Companion animal veterinarians discuss aspects of one health with pet owners during most veterinary appointments

OBJECTIVE

To examine the prevalence and context of one-health conversations between veterinarians and clients in companion animal practice.

SAMPLE

A random selection of 60 companion animal veterinarians; a convenience sample of 917 interactions from Southern Ontario, Canada. Of these, 100 audio-video-recorded interactions including 47 of 60 veterinarians were randomly selected for inclusion in this study.

METHODS

Audio-video recordings were made of veterinarian-client-patient interactions between November 2017 and January 2019. A researcher-generated coding framework was developed and used to assess the prevalence and content of one-health topics communicated during veterinary appointments.

RESULTS

Of the interactions assessed, 60 were preventive care and 40 were health problem appointments. Further, 78% (78/100) included at least 1 discussion related to one health. One-health topics included zoonoses (28% [28/100]), animal behavior (25% [25/100]), illness/disease (20% [20/100]), activity level/exercise (16% [16/100]), nutrition (16% [16/100]), dentistry (6% [6/100]), body weight (3% [3/100]), animal welfare (3% [3/100]), dog/cat bites (2% [2/100]), cannabis (2% [2/100]), and aging (1% [1/100]). Zoonotic diseases were mentioned in 65 appointments, 28 of which evolved into a one-health discussion. Antibiotics were discussed in 27 appointments, none of which were discussed in relation to one health (eg, antimicrobial resistance).

CLINICAL RELEVANCE

Findings suggest that one-health topics are raised within most veterinary appointments. Opportunities exist for more comprehensive one-health conversations between veterinarians and their clients, particularly in relation to zoonotic diseases and antimicrobials.

Use of health parameter trends to communicate pet health information in companion animal practice: A mixed methods analysis

BACKGROUND

Reviewing patient health parameter trends can strengthen veterinarian-client-patient relationships. The objective of this study is to identify characteristics associated with veterinarians' communication of health parameter trends to companion animal clients.

METHODS

Using a sequential exploratory mixed methods design, independent pet owner (n = 27) and veterinarian (n = 24) focus groups were conducted and analysed via content analysis to assess perceptions of how health parameter trends are communicated by veterinarians. Subsequently, a quantitative assessment of video recorded veterinary appointments (n = 917) compared characteristics identified in focus groups with health parameter trend discussions in practice. A mixed logistic model was used to assess characteristics associated with the occurrence of weight trend discussions.

RESULTS

Fifteen characteristics relating to veterinarians' use of health parameter trends were identified across focus groups. Veterinarians discussed 77 health parameter trends in relation to bodyweight (57/77), blood work (15/77) and other health parameters (5/77), within 73 (73/917) appointments. The odds of a weight trend discussion were higher if the veterinarian identified the pet as overweight or obese compared to an ideal bodyweight (odds ratio (OR) = 2.17; 95% confidence interval (CI) = 1.15-4.09; p = 0.016).

CONCLUSION

Mention of a health parameter trend was uncommon and rarely included use of visual aids. Health parameter trends related to bodyweight were discussed reactively, rather than proactively.

"Sewing Is Part of Our Tradition": A Case Study of Sewing as a Strategy for Arts-Based Inquiry in Health Research With Inuit Women

In this article, we present a case study of sewing as a strategy for arts-based inquiry in health research, situated within a broader project that highlighted Nunavut Inuit women's childbirth experiences. Five focus groups were hosted as sewing sessions with pregnant women (N = 19) in Iqaluit, Nunavut (2017-2018). Women's reflections on the sessions, and the significance of sewing to Inuit, were integrated with researchers' critical reflections to examine the value of sewing as a strategy for arts-based inquiry within a focus group method: results related to the flexibility of the sessions; how collective sewing created space for voicing, sharing, and relating; sewing as a tactile and place-specific practice tied to Inuit knowledge and tradition; and lessons learned. Our results underscore the possibilities of arts-based approaches, such as sewing, to enhance data gathering within a focus group method and to contribute to more locally appropriate, place-based methods for Indigenous health research.

Companion animal veterinarians' and veterinary clients' perceptions of information exchanged while communicating about blood tests

BACKGROUND

Blood tests play a vital role in veterinary medicine, as they enable veterinarians to make decisions about their patients' medical care and provide opportunities to engage clients in veterinary care. The objective of this study was to explore perspectives of veterinary clients and veterinarians on current reporting practices for blood tests ordered in companion animal practice. The type of information communicated and client information seeking behaviours were examined.

METHODS

Two online surveys were distributed using snowball sampling: one targeting veterinary clients and one targeting veterinarians.

RESULTS

In total, 529 veterinary client and 416 veterinarian surveys were included in analyses. Significant differences were found between what blood test information veterinarian respondents felt they provided clients and what client respondents perceived they received with regard to their pet's blood tests. Almost 60% of clients somewhat or strongly agreed that they search the Internet if they do not understand why a test was ordered or what the results mean. Half of clients reported that they never receive a written report of their pet's blood work, 81% of whom were interested in receiving a copy.

CONCLUSION

Results of this research demonstrate opportunities to improve veterinarians' and clients' communication about blood tests.

Evaluating shared decision-making between companion animal veterinarians and their clients using the Observer OPTION5 instrument

BACKGROUND

Communication practices used by veterinarians can impact client's involvement in decision-making. The objective of this study was to evaluate the level of client involvement in veterinary care decisions and factors impacting client involvement.

METHODS

A random sample of practising companion animal veterinarians and a convenience sample of pet owners were recruited. Each consultation was audio-video recorded and analyzed using the Observer OPTION⁵ instrument, adapted from human medicine, to assess veterinarians' level of shared decision-making. A mixed linear model was used to assess statistical associations between veterinarian, client and appointment-level factors and OPTION⁵ scores.

RESULTS

Sixty veterinarians and 909 of their clients were audio-video recorded during a consultation, of which 717 interactions included a decision identified for analysis using the OPTION⁵ instrument. Elements consistent with shared decision-making were uncommon, with a mean OPTION⁵ score of 22.6 (median = 20.0; sd = 13.05; range = 0-75) out of 100. OPTION⁵ scores were positively associated with the length of the appointment and negatively associated with the veterinarian's years in practice when controlling for statistical interaction between client income and appointment type.

CONCLUSION

Findings suggest an opportunity exists for veterinarians to incorporate more client involvement through increased use of shared decision-making behaviours during veterinary consultations.

Evaluation of associations between owner presence and indicators of fear in dogs during routine veterinary examinations

OBJECTIVE

To evaluate the influence of owner presence on behavioral and physiologic indicators of fear in dogs during routine physical examinations.

ANIMALS

32 client-owned dogs.

PROCEDURES

Dogs underwent a standardized, video-recorded examination consisting of 6 phases (examination of the head, lymph node palpation, body palpation, axillary temperature measurement, heart rate assessment, and respiratory rate assessment) with or without their owner present in a randomized, controlled study. Behaviors reported to be indicative of fear, including reduced posture, avoidance, escape, lip licking, body shaking, yawning, and vocalizing, were assessed during each phase, and physiologic measurements were assessed during relevant phases by the investigator. Owner presence and sex and age of dogs were investigated for associations with behavioral signs of fear; behavioral and physiologic measurements were compared between groups (owner present vs owner absent).

RESULTS

Dogs in the owner-present group had a lower rate of vocalizations, lower mean axillary temperature, and higher rate of yawning than dogs in the owner-absent group. Female dogs in the owner-absent group had a higher heart rate than females and males in the owner-present group and males in the owner-absent group, and the rate of lip licking decreased as age increased in the owner-present group. The presence of reduced body posture and rates of lip licking, avoidance behavior, and escape behavior were associated with examination phase.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that, when practical, owners should be encouraged to remain with their dog during routine veterinary examinations. However, effects of owner presence during procedures require further investigation. (J Am Vet Med Assoc 2020;257:1031-1040).

Ontario Veterinary College First-Year Veterinary Students' Perceptions of Companion Animal Nutrition and Their Own Nutrition: Implications for a Veterinary Nutrition Curriculum

Extant research shows veterinarians face increasing challenges in discussing nutrition with clients despite receiving professional nutrition education in the veterinary medical curriculum. This article's aim is to elicit student veterinarians' baseline nutrition-related perceptions and nutrition information-seeking behaviors at the time of entering veterinary school. Participants were newly enrolled veterinary students at the Ontario Veterinary College (n = 120). Focus group discussions (n = 19) informed the design of an online questionnaire capturing students' demographics and perceptions of their own and their pets' nutrition. Students reported being influenced by individual factors (e.g., time), social networks (e.g., family), and surrounding environment (e.g., cost, contradictory media messages). Overall, 58% of students considered themselves knowledgeable about pet nutrition when commencing veterinary school, with 71% prioritizing their pets' diets as much as their own. Students' confidence in finding pet nutrition information was correlated with perceived accessibility (r = .76, p = .001) and perceived quantity of information available on pet nutrition (r = .83, p = .001), but not quality of information (r = .13, p = .03). In general, students relied on and trusted veterinarians for nutrition advice. However, 94% of students mistrusted pet food companies' motivations. Our data support that students entering veterinary school have their own perceptions on pet nutrition that impact nutrition education, suggesting this as an important consideration in the design and delivery of a veterinary nutrition curriculum. Veterinary medical faculty should be encouraged to discuss baseline nutrition information and address any misconceptions to prepare students for future consultations with clients.

Pet owners' and veterinarians' perceptions of information exchange and clinical decision-making in companion animal practice

One of the most complex aspects of the veterinarian-client-patient interaction is the clinical decision-making process. Research suggests that the approach to communication used by veterinarians can impact veterinary clients’ involvement in the decision-making process and their ultimate satisfaction. Using different approaches to the decision-making process may affect how information is exchanged and consequently how decisions are made. The objective of this study was to determine pet owners’ expectations with respect to information exchange and decision-making during veterinarian-client-patient interactions and to compare veterinarians’ perceptions of those expectations and the challenges they face in meeting them. Five pet owner focus groups (27 owners) and three veterinarian focus groups (24 veterinarians) were conducted with standardized open-ended questions and follow-up probes. Thematic analysis of the transcribed data was conducted to identify trends and patterns that emerged during the focus groups. Three pet owner-based themes were identified: 1) understanding the client; 2) providing information suitable for the client; and 3) decision-making. In addition, three barriers for veterinarians affecting information exchange and decision-making were identified: 1) time constraints; 2) involvement of multiple clients; and 3) language barriers. Results suggest that pet owners expect to be supported by their veterinarian to make informed decisions by understanding the client’s current knowledge, tailoring information and educating clients about their options. Breakdowns in the information exchange process can impact pet owners’ perceptions of veterinarians’ motivations. Pet owners’ emphasis on partnership suggests that a collaborative approach between veterinarians and clients may improve client satisfaction.

Pet owners' online information searches and the perceived effects on interactions and relationships with their veterinarians

Objective: To explore pet owners’ online search experiences for pet health information and the perceived effects on their interactions and relationships with veterinarians. Background: Few studies have examined pet owners’ online searches for pet health information; even less is known about how these search experiences may impact pet owners’ interactions and relationships with veterinarians, including any effects on bond-centered care. Methods: Qualitative study consisting of five focus groups conducted with 26 pet owners in the Greater Toronto Area, Ontario, Canada, between June to September 2016. All interviews were audio-recorded and transcribed verbatim. QSR NVivo 11® was used to facilitate organisation of focus group data for thematic analysis. Results: Participating pet owners frequently referred to their relationships with veterinarians when discussing experiences searching online for pet health information. Owners reported choosing either to disclose or withhold declaring their online searches to veterinarians, depending on whether participants perceived a beneficial or detrimental impact on a “good” professional relationship with their veterinarian. Perceptions of veterinarians' reactions towards declaration of online searches were mixed, and influenced pet owners’ views of the existing relationship. Conclusion: Pet owners viewed their veterinarians as their most trusted source of pet health information, but many owners also wanted supplemental information from online searches. Owners preferred veterinarians refer them to online pet health resources, ideally those affiliated with the veterinary profession. Searching for pet health information online does not displace veterinarians’ guidance. Rather, the veterinarian-owner relationship was perceived to be strengthened when online searches were openly discussed with veterinarians. Implications: Findings offer insight into pet owners’ expectations of veterinarians within the context of online pet health information, providing ideas for veterinarians to strengthen bonds with owners such as; showing support of owners’ online pet health information searching by recommending resources and considerations about communicating professional opinions to owners regarding online information.  

A cross-sectional study of pet owners' attitudes and intentions towards nutritional guidance received from veterinarians

BACKGROUND

Beliefs of pet owners strongly influence their decision-making surrounding their pets' diet. Thus, nutritional guidance is an essential component of veterinary practice and integral to managing rising rates of pet obesity. This study examined pet owners' trust of, perceived effectiveness of, and intentions to follow nutritional guidance received from their veterinarian in managing their pets' diet.

METHODS

A cross-sectional study of 1402 dog and cat owners in the USA and Canada was conducted using an online questionnaire tool. Data were analysed using descriptive statistics and logistic regression modelling.

RESULTS

Clients are concerned about the effectiveness of veterinary nutrition recommendations. Cat owners were more likely than dog owners to consider the nutritional guidance they receive from veterinarians effective for their pets' diet (1.75, P=0.04). Length of pet ownership, feeding dry diets and frequency of veterinary visits were all positively associated with owners considering veterinary nutritional guidance to be effective in managing pets' diet.

CONCLUSION

Identifying these perspectives can aid in developing strategies to provide nutrition support to pet owners to improve their perceptions of, self-efficacy with, and compliance with veterinary nutrition recommendations.

National trends in sexual health indicators among gay and bisexual men disaggregated by ethnicity: repeated cross-sectional behavioural surveillance in New Zealand

OBJECTIVES

To assess trends in sexual health outcomes among men who have sex with men (MSM) disaggregated by ethnicity.

DESIGN

Repeated cross-sectional.

SETTING

Behavioural surveillance data from 2006, 2008, 2011 and 2014 were collected in-person and online across Aotearoa New Zealand.

PARTICIPANTS

Eligible participants were self-identified men aged 16 years or older who reported sex with another man in the past 5 years. We classified 10 525 participants' ethnicities: Asian (n=1003, 9.8%), Māori (Indigenous people of Aotearoa New Zealand, n=1058, 10.3%), Pacific (n=424, 4.1%) and European (n=7867, 76.8%).

OUTCOME MEASURES

The sexual health outcomes examined were >20 recent (past 6 months) male sexual partners, past-year sexually transmitted infection (STI) testing, past-year STI diagnosis, lifetime and past-year HIV testing, lifetime HIV-positive diagnosis and any recent (past 6 months) condomless anal intercourse with casual or regular partners.

RESULTS

When disaggregated, Indigenous and ethnic minority groups reported sexual health trends that diverged from the European MSM and each other. For example, Asian MSM increased lifetime HIV testing (adjusted OR, AOR=1.31 per survey cycle, 95% CI 1.17 to 1.47) and recent HIV testing (AOR=1.14, 95% CI 1.02 to 1.28) with no changes among Māori MSM or Pacific MSM. Condomless anal intercourse with casual partners increased among Māori MSM (AOR=1.13, 95% CI 1.01 to 1.28) with no changes for Asian or Pacific MSM. Condomless anal intercourse with regular partners decreased among Pacific MSM (AOR=0.83, 95% CI 0.69 to 0.99) with no changes for Asian or Māori MSM.

CONCLUSIONS

Population-level trends were driven by European MSM, masking important differences for Indigenous and ethnic minority sub-groups. Surveillance data disaggregated by ethnicity highlight inequities in sexual health service access and prevention uptake. Future research should collect, analyse and report disaggregated data by ethnicity to advance health equity.

Cross-sectional survey of cat handling practices in veterinary clinics throughout Canada and the United States

OBJECTIVE

To assess handling techniques commonly used during routine examinations and procedures used for calm, fearful, and aggressive cats by veterinarians and nonveterinarian staff at Canadian and US veterinary practices and to evaluate demographic factors associated with those handling techniques.

SAMPLE

310 veterinarians and 944 nonveterinarians who handle cats at Canadian and US veterinary practices.

PROCEDURES

An online questionnaire was developed to evaluate respondent demographics and use of common cat handling practices and techniques. A snowball sampling method was used to send a link to the questionnaire to members of Canadian and US veterinary-affiliated groups. Descriptive statistics were generated; logistic regression was used to identify demographic factors associated with the use of minimal and full-body restraint with scruffing during routine examination and procedures for fearful and aggressive cats.

RESULTS

Full-body restraint was used to handle cats of all demeanors, although its frequency of use was greatest for fearful and aggressive cats. Veterinarians and nonveterinarians who graduated from veterinary training programs before 2006 were less likely to use full-body restraint for cats of all demeanors, compared with nonveterinarians who did not graduate or graduated between 2006 and 2015. Other factors associated with decreased use of full-body restraint included working at an American Association of Feline Practitioners-certified practice and working at a Canadian practice.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that full-body restraint is commonly used to handle cats. Further research is necessary to determine whether current handling recommendations are effective in decreasing stress for cats during veterinary visits.

Ethnicity classification systems for public health surveys: experiences from HIV behavioural surveillance among men who have sex with men

Background

Race and ethnicity classification systems have considerable implications for public health, including the potential to reveal or mask inequities. Given increasing “super-diversity” and multiple racial/ethnic identities in many global settings, especially among younger generations, different ethnicity classification systems can underrepresent population heterogeneity and can misallocate and render invisible Indigenous people and ethnic minorities. We investigated three ethnicity classification methods and their relationship to sample size, socio-demographics and sexual health indicators.

Methods

We examined data from New Zealand’s HIV behavioural surveillance programme for men who have sex with men (MSM) in 2006, 2008, 2011, and 2014. Participation was voluntary, anonymous and self-completed; recruitment was via community venues and online. Ethnicity allowed for multiple responses; we investigated three methods of dealing with these: Prioritisation, Single/Combination, and Total Response. Major ethnic groups included Asian, European, indigenous Māori, and Pacific. For each classification method, statistically significant associations with ethnicity for demographic and eight sexual health indicators were assessed using multivariable logistic regression.

Results

Overall, 10,525 MSM provided ethnicity data. Classification methods produced different sample sizes, and there were ethnic disparities for every sexual health indicator. In multivariable analysis, when compared with European MSM, ethnic differences were inconsistent across classification systems for two of the eight sexual health outcomes: Māori MSM were less likely to report regular partner condomless anal intercourse using Prioritisation or Total Response but not Single/Combination, and Pacific MSM were more likely to report an STI diagnosis when using Total Response but not Prioritisation or Single/Combination.

Conclusions

Different classification approaches alter sample sizes and identification of health inequities. Future research should strive for equal explanatory power of Indigenous and ethnic minority groups and examine additional measures such as socially-assigned ethnicity and experiences of discrimination and racism. These findings have broad implications for surveillance and research that is used to inform public health responses.

Mapping the maternal health research landscape in Nunavut: A systematic search & critical review of methodology

Nunavut's maternal healthcare system is characterized by rapid transition from community-based birth to a practice of obstetric evacuation and institutionalized birth. Given calls for Inuit self-determination in research, maternal health research - which informs healthcare practices and policies - may need to be conducted differently, using different research methodologies, to include Inuit women's voices and lived experiences. In light of these calls, this article systematically synthesized the published maternal health literature in Nunavut and critically examined reported research methods. This systematic search and critical review involved a comprehensive database search and multi-level eligibility screening conducted by two independent reviewers. Data on the temporal, geographic, methodological, and topical range of studies were extracted, then descriptive statistics were calculated to summarize these data. A hybrid inductive and deductive qualitative analysis of the full-text articles was conducted to critically analyze research methodology. The initial search yielded 2656 distinct articles and twenty-eight articles met the inclusion criteria. These articles were published from 1975 to 2016, mostly used quantitative research methodology (71.4%), were written from clinical perspectives (57.1%), and focused on maternity care (53.6%). Emergent themes related to both the contributions and areas for growth of research methodology in the conceptualization, initiation, implementation, reporting, and knowledge mobilization stages of the research process. This review revealed opportunities for maternal health researchers to: redress the ongoing impacts of colonization; further include Inuit definitions of health and perspectives on birth in study designs; explore new methodologies that resonate with Inuit ways of knowing; continue (re)aligning research with community priorities; and move from consultation and collaborative partnership in research to Inuit leadership and data ownership. Indeed, this review illustrates that at each step of the research process, opportunity exists for Inuit perspectives and active involvement to shape and define maternal health research in Nunavut.

The Perceived Importance, Emphasis, and Confidence in Veterinary Nutrition Education of First-Year Canadian and US Veterinary Students

Veterinarians play a critical role in providing nutrition consultation and supporting clients to adopt healthy dietary habits for their pets; thus applicable, informative nutrition education in veterinary schools is essential. The aim of this study was to explore incoming veterinary students' perceived importance, emphasis, and confidence in the veterinary nutrition education they will receive. First-year veterinary students at all 5 Canadian and 5 randomly selected US veterinary schools were invited to complete a 31-item questionnaire. Response rate was 34.6% (n = 326). Descriptive statistics and multivariate logistic regression were performed. While most students (92%) considered nutrition education to be an important component of veterinary training, 64% felt it will not be a subject of great emphasis. Veterinary students at schools with a board-certified veterinary nutrition faculty were more likely to perceive higher emphasis on nutrition education (p < 0.001). In the multivariate analysis, academic self-efficacy was a positive predictor of students' perceived confidence in how well they anticipate their nutrition education that will prepare them for their clinical roles (p = 0.003). Examining the perceptions of veterinary students entering veterinary school is an important aspect to consider in the design and delivery of a veterinary nutrition curriculum and maybe equally important for students entering other professional health programs.

Students' Experiences of Seeking Web-Based Animal Health Information at the Ontario Veterinary College: Exploratory Qualitative Study

BACKGROUND

Although searching for health information on the internet has offered clear benefits of rapid access to information for seekers such as patients, medical practitioners, and students, detrimental effects on seekers' experiences have also been documented. Health information overload is one such side effect, where an information seeker receives excessive volumes of potentially useful health-related messages that cannot be processed in a timely manner. This phenomenon has been documented among medical professionals, with consequences that include impacts on patient care. Presently, the use of the internet for health-related information, and particularly animal health information, in veterinary students has received far less research attention.

OBJECTIVE

The purpose of this study was to explore veterinary students' internet search experiences to understand how students perceived the nature of Web-based information and how these perceptions influence their information management.

METHODS

For this qualitative exploratory study, 5 separate focus groups and a single interview were conducted between June and October 2016 with a sample of 21 veterinary students in Ontario, Canada.

RESULTS

Thematic analysis of focus group transcripts demonstrated one overarching theme, The Overwhelming Nature of the Internet, depicted by two subthemes: Volume and Type of Web-based Health Information and Processing, Managing, and Evaluating Information.

CONCLUSIONS

Integrating electronic health information literacy training into human health sciences students' training has shown to have positive effects on information management skills. Given a recent Association of American Veterinary Medical Colleges report that considers health literacy as a professional competency, results of this study point to a direction for future research and for institutions to contemplate integrating information literacy skills in veterinary curricula. Specifically, we propose that the information literacy skills should include knowledge about access, retrieval, evaluation, and timely application of Web-based information.

Getting a grip: cats respond negatively to scruffing and clips

Use of scruffing and scruffing tools (eg, clipnosis clips) to immobilise cats is contentious, and cat handling guidelines vary in recommendations regarding these techniques. The current study examined whether cats show negative responses to the following restraint methods: (1) scruff (n=17), (2) clip application to the dorsal neck skin (n=16) and (3) full body (a known negative; n=19). Each cat was also handled with passive restraint (control) for comparison. During handling, cats were examined for behavioural (side/back ear positions, vocalisations, lip licking) and physiological (pupil dilation ratio, respiratory rate) responses. Full-body restrained cats showed more negative responses than passively restrained cats (respiratory rate: p=0.006, F_3,37=4.31, p=0.01; ear p=0.002, F_3,49=6.70, p=0.0007; pupil: p=0.007, F_3,95=14.24, p=0.004; vocalisations: p=0.009, F_3,49=4.85, p=0.005) and scruff-restrained cats (pupil: p=0.009; vocalisations: p=0.04). Clip restraint resulted in more negative responses than passive (pupil: p=0.01; vocalisations: p=0.007, ear p=0.02) and scruff restraint (pupil p=0.01; vocalisations: p=0.02). No differences were detected between full-body restraint, known to be aversive, and clip restraint. Full-body restraint and clip restraint resulted in the greatest number of negative responses, scruffing resulted in fewer negative responses and passive restraint showed the least number of responses. We therefore recommend against the use of full-body and clip restraint, and suggest that scruff restraint should be avoided when possible.

Factors associated with hematuric struvite crystalluria in cats

Objectives

The aim of the study was to identify any dietary, signalment, geographic and clinical factors associated with hematuric struvite crystalluria (HSC) in a population of cats that visit general care veterinary hospitals in the USA.

Methods

In total, 4032 cats that had a first-time diagnosis of HSC and 8064 control cats with no history of hematuria or crystalluria were identified from medical records of all cats examined between 2007 and 2011 at 790 US veterinary hospitals. Extracted variables included age, sex, neuter status, breed, diet, urinalysis results and history of cystitis. Potential associations between these variables and HSC were estimated.

Results

Controlling for other factors, young cats fed a dry diet had an increased likelihood of HSC relative to young cats fed a non-dry diet. However, as age increased, the likelihood of HSC declined for cats fed a dry diet and increased for cats fed a non-dry diet. Moreover, the odds of HSC were significantly greater when cats were unneutered (vs neutered; odds ratio [OR] 45.52) or had a thin (vs heavy) body condition (OR 23.81), diagnosis of cystitis (OR 2.84), urine protein concentration >30 mg/dl (OR 4.72), alkaline (vs neutral) urine pH (OR 3.34), pyuria (OR 23.67) or bacteriuria (OR 2.24).

Conclusions and relevance

The present study provides estimates of the strengths of association between HSC and certain signalment and clinical characteristics of cats. This information could help clinicians to perform a more directed screening for struvite crystalluria in certain cat populations. Follow-up studies that build on the findings of this study could explore the clinical importance of HSC in cats.

Frequent condom use with casual partners varies by sexual position among younger gay and bisexual men in New Zealand: national behavioural surveillance 2006-2011

Background Condom promotion remains a cornerstone of HIV/STI control, but must be informed by evidence of uptake and address disparities in use. This study sought to determine the prevalence of, and demographic, behavioural and relational factors associated with, condom use during insertive and receptive anal intercourse with casual partners among younger gay, bisexual and other men who have sex with men (YMSM) in New Zealand.

METHODS

The 2006-2011 national HIV behavioural surveillance data for YMSM aged 16-29 years was pooled. Separately for each sexual position, frequent (always/almost always) versus infrequent condom use was regressed onto explanatory variables using manual backward stepwise multivariable logistic regression analysis.

RESULTS

Three-quarters of YMSM reported frequent condom use during insertive (76.0%) and receptive (73.8%) anal intercourse. YMSM who were exclusively insertive were more likely to report frequent condom use than versatile YMSM. Factors positively associated with frequent condom use, irrespective of sexual position were: in-person versus web-based recruitment, testing HIV negative versus never testing or testing HIV positive, having no recent sex with women, reporting two to five versus one male sexual partner in the past 6 months, reporting no current regular partner, but if in a regular relationship, reporting a boyfriend-type versus fuckbuddy-type partner, and frequent versus infrequent regular partner condom use. Pacific ethnicity and less formal education were negatively associated with frequent condom use only during receptive anal intercourse.

CONCLUSIONS

The findings from this study demonstrate that condom norms can be actively established and maintained among YMSM. Condom promotion efforts must increase YMSM's capacity, agency and skills to negotiate condom use, especially for the receptive partner.

Milestone Educational Planning Initiatives in Veterinary Medical Education: Progress and Pitfalls

Three milestone educational planning initiatives engaged the veterinary medical profession in the United States and Canada between 1987 and 2011, namely the Pew National Veterinary Education Program, the Foresight Project, and the North American Veterinary Medical Education Consortium. In a quantitative study, we investigated the impact of these initiatives on veterinary medical education through a survey of academic leaders (deans, previous deans, and associate deans for academics from veterinary medical schools that are members of the Association of American Veterinary Medical Colleges) to assess their perspectives on the initiatives and eight recommendations that were common to all three initiatives. Two of the recommendations have in effect been implemented: enable students to elect in-depth instruction and experience within a practice theme or discipline area (tracking), and increase the number of graduating veterinarians. For three of the recommendations, awareness of the issues has increased but substantial progress has not been made: promote diversity in the veterinary profession, develop a plan to reduce student debt, and develop a North American strategic plan. Lastly, three recommendations have not been accomplished: emphasize use of information more than fact recall, share educational resources to enable a cost-effective education, and standardize core admissions requirements. The educational planning initiatives did provide collaborative opportunities to discuss and determine what needs to change within veterinary medical education. Future initiatives should explore how to avoid and overcome obstacles to successful implementation.

Evaluation of a welfare assessment tool to examine practices for preventing, recognizing, and managing pain at companion-animal veterinary clinics

Successful prevention, recognition, and treatment of pain are integral to ensuring veterinary patient welfare. A canine and feline welfare assessment tool, incorporating verbal interviews with veterinarians using open-ended questions, was developed to assess pain management practices that safeguard and improve patient welfare. The tool was evaluated in 30 companion- and mixed-animal veterinary clinics in Ontario in order to assess its reliability, feasibility, and validity, while also benchmarking current practices. Responses were analyzed according to a scoring scheme developed based on published literature and expert opinion. Based on weighted kappa statistics, interview scoring had substantial inter-observer (K_w = 0.83, 0.73) and near-perfect intra-observer (K_w = 0.92) agreement, which suggests that the tool reliably collects information about pain management practices. Interviews were completed at all recruited clinics, which indicates high feasibility for the methods. Validity could not be assessed, as participants were reluctant to share information about analgesic administration from their clinical records. Descriptive results indicated areas for which many veterinarians are acting in accordance with best practices for pain management, such as pre-emptive and post-surgical analgesia for ovariohysterectomy patients, and post-surgical care instructions. Areas that offer opportunity for enhancement were also highlighted, e.g., training veterinary staff to recognize signs of pain and duration of analgesia in ovariohysterectomy patients after discharge. Overall, based on this limited sample, most veterinarians appear to be effectively managing their patients' pain, although areas with opportunity for enhancement were also identified. Further research is needed to assess trends in a broader sample of participants.

Iron release from the Lucky Iron Fish®: safety considerations

BACKGROUND AND OBJECTIVES

The principal objective was to explore in greater detail safety issues with regard to the use of the Lucky Iron Fish® (fish) as a treatment for iron deficiency and iron deficiency anaemia in women in rural Cambodia.

METHODS AND STUDY DESIGN

Experiments were done to determine: (1) purity of the iron in the fish by mass spectroscopy; (2) release of iron and contaminants released during boiling in water using inductive-ly-coupled plasma optical emission spectroscopy; (3) the impact of cooking time, acidity and number of fish in acidified water and two types of Khmer soups; and (4) drinkability of the water after boiling with different num-bers of fish.

RESULTS

The fish is composed primarily of ferrous iron with less than 12% non-ferrous iron. Contaminants were either not detectable or levels were below the acceptable standards set by the World Health Organization. The length of time boiling the fish and the acidity of the water increased iron release but even with 5 fish boiled for 60 minutes, iron levels only approached levels where side effects are observed. Boiling one fish in water did not affect the perception of colour, smell or taste of the water but boiling in water with two or more fish resulted in the water being unpalatable which further limits the potential for iron toxicity from using the fish.

CONCLUSIONS

The results suggest that the Lucky Iron Fish™ may be a safe treatment for iron deficiency.

Anemia in Cambodia: a cross-sectional study of anemia, socioeconomic status and other associated risk factors in rural women

Iron deficiency and associated anemia are severe public health problems, which are prevalent in the developing world. We conducted a cross-sectional survey, comprised of written interview questions and laboratory analysis of blood biomarkers, in Kandal Province, Cambodia. The objective of this study is to examine possible factors that are associated with anemia in rural Cambodia. Data on socioeconomic status, water source/treatment practices, and meat consumption was also collected. Of the 297 women surveyed, 51.2% were anemic. Of those women found to be anemic, iron deficiency was implicated in 9.7% of cases (SF <15 ng/L), with an additional 18.5% reported to be borderline iron deficient (serum ferritin=15-30 ng/L). Meat consumption was very low, with nearly one-half of the women consuming meat one time per month or less. This study highlights the multi-faceted etiology of anemia in Cambodia and emphasizes the need for comprehensive nutrition surveying in order to better inform prevention and treatment programming and policy development.

Younger Gay and Bisexual Men's Condom Use With Main Regular Sexual Partner in New Zealand

Main partners are a common source of new HIV infections among men who have sex with men (MSM). National behavioral surveillance data (2006-2011) for younger MSM (YMSM, aged 16-29) in New Zealand were analyzed to investigate condom use during anal intercourse with a regular partner (boyfriend/fuckbuddy) by sexual position (insertive/receptive). Backward-stepwise multivariate multinomial logistic regression was used to identify demographic, relational, behavioral, and cognitive factors associated with condom use frequency (high, medium, low). Most YMSM who reported a current regular partner (n=1,221) classified them as a boyfriend (59.5%) versus fuckbuddy (40.5%), though condom use was higher with the latter partner type. Condom use or nonuse was habitual across partners, although insertive sexual position was positively associated with condom use. YMSM who believed condoms reduce sensitivity reported lower condom use. Condoms remain the leading HIV/STI prevention tool for YMSM; efforts to improve condom use must consider sexual position and relationship factors.

Habitual condom use across partner type and sexual position among younger gay and bisexual men: findings from New Zealand HIV behavioural surveillance 2006-2011

Objectives

Our objectives were to investigate demographic and behavioural factors associated with condom use and to examine how habitual condom use was across partner types and sexual positions among younger men who have sex with men (YMSM), aged 16–29, surveyed in New Zealand.

Methods

We analysed the 2006–2011 national HIV behavioural surveillance data from YMSM who reported anal intercourse in four scenarios of partner type and sexual position: casual insertive, casual receptive, regular insertive and regular receptive. For each, respondents’ condom use was classified as frequent (always/almost always) or otherwise, with associated factors identified with multivariate mixed-effect logistic regression. Habitual condom use across scenarios was examined using a latent variable technique that estimated the intraclass correlation coefficient (ICC).

Results

Frequent condom use was reported for 63.6% of 5153 scenarios reported from 2412 YMSM. Frequent use increased from boyfriend to fuckbuddy to casual partners. Infrequent use was associated with online recruitment, Pacific ethnicity, less education, HIV positivity, sex with women, having ≥20 sexual partners versus 1 and reporting insertive and receptive sexual positions. Frequent condom use was associated with having two to five sexual partners versus one and shorter regular partnerships. The ICC=0.865 indicated highly habitual patterns of use; habitual infrequent condom use was most prevalent with regular partners (53.3%) and habitual frequent condom use was most prevalent with casual partners (70.2%) and for either sexual position (50.5% and 49.1%).

Conclusions

Habitual condom use among YMSM highlights the value of early, engaging and sustained condom promotion. Public health should provide better and more compelling condom education, training and promotion for YMSM.

Risk factors associated with struvite urolithiasis in dogs evaluated at general care veterinary hospitals in the United States

OBJECTIVE

To identify factors associated with development of struvite urolithiasis in dogs evaluated at general care veterinary hospitals in the United States.

DESIGN

Retrospective case-control study.

ANIMALS

508 dogs with a first-time diagnosis of struvite urolithiasis and 7,135 control dogs.

PROCEDURES

Electronic medical records of all dogs evaluated at 787 general care veterinary hospitals in the United States between October 2007 and December 2010 were reviewed to identify dogs that developed struvite urolithiasis and 2 groups of control dogs with no history of urolithiasis. Information extracted included diet, age, sex, neuter status, breed size category, hospital location, and date of diagnosis. Urinalysis results, urolith composition, and other disease conditions were recorded if applicable. Potential risk factors were assessed with univariable and multivariable regression analysis.

RESULTS

Toy- or small-sized breeds had significantly greater odds of struvite urolithiasis, compared with medium- or large-sized breeds. Neutering significantly increased the odds of this outcome in females only; sexually intact females were more likely to develop struvite urolithiasis than were sexually intact males, but only up to 5 years of age. Urinary factors significantly associated with the outcome were basic (vs acidic) pH, presence of RBCs or WBCs, protein concentration > 30 mg/dL, and ketone concentration ≥ 5 mg/dL.

CONCLUSIONS AND CLINICAL RELEVANCE

Evaluation of demographic characteristics and urinalysis results may be useful in the early identification of struvite urolithiasis in dogs. Periodic urinalysis in dogs is recommended because of the potential health impact of a late diagnosis of urolithiasis.

Women's nutrient intakes and food-related knowledge in rural Kandal province, Cambodia

In Cambodia, both anaemia and vitamin A deficiency are serious health problems. Despite this, few comprehensive nutritional surveys have been completed to date. This study evaluates the adequacy of iron and vitamin A intakes, as well as women's nutritional knowledge in rural Kandal province. Twenty-four hour recalls, pile sort activities, socioeconomic surveys, focus groups, and market surveys were carried out with 67 women from 5 villages in rural Kandal Province. Ninety seven percent of women did not meet their daily-recommended intake of iron, while 70% did not meet their daily-recommended intake of vitamin A. Although many women consume vitamin A-rich and iron rich-foods daily, they do not consume large enough quantities of these foods. Results suggest that both the cost of foods as well as the extent of health knowledge is linked to nutritional practice. Most animal-source iron and vitamin A-rich foods are considered expensive; however, small fish, and several plant-source vitamin A-rich foods are inexpensive and easy to access. Despite health education, food restrictions lead some healthy foods to be considered to be harmful to women. Ultimately, this study demonstrates the importance of developing comprehensive nutritional interventions in Cambodia. Health programming must provide women with not only suggestions to include low-cost nutrient-rich foods, but also advise them about the quantities that are likely to have an impact on nutritional status. Programs should take a community-based, inter-sectoral approach that simultaneously combines culturally informed health education with initiatives that combat poverty and increase access to nutrient rich foods.

Flock prevalence of exposure to avian adeno-associated virus, chicken anemia virus, fowl adenovirus, and infectious bursal disease virus among Ontario broiler chicken flocks

Samples from 231 randomly selected commercial broiler chicken flocks in Ontario were tested at slaughter for exposure to chicken anemia virus (CAV), fowl adenovirus (FAdV), and infectious bursal disease virus (IBDV). Fifteen blood samples per flock were collected and analyzed for the presence of antibodies against CAV, FAdV, and IBDV by ELISA or agar gel immunodiffusion test. Fifteen cecal tonsils and cloacal swabs per flock were analyzed for the presence of CAV, FAdV, and IBDV by PCR. The prevalence of exposure to avian adeno-associated virus (AAAV) was estimated by a PCR test on a subset of FAdV-PCR-positive samples from 178 flocks. Genotypes of FAdV and IBDV were identified on a subset of isolates (n = 353 and 45, respectively). The flock-level period prevalence of exposure to AAAV, CAV, FAdV, and IBDV during grow-out were 88.76% (95% CI: 84.08-93.45%), 77.06% (95% CI: 71.59-82.52%), 96.54% (95% CI: 94.16-98.91%), and 48.92% (95% CI: 42.42-55.41%), respectively. Results of a multivariable logistic regression model showed a significant association of exposure to FAdV with exposure to AAAV (OR = 18.57, 95% CI: 3.67-93.86, P = 0.004) but not with exposure to CAV (P = 0.7752) or exposure to IBDV (P = 0.2274). Pathogenic FAdV genotypes (FAdV-02, FAdV-08, and FAdV-11) constituted 39.38% of the isolates. The most-common IBDV genotypes identified were IBDV NC171 (60%) and IBDV 05SA8 (28.89%). This is the first large-scale study to estimate the baseline flock prevalence of exposure to AAAV, CAV, FAdV, and IBDV in commercial broiler flocks in Canada. Potentially pathogenic genotypes of FAdV and IBDV that can guide vaccine development and disease control efforts in Ontario were identified.

Factors associated with recent HIV testing among younger gay and bisexual men in New Zealand, 2006-2011

Background

Understanding HIV testing behaviour is vital to developing evidence-based policy and programming that supports optimal HIV care, support, and prevention. This has not been investigated among younger gay, bisexual, and other men who have sex with men (YMSM, aged 16-29) in New Zealand.

Methods

National HIV sociobehavioural surveillance data from 2006, 2008, and 2011 was pooled to determine the prevalence of recent HIV testing (in the last 12 months) among YMSM. Factors associated with recent testing were determined using manual backward stepwise multivariate logistic regression.

Results

Of 3,352 eligible YMSM, 1,338 (39.9%) reported a recent HIV test. In the final adjusted model, the odds of having a recent HIV test were higher for YMSM who were older, spent more time with other gay men, reported multiple sex partners, had a regular partner for 6-12 months, reported high condom use with casual partners, and disagreed that HIV is a less serious threat nowadays and that an HIV-positive man would disclose before sex. The odds of having a recent HIV test were lower for YMSM who were bisexual, recruited online, reported Pacific Islander or Asian ethnicities, reported no regular partner or one for >3 years, were insertive-only during anal intercourse with a regular partner, and who had less HIV-related knowledge.

Conclusion

A priority for HIV management should be connecting YMSM at risk of infection, but unlikely to test with appropriate testing services. New generations of YMSM require targeted, culturally relevant health promotion that provides accurate understandings about HIV transmission and prevention.

An investigation of resistance to β-lactam antimicrobials among staphylococci isolated from pigs with exudative epidermitis

Background

A high proportion of staphylococci isolated from pigs affected with exudative epidermitis were found to be resistant to β-lactam antimicrobials. The primary objective of this research was to investigate and characterize β-lactam resistance in Staphylococcus hyicus, Staphylococcus aureus and other staphylococci isolated from these pigs.

Results

The antimicrobial resistance patterns of 240 staphylococci isolates were determined by disk diffusion, of which 176 (73.3%) of the isolates were resistant to 3 β-lactams (penicillin G, ampicillin, and ceftiofur). The presence of mecA gene was identified in 63 staphylococci isolates from skin samples by PCR. The mecA gene was identified in 19 S. aureus, 31 S. hyicus, 9 Staphylococcus chromogenes, 2 Staphylococcus pseudintermedius isolates, and in 1 isolate each of Staphylococcus arlettae, and Staphylococcus cohnii subspecies urealyticus. From SCCmec typing results, the majority (45/63, 71.4%) were shown to be SCCmec type V. One isolate was SCCmec III. Fourteen isolates were detected as mec class A, mec class C or ccr type 5. The ccr complex and mec complex was not detected in 3 isolates of methicillin resistant S. hyicus (MRSH) based on multiplex PCR. Of the 30 isolates of MRSA identified from nasal samples of the pigs, 29 isolates were SCCmec type V and 1 isolate was SCCmec type II. Staphyloccoci isolates that were mecA negative but resistant to β-lactam antimicrobials were further examined by screening for mecC, however all were negative. Furthermore, the majority of mecA negative β-lactam resistant staphylococci isolates were susceptible to oxacillin and amoxicillin-clavulanic acid in a double disk diffusion test.

Conclusions

Methicillin resistance can be identified in a variety of staphylococcal species isolated from pigs. In this study there was a great deal of similarity in the SCCmec types between staphylococcal species, suggesting that resistance may be passed from one species of staphylococci to another species of staphylococci. While this has been reported for acquisition of methicillin-resistance from coagulase negative staphylococci to S. aureus, these data suggest that transmission to or from the porcine pathogen S. hyicus may also occur. The identification of methicillin resistance in a variety of staphylococcal species in pigs does raise concerns about the spread of serious multi-drug resistance in food producing animals and warrants further study.

Bayesian analysis of risk factors for infection with a genotype of porcine reproductive and respiratory syndrome virus in Ontario swine herds using monitoring data

Porcine reproductive and respiratory syndrome (PRRS) has a worldwide distribution. This economically important endemic disease causes reproductive failure in breeding stock and respiratory tract illness in young pigs. In Ontario restricted fragment length polymorphism (RFLP) 1-18-4 has been determined as one of the most common virus genotypes. Individual-level models (ILMs) for infectious diseases, fitted in a Bayesian MCMC framework, have been used to describe both the spatial and temporal spread of diseases. They are an intuitive and flexible class of models that can take into account population heterogeneity via various individual-level covariates. The objective of this study is to identify relative importance of risk factors for the spread of the genotype 1-18-4 from monitoring data in southern Ontario using ILMs. Specifically, we explore networks through which resources are obtained or delivered, as well as the ownership structure of herds, and identify factors that may be contributing to high risk of infection. A population of 316 herds which experienced their PRRS outbreaks between September 2004 and August 2007 are included in the analyses, in which 194 (61%) are sow herds. During the study period, 45 herds (27 sow herds) experienced their first outbreak due to RFLP 1-18-4. Our results show that the three relatively most important factors for the spread of 1-18-4 genotype in Ontario swine herds were sharing the same herd ownership, gilt source and market trucks. All other networks had relatively smaller impact on spread of this PRRSV genotype. Spatial proximity could not be identified as important contributor to spread. Our findings also suggest that gilt acclimation should be practiced whenever possible and appropriate to reduce the risk for the herd and for others as it is already widely implemented and recommended in the North American swine industry.

An investigation of exudative epidermitis (greasy pig disease) and antimicrobial resistance patterns of Staphylococcus hyicus and Staphylococcus aureus isolated from clinical cases

Exudative epidermitis (EE) is a common skin disease of young pigs, caused mainly by Staphylococcus hyicus. Increased prevalence of EE and poor response to treatment are reported. Common strategies used by Ontario pork producers to treat pigs with EE were determined using a survey. Injection of penicillin G was reported as the most common parenteral antibiotic choice. Antimicrobial resistance patterns of S. hyicus and Staphylococcus aureus isolated from clinical cases (30 herds with samples from approximately 6 pigs per farm) showed that 97% of S. hyicus isolates were resistant to penicillin G and ampicillin; 71% of these isolates were resistant to ceftiofur. Similar resistance was noted among S. aureus isolates. Antimicrobial resistance has become a problem in the treatment of EE in Ontario.

Owned dog demography in Todos Santos Cuchumatán, Guatemala

A thorough knowledge of the dog demography should be an integral element in the planning, implementation and evaluation of dog population control measures. In May 2008, a door-to-door household census of human and owned canine populations was conducted in 12 contiguous neighbourhoods in the town of Todos Santos Cuchumatán, Guatemala. During the census, household and footpath data were recorded using a handheld Global Positioning System (GPS), and used to create digital census route maps, and perimeter and area estimates of the study region. Approximately 99% of all households (472/476) participated in the census, representing 2461 people in the overall estimated study region area of 80 hectares (ha). A total of 382 dogs were owned by 50.8% (240/472) of households, yielding means of 0.8 (382/472) owned dogs per household and 1.6 (382/240) dogs per dog-owning household. Of the total 382 owned dogs, 88.2% (337/382) were aged three months or older; of these, 68.5% (231/337) were reported as not normally being confined on the household property during the average day, and 9.7% (24/247) of the males and none of the females (0/81) were reported to be neutered. Of the households that owned female dogs, 89.7% (52/58) and 91.4% (53/58) reported that they would have females surgically or non-surgically neutered, respectively, if these services were available. Of the households that owned male dogs, 90.3% (176/195) and 92.3% (180/195) reported that they would have males surgically or non-surgically neutered, respectively, if these services were available. Approximately 72% (238/330) of owned dogs were vaccinated for rabies, and 80% (187/238) of these were males. The owned dog male:female ratio was 2.6:1 (275/107), the owned dog:human ratio was 1:6.4 (382/2461), and the absolute density was 478 (382/0.80) owned dogs/km(2). This knowledge of the owned dog demography was generated using simple means and has been of direct use in support of, and as baseline data for the planning, implementation and evaluation of subsequent dog population control measures in this population; they may be of similar use in other comparable populations.

Anemia in Cambodia: prevalence, etiology and research needs

Anemia is a severe global public health problem with serious consequences for both the human and socio-economic health. This paper presents a situation analysis of the burden of anemia in Cambodia, including a discussion of the country-specific etiologies and future research needs. All available literature on the prevalence and etiology of anemia in Cambodia was collected using standard search protocols. Prevalence data was readily identified for pre-school aged children and women of reproductive age, but there is a dearth of information for school-aged children, men and the elderly. Despite progress in nation-wide programming over the past decade, anemia remains a significant public health problem in Cambodia, especially for women and children. Anemia is a multifaceted disease and both nutritional and non-nutritional etiologies were identified, with iron deficiency accounting for the majority of the burden of disease. The current study highlights the need for a national nutrition survey, including collection of data on the iron status and prevalence of anemia in all population groups. It is impossible to develop effective intervention programs without a clear picture of the burden and cause of disease in the country.

Iron content of Cambodian foods when prepared in cooking pots containing an iron ingot

OBJECTIVES

To investigate the effect of cooking with an iron ingot on the iron content of several water and Cambodian food preparations.

METHODS

Various food and water samples were prepared, in replicate, in glass and aluminium pots with and without an iron ingot. The samples were subjected to iron content analysis using standard ICP-OES procedures.

RESULTS

Prepared with an ingot, the iron content was 76.3 μg iron/g higher in lemon water, 32.6 μg iron/g higher in pork soup and 3.3 μg iron/g higher in fish soup, than in the same foods prepared without an ingot. Acidity of the food samples was positively associated with iron leaching.

CONCLUSIONS

Even when taking into account the low bioavailability of contaminant iron, approximately 75% of the daily iron requirement can be met by consuming 1L of lemon water prepared with an iron ingot. Its use may be a cheap and sustainable means of improving iron intake for those with iron-deficient diets.

The REFLECT statement: methods and processes of creating reporting guidelines for randomized controlled trials for livestock and food safety

The conduct of randomized controlled trials in livestock with production, health, and food-safety outcomes presents unique challenges that might not be adequately reported in trial reports. The objective of this project was to modify the CONSORT (Consolidated Standards of Reporting Trials) statement to reflect the unique aspects of reporting these livestock trials. A 2-day consensus meeting was held on November 18-19, 2008 in Chicago, IL, to achieve the objective. Before the meeting, a Web-based survey was conducted to identify issues for discussion. The 24 attendees were biostatisticians, epidemiologists, food-safety researchers, livestock production specialists, journal editors, assistant editors, and associate editors. Before the meeting, the attendees completed a Web-based survey indicating which CONSORT statement items would need to be modified to address unique issues for livestock trials. The consensus meeting resulted in the production of the REFLECT (Reporting Guidelines for Randomized Control Trials) statement for livestock and food safety and 22-item checklist. Fourteen items were modified from the CONSORT checklist, and an additional subitem was proposed to address challenge trials. The REFLECT statement proposes new terminology, more consistent with common usage in livestock production, to describe study subjects. Evidence was not always available to support modification to or inclusion of an item. The use of the REFLECT statement, which addresses issues unique to livestock trials, should improve the quality of reporting and design for trials reporting production, health, and food-safety outcomes.

The REFLECT statement: methods and processes of creating reporting guidelines for randomized controlled trials for livestock and food safety

The conduct of randomized controlled trials in livestock with production, health, and food-safety outcomes presents unique challenges that may not be adequately reported in trial reports. The objective of this project was to modify the CONSORT (Consolidated Standards of Reporting Trials) statement to reflect the unique aspects of reporting these livestock trials. A two-day consensus meeting was held on November 18-19, 2008 in Chicago, Ill, United States of America, to achieve the objective. Prior to the meeting, a Web-based survey was conducted to identify issues for discussion. The 24 attendees were biostatisticians, epidemiologists, food-safety researchers, livestock production specialists, journal editors, assistant editors, and associate editors. Prior to the meeting, the attendees completed a Web-based survey indicating which CONSORT statement items may need to be modified to address unique issues for livestock trials. The consensus meeting resulted in the production of the REFLECT (Reporting Guidelines for Randomized Control Trials) statement for livestock and food safety (LFS) and 22-item checklist. Fourteen items were modified from the CONSORT checklist, and an additional sub-item was proposed to address challenge trials. The REFLECT statement proposes new terminology, more consistent with common usage in livestock production, to describe study subjects. Evidence was not always available to support modification to or inclusion of an item. The use of the REFLECT statement, which addresses issues unique to livestock trials, should improve the quality of reporting and design for trials reporting production, health, and food-safety outcomes.

Prevalence of Yersinia enterocolitica shedding and bioserotype distribution in Ontario finisher pig herds in 2001, 2002, and 2004

We investigated characteristics of Yersinia enterocolitica infection in Ontario finisher pig herds. Our specific objectives were to estimate or test: prevalence of Y. enterocolitica shedding in finisher pigs, bioserotype distribution, agreement between the herd-level tests based on sampling pig and pooled fecal samples, whether bioserotypes cluster by farms, and whether Y. enterocolitica-positive herds cluster spatially. In total, 3747 fecal samples were collected from 100 farms over the years 2001, 2002, and 2004 (250 total herd visits). Fecal samples were tested by culture and positive isolates were biotyped and serotyped. Apparent pig-level prevalence of Y. enterocolitica was 1.8%, 3.2%, and 12.5% in 2001, 2002, and 2004, respectively. Estimated true pig-level prevalence of Y. enterocolitica was 5.1%, 9.1%, and 35.1% in 2001, 2002, and 2004, respectively. Herd-level prevalence was 16.3%, 17.9%, and 37.5% in 2001, 2002, and 2004, respectively. In all years, the most common bioserotype was 4, O:3, followed by bioserotype 2, O:5,27. Kappa between herd-level status based on pig and pooled samples ranged between 0.51 and 0.68 for biotype 1A and bioserotype 4, O:3, respectively. For 4, O:3, a significant bias in discordant pairs was detected, indicating that pig samples were more sensitive than pooled samples in declaring a herd as positive. Farms tended to be repeatedly positive with the same bioserotype, but positive study farms did not cluster spatially (suggesting lack of between herd transmission and lack of a common geographic risk factor).

The REFLECT statement: methods and processes of creating reporting guidelines for randomized controlled trials for livestock and food safety

The conduct of randomized controlled trials in livestock with production, health, and food-safety outcomes presents unique challenges that may not be adequately reported in trial reports. The objective of this project was to modify the CONSORT (Consolidated Standards of Reporting Trials) statement to reflect the unique aspects of reporting these livestock trials. A two-day consensus meeting was held on November 18-19, 2008 in Chicago, IL, United States of America, to achieve the objective. Prior to the meeting, a Web-based survey was conducted to identify issues for discussion. The 24 attendees were biostatisticians, epidemiologists, food-safety researchers, livestock-production specialists, journal editors, assistant editors, and associate editors. Prior to the meeting, the attendees completed a Web-based survey indicating which CONSORT statement items may need to be modified to address unique issues for livestock trials. The consensus meeting resulted in the production of the REFLECT (Reporting Guidelines For Randomized Control Trials) statement for livestock and food safety (LFS) and 22-item checklist. Fourteen items were modified from the CONSORT checklist, and an additional sub-item was proposed to address challenge trials. The REFLECT statement proposes new terminology, more consistent with common usage in livestock production, to describe study subjects. Evidence was not always available to support modification to or inclusion of an item. The use of the REFLECT statement, which addresses issues unique to livestock trials, should improve the quality of reporting and design for trials reporting production, health, and food-safety outcomes.

Prevalence of Campylobacter spp isolated from grower-finisher pigs in Ontario

This study aimed to establish the prevalence of Campylobacter spp. in 80 Ontario grower-finisher pig herds. Ninety-nine percent of the isolates yielded Campylobacter, C coli being the most common species detected. Control of this microorganism must rely on careful food processing and storage of pork, rather than on an on-farm approach.

Evaluation of enzyme-linked immunosorbent assay (ELISA) tests and culture for determining Salmonella status of a pig herd

The purpose of this study was to evaluate Salmonella ELISA tests and a culture technique to determine Salmonella status using samples collected from commercial herds. Faecal samples from 15 finisher pigs on each of 40 swine farms were cultured for Salmonella. Sera from the same 600 pigs were analysed for the presence of antibodies to Salmonella by means of two different ELISA kits Salmotype (Salmotype Labordiagnostik, Leipzig, Germany) and IDEXX (Herdchek* Salmonella; IDEXX Laboratories, Schiphol-Rijk, Noord-Holland, The Netherlands). The Salmotype ELISA test demonstrated a moderate ability to differentiate culture-positive pigs from culture-negative pigs while IDEXX was relatively poor in classifying those pigs correctly (The area under the curves were 0.79 and 0.65 for Salmotype and IDEXX respectively). The maximum value of sensitivity plus specificity was gained at the cut-off optical density (OD) > or =25% for Salmotype (sensitivity 0.65, specificity 0.84) and at the OD > or =9% for IDEXX (sensitivity 0.59, specificity 0.69). The maximum herd sensitivity and herd specificity was 0.64 (95% CI 0.49-0.79) and 0.72 (95% CI 0.59-0.86) for the Salmotype test and 0.73 (95% CI 0.59-0.87) and 0.62 (95% CI 0.47-0.77) for the IDEXX. Culture and the ELISA tests showed fair agreement at the herd level (kappa=0.3, P<0.05). Likewise there was significant disagreement between the two ELISA tests at the pig level, but very good agreement between the two ELISA tests (kappa=0.8, P<0.0001) at the herd level. The coating antigens in Salmotype and IDEXX represent only 48% of the antigens of Salmonella isolated in our study and need to be revised based upon the Salmonella serovar distribution in Ontario.

Postweaning mortality in Manitoba swine

A case-control study to investigate the contribution of postweaning multisystemic wasting syndrome (PMWS) and Porcine circovirus type 2 (PCV-2) to deaths among piglets of nursery age (19 to 68 d) in Manitoba indicated a significant positive association between PCV-2 infection and an increased mortality rate in nursery pigs. The clinical syndrome PMWS was seldom recognized in case or control herds; however, PCV-2 infection was widespread at the herd level. Other factors more strongly associated with increased piglet mortality rate than herd level PCV-2 infection were Mycoplasma hyopneumonia infection, porcine reproductive and respiratory syndrome (PRRS), and diarrhea caused by Eschericia coli K88. Management factors associated with case herd status included close proximity to other herds, larger number of sows supplying pigs to the nursery, larger range in age and weight going into the nursery, the moving of lightweight pigs into another nursery room at the end of the nursery fill, and not using spray-dried plasma in the 1st nursery ration. These results highlight the host-agent-environment triad leading to high nursery-barn mortality rates.