Understanding parent engagement in advanced allied health single session therapy for children with developmental and behavioural disabilities

BACKGROUND

Increasingly, health services are adopting short-term consultative therapy models, such as single session therapy, to cope with increased service demands, finite budgets and changing consumer expectations. Within the paediatric sub-specialty of child development and behaviour, allied health clinicians are central to supporting families to understand their children, provide therapeutic interventions and help achieve optimal developmental and health outcomes. This study aimed to describe parents'/caregivers' engagement during advanced allied health consultations utilizing a single session therapy framework for managing neurodevelopmental and behavioural concerns in children.

METHODS

Between March to June 2021, 14 parents participated in a qualitative study involving focus groups. Reflexive thematic analysis was used to code and interpret the data to understand and explore families' engagement in single session therapy.

RESULTS

Three overarching themes relating to parents' engagement during consultations emerged from the data: connection with the clinician, parental attributes and organizational influences. Clinician connection was the prominent construct that enhanced parent attributes and the positive perception of the organization in an ongoing manner. There was a complex interplay between the behavioural and affective components of the clinician, parents and the organization to create mutual presence, valued time, understanding and action.

CONCLUSIONS

This study demonstrates the importance of clinician connection, parental attributes and organizational influences to enhance engagement in therapeutic consultations. These factors are interrelated and are a complex blend of behaviour and internal states and highly individualized for each family. Understanding how services can continue to engage families is integral to ongoing sustainability and overall health and well-being.

Picky Eating in Children: A Scoping Review to Examine Its Intrinsic and Extrinsic Features and How They Relate to Identification

The health benefits and importance of family mealtimes have been extensively documented. Picky eating can impact this complex activity and has numerous extrinsic (or external) and intrinsic (or internal) features. Occupational therapists work with children and their families by looking at both intrinsic and extrinsic influences and are therefore well-placed to work within this context. This scoping review comprises a comprehensive search of key health industry databases using pre-determined search terms. A robust screening process took place using the authors pre-agreed inclusion and exclusion criteria. There were 80 studies that met the inclusion criteria, which were then mapped using content analysis. The most common assessments used to identify picky eating relied on parental reports and recall. Often additional assessments were included in studies to identify both the intrinsic and extrinsic features and presentation. The most common reported intrinsic features of the child who is a picky eater included increased sensitivity particularly to taste and smell and the child's personality. Extrinsic features which appear to increase the likelihood of picky eating are authoritarian parenting, rewards for eating, and pressuring the child to eat. Most commonly reported extrinsic features that decrease the likelihood of picky eating are family meals, responsive parents, and involving the child in the preparation of food. In conclusion, there is a lack of published papers addressing the role of occupational therapists in the assessment and identification of picky eating in children. There appears to be a complex interplay between intrinsic and extrinsic features which impact caregiver responses and therefore on the picky eater.

Sustainability in Nutrition: Potential Guiding Statements for Education and Practice

OBJECTIVE

To explore and synthesize local and practice-based perspectives of sustainability to develop a set of proposed guiding thematic statements that will assist academics to contextualize, prioritize, and integrate sustainability-focused activities or a sustainability lens in a nutrition and dietetic (N&D) program.

DESIGN

Participatory action research process using an online survey, workshop, and interviews.

SETTING

Australian Regional University.

PARTICIPANTS

A total of 95 N&D undergraduate students, 7 N&D academics, and 10 Australian nutrition practitioners.

PHENOMENON OF INTEREST

Sustainability in N&D learning, teaching, and practice.

ANALYSIS

Qualitative inductive content analysis of responses from each participant group and combined themes.

RESULTS

There were 4 key themes, each comprising 4-8 subthemes, identified as follows: sustainability thinking, future-focused views, stewardship, and sustaining the nutrition profession.

CONCLUSIONS AND IMPLICATIONS

There may be opportunities for N&D competencies in Australia to better reflect the ways of being that sustainability in nutrition practice means. Confirmation of these findings among other N&D professionals (academics and practitioners) and students, both in Australia and elsewhere, is warranted to further develop these proposed statements. Future research is needed to describe more explicitly what sustainability looks like in practice, providing specific examples to assist educators to frame sustainability authentically.

Development and test-retest reliability assessment of a low-cost, 3D printed tool for assessing different aspects of hand dexterity

BACKGROUND

Hand dexterity assessments related to fine motor movements are routinely administered in clinical settings to ascertain an individual's hand function. However, to perform a detailed assessment multiple devices are needed which can be time-consuming and costly to administer.

PURPOSE

We designed and assessed the test-retest reliability of a 3D printed dexterity device in a cohort of healthy young adults and community-dwelling older adults. This study examines the reliability of the device, association between perceived fine motor gripping and manipulation dexterity components, and dominant hand outperformance during both tasks.

STUDY DESIGN

Test-retest study of a clinical measurement tool.

METHODS

A convenience sample of thirty-six healthy community-dwelling older and young adults was included in our study. The device was used to collect data at two testing sessions to establish test-retest reliability. Fine motor manipulation dexterity was assessed by lifting notched pegs over a vertical barrier and inserting them into randomly oriented holes sequentially. Fine motor gripping dexterity was assessed by taking these notched pegs out of the holes, lifting them over the barrier and dropping them into a large container.

RESULTS

Intraclass correlation coefficient (ICC)_2,1 showed good to excellent test-retest reliability on the dominant and nondominant hands when using the device. Only modest association was found within-hand for the gripping versus manipulation dexterity tests. The between-hand motor gripping dexterity test demonstrated a strong association; however, between-hand the motor manipulation dexterity test was only moderately associated.

CONCLUSION

The device was reliable, discriminated between the motor gripping and motor manipulating dexterity tasks, and was sensitive to handedness during the motor manipulating dexterity task. It shows promise as a hand dexterity assessment device which may provide efficiency and cost advantages. It is freely available via http://www.rehabtools.org/dexterity.html.

What Factors Influence Clinicians' Use of Technology in Neurorehabilitation? A Multisite Qualitative Study

OBJECTIVE

Technology is being increasingly used for physical assessment and interventions in health care settings. However, clinical adoption is relatively slow, and the factors affecting use remain underexplored. This study aimed to investigate factors influencing technology use by clinicians working in neurorehabilitation.

METHODS

In this qualitative study, 9 physical therapists and 9 occupational therapists (N = 18) were recruited from urban and regional locations in Australia and in Singapore. Three 60-minute focus groups were conducted via video conferencing. Each group comprised 3 physical therapists and 3 occupational therapists working across different neurorehabilitation settings. Participants were asked to discuss which technologies they used in their workplace for physical assessment and treatment and barriers, motivators, and future desires for technology use. Transcripts were analyzed independently using an inductive approach to generate codes and themes.

RESULTS

Our results comprised 3 themes and 7 categories. These were encompassed by a single overarching theme, namely "Technology use is influenced by the benefits and challenges of the technology itself, users, and organizational context." Themes showed that technology should promote effective interventions, is preferred if easy to use, and should be dependable. Furthermore, clinical reasoning is important, and users have varying levels of receptivity and confidence in technology use. Also, organizational resources are required, along with supportive cultures and processes, to facilitate technology use.

CONCLUSIONS

The themes identified multiple and interlinking factors influencing clinicians' use of technology in neurorehabilitation settings. Clinicians often consider context-specific benefits and challenges when deciding whether to use technology. Although our study found that clinicians generally perceived technology as having a beneficial role in improving health outcomes, there were several challenges raised. Therefore, the characteristics of the technology itself, individual users, and organizational context should be considered.

IMPACT

These findings will guide successful technology implementation and future developments.

Reducing time between referral and diagnosis in paediatric outpatient neurodevelopmental and behavioural clinics

AIM

This study investigated the impact of a transdisciplinary advanced allied health practitioner (AAHP) in a public hospital general paediatric outpatient department for children referred for concerns with neurodevelopment, learning and/or behaviour. It was hypothesised that time from referral to initial consultation and diagnosis was reduced for children initially assessed by AAHP. It was also hypothesised that children seen by AAHP were less likely to require a medical specialist appointment.

METHODS

De-identifiable data were gathered from hospital records both retrospectively and prospectively for each group. Data were collected from: 75 children who attended a medical consultation only clinic in 2014; 75 children who attended an AAHP clinic and a medical officer in 2014 and 75 children who attended an AAHP clinic and a medical officer 2 years after establishment in 2016/2017.

RESULTS

On average, 52% children were managed independently by the AAHP. Wait time from referral to consultation significantly decreased from 169 days to 48 days. Similarly, time from referral to diagnosis significantly reduced by almost a half, from 57.2 to 30.59 weeks.

CONCLUSION

This study provides preliminary evidence that utilisation of transdisciplinary AAHPs in general paediatric outpatient departments may reduce waitlists, reduce amount of medical specialist appointments required and provide earlier diagnosis for children with neurodevelopmental, behavioural and/or learning difficulties.

Digital technologies in undergraduate and postgraduate education in occupational therapy and physiotherapy: a scoping review

OBJECTIVE

The objective of this scoping review was to map research in the use of digital technologies in occupational therapy and physiotherapy education in terms of the type of digital technology used, how the digital technology is applied, and the author-reported outcomes of digital technology use.

INTRODUCTION

The ubiquitous nature of digital technology has influenced higher education, offering benefits of integrating digital technologies into curricula. However, the extent of the application of digital technologies in higher education in occupational therapy and physiotherapy warrants investigation. This scoping review mapped the reported applications of digital technology in both undergraduate and postgraduate occupational therapy and physiotherapy education.

INCLUSION CRITERIA

Research studies on the use of digital technology in undergraduate and/or postgraduate education in occupational therapy and/or physiotherapy were considered for inclusion in this scoping review.

METHODS

A comprehensive search strategy using multiple databases was employed to find relevant studies. Keywords and the derivatives of "digital technology," "education," "occupational therapy" and "physiotherapy" were used. The databases searched included MEDLINE via PubMed, the Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), EBSCOhost Education Research Complete, EBSCOhost ERIC, EBSCOhost MasterFILE Premier, EBSCOhost CINAHL Complete, OT Database, OT Seeker and Scopus. Google Scholar was also searched. The filter "humans" was applied, where possible. Peer-reviewed qualitative and quantitative research studies were considered for inclusion. Owing to the rapid development of technologies, studies that were published from January 2013 to April 2019 were included. This review only included papers available in English. The relevant studies and their reported outcomes were organized and analyzed thematically.

RESULTS

The initial search yielded 2853 articles. Title, abstract and full-text review yielded 52 suitable papers meeting criteria. The final data set represented 4038 participants. Data were analyzed according to three main categories, namely, type of technology used, application of digital technology and author-reported outcomes. The review showed that occupational therapy and physiotherapy educators have used a wide variety of digital technologies, including quizzes, videos, social media, learning management systems and content repositories. Digital technologies have been applied in a range of learning and teaching contexts, including feedback and assessment, clinical skills and techniques, professional behaviors, clinical reasoning and fieldwork supervision. Author-reported outcomes varied between studies and were associated with student factors (e.g. anxiety, self-efficacy), technical difficulties when implementing digital technology, as well as financial costs.

CONCLUSION

A wide variety of digital technologies can support learning and teaching across many contexts in occupational therapy and physiotherapy education. Technology should not be used in isolation and must be aligned to the proposed learning outcomes. Studies highlight the need for face-to-face contact with lecturers and fellow students in addition to the use of digital technology.

Digital technologies in occupational therapy and physiotherapy undergraduate and postgraduate education: a scoping review protocol

REVIEW QUESTION AND OBJECTIVE

How have digital technologies been used in occupational therapy and physiotherapy undergraduate and postgraduate education?Specifically, the objective of this scoping review is to present an overview of research on the use of digital technologies in terms of type of digital technology used, pedagogy associated with the use of digital technology, subject/topic/area of application, experiences/perception of digital technology used, outcomes of the digital technology used and challenges to the use of digital technologies in occupational therapy and physiotherapy undergraduate and postgraduate education.

Taking back a little of what you have lost: the meaning of using an Environmental Control System (ECS) for people with high cervical spinal cord injury

PURPOSE

Assistive technologies have deep and personal meanings for people with disabilities. This study sought to provide an in-depth exploration of the subjective meaning of Environmental Control System (ECS) use for people with high cervical spinal cord injury.

MATERIALS AND METHOD

Interpretative Phenomenological Analysis (IPA) was used to explore the personal meaning of ECS. In-depth interviews with five participants were analyzed according to recommended IPA guidelines to produce a rich phenomenological account of lived experience.

RESULTS

This study identified two overarching themes, one of which was the subject of an earlier publication. This paper focuses on the second theme "taking back a little of what you have lost" and its two main components "reclaiming a little doing" and "feeling enabled". Doing everyday things, being less dependent on others and feeling safer and less needy all contributed to participants experience of regaining something important of what had been lost.

CONCLUSIONS

A nuanced range of meanings, demonstrating how "a little can mean a lot" emerged from this study. For those with high cervical spinal cord injury, "reclaiming a little doing" resulted in subtle, but subjectively significant, improvements in identity, relationships and well-being, while "feeling enabled" was both enjoyable and empowering and led to an increased sense of safety and reduced neediness. The potentially powerful impact on individuals with life-altering injuries of reclaiming a little of what they had lost, supports the value of more widespread access to and provision of ECS. Implications for rehabilitation While ECS use produces only a "little" objective change in activity levels, it subjectively means "a lot" to people with high level injuries. ECS enable people to "do" everyday things as well help in supporting them to "feel" less dependent and needy. Using ECS facilitates much more than functional tasks and a sense of security. It helps promote positive self-perception and continuity of being. It is important for those with high cervical spinal cord injuries to have access to ECS to ensure they can enjoy both psychological and physical benefits.

Smart-device environmental control systems: experiences of people with cervical spinal cord injuries

BACKGROUND

Environmental control systems (ECS) are devices that enable people with severe physical limitations to independently control household appliances. Recent advancements in the area of environmental control technology have led to the development of ECS that can be controlled through mainstream smart-devices. There is limited research on ECS within Australia and no known research addressing smart-device ECS. The current study sought to explore users' experiences with smart-device ECS within Australia.

METHODS

The study followed a single embedded case study method. Participants (n = 5) were existing ECS users with a cervical spinal cord injury. Data were collected through semi-structured interviews with participants, reflexive journals and field notes. An inductive approach was used to analyze the data thematically.

RESULTS AND CONCLUSIONS

The experience of using a smart-device ECS presented both opportunities and costs to users. The opportunities included: independent control, choice, peace of mind, connection, effective resource use, and control over smart-phone functions and applications. The associated costs included: financial, time, frustration, and technical limitations. While findings are similar to previous research into traditional ECS this study indicates that smart-device ECS also offered a new opportunity for users to access mainstream smart-device functions and applications. Future research should investigate methods and resources that practitioners could utilize to better support new users of smart-device ECS. Implications for Rehabilitation As with traditional environmental control systems, users of smart environmental control systems report increased independence, choice and control. Smart-device environmental control systems provide users with access to mainstream smart-device functions and applications, which facilitate connection to family and the outside world. The costs to the user of smart-device environmental control systems include monetary and time investment, dealing with technical limitations and resulting frustration. Prescribers and installers must consider ways to mitigate these costs experienced by users.

The meaning ascribed to wheeled mobility devices by individuals who use wheelchairs and scooters: a metasynthesis

PURPOSE

To synthesize qualitative study findings on the meaning ascribed to wheelchairs and wheeled mobility devices (WMD) by WMD users.

METHOD

Bibliographic databases were systematically searched up to January 2015 to identify relevant papers. Reviewers selected studies, assessed methodological quality and thematically synthesized findings using a metasynthesis process described by Thomas and Harden (2008).

RESULTS

Twenty articles were included. Four descriptive themes emerged: physical environment interaction; sociocultural experiences; participation in activities and occupations; and WMD-self relationship. WMD use was found to be a complex experience that can fluctuate through interaction with aspects of the environment and opportunities for participation. The analytic theme, dynamic duality of WMD experience, addressed the simultaneous enabling and disabling aspects of WMD use.

CONCLUSIONS

Metasyntheses enable researchers to gain a deeper understanding of issues by examining findings across studies. Findings of this study provide a framework for understanding the complexity of WMD use. The framework has practical applications for clinicians and users of WMD in understanding the experience of WMD to be neither singular nor static. Implications for Rehabilitation The meaning of wheeled mobility device (WMD) use is dynamically influenced by the environment and opportunities afforded for occupational and social participation. A duality of experiences can emerge for WMD users, where wheeled mobility use can be at the same time positive and negative, based on the interaction with the environment. Clinicians need to determine the meaning that each individual user ascribes to the WMD, and to consider how that meaning may change over time. By understanding the meaning ascribed to WMD use by individuals, clinicians can be better prepared to work with the WMD users to address negative reinforcers of the experience in physical and sociocultural environments as well as highlighting the positive experiences.

Characterization of human breast cancer tissues by infrared imaging

Fourier Transform InfraRed (FTIR) spectroscopy coupled to microscopy (IR imaging) has shown unique advantages in detecting morphological and molecular pathologic alterations in biological tissues. The aim of this study was to evaluate the potential of IR imaging as a diagnostic tool to identify characteristics of breast epithelial cells and the stroma. In this study a total of 19 breast tissue samples were obtained from 13 patients. For 6 of the patients, we also obtained Non-Adjacent Non-Tumor tissue samples. Infrared images were recorded on the main cell/tissue types identified in all breast tissue samples. Unsupervised Principal Component Analyses and supervised Partial Least Square Discriminant Analyses (PLS-DA) were used to discriminate spectra. Leave-one-out cross-validation was used to evaluate the performance of PLS-DA models. Our results show that IR imaging coupled with PLS-DA can efficiently identify the main cell types present in FFPE breast tissue sections, i.e. epithelial cells, lymphocytes, connective tissue, vascular tissue and erythrocytes. A second PLS-DA model could distinguish normal and tumor breast epithelial cells in the breast tissue sections. A patient-specific model reached particularly high sensitivity, specificity and MCC rates. Finally, we showed that the stroma located close or at distance from the tumor exhibits distinct spectral characteristics. In conclusion FTIR imaging combined with computational algorithms could be an accurate, rapid and objective tool to identify/quantify breast epithelial cells and differentiate tumor from normal breast tissue as well as normal from tumor-associated stroma, paving the way to the establishment of a potential complementary tool to ensure safe tumor margins.

Label-free phenotyping of peripheral blood lymphocytes by infrared imaging

It is now widely accepted that the immune microenvironment of tumors and more precisely Tumor Infiltrating Lymphocytes (TIL) play an important role in cancer development and outcome. TILs are considered to be important prognostic and predictive factors based on a growing body of clinical evidence; however, their presence at the tumor site is not currently assessed routinely. FTIR (Fourier transform infrared) imaging has proven it has value in studying a range of tumors, particularly for characterizing tumor cells. Currently, very little is known about the potential for FTIR imaging to characterize TIL. The present proof of concept study investigates the ability of FTIR imaging to identify the principal lymphocyte subpopulations present in human peripheral blood (PB). A negative cell isolation method was employed to select pure, label-free, helper T cells (CD4(+)), cytotoxic T cells (CD8(+)) and B cells (CD19(+)) from six healthy donors PB by Fluorescence Activated Cell Sorting (FACS). Cells were centrifuged onto Barium Fluoride windows and ten infrared images were recorded for each lymphocyte subpopulation from all six donors. After spectral pre-treatment, statistical analyses were performed. Unsupervised Principal Component Analyses (PCA) revealed that in the absence of donor variability, CD4(+) T cells, CD8(+) T cells and B cells each display distinct IR spectral features. Supervised Partial Least Square Discriminant Analyses (PLS-DA) demonstrated that the differences between the three lymphocyte subpopulations are reflected in their IR spectra, permitting their individual identification even when significant donor variability is present. Our results also show that a distinct spectral signature is associated with antibody binding. To our knowledge this is the first study reporting that FTIR imaging can effectively identify T and B lymphocytes and differentiate helper T cells from cytotoxic T cells. This proof of concept study demonstrates that FTIR imaging is a reliable tool for the identification of lymphocyte subpopulations and has the potential for use in characterizing TIL.

Breast cancer and melanoma cell line identification by FTIR imaging after formalin-fixation and paraffin-embedding

Over the past few decades, Fourier transform infrared (FTIR) spectroscopy coupled to microscopy has been recognized as an emerging and potentially powerful tool in cancer research and diagnosis. For this purpose, histological analyses performed by pathologists are mostly carried out on biopsied tissue that undergoes the formalin-fixation and paraffin-embedding (FFPE) procedure. This processing method ensures an optimal and permanent preservation of the samples, making FFPE-archived tissue an extremely valuable source for retrospective studies. Nevertheless, as highlighted by previous studies, this fixation procedure significantly changes the principal constituents of cells, resulting in important effects on their infrared (IR) spectrum. Despite the chemical and spectral influence of FFPE processing, some studies demonstrate that FTIR imaging allows precise identification of the different cell types present in biopsied tissue, indicating that the FFPE process preserves spectral differences between distinct cell types. In this study, we investigated whether this is also the case for closely related cell lines. We analyzed spectra from 8 cancerous epithelial cell lines: 4 breast cancer cell lines and 4 melanoma cell lines. For each cell line, we harvested cells at subconfluence and divided them into two sets. We first tested the "original" capability of FTIR imaging to identify these closely related cell lines on cells just dried on BaF2 slides. We then repeated the test after submitting the cells to the FFPE procedure. Our results show that the IR spectra of FFPE processed cancerous cell lines undergo small but significant changes due to the treatment. The spectral modifications were interpreted as a potential decrease in the phospholipid content and protein denaturation, in line with the scientific literature on the topic. Nevertheless, unsupervised analyses showed that spectral proximities and distances between closely related cell lines were mostly, but not entirely, conserved after FFPE processing. Finally, PLS-DA statistical analyses highlighted that closely related cell lines are still successfully identified and efficiently distinguished by FTIR spectroscopy after FFPE treatment. This last result paves the way towards identification and characterization of cellular subtypes on FFPE tissue sections by FTIR imaging, indicating that this analysis technique could become a potential useful tool in cancer research.

Irish Occupational Therapists' Views of Electronic Assistive Technology

Introduction:

Electronic assistive technology (EAT) includes computers, environmental control systems and information technology systems and is widely considered to be an important part of present-day life.

Method:

Fifty-six Irish community occupational therapists completed a questionnaire on EAT. All surveyed were able to identify the benefits of EAT.

Results:

While respondents reported that they should be able to assess for and prescribe EATs, only a third (19) were able to do so, and half (28) had not been able to do so in the past. Community occupational therapists identified themselves as havinga role in a multidisciplinary team to assess for and prescribe EAT.

Conclusion:

Results suggest that it is important for occupational therapists to have up-to-date knowledge and training in assistive and computer technologies in order to respond to the occupational needs of clients.

Seroprevalence of Actinobacillus pleuropneumoniae serovars 2, 3 and 9 in slaughter pigs from Belgian fattening farms

Fifty randomly selected fattening pig herds were studied to investigate the epidemiological characteristics of infections with Actinobacillus pleuropneumoniae serovars 2, 3 and 9, and to identify risk factors for their within-herd seroprevalences. Information about 13 farm characteristics was obtained by means of a questionnaire and used to assess potential risk factors for the percentage of slaughter pigs with antibodies against each of the three serovars. The presence of antibodies was measured with an indirect ELISA. The median within-herd seroprevalence for serovar 2 was 58 per cent (range 0 to 100 per cent), for serovar 3, 53 per cent (range 10 to 95 per cent), and for serovar 9, 35 per cent (range 5 to 100 per cent). All but one farm tested positive for A pleuropneumoniae serovar 2, and all the farms were positive for A pleuropneumoniae serovars 3 and 9. There was a positive association (P < 0.05) between each pair of serovars. The within-herd seroprevalence of serovar 2 was significantly associated with the density of pig herds in the municipality (odds ratio [OR] = 1.60; P < 0.05) and with the absence of preventive medication at the start of the fattening period (OR = 2.77; P < 0.10). No significant risk factors were found for serovar 3. The percentage of pigs positive for serovar 9 was significantly associated with a slaughter date in June (OR = 2.30; P < 0.10) and with herds in which the finishing houses were not divided into separate compartments (OR = 2.99; P < 0.05).

Effectiveness of treatment with lincomycin hydrochloride and/or vaccination against Mycoplasma hyopneumoniae for controlling chronic respiratory disease in a herd of pigs

A herd of pigs infected with Mycoplasma hyopneumoniae was used in a double-blind randomised trial to assess the effectiveness of three control strategies against chronic respiratory disease in growing-finishing pigs. One group of 61 pigs received 220 ppm lincomycin hydrochloride in the feed from day 71 to day 91, a second group was vaccinated against M. hyopneumoniae at four and 28 days of age, and a third group received both treatments; a fourth group was left untreated as a control. Throughout the nursery-finishing period (day 29 to slaughter) the average daily weight gain and feed conversion rate of all the treated groups were slightly better than in the controls, but there were no significant differences between them. There were no significant differences between the treated groups in terms of clinical signs, serology, pathology or mortality, which was very low throughout the trial.

A comparative study of the preventive use of tilmicosin phosphate (Pulmotil premix) and Mycoplasma hyopneumoniae vaccination in a pig herd with chronic respiratory disease

This study was conducted to compare the effects of a preventive in-feed medication programme using tilmicosin (Pulmotil 200 premix, Elanco Animal Health) at 200 p.p.m. with those of Mycoplasma hyopneumoniae (Mh) vaccination programme (Stellamune Mycoplasma, Pfizer Animal Health). A pig herd with chronic respiratory disease in which infection with Mh played an important role was selected, and a total of 204 piglets were randomly allocated to either the medication (P) or the vaccination (V) group. Pigs in the P group received medicated feed for 3 weeks after weaning (days 34-55), and for 2 weeks late in the nursery period (days 77-98). The piglets in the V group were vaccinated twice intramuscularly, at 4 and 22 days of age. The two groups were compared on the basis of average daily gain (ADG), feed conversion rate (FCR), additional curative medication days (CMD), overall mortality (major variables), a coughing index, pneumonia lesions, and serology against Mh, influenza H1N1 and influenza H3N2 viruses, Actinobacillus pleuropneumoniae (App) and porcine reproductive and respirator, syndrome virus (PRRSV) (minor variables). No significant differences (P > 0.05) were observed for ADG (555 g/day in P group; 567 g/day in V group), FCR (2.64 in P group; 2.41 in V group) and mortality rate (11% in P group; 7% in V group). The average number of additional curative medication days (CMD) per pig was significantly higher (P < 0.01) in the P group (1.5) than in the V group (0.58). At slaughter age, the serological results and the prevalence of macroscopic lung lesions were comparable in the two groups (P > 0.05). With the exception of CMD, the preventive use of tilmicosin at this swine farm was found to confer similar beneficial effects to Mh vaccination.

Efficacy of tilmicosin phosphate (Pulmotil premix) in feed for the treatment of a clinical outbreak of Actinobacillus pleuropneumoniae infection in growing-finishing pigs

A double-blind randomized clinical trial was carried out to investigate the efficacy of tilmicosin (Pulmotil premix) for the treatment of a clinical outbreak of Actinobacillus pleuropneumoniae infection in growing-finishing pigs. The effects of tilmicosin administration in the feed at 400 mg/kg and an injection therapy of clinically diseased pigs with long-acting oxytetracycline (Terramycine LA) at 20 mg/kg bodyweight were compared. Both groups, totalling 147 pigs, were compared during a medication period of 15 days and a post-medication period of 11 days by means of different clinical and performance parameters. During the medication period, the tilmicosin group showed a significant advantage with respect to the number of new disease cases (P < 0.01), and a non-significant advantage regarding the number of removed pigs (P = 0.16), the number of sick pigs that recovered (P = 0.27) and the time to recovery (P = 0.42). During the post-medication period, the pigs of the tilmicosin group showed numerical non-significant benefits (P > 0.05) with respect to the clinical parameters. During the overall study period (26 days), the average daily gain and the feed conversion ratio were both significantly (P < 0.01) better in pigs from the tilmicosin group compared with pigs from the oxytetracycline group. This study demonstrated that in-feed medication of tilmicosin at a dosage of 400 mg/kg is efficacious for the treatment of a clinical respiratory disease outbreak of A. pleuropneumoniae infection in growing-finishing pigs. Compared with oxytetracycline injection of clinically diseased pigs, the tilmicosin treatment is particularly beneficial in the prevention of new disease cases while increasing or maintaining the performance of the pigs.

Herd factors associated with the seroprevalences of Actinobacillus pleuropneumoniae serovars 2, 3 and 9 in slaughter pigs from farrow-to-finish pig herds

This cross-sectional epidemiologic study was conducted in 150 randomly selected farrow-to-finish pig herds to investigate descriptive epidemiological characteristics of infections with three different serovars of Actinobacillus pleuropneumoniae, and to identify risk factors for the within-herd seroprevalences of these serovars. Different farm characteristics (n = 28) were examined as potential risk factors for the percentage of pigs with antibodies against serovars 2, 3 and 9. The presence of antibodies was measured using an indirect ELISA. Logistic regression analyses were used to assess the associations between the potential risk factors and the proportion of seropositive pigs. The median within-herd seroprevalences were 95% (range: 0-100%), 100% (range: 10-100%), and 35% (range: 0-100%) for serovars 2, 3, and 9, respectively. There was a positive association (P < 0.001) between each of these serovars. The within-herd seroprevalence of serovar 2 was significantly higher in farms that purchased gilts from > or = 2 origin herds (OR = 2.33; P < 0.05) and in farms with poor biosecurity measures (OR = 4.62; P < 0.05). The proportion of pigs seropositive for serovar 3 was significantly higher when tested pigs were slaughtered in May-August and in November-December (OR = 5.96; P < 0.001), in herds without a growing unit (OR = 2.63; P < 0.01), and in herds with a direct air-entry into the finishing unit (OR = 1.92; P < 0.05). The within-herd seroprevalence of serovar 9 increased significantly in herds with poor biosecurity measures (OR = 1.76; P < 0.05). The study documented that infections with A. pleuropneumoniae serovars 2, 3, and 9 were very common in the selected herds, and that the sero-epidemiological characteristics and risk factors showed some variation depending on the serovar. The purchase policy of gilts and biosecurity measures are risk factors that can be improved fairly easily on pig farms.

Non-infectious factors associated with macroscopic and microscopic lung lesions in slaughter pigs from farrow-to-finish herds

A cross-sectional epidemiological study was conducted in 150 randomly selected farrow-to-finish herds to investigate which non-infectious factors might act as risk indicators for the prevalence and severity of macroscopic and microscopic lung lesions in slaughter pigs. Data were collected during herd visits through inspections of the pigs and through interviews with the farmers. Macroscopic lung lesions of pneumonia and pleuritis were recorded at slaughter from 25 pigs per herd, and microscopic lung lesions of lymphohistiocytic infiltration were recorded from 10 pigs per herd. The median herd level prevalences were 24 per cent for pneumonia, 16 per cent for pleuritis and 60 per cent for lymphohistiocytic infiltration. Pneumonia lesions were negatively associated with pleuritis lesions and positively associated with lymphohistiocytic infiltration. Pleuritis lesions were negatively associated with lymphohistiocytic infiltration. The prevalence and the severity of pneumonia lesions were increased by a high frequency of purchasing gilts and by a slaughter date in January to February. The presence of a growing unit also increased the severity of pneumonia. The prevalence and the severity of pleuritis lesions were higher when there were more pig herds in the municipality, and when there were poor biosecurity measures, and their prevalence was increased by a slaughter date in January to February, and their severity by a slaughter date in March to April. An increase in the airspace stocking density in the finishing unit also increased the prevalence of pleuritis. The prevalence and the severity of lymphohistiocytic infiltration in the lung tissue were higher in herds purchasing gilts. Pigs raised in pens with slatted floors were also at higher risk of more severe lesions of lymphohistiocytic infiltration.

Herd factors associated with the seroprevalences of four major respiratory pathogens in slaughter pigs from farrow-to-finish pig herds

The objective of this study was to investigate sero-epidemiological aspects of Mycoplasma hyopneumoniae (Mh), influenza H1N1 and H3N2 viruses and Aujeszky disease virus (ADV) in fattening pigs from 150 randomly selected farrow-to-finish pig herds. Different herd factors were examined as potential risk indicators for the percentage of pigs with antibodies against the 4 pathogens. The median within-herd seroprevalences of the pathogens were: Mh 76%, H1N1 100%, H3N2 40% and ADV 53%. There was a positive association between the seroprevalences of both influenza viruses, and a negative association between the seroprevalences of ADV and H1N1. The percentage of pigs seropositive for Mh increased with the purchase of gilts and with the season (slaughter date in March-April). The within-herd seroprevalences of both influenza viruses were higher in the case of a higher density of pig herds in the municipality. A higher number of fattening pigs per pen additionally increased the risk of being seropositive for H3N2. The percentage of pigs with anti-gE-antibodies against the wild type ADV increased with higher airspace stocking density in the finishing unit, increasing herd size, increasing number of pig herds in the municipality and slaughter date in March-April. Increased seroprevalences for these 4 respiratory pathogens were mostly associated with pig density in the herd and its vicinity, the winter period, and with the purchase of gilts. Purchase of gilts, number of fattening pigs per pen and airspace stocking density are risk factors that can be managed directly by farmers striving to attain a high respiratory health status of pigs.

Risk indicators for the seroprevalence of Mycoplasma hyopneumoniae, porcine influenza viruses and Aujeszky's disease virus in slaughter pigs from fattening pig herds

Epidemiological aspects of Mycoplasma hyopneumoniae (Mh), influenza H1N1 and H3N2 viruses, and Aujeszky's disease virus (ADV) were investigated in slaughter pigs from 50 fattening pig herds. Herd factors as potential risk indicators for respiratory disease were obtained by means of a questionnaire. At slaughter, blood samples were collected from each herd, and the proportion of seropositive pigs per herd was assessed for each of these pathogens. The median herd-level seroprevalence of the agents were: Mh 88%, H1N1 100%, H3N2 60% and ADV 90%. The percentage of herds in which all investigated fattening pigs were seronegative for these agents was: Mh 0%, H1N1 0%, H3N2 12% and ADV 18%. The percentage of herds in which all investigated fattening pigs were seropositive for these agents was: Mh 8%, H1N1 71%, H3N2 22% and ADV 40%. A positive association was found between influenza H1N1 and H3N2 viruses, and a negative association between influenza H3N2 virus and ADV. There were no risk indicators for the seroprevalence of Mh. Three risk indicators were associated with the seroprevalence of influenza H1N1 virus: a fully slatted floor, an increasing number of pigs in the municipality and dry feeding. Three risk indicators were found for the seroprevalence of influenza H3N2 virus: purchase of pigs from > or = two herds, an increasing number of pigs in the municipality and natural ventilation. The seroprevalence of ADV was influenced by two risk indicators: an increasing number of pig herds in the municipality and an increasing number of pigs per pen.

Effect of vaccination against Mycoplasma hyopneumoniae in pig herds with an all-in/all-out production system

A multi-site field study was conducted to evaluate an inactivated Mycoplasma hyopneumoniae (Mh) vaccine in 14 pig herds infected by Mh and practising an all-in/all-out production system. In each herd, a vaccinated and control group of 250 pigs each were compared during the growing/finishing period with respect to performance parameters (major variables) and by means of clinical, serological and pathological parameters (ancillary variables). Mh vaccination significantly (P < 0.05) improved daily weight gain (+22 g), feed conversion ratio (-0.07), medication costs (-0.476 ECU/pig) (1 ECU = US$1.0269542), prevalence of pneumonia lesions (-14%) and severity of pneumonia lesions (-3%). Mortality rate, severity of coughing and carcass quality were not significantly influenced by Mh vaccination. Serological results of Mh and other respiratory pathogens are presented and discussed. A cost-benefit analysis based on significantly improved performance parameters demonstrated that Mh vaccination was economically attractive as it resulted in an increase of the net return to labour with 1.300 ECU per finishing pig sold. The sensitivity of the economic benefit was illustrated towards fluctuations in pig finishing prices.

The effect of vaccination against Mycoplasma hypopneumoniae in pig herds with a continuous production system

An inactivated Mycoplasma hyopneumoniae vaccine was evaluated in five pig herds clinically infected with enzootic pneumonia and practising a continuous production system in the growing/finishing unit. In each herd, a vaccinated and control group of approximately 47 pigs each were individually monitored from birth until slaughter. Vaccinated pigs received the first dose at about 1 week of age and the second approximately 3 weeks later. During all production stages, an equal number of vaccinated and control pigs was present in the same pen. Both groups were compared with respect to zootechnical parameters (major variables) and by means of serological, pathological, and bacteriological parameters (ancillary variables). Daily weight gain was improved by 14 gr/day during the period from 8 days of age until slaughter (P = 0.0486) and by 25 gr/day during the growing/finishing period (P = 0.0067). Mortality rate, and the costs for curative medication were not significantly improved by vaccination. The results of the ancillary variables are presented and discussed.

Enzootic pneumonia in pigs

This article reviews current knowledge concerning enzootic pneumonia. Enzootic pneumonia, caused by Mycoplasma hyopneumoniae and exacerbated by secondary invaders, occurs worldwide and has been known for many years. The organism, with its typical characteristics, invades the respiratory tract in several successive steps. Clinical symptoms and lesion development are the result of the pathogenic capacity of Mycoplasma hyopneumoniae and the defence reactions in the lung. The economic relevance of pneumonia is influenced to a large extent by common secondary infections which follow an initial M. hyopneumoniae infection. Different tests for the diagnosis of pneumonia in individual pigs and in groups are available. Treatment and control is not simple since enzootic pneumonia is a multi-factorial disease. Some epidemiological aspects and the most important measures for prevention of the disease are described.

Influence of the oestrous cycle on experimental intrauterine E. coli infection in the sow

The influence of the oestrous cycle on the onset of endometritis in the sow was studied. Ten pubertal, unmated gilts of the Belgian Negative Landrace were used. Nine gilts were inoculated into the uterus by laparotomy with a suspension of an E. coli strain isolated from the uterus of a discharging sow from a herd having many problems with vaginal discharge and a lowered fertility. One gilt was as a control inoculated with 2 ml of a PBS-solution. All sows inoculated during dioestrus developed clinical symptoms, but only 1 of the 5 gilts inoculated at standing oestrus developed a vaginal discharge. These data confirm the hypothesis that the stage of the oestrous cycle has an important influence on the onset of endometritis. The resistance to E. coli infections was higher when the gilts were inoculated during oestrus.

25 years of a unique chromosome-breakage system. I. Principal features and comparison to other systems

The principal features of the D. robusta chromosome-breakage system are reviewed and compared to intrinsic chromosome-breakage systems in other Drosophila species, particularly the 'hybrid dysgenesis' systems of D. melanogaster. The data indicate that the D. robusta system is unique in many respects, especially in its combination of a reciprocal cross effect, traceable to its maternal or cytoplasmic inheritance, exclusive susceptibility of the paternal chromosomes, and the randomness of the breaks on the chromosomes.