[Specialist Training in Psychiatry and Psychotherapy : Evaluation of the East Westphalia-Lippe Academy curriculum]. / Facharztweiterbildung Psychiatrie und Psychotherapie : Evaluation des Curriculums eines Weiterbildungsverbunds in Ostwestfalen-Lippe.

BACKGROUND: Despite of the undisputed impact of education quality on becoming a specialist in psychiatry and psychotherapist, systematic studies in this field do not exist in Germany, apart from the evaluation of practical education by the medical councils. MATERIALS AND METHODS: The Akademie-OWL, an education union of psychiatric clinics in the East Westphalia region of Germany, has provided 12-item questionnaire-based routine evaluations of theoretical education seminars since 2009. Seminars are held by consultants of psychiatry and psychotherapy within six separate weeks over a period of four years. All lecturers receive feedback from the evaluation. The results of this ongoing evaluation are presented using a typical example and in an aggregated format as a time series on the basis of one global item. RESULTS: The data show that (1) the full range of a five-point Likert scale is used by the candidates, (2) psychiatric competences of the lecturers are more positively evaluated than their didactic competences, (3) neither within the four-years period of psychiatric education nor between different generations of candidates are systematic changes of evaluation results observed, and (4) minor to moderate differences of evaluation were observed between the different thematic fields of psychiatry and psychotherapy. DISCUSSION: These results indicate the need of more systematic education research on establishing valid and reliable specific instruments as well as the need of systematic training of didactic competences of teaching consultants.

Equine disease events resulting from international horse movements: Systematic review and lessons learned.

REASONS FOR PERFORMING STUDY: An analysis of the factors leading to equine disease events was used to support the development of international recommendations for mitigating the risk of disease dissemination through sport horse movements (high health, high performance - 'HHP' horses). OBJECTIVES: A review was undertaken to identify the factors resulting in equine disease events following international movement of horses to draw lessons in support of the development of international recommendations for the safe movements of a specific subpopulation of horses: the HHP sport horses. STUDY DESIGN: Systematic review carried out in accordance with the PRISMA statement. METHODS: The review covered disease events that occurred from 1995 to 2014, identified from the databases of the World Organisation for Animal Health (OIE) and international surveillance reports. RESULTS: Overall, 54 disease events were identified, of which 7 were contained in post arrival quarantine and the others resulted in the introduction of pathogens into importing countries. For 81% of the introductions, the OIE recommendations applicable to the diseases involved had not been complied with. Subclinical infections are a challenge for international trade: 88% of the regulated movements that resulted in introductions involved infected horses that showed no clinical signs at the time of import. Biosecurity and management practices in resident equine populations were identified as important mitigating factors in preventing disease spread to the local horse population. CONCLUSIONS: The global increase in international horse movements, if not appropriately regulated and supervised by competent veterinary authorities and respective equine industry partners, could potentially lead to increased global spread of infectious equine diseases. Appropriate mitigation measures and compliance with OIE import recommendations for specific diseases can significantly reduce this risk. The recommendations proposed under the HHP approach take into account the mitigation measures identified by this review as important factors in preventing pathogen introduction and spread.

'High-health, high-performance' horses: risk mitigation strategies for OIE-listed diseases.

The 'high-health, high-performance' (HHP) horse concept has been developed by the World Organisation for Animal Health (OIE) together with the F6ddration Equestre Internationale and the International Federation of Horseracing Authorities. This concept is outlined in the OIE Terrestrial Animal Health Code (Chapter 4.16). It aims to address impediments to the international movement of competition horses through a harmonised, practically feasible, globally applicable framework based on simplified certification requirements for the temporary importation of HHP horses and for their return to their country of usual residence. Based on the principle of compartmentalisation, the high health status of these horses would be established by the application, at all times, of stringent health management practices and biosecurity measures to create and maintain a functional separation between horses within the defined compartment and all other equids. These provisions are intended to mitigate the risk of disease spread for most OIE-listed diseases. For six OIE-listed diseases (African horse sickness, equine influenza, equine infectious anaemia, equine piroplasmosis, glanders and Venezuelan equine encephalomyelitis), the OIE recommends disease-specific mitigation measures, which have been included in a model HHP Veterinary Certificate, to provide additional guarantees to mitigate the risk of disease spread. This article presents the HH P disease risk mitigation strategy. It demonstrates how continuous observance of the HHP biosecurity measures and health management practices provides a scientific rationale for limiting the list of diseases for which HHP horses should be screened with respect to their temporary importation for competition purposes.

Animal trypanosomosis: making quality control of trypanocidal drugs possible.

African animal trypanosomosis is arguably the most important animal disease impairing livestock agricultural development in sub-Saharan Africa. In addition to vector control, the use oftrypanocidal drugs is important in controlling the impact of the disease on animal health and production in most sub-Saharan countries. However, there are no internationally agreed standards (pharmacopoeia-type monographs or documented product specifications) for the quality control of these compounds. This means that it is impossible to establish independent quality control and quality assurance standards for these agents. An international alliance between the Food and Agriculture Organization of the United Nations, the International Federation for Animal Health, the Global Alliance for Livestock Veterinary Medicines, the University of Strathclyde and the International Atomic Energy Agency (with critical support from the World Organisation for Animal Health) was established to develop quality control and quality assurance standards for trypanocidal drugs, with the aim of transferring these methodologies to two control laboratories in sub-Saharan Africa that will serve as reference institutions for their respective regions. The work of the international alliance will allow development of control measures against sub-standard or counterfeit trypanocidal drugs for treatment of trypanosome infection. Monographs on diminazene aceturate (synonym: diminazene diaceturate), isometamidium chloride hydrochloride, homidium chloride and bromide salts and their relevant veterinary formulations for these agents are given in the annex to this paper. However, the authors do not recommend use of homidium bromide and chloride, because of their proven mutagenic properties in some animal test models and their suspected carcinogenic properties.

Preliminary assessment of bovine tuberculosis at the livestock/wildlife interface in two protected areas of northern Botswana.

Protected areas of northern Botswana such as the Okavango Delta (OD) or Chobe National Park (CNP) are well-known hot spots for the conservation of African wildlife. However, their infection status regarding bovine tuberculosis (BTB) at the domestic/wildlife interface has never been investigated. To provide preliminary baseline data on the circulation of Mycobacterium bovis in those sites, we performed a cross-sectional survey on 130 buffalo in both protected areas (60 individuals from CNP and 70 from OD) and 818 cattle in their surrounding communal lands (369 in CNP and 449 in the OD). Whole-blood samples were tested using a commercial interferon-gamma assay (IFN-γ) with modifications. The apparent BTB prevalence in buffalo was nil in CNP and 0.7% 95% CI [0.2-1.9] in the OD, while the apparent BTB prevalence in cattle was 0.7% 95% CI [0.2-2.1] in the OD and 2.4% 95% CI [1.2-4.7] in CNP. True prevalence values calculated on the basis of the locally applicable IFN-γ test performance suggested that BTB prevalence was nil in both buffalo populations and in cattle from the OD interface, but reached 2.3% 95% CI [0.2-4.5] in cattle populations around CNP. The results of a questionnaire survey conducted among a sample of farmers living in the communities adjacent to each conservation area (97 and 38 persons in the OD and CNP, respectively) suggested a higher risk of the circulation of M. bovis at the wildlife/livestock interface of the CNP than at that of the OD. However, further comprehensive studies are needed to confirm the circulation of M. bovis and to monitor the inter-species and transboundary transmission of BTB in northern Botswana.

Building capacity for improved veterinary epidemiosurveillance in southern Africa.

A workshop to produce recommendations on training requirements for improved epidemiosurveillance of livestock diseases in southern Africa was organised at the Department of Veterinary Tropical Diseases in the Veterinary Faculty of the University of Pretoria. It was attended by 23 persons representing 10 different southern African countries. The majority of the participants were actively involved in veterinary epidemiosurveillance and many of them were members of the SADC Epidemiology and Informatics Subcommittee. Discussions focused on (i) epidemiosurveillance networks and their 2 main components, i.e. (ii) diagnosis and (iii) information flow. The debates were guided by 3 questions; (i) what are the requirements for an effective network, (ii) what cannot be achieved with existing capacity and (iii) how can the current capacity be improved. Workshop participants developed lists of realistic capacity building needs, which were divided into structural needs and training requirements. Structural needs mainly concerned communication means and quality assurance. With regard to training, the need for appropriate continuing education of all actors at the various disease management levels (non-professional, para-professional, professional) was expressed. Special emphasis was put on capacity building at the lowest level, i.e. the livestock owner and the para-professionals at the community level. At the international level, it was felt that special emphasis should be put on building capacity to improve the understanding of international agreements on trade in animals and animal products and to improve the capacity of negotiating such agreements.

Molecular detection of Ehrlichia ruminantium infection in Amblyomma variegatum ticks in The Gambia.

In West Africa, losses due to heartwater disease are not known because the incidence/prevalence has not been well studied or documented. To develop a diagnostic tool for molecular epidemiology, three PCR-based diagnostic assays, a nested pCS20 PCR, a nested map1 PCR and a nested reverse line blot (RLB) hybridization assay, were evaluated to determine their ability to detect infection in vector ticks, by applying them simultaneously to A. variegatum field ticks to detect Ehrlichia ruminantium, the causative agent of heartwater. The nested pCS20 PCR assay which amplified the pCS20 gene fragment showed the highest detection performance with a detection rate of 16.6%; the nested map1 PCR, which amplified the gene encoding the major antigenic protein1 (map1 gene) showed a detection rate of 11% and the RLB, based on the 16S rDNA sequence of anaplasma and ehrlichial species, detected 6.2%. The RLB, in addition, demonstrated molecular evidence of Ehrlichia ovina, Anaplasma marginale and Anaplasma ovis infections in The Gambia. Subsequently, the pCS20 assay was applied to study the prevalence and distribution of E. ruminantium tick infection rates at different sites in five divisions of The Gambia. The rates of infection in the country ranged from 1.6% to 15.1% with higher prevalences detected at sites in the westerly divisions (Western, Lower River and North Bank; range 8.3-15.1%) than in the easterly divisions (Central River and Upper River; range 1.6-7.5%). This study demonstrated a gradient in the distribution of heartwater disease risk for susceptible livestock in The Gambia which factor must be considered in the overall design of future upgrading programmes.

Trypanosomiasis control in Boran cattle in Kenya: a comparison between chemoprophylaxis and a parasite detection and intravenous treatment method using isometamidium chloride.

Two methods of trypanosome control in Boran cattle kept under very high trypanosomiasis risk were compared: the traditional intramuscular isometamidium chloride prophylaxis with a parasite detection and intravenous isometamidium chloride treatment method. The results were related to a control group under diminazene aceturate treatment. Isometamidium chloride at 0.25 mg/kg as routinely used by the ranch was of little benefit by either method, with breakthrough infections occurring as early as one week after treatment. When isometamidium chloride at 1 mg/kg was used, the curative intravenous method appeared to be superior to the intramuscular prophylaxis with regard to cost of drugs and to a 31% higher weight gain over a 30 week period. Weekly infection rates in the intravenous group decreased over time, despite an increasing trypanosomiasis challenge, with a mean interval of 6.4 weeks between treatments as compared with 4.3 weeks in a diminazene aceturate control group. It was concluded that isometamidium chloride given intravenously had not only a very good therapeutic but also a considerable prophylactic effect of not less than four weeks.