Distress management.

The integration of psychosocial care into the routine care of all patients with cancer is increasingly being recognized as the new standard of care. These NCCN Clinical Practice Guidelines in Oncology for Distress Management discuss the identification and treatment of psychosocial problems in patients with cancer. They are intended to assist oncology teams identify patients who require referral to psychosocial resources and to give oncology teams guidance on interventions for patients with mild distress to ensure that all patients with distress are recognized and treated.

Survey of Management Practices and Farmers' Perceptions of Diseases on Organic Dairy Cattle Farms in California.

In 2019, California accounted for approximately 40% of organic products in the US, and dairy products and milk were the top organic commodity in the state. The objective of this study was to describe organic dairy cattle farmers' management practices and perceptions of diseases in California. A survey inquiring about farm history and demographics, animal diseases, parasite problems, housing and pasture management, and organic education, was mailed to 160 organic dairy farms, of which 36 (22.5%) responded. Among respondents, the majority (83.9%) were located in Northern California; median farm size was 310 cows, and the dominant breed was Holstein (60.0%). Respondents were more likely to report mastitis in cows (45.2%), pinkeye in heifers (31.3%), and digestive problems in calves (47.0%), as issues affecting their stock "often" or "almost always" in the last 12 months. Although most farmers vaccinated their cattle against Bovine Viral Diarrhea (86.1%) and Escherichia coli mastitis (80.6%), they still described that these diseases frequently impacted their animals. Over half of the farmers did not perceive gastrointestinal parasites or biting flies to be a problem and did not observe signs of lice and mites. According to the results, the management of disease in all age classes is a concern; options and efficacies of alternative therapeutic methods, as well as preventive measures for organic dairies need to be further explored.

Epidemiology of antimicrobial resistance (AMR) on California dairies: descriptive and cluster analyses of AMR phenotype of fecal commensal bacteria isolated from adult cows.

BACKGROUND: This study describes the occurrence of antimicrobial resistance (AMR) in commensal Escherichia coli and Enterococcus/Streptococcus spp. (ES) isolated from fecal samples of dairy cows and assesses the variation of AMR profiles across regions and seasons following the implementation of the Food and Agricultural Code (FAC) Sections 14400-14408 (formerly known as Senate Bill, SB 27) in California (CA). METHODS: The study was conducted on ten dairies distributed across CA's three milk sheds: Northern California (NCA), Northern San Joaquin Valley (NSJV), and the Greater Southern California (GSCA). On each study dairy, individual fecal samples were collected from two cohorts of lactating dairy cows during the fall/winter 2018 and spring/summer 2019 seasons. Each cohort comprised of 12 cows per dairy. The fecal samples were collected at enrollment before calving (close-up stage) and then monthly thereafter for four consecutive time points up to 120 days in milk. A total of 2,171 E. coli and 2,158 ES isolates were tested for antimicrobial susceptibility using the broth microdilution method against a select panel of antimicrobials. RESULTS: The E. coli isolates showed high resistance to florfenicol (83.31% ± 0.80) and sulphadimethoxine (32.45%), while resistance to ampicillin (1.10% ± 0.21), ceftiofur (1.93% ± 0.29), danofloxacin (4.01% ± 0.42), enrofloxacin (3.31% ± 0.38), gentamicin (0.32% ± 0.12) and neomycin (1.61% ± 0.27) had low resistance proportions. The ES isolates were highly resistant to tildipirosin (50.18% ± 1.10), tilmicosin (48% ± 1.10), tiamulin (42%) and florfenicol (46% ± 1.10), but were minimally resistant to ampicillin (0.23%) and penicillin (0.20%). Multidrug resistance (MDR) (resistance to at least 1 drug in ≥3 antimicrobial classes) was observed in 14.14% of E. coli isolates and 39% of ES isolates. Escherichia coli isolates recovered during winter showed higher MDR prevalence compared to summer isolates (20.33% vs. 8.04%). A higher prevalence of MDR was observed in NSJV (17.29%) and GSCA (15.34%) compared with NCA (10.10%). CONCLUSIONS: Our findings showed high rates of AMR to several drugs that are not labeled for use in lactating dairy cattle 20 months of age or older. Conversely, very low resistance was observed for drugs labeled for use in adult dairy cows, such as cephalosporins and penicillin. Overall, our findings identified important differences in AMR by antimicrobial class, region and season.

Self-care strategies for nurses: A psycho-educational intervention for stress reduction and the prevention of burnout.

The purpose of this project is to develop and evaluate a psycho-educational program that assists nurses to develop stress management plans. Discussion of nursing-specific risk factors, practice with relaxation techniques, and exploration via art are used as interventions. Quantitative and qualitative measures of stress and burnout are conducted pre- and postcourse using the Maslach Burnout Inventory, Draw-a-Person-in-the-Rain Art Assessment, and wellness plans. Descriptive statistics are used, and preliminary analysis indicates that the course is useful in impacting levels of emotional exhaustion. There are opportunities for evolving the program so that more enduring change in self-care is generated.

Effects of stacked wedge pads and chains applied to the forefeet of Tennessee Walking Horses for a five-day period on behavioral and biochemical indicators of pain, stress, and inflammation.

OBJECTIVE To determine the effects of stacked wedge pads and chains applied to the forefeet of Tennessee Walking Horses on behavioral and biochemical indicators of pain, stress, and inflamation. ANIMALS 20 Tennessee Walking Horses. PROCEDURES Horses were randomly assigned to 2 treatment groups: keg shoes (control; n = 10) or stacked wedge pads and exercise with chains (10). Ten days before treatment application, an accelerometer was attached at the left metatarsus of each horse to record daily activity. Horses were exercised for 20 minutes daily, beginning on day -7. On day 0, exercise ceased, the forefeet were trimmed, and the assigned treatment was applied. From days 1 through 5, horses were exercised as before. Blood samples for measurement of plasma cortisol, substance P, and fibrinogen concentrations were collected on days -5, 1, and 5 before and after exercise and every 30 minutes thereafter for 6 hours. RESULTS No significant differences in plasma concentrations of cortisol, substance P, and fibrinogen were detected between groups. Although lying behaviors changed after shoes were applied, these behaviors did not differ significantly between groups. Shoeing appeared to have altered behavior to a greater extent than did the type of treatment applied. CONCLUSIONS AND CLINICAL RELEVANCE Application of stacked wedge pads and chains to the forefeet of horses for a 5-day period as performed in this study evoked no acute or subacute stress or nociceptive response as measured. Although these findings should not be extrapolated to the long-term use of such devices in Tennessee Walking Horses performing the running walk, the data should be considered when making evidence-based decisions relating to animal welfare and the use of stacked wedge pads and chains.

Effect of switch trimming on udder and teat hygiene of dairy cows.

The study objective was to determine the effects of trimming the switch of dairy cows on teat-end bacterial counts and udder hygiene scores. Cows (n = 102) were blocked by days in milk, milk production, and parity and then assigned to (a) treatment (trimming of their tail switch using a commercially available trimmer), or (b) control (unaltered tails). Udder hygiene was recorded for cows on Days 0 (initiation of treatment), 32, and 64. A subset of cows (n = 21) was used to assess Streptococci and coliform bacterial populations on teat ends. Samples were collected by swabbing the left front teat end before milking on Days 0, 32, and 64 and were cultured within 24 hr of sampling. The GLIMMIX and PROC Frequency (SAS Version 9.3) were used to analyze data. There were no treatment effects of switch trimming on hygiene scores or bacterial counts. These findings suggest that udder hygiene may not be driven by tail status. Environmental and management factors, such as cleanliness, stall bedding, and stall design, may be more important contributing factors in maintaining udder health.

A Case Study of Behaviour and Performance of Confined or Pastured Cows During the Dry Period.

The objectives of this study were to determine the effect of the dry cow management system (pasture or confined) on: (1) lying behaviour and activity; (2) feeding and heat stress behaviours; (3) intramammary infections, postpartum. Non-lactating Holstein cows were assigned to either deep-bedded, sand freestalls ( n = 14) or pasture ( n = 14) using rolling enrollment. At dry-off, cows were equipped with an accelerometer to determine daily lying time (h/d), lying bouts (bouts/d), steps (steps/d) and divided into periods: far-off (60 to 15 d prepartum), close-up (14 to 1 d prepartum), calving (calving date) and postpartum (1 to 14 d postpartum). Respiration rates were recorded once weekly from dry off to calving from 1300 to 1500 h. Feeding displacements were defined as one cow successfully displacing another from the feed bunk and were recorded once per week during the 2 h period, immediately after feeding at 800 h. Pastured cows were fed a commercial dry cow pellet during far-off and total mixed ration during close-up, with free access to hay and grazing. Freestall housed cows were fed a total mixed ration at far-off and close-up. Cows housed in freestalls were moved to a maternity pen with a mattress at commencement of labour. Pastured cows calved in pasture. After calving, all cows were commingled in a pen identical to the freestall housing treatment. Cows housed in freestalls laid down for longer during far-off and close-up periods, had fewer lying bouts during the calving period and took fewer steps throughout the study period when compared to pastured cows. Freestall housed cows experienced more displacements after feeding than did pastured cows. Respiration rates increased with an increasing temperature humidity index, more in pastured cows than in freestall housed cows. Pastured cows altered their lying behaviour and activity, suggesting a shift in time budget priorities between pastured and confined dry cows. Pastured cows also experienced less aggression around feeding but may be more susceptible to heat stress.