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Background: The Children and Young People's Mental Health Trailblazer programme is funding the creation of new mental health support teams to work in schools and further education colleges. Mental health support teams directly support children and young people with 'mild to moderate' mental health problems and work with school and college staff to promote well-being for all. A new workforce of education mental health practitioners is being trained for the teams. Objective(s): The National Institute for Health and Care Research Birmingham, RAND and Cambridge Evaluation Rapid Evaluation Centre and Policy Innovation and Evaluation Research Unit undertook an early evaluation of the Trailblazer programme to examine the development, implementation and early progress of mental health support teams in the programme's first 25 'Trailblazer' sites. Design: A mixed-methods evaluation, comprising three work packages: 1. Establishing the baseline and understanding the development and early impacts of the Trailblazer sites, including two rounds of surveys with key informants and participating education settings in all 25 sites. 2. More detailed research in five purposively selected Trailblazer sites, including interviews with a range of stakeholders and focus groups with children and young people. 3. Scoping and developing options for a longer-term assessment of the programme's outcomes and impacts. Fieldwork was undertaken between November 2020 and February 2022. The University of Birmingham Institute for Mental Health Youth Advisory Group was involved throughout the study, including co-producing the focus groups with children and young people. Results: Substantial progress had been made implementing the programme, in challenging circumstances, and there was optimism about what it had the potential to achieve. The education mental health practitioner role had proven popular, but sites reported challenges in retaining education mental health practitioners, and turnover left mental health support teams short-staffed and needing to re-recruit. Education settings welcomed additional mental health support and reported positive early outcomes, including staff feeling more confident and having faster access to advice about mental health issues. At the same time, there were concerns about children who had mental health problems that were more serious than 'mild to moderate' but not serious enough to be accepted for specialist help, and that the interventions offered were not working well for some young people. Mental health support teams were generally spending more time supporting children with mental health problems than working with education settings to develop 'whole school' approaches to mental health and well-being, and service models in some sites appeared to be more clinically oriented, with a strong focus on mental health support teams' therapeutic functions. Limitations: Despite efforts to maximise participation, survey response rates were relatively low and some groups were less well represented than others. We were not able to gather sufficiently detailed data to develop a typology of Trailblazer sites, as was planned. Conclusions: Key lessons for future programme implementation include: - Whether mental health support teams should expand support to children and young people with more complex and serious mental health problems. - How to keep the twin aims of prevention and early intervention in balance. - How to retain education mental health practitioners once trained. Future work: The findings have important implications for the design of a longer-term impact evaluation of the programme, which is due to commence in summer 2023. Study registration: Ethical approval from the University of Birmingham (ERN_19-1400 - RG_19-190) and London School of Hygiene and Tropical Medicine (Ref: 18040) and Health Research Authority approval (IRAS 270760). Funding: The Birmingham, RAND and Cambridge Evaluation Rapid Evaluation Centre is funded by the National Institute for Health and Care Research Health Services and Delivery Research programme (HSDR 16/138/31). The Policy Innovation and Evaluation Research Unit is funded by the NIHR Policy Research Programme (PR-PRU-1217-20602).
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Educação em Saúde , Saúde Mental , Adolescente , Humanos , Criança , Inquéritos e Questionários , Grupos Focais , Instituições AcadêmicasRESUMO
When looking to improve animal welfare, it is essential to understand the viewpoints of stakeholders in the industry. Previous research has engaged stakeholders such as farmers, veterinarians, and the public to better understand future dairy industry directions. However, the use of perspective-taking as a tool to overcome farmer's focus on current barriers to the industry has not been explored. Therefore, the aims of this study were to have farmers take the perspective of the cow, to elicit: (1) farm elements that are essential to create a cow-centric dairy system, and (2) how this system can be achieved in the next 50 years. To do this, we employed participatory methods (photo elicitation, timelining) to generate discussion with 12 New Zealand dairy farmers. Pasture access is frequently cited as an integral component for promoting good welfare in dairy cows, thus, this cohort of farmers was considered a good case study as they all had experience managing cows in grazing systems. Participants were asked to create a cow-centric farm design, and a pathway to implementation. Following thematic analysis of the multiple data sources, the results are presented under the following three themes: (1) cow-centric farm designs (environmental considerations, cow handling and care), (2) timeline to achieve and sequence of implementation ("low hanging fruit" and long-term investments), and (3) assumptions and resources needed (including financial considerations, technology, farmer buy-in, regulations and enforcement and other stakeholder involvement). By better understanding how current industry practice aligns, and also differs, from what the cow would want, we can work towards future management systems that incorporate the requirements of all stakeholders, including the cow.
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Fazendeiros , Médicos Veterinários , Feminino , Bovinos , Animais , Humanos , Fazendas , Indústria de Laticínios/métodos , Bem-Estar do AnimalRESUMO
There is growing evidence that animal personality is linked to a range of productivity traits in farm animals, including dairy cattle. To date, the methodology for assessing personality traits of dairy cattle is time consuming and often requires a test arena, which limits the opportunity for commercial farms to use personality traits of dairy cattle for individualized management. This study investigated whether personality traits of pastured dairy cattle, scored in short behavioral tests, are associated with daily behavioral patterns and milk production. Cows (n = 87) were exposed twice to each of 5 behavioral tests, where their responses to novel or putatively stressful situations were scored on an ordinal scale for investigative and reactive behavior toward a novel object and a novel human after exiting the milking parlor, response to restraint in a crush, avoidance distance from an approaching human in the paddock, and response to milking (step-kick behavior). Most behavior test scores were consistent over the 2 test repeats (using repeatability estimates, Mann-Whitney U test of difference between repeats, and Spearman rank correlation). Behavior test scores were subjected to a principal components analysis that revealed intertest relationships in 3 factors of correlated sets of test scores, interpreted as personality traits (fearful of humans, calm-investigative, and reactive to milking). Regression analyses determined how these traits were associated with daily grazing, ruminating, and lying behaviors, and milk production (after controlling for cow age, breed, lactation status, group, and climate variables). Cows that were more fearful of humans (high avoidance distance, reactive toward the novel human) had reduced lying time compared with cows that scored low on this trait. Cows that were more calm (during restraint) and investigative (toward the novel object) had greater grazing time, which likely contributed to their greater milk production compared with cows that scored low on this trait. Cows that were more reactive to milking produced less milk than cows that scored low on this trait. These results indicate that individual differences in daily behavior patterns and milk production of dairy cattle are associated with personality traits of cows, measured using several short behavioral tests. These methods may be useful for characterizing grazing dairy cattle on commercial farms, which could aid in understanding individual behavior patterns and provide opportunities for individualized management.
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Indústria de Laticínios , Lactação , Animais , Comportamento Animal/fisiologia , Bovinos , Indústria de Laticínios/métodos , Fazendas , Feminino , Lactação/fisiologia , Leite , PersonalidadeRESUMO
Separation of the cow and calf shortly after birth is a common practice on commercial dairy farms around the world, but there are emerging concerns about this practice among citizens and other stakeholders. Continuous improvement of on-farm management practices in collaboration with dairy sector stakeholders increases the likelihood that farming systems evolve in a way that is consistent with societal expectations. Few commercial dairy farms provide extended cow-calf contact, and there is little understanding of how dairy farmers view this practice. This study examined the views of New Zealand dairy farmers toward providing cow-calf contact, particularly the barriers to adopting such a system in a seasonal-calving pasture-based dairy system. Standard farm practice in New Zealand is to remove the calf from the cow around 24 h (but could be up to 48 h) after birth. These conventional farmers (n = 63) were randomly selected from the database of all dairy farmers in New Zealand and telephone-interviewed using a semistructured interview format. Their responses to questions about providing cow-calf contact (defined as contact beyond the standard practice of 48 h) were analyzed using thematic analysis. Three major themes of concern were identified by these farmers about providing cow-calf contact as follows: (1) poor animal welfare, especially the risk of mastitis in the dam, inadequate colostrum for the calf, increased stress from delayed separation, and lack of shelter for calves while outdoors with the cow; (2) increased labor and stress on staff; and (3) system-level changes required, including infrastructure and herd management. Many of these concerns stemmed from challenges related to the nature of large-scale seasonal-calving pasture-based dairy systems, where a large number of calves are born in a short period of time and may be exposed to inclement weather in late winter in some areas. Several small-scale farmers (n = 4) providing cow-calf contact for longer than standard practice of 48 h were also interviewed; all permitted contact for at least 4 wk. These farmers also felt that animal welfare and health were important, and that this was promoted in their cow-calf contact systems. Concerns about colostrum and mastitis, for example, were not raised by these farmers, but they did agree that additional infrastructure and shelter were important considerations for cow-calf contact systems. Some conventional farmers expressed cognitive dissonance in that they theoretically preferred cow-calf contact but could not see it being realistic or practical to implement. Farmers currently providing longer cow-calf contact may be a useful resource for better understanding of how practical and economical cow-calf contact systems could be adopted on commercial pastoral dairy farms.
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Indústria de Laticínios , Fazendeiros , Bem-Estar do Animal , Animais , Bovinos , Fazendas , Feminino , Humanos , Nova Zelândia , GravidezRESUMO
In pasture-based systems, cows may spend several hours away from the paddock and may also walk several kilometres to meet daily milking requirements; this could lead cows to experience time constraints for grazing, ruminating and lying time in the paddock. This study investigated how walking distance and time spent away from the paddock affected daily behavioural patterns (i.e., grazing, ruminating and lying time) and milk yield. Dairy cows were managed in three rotationally grazed groups (n = 29 cows each) on the same farm and milked twice daily. A triaxial ear tag accelerometer on each cow recorded daily duration of grazing and ruminating, and a leg-based accelerometer recorded the daily lying time, for 13 days. GPS collars on four cows per group recorded the daily walking distance and total time away from the paddock for the group. A mixed repeated measures model tested how time off-paddock and walking distance affected the daily behavioural patterns; age, breed, milk yield and maximum ambient temperature were used as covariates with group as the observational unit. A second similar model tested how these factors affected milk yield. Walking distance and time spent away from the paddock were not correlated. When daily walking distance increased (to a maximum of 4 km/d), cows spent more time grazing and less time ruminating, but lying time was not affected. This result may, in part, be related to the greater energy expenditure demands for walking longer distances and milk production. When time away from the paddock increased (to a maximum of 4 h/d), cows spent less time lying, but grazing and ruminating times were not affected. Milk yield was not affected by walking distance, but one of the groups experienced a lower milk yield when time away from the paddock was increased. This result suggests that, for some cows, lying times may be shorter when experiencing a longer time away from the paddock, which may also affect milk yield. Overall, this study indicates that paddock behaviours are associated with walking distance to the milking parlour and time spent away from the paddock. Efforts to reduce walking distance and time spent away from the paddock are likely to provide cows with greater opportunity to engage in daily behaviours in the paddock that meet their needs and maintain their milk yield.
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Corticosteroid-binding globulin (CBG) is a non-inhibitory member of the serpin superfamily of serine protease inhibitors and carries the majority of cortisol in circulation. It can be cleaved by neutrophil elastase at its exposed reactive centre loop which decreases its affinity for cortisol allowing the release of most of the cortisol at sites of inflammation. Intact and elastase cleaved CBG can be distinguished from each other and can coexist in circulation but with unknown half-lives. Here we treated a portion of purified human CBG with elastase, terminated the digestion and then combined this portion with intact human CBG and measured their respective half-lives in rabbits by ELISA. This investigation shows for the first time that the half-lives of intact and elastase cleaved CBG are identical (â¼10h). This is an important finding as it implies that in conditions such as sepsis and septic shock where levels of intact CBG are low and the proportion of cleaved CBG is high that this is likely sustained which may affect the CBG mediated targeted delivery of cortisol to sites of inflammation. Furthermore the residual binding of cortisol to cleaved CBG may alter the overall buffering capacity of CBG for cortisol resetting the baseline concentration of free cortisol.
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Hidrocortisona/metabolismo , Elastase Pancreática/metabolismo , Transcortina/metabolismo , Animais , Meia-Vida , Humanos , Coelhos , Soro/metabolismo , Transcortina/administração & dosagem , Transcortina/farmacocinéticaRESUMO
The study aimed to identify factors that may affect the likelihood that people with intellectual disabilities will find employment through a supported employment agency. A retrospective analysis of the files of the last 200 individuals to use such an agency was carried out. Variables were identified that may influence outcome, such as demographic factors, job preferences and identified support needs. A specific rating of staff assessed client motivation was developed from written comments made by staff. Staff assessed motivation after two weeks on the scheme was found to be the only significant predictor of employment outcome. Motivation levels decreased for all groups of participants while at the agency, irrespective of work outcome. This study highlights that a greater emphasis on motivation within employment agencies may increase the chances of people with intellectual disability finding work.