A risk assessment approach to meticillin-resistant Staphylococcus aureus (MRSA) in pet dogs

A risk assessment approach was used to: a) define the risk of acquisition of meticillin-resistant Staphylococcus aureus (MRSA) in pet dogs over a defined time period, b) attempt to identify important priority data gaps for future research efforts in this area and c) comment on the usefulness of risk assessment in this regard, in a data sparse area and in a field in which it has not previously been used. A conceptual model was defined that identified the potential pathways for acquisition of MRSA in a pet dog over any given 24 hours. A qualitative risk assessment, using categorical qualitative estimators and combining estimates using a matrix approach was undertaken. It was found that this approach was unsatisfactory for the specification of this biological model that encompassed a non-modular, non-sequential form, characterised by non-mutually exclusive pathways of acquisition. Modification of the categorical descriptors enabled a relative, rather than absolute assessment of risk and resulted in the conclusion that both veterinary and non-veterinary routes were potentially important for the acquisition of MRSA in pet dogs and that family members and staff were likely to be the most important sources of the organism in the community and veterinary clinic environments respectively. Given the limitations encountered, a quantitative risk assessment was pursued. Data gaps that were defined within the qualitative risk assessment were addressed through dedicated data-collection studies and an expert opinion elicitation exercise. The studies found a lower veterinary environmental and staff prevalence than had previously been reported, corroborated prior estimates of dog-dog and dog-human interactions and justified the inclusion of dog foods as environmental sources of MRSA rather than independent and important sources in their own right. The expert opinion elicitation exercise used a modified technique to obtain numerous estimates relating to prevalence and transmission of MRSA. However, it was found that experts lacked confidence in estimation of transmission variables in particular, and the resulting distributions for these variables demonstrated divergence between experts and resulted in wide and poorly-informative combined distributions. These results were utilised, along with published and unpublished data, to parameterise a second order stochastic simulation-based quantitative risk assessment model. The model produced a biologically plausible outcome and allowed the application of sensitivity analyses with the intention of identifying areas of putative importance for future research efforts. The implementation of logistic regression analyses directly to the input/output relationship within the simulation model represented a novel application of a variance-based sensitivity analysis technique in the area of veterinary medicine, and was implemented with and without the consideration of interaction terms. In addition, one-at-a-time (OAT) and Plackett-Burman (P-B) analyses were also completed. The results of the sensitivity analyses were complicated and ambiguous. While family members and the environment were identified as potentially important independent and non-independent sources of MRSA, respectively, it was not possible to discount, or defensibly rank the importance of other sources. In conclusion, it was found that, despite the application of well researched and previously utilised methods, marked limitations were encountered in the use of risk assessment to address a biologically complex phenomenon that is characterised by sparse data such as this

China\u27s New Foreign Law Firm Regulations: A Step in the Wrong Direction

Following China\u27s accession to the World Trade Organization ( WTO ), the Chinese government issued new regulations governing foreign law firms in China. A number of commentators have analyzed these regulations to evaluate whether China is \u27on track to fulfilling the commitments it undertook to gain entry to the WTO. However, a more basic question that should be addressed is whether the new regulations meet China\u27s goals in joining the WTO: to foster trade and economic development and to accelerate the growth of China\u27s legal profession. Although China appeared willing to engage in significant liberalization of the legal services sector when it joined the WTO, the new regulations reflect a much more cautious approach in recognition of the vulnerability of Chinese law firms to foreign competition. On one hand, the regulations shield an infant domestic industry from competition in spheres of activity where Chinese law firms already dominate, while, on the other hand, they favor the expansion into China of some of the largest foreign firms in the world by erecting costly barriers to entry that deter entry by smaller foreign firms. As China\u27s market forle gal services expands, and the demand for legal expertise in complex commercial transactions grows, Chinese firms, which lack a deep pool of attorneys experienced in commercial transactions, are likely to be squeezed out of the transactional segment of the market by larger, more efficient foreign firms. China\u27s approach in adopting the new regulations fails to recognize the benefits of competition and the regulations should therefore be revised. By lowering barriers to entry and permitting free interaction between Chinese and foreign lawyers, China can accelerate the development of its legal services sector and continue to sustain high levels of economic growth

Final Report of a Novel and Successful Online Public Health Capacity Building Experiment – Peoples-uni

The People’s Open Access Education Initiative (Peoples-uni) was established as an educational charity to help reduce inequalities in access to the higher education required to build Public Health capacity through workforce development for health professionals in low- to middle-income countries (LMICs). Online learning, using open source software, Open Educational Resources and an international cadre of volunteer tutors, underpinned a low cost programme which produced a number of successful outcomes including university validated master’s level awards, continuing professional development, positive feedback from students, and the application by alumni of skills learned. Peoples-uni closed in 2021, its programme taken over by another organisation, and this paper builds on previous reports to summarise the experience and draw lessons for others who may wish to contribute in a similar way

"Prevention is the biggest success”: barriers and enablers to personal biosecurity in the thoroughbred breeding industry

Employees in the equine industry are at occupational risk of zoonoses such as Hendra virus and equine chlamydiosis through exposure to infected materials. This study aimed to gain a deeper understanding of the views and experiences of employees, and the key drivers of infection control and personal biosecurity (PB) practices in the Thoroughbred breeding industry. Methods: An exploratory qualitative study was conducted in 2018 in New South Wales, Australia using interviews (9) and small group discussions (7). The 29 participants included veterinarians, veterinary nurses, foaling staff, stud managers and laboratory personnel working in a range of equine medicine settings. Interviews and focus groups were recorded, transcribed and analysed manually by at least two members of the research team. An iterative approach was used to derive themes. Results: Five main themes emerged: (i) greater awareness of current and emerging infectious risks promotes use of Personal Protective Equipment (PPE); (ii) currently available PPE is not comfortable, practical or well-suited to equine reproductive work in Australia’s hot climate; (iii) creating supportive environments for PB reduces risk of exposure to infectious materials; (iv) strong leadership is required to implement sustainable change in workplace culture and practices; and (v) policy and economic factors play an important role in adopting biosecurity (BS) and PB measures in the workplace. Personnel working in the Australian Thoroughbred breeding industry face unique zoonotic risks in a challenging physical environment. A qualitative approach provided rich insights into social and physical factors motivating BS and PB in this occupational group. There is an opportunity for collaboration between Public Health services and industry partners to develop and implement strategies most likely to be effective in ensuring consistent uptake of PB measures in the workplace

Pengaruh Jumlah Dan Kriteria Buah Muda Yang Dipertahankan Terhadap Hasil Buah Mangga ( Effect of Number and Criteria of Maintained Young Fruits on Yield of Mango)

The aim of this research was to get optimum number of maintained young fruit per panicle and good criteria of fruit that must be maintained so it will get a high yield of mango. The factors under investigation were number of young fruit to be maintained per panicle: 2, 4, and 6; the criteria of young fruit to be maintained: the biggest fruit, fruit attached at the beginning of panicle, and fruit attached at panicle at the same distance. The result of research showed that 6 fruits that maintained per panicle gave the highest weight per tree of mango (33,45 kg), but the lowest weight per fruit (466,98 kg). Maintaining the 2 biggest fruits of mango gave the highest weight per fruit (510,53 g)

Reproduction of contagious bovine pleuropneumonia via aerosol-based challenge with Mycoplasma mycoides subsp. mycoides.

Contagious bovine pleuropneumonia (CBPP) is a respiratory disease caused by Mycoplasma mycoides subsp. mycoides. Infection occurs via Mycoplasma-containing droplets and therefore requires close contact between animals. The current infection models are suboptimal and based on intratracheal installation of mycoplasmas or in-contact infection. This work tested the infection of adult cattle via aerosols containing live mycoplasmas mimicking the infection of cattle in the field. Therefore, we infected six cattle with aerosolized Mycoplasma mycoides subsp. mycoides strain Afadé over seven consecutive days with altogether 109 colony forming units. All animals seroconverted between 11-24 days post infection and five out of six animals showed typical CBPP lesions. One animal did not show any lung lesions at necropsy, while another animal had to be euthanized at 25 days post infection because it reached endpoint criteria. Seroconversion confirmed successful infection and the spectrum of clinical and lesions observed mirrors epidemiological models and the field situation, in which only a fraction of animals suffers from acute clinical disease post infection

Q Fever Knowledge, Attitudes and Vaccination Status of Australia’s Veterinary Workforce in 2014

Q fever, caused by Coxiella burnetii, is a serious zoonotic disease in humans with a worldwide distribution. Many species of animals are capable of transmitting C. burnetii, and consequently all veterinary workers are at risk for this disease. An effective Q fever vaccine has been readily available and used in Australia for many years in at-risk groups, and the European Centre for Disease Prevention and Control has recently also called for the use of this vaccine among at-risk groups in Europe. Little is known about attitudes towards this vaccine and vaccine uptake in veterinary workers. This study aimed to determine the Q fever vaccination status of veterinarians and veterinary nurses in Australia and to assess and compare the knowledge and attitudes towards Q fever disease and vaccination of each cohort. An online cross-sectional survey performed in 2014 targeted all veterinarians and veterinary nurses in Australia. Responses from 890 veterinarians and 852 veterinary nurses were obtained. Binary, ordinal and multinomial logistic regression were used to make comparisons between the two cohorts. The results showed that 74% of veterinarians had sought vaccination compared to only 29% of veterinary nurses. Barriers to vaccination among those not vaccinated did not differ between cohorts, and included a lack of perceived risk, financial expense, time constraints, and difficulty in finding a vaccine provider. Poor knowledge and awareness of Q fever disease and vaccination were additional and notable barriers for the veterinary nursing cohort, suggesting veterinary clinics and veterinarians may not be meeting their legal responsibility to educate staff about risks and risk prevention. Further evaluation is needed to identify the drivers behind seeking and recommending vaccination so that recommendations can be made to improve vaccine uptake

The impact of hypoglycaemia on quality of life among adults with type 1 diabetes:Results from “YourSAY: Hypoglycaemia”

Aims Research on hypoglycaemia and quality of life (QoL) has focused mostly on severe hypoglycaemia and psychological outcomes, with less known about other aspects of hypoglycaemia (e.g., self-treated episodes) and impacts on other QoL domains (e.g., relationships). Therefore, we examined the impact of all aspects of hypoglycaemia on QoL in adults with type 1 diabetes (T1DM). Methods Participants completed an online survey, including assessment of hypoglycaemia-specific QoL (using the 12-item Hypoglycaemia Impact Profile). Mann-Whitney U tests examined differences in hypoglycaemia-specific QoL by hypoglycaemia frequency, severity, and awareness. Hierarchical linear regression examined associations with QoL. Results Participants were 1028 adults with T1DM (M ± SD age: 47 ± 15 years; diabetes duration: 27 ± 16 years). Severe and self-treated hypoglycaemia and impaired awareness negatively impacted on overall QoL and several QoL domains, including leisure activities, physical health, ability to keep fit/be active, sleep, emotional well-being, spontaneity, independence, work/studies, and dietary freedom. Diabetes distress was most strongly associated with hypoglycaemia-specific QoL, followed by generic emotional well-being, fear of hypoglycaemia, and confidence in managing hypoglycaemia. Hypoglycaemia frequency and awareness were no longer significantly associated with QoL once psychological factors were considered. Conclusions Hypoglycaemia negatively impacts on several QoL domains. Psychological factors supersede the effect of hypoglycaemia frequency and awareness in accounting for this negative impact

The Ursinus Weekly, February 25, 1952

Frats begin rushing for new pledges • Sororities to start rushing March 3 • Any student urged to try out for Spring production • Freshman dance to be celestial • Group plays postponed • History of Anglo-Egyptian relations traced by speaker • Jeanne Careless chosen queen • Campaign against cutting campus begun by WSGA • Newman Club hears psychology talk • Blood donations sought again here • Piano-violin concert received favorably by Ursinus audience • Economics of marriage discussed at seminar • Fastnacht ball planned by clubs • Editorials: Needed - codified law; Is Korean War necessary? • Student Union ideas given • Five initiated into Rosicrucians society • Canterbury Club holds supper • Engagement • Forum tickets available • Former German student comes to Ursinus this semester • Dr. C. L. Chandler receives honor • Mr. Dolman gives Twain selections at English readings • Guest lecturer tells of history of aeronautics • Ursinus students glimpse preview of Mardi Gras scene • Grizzlies trounce Textile to break losing streak • Badminton squad defeats Rosemont in opening game • Beaver College basketball team deadlocks Snell\u27s Belles at 25 • Girls\u27 intramural loop is underway • Beaver hands Ursinus Mermaids first loss • Penn JVs overpower girls\u27 badminton team • Chess Club wins • Grizzlies defeated by Bucknell team • Ursinus quintet stifles Ford rally to win 71-51 • League I champs may be crowned in tonight\u27s play • Doctor speaks on psychiatry to studentshttps://digitalcommons.ursinus.edu/weekly/1535/thumbnail.jp

Restoration of self-awareness of hypoglycemia in adults with long-standing type 1 diabetes: hyperinsulinemic-hypoglycemic clamp substudy results from the HypoCOMPaSS trial.

OBJECTIVE: Impaired awareness of hypoglycemia (IAH) and defective counterregulation significantly increase severe hypoglycemia risk in type 1 diabetes (T1D). We evaluated restoration of IAH/defective counterregulation by a treatment strategy targeted at hypoglycemia avoidance in adults with T1D with IAH (Gold score ≥4) participating in the U.K.-based multicenter HypoCOMPaSS randomized controlled trial. RESEARCH DESIGN AND METHODS: Eighteen subjects with T1D and IAH (mean ± SD age 50 ± 9 years, T1D duration 35 ± 10 years, HbA1c 8.1 ± 1.0% [65 ± 10.9 mmol/mol]) underwent stepped hyperinsulinemic-hypoglycemic clamp studies before and after a 6-month intervention. The intervention comprised the HypoCOMPaSS education tool in all and randomized allocation, in a 2 × 2 factorial study design, to multiple daily insulin analog injections or continuous subcutaneous insulin infusion therapy and conventional glucose monitoring or real-time continuous glucose monitoring. Symptoms, cognitive function, and counterregulatory hormones were measured at each glucose plateau (5.0, 3.8, 3.4, 2.8, and 2.4 mmol/L), with each step lasting 40 min with subjects kept blinded to their actual glucose value throughout clamp studies. RESULTS: After intervention, glucose concentrations at which subjects first felt hypoglycemic increased (mean ± SE from 2.6 ± 0.1 to 3.1 ± 0.2 mmol/L, P = 0.02), and symptom and plasma metanephrine responses to hypoglycemia were higher (median area under curve for symptoms, 580 [interquartile range {IQR} 420-780] vs. 710 [460-1,260], P = 0.02; metanephrine, 2,412 [-3,026 to 7,279] vs. 5,180 [-771 to 11,513], P = 0.01). Glycemic threshold for deterioration of cognitive function measured by four-choice reaction time was unchanged, while the color-word Stroop test showed a degree of adaptation. CONCLUSIONS: Even in long-standing T1D, IAH and defective counterregulation may be improved by a clinical strategy aimed at hypoglycemia avoidance