Prevalence of human papillomavirus in women attending cervical screening in the UK and Ireland:New data from northern Ireland and a systematic review and meta-analysis

There is substantial international variation in human papillomavirus (HPV) prevalence; this study details the first report from Northern Ireland and additionally provides a systematic review and meta-analysis pooling the prevalence of high-risk (HR-HPV) subtypes among women with normal cytology in the UK and Ireland. Between February and December 2009, routine liquid based cytology (LBC) samples were collected for HPV detection (Roche Cobas® 4800 [PCR]) among unselected women attending for cervical cytology testing. Four electronic databases, including MEDLINE, were then searched from their inception till April 2011. A random effects meta-analysis was used to calculate a pooled HR-HPV prevalence and associated 95% confidence intervals (CI). 5,712 women, mean age 39 years (±SD 11.9 years; range 20-64 years), were included in the analysis, of which 5,068 (88.7%), 417 (7.3%) and 72 (1.3%) had normal, low, and high-grade cytological findings, respectively. Crude HR-HPV prevalence was 13.2% (95% CI, 12.7-13.7) among women with normal cytology and increased with cytological grade. In meta-analysis the pooled HR-HPV prevalence among those with normal cytology was 0.12 (95% CIs, 0.10-0.14; 21 studies) with the highest prevalence in younger women. HPV 16 and HPV 18 specific estimates were 0.03 (95% CI, 0.02-0.05) and 0.01 (95% CI, 0.01-0.02), respectively. The findings of this Northern Ireland study and meta-analysis verify the prevalent nature of HPV infection among younger women. Reporting of the type-specific prevalence of HPV infection is relevant for evaluating the impact of future HPV immunization initiatives, particularly against HR-HPV types other than HPV 16 and 18. J. Med. Virol. 85:295-308, 2013. © 2012 Wiley Periodicals, Inc. Copyright © 2012 Wiley Periodicals, Inc.

Investigation into the effect of molybdenum-site substitution on the performance of Sr2Fe1.5Mo0.5O6-δ for intermediate temperature solid oxide fuel cells

In this paper, niobium doping is evaluated as a means of enhancing the electrochemical performance of a Sr₂Fe_1.5Mo_0.5O_6-δ (SFM) perovskite structure cathode material for intermediate temperature solid oxide fuel cells (IT-SOFCs) applications. As the radius of Nb approximates that of Mo and exhibits +4/+5 mixed valences, its substitution is expected to improve material performance. A series of Sr₂Fe_1.5Mo_0.5-xNb_xO_6-δ (x = 0.05, 0.10, 0.15, 0.20) cathode materials are prepared and the phase structure, chemical compatibility, microstructure, electrical conductivity, polarization resistance and power generation are systematically characterized. Among the series of samples, Sr₂Fe_1.5Mo_0.4Nb_0.10O_6-δ (SFMNb_0.10) exhibits the highest conductivity value of 30 S cm^-1 at 550°C, and the lowest area specific resistance of 0.068 Ω cm² at 800°C. Furthermore, an anode-supported single cell incorporating a SFMNb_0.10 cathode presents a maximum power density of 1102 mW cm^-2 at 800°C. Furthermore no obvious performance degradation is observed over 15 h at 750°C with wet H₂(3% H₂O) as fuel and ambient air as the oxidant. These results demonstrate that SFMNb shows great promise as a novel cathode material for IT-SOFCs.

Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials

BACKGROUND: The optimal ways of using aromatase inhibitors or tamoxifen as endocrine treatment for early breast cancer remains uncertain.

METHODS: We undertook meta-analyses of individual data on 31 920 postmenopausal women with oestrogen-receptor-positive early breast cancer in the randomised trials of 5 years of aromatase inhibitor versus 5 years of tamoxifen; of 5 years of aromatase inhibitor versus 2-3 years of tamoxifen then aromatase inhibitor to year 5; and of 2-3 years of tamoxifen then aromatase inhibitor to year 5 versus 5 years of tamoxifen. Primary outcomes were any recurrence of breast cancer, breast cancer mortality, death without recurrence, and all-cause mortality. Intention-to-treat log-rank analyses, stratified by age, nodal status, and trial, yielded aromatase inhibitor versus tamoxifen first-event rate ratios (RRs).

FINDINGS: In the comparison of 5 years of aromatase inhibitor versus 5 years of tamoxifen, recurrence RRs favoured aromatase inhibitors significantly during years 0-1 (RR 0·64, 95% CI 0·52-0·78) and 2-4 (RR 0·80, 0·68-0·93), and non-significantly thereafter. 10-year breast cancer mortality was lower with aromatase inhibitors than tamoxifen (12·1% vs 14·2%; RR 0·85, 0·75-0·96; 2p=0·009). In the comparison of 5 years of aromatase inhibitor versus 2-3 years of tamoxifen then aromatase inhibitor to year 5, recurrence RRs favoured aromatase inhibitors significantly during years 0-1 (RR 0·74, 0·62-0·89) but not while both groups received aromatase inhibitors during years 2-4, or thereafter; overall in these trials, there were fewer recurrences with 5 years of aromatase inhibitors than with tamoxifen then aromatase inhibitors (RR 0·90, 0·81-0·99; 2p=0·045), though the breast cancer mortality reduction was not significant (RR 0·89, 0·78-1·03; 2p=0·11). In the comparison of 2-3 years of tamoxifen then aromatase inhibitor to year 5 versus 5 years of tamoxifen, recurrence RRs favoured aromatase inhibitors significantly during years 2-4 (RR 0·56, 0·46-0·67) but not subsequently, and 10-year breast cancer mortality was lower with switching to aromatase inhibitors than with remaining on tamoxifen (8·7% vs 10·1%; 2p=0·015). Aggregating all three types of comparison, recurrence RRs favoured aromatase inhibitors during periods when treatments differed (RR 0·70, 0·64-0·77), but not significantly thereafter (RR 0·93, 0·86-1·01; 2p=0·08). Breast cancer mortality was reduced both while treatments differed (RR 0·79, 0·67-0·92), and subsequently (RR 0·89, 0·81-0·99), and for all periods combined (RR 0·86, 0·80-0·94; 2p=0·0005). All-cause mortality was also reduced (RR 0·88, 0·82-0·94; 2p=0·0003). RRs differed little by age, body-mass index, stage, grade, progesterone receptor status, or HER2 status. There were fewer endometrial cancers with aromatase inhibitors than tamoxifen (10-year incidence 0·4% vs 1·2%; RR 0·33, 0·21-0·51) but more bone fractures (5-year risk 8·2% vs 5·5%; RR 1·42, 1·28-1·57); non-breast-cancer mortality was similar.

INTERPRETATION: Aromatase inhibitors reduce recurrence rates by about 30% (proportionately) compared with tamoxifen while treatments differ, but not thereafter. 5 years of an aromatase inhibitor reduces 10-year breast cancer mortality rates by about 15% compared with 5 years of tamoxifen, hence by about 40% (proportionately) compared with no endocrine treatment.

FUNDING: Cancer Research UK, Medical Research Council.

Serum Cytokines and Adipokines in Periodontitis

Objective: To investigate whether there was an association between serum levels of pro-inflammatory cytokines, adipokines and periodontitis in 60-70 year-old men in Northern Ireland. Methods: Test subjects (n=61) with established periodontitis, categorised by loss of periodontal attachment (PAL) and pocketing of at least 5mm, were matched for age, smoking and BMI with controls (n=60) who were periodontitis resistant (no PAL or pocketing over 3mm). Serum levels of IL 1 alpha, TNF alpha, IL 6, adiponectin, resistin, leptin and C-reactive protein (CRP) were measured from serum using a multiplex array (Randox, UK). Mann Whitney analysis was used with the level of significance set at p<0.05. Results: There was considerable inter-individual variability in all the analytes measured. There was a significantly higher level of IL 6 in men with periodontitis (3.25 pg/ml, SD 2.29) than in those with no periodontitis (2.38 pg/ml, SD1.62), p=0.0041 (after Bonferroni correction for multiple testing p=0.029). Serum IL 6 was strongly correlated with CRP: r=0.52 (95% CI 0.38-0.64), p<0.0001. There was a lower serum level of adiponectin in men with periodontitis (3662.1 ng/ml, SD 2383.4) compared with those who were periodontitis resistant (4265.9 ng/ml, SD 2266.0), which just escaped statistical significance at p=0.068. There were no significant differences in the serum levels of any of the other analytes measured in relation to periodontal status. Conclusions: There was evidence in the 60-70 year-old male population investigated that periodontitis was associated with an increased serum level of IL 6.

Avaliação do perfil de cuidado de enfermagem geriátrico em hospitais de Portugal

A transição demográfica e epidemiológica da população portuguesa tem e terá um enorme impacto na utilização dos recursos de saúde. Atualmente, as pessoas idosas representam um dos grupos etários com taxas de internamento hospitalar mais significativos. Contudo, os dados sobre a hospitalização destas pessoas têm demonstrado resultados de saúde negativos, nomeadamente, o declínio funcional e cognitivo e o risco elevado de eventos adversos. Os/as enfermeiros/as têm um papel crucial na mudança desta realidade. Deste modo, a associação entre o contexto no qual decorre o cuidado de enfermagem geriátrica e os resultados deste cuidado relativos a/os utentes, enfermeiros/as e organizações têm sido proficuamente documentados. Algumas estratégias para promover a qualidade do cuidado geriátrico e a segurança das pessoas idosas hospitalizadas consistem em avaliar e (re)criar o ambiente de trabalho geriátrico dos/as enfermeiros/as (AGTE) e capacitar e treinar estes/as profissionais no cuidado à pessoa idosa. Embora, internacionalmente, os dados demonstrem a associação entre as características de hospitais e/ou enfermeiros/as e o AGTE, não existem estudos em Portugal nesta área, bem como sobre o conhecimento e as atitudes destes profissionais no contexto hospitalar. Por conseguinte, este estudo teve como objetivos: 1) traduzir, adaptar culturalmente e validar as escalas que compõem o questionário Geriatric Institucional Assessment Proflie (GIAP) para a população portuguesa; 2) analisar o AGTE (fatores intrínsecos e extrínsecos) que apoiam ou dificultam a adoção das melhores práticas geriátricas em hospitais portugueses; 3) analisar as atitudes e conhecimento de enfermeiros/as acerca de quatro síndromes geriátricas (úlceras de pressão, distúrbio do sono, contenção física e incontinência), destacando as boas práticas e os problemas encontrados nos hospitais portugueses; 4) analisar a relação entre as variáveis demográficas, profissionais e as características dos hospitais e as escalas que compõem o GIAP – versão portuguesa; 5) conhecer as perceções de enfermeiros/as acerca do cuidado às pessoas idosas hospitalizadas e dos obstáculos enfrentados para desenvolver um cuidado de boa qualidade; e 6) analisar a relação entre a perceção de enfermeiros/as sobre o AGTE e o conhecimento e atitudes geriátricas destes profissionais em função da região e unidade de internamento. Este estudo foi desenvolvido com base num método quantitativo do tipo exploratório-descritivo, transversal, prospetivo e correlacional. A amostra foi constituída por 1.068 enfermeiros/as de cinco hospitais da região norte e centro do país. A recolha de dados foi desenvolvida através de autopreenchimento do GIAP – versão portuguesa. De entre os principais resultados destacam-se: 1) a obtenção de um instrumento válido e fiável para avaliar o AGTE e conhecimentos e atitudes geriátricas; 2) a perceção de enfermeiros/as sobre o cuidado às pessoas idosas como sendo predominantemente negativa; 3) a perceção de enfermeiros/as sobre o apoio insuficiente dos líderes hospitalares para promover um AGTE favorável; 4) o cuidado a pessoas idosas com comportamentos inadequados e o uso de recursos geriátricos como os principais fatores que influenciam a eficácia e a qualidade do cuidado geriátrico; 5) a lacuna de conhecimento e atitudes negativas de enfermeiros/as acerca das quatro síndromes geriátricas; 6) a conceptualização de um modelo sobre a associação das características de enfermeiros/as, dos hospitais do estudo e das perceções destes/as profissionais sobre o cuidado geriátrico com o AGTE e o conhecimento e atitudes geriátricos; 7) a falta de apoio familiar, a descontinuidade e a escassez de tempo para o cuidado como principais obstáculos no cuidado à pessoa idosa hospitalizada; e 8) o perfil de cuidado geriátrico nos hospitais da região norte e centro de Portugal como tendencialmente homogéneo. Os resultados deste estudo sustentam a necessidade de um maior investimento dos decisores políticos, administradores hospitalares e docentes de Enfermagem na capacitação dos/as enfermeiros/as para o cuidado geriátrico e na promoção de um AGTE mais favorável. Também oferece recomendações significativas nos domínios da decisão política, da gestão institucional e da prática profissional que devem ser alvo de uma discussão alargada entre os vários agentes com responsabilidade nestes domínios. Espera-se que este estudo possa contribuir para a promoção de um contexto favorável ao desenvolvimento de um cuidado de enfermagem geriátrica de boa qualidade às pessoas hospitalizadas.

Methodological aspects of a mathematical programming model to evaluate soil tillage technologies in a risky environment

In this work we develop a methodology for the economic evaluation of soil tillage technologies, in a risky environment, and to capture the influence of farmer behaviour on his technology choice. The model has short-term activities, that change with the type of year, and long-term activities, in which sets of traction investment activities are included. Although these activities do not change with the type of year, they lead to different availability of resources for each type of year, since the same tractor has different available fieldwork days under different weather conditions. We prove that the model is sensitive to the greater income variability resulting from the use of alternative technologies and to the balance between income and risk, accounting for the probability of occurrence of each state of nature and giving an investment solution that considers the best production plan for each type of year. (c) 2005 Elsevier B.V. All rights reserved.

Variabilidad de las condiciones oceanográficas en el punto fijo Paita (05°04’S – 81°16´W), abril 2014 – octubre 2015

En los años 2014 y 2015 el mar peruano ha presentado marcadas alteraciones que repercutieron positiva o negativamente en la concentración y distribución de los recursos vivos del mar. Estas alteraciones ocasionadas por factores océano-atmosféricos (ondas, vientos etc.) se reflejan claramente en la serie de parámetros oceanográficos del Punto Fijo Paita, lo que nos permite el seguimiento del arribo, intensidad y posibles efectos de las ondas en la costa peruana. En estos 2 últimos años, el IMARPE viene realizando un monitoreo continuo en el Punto Fijo Paita a través del programa: Proyecto por Resultados El Niño (PpR 068 EN), y se ha podido catalogar en el año 2014 el desarrollo de un evento El Niño costero de intensidad moderada según el Índice Costero El Niño (ICEN; ENFEN 2012), asimismo, a partir de mayo del 2015 a la actualidad, se viene desarrollando otro evento El Niño costero de intensidad fuerte; este último asociado a las anomalías en el acoplamiento océano-atmosfera en el Pacífico Central, a la propagación de ondas Kelvin hacia el Pacífico Oriental y a las fluctuaciones que vienen presentando los vientos en el Pacífico Ecuatorial Oriental y Sudoriental.

L'Écho de Paris

1920/01/11 (Numéro 12930).

Un été dans le Sahara

UANL

Potential use of a recombinant replication-defective adenovirus vector carrying the C-terminal portion of the P97 adhesin protein as a vaccine against Mycoplasma hyopneumoniae in swine.

Mycoplasma hyopneumoniae causes severe economic losses to the swine industry worldwide and the prevention of its related disease, enzootic porcine pneumonia, remains a challenge. The P97 adhesin protein of M. hyopneumoniae should be a good candidate for the development of a subunit vaccine because antibodies produced against P97 could prevent the adhesion of the pathogen to the respiratory epithelial cells in vitro. In the present study, a P97 recombinant replication-defective adenovirus (rAdP97c) subunit vaccine efficiency was evaluated in pigs. The rAdP97c vaccine was found to induce both strong P97 specific humoral and cellular immune responses. The rAdP97c vaccinated pigs developed a lower amount of macroscopic lung lesions (18.5 ± 9.6%) compared to the unvaccinated and challenged animals (45.8 ± 11.5%). rAdP97c vaccine reduced significantly the severity of inflammatory response and the amount of M. hyopneumoniae in the respiratory tract. Furthermore, the average daily weight gain was slightly improved in the rAdP97c vaccinated pigs (0.672 ± 0.068 kg/day) compared to the unvaccinated and challenged animals (0.568 ± 0.104 kg/day). A bacterin-based commercial vaccine (Suvaxyn® MH-one) was more efficient to induce a protective immune response than rAdP97c even if it did not evoke a P97 specific immune response. These results suggest that immunodominant antigens other than P97 adhesin are also important in the induction of a protective immune response and should be taken into account in the future development of M. hyopneumoniae subunit vaccines.

New insights into small molecules inhibitors and protein-protein interactions of VirB8 : a critical conserved component of the type IV secretion system.

Les systèmes bactériens de sécrétion de type IV (T4SS) sont constitués d’un ensemble de 8 à 12 protéines conservées. Ces dernières sont utilisées lors de la translocation de protéines, la translocation de complexes ADN-protéines mais aussi pour le transport de ces derniers au travers de la membrane cellulaire. Les T4SS, en tant que facteurs de virulence pour beaucoup de pathogènes comme Brucella suis, sont donc d’excellents modèles cibles pour le développement de médicaments d’antivirulence. Ces médicaments, en privant le pathogène de son facteur essentiel de virulence : le T4SS, constituent une alternative ou encore une amélioration des traitements antibiotiques utilisés actuellement. VirB8, un facteur d’assemblage conservé dans le T4SS, forme des dimères qui sont importants pour la fonction des T4SS dans ces pathogènes. De par ses interactions multiples, VirB8 est un excellent modèle pour l’analyse des facteurs d’assemblage mais aussi en tant que cible de médicaments qui empêcheraient son interaction avec d’autres protéines et qui, in fine, désarmeraient les bactéries en les privant de leur fonctions essentielles de virulence. À ce jour, nous savons qu’il existe un équilibre monomère-dimère et un processus d’homodimerization de VirB8 dont l’importance est vitale pour la fonctionnement biologique des T4SSs. En se basant sur des essais quantitatifs d’interaction, nous avons identifié (i) des sites potentiels d’interaction avec d’autres protéines VirB du T4SS mais aussi (ii) isolé des petites molécules inhibitrices afin de tester la fonction protéique de VirB8. Afin de déterminer les acides aminés importants pour l’hétérodimérization de VirB8 avec VirB10, nous avons effectué des expériences de mutagenèse aléatoire, de phage display et d’arrimage moléculaire in silico. Ces expériences ont démontré l’importance de trois acides aminés localisés sur le feuillet β : R160, S162, T164 et I165. Ces derniers seraient importants pour l’association de VirB8 avec VirB10 étant donné que leur mutagenèse entraine une diminution de la formation du complexe VirB8-VirB10. L’objectif actuel de notre projet de recherche est de pouvoir mieux comprendre mais aussi d’évaluer le rôle de VirB8 dans l’assemblage du T4SS. Grace à un méthode de criblage adaptée à partir de la structure de VirB8, nous avons pu identifié une petite molécule inhibitrice BAR-068, qui aurait un rôle prometteur dans l’inhibition du T4SS. Nous avons utilisé la spectroscopie par fluorescence, l’essai à deux hybrides, le cross-linking et la cristallographie afin de déterminer le mécanisme d'interaction existant entre VirB8 et BAR-068. Ces travaux pourraient permettre de nombreuses avancées, notamment en termes de compréhension des mécanismes d’inhibition du T4SS. Notre objectif ultime est de pouvoir caractériser la séquence d’évènements essentiels à l’assemblage et au fonctionnement du T4SS. De manière globale, notre projet de recherche permettrait de révéler les grands principes d’assemblage des protéines membranaires, les processus de sécrétion de protéines chez les bactéries mais aussi de proposer une nouvelle stratégie lors du développement de drogues antimicrobiennes.

La dimension politique du soleil

Qu’il ait fallu attendre « Lignes aériennes » (2002) pour que les critiques s’avisent que la poésie de Pierre Nepveu avait quelque chose à dire de la politique et de l’histoire en cours est proprement aberrant. Où regardent-ils donc? Faut-il que le poème exhibe des drapeaux rouges, bleus ou noirs; qu’il vienne d’un écrivain bien connu pour ses positions sociales et dûment affilié au parti dont le commun des publicistes espère qu’il soit; qu’il aragone à tout vent ou soit atteint de la sartrose, cette maladie mal engagée de la foi; que ses vers attestent des affinités militantes, quitte à faire rimer des slogans; que son auteur soit de tel réseau ma chère; faut-il cela pour qu’un poème soit politique ou pour qu’il ait une dimension politique? Sainte-Beuve, décidément, empeste encore, aujourd’hui déguisé en sociologue de rencontre pour département de lettres, prompt à se donner l’illusion d’avoir quelque chose à dire en filant des « postures » et des « stratégies » qui renvoient encore et toujours à des intentions conspiratoires : l’auteur, figurez-vous, est de retour, il n’écrit pas, il fomente pour faire carrière. [Introduction]

Dimensionierung und Gestaltung von Laufställen für behornte Milchkühe unter Berücksichtigung des Herdenmanagements

Die Haltung von Milchkühen in einem Laufstall hat sich aus arbeitswirtschaftlichen und Kostengründen stark verbreitet. Im Biolandbau wird diese Entwicklung vor allem aufgrund der höheren Tiergerechtheit dieser Haltungsform forciert. Gleichzeitig werden die allermeisten Kühe für die Laufstallhaltung jedoch enthornt, unter anderem weil sich in den üblichen Ställen mit Normmassen und –konzepten Probleme mit Verletzungen unter den Tieren ergaben. Dabei sprechen die Richtlinien und Verordnungen für biologisch wirtschaftende Betriebe deutlich gegen zootechnische Eingriffe. Das Ziel dieser Arbeit war deshalb, zu prüfen, welche stallbaulichen Voraussetzungen eine Haltung horntragender Kühe im Laufstall gelingen lassen und mit welchen Managementmassnahmen diese optimiert werden kann. Dazu wurde zum einen in einer experimentellen Untersuchung an vier Kuhgruppen im cross-over-Design geprüft, wie sich ein gegenüber der Norm erhöhtes Platzangebot in verschiedenen Stallbereichen (Wartebereich: Crowding vs. unbeengt, Tier:Fressplatz-Verhältnis: 1:1 vs. 1:1,25, Liegefläche: 4,5 vs. 8,0 m2/Kuh, Laufhofffläche: 0 vs. 4,5 vs. 9,0 m2/Kuh) auf das (Sozial-)Verhalten behornter Kühe auswirkt, insbesondere auf das Ausmass an agonistischen Interaktionen und auf die Anzahl der Läsionen am Integument der Kühe. Zum anderen wurde in einer Praxiserhebung in 62 zumindest teilweise behornten Milchviehherden untersucht, welche Beziehungen zwischen dem Auftreten von Verletzungen und den Dimensionen und der Gestaltung der Laufställe sowie dem Herdenmanagement, der Mensch-Tier-Beziehung und den Charakteristika der Herde bestehen. Zudem wurden durch Interviews die in der Praxis vorrangig bestehenden Probleme eruiert und die Erfahrungen der Landwirte zusammengetragen. Im Experiment traten im Wartebereich beim grösseren Platzangebot statistisch auffällig (p=0,068) weniger agonistische Interaktionen unter den Kühen auf, die Zahl der Verletzungen zeigte keinen Unterschied. Im Fressbereich hatte eine Erhöhung der Anzahl Fressplätze keinen Einfluss. Eine grössere Liegefläche/Kuh auf der Tiefstreu hatte jedoch statistisch auffällig weniger agonistische Interaktionen, eine Abnahme der Läsionszahlen sowie längere Liegezeiten und kürzere Stehzeiten (im Stall) pro Tag und damit gleichzeitig eine erhöhte Herdensynchronität zur Folge (p=0,068). Ebenso bewirkte ein erhöhtes Laufhofflächenangebot/Kuh eine geringere Häufigkeit an agonistischen Interaktionen, eine Abnahme der Läsionszahlen sowie erhöhte Aufenthaltsdauern im Laufhof (jeweils p=0,068). In der Praxiserhebung konnten aus 113 Faktoren über Vorselektionen mittels univariaten Analysen (ANOVA) und multivariaten Regressionsanalysen in zwei Modellen multivariate Regressionsanalysen gerechnet werden, um die erklärenden Faktoren für die Variation der Verletzungen durch Hörner zu finden. Modell I (alle Betriebe, ohne Faktoren des Liegebereiches (Liegeboxenfaktoren)) wies einen Erklärungswert R2 von 0,825 und eine Signifikanz von p < 0,001 auf, Modell II (Liegeboxenbetriebe, alle Faktoren) einen Erklärungswert R2 von 0,882 und eine Signifikanz von p < 0,001. Als signifikante erklärende Faktoren für wenige Verletzungen verblieben in diesen Modellen der Stalltyp inkl. der Gliederung der Funktionsbereiche (unverbaut und übersichtlich mit klar getrennten Bereichen), eine hohe Anzahl Viehbürsten, breite Laufflächen, keine Hindernisse im Laufbereich, wenige Mitarbeiter, ein hoher Anteil eigener in die Herde eingegliederter Tiere, wenige Eingliederungen in den letzten sechs Wochen, die Rasse Fleckvieh, keine einzelnen unbehornten Kühe in der Herde und ein geringes Verletzungspotential der Hörner. Aus der Erfahrung der Landwirte ist der Fressbereich der Hauptproblembereich. Aus den Ergebnissen lässt sich schlussfolgernd sagen, dass ein Laufstall mit grosszügiger, deutlich über der Norm liegender Dimensionierung der flächigen Stallbereiche (Wartebereich, Liegefläche und Laufhoffläche/Kuh) für behornte Kühe günstige Haltungsbedingungen bietet. Engstellen hingegen bergen Konfliktpotential. Bei der Stallkonzeption muss eine klare Gliederung der Funktionsbereiche angestrebt werden, wenn Auseinandersetzungen vermieden werden sollen. Ein Tier:Fressplatz-Verhältnis von 1:1 mit ein paar Reserveplätzen scheint ausreichend, allerdings muss auf ein wirklich horngeeignetes Fressgitter mit sicherer Fixierung besonderen Wert gelegt werden. Im Management der Herde muss das Augenmerk vor allem auf das Vorgehen bei der Eingliederung von Tieren in die Herde gelegt werden. Da Eingliederungen das soziale Gefüge der Herde ändern, lassen sich mit möglichst wenig Eingliederungen von möglichst bekannten, also eigenen Tieren Auseinandersetzungen mit Verletzungen vermeiden. Günstig ist zudem, wenn nur eine Person die Herde betreut. Eine nur symptomatische, aber sehr effektive Massnahme zur Verringerung der Verletzungszahlen ist das Senken der Verletzungsgefahr der Hörner durch Entfernen spitzer Hornspitzen.