Organizing professionals and their impact on performance:the case of public health doctors in the Italian SSN

Hybrid professional managers have been associated with improvements in the performance of public sector organisations. However, less attention has been given to differences within this category. Drawing on board human capital theory, we focus on an emerging group of ‘organising professionals’ with earlier and deeper exposure to management training and education: generalist clinical hybrids drawn from public health in the Italian healthcare system. Specifically, we investigate the impact that these hybrid hospital CEOs have on organisational performance in comparison with other backgrounds. The results indicate that this form of generalist hybrid professionalism has distinct, if not dramatic, consequences for performance

Clinical investigation on Theileria equi and Babesia caballi infections in Italian donkeys

Background: Interest in the welfare and diseases of donkeys is constantly increasing in several countries. Despite this, clinical research into donkeys needs to be in continual development since they show different reactions compared to horses in many conditions, including infectious diseases, and need specific clinical and therapeutic approaches. No reports are currently available on clinical and clinical pathology data regarding donkeys with natural piroplasms infection. Results: Venous blood samples were taken from one hundred and thirty eight donkeys and underwent indirect fluorescent antibody test (IFAT) to detect IgG antibodies against Theileria equi and Babesia caballi and real-time polimerase chain reaction (PCR) to detect Babesia spp. and Theileria spp.. Clinical examinations, haematological analyses and serum bilirubin evaluation were also performed and compared with positive or negative status. A seroprevalence of 40.6% and 47.8% was found for T. equi and B. caballi, respectively; double positivity was detected in 19.6% of the animals. PCR results showed that 17.4% of the animals tested positive for T.equi and 3.6% for B. caballi with no double positivity. Twelve donkeys (8.7%) had clinical signs consistent with chronic forms of the disease and no acute forms were detected. Fifty-eight donkeys had haematological and serum bilirubin alterations and 56 (96.6%) of them were IFAT and/or PCR positive. Changes in erythrocyte number, packed cell volume, hemoglobin concentration, mean corpuscular hemoglobin, platelets number and total bilirubin were significantly associated with positive and symptomatic animals. Conclusion: Nonspecific clinical presentation seems to be very common in donkeys and several clinical pathology alterations persist after natural infection. Therefore, apparently healthy donkeys can have masked but severe clinical pathology alterations. Acute forms are very seldom observed in donkeys. Clinical monitoring of chronically infected donkeys is recommended since such animals represent a risk both for transmission to other animals and for their own health; furthermore, their production performances could be reduced. The study should also be intended as a contribution for veterinary practitioners because it describes the most usual clinical presentations and laboratory findings of equine piroplasmosis in naturally infected donkeys in endemic areas

Ascaridia galli: a report of erratic migration

This paper describes a case of an unusual recovery of adult Ascaridia galli in hen's egg. Several data are available on this occurrence but it appears to be the first case described in Italy. The worm was identified as an adult female, 6.8 cm in length, with three trilobed lips, cervical narrow alae, oesophagus club-shaped without posterior bulb, vulva near the middle of body, with gravid uteri containing a large number of eggs. The presence of Ascaridia galli in hen's eggs cannot be considered as hazard for public health but may be cause of a potential consumer complaint. Moreover it is a sign of presence of ascaridiosis, parasitosis that still produces economic losses in modern poultry production system

Absence of Viable Toxoplasma gondii in Artisanal Raw-Milk Ewe Cheese Derived from Naturally Infected Animals

The presence of viable Toxoplasma gondii was investigated in artisanal cheeses made from milk of naturally infected ewes. Ewe milk was analyzed beforehand for the presence and vitality of T. gondii by loop-mediated isothermal amplification (LAMP) and reverse-transcriptase PCR (RT-PCR), respectively. Cheeses were prepared from raw milk following a traditional cheesemaking process. The cheese obtained from T. gondii-positive milk was analyzed by LAMP to detect Toxoplasma DNA-positive samples. RT-PCR was then carried out to assess the viability of the parasites in T. gondii-positive milk samples and fresh cheese, after 5 and 15 days of ripening. Physical-chemical parameters of cheeses were also investigated. All cheese samples derived from T. gondii-positive milk were positive according to LAMP, at both 5 and 15 days of ripening, while none of the samples were positive according to RT-PCR. Thus, while the presence of the parasite was demonstrated by the detection of specific DNA, the absence of detectable T. gondii RNA supports the hypothesis that changes in the chemical and physical characteristics occurring during the cheesemaking process and ripening period, could be sufficient to inactivate viable T. gondii in milk, minimizing the risk of human infection through consumption of raw sheep milk cheese

Polysynovitis in a horse due to Borrelia burgdorferi sensu lato infection – Case study

Lyme borreliosis (LB) is a multi-systemic tick-borne disease affecting both humans and animals, including horses, and is caused by a group of interrelated spirochetes classified within the Borrelia burgdorferi sensu lato (s.l.) complex. Despite the high reported seroprevalence in the European equine population for B. burgdorferi s.l., to-date no documented clinical cases have been described. A 6-year-old Paint gelding was referred with a history of three weeks of fever, intermittent lameness and digital flexor tendon sheath effusion of the right hind limb. Based on a strict diagnostic protocol, which included serological tests for infectious diseases and molecular investigations, a final diagnosis was made of polysynovitis due to B. burgdorferi s.l. infection. An unreported aspect observed in this case was the absence of the pathogen DNA in two of the affected joints. To the authors' knowledge, the case described represents the first documented clinical case of equine LB in Italy. Moreover, the absence of pathogen DNA in two of the affected joints observed in this case revealed a possible similarity with the same condition described in humans, where an immunomediated pathogenesis for arthropathy due to B. burgdorferi s.l. infection is suspected. Since humans and horses share the same habitat, this report supports the role of the horse as potential sentinel for human biological risk

Efficacy of milbemycin oxime/afoxolaner chewable tablets (NEXGARD SPECTRA®) against Capillaria aerophila and Capillaria boehmi in naturally infected dogs

BACKGROUND: Capillaria aerophila and Capillaria boehmi parasitize the respiratory system of wild and domestic carnivores. Capillaria aerophila inhabits the trachea and bronchi of dogs and cats, while C. boehmi affects the nasal cavities and sinuses of dogs. In dogs the infection may be subclinical or characterized by varying respiratory distress.METHODS: The present study evaluated the efficacyof an oral formulation containing milbemycin oxime and afoxolaner (NEXGARD SPECTRA) in dogs naturally infected with C. aerophila and/or C. boehmi from three enzootic areas of Italy. Dogs were enrolled pending fecal examination and molecular confirmation of respiratory capillarioses. Dogs were allocated in two groups: Group 1 (G1, 25 dogs), treated with a negative control product with no anthelmintic activity (afoxolaner, NEXGARD), and Group 2 (G2, 26 dogs), treated with NEXGARD SPECTRA. At the day of treatment administration (Day 0), all dogs were clinically examined. Dogs were again subjected to clinical and fecal examinations at Days 28 (±4) and 56 (±2). The primary criterion for treatment efficacy was the reduction of fecal Capillaria egg counts in G2 compared with G1. The regression of/recovery from baseline clinical signs was considered as a further efficacy criterion.RESULTS: Percentage reduction of fecal Capillaria egg counts in the NEXGARD SPECTRA group compared to the control group was >97% on Day 28 and 100% on Day 56, respectively (p<0.05 for both time points). Twelve of the 13 dogs in the NEXGARD SPECTRA group with respiratory signs prior to treatment were free of clinical signs at the end of the study. Conversely, the six control group dogs with respiratory signs prior to treatment remained symptomatic.CONCLUSIONS: Results of the present study showed that NEXGARD SPECTRA was safe and highly efficacious in the reduction of C. aerophila and C. boehmi eggs after one treatment with a complete reduction of the egg output after the second administration associated with a recovery from respiratory signs

Transmission of Rickettsia raoultii and Rickettsia massiliae DNA by Dermacentor reticulatus and Rhipicephalus sanguineus (s.l.) ticks during artificial feeding

BACKGROUND : Tick-borne rickettsial pathogens are emerging worldwide and pose an increased health risk to both humans and animals. A plethora of rickettsial species has been identified in ticks recovered from human and animal patients. However, the detection of rickettsial DNA in ticks does not necessarily mean that these ticks can act as vectors for these pathogens. Here, we used artificial feeding of ticks to confirm transmission of Rickettsia massiliae and Rickettsia raoultii by Rhipicephalus sanguineus (sensu lato) and Dermacentor reticulatus ticks, respectively. The speed of transmission was also determined. METHODS : An artificial feeding system based on silicone membranes were used to feed adult R. sanguineus (s.l.) and D. reticulatus ticks. Blood samples from in vitro feeding units were analysed for the presence of rickettsial DNA using PCR and reverse line blot hybridisation. RESULTS : The attachment rate of R. sanguineus (s.l.) ticks were 40.4% at 8 h post-application, increasing to 70. 2% at 72 h. Rickettsia massiliae was detected in blood samples collected 8 h after the R. sanguineus (s.l.) ticks were placed into the in vitro feeding units. D. reticulatus ticks were pre-fed on sheep and subsequently transferred to the in vitro feeding system. The attachment rate was 29.1 % at 24 h post-application, increasing to 43.6 % at 96 h. Rickettsia raoultii was detected in blood collected 24 h after D. reticulatus was placed into the feeding units. CONCLUSIONS : Rhipicephalus sanguineus (s.l.) and D. reticulatus ticks are vectors of R. massiliae and R. raoultii, respectively. The transmission of R. massiliae as early as 8 h after tick attachment emphasises the importance of removing ticks as soon as possible to minimise transmission. This study highlights the relevance of in vitro feeding systems to provide insight into the vectorial capacity of ticks and the dynamics of tick-borne pathogen transmission.http://www.parasitesandvectors.comam2018Veterinary Tropical Disease

Seroprevalence and risk factors for Toxoplasma gondii in sheep in Grosseto district, Tuscany, Italy

Abstract Background Serum samples from 630 milk sheep, in 33 dairy flocks representative of the southern area of the Tuscany region, were tested for the presence of antibodies to Toxoplasma gondii using an indirect immunofluorescence antibody test (IFAT). Questionnaires exploring the management system were completed by the veterinarian in charge of the flocks. Results At least one seropositive animal was found in 32 of the 33 flocks tested (97.0%; 95% CI: 84.2%, 99.9%). In the positive flocks, median seroprevalence was 29.4% (interquartile range: 15.9%-46.1%). Overall animal-level seroprevalence, adjusted for sampling weights and test sensitivity and specificity, was 33.3% (95% CI: 24.8%, 42.7%). In a multivariable negative binomial regression model the number of seropositive animals in a flock decreased with increasing flock size (for >400 vs. CR) = 0.62; 95% CI: 0.41, 0.95; P = 0.028) and was greater on farms where stray cats had access to animals’ water (CR = 1.54; 95% CI: 1.05, 2.26; P = 0.027). Conclusions Small flock size and access of cats to water are potential risk factors for Toxoplasma infection in sheep in the Grosseto district in Tuscany, Italy. Sheep could be an important source of T. gondii infection in humans, since we estimate that between 25% and 43% of sheep in the district were seropositive. Toxoplasmosis is also likely to be an important cause of abortion in sheep in the district. Control and prophylactic measures must be adopted to improve the rearing system and the implementation of health promoting programmes in a joint effort between sheep farmers, farmers’ associations and veterinarians to inform about the means of transmission of the infection and for a better understanding of the disease.</p

Seroprevalence and risk factors for Toxoplasma gondii in sheep in Grosseto district, Tuscany, Italy

BACKGROUND: Serum samples from 630 milk sheep, in 33 dairy flocks representative of the southern area of the Tuscany region, were tested for the presence of antibodies to Toxoplasma gondii using an indirect immunofluorescence antibody test (IFAT). Questionnaires exploring the management system were completed by the veterinarian in charge of the flocks. RESULTS: At least one seropositive animal was found in 32 of the 33 flocks tested (97.0%; 95% CI: 84.2%, 99.9%). In the positive flocks, median seroprevalence was 29.4% (interquartile range: 15.9%-46.1%). Overall animal-level seroprevalence, adjusted for sampling weights and test sensitivity and specificity, was 33.3% (95% CI: 24.8%, 42.7%). In a multivariable negative binomial regression model the number of seropositive animals in a flock decreased with increasing flock size (for >400 vs. <300 animals: count ratio (CR) = 0.62; 95% CI: 0.41, 0.95; P = 0.028) and was greater on farms where stray cats had access to animals’ water (CR = 1.54; 95% CI: 1.05, 2.26; P = 0.027). CONCLUSIONS: Small flock size and access of cats to water are potential risk factors for Toxoplasma infection in sheep in the Grosseto district in Tuscany, Italy. Sheep could be an important source of T. gondii infection in humans, since we estimate that between 25% and 43% of sheep in the district were seropositive. Toxoplasmosis is also likely to be an important cause of abortion in sheep in the district. Control and prophylactic measures must be adopted to improve the rearing system and the implementation of health promoting programmes in a joint effort between sheep farmers, farmers’ associations and veterinarians to inform about the means of transmission of the infection and for a better understanding of the disease.Additional file 1: Audit form on rearing practices from 33 farms in Grosseto district, Tuscany, Italy.The study idea was conceived by BCG. BCG, PS and AC participated in the design of the study. FV and IM participated in the acquisition of the laboratory data. AC collected serum samples with the attending veterinarians and helped administering the questionnaire. PT and VC provided previously acquired reference data. BCG and PT carried out the statistical analysis. Data interpretation was done by all authors. BCG and PT drafted the manuscript. All authors contributed to the critical revision of the manuscript for important intellectual content and have seen and approved the final draft.The authors thank all those colleagues who have helped in our on-going research projects, in particular Prof. Barend Louis Penzhorn and Dr Nada Abu Samra of the University of Pretoria, Faculty of Veterinary Science, Onderstepoort, South Africa; Dr Carlo Crotti and Dr Ludovico Renda, veterinary practitioners in Perugia, Italy, and Prof. Piergili Fioretti, University of Perugia, Italy. The authors also express sincere appreciation to members of Polyglot, Perugia, for a careful reading and comments on the article. The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the University of Perugia. Within the framework of the dottorato di ricerca «Sanità animale, produzioni zootecniche e sicurezza degli alimenti – XXVIII Ciclo» this research was supported by a grant from Fondazione Cassa di Risparmio di Perugia, Italy.http://www.biomedcentral.com/1746-6148/9/25am2013ab201