydrogen sulphide and carbon dioxide, as well as wet and dry bulb temperature, dew point, air speed and depth of faeces that the sheep stood in, were measured on two ship voyages in which sheep were transported from Australia to the Middle East. Daily measurements were made at 20 measurement locations over 12 days. At four sites, the mean ammonia concentration for the voyage was above the recommended maximum limit for the live export industry (25 ppm). The mean ammonia concentrations at the remaining 16 sites were below 18 ppm and considered safe. High ammonia concentrations were localised and occurred particularly on closed decks, as well as at the front of the vessel and near the engine block on open decks. Ammonia concentration on the open decks was correlated with cumulative wind during the voyage, air speed, dew point, wet bulb temperature and faecal pad depth, and on the closed decks with dew point, and wet and dry bulb temperature. Hydrogen sulphide (<1.8 ppm) and carbon dioxide (<1900 ppm) concentrations were low and did not pose a risk to animal or human welfare or health. The results suggest that high ammonia concentrations occur in those parts of the ship where there is insufficient ventilation and/or high temperatures and humidity.

Macronyssid mites in oral mucosa of long-nosed bats: occurrence and associated pathology.

Macronyssid mites (Radfordiella) have been found in the oral mucosa of the long-nosed bat (Leptonycteris nivalis), which occurs from Texas southward throughout much of Mexico. This is the first report of mites of the suborder Mesostigmata attached in the oral cavity of a mammal. Osteolysis of hard palate and odontolysis of teeth result from infestations of mites adjacent to the upper premolars and molars; destruction of bone, teeth, and Connective tissue often leads to exfoliation of teeth in life. Oral mites have not been found in Leptonycteris sanborni, a species in part sympatric with Leptonycteris nivalis.

The origin and foot condition of horses slaughtered in Australia for the human consumption market.

REASONS FOR PERFORMING STUDY: There are ethical concerns regarding the loss of horses from various equine industries and their corresponding slaughter. However, to date, no empirical evidence regarding the extent of this loss, nor of the condition of horses involved, exists within Australia. OBJECTIVES: To determine the approximate ages, brand type and condition of feet of horses relinquished to an export abattoir in Australia. METHOD: Data were collected from 340 horses processed at an Australian abattoir from November 2007-January 2008. Foot abnormalities, injuries and hoof indicators of overgrown and untrimmed hooves were assessed together with a dental inspection. Observations of brand were used to determine horse origin. RESULTS: The dental age of 60% of horses was 57 years, and 53% originated from the racing industry (40% Thoroughbred and 13% Standardbred). A total of 81% of the horses had overgrown or untrimmed hooves. Standardbred horses had fewer grass cracks and more injuries to the coronary band than Thoroughbreds, probably due to pacing and trotting activities. CONCLUSIONS: Just over half of the horses slaughtered at an Australian abattoir on 3 working days were aged (7 years and emanated from the racing industry. Foot problems were common. POTENTIAL RELEVANCE: Future research should identify means of reducing the number of horses slaughtered and preventative measures for foot disorders.

Climatic influences on the mortality of sheep during long-distance sea transport.

Research on the causes of sheep death in sea voyages from Australia to the Middle East is limited, in particular little is known about the influence of climatic factors. Mortality data from 417 shipments of sheep exported over an 11-year period (November 2004 to June 2015) were modelled retrospectively to determine associated climatic factors. The statistical analysis were performed for both the full data set with 417 voyages based on actual and estimated departure and arrival dates and a restricted data set with 71 voyages based on actual dates. The results of the full data set demonstrated a seasonal mortality pattern, with more deaths occurring on sea voyages leaving Australia in the southern hemisphere winter or spring than those departing in Australian summer or autumn. Heat stress and inadequate fat mobilisation for energy supply when sheep are inappetant on shipments may explain this seasonality. Based on these two models, the voyage and weather factors associated with sheep mortalities included departure year, autumn departure in the southern hemisphere, voyage duration, single or multiple loading port(s), weekly mean dry bulb temperature and wind speed at departure ports, and humidity at destination ports. Significant correlations were observed between weather variables at the departure ports in the Australian winter and a high sheep mortality rate during voyages. This, together with the anticipated increased heat stress risk as a result of climate change, suggests that there could be review of the trade from Australia in the southern hemisphere winter. The influence of weather at the departure ports should be considered in sheep mortality prediction models, especially Australia's heat stress risk assessment model.

Evaluation of biochemical and ultrasonographic measurements as indicators of undernutrition in cattle.

Body condition scoring (BCS) gives an indication of the nutritional status of an animal and it is thus an invaluable management tool in domestic livestock systems. It is, however, subjective. This study aimed at identifying biochemical indicators which could be objectively used as an indicator of undernutrition in ruminants. Blood samples were collected from 50 cattle with BCS < or =1 and from 50 cattle with BCS > or =2.5, using a 0-5 scale, and analysed for albumin, urea, creatinine, fructosamine, beta-hydroxybutyrate, non-esterified fatty acids, total serum protein and haematocrit. Rumpfat and ribfat thickness and marbling relative index were determined ultrasonographically in 15 of the low BCS group and 13 of the high BCS group. The laboratory measure with the best predictive ability for severe undernutrition was albumin, which correctly classified 94% of cattle, using a cut-off of 31.5 g/l. In contrast to a previous study, our study did not find the fructosamine:albumin ratio to be an accurate test to indicate undernutrition in cattle. Ultrasonic measurement of subcutaneous rumpfat and ribfat proved to reliably predict undernutrition, but may, however be impractical for routine use under most field conditions.

Real-world use of fidaxomicin in a large UK tertiary hospital: how effective is it for treating recurrent disease?

All courses of fidaxomicin use in the study hospital were reviewed. It was used for first recurrence (six times), second recurrence (eight times) and one case of third recurrence. One patients received fidaxomicin as first-line treatment. Eight patients initially responded to therapy; of these, three patients were asymptomatic at 90 days, three patients remained asymptomatic at 30 days, and two patients had recurrences five and nine days after stopping therapy. Four patients failed to respond; of these, two patients required faecal transplantation and one patient required a colectomy. Two patients deteriorated and two patients died. Fidaxomicin was well tolerated. These findings suggest that the utility of fidaxomicin at this stage of infection is unclear.

Two- or four-hour lying deprivation on the behavior of lactating dairy cows.

Cows are often temporarily deprived of the opportunity to lie down while waiting for veterinary or reproductive procedures. Sixty cows were deprived of the opportunity to lie down for 0, 2, or 4 h by confining them in pairs in a small indoor pen. Behavior was recorded during deprivation and for 40 h afterwards. In the first 2 and 4 h of the experiment, cows that were not deprived chose to lie down for 70 and 142 min, respectively. When cows were discouraged from lying, they regularly stomped their legs, repositioned themselves, but never lay down. In the 4-h treatment, both stomping and repositioning increased after the first hour. Butting and weight shifting (displacing weight from one side of the body to the other) increased during deprivation, indicating restlessness. Cows deprived for 4 h sniffed and rubbed their heads against the housing more than cows deprived for 0 or 2 h. Time spent feeding and standing without ruminating increased with the duration of deprivation, especially during the early stages; standing ruminating also increased in the final stages. After deprivation, feeding time decreased, which compensated for the increase during deprivation. By 40 h after deprivation, the lying-deprived cows had recovered approximately 40% of their lost lying time. Milk yield was not affected by lying deprivation. It is concluded that cows experience discomfort during short periods of lying deprivation, after which they recover some, but not all, of the lost lying time by rescheduling feeding and standing time.

The effectiveness of out-of-hours dental services: I. Pain relief and oral health outcome.

OBJECTIVE: To compare the effectiveness of four types of out-of-hours emergency dental service, including both 'walk-in' and telephone-access services. BASIC DESIGN: Questionnaire survey of patients attending weekend emergency dental services, with measurement of self-reported oral health status and dental pain (at attendance and follow-up) and retrospective judgements of change in oral health status. SETTING: Two health authorities in South Wales, UK. SUBJECTS: A total of 783 patients who completed questionnaires at attendance, and 423 who completed follow-up questionnaires. RESULTS: For patients who saw a dentist there were no consistent differences in the effectiveness of the four services, whether measured as pain relief, oral health gain or using patients' retrospective transition judgements about feeling better after their episode of emergency dental care. The proportion of patients reporting no improvement (transition judgements), either an hour after or the day after seeing the dentist, was surprisingly high (30-40% and 23-38% respectively). Although the 'rotas for all' - a telephone-access GDP-provided service for both registered and unregistered patients - achieved both the highest reductions in pain scores and the greatest improvements in dental health status between attendance and follow-up, this effect may reflect health gains due to care received after the episode of emergency dental care. CONCLUSIONS: Neither the setting where emergency dental patients are seen, nor the type of dentist who sees them, appear to have any significant effect on patient-reported health outcomes. Although further exploration of the factors that predict poor pain relief or low oral health gain is required, future research on these services should focus on the process of care and accessibility.

The effectiveness of out-of-hours dental services: II. patient satisfaction.

OBJECTIVE: To compare patients' satisfaction with four types of out-of-hours emergency dental service, including both 'walk-in' and telephone-access services. BASIC DESIGN: Postal questionnaire survey of patients who had attended weekend emergency dental services. Patient satisfaction measured using an adapted version of a questionnaire developed for assessing out-of-hours medical services. SETTING: Two health authorities in South Wales, UK. SUBJECTS: The 411 patients who saw a dentist and completed the patient satisfaction questionnaire. RESULTS: The quality of the dentist-patient encounter was similar across services, with most patients being satisfied with the dentist's attitude and manner, the explanations and advice given, and having to see an unfamiliar dentist. Satisfaction was lower, and differed more across services in relation to service accessibility and delays in getting to see a dentist out-of-hours. The walk-in services were perceived as the least accessible: around 40% said they had problems contacting a dentist when the surgery was closed (compared with 16% and 29% in the other two, telephone-access services). Only 12-14% of telephone-access patients said they would be 'happy with advice plus a reliable appointment when surgeries re-opened', whereas almost half of walk-in patients thought this. CONCLUSIONS: Despite overall satisfaction with the dentist-patient encounter, there was relative dissatisfaction with the accessibility of all services, especially the walk-in services. Out-of-hours dental services should be better designed to reflect patients' needs: the need for telephone advice as well as face-to-face consultations, and greater awareness that theoretically available services may be difficult to access unless public expectations and awareness are raised.

Ethical perspectives of the Australian live export trade.

OBJECTIVE: To examine the ethical perspectives of the Australian live export trade. DESIGN AND METHOD: The perspectives of farmers and other industry personnel, overseas consumers, the Australian public, veterinarians and the assumed interests of transported animals are compared in relation to the ethical consequences. Animal welfare, societal, personal and professional ethics are identified and the ratification of different perspectives considered. RESULTS AND CONCLUSIONS: There are positive and negative aspects of the trade for each stakeholder group, and the overall position adopted by any individual reflects their perspective of the balance of these components. The debate as to whether Australia should continue with the trade will be best served by consideration of the interests of all parties in the trade, including the consumers and animals, which are among the most affected by the trade. There is a need for further research to address the major welfare problems for the animals, an openness to inspection on the part of the trade and balance in media reporting.

Cost effectiveness analysis of using quantitative ultrasound as a selective pre-screen for bone densitometry.

It has been suggested that quantitative ultrasound (QUS) could be used as a selective population pre-screen, to maximise the cost effectiveness of referral for dual energy X-ray absorptiometry (DXA) assessment of bone mineral density (BMD). We set out to examine how such an approach might perform in the assessment of women who were referred by general practitioners for DXA via the open access service in Cardiff. In 115 women aged 40-80 (mean 69) years we used DXA to measure BMD at lumbar spine and hip, and QUS to measure broadband ultrasound attenuation (BUA) in the heel. A bottom-up approach was used to estimate the costs of DXA and QUS. We examined the cost effectiveness of using QUS as a pre-screen, only referring subjects for the more expensive DXA assessment if BUA were less than a pre-determined threshold. The unit costs of pencil-beam DXA and QUS were approximately 44 UK pounds and 16 UK pounds respectively. We identified a BUA threshold of 60 dB/MHz as the most cost effective, and calculated a sensitivity of 81% and specificity of 89% in identifying those subjects whom DXA assessment subsequently identified as having osteoporosis. At the BUA threshold of 60 dB/MHz, pre-screening saved 969 UK pounds at the expense of missing ten women with osteoporosis as diagnosed by DXA. Therefore the cost per additional woman with osteoporosis identified using DXA alone was only 97 UK pounds. QUS assessment does not appear to have a significant cost effective benefit as a pre-screen for DXA in the studied population. A QUS pre-screen would be cost effective only if this investigation could be performed at a substantially lower cost.

Physiological and behavioral responses of sheep to simulated sea transport motions.

The motion of ships can cause discomfort and stress in humans, but little is known about the impact on sheep welfare, despite many sheep traveling long distances by ship during live export. We tested whether exposing sheep to roll (side to side movement), heave (up and down movement), and pitch (front to back movement) with similar amplitude and period conditions to a commercial livestock transport vessel would affect their behavior and physiology. Specifically, we tested the effects of these motions and a control treatment on behavior, heart rate variability, rumination, body posture, and balance of sheep. Four sheep (37 ± 0.1 kg) were restrained in pairs in a crate, which was placed on a moveable and programmable platform that generated roll and pitch motions. An electric forklift was used to produce heave motion. The treatments were applied for 30 min each time in a changeover design with 1 repetition over 8 consecutive days. Sheep behavior was recorded continuously from video records, and heart rate monitors were attached to determine heart rate and its variability. Heave reduced the time that sheep spent ruminating, compared with the other 3 treatments ( < 0.001). The 2 sheep spent more time during heave with their heads 1 above the head of the other ( < 0.001) and looking toward their companion ( = 0.02), indicating greater affiliative behavior. Sheep spent more time during heave standing with their back supported on the crate ( = 0.006) and less time lying down ( = 0.01). Roll caused more stepping motions than pitch and control, indicating loss of balance ( < 0.001). Sheep experiencing heave and roll had increased heart rates and reduced interbeat intervals (IBI) compared to the control ( < 0.001). The IBI of sheep in the heave treatment had an increased ratio of low to high frequency duration ( = 0.01), indicating reduced parasympathetic control of stress responses. Therefore, there was both behavioral and physiological evidence that heave and roll caused stress, with sheep experiencing roll apparently coping better by regular posture changes and heave causing the sheep to seek the close presence of their companion.