Applying ethological and health indicators to practical animal welfare assessment

There is a growing effort worldwide to develop objective indicators for animal welfare assessment, which provide information on an animal’s quality of life, are scientifically trustworthy, and can readily be used in practice by professionals. Animals are sentient beings capable of positive and negative emotion, and so these indicators should be sensitive not only to their physical health, but also to their experience of the conditions in which they live. This paper provides an outline of ethological research aimed at developing practical welfare assessment protocols. The first section focuses on the development and validation of welfare indicators generally, in terms of their relevance to animal well-being, their interobserver reliability, and the confidence with which the prevalence of described features can be estimated. Challenges in this work include accounting for the ways in which welfare measures may fluctuate over time, and identifying measures suited to monitoring positive welfare states. The second section focuses more specifically on qualitative welfare indicators, which assess the ‘whole animal’ and describe the expressive qualities of its demeanour (e.g. anxious, content). Such indicators must be validated in the same way as other health and behaviour indicators, with the added challenge of finding appropriate methods of measurement. The potential contribution of qualitative indicators, however, is to disclose an emotional richness in animals that helps to interpret information provided by other indicators, thus enhancing the validity of welfare assessment protocols. In conclusion, the paper emphasises the importance of integrating such different perspectives, showing that new knowledge of animals and new ways of relating to animals are bot

Accounting for Housing in Poverty Analysis

The treatment of housing in the definition of income used to measure poverty makes a big difference to who is counted as poor. Both the Before Housing Costs (BHC) and After Housing Costs (AHC) measures in current use in the UK pose problems. BHC income does not capture the advantages of living in owner-occupied housing and AHC income might not account for the benefits of living in higher-quality accommodation. We explore the potential of including in income the difference between the estimated value of housing consumed and housing costs, which we refer to as net imputed rent. We investigate whether findings about child and pensioner poverty, and judgements about the effectiveness of poverty-reducing policies, are affected by accounting for housing in this way

Are Child's Class C Patients With Acute Variceal Bleeding Worth Treating?

In the ten year period January 1980 to December 1989, 102 patients with Child’s Class C liver disease (Pugh's Modification) were admitted with acute variceal bleeding to one surgical unit with a policy of early sclerotherapy. There were 56 males and 46 females; the average age was 55 years (range 28–77). Fifty-three suffered from alcoholic cirrhosis. Four died before definitive treatment could be carried out, three from liver failure and one from uncontrolled bleeding. Of the remaining 98 patients, eight had urgent oesophageal transection with three deaths from hepatorenal failure; 90 had sclerotherapy with 19 hospital deaths, nine from recurrent bleeding, eight from liver failure often coupled with renal failure and two from respiratory complications. Of the 76 who survived to leave hospital, 52 received chronic injection sclerotherapy, 10 had elective oesophageal transection and 14 did not have further elective intervention for various reasons. Surviving patients have been followed up at a special Liver Clinic with minimum follow up of one year. Although no patient has yet survived ten years, the one, five and eight year survivals of 50%, 21% and 13% suggest that salvage of thdse patients is worthwhile

Patients\u27 experiences of a clinical pharmacist integrated into a General Practice setting

Presentation at 2015 Primary Health Care Research Conference, Adelaide, Australia, 29-31 July

Mechanical and Topographical Changes on Dentine Following Citric Acid Exposure

Objectives: 1. To determine the effects of short-term exposure of dentine to different concentrations and pH of citric acid; 2. To determine the stiffness and topographical changes associated with dentine erosion. Methods: Bovine incisors were prepared into 20 dentine discs (5mm3 ) and polished with 0.05\ub5m Al2 O 3 paste. Erosion was measured in terms of topographical and stiffness changes using atomic force microscope (AFM, Nanowizard 3, JPK Instruments). Specimens were exposed via the AFM liquid flow-cell to 1wt% or 6wt% citric acid, either unbuffered (pH 2.17 or 1.88, respectively) or buffered (pH 3.8) for repeated 20s cycles of citric acid up-to 120s. Baseline measured in PBS only. A representative sample was selected from each group for post-erosion scanning electron microscope (SEM) assessment. Results: Table 1 outlines stiffness results and AFM topography images demonstrate all groups post-erosion. The 1% buffered group had the least measurable changes across all time intervals and the 6% unbuffered citric acid had the greatest overall impact on the surface. The 6% buffered acid was more erosive compared with the 1% unbuffered acid, in terms of both stiffness and topography changes, between 20s and 80s exposures. However, the 1% unbuffered group had similar erosive surface changes, as for the 6% buffered samples, with increasing exposure times at 100s onwards. SEM and AFM topography showed a similar loss of peri-tubular dentine with enlargement of the tubules. AFM also demonstrated increased surface height variations with increasing exposure times and similar erosive trends to mechanical stiffness changes. Conclusions: The data shows that citric acid concentration is more critical to early erosive changes on dentine compared with a lower pH, demonstrated by stiffness elasticity reduction and structural changes. The 1% buffered group was the least erosive acid, compared with the 6% unbuffered solution which had the greatest surface changes. These AFM findings were supported by SEM dat

The US Distribution of Physicians from Lower Income Countries

Introduction: Since the 1960 s, the number of international medical graduates (IMGs) in the United States has increased significantly. Given concerns regarding the effects of this loss to their countries of origin, the authors undertook a study of IMGs from lower income countries currently practicing in the United States. Methods: The AMA Physician Masterfile was accessed to identify all 265,851 IMGs in active practice in the United States. These were divided by state of practice and country of origin. World Bank income classification was used to identify lowe

Taking down ‘the Ivory Tower’: leveraging academia for better health outcomes in Uganda

http://deepblue.lib.umich.edu/bitstream/2027.42/112732/1/12914_2011_Article_147.pd

A survey of Sub-Saharan African medical schools

<p>Abstract</p> <p>Background</p> <p>Sub-Saharan Africa suffers a disproportionate share of the world's burden of disease while having some of the world's greatest health care workforce shortages. Doctors are an important component of any high functioning health care system. However, efforts to strengthen the doctor workforce in the region have been limited by a small number of medical schools with limited enrolments, international migration of graduates, poor geographic distribution of doctors, and insufficient data on medical schools. The goal of the Sub-Saharan African Medical Schools Study (SAMSS) is to increase the level of understanding and expand the baseline data on medical schools in the region.</p> <p>Methods</p> <p>The SAMSS survey is a descriptive survey study of Sub-Saharan African medical schools. The survey instrument included quantitative and qualitative questions focused on institutional characteristics, student profiles, curricula, post-graduate medical education, teaching staff, resources, barriers to capacity expansion, educational innovations, and external relationships with government and non-governmental organizations. Surveys were sent via e-mail to medical school deans or officials designated by the dean. Analysis is both descriptive and multivariable.</p> <p>Results</p> <p>Surveys were distributed to 146 medical schools in 40 of 48 Sub-Saharan African countries. One hundred and five responses were received (72% response rate). An additional 23 schools were identified after the close of the survey period. Fifty-eight respondents have been founded since 1990, including 22 private schools. Enrolments for medical schools range from 2 to 1800 and graduates range from 4 to 384. Seventy-three percent of respondents (n = 64) increased first year enrolments in the past five years. On average, 26% of respondents' graduates were reported to migrate out of the country within five years of graduation (n = 68). The most significant reported barriers to increasing the number of graduates, and improving quality, related to infrastructure and faculty limitations, respectively. Significant correlations were seen between schools implementing increased faculty salaries and bonuses, and lower percentage loss of faculty over the previous five years (<it>P </it>= 0.018); strengthened institutional research tools (<it>P </it>= 0.00015) and funded faculty research time (<it>P </it>= 0.045) and greater faculty involvement in research; and country compulsory service requirements (<it>P </it>= 0.039), a moderate number (1-5) of post-graduate medical education programs (<it>P </it>= 0.016) and francophone schools (<it>P </it>= 0.016) and greater rural general practice after graduation.</p> <p>Conclusions</p> <p>The results of the SAMSS survey increases the level of data and understanding of medical schools in Sub-Saharan Africa. This data serves as a baseline for future research, policies and investment in the health care workforce in the region which will be necessary for improving health.</p