Comparison between intrauterine application of an antibiotic and an herbal product to treat clinical endometritis in dairy cattle - A randomized multicentre field study.

Uterine diseases are main indications for antibiotic use in dairy cows. To test a non-antibiotic treatment option, we compared the effect of an intrauterine cephapirin (Metricure®; cefapirin benzathin 500 mg per dosis; CEPH) with an intrauterine applied herbal product (25 ml of EucaComp® PlantaVet containing alcoholic extracts of Calendula officinalis L., Mellissa officinalis L., Origanum majorana L. and Eucalyptus globulus Labill. (EUC)) on the clinical cure of endometritis. Examinations of 816 cows between 21 and 35 days after calving were performed and cases of clinical endometritis (n = 169) were included. Diagnosis based on a scoring system for vaginal discharge. Study animals were randomly assigned to one of two treatment groups and treated immediately. After excluding animals with incomplete datasets, 136 cows (EUC: n = 61; CEPH: n = 75) remained for the final analysis. In total, 64% (EUC: 61%, CEPH: 67%) of analysed endometritis cases were considered as clinically cured 14 ± 2 days after the first treatment, 15% stayed uncured after the application of a maximum of two consecutive treatments, leading to an overall clinical cure rate of 85% (EUC: 82%, CEPH: 88%). No statistically difference in clinical cure rates could be observed between both treatment groups nor 14 ± 2 days after the first treatment (p = 0.956) neither regarding the overall cure rate (p = 0.923). In conclusion, the clinical cure of dairy cows' endometritis after the intrauterine application of the herbal product was non-inferior to the intrauterine application of the antibiotic cephapirin. These results could contribute to reduce the antimicrobial use in the daily veterinary routine treatment of endometritis.

"Making change by shared doing": An examination of occupation in processes of social transformation in five case studies.

BACKGROUND: As social and health inequalities deepen around the world, scholarship in occupational therapy and occupational science has increasingly emphasised the role of occupation as a powerful tool in transformative processes. OBJECTIVE: To explore how opportunities for everyday doing together may contribute to processes of social transformation by identifying ways occupation is being taken up in socially-transformative practice. MATERIAL AND METHODS: A generic descriptive qualitative case study design was utilised in order to describe current practice examples and identify ways occupation was being taken up in five initiatives working towards social transformation located in Canada, Germany, South Africa and the United Kingdom. RESULTS: Focussing on the positioning of occupation within the initiatives, three themes were developed: The intentionality of the process, the nature of occupation within the initiatives, and the role of occupation within the processes of social transformation. CONCLUSIONS AND SIGNIFICANCE: Providing examples of agency on the micro level and of engagement with socioeconomic, political and cultural power structures at the societal level, this analysis raises important considerations in addressing how occupational therapy practice can move in socially responsive and transformative directions.

[Gait Training for Lower Limb Amputees - A Systematic Review Based on the Research Pyramid]. / Gangtraining nach Amputation der unteren Extremität ­ Ein systematisches Pyramiden-Review.

BACKGROUND: Lower extremity amputation patients have gait asymmetries which can lead to further complaints in other joints of the body. METHOD: Five relevant databases were systematically searched for studies about gait training methods among people with transtibial and transfemoral amputations, followed by an evaluation of the methodical power of the eight references. Subsequently, the studies were categorized into the evidence classes of the research pyramid. The aim was to give treatment recommendations for this patient group. RESULTS: All training methods show an improvement in gait parameters of the patients. In seven studies at least four different training forms are used within one training intervention. Therefore, a combination of different forms seems promising. A long-term statement among these methods could not be made. Due to the high variability in intervention methods and outcome parameters, an aggregation of data and meta-analyses were not possible. CONCLUSION: The Evidence-Based Amputee Rehabilitation Program provides a good basis for a standardized training method. It should be supplemented with functional dual-task training and education. In further research a specific duration and intensity of such a program needs to be investigated. On top of that further qualitative and observational research is needed to generate statements which optimize the gait training in the physiotherapeutic routine practice.

The emergence of physiotherapy in Germany from the mid-19th to the mid-20th centuries: A "female profession" concerned with movement in the health care arena.

Background: The history of physiotherapy in Germany dates back to the mid-nineteenth century, when German physicians discovered Swedish medical gymnastics as a therapeutic treatment modality. From the early 20th century onwards, physiotherapy slowly began to establish itself as a field of activity specifically for women of the middle classes who provided assistive services to medical doctors.Method: Extensive overview of published and unpublished research on the history of German physiotherapy as well as select primary sources from the 19th and 20th centuries. Additionally reference is made to historical research regarding the emergence of the physical culture and life reform movements, as well as on gender research regarding upper and middle class female employment opportunities in the social and health care sector. Findings: This study outlines the two leitmotifs of physiotherapy's incorporation into the medical sector (i.e. medicalisation) and its (self-)image as a "female profession" (i.e. feminisation) as two intertwined historical phenomena shaping the critical period when physiotherapy assumed its role as a health profession in Germany. These developments from the mid-19th to the mid-20th centuries resulted in the emergence of a "female profession" with a distinct focus on the role of movement as a treatment modality.Discussion: Critical engagement with a handed down professional self-image is needed. On the basis of my historiographical overview, I suggest a future research agenda which would result in a more appropriate understanding of early physiotherapists in Germany as historical agents.

Effects of a Multicomponent Herbal Extract on the Course of Subclinical Ketosis in Dairy Cows - a Blinded Placebo-controlled Field-study.

A blinded placebo-controlled multi-center on-farm trial was conducted in dairy cows with subclinical ketosis to investigate effects of a multicomponent herbal extract. Blood ketone levels were measured weekly in early lactating cows from 16 Swiss herds. Cows were subclassified based on their initial blood-ß-hydroxybutyrate levels (≥ 1.0 [KET-low, 84 cows] and > 1.2 mmol/L [KET-high, 39 cows]) and randomly distributed to 3 groups treated orally with herbal extract containing Camellia sinensis, Cichcorium intybus, Gentiana lutea, Glycyrrhiza glabra, Taraxacum officinale, Trigonella foenum-graecum, and Zingiber officinale, sodium propionate, or placebo twice a day for 5 days. Milk yield, milk acetone, blood-ß-hydroxybutyrate, glucose, nonesterified fatty acids, gamma-glutamyl transferase, and glutamate dehydrogenase were analyzed over 2 wk. Linear mixed effect models were used for data analysis. No effects were found for nonesterifed fatty acids, gamma-glutamyl transferase, and glucose. Significantly higher glutamate dehydrogenase (29.71 U/L) values were found in herbal extract-treated animals compared to sodium propionate on day 7 (22.33 U/L). By trend, higher blood-ß-hydroxybutyrate levels (1.36 mmol/L) were found in the placebo group of KET-high-cows on day 14 compared to the sodium propionate group (0.91 mmol/L). Milk yields of all treatment groups increased. Milking time and treatment showed a significant interaction for milk acetone: sodium propionate led to an immediate decrease, whereas herbal extracts resulted in a milk acetone decrease from day 7 on, reaching significantly lower milk acetone on day 14 (3.17 mg/L) when compared to placebo (4.89 mg/L). In conclusion, herbal extracts and sodium propionate are both likely to improve subclinical ketosis in dairy cows, however, by different modes of action.

A multicomponent herbal feed additive improves somatic cell counts in dairy cows - a two stage, multicentre, placebo-controlled long-term on-farm trial.

In contrast to natural and historical diets of wild and domesticated ruminants, the diversity of plant species is limited in diets of modern dairy cows. Are "production diseases" linked to this? We conducted a trial to test the effects of a multicomponent herbal feed additive (HFA) on health, performance and fertility traits. A dose-finding study (DF) with 62 cows on 11 commercial farms compared a low (50 g) and a high (100 g) dose of HFA (HFA-50, HFA-100) with a placebo (PL). In a subsequent field trial (FT) with 280 cows on 30 commercial farms, HFA-100 was compared to PL. Cows were randomly assigned to HFA and PL groups and received HFA or PL individually daily from 14 days pre- to 300 days post-calving. Data were analysed with mixed effects models. No differences between HFA and PL were found regarding performance, body condition score and overall culling rates. A tendency towards lower milk urea for HFA-100 compared to PL (p = .06) was found in DF. HFA significantly reduced elevated milk acetone observations (≥10 mg/L) in the first 10 lactation weeks (HFA-100: 4%; HFA-50: 4%; PL: 12%) in DF. HFA-50 significantly reduced lameness incidence (HFA-100: 11%; HFA-50: 2%; PL: 14%) in DF. Calving intervals were 15 days shorter in HFA compared to PL in both trials, which could be confirmed by tendency (p = .07) in FT. In both trials, the proportion of test days with elevated somatic cell score (≥3.0) was significantly lower in HFA compared to PL (DF: HFA-100: 40%, HFA-50: 45% and PL: 55%; FT: HFA-100: 38% and PL: 55%) which is also reflected by tendency (p = .08) in lower culling rates due to udder diseases in FT. HFA showed no negative impact on any of the measured parameters. The effects of HFA indicate a potential of phytochemically rich and diverse feed additives for dairy cows' nutrition and physiology.

Critical dialogical approach: A methodological direction for occupation-based social transformative work.

BACKGROUND: Calls for embracing the potential and responsibility of occupational therapy to address socio-political conditions that perpetuate occupational injustices have materialized in the literature. However, to reach beyond traditional frameworks informing practices, this social agenda requires the incorporation of diverse epistemological and methodological approaches to support action commensurate with social transformative goals. AIM: Our intent is to present a methodological approach that can help extend the ways of thinking or frameworks used in occupational therapy and science to support the ongoing development of practices with and for individuals and collectives affected by marginalizing conditions. METHOD: We describe the epistemological and theoretical underpinnings of a methodological approach drawing on Freire and Bakhtin's work. RESULTS: Integrating our shared experience taking part in an example study, we discuss the unique advantages of co-generating data using two methods aligned with this approach; dialogical interviews and critical reflexivity. DISCUSSION: Key considerations when employing this approach are presented, based on its proposed epistemological and theoretical stance and our shared experiences engaging in it. SIGNIFICANCE: A critical dialogical approach offers one way forward in expanding occupational therapy and science scholarship by promoting collaborative knowledge generation and examination of taken-for-granted understandings that shape individuals assumptions and actions.

Administration of brain natriuretic peptide improves cardiac function following operations using extracorporeal circulation in an animal model.

The critical phase during cardiosurgical procedures is weaning the diseased heart from the ECC (extracorporeal circulation). Post-ischaemic heart failure sometimes requires the administration of inotropic and/or vasconstrictive agents. The natriuretic peptides influence pre- and after-load through their natriuretic, diuretic and vasodilating actions. To date, there are only a few reports describing the therapeutic effect of BNP (brain natriuretic peptide) administration during cardiosurgical procedures. The aim of the present study was to evaluate the effect of BNP administration following ECC in an animal model. Surgery was performed on 20 pigs using ECC. A 30-min ischaemic episode was simulated. Following de-clamping, BNP was administered to the BNP group (n=10) by an i.v. (intravenous) bolus at 0.3 microg x kg(-1) of body weight x min(-1), followed by an infusion at a rate of 0.015 microg x kg(-1) of body weight x min(-1) for 60 min. The animals in the control group (n=10) received a saline solution instead of BNP. Haemodynamic and clinical chemistry parameters as well as the amount of catecholamines that were required were measured. All of the animals in the BNP group had a significantly better cardiac output and cardiac index at the end of the experiment. Seven out of 10 animals from the control group required catecholamines, whereas only one animal from the BNP group did. Creatine kinase levels were significantly lower in the BNP group. Systemic vascular resistance was markedly lower in the BNP group. In conclusion, administration of BNP is highly effective in treating post-ischaemic heart failure following ECC. Haemodynamics are greatly improved, and there is almost no need for pharmacological support.