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To fight homophobia in schools in Québec, many teachers rely on community organizations such as the Groupe de Recherche et d'Intervention Sociale (Research and Social Intervention Group) to address sexual diversity in class. This article documents major outcomes of these workshops as seen by students. Students identified topics related to sexuality and gender inversion as controversial, especially when involving men. The authors present how GRIS leaders decided to adapt intervention practices following such findings.

A major hurdle in pediatric formulation development is the lack of safety and toxicity data on some of the commonly used excipients. While the maximum oral safe dose for several kinds of excipients is known in the adult population, the doses in pediatric patients, including preterm neonates, are not established yet due to the lack of evidence-based data. This paper consists of four parts: (1) country-specific perspectives in different parts of the world (current state, challenges in excipients, and ongoing efforts) for ensuring the use of safe excipients, (2) comparing and contrasting the country-specific perspectives, (3) past and ongoing collaborative efforts, and (4) future perspectives on excipients for pediatric formulation. The regulatory process for pharmaceutical excipients has been developed. However, there are gaps between each region where a lack of information and an insufficient regulation process was found. Ongoing efforts include raising issues on excipient exposure, building a region-specific database, and improving excipient regulation; however, there is a lack of evidence-based information on safety for the pediatric population. More progress on clear safety limits, quantitative information on excipients of concern in the pediatric population, and international harmonization of excipients' regulatory processes for the pediatric population are required. [ABSTRACT FROM AUTHOR]

Background: Education and training may improve the prescription of pediatric parenteral nutrition. The aim was to evaluate the impact of an e-learning method on parenteral nutrition prescription skills among pediatric residents in 2 pediatric hospitals.Methods: A randomized double-blind control study was conducted over a 9-month period among pediatric residents in HOSP1, Geneva, Switzerland, where physicians prescribe parenteral nutrition directly, and in HOSP2, Montreal, Canada, where physicians prescribe only occasionally because clinical pharmacists are devoted to this activity. The intervention consisted of an e-learning session about key issues of parenteral nutrition. Physician parenteral nutrition knowledge was evaluated with a standardized questionnaire based on clinical cases before and after the e-learning in the intervention groups; in the control groups, only the 2 tests were conducted. In HOSP1, participants also underwent iterative tests every 2 months to measure the retention of knowledge.Results: Sixty-five physicians participated. Initial knowledge scores were higher in HOSP1 (pretest scores 180 ± 29 vs 133 ± 24, p < 0.001). Overall, there was no significant difference in the impact of the e-learning intervention between the control and e-learning groups (p > 0.05). A significant knowledge improvement was observed in HOSP2 in the e-learning group (p = 0.033). Iterative tests in HOSP1 showed persistence of knowledge without significant differences between the groups. E-learning satisfaction among the participants was outstanding (100%).Conclusion: E-learning seems to be an effective method for teaching parenteral nutrition among pediatric residents and fellows at the beginning of the training. High satisfaction with this teaching method was observed in this study. [ABSTRACT FROM AUTHOR]

Individuals accept additional paid work, in terms of salary increase or more hours, with the expectation they will be financially better off than before. Unfortunately, for recipients of Income Assistance in the province of British Columbia, additional hours of employment or an increase in wages, such as an increase in minimum wage, in some circumstances may actually take money out of their pocket. This is due to the design of Income Assistance and its unintended interactions with other income and social support programs and the tax system. In this paper, we illustrate cases where B.C. residents receiving Disability Assistance or Temporary Assistance (the two main programs that comprise Income Assistance in B.C.) have less after-tax income after working additional hours of employment. In modelling after-tax income for recipients of Disability Assistance and Temporary Assistance as they increase their hours of paid work, we detail when and how additional income earned from paid work affects not only their income assistance levels, but also their eligibility and receipt of some general and health-related supplemental benefits. We show that, as Income Assistance recipients allocate more hours to paid work, the reductions in total after-tax income can be sizable. For example, if a single person receiving Disability Assistance (earning a wage of approximately $15 per hour) increases his or her paid work hours from 16 hours a week to 35 hours a week, it reduces his or her total after-tax income by $1,500 a year. This loss is not just limited to a decline in after-tax income. Access to some general and health-related supplemental benefits provided to Income Assistance recipients may also be lost from working these additional hours.1 By addressing these program-design elements of the current Income Assistance program, the B.C. government can improve the well-being of those receiving Income Assistance. Reforms may also decrease expenditures on Income Assistance in the long-run. Allowing recipients to increase their hours of work or earnings within the year, as their situation permits, without the risk of having their benefits reduced, may actually help more people transition from Income Assistance towards permanent employment, thus breaking the cycle of poverty and increasing social inclusion. Many recipients of Income Assistance already face numerous barriers to paid work, other than those analyzed here, as the result of disability-related employment constraints. After-tax income reductions like those described here create another barrier to employment for these populations that the B.C. government can and should address. Canada's commitment to improving social inclusion for specific populations, such as persons with disabilities, heighten the importance of identifying inequalities and poverty traps within our income assistance system. Institutional barriers to inclusive activities such as employment must be removed to meet these commitments. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Parliamentary Review is the property of Canadian Parliamentary Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal for the Scholarship of Teaching & Learning is the property of Society for Teaching & Learning in Higher Education and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In May of 2011, a decision was made by city council in Calgary, Canada, to cease community water fluoridation and to re-allocate the annual operating costs to targeted dental programming. The purpose of this study was to critically analyze this decision as an example of a shift from a universal approach (fluoridation) to a targeted approach (dental programming delivered to children in low-income communities). We were especially interested in how the concept of equity played out in the deliberations, and we used Hilary Graham’s three conceptualizations of equity as a framework. We examined publicly available municipal council documents pertaining to this policy decision, with a prominent focus on the 26 January 2011 meeting of the Standing Policy Committee on Utilities and Environment at which Calgarians (citizens and professionals) were invited to speak. We extracted and critiqued statements or exchanges pertaining to equity or related concepts (e.g. poverty). We observed different perspectives on the concept of equity, and the notion of community water fluoridation as equitable. In particular, there was a tendency, expressed strongly by some participants in the debate, to conflate equity and poverty (Graham’s ‘disadvantages’ conceptualization of equity), such that a targeted approach was seen as the only viable way of addressing the dental health needs of children living in poverty. This research is timely considering the apparently increasing frequency of cessation of fluoridation in Canada, the consequent search for alternative approaches to preventive dental health, and the apparently strong appeal of a targeted approach. [ABSTRACT FROM PUBLISHER]

The use of hypothermia as a means to save energy is well documented in birds. This energy-saving strategy is widely considered to occur exclusively at night in diurnally active species. However, recent studies suggest that facultative hypothermia may also occur during the day. Here, we document the use of daytime hypothermia in foraging Black-capped Chickadees Poecile atricapillus wintering in eastern Canada. We measured the body temperature ( Tb) of 126 individuals (plus 48 repeated measures) during a single winter and related values to ambient temperature ( Ta) at the time of capture. We also tested whether daytime hypothermia was correlated with the size of body reserves (residuals of mass on structural size and fat score) and levels of metabolic performance (basal metabolic rate and maximum thermogenic capacity). We found that Tb of individual birds was lower when captured at low Ta, reaching values as low as 35.5 °C in actively foraging individuals. Tb was unrelated to metabolic performance or measures of body reserves. Therefore, daytime hypothermia does not result from individuals being unable to maintain Tb during cold spells or to a lack of body reserves. Our data also demonstrated a high level of individual variation in the depth of hypothermia, the causes of which remain to be explored. [ABSTRACT FROM AUTHOR]

Copyright of Criminologie is the property of Presses de l'Universite de Montreal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Sex differences in the effects of sleep duration on dietary intake and eating behaviours were examined prospectively in relation to overweight/obesity at ages 6 and 7. Using data from a representative sample (QLSCD 1998-2010) of children born in the province of Québec (Canada), 1106 children were followed to age 6 and 1015 to 7 years. Average nocturnal sleep duration was surveyed annually from 2.5-6 years, food-frequency and eating behaviour questionnaires were administered at age 6, and body weight and height were measured at 6 and 7 years. Associations were examined longitudinally and mediation examined with adjustments for potential confounders. In boys and girls, shorter sleep duration patterns were associated significantly with less favourable dietary intakes at 6 years: boys consumed vegetables and fruits less frequently and meats/alternatives more frequently than boys with longer sleep patterns; and girls consumed vegetables, fruits and milk products less frequently and soft-drinks more frequently than girls with longer sleep patterns. However, boys with shorter sleep patterns were also more likely to eat at irregular hours or to eat too much/fast at 6 years. These behaviours, and not dietary intake, mediated an inverse association between sleep duration and overweight/obesity in boys. Sleep duration did not associate with any problem eating behaviours or overweight/obesity in girls. Shorter sleep in early childhood appears to associate with problematic eating behaviours in boys and diet quality in both sexes, regardless of an association with overweight/obesity. This is important for public health and should be considered in relation to other diet-related diseases. [ABSTRACT FROM AUTHOR]

The lipid content of seven samples of sinking particles collected with sediment traps moored at ∼100 m depth in summer and fall across the Canadian Beaufort Shelf (Arctic Ocean) was investigated. Our main goal was to quantify and characterize the biotic and abiotic degradation processes that acted on sinking material during these periods. Diatoms, which dominated the phytoplanktonic assemblage in every trap sample, appeared to be remarkably sensitive to Type II (i.e. involving singlet oxygen) pho-todegradation processes in summer, but seemed to be relatively unaffected by biotic degradation at the same time. Hence, the relative recalcitrance of phytodetritus towards biodegradation processes during the Arctic midnight sun period was attributed to the strong photodegradation state of heterotrophic bacteria, which likely resulted from the efficient transfer of singlet oxygen from photodegraded phytoplanktonic cells to attached bacteria. In addition, the detection in trap samples of photoproducts specific to wax ester components found in herbivorous copepods demonstrated that zooplank-tonic faecal material exported out of the euphotic zone in summer were as well affected by Type II photodegradation processes. By contrast, sinking particles collected during the autumn were not influenced by any light-driven stress. Further chemical analyses showed that photodegraded sinking particles contained an important amount of intact hydroperoxides, which could then induce a strong oxidative stress in underlying sediments. [ABSTRACT FROM AUTHOR]

Background: Osteochondral autografts in mosaicplasty are inserted in a press-fit fashion, and hence, patients are kept nonweightbearing for up to 2 months after surgery to allow bone healing and prevent complications. Very little has been published regarding alternative fixation techniques of those grafts.Hypothesis: Osteochondral autografts stabilized with a resorbable osteoconductive bone cement would have a greater load-bearing capacity than standard press-fit grafts.Study Design: Controlled laboratory study.Methods: Biomechanical testing was conducted on 8 pairs of cadaveric bovine distal femurs. For the first 4 pairs, 6 single osteochondral autografts were inserted in a press-fit fashion on one femur. On the contralateral femur, 6 grafts were stabilized with a calcium triglyceride osteoconductive bone cement. For the 4 remaining pairs of femurs, 4 groups of 3 adjacent press-fit grafts were inserted on one femur, whereas on the contralateral femur, grafts were cemented. After a maturation period of 48 hours, axial loading was applied on all single grafts and on the middle graft of each 3-in-a-row series.Results: For the single-graft configuration, median loads required to sink the press-fit and cemented grafts by 2 and 3 mm were 281.87 N versus 345.56 N (P = .015) and 336.29 N versus 454.08 N (P = .018), respectively. For the 3-in-a-row configuration, median loads required to sink the press-fit and cemented grafts by 2 and 3 mm were 260.31 N versus 353.47 N (P = .035) and 384.83 N versus 455.68 N (P = .029), respectively.Conclusion: Fixation of osteochondral grafts using bone cement appears to improve immediate stability over the original mosaicplasty technique for both single- and multiple-graft configurations.Clinical Relevance: Achieving greater primary stability of osteochondral grafts could potentially accelerate postoperative recovery, allowing early weightbearing and physical therapy. [ABSTRACT FROM PUBLISHER]

Hydrological forecasting consists in the assessment of future streamflow. Current deterministic forecasts do not give any information concerning the uncertainty, which might be limiting in a decision-making process. Ensemble forecasts are expected to fill this gap. In July 2007, the Meteorological Service of Canada has improved its ensemble prediction system, which has been operational since 1998. It uses the GEM model to generate a 20-member ensemble on a 100 km grid, at mid-latitudes. This improved system is used for the first time for hydrological ensemble predictions. Five watersheds in Quebec (Canada) are studied: Chaudière, Châteauguay, Du Nord, Kénogami and Du Lièvre. An interesting 17-day rainfall event has been selected in October 2007. Forecasts are produced in a 3 h time step for a 3-day forecast horizon. The deterministic forecast is also available and it is compared with the ensemble ones. In order to correct the bias of the ensemble, an updating procedure has been applied to the output data. Results showed that ensemble forecasts are more skilful than the deterministic ones, as measured by the Continuous Ranked Probability Score (CRPS), especially for 72 h forecasts. However, the hydrological ensemble forecasts are under dispersed: a situation that improves with the increasing length of the prediction horizons. We conjecture that this is due in part to the fact that uncertainty in the initial conditions of the hydrological model is not taken into account. [ABSTRACT FROM AUTHOR]

Background: Drug expenditures per capita have drastically increased over the last quarter century in Canada, with a share of overall healthcare costs rising from 8.8% in 1980 to 16.8% in 2002. Pressure to curb expenditure on drugs has increased accordingly, but containing drug expenditure might increase costs elsewhere in the healthcare sector.Objective: To measure substitution patterns between drugs and other healthcare resources over the last 25 years and thus assess whether containing drug costs might result in higher expenditure elsewhere in the healthcare system.Methods and Data: A production function approach was used, in which life expectancy was modelled as a function of per capita drugs and non-drug healthcare resources, among other factors. Estimates are used to calculate a marginal rate of substitution, or trade-off, between drugs and non-drug healthcare resources, for a given level of life expectancy in the population. The model is estimated from a societal perspective, with panel data techniques using Canadian provincial-level data on health expenditure and spending on physicians per capita for the period 1980-2002, as well as individual survey data on lifestyle habits such as cigarette consumption and body mass index.Result: Using life expectancy at birth for males as the production function, increasing drug spending by Can 1.00 dollars (constant 2003 values) was accompanied by a decrease of Can 1.48 dollars in non-drug, non-physician healthcare resources over the study period, without affecting life expectancy at birth. Results using life expectancy at birth for females as the production function showed a decrease of Can 1.05 dollars in non-drug, non-physician healthcare resources over the same period.Conclusion: Using life expectancy as a general health indicator, results suggest that increases in drug spending could be more than offset by decreases in other healthcare spending without affecting the health of the population. This suggests that better access to drugs may be an effective strategy to decrease overall healthcare costs. Freeing up healthcare dollars by reallocating spending towards drugs could provide opportunities for overall healthcare cost savings without negatively impacting the health of the population. [ABSTRACT FROM AUTHOR]

We investigate the causes of increasing concentration in the Canadian air carriers industry over the last four decades, and assess possible links with deregulation and investment decisions. We measure the technology of firms in a dynamic framework that includes regulation. The model is tested with data on seven air carriers operating between 1960 and 1999. Traditional technological parameters are recovered: marginal factor productivity, returns to scale, and technical change. We conclude that deregulation only had a slight positive impact on productivity and that it may have contributed to increasing concentration by allowing firms to expand and fully capture returns to scale. [Copyright &y& Elsevier]

Background: Summary measures of health that combine mortality and morbidity into a single indicator are being estimated in the Canadian context for approximately 200 diseases and conditions. To manage the large amount of data and calculations for this many diseases, we have developed a structured workbook system with easy to use tools. We expect this system will be attractive to researchers from other countries or regions of Canada who are interested in estimating the health-adjusted life years (HALYs) lost to premature mortality and year-equivalents lost to reduced functioning, as well as population attributable fractions (PAFs) associated with risk factors. This paper describes the workbook system using cancers as an example, and includes the entire system as a free, downloadable package. Methods: The workbook system was developed in Excel and runs on a personal computer. It is a database system that stores data on population structure, mortality, incidence, distributions of cases entering a multitude of health states, durations of time spent in health states, preference scores that weight for severity, life table estimates of life expectancies, and risk factor prevalence and relative risks. The tools are Excel files with embedded macro programs. The main tool generates workbooks that estimate HALY, one per disease, by copying data from the database into a pre-defined template. Other tools summarize the HALY results across diseases for easy analysis. Results: The downloadable zip file contains the database files initialized with Canadian data for cancers, the tools, templates and workbooks that estimate PAF and a user guide. The workbooks that estimate HALY are generated from the system at a rate of approximately one minute per disease. The resulting workbooks are self-contained and can be used directly to explore the details of a particular disease. Results can be discounted at different rates through simple parameter modification. Conclusion: The structured workbook approach offers researchers an efficient, easy to use, and easy to understand set of tools for estimating HALY and PAF summary measures for their country or region of interest. [ABSTRACT FROM AUTHOR]

To estimate cost-effectiveness of routine and catch-up vaccination of Canadian children with seven-valent pneumococcal conjugate vaccine, a simulation model was constructed. In base scenario (vaccination coverage: 80%, and vaccine price: $58 per dose), pneumococcal disease incidence reduction would be superior to 60% for invasive infections, and to 30% for non-invasive infections, but the number of deaths prevented would be small. Annual costs of routine immunization would be $71 million (98% borne by the health system). Societal benefit to cost ratio would be 0.57. Net societal costs per averted pneumococcal disease would be $389 and 125,000 per life-year gained (LYG). Vaccine purchase cost is the most important variable in sensitivity analyses, and program costs would be superior to societal benefits in all likely scenarios. Vaccination would result in net savings for society, if vaccine cost is less than $30 per dose. Economic indicators of catch-up programs are less favorable than for routine infant immunization. [Copyright &y& Elsevier]

The purpose of this study was to examine the difference in lifestyle and morphometric factors that affect bone mineral and the attainment of peak bone mass in 168 healthy Asian (n = 58) and Caucasian (n = 110) Canadian, prepubertal girls and boys (mean age 8.9+/-0.7) living in close geographical proximity. DXA (Hologic 4500) scans of the proximal femur (with regions), lumbar spine, and total body (TB) were acquired. We report areal bone mineral densities (aBMD g/cm(2)) at all sites and estimated volumetric density (aBMD, g/cm(3)) at the femoral neck. Dietary calcium, physical activity, and maturity were estimated by questionnaire. Of these prepubertal children, all of the boys and 89% of the girls were Tanner stage 1. A 2x2 ANOVA demonstrated no difference between ethnicities for height, weight, body fat, or bone mineral free lean mass. Asian children consumed significantly less dietary calcium (35%) on average and were significantly less active (15%) than their Caucasian counterparts (P<0.001). There were significant ethnicity main effects for femoral neck bone mineral content (BMC) and alphaBMD (both P<0.001) and significant sex by ethnicity interactions (P<0.01). The Asian boys had significantly lower femoral neck BMC (11%), aBMD (8%), and vBMD (4.4%). At the femoral neck, BMFL mass, sex, and physical activity explained 37% of the total variance in aBMD (P<0.05). In summary, this study demonstrated differences in modifiable lifestyle factors and femoral neck bone mineral between Asian and Caucasian boys. [ABSTRACT FROM AUTHOR]

In an era of fiscal restraint, it is important to evaluate the resources required to diagnose and treat serious illnesses. As breast cancer is the major malignancy affecting Canadian women, Statistics Canada has analysed the resources required to manage this disease in Canada, and the associated costs. Here we report the cost of initial diagnosis and treatment of nonmetastatic breast cancer, including adjuvant therapies. Treatment algorithms for Stages I, II, and III of the disease were derived by age group (< 50 or ≤ 50 years old), principally from Canadian cancer registry data, supplemented, where necessary, by the results of surveys of Canadian oncologists. Data were obtained on breast cancer incidence by age, diagnostic work-up, stage at diagnosis, initial treatment, follow-up practice, duration of hospitalization and direct care costs. The direct health care costs associated with 'standard' diagnostic and therapeutic approaches were calculated for a cohort of 17 700 Canadian women diagnosed in 1995. Early stage (Stages I and II) breast cancer represented 87% of all incident cases, with 77% of cases occurring in women ≤ 50 years. Variations were noted in the rate of partial vs total mastectomy, according to stage and age group. Direct costs for diagnosis and initial treatment ranged from $8014 for Stage II women ≤ 50 years old, to $10 897 for Stage III women < 50 years old. Except for Stage III women < 50 years old, the largest expenditure was for hospitalization for surgery, followed by radiotherapy costs. Chemotherapy was the largest cost component for Stage III women < 50 years old. This report describes the cost of diagnosis and initial treatment of nonmetastatic breast cancer in Canada, assuming current practice patterns. A second report will describe the lifetime costs of treating all stages of breast cancer. These data will then be incorporated into Statistics Canada's Population Health Model (POHEM) to perform cost-effectiveness studies of... [ABSTRACT FROM AUTHOR]

The article provides information on the development of mandatory self-learning modules (SLMs) on professionalism concepts for Canadian medical schools. It discusses the lack of teaching of professionalism in clerkship despite students assuming more clinical responsibilities. Student evaluation of the SLMs is also covered.

Abstract: To render a diagnosis pediatricians rely upon reference standards for bone mineral density or bone mineral content, which are based on cross-sectional data from a relatively small sample of children. These standards are unable to adequately represent growth in a diverse pediatric population. Thus, the goal of this study was to develop sex and site-specific standards for BMC using longitudinal data collected from four international sites in Canada and the United States. Data from four studies were combined; Saskatchewan Paediatric Bone Mineral Accrual Study (n =251), UBC Healthy Bones Study (n =382); Penn State Young Women''s Health Study (n =112) and Stanford''s Bone Mineral Accretion study (n =423). Males and females (8 to 25 years) were measured for whole body (WB), total proximal femur (PF), femoral neck (FN) and lumbar spine (LS) BMC (g). Data were analyzed using random effects models. Bland–Altman was used to investigate agreement between predicted and actual data. Age, height, weight and ethnicity independently predicted BMC accrual across sites (P <0.05). Compared to White males, Asian males had 31.8 (6.8) g less WB BMC accrual; Hispanic 75.4 (28.2) g less BMC accrual; Blacks 82.8 (26.3) g more BMC accrual with confounders of age, height and weight controlled. We report similar findings for the PF and FN. Models for females for all sites were similar with age, height and weight as independent significant predictors of BMC accrual (P <0.05). We provide a tool to calculate a child''s BMC Z-score, accounting for age, size, sex and ethnicity. In conclusion, when interpreting BMC in pediatrics we recommend standards that are sex, age, size and ethnic specific. [Copyright &y& Elsevier]

Alfalfa (Medicago sativa L.) cut at sundown has been shown to contain greater concentration of total nonstructural carbohydrates (TNC) than that cut at sunup. Fourteen multiparous (8 ruminally cannulated) and 2 primiparous lactating dairy cows were randomly assigned to 2 treatments in a crossover design (2 periods of 24 d) to investigate the effects of alfalfa daytime cutting management on ruminal metabolism, nutrient digestibility, N balance, and milk yield. Half of each alfalfa field (total of 3 fields) was cut at sundown (PM) after a sunny day, whereas the second half was cut at sunup (AM) on the following day. Both PM and AM cuts were field-wilted and harvested as baleage (531 ± 15.0 g of dry matter/kg of fresh matter). Bales (PM and AM) were ranked according to their concentrations of TNC, paired, and each pair of PM and AM baleages was then assigned to each experimental day (total of 48 d). The difference in TNC concentration between PM and AM baleages fed during the 10 d of data and sample collection varied from -10 to 50 g/kg of dry matter. Each pair of baleage was fed ad libitum to cows once daily with no concentrate. Ruminal molar proportion of acetate and total volatile fatty acid concentration were greater in animals fed the AM baleage, whereas the proportion of valerate was greater with PM baleage; no other significant changes in ruminal molar proportions of volatile fatty acids were observed between forage treatments. Digestible organic matter intake, organic matter digestibility, and plasma Lys concentration were significantly greater in cows fed PM alfalfa, suggesting that more nutrients were available for milk synthesis. Significantly lower body weight gain and retained N as a proportion of N intake were observed in cows fed PM alfalfa, thus suggesting that nutrients were channeled to milk synthesis rather than to body reserves. Intake of dry matter (+1.0 kg/d), and yields of milk (+1.0 kg/d), milk fat (+70 g/d), and milk protein (+40 g/d) were significantly greater in cows fed PM vs. AM alfalfa. Concentration of milk urea N and excretion of urea N as a proportion of total urinary N were significantly reduced, and milk N efficiency was increased when feeding PM vs. AM alfalfa, indicating an improvement in N utilization. Increasing the TNC concentration of alfalfa by shifting forage cutting from sunup to sundown improved N utilization and milk production in late-lactation dairy cows. [ABSTRACT FROM AUTHOR]