ITC/USA 2015 Conference Proceedings / The Fifty-First Annual International Telemetering Conference and Technical Exhibition / October 26-29, 2015 / Bally's Hotel & Convention Center, Las Vegas, NV / This paper looks at the migration paradox from a holistic perspective, revisits the Smarter Antenna concept and looks for synergetic solutions. The architecture presented also builds on the momentum of the relentless migration to network technology (that has already transformed telemetry data centers) and pushes it to the vehicle. The results are reduced costs and exciting new functionality, such as better situational awareness for mission conduct and range safety. Spatial and temporal domains are harnessed as aggressively as the frequency domain to enable denser spectral utilization and other exciting benefits. Imagine a Test Range no longer reliant on tracking systems (almost)!

Thesis (MScAgric)--Stellenbosch University, 2001. / ENGLISH ABSTRACT: The goat is a significant domestic animal throughout the world today. With an estimated world goat population of 590 million goats in 1991 (FAO, 1991 as citied by Haenlein, 1996) it is impossible to consider the goat as insignificant. The need for milk, and it seems particularly goat’s milk, is obvious if one considers the increase in dairy goat populations over the past 20 years. Across the globe the dairy goat population has increased by 52% while in developing and developed countries, there has been an increase of 56% and 17%, respectively (Haenlein, 2000). The goat dairy industry in South Africa is still very underdeveloped, yet it holds tremendous potential for the entrepreneur willing to take the risk and do the job correctly. With the present South African financial situation the opportunities that exist for exporting value added products to countries with stronger currencies is a market with extraordinary potential. In New Zealand, the national herd consists of approximately 16000 dairy goats and 90% of the milk produced is turned to powdered milk and then exported to the East, a valuable source of foreign currency. In South Africa, the same potential exists and with some vision and hard work the dairy goat industry can make a valuable contribution to generating foreign currency. Research into the protein requirements and particularly protein degradability requirements of dairy goats is scarce, yet in recent years there has been an increased interest in the effect of protein supplementation to lactating animals (Mishra & Rai, 1996). In the work of Mishra & Rai (1996) there were benefits obtained from the use of different rumen degradable proteins for lactating dairy goat does. The does on the highly degradable protein diet had a better feed intake while the does on the low degradable protein diet gave a higher milk production. Other research on this field of study has also delivered positive results with more than one species of lactating animal that had increased levels of UDP in the diet (Robinson et al., 1991 and Christensen et al., 1993). Loerch et al. (1995) suggested that improved production by making use of rumen undegradable proteins would have no effect if crude protein were not a limiting factor in production. Pailan & Kaur (1995) and Mishra & Rai (1996) did research on lowered CP levels with increased UDP levels in lactating dairy does. They used of three diets, with the one having a 20% lower CP value but an increased level of UDP (40-45% of total CP). From this work it was concluded that a decreased CP level and an increased level of UDP is able to sustain production when compared with diets with a higher CP value. The current study consists of two trials. In the first trial the effect of weaning age and dietary protein degradability on the growth of Saanen kids was investigated. In the second trial the effect of dietary protein degradability on the production of lactating Saanen does was investigated. Fifty-eight Saanen kids were divided into groups to determine the effect of weaning age (42 vs. 70 days) on animal performance. Within the weaning day treatments, the kids were again divided into two dietary treatments. One group received a low UDP creep diet (LC) and the other a high UDP creep diet (HC). The two creep diets were formulated with rumen degradable: undegradable protein (RDP : UDP) ratios of 70:30 and 60: 40, referred to as LC and HC, respectively. However, the results from the degradability trial indicated no difference in RDP: UDP ratios for the low and high creep (72:28 and 73:27 respectively) diets. At 15.66 ± 3.09 kg the kids were taken off the creep diet and put on the growth diet. At this transition, the kids in each of the 4 established treatments were again randomly divided into two dietary treatments, a high or a low UDP growth diet, resulting in a total of eight treatments for the trial. The two growth diets were formulated with RDP: UDP ratios of 70:30 and 60:40, referred to as low growth (LG) and high growth (HG) respectively. Results from the degradability trial indicated RDP: UDP ratios for the LG and HG of 73:27 and 68:32 respectively. The growth trial was conducted over 140 days and feed intake, bodyweight change and feed conversion efficiency were compared for each of the 8 treatments. From the trial with the Saanen kids it was concluded that weaning dairy goat kids at 42 days of age when feed intake was 240 g/day resulted in similar growth rates when compared with weaning at 70 days. The two creep diets did not differ in RDP: UDP ratios and thus no conclusion can be made regarding the influence of the creep diets on the growth of Saanen kids from 20 to 80 days of age. The two growth diets did in fact differ from one another, in terms of RDP: UDP however, protein degradability had no influence on the performance of the Saanen kids from 80 to 140 days of age. Twenty-one lactating Saanen does were randomly assigned to one of three experimental diets. The treatments had two RDP: UDP ratios and two crude protein (CP) levels. Treatments were formulated to be 1) RDP: UDP = 70:30, CP = 20 % 2) RDP: UDP = 62:38, CP = 20% and 3) RDP: UDP = 62:38, CP = 18.3%. In the production trial the does were milked for 120 days, during which milk yield, milk composition, bodyweight change, feed intake and feed conversion efficiency were compared between the treatments. In the digestibility and nitrogen metabolism trial, 18 does varying from 84 to 110 days in lactation, were used to compare the experimental diets. Furthermore, the experimental diets were compared in a degradability and rate of passage trial using cannulated Dohne merino wethers. Results from the degradability trial indicated that the low UDP, low protein high UDP and high UDP diets had RDP: UDP ratios of 82:18, 78:22 and 79:21 respectively, and that the dietary protein degradability did not differ significantly between diets. Results from the production trial indicated that there was a significant difference in feed intake, dry matter (DM) intake and bodyweight. The does on the low UDP diet had significantly higher feed intakes and DM intakes and were significantly heavier at the end of the trial period. As the diets didn’t differ in protein degradability other factors must have influenced the intakes between diets. Palatability may have influenced feed and DM intake, as the low protein high UDP and high UDP diets both contained higher levels of fishmeal. No significant differences in milk production, milk composition or milk production efficiency were observed. Besides the fact that the diets did not differ in effective protein degradability, large variations in milk production between animals and low numbers of animals per treatment limited the ability to measure a difference between the treatments. Results from the digestibility trial varied between diets with the low UDP diet having a significantly lower digestibility overall than the other two diets. Reasons for the difference in digestibility could be due to the difference in rate of passage (low UDP = 0.064/hour versus the 0.044- 0.045/hour of the low protein and high UDP diets respectively) and the high ADF value of the low UDP diet. Because no difference in effective protein degradability existed between the diets it is not possible to make an accurate conclusion on whether or not the dietary protein degradability had an influence on production parameters tested in this trial. / AFRIKAANSE OPSOMMING: Huidiglik is die bok ‘n belangrike gedomestikeerde dier dwarsoor die wereld. Aangesien die wereldwye bokpopulasie in 1991 op 590 miljoen geraam is (FAO, soos aangehaal deur Haenlein, 1996), is dit onmoontlik om die bok as onbelangrik te beskou. Die behoefte aan melk, en dan veral bokmelk, is duidelik as mens die toename in bokpopulasies oor die afgelope 20 jaar in ag neem. Wereldwyd het die melkbokpopulasie met 52% toegeneem, terwyl dit in ontwikkelende en ontwikkelde lande met 56% en 17% onderskeidelik, toegeneem het (Haenlein, 2000). Ten spyte van die feit dat die bokmelk-industrie in Suid-Afrika nog baie onderontwikkel is, is daar geweldige potensiaal vir die entrepeneur wat bereid is om ‘n risiko te loop en die taak korrek aan te pak. Binne die huidige Suid-Afrikaanse finansiele situasie bestaan daar veral geleenthede om waardetoegevoegde produkte na lande waarvan die wisselkoers sterker is, uit te voer. In Nieu Zeeland is die nasionale kudde ongeveer 16000 melkbokke en 90% van die geproduseerde melk word verwerk na poeiermelk en uitgevoer na die Ooste. In Suid-Afrika bestaan dieselfde potensiaal en met die korrekte visie en harde werk kan die melkbok-industrie ‘n belangrike bydra lewer om buitelandse valuta te verdien. Alhoewel navorsing aangaande die proteien-degradeerbaarheidsbehoeftes van melkbokke skaars is, bestaan daar die afgelope paar jaar ‘n toenemende belangstelling in die effek van proteien supplementering aan lakterende diere (Mishra & Rai, 1996). In die werk van Mishra & Rai (1996) is die voordele om verskillende rumen degraderende proteTenvlakke in lakterende melkbokke te gebruik, aangetoon. Ooie op ‘n hoogs degradeerbare prote'fen-dieet het beter voerinnames getoon, terwyl die ooie op ’n laag degradeerbare prote'fen-dieet hoer melkproduksies gelewer het. Navorsing van hierdie aard op ander lakterende spesies het ook positiewe resultate met ‘n toename in verbyvloeiprote'ien in die dieet gelewer (Robinson et al., 1991 en Christensen et al., 1993). Loerch et al. (1995) het voorgestel dat ‘n verbeterde produksie, deur gebruik te maak van verbyvloeiprote'fn, geen effek sal he as ruprote'fen (RP) nie ‘n beperkende faktor i.t.v produksie is nie. Beide Pailan & Kaur (1995) & Mishra en Rai (1996) het navorsing gedoen op die invloed van verlaagde RP-vlakke en verhoogde nie-degradeerbare protein (NDP) vlakke in die diete van lakterende melkooie. Daar is gebruik gemaak van drie diete, waarvan die een dieet ‘n 20% laer RPinhoud, maar ‘n verhoodge NDP-vlak (40-45% van totale RP) gehad het. Vanuit hierdie werk is die gevolgtrekking gemaak dat ‘n verlaging in RP-vlak en ‘n verhoging in NDP-vlak dieselfde produksie kan onderhou, soos met ‘n hoer RP-inhoud. Die huidige navorsing bestaan uit twee proewe. In die eerste proef is die effek van speenouderdom en dieet-prote'fen-degradeerbaardheid op die groei van Saanen-lammers ondersoek. In die tweede proef is die effek van dieet-proteien-degradeerbaardheid op die produksie van lakteerende Saanen melkbokke ondersoek. Agt-en-vyftig Saanen-lammers is verdeel in twee speenouderdom-behandelings, nl. ‘n 42 dae (42) en ‘n 70 dae (70) speenouderdom. Binne hierdie speenouderdom-behandelings is die lammers verder verdeel in twee dieet-behandelings. Die een groep het ‘n lae NDP kruiprantsoen (LK) en die ander ‘n hoe NDP kruiprantsoen (HK) ontvang. Die twee kruiprantsoene was geformuleer om rumen degradeerbare proteien (RDP): NDP verhoudings van 70:30 (LK) en 60:40 (HK) te bevat, maar die resultate van die degradeerbaarheidsproef het aangetoon RDP: NDP verhoudings van 77:23 (LK) en 78:22 (HK). Die lammers is vanaf die kruipdieet oorgeplaas op ‘n groeidieet by ‘n gemiddelde lewende massa van 15.99±3.09 kg. Tydens hierdie oorplasing is die lammers van die vier bestaande behandelings verdeel in ‘n verdere twee dieetbehandelings, nl. ‘n hoe of ‘n lae NDP groei-dieet (LG en HG onderskeidelik), met die gevolg dat ‘n totaal van agt behandelings in hierdie proef bestaan het. Die twee groeidiete is geformuleer met RDP: NDP verhoudings van 70: 30 (LG) en 60: 40 (HG) onderskeidelik, maar die resultate van die degradeerbaarheidsproef het aangetoon RDP: NDP verhoudings van 78:22 (LG) en 72:28 (HG). Die groeiproef is uitgevoer oor 140 dae en voerinname, verandering in liggaamsgewig en voeromsettingsdoeltreffendheid (VOD) is vergelyk tussen die agt behandelings. Uit die lammerproef is die gevolgtrekking gemaak dat boklammers wat op 42 dae gespeen is, wanneer voerinname 240g/dag is, soortgelyke resultate i.t.v. groeitempo lewer as lammers wat op 70 dae gespeen is. Die twee kruiprantsoene het nie van mekaar in RDP: NDP verskil nie en dus kan geen gevolgtrekking gemaak word omtrentdie invloed van dieet-protel'en-degradeerbaarheid op die groei van Saanen boklammers van 20 tot 80 dae ouderdom. Die twee groei diete het van mekaar verskil in RDP: NDP maar dieet-proteien-degradeerbaardheid het geen invloed op die groei van die Saanen boklammers van 80 tot 140 dae ouderdom gehad nie. Een-en-twintig lakterende Saanen-ooie is ewekansig in drie groepe. Die behandelings het twee RDP: NDP-verhoudings en twee ruprotei'en (RP) -peile ingesluit. Behandelings was 1) RDP: NDP = 70:30, RP = 20% 2) RDP: NDP = 62:38, RP = 20% en 3) RDP: NDP = 62:38, RP = 18.3%. Tydens hierdie produksieproef is die ooie vir 120 dae gemelk en die melkopbrengs, melksamestelling, verandering in liggaamsgewig, voerinname en VOD bepaal en vergelyk tussen behandelings. In die verterings- en stikstofmetabolismeproef is 18 ooie gebruik om die diete te vergelyk. Verder is die diete ook vergelyk in ‘n degraderings- en deurvloeitempoproef met gekannuleerde Dohne merino hamels. Dieet-proteien-degradeerbaardheid waardes verkry uit die degradeerbaarheidsproef het aangedui dat die bepaalde RDP: NDP verhoudings was 82:18, 78:22 en 79:21 vir die lae NDP, lae prote'fen hoe NDP en hoe NDP diete, en dat daar geen verskil in dieet-prote'fen-degradeerbaardheid was tussen die drie rantsoene. Resultate van die produksieproef dui daarop dat daar verskille in voerinname, droematerialinname, en liggaamsgewig tussen die drie rantsoene was. Die ooie op die laer NDP rantsoen het ‘n hoe voer en DM inname gehad en was swaarder na 120 dae in die proef as die ooie in die ander twee behandelings. Redes vir hierdie verskille is nie as gevolg van dieet-proteiendegradeerbaarheid nie. Die smaaklikheid kon dalk ‘n rol gespeel het omdat dat die twee hoe NDP rantsoene hoer vlakke van vismeel gehad het. Daar was geen verskil in melkproduksie, melksamestelling en melkproduksiedoeltreffenheid tussen die drie behandelings. Resultate van die verteringsproef het tussen die laer NDP-rantsoen en die ander twee rantsoene gevarieer. Die rede vir die verskil in verteerbaarheid mag wees a.g.v. verskillende deurvloeitempo’s (laer NDP = 0.064/uur teenoor 0.044 - 0.045/uur vir die laeproteien en hoe-proteienrantsoene) en die ADF waarde wat van die lae NDP rantsoen verskil het van die ander twee rantsoene. Omdat die resultate van die degradeerbaarheidsproef aangedui het dat daar geen verskil in dieet-proteiendegradeerbaardheid was nie is dit nie moontlik om ‘n gevolgtrekking te maak random die invloed van dieet-proteien-degradeerbaardheid op die produksie van lakterende Saanen melkbokke nie.

Thesis (MSc)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: The purpose of this study was to evaluate the effects of age, sex, region and cropping methodology on the meat quality of impala. Forty impala were cropped during separate day and night operations at the Mara Agricultural Development Centre. Carcass pH45 (measured in M. longissimus dorsi 45 minutes post mortem) was higher in night cropped animals (6.67 ± 0.111; P<0.05) compared to the day cropped animals (6.55 ± 0.236). The ultimate carcass pH (pHu) of animals cropped at night was lower (5.39 ± 0.081; P<0.05) compared to those cropped in the day (5.45 ± 0.108). Non-linear regression analysis showed that the rate of pH decline of the night cropped animals was slower than that of the day cropped animals (P<0.05). The cooling rate of the M. longissimus dorsi was twice as fast in the night cropped group (P<0.05). Shear force values and drip losses of the night cropped animals were both lower (19.11 ± 5.675 g/mm2 and 2.93 ± 1.597% respectively; PO.OS) compared to those of day cropped animals (23.42 ± 8.128 g/mm2 and 4.15 ± 2.339%). The results indicate that nighttime cropping has a beneficial effect on certain meat quality parameters compared to daytime cropping. A second group of impala was sampled at the Musina Experimental Farm in the Limpopo Province of South Africa. Live weights of the Mara animals (50.23 ± 9.32 kg) were higher (P<0.05) than the Musina animals (44.25 ± 10.81 kg). Impala sampled at Mara had significantly higher dressing percentages than those at Musina (P<0.05). Impala ewes from both regions had a higher lipid content (P<0.05), but the sex of the animal had no effect on the remaining chemical parameters. The crude protein content of impala at Musina (24.88 ± 1.044%) was higher (P<0.05) than the Mara animals (23.80 ± 0.840%). Regional differences (P<0.05) were found in the amounts of phosphorous and calcium in the meat. Female animals at Mara showed higher proportions (P<0.05) of saturated (SFA), and mono-unsaturated fatty acids than the male animals. Males from both regions showed higher proportions (P<0.05) of poly-unsaturated fatty acids. Myristic, palmitic and stearic acid formed the greatest proportion of the SFA component for males and females from both regions. Samples of the M. semi-membranosus (SM), M. deltoideus (D), M. longissimus dorsi et laborum (LO), and M. psoas major (PS) were analysed for citrate synthase (CS) and phosphofructo-kinase activities. MHC distribution varied significantly between 0, SM and LD (P<O.05). D expressed more MHC I, and less MHC lIa than the other three muscle groups. Positive correlations were found between age and MHC I in 0 (r=O.93; P<O.05) and CS and weight of the animal in D (r=O.76; P<O.05). The enzyme activities and MHC distribution indicate that energy in the impala is produced to a large extent via oxidative pathways. / AFRIKAANSE OPSOMMING: Die doel van hierdie studie was om die invloed van ouderdom, geslag, area, en uitdunmetodes op die vleiskwalitiet van rooibokke te evalueer. Veertig rooibokke is gedurende afsonderlike dag en nag uitdunningsoperasies by die Mara Landboukundige Ontwikkelings Sentrum geoes. Karkas pH45 (gemeet in die M. longissimus dorsi 45 minute post mortem) was hoër (P<0.05) in nag-geoesde diere (6.67 ± 0.11) in vergelyking met die dag-geoesde diere (6.55 ± 0.23). Die finale pH (pHu) van diere wat in die nag geoes is (5.39 ± 0.08) was laer (P<0.05) in vergelyking met die wat in die dag geoes is (5.45 ± 0.11). Nie-lineêre regressie analise toon dat die tempo van pH-daling van die nag-geoesde diere merkbaar stadiger was as die dag-geoesde diere (P<0.05). Die afkoelings tempo van die M. longissimus dorsi et lumborum was twee keer vinniger in die nag geoesde groep (P<0.05). Die gemiddelde skeurkragwaarde en drupverlies was beide laer (P<0.05) vir nag geoesde diere (respektiewelik 19.11 ± 5.67 g/mm2 en 2.93 ± 1.59%) in vergelyking met diere wat in die dag geoes is (23.42 ± 8.12 g/mm2 en 4.15 ± 2.33%). Die resultate toon dat nag-uitdunning 'n voordelige effek op vleiskwaliteit gehad het, in vergelyking met dag-uitdunning. 'n Tweede groep van rooibokke is gemonster by die Musina Eksperimentele plaas in die Limpopo Provinsie in Suid-Afrika. Die gewigte van die Mara diere (50.23 ± 9.32 kg) was hoër (P<0.05) as die van die Musina diere (44.25 ± 10.81 kg). Die Mara groep het hoër uitslag persentasies (P<0.05) gehad. Vroulike diere in beide areas het 'n hoër vet inhoud (P>O.05) gehad. Die ru-proteien inhoud van die Musina diere (24.88 ± 1.04%) was hoër (P<0.05) as die van die Mara diere (23.80 ± 0.84%). Area verskille (P<0.05) is gevind in die fosfaat en kalsium inhoud in die vleis. Vroulike diere by Mara het 'n hoër proporsie (P<0.05) van versadigde en mono-onversadige vetsure in die weefsel as manlike diere gehad. Manlike diere van beide areas het 'n hoër proporsie (P<0.05) van poli-onversadige vetsure (P<0.05) as die vroulike diere getoon. Miristien, palmitien en stearien suur was kwantitatief die belangrikste vetsure in manlike en vroulike diere van beide areas. Monsters van die M. semi-membranosus (SM), M. deltoideus (D), M. longissimus dorsi et laborum (LO), en M. psoas major (PS), van die rooibokkarkasse is ontleed vir sitraatsintase (SS) en fosfofruktokinase aktiwiteite (FFK). MSK verspreiding het merkbaar varieer tussen 0, SM en LO (P<O.05). 0 toon meer MSK I en minder MSKlia as die ander drie spiergroepe (P<O.05). Postiewe korrelasies is bevind tussen ouderdom en MSK I in 0 (r=O.93; P<O.05), asook tussen SS en die gewig van die dier in o (r=O.76; P<O.05). Die ensiemaktiwiteite en MSK verspreiding toon dat energie in die rooibok tot 'n groot mate deur die oksidatiewe paaie geproduseer word.

The Mexican American population is the largest and fastest growing Latino subgroup in the United States. Research has indicated Mexican Americans experience as many, if not more, mental health problems as other ethnic groups, including anxiety, depression, agoraphobia, simple phobia, drug and alcohol abuse, and increased rates of suicide. Mexican Americans, however, are among some of the most underserved by the mental health community. Little research, however, has focused on parents’ beliefs about their adolescents’ mental health, their utilization of mainstream mental health services, or their use of alternative resources for addressing their adolescent’s problems. This is particularly troubling given Mexican American youth have disproportionately high rates of substance abuse, delinquency, depression and suicide. Mexican American youth’s utilization patterns mirror those of adults, with lower rates of utilization than their peers of other ethnicities, and higher rates of early termination of treatment. The purpose of this qualitative study was to examine a number of topics related to Mexican American mothers’ perspectives on adolescent mental health, including factors that contribute to problems, steps parents would be willing to take to help their adolescent, their beliefs about the use of mental health professionals, and their use of alternatives such as curanderos, priests, or family reliance to address their adolescent mental health problems. Participants were 27 mothers of adolescents who identify themselves as being of Mexican descent (Mexican; Mexican American). Mothers who agreed to participate were interviewed in person using a semi-structured interview format. The results revealed considerable consistency in the participants’ views regardless of family history, adolescent problems faced, language spoken, and their generation in the U.S. The results of this study indicated that the Mexican American mothers who participated were attuned to adolescent functioning, with a keen sense for determining whether their adolescent is experiencing problems. The participants were able to navigate a complex system that involved considering other resources in their surroundings to address their adolescent’s problems. Overall, participants indicated positive regard toward the use of family, church, schools, and professionals in helping their adolescent, while the use of traditional folk healers, such as curanderos, was only minimally indicated. / text

Successful treatment of chronic hepatitis C virus (HCV) leads to significant benefits in both hepatic and extrahepatic morbidity and mortality. However, treatment is costly and onerous. The purpose of this study was to evaluate the resource utilization and healthcare costs of chronic HCV patients who are treated versus those who are not treated. Patients eligible for this study were Texas Medicaid patients ≥18 and ≤63 years who had evidence of chronic HCV during the identification period (1/1/07-9/30/11) and continuous enrollment throughout the analysis period. High dimensional propensity scoring techniques were used to match treated vs. untreated patients (1:2 ratio). Unadjusted and adjusted analyses compared the healthcare costs and utilization between patient cohorts at 6 and 18 months. For those treated, adherence was measured by proportion of days covered and persistence was evaluated as a gap in medication (of one fill) as determined by refill records. There were a total of 24,032 patients identified with chronic HCV. After high dimensional propensity scoring, there were no significant differences in key clinical and demographic characteristics between treated (n=939) and untreated (n=1878) cohorts. Over 97% of patients had evidence of end stage liver disease at baseline. Based on adjusted analyses of total costs using a generalized linear regression model, the mean difference in costs between the treated vs. untreated patients was $13,960 (SE $458, p<0.001). At 18 months of follow-up, the adjusted mean all-cause costs were $20,834 higher for treated patients (n=456) compared to those untreated (n=849) (p<0.001); however, mean outpatient costs were $1,894 (SE $274) less in treated vs. untreated patients. For those treated, the average HCV medication PDC was 71%, and by the end of 24 weeks, only 42.3% of patients remained on HCV therapy. This study did not show short-term cost offsets, but the sub-analysis following patients for 18 months showed trends in downstream cost offsets. Most patients had advanced liver disease, reducing the chances of successful treatment and averting liver disease sequelae. Earlier identification and treatment could bend the cost curve before these patients reached the more advanced stages seen in this costly cohort. / text

Asthma is a prevalent chronic disease with high health care utilization and excessive costs. Adherence to asthma long-term controller medications is one of the key drivers to improve asthma management. The purpose of this study was to investigate how patient characteristics and medication regimens, including adherence, impact asthma-related outcomes, which was represented by the use of quick-relief medications: oral corticosteroids (OCSs) and short-acting [beta]2-agonists (SABAs). Texas Medicaid prescription claims from July 1, 2008 to August 31, 2010 were retrospectively analyzed. Patients aged 5-63 years with a primary diagnosis of asthma (ICD-9 code 493) and four or more prescription claims for any asthma medication in one year (persistent asthma) were included. The primary outcomes were adherence to asthma long-term controller medications estimated by Proportion of Days Covered (PDC) and asthma control defined by the number of OCS and SABA claims. A total of 32,172 patients were included in the study. The majority of the patients were on monotherapy (58.9%), with leukotriene receptor antagonists (LTRAs) being most commonly prescribed (65.6%). Among patients on combination therapy (41.1%), fixed dose combinations of inhaled corticosteroids (ICSs) plus long-acting β-agonists (LABAs) were most commonly prescribed (51.9%). Mean (±SD) adherence to controller therapy was 32.2% (±19.7). Patients on LTRAs were 7.7% more adherent compared to patients on ICS therapy, and patients on fixed dose combination therapy were 4.5% more adherent compared to patients on concurrent therapy, while controlling for covariates (age, gender, race, number of non-study medications) (p<0.0001). The likelihood of having 6 or more claims for SABA in one year was significantly higher for adherent (PDC≥50%) patients (p<0.0001). However, the likelihood of OCS use was significantly higher for nonadherent (PDC<50%) patients compared to those who were adherent (p<0.0001). In conclusion, adherence to long-term controller medications was low among patients with asthma. Healthcare providers should emphasize adherence to controller therapy among patients with asthma. Being adherent is critical in prevention of asthma exacerbations requiring OCS use. As frequent SABA use signals poor asthma control, healthcare providers and patients (both adherent and nonadherent) should be educated/re-educated about SABA inhaler use. / text

Studies were conducted to determine the suitability of diaminopimelic acid (DAP), lysine and lysine-leucine as bacterial markers, and to compare ruminal, postruminal and total tract protein utilization and bacterial protein synthesis of sorghum grain, corn and barley based diets by beef steers. Six abomasally fistulated steers were fed 81% grain diets with 10.7% crude protein (CP) in a replicated 3 x 3 Latin square design. Diaminopimelic acid, lysine and leucine were determined in bacteria isolated from abomasal digesta (two sampling times) and rumen contents, and the ratios were used to estimate percent abomasal bacterial protein. Diaminopimelic acid concentrations in ruminal and abomasal bacteria were positively correlated (r = .40), but correlations between sample sites for lysine and leucine were essentially zero. Correlations between abomasal sampling times for the three amino acid concentrations were positive (mean r = .44). Rankings of percent bacterial protein in abomasal digesta for dietary treatments were similar based on amino acid ratio methods (DAP vs lysine vs lysine-leucine) using bacteria of rumen contents. Digestibility and bacterial synthesis data were based on lysine-leucine ratios from bacteria of rumen contents and chromium oxide ratios (digesta flow marker). Ruminal digestibilities of organic matter (OM), corrected for bacterial OM synthesis in the rumen, tended to be lower (P < .07) for sorghum grain and corn diets than for the barley diet (43, 48 vs 62%, respectively). Mean ruminal and postruminal CP digestibilities were similar (P > .05) for the three diets (-38 and 72%, respectively). Apparent total tract CP digestibility was lower (P < .05) for the sorghum grain diet than for corn or barley diets (61 vs 66 and 68%, respectively). Ruminal digestibility of feed nitrogen was lower for the sorghum grain and corn diets than for the barley diet (27 and 40 vs 69%, respectively). Percent bacterial nitrogen in the abomasum was much higher (P < .05) for the barley diet compared to the sorghum grain and corn diets (72 vs 47 and 53%, respectively). Postruminal digestibility of bacterial nitrogen was lower (P < .05) for the sorghum grain and corn diets compared to the barley diet. It is postulated that the lower apparent digestibility of sorghum grain protein in the total tract is related to a lower extent of feed protein and OM digested in the rumen.

Effects of tallow supplementation on dietary nutrient and minimal amino acid utilization in the laying hen were studied in two experiments. In the first experiment diets contained six levels of animal tallow ranging from 0 to 10%. Percent egg production and egg mass were not significantly affected by tallow. Body weight was significantly increased by 2% tallow was maximum at 6%. Addition of up to 6% fat improved feed conversion without adversely affecting other production characteristics. Metabolizable energy (ME) intake increased from 305.1 to 322.4 kcal/hen/d over the range of 0 to 6% tallow with no further improvement at higher tallow levels. Maximum net energetic efficiency was obtained with 2 and 4% tallow. Ability to digest tallow declined significantly with hen age. Higher tallow ME values were obtained from calorimetry data than from digestibility measurements due to beneficial effects of tallow on digestibilities of fat and protein in the basal diet. No improvement in starch retention was observed with tallow supplementation. In the second experiment, diets containing four levels of protein (15.0, 13.6, 15.0 + methionine and 17.0%) without and with 3% tallow were fed to hens housed in an open cage house or an insulated, evaporatively cooled house. Egg production and egg mass were significantly higher in the insulated house. This study indicates that reducing total protein below the National Research Council (NRC, 1984) recommended level significantly reduced egg production by birds housed in an open house. Supplemental methionine to provide .60% TSAA was required for maximum egg production. Egg production was significantly improved with the low protein diet when 3% tallow was added; however, egg production rate supported by this combination was significantly below that obtained with the 17% protein diet either with or without added tallow. For birds housed in the insulated, evaporatively cooled house the diet based on the NRC amino acid recommendations appeared to be optimal for performance, even with a lower protein level. No additional benefits were obtained in egg production with 3% tallow in any of the diets under these housing conditions.

Purpose: The purpose of this research was to estimate the impact of Medicare Part D on prescription and medical utilization among Arizona's senior dual eligible population.Methods: Generalized estimating equations were used to analyze changes in utilization among dual eligibles (Arizona Health Care Cost Containment (AHCCCS) beneficiaries between the ages of 66 and 80 as of January 1, 2006) relative to a "comparison" group ineligible for Part D (AHCCCS beneficiaries between the ages of 50 and 62 as of January 1, 2006) for the first two years following the implementation of Part D. Medical and pharmacy claims from AHCCCS from January 1, 2005 to December 31, 2007 were used in this analysis.Results: The dual eligibles and Part D ineligible comparison group were similar in their level and trend of utilization of over-the-counter (OTC) medications and benzodiazepines in the pre-Part D period. Following implementation of Part D, there was an immediate decline in utilization of both OTC medications and benzodiazepines in the dual eligibles relative to the comparison group (p<0.001).Increasing trends for both the dual eligible and comparison group were observed during the pre-Part D period for total prescription utilization, generic medication utilization and antidepressant use. After the implementation of Medicare Part D, utilization of these drug classes was significantly lower among the dual eligibles relative to the comparison group.Trends in physician office visits were similar between the dual eligible group and comparison group for the entire study period. During the first month of Part D, the dual eligibles had a statistically significantly larger increase in physician visits over the previous month relative to the comparison group (p=0.001). The trend in hospitalizations between the two groups significantly differed during the pre-period, precluding meaningful comparisons between the groups for this particular outcome.Conclusion: This study supports the belief that medication use for dual eligible Medicare beneficiaries was disrupted by the transition of outpatient drug benefits from Medicaid to Medicare Part D.

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