Efficacy of vitamin D2 in maintaining serum total vitamin D concentrations and bone mineralisation in adult dogs fed a plant-based (vegan) diet in a 3-month randomised trial

Dogs are considered omnivores based on their evolution consuming diets including animal tissue. Few feeding trials evaluating the nutritional suitability of exclusively plant-based (vegan) diets in dogs have been published, and the efficacy of vitamin D2 in maintaining canine serum vitamin D levels has not been clearly determined. A blinded dietary trial included sixty-one healthy desexed adult dogs: thirty-one fed an experimental extruded vegan diet (PLANT) and thirty fed a commercial extruded meat-based diet (MEAT) for 3 months. Dogs were screened via veterinary examination and routine laboratory analyses prior to enrolment, at baseline and exit timepoints. Body composition was measured by dual-energy X-ray absorptiometry and blood was collected for vitamin D profiling. All dogs maintained health parameters, body weight and composition throughout the study. Dogs maintained on PLANT demonstrated a significant reduction in platelet count, creatinine, blood urea nitrogen and cholesterol, though values remained within normal reference ranges. Dogs fed PLANT also demonstrated a shift from vitamin D3 to vitamin D2 metabolites, though total vitamin D analogue levels were unchanged, with the exception of 24,25-dihydroxyvitamin D. Bone mineral content and density did not differ from baseline values. Health status was maintained in dogs fed PLANT and vitamin D2 appeared efficacious in maintaining serum total vitamin D concentrations and bone mineralisation. Findings support the hypothesis that PLANT was comparable to MEAT for maintenance of healthy adult dogs for at least 3 months and identified areas where further research is warranted to elucidate the potential risks and benefits of plant-based (vegan) diets.

Vaccine efficacy against SARS-CoV-2 for Pfizer BioNTech, Moderna, and AstraZeneca vaccines: a systematic review

The purpose of this systematic review was to report on the vaccine efficacy (VE) of three SARS-CoV-2 vaccines approved by Health Canada: Pfizer BioNTech, Moderna, and AstraZeneca. Four databases were searched for primary publications on population-level VE. Ninety-two publications matched the inclusion criteria, and the extracted data were separated by vaccine type: mRNA vaccines (Pfizer and Moderna) and the AstraZeneca vaccine. The median VE for PCR-positive patients and various levels of clinical disease was determined for the first and second doses of both vaccine types against multiple SARS-CoV-2 variants. The median VE for PCR-positive infections against unidentified variants from an mRNA vaccine was 64.5 and 89%, respectively, after one or two doses. The median VE for PCR-positive infections against unidentified variants from the AstraZeneca vaccine was 53.4 and 69.6%, respectively, after one or two doses. The median VE for two doses of mRNA for asymptomatic, symptomatic, and severe infection against unidentified variants was 85.5, 93.2, and 92.2%, respectively. The median VE for two doses of AstraZeneca for asymptomatic, symptomatic, and severe infection against unidentified variants was 69.7, 71, and 90.2%, respectively. Vaccine efficacy numerically increased from the first to the second dose, increased from the first 2 weeks to the second 2 weeks post-vaccination for both doses, but decreased after 4 months from the second dose. Vaccine efficacy did not differ by person's age.

Owner perception of health of North American dogs fed meat- or plant-based diets

BACKGROUND

Some dog owners elect to feed their dog a plant-based food either as part of or for their entire dietary intake. Being omnivores or facultative carnivores, a strictly plant-based diet is not the natural type of food dogs evolved to consume, leaving some question as to whether this feeding management strategy is safe and healthy for dogs.

OBJECTIVES

This study surveyed owner perceptions of health and wellbeing of dogs and compared between those fed meat-based and plant-based diets.

METHODS

A web-based questionnaire was distributed to pet owners to collect data on dog characteristics, husbandry, health and wellbeing. Univariate comparisons between diet groups was made by chi square analyses or Kaplan-Meier tests as appropriate, with a significance cut-off value of 0.05. Multivariate models were negative binomial and logistic regression for count and categorical data, respectively.

RESULTS

Owners feeding plant-based diets to their dog reported fewer health disorders, specifically with respect to ocular or gastrointestinal and hepatic disorders. Dog longevity was reported to be greater for dogs fed plant-based diets. Owners feeding plant-based diets to their dogs relied less on veterinary associates for nutrition information, versus dog owners feeding meat-based diets.

CONCLUSIONS

Dog owners feeding a plant-based diet did not perceive adverse health effects in their dogs. The results might suggest an association between feeding a plant-based diet and perceived health and longevity, however inherent bias and limitations associated with surveys of owner perception must be considered, and objective research is required to determine if plant-based diets truly affect canine health.

Sociodemographic factors associated with knowledge of type 2 diabetes in rural Tamil Nadu, India

INTRODUCTION

This study aimed to investigate awareness of type 2 diabetes and how sociodemographic factors influence diabetes knowledge in a rural population of Tamil Nadu, India. Previous research has identified poor awareness of diabetes in several low and middle-income countries, which can lead to a high prevalence of undiagnosed diabetes. India having the second highest prevalence of diabetes globally, it is increasingly important to assess how diabetes can be addressed in rural Indian populations.

METHODS

Systematic random sampling was used to gather study participants in 17 villages within the Krishnagiri district of Tamil Nadu, India. Data on diabetes knowledge was collected using a validated questionnaire. Knowledge score range was 0-8; a score of zero was designated as 'low knowledge', scores 1-4 as 'moderate knowledge', and scores 5-8 as 'good knowledge'. Associations between sociodemographic factors and composite diabetes knowledge score were assessed using a multinomial logistic GLLAMM model in Stata.

RESULTS

A total of 753 individuals participated in the study. The average age of participants was 47 years and 55% were women. Overall awareness of diabetes was low, with 66% of individuals having no knowledge of diabetes. Only 16% and 17% achieved a moderate and a good knowledge score, respectively. Achieving a moderate knowledge score was significantly positively associated with education, wealth, participation in the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), and business ownership as a source of income. Achieving a good knowledge score was significantly positively associated with education, wealth, rurality, participation in MGNREGA, business ownership as a source of income, and frequency of healthcare utilization. Rurality was significantly negatively associated (relative risk ratio (95% confidence interval)) with both moderate knowledge score (0.34 (0.19-0.59)), and good knowledge score (0.43 (0.24-0.74)). The strongest predictor of having a good knowledge score was having a high-school graduate or post-secondary education (11.07 (4.44-27.61)). Enrolment in MGNREGA employment was the strongest predictor for having a moderate knowledge score (3.27 (1.93-5.54)), as well as strongly associated with having a good knowledge score (2.39 (1.31-4.36)).

CONCLUSION

The low awareness of diabetes among participants of this study raises serious concerns for public health in India. Public health efforts must prioritize health equity to lessen the impacts of diabetes in rural populations, where individuals face systemic barriers to receiving prevention and treatment for conditions such as diabetes.

Experiences of wellbeing and resilience among refugee mothers and families in Calgary during the COVID-19 pandemic, and the role of participation in HIPPY, a home visiting program

<abstract> <p>In order to provide meaningful and effective support to refugees in Canada during the COVID-19 pandemic, as well as during post-pandemic recovery efforts, it is critical to explore the experiences of refugee mothers and families during the pandemic, and to identify sources of resilience that can be leveraged to promote individual and household wellbeing. From November 2020 to June 2021, we conducted in-depth interviews with mothers from refugee backgrounds (n = 28) who resettled in Calgary, Alberta and are currently participating in the Multicultural Home Instruction for Parents of Preschool Youngsters (HIPPY) program. Interviews were conducted virtually using Microsoft Teams; we sought to better understand the pathways and barriers to wellbeing experienced by refugee mothers during the pandemic. The results indicate that the refugee mothers and families in our study experienced widespread disruptions to education and employment and increased motherhood burden, contributing to diminished wellbeing. Mental health was further impacted by heightened levels of worry, stress and social isolation, as well as intense fear pertaining to the spread of SARS-CoV-2. Some mothers reported experiencing barriers to accessing healthcare services and reliable health information during the pandemic. In the face of these challenges, the mothers demonstrated great resilience and identified tangible individual, household and extra-household factors and resources that supported them in coping with the impact of the COVID-19 pandemic. Additionally, our findings suggest that participation in HIPPY played a significant role in fostering the resilience of the participating mothers and families during the pandemic, speaking to the potential of home visiting intervention models in mitigating household hardship during current and future public health crises.</p> </abstract>

A cross-sectional study of owner-reported health in Canadian and American cats fed meat- and plant-based diets

Background

Cats, being obligate carnivores, have unique dietary requirements for nutrients most commonly found in dietary ingredients of animal origin. As such, feeding a diet devoid of animal-derived ingredients has been postulated as a possible cause of nutrient imbalances and adverse health outcomes. A small proportion of cat owners feed strictly plant-based diets to the cats in their care, yet the health and wellness of cats fed these diets has not been well documented.

Results

A total of 1325 questionnaires were complete enough for inclusion. The only exclusion criterion was failure to answer all questions. Most cats, 65% (667/1026), represented in the survey were fed a meat-based diet and 18.2% (187/1026) were fed a plant-based diet, with the rest fed either a combination of plant-based with meat-based (69/1026, 6.7%) or indeterminable (103/1026, 10%). Cat age ranged from 4 months to 23 years, with a median of 7 years, and was not associated with diet type. No differences in reported lifespan were detected between diet types. Fewer cats fed plant-based diets reported to have gastrointestinal and hepatic disorders. Cats fed plant-based diets were reported to have more ideal body condition scores than cats fed a meat-based diet. More owners of cats fed plant-based diets reported their cat to be in very good health.

Conclusions

Cat owner perception of the health and wellness of cats does not appear to be adversely affected by being fed a plant-based diet. Contrary to expectations, owners perceived no body system or disorder to be at particular risk when feeding a plant-based diet to cats. This study collected information from cat owners and is subject to bias, as well as methodological limitations. Further research is warranted to determine if these results are replicable in a prospective investigation.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12917-021-02754-8.

Rehabilitation Teachers and Orientation & Mobility Instructors: Interprofessional Perceptions

This article reports the findings of a nationwide survey of rehabilitation teachers and orientation and mobility instructors, designed to identify their interprofessional perceptions. The Interprofessional Perceptions Scale (IPS) was used to determine perceptions relating to the general areas of mutual respect, relative roles, professional competence, and professional status. Subjects in each group reported a generally positive attitude toward the other group of professionals. However, issues relating to professional role and professional status appear to cause some difficulty between the groups. Suggestions for increasing teamwork efficiency are presented.

Medical infrared thermal imaging of syringomyelia in the Cavalier King Charles Spaniel

Background

Medical infrared thermal imaging (MITI) is a non-invasive imaging modality gaining popularity in the veterinary field. An infrared camera captures emission of heat and creates a color map in the form of a thermogram. Topical heat emission is influenced by localized disease processes as a result of autonomic nervous system imbalance. The purpose of this study was to determine the utility of using thermography to identify changes in thermographic patterns associated with syringomyelia (SM) presence or absence in Cavalier King Charles Spaniels (CKCS) with Chiari-like Malformation (CLM).

Results

In CKCS with CLM, MITI was most accurate at a texture distance of 6. Optimizing imaging feature sets produced a highest accuracy of 69.9% (95% CI: 59.5–79.0%), with 81.3% sensitivity and 57.8% specificity for identifying the presence of syringomyelia.

Conclusion

Thermographic image analysis is a successful non-invasive, diagnostic test that can be used to screen for syringomyelia presence in a CKCS with CLM.

Socio-demographic patterning of the individual-level double burden of malnutrition in a rural population in South India: a cross-sectional study

BACKGROUND

The double burden of malnutrition is the co-occurrence of undernutrition (e.g. underweight, stunting, and micronutrient deficiencies) and over-nutrition (e.g. obesity, type 2 diabetes, and cardiovascular disease) at the population, household, or individual level. The objectives of this study were to determine the extent and determinants of individual-level co-morbid anemia and overweight and co-morbid anemia and diabetes in a population in rural Tamil Nadu, South India.

METHODS

We undertook a cross-sectional study of adults (n = 753) in a rural region of Tamil Nadu, South India. A survey assessed socio-demographic factors, physical activity levels, and dietary intake. Clinical measurements included body-mass index, an oral glucose tolerance test, and blood hemoglobin assessments. Multivariable logistic regression analyses were used to determine associations between risk factors and two co-morbid double burden pairings: (1) anemia and overweight, and (2) anemia and diabetes.

RESULTS

Prevalence of co-morbid anemia and overweight was 23.1% among women and 13.1% among men. Prevalence of co-morbid anemia and diabetes was 6.2% among women and 6.3% among men. The following variables were associated with co-morbid anemia and overweight in multivariable models [odds ratio (95% confidence interval)]: female sex [2.3 (1.4, 3.85)], high caste [3.2 (1.34, 7.49)], wealth index [1.1 (1.00, 1.12)], rurality (0.7 [0.56, 0.85]), tobacco consumption [0.6 (0.32, 0.96)], livestock ownership [0.5 (0.29, 0.89)], and energy-adjusted meat intake [1.8 (0.61, 0.94)]. The following variables were associated with co-morbid anemia and diabetes in multivariable models: age [1.1 (1.05, 1.11)], rurality [0.8 (0.57, 0.98)], and family history of diabetes [4.9 (1.86, 12.70).

CONCLUSION

This study determined the prevalence and factors associated with individual-level double burden of malnutrition. Women in rural regions of India may be particularly vulnerable to individual-level double burden of malnutrition and should be a target population for any nutrition interventions to address simultaneous over- and undernutrition.

A descriptive study of on-farm biosecurity and management practices during the incursion of porcine epidemic diarrhea into Canadian swine herds, 2014

Porcine epidemic diarrhea virus (PEDV) emerged into Canada in January 2014, primarily affecting sow herds. Subsequent epidemiological analyses suggested contaminated feed was the most likely transmission pathway. The primary objective of this study was to describe general biosecurity and management practices implemented in PEDV-positive sow herds and matched control herds at the time the virus emerged. The secondary objective was to determine if any of these general biosecurity and farm management practices were important in explaining PEDV infection status from January 22, 2014 to March 1, 2014. A case herd was defined as a swine herd with clinical signs and a positive test result for PEDV. A questionnaire was used to a gather 30-day history of herd management practices, animal movements on/off site, feed management practices, semen deliveries and biosecurity practices for case (n = 8) and control (n = 12) herds, primarily located in Ontario. Data was analyzed using descriptive statistics and random forests (RFs). Case herds were larger in size than control herds. Case herds had more animal movements and non-staff movements onto the site. Also, case herds had higher quantities of pigs delivered, feed deliveries and semen deliveries on-site. The biosecurity practices of case herds were considered more rigorous based on herd management, feed deliveries, transportation and truck driver practices than control herds. The RF model found that the most important variables for predicting herd status were related to herd size and feed management variables. Nonetheless, predictive accuracy of the final RF model was 72%.

Medical infrared thermal imaging of canine appendicular bone neoplasia

Background

Medical infrared thermal imaging (MITI) is a noninvasive imaging modality used in veterinary medicine as a screening tool for musculoskeletal and neurological disease processes. An infrared camera measures the surface body heat and produces a color map that represents the heat distribution. Local trauma or disease can impair the autonomic nervous system, which leads to changes in the local dermal microcirculation and subsequent alteration of surface body heat. Disruption of autonomic flow to the cutaneous vasculature at deeper levels can also result in asymmetric thermographic results. The purpose of this study was to evaluate surface temperature differences between limbs affected by bone neoplasia and their normal contralateral limbs.

Results

A statistically significant difference in average temperature was noted between regions of interest of the two groups (paired difference: 0.53 C° ± 0.14; P = 0.0005). In addition, pattern recognition analysis yielded a 75–100% success rate in lesion identification.

Conclusions

Significant alterations noted with average temperature and thermographic patterns indicate that MITI can document discernible changes associated with the presence of canine appendicular bone tumors. While MITI cannot be used as the sole diagnostic tool for bone cancer, it can be used as a screening modality and may be applicable in early detection of cancer.

Impact of legislation on youth indoor tanning behaviour: A systematic review

Jurisdictions around the world have implemented indoor tanning legislations, which aim to protect all individuals, especially youth, from dangers of artificial ultraviolet radiation exposure. The objective of this study was to conduct a systematic review to synthesize the available peer-reviewed literature to determine whether indoor tanning legislation has impacted the prevalence of youth indoor tanning. Following PRISMA guidelines, six databases were searched in 2016. Reference lists from relevant articles were also searched. An updated literature search was conducted in 2018. Each article was critically appraised using a merged checklist created from two previously validated checklists. All articles meeting the inclusion criteria were retained after appraisal. Seven studies, all conducted in the U.S., met the inclusion criteria. All studies used an observational, cross-sectional design. There were small absolute decreases in youth indoor tanning prevalence after legislation vs before (n = 3, mean = 3% decrease, range = 1%-6% decrease). Prevalence of youth indoor tanning was significantly lower in states with indoor tanning legislation vs states without legislation (n = 4, mean = 5% lower, range = 1%-18% lower). Prevalence of youth indoor tanning was lower in states with longer standing indoor tanning legislation vs states with more recently implemented legislation (n = 2, mean = 9% lower, range = 2%-20% lower). Indoor tanning legislation is generally associated with lower indoor tanning prevalence among youth. The small percent differences equate to millions of youth at the population level. Longer time lapses from legislation implementation to evaluation, coupled with greater enforcement, compliance, legislative stringency, and public education may result in even more pronounced declines in youth indoor tanning prevalence.

Factors Associated With Time to Elimination of Porcine Epidemic Diarrhea Virus in Individual Ontario Swine Herds Based on Surveillance Data

Porcine epidemic diarrhea virus (PEDV) emerged into Canada in January of 2014. The virus was considered to be of high importance and the number of new cases were tracked using different mechanisms by stakeholders such as veterinary services from the provincial government and the swine industry. In addition to the initial date of infection, veterinary organizations in the swine industry maintained a disease control program (DCP) database that contained the date of declaration of freedom from PEDV in individual herds. Such data allowed for the determination of the duration of PEDV infection in individual herds based on herd type, year and season of diagnosis. Therefore, the objective of this study was to determine time to PEDV elimination in Ontario swine herds infected between 2014 and 2017, on the basis of records from the DCP database; and to identify factors associated with the likelihood of elimination. Duration of time to eliminate PEDV was estimated using Kaplan-Meier survival curves. The final Cox's proportional hazard model included herd type, season and year of diagnosis. The hazard of PEDV elimination for premises that were farrow-to-wean was 3.36 times larger (P-value: 0.044, 95% CI: 1.03, 10.93) than for farrow-to-feeder herds. Herds diagnosed in the summer and fall had hazard ratios of 1.40 (P-value: 0.044, 95% CI: 1.03, 10.93) and 7.32 (P-value: <0.001, 95% CI: 3.12, 17.18), respectively compared to herds diagnosed in the winter months. The hazard ratio for herds diagnosed in 2015 was 0.54 (P-value: 0.015, 95% CI: 0.33, 0.89) compared to herds diagnosed in 2014. Factors associated with time to elimination are likely reflective of the complexity of infection control practices applied in herds with different demographics and population structures, seasonal variability in the pathogen transmissibility, and the availability of resources to manage an emerging production-limiting disease. The median times to elimination were relatively long, which could be due to how it was measured, decisions made at the level of individual herds or delays related to reporting PEDV elimination. Design of control measures for production-limiting diseases at the regional level should take these factors into consideration.

A systematic review of compliance with indoor tanning legislation

BACKGROUND

Many jurisdictions have enacted indoor tanning legislation in response to the health risks of artificial ultraviolet (UV) radiation exposure. Key components of these legislations include banning minors' access, requiring parental consent or accompaniment, providing protective eyewear, posting health warning signs, and communicating important health risk information. However, legislation must be complied with to be impactful. Evidence around compliance with indoor tanning legislations has not been synthesized and is an important step toward determining changes in practice due to legislation.

METHODS

A systematic review was conducted to obtain peer-reviewed literature about compliance with indoor tanning legislation worldwide. Six databases were searched, resulting in 12,398 citations. Sixteen studies met the inclusion criteria (peer-reviewed scientific studies, published in English, focused primarily on compliance with indoor tanning legislations, and focused on commercial indoor tanning in indoor tanning facilities).

RESULTS

Compliance with most aspects of indoor tanning legislation varied widely. There was good compliance for provision of protective eyewear (84 to 100%; mean = 92%; SD = 8). Compliance with age restrictions ranged from 0 to 100% (mean = 65%; SD = 25), while compliance with posting warning labels in the required locations within a tanning facility ranged from 8 to 72% (mean = 44%; SD = 27). Variation in compliance may be due to true differences, study methodology, or temporal trends.

CONCLUSIONS

Variability in compliance with indoor tanning legislation, as found in this systematic review, indicates the legislations may not be having their intended protective effects on the public's health. The reasons for such low and varied compliance with certain aspects of legislation, and high compliance with other aspects of legislation, deserve further attention in future research to inform best practices around ensuring high and consistent compliance with indoor tanning legislations worldwide.

An epidemiological investigation of the early phase of the porcine epidemic diarrhea (PED) outbreak in Canadian swine herds in 2014: A case-control study

The first case of porcine epidemic diarrhea (PED) in Canada was diagnosed in January 2014 in Ontario, approximately 9 months after PED emerged in the United States. An early investigation of the Canadian outbreak suspected that the probable source of the virus was contaminated feed. The objective of this study was to evaluate the role of feed and other possible factors in the early phase of the PED outbreak in Canadian swine herds. The study period of interest for this case-control study was January 22nd to March 1st, 2014. A case herd was defined as a swine herd with a confirmed positive laboratory diagnostic test (RT-PCR) results for PED virus, along with pigs exhibiting typical clinical signs at the herd level during the study period. A questionnaire was administered to participating producers from the 22 Canadian swine herds enrolled (n = 9 case and n = 13 control herds). Case herd producers were asked to provide information from the initial day of onset of clinical signs and 30 days prior to that day. Control herds were matched to a case herd on the basis of province, herd type and approximate size. The period of interest for a control herd was matched to the initial day of clinical signs of PED for the case herd, along with the 30 days prior to this day. The questionnaire questions focused on herd demographics, biosecurity protocols, live animal movements onto and off sites, deadstock movements, feed and people movements for both the case and control herds. The questionnaire for control herds were based on their matched case's period of interest, and together with case herds formed a matched stratum. Multivariable exact conditional logistic regression and mixed multivariable logistic regression models, with the matched stratum as a random effect, were used to assess the association between various risk factors and the odds of PED introduction into a herd. After adjusting for biosecurity practices, the odds of a PED occurrence was 38.1 (95% CI: 2.7-531.3) times greater for herds receiving feed from a single feed company that provided potentially contaminated feed (P = 0.007) than herds that did not. The number of live pigs delivered onto sites, semen deliveries and the frequency of deadstock pickups were not associated with PED status during the initial phase of the outbreak in univariable analyses. This study supports the role of potentially contaminated feed from a single feed company as a significant risk factor for PED viral introduction during the early phase of the Canadian outbreak.

Determinants of internal migrant health and the healthy migrant effect in South India: a mixed methods study

Background

Internal labour migration is an important and necessary livelihood strategy for millions of individuals and households in India. However, the precarious position of migrant workers within Indian society may have consequences for the health of these individuals. Previous research on the connections between health and labour mobility within India have primarily focused on the negative health outcomes associated with this practice. Thus, there is a need to better identify the determinants of internal migrant health and how these determinants shape migrant health outcomes.

Methods

An exploratory mixed methods study was conducted in 26 villages in the Krishnagiri district of Tamil Nadu. Sixty-six semi-structured interviews were completed using snowball sampling, followed by 300 household surveys using multi-stage random sampling. For qualitative data, an analysis of themes and content was completed. For quantitative data, information on current participation in internal labour migration, in addition to self-reported morbidity and determinants of internal migrant health, was collected. Morbidity categories were compared between migrant and non-migrant adults (age 14–65 years) using a Fisher’s exact test.

Results

Of the 300 households surveyed, 137 households (45.7%) had at least one current migrant member, with 205 migrant and 1012 non-migrant adults (age 14–65 years) included in this study.

The health profile of migrant and non-migrants was similar in this setting, with 53 migrants (25.9%) currently suffering from a health problem compared to 273 non-migrants (27.0%). Migrant households identified both occupational and livelihood factors that contributed to changes in the health of their migrant members. These determinants of internal migrant health were corroborated and further expanded on through the semi-structured interviews.

Conclusions

Internal labour migration in and of itself is not a determinant of health, as participation in labour mobility can contribute to an improvement in health, a decline in health, or no change in health among migrant workers. Targeted public health interventions should focus on addressing the determinants of internal migrant health to enhance the contributions these individuals can make to their households and villages of origin.

Perioperative analgesic use by Ontario veterinarians, 2012

The objectives of this study were to describe the routine use of analgesics by Ontario veterinarians for common surgeries in dogs and cats, and to compare routine use of analgesics between species and surgeries, using Chi-square analyses. In total, 239 veterinarians responded to the questionnaires; a response rate of 13.1%. Fifty-two percent to 79% of veterinarians used meloxicam for both species and all surgeries. Approximately 9% of veterinarians did not use analgesics for dog ovariohysterectomy and castration, while 16% to 22% did not use analgesics for these surgeries in cats. Veterinarians used and dispensed analgesics to dogs more often than to cats (P < 0.05). Many (60% or more) veterinarians administered analgesics pre-emptively to both dogs and cats for all surgeries. Continuing education for veterinarians needs to focus on understanding of pre-emptive analgesia, preventive analgesia, and the importance of dispensing analgesic drugs after surgery for all surgeries.

The internal migration-development nexus: Evidence from southern India

This study examines the extent to which the internal migration-development nexus is operational in four panchayats or village councils in northwest Tamil Nadu. We investigate who participates in labor migration in this context and explore the experiences of and outcomes from labor migration for migrant workers and their households. In addition, we examine the motivations for migration among migrant households and the barriers to migration among non-migrant households. We argue that internal labor migration can contribute to development in this setting. However, recognition of the barriers to and within migration is needed to frame subsequent policy discussions and rural development planning.

Survey of Ontario veterinarians' knowledge and attitudes on pain in dogs and cats in 2012

Appropriate management of animal pain is a critical component of optimal animal welfare in small animal veterinary clinics. An online convenience survey was used to examine the knowledge and attitudes of practicing veterinarians in Ontario about pain in dogs (n = 100) and cats (n = 139). Veterinarian participants showed strong agreement with the need for appropriate animal pain relief, and low agreement with lack of analgesic use due to cost or side effects. All of the surgical procedures included in the survey were ranked as being moderately to highly painful, but female veterinarians had higher median rankings. Importantly, 78% of veterinarians thought their knowledge about pain recognition was sufficient. Selection bias might have resulted in overestimates of attitudes about pain in comparison to the general veterinary population. However, these results suggest that knowledge and attitudes related to pain assessment and treatment in dogs and cats have improved since the last similar survey in 2001.

Decoding the Type 2 Diabetes Epidemic in Rural India

Type 2 diabetes mellitus is an escalating public health problem in India, associated with genetic susceptibility, dietary shift, and rapid lifestyle changes. Historically a disease of the urban elite, quantitative studies have recently confirmed rising prevalence rates among marginalized populations in rural India. To analyze the role of cultural and sociopolitical factors in diabetes onset and management, we employed in-depth interviews and focus groups within a rural community of Tamil Nadu. The objectives of the study were to understand sources and extent of health knowledge, diabetes explanatory models, and the impact of illness on individual, social, and familial roles. Several cultural, socioeconomic, and political factors appear to contribute to diabetes in rural regions of India, highlighting the need to address structural inequities and empower individuals to pursue health and well-being on their own terms.

Factors associated with glucose tolerance, pre-diabetes, and type 2 diabetes in a rural community of south India: a cross-sectional study

BACKGROUND

India's national rural prevalence of type 2 diabetes has quadrupled in the past 25 years. Despite the growing rural burden, few studies have examined putative risk factors and their relationship with glucose intolerance and diabetes in rural areas. We undertook a cross-sectional study to determine the prevalence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes in a rural area of south India. In addition, we determined which factors were associated with type 2 diabetes.

METHODS

We sampled 2 % of the adult population from 17 villages using a randomized household-level sampling technique. Each participant undertook a questionnaire that included basic descriptive information and an assessment of socioeconomic status, physical activity, and dietary intake. Height, weight, waist and hip circumference, and blood pressure measurements were taken. An oral glucose tolerance test was used to determine diabetes status. We used stepwise logistic model building techniques to determine associations between several putative factors and type 2 diabetes.

RESULTS

753 participants were included in the study. The age- and sex-standardized prevalence of IFG was 3.9 %, IGT was 5.6 %, and type 2 diabetes was 10.8 %. Factors associated with type 2 diabetes after adjusting for confounders included physical activity [OR 0.81], rurality [OR 0.76], polyunsaturated fat intake [OR 0.94], body mass index [OR 1.85], waist to hip ratio [OR 1.62], and tobacco consumption [OR 2.82].

CONCLUSION

Our study contributes to the growing body of research suggesting that diabetes is a significant concern in rural south India. Associated risk factors should be considered as potential targets for reducing health burdens in India.

Factors associated with BMI, underweight, overweight, and obesity among adults in a population of rural south India: a cross-sectional study

BACKGROUND

Overweight, obesity, and related chronic diseases are becoming serious public health concerns in rural areas of India. Compounded with the existing issue of underweight, such concerns expose the double burden of disease and may put stress on rural healthcare. The purpose of this article was to present the prevalence and factors associated with underweight, overweight, and obesity in an area of rural south India.

METHODS

During 2013 and 2014, a random sample of adults aged 20-80 years were selected for participation in a cross-sectional study that collected information on diet (using a food frequency questionnaire), physical activity (using the Global Physical Activity Questionnaire), socioeconomic position (using a wealth index), rurality (using the MSU rurality index), education, and a variety of descriptive factors. BMI was measured using standard techniques. Using a multivariate linear regression analysis and multivariate logistic regression analyses, we examined associations between BMI, overweight, obesity, and underweight, and all potential risk factors included in the survey.

RESULTS

Age and sex-adjusted prevalence of overweight, obesity class I, and obesity class II were 14.9, 16.1, and 3.3 % respectively. Prevalence of underweight was 22.7 %. The following variables were associated with higher BMI and/or increased odds of overweight, obesity class I, and/or obesity class II: Low physical activity, high wealth index, no livestock, low animal fat consumption, high n-6 polyunsaturated fat consumption, television ownership, time spent watching television, low rurality index, and high caste. The following variables were associated with increased odds of underweight: low wealth index, high rurality index, and low intake of n-6 PUFAs.

CONCLUSION

Underweight, overweight, and obesity are prevalent in rural regions of southern India, indicating a village-level dual burden. A variety of variables are associated with these conditions, including physical activity, socioeconomic position, rurality, television use, and diet. To address the both underweight and obesity, policymakers must simultaneously focus on encouraging positive behaviour through education and addressing society-level risk factors that inhibit individuals from achieving optimal health.

Determinants of Primary School Non-Enrollment and Absenteeism: Results from a Retrospective, Convergent Mixed Methods, Cohort Study in Rural Western Kenya

Background

Education is a key element in the socioeconomic development required to improve quality of life in Kenya. Despite the introduction of free primary education, primary school enrollment and attendance levels remain low. Drawing on qualitative and quantitative data, this study explores the determinants of non-enrollment and absenteeism in rural western Kenya and potential mitigation strategies to address these issues.

Methods

The study was conducted in Bwaliro village in rural western Kenya. A random sample of 64 students was obtained by blocking the village primary school’s student population according to grade level, gender, and orphan status. Qualitative and quantitative data were collected through interviews with parents, guardians, and key informants, and focus group discussions with students. Quantitative data were compared using chi-square tests, Student’s T-test, and Poisson regressions. Qualitative data were analyzed using thematic content analysis.

Results

Malaria, menstruation, and lack of money were among the most notable determinants of primary school dropout and absenteeism, and these factors disproportionately impacted orphans and female students. Potential mitigation strategies suggested by the community included provision of malaria treatment or prevention, reduction in education costs, expansion of the established school-feeding program, and provision of sanitary pads.

Conclusion

Despite free primary education, numerous factors continue to prevent children in rural western Kenya from attending primary school. The findings suggest that interventions should primarily target orphaned and female students. Prior to implementation, suggested mitigation strategies should be assessed for cost-effectiveness.

Investigation of biosecurity risks associated with the feed delivery: A pilot study

This study explored potential biosecurity issues related to the delivery of feed to commercial farms. A pilot study was conducted to collect information about the day-to-day feed delivery, including biosecurity concerns at the level of the feed truck, the driver, and the farm. In addition, a reusable rubber boot was tested in an effort to increase the proportion of farms at which truck drivers wore clean footwear, and to explore an alternative to the standard plastic disposable boots that may be unsafe in winter conditions. Most farms did well in terms of proper dead-stock management and keeping the farm lane and feed bin areas clean. The provision of reusable rubber boots significantly increased the proportion of deliveries in which the driver wore clean footwear.

A systematic review and meta-analysis of the proportion of dogs surrendered for dog-related and owner-related reasons

Companion-animal relinquishment is a worldwide phenomenon that leaves companion animals homeless. Knowing why humans make the decision to end their relationship with a companion-animal can help in our understanding of this complex societal issue and can help to develop preventive strategies. A systematic review and meta-analysis was conducted to summarize reasons why dogs are surrendered, and determine if certain study characteristics were associated with the reported proportions of reasons for surrender. Articles investigating one or more reasons for dog surrender were selected from the references of a published scoping review. Two reviewers assessed the titles and abstracts of these articles, identifying 39 relevant articles. From these, 21 articles were further excluded because of ineligible study design, insufficient data available for calculating a proportion, or no data available for dogs. Data were extracted from 18 articles and meta-analysis was conducted on articles investigating reasons for dog surrender to a shelter (n=9) or dog surrender for euthanasia (n=5). Three studies were excluded from meta-analysis because they were duplicate populations. Other reasons for excluding studies from meta-analysis were, (1) the study only investigated reasons for dog re-relinquishment (n=2) and (2) the study sample size was <10 (n=1). Two articles investigated reasons for both dog surrender to a shelter and dog surrender for euthanasia. Results of meta-analysis found owner health/illness as a reason for dog surrender to a shelter had an overall estimate of 4.6% (95% CI: 4.1%, 5.2%). For all other identified reasons for surrender there was significant variation in methodology among studies preventing further meta-analysis. Univariable meta-regression was conducted to explore sources of variation among these studies. Country was identified as a significant source of variation (p<0.01) among studies reporting behavioural problems as a reason for dog surrender for euthanasia. The overall estimate for studies from Australia was 10% (95% CI: 8.0%, 12.0%; I(2)=15.5%), compared to 16% (95% CI: 15.0%, 18.0%; I(2)=20.2%) for studies from other countries. The present systematic review and meta-analysis highlights the need for further research and standardization of data collection to improve understanding of the reasons for dog relinquishment.

Association between the genetic similarity of the open reading frame 5 sequence of Porcine reproductive and respiratory syndrome virus and the similarity in clinical signs of Porcine reproductive and respiratory syndrome in Ontario swine herds

A study of Ontario swine farms positive for Porcine reproductive and respiratory syndrome virus (PRRSV) tested the association between genetic similarity of the virus and similarity of clinical signs reported by the herd owner. Herds were included if a positive result of polymerase chain reaction for PRRSV at the Animal Health Laboratory at the University of Guelph, Guelph, Ontario, was found between September 2004 and August 2007. Nucleotide-sequence similarity and clinical similarity, as determined from a telephone survey, were calculated for all pairs of herds. The Mantel test indicated that clinical similarity and sequence similarity were weakly correlated for most clinical signs. The generalized additive model indicated that virus homology with 2 vaccine viruses affected the association between sequence similarity and clinical similarity. When the data for herds with vaccine-like virus were removed from the dataset there was a significant association between virus similarity and similarity of the reported presence of abortion, stillbirth, preweaning mortality, and sow/boar mortality. Ownership similarity was also found to be associated with virus similarity and with similarity of the reported presence of sows being off-feed, nursery respiratory disease, nursery mortality, finisher respiratory disease, and finisher mortality. These results indicate that clinical signs of PRRS are associated with PRRSV genotype and that herd ownership is associated with both of these.

Association Between PRRSV ORF5 Genetic Distance and Differences in Space, Time, Ownership and Animal Sources Among Commercial Pig Herds

The objective of this study was to investigate associations between genetic distance of porcine reproductive and respiratory syndrome virus (PRRSV) detected in Ontario swine herds, and the distance between the herds with respect to space, time, ownership and animal sources. PRRSV sequence data between September 2004 and August 2007 were obtained from the Animal Health Laboratory of the University of Guelph. Geographical coordinates were obtained from the Ontario Pork marketing board, and network information about ownership and animal suppliers was obtained using a telephone interview. The matrices of sequence, spatial, temporal and network distances were generated and were analysed using the Mantel test, and using linear-mixed models with P-values based on random permutations. A total of 438 PRRSV isolates from 329 premises and 232 ownerships were originally included; 57 of the isolates were considered vaccine type. The Mantel correlation test indicated that there was positive correlation between sequence distance and geographic distance (r = 0.11, P = 0.001), as well as sequence distance and temporal distance (r = 0.03, P = 0.03), with similar results reported after adjusting for the ownership distance. Mantel correlogram suggested existence of spatial correlation up to ~30 km distance. Multivariable linear-mixed model for association between genetic distance and space-time distance was characterized by the three-way interaction among space, time and ownership (P < 0.001). It suggested that positive association between sequence similarity and spatial proximity exists in herds under different ownerships, but its magnitude is very small. In contrast, for pairs of herds under identical ownership, the spatial association was more complex. This could be a consequence of interactions within ownerships, or alternatively decisions made about sampling of herds for diagnostic purposes. Of the networks evaluated, ownership (P < 0.001) and gilt supplier (P < 0.001) showed the highest magnitude of association with genetic distance and should be investigated further for their impact on disease spread.

Biomarkers in the assessment of acute and chronic kidney diseases in the dog and cat

In both human and veterinary medicine, diagnosing and staging renal disease can be difficult. Measurement of glomerular filtration rate is considered the gold standard for assessing renal function but methods for its assessment can be technically challenging and impractical. The main parameters used to diagnose acute and chronic kidney disease include circulating creatinine and urea concentrations, and urine-specific gravity. However, these parameters can be insensitive. Therefore, there is a need for better methods to diagnose and monitor patients with renal disease. The use of renal biomarkers is increasing in human and veterinary medicine for the diagnosis and monitoring of acute and chronic kidney diseases. An ideal biomarker would identify site and severity of injury, and correlate with renal function, among other qualities. This article will review the advantages and limitations of renal biomarkers that have been used in dogs and cats, as well as some markers used in humans that may be adapted for veterinary use. In the future, measuring a combination of biomarkers will likely be a useful approach in the diagnosis of kidney disorders.

An assessment of external biosecurity on Southern Ontario swine farms and its application to surveillance on a geographic level

Risk-based surveillance is becoming increasingly important in the veterinary and public health fields. It serves as a means of increasing surveillance sensitivity and improving cost-effectiveness in an increasingly resource-limited environment. Our approach for developing a tool for the risk-based geographical surveillance of contagious diseases of swine incorporates information about animal density and external biosecurity practices within swine herds in southern Ontario. The objectives of this study were to group the sample of herds into discrete biosecurity groups, to develop a map of southern Ontario that can be used as a tool in the risk-based geographical surveillance of contagious swine diseases, and to identify significant predictors of biosecurity group membership. A subset of external biosecurity variables was selected for 2-step cluster analysis and latent class analysis (LCA). It was determined that 4 was the best number of groups to describe the data, using both analytical approaches. The authors named these groups: i) high biosecurity herds that were open with respect to replacement animals; ii) high biosecurity herds that were closed with respect to replacement animals; iii) moderate biosecurity herds; and iv) low biosecurity herds. The risk map was developed using information about the geographic distribution of herds in the biosecurity groups, as well as the density of swine sites and of grower-finisher pigs in the study region. Finally, multinomial logistic regression identified heat production units (HPUs), number of incoming pig shipments per month, and herd type as significant predictors of biosecurity group membership. It was concluded that the ability to identify areas of high and low risk for disease may improve the success of surveillance and eradication projects.

Investigation of strategies for the introduction and transportation of replacement gilts on southern Ontario sow farms

BACKGROUND

Porcine reproductive and respiratory syndrome (PRRS) is of major concern to the swine industry; infection with the virus can lead to production losses, morbidity, and mortality within swine operations. Biosecurity practices related to the management of replacement animals are important for the prevention and control of the PRRS virus, as well as other diseases. The objectives of this study were: (i) to describe individual biosecurity practices related to the introduction and transportation of replacement gilts on southern Ontario sow farms, and (ii) to understand patterns in the implementation of these practices. The second objective was accomplished using multiple correspondence analysis (MCA), which allows visualization of the relationships between individual practices and provides information about which practices frequently occur together, and which practices rarely occur together. These patterns constitute strategies for the implementation of biosecurity practices related to the introduction and transportation of replacement gilts. Data were collected using version 2 of the Production Animal Disease Risk Assessment Program's survey for the breeding herd. Two subsets of variables were retained for analysis; one subset pertained to how replacements were managed upon arrival to the farm, and the other pertained to the transportation of genetic animals.

RESULTS

For both subsets of variables, the results of the MCA procedure were similar; in both solutions the 1st dimension separated herds that were closed with respect to replacement animals from herds that were open, and the 2nd dimension described how open herds managed replacements. The most interesting finding of this study was that, in some cases where a risky practice was being implemented, it was closely associated with other biosecurity practices that may mitigate that risk.

CONCLUSIONS

The findings from this approach suggest that one cannot always examine biosecurity on a variable-by-variable basis. Even if a practice that is generally considered high-risk is being implemented, it may be balanced by other practices that mitigate that risk. Thus, the overall biosecurity strategy on a farm must be considered instead of only examining the implementation of individual practices.

Low central venous oxygen saturation is associated with increased mortality in critically ill dogs

OBJECTIVES

To investigate relationships between central venous oxygen saturation (ScvO(2)) and survival to hospital discharge in dogs. Central venous oxygen saturation is an accessible measure of the balance between systemic oxygen delivery and consumption.

METHODS

Prospective observational cohort study, enrolling 126 client-owned dogs with central venous catheters. Central venous oxygen saturation was measured over the 24 hours following intensive care unit admission. Poor outcome was defined as death or euthanasia performed for moribund status. Regression analysis identified independent predictors of non-survival and physiologic parameters associated with central venous oxygen saturation. Area under the receiver operator curve analysis identified a cut-off point of central venous oxygen saturation, below which central venous oxygen saturation decrease was associated with increased mortality risk.

RESULTS

Mortality risk was 30·9%. Low central venous oxygen saturation was associated with poor outcome (P<0·05). Area under the receiver operator curve analysis selected a central venous oxygen saturation of 68% as the point below which a fall in central venous oxygen saturation was associated with increased mortality risk. For each 10% drop in central venous oxygen saturation below 68%, odds of non-survival increased by 2·66 times (P=0·0002, 95% confidence interval of odds ratio=1·45 to 4·85). Central venous oxygen saturation was equivalent to lactate in predicting non-survival. Predictors of central venous oxygen saturation (packed cell volume, mean arterial blood pressure, fever, % arterial haemoglobin saturation as measured by pulse oximeter) were consistent with hypothesised physiologic mechanisms.

CLINICAL SIGNIFICANCE

Central venous oxygen saturation was a strong mortality predictor. Further work is needed to determine if therapy targeting central venous oxygen saturation can reduce mortality in canine intensive care unit patients.

Refractometric total plasma protein measurement as a cage-side indicator of hypoalbuminemia and hypoproteinemia in hospitalized dogs

OBJECTIVE

To assess the relationship between total plasma protein (TPP) as measured by refractometry and serum hypoalbuminemia and hypoproteinemia in hospitalized dogs.

DESIGN

Retrospective, observational study conducted over 6-month period between March and August 2008.

SETTING

University teaching hospital.

ANIMALS

Four hundred and three hospitalized dogs in an ICU.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

TPP, serum albumin, total protein, glucose, urea, cholesterol was measured from dogs enrolled in study. TPP was evaluated as a predictor for hypoalbuminemia defined both as albumin <25 g/L (<2.5 g/dL) and albumin <20 g/L (<2.0 g/dL), and serum hypoproteinemia, defined as serum total protein <40 g/L (<4.0 g/dL), using logistic regression. Impact of glucose, urea, cholesterol, and total bilirubin on refractometric readings were also assessed. TPP predicted hypoalbuminemia at albumin concentrations of <25 g/L (<2.5 g/dL) and <20 g/L (<2.0 g/dL) (P<0.001). A TPP<60 g/L (<6.0 g/dL) predicted albumin <25 g/L (<2.5 g/dL) with 73% sensitivity and 86% specificity. A TPP<58 g/L (<5.8 g/dL) predicted a serum albumin <20 g/L (<2.0 g/dL) with 70% sensitivity and 80% specificity. For dogs with known risk factors where specificity optimization may be appropriate, refractometer TPP<50 g/L (<5.0 g/dL) and <48 g/L (<4.8 g/dL) predicted hypoalbuminemia at each level with >95% specificity, although sensitivity was poor. Refractometer TPP<58 g/L (<5.8 g/dL) predicted serum total protein of <40 g/L (<40 g/dL) with sensitivity of 82% and specificity of 84%. Hypercholesterolemia and hyperglycemia significantly affected TPP readings; an increase in serum glucose by 10 mmol/L (180 mg/dL) was associated with an average independent increase in refractometer TPP of 2.27 g/L (0.23 g/dL) (P<0.001, 95% confidence interval=1.08-3.47) and an increase in serum cholesterol of 1 mmol/L (38.6 mg/dL) was associated with an average independent increase in refractometer TPP of 1.36 g/L (0.14 g/dL) (P<0.001, 95% confidence interval=1.12-1.59).

CONCLUSION

Suboptimal sensitivity limits the use of refractometric TPP for prediction of hypoalbuminemia in the context of patient screening; a high proportion of false negatives may result. However, identification of a refractometric TPP<58 g/L is strongly indicative of both serum hypoalbuminemia and hypoproteinemia, with high specificity, and warrants further investigation. Refractometric readings may be falsely increased in patients with hyperglycemia or hypercholesterolemia.

An observational study on the prevalence and impact of Isospora suis in suckling piglets in southwestern Ontario, and risk factors for shedding oocysts

An observational study was conducted to determine the prevalence of Isospora suis oocysts in fecal samples from suckling piglets in Ontario, and to evaluate the relationship between the presence of I. suis oocysts and diarrhea. Fifty farms and 709 litters of piglets were included in the study. Oocysts were detected on 70% of farms, with 187 litters infected. A litter of pigs that was positive for oocysts was significantly more likely to exhibit diarrhea than a litter that was negative [odds ratio (OR) = 4.0; 95% confidence interval (CI) = 2.8 to 5.8; P < 0.001]. Management and housing factors were examined with respect to risk factors for the presence of I. suis. Farms that did not use a detergent when cleaning farrowing crates were 10-times more likely to be positive for I. suis than those that used a detergent (P = 0.007). It was concluded that coccidiosis is a common problem on Ontario swine farms.

The Feline Acute Patient Physiologic and Laboratory Evaluation (Feline APPLE) Score: a severity of illness stratification system for hospitalized cats

BACKGROUND

Scores allowing objective stratification of illness severity are available for dogs and horses, but not cats. Validated illness severity scores facilitate the risk-adjusted analysis of results in clinical research, and also have applications in triage and therapeutic protocols.

OBJECTIVE

To develop and validate an accurate, user-friendly score to stratify illness severity in hospitalized cats.

ANIMALS

Six hundred cats admitted consecutively to a teaching hospital intensive care unit.

METHODS

This observational cohort study enrolled all cats admitted over a 32-month period. Data on interventional, physiological, and biochemical variables were collected over 24 hours after admission. Patient mortality outcome at hospital discharge was recorded. After random division, 450 cats were used for logistic regression model construction, and data from 150 cats for validation.

RESULTS

Patient mortality was 25.8%. Five- and 8-variable scores were developed. The 8-variable score contained mentation score, temperature, mean arterial pressure (MAP), lactate, PCV, urea, chloride, and body cavity fluid score. Area under the receiver operator characteristic curve (AUROC) on the construction cohort was 0.91 (95% CI, 0.87-0.94), and 0.88 (95% CI, 0.84-0.96) on the validation cohort. The 5-variable score contained mentation score, temperature, MAP, lactate, and PCV. AUROC on the construction cohort was 0.83 (95% CI, 0.79-0.86), and 0.76 (95% CI, 0.72-0.84) on the validation cohort.

CONCLUSIONS AND CLINICAL IMPORTANCE

Two scores are presented enabling allocation of an accurate and user-friendly illness severity measure to hospitalized cats. Scores are calculated from data obtained over the 1st 24 hours after admission, and are diagnosis-independent. The 8-variable score predicts outcome significantly better than does the 5-variable score.

The acute patient physiologic and laboratory evaluation (APPLE) score: a severity of illness stratification system for hospitalized dogs

BACKGROUND

Objective risk stratification models are used routinely in human critical care medicine. Applications include quantitative and objective delineation of illness severity for patients enrolled in clinical research, performance benchmarking, and protocol development for triage and therapeutic management.

OBJECTIVE

To develop an accurate, validated, and user-friendly model to stratify illness severity by mortality risk in hospitalized dogs.

ANIMALS

Eight hundred and ten consecutive intensive care unit (ICU) admissions of dogs at a veterinary teaching hospital.

METHODS

Prospective census cohort study. Data on 55 management, physiological, and biochemical variables were collected within 24 hours of admission. Data were randomly divided, with 598 patient records used for logistic regression model construction and 212 for model validation.

RESULTS

Patient mortality was 18.4%. Ten-variable and 5-variable models were developed to provide both a high-performance model and model maximizing accessibility, while maintaining good performance. The 10-variable model contained creatinine, WBC count, albumin, SpO(2) , total bilirubin, mentation score, respiratory rate, age, lactate, and presence of free fluid in a body cavity. Area under the receiver operator characteristic (AUROC) on the construction data set was 0.93, and on the validation data set was 0.91. The 5-variable model contained glucose, albumin, mentation score, platelet count, and lactate. AUROC on the construction data set was 0.87, and on the validation data set was 0.85.

CONCLUSIONS AND CLINICAL IMPORTANCE

Two models are presented that enable allocation of an accurate and user-friendly illness severity index for dogs admitted to an ICU. These models operate independent of primary diagnosis, and have been independently validated.

Prevalence and antimicrobial resistance in Campylobacter spp. isolated from retail chicken in two health units in Ontario

Campylobacter is an important enteric pathogen of humans and can cause diarrhea, fever, and abdominal pain. Campylobacter infections have frequently been associated with the handling and consumption of raw and undercooked poultry. Antimicrobial resistance among Campylobacter strains is of concern in the treatment of campylobacteriosis in vulnerable populations. A 2-year multidisciplinary study was conducted in the Perth and Wellington-Dufferin-Guelph public health units in Ontario, Canada, to investigate the prevalence and antimicrobial resistance of Campylobacter spp. in retail chicken. Retail chicken samples were collected from randomly selected stores in these health units. Resulting Campylobacter isolates were tested for susceptibility to amoxicillin-clavulanic acid (AMC), ampicillin (AMP), chloramphenicol (CHL), ciprofloxacin (CIP), clindamycin (CLI), erythromycin (ERY), gentamicin (GEN), nalidixic acid (NAL), tetracycline (TCY), and trimethoprim-sulfamethoxazole (SXT) using the E test. The prevalence of Campylobacter in 1,256 retail chicken samples was 59.6%. Of these positive samples, 9% contained Campylobacter coli, 1% contained Campylobacter lari, and 90% contained Campylobacter jejuni. Of the chicken isolates that were resistant to one or more antimicrobial agents, 301 isolates (40%) were resistant to one agent, 374 (50%) were resistant to two, 39 (5%) were resistant to three, 20 (3%) were resistant to four, and 6 (1%) were resistant to five. Nine isolates (1%) were susceptible to all antimicrobial agents tested. All isolates were susceptible to AMC, CHL, and GEN. Less than 10% of isolates were resistant to NAL, CIP, CLI, ERY, and AMP. Resistance to TCY was common (56%). No isolates had a resistance pattern that included all three antimicrobials important in the treatment of human campylobacteriosis (CIP, ERY, and TCY); however, 24 isolates (3.2%) were resistant to at least two of these antimicrobials.

Clinical signs and their association with herd demographics and porcine reproductive and respiratory syndrome (PRRS) control strategies in PRRS PCR-positive swine herds in Ontario

The purposes of this study were to describe the clinical signs observed in PRRS positive herds during a porcine reproductive and respiratory syndrome (PRRS) outbreak in Ontario and to determine associations between these clinical signs and herd demographics and PRRS control strategies. All PRRS polymerase chain reaction-(PCR)-positive submissions to a diagnostic laboratory between September 1, 2004 and August 31, 2007 were identified (n = 1864). After meeting eligibility requirements and agreeing to voluntary study participation, producers from 455 of these submissions were surveyed for information on clinical signs observed in their herds, herd demographics, and PRRS control strategies used in their herds at the time that the PCR-positive samples were taken. Larger herd size was associated with an increased risk of reporting abortion, weakborn piglets, off-feed sows, and sow mortality in sow herds, and with an increased risk of reporting mortality in finishing herds. When disease control strategies were examined, use of a commercial PRRS vaccine in sows and gilts was associated with a decreased risk of reporting weakborn pigs and high pre-weaning mortality, while the use of serum inoculation in breeding animals was associated with an increased risk of reporting off-feed sows and sow mortality. Providing biofeedback of stillborn/mummified piglets, placenta or feces to gilts was associated with an increased risk of reporting respiratory disease and mortality in finishing pigs while all-in/all-out flow in farrowing rooms was associated with an increased risk of reporting sow mortality and weakborn piglets.

Evaluating the efficacy of teaching methods regarding prevention of human epilepsy caused by Taenia solium neurocysticercosis in Western Kenya

Taenia solium neurocysticercosis is a major cause of adult-onset epilepsy in developing countries. A questionnaire was administered to 282 Kenyan farmers, followed by a workshop, a second questionnaire, one-on-one training, and a third questionnaire. People who attended workshops were more likely to know how T. solium causes epilepsy in humans in the third visit than the second (P = 0.001). The likelihood that farmers would tether their pigs 100% of the time, limiting exposure to tapeworm eggs, increased after the first (P < 0.001) and second visits (P < 0.001). Farmers were more likely to have heard of Cysticercus cellulosae in the second (P = 0.001) and third visits (P = 0.007), and to know how pigs acquire infection in the second (P = 0.03) and third visits (P = 0.003). Farmers with at least a grade 8 education were more likely to know how T. solium is transmitted to humans in the second (P = 0.001) and third visits (P = 0.009), and were more likely to understand the relationship between epilepsy and T. solium in the second (P = 0.03) and third visits (P = 0.03). Grade 8 education may enhance learning from written material. Workshops followed by individual on-farm training enhanced knowledge acquisition and behavior changes. Training local government extension workers contributed to the sustainability of this project.

Using data collected for production or economic purposes to research production animal welfare: an epidemiological approach

Epidemiologists use the analyses of large data sets collected for production or economic purposes to research production nonhuman animal welfare issues in the commercial setting. This approach is particularly useful if the welfare issue is rare or hard to reproduce. However, to ensure the information is accurate, it is essential to carefully validate these data. The study used economic data to research in-transit deaths of finishing pigs. The most appropriate model to fit the distribution of the outcome must be selected. A negative binomial model fit these data because the prevalence was low and most lots of pigs had no deaths. The study used hierarchical dummy variables to identify thresholds of temperature and humidity above which in-transit losses increased. Multiple variable modeling provides the foundation for the strength of epidemiological research. The model identifies the association between each factor and the outcome after controlling for the other factors in the model. The study evaluated confounding and interaction. Bias may be introduced when data are limited to one farm system, one abattoir, or one season. Census data enable us to understand the entire industry.

Comparison of agar dilution and E-test for antimicrobial susceptibility testing of Campylobacter coil isolates recovered from 80 Ontario swine farms

The primary aim of this study was to evaluate the level of agreement of the E-test for in vitro antimicrobial susceptibility testing of Campylobacter coli using the agar dilution technique, which is the approved method. A convenience sample of 80 Ontario swine farms was chosen for this study; each farm was visited from January to June 2004. A total of 233 isolates of C. coli were tested for susceptibility to 10 antimicrobials by agar dilution and the E-test. Performance of the tests was evaluated using 7 quality control strains: Escherichia coli ATCC 25922, Staphylococcus aureus ATCC 29213, Campylobacter jejuni ATCC 33560, and Campylobacter coli ATCC 33559 for the E-test and E. coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853, and C. jejuni ATCC 33560 for the agar dilution test. Weighted Cohen's kappa and prevalence-adjusted bias-adjusted kappa (PABAK) tests were used for statistical analysis. The E-test and agar dilution test results had a strong agreement when resistance to streptomycin and tetracycline were evaluated (weighted kappa: 0.68 and 0.66, respectively). However, marked disagreement was detected when testing susceptibility to nalidixic acid and ampicillin (0.15 and 0.22, respectively). Almost perfect agreement was detected by PABAK when testing susceptibility to gentamicin (0.99). Agreement was found to be moderate for ciprofloxacin, azithromycin, clindamycin, erythromycin, and chloramphenicol. Although the level of agreement between the E-test and agar dilution depended on the antimicrobial being tested, the E-test always detected a lower proportion of resistant isolates compared to agar dilution.

Methicillin resistant Staphylococcus aureus colonization in pigs and pig farmers

Methicillin resistant Staphylococcus aureus (MRSA) colonization has recently been identified in pigs and people that work with pigs, raising concerns about the role of pigs as reservoirs of MRSA for human infection. The objectives of this study were to evaluate the prevalence of MRSA colonization in pigs and pig farmers in Ontario, Canada and to characterize MRSA strains. Nasal and rectal swabs were collected from 285 pigs from three different age groups from 20 pig farms. Nasal swabs were collected from farm personnel and a brief questionnaire was also administered. The prevalence of MRSA colonization in farms was 45% (9/20) whereas the prevalence in pigs was 24.9% (71/285). There was no difference in MRSA colonization between age groups. The prevalence of MRSA colonization in pig farmers was 20% (5/25). There was a correlation between the presence of MRSA in pigs and humans on farms (P value=0.001). The results of spa typing revealed the predominant strain in pigs and humans was eGenomics spa type 539 (Ridom t034, clonal complex 398) which accounted for 59.2% of isolates and has been reported in pigs in Europe. A common human epidemic clone, CMRSA-2 (USA100, clonal complex 5) was also found in both pigs and pig personnel. Indistinguishable strains were found in pigs and pig personnel on all five farms with a colonized human. This study demonstrates that MRSA is common in pigs in Ontario, Canada, and provides further support to concerns about transmission of MRSA between pigs and humans.

Prevalence of resistance to 11 antimicrobials among Campylobacter coill isolated from pigs on 80 grower-finisher farms in Ontario

We carried out a cross-sectional study to investigate antimicrobial resistance patterns of Campylobacter coli isolated from Ontario grower-finisher pigs. From January to June 2004, 1200 samples were collected from 80 farms by obtaining a constant number (15) of fecal samples per farm. Susceptibility of the isolates to 11 antimicrobial drugs was determined by the agar-dilution technique. The overall prevalence of resistance to 1 or more antimicrobials among the isolates was 99.2%. High levels of resistance were observed for azithromycin, clindamycin, erythromycin, streptomycin, and tetracycline: 91.7%, 82.5%, 81.4%, 70.7%, and 63.7%, respectively. For sulfamethoxazole, ampicillin, and nalidixic acid, resistance was observed in 40.3%, 26.6%, and 22.7% of the isolates, respectively. Although at very low levels, resistance was observed for ciprofloxacin (a fluoroquinolone), chloramphenicol, and gentamicin: in 2.4%, 1.7%, and 0.2%, respectively. Many of the isolates (29.7%) were resistant to 5 antimicrobials, the most common being azithromycin, clindamycin, erythromycin, streptomycin, and tetracycline. Isolates from the same farm showed at least 5 patterns of resistance. Results from this study indicate high levels of resistance to the antimicrobial drugs most commonly used in the Canadian swine industry (macrolides, lincosamides, and tetracyclines) among C. coli isolated from grower-finisher pigs in Ontario. Macrolides and fluoroquinolones are the drugs most commonly used to treat severe human campylobacteriosis. Fortunately, at present, there is little resistance to fluoroquinolones among C. coli from pigs in Ontario.

The effect of feeding fermented liquid whey plus dextrose inoculated with specific lactic acid bacteria of pig origin to weanling pigs challenged with Escherichia coli O149:K91:F4

The objective of this study was to determine the efficacy of using fermented liquid whey inoculated with specific lactic acid bacteria of pig origin to reduce the severity and progression of postweaning enterotoxigenic Escherichia coli diarrhea in weanling pigs challenged with E. coli O149:K91:F4. Based on two trials, it was determined that feeding inoculated fermented whey in a liquid diet did not affect growth performance or the severity or duration of postweaning diarrhea compared with a conventional dry feed containing an antibiotic. Because this study is one of very few examining the use of liquid feed and co-products inoculated with probiotics to control postweaning E. coli diarrhea, more studies are needed to confirm these results.