Model or meal? Farm animal populations as models for infectious diseases of humans

In recent decades, theory addressing the processes that underlie the dynamics of infectious diseases has progressed considerably. Unfortunately, the availability of empirical data to evaluate these theories has not grown at the same pace. Although laboratory animals have been widely used as models at the organism level, they have been less appropriate for addressing issues at the population level. However, farm animal populations can provide empirical models to study infectious diseases at the population level

Epidemiological model for Clostridium difficile transmission in healthcare settings

OBJECTIVE: Recent outbreaks of Clostridium difficile infection (CDI) have been difficult to control, and data indicate the importance of different sources of transmission may have changed. Our objectives were to evaluate the contributions of asymptomatic and symptomatic C. difficile carriers to new colonizations and to determine the most important epidemiological factors influencing C. difficile transmission. DESIGN: Retrospective cohort SETTING AND PATIENTS: All patients admitted to medical wards at a large tertiary care hospital in the US from Jan 1 to Dec 31, 2008. METHODS: Data from six medical wards and published literature were used to develop a compartmental model of C. difficile transmission. Patients could be in one of five transition states in the model: resistant to colonization (R), susceptible to colonization (S), asymptomatically colonized without protection against CDI (C(−)), asymptomatically colonized with protection against CDI (C(+)), and patients with CDI (D). RESULTS: The contributions of C(−), C(+) and D patients to new colonizations were similar. The simulated basic reproduction number ranged from .55 to 1.99, with median 1.04. These values suggest that transmission within the ward alone from patients with CDI cannot sustain new C. difficile colonizations, and therefore, the admission of colonized patients plays an important role in sustaining transmission in the ward. The epidemiological parameters that ranked as the most influential were the proportion of admitted C(−) and the transmission coefficient for asymptomatic carriers. CONCLUSION: Our study underscores the need to further evaluate the role of asymptomatically colonized patients in C. difficile transmission in the healthcare setting

The risk and control of Salmonella outbreaks in calf-raising operations: a mathematical modeling approach

Salmonellosis in calves has economic and welfare implications, and serves as a potential source of human infections. Our objectives were to assess the risk of Salmonella spread following its introduction into a herd of pre-weaned calves and to evaluate the efficacy of control strategies to prevent and control outbreaks. To meet these objectives, we developed a model of Salmonella transmission within a pre-weaned group of calves based on a well documented outbreak of salmonellosis in a calf-raising operation and other literature. Intervention scenarios were evaluated in both deterministic and stochastic versions of the model. While the basic reproduction number (R0) was estimated to be 2.4, simulation analysis showed that more than 60% of the invasions failed after the introduction of a single index case. With repeated introduction of index cases, the probability of Salmonella spread was close to 1, and the tested control strategies were insufficient to prevent transmission within the group. The most effective strategies to control ongoing outbreaks were to completely close the rearing operation to incoming calves, to increase the proportion of admitted calves that were immunized (\u3e75%), and to assign personnel and equipment to groups of calves

Rethinking the learning space at work and beyond: The achievement of agency across the boundaries of work-related spaces and environments

This paper focuses on the notion of the learning space at work and discusses the extent to which its different configurations allow employees to exercise personal agency within a range of learning spaces. Although the learning space at work is already the subject of extensive research, the continuous development of the learning society and the development of new types of working spaces calls for further research to advance our knowledge and understanding of the ways that individuals exercise agency and learn in the workplace. Research findings suggest that the current perception of workplace learning is strongly related to the notion of the learning space, in which individuals and teams work, learn and develop their skills. The perception of the workplace as a site only for work-specific training is gradually changing, as workplaces are now acknowledged as sites for learning in various configurations, and as contributing to the personal development and social engagement of employees. This paper argues that personal agency is constructed in the workplace, and this process involves active interrelations between agency and three dimensions of the workplace (individual, spatial and organisational), identified through both empirical and theoretical research. The discussion is supported by data from two research projects on workplace learning in the United Kingdom. This paper thus considers how different configurations of the learning space and the boundaries between a range of work-related spaces facilitate the achievement of personal agency

Uncovering treatment burden as a key concept for stroke care: a systematic review of qualitative research

<b>Background</b> Patients with chronic disease may experience complicated management plans requiring significant personal investment. This has been termed ‘treatment burden’ and has been associated with unfavourable outcomes. The aim of this systematic review is to examine the qualitative literature on treatment burden in stroke from the patient perspective.<p></p> <b>Methods and findings</b> The search strategy centred on: stroke, treatment burden, patient experience, and qualitative methods. We searched: Scopus, CINAHL, Embase, Medline, and PsycINFO. We tracked references, footnotes, and citations. Restrictions included: English language, date of publication January 2000 until February 2013. Two reviewers independently carried out the following: paper screening, data extraction, and data analysis. Data were analysed using framework synthesis, as informed by Normalization Process Theory. Sixty-nine papers were included. Treatment burden includes: (1) making sense of stroke management and planning care, (2) interacting with others, (3) enacting management strategies, and (4) reflecting on management. Health care is fragmented, with poor communication between patient and health care providers. Patients report inadequate information provision. Inpatient care is unsatisfactory, with a perceived lack of empathy from professionals and a shortage of stimulating activities on the ward. Discharge services are poorly coordinated, and accessing health and social care in the community is difficult. The study has potential limitations because it was restricted to studies published in English only and data from low-income countries were scarce.<p></p> <b>Conclusions</b> Stroke management is extremely demanding for patients, and treatment burden is influenced by micro and macro organisation of health services. Knowledge deficits mean patients are ill equipped to organise their care and develop coping strategies, making adherence less likely. There is a need to transform the approach to care provision so that services are configured to prioritise patient needs rather than those of health care systems

Columnar and Equiaxed Solidification of Al-7 wt.% Si Alloys in Reduced Gravity in the Framework of the CETSOL Project

International audienceDuring casting, often a dendritic microstructure is formed, resulting in a columnar or an equiaxed grain structure, or leading to a transition from columnar to equiaxed growth (CET). The detailed knowledge of the critical parameters for the CET is important because the microstructure affects materials properties. To provide unique data for testing of fundamental theories of grain and microstructure formation, solidification experiments in microgravity environment were performed within the European Space Agency Microgravity Application Promotion (ESA MAP) project Columnar-to-Equiaxed Transition in SOLidification Processing (CETSOL). Reduced gravity allows for purely diffusive solidification conditions, i.e., suppressing melt flow and sedimentation and floatation effects. On-board the International Space Station, Al-7 wt.% Si alloys with and without grain refiners were solidified in different temperature gradients and with different cooling conditions. Detailed analysis of the microstructure and the grain structure showed purely columnar growth for nonrefined alloys. The CET was detected only for refined alloys, either as a sharp CET in the case of a sudden increase in the solidification velocity or as a progressive CET in the case of a continuous decrease of the temperature gradient. The present experimental data were used for numerical modeling of the CET with three different approaches: (1) a front tracking model using an equiaxed growth model, (2) a three-dimensional (3D) cellular automaton–finite element model, and (3) a 3D dendrite needle network method. Each model allows for predicting the columnar dendrite tip undercooling and the growth rate with respect to time. Furthermore, the positions of CET and the spatial extent of the CET, being sharp or progressive, are in reasonably good quantitative agreement with experimental measurements

The theoretical status of B¯ − B-mixing and lifetimes of heavy hadrons.

In this talk we review the theoretical status of the lifetime ratios of heavy hadrons and of the B-mixing quantities ΔMs, ΔΓs and φs. While ΔMs and ΔΓs suffer from large uncertainties due to the badly known decay constants, the ratio ΔΓs/ΔMs can be determined with almost no non-perturbative uncertainties, therefore it can be used to look for possible new physics effects

The effect of Mycobacterium avium ssp paratuberculosis infection on clinical mastitis occurrence in dairy cows

Endemic diseases can be counted among the most serious sources of losses for livestock production. In dairy farms in particular, one of the most common diseases is Johne's disease, caused by Mycobacterium avium ssp. paratuberculosis (MAP). Infection with MAP causes direct costs because it affects milk production, but it has also been suspected to increase the risk of clinical mastitis (CM) among infected animals. This might contribute to further costs for farmers. We asked whether MAP infection represents a risk factor for CM and, in particular, whether CM occurrences were more common in MAP-infected animals. Our results, obtained by survival analysis, suggest that MAP-infected cows had an increased probability of experiencing CM during lactation. These results highlight the need to account for the interplay of infectious diseases and other health conditions in economic and epidemiological modeling. In this case, accounting for MAP-infected cows having an increased CM occurrence might have nonnegligible effects on the estimated benefit of MAP control

Use of an Individual-based Model to Control Transmission Pathways of Mycobacterium avium Subsp paratuberculosis Infection in Cattle Herds

Johne’s disease (JD) is a chronic enteric disease in cattle caused by Mycobacterium avian subsp. paratuberculosis (MAP). Eradicating JD is a difficult task due to the long incubation period of MAP, inefficient diagnostic tests, and delayed clinical signs. Effective control strategies can help farmers to reduce prevalence, but those most acceptable to farmers combine specific information about lactation performance and testing results, which existing models do not provide. This paper presents an individual-based model of MAP infection dynamics and assesses the relative performance of the applied alternative control strategies. The base dairy herd model included the daily life events of a dairy cow and reflects several current dairy management processes. We then integrated MAP infection dynamics into the model. The model adopted four different test-based control strategies based on risk-based culling decisions and three hygiene scenarios. The model tracked the source of each infection and quantified the efficacy of each control strategy in reducing the risks of different transmission routes. The results suggest that risk-based culling can reduce prevalence compared with no control, but cannot eliminate the infection. Overall, this work provides not only a valuable tool to investigate MAP transmission dynamics but also offers adaptability to model similar infectious diseases