ESTIMATING COMPARATIVE COSTS OF PRODUCING MILK AMONG THE SOUTHERN STATES

Production Economics,

LEVEL OF STRUCTURAL AGGREGATION AND PREDICTIVE ACCURACY OF MILK SUPPLY RESPONSE ESTIMATES

Milk supply response was estimated for Pennsylvania using three different levels of structural aggregation. The base level involved the estimation of milk production in a single equation. Under the second method, production was the product of two equations: milk per cow and number of milk cows. The third method factored production into three equations: milk per cow, number of dairy farms, and number of cows per farm. As expected, the greater the degree of disaggregation the more was learned about the structural aspects of milk production. At the same time, predictive accuracy generally decreased, but the differences among models was slight.Livestock Production/Industries,

DEFINING AND MEASURING RURALITY

Community/Rural/Urban Development,

ESTIMATING THE RELATIVE RURALITY OF U.S. COUNTIES

Community/Rural/Urban Development,

Responding to unexpected infant deaths : experience in one English region

New national procedures for responding to the unexpected death of a child in England require a joint agency approach to investigate each death and support the bereaved family. As part of a wider population-based study of sudden unexpected deaths in infancy (SUDI) we evaluated the implementation of this approach. Methods: A process evaluation using a population-based study of all unexpected deaths from birth to 2 years in the South West of England between January 2003 and December 2006. Local police and health professionals followed a standardised approach to the investigation of each death, supported by the research team set up to facilitate this joint approach as well as collect data for a wider research project. Results: We were notified of 155/157 SUDI, with a median time to notification of 2 hours. Initial multi-agency discussions took place in 93.5% of cases. A joint home visit by police officers with health professionals was carried out in 117 cases, 75% within 24 hours of the death. Time to notification and interview reduced during the 4 years of the study. Autopsies were conducted on all cases, the median time to autopsy being 3 days. At the conclusion of the investigation, a local multi-agency case discussion was held in 88% of cases. The median time for the whole process (including family support) was 5 months. Conclusions: This study has demonstrated that with appropriate protocols and support, the joint agency approach to the investigation of unexpected infant deaths can be successfully implemented

Hazardous cosleeping environments and risk factors amenable to change: case-control study of SIDS in south west England

Objectives: To investigate the factors associated with sudden infant death syndrome (SIDS) from birth to age 2 years, whether recent advice has been followed, whether any new risk factors have emerged, and the specific circumstances in which SIDS occurs while cosleeping (infant sharing the same bed or sofa with an adult or child). Design: Four year population based case-control study. Parents were interviewed shortly after the death or after the reference sleep (within 24 hours) of the two control groups. Setting: South west region of England (population 4.9 million, 184 800 births). Participants: 80 SIDS infants and two control groups weighted for age and time of reference sleep: 87 randomly selected controls and 82 controls at high risk of SIDS (young, socially deprived, multiparous mothers who smoked). Results: The median age at death (66 days) was more than three weeks less than in a study in the same region a decade earlier. Of the SIDS infants, 54% died while cosleeping compared with 20% among both control groups. Much of this excess may be explained by a significant multivariable interaction between cosleeping and recent parental use of alcohol or drugs (31% v 3% random controls) and the increased proportion of SIDS infants who had coslept on a sofa (17% v 1%). One fifth of SIDS infants used a pillow for the last sleep (21% v 3%) and one quarter were swaddled (24% v 6%). More mothers of SIDS infants than random control infants smoked during pregnancy (60% v 14%), whereas one quarter of the SIDS infants were preterm (26% v 5%) or were in fair or poor health for the last sleep (28% v 6%). All of these differences were significant in the multivariable analysis regardless of which control group was used for comparison. The significance of covering the infant’s head, postnatal exposure to tobacco smoke, dummy use, and sleeping in the side position has diminished although a significant proportion of SIDS infants were still found prone (29% v 10%). Conclusions: Many of the SIDS infants had coslept in a hazardous environment. The major influences on risk, regardless of markers for socioeconomic deprivation, are amenable to change and specific advice needs to be given, particularly on use of alcohol or drugs before cosleeping and cosleeping on a sofa

Delivery of Interventions for Multiple Lifestyle Factors in Primary Healthcare Settings:A Narrative Review Addressing Strategies for Effective Implementation

The escalating burden of lifestyle-related diseases stands as a critical global public health challenge, contributing substantially to the prevalence of chronic conditions and a large portion of premature mortality. Despite this, concise evidence-based lifestyle interventions targeting physical inactivity, nutrition, alcohol and smoking continue to be underutilised. Although good evidence exists for addressing the four lifestyle-related risk factors independently, rarely do these present in isolation. Evidence is lacking regarding how to integrate interventions targeting multiple risk factors. Consequently, this paper aims to provide an overview of the evidence for delivering multiple interventions in primary healthcare settings. Different lifestyle factors are inter-related, with decisions around ordering of the delivery of multiple lifestyle interventions an important consideration. There is evidence supporting the effectiveness of addressing some lifestyle factors simultaneously (e.g., physical activity and nutrition), although smoking cessation may be delivered best in a sequential approach. While the World Health Organisation highlights four key lifestyle factors (nutrition, physical activity, alcohol and smoking), incorporating additional elements such as sleep, mental well-being and social connectedness offers a holistic framework for promoting well-being. Despite the presentation of multiple behaviour risk factors being commonplace in healthcare settings, the evidence (outlined in the paper) for how best to deliver interventions to address this is limited, with further research and subsequent clinical guidance required. In order to address the barriers to delivering lifestyle interventions in primary care, innovation will be required. The use of non-medical personnel, social prescribers and health coaches has the potential to alleviate time constraints, whilst mounting evidence exists for group consultations for addressing lifestyle-related non-communicable diseases (NCDs). If the challenges to implementation can be addressed, and if healthcare systems can adapt for the promotion of healthy lifestyles, the impact of NCDs can be mitigated.</p

Shock Speed, Cosmic Ray Pressure, and Gas Temperature in the Cygnus Loop

Upper limits on the shock speeds in supernova remnants can be combined with post-shock temperatures to obtain upper limits on the ratio of cosmic ray to gas pressure (P_CR / P_G) behind the shocks. We constrain shock speeds from proper motions and distance estimates, and we derive temperatures from X-ray spectra. The shock waves are observed as faint H-alpha filaments stretching around the Cygnus Loop supernova remnant in two epochs of the Palomar Observatory Sky Survey (POSS) separated by 39.1 years. We measured proper motions of 18 non-radiative filaments and derived shock velocity limits based on a limit to the Cygnus Loop distance of 576 +/- 61 pc given by Blair et al. for a background star. The PSPC instrument on-board ROSAT observed the X-ray emission of the post-shock gas along the perimeter of the Cygnus Loop, and we measure post-shock electron temperature from spectral fits. Proper motions range from 2.7 arcseconds to 5.4 arcseconds over the POSS epochs and post-shock temperatures range from kT ~ 100-200 eV. Our analysis suggests a cosmic ray to post-shock gas pressure consistent with zero, and in some positions P_CR is formally smaller than zero. We conclude that the distance to the Cygnus Loop is close to the upper limit given by the distance to the background star and that either the electron temperatures are lower than those measured from ROSAT PSPC X-ray spectral fits or an additional heat input for the electrons, possibly due to thermal conduction, is required.Comment: Submitted to ApJ, 7 color figure