A multiarm randomized field trial evaluating strategies for udder health improvement in Swiss dairy herds.

The aims of this study were to quantify the effectiveness of specialist advice about udder health in Swiss dairy herds and to compare 3 different udder health improvement strategies against a negative control group. In 2010, 100 Swiss dairy herds with a high (between 200,000 and 300,000 cells/mL) yield-corrected bulk milk somatic cell count (YCBMSCC) were recruited for a 1-yr multiarm randomized field trial. The herds were visited between September and December 2011 to evaluate udder health-management practices and then randomly allocated into 1 of 4 study arms containing 25 herds each. The negative control study arm received neither recommendations for improving udder health nor any active support. The remaining 75 farmers received a herd-specific report with recommendations to improve udder health management. The positive control study arm received no further active support during 2012. The veterinarian study arm received additional support in the form of monthly visits by their herd veterinarian. Finally, the study group study arm received support in the form of bimonthly study group meetings where different topics concerning udder health were discussed. One year later, implementation of recommendations and changes in udder health were assessed. Of the recommendations given, 44.3% were completely implemented, 23.1% partially, and 32.6% were not implemented. No differences in implementation of recommendations were noted between the 3 study arms. At study enrollment, farmers were asked for the study arm of their preference but were subsequently randomly assigned to 1 of the 4 study arms. Farmers that were assigned to the study arm of their preference implemented more recommendations than farmers assigned to a study arm not of their preference. No decrease in the within-herd prevalence of cows that had a high (≥200,000 cells/mL) composite somatic cell count was observed in herds that had a YCBMSCC ≥200,000 cells/mL at the start of intervention. However, the 3 study arms with intervention (positive control, the veterinarian, and the study groups) prevented an increase in the within-herd prevalence of cows that had a high somatic cell count in herds with a low YCBMSCC at the start of the intervention compared with the negative control study arm. In the year after sending the report, herds assigned to the study group study arm had a reduced incidence rate of treated mastitis cases in comparison with the year before sending the report.

[Cost-benefit analysis of an intervention to improve udder health in Swiss dairy farms]. / Kosten-Nutzen-Analyse einer Intervention zur Verbesserung der Eutergesundheit in Schweizer Milchviehbetrieben.

The objective of this study was to calculate the national costs associated with udder health in Switzerland and to estimate the cost effectiveness of an udder health intervention program. In 49 farms, yearly mastitis associated costs before and during an intervention were collected at herd level. Costs were calculated for each lactating cow being present in the herd. At the beginning of the intervention, 24 farms received a report with recommendations to improve the udder health. In the following year, those herds were followed-up by their veterinarian at a monthly basis. The other 25 farms were used as a negative control group and neither received any recommendations nor any follow-up. In the first year of analysis (2010), the median udder health associated costs were 209.- Swiss Francs for each lactating cow, regardless of the intervention group. During the intervention period (2012), mastitis associated costs were 191.- Swiss Francs for control farms and 396.- Swiss Francs for farms with veterinary intervention on a monthly basis. The median additional costs for herds with intervention were 159.- Swiss Francs per lactating cow. At the national level, mastitis associated costs were estimated at 129.4 millions of Swiss Francs per year. The cost effectiveness of future mastitis control programs can be evaluated with the help of the deterministic model developed during this study.

Le but du présent travail était de calculer les coûts de la santé de la mamelle dans des exploitations laitières suisses et d'estimer l'efficacité économique d'une intervention en vue de l'améliorer. Pour cela on a relevé les coûts liés aux mammites sur une année dans 49 exploitations, et cela durant l'année précédant l'intervention puis dans l'année de l'intervention et on l'a divisé par le nombre de vaches en lactation. Vingt-quatre exploitations ont reçu au début de l'étude des recommandations en vue d'améliorer la santé de la mamelle et ont ensuite été suivies mensuellement durant une année par leur vétérinaire d'exploitation. Les 25 autres exploitations n'ont reçu aucune recommandation et ont été utilisées comme groupe de contrôle. Dans la première année d'analyse (2 ans avant l'intervention, 2010), les coûts moyens de la santé de la mamelle, indépendamment du groupe s'élevaient à CHF 209.­ par vache en lactation. Durant l'année de l'intervention, ils se montaient à CHF 191.­ pour les exploitations de contrôle contre CHF 396.- pour les exploitations suivies. Les dépenses supplémentaires durant l'intervention s'élevaient en moyenne à CHF 159.­ par vache en lactation. Au niveau national, on estime les coûts liés aux mammites à CHF 129.4 millions. Les modèles de calcul utilisés dans la présente étude permettent de juger à l'avenir de la rentabilité des programmes de contrôle des mammites.

[Illness behaviour: the influence of age, sex and socio-economic status (author's transl)]. / Krankheitsverhalten: Der Einfluss von Alter, Geschlecht und sozio-ökonomischen Merkmalen.

Some results of a study done in 1975/76 in Basle are presented (N=422 people working in administrative and industrial firms). Generally medicine takers are to be found in a high percentage already in the group with little symptoms. On the other side many of those reporting a high number of symptoms do not consult a physician. The number of symptoms reported is higher with progressive age, women and lower socio-economic status. Nevertheless we do not find an increase of consultations with a physician in the same direction.

[Illness behavior: design for an empirical study of the determining factors]. / Krankheitsverhalten: Entwurf für eine empirische Untersuchung der bestimmenden Faktoren

A large gap is existing between the system of medical services and the "consumer". It is necessary to reinforce preventive attitudes and behavior should prepare the fundamental concepts. A research design is presented.

[Illness behavior: preliminary results of an empirical study in Basel]. / Krankheitsverhalten: Erste Ergebnisse einer empirischen Untersuchung in Basel

Preliminary data of inquiry on illness behavior are presented. 94% of the subjects (N =472 people working in administrative and industrial firms) reported at least one symptom within 1 month. Their consecutive activities are described.