A survey of Canadian specialist anesthesiologists and family practice anesthetists: rural operating room use, a mixed model of care, and mentoring.

PURPOSE: The aim of this project was to collect data on the delivery of anesthesia in Canada. Specifically, our goal was to increase knowledge by identifying provider demographics and different models of anesthesia delivery, and to explore relationships among specialist anesthesiologists (SAs) and family practice anesthetists (FPAs) with a focus on mentoring. METHODS: An online questionnaire was circulated to SAs and FPAs holding membership with the Canadian Anesthesiologists' Society or the Society of Rural Physicians of Canada. A total of 274/2,578 individuals completed the survey (170 SAs and 104 FPAs), providing a response rate of 10.6%. The survey included questions about demographics, anesthesia training, anesthesia resources, models of care, and mentoring relationships. RESULTS: Three major themes emerged from the data: 1) FPAs and rural operating rooms are underused resources as 65% (64/98) of FPAs reported having capacity to increase their individual volume of anesthesia services and 41% (40/98) thought capacity existed within their hospital to increase the volume of surgery; 2) 20 hospitals employed a mixed model of anesthesia care whereby SAs and FPAs worked collectively within the same site; providers working within this model reported high levels of satisfaction and independence; 3) most SAs and FPAs perceived a benefit to mentoring and were interested in participating in a mentoring program. CONCLUSION: This survey shows perceived capacity to expand surgical services in rural areas, a precedent for a mixed SA-FPA model of anesthesia delivery at the same site, and desire for anesthesia providers to engage in mentoring. Such options should be considered to strengthen the physician-led anesthesiology profession in Canada.

RéSUMé: OBJECTIF: L'objectif de ce projet était de recueillir des données sur la prestation de l'anesthésie au Canada. Plus précisément, notre objectif était d'accroître les connaissances en identifiant les caractéristiques démographiques des prestataires et les différents modèles de prestation d'anesthésie, et d'explorer les relations entre les anesthésiologistes spécialisé·es (AS) et les anesthésiologistes en médecine familiale (AMF) en mettant l'accent sur le mentorat. MéTHODE: Un questionnaire en ligne a été distribué aux AS et aux AMF membres avec la Société canadienne des anesthésiologistes ou la Société de la médecine rurale du Canada. Au total, 274 personnes sur 2578 ont répondu à l'enquête (170 AS et 104 AMF), soit un taux de réponse de 10,6 %. L'enquête comprenait des questions sur les données démographiques, la formation en anesthésie, les ressources en anesthésie, les modèles de soins et les relations de mentorat. RéSULTATS: Trois grands thèmes se sont dégagés des données : 1) Les AMF et les salles d'opération en milieu rural sont des ressources sous-utilisées, puisque 65 % (64/98) des AMF ont déclaré avoir la capacité d'augmenter le volume individuel de leurs services d'anesthésie et 41 % (40/98) pensaient qu'il existait une capacité au sein de leur hôpital pour augmenter le volume chirurgical; 2) 20 hôpitaux utilisent un modèle mixte de soins d'anesthésie dans lequel les AS et les AMF travaillent collectivement sur le même site; les prestataires qui travaillent dans le cadre de ce modèle ont fait état de niveaux élevés de satisfaction et d'indépendance; 3) la plupart des AS et des AMF perçoivent un avantage au mentorat et sont intéressé·es à participer à un programme de mentorat. CONCLUSION: Cette enquête montre la capacité perçue d'étendre les services chirurgicaux dans les zones rurales, un précédent pour un modèle mixte AS-AMF de prestation d'anesthésie sur le même site, et le désir des prestataires d'anesthésie de s'engager dans le mentorat. De telles options devraient être envisagées pour renforcer la profession médicale de l'anesthésiologie au Canada.

Modeling the effect of surgical sterilization on owned dog population size in Villa de Tezontepec, Hidalgo, Mexico, using an individual-based computer simulation model.

Surgical sterilization programs for dogs have been proposed as interventions to control dog population size. Models can be used to help identify the long-term impact of reproduction control interventions for dogs. The objective of this study was to determine the projected impact of surgical sterilization interventions on the owned dog population size in Villa de Tezontepec, Hidalgo, Mexico. A stochastic, individual-based simulation model was constructed and parameterized using a combination of empirical data collected on the demographics of owned dogs in Villa de Tezontepec and data available from the peer-reviewed literature. Model outcomes were assessed using a 20-year time horizon. The model was used to examine: the effect of surgical sterilization strategies focused on: 1) dogs of any age and sex, 2) female dogs of any age, 3) young dogs (i.e., not yet reached sexual maturity) of any sex, and 4) young, female dogs. Model outcomes suggested that as surgical capacity increases from 21 to 84 surgeries/month, (8.6% to 34.5% annual sterilization) for dogs of any age, the mean dog population size after 20 years was reduced between 14% and 79% compared to the base case scenario (i.e. in the absence of intervention). Surgical sterilization interventions focused only on young dogs of any sex yielded greater reductions (81% - 90%) in the mean population size, depending on the level of surgical capacity. More focused sterilization targeted at female dogs of any age, resulted in reductions that were similar to focusing on mixed sex sterilization of only young dogs (82% - 92%). The greatest mean reduction in population size (90% - 91%) was associated with sterilization of only young, female dogs. Our model suggests that targeting sterilization to young females could enhance the efficacy of existing surgical dog population control interventions in this location, without investing extra resources.

Owned dog ecology and demography in Villa de Tezontepec, Hidalgo, Mexico.

Dog overpopulation in developing countries has negative implications for the health and safety of people, including the transmission of zoonotic diseases, physical attacks and intimidation to humans and animals, as well as impacts on canine welfare. Understanding the ecology and demographic characteristics of a dog population can help in the planning and monitoring of canine population control programs. Little data exist regarding demography and dynamics of domestic dog populations in semi-urban areas in Mexico. A cross-sectional study was carried out between October 21 and November 7, 2015, to characterize the dog ecology and demography in Villa de Tezontepec, Hidalgo, Mexico. A face-to-face survey was used to collect data from randomly selected households in four contiguous communities using stratified two-stage cluster sampling. Within each household, adults answered questions related to their dogs and their experiences with dog bites and aggression. A total of 328 households were interviewed, representing a participation rate of 90.9% (328/361) and 1,450 people. Approximately 65.2% of the households owned one or more dogs, with a mean of 1.3 (SD=1.5) and 2.0 (SD=1.5) owned dogs in all participant households and dog-owning households, respectively. The human: owned dog ratio for all participant households was 3.4:1 (1450/428), and for the dog-owning households was 2.3:1 (984/428). The owned dog male: female ratio was 1.4:1 (249/179). Approximately 74.4% (95.0% CI=69.8% - 78.7%) of the owned dogs were older than one year (mean age: 2.9 years; SD=2.5). The mean age of owned female dogs at first litter was 1.9 years (SD=1.2) and the mean litter size was 4.2 puppies (SD=2.1). Approximately 36.9% (95.0% CI=31.8% - 46.4%) of the females were spayed, and 14.1% (95.0% CI=10.7% - 19.7%) of the males were neutered. Only 44.9% (95.0% CI=40.1% - 49.7%) were always confined when unsupervised. Approximately 84.4% (95.0% CI=80.6% - 87.7%) were reported to have been vaccinated against rabies in 2015. The knowledge of owned dog demography and ecology provided by this study can inform local government planning of dog population control interventions, and could serve as a baseline for the development of agent-based models to evaluate the effects of different dog population control strategies on dog demography.