Most students have experience making radiographs prior to veterinary school but have limited radiation safety training.

The use of radiation for the diagnosis of various medical conditions is ubiquitous in veterinary medicine, and manual restraint of a patient during X-ray exposure has become commonplace. Many prospective veterinary students have been involved with radiographs in general practice prior to veterinary school. Their experiences and level of safety training are largely unknown.   This prospective survey study involved two web-based questionnaires that were used to evaluate the experiences, knowledge, and attitudes toward radiation and how these changed following a radiation safety lecture as part of their first-year curriculum. The questionnaires were distributed to 122 first-year veterinary students before and after this lecture. All participating students (100%) had worked in a veterinary hospital prior to admission to veterinary school and 79% were involved in making radiographs; however, only 28% reported receiving radiation safety training. The content of the safety training reported was variable. After the radiation safety lecture, students were more likely to report that the radiation safety training they had received was useful, but fewer students reported feelings of safety when using radiation. Despite most students being involved with radiation in practice, few had received radiation safety training, as hypothesized. Contrary to our second hypothesis, a single lecture did significantly improve knowledge and attitudes in several, but not all, instances. Importantly, once students gained knowledge regarding radiation, they placed more importance on its safe use. These results suggest that in-clinic training of students in radiation safety is insufficient and that lecture-based training is useful for certain concepts.

Excellent Agreement of In-Person Scoring versus Scoring of Digitally Recorded Simulated Suture Skills Examination.

This study's objective was to evaluate the agreement between in-person performance scores and digitally recorded assessment scores by the same examiner using a simulated suturing skill examination. With ethics approval, veterinary students underwent a simulated skills examination proctored by an in-person examiner and simultaneously digitally recorded using two wide-angle cameras mounted overtop and to the side of the surgical field. Performance scores were based on a nine-item rubric. In-person examination scores were compared for agreement with those obtained by blind review of the digital recording of the same session, by the same examiner, 6-18 months following the in-person examination. Thirty-nine students were enrolled. All rubric categories could be assessed during digital assessment of the recording from the camera mounted above the surgical area. In two instances, the side digital recording had to be reviewed to confirm correct needle holder grip. Concordance correlation between performance scores from in-person and post hoc digital assessment was excellent (r = .93). The excellent agreement between in-person and digital assessment suggests that digitally recording skills examinations can provide adequate suturing skills assessment, presenting several benefits. Digitally recorded assessment allows for anonymity, which can reduce assessor bias/favoritism, provide a record of performance that students can review and critically self-reflect upon, and reduce the number of in-person examiners required to complete surgical skills examinations. Additionally, digitally recorded assessment could become an option for students who experience anxiety performing a skills exam in the presence of an examiner.

Temperature and place associations with Inuit mental health in the context of climate change.

BACKGROUND: Climate change has important implications for mental health globally. Yet, few studies have quantified the magnitude and direction of associations between weather and mental health-related factors, or assessed the geographical distribution of associations, particularly in areas experiencing rapid climatic change. This study examined the associations between air temperature variables and mental health-related community clinic visits across Nunatsiavut, Labrador, Canada, and the place-specific attributes of these associations. METHODS: Daily de-identified community clinic visit data were collected from the provincial electronic health recording system and linked to historical weather data (2012-2018). A multilevel, multivariable negative binomial regression model was fit to investigate associations between temperature variables and mental health-related community clinic visits across the region, adjusting for seasonality as a fixed effect and community as a random effect. A multivariable negative binomial model was then fit for each Nunatsiavut community, adjusting for seasonality. RESULTS: Mental health-related visits contributed to 2.4% of all 228,104 visit types across the study period; this proportion ranged from 0.6% to 11.3% based on community and year. Regionally, the incidence rate of mental health-related community clinic visits was greater after two weeks of warm average (i.e. above -5ᵒC) temperatures compared to temperatures below -5ᵒC (IRR-5≤5ᵒC = 1.47, 95% CI = 1.21-1.78; IRR6≤15ᵒC = 2.24, 95% CI = 1.66-3.03; IRR>15ᵒC = 1.73, 95% CI = 1.02-2.94), and the incidence rate of mental health-related clinic visits was lower when the number of consecutive days within -5 to 5ᵒC ranges (i.e. temperatures considered to be critical to land use) increased (IRR = 0.96; 95% CI = 0.94-0.99), adjusting for seasonal and community effects. Community-specific models, however, revealed that no two communities had the same association between meteorological conditions and the incidence rate of daily mental health-related visits. DISCUSSION: Regionally, longer periods of warm temperatures may burden existing healthcare resources and shorter periods of temperatures critical to land use (i.e. -5 to 5ᵒC) may present enjoyable or opportunistic conditions to access community and land-based resources. The heterogeneity found in temperature and mental health-related clinic visits associations across Nunatsiavut communities demonstrates that place quantitatively matters in the context of Inuit mental health and climate change. This evidence underscores the importance of place-based approaches to health policy, planning, adaptation, and research related to climate change, particularly in circumpolar regions such as Nunatsiavut where the rate of warming is one of the fastest on the planet.

Stress, anxiety, depression, and resilience in Canadian farmers.

PURPOSE: To estimate the prevalence of stress, anxiety, depression, and resilience amongst Canadian farmers. METHODS: An online cross-sectional survey using validated psychometric scales [Perceived Stress Scale (PSS), Hospital Anxiety and Depression Scale, Connor-Davidson Resilience Scale] conducted with farmers in Canada between September 2015 and February 2016. RESULTS: 1132 farmers participated in the study. The average PSS score was 18.9. Approximately 57% and 33% of participants were classified as possible and probable cases for anxiety, respectively; the respective proportions for depression were 34% and 15%. The average resilience score was 71.1. Scores for stress, anxiety, and depression were higher, and resilience lower, than reported normative data. Females scored less favorably on all mental health outcomes studied, highlighting important gender disparities. CONCLUSIONS: These results highlight a significant public health concern amongst farmers, and illustrate a critical need for research and interventions related to farmer mental health. These findings are important for policymakers, physicians, and public and mental health service providers, and can help to inform decision-making, policy recommendations, resource allocation, and development and delivery of training programs for farmers.

A survey of veterinarian mental health and resilience in Ontario, Canada.

Our goal was to help address a lack of mental health research on Canadian veterinarians through estimation of the prevalence of depression, anxiety, compassion fatigue, burnout, and resilience in veterinarians in Ontario. We conducted a cross-sectional study using an online survey that investigated demographics, mental health, self-reported overall health, and satisfaction with sources of support. Validated, psychometric scales were used to measure depression, anxiety, burnout, compassion fatigue, and resilience. The mental health indices of participating veterinarians were in line with those of veterinarians in other regions, and reflective of poorer mental health compared to the general population. The scores for females tended towards poorer mental health relative to males. Reported levels of burnout and secondary traumatic stress were of particular concern. These results can be used to support evidence-based interventions to help veterinarians and veterinary students build their resilience so that they may better thrive in the face of occupational stresses.

Enquête sur la santé mentale et la résilience des vétérinaires en Ontario, Canada. Notre objectif était d'aider à résoudre un manque de recherche en santé mentale chez les vétérinaires canadiens par une estimation de la prévalence de dépression, anxiété, fatigue de compassion, épuisement, et résilience chez les vétérinaires en Ontario. Nous avons mené une étude transversale en utilisant un sondage en ligne qui examinait les données démographiques, la santé mentale, l'état de santé général auto-rapporté, et la satisfaction avec les sources de soutien. Des échelles psychométriques validées furent utilisées pour mesurer la dépression, l'anxiété, l'épuisement, la fatigue de compassion, et la résilience. Les indicateurs de santé mentale des vétérinaires participants étaient conformes avec ceux de vétérinaires dans d'autres régions, et révélateurs d'une moins bonne santé mentale comparativement à la population générale. Les pointages pour les femmes tendaient vers une moins bonne santé mentale relativement aux hommes. Les niveaux rapportés d'épuisement et de stress traumatique secondaire étaient particulièrement inquiétants. Ces résultats peuvent être utilisés pour soutenir des interventions factuelles afin d'aider les vétérinaires et les étudiants vétérinaires à développer leur résilience afin qu'ils soient en mesure de mieux se développer vis-à-vis les stress occupationnels.(Traduit par Dr Serge Messier).

An Examination of Myers-Briggs Type Indicator Personality, Gender, and Career Interests of Ontario Veterinary College Students.

The objectives of this study were to describe the Myers-Briggs Type Indicator (MBTI) distribution of Ontario Veterinary College (OVC) veterinary students (n = 1,249), and to evaluate its associations with gender and career interests. This was achieved by collecting pre-matriculation data from 11 graduating classes. Overall, OVC veterinary students were diverse in their MBTI types and preferences, as well as career interests. Extraversion, Sensing, Thinking, and Judging were the most prevalent preferences. Female veterinary students were 2.96 (95% CI = 2.11-4.17) times more likely to demonstrate the Feeling preference and 1.89 (95% CI = 1.41-2.56) more likely to prefer Judging, compared to male students (who were more likely to prefer the Thinking and Perceiving preferences, respectively). At entry to the veterinary program, students who preferred Intuition (vs. Sensing) were 2.08 (95% CI = 1.33-3.33) times more likely to be interested in a veterinary career other than practice, and 1.92 (95% CI = 1.43-2.56) times more likely to be undecided about their future veterinary career path. Both at entry to the program and in their final-year stream choice, students of the Thinking preference were more likely to select equine or food animal, rather than small animal practice, compared to students of the Feeling preference. There were additional significant associations regarding MBTI preferences and career interests. This study highlights the diversity of veterinary students, and provides an opportunity for educators to potentially expand their teaching methods and career guidance resources to better reach students of all MBTI preferences.

Effects of Mock Facebook Workday Comments on Public Perception of Professional Credibility: A Field Study in Canada.

BACKGROUND: There is considerable discussion of risks to health professionals' reputations and employment from personal social media use, though its impacts on professional credibility and the health professional-client relationship are unknown. OBJECTIVE: The aim of this study was to test the extent to which workday comments posted to health professionals' personal Facebook profiles influence their credibility and affect the professional-client relationship. METHODS: In a controlled field study, participants (members of the public) reviewed randomly assigned mock Facebook profiles of health professionals. The 2×2×2 factorial design of mock profiles included gender (female/male), health profession (physician/veterinarian), and workday comment type (evident frustration/ambiguous). Participants then rated the profile owner's credibility on a visual analog scale. An analysis of variance test compared ratings. Mediation analyses tested the importance of credibility ratings on participants' willingness to become a client of the mock health professional. RESULTS: Participants (N=357) rated health professionals whose personal Facebook profile showed a comment with evident frustration rather than an ambiguous workday comment as less credible (P<.001; mean difference 11.18 [SE 1.28]; 95% CI 8.66 to 13.70). Furthermore, participants indicated they were less likely to become clients of the former when they considered credibility (standardized beta=.69; P<.001). Credibility explained 86% of the variation in the relationship between the type of workday comment and the participant's willingness to become a client of the health professional. CONCLUSIONS: This study provides the first evidence of the impact of health professionals' personal online disclosures on credibility and the health relationship. Public perceptions about professionalism and credibility are integral to developing the evidence base for e-professionalism guidelines and encouraging best practices in social media use.

Evaluation of bulk tank milk PCR and bulk tank milk modified ELISA tests for the detection of paratuberculosis at the herd level in goat and sheep dairies in Ontario, Canada.

Early identification of dairy goat herds and dairy sheep flocks infected with Mycobacterium avium ssp. paratuberculosis is important for controlling this infection and minimizing economic losses. The objective of this study was to evaluate 2 bulk tank milk (BTM) paratuberculosis tests (PCR and modified ELISA) as potential herd-level tests. These tests were compared with the results obtained from testing 20 randomly selected lactating animals per farm (>2 yr) with an individual animal test (fecal culture, fecal PCR, serum ELISA, and milk ELISA). The study was conducted using 29 dairy goat herds and 21 dairy sheep flocks in Ontario, Canada, visited between October 2010 and August 2011. The sensitivity of the BTM PCR was poor in both the dairy goat herds (0.0%) and dairy sheep flocks (25.0%), but exhibited 100% specificity in both species. In comparison, the BTM modified ELISA demonstrated higher sensitivity. In goats, sensitivity ranged from 33.3 to 34.8% when fecal culture and PCR were the reference tests, respectively (specificities were both 100%), and 71.4 to 87.5% when the milk and serum ELISA, respectively, were the reference tests (specificities were 86.4 and 95.2%). The BTM modified ELISA in dairy sheep demonstrated comparable sensitivities, but lower specificities. When fecal culture and PCR were the reference test, sensitivities were 50.0 and 46.7%, respectively (specificities were 77.8 and 83.3%). The sensitivities when the milk and serum ELISA were the reference tests were 87.5 and 72.7%, respectively (specificities were 92.3 and 100%). Fecal PCR was the only individual animal test to identify significantly more farms as positive than the BTM PCR and modified ELISA test in both species. Therefore, whereas the BTM modified ELISA may provide an organization or control program with a high level of confidence that a BTM-positive farm is actually positive (high positive predictive value), if a producer wishes to increase the odds that a positive farm will test positive, so as not to miss an infection, then sampling and testing 20 animals with fecal PCR will better meet that objective.

Occupational stressors and desired changes for wellness amongst employees at a Canadian animal welfare organization.

While occupational stressors in human caregiving environments have been well-explored, little is known about these stressors in the animal caregiving professions. To address this, a cross-sectional survey was conducted (June and July, 2016) with employees at a Canadian animal welfare organization to explore perceived occupational stressors and desired wellness resources. Responses to open-ended questions were analyzed via thematic network analysis. Themes related to employee stress included: inability to provide desired level of animal care, poor team environment, overwork, challenges working with the public, and personal safety and vulnerability. Desired resource themes were: reduce overwork and address staffing issues, team building, creation of a wellness culture, and mental health training. These results shed light on occupational stressors facing animal welfare employees at a Canadian animal welfare organization. Recommendations to promote positive mental health and wellness within this, and potentially similar, organizations are discussed.

Facteurs de stress au travail et changements souhaités pour le bien-être parmi les employés d'une organisation canadienne de bien-être animal. Même si les facteurs de stress au travail dans les milieux de prestation de soins aux humains ont été bien explorés, on en sait encore peu dans les professions de prestation de soins aux animaux. Pour aborder cette situation, une enquête transversale a été réalisée (en juin et en juillet 2016) auprès d'employés dans une organisation canadienne de bien-être animal afin d'explorer les facteurs de stress au travail perçus et les ressources de bien-être souhaitées. Les réponses à des questions ouvertes ont été analysées à l'aide d'une analyse de réseaux thématiques. Les thèmes reliés au stress des employés mentionnés incluaient notamment : incapacité de fournir le niveau souhaité de soins aux animaux, mauvais environnement d'équipe, surcharge de travail, difficultés de travail avec le public ainsi que sécurité personnelle et vulnérabilité. Les thèmes de ressources souhaitées étaient : réduction de la surcharge de travail et gestion des problèmes de dotation en personnel, consolidation d'équipe, création d'une culture de bien-être et formation en santé mentale. Ces résultats mettent en lumière les facteurs de stress au travail auxquels font face les employés dans une organisation canadienne de bien-être animal. Les recommandations afin de promouvoir une santé mentale et un bien-être positifs dans cette organisation et des organismes semblables sont discutées.(Traduit par Isabelle Vallières).

Effect of age of introduction to an automated milk feeder on calf learning and performance and labor requirements.

Group housing of dairy calves with automated milk feeders (AMF) is increasingly being used, but the effect of introducing calves to the AMF at a very young age (<24 h) on calf performance, health, and welfare, as well as farm personnel labor requirements are unknown. The objective of this controlled trial was to investigate whether early (<24 h after birth) introduction of calves affects the time to learn how to drink from the AMF, labor requirements for feeding milk during the learning phase, and average daily gain during the milk-feeding period compared with calves conventionally introduced at 5 d of age. Sixty Holstein calves (heifers and bulls) were assigned at birth to either early introduction (<24 h after birth) or conventional introduction (at 5 d of age) to the group pen with AMF. After birth, calves were housed in individual pens and then introduced, based on assigned treatment, to the group pen with an AMF and a continuous flow stocking approach. Calves were fed milk replacer and gradually weaned from d 47 to 60 of age. Calves had access to starter from 5 d of age, and to water and straw right after colostrum feeding. We measured the time between first training to use the AMF and first unassisted visit to the AMF with milk intake, the number of assisted visits until the calf was independent in its use of the AMF (successful learning), and the total time required for milk feeding (labor) until successful learning. Calves were weighed at birth, 30, 46, and 61 d of age, and were monitored daily for signs of disease. Daily milk and starter intake per calf were automatically recorded. Early-introduced calves took longer to successfully learn to use the AMF {64.9 h [95% confidence interval (CI) = 59.1 to 77.9] vs. 31.4 h (95% CI = 22.8 to 47.9)} and tended to require more assisted visits [7.8 visits (95% CI = 6.2 to 9.7) vs. 5.9 visits (95% CI = 4.8 to 7.5)] compared with conventionally introduced calves. Labor for milk feeding was greater for conventionally introduced calves relative to early-introduced calves [145.6 min (95% CI = 125.1 to 169.4) vs. 39.9 min (95% CI= 33.5 to 47.6)]. Disease risk was similar between treatments but the risk of severe versus mild diarrhea was greater for early- compared with conventionally introduced calves (odds ratio = 4.7; 95% CI 1.01 to 31.1). Early-introduced calves consumed less milk during the first days of life compared with conventionally introduced calves (d 2 = 5.5 vs. 6.4 L; d 3 = 7.0 vs. 8.2 L; d 4 = 7.0 vs. 8.4 L; d 6 = 6.4 vs. 7.9 L; d 7 = 6.0 vs. 7.0 L, respectively), with no differences after 8 d. We found no effect of treatment on average daily gain. Although introducing calves <24 h after birth required more assistance to use the AMF, farm labor for milk feeding tasks was less for early-introduced calves. Thus, with early introduction to AMF, a trade-off may exist between reduced labor per calf, with no effect on weight gain, but potentially a higher risk of severe diarrhea (vs. mild).

Associations between management practices and within-pen prevalence of calf diarrhea and respiratory disease on dairy farms using automated milk feeders.

Data on management practices used with automated milk feeders (AMF) are needed to identify factors associated with calf health in these systems. The objectives of this observational, longitudinal, cross-sectional study were to estimate the prevalence of calf diarrhea (CD) and bovine respiratory disease (BRD), and to identify factors associated with prevalence of these diseases at the pen level on dairy farms feeding milk to group-housed calves with AMF. Seventeen dairy farms with AMF in Ontario, Canada, were visited 4 times, seasonally, over 1 yr. The clinical health of all calves (n = 1,488) in pens (n = 35) with AMF was scored to identify the number of calves with CD and BRD. Data on calf, feeder, and pen management practices were analyzed using generalized linear mixed regression models for each disease. Overall calf-level prevalence of CD and BRD were 23 and 17%, respectively. Median (interquartile range, IQR) within-pen prevalence of CD and BRD were 17% (7 to 37%) and 11% (0 to 28%), respectively. Median age (IQR) for diarrheic calves was 25 d (16 to 42 d), and for calves with BRD was 43 d (29 to 60 d). Factors associated with lower within-pen prevalence of CD were the administration of vitamin E and selenium at birth [odds ratio (OR) = 0.56; 95% confidence interval (CI): 0.32 to 0.99], feeding of probiotics (OR = 0.44, 95% CI: 0.22 to 0.93), and adding fresh bedding every 2 to 3 d (OR = 0.43; 95% CI: 0.24 to 0.76) compared with every 7 or more days. In contrast, sharing air with older cattle (>9 mo old) was associated with increased within-pen prevalence of CD (OR = 4.54, 95% CI: 1.88 to 10.52). Additionally, total bacteria counts ≥100,000 cfu/mL in milk samples taken from the AMF mixing jar were associated with increased within-pen prevalence of CD during the summer visit (OR = 3.34; 95% CI: 1.31 to 8.54). Increased total solids in milk or milk replacer (OR = 0.48, 95% CI: 0.27 to 0.85) and feeding whole milk versus milk replacer (OR = 0.29, 95% CI: 0.11 to 0.75) were associated with lower within-pen prevalence of BRD. Factors associated with greater within-pen prevalence of BRD were sharing air with weaned cattle up to 8 mo old (OR = 3.21, 95% CI: 1.26 to 8.16), and greater depth of the wet bedding pack. The use of maternity pens for reasons other than just calving was associated with increased prevalence of both CD and BRD (OR = 1.85, 95% CI: 1.03 to 3.33; OR = 2.61, 95% CI: 1.21 to 5.58, respectively). These results suggest that isolation from older animals and frequent cleaning of the feeder and pen may help to reduce disease prevalence in group-housed calves fed with an AMF.

A survey of dairy calf management practices among farms using manual and automated milk feeding systems in Canada.

Dairy calves in North America traditionally are housed individually and fed by manual milk feeding (MMF) systems with buckets or bottles. Automated milk feeders (AMF) allow for more natural milk feeding frequencies and volumes, and calves are usually housed in groups. The objectives of this study were to (1) determine the prevalence of various milk-fed calf management and feeding practices and (2) compare these practices between dairy farms using MMF and AMF systems. A national online survey was performed from January to May 2015 to quantify management practices for the care of milk-fed dairy calves in Canada. A total of 670 responses were received (6% of all dairy farms in Canada). Among respondents, 16% used AMF and 84% used MMF. Seventy percent of the farms using AMF had freestall barns compared with only 48% of those using MMF. A greater proportion of AMF farms (30%) also had automatic milking systems (AMS) compared with MMF farms (8%). Among tiestall farms, a herd size of >80 milking cows was associated with having an AMF [odds ratio (OR) = 3.8; 95% confidence interval (CI): 1.6-11.4]. For freestall or bedded-pack farms, a herd size of >80 milking cows (OR = 3.5; CI: 1.8-6.6), having an AMS (OR = 3.1; CI: 1.6-5.7), and use of cow brushes (OR = 3.1; CI: 1.3-6.9) were associated with having an AMF. Calves fed with AMS typically were housed in groups of 10 to 15, whereas almost 76% of the farms with MMF housed calves individually. Although both AMF and MMF farms fed similar amounts of milk in the first week of life (median = 6 L/d), the cumulative volume fed in the first 4 wk differed significantly, with a median of 231 versus 182 L for AMF and MMF, respectively. Median peak milk allowance was higher for AMF than for MMF (10 vs. 8 L/d, respectively). In summary, farms using AMF were larger, provided more milk to calves, and used more automation in general (i.e., in other areas of their operation). These data provide insights into calf-rearing practices across Canada and into how the use of AMF is affecting calf feeding and management on dairy farms.

Prevalence and risk factors for Coxiella burnetii seropositivity in small ruminant veterinarians and veterinary students in Ontario, Canada.

Coxiella burnetii is a zoonotic pathogen that causes Q fever in humans. Serological and questionnaire data on C. burnetii were obtained from 32 small ruminant veterinarians and veterinary students in Ontario, Canada, in February 2012. Overall, 59% of participants were seropositive; advanced stage of career and increased age were associated with seropositivity.

Prévalence et facteurs de risques pour la séropositivité àCoxiella burnetiichez les vétérinaires des petits ruminants et les étudiants en médecine vétérinaire en Ontario, au Canada.Coxiella burnetii est un agent pathogène zoonotique qui cause la fièvre Q chez les humains. Des données sérologiques et provenant de réponses à un questionnaire portant sur C. burnetii ont été obtenues auprès de 32 vétérinaires et étudiants en médecine vétérinaire en Ontario, au Canada, en février 2012. Globalement, 59 % des participants étaient séropositifs; un stade de carrière avancé et un âge supérieur étaient associés à la séropositivité.(Traduit par Isabelle Vallières).

Evaluation of fecal culture and fecal RT-PCR to detect Mycobacterium avium ssp. paratuberculosis fecal shedding in dairy goats and dairy sheep using latent class Bayesian modeling.

BACKGROUND: The study's objective was to evaluate the ability of fecal culture (FCUL) and fecal PCR (FPCR) to identify dairy goat and dairy sheep shedding Mycobacterium avium ssp. paratuberculosis. A cross-sectional study of the small ruminant populations was performed in Ontario, Canada between October 2010 and August 2011. Twenty-nine dairy goat herds and 21 dairy sheep flocks were visited, and 20 lactating females > two years of age were randomly selected from each farm resulting in 580 goats and 397 sheep participating in the study. Feces were collected per rectum and cultured using the BD BACTEC™ MGIT™ 960 system using a standard (49 days) and an extended (240 days) incubation time, and underwent RT-PCR based on the hsp-X gene (Tetracore®). Statistical analysis was performed using a 2-test latent class Bayesian hierarchical model for each species fitted in WinBUGS. RESULTS: Extending the fecal culture incubation time statistically improved FCUL sensitivity from 23.1 % (95 % PI: 15.9-34.1) to 42.7 % (95 % PI: 33.0-54.5) in dairy goats and from 5.8 % (95 % PI: 2.3-12.4) to 19.0 % (95 % PI: 11.9-28.9) in dairy sheep. FPCR demonstrated statistically higher sensitivity than FCUL (49 day incubation) with a sensitivity of 31.9 % (95 % PI: 22.4-43.1) in goats and 42.6 % (95 % PI: 28.8-63.3) in sheep. CONCLUSIONS: Fecal culture demonstrates such low sensitivity at the standard incubation time it cannot be recommended as a screening test to detect shedding of MAP in either goats or sheep. Extending the incubation time resulted in improved sensitivity; however, it is still disappointingly low for screening purposes. Fecal PCR should be the screening test of choice in both species; however, it is important to recognize that control programs should not be based on testing alone when they demonstrate such low sensitivity.

Exploring the relationships between small non-community drinking water system characteristics and water system performance in Ontario, Canada.

The objectives of this work were to investigate the relationships between characteristics of small non-community drinking water systems (SDWSs) and the performance of these systems with respect to Escherichia coli testing and risk ratings. Ontario-wide SDWS data were analysed using regression models with outcomes of (1) having an adverse E. coli test result in the 12 months prior to the last inspection and (2) the SDWS risk rating (high/medium vs. low risk) that is assigned by public health inspectors. Almost 34% (2,364/7,003) of SDWSs did not utilize treatment, more commonly for ground water than surface supplies (P < 0.001). The odds of having a positive E. coli test result were greater in systems using ground water with treatment (OR = 2.00; 95% CI 1.23-3.24) and surface water with treatment (OR = 1.97; 95% CI 1.05-3.71) compared to ground water with no treatment. The odds of having a water system rated high or medium compared to low risk was greater if the water system operated seasonally (OR = 1.36; 95% CI 1.17-1.59), had an adverse E. coli test result (OR = 1.66; 95% CI 1.09-2.53), and in specific facility types. This research helps to inform existing training opportunities available to SDWS operators in Ontario, and to better standardize the SDWS risk assessment process.

Does the public receive and adhere to boil water advisory recommendations? A cross-sectional study in Newfoundland and Labrador, Canada.

BACKGROUND: Highly publicized water supply problems highlight the importance of safe drinking water to the public. Boil water advisories (BWAs) are an important precautionary measure meant to protect public health by ensuring drinking water safety. Newfoundland and Labrador, Canada is a prime location for exploring public notification practices and adherence to recommendations as there were a total of 215 BWAs, affecting 6 % of the provincial population, in 145 communities between April 2006 and March 2007 when data for the present study were collected. METHODS: Residents who received household water from a public water supply were randomly selected for a telephone interview. Collected data included participants' notification of boil water advisory, satisfaction with information provided, and their adherence to recommendations. RESULTS: Most participants learned that a BWA had been issued or lifted in their community through radio, television, or word of mouth. BWAs were issued for a range of operational reasons. Almost all participants who had experienced a BWA reported wanting more information about the reasons a BWA had been issued. Low adherence to water use recommendations during a BWA was common. CONCLUSIONS: This study is first to report on public adherence to boil water advisory recommendations in Canada. The findings raise public health concerns, particularly given the high number of BWAs issued each year. Further studies in partnership with community stakeholders and government decision-makers responsible for overseeing public water systems are needed to assess the perceptions of BWAs, the reasons for non-adherence, and to identify information dissemination methods to increase information uptake and public adherence with acceptable uses of public drinking water during a BWA.

Paratuberculosis on small ruminant dairy farms in Ontario, Canada: A survey of management practices.

A cross-sectional study was undertaken (October 2010 to August 2011) to determine the risk factors for dairy goat herds and dairy sheep flocks testing positive for paratuberculosis (PTB) in Ontario, Canada. A questionnaire was administered to 50 producers during a farm visit in which concurrently, 20 randomly selected, lactating animals over the age of 2 years underwent sampling for paratuberculosis testing. Only 1 of 50 farms (2.0%) was closed to animal movement, whereas 96.6% of dairy goat farms and 94.1% of sheep farms purchased livestock from other producers. Only 10.3% of dairy goat, and no dairy sheep farms used artificial insemination. Manure was spread on grazing pastures by 65.5% and 70.6% of dairy goat and dairy sheep farms, respectively. Because of the high true-prevalence of paratuberculosis infection detected, no risk factor analysis could be performed. This study demonstrates that biosecurity practices conducive to transmission of PTB are highly prevalent in Ontario small ruminant dairy farms.

La paratuberculose dans les fermes laitières de petits ruminants de l'Ontario, au Canada : enquête sur les pratiques de gestion. Une étude transversale (d'octobre 2010 à août 2011) a été entreprise afin de déterminer les facteurs de risque pour les troupeaux de chèvres laitières et de brebis laitières obtenant des résultats positifs pour la paratuberculose (PTB) en Ontario, au Canada. Un questionnaire a été soumis à 50 producteurs durant une visite à la ferme pendant laquelle, parallèlement, 20 animaux en lactation âgés de plus de 2 ans, qui étaient choisis au hasard, ont subi un prélèvement pour un test de paratuberculose. Seulement 1 des 50 fermes (2,0 %) était fermée au mouvement des animaux, tandis que 96,6 % des fermes de chèvres laitières et 94,1 % des fermes de brebis achetaient des animaux d'autres producteurs. Seulement 10,3 % des fermes de chèvres laitières, et aucune ferme de brebis laitières, avaient eu recours à l'insémination artificielle. Le fumier était épandu dans les pâturages par 65,5 % et 70,6 % des fermes de chèvres laitières et de brebis laitières, respectivement. En raison de la prévalence réelle élevée détectée pour l'infection par la paratuberculose, aucune analyse de facteur de risque n'a pu être réalisée. Cette étude démontre que les pratiques de biosécurité propices à la transmission de la PTB sont hautement prévalentes dans les fermes de petits ruminants de l'Ontario.(Traduit par Isabelle Vallières).

Prevalence of paratuberculosis in the dairy goat and dairy sheep industries in Ontario, Canada.

A cross-sectional study was undertaken (October 2010 to August 2011) to estimate the prevalence of paratuberculosis in the small ruminant dairy industries in Ontario, Canada. Blood and feces were sampled from 580 goats and 397 sheep (lactating and 2 y of age or older) that were randomly selected from 29 randomly selected dairy goat herds and 21 convenience-selected dairy sheep flocks. Fecal samples were analyzed using bacterial culture (BD BACTEC MGIT 960) and polymerase chain reaction (Tetracore); serum samples were tested with the Prionics Parachek enzyme-linked immunosorbent assay (ELISA). Using 3-test latent class Bayesian models, true farm-level prevalence was estimated to be 83.0% [95% probability interval (PI): 62.6% to 98.1%] for dairy goats and 66.8% (95% PI: 41.6% to 91.4%) for dairy sheep. The within-farm true prevalence for dairy goats was 35.2% (95% PI: 23.0% to 49.8%) and for dairy sheep was 48.3% (95% PI: 27.6% to 74.3%). These data indicate that a paratuberculosis control program for small ruminants is needed in Ontario.

Prévalence de la paratuberculose dans l'industrie des chèvres et des brebis laitières en Ontario, au Canada. Une étude de prévalence a été entreprise (d'octobre 2010 à août 2011) afin d'estimer la prévalence de la paratuberculose dans les industries laitières des petits ruminants en Ontario, au Canada. Du sang et des fèces ont été prélevés auprès de 580 chèvres et de 397 brebis (en lactation et âgées de 2 ans et plus) qui ont été choisies au hasard parmi 29 troupeaux de chèvres laitières et 21 troupeaux de brebis laitières choisis au hasard. Des échantillons de fèces ont été analysés à l'aide d'une culture bactérienne (BD BACTEC MGIT 960) et d'une amplification en chaîne par la polymérase (Tetracore); des échantillons de sérum ont été analysés à l'aide d'un ELISA Prionics Parachek. À l'aide d'un modèle Bayesien de variable à classe latente permettant de comparer 3 tests imparfaits, la véritable prévalence à la ferme a été estimée à 83,0 % (IP de 95 % : 62,6 %­98,1 %) pour les chèvres laitières et à 66,8 % (IP de 95 % : 41,6 %­91,4 %) pour les brebis laitières. La véritable prévalence à la ferme pour les chèvres laitières était de 35,2 % (IP de 95 % : 23,0 %­49,8 %) et et de 48,3 % (IP de 95 % : 27,6 %­74,3 %) pour les brebis laitières. Ces données signalent le besoin d'un programme de contrôle de la paratuberculose en Ontario.(Traduit par Isabelle Vallières).

Experience, training and confidence among small, non-community drinking water system operators in Ontario, Canada.

The water operator plays an important role in water safety; however, little published research exists that has examined this role. The purpose of this study was to develop a greater understanding of the experience, existing knowledge, confidence and future training needs of the small, non-community drinking water operator in Ontario in order to help guide future outreach and training opportunities. A cross-sectional telephone survey of 332 small, non-community drinking water operators in Ontario was conducted in July and August 2011. Survey questions pertained to respondents' experience as operators, formal training, perceived importance of water safety issues, confidence in handling water safety issues, and future training needs. Approximately 16% (54/330) of respondents had one year or less experience as a water operator, and 60% (199/332) reported that being a water operator was not a chosen profession. Only 37% (124/332) of operators reported completing operator training. Respondents reported a preference for online training courses or on-site training (compared with a classroom setting). Low training rates, inexperience, and in certain situations, low confidence, among many small water system operators highlight a need to provide continued support to the development of ongoing training opportunities in this population.

Global incidence of human Shiga toxin-producing Escherichia coli infections and deaths: a systematic review and knowledge synthesis.

OBJECTIVES: Shiga toxin-producing Escherichia coli (STEC) are an important cause of foodborne disease, yet global estimates of disease burden do not exist. Our objective was to estimate the global annual number of illnesses due to pathogenic STEC, and resultant hemolytic uremic syndrome (HUS), end-stage renal disease (ESRD), and death. MATERIALS: We searched Medline, Scopus, SIGLE/OpenGrey, and CABI and World Health Organization (WHO) databases for studies of STEC incidence in the general population, published between January 1, 1990 and April 30, 2012, in all languages. We searched health institution websites for notifiable disease data and reports, cross-referenced citations, and consulted international knowledge experts. We employed an a priori hierarchical study selection process and synthesized results using a stochastic simulation model to account for uncertainty inherent in the data. RESULTS: We identified 16 articles and databases from 21 countries, from 10 of the 14 WHO Sub-Regions. We estimated that STEC causes 2,801,000 acute illnesses annually (95% Credible Interval [Cr.I.]: 1,710,000; 5,227,000), and leads to 3890 cases of HUS (95% Cr.I.: 2400; 6700), 270 cases of ESRD (95% Cr.I.: 20; 800), and 230 deaths (95% Cr.I.: 130; 420). Sensitivity analyses indicated these estimates are likely conservative. CONCLUSIONS: These are the first estimates of the global incidence of STEC-related illnesses, which have not been explicitly included in previous global burden of disease estimations. Compared to other pathogens with a foodborne transmission component, STEC appears to cause more cases than alveolar echinococcosis each year, but less than typhoid fever, foodborne trematodes, and nontyphoidal salmonellosis. APPLICATIONS: Given the persistence of STEC globally, efforts aimed at reducing the burden of foodborne disease should consider the relative contribution of STEC in the target population.