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1.
J Dairy Sci ; 101(8): 7095-7105, 2018 Aug.
Article in English | MEDLINE | ID: mdl-29885898

ABSTRACT

Holstein cows (n = 30) were balanced by days in milk, milk production, and parity (91 ± 5.9 d in milk, 36.2 ± 2.5 kg/d, and 3.1 ± 1.4, respectively) and fed OmniGen-AF (OG; Phibro Animal Health, Teaneck, NJ), an immune stimulant, at 0 g/cow per d for control (CON) or 56 g/cow per d for OG for 52 d on a commercial dairy. At 52 d of the study cows were randomly selected (n = 12) from both groups (6 OG and 6 CON) and housed in environmentally controlled rooms at the Agricultural Research Complex for 21 d at the University of Arizona. Cows were subjected to 7 d of thermoneutral (TN) conditions, 10 d of heat stress (HS), and 4 d of recovery (REC) under TN conditions. Feed intake, milk production, and milk composition were measured daily. Rectal temperatures (RT) and respiration rates (RR) were recorded 3 times per day (600, 1400, and 1800 h). Blood samples were taken on d 7 (TN), 8 (HS), 10 (HS), 17 (HS), and 18 (TN) during the Agricultural Research Complex segment. Cows in HS had higher RR and RT and water intake and lower dry matter intake and milk yield than these measures in TN. There was a treatment × environment interaction with cows fed OG having lower RR and RT and higher dry matter intake during peak thermal loads than CON. However, milk yield did not differ between groups. Cows fed OG had lower milk fat percent than CON (3.7 vs 4.3%) during HS. The SCC content of milk did not differ between treatment groups but rose in both groups during the REC phase following HS. Plasma insulin and plasma glucose levels were not different between groups. However, plasma insulin in both groups was lower during acute HS, then rose across the HS period, and was highest during the REC phase. Plasma cortisol levels were highest in all cows on the first day of HS (d 8) but were lower in cows fed OG compared with CON. However, plasma ACTH concentrations were elevated in OG-fed animals at all times samples were collected. Plasma ACTH was also elevated in cows fed both OG and CON during HS. Feeding OG reduced plasma cortisol during acute but not chronic HS and increased basal plasma ACTH, suggesting that OG treatment may alter the hypothalamic pituitary adrenal axis.


Subject(s)
Cattle Diseases/physiopathology , Cattle/physiology , Diet , Heat Stress Disorders/veterinary , Milk/chemistry , Animal Feed , Animals , Female , Heat Stress Disorders/physiopathology , Hot Temperature , Hypothalamo-Hypophyseal System , Lactation , Pituitary-Adrenal System , Pregnancy
2.
J Dairy Sci ; 100(5): 4025-4037, 2017 May.
Article in English | MEDLINE | ID: mdl-28237583

ABSTRACT

The objective of this study was to investigate the direct effects of feed supplements niacin and betaine on the heat shock responses of in vitro cultured cells derived from bovine mammary and uterine tissues. First, we determined the mRNA expression profiles of the niacin receptor (GPR109A) in bovine tissues (liver, skin, uterus, udder, and ovary) and in cells derived from bovine mammary epithelium (mammary alveolar cells, MAC-T; bovine mammary epithelial cells, BMEC) and endometrium (bovine endometrial cells, BEND). We found that GPR109A was distributed in all examined tissues and cells, and the highest expression was in cells from skin and udder. Second, we evaluated the effects of niacin treatment on the mRNA abundance of heat shock proteins 70 and 27 (HSP70 and HSP27) in MAC-T, BMEC, and BEND under thermoneutral conditions and heat stress, and whether these effects were associated with alterations in the mRNA expression of prostaglandin E2 synthesis-related genes, including cyclooxygenase 1 and 2 (COX-1 and COX-2) and microsomal prostaglandin E synthase 1 and 2 (mPGES-1 and mPGES-2). Quantitative PCR data indicated that niacin suppressed HSP70 mRNA expression in BMEC and both HSP70 and HSP27 in BEND under thermoneutral conditions. Only COX-2 expression was downregulated by niacin in BMEC; other prostaglandin E2 synthesis-related genes stayed unaltered in BMEC and BEND. The mRNA abundance of HSP70, COX-1, COX-2, and mPGES-1 were elevated in niacin-treated MAC-T. During heat stress, niacin increased mRNA levels of HSP70 and HSP27 in MAC-T and HSP27 in BEND, but decreased HSP70 in BMEC. Although mPGES-2 was stimulated by niacin in BEND, the mRNA expression of prostaglandin E2 synthesis-related genes were consistent with neither HSP70 nor HSP27 expression patterns in niacin-treated BMEC and MAC-T. These data suggest that the effects of niacin on heat shock protein expression and prostaglandin E2 synthesis were not well coupled in these cells. Finally, we tested the effects of betaine treatment on viability and apoptosis in BMEC. Compared with control cultures, viability was higher in betaine-treated cells at 8 h under thermoneutral conditions and at 16 h in heat stress, and apoptotic rates were lower at 8 h. Our data support a dual role for niacin in regulating heat shock protein expression in normal and heat-shocked cells derived from mammary and uterine tissues, and positive effects of betaine in regulating mammary cell viability during heat stress.


Subject(s)
Betaine , Niacin , Animals , Cattle , HSP70 Heat-Shock Proteins , Heat-Shock Proteins/genetics , Heat-Shock Response , RNA, Messenger
3.
J Dairy Sci ; 99(12): 9745-9753, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27720159

ABSTRACT

Betaine (BET), a natural, organic osmolyte, improves cellular efficiency by acting as a chaperone, refolding denatured proteins. To test if dietary BET reduced the effect of heat stress (HS) in lactating dairy cows, multiparous, lactating Holstein cows (n=24) were blocked by days in milk (101.4±8.6 d) and randomly assigned to 1 of 3 daily intakes of dietary BET: the control (CON) group received no BET, mid intake (MID) received 57mg of BET/kg of body weight, and high dose (HI) received 114mg of BET/kg of body weight. Cows were fed twice daily and BET was top-dressed at each feeding. Cows were milked 2 times/d and milk samples were taken daily for analysis. Milk components, yield, feed intake, and water intake records were taken daily. Rectal temperature and respiration rate were taken 3 times/d at 0600, 1400, and 1800h. Cows were housed in environmentally controlled rooms and were allowed acclimation for 7d at thermoneutral (TN) conditions with a mean temperature-humidity index of 56.6. Cows were then exposed to 7d of TN followed by 7d of HS represented by a temperature-humidity index of 71.5 for 14d. This was followed by a recovery period of 3d at TN. Dietary BET increased milk yield during the TN period. No differences were found between BET and CON in total milk production or milk composition during HS. The increase in water intake during HS was not as great for cows fed BET compared with controls. The cows on CON diets had higher p.m. respiration rate than both MID and HI BET during HS, but lower rectal temperature compared with BET. No difference was found in serum glucose during TN, but cows given HI had elevated glucose levels during HS compared with CON. No differences were found in serum insulin levels between CON and BET but an intake by environment interaction was present with insulin increasing in HI-treated lactating dairy cows during HS. The heat shock response [heat shock protein (HSP) 27 and HSP70] was upregulated in bovine mammary epithelial cells in vitro. Blood leukocyte HSP27 was downregulated at the HI dose under TN conditions and HSP70 was upregulated at the HI dose and this effect was increased by HS. No effect was seen with the MID dose with HSP27 or HSP70. The lack of effect of BET at MID may be associated with uptake across the gut. We conclude that BET increased milk production under TN conditions and was associated with reduced feed and water intake and slightly increased body temperatures during HS of cows fed BET. The effect of BET on milk production was lost during HS with HI BET, whereas serum glucose levels increased during HS.


Subject(s)
Betaine/pharmacology , Lactation , Animal Feed , Animals , Cattle , Diet/veterinary , Female , Heat Stress Disorders/veterinary , Hot Temperature , Milk , Stress, Physiological
4.
J Dairy Sci ; 98(1): 118-27, 2015 Jan.
Article in English | MEDLINE | ID: mdl-25468707

ABSTRACT

Cattle show several responses to heat load, including spending more time standing. Little is known about what benefit this may provide for the animals. Data from 3 separate cooling management trials were analyzed to investigate the relationship between behavioral patterns in lactating dairy cows experiencing mild to moderate heat stress and their body temperature. Cows (n=157) were each fitted with a leg data logger that measured position and an intravaginal data logger that measures core body temperature (CBT). Ambient conditions were also collected. All data were standardized to 5-min intervals, and information was divided into several categories: when standing and lying bouts were initiated and the continuance of each bout (7,963 lying and 6,276 standing bouts). In one location, cows were continuously subjected to heat-stress levels according to temperature-humidity index (THI) range (THI≥72). The THI range for the other 2 locations was below and above a heat-stress threshold of 72 THI. Overall and regardless of period of day, cows stood up at greater CBT compared with continuing to stand or switching to a lying position. In contrast, cows lay down at lower CBT compared with continuing to lie or switching to a standing position, and lying bouts lasted longer when cows had lower CBT. Standing bouts also lasted longer when cattle had greater CBT, and they were less likely to lie down (less than 50% of lying bouts initiated) when their body temperature was over 38.8°C. Also, cow standing behavior was affected once THI reached 68. Increasing CBT decreased lying duration and increased standing duration. A CBT of 38.93°C marked a 50% likelihood a cow would be standing. This is the first physiological evidence that standing may help cool cows and provides insight into a communally observed behavioral response to heat.


Subject(s)
Behavior, Animal/physiology , Body Temperature , Cattle/physiology , Heat Stress Disorders/veterinary , Lactation/physiology , Animals , Cattle Diseases/physiopathology , Climate , Dairying , Female , Heat Stress Disorders/physiopathology , Hot Temperature , Humidity , Random Allocation , Temperature
5.
J Anim Sci ; 91(10): 4984-90, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23942707

ABSTRACT

The effects of bacitracin methylene disalicylate (BMD) and scours on the fecal microbiome, animal performance, and health were studied in Holstein bull calves. Holstein bull calves (n = 150) were obtained from a single source at 12 to 24 h of age. Bull calves were randomly assigned to 1 of 2 treatments including CON (no BMD; n = 75 calves) and BMD (n = 75 calves). Starting 3 d after arrival, BMD was added into milk replacer (0.5 g/feeding; twice daily) and fed to the calves for 10 consecutive d. No differences (P > 0.10) were observed in ADG for d 0 to 28 and d 0 to 56, DMI for d 0 to 28, d 29 to 56, and d 0 to 56, or G:F for d 0 to 28, d 29 to 56, and d 0 to 56; ADG for d 29 to 56 tended to increase (P < 0.10) for BMD-treated calves compared with controls. Fecal samples were collected from 15 scouring calves and 10 cohorts (nonscouring calves received on the same day and administered the same treatment as the scouring calves). Animal morbidity and fecal score did not vary between the 2 treatments. Mortality was not influenced by the treatments in the BMD administration period or throughout the experiment. Fecal samples were subjected to pyrotagged 454 FLX pyrosequencing of 16S rRNA gene amplicon to examine compositional dynamics of fecal microbes. Escherichia, Enterococcus, and Shigella had greater (P < 0.05) populations in the BMD group whereas Dorea, Roseburia, Fecalibacterium, Papillibacter, Collinsella, Eubacterium, Peptostreptococcus, and Prevotella were decreased (P < 0.05) by BMD treatment. Genus populations were also compared between scouring and nonscouring calves. Streptococcus was the only genus that had notable increase (P < 0.05) in fecal samples from scouring calves whereas populations of Bacteroides, Roseburia, and Eubacterium were markedly (P < 0.05) greater in nonscouring calves. These results show that BMD has the ability to alter the composition of the fecal microbiome but failed to improve performance in Holstein bull calves. Discrepancy of microorganism profiles between scouring and nonscouring calves might be associated with the occurrence of scours and bacterial genera identified might be potential target of treating diarrhea.


Subject(s)
Bacitracin/pharmacology , Bacteria/classification , Bacteria/genetics , Cattle Diseases/microbiology , Diarrhea/veterinary , Gastrointestinal Tract/microbiology , Animal Feed/analysis , Animals , Animals, Newborn , Bacitracin/administration & dosage , Bacteria/drug effects , Cattle , Cattle Diseases/prevention & control , Diarrhea/microbiology , Diarrhea/prevention & control , Feces/microbiology , Male , RNA, Bacterial/genetics , RNA, Ribosomal, 16S/genetics
6.
J Dairy Sci ; 96(7): 4738-50, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23684043

ABSTRACT

Cows readily seek shade to reduce solar heat load during periods of high ambient temperature. Typically, auxiliary cooling systems are oriented to maximize cooling for shaded cows. However, when a shade structure is oriented north-south, stationary fan and mister cooling systems are unable to track shade as the sun's angle shifts throughout the day, and thus can become ineffective. The FlipFan Dairy Cooling System (Schaefer Ventilation Equipment, Sauk Rapids, MN) employs fans and misters that follow shade and compensate for wind speed by rotating on a horizontal axis. Multiparous, lactating Holstein cows (n=144) on a commercial dairy in Arizona were cooled by a fixed system comprised of stationary fans and misters acting as control or the adjustable FlipFan operated for 16.5 h/d (0830 to 0100 h). Core body temperatures (CBT) of 64 cows (4 pens/treatment; 8 cows/pen; 6d) and lying behavior of 144 cows (4 pens/treatment; 18 cows/pen; 5d) were collected by intravaginal and leg data loggers, respectively. Cows were balanced by milk production, blocked by days in milk, and randomly assigned to pen within block. Pen was the experimental unit. In a second experiment, isothermal maps were developed using a fixed system of thermal data loggers arranged in the shaded areas of the pens at different times of day and were analyzed for differences in the temperature-humidity index (THI) achieved by each cooling treatment. Ambient conditions consisted of a mean temperature of 33.0°C, mean relative humidity of 40.3%, and mean THI of 80.2. Mean 24-h CBT for FlipFan was lower than control (38.9 vs. 39.1±0.04°C). A treatment × time interaction was observed in which CBT of FlipFan was 0.4°C lower than control from 0600 to 0800h and 1500 to 1600h. Cows cooled by FlipFan spent more time lying down compared with those cooled by control (9.5 vs. 8.6 h/d). Cows under FlipFan had more frequent lying bouts than did those under control (12.8 vs. 10.7 bouts/d). Lower CBT and decreased standing time are consistent with the findings of other studies when ambient heat load was reduced. In the second experiment, the FlipFan system achieved a lower THI in the morning and evening (5.9 and 1.7%, respectively), and the THI also tended to be 0.8% lower in the afternoon compared with that of control. Results indicate that FlipFan is more effective than a stationary fan and mister system at decreasing CBT, increasing lying time and bouts, and providing a more desirable microenvironment for cows throughout the day in a semiarid environment.


Subject(s)
Air Conditioning/instrumentation , Behavior, Animal/physiology , Body Temperature , Cattle/physiology , Desert Climate , Humidity , Animals , Arizona , Female , Housing, Animal , Lactation/physiology , Posture/physiology
7.
J Anim Sci ; 90(8): 2818-25, 2012 Aug.
Article in English | MEDLINE | ID: mdl-22408085

ABSTRACT

As the dairy industry continues to grow, more dairy calves are available for dairy, beef, and veal purposes. Rearing systems must be highly efficient to make this industry cost efficient, making the evaluation of rearing methods important to establish the most practical method. A study was designed and conducted to evaluate effects of housing and feeding systems on performance of neonatal Holstein bull calves. Treatments (2 × 2 factorial arrangement) consisted of: 1) individually housed, bottle-fed (n = 5 bull calves); 2) individually housed, bucket-fed (n = 5 bull calves); 3) group-housed, bottle-fed (n = 5 pens; 4 bull calves/pen); and 4) group-housed, bucket- (trough) fed (n = 5 pens; 3 or 4 bull calves/pen). Feeding treatments began on d 7 when calves had been acclimated to their new environment. Body weight measurements were collected every 7 d and blood samples were collected on d 0, 28, 55, and 66 for ß-hydroxybutyrate (BHBA) concentration as a gross indicator of ruminal development. No housing × feeding interactions or feeding treatment effects were observed (P > 0.10). Average DMI (dry feed plus milk replacer) was increased (P < 0.05) for group-housed vs. individual animals after d 41, and final BW was greater (P < 0.05) for group-housed calves compared with individually housed calves. Feed efficiency and ADG, however, remained similar (P > 0.10) for all treatments. Fecal scores (P > 0.26), CV for BW (P > 0.26), and BHBA concentrations (P > 0.14) showed no differences among treatments. Housing system had greater effect on calf performance compared with milk feeding regimen.


Subject(s)
Animal Husbandry , Animals, Newborn , Cattle/growth & development , Housing, Animal , Aging , Animal Feed , Animal Nutritional Physiological Phenomena , Animal Welfare , Animals , Dairying , Diet/veterinary , Male
8.
Qual Saf Health Care ; 19(1): 3-8, 2010 Feb.
Article in English | MEDLINE | ID: mdl-20172875

ABSTRACT

OBJECTIVES: In an effort to improve patient safety attitudes and skills among third-year medical students, two patient safety training sessions were added to their curriculum, complementing a previously implemented second-year curriculum on quality improvement, patient safety and teamwork. METHODS: Safety attitudes and skills were assessed before and after students completed the medicine clerkship training and were compared with historical controls. Students identified and reported on observed safety events, with their reports matched to event type and harm score with contemporaneous safety reports from University of Missouri's Patient Safety Network (PSN). Comparisons were assessed by five internal safety experts using criteria for report submission "worthiness", blame tone, target of blame and presence/strength of proposed solutions. RESULTS: Students completing the third-year safety booster conferences expressed statistically higher comfort levels with identifying the cause of an error than did the student control group (p<0.05). Medical students proposed safety interventions that were more robust than those suggested by event reporters regarding similar events within our health system (p<0.0001). The worthiness and blame tone of medical student reports were not statistically different than event reports in PSN. CONCLUSIONS: Completion of two 1-h patient safety booster conferences in the third year of medical school led to increased student comfort in safety event analysis. Students documented stronger resolution robustness scores, suggesting similar training should be offered to PSN reporters. Medical students represent an underutilised resource for identifying and proposing solutions for patient safety issues.


Subject(s)
Clinical Clerkship , Clinical Competence/standards , Curriculum , Medical Errors/prevention & control , Patient Safety , Students, Medical , Academic Medical Centers , Attitude of Health Personnel , Humans , Missouri , Patient Safety/standards , Students, Medical/psychology
9.
Qual Saf Health Care ; 18(5): 325-30, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19812092

ABSTRACT

BACKGROUND: When patients experience unexpected events, some health professionals become "second victims". These care givers feel as though they have failed the patient, second guessing clinical skills, knowledge base and career choice. Although some information exists, a complete understanding of this phenomenon is essential to design and test supportive interventions that achieve a healthy recovery. METHODS: The purpose of this article is to report interview findings with 31 second victims. After institutional review board approval, second victim volunteers representing different professional groups were solicited for private, hour-long interviews. The semistructured interview covered demographics, participant recount of event, symptoms experienced and recommendations for improving institutional support. After interviews, transcripts were analyzed independently for themes, followed by group deliberation and reflective use with current victims. RESULTS: Participants experienced various symptoms that did not differ by sex or professional group. Our analysis identified six stages that delineate the natural history of the second victim phenomenon. These are (1) chaos and accident response, (2) intrusive reflections, (3) restoring personal integrity, (4) enduring the inquisition, (5) obtaining emotional first aid and (6) moving on. We defined the characteristics and typical questions second victims are desperate to have answered during these stages. Several reported that involvement in improvement work or patient safety advocacy helped them to once again enjoy their work. CONCLUSIONS: We now believe the post-event trajectory is largely predictable. Institutional programs could be developed to successfully screen at-risk professionals immediately after an event, and appropriate support could be deployed to expedite recovery and mitigate adverse career outcomes.


Subject(s)
Health Personnel/psychology , Medical Errors/psychology , Professional-Patient Relations , Stress Disorders, Post-Traumatic/psychology , Anecdotes as Topic , Clinical Competence , Female , Humans , Interviews as Topic , Male
10.
Qual Saf Health Care ; 17 Suppl 1: i13-32, 2008 Oct.
Article in English | MEDLINE | ID: mdl-18836062

ABSTRACT

As the science of quality improvement in health care advances, the importance of sharing its accomplishments through the published literature increases. Current reporting of improvement work in health care varies widely in both content and quality. It is against this backdrop that a group of stakeholders from a variety of disciplines has created the Standards for QUality Improvement Reporting Excellence, which we refer to as the SQUIRE publication guidelines or SQUIRE statement. The SQUIRE statement consists of a checklist of 19 items that authors need to consider when writing articles that describe formal studies of quality improvement. Most of the items in the checklist are common to all scientific reporting, but virtually all of them have been modified to reflect the unique nature of medical improvement work. This "Explanation and Elaboration" document (E & E) is a companion to the SQUIRE statement. For each item in the SQUIRE guidelines the E & E document provides one or two examples from the published improvement literature, followed by an analysis of the ways in which the example expresses the intent of the guideline item. As with the E & E documents created to accompany other biomedical publication guidelines, the purpose of the SQUIRE E & E document is to assist authors along the path from completion of a quality improvement project to its publication. The SQUIRE statement itself, this E & E document, and additional information about reporting improvement work can be found at http://www.squire-statement.org.


Subject(s)
Publishing/standards , Quality of Health Care , Health Services Research/standards
11.
Postgrad Med J ; 84(990): 211-6, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18424579

ABSTRACT

PROBLEM: Although Morbidity and Mortality conferences (MMC) were originally designed to promote quality care through careful analysis of adverse events, focus on individual actions or the fear of incrimination may interfere with identification of system issues contributing to the adverse outcomes. DESIGN: Pre- and post-intervention assessments of participant attitudes toward patient safety and conference redesign were performed utilizing an attitudinal survey. Participants provided a unique identifier for paired-means procedure. A list of contributing factors, recommended solutions, and targeted system improvements was maintained with ongoing progress recorded. SETTING: Department of Internal Medicine training program at University of Missouri-Columbia, an academic health care center affiliated with the University of Missouri Hospitals and Clinics and the Harry S. Truman Veteran's Administration Hospital. PARTICIPANTS: Residents and fellows from the Department of Internal Medicine residency program. EDUCATIONAL OBJECTIVES: (1) Distinguish between culture of blame/shame and patient safety culture, (2) Identify gaps in quality contributing to adverse outcomes, (3) Identify strategies to close gaps, (4) Participate in root cause analysis, demonstrating an ability to review an adverse event and recommend an action plan. STRATEGIES FOR CHANGE: An interdisciplinary team modified the internal medicine MMC to emphasize a better understanding of patient safety principles and system-based practice interventions. For each adverse event analyzed, root causes were identified, followed by discussion of system interventions that might prevent future such events. KEY MEASURES FOR IMPROVEMENT: (1) Attitudes of residents and fellows regarding patient safety, as measured on a 20 item, five-point ordinal scale (strongly disagree to strongly agree) survey, (2) System improvements generated from the Patient Safety M&M Conferences (PSMMC), and (3) Attendance at PSMMC. EFFECTS OF CHANGE: Clinical outcomes: Conference participants offered 121 system improvement recommendations; 39 suggested system interventions were pursued based upon the likelihood of achieving high impact changes. These targeted changes were assigned to department/facility representatives with 23 (59%) improvements implemented, 11 (28%) partially implemented or in progress, and five (13%) abandoned due to impracticality or redundancy. Educational outcomes: Surveys were completed by 58 residents and fellows before and after modification of conference format. Six of the 20 survey items showed significant change with four of these changes occurring in the desired direction. Eleven of the remaining 14 responses changed in the desired direction, but did not reach statistical significance. Average MMC attendance increased from 41+/-8 to 50+/-10 (p<0.03) participants. LESSONS LEARNT: The new PSMMC initiated multiple improvements in the quality of patient care without sacrificing attendance or attitudes of the residents or fellows. The new PSMMC promotes opportunities for participants to improve quality of patient care in a safe and nurturing environment.


Subject(s)
Internal Medicine/education , Internship and Residency/standards , Academic Medical Centers , Attitude of Health Personnel , Humans , Internal Medicine/standards , Missouri , Quality of Health Care
12.
Arch Environ Contam Toxicol ; 54(1): 44-56, 2008 Jan.
Article in English | MEDLINE | ID: mdl-17721798

ABSTRACT

The objectives of this study were to determine the influence of salinity (2.5, 5, 15, and 25 ppt) at dissolved organic carbon (DOC) concentrations of 1.3-3.3 mg/L and DOC concentrations of 2, 4, 6, and 8 mg/L at a fixed salinity of 10 ppt on the acute toxicity (96-h LC50s) of copper to the sensitive estuarine copepod, Eurytemora affinis. For both salinity and DOC experiments, various other chemical constituents such as DOC, Ca2+, Cl(-), Mg2+, Na+, K+, SO4 (2-) , hardness, alkalinity, salinity, pH, temperature, and dissolved oxygen were measured at selected copper concentrations at test initiation and test termination. Dissolved copper, copper speciation, and organic copper complexation were measured at various test conditions during the salinity and DOC experiments. Ninety-six-hour dissolved copper LC50 values for the four salinities ranged from 58 microg/L (25 ppt) to 104 microg/L (5 ppt) with intermediate values of 71 microg/L (2.5 ppt) and 68 microg/L (15 ppt). The 58, 68, and 71 microg/L LC50 values were not significantly different. Copper LC50 values at 5 ppt were higher than at both 15 and 25 ppt. The isosmotic salinity of E. affinis is approximately 5-10 ppt, which was a likely factor for why the LC50 value increased for copper at 5 ppt. The dissolved copper 96-h LC50s for E. affinis increased from 76 to 166 microg/L as DOC increased from 2 to 8 mg/L. This result is not surprising and is consistent with reported values for other saltwater species.


Subject(s)
Carbon/analysis , Copepoda/drug effects , Copper/toxicity , Water Pollutants, Chemical/toxicity , Animals , Calcium/analysis , Lethal Dose 50 , Magnesium/analysis , Salinity , Sulfates/analysis
13.
Qual Saf Health Care ; 16(6): 422-7, 2007 Dec.
Article in English | MEDLINE | ID: mdl-18055885

ABSTRACT

PROBLEM: Although morbidity and mortality conferences (MMCs) are meant to promote quality care through careful analysis of adverse events, focus on individual actions or the fear of incrimination may interfere with identification of system issues contributing to the adverse outcomes. DESIGN: Participant attitudes before and after the intervention towards patient safety and conference redesign were assessed using an attitudinal survey. A list of contributing factors, recommended solutions and targeted system improvements was maintained with ongoing progress recorded. SETTING: Department of Internal Medicine training programme at University of Missouri-Columbia. PARTICIPANTS: Residents and fellows from the above residency programme. EDUCATIONAL OBJECTIVES: (1) Distinguish between culture of blame/shame and patient safety culture, (2) identify gaps in quality contributing to adverse outcomes (3) identify strategies to close gaps and (4) participate in root cause analysis, demonstrating an ability to review an adverse event and recommend an action plan. STRATEGIES FOR CHANGE: An interdisciplinary team modified the internal medicine MMC to emphasise a better understanding of patient safety principles and system-based practice interventions. For each adverse event analysed, root causes were identified, followed by discussion of system interventions that might prevent future such events. KEY MEASURES FOR IMPROVEMENT: (1) Attitudes of residents and fellows regarding patient safety, as measured on a 20-item, five-point ordinal scale survey, (2) system improvements generated from the patient safety MMC (PSMMC) and (3) attendance at PSMMC. EFFECTS OF CHANGE: Clinical outcomes: 121 system improvement recommendations were made and 39 were pursued on the basis of likelihood of achieving high impact changes. 23 improvements were implemented, 11 were partially implemented or in progress, and 5 were abandoned due to impracticality or redundancy. Educational outcomes: 58 residents and fellows completed surveys before and after modification of conference format. 6/20 survey items showed substantial change with four of these changes occurring in the desired direction. Eleven of the remaining 14 responses changed in the desired direction. Average MMC attendance increased from 41+/-8 to 50+/-10 participants (p<0.03). LESSONS LEARNT: The new PSMMC initiated multiple improvements in the quality of patient care without sacrificing attendance or attitudes of the residents or fellows. The new PSMMC promotes opportunities for participants to improve quality of patient care in a safe and nurturing environment.


Subject(s)
Academic Medical Centers/organization & administration , Internship and Residency/organization & administration , Medical Audit , Medical Errors/prevention & control , Outcome Assessment, Health Care , Quality Assurance, Health Care , Safety Management , Academic Medical Centers/standards , Attitude of Health Personnel , Humans , Iatrogenic Disease/epidemiology , Internship and Residency/standards , Medical Errors/mortality , Medical Errors/statistics & numerical data , Missouri , Organizational Culture , Program Evaluation , Systems Analysis , Truth Disclosure
17.
Risk Anal ; 20(5): 545-72, 2000 Oct.
Article in English | MEDLINE | ID: mdl-11110205

ABSTRACT

A probabilistic risk assessment was conducted to evaluate the likelihood and ecological significance of potential toxic effects of diazinon in the Sacramento-San Joaquin system. Diazinon, an organophosphorus insecticide, is used in the Sacramento-San Joaquin River Basin as a dormant spray on almonds and other tree crops, as well as for other agricultural and urban applications. Diazinon and other pesticides have been detected in the Sacramento and San Joaquin Rivers and their tributaries. Diazinon exposure was characterized based on monitoring programs conducted in 1991-94. Diazinon effects were characterized using laboratory toxicity data for 63 species, supplemented by results from field mesocosm and microcosm studies. The assessment addressed the possibility that reductions in invertebrate populations could lead to impacts on species of fish that feed on those invertebrates. The risk assessment concluded that fish in these rivers are not at risk from the direct effects of diazinon in the water. Invertebrates are at greater risk, especially in agriculturally dominated streams and drainage channels during January and February. Cladocerans--including Daphnia magna and Ceriodaphnia dubia, two common bioassay species--are especially sensitive to diazinon and other organophosphates and are likely to be subject to acute toxic effects in some locations at some times. Any ecological damage that may occur, however, is brief and limited to cladocerans. None of the fish species of concern depend on cladocerans as critical components of their diet. Invertebrates that are not affected by observed concentrations of diazinon (copepods, mysids, amphipods, rotifers, and insects) are preferred foods for fish in the Sacramento-San Joaquin system.


Subject(s)
Diazinon/toxicity , Insecticides/toxicity , Animals , California , Ecosystem , Fishes , Invertebrates/drug effects , Risk Assessment , Water Pollutants, Chemical/toxicity
18.
Crit Rev Toxicol ; 29(4): 367-437, 1999 Jul.
Article in English | MEDLINE | ID: mdl-10451264

ABSTRACT

Irgarol 1051 is an algaecide used in copper-based antifoulant paints for controlling fouling organisms on the hulls of recreational and commercial watercraft. Paints containing this algaecide have been used in Europe since the mid-1980s. In 1998, the first antifouling paints containing Irgarol 1051 were registered for use in the U. S. To examine the risk that Irgarol may pose to aquatic ecosystems, a probabilistic ecological risk assessment was conducted using distributions of exposure and toxicity data. Exposure data for this assessment were derived from 11 monitoring studies (146 stations) conducted in marinas, estuaries, and coastal waters from 1992 to 1997 in six European countries. A comparison of 90th percentile concentrations pooled by station types across all regions showed that concentrations in marinas (316 ng/l) were higher than in estuaries and coastal waters (41 and 19 ng/l, respectively). A 90th percentile of 133 ng/l was reported for all pooled stations. Temporal trends showed that Irgarol concentrations typically peaked in early summer after launching of small boats with much lower concentrations occurring during the spring, fall, and winter. Toxicity data used for this risk assessment were derived primarily from unpublished studies submitted to regulatory agencies. Because Irgarol is a photosynthesis-inhibiting herbicide, it is much more toxic to plants than animals. Toxicity values for animals (fish and invertebrates) were much greater than concentrations of Irgarol reported in the environment. Therefore, a conservative approach using a distribution of only plant toxicity data (EC50s for plant growth) was used to derive a 10th percentile of 136 ng/l. This plant toxicity benchmark of 136 ng/l was used for risk characterization. Results from probabilistic analysis showed that ecological risk from Irgarol exposure was low in estuaries, coastal areas, and various open-type marinas. However, 10% or more of the plant species in enclosed marinas with low flushing rates may be exposed to Irgarol concentrations that would reduce photosynthesis activity and growth during the summer. Ecological risk to these sensitive plant species in enclosed marinas will likely be moderated because of the reversibility of Irgarol's inhibition of photosynthesis and the rapid recovery potential of plant communities. The ecological significance of marinas that generally contain numerous stressors such as trace metals, tributyltin, petroleum hydrocarbons, high nutrient concentrations, and low dissolved oxygen concentrations is a management issue that needs to be addressed.


Subject(s)
Ecology , Eukaryota/drug effects , Herbicides/toxicity , Paint/toxicity , Triazines/toxicity , Water Pollutants/toxicity , Biomass , Herbicides/chemistry , Models, Biological , Paint/analysis , Risk Assessment/methods , Ships , Triazines/chemistry
20.
J Appl Physiol (1985) ; 82(1): 23-31, 1997 Jan.
Article in English | MEDLINE | ID: mdl-9029194

ABSTRACT

The site of action of endogenous and exogenous nitric oxide (NO) in isolated pig lungs was investigated by using arterial, double, and venous occlusions, which allowed precapillary, postcapillary, and venous segments to be partitioned into arterial, precapillary, postcapillary, and venous segments. NG-nitro-L-arginine (L-NNA; 10(-5) M) increased resistance in the arterial (35 +/- 6.6%. P = 0.003), precapillary (39.3 +/- 5.1%, P = 0.001), and venous (18.3 +/- 4.8%, P = 0.01) segments, respectively. Sodium nitroprusside (10(-5) M) NO (80 parts/million) reversed the effects of L-NNA. Total pulmonary vascular resistance fell with increasing flow, due to a fall in precapillary resistance and dynamic resistance, and was significantly lower than mean total resistance. L-NNA increased the resistances but did not alter the pattern of the pressure-flow relationships. It is concluded that, in isolated pig lungs, the effect of endogenous NO seems to be dependent on flow in the arterial segment and independent of flow in the precapillary segment, but variation of its release does not appear to be fundamental to accommodation to changes in steady flow.


Subject(s)
Lung/drug effects , Nitric Oxide/pharmacology , Vascular Resistance/drug effects , Animals , Dose-Response Relationship, Drug , Female , In Vitro Techniques , Male , Swine
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