Experimental in vitro transmission of Babesia sp. (EU1) by Ixodes ricinus

Babesia sp. (EU1), first characterized in 2003, has been implicated in human cases of babesiosis in Italy, Austria and Germany. It has been identified in roe deer and in its suspected tick vector, Ixodes ricinus, in several European countries. The aim of the present study was to validate the competence of I. ricinus as a vector of Babesia sp. (EU1) via experimental infections. For this purpose, a parasite strain isolated from roe deer was cloned in sheep erythrocytes. After experimental infections, parasite DNA was successfully amplified by PCR in both eggs and larvae originating from infected I. ricinus females and in the salivary glands of females exposed to Babesia sp. (EU1) as nymphs. We also demonstrate that infected females were able to transmit parasite DNA during a new blood meal. Together with previous epidemiological studies, these results validate I. ricinus as a competent vector for Babesia sp. (EU1)

Building inclusive and welcoming student health centers for transgender students

INTRODUCTION: While health, wellness, and healthcare are essential to every human being, not much is known about the health and healthcare experiences of transgender students on college campuses. Understanding these healthcare experiences are important because when we recognize them, we can establish a healthy relationship of trust. There is a growing number of transgender students on West Chester University campus, who felt they were not getting the appropriate support and care. As a result, a project was started at student health services to help transgender students effectively access sensitive and welcoming care and support. METHODS: To address the needs of the transgender student population and improve the model of care at student health services, gaining a better understanding of the transgender community was a vital step. To become familiarized with their needs and health concerns, a Likert survey was created and disseminated to investigate the current issues regarding barriers of adequate care. Additionally, to identify the barriers of providing adequate care, student and health professional interviews were completed. The students involved in the interviews and questionnaires were recruited through LGBTQ Support Services Center on West Chester University’s campus. A needs assessment was also created to gain a better understanding of the health needs of the transgender student community. The available resources and services provided to the LGBTQ students at West Chester University were reviewed and compared to other colleges and universities. RESULTS: Students expressed that they felt the healthcare providers were underprepared to provide care and that their care could be improved upon. Through meeting with students and clinicians, a key barrier was the unfamiliarity with transgender health and in addressing transgender-specific health needs. It was also discovered that being unprepared to provide care, resulted in unconscious and implicit bias and the perpetuation of transgender exclusive practices. DISCUSSION: This project identified themes, barriers and areas of concern expressed by transgender students. By identifying these elements, further research can be conducted to better understand student’s perceptions and feelings when seeking healthcare, and whether these experiences impact health outcomes. The purpose of this project was to create an atmosphere geared towards providing healthcare services that are inclusive to all people of all gender identities. With the growing number of transgender students on college campuses, establishing welcoming health setting for students is very important

Le droit à sa place

À l’aide de témoignages de femmes vivant de l’itinérance visible et de l’itinérance cachée, cet article illustre comment celles-ci sont victimes de la violation de droits liés à leur condition. Ces droits bafoués révèlent que la violence familiale et conjugale, le refus d’accomplir un rôle d’aidante naturelle et la pauvreté sont également des portes d’entrée dans l’errance et l’itinérance. Ces trois aspects semblent par ailleurs contribuer à l’apparition de problèmes de dépendance (alcool et toxicomanie) et de santé mentale usuellement liés à l’entrée dans l’itinérance. Pour trouver des solutions durables à l’errance et à l’itinérance des femmes, travailler à la promotion de droits fondamentaux tels que l’accès au logement ou à des services appropriés semble donc insuffisant. Il est nécessaire de se pencher également sur les mécanismes et les formes d’oppression des femmes et leurs produits que sont la pauvreté, la violence et le travail domestique imposé. Trois enjeux sont soulevés pour l’intervention : 1) la reconnaissance de la non-visibilité de femmes à risque ou en situation d’errance et d’itinérance et le défi que ceci représente dans le cadre de pratiques d’interventions et de prévention fondées principalement sur l’apparence physique des personnes et des comportements associés à la maladie mentale ou la toxicomanie; 2) la nécessité de maintenir et de développer des services tenant compte de facteurs structuraux, notamment pour les femmes pauvres et leurs enfants; et 3) la reconnaissance des droits bafoués.Through interview excerpts with women living or having lived hidden or visible homelessness, the authors show how these women are victims of rights violation related to their status as women. These violations of rights reveal how violence, refusal to accomplish a role as « informal » caregiver as well as poverty might lead to homelessness. Distress linked to violence, poverty and traditional gender role compliance seem also to foster dependence (use of drugs and alcohol) and mental health problems that are often linked to causes of homelessness. To find durable answers to homelessness, work on right promotion is thus insufficient. It is necessary to also work on the structural mechanism of women’s oppression and its by-products that are poverty, violence and imposed domestic work. The authors present three challenges for intervention: the invisibility of women at risk, the necessity to maintain and develop services which take into account structural factors notably for poor women and their children and work for rights recognition

Attitudes and Practice Patterns in the Use of OMM in Patients with Serious Illness

INTRODUCTION: In addition to evidence-based medicine, the osteopathic approach to person-centered care consists of the osteopathic philosophy of integrated structure and function and applying manual techniques to treat somatic dysfunction. Known collectively as Osteopathic Manipulative Medicine (OMM), this approach can be utilized when treating patients with both chronic and acute conditions; however, there is limited data on how often or to what extent OMM is used to treat pain and other symptoms in patients facing serious or life-limiting illnesses. METHODS: A voluntary, anonymous survey was created to capture the practice patterns and attitudes of osteopathic physicians, regardless of specialty, in the uses and benefits of OMM in treating patients with serious illness. The survey was approved by the IRB and designed using a Likert-scale, multiple choice format using Redcap software and permission to distribute the survey electronically was granted from various national and local professional organizations including the American Osteopathic Association (AOA), Pennsylvania Osteopathic Medical Association (POMA) and the PCOM alumni association. Among key data analyzed were the frequency of OMM use in serious or life-limiting illness (Cancer, CHF, and COPD), attitudes about OMM, beliefs about OMM, and use of OMM in older adults. RESULTS: Osteopathic Physicians that utilize OMM when treating patients with serious illness have found OMM to be beneficial when treating certain conditions such as chronic and musculoskeletal pain, shortness of breath, and nausea. The physicians who use OMM also felt comfortable and proficient when utilizing it to treat certain conditions. They also felt their foundation in osteopathic Medicine enabled them to approach and care for patients with empathy and compassion. DISCUSSION: OMM is used by many osteopathic physicians when treating pain and other symptoms of patients who have serious illness. OMM has been found to be beneficial when treating conditions related to CHF, COPD, and Cancer. Osteopathic Physicians who do utilize Osteopathic Manipulative Medicine believe that their training has allowed them to engage and treat patients with compassion and empathy

Analysis of iatrogenic risk related to anticholinergic effects using two scales in acute geriatric inpatient unit

Anticholinergic medications are responsible for most frequent adverse drug effects. Two scales have been elaborated as tools for prescribers: the Anticholinergic Drug Scale (ADS) of Carnahan et al., and the Anticholinergic Risk Scale (ARS) of Rudolph et al. The objective of this study was to analyze the diagnostic performance of both scales for predicting signs related to an anticholinergic effect. Method: Medical records of 1379 patients aged 75 years or older hospitalized in a geriatric acute care unit between 2002 and 2005 were studied. The analyze was made retrospectively, but data were collected prospectively. Results: Risk of appearance of total anticholinergic signs (ADS : OR 1,45, CI 95% [1,03-2,03], p=0,037 and ARS : OR 1,98, CI 95% [1,19-3,28] p<0,01) and peripheral signs (ADS: OR 1,66, CI 95% [1,22-2,26], p<0,01 and ARS : OR 1,81, CI 95% [1,19-2,75], p<0,01) increased when score was >= 3 with both scales, which wasn\u27t the case for central signs. Conclusion: Both scales permitted to detect an increased risk of appearance of total and peripheral anticholinergic signs, but not the centrals as delirium. Interest of total anticholinergic burden remains to be demonstrated, especially for delirium risk assessment

Gastrointestinal nematode and lungworm infections in organic dairy calves reared with nurse cows during their first grazing season in western France

The rearing system of dairy calves with nurse cows has been developing since 2010 in organic farms in western France. This system allows cow-calf contact until a weaning age close to the natural weaning for cattle and is characterized by an early turnout for calves at around one month of age with their nurse cows and a first grazing season with mixed grazing of calves and adults at a ratio of 2–4 calves per nurse cow. The objectives of this study were to assess the gastrointestinal (GIN) and lungworm infections in such reared calves and their variability during the first grazing season. Faecal egg count (FEC), pepsinogen (PEP) concentration and Ostertagia ELISA optical density ratio (ODR) were determined in calves (n =497) at housing in 33 groups from 24 farms in 2018, and in calves (n =405) and nurse cows (n =199) throughout the 2019 grazing season in 41 groups from 20 farms. For lungworm infection, information was obtained during 2019 through the recording of coughing epi-sodes along the grazing season and the Dictyocaulus ELISA ODR determination at housing both in calves and nurses. Results indicated that the level of GIN infection was overall low for calves during the first grazing season with PEP and Ostertagia ODR group-average values ranging from 0.97 to 1.6 U Tyr and 0.23 to 0.71 ODR respectively. No anthelmintic treatment being given in any group of calves. Ostertagia ODR values increased with the duration of the grazing season (>240 d) and with the ratio calves/nurse (>2). GIN parameters for nurses remained fairly stable during the grazing season with mean FEC, PEP and Ostertagia ODR group-average values of 13 epg, 2.28 U Tyr and 0.81 ODR, respectively. Antibodies against lungworms were detected in 3–62 % of calves depending on the duration of grazing, but only 6% of calves showed a coughing episode. The dilution effect due to the mixed grazing of resistant (nurse cows) and susceptible (calves) animals associated with predominant milk diet of calves during the first months of grazing in combination with protective grazing management allow calves to be turned out at an early age without using anthelmintic treatments. Further studies are needed to assess the GIN infection dynamics during the second grazing season in weaned heifers

Suckling Dairy Calves/Nurse Cows System And Risk Of Gastrointestinal Nematodes Infection During The First Grazing Season In Organic Farms

In dairy farms, new rearing practices of calves with nurse cows have been developed by farmers but still remain poorly documented. The objective was to assess the impact of rearing suckling calves with nurse cows on the same pastures on the risk of gastrointestinal nematode (GIN) infection in calves. The grazing management has been recorded for each group. Serum pepsinogen level and GIN egg excretion per gram of faeces (epg) were determined in 438 calves belonging to 38 groups from 30 farms in the western part of France at housing (October 2018 to January 2019). The maximum number of infective larval generations met by the animals (LG) in each pasture plot was modelled by Parasit’Sim expert system. The data were analyzed using logistic regression (univariate and multivariate). Mean parasiticological parameters per group were low. On average, the serum pepsinogen level was 1.1 units of tyrosine (U Tyr) and the GIN egg output was 130 epg. Pasture infectivity was above LG4 for 2/3 of the groups. These results suggest that rearing suckling dairy calves with nurse cows decreases the level of GIN infection in calves at the end of the 1st grazing season compared with putting out to pasture weaned heifers alone. This can be explained by i) the fact that cows were immune and have a cleansing effect on the pastures when eating a lot of larvae while excreting few eggs and ii) Because not weaned calves had a slow larval intake when drinking milk from nurse cows

Performance and health status of dairy calves reared with nurse cows, a 2-year study involving 3 cohorts

The agro-ecological transition is based on “bottom up” innovation processes developed by agricultural stakeholders. The role of researchers is now to accompany this process by working closely with them. Since the 90s, groups of dairy farmers have been set up in many developed countries to exchange information about intensive grazing management. Within these groups, organic dairy breeders have experimented new cow-calf rearing practices, in which a specific batch of lactating cows is constituted in order to nurse and raise 2-4 calves each (usually replacement heifers) for several months on pasture. The objective of our study was to assess effects of this innovative rearing system on growth and health of the calves, with a focus on the risk of grazing parasite (gastrointestinal nematodes). On an experimental organic farm located in East of France, we designed a cow-calf rearing system in collaboration with farmers experienced on this practice. A 2-year study of 3 cohorts of 9, 16 and 23 calves was conducted from 2016 to 2019. We weighed, recorded all health events and measured different parasitic indicators at key times of the grazing season. Calves showed a fast and steady growth during the 2 years of follow-up, allowing a calving at 24 months old. Parasitic risks were low, with nurse cows playing a protective role towards infection. In addition, early immunity against gastrointestinal nematodes was developed in calves. Throughout the study, the calves did not receive any antibiotic nor anti-parasitic treatments. Only one calf died due to ruminal tympany. Rearing calves with nurse cows seems to be of real interest for their growth and health, and in particular the management of parasitic risks. Further studies in other farms are needed to validate these results