Comparison of testing for failure of passive transfer in calf serum using four different testing methods.

Failure of passive transfer (FPT) in calves is defined as failure to absorb colostral antibodies sufficient to achieve a serum immunoglobulin G (IgG) concentration of > 10 g/L within the first week of life. The aim of this study was to compare four different tests to diagnose FPT in a convenience sample of 1-7 day old dairy calves in Scotland. Published cutpoints for Brix and total protein (TP) refractometry and zinc sulphate turbidity (ZST) were compared with the reference test radial immunodiffusion (RID) for suitability to detect FPT. In addition, the current commercial RID reference test offered in Scotland was validated. FPT prevalence was estimated to be 14.17% (95% confidence intervals, 10.58-17.75) based on RID test results. There was moderate agreement between the reference (RID) and indirect tests (kappa=0.28 for Brix; 0.34 for TP; 0.24 for ZST). Brix and TP refractometry underestimated IgG concentration, resulting in an overestimation of FPT prevalence (40.54% and 29.46%, respectively). Similarly, ZST overestimated the prevalence of FPT (46.29%), but the variability was more consistent across all IgG concentrations. The performance of all three indirect methods was improved by lowering test cutpoints (to 5 g/dL for TP; 8.2% for Brix; 15 units for ZST) which improved test specificity and accuracy of these screening tests.

Effect of patient education on palliative care knowledge and acceptability of outpatient palliative care services among gynecologic oncology patients: A randomized controlled trial.

OBJECTIVES: A randomized control trial (RCT) to estimate the effect of an interventional video on improving palliative care knowledge, acceptability and attendance to outpatient services in gynecologic oncology patients. METHODS: Women receiving treatment for gynecologic malignancy recruited at an academic tertiary care center were randomized to: palliative care educational video or non-directive cancer center video. The primary outcome was referral to palliative care. Function and knowledge were assessed using the Functional Assessment of Cancer Therapy and the Palliative Care Knowledge Scale. Data analyses were performed using t-tests, Wilcoxon rank sum or Fisher's exact tests with significance level of α = 0.05. RESULTS: 111 women were enrolled. Demographic characteristics were equally distributed between groups with respect to age, race, cancer, and stage. There was no statistical difference in knowledge scores or in referral to palliative care between the patients that watched the educational versus control video (29% vs. 27%; p = .79). Secondary analysis showed a statistically significant increase in utilization of palliative care services compared to historic institutional data (8.8% to 31.5%; p ≤.001). Further, those referred had significantly worse baseline functional scores. CONCLUSIONS: Use of a palliative care educational video did not increase knowledge or acceptability of palliative services within this RCT. However, the rate of patients referred to palliative care tripled compared to historic rates. Further studies should investigate whether discussion regarding palliative care services alone may increase desire for referral, and if use of Fact-G scores may identify patients in greatest need of services.