Understanding the role of household hygiene practices and foodborne disease risks in child stunting: a UKRI GCRF Action Against Stunting Hub protocol paper.

INTRODUCTION: Environmental hygiene and food safety are important determinants of child stunting. This research aims to explore the relationship between child stunting and household hygiene practices and behaviours, including the availability of water, sanitation and hygiene (WASH) facilities; the use of safe food and good quality drinking water (especially when used for complementary feeding); hygienic practices in food transport, storage and preparation and the control of cross-contamination from animals, their produce and waste. METHODS AND ANALYSIS: This study is part of a wider observational study which aims to investigate the interdisciplinary factors contributing to child stunting using a 'whole child' paradigm. The observational study recruits women during pregnancy in Hyderabad, India, Lombok, Indonesia and Kaffrine, Senegal, and dyads (ie, 500 mother-infant pairs per country) are followed longitudinally up to 24 months after birth. Within the interdisciplinary niche, the study here has developed tools to investigate the potential exposure pathways to environmental pathogen contamination of foods and water. Holistic WASH and food safety data collection tools have been developed to explore exposure pathways at the household level, including: (1) survey questionnaires; (2) spot-checks; (3) biological sampling of drinking water, food and domestic surfaces and (4) direct observation. An integrated analytical approach will be used to triangulate the evidence in order to examine the relationships between child stunting, WASH and food safety behaviours. ETHICS AND DISSEMINATION: Ethical approval of the study was granted by the ethics committee of the LSHTM, RVC, ILRI, ICMR, IIPHG, SEAMEO-RECFON, University of Cheikh Anta Diop. Findings of the study will be disseminated through publication in peer-reviewed journals, relevant international conferences, public engagement events, and policy-maker and stakeholder events.

Reshaping surveillance for infectious diseases: less chasing of pathogens and more monitoring of drivers.

Animal health surveillance, despite its name, tends to focus on looking for disease. Often this involves searching for cases of infection with known pathogens (â€Ëœpathogen chasing'). Such an approach is both resource intensive and limited by the requirement for prior knowledge of disease likelihood. In this paper, the authors propose the gradual reshaping of surveillance towards the systems level, focusing on the processes (â€Ëœdrivers') that promote disease or health, rather than on the presence or absence of specific pathogens. Examples of relevant drivers include land-use change, increasing global interconnectedness, and finance and capital flows. Importantly, the authors suggest that surveillance should focus on detecting changes in patterns or quantities associated with such drivers. This would generate systems-level, risk-based surveillance information to identify areas where additional attention may be needed, and, over time, inform the implementation of prevention efforts. The collection, integration and analysis of data on drivers is likely to require investment in improving data infrastructures. A period of overlap would allow the two systems (traditional surveillance and driver monitoring) to be compared and calibrated. This would also lead to a better understanding of the drivers and their linkages, and thereby generate new knowledge that can improve surveillance and inform mitigation efforts. Since surveillance of drivers may give signals when changes are occurring, which could act as alerts and enable targeted mitigation, this might even enable disease to be prevented before it happens by directly intervening in the drivers themselves. Such surveillance focused on the drivers could be expected to bring additional benefits, since the same drivers promote multiple diseases. Further, focusing on drivers rather than pathogens should enable control of currently unknown diseases, making this approach particularly timely, given the increasing risk of emergence of new diseases.

La surveillance de la santé animale a tendance, malgré son nom, à se focaliser sur la recherche des maladies. Elle implique souvent de chercher les cas d'infection par des agents pathogènes connus (" chasse aux agents pathogènes "). Ce type d'approche exige non seulement beaucoup de ressources, mais elle est aussi limitée par la nécessité d'avoir une connaissance préalable de la probabilité de survenue de la maladie en question. Dans cet article, les auteurs proposent une refonte progressive de la surveillance pour la déplacer au niveau systémique, en se concentrant sur les processus (" facteurs ") influençant la maladie ou la santé plutôt que sur la présence ou non d'agents pathogènes spécifiques. Parmi les facteurs pertinents, on peut citer les changements dans l'utilisation des sols, l'interconnexion accrue au niveau mondial et les flux financiers et de capitaux. Les auteurs soulignent cet élément important : la surveillance devrait se focaliser sur la détection de changements au niveau des schémas ou des quantités associés à ces facteurs. Cela permettrait d'obtenir des informations de surveillance au niveau systémique et basées sur les risques, afin d'identifier les domaines auxquels il pourrait être nécessaire de porter une attention particulière - ce qui informerait, à terme, la mise en oeuvre des efforts de prévention. Il est probable qu'une amélioration des infrastructures de données soit nécessaire pour assurer la collecte, l'intégration et l'analyse des données sur les facteurs. Une période de chevauchement permettrait de comparer et de calibrer les deux systèmes (surveillance traditionnelle et surveillance des facteurs). Les facteurs et les liens entre eux seraient également mieux compris, ce qui générerait de nouvelles connaissances pouvant améliorer la surveillance et informer les efforts d'atténuation. Grâce à la surveillance des facteurs, des signaux pourraient être identifiés lorsque des changements se produisent, ce qui constituerait une alerte pour que des efforts d'atténuation ciblés soient mis en place afin d'intervenir directement sur les facteurs eux-mêmes et donc prévenir une maladie avant même qu'elle ne survienne. On peut s'attendre à ce que ce type de surveillance centrée sur les facteurs apporte des bénéfices supplémentaires, puisque les mêmes facteurs peuvent favoriser de multiples maladies. De surcroît, cette orientation axée sur les facteurs plutôt que sur les agents pathogènes devrait permettre de contrôler des maladies aujourd'hui inconnues, ce qui rend cette approche d'autant plus opportune, compte tenu du risque croissant d'émergence de nouvelles maladies.

La vigilancia zoosanitaria, pese a lo que su nombre indica, tiende a centrarse en la búsqueda de enfermedades, lo que a menudo pasa por tratar de localizar casos de infección por un patógeno conocido ("persecución de patógenos"). Semejante método no solo exige cuantiosos recursos, sino que además presenta la limitación de que obliga a conocer de antemano la probabilidad de aparición de una enfermedad. Los autores proponen una remodelación gradual de la vigilancia tendente a dotarla de carácter sistémico y a centrarla no tanto en la presencia o ausencia de determinados patógenos, sino en los procesos ("inductores" o "factores de inducción", drivers) que favorecen la enfermedad o la salud. Son ejemplo de tales procesos la evolución de los usos del suelo, el creciente nivel de interconexión mundial o los flujos financieros y de capitales. Un aspecto importante que apuntan los autores es que la vigilancia debería tener por objetivo la detección de cambios en las características o cantidades de esos factores de inducción. Ello generaría información de vigilancia basada en el riesgo de carácter sistémico, que serviría para determinar aquellas zonas a las que convendría prestar más atención y, con el tiempo, fundamentar la realización de actividades de prevención. Es probable que la obtención, integración y análisis de datos sobre los factores de inducción exijan inversiones para mejorar las infraestructuras de datos. Si hubiera una fase de solapamiento, sería posible comparar y valorar los resultados de ambos sistemas (vigilancia tradicional y seguimiento de los factores de inducción). Ello serviría para entender mejor los inductores y su vinculación recíproca, lo que generaría nuevos conocimientos con los que perfeccionar la vigilancia y en los que cimentar las actividades de mitigación. Dado que la vigilancia de los inductores puede generar una señal cuando se estén produciendo cambios, señal que a su vez activaría una alerta y propiciaría medidas selectivas de mitigación, podría ser que ello sirviera incluso para prevenir una enfermedad antes de que surgiera, actuando directamente sobre los propios factores de inducción. Cabría pensar que semejante tipo de vigilancia, centrarse en los inductores, puede tener otros efectos beneficiosos, en la medida en que un mismo inductor alimenta la aparición de varias enfermedades. Además, el hecho de centrarse en los factores de inducción, y no tanto en los patógenos, debería servir para controlar enfermedades actualmente desconocidas, por lo que este planteamiento, ante el creciente riesgo de aparición de nuevas enfermedades, resulta especialmente oportuno.

Brucellosis remains a neglected disease in the developing world: a call for interdisciplinary action.

BACKGROUND: Brucellosis is an endemic zoonotic disease in most of the developing world that causes devastating losses to the livestock industry and small-scale livestock holders. Infected animals exhibit clinical signs that are of economic significance to stakeholders and include reduced fertility, abortion, poor weight gain, lost draught power, and a substantial decline in milk production. In humans, brucellosis typically manifests as a variety of non-specific clinical signs. Chronicity and recurring febrile conditions, as well as devastating complications in pregnant women are common sequelae. DISCUSSION: In regions where the disease is endemic, brucellosis has far-reaching and deleterious effects on humans and animals alike. Deeply entrenched social misconceptions and fear of government intervention contribute to this disease continuing to smolder unchecked in most of the developing world, thereby limiting economic growth and inhibiting access to international markets. The losses in livestock productivity compromise food security and lead to shifts in the cognitive competency of the working generation, influence the propagation of gender inequality, and cause profound emotional suffering in farmers whose herds are affected. The acute and chronic symptoms of the disease in humans can result in a significant loss of workdays and a decline in the socioeconomic status of infected persons and their families from the associated loss of income. The burden of the disease to society includes significant human healthcare costs for diagnosis and treatment, and non-healthcare costs such as public education efforts to reduce disease transmission. CONCLUSION: Brucellosis places significant burdens on the human healthcare system and limits the economic growth of individuals, communities, and nations where such development is especially important to diminish the prevalence of poverty. The implementation of public policy focused on mitigating the socioeconomic effects of brucellosis in human and animal populations is desperately needed. When developing a plan to mitigate the associated consequences, it is vital to consider both the abstract and quantifiable effects. This requires an interdisciplinary and collaborative, or One Health, approach that consists of public education, the development of an infrastructure for disease surveillance and reporting in both veterinary and medical fields, and campaigns for control in livestock and wildlife species.

Trade patterns facilitating highly pathogenic avian influenza virus dissemination in the free-grazing layer duck system in Vietnam.

Highly pathogenic avian influenza (HPAI) viruses continue to threaten smallholder poultry producers in several South-east Asian countries, including Vietnam. In particular, the free-grazing duck system has been repeatedly highlighted as a major risk factor for HPAI outbreaks. Free-grazing ducks, which scavenge on rice paddies after the harvest, account for a large proportion of the duck population in Vietnam and the wider South-east Asian region. However, the structure and dynamics of the free-grazing duck production from farm to consumption has not been described for Vietnam. In this study, we used a value chain approach to provide a complete picture of the actors involved in the production and marketing of free-grazing duck eggs and spent layer ducks, as well as to investigate the governance structure of this food system. Group interviews and key informant interviews were conducted in two provinces located in the Mekong River Delta (MRD) and the Red River Delta (RRD). The results presented here highlight similarities and differences in farming and trade practices between the two provinces. The trade of spent layer ducks involved large volumes of live ducks being sent to China and Cambodia for consumption, generating a substantial risk of transboundary spread of pathogens, including HPAI viruses. We describe the major role of "duck yards", which act as hubs in the northbound trade of spent layer ducks. These yards should be considered as essential links in the value chain of spent layer ducks when considering HPAI surveillance and control. The veterinary authorities are only marginally involved in the value chain activities, and their influence could be strengthened by increasing surveillance activities for instance in duck yards. Last, we discuss the dynamics of the duck value chain and further implications for future HPAI management policies.

Brucellosis in West and Central Africa: A review of the current situation in a changing landscape of dairy cattle systems.

Brucellosis is a neglected endemic zoonosis in West and Central Africa. In this narrative review, evidence of livestock and human infection is presented along with details of past and current control strategies in 14 selected countries. Data from available literature is combined with expert opinion elicited during a regional workshop on brucellosis diagnostics. Demographic changes that affect both the epidemiology of brucellosis and the success of control or surveillance are also considered. The evidence suggests that brucellosis prevalence in emerging peri-urban dairy cattle systems may be higher than that found in traditional transhumant extensive systems. Accurate microbiological and epidemiological evidence across the region is lacking but it appears there is inherent interest in controlling the disease. There are many data gaps which require collaborative future research to evaluate fully the social and economic impact of the disease in an evolving livestock sector heavily influenced by high rates of urbanisation and regional population growth.

Economic evaluation of the eradication program for bovine viral diarrhea in the Swiss dairy sector.

Since 2008, the Swiss veterinary service has been running a mandatory eradication program for Bovine Viral Diarrhea (BVD) that is focused on detecting and eliminating persistently infected (PI) animals. Detection was initially based on antigen testing from ear tag samples of the entire cattle population, followed by antigen testing of all newborn calves until 2012. Since then, bulk milk serology (dairy herds) and blood sample serology (beef herds) have been used for the surveillance of disease-free herds. From 2008 to 2012, the proportion of newborn PI calves decreased from 1.4% to less than 0.02%. However, this success was associated with substantial expenditures. The aim of this study was to conduct an economic evaluation of the BVD eradication program in the Swiss dairy sector. The situation before the start of the program (herd-level prevalence: 20%) served as a baseline scenario. Production models for three dairy farm types were used to estimate gross margins as well as net production losses and expenditures caused by BVD. The total economic benefit was estimated as the difference in disease costs between the baseline scenario and the implemented eradication program and was compared to the total eradication costs in a benefit-cost analysis. Data on the impact of BVD virus (BVDV) infection on animal health, fertility and production parameters were obtained empirically in a retrospective epidemiological case-control study in Swiss dairy herds and complemented by literature. Economic and additional production parameters were based on benchmarking data and published agricultural statistics. The eradication costs comprised the cumulative expenses for sampling and diagnostics. The economic model consisted of a stochastic simulation in @Risk for Excel with 20,000 iterations and was conducted for a time period of 14 years (2008-2021). The estimated annual financial losses in BVDV infected herds were CHF 85-89 per dairy cow and CHF 1337-2535 for an average farm, depending on the production type. The median net present value (NPV) was estimated at CHF 44.9 million (90% central range: CHF 13.4 million-69.4 million) and the break-even point to have been reached in 2015. Overall, the outcomes demonstrate that the Swiss BVD eradication program results in a net benefit for the dairy sector. These findings are relevant for planning similar BVD control programs in other countries.

Economic assessment of an emerging disease: the case of Schmallenberg virus in France.

Schmallenberg virus (SBV) was first detected in 2011 in Germany and then in France in 2012. This study simulates the production of different ruminant systems in France and estimates, through partial budget analyses, the economic cost of SBV at the farm level, under two disease scenarios (a high-impact and low-impact scenario). A partial budget is used to evaluate the financial effect of incremental changes, and includes only resources or production that will be changed. In the high-impact scenario, the estimated impact of SBV ranged from €23 to €43 per cow per year and €19 to €37 per ewe per year. In the low-impact scenario, it was approximately half (for cows) or one-third (for ewes) of this amount. These financial impacts represent 0.6% to 63% of the gross margin, depending on the chosen scenario and the livestock system being considered. The impacts of SBV come mainly from: the extra costs from purchasing and raising replacement heifers and losses in milk production (dairy cows); the losses in calf or lamb production (beef systems and meat sheep); and the losses in milk production and from unsold replacement lambs (dairy sheep). The use of integrated production and economic models enabled the authors to estimate the cost of SBV and to tackle the problem of scarce data, which is a difficulty for most emerging diseases, by their very nature. It also allowed the authors to develop an accurate disease impact assessment for several production systems, over a short time span. Extrapolating from this economic assessment to predict the scenario in coming years depends on the immunity period of the disease and the length of the production cycles.

Le virus de Schmallenberg a été détecté pour la première fois en 2011 en Allemagne, puis en France en 2012. Les auteurs présentent une étude de simulation de plusieurs systèmes de production de ruminants en France, dont l'objectif était d'estimer, à partir d'analyses budgétaires partielles, les coûts économiques du virus de Schmallenberg à l'échelle des exploitations, sous deux scénarios différents (hypothèses d'un fort impact et d'un faible impact de la maladie, respectivement). Une analyse budgétaire partielle sert à évaluer les conséquences financières d'un changement graduel et ne prend en compte que les modifications effectives en termes de ressources et de production. Dans l'hypothèse d'un impact fort de la maladie, l'impact annuel estimé du virus de Schmallenberg variait de 23 à 43 euros par vache et de 19 à 37 euros par brebis. Dans l'hypothèse d'un impact faible, l'impact annuel était deux fois moindre chez les vaches et trois fois moindre chez les brebis que dans la première hypothèse. Ces impacts financiers représentent 0,6 % à 63 % de la marge brute en fonction du scénario choisi et du système de production. Les impacts du virus de Schmallenberg découlent principalement des coûts supplémentaires induits par l'achat et le maintien de génisses de remplacement et d'une baisse de la production de lait (vaches laitières), des pertes de veaux ou d'agneaux (bovins et ovins de boucherie), d'une baisse de la production de lait et du coût des agnelles de remplacement invendues (brebis laitières). L'utilisation de modèles intégrant les aspects économiques et les données de production a permis aux auteurs d'estimer le coût du virus de Schmallenberg malgré la pénurie de données, s'attaquant ainsi à une difficulté inhérente à la plupart des maladies émergentes. Cela leur a également permis d'effectuer une évaluation précise de l'impact sanitaire dans plusieurs systèmes de production, sur une durée courte. La possibilité d'extrapoler à partir de cette évaluation économique un scénario pour les années à venir dépend de la période d'immunité vis-à-vis de la maladie et de la durée des cycles de production.

El virus de Schmallenberg fue detectado por primera vez en 2011 en Alemania y ulteriormente en 2012 en Francia. Los autores describen un estudio en el que se simularon distintos sistemas de producción de rumiantes en Francia y se estimó, con análisis presupuestarios parciales, el coste económico que entrañaría para una explotación el virus de Schmallenberg en dos hipotéticas situaciones sanitarias (una situación con efectos profundos y otra con efectos leves). El análisis presupuestario parcial sirve para evaluar los efectos económicos de cambios graduales, e incluye únicamente aquellos recursos y aspectos de la producción que experimentarán cambios. En la hipótesis de efectos profundos, el impacto estimado de la infección por el virus de Schmallenberg oscilaba entre 23 y 43 euros anuales por vaca y entre 19 y 37 euros anuales por oveja hembra. La hipótesis de efectos leves deparaba importes de aproximadamente la mitad (en el caso de las vacas) o un tercio (en el de las ovejas). Este impacto económico representa del 0,6% al 63% del margen bruto, dependiendo de la hipótesis elegida y del sistema productivo de que se trate. Los efectos de la infección por el virus de Schmallenberg se concretan básicamente en: los costos suplementarios derivados de adquirir y criar vaquillas de sustitución y de obtener una menor producción de leche (vacas lecheras); las pérdidas de terneros o corderos (sistemas de bovino u ovino cárnicos); y los costos derivados de la menor producción de leche y de no vender las corderas de sustitución (ovejas lecheras). El uso de modelos que integran los factores productivos y económicos sirvió a los autores para estimar el costo del virus de Schmallenberg a pesar de la escasez de datos, que, por la propia naturaleza de las enfermedades emergentes, es una dificultad común a la mayoría de ellas. También les permitió evaluar con exactitud el impacto de la enfermedad en distintos sistemas productivos en un breve lapso de tiempo. La realización de extrapolaciones a partir de esta evaluación económica para pronosticar la situación en años venideros depende del periodo de inmunidad respecto de la enfermedad y de la duración de los ciclos productivos.

Achieving an optimal allocation of resources for animal health surveillance, intervention and disease mitigation.

The primary role of animal health economics is to inform decision-making by determining optimal investments for animal health. Animal health surveillance produces information to guide interventions. Consequently, investments in surveillance and intervention must be evaluated together. This article explores the different theoretical frameworks and methods developed to assess and optimise the spending of resources in surveillance and intervention and their technical interdependence. The authors present frameworks that define the relationship between health investment and losses due to disease, and the relationship between surveillance and intervention resources. Surveillance and intervention are usually considered as technical substitutes, since increased investments in surveillance reduce the level of intervention resources required to reach the same benefit. The authors also discuss approaches used to quantify externalities and non-monetary impacts. Finally, they describe common economic evaluation types, including optimisation, acceptability and least-cost studies.

L'économie de la santé animale a pour rôle primordial d'étayer la prise de décisions en définissant les meilleurs investissements en santé animale. Les activités de surveillance de la santé animale permettent de réunir les informations nécessaires pour guider les interventions. Par conséquent, il est nécessaire d'évaluer en même temps les investissements dans la surveillance et ceux dans les interventions. Les auteurs exposent les différents cadres théoriques et méthodologiques permettant d'évaluer et d'optimiser l'utilisation des ressources allouées à la surveillance et aux interventions et en font ressortir l'interdépendance technique. Les cadres présentés mettent en rapport les investissements dans la santé avec les pertes dues aux maladies et définissent les relations entre les ressources allouées à la surveillance et celles allouées aux interventions. La surveillance et les interventions sont généralement considérées comme des substitus tecniques, dans la mesure où toute augmentation des investissements dans la surveillance réduit d'autant le volume des ressources allouées aux interventions, pour un bénéfice équivalent. Les auteurs examinent également les approches utilisées pour quantifier les externalités ainsi que les impacts non monétaires. Enfin, ils décrivent plusieurs types d'évaluations économiques courantes, dont l'optimisation, l'acceptabilité et les analyses du moindre coût.

La economía de la sanidad animal tiene por función básica fundamentar la adopción de decisiones por el expediente de determinar cuáles son las inversiones óptimas desde el punto de vista zoosanitario. La vigilancia zoosanitaria genera información con la cual orientar las intervenciones. Por consiguiente, es necesario evaluar conjuntamente las inversiones en vigilancia y las destinadas a intervenciones. Los autores examinan los diferentes métodos y marcos teóricos que se han elaborado para evaluar y optimizar el gasto de recursos en labores de vigilancia y en intervenciones, así como su interdependencia técnica. En este sentido, presentan una serie de marcos que definen la relación entre inversiones en sanidad y pérdidas por enfermedades y la relación entre recursos para vigilancia y recursos para intervenciones. En general se considera que la vigilancia y las intervenciones son técnicamente interdependientes, toda vez que una mayor inversión en vigilancia reduce la cuantía de los recursos para intervenciones que hacen falta para obtener el mismo beneficio. Los autores también reflexionan sobre los métodos empleados para cuantificar los factores externos (externalidades) y las repercusiones no monetarias. Por último, describen los tipos más frecuentes de evaluación económica, como los de optimización, aceptabilidad o análisis del costo mínimo.

Active animal health surveillance in European Union Member States: gaps and opportunities.

Animal health surveillance enables the detection and control of animal diseases including zoonoses. Under the EU-FP7 project RISKSUR, a survey was conducted in 11 EU Member States and Switzerland to describe active surveillance components in 2011 managed by the public or private sector and identify gaps and opportunities. Information was collected about hazard, target population, geographical focus, legal obligation, management, surveillance design, risk-based sampling, and multi-hazard surveillance. Two countries were excluded due to incompleteness of data. Most of the 664 components targeted cattle (26·7%), pigs (17·5%) or poultry (16·0%). The most common surveillance objectives were demonstrating freedom from disease (43·8%) and case detection (26·8%). Over half of components applied risk-based sampling (57·1%), but mainly focused on a single population stratum (targeted risk-based) rather than differentiating between risk levels of different strata (stratified risk-based). About a third of components were multi-hazard (37·3%). Both risk-based sampling and multi-hazard surveillance were used more frequently in privately funded components. The study identified several gaps (e.g. lack of systematic documentation, inconsistent application of terminology) and opportunities (e.g. stratified risk-based sampling). The greater flexibility provided by the new EU Animal Health Law means that systematic evaluation of surveillance alternatives will be required to optimize cost-effectiveness.

The association between meal timing and frequency with cardiometabolic profile in patients with bipolar disorder.

OBJECTIVE: The goal of this study was to explore the association of timing of and frequency of meals with markers of cardiometabolic risk in patients with bipolar disorder in out-patient maintenance treatment. METHODS: We used Pittsburgh Sleep Diary and actigraphy measures for individuals with bipolar I disorder. Linear and logistic regression analyses were used to determine whether dinnertime, instability of dinnertime, and/or interval between meals were associated with metabolic syndrome and its components. RESULTS: Later dinnertime was associated with greater waist circumference (ß = 0.25, P = 0.02) after adjusting for age, sex, dinner-to-bed interval, and sleep duration. Longer breakfast-to-lunch intervals were also associated with greater waist circumferences (ß =-.35, P = .002) after adjusting for age, sex, and sleep duration. Neither instability of dinnertime nor number of meals per day was associated with the metabolic syndrome or its components. CONCLUSION: Weight gain is often perceived as inevitable side-effect of medications. While patients often need to be on medication to function, a more careful lifestyle assessment with attention to social rhythms and timing of activities may be critical not only for mood stability, but also to reduce cardiovascular risk.

Assessing the expenditure distribution of animal health surveillance: the case of Great Britain.

Animal health surveillance in Great Britain (GB) is conducted through public and private initiatives, yet there is no consolidated information on these activities and their outcomes. We developed an inventory of livestock health surveillance programmes in GB to identify gaps in resource use and potential synergies that could be exploited. The inventory contained details of 36 livestock surveillance activities active in 2011. Data were collected by questionnaire and interviews. Livestock health surveillance funding was found to be unevenly distributed between species: the vast majority (approximately 94 per cent) was spent on cattle diseases (tuberculosis surveillance accounted for most of this expenditure), with 2 per cent on pigs, 2 per cent on sheep/goats, 1 per cent on poultry, and 1 per cent on antimicrobial resistance surveillance across all species. Consequently, surveillance efforts in GB appears heavily skewed towards regions with high cattle densities, particularly high-prevalence tuberculosis areas such as the southwest. The contribution of private schemes to surveillance funding was hard to quantify due to limited access to data, but was estimated to be about 10 per cent. There is scope to better understand the benefits of surveillance, enhance data sharing, clarify costs and identify who pays and who gains. Health surveillance should be considered within the sharing of responsibilities for disease control.

A review of the metrics for One Health benefits.

One Health as a concept has been with us for many years, yet it is only recently that it is actively being discussed as a way of mitigating risks in society. Initiatives in the use of this concept require methods to monitor the benefits gained from an holistic approach to health, yet there is an absence of adequate frameworks to measure One Health benefits. This paper explores the problem with a review of the available literature and an examination of methods used. It concludes that most published work on One Health describes how this concept is valuable without trying to estimate the size of benefit or type of value. A framework for measuring the advantages of a One Health approach is needed and, through the process of an international workshop and the development of a One Health business case, the authors are working towards its development.

Influences of farmer and veterinarian behaviour on emerging disease surveillance in England and Wales.

Surveillance for new and re-emerging animal diseases in England and Wales is based on post-mortem and syndromic analysis of laboratory data collated in a central database by the Animal Health and Veterinary Laboratories Agency (AHVLA), with the aim of providing early warning of disease events prior to clinical diagnosis. Understanding the drivers for participation in such systems is critical to the success of attempts to improve surveillance sensitivity. The aim of this study was to investigate the decision-making process governing the submission of biological samples on which this surveillance system is based by use of questionnaires. Data extracted were used to structure and parameterize scenario trees modelling the probability of generating an entry in the surveillance database. The mean probability for database entry per case ranged from 0.085 for neurological disorders to 0.25 for enteric disease. These findings illustrate the importance of on-farm decision making to the generation of surveillance data.

Proposed terms and concepts for describing and evaluating animal-health surveillance systems.

The information provided by animal-health surveillance helps to reduce the impact of animal diseases. The widespread movement of animals and their products around the world results in an increasing risk that disease will spread. There is, therefore, a need for exchange between countries of comparable information about disease incidence; the exchange must be based on a common understanding of surveillance approaches and how surveillance systems are designed and implemented. Establishing agreed-upon definitions of surveillance terms would be a first step in achieving this standardisation, and will enhance transparency and confidence. To this end, a workshop was held with the aim of agreeing upon key terms and concepts for animal-health surveillance. In this paper, we describe the methods used at the workshop and summarise the discussions. A complete list of all the proposed definitions including lists of characteristics that can be used to describe surveillance activities and attributes for evaluation of surveillance is available in the workshop report (available at http://www.defra.gov.uk/ahvla-en/disease-control/surveillance/icahs-workshop/). Some important issues were highlighted during these discussions; of particular note was the importance of economic efficiency as an evaluation attribute. Some remaining inconsistencies in the proposed use of terms are highlighted (including the definition of 'risk-based surveillance' and the use of the term 'event-based surveillance').

Neuroimaging methods for adolescent substance use disorder prevention science.

Magnetic resonance imaging (MRI) methods safely provide in vivo indicators of cerebral macrostructure, microstructure, and activation that can be examined in relation to substance use disorder (SUD) risks and effects. This article will provide an overview of MRI approaches, including volumetric measures, diffusion tensor imaging, and functional MRI, that have been applied to studies of adolescent neuromaturation in relationship to risk phenotypes and adolescent SUD. To illustrate these applications, examples of research findings will be presented. MRI indicators have demonstrated that neurobiological maturation continues throughout adolescence. MRI research has suggested that variations in neurobiological maturation may contribute to SUD risk, and that substance use adversely influences adolescent brain development. Directly measured neurobiological variables may be viable preventive intervention targets and outcome indicators. Further research is needed to provide definitive findings on neurodevelopmental immaturity as an SUD risk and to determine the directions such observations suggest for advancing prevention science.

Economic principles for resource allocation decisions at national level to mitigate the effects of disease in farm animal populations.

This paper originated in a project to develop a practical, generic tool for the economic evaluation of surveillance for farm animal diseases at national level by a state veterinary service. Fundamental to that process is integration of epidemiological and economic perspectives. Using a generalized example of epidemic disease, we show that an epidemic curve maps into its economic equivalent, a disease mitigation function, that traces the relationship between value losses avoided and mitigation resources expended. Crucially, elementary economic principles show that mitigation, defined as loss reduction achieved by surveillance and intervention, must be explicitly conceptualized as a three-variable process, and the relative contributions of surveillance and intervention resources investigated with regard to the substitution possibilities between them. Modelling the resultant mitigation surfaces for different diseases should become a standard approach to animal health policy analysis for economic efficiency, a contribution to the evolving agenda for animal health economics research.

Backyard chicken keeping in the Greater London Urban Area: welfare status, biosecurity and disease control issues.

1. The aim of the study was to collect baseline data on welfare, biosecurity and diseases of backyard chickens kept in the Greater London Urban Area (GLUA), United Kingdom (UK). 2. A total of 65 backyard chicken flock-keepers were recruited from May to July 2010 through adverts on websites, at City farms, veterinary practices and pet feed stores and surveyed by means of a questionnaire. A total of 30 responses were suitable for analysis. 3. Information on keepers' and flocks' characteristics, housing and husbandry practices and owners' knowledge of health problems in chickens and zoonotic diseases was collected. A welfare assessment protocol was developed and the flocks assessed accordingly. 4. Results showed that chickens were generally provided with living conditions that allowed them to perform their natural behaviours. 5. Most of the flock owners did not comply with the regulations of the Department for Environment, Food and Rural Affairs (Defra) on the feeding of catering waste. 6. Disease prevention measures such as vaccination and biosecurity, including limiting the access of human visitors, wild birds and rodents to the flocks were rare. 7. A lack of avian and zoonotic disease knowledge and awareness among the owners has implications for disease control and highlights the need for improved communication between owners, authorities and veterinarians.

Sleep duration is associated with dyslipidemia in patients with bipolar disorder in clinical remission.

BACKGROUND: The pathways to increased cardiovascular risk in bipolar disorder include health behaviors, psychosocial stress and long-term medication exposure. However, the evidence that the association between cardiovascular risk factors and bipolar disorder remains significant after controlling for these co-factors suggests that additional important risk factors have yet to be identified. Our hypothesis is that disturbances in the sleep-wake cycle are an important and under-recognized pathway through which affective disorders lead to increased cardiovascular risk. METHODS: In patients with bipolar disorder type 1 in clinical remission, we: 1) explored whether sleep disturbance predicted the endorsement of NCEP ATP-III criteria for dyslipidemia, independent of other lifestyle factors and 2) tested the association between low HDL (NCEP-ATP III) and sleep duration measured with actigraphy over an eight-day period. RESULTS: Median sleep duration is significantly associated with low HDL. The risk of having low HDL increases by 1.23 with every 30 minutes of reduced sleep time. LIMITATIONS: Since sleep patterns in patients with bipolar disorder are variable and irregular, it is possible that other sleep characteristics, not present during the span of our study, or the variability itself may be what drives the increased cardiovascular risk. CONCLUSIONS: Sleep characteristics of patients with bipolar disorder in clinical remission are associated with cardiovascular risk. More specifically, sleep duration was associated with low HDL. Clinicians should pay special attention to sleep hygiene in treating individuals with bipolar disorder, even when they are in clinical remission.

An economic model to evaluate the mitigation programme for bovine viral diarrhoea in Switzerland.

Economic analyses are indispensable as sources of information to help policy makers make decisions about mitigation resource use. The aim of this study was to conduct an economic evaluation of the Swiss national mitigation programme for bovine viral diarrhoea virus (BVDV), which was implemented in 2008 and concludes in 2017. The eradication phase of the mitigation programme comprised testing and slaughtering of all persistently infected (PI) animals found. First, the whole population was antigen tested and all PI cattle removed. Since October 2008, all newborn calves have been subject to antigen testing to identify and slaughter PI calves. All mothers of PI calves were retested and slaughtered if the test was positive. Antigen testing in calves and elimination of virus-carriers was envisaged to be conducted until the end of 2011. Subsequently, a surveillance programme will document disease freedom or detect disease if it recurs. Four alternative surveillance strategies based on antibody testing in blood from newborn calves and/or milk from primiparous cows were proposed by Federal Veterinary Office servants in charge of the BVDV mitigation programme. A simple economic spreadsheet model was developed to estimate and compare the costs and benefits of the BVDV mitigation programme. In an independent project, the impact of the mitigation programme on the disease dynamics in the population was simulated using a stochastic compartment model. Mitigation costs accrued from materials, labour, and processes such as handling and testing samples, and recording results. Benefits were disease costs avoided by having the mitigation programme in place compared to a baseline of endemic disease equilibrium. Cumulative eradication costs and benefits were estimated to determine the break-even point for the eradication component of the programme. The margin over eradication cost therefore equalled the maximum expenditure potentially available for surveillance without the net benefit from the mitigation programme overall becoming zero. Costs of the four surveillance strategies and the net benefit of the mitigation programme were estimated. Simulations were run for the years 2008-2017 with 20,000 iterations in @Risk for Excel. The mean baseline disease costs were estimated to be 16.04 m CHF (1 Swiss Franc, CHF=0.73 € at the time of analysis) (90% central range, CR: 14.71-17.39 m CHF) in 2008 and 14.89 m CHF (90% CR: 13.72-16.08 m CHF) in 2009. The break-even point was estimated to be reached in 2012 and the margin over eradication cost 63.15m CHF (90% CR: 53.72-72.82 m CHF). The discounted cost for each surveillance strategy was found to be smaller than the margin, so the mitigation programme overall is expected to have a positive net economic benefit irrespective of the strategy adopted. For economic efficiency, the least cost surveillance alternative must be selected.