Supplemental trace minerals (zinc, copper, and manganese) as sulfates, organic amino acid complexes, or hydroxy trace-mineral sources for shipping-stressed calves.

Crossbred calves (n = 350; average BW 240 ± 1 kg) were obtained from regional livestock auctions. Within each set (block, n = 4), calves were stratified by BW and arrival sex into 1 of 8, 0.42-ha pens (10 to 12 calves per pen). Pens were assigned randomly to 1 of 3 treatments consisting of supplemental Zn (360 mg/d), Mn (200 mg/d), and Cu (125 mg/d) from inorganic (zinc sulfate, manganese sulfate, and copper sulfate; n = 2 pens per block), organic (zinc amino acid complex, manganese amino acid complex, and copper amino acid complex; Availa-4, Zinpro Corp., Eden Prairie, MN; n = 3 pens per block), and hydroxy (IntelliBond Z, IntelliBond C, and IntelliBond M; Micronutrients, Indianapolis, IN; n = 3 pens per block) sources. During the 42- to 45-d backgrounding period calves had ad libitum access to bermudagrass hay and were fed corn and dried distillers grain-based supplements that served as carrier for the treatments. After removal of data for chronic (n = 6) and deceased (n = 1) calves, trace-mineral source had no effect on final or intermediate BW (P = 0.86) or ADG (P ≥ 0.24). With all data included in the analysis, dietary treatments had no effect on the number treated once (P = 0.93), twice (P = 0.71), or 3 times (P = 0.53) for bovine respiratory disease or on the number of calves classified as chronic (P = 0.55). Based on these results, trace-mineral source had no effect on total BW gain, ADG, or morbidity during the receiving phase in shipping-stressed cattle.

Effects of caffeine on session ratings of perceived exertion.

This study examined effects of caffeine on session ratings of perceived exertion (RPE) following 30 min constant-load cycling. Individuals (n = 15) of varying aerobic fitness completed a [Formula: see text] max trial and two 30 min cycling bouts (double-blind, counterbalanced) following ingestion of 6 mL/kg of caffeine or matched placebo. RPE overall, legs and breathing were estimated every 5 min and session RPE was estimated 30 min post-exercise using the OMNI pictorial scale. Session RPE for caffeine and placebo trails were compared using paired t test. Between-trial comparisons of HR, RPE overall, RPE legs and RPE breathing were analyzed using an independent 2 (trial) × 6 (time point) repeated measures analysis of variance (ANOVA) for each dependent variable. Caffeine resulted in a significantly lower session RPE (p < 0.05) for caffeine (6.1 ± 2.2) versus placebo (6.8 ± 2.1). Acute perceptual responses were significantly lower for caffeine for RPE overall (15, 20, 25, and 30 min), RPE breathing (15, 20, 25, and 30 min) and RPE legs (20 and 30 min). Survey responses post-exercise revealed greater feelings of nervousness, tremors, restlessness and stomach distress following caffeine versus placebo. Blunted acute RPE and survey responses suggest participants responded to caffeine ingestion. Caffeine decreased acute RPE during exercise which could partially account for lower session RPE responses. However, decreased session RPE could also reveal a latent analgesic affect of caffeine extending into recovery. Extending the understanding of session RPE could benefit coaches in avoiding overtraining when adjusting training programs.

Provision of trauma teams in Scotland: a national survey.

BACKGROUND AND AIMS: Trauma is still the leading cause of mortality in the first four decades of life. Despite numerous reports on how trauma care could be improved in the UK, treatment has been shown to be inconsistent and of poor quality. Trauma teams have been shown to have a positive effect on outcome. A study was undertaken to determine the prevalence of trauma teams in Scotland. METHODS: A telephone survey was performed of 24 hospitals with emergency departments in which the senior clinician was interviewed regarding the provision of trauma teams. RESULTS: Five (21%) of the hospitals questioned had trauma teams. The most common reasons for not having one were no problem with the current system in eight cases (44%) and an inability to include sufficiently senior staff on the team in six cases (24%). CONCLUSIONS: There are few trauma teams in Scottish acute hospitals. There was little enthusiasm for introducing them for a variety of reasons. Local evidence of benefit is probably needed before their adoption becomes widespread.

Effectiveness evaluation of several cattle anthelmintics via the fecal egg count reduction test.

Utilizing groups of cograzed, naturally infected beef-type heifers, three fecal egg count reduction tests were conducted in the later months of 2007 at the University of Arkansas. Each test was 28 days in length consisting of individual animal fecal nematode egg counts and coprocultures. Both original and generic ivermectin injectable formulations were used in two of the tests at 0.2 mg/kg BW, with FECR percentages never exceeding 90% in either test. Oral fenbendazole was evaluated at 5 and 10 mg/kg BW, with FECR%'s exceeding 90% on all occasions, but with a precipitous drop when recently treated animals were treated at the lower dose. Evaluated in one test, injectable moxidectin given at 0.2 mg/kg BW resulted in egg count reductions of 96-92% (days 7 to 28). Also evaluated in one test, albendazole delivered orally at 10 mg/kg BW was 98% and 97% effective at 17 and 28 days post-treatment. For all tests, coprocultures conducted post-treatment contained only Cooperia spp. larvae (benzimidazole use), relatively unmodified percentages of Cooperia spp. and Haemonchus spp. larvae (ivermectin use), and primarily Cooperia spp. larvae with a small percentage of Haemonchus spp. larvae (moxidectin use).

Frequent use of medical services. Patient reports of intentions to seek care.

OBJECTIVE: To examine differences between frequent and infrequent users in decisions to seek medical care based on symptom type and duration of experience of the symptom. DESIGN: Retrospective study. SETTING: University family practice clinic. PATIENTS: Fifty-eight of 130 patients returned the completed instruments, a response rate of 45%. MAIN OUTCOME MEASURES: The following two instruments were used: the Intentions to Seek Care questionnaire, which measures intention to see a physician, self-treat, or use medications for 11 different symptoms after three time periods--1 day, 3 days, and 1 week of symptom duration--and the SF-36 Health Survey measure. RESULTS: Initial analyses suggested that patients perceive three clusters of symptoms, which we have labeled as serious, mild, and psychological. Scale scores for these groups of symptoms yielded significant reliability and were used in subsequent analyses. Multivariate analysis of variance comparing source of care, symptom duration, and frequent vs infrequent user groups indicated that both user groups are more likely to seek care from physicians for symptoms that are serious. Analysis of mild and psychological symptoms yielded significant three-way interactions, with frequent users more likely than infrequent users to seek care from physicians at a 1-day duration. Such differences disappear by 7 days. Significantly lower scores were obtained on five of the eight SF-36 Health Survey dimensions for the infrequent users. CONCLUSIONS: Frequent users are more likely than infrequent users to report that they would seek care for minor symptoms. Infrequent users tend to self-treat for 3 to 7 days, after which time physician advice is sought. Efforts to teach patients optimal timing of use for different symptoms may be an effective intervention.

Publication productivity in academic family medicine departments.

BACKGROUND AND OBJECTIVES: The purpose of this study was to quantify research publication productivity of family medicine departments in selected family medicine and interdisciplinary journals. METHODS: A 5-year journal search was conducted to identify original research articles published by family medicine department faculty. Publication productivity of all departments was ranked, and regression analysis was used to identify predictors of publication productivity. RESULTS: The departments leading in publication productivity published more than 25 articles over the 5-year period. The number of faculty and mean dollar value of family medicine department establishment grants were the strongest predictors of publication productivity. When adjusted for departmental size, some departments were found to have high publication productivity per faculty member, even though total numbers of departmental publications were low in comparison to other departments. CONCLUSIONS: This study identified one way of comparing departments in terms of publication productivity. Large departments, and those with more developmental grant support, have the highest publication productivity.

'White coat' hypertension in children.

BACKGROUND: Research with ambulatory blood pressure monitoring (ABPM) clearly demonstrates the importance of identifying "white coat" hypertension before making the diagnosis of hypertension. While the existence of white coat hypertension has been documented in adults, it is unknown whether this phenomenon is present during childhood. Therefore, the purposes of this study were to determine whether white coat hypertension exists in children with a positive family history of essential hypertension; and if it exists, to compare 24-hour ambulatory blood pressure patterns among normotensive, white coat hypertensive, and hypertensive children. METHODS: One hundred fifty-nine children (aged 5 to 15 years) participated in the study. Based on office systolic and diastolic measurements and 24-hour ABPM, subjects were placed into one of three groups: normotensive, white coat hypertensive, and hypertensive. RESULTS: Forty-four percent of 34 subjects with systolic blood pressures greater than or equal to 95th percentile were reclassified as white coat hypertensive; 56% remained hypertensive. Group comparisons of 24-hour ABPM patterns showed significant differences between groups. Also, the ABPM patterns of white coat hypertensive patients were significantly different from those of normotensive patients. CONCLUSIONS: This study documented the existence of white coat hypertension in children and showed that white coat hypertensive children were significantly different from normotensive and hypertensive children on most comparisons of 24-hour ABPM data. Also, when age and sex were controlled, heavier children had a more significant chance of having elevated systolic blood pressure than normal-weight children, regardless of their race, height, or body mass index.

Ambulatory blood pressure monitoring in hypertension.

Compared with blood pressure measurements in the office setting, ambulatory blood pressure monitoring offers a more accurate and reliable method of diagnosing and managing hypertension. Indications for ambulatory blood pressure monitoring include borderline hypertension, a discrepancy between home and office blood pressure measurements, persistent blood pressure elevation in the office with no end-organ damage, episodic elevations of blood pressure or suggestive symptoms, hypertension resistant to treatment, episodic angina not related to exercise, end-organ damage but normal office blood pressure readings, and evaluation of the efficacy of antihypertensive agents. Several cases are presented for review.

Risk for bladder cancer. Psychological impact of notification.

Informing persons that they have been exposed to a carcinogenic chemical (beta-naphthylamine) may adversely affect these persons and their families. The purpose of this study was to identify and assess the psychological impact of a bladder cancer notification and screening program on persons at risk and their families. Approximately 140 subjects were randomly selected from 850 workers exposed to beta-naphthylamine. The Family APGAR, Impact of Event Scale, and Improved Readability Form of the Minnesota Multiphasic Personality Inventory were administered within four weeks of the initial medical screening and readministered six months later. Results show no evidence of disruption to families or substantive psychopathology among these persons. While the actual acquisition of cancer is undoubtedly a psychological trauma, mere notification of risk may not be traumatic in every situation.

KIE: It has been suggested that informing people that they have been exposed to a carcinogenic chemical may have an adverse psychological impact on them and their families. This study assessed the impact on 140 randomly selected subjects from a population of 850 persons enrolled in a bladder cancer screening and notification program. Administration of psychological tests within four weeks and again six months after the medical screening showed no evidence of substantial psychopathology or family disruption. The investigators caution that additional studies in similar populations and work environments must be performed before any firm conclusions can be drawn.

Practice and career satisfaction among residency trained family physicians: a national survey.

This paper reports the results of a national survey of perceptions of practice and career satisfaction among the first cohorts of residency-trained family physicians. The findings indicate that a large majority of the respondents (n = 876), most of whom had been in practice for only three years or less at the time of the survey in 1979, were well satisfied with their careers and work in general as well as with their residency training, practice arrangements and facilities, colleague relationships, and hospital privileges. Several sources of relative dissatisfaction and difficulty were reported by the physicians, however, including practice time pressures, the necessity of treating emotional problems beyond their training, financial costs associated with operating their practice, paperwork, and perceived interference of external regulations and/or agencies in the physician-patient relationship.

Behavioral science and family practice: a status report.

The purpose of this study was to assess the current status of behavioral science instruction in family practice residency training programs. The primary areas of interest were: (1) characteristics of those who teach behavioral science (number of persons teaching behavioral science by discipline and academic degree, number and percent of time behavioral science personnel employed, work responsibilities, academic unit responsible for instruction, description of those who provide inservice training in behavioral science ), (2) the relative importance of various behavioral science topics as perceived by faculty/staff (21 topics), and (3) preferred methods of instruction. The data revealed a wide variety of persons involved in behavioral science instruction, a strong emphasis placed on communication and counseling skills, and similar, but not innovative, teaching methods used for behavioral science instruction.

A model for communication skills development for family practice residents.

The purpose of this paper is twofold: (1) to demonstrate the need for including interpersonal communication skills training in family practice residency programs, and (2) to present a communication model that can be used for such training. Interpersonal communication skills are important in almost all areas of contact with patients: history taking, physical examination, prescription writing and patient education, counseling, and psychotherapy. Presentation of the communication model includes definition of the interpersonal communication skills that would be stressed in family practice residency programs. These skills include empathy, respect, warmth, concreteness, genuineness, self-disclosure, confrontation, immediacy, and behavior modification. Examples of how a family physician may communicate each of these skills are also included. The implementation of the communication model in a department of family practice for training residents and faculty in the use of these communication skills is also described.