Infektiöse Lahmheiten beim Schaf – Therapie möglichkeiten in der tierärztlichen Praxis

Infektiöse Klauenerkrankungen des Schafes sind unter den Aspekten des Tierschutzes, der Diagnose und der Behandlung problematisch. Neben den Einzeltiererkrankungen und Lahmheiten im Zusammenhang mit Allgemeinerkrankungen stellen insbesondere die auf Herdenbasis auftretenden infektiösen Klauenerkrankungen wie die Moderhinke den behandelnden Tierarzt aus mehreren Gründen vor Probleme. In dem Artikel werden die verschiedenen Klauenerkrankungen kurz dargestellt und Hinweise zum Vorgehen bei der Therapie infektiöser Klauenkrankheiten des Schafes, zur Auswahl der Behandlungsmethode und zum Einsatz von Medikamenten gegeben. Die verschiedenen Behandlungsmaßnahmen wie Klauenschnitt, Klauenbäder, lokale und systemische antibiotische Therapie sowie die prophylaktische Impfung werden beschrieben und unter Berücksichtigung internationaler Forschungsergebnisse diskutiert. Bei der Auswahl der Medikamente zeigt sich, dass aufgrund fehlender Zulassungen in Deutschland der behandelnde Tierarzt beinahe regelmäßig gezwungen ist, Arzneimittel umzuwidmen. Die Problematik der medikamentösen Versorgung der kleinen Wiederkäuer als „minor species“ wird verdeutlicht und mit dem Aufruf an die involvierten Stellen verbunden, an einer Verbesserung dieser für alle Seiten unbefriedigenden Situation mitzuarbeiten.

Empfehlung für die Haltung von Schafen und Ziegen der Deutschen Gesellschaft für die Krankheiten der kleinen Wiederkäuer, Fachgruppe der DVG

Es werden Empfehlungen für die verschiedenen Haltungsformen auf der Basis der gesetzlichen Rahmenbedingungen für die Haltung von Schafen und Ziegen zusammengefasst. Berücksichtigung finden dabei die Wanderschäferei, die Hüte- und Koppelschafhaltung sowie die Alpung. Intensiv wird auf die Belange der Weidehaltung, der Stallhaltung, der Versorgung mit Futter und Wasser, der Geburt, der Lämmeraufzucht und der Gesundheitsvorsorge eingegangen. Dabei werden die Rahmenbedingungen sowohl für die extensive als auch für die intensive Haltung und Nutzung von Schafen und Ziegen abgesteckt. Die speziesspezifischen Kompensationsmöglichkeiten, deren Grenzen und Anzeichen der Dekompensation werden exemplarisch aufgezeigt. Durch die Einhaltung dieser Empfehlungen sollen den in unserer Obhut gehaltenen Nutztieren die „fünf Freiheiten (13)” zuverlässig gewährt werden: 1. Freisein von Hunger und Durst, 2. Freisein von Unbehagen, 3. Freisein von Schmerz, Verletzungen und Krankheiten, 4. Freisein zum Ausleben normaler Verhaltensweisen und 5. Freisein von Angst und Leiden.

Endogenous formation of preferences: Choices systematically change willingness-to-pay for goods

Standard decision theory assumes that choices result from stable preferences. This position has been challenged by claims that the act of choosing between goods may alter preferences. To test this claim, we investigated in three experiments whether choices between equally valued snack food items can systematically shape preferences. We directly assessed changes in participants' willingness-to-pay for these items, some of which could be bought at an auction after the experiment, while others could not. We found that chosen items were valued higher, and nonchosen items were valued lower; yet this postdecisional refinement of preferences was only observed for choices and valuations that were relevant, that is, incentive-compatible for items that were available for consumption. Supplementary analyses revealed that incentive-incompatible elicitations of preferences were unreliable and may have masked potential effects of choices on preferences. In conclusion, we propose that preferences can change endogenously, that is, in the absence of external feedback or information, but rather as a function of previous relevant choices. (PsycINFO Database Record

[Preferred Medical Specialties of Medical Students in Contrast to the Need for General Practitioners in Saxony]

Aim of the study: Especially in the rural areas of Germany, there are not enough general practitioners (GPs) for primary care. Preferred medical specialties of medical students can help get an estimate of the number of future GPs. This study compares this estimate to the current need for GPs in Saxony. Methods: 587 medical students at the second, sixth and tenth semester were invited to take part in an anonymous cross-sectional study regarding their specialty preferences at the Technical University Dresden. Based on the data of the medical requirements for Saxony, 4 model calculations were generated for comparison of the estimated numbers of future GPs and the current need for GPs. Results: The most commonly preferred medical specialties were surgery (19.1%), internal medicine (12.9%), pediatrics (11.6%) and general practice (9.9%). A significant increase in specialist preference for GP was observed from the sixth (4.9%) to the tenth semester (14.0%). The model calculations show that approximately 29% to 111% of the open positions for GPs could be filled by the potential new GPs from Dresden. Conclusion: Currently, medical students planning to become GPs cannot meet the corresponding need for GPs. Future studies should include the points of view of students, continuing education assistants, GPs and patients.

[Amendments to the Drinking Water Ordinance: Legionellae in Hot Water Systems - Data from the Public Health Authority Frankfurt am Main, Germany]

BACKGROUND

The first and second amendment to the Drinking Water Ordinance came in to force in the years 2011 and 2012 causing additional tasks and responsibilities for operators of commercial large-scale systems, usually hot water systems in large residential buildings, and for the local health authorities. This article describes the experiences of the health authority in Frankfurt/Main with these new regulations. Some of the revisions in the first amendment of the ordinance (TrinkwV 2001 (2011)) were omitted in the second revision (TrinkwV 2001 (2012)) such as the obligation to notify for large-scale systems. Furthermore, the intervals between the obligatory inspections were extended from 1 to 3 years and merely exceedances of the legal limits were to be notified in contrast to the previous obligation to notify all values.

RESULTS

On the basis of the TrinkwV 2001 (2011) a large additional staff requirement had been estimated (13/21 positions). After the TrinkwV 2001 (2012) the tasks can be accomplished by less than 2 employees. While the notification obligation was still in force, the health authority received 4,461 notifications of large-scale systems, since then a further 477 have been notified. Of a total of 1,335 initial analyses, 794 (60%) exceeded the technical action value and in 113 properties with values exceeding 10,000/100 ml a usage restriction was necessary.

CONCLUSIONS

Due to the suspension of the notification obligation to report any result of the analyses performed the assessment of the reports on large-scale systems has become difficult. An appropriate assessment of the implementation of the regulation is not possible, since the total number of large-scale systems is not known and a failure to report may result from a measured value below the technical action value as well as from a not inspected system. The large number of usage restrictions is an indication for the necessity to inspect and if required to treat and restore the system.

Psychological and interactional characteristics of patients with somatoform disorders: Validation of the Somatic Symptoms Experiences Questionnaire (SSEQ) in a clinical psychosomatic population

OBJECTIVE

The new DSM-5 Somatic Symptom Disorder (SSD) emphasizes the importance of psychological processes related to somatic symptoms in patients with somatoform disorders. To address this, the Somatic Symptoms Experiences Questionnaire (SSEQ), the first self-report scale that assesses a broad range of psychological and interactional characteristics relevant to patients with a somatoform disorder or SSD, was developed. This prospective study was conducted to validate the SSEQ.

METHODS

The 15-item SSEQ was administered along with a battery of self-report questionnaires to psychosomatic inpatients. Patients were assessed with the Structured Clinical Interview for DSM-IV to confirm a somatoform, depressive, or anxiety disorder. Confirmatory factor analyses, tests of internal consistency and tests of validity were performed.

RESULTS

Patients (n=262) with a mean age of 43.4 years, 60.3% women, were included in the analyses. The previously observed four-factor model was replicated and internal consistency was good (Cronbach's α=.90). Patients with a somatoform disorder had significantly higher scores on the SSEQ (t=4.24, p<.001) than patients with a depressive/anxiety disorder. Construct validity was shown by high correlations with other instruments measuring related constructs. Hierarchical multiple regression analyses showed that the questionnaire predicted health-related quality of life. Sensitivity to change was shown by significantly higher effect sizes of the SSEQ change scores for improved patients than for patients without improvement.

CONCLUSION

The SSEQ appears to be a reliable, valid, and efficient instrument to assess a broad range of psychological and interactional features related to the experience of somatic symptoms.

[Water requirements, water supply and thermoregulation in small ruminants in pasture-based husbandry systems]

Water is an essential source of life and is available to animals as free water, water content of feed, film water (e. g. dew) and metabolic water. The water requirements of small ruminants are influenced by the type of feed, climate, stage of production, type and length of the fleece or hair coat, husbandry factors and the general health of the animal. Differences in water metabolism, drinking behaviour and the efficiency of temperature regulation are further influenced by species, breed, production type, husbandry system, acclimatisation and adaptation. Small ruminants have been, and are still predominantly kept in extensive husbandry systems. They are therefore genetically and phenotypically well adapted to these conditions and possess a range of physiological and behavioural mechanisms to deal with adverse and suboptimal weather conditions. Regarding animal welfare, there is considerable debate in the discussion and assessment of what constitutes a sufficient water supply for small ruminants under different husbandry conditions, often involving differences between theoretical demands and practical experience. This publication reviews and summarises the current literature regarding water requirements, water metabolism and thermoregulatory mechanisms of small ruminants to provide the basis for an informed assessment of extensive husbandry systems in terms of compliance with animal-welfare requirements.

[The Somatic Symptoms Experiences Questionnaire (SSEQ): a new self-report instrument for the assessment of psychological characteristics of patients with somatoform disorder]

Psychological symptoms of somatoform disorders will be part of their new definition in DSM-5. We developed the Somatic Symptoms Experiences Questionnaire (SSEQ) as a self-report questionnaire to assess important psychological characteristics of patients with somatoform disorders. Item selection and identification of factor structure, as well as reliability and validity have been checked in a sample of N=453 psychsomatic outpatients. Results of a principal components analysis with Promax-rotation suggested 4 factors (health worries, illness experience, difficulties in interaction with doctors, impact of illness). Validity analyses confirmed associations between the SSEQ-Scores and the physical disability of patients. Although further assessments of psychometric qualities are needed, the questionnaire appears to be well-suited for future assessment of relevant psychological features of somatoform disorders.

Health-related quality of life, depression, and anxiety in patients with autoimmune hepatitis

BACKGROUND & AIMS

Improving health related quality of life (HrQoL) in patients with chronic diseases such as autoimmune hepatitis (AIH) should be a major treatment goal. However, little is known on the HrQoL in patients with AIH, and the topic is not given attention in current practice guidelines. We therefore conducted a single center study evaluating HrQoL in 103 consecutive outpatients with AIH.

METHODS

Patient-reported HrQoL data were analysed in relation to clinical disease parameters and compared to representative data of the German population as well as control patients.

RESULTS

Based on patient-reported data, a major depressive syndrome (10.8%) was found to be five times more frequent in AIH patients compared to the general population (p<0.001). The rate of severe symptoms of anxiety was also found to be significantly increased compared to the general population (p=0.006). In seven of the eleven patients who scored for a major depressive syndrome a psychiatric comorbidity had not been diagnosed before. Major factors associated with depression and anxiety were concerns with regard to the progression of the liver disease.

CONCLUSIONS

This study identified--for the first time--a high rate of previously unrecognized severe symptoms of depression and anxiety in patients with AIH. Of importance for daily clinical practice, the factors associated with these symptoms may in part be amenable to targeted counselling and adequate treatment of the disease, thereby offering the chance to improve the care and HrQoL of AIH-patients.