324 research outputs found

    1982 Planning Prices and Livestock Budgets

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    This publication provides tables and worksheets for calculating budgets for beef cows and calves, stockers and feeders, feeding calves and yearlings, ewes and lambs, feeding lambs, market hogs, feeder pigs, milk, dairy, laying hens, goose, and turkey production in 1982

    Management Guide for Planning a Farm or Ranch Business

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    This guidebook contains reference material for planning a farm business. Farm business planning for better family living, high profit farm plans, budgeting for more profit, management strategies in beef production, a partial budget for planned changes, and reference tables for crops, livestock, labor, machinery, labor, loans, and social security and income tax are included

    Management Guide for Planning a Farm or Ranch Business

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    This guidebook contains reference material for planning a farm business. Farm business planning for better family living, high profit farm plans, budgeting for more profit, management strategies in beef production, a partial budget for planned changes, and reference tables for crops, livestock, labor, machinery, labor, loans, and social security and income tax are included

    Ten Steps in Planning Your Farm or Ranch Business

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    This publication provides information on land use and estimating direct costs per acre for growing and harvesting grain and forage crops. Guides for preparing land use and cropping systems, planning livestock enterprises, calculating labor requirements and distribution, and summarizing costs and returns for the plan are also included

    Race Differences in Initial Presentation, Early Treatment, and 1-year Outcomes of Pediatric Crohnʼs Disease: Results from the ImproveCareNow Network

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    BACKGROUND: Racially disparate care has been shown to contribute to suboptimal health care outcomes for minorities. Using the ImproveCareNow network, we investigated differences in management and outcomes of pediatric patients with Crohn's disease at diagnosis and 1-year postdiagnosis. METHODS: ImproveCareNow is a learning health network for pediatric inflammatory bowel disease. It contains prospective, longitudinal data from outpatient encounters. This retrospective study included all patients with Crohn's disease ≤21 years, September 2006 to October 2014, with the first recorded encounter ≤90 days from date of diagnosis and an encounter 1 year ±60 days. We examined the effect of race on remission rate and treatment at diagnosis and 1 year from diagnosis using t-tests, Wilcoxon rank-sum tests, χ statistic, and Fisher's exact tests, where appropriate, followed by univariate regression models. RESULTS: Nine hundred seventy-six patients (Black = 118 (12%), White = 858 (88%), mean age = 13 years, 63% male) from 39 sites were included. Black children had a higher percentage of Medicaid insurance (44% versus 11%, P < 0.001). At diagnosis, Black children had more active disease according to physician global assessment (P = 0.027), but not by short Pediatric Crohn's Disease Activity Index (P = 0.67). Race differences in treatment were not identified. Black children had lower hematocrit (34.8 versus 36.7, P < 0.001) and albumin levels (3.6 versus 3.9, P = 0.001). At 1 year, Black children had more active disease according to physician global assessment (P = 0.016), but not by short Pediatric Crohn's Disease Activity Index (P = 0.06). CONCLUSIONS: Black children with Crohn's disease may have more severe disease than White children based on physician global assessment. Neither disease phenotype differences at diagnosis nor treatment differences at 1-year follow-up were identified

    Racial Disparities in Readmission, Complications, and Procedures in Children with Crohnʼs Disease:

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    Racial disparities in care and outcomes contribute to mortality and morbidity in children however the role in pediatric Crohn’s disease (CD) is unclear. In this study, we compared cohorts of Black and White children with CD to determine the extent race is associated with differences in readmissions, complications, and procedures among hospitalizations in the United States

    Assessment of Sex Differences for Treatment, Procedures, Complications, and Associated Conditions Among Adolescents Hospitalized with Crohnʼs Disease:

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    Sex differences among adults in healthcare treatment and outcomes have been reported, however, there is a paucity of literature regarding pediatric populations, particularly adolescents with Crohn’s disease (CD). The objective was to identify whether sex differences exist with respect to complications, procedures, and medication usage (corticosteroids, biologic agents, and total parenteral nutrition (TPN)) among hospitalized adolescents with CD

    Gene Expression Changes Associated with Resistance to Intravenous Corticosteroid Therapy in Children with Severe Ulcerative Colitis

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    Microarray analysis of RNA expression allows gross examination of pathways operative in inflammation. We aimed to determine whether genes expressed in whole blood early following initiation of intravenous corticosteroid treatment can be associated with response.From a prospectively accrued cohort of 128 pediatric patients hospitalized for intravenous corticosteroid treatment of severe UC, we selected for analysis 20 corticosteroid responsive (hospital discharge or PUCAI ≤45 by day 5) and 20 corticosteroid resistant patients (need for second line medical therapy or colectomy, or PUCAI >45 by day 5). Total RNA was extracted from blood samples collected on day 3 of intravenous corticosteroid therapy. The eluted transcriptomes were quantified on Affymetrix Human Gene 1.0 ST arrays. The data was analysed by the local-pooled error method for discovery of differential gene expression and false discovery rate correction was applied to adjust for multiple comparisons.A total of 41 genes differentially expressed between responders and non-responders were detected with statistical significance. Two of these genes, CEACAM1 and MMP8, possibly inhibited by methylprednisolone through IL8, were both found to be over-expressed in non-responsive patients. ABCC4 (MRP4) as a member of the multi-drug resistance superfamily was a novel candidate gene for corticosteroid resistance. The expression pattern of a cluster of 10 genes selected from the 41 significant hits were able to classify the patients with 80% sensitivity and 80% specificity.Elevated expression of several genes involved in inflammatory pathways was associated with resistance to intravenous corticosteroid therapy early in the course of treatment. Gene expression profiles may be useful to classify resistance to intravenous corticosteroids in children with severe UC and assist with clinical management decisions

    Feasibility and Validity of the Pediatric Ulcerative Colitis Activity Index in Routine Clinical Practice

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    The Pediatric Ulcerative Colitis Activity Index (PUCAI) is a non-invasive disease activity index developed as a clinical trial endpoint. More recently, practice guidelines have recommended the use of PUCAI in routine clinical care. We therefore sought to evaluate the feasibility, validity and responsiveness of PUCAI in a large, diverse collection of pediatric gastroenterology practices

    Implementable Strategies and Exploratory Considerations to Reduce Costs Associated with Anti-TNF Therapy in Inflammatory Bowel Disease:

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    A health care system is needed where care is based on the best available evidence and is delivered reliably, efficiently, and less expensively (best care at lower cost). In gastroenterology, anti-tumor necrosis factor (anti-TNF) agents represent the most effective medical therapeutic option for patients with moderate-to-severe inflammatory bowel disease (IBD), but are very expensive and account for nearly a quarter of the cost of IBD care, representing a major area of present and future impact in direct health care costs. The ImproveCareNow Network, consisting of over 55 pediatric IBD centers, seeks ways to improve the value of care in IBD – curtailing unnecessary costs and promoting better health outcomes through systematic and incremental quality improvement initiatives. This report summarizes the key evidence to facilitate the cost-effective use of anti-TNF agents for patients with IBD. Our review outlines the scientific rationale for initiating cost-reducing measures in anti-TNF use and focuses on three implementable strategies and four exploratory considerations through practical clinical guidelines, as supported by existing evidence. Implementable strategies can be readily integrated into today’s daily practice, while exploratory considerations can guide research to support future implementation
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