RESUMEN

Background: 37.5% of deaths in our area occur in hospital. There are known high unmet needs of adult patients dying in hospital, this unmet need can be reduced by using an individualised care plan and specialist palliative care review. Intervention: In 2022 UHSussex developed an electronic comfort observation chart and individualised care plan, with a centralised dashboard allowing Palliative Care Teams (SPCT) to view trends, target interventions, and a rolling prospective audit. Results: 3000 patients have had their care supported with electronic comfort observations (e-comfort obs). Over 72% of all deaths in the Trust in the last 3 months have been on e-comfort obs, with 2/3 of all deaths in the first 12 months on e-comfort obs. The average length of time on e-comfort obs is 4 days resulting in 70,000 sets of e-comfort obs recorded since launch. Seven percent of e-comfort obs record moderate or severe symptoms. We have identified benefits to people who are dying, those important to them, ward staff, SPCT and on a systems level. Conclusion: E-comfort obs can be successfully embedded in a large acute Trust. This development should improve quality of end of life care in our hospitals both for individuals and for future patients, through on-going targeted education and intervention. Further work is needed to develop the system further including integrating data from electronic prescribing.

RESUMEN

In this commentary, we urge that a Data Monitoring Committee (DMC) should operate as a collective, that is, as a unitary whole. In so doing, its recommendations should emerge through a consensus development process, not through a vote of the members. The summary notes of its closed session, that is, its minutes, should report the recommendations of the DMC and, if necessary, the justification for those recommendations; it should not attribute opinions to individual members. Importantly, the proceedings of the DMC meetings should not be electronically recorded.

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RESUMEN

While benchmarking is already used for the assessment of performance gaps in cattle herd management and welfare concerns, its application to quantifying claw health performance is relatively new. The goal here was to establish a benchmarking system for claw health in Austrian dairy cattle. We used electronically registered claw health data of cows from 512 dairy herds documented by professional hoof trimmers, culling data from the same herds, and locomotion scores taken at regular milk performance testings in 99 dairy herds during 2020. Mean, median and the 10th, 25th, 75th, and 90th percentiles of the incidences of risk of lameness, 13 common claw lesions, and the annual culling risk directly related to claw and limb disorders were used as key performance indicators. Only validated data sets were used and participating trimmers and locomotion scorers had to pass interobserver reliability tests with weighted Cohen's kappa values ≥ 0.61 indicating substantial interobserver agreement. This claw health benchmarking system is intended to be used henceforth in the transnational cattle data network (RDV) by all participating farmers and is also available for veterinarians and consultants, with the agreement of respective farmers.

RESUMEN

We investigated if sexual behaviour of rams can be assessed with an electronic Alpha-Detector (AD) which automatically records mounts of mating rams. To evaluate the rams' libido (i.e. all sexual activities), we used six intact and six vasectomised rams in pen tests in three different seasons (late spring, autumn and early spring). The pen tests consisted of 30-min visual observations of each ram placed in a group of six Merino ewes (three ewes in oestrus and three ewes not in oestrus). In the pen tests, sexual behaviour was recorded and divided into two categories: pre-copulatory and copulatory. For validation purposes, during the pen tests the 12 rams were equipped with the AD and the number of times the 18 oestrous ewes were mounted were counted over a period of 3 days. Of the 1191 mounts visually identified in the six 30-min sessions, 1026 were recorded automatically by the AD (i.e. 94%). The paddock test is an automated method consisting of the same rams wearing an AD and placed in a flock of ~250 Merino ewes on two occasions (late spring (spring 1) and early spring of the following year (spring 2)), their copulatory activities were automatically recorded over a 5-day period. The results of the pen tests in the three seasons revealed no difference between the two types of rams (breeding v. detecting rams). Based on live observations high correlations (r=+0.81, P<0.003 for breeding and r=+0.76, P<0.02 for detecting rams) were found between pre-copulatory and copulatory behaviours. The libido of the two types of rams measured in pen tests showed high repeatability across the three seasons (83 and 75%, P<0.05 for copulatory and pre-copulatory behaviours, respectively). When measured automatically in paddock tests over two consecutive springs, even higher repeatability was observed in both breeding (94%; P<0.01) and detecting rams (97%; P<0.004) in the number of mounts. In addition, high correlations (+0.89

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RESUMEN

Claw health and lameness data from five dairies with compost bedded barns (n = 201 data sets) were evaluated and compared with data from five dairy herds housed in freestall cubicle barns (n = 297 data sets). They were matched for having the same cow numbers, flooring type and similar milk yield. The prevalence of lameness, claw lesions and their severity grades were analysed. Two claw health indicators, the cow claw score (CCS) and the farm claw score (FCS), were calculated using a computerised claw trimming database programme; there was no significant difference in overall lameness prevalence in cows from five compost bedded barns (18.7%) compared to cows from five freestall cubicle herds (14.9%). A cumulative link mixed model (CLMM) did not show significant differences in locomotion between different types of bedding material, flooring system, breed, visit number, observer and time since last trimming, but locomotion was significantly influenced by CCS. Another CLMM tested the impact of parameters mentioned on CCS and showed significant influence of flooring type, visit number and cattle breed. Statistically significant differences in the prevalence of claw disorders between compost bedded and freestall cubicle barns were found for white line disease (WLD; 20.4% and 46.6%, respectively), heel horn erosion (HHE; 26.9% and 59.9%, respectively), concave dorsal wall as a result of chronic laminitis (6.5% and 15.9%, respectively) and for interdigital hyperplasia (0.2% and 3.1%, respectively). The results of this study indicate that compost dairy barns are a good alternative to common cubicle housing systems in terms of lameness, claw health and animal welfare.

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