Disease Investigations & Initial Response: Considerations from Policy to Farm.

Transboundary animal disease (TAD) investigations are conducted routinely across the United States to rule out diseases of significant economic, trade, and/or food security importance. Established protocols exist for TAD investigations and disease response based on national and international policy; however, now more than ever, private practitioners may be called upon to assist in these investigations and response activities and may play an important role in communications, sample collection, and disease surveillance. Successful implementation of disease investigation and response, with or without vaccination, requires a collaborative effort between regulatory officials, industry groups, private practitioners, and producers.

Economic impact of Bluetongue: a review of the effects on production.

Bluetongue (BT) is often said to be a disease of severe economic consequence with a global estimate of US$ 3 billion. This review describes the most relevant contribution in the extant literature on production related losses due to BT. In summary, the impact of the endemic situations appears to be relatively small and surrounds the impacts on flock and herd fertility. The largest and most serious impact with BT in the epidemic situations has been in the reactions to the presence and risk of the disease. Such a reaction, in hindsight, has been far greater than the production losses caused by the disease. More data are required with more careful analysis to provide better impact assessment for BT. This would offer the ground for research prioritisation and the rebalancing of resource allocation. Such an economic impact assessment should follow scientific methods mirroring the careful and thorough biological work on BT.

A summer of cricket: prospective evaluation of all contacts with medical services at Edgbaston cricket ground during summer 2009.

OBJECTIVES: Crowd contact rates with medical services at cricket matches are unknown. The aim of this study was to detail every contact made with medical services at an international test cricket ground, whether medical or not. METHODS: Prospective, observational study of 22 matches, from county to international level, over the 2009 summer cricket season at Edgbaston Cricket Ground, Birmingham, UK. RESULTS: Four hundred and forty-four contacts from 22 matches attended by 183 387 spectators produced an incidence rate of 24/10 000. Nearly three-quarters of contacts were male (74%, n=325) and the mean age was 36 years (95% confidence interval 35-38 years). Contact rates increased with crowd size (Pearson's coefficient 0.877, P<0.001). The majority of the presentations were for new illness or injury [262 (59%)]. There was a high proportion of 'opportunistic' presentations [111 (25%)], which included advice or treatment for existing wounds or injuries, requests to use medical facilities (e.g. injecting insulin) and nonmedical contacts (e.g. repair of clothes). Eighteen patients were either sent home directly, to a minor injuries unit or to hospital. Seven ambulance transfers to hospital were required [2% (7/444)]. CONCLUSION: Contact rates with medical services at cricket matches were high (24/10 000 spectators), probably because of longer and multiday events. Match day services are often used for opportunistic and nonmedical contacts at large sports stadia, which produced nearly one-quarter of contacts over a summer of cricket at Edgbaston. This study adds unique and comprehensive data of medical requirements for crowds at all-day and multiday events.

Strengthening medical appraisal: reactions to proposals for a new appraisal system to support revalidation.

This paper introduces the first stage of the NHS Revalidation Support Team's (RST) proposals to strengthen medical appraisal. It reports on four focus groups held at London Deanery in 2010, with the aim of gauging initial reactions from general practitioners (GPs). The four groups consisted of two groups of appraisers and two groups of appraisees. After presentation of the proposals to strengthen appraisal, participants were invited to make comparisons between existing appraisal, and the new proposals, Interestingly, the matter which attracted most discussion was a proposal to include an element of self-assessment by the appraisee prior to appraisal, and not, as might have been expected, the proposals for assessment of the appraisee's progress towards revalidation by the appraiser. Since these focus groups, the model of strengthened medical appraisal referred to in this paper has been the subject of testing in the pathfinder pilot, a large scale pilot involving 3000 doctors in various settings in England. The evaluation of the pathfinder pilot was published (July 2011). After further refinement of the appraisal process, including taking into account new GMC and Royal College publications and more testing and piloting, the final version of medical appraisal to support revalidation, known as the Medical Appraisal Guide (MAG) is due to be published in March 2012, in time to permit the expected commencement of revalidation in late 2012.