Effect of body fatness and glucogenic supplement on lipid and protein mobilization and plasma leptin in dairy cows.

Twenty-four multiparous Ayrshire cows were used in an experiment to test the effect of body fatness and glucogenic supplement, fed during the transition period, on lipid and protein mobilization and plasma hormone concentrations. Eight weeks before their expected calving date, the cows were divided into blocks of 4. Two cows with the highest body condition score within each block were then allocated to a test (T) group and the other 2 cows to a control (C) group. To scale up the differences between fatter and thinner cows, the estimated energy allowance was 40% higher in group T than in group C between d 56 and 21 prepartum. For the final 3 wk before calving, all the cows were fed according to energy recommendations for pregnant cows. Within C and T groups and blocks, cows were randomly assigned into groups with (G1) or without (G0) glucogenic supplement. Division to G0 and G1 groups was made 2 wk before the expected calving and continued for 56 d postpartum. After calving, all the cows received grass silage ad libitum and a common daily concentrate allowance. No significant differences were detected in feed intake and milk yield between C and T. The T groups showed an earlier rise of nonesterified fatty acids as calving approached and had higher plasma nonesterified fatty acids during the final week of pregnancy and lactation wk 1 to 3. At the same time, adipose tissue samples from fatter cows tended to show higher in vitro lipolytic responses to added norepinephrine, as monitored by glycerol release. Protein mobilization was elevated during the final week of pregnancy and tended to be more increased in fatter cows. Glucogenic supplement did not decrease lipid or protein mobilization. Fatter cows had higher plasma leptin concentration prepartum, showed a more pronounced decrease in leptin concentration near calving, and had higher plasma leptin concentration after calving. In conclusion, fatter cows initiated more extensive mobilization of body fat before calving and this continued during the first lactation weeks. Plasma leptin concentration in early-lactation cows was associated with body fatness and not with estimated energy balance.

Effect of concentrate crude protein level on grass silage intake, milk yield and nutrient utilisation by dairy cows in early lactation.

Twenty-one multiparous dairy cows were fed concentrates containing three levels (119, 154 and 191 g/kg DM) of crude protein (CP) during the first ten weeks of lactation. Part of the grain and molassed sugar beat pulp was substituted with 0% (RSM0), 15% (RSM15) or 30% (RSM30) repeseed meal. Wilted grass silage was fed ad libitum after calving. The average response between RSM0 and RSM15 was +1.66 kg milk/d per percentage unit change in concentrate CP content. No further response occurred between RSM15 and RSM30. The positive effect of RSM inclusion was seen throughout the experimental period and was associated with increased plasma non esterified fatty acids (NEFA) and decreased plasma insulin concentration one week after calving, and higher efficiency of metabolisable energy utilisation for milk production. Digestibility of the diet remained unaffected. Milk and plasma urea tended to increase with RSM30 indicating excessive supply of rumen degradable protein. Because of the limited potential of cows to compensate for a deficit in feed protein supply by mobilising tissue protein, a substantial milk yield response can be achieved with a moderate level of protein supplementation during early lactation.

Fat infiltration in liver and activity of lecithin:cholesterol acyltransferase in serum of dry and lactating dairy cows.

To study the relationship between fat infiltration in the liver and the decrease in the activity of serum lecithin:cholesterol acyltransferase (LCAT), blood and liver samples were taken from 14 multiparous (MP) and 16 primiparous (PP) dairy cows four weeks and one week before, and one, four and eight weeks after calving. During the dry period, half the animals received a protein supplement. LCAT activity decreased significantly in all groups before parturition, but returned to the initial level within 1-4 weeks after parturition. There were no differences between the feeding groups, but after calving, the LCAT activity in the MP cows was significantly lower than in the PP cows. Fat infiltration was not detected in the PP cows, and in the MP cows fat infiltration was mild and fell within the physiological range. There was no correlation between liver fat content and the activity of LCAT in serum. These results suggest that shortly before and after parturition, the activity of LCAT in serum is limited by post-transcriptional regulation, possibly by the availability of amino acid for export protein synthesis in the liver.

Production of monoclonal antibodies and enzyme immunoassay to bovine retinol-binding protein and determination of retinol-binding protein serum levels and retinol concentrations in serum and liver in dairy cows before and after parturition.

To study vitamin A transport in dairy cows and heifers around parturition, an enzyme immunoassay for bovine retinol binding protein (RBP) was developed and serum levels determined. Serum and liver concentrations of retinol were assayed by HPLC. Four weeks before expected calving the cows and heifers were divided into two groups each, and half of the animals received a protein supplementation during the dry period. The mean serum RBP concentration 4 weeks before calving was 42 mg l-1 for the cows and 44 mg l-1 for the heifers. The serum retinol concentrations were 0.53 mg l-1 for the cows and 0.42 mg l-1 for the heifers, and the liver retinol concentrations 0.30 mg l-1 and 0.13 mg g-1, respectively. In the groups without protein supplementation there was a significant decrease in serum RBP at sampling 1 week before parturition compared to initial values. The measurement of serum RBP may prove useful in assessment of amino acid availability in dairy cows.

Barriers to adherence to highly active antiretroviral therapy as expressed by people living with HIV/AIDS.

The primary objective of this study was to gain a clearer understanding of the barriers to adherence to highly active antiretroviral therapy (HAART) faced by people living with HIV/AIDS (PLWHIV/AIDS) on Long Island, New York. Focus group, a qualitative research method, was used to study these barriers. The study was conducted in 1998 on Long Island, NY, at five institutions that provide services to 1700 PLWHIV/AIDS. Five focus groups were conducted with 6 to 13 PLWHIV/AIDS in each group, a total of 39 subjects. PLWHIV/AIDS identified eight common barriers to adherence to HAART. In descending order, the barriers include: (1) frequency and severity of side effects, (2) conflicts with daily routines, (3) dietary requirements, (4) frequency of taking medications, (5) number and dosage of medications, (6) psychosocial factors (i.e., stress, feeling good, and bad news), (7) pharmacy refills, and (8) physiological needs (i.e., sleep, hunger, or thirst). Many factors play a role in the success or failure of HAART, including preexisting drug resistance, drug-drug interactions, and the ability of PLWHIV/AIDS to adhere to a rigid and frequently changing medication regimen. The information gleaned from focus groups is limited in that it may not be generalized to a larger population with any known reliability. However, clinicians sensitive to barriers to adherence to HAART, including those identified by PLWHIV/AIDS in this study, may play a more proactive role in supporting adherence to the medication regimen, increasing the durability of effective viral suppression, decreasing morbidity and mortality, and decreasing the selection and transmission of resistant strains of HIV.

Safer-sex education for persons with mental illness.

1. Safer-sex education is crucial for controlling the spread of HIV and this education is within the realm of nursing practice. 2. Safer-sex education for persons with mental illness must include repetitive, interactive education capitalizing on verbal, visual, written, tactile, and motor skill teaching methods to compensate for learning disabilities that have been identified in this population. 3. In this study, individual rather than a group teaching approach to the sensitive subject of safer-sex provided the most learning. The study subjects did not exhibit overt sexual behavior, increased sexual acting out, regression, or overstimulation when safer-sex education was presented.

Drug therapy in elderly patients: diagnosis of drug-related problems.

Given the multiple diseases and vulnerability of the elderly to develop adverse drug effects, it is incumbent on the nurse to monitor and critically evaluate the patient's conditions. Attempts must be made to further develop and/or refine existing systematic process to delineate and prevent drug-related health problems. Non-drug form of treatment or use of the fewest possible medications (three or less) must always be considered. The wide variation from one elderly individual to another requires careful individualized monitoring of drug effects on an ongoing basis. Knowledge of geropharmacology and continuous study of new drugs and their effects are essential to recognize actual and potential drug-related problems and promote the health, and safety of elderly individuals.