Estimating US dairy clinical disease costs with a stochastic simulation model.

A farm-level stochastic model was used to estimate costs of 7 common clinical diseases in the United States: mastitis, lameness, metritis, retained placenta, left-displaced abomasum, ketosis, and hypocalcemia. The total disease costs were divided into 7 categories: veterinary and treatment, producer labor, milk loss, discarded milk, culling cost, extended days open, and on-farm death. A Monte Carlo simulation with 5,000 iterations was applied to the model to account for inherent system variation. Four types of market prices (milk, feed, slaughter, and replacement cow) and 3 herd-performance factors (rolling herd average, product of heat detection rate and conception rate, and age at first calving) were modeled stochastically. Sensitivity analyses were conducted to study the relationship between total disease costs and selected stochastic factors. In general, the disease costs in multiparous cows were greater than in primiparous cows. Left-displaced abomasum had the greatest estimated total costs in all parities ($432.48 in primiparous cows and $639.51 in multiparous cows). Cost category contributions varied for different diseases and parities. Milk production loss and treatment cost were the 2 greatest cost categories. The effect of market prices were consistent in all diseases and parities; higher milk and replacement prices increased total costs, whereas greater feed and slaughter prices decreased disease costs.

Effect of dietary copper source on response to coliform mastitis in dairy cows.

The effect of organic or inorganic dietary Cu on Escherichia coli mastitis was investigated in first-lactation heifers. Twenty-eight primigravid Holstein heifers were assigned to 3 treatments in a completely randomized block design with 10 blocks of 3 animals grouped by expected calving date. Treatments were as follows: basal diet [7.1 mg Cu/kg of dry matter (DM); CON] and diets supplemented with Cu (10 mg/kg of DM) as Cu sulfate (CUS) or as Cu proteinate (CUP). Treatments were fed individually from 60 d prepartum through 49 d of lactation. All heifers were marginally deficient at the onset of the experiment (liver Cu of 60 mg/kg) and did not differ between groups. Mean liver Cu concentrations were about 3-fold greater in CUS and CUP compared with CON at d 0, 21, and 42 of lactation. At d 34 postpartum, one pathogen-free quarter per cow was infused with Escherichia coli strain 727. Copper supplementation did not lower peak responses to challenge; however, CUP tended to offer some benefits: milk bacterial count with CUP was lower compared with CON at 24, 48, and 72 h and lower than CUS at 24 and 96 h, and postchallenge milk production tended to be greater for CUP. Clinical udder score was lower at 12 h for CUP and CUS compared with CON, and at 144 h CUP had lower clinical scores compared with CUS or CON. Somatic cell count, dry matter intake, plasma Cu, and plasma ceruloplasmin did not differ between treatments. Compared with the control diet or Cu sulfate supplement, supplementation with Cu proteinate tended to improve the clinical status of cows after live E. coli intramammary challenge.

Social and affective development in infants with a manic-depressive parent.

The authors observed seven infants who had a manic-depressive parent longitudinally in a structured laboratory setting with their mothers at ages 12, 15, and 18 months. The infants' attachment and affiliative behaviors and the patterning of their affective responses were assessed according to systematic measures and compared with those of a matched control group. The proband infants appeared to show a disturbance in the quality of their attachments to their mothers as well as a generalized disturbance in their capacities to regulate their emotions adaptively. There appeared to be an increasing severity of disturbance with increasing age. The authors discuss the implications of these findings.

A developmental view of affective disturbances in the children of affectively ill parents.

The authors review the various clinical and experimental studies of children of parents with affective illness, spanning infancy, childhood, and early adolescence and including their own and the studies reported in this Special Section of the Journal. They find a clear tendency to early disturbances in these children that seems related to adult affective illness in the areas of affect regulation and social interaction. Although these findings suggest a developmental line of affective illness linking child and adult forms, many issues need further clarification.

Psychosocial adaptation of 39 adolescents with sex chromosome abnormalities.

OBJECTIVES: Children with sex chromosome abnormalities (SCA) are known to be at increased risk for neuromotor, language, learning, and behavioral problems, but little is known of psychosocial adaptation of SCA adolescents. This study was conducted to evaluate psychologic characteristics of unselected SCA adolescents, including socialization, educational progress, separation from family, and incidence and severity of psychiatric disturbance. METHODS: Thirty-nine propositi identified through the screening of 40,000 consecutive Denver newborns, including boys with 47,XXY karyotypes and girls with 47,XXX, 45,X, and partial X monosomy, or SCA mosaic karyotypes, have been followed longitudinally into adolescence. Twenty-seven siblings served as controls. Between 12 and 19 years of age, all participated in blind psychiatric interviews and were administered standardized intelligence and achievement tests. RESULTS: SCA propositi demonstrated a mean IQ score 21 points lower than that of control subjects. In addition, lower mean scores were seen on achievement test results as well as lower overall psychosocial adaptation scores and increased incidence of psychiatric disturbance. Depression was the most frequent psychiatric diagnosis. Propositi were more likely to receive special education assistance in high school and were less likely to graduate from high school than were controls. Of the three nonmosaic propositi groups, the 47,XXX girls demonstrated the poorest overall psychosocial adaptation and highest degree of psychiatric disturbance. Mosaic girls were indistinguishable from control subjects. Marked variability was found among all three nonmosaic groups, with some individuals in each group demonstrating relatively strong psychosocial adaptation. CONCLUSIONS: The presence of nonmosaic sex chromosome abnormality increases the risk for impeded cognitive skills, learning abilities, and psychosocial adaptation in adolescence. The factors that allow for stronger adaptation in some of these adolescents include the presence of a stable and supportive family environment. The outlook for adaptation in unselected SCA adults remains uncertain.

47,XXX: what is the prognosis?

Eleven unselected 47,XXX girls, now 15 to 22 years of age, have been observed from birth in a prospective study of children with sex chromosome anomalies. A description of their growth and development is presented. The 47,XXX infants were not generally distinguishable from chromosomally normal children in the first year of life, even though there was a slight delay in neuromotor development. By 2 years of age, developmental delays in speech and language often became evident, and speech therapy was often necessitated in the preschool years. Early school problems included speech and language deficiencies, lack of coordination, poor academic performance, and immature behavior; these persisted throughout the school years. By high school age, a 47,XXX girl was generally tall and often subject to somatic complaints. Sexual development was generally normal. Seven of the 11 propositae had a diagnosed psychiatric disorder or disturbance at some time during adolescence. Variability within this syndrome is great; one proposita is in college and another is mentally retarded. The frequency of the diagnosis of the 47,XXX karyotype by genetic amniocentesis is estimated to be 1/1000, the same incidence as in the newborn population. Expectant parents must be counseled as to the significance of this karyotype and prognostic information must be given. Suggested guidelines are included.

Neuropsychological and functional cognitive skills of 35 unselected adults with sex chromosome abnormalities.

This report presents data defining the neuropsychological and cognitive phenotypes of a group of adults with sex chromosome abnormalities identified at birth through the chromosome screening of 40,000 consecutive newborns between 1964 and 1974. In all three nonmosaic groups, reading skills were impaired and intelligence quotients were on average reduced more than 20 points relative to controls. The 47,XXX women demonstrated greatest overall impairment, including reduced scores on tests of conceptualization and problem solving. 45,X women demonstrated impairment in spatial thinking skills, and 47,XXY men in verbal processing skills. No reduced scores were found in the female mosaic group. Marked variability in scores was seen in all groups; some propositi have been unable to hold any job, whereas others have completed college and are professionally employed.

Psychosocial competence of unselected young adults with sex chromosome abnormalities.

Very little is known about the adult adaptation of individuals with sex chromosome abnormalities (SCA) except for a few reports based upon biased samples of clinically identified patients. This first report from the Denver SCA study on the adult psychosocial adaptation of 36 unselected propositi, identified at birth, shows a continuation of mild psychological and social problems. Psychiatric interviews and self-reported information revealed that adaptation is quite variable, with many of the nonmosaic propositi not faring as well as their siblings, but in a few instances exceeding the success of brothers and sisters. Within this group of SCA subjects a subset demonstrated more marked pathology and a tendency to over-rate their social adaptation relative to the psychiatric interviewer, suggesting that the exclusive use of self-report questionnaires may not provide accurate assessment of psychological characteristics in this and other special populations. The full adult SCA behavioral phenotype has not yet been established but is emerging through additional reports from this and other studies of unselected SCA adults.

Depressed mothers: they don't always look as bad as they feel.

OBJECTIVE: The relationship of maternal depression to self-report and observational data was investigated in a sample of depressed (n = 30) and nondepressed women (n = 32) and their 3-year-old children. Depression characteristics (diagnostic subtype/remission status) were related to maternal self-report and mother-child interactions. METHOD: Mothers completed standardized questionnaires and the dyad was observed in the laboratory. Observations were rated for maternal behavior and child attachment. RESULTS: There were no differences between depressed and nondepressed groups on observational measures; depressed mothers' self-report was consistently more negative. Within the depressed group, women with more severe/chronic depression showed behavioral differences but were no different from less depressed women on self-report measures. Women in remission improved for self-report, but not for observational data. CONCLUSIONS: The consequences of maternal depression vary depending on type of depression, severity, chronicity, current mood status, and on how the impact of depression is measured.

Data collection techniques.

We have provided an overview of techniques used to assess variables in the applied behavioral sciences. Most of the methods are used by both quantitative/positivist and qualitative/constructivist researchers but to different extents. Qualitative researchers prefer more open-ended, less structured data collection techniques than do quantitative researchers. Direct observation of participants is common in experimental and qualitative research; it is less common in so-called survey research, which tends to use self-report questionnaires. It is important that investigators use instruments that are reliable and valid for the population and purpose for which they will be used. Standardized instruments have manuals that provide norms and indexes of reliability and validity. However, if the populations and purpose on which these data are based are different from yours, it may be necessary for you to develop your own instrument or provide new evidence of reliability and validity.

Postponing pregnancy after perinatal death: perspectives on doctor advice.

The Perinatal Loss Interview was administered to 24 mothers who had experienced perinatal loss and were raising a child born subsequent to the loss; mothers were asked about postponing subsequent pregnancy, including what their doctors advised. Mothers were dissatisfied with doctor advice, reporting that the timing of a subsequent pregnancy was a personal decision and many factors influenced their decision. Furthermore, regardless of timing, most mothers reported overprotective and replacement feelings toward the subsequent child. These results imply that physicians may be most effective by educating mothers about advantages and disadvantages of postponing pregnancy so that an informed decision can be made.

Attachment and feeding problems: a reexamination of nonorganic failure to thrive and attachment insecurity.

OBJECTIVE: To examine the relationship between attachment patterns, degree of security, and feeding problems. METHOD: Three groups of toddlers (age range = 12-37 months) were included: toddlers with infantile anorexia (n = 33), picky eaters (n = 34), and healthy eaters (n = 34). Participants in each group were matched for age, socioeconomic status, gender, and ethnicity. Attachment patterns and degree of attachment security were assessed through the Ainsworth Strange Situation. RESULTS: The infantile anorexia group exhibited a higher rate of insecure attachment relationships than the picky eater and healthy eater groups. When measured on a continuous scale, the infantile anorexia group also displayed a higher degree of insecurity than the other groups. Contrary to previous research, elevated rates of type D attachments were not present within the infantile anorexia group. CONCLUSIONS: Feeding problems and growth deficiencies can occur within the context of organized and secure attachment child-parent relationships. However, insecure attachment relationships may intensify feeding problems and may lead to more severe malnutrition. Implications for the treatment of specific feeding problems are discussed.

Transition from adolescence to early adulthood: adaptation and psychiatric status of women with 47,XXX.

OBJECTIVE: To investigate the adolescent and early adult adaptation of a group of 47,XXX women as compared with their siblings, addressing developmental differences in adaptation and psychiatric status. METHOD: Subjects included eleven 47,XXX women and nine female sibling controls. Interviews during adolescence and during early adulthood were semistructured and included a psychiatric evaluation. Four areas of inquiry were (1) relationships with other family members, (2) sense of self-esteem, (3) sexual identity and preference, and (4) responses to life stressors. A DSM-IV psychiatric diagnosis was assigned where appropriate. The Schedule for Affective Disorders and Schizophrenia-Lifetime version was also administered, and assessments of overall functioning and adaptation were completed. RESULTS: The 47,XXX women during adolescence and young adulthood were less well adapted; had more stress; had more work, leisure, and relationship problems; had a lower IQ; and showed more psychopathology when contrasted with the comparison group. However, most of the 47,XXX women were self-sufficient and functioning reasonably well, albeit less well than their siblings. CONCLUSIONS: This longitudinal study has clarified that previously reported outcomes of severe psychopathology and antisocial behavior in individuals with sex chromosome anomalies are rare and variability in the behavioral phenotype is much larger than originally appreciated.

Infant-initiated weaning from the breast in the first year.

Mothers of 50 healthy breast-fed infants for whom weaning had been completed by the first birthday were administered a maternal feeding and weaning questionnaire developed by the authors. A major purpose of the questionnaire was to investigate the phenomenon of infant-initiated weaning, which is commonly, but somewhat misleadingly referred to as 'self-weaning'. 46% of the infants were reported by their mothers to have initiated weaning. The onset of this behavior occurred most frequently at 5 and 9 months of age. Most mothers attributed it to their infants' increased exploratory and nutritional desires and a concomitant reduced interest in breast-feeding. It is suggested, that rather than being weaning behavior per se, this behavior (at least that which occurs between approximately 5 and 9 months of age) may actually be a common correlate of the cognitive and physical discontinuities or 'spurts' in development which are known to occur during this interval, but that it can, and often does indirectly lead to a relatively easy mutual weaning from the breast if met with appropriate and timely maternal intervention.

Self-disclosure and the treatment of substance abuse.

Identification and treatment of the substance-abusing physician has led to outcome studies focusing on years of abstinence and resultant work performance, but little has been written addressing the therapeutic changes recovery brings in the personal lives of these physicians or in their approach to similarly addicted patients. The unique position of recovering psychiatrists engaged in the treatment of substance-abusing patients has not been addressed. Self-disclosure is a major issue and becomes unavoidable if the psychiatrists meet their patients at Twelve-Step meetings. This paper begins a discussion of the issues of self-disclosure and anonymity for recovering psychiatrists. The informal method used to gather information highlights the sensitivity of these issues for both patients and psychiatrists. The clinical examples show the importance of evaluating the psychodynamic impact of self-disclosure on the patient, the psychiatrist, and their treatment relationship.

Lactating cows become partially refractory to frequent intramammary endotoxin infusions: recovery of milk yield despite a persistently high somatic cell count.

Midlactation cows were infused with 10 micrograms endotoxin in the same two homolateral quarters after each of several consecutive milkings to study the effect of prolonged, endotoxin-induced mastitis on lactational performance. The initial infusion induced an acute response with systemic involvement. Inflammation developed in infused quarters, and milk production declined and milk composition was altered in all quarters. Subsequent infusions failed to induce systemic responses. Furthermore, milk yield and composition in uninfused quarters returned to pre-treatment levels despite further infusions. In infused quarters, milk yield, protein percentage and serum albumin concentration showed partial recovery during the endotoxin infusion period. In contrast, decreased lactose concentration, and increased cell count, N-acetyl-beta-D-glucosaminidase and lactoferrin levels persisted throughout the infusion period. After infusions were stopped, all measurements returned to near pretreatment levels. These data demonstrate that systemic, but not local, responses become refractory to multiple intramammary endotoxin infusions, and that multiple infusions have continued but little progressive or permanent, inhibitory effects on lactational performance despite a persistent mammary leucocytosis.

Summer fescue toxicity in dairy steers fed tall fescue seed.

Seeds of the tall fescue ( Festuca arundinacea Schreb .) cultivars Kentucky 31 and an experimental ryegrass X tall fescue hybrid derivative strain (G1-307), and orchard grass (OG) seed were fed in a carrier diet to calves in controlled environmental rooms (31 to 32 C). Both tall fescue varieties produced symptoms of summer toxicosis in dairy steers. Total feed intake (P less than .01) and water intake (P less than .01) of calves were reduced by the tall fescue seed diets when compared with orchard grass. Steers fed G1-307 and Kentucky 31 tall fescue lost (NS) 17.5 and 7.8 kg of body weight, respectively, while those consuming orchard grass gained (P less than .01) 6.2 kg during the experiment. Rectal temperatures were lower (P less than .05) in the calves fed OG (39.4 C) when compared with those fed G1-307 (40.6 C) and Kentucky 31 (40.8 C) tall fescue seed, respectively. In a second trial Kentucky 31 seed was fed in a carrier diet to Holstein steers at graded levels of 0, 350, 700 and 1,050 g seed/d. Consumption of 700 and 1,050 g seed/d adversely affected performance of steers. Total feed intake was lower and water intake was reduced (P less than .05), with rectal temperatures being elevated (P less than .01) in these two groups when compared with 0- or 350-g treatments. No significant differences were detected in body weight changes in this trial. Respiration rates were not significantly affected in either trial. Results of these trials with the young bovine indicate that a toxic substance(s) is present in tall fescue seed.

Effect of chromium tripicolinate supplementation on porcine immune response during the postweaning period.

A total of 60 pigs from 15 litters were used during two experiments to assess the effects of maternal supplementation of Cr tripicolinate on performance and immune status of the offspring during the first 42 d after weaning. Gilts were raised on diets with either 0 (-Cr) or 200 (+Cr) ppb supplemental Cr from Cr tripicolinate. Their offspring were weaned at about 23 d of age. Pigs from dams fed supplemental Cr were fed Cr-supplemented diets after weaning and pigs from unsupplemented dams were not fed supplemental Cr. Pigs were housed in groups of three according to litter origin (six -Cr and nine +Cr) and BW. Feed and water were available for ad libitum consumption. Serum was collected 24 h after birth, the day after weaning (d 0), and, subsequently, every 7 d through d 28 for measurement of total immunoglobulin (Ig) G and IgM. For the 42-d nursery period, ADG (511 and 531 g/d for -Cr and +Cr, respectively), ADFI (827 and 851 g/d), and gain:feed (0.62 and 0.62) were not affected (P > 0.15) by Cr. Total IgG was not affected (P > 0.10) by Cr on d 0 (7.6 and 7.7 mg/mL for -Cr and +Cr, respectively) or on d 7 (6.3 and 6.1 mg/mL for -Cr and +Cr, respectively), when the lowest concentrations were observed. By d 28, total IgG had risen (11.7 and 8.9 mg/mL for -Cr and +Cr, respectively) and was affected by Cr (P = 0.03). Total IgM followed a similar pattern and was lowest on d 7. In each trial, IgG at 24 h after birth was inversely related to IgG from d 14 through 28 in the nursery. Additionally, the lowest Ig concentrations occurred between 4 and 5 wk of age, rather than at weaning (23 d of age); this may represent a vulnerable period for weanling pigs. Supplementation of the weanling pig diets with Cr tripicolinate did not significantly affect performance and immune status during the postweaning period.

Effect of chromium tripicolinate supplementation on porcine immune response during the periparturient and neonatal period.

A total of 36 gilts were used to assess the effects of Cr tripicolinate supplementation on immune response in sows and their offspring during the periparturient and neonatal period. Gilts were raised from weaning to reproductive age on diets with either 0 (-Cr) or 200 (+Cr) ppb supplemental Cr from CrPic. Subsequently, 22 gilts (9 -Cr and 13 +Cr) in parity 1 and 16 sows in parity 2 (7 -Cr and 9 +Cr) underwent immune status testing. Only sows that completed all procedures in parity 1 were included in parity 2. Sows were immunized with ovalbumin about 3 wk (d 0), and again 14 d later for gilts, prior to anticipated farrowing, and serum was collected on d 0 and at 14-d intervals for a total of four samples. Serum was collected from five to six pigs/litter at 24 h after birth, three or six pigs/litter the day after weaning (25 d of age) in parity 1, and three pigs/litter the day of weaning (20 d of age) in parity 2. Milk was collected at 1 h (colostrum), 6.5 d (early), and 19 d (late) after farrowing. The only effect of Cr on total immunoglobulin (Ig) concentration was on sow serum IgG (21.7 and 24.1 mg/mL for -Cr and +Cr, respectively; P = 0.08) and IgM (11.0 and 12.5 mg/mL; P = 0.06) on d 0. No effect (P > 0.15) of Cr was observed on the IgG antibody response to ovalbumin, but Cr was associated (P < 0.10) with a decreased IgM antibody response to ovalbumin beginning on d 14. In parity 2, colostral total IgG increased (80.6 and 92.4 mg/mL for parity 1 and 2, respectively; P = 0.06), which was reflected in the neonates at 24 h after birth (33.6 and 39.7 mg/mL; P = 0.01) and at weaning (7.3 and 13.3 mg/mL; P < 0.001). Supplementation of Cr tripicolinate had minimal effects on humoral antibody response of the dam or its transfer to the neonate; however, parity greatly influenced the concentrations of immunoglobulins in the milk and their transfer to the neonate.

Porcine immunoglobulin transfer after prepartum treatment with selenium or vitamin E.

Responses to prepartum injection of sows with Se and vitamin E (E) were evaluated by determining immunoglobulin (IgA, IgM, IgG) levels in the colostrum and serum of the sows and the serum of their offspring. Fifty-four sows (40 multiparous, 14 primiparous) receiving diets adequate in E and Se according to current NRC (1988) standards were randomly allotted to four treatment groups in which a single i.m. injection of saline (controls), 5 mg of Se, 1,000 IU of E, or both Se and E were given on d 100 of gestation. Sows were bled prior to and 7 d after injection, at farrowing and on d 14 and 28 of lactation. Colostral samples were collected at the initiation of farrowing. Pigs were bled 20 h postpartum and at 14 and 28 d of age. Major immunoglobulin changes in the serum of the sows due to treatment were not seen prior to parturition. Injections of Se and(or) E resulted in higher colostral IgM levels (8.4, 10.7, 9.8 and 9.6 mg/ml, respectively), but only the response from Se was significant (P less than .05). Concentrations of colostral IgA or IgG were not affected by treatment (P greater than .30). Compared with controls, all three treatments increased (P less than .10) IgM concentrations in serum from pigs at birth (28.3, 33.3, 36.0 and 33.5 mg/ml, respectively), whereas IgA and IgG concentrations were not affected (P greater than .30).(ABSTRACT TRUNCATED AT 250 WORDS)