Effects of feeding diets varying in energy and nutrient density to Hy-Line W-36 laying hens on production performance and economics.

The objectives of this study were to evaluate the effects of feeding 5 different energy and nutrient dense diets to Hy-Line W-36 hens on long-term performance and economics. A total of 480 19 wk old Hy-Line W-36 Single Comb White Leghorn hens were weighed and randomly allocated to 6 replicate groups of 16 hens each (2 adjacent cages containing 8 hens per cage, 60.9×58.4 cm) per dietary treatment in a randomized complete block design. The hens were fed 5 treatment diets formulated to contain 85, 90, 95, 100, and 105% of the energy and nutrient recommendations stated in the 2009 Hy-Line Variety W-36 Commercial Management Guide. Production performance was measured for 52 wk from 19 to 70 wk age. Over the course of the trial, a significant increasing linear response to increasing energy and nutrient density was seen for hen-day egg production, egg weight, egg mass, feed efficiency, energy intake, and body weight (BW). Feed intake showed no significant linear level response to increasing energy and nutrient density except during the early production cycle. No consistent responses were noted for egg quality, percent yolk, and percent egg solids throughout the study. Significant linear responses due to energy and nutrient density were seen for egg income, feed cost, and income minus feed cost. In general, as energy and nutrient density increased, egg income and feed cost per hen increased, but income minus feed cost decreased. Overall, these results indicate that feeding Hy-Line W-36 hens increasing energy and nutrient-dense diets will increase egg production, egg weight, egg mass, feed efficiency, energy intake, BW, egg income, and feed cost, but decrease egg income minus feed cost. However, these benefits do not take effect in early production and seem to be most effective in later stages of the production cycle, perhaps "priming" the birds for better egg-production persistency with age.

Improving the health of Oklahomans through clinical prevention, part II: Screening to identify early-stage disease and risk factors.

The purpose of screening is to identify asymptomatic disease, or risk factors for disease, so that interventions can occur as early as possible in the disease process. The primary goal is to decrease the morbidity the patient experiences from the disease. For infectious diseases, screening can benefit not only the individual with the disease but also the community, since infectious persons can be identified and treated prior to transmitting the disease to others. Although screening can be very beneficial to the individual and to the community, it can also have adverse outcomes if not used appropriately. In this article we will discuss current recommendations for the use of screening tests and their role in addressing the leading causes of morbidity and mortality in Oklahoma. In general, physicians should consistently screen for the risk factors for cardiovascular disease and stroke (hypertension, high cholesterol, obesity and diabetes) and for early-stage cancers of the colon, breast, and cervix. They should also consider screening Native Americans for diabetes and persons at increased risk for certain infectious diseases, particularly sexually transmitted diseases.

Improving the health of Oklahomans through clinical prevention. Part 1: Counseling to decrease major risk factors.

Compared to other states, Oklahomans suffer higher levels of morbidity and mortality from several common conditions--coronary heart disease, chronic lung disease, stroke and injury. Unhealthy personal behaviors contribute significantly to each of these conditions, thus rendering them at least partially preventable by changing those behaviors. Research has shown that many patients will modify unhealthy behaviors as a result of services provided by physicians or staff in their offices, often with briefly delivered messages. In this report we will discuss the most common preventable illnesses suffered by Oklahomans and the risk factors associated with those illnesses. Physicians should make maximum use of their ability to promote healthy behaviors by their patients, with emphasis on the risk factors associated with significant morbidity in the state. They should also focus on those risk factors patients are likely to change following physician counseling, as determined by prevention research and described in the U.S. Preventive Services Task Force document Guide to Clinical Preventive Services. In general, physicians should consistently deliver messages that address tobacco products, alcohol and other drugs, the use of seat belts, and diet and exercise. Also, they should recommend that all women of childbearing age who are capable of becoming pregnant take a multivitamin containing folic acid daily.

Improving the health of Oklahomans through clinical prevention, Part III: Immunizations and chemoprophylaxis.

Vaccines are one of the greatest achievements of biomedical science and public health and are clearly one of the most effective tools of clinical prevention. Diseases that once caused significant morbidity and mortality in Americans--particularly children--have been virtually eliminated from the population through effective immunization programs. But until these diseases have been eradicated globally we must continue to maintain high immunization levels to prevent their return; a 90% coverage rate has been set as the national goal for recommended vaccines in preschool age children. In Oklahoma we have only achieved that goal for two vaccines (measles and polio) and for the last several years we have ranked near the bottom in vaccine coverage rates compared to other states. Although achieving high vaccination rates in children involves numerous partners, private physicians must play a major role in that effort since they are the primary vaccine providers in the state. Physicians should also be alert to the vaccine needs of their adolescent and adult patients, particularly for pneumococcal disease, influenza, hepatitis A and B, and tetanus. This article describes current vaccination levels in Oklahoma children and adults for several routine and newly recommended vaccines and discusses the role of private physicians in maintaining and improving immunization coverage.

Nonmarital births in Oklahoma 1975-1995.

This report uses data from the Oklahoma State Department of Health to describe past trends and current patterns of nonmarital births in Oklahoma. Between 1975 and 1995, the percentage of unmarried women delivering a live birth in Oklahoma increased from 12% to 31%. Adult nonmarital births increased faster than teen nonmarital births, but teens had a higher percentage of nonmarital births. White rates increased faster than African-American and Native American rates, but African-Americans had a higher percentage of nonmarital births. Unmarried women who give birth were more likely to be poor and lack education; additionally, they were less likely to receive early prenatal care, more likely to have had low weight births, and more likely to have had an unintended pregnancy. Birth outcomes are poorer among unmarried women, but this may be due to poverty and education rather than marital status alone.

PIP: This study examined trends in nonmarital births during 1975-95 in Oklahoma. Data were obtained from the Oklahoma State Department of Health vital records and the Oklahoma Pregnancy Risk Assessment Monitoring System's annual surveys during 1988-95. Findings indicate that the percentage of unmarried women delivering a live birth in Oklahoma increased from 12% to 31% during 1975-99, a 158% increase. Nonmarital births rose from 5075 to 13,856. By 1995, almost one-third of births in Oklahoma were to unmarried women. Adult nonmarital births increased more rapidly than adolescent nonmarital births, especially among unmarried women aged 30-34 years. Most of the increase in older women with nonmarital births was from women who had nonmarital births as teens. Adolescents had a higher percentage of nonmarital births: 76% for women aged 15-17 years compared to 14.1% for women aged 30-34 years. White rates increased faster than African-American and Native-American rates (a 2.7-fold increase compared to 1.6- and 2.8-fold increases, respectively). African-Americans had a higher percentage of nonmarital births (69.2%) compared to White women (24.5%). Unmarried women were more likely to be poor and lack education and less likely to receive early prenatal care. 53.1% lived below the Federal Poverty Level. Unmarried mothers were more likely to have had a low-birth-weight baby and an unintended pregnancy. The percentage of nonmarital births in 1945 was only 3.4%, which means an 800% increase during 1945-95, a 50-year period of time. The state pattern followed a national pattern of increase.

Alcohol consumption among Oklahoma women: before and during pregnancy. The PRAMS Working Group. Pregnancy Risk Assessment Monitoring System.

The Pregnancy Risk Assessment Monitoring System (PRAMS) utilizes a population-based survey of Oklahoma women with a recent live birth to examine the rates of alcohol consumption before and during pregnancy. Nearly one-half of Oklahoma women report using alcohol during the three months before pregnancy and one in thirteen women consume alcohol during the three months prior to delivery. Moderate to heavy alcohol use before pregnancy was associated with additional perinatal risk factors including unintended pregnancy, inadequate prenatal care, smoking, and physical abuse. Health providers play an important role in the prevention of alcohol related birth impairments such as fetal alcohol syndrome through early detection of problem drinking, patient education and appropriate referrals. However, one in four Oklahoma mothers report their health care provider did not talk to them about the harmful effects alcohol can have on their baby.

Infant mortality in Oklahoma, 1970-1990.

Patterns of infant mortality in Oklahoma are unlike the rest of the United States. Oklahoma has a significantly higher post neonatal mortality rate than the United States, with SIDS and congenital disorders being the leading causes of death in that age group. Conversely, Oklahoma has a significantly lower neonatal mortality rate than the United States. Vital statistics information for the period 1970-1990 are examined to describe patterns of infant death in Oklahoma. Despite long-term decreasing trends in infant death, disconcerting trends were observed in 1990 suggesting that a stronger infant mortality reduction strategy is needed in Oklahoma. Potential areas for public health intervention are suggested based on Oklahoma-specific data.

Cigarette smoking among women in Oklahoma: before, during, and after pregnancy.

Data from the Oklahoma Pregnancy Risk Assessment Monitoring System (PRAMS) were assessed to determine the prevalence of maternal cigarette smoking and its relationship to pregnancy outcomes. A mail and telephone questionnaire was used to survey mothers between four and six months postpartum to obtain information about smoking and other maternal behaviors. Monthly samples were drawn from the state's live birth registry utilizing a systematic stratified sampling approach based on infant birth weight. A total of 3,051 responses were received between 1988 and 1990 for an overall return rate of 70%. Results of the study show approximately one-third (32%) of women in Oklahoma smoked 3 months prior to pregnancy, 22% smoked in their last 3 months of pregnancy, and 29% smoked shortly after delivery. Women who smoked during pregnancy were 2.2 times more likely to deliver a low birth weight (LBW) infant than nonsmokers, and 1.4 times more likely to have gained less than the recommended amount of weight. Additionally, women who smoked during pregnancy were 1.4 times more likely to begin prenatal care in the second or third trimester, or to receive no care at all. In conclusion, maternal smoking cessation has the potential for dramatically reducing preventable adverse outcomes of pregnancy.

Reproductive genetic services in rural Oklahoma.

The system of reproductive care as it relates to genetic services for women in rural Oklahoma is addressed. Description of reproductive services and genetic reproductive services for rural women is described and barriers to accessing reproductive genetic care are identified. The barriers and any progress that has been made in breaking these barriers will be described under four general categories: (1) financial barriers; (2) system capacity barriers; (3) organizational practices and atmosphere of services, and (4) cultural, personal and other system barriers.

A thirty-year review of maternal mortality in Oklahoma, 1950 through 1979.

Oklahoma's Maternal Mortality Committee has been active since 1941. During the 30-year period 1950 through 1979, the committee reviewed in detail 75.9% of the pregnancy-related deaths that occurred in Oklahoma. The maternal mortality ratio in 1950 was 95.1/100,000 live births, and for 1979 it was 8.1/100,000 live births, a decrease of 91.5%. The risk of death from childbearing remained greater for black women than for American Indian or white women throughout the three decades. For American Indian women, the risk of death associated with pregnancy has decreased and is almost equal to the risk for white women. The Maternal Mortality Committee estimated that two thirds of Oklahoma's maternal deaths were preventable. The proportion of deaths judged preventable did not vary substantially during the study period. We conclude that maternal mortality in Oklahoma can be reduced to fewer than three deaths per 100,000 live births. Intensive monitoring and investigation of deaths and their causes by local maternal mortality committees continues to be an important mechanism for obtaining information to assist health workers in the prevention of deaths.