Dry matter intake from parturition to midlactation.

Six years of data from the Purina Research Center were summarized to quantitate relationships among DMI, DIM, BW, and 4% FCM. Cows were fed individually and housed in a tie-stall barn from parturition to 21 wk postpartum. Best overall equation predicting DMI was kg DMI = .008037 x kg BW + .3134 x kg 4% FCM + .2286 x DIM - .002176 x (DIM)2 + .00000705 x (DIM)3, R2 = .64, CV percentage = 11.1. Data were best fit when separate equations were developed for each week postpartum up to 6 wk and then for periods including 6 to 8, 9 to 13, and 14 to 20 wk. The commonly used equation, kg DMI = .02 x kg BW + .33 x kg 4% FCM, overestimated DMI until wk 10 but underestimated DMI thereafter. The NRC multifactor DMI estimates could be lower or higher than equations developed up to wk 8, depending on values chosen within range of several factors. At wk 8 and beyond, NRC estimates were lower than equations developed, even when highest level within range of several factors was chosen. Calculated energy balances resulted in greater and extended energy deficit for cows in their second or later lactation compared with first lactation. Loss of BW alone was a poor indicator of energy status in early lactation.

Breaking bad news: medical undergraduate communication skills teaching and learning.

Teaching on the theme of 'breaking bad news' was selected for special development as part of an introductory course on communication skills for preclinical medial students in 1987. Eight parents of handicapped children and three patients terminally ill with neoplastic diseases cooperated in a series of semi-structured group discussions in which students were encouraged to interact with patients and children. The patients/parents readily assumed the role of teachers and where it was possible, they participated in similar sessions the following year. Analysis of questionnaires indicated that the plan had proved acceptable to patients, relatives and students. Follow-up of student opinion one year later indicated that students felt they had derived benefit from these opportunities to learn first-hand from patients and parents of handicapped children.

Glomerular filtration rate in schoolgirls with covert bacteriuria.

Clearance of technetium-99m-labelled diethylenetriaminepenta-acetic acid was used to measure total and individual kidney glomerular filtration rates in 48 girls with covert bacteriuria. The mean (+/- SD) of the total rates of 18 girls with scarred kidneys (99 +/- 24 ml/min/1.73 m2) was significantly (0.005 greater than p greater than 0.002) lower than that in 30 girls with unscarred kidneys (119 +/- 18 ml/min/1.73 m2). This reduction in glomerular filtration was related to the loss of kidney substance associated with scarring rather than to vesicoureteric reflux. The glomerular filtration rate was unrelated to the duration of bacteriuria. These findings suggest that in girls aged 4 and over neither vesicoureteric reflux nor covert bacteriuria contributes to the progression of kidney damage.