Understanding changes and stability in the long-term use of technologies by seniors who are aging in place: a dynamical framework.

BACKGROUND: If technologies are to support aging in place, then it is important to develop fundamental knowledge on what causes stability and changes in the use of technologies by seniors. However, longitudinal studies on the long-term use of technologies that have been accepted into the home (i.e., post-implementation use) are very scarce. Many factors potentially could influence post-implementation use, including life events, age-related decline, changes in personal goal orientation, and various types of social influences. The aforementioned factors are likely to be interrelated, adding to the complexity. The goal of this study is to better understand changes and stability in the use of technologies by independent-living seniors, by using a dynamical systems theory approach. METHODS: A longitudinal qualitative field study was conducted involving home visits to 33 community-dwelling seniors in the Netherlands, on three occasions (2012-2014). Interviews were held on technology usage patterns, including reasons for stable, increased, declined and stopped use. Technologies were included if they required electric power in order to function, were intended to be used in or around the home, and could support activities of daily living, personal health or safety, mobility, communication, and physical activity. Thematic analysis was employed, using constant case comparison to better understand dynamics and interplay between factors. In total, 148 technology use patterns by 33 participants were analyzed. RESULTS: A core of six interrelated factors was closely linked to the frequency of technology use: emotional attachment, need compatibility, cues to use, proficiency to use, input of resources, and support. Additionally, disruptive forces (e.g., social influences, competition with alternative means, changes of personal needs) could induce change by affecting these six factors. Furthermore, long-term technology use was in some cases more resilient to disruption than in other cases. Findings were accumulated in a new framework: Dynamics In Technology Use by Seniors (DITUS). CONCLUSIONS: Similar to aging, the use of technologies by older people is complex, dynamic and personal. Periods of stability and change both occur naturally. The DITUS framework can aid in understanding stability and instability of technology use, and in developing and implementing sustainable technological solutions for aging in place.

Child and adult spinal tuberculosis at tertiary hospitals in the Western Cape, South Africa: 4-year burden and trend.

The aim of this retrospective review was to assess the overall burden and trend in spinal tuberculosis (TB) at tertiary hospitals in the Western Cape Province of South Africa. All spinal TB cases seen at the province's three tertiary hospitals between 2012 and 2015 were identified and clinical records of each case assessed. Cases were subsequently classified as bacteriologically confirmed or clinically diagnosed and reported with accompanying clinical and demographic information. Odds ratios (OR) for severe spinal disease and corrective surgery in child vs. adult cases were calculated. A total of 393 cases were identified (319 adults, 74 children), of which 283 (72%) were bacteriologically confirmed. Adult cases decreased year-on-year (P = 0.04), however there was no clear trend in child cases. Kyphosis was present in 60/74 (81%) children and 243/315 (77%) adults with available imaging. Corrective spinal surgery was performed in 35/74 (47%) children and 80/319 (25%) adults (OR 2.7, 95% confidence interval 1.6-4.5, P = 0.0003). These findings suggest that Western Cape tertiary hospitals have experienced a substantial burden of spinal TB cases in recent years with a high proportion of severe presentation, particularly among children. Spinal TB remains a public health concern with increased vigilance required for earlier diagnosis, especially of child cases.

Origins and consequences of technology acquirement by independent-living seniors: towards an integrative model.

BACKGROUND: Living independently can be challenging for seniors. Technologies are expected to help older adults age in place, yet little empirical research is available on how seniors develop a need for technologies, how they acquire these technologies, and how these subsequently affect their lives. Aging is complex, dynamic and personal. But how does this translate to seniors' adoption and acceptance of technology? To better understand origins and consequences of technology acquirement by independent-living seniors, an explorative longitudinal qualitative field study was set up. METHODS: Home visits were made to 33 community-dwelling seniors living in the Netherlands, on three occasions (2012-2014). Semi-structured interviews were conducted on the timeline of acquirements, and people and factors involved in acquirements. Additionally, participants were interviewed on experiences in using technologies since acquirement. Thematic analysis was employed to analyze interview transcripts, using a realist approach to better understand the contexts, mechanisms and outcomes of technology acquirements. RESULTS: Findings were accumulated in a new conceptual model: The Cycle of Technology Acquirement by Independent-Living Seniors (C-TAILS), which provides an integrative perspective on why and how technologies are acquired, and why these may or may not prove to be appropriate and effective, considering an independent-living senior's needs and circumstances at a given point in time. We found that externally driven and purely desire-driven acquirements led to a higher risk of suboptimal use and low levels of need satisfaction. CONCLUSIONS: Technology acquirement by independent-living seniors may be best characterized as a heterogeneous process with many different origins, pathways and consequences. Furthermore, technologies that are acquired in ways that are not congruent with seniors' personal needs and circumstances run a higher risk of proving to be ineffective or inappropriate. Yet, these needs and circumstances are subject to change, and the C-TAILS model can be employed to better understand contexts and mechanisms that come into play.

The relation between social network site usage and loneliness and mental health in community-dwelling older adults.

BACKGROUND: Loneliness is expected to become an even bigger social problem in the upcoming decades, because of the growing number of older adults. It has been argued that the use of social network sites can aid in decreasing loneliness and improving mental health. The purpose of this study was to examine whether and how social network sites usage is related to loneliness and mental health in community-dwelling older adults. METHOD: The study population included community-dwelling older adults aged 60 and over residing in the Netherlands (n = 626) collected through the LISS panel (www.lissdata.nl). Univariate and multivariate linear regression analyses, adjusted for potentially important confounders, were conducted in order to investigate the relation between social network sites usage and (emotional and social) loneliness and mental health. RESULTS: More than half of the individuals (56.2%) reported to use social network sites at least several times per week. Social network sites usage appeared unrelated to loneliness in general, and to emotional and social loneliness in particular. Social network sites usage also appeared unrelated to mental health. Several significant associations between related factors and the outcomes at hand were detected. CONCLUSION: In this sample, which was representative for the Dutch population, social network sites usage was unrelated to loneliness and/or mental health. The results indicate that a simple association between social network site usage and loneliness and mental health as such, cannot automatically be assumed in community-dwelling older adults.

Aortopulmonary window, left coronary artery aneurysm, and redundant aortic valve leaflet in a calf: the use of multimodal imaging to diagnose congenital heart disease.

A 2-month-old male Holstein calf was presented for evaluation of a continuous systolic murmur. A grade V/VI left basilar continuous murmur and a grade IV/VI right basilar continuous murmur was auscultated upon evaluation with increased respiratory effort, wheezes, and crackles. Multimodality diagnostics were performed on this patient for further workup and included transthoracic and transesophageal echocardiography, fluoroscopy guided angiography, and gross necropsy with histopathology. An aortopulmonary window with continuous left-to-right shunting was identified at the level of the left aortic sinus of Valsalva with a severely dilated left coronary artery and left-sided congestive heart failure. This case report outlines the diagnostic workup of a rare congenital heart defect and secondary cardiac abnormalities not previously identified in veterinary literature.

Tricuspid valve dysplasia and a patent foramen ovale resulting in severe tricuspid regurgitation and right-heart dilation in a Red Angus calf.

A two-month-old Red Angus heifer calf presented to the University of Wisconsin Veterinary Care for evaluation of suspected severe bronchopneumonia. Pertinent physical exam findings included tachycardia, tachypnea, dyspnea with a significant abdominal component, and cyanotic mucous membranes. On thoracic auscultation, wheezes were present bilaterally, as well as a grade 2/6 right apical systolic murmur. Thoracic radiographs revealed cardiomegaly, most severely affecting the right side. Echocardiography showed tricuspid valve dysplasia, resulting in severe tricuspid regurgitation and right-heart dilation, as well as a patent foramen ovale. A postmortem examination confirmed the presence of the aforementioned cardiac abnormalities and revealed only mild pulmonary changes. This case report is the first to describe tricuspid dysplasia in the absence of multiple, complex congenital cardiac abnormalities in a calf, and it highlights the value of echocardiography for an antemortem diagnosis.

Workmen's compensation for occupational hand injuries.

BACKGROUND: The Compensation for Occupational Injuries and Diseases Act No. 130 of 1993, as amended in 1997 (COIDA), provides payment to healthcare providers for treatment of occupational injuries in South Africa (SA). Patients and employers are often unaware of procedures for claiming, and patients then carry the burden of costs themselves. Additionally, under-billing results in a loss of income for treating hospitals. Hand injuries are common occupational injuries and form the focus of this study. OBJECTIVES: To investigate whether occupational hand injuries treated at the Martin Singer Hand Unit at Groote Schuur Hospital, Cape Town, were accurately captured and allocated correct professional fee coding and billing. Accurate capturing and billing would allow for access to the Compensation Fund and allocation of finances to improve service delivery, as well as avoid unnecessary costs to otherwise uninsured patients. METHODS: All new hand injuries presenting to the hand unit at the hospital in August 2017 were sampled in a retrospective folder review. Injuries on duty (IODs) were identified and analysed further. Coding and billing were compared with independent private quotes. RESULTS: Sixty new hand injuries presented during the month. Fifteen were IODs, but only 6 were recognised by administration. The other 9 were billed at minimum income rates and 5 of these patients also had operations, which were not billed for. A total of ZAR88 871.99 was under-billed in terms of professional fees only. The 9 incorrectly classified patients had to bear costs themselves at a median of ZAR130.00 each. CONCLUSIONS: There were large discrepancies in billing for occupational hand injuries. This resulted in costs to the patients and loss of income for the facility. Access to the Compensation Fund is vital in financing resources in the overburdened public sector. Suggestions for improvement include accessing COIDA funds in order to improve administration at the unit, so improving identification, coding and billing of occupational hand injuries.

Enhanced bactericidal activity against Escherichia coli in calves fed Morinda citrifolia (Noni) puree.

BACKGROUND: Although adequate colostrum intake and properly used antibiotics can provide much protection for the bovine neonate, increased antibiotic scrutiny and consumer demand for organic products have prompted investigations of natural immunomodulators for enhancing calf health. One plant-based immunomodulator, Morinda citrifolia (noni) fruit, is a well-recognized natural product that has a broad range of immunomodulatory effects. HYPOTHESIS: Neonatal calves fed noni puree would demonstrate whole blood phagocytic capacity in Gram-negative and Gram-positive in vitro assays. ANIMALS: Blood samples from 18 neonatal Holstein bull calves. METHODS: Calves were divided into 2 groups: Group 1 comprised control calves, whereas Group 2 received 30 mL of noni puree twice a day in milk replacer. Day 0 blood samples were obtained between 36 and 48 hours of age before the first feeding of puree. Ethylenediaminetetraacetic acid anticoagulated blood was collected from each calf on days 0, 3, 7, and 14. Bactericidal assays were performed to estimate the percentage killing of Escherichia coli and Staphylococcus epidermidis. RESULTS: Blood samples from noni puree-fed calves displayed significantly more E. coli bacterial killing than did controls on day 14, and although differences were not significant on days 0, 3, and 7, bacterial killing progressively increased over time. There was no significant difference between the groups for S. epidermidis killing. CONCLUSIONS AND CLINICAL IMPORTANCE: The immunomodulatory effect of noni puree may prove valuable in the future as production animal antibiotic use becomes more restricted. Additional clinical trials are warranted to investigate the clinical application of noni puree in promoting calf health.

Quality Control of Compounded Crystalloid Fluids for Intravenous Delivery to Horses.

BACKGROUND: Periodic lack of availability and high cost of commercially produced isotonic fluids for intravenous (IV) use in horses have increasingly led to use of home-made or commercially compound fluids by veterinarians. Data regarding the quality control and safety of compounded fluids would be of benefit to equine veterinarians. OBJECTIVES: To compare electrolyte concentrations, sterility, and endotoxin contamination of commercially available fluids to 2 forms of compounded isotonic crystalloid fluids intended for IV use in horses. METHODS: Prospective study. Two methods of preparing compounded crystalloids formulated to replicate commercial Plasma-Lyte A (Abbott, Chicago, IL) were compared. One formulation was prepared by a hand-mixed method involving chlorinated drinking water commonly employed by equine practitioners, and the other was prepared by means of ingredients obtained from a commercial compounding pharmacy. The variables for comparison were electrolyte concentrations, sterility, and presence of endotoxin contamination. RESULTS: Electrolyte concentrations were consistent within each product but different between types of fluids (P < 0.0001). Hand-mixed fluids had significantly more bacterial contamination compared to commercial Plasma-Lyte A (P = 0.0014). One of the hand-mixed fluid samples had detectable endotoxin contamination. CONCLUSIONS AND CLINICAL IMPORTANCE: Chlorinated drinking water is not an acceptable source of water to compound isotonic fluids for IV administration. Equine practitioners should be aware of this risk and obtain the informed consent of their clients.

Environmental context for the terminal Ediacaran biomineralization of animals.

In terminal Ediacaran strata of South China, the onset of calcareous biomineralization is preserved in the paleontological transition from Conotubus to Cloudina in repetitious limestone facies of the Dengying Formation. Both fossils have similar size, funnel-in-funnel construction, and epibenthic lifestyle, but Cloudina is biomineralized, whereas Conotubus is not. To provide environmental context for this evolutionary milestone, we conducted a high-resolution elemental and stable isotope study of the richly fossiliferous Gaojiashan Member. Coincident with the first appearance of Cloudina is a significant positive carbonate carbon isotope excursion (up to +6‰) and an increase in the abundance and (34) S composition of pyrite. In contrast, δ(34) S values of carbonate-associated sulfate remain steady throughout the succession, resulting in anomalously large (>70‰) sulfur isotope fractionations in the lower half of the member. The fractionation trend likely relates to changes in microbial communities, with sulfur disproportionation involved in the lower interval, whereas microbial sulfate reduction was the principal metabolic pathway in the upper. We speculate that the coupled paleontological and biogeochemical anomalies may have coincided with an increase in terrestrial weathering fluxes of sulfate, alkalinity, and nutrients to the depositional basin, which stimulated primary productivity, the spread of an oxygen minimum zone, and the development of euxinic conditions in subtidal and basinal environments. Enhanced production and burial of organic matter is thus directly connected to the carbon isotope anomaly, and likely promoted pyritization as the main taphonomic pathway for Conotubus and other soft-bodied Ediacara biotas. Our studies suggest that the Ediacaran confluence of ecological pressures from predation and environmental pressures from an increase in seawater alkalinity set the stage for an unprecedented geobiological response: the evolutionary novelty of animal biomineralization.

Leucocytoclastic vasculitis associated with Staphylococcus intermedius in the pastern of a horse.

A pregnant quarterhorse mare became acutely lame as a result of severe swelling of its right hind leg, thought to have been caused by a fracture or a muscle tear. Diagnostic procedures ruled out a traumatic musculoskeletal cause and a physical examination revealed chronic pastern dermatitis ('scratches'/'grease heel'). Histopathological evaluation of biopsy samples from the right hind leg was consistent with a leucocytoclastic vasculitis, and culture yielded Staphylococcus intermedius. The treatment and infectious causes of pastern dermatitis are discussed.

Preclinical investigation of L-FMAU as an anti-hepatitis B virus agent.

Preclinical aspects of a potent anti-hepatitis B virus (HBV) L-nucleoside, 1-(2-fluoro-5-methyl-beta-L-arabino-furanosyl)uracil (L-FMAU) are described. L-FMAU was prepared from L-ribose derivatives via either L-xylose or L-arabinose. L-FMAU shows potent antiviral activity against hepatitis B virus (EC50 5.0 microM in H1 cells) with high selectivity in vitro. L-FMAU is not incorporated into mitochondrial DNA and no significant lactic acid production was observed in vitro. L-FMAU is phosphorylated by thymidine kinase as well as deoxycytidine kinase, ultimately to the triphosphate, which inhibits HBV DNA polymerase as the mechanism of antiviral action. Preliminary in vivo toxological studies suggest no apparent toxicity for 30 days at 50 mg/kg/day in mice and for 3 months in woodchucks (10 mg/kg/day). L-FMAU also has respectable bioavailability in rats. L-FMAU shows potent anti-HBV activity in vivo against woodchuck hepatitis virus in chronically infected woodchucks and there is no significant virus rebound after cessation of the drug treatment.

Effect of experimental infection of cattle with bovine herpesvirus-1 (BHV-1) on the ex vivo interaction of bovine leukocytes with Mannheimia (Pasteurella) haemolytica leukotoxin.

Mannheimia (Pasteurella) haemolytica A1 produces an extracellular leukotoxin (LKT) that is reported to bind the beta(2)-integrin CD11a/CD18 (LEA-1) on ruminant leukocytes. LKT binding induces activation, and subsequent cytolysis, of these cells. It is well known that active viral infection greatly increases the susceptibility of cattle to pasteurellosis. To better understand the mechanism by which this occurs, we investigated the effects of experimental in vivo infection of cattle with bovine herpes virus-1 (BHV-1) on the ex vivo interaction of bovine leukocytes with the M. haemolytica LKT. In this study, we demonstrated that active BHV-1 infection increased the expression of the beta(2)-integrin CD11a/CD18 (as defined by the mAb BAT75) on bovine peripheral blood neutrophils, enhanced the binding of LKT to bronchoalveolar lavage (BAL) leukocytes and peripheral blood neutrophils, and increased the killing of BAL leukocytes and peripheral blood leukocytes by LKT. In addition, BHV-1 greatly increased the number of BAL, resulting in many more LKT-responsive cells being present in the lungs. These findings might explain in part the increased susceptibility of BHV-1 infected cattle to pneumonic pasteurellosis.

Medical treatment of cholangiohepatitis and cholelithiasis in mature horses: 9 cases (1991-1998).

The medical approach to treatment of cholangiohepatitis and cholelithiasis in 9 horses is described. Seven horses were treated successfully and returned to normal use, with a minimum follow-up period of 12 months. Long-term antimicrobial therapy was believed to be critical in those cases that survived, with a median treatment duration of 51 days (range 17-124 days). Treatment failure was associated with severe periportal and bridging hepatic fibrosis from biopsy material obtained at admission in 2 horses, one of whom also presented with hyperammonaemic hepatic encephalopathy. Transabdominal ultrasound was used diagnostically in each case to obtain hepatic biopsy material for histopathology and bacterial culture, to evaluate hepatic size and echogenicity and to identify and monitor the dissolution of hepatoliths. Histologically, all horses had evidence of suppurative cholangiohepatitis with varying degrees of periportal and bridging fibrosis. Discrete hyperechoic calculi were identified in 4 cases, but all horses had ultrasonographic evidence of biliary obstruction with numerous dilated bile ducts. Aerobic and anaerobic cultures of liver biopsy material were negative from 7 horses, but 2 different species of Escherichia coli were obtained from one horse, and Bacteroides vulgatus and Escherichia coli were isolated from another. In all 7 horses that survived, clinical recovery was seen before normalisation of biochemical indices of hepatobiliary function including gammaglutamyl transaminopeptidase (GGT), alkaline phosphatase (AP), bile acids and serum bilirubin. Serum GGT levels were monitored extensively as a marker of hepatobiliary disease and actually increased during the initial period of clinical improvement in horses that recovered. Supportive medical therapy with i.v. fluids was also a critical part of the therapy of several cases in this report, both acutely and in the management of chronic cases that deteriorated clinically during treatment. Previous therapeutic failures may well be related to treatment periods of inadequate duration, and the authors recommend that antimicrobial therapy should be continued until GGT values are normal.

Clostridial myonecrosis in horses (37 cases 1985-2000).

REASONS FOR PERFORMING STUDY: Previous reports of clostridial myonecrosis have either focused on individual case reports or have been small retrospective studies reporting very high mortality rates. OBJECTIVES: The objective of this study was to describe the outcome of cases of clostridial myonecrosis submitted to 2 referral equine hospitals in the United States over a 15 year period. METHODS: A retrospective study of case material selected on the basis of positive Clostridium spp. culture or the identification of Clostridium spp. by specific fluorescent antibody testing from soft tissue wounds was performed at Cornell and Wisconsin. RESULTS: 37 cases of clostridial myonecrosis were documented. Twenty-seven horses survived, 8 were subjected to euthanasia and 2 died during treatment for an overall survival rate of 73%. Twenty-five cases (68%) were associated with Clostridium perfringens alone, 6 cases (16%) with Cl. septicum alone, 4 cases with mixed clostridial infections (11%), 1 case with Cl. sporogenes and 1 with an unspeciated Clostridium spp. The highest survival rate of 81% was documented for those cases from which Cl. perfringens alone was isolated. The most common antecedent condition prior to referral was colic. The myonecrotic lesion occurred within 6-72 h of a soft tissue injection in 34 cases but was associated with a wound or laceration in the remaining 3 cases. Of the 34 cases associated with recent injections, 24 were associated with i.m. injections in the cervical region, 4 in the semimembranosus/semitendinosus region, 3 in the gluteal region, 2 with perivascular leakage of drugs administered into the jugular vein and 1 case developed simultaneously in the gluteal and neck region following injections at both sites. CONCLUSIONS: Clostridial myonecrosis can occur following the i.m. or inadvertent perivascular administration of a wide variety of commonly administered drugs. It is most common in the neck musculature. Aggressive treatment can be associated with survival rates of up to 81% for cases due to Cl. perfringens alone. Survival rates for other Clostridial spp. tend to be lower. POTENTIAL RELEVANCE: A combination of high dose i.v. antibiotic therapy and surgical fenestration/debridement is the best approach to cases of clostridial myonecrosis. With rapid diagnosis and therapeutic intervention, horses may have up to an 81% chance of survival.

Presumed clostridial and aerobic bacterial infections of the cornea in two horses.

Microscopic examination of Gram-stained tissue specimens collected from severe corneal ulcers in 2 horses revealed large gram-positive rods suggestive of Clostridium spp. Clostridium perfringens was isolated from specimens collected from horse 1; anaerobic organisms were not detected in specimens from horse 2. Aerobic bacterial culture revealed Aeromonas hydrophila and Enterobacter cloacae in specimens collected from horses 1 and 2, respectively. An insect exoskeleton was presumed to be the underlying cause of ulceration in horse 1. Cause of ulceration in horse 2 was not determined. Antibiotics used to treat the corneal infections included ticarcillin disodium-clavulanic acid injected one time subconjunctivally and chloramphenicol applied topically at frequent intervals. Horse 2 also received penicillin or trimethoprim-sulfadiazine. Small leukomas were the only lesion remaining between 2 and 7 months after initial evaluation. Chloramphenicol applied topically appears to be an effective treatment against clostridial corneal infections in horses.

Multicentric schwannomas causing chronic ruminal tympany and forelimb paresis in a Holstein cow.

A nine-year-old Holstein cow that developed recurrent ruminal tympany and an abnormal forelimb gait and posture ultimately became recumbent and unable to rise, and was euthanased. A postmortem examination demonstrated numerous schwannomas affecting peripheral nerves and several thoracic and abdominal viscera.

Hypokalemia, muscle weakness, and recumbency in dairy cattle.

Seventeen cases of severe hypokalemia (serum or plasma potassium < or = 2.1 mEq/L) in association with profound muscle weakness and recumbency in lactating dairy cattle were included in a retrospective study. The cattle were from 15 different farms. Eleven of the 17 animals were recumbent at presentation while the remaining six became recumbent within 6 hours of admission. Both multiparous cows (n = 11) and first calf heifers (n = 6) were included. The median days in milk was 21 (range: 5 to 110), and chronic, recurrent ketosis (15 of the 17 cases) was the most common preexistent condition. Potential musculoskeletal and neurologic causes of recumbency were ruled out on the basis of physical examination and ancillary diagnostics. Ten of the 17 animals were euthanized and underwent full necropsy examination that demonstrated ischemic muscle damage and varying degrees of hepatic lipidosis. Aggressive potassium supplementation was instituted in all 17 cases either orally, intravenously, or by a combination of both routes. In the seven individuals that survived, potassium supplementation was administered orally and intravenously in five, orally only in one, and intravenously only in one.

Spina bifida: a multidisciplinary perspective on a many-faceted condition.

Open spina bifida or myelomeningocele (SBM) is the most common birth defect involving the central nervous system, second only in incidence to congenital cardiac disease. Outcomes in this disorder were poor until the mid-20th century, when modern neurosurgical techniques (closing the lesion and treating hydrocephalus) and treatment for the neuropathic bladder addressed the major causes of mortality, although SBM may still be poorly treated in the developing world. Initial management - or mismanagement - has a profound impact on survival and long-term quality of life.

Effects of gestational age on physical findings of immaturity, body weight, and survival in neonatal alpacas (2002-2010).

BACKGROUND: Gestational duration is highly variable in camelids (reference range 330-360 days), and a definition for prematurity has not been established. Anecdotally, it is suggested that crias born outside of this have increased incidence of physical findings of immaturity (tendon laxity, floppy ears, and unerupted teeth) and need increased intensive support in the neonatal period. OBJECTIVES: Low gestational age (<330 days) is associated with physical findings of immaturity, low birth weight, more intensive and expensive care, but not decreased short-term survival. ANIMALS: A total of 130 alpacas presented to the University of Wisconsin. METHODS: Retrospective study of all neonatal crias <1 month of age. RESULTS: Of 130 neonatal alpacas presented, 86 (66%) had gestational age recorded (range 312-393 days). There were 16 (18.6%) crias with gestational age below 330 days. Crias born before 330 days were lighter at birth (mean 6.4 kg, SD 1.3 kg) than those born after 330 days (mean 7.4 kg, SD 1.7 kg, P = .002). Clinically immature crias had lower birth weights (mean 6.5 kg, SD 1.5 kg) than physically mature crias (mean 8.8 kg, SD 3.2 kg, P = .05). Survival rates were similar in all groups (premature 77%, mature 88%, P = .12). However, treatment costs were higher in crias born prior to 330 days with physical findings at birth consistent with immaturity compared with gestationally mature crias and those born prior to 330 days but with a physically mature appearance. CONCLUSIONS: Crias born before 330 days and those with physical findings of immaturity have a good prognosis, but require more intensive care, resulting in higher treatment costs.