Systematic Review of Prognostic Factors for Mortality in Dogs with Immune-mediated Hemolytic Anemia

BACKGROUND: Treatment of dogs with primary immune‐mediated hemolytic anemia (IMHA) is difficult and frequently unrewarding. Prognostic factors have been evaluated in a number of previous studies, and identification of such factors would be beneficial to enable selection of appropriate therapeutic regimens and supportive care. OBJECTIVES: The aim of the current study was to undertake a critical appraisal of the risk of bias in evidence relating to prognostic indicators for mortality in dogs with IMHA. ANIMALS: Three hundred and eighty client‐owned dogs with spontaneous primary idiopathic IMHA reported in 6 previous studies. METHODS: A systematic review was conducted to evaluate evidence relating to prognostic factors for mortality in dogs with primary IMHA. Search tools were employed to identify articles and a validated appraisal tool was used to assess the quality of individual studies by considering inclusion and exclusion criteria, measurement of prognostic, outcome and confounding variables, and statistical methods. RESULTS: Few studies evaluated prognostic indicators for IMHA in dogs, and all of these suffered from methodologic flaws in at least 1 major area. Fifteen different variables were identified as prognostic indicators, with 2 variables identified by >1 study. CONCLUSIONS AND CLINICAL IMPORTANCE: There are few pieces of high‐quality evidence available to enable estimation of prognosis for dogs presenting with primary IMHA

A qualitative study of the impact of surprises and challenges on the identity-building and socialization of new principals

The role of the school principal is an important one. Nettles and Herrington (2007) confirmed, “the school principal is regarded as critical to school success and student achievement” (p. 729). Every year, new leaders are needed to fill this vital role as a result of the high rates of principal turnover (Browne-Ferrigno, 2003; Stevenson, 2006). New principals, however, must quickly adapt to their new role; “. . . a newly appointed principal is expected to take on the full set of responsibilities (Galdames, Montecinos, Campos, Ahumada, & Leiva, 2008, p. 319). Research into the unique experiences of new principals is vital due to the importance of the principal’s role. This research study illuminates the challenges these individuals will face in pursuit of the goals set forth for their schools and has the potential to ultimately help better support and prepare new principals. This study was a qualitative study that involved five participants and data collected through a series of four interviews, three focus groups, and participant reflective journaling through the first 8 months new principals in Cross Keys County Schools were in their roles. All participants participated in each of four interviews and attended at least one of the three focus groups. Participation in reflective journaling was limited. The data collection and analysis were intended to address the following research questions: "What do new principals believe the principalship is like as they begin their work?"; "How do the surprises and challenges new principals encounter support their socialization into the principalship?"; and "How do the surprises and challenges new principals encounter influence their emergent and professional identity?" Understanding these challenges and being aware of the specific knowledge and skills principals need can help new principals to ease the transition into the role and can minimize the challenges and surprises they encounter, particularly given the high number of new principals in the local district and the potential impact on the students they serve. The following themes emerged from the analysis of data collected and existing research. The new principals in this study clarified and realized their core values in their new role. They also developed meaningful relationships with stakeholders and this partnership enabled them to build a positive school culture. Confidence in their abilities increased over time and this confidence enabled them to leverage their power and positionality. The new principals focused on cultural leadership and struggled to focus on instructional leadership. Finally, new principals largely socialized within the school setting with families, students, and staff members as opposed to others within the organization

Good agreement of conventional and gel-based direct agglutination test in immune-mediated haemolytic anaemia

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to compare a gel-based test with the traditional direct agglutination test (DAT) for the diagnosis of immune-mediated haemolytic anaemia (IMHA).</p> <p>Methods</p> <p>Canine (n = 247) and feline (n = 74) blood samples were submitted for DAT testing to two laboratories. A subset of canine samples was categorized as having idiopathic IMHA, secondary IMHA, or no IMHA.</p> <p>Results</p> <p>The kappa values for agreement between the tests were in one laboratory 0.86 for canine and 0.58 for feline samples, and in the other 0.48 for canine samples. The lower agreement in the second laboratory was caused by a high number of positive canine DATs for which the gel test was negative. This group included significantly more dogs with secondary IMHA.</p> <p>Conclusions</p> <p>The gel test might be used as a screening test for idiopathic IMHA and is less often positive in secondary IMHA than the DAT.</p

Study Protocol for the Breathe Easier Trial: a Pilot Rct of a Dyad-Based, Multiple-Behavior Intervention for Improving Physical and Emotional Health in Survivors Facing Lung Cancer

Background: Research targeting survivors of lung cancer has yet to adequately address the management of physical deconditioning and unresolved symptoms (dyspnea, fatigue). The objective of the Breathe Easier trial is to test the feasibility and preliminary effects of a theory-based, multiple-behavior intervention (physical activity, smoking reduction for current smokers, stress management) targeting survivors of localized non-small-cell lung cancer (NSCLC, stages I-III) and their supportive partners. Methods: This pilot RCT will enroll 30 dyads (60 participants). Each dyad will consist of one survivor and one partner (defined as a family member or friend) Dyads will be randomized to the Intervention Group (IG) or the Attention Control Group (AC). IG members will receive the 12-week, home-based intervention based on the individual and family self-management theory, which targets improvements in self-efficacy, social support, and self-regulation. Improvement in lifestyle behaviors is a proximal outcome. Improvements in physical and emotional health are distal outcomes. Breathe Easier (IG) includes educational content written in plain language as well as breathing exercises and meditations; SMART goal setting; daily text messaging; and weekly telephone calls with trained staff. The AC program includes relevant National Institutes of Health publications plus weekly telephone chats. Members who currently smoke will also receive an evidence-based smoking cessation resource. Discussion: Breathe Easier focuses on changes in multiple behaviors in dyads coping with a diagnosis of NSCLC (stages I-III) with the overall purpose of improving physical and emotional health. Findings will provide additional evidence of the feasibility and preliminary effects of this intervention. Trial Registration: ClinicalTrials.gov Identifier: NCT05956782; This trial was registered retrospectively

Analysis of DLA-DQB1 and polymorphisms in CTLA4 in Cocker spaniels affected with immune-mediated haemolytic anaemia

BACKGROUND: Cocker spaniels are predisposed to immune-mediated haemolytic anaemia (IMHA), suggesting that genetic factors influence disease susceptibility. Dog leukocyte antigen (DLA) class II genes encode major histocompatibility complex (MHC) molecules that are involved in antigen presentation to CD4(+) T cells. Several DLA haplotypes have been associated with autoimmune disease, including IMHA, in dogs, and breed specific differences have been identified. Cytotoxic T lymphocyte antigen 4 (CTLA4) is a critical molecule involved in the regulation of T-cell responses. Single nucleotide polymorphisms (SNPs) in the CTLA4 promoter have been shown to be associated with several autoimmune diseases in humans and more recently with diabetes mellitus and hypoadrenocorticism in dogs. The aim of the present study was to investigate whether DLA-DQB1 alleles or CTLA4 promoter variability are associated with risk of IMHA in Cocker spaniels. RESULTS: There were a restricted number of DLA-DQB1 alleles identified, with a high prevalence of DLA-DQB1*007:01 in both groups. A high prevalence of DLA-DQB1 homozygosity was identified, although there was no significant difference between IMHA cases and controls. CTLA4 promoter haplotype diversity was limited in Cocker spaniels, with all dogs expressing at least one copy of haplotype 8. There was no significant difference comparing haplotypes in the IMHA affected group versus control group (p = 0.23). Homozygosity for haplotype 8 was common in Cocker spaniels with IMHA (27/29; 93 %) and in controls (52/63; 83 %), with no statistically significant difference in prevalence between the two groups (p = 0.22). CONCLUSIONS: DLA-DQB1 allele and CTLA4 promoter haplotype were not found to be significantly associated with IMHA in Cocker spaniels. Homozygosity for DLA-DQB1*007:01 and the presence of CTLA4 haplotype 8 in Cocker spaniels might increase overall susceptibility to IMHA in this breed, with other genetic and environmental factors involved in disease expression and progression

Global Increase in Climate-Related Disasters

Intense climate-related disasters - floods, storms, droughts, and heat waves - have been on the rise worldwide. At the same time and coupled with an increasing concentration of greenhouse gases in the atmosphere, temperatures, on average, have been rising, and are becoming more variable and more extreme. Rainfall has also been more variable and more extreme. Is there an ominous link between the global increase of these hydrometeorological and climatological events on the one side and anthropogenic climate change on the other? This paper considers three main disaster risk factors - rising population exposure, greater population vulnerability, and increasing climate-related hazards - behind the increased frequency of intense climate-related natural disasters. In a regression analysis within a model of disaster risk determination for 1971-2013, population exposure measured by population density and people's vulnerability measured by socioeconomic variables are positively linked to the frequency of these intense disasters. Importantly, the results show that precipitation deviations are positively related to hydrometeorological events, while temperature and precipitation deviations have a negative association with climatological events. Moreover, global climate change indicators show positive and highly significant effects. Along with the scientific association between greenhouse gases and the changes in the climate, the findings in this paper suggest a connection between the increasing number of natural disasters and man-made emissions of greenhouse gases in the atmosphere. The implication is that climate mitigation and climate adaptation should form part of actions for disaster risk reduction