Risk factors for serious injury during falls by older persons in the community

BACKGROUND

Serious fall injury represents a little studied, yet common and potentially preventable, cause of morbidity and mortality among older persons. We determined the frequency of, and risk factors for, experiencing serious fall injury events among older persons in the community.

SUBJECTS

A representative sample of 1103 community-living persons aged 72 years and older underwent comprehensive baseline and 1-year evaluations.

MAIN OUTCOME MEASURES

During a median 31 months of follow-up, fall data were obtained using fall calendars. Injury data were obtained from telephone interviews and from surveillance of emergency room and hospital records.

RESULTS

At least one fall was experienced by 546 (49%) participants. A total of 123 participants, representing 23% of fallers and 12% of the cohort, experienced 183 serious fall injury events. The factors independently associated with experiencing a serious injury during a fall included cognitive impairment (adjusted odds ratios 2.2; 95% confidence interval 1.5, 3.2); presence of at least two chronic conditions (2.0; 1.4, 2.9); balance and gait impairment (1.8; 1.3, 2.7); and low body mass index (1.8; 1.2, 2.5). In a separate analysis, including only subjects who fell, female gender (1.8; 1.1, 2.9) as well as most of the above factors were associated with experiencing a fall injury.

CONCLUSIONS

Several readily identifiable factors appeared to distinguish the subgroup of older fallers at risk for suffering a serious fall injury. These factors should help guide who and what to target in prevention efforts.

Predictors of automobile crashes and moving violations among elderly drivers

OBJECTIVE

To identify the factors associated with automobile crashes, moving violations, and being stopped by police in a cohort of elderly drivers.

DESIGN

Prospective cohort study.

SETTING

Urban community.

PARTICIPANTS

All 283 persons who drove between 1990 and 1991, selected from a representative cohort of community-living persons aged 72 years and older in New Haven, Connecticut.

MEASUREMENTS

Data on independent variables in five domains (demographic, health, psychosocial, activity, and physical performance) were collected in structured interviews before events occurred. The outcome measure was the self-report of involvement in automobile crashes, moving violations, or being stopped by police in a 1-year period.

RESULTS

Of the 283 drivers, 13% reported a crash, a moving violation, or being stopped by police in 1 year. The baseline factors associated with the occurrence of adverse events in multivariable analysis (with adjustment for driving frequency and housing type) were the following: poor design copying on the Mini-Mental State Examination (relative risk, 2.7; 95% CI, 1.5 to 5.0), fewer blocks walked (relative risk, 2.3; CI, 1.3 to 4.0), and more foot abnormalities (relative risk, 1.9; CI, 1.1 to 3.3). These risk factors were combined for assessment of their ability to predict the occurrence of adverse driving events. If no factors were present, 6% of drivers had events; if 1 factor was present, 12% had events; if 2 factors were present, 26% had events; and if 3 factors were present, 47% had events.

CONCLUSIONS

In this urban population, several simple clinical measures correlated with the risk for adverse driving events.

Socioeconomic factors and asthma hospitalization rates in New York City

Asthma morbidity and mortality are not distributed homogeneously among populations. To assess the relationship between asthma hospitalization rates and socioeconomic factors, we conducted an ecologic analysis using small geographical areas defined by postal zip code in New York City. Asthma hospitalization rates correlated with low median family income, percentage of minorities in the population, and percentage of children under the age of 18. Lack of access to preventive health care, poor housing conditions, environmental exposures, and genetic susceptibility may contribute to high incidence of asthma in some neighborhoods. This report supports the role of socioeconomic factors in asthma and serves to provide data for regulatory and health agencies to concentrate their efforts on neighborhoods most in need.

Management of intramedullary spinal cord tumors

From January 1962 to May 1979, 23 patients with biopsy-proved intramedullary spinal cord tumors were treated initially with total resection, subtotal resection, irradiation, or subtotal resection and irradiation. Local control was achieved in 1/2 patients after total resection, 1/3 after subtotal resection, 8/9 after subtotal resection and radiation therapy, and 5/8 after radiation therapy alone. The patients with ependymomas exhibited a radiation dose-response relationship; of eight patients followed five or more years postirradiation, local control was achieved in 2/3 with time dose fraction (TDF) less than 55, 2/3 with TDF 55-65, and 2/2 with TDF greater than 65. The actuarial 5- and 10-year survival rates were 58% and 23% for astrocytoma, and 100% and 73% for patients with ependymoma, respectively. Neurological deficits improved or became totally normal after initial irradiation. Patterns of failure, management of recurrences, and radiotherapeutic techniques and dose recommendations are discussed.

A randomized, double masked, controlled trial of botulinum toxin type A in essential hand tremor

OBJECTIVE

To evaluate the safety and efficacy of botulinum toxin type A injection in essential tremor of the hand.

BACKGROUND

Botulinum toxin type A is an effective treatment for dystonia, spasticity, and other movement disorders and has been found to be useful in open-label studies and one double-masked study of essential hand tremor.

METHODS

One hundred thirty-three patients with essential tremor were randomized to low-dose (50 U) or high-dose (100 U) botulinum toxin type A (Botox) or vehicle placebo treatment. Injections were made into the wrist flexors and extensors. Patients were followed for 16 weeks. The effect of treatment was assessed by clinical rating scales, measures of motor tasks and functional disability, and global assessment of treatment. Hand strength was evaluated by clinical rating and by a dynamometer.

RESULTS

Both doses of botulinum toxin type A significantly reduced postural tremor on the clinical rating scales after 4 to 16 weeks. However, kinetic tremor was significantly reduced only at the 6-week examination. Measures of motor tasks and functional disability were not consistently improved with botulinum toxin type A treatment. Grip strength was reduced for the low- and high-dose botulinum toxin type A groups as compared with the placebo group. Adverse reactions consisted mainly of dose-dependent hand weakness.

CONCLUSION

Botulinum toxin type A injections for essential tremor of the hands resulted in significant improvement of postural, but not kinetic, hand tremors and resulted in limited functional efficacy. Hand weakness is a dose-dependent significant side effect of treatment at the doses used in this study.

Remifentanil for endotracheal intubation in neonates: a randomised controlled trial

OBJECTIVE

To evaluate the efficacy and safety of remifentanil as a premedication in neonates undergoing elective endotracheal intubation.

DESIGN

A double-blind randomised controlled trial.

SETTING

Tertiary care neonatal intensive care unit.

PATIENTS

Haemodynamically stable term and preterm neonates requiring elective endotracheal intubation.

INTERVENTIONS

Infants in the intervention arm received remifentanil (3 microg/kg) and normal saline placebo. The control group received fentanyl (2 microg/kg) and succinylcholine (2 mg/kg). Both groups also received atropine (20 microg/kg) as part of the premedication regime.

MAIN OUTCOME MEASURES

The primary outcome was time to successful intubation. Secondary outcomes included time to return of spontaneous respirations, oxygen saturation, heart rate and blood pressure changes during the procedure, adverse events and a survey of intubation conditions.

RESULTS

A total of 15 infants were randomised to each group. Baseline characteristics were similar in both groups. The median time to successful intubation was not statistically different (247 s in the remifentanil group vs 156 s in the fentanyl group, p=0.88). The intubation conditions were rated more favourably with fentanyl by the intubators. Although not statistically significant, chest wall rigidity was observed more commonly with remifentanil.

CONCLUSIONS

Although remifentanil is comparable to fentanyl and succinylcholine in attenuating adverse physiologic responses during neonatal intubation, muscle rigidity is a concern at doses of 3 microg/kg. Further trials are required to evaluate ideal dosing regimens and combinations of agents for use with remifentanil in neonates.

Intravenous immunoglobulin induces interferon-gamma and interleukin-6 in vivo

Immunoglobulin is known to be an immunomodulator. It can induce protein mediators from mononuclear cells, particularly monocytes in vitro. Intravenous immunoglobulin (IVIg) has been used as a therapy in several clinical situations. In this study, the influence of IVIg infusion on the plasma levels of two protein mediators, interferon-gamma (IFN-gamma) and interleukin-6 (IL-6), was assessed in patients with secondary generalized epilepsy. Compared to preinfusion levels, plasma interferon-gamma was increased in 18 of 18 patients 20 min after the 6- to 8-hr infusion of IVIg. Plasma interferon-gamma levels reached their peak at various times from 20 min to 3 days post IVIg infusion, dependent upon the individual patient. Plasma IL-6 levels also increased after IVIg infusion. Generally, IL-6 reached its peak level after IFN-gamma. No activated T cells or B cells were observed as determined by the expression of surface CD25, CD23, and HLA-DR 20 min following the infusion when the IFN-gamma and IL-6 levels were assessed. The expression of the high-affinity receptor for IgG, CD64, on monocytes was significantly enhanced after IVIg infusion, while the low-affinity receptor for IgG, CD32, was only slightly increased. Cytoplasmic staining of PBMC indicates that both CD16-positive and CD16-negative cells may contribute to the increase seen in plasma IFN-gamma. These data raise the possibility that the therapeutic effects of intravenous immunoglobulin may be related, at least in part, to the immunomodulatory activity as demonstrated by the changes in plasma levels of IFN-gamma and IL-6.

Radiation therapy of keratoacanthoma

We report the radiation therapy of keratoacanthoma in 13 patients using orthovoltage X rays and electrons. All patients had an excellent cosmetic result, and time to regression was dose dependent up to a dose corresponding to TDF 50; increasing dose beyond this level did not accelerate time to regression past 2.4 months. We also note a heretofore undocumented association between keratoacanthoma and second malignancy.

Non-metastatic locally advanced cancer of the breast treated with radiation

One hundred forty-seven female patients with retrospectively classified (AJCCS 1977) Stage III and nonmetastatic noninflammatory Stage IV breast carcinoma from June 1958 to December 1978 were studied to determine the effects of primary radiation on local recurrence and survival. Fifty-one patients recurred in the breast; 24 patients recurred in the local-regional area of breast and draining lymphatics and 15 patients recurred in the axilla only. Distant metastases developed in 97 patients. The 5 year actuarial survival was 24%. Decreased recurrence rates were associated with megavoltage and higher doses of radiation (34% vs. 65%); with smaller tumors (27% vs. 57%); with total extirpation of gross tumor (33% vs. 53%); and with those tumors that were given a "boost dose" (26% vs. 58%). The addition of systemic treatment did not appreciably alter either local-regional recurrence or survival. However, most of the patients received endocrine ablation or single-agent chemotherapy. Polyagent chemotherapy was used late in the series, making its true impact on survival difficult to evaluate.

Dose escalation of definitive radiation is not associated with improved survival for cervical esophageal cancer: a National Cancer Data Base (NCDB) analysis

For cervical esophageal cancer (CEC), National Comprehensive Cancer Network guidelines support RT to 50-50.4 Gy with chemotherapy but acknowledge higher doses may be appropriate. This study uses the National Cancer Database (NCDB) to characterize RT practices and identify if a dose-response relationship exists for overall survival (OS) for definitive treatment of CEC. We queried the NCDB for patients diagnosed with Stage I-III CEC from 2004 to 2013, and selected patients receiving definitive RT with doses between 50 and 74 Gy. Using multivariate logistic regression, the database was analyzed to determine factors associated with use of RT > 50.4 Gy. Patients were then stratified into three dose categories. Predictors of OS were analyzed with univariate and multivariate methods using the Kaplan-Meier curves, the log-rank test, and the Cox proportional hazards analysis. We stratified 789 patients with CEC who were treated with definitive radiation ± chemotherapy: 50-50.4 Gy ('standard'), >50.4 and <66 Gy ('medium'), and 66-74 Gy ('high'). Of these patients, 215 (27%) received standard doses, 375 (48%) received medium doses, and 199 (25%) received high doses. Patients with Medicaid insurance and those with Stage II disease were less likely (P < 0.05) to receive >50.4 Gy. Sex, histology, distance to treatment facility, and academic/community facility type were not significantly associated with receipt of >50.4 Gy. There was no association between dose and OS for the medium or high groups when using univariate analysis or analysis adjusted for demographic, facility, and clinical attributes. Stage III disease and the Charlson-Deyo scores of 1 or 2 were associated with higher mortality (P < 0.05), while female sex and use of chemotherapy were associated with lower mortality (P < 0.01). Nearly three-fourths of CEC patients in the United States are treated with RT > 50.4 Gy. Higher radiation doses were not associated with increased OS in CEC patients in the NCDB.

Impact of a joint labor-management ergonomics program on upper extremity musculoskeletal symptoms among garment workers

This study evaluated the effect of an ergonomics intervention program on the prevalence and intensity of symptoms of upper extremity work-related musculoskeletal disorders among 36 garment workers performing an operation called spooling. Adjustable chairs were introduced and workers were trained in their use. Symptom surveys were administered prior to and 6 months after introduction of adjustable chairs. Quantitative pre- and post-intervention measurement of joint position was performed utilizing videotapes among a subgroup of nineteen. Eighty nine percent of the cohort reported pain in either the neck or at least one upper extremity anatomic site prior to the adjustable chair intervention. Among subjects reporting pain at baseline, there were significantly decreased pain levels in 10 of 11 anatomic sites after the intervention. Among all subjects, the proportion reporting pain decreased for each anatomic site following the intervention, with statistically significant decreases in 3 sites. However, there were only modest declines in awkward posture among the videotaped subgroup. This study suggests that introduction of an ergonomics program focused on education and introduction of an adjustable chair may diminish musculoskeletal symptomatology in apparel manufacturing workers.

Genomic-based genetic parameters for resilience across lactations in North American Holstein cattle based on variability in daily milk yield records

Considering the increasing challenges imposed by climate change and the need to improve animal welfare, breeding more resilient animals capable of better coping with environmental disturbances is of paramount importance. In dairy cattle, resilience can be evaluated by measuring the longitudinal occurrences of abnormal daily milk yield throughout lactation. Aiming to estimate genetic parameters for dairy cattle resilience, we collected 5,643,193 daily milk yield records on automatic milking systems (milking robots) and milking parlors across 21,350 lactations 1 to 3 of 11,787 North American Holstein cows. All cows were genotyped with 62,029 SNPs. After determining the best fitting models for each of the 3 lactations, daily milk yield residuals were used to derive 4 resilience indicators: weighted occurrence frequency of yield perturbations (wfPert), accumulated milk losses of yield perturbations (dPert), and log-transformed variance (LnVar) and lag-1 autocorrelation (r_auto) of daily yield residuals. The indicator LnVar presented the highest heritability estimates (±standard error), ranging from 0.13 ± 0.01 in lactation 1 to 0.15 ± 0.02 in lactation 2; the other 3 indicators had relatively lower heritabilities across the 3 lactations (0.01-0.06). Based on bivariate analyses of each resilience indicator across lactations, stronger genetic correlations were observed between lactations 2 and 3 (0.88-0.96) than between lactations 1 and 2 or 3 (0.34-0.88) for dPert, LnVar, and r_auto. For the pairwise comparisons of different resilience indicators within each lactation, dPert had the strongest genetic correlations with wfPert (0.64) and r_auto (0.53) in lactation 1, whereas the correlations in lactations 2 and 3 were more variable and showed relatively high standard errors. The genetic correlation results indicated that different resilience indicators across lactations might capture additional biological mechanisms and should be considered as different traits in genetic evaluations. We also observed favorable genetic correlations of these resilience indicators with longevity and Net Merit index, but further biological validation of these resilience indicators is needed. In conclusion, this study provided genetic parameter estimates for different resilience indicators derived from daily milk yields across the first 3 lactations in Holstein cattle, which will be useful when potentially incorporating these traits in dairy cattle breeding schemes.

Race and tardive dyskinesia among outpatients at a CMHC

OBJECTIVE

In a previous study of outpatients with chronic mental illness who were treated with neuroleptic medication, the authors found a higher incidence of tardive dyskinesia among blacks than among whites. In this study the authors examined psychosocial, clinical, treatment, and medical correlates of race that might explain this finding.

METHODS

Extensive baseline data were obtained for 398 outpatients at risk for tardive dyskinesia. Pearson and Mantel-Haenszel chi square analyses were used to determine significant associations between a large number of variables and race.

RESULTS AND DISCUSSION

Compared with whites, nonwhites were more likely to be younger, less skilled, and unmarried; to report contacts with relatives outside the home; to have a diagnosis of schizophrenia; and to receive higher doses of neuroleptic drugs primarily through depot medications. Nonwhites were less likely to receive nonneuroleptic psychotropics, to wear dentures, and to report social contact with fathers. None of these racial differences explained more than a trivial portion of the association between race and the incidence of tardive dyskinesia.

CONCLUSIONS

These results suggest the need for studies of differences in diagnostic and prescribing practices for black and white patients and of differences in the action and side effects of neuroleptics.

Unraveling the genomic background of resilience based on variability in milk yield and milk production levels in North American Holstein cattle through genome-wide association study and Mendelian randomization analyses

Breeding more resilient animals will benefit the dairy cattle industry in the long term, especially as global climate changes become more severe. Previous studies have reported genetic parameters for various milk yield-based resilience indicators, but the underlying genomic background of these traits remain unknown. In this study, we conducted GWAS of 62,029 SNPs with 4 milk yield-based resilience indicators, including the weighted occurrence frequency (wfPert) and accumulated milk losses (dPert) of milk yield perturbations, and log-transformed variance (LnVar) and lag-1 autocorrelation (rauto) of daily yield residuals. These variables were previously derived from 5.6 million daily milk yield records from 21,350 lactations (parities 1-3) of 11,787 North American Holstein cows. The average daily milk yield (ADMY) throughout lactation was also included to compare the shared genetic background of resilience indicators with milk yield. The differential genetic background of these indicators was first revealed by the significant genomic regions identified and significantly enriched biological pathways of positional candidate genes, which confirmed the genetic difference among resilience indicators. Interestingly, the functional analyses of candidate genes suggested that the regulation of intestinal homeostasis is most likely affecting resilience derived based on variability in milk yield. Based on Mendelian randomization analyses of multiple instrumental SNPs, we further found an unfavorable causal association of ADMY with LnVar. In conclusion, the resilience indicators evaluated are genetically different traits, and there are causal associations of milk yield with some of the resilience indicators evaluated. In addition to providing biological insights into the molecular regulation mechanisms of resilience derived based on variability in milk yield, this study also indicates the need for developing selection indexes combining multiple indicator traits and taking into account their genetic relationship for breeding more resilient dairy cattle.

Genetic parameters for calf feeding traits derived from automated milk feeding machines and number of bovine respiratory disease treatments in North American Holstein calves

Precision livestock farming technologies, such as automatic milk feeding machines, have increased the availability of on-farm data collected from dairy operations. We analyzed feeding records from automatic milk feeding machines to evaluate the genetic background of milk feeding traits and bovine respiratory disease (BRD) in North American Holstein calves. Data from 10,076 preweaning female Holstein calves were collected daily over a period of 6 yr (3 yr included per-visit data), and daily milk consumption (DMC), per-visit milk consumption (PVMC), daily sum of drinking duration (DSDD), drinking duration per-visit, daily number of rewarded visits (DNRV), and total number of visits per day were recorded over a 60-d preweaning period. Additional traits were derived from these variables, including total consumption and duration variance (TCV and TDV), feeding interval, drinking speed (DS), and preweaning stayability. A single BRD-related trait was evaluated, which was the number of times a calf was treated for BRD (NTT). The NTT was determined by counting the number of BRD incidences before 60 d of age. All traits were analyzed using single-step genomic BLUP mixed-model equations and fitting either repeatability or random regression models in the BLUPF90+ suite of programs. A total of 10,076 calves with phenotypic records and genotypic information for 57,019 SNP after the quality control were included in the analyses. Feeding traits had low heritability estimates based on repeatability models (0.006 ± 0.0009 to 0.08 ± 0.004). However, total variance traits using an animal model had greater heritabilities of 0.21 ± 0.023 and 0.23 ± 0.024, for TCV and TDV, respectively. The heritability estimates increased with the repeatability model when using only the first 32 d preweaning (e.g., PVMC = 0.040 ± 0.003, DMC = 0.090 ± 0.009, DSDD = 0.100 ± 0.005, DS = 0.150 ± 0.007, DNRV = 0.020 ± 0.002). When fitting random regression models (RRM) using the full dataset (60-d period), greater heritability estimates were obtained (e.g., PVMC = 0.070 [range: 0.020, 0.110], DMC = 0.460 [range: 0.050, 0.680], DSDD = 0.180 [range: 0.010, 0.340], DS = 0.19 [range: 0.070, 0.430], DNRV = 0.120 [range: 0.030, 0.450]) for the majority of the traits, suggesting that RRM capture more genetic variability than the repeatability model with better fit being found for RRM. Moderate negative genetic correlations of -0.59 between DMC and NTT were observed, suggesting that automatic milk feeding machines records have the potential to be used for genetically improving disease resilience in Holstein calves. The results from this study provide key insights of the genetic background of early in-life traits in dairy cattle, which can be used for selecting animals with improved health outcomes and performance.

Trait development and genetic parameters of resilience indicators based on variability in milk consumption recorded by automated milk feeders in North American Holstein calves

The implementation of automated milk feeders (AMF) on precision dairy farms has enabled efficient management of large numbers of group-housed replacement calves with reduced labor requirements and improved calf welfare. In this study, we investigated the feasibility of deriving calf resilience indicators based on variability in milk consumption using data from 10,076 North American Holstein calves collected between 2015 and 2021. We modeled and evaluated deviations in observed and predicted daily milk consumption trajectories as indicators of resilience to environmental perturbations. We also analyzed average milk intake and the number of treatments for bovine respiratory disease (BRD) and their genetic correlations with the derived resilience parameters. Milk consumption was recorded using the Förster-Technik AMF. Deviations in cumulative milk intake were modeled using various methods, including quantile regression and the Gompertz function. Ten resilience indicators were derived to quantify the degree and duration of perturbations, including amplitude, perturbation time, recovery time, and deviation velocities. After data editing, genomic data from 9,273 calves and pedigree information from 10,076 calves with 321,388 phenotypic records were used to estimate genetic parameters for 12 traits, including 10 calf resilience indicators as well as average milk intake and treatments for bovine respiratory disease. Substantial phenotypic variability was observed for all calf resilience indicators derived and genetic parameters related to these novel resilience indicators were estimated. The heritability estimates for the resilience traits are as follows: amplitude of the deviation (in L) 0.047 (0.032, 0.064) (HPD interval), perturbation time of deviation (in d) 0.011 (0.0056, 0.016), recovery time of the deviation (in d) 0.025 (0.016, 0.035), maximum velocity of perturbation (L/d) 0.039 (0.024, 0.053), average velocity of perturbation (L/d) 0.038 (0.022, 0.050), area between the curves (L x d) 0.039 (0.027, 0.054), recovery ratio 0.053 (0.036, 0.072), deviation variance 0.049 (0.32, 0.068), log-deviation variance 0.027 (0.016, 0.044), deviation auto-correlation 0.010 (0.0042, 0.017) and number of deviation occurrences 0.023 (0.0094, 0.036). Some of the highlighted genetic correlations observed with average milk consumption include amplitude: 0.569 (0.474, 0.666), perturbation time: -0.534 (-0.73, -0.342), and average velocity: 0.554 (0.432, 0.672). Similarly, the genetic correlations between the number of times treated for BRD with perturbation time was 0.494 (0.251, 0.723), -0.294 (-0.52, -0.095) with number of deviations, and 0.348 (0.131, 0.578) with deviation autocorrelation. This study highlights the genetic influence on various resilience traits in calves, including amplitude, perturbation time, recovery time, and velocity measures of the perturbation. Our findings suggest the need for prioritizing genetic selection based on traits like recovery time, which exhibits higher heritability and a moderate genetic correlation with the number of times a calf is treated for BRD. The combination of AMF data, mathematical modeling, and genomic evaluation provides a comprehensive framework for assessing and breeding more resilient dairy calves in the face of environmental and health challenges.

Action research applied to a preceptorship program

In this article the authors describe the development of a framework designed to discuss expectations between preceptors, orientees, nursing unit managers and clinical nurse educators. Action research theory provided the framework for this process. Preceptors found the process of articulating expectations helpful, relevant, and meaningful to their practice.

Environmental and biological factors that influence feeding behavior of Holstein calves in automated milk feeding systems

Automated milk feeders (AMF) used for dairy calves continuously provide individual feeding behavior measurements. The objective of this retrospective cohort study was to evaluate the association between temperature-humidity index (THI), birth weight, and dam parity characteristics on feeding behavior (i.e., milk consumption and drinking speed). Historical data sets generated from a single commercial dairy farm, where healthy (not treated for bovine respiratory disease, enteric disease, or injury) Holstein calves were fed up to 24 L/d of milk, were used for the analysis. A total of 5,312 female Holstein calves born between August 2015 and August 2021 (mean birth weight ± standard deviation: 40.7 ± 4.7 kg) on a commercial dairy farm were fed up to 24 L/d of nonsaleable milk for the first 32 d. For the analyses, feeding behavior data from the AMF system were combined with demographic data from the farm management software, and weather records from the closest public weather station (7 km away). Linear mixed models used to analyze daily milk consumption and drinking speed included THI, birth weight, dam parity, and feeding day as fixed effects, and feeder and calf within feeder as random effects. These models explained 57% of the total variation in milk consumption and 48% of the variation in drinking speed. Calves born from primiparous cows had the lowest milk consumption and the greatest drinking speed in comparison to calves born from multiparous cows. Calves with heavier birth weights had higher milk consumption and faster drinking speed than lighter calves. Drinking speed was negatively associated with THI. Including data derived from individual calves and their environmental conditions in data sets exploring feeding behavior from AMF would control for variation and improve the predictive models for performance assessment.